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A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?
- A. Mucus and blood in stools.
- B. Increased appetite.
- C. Jaundice.
- D. Drooling.
Correct Answer: A
Rationale: Mucus and blood in stools, often described as 'currant jelly' stools, are a common symptom of intussusception. Increased appetite is not typically associated with intussusception. In fact, children with this condition may experience decreased appetite due to abdominal pain. Jaundice is not a symptom of intussusception. Jaundice, a yellowing of the skin and eyes, is more commonly associated with liver conditions. Drooling is not a typical symptom of intussusception. Symptoms of intussusception are primarily gastrointestinal, including abdominal pain and bloody stools.
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A nurse is collecting data from an infant who has otitis media. Which of the following findings should the nurse expect?
- A. Bluish-green discharge from the ear canal
- B. Erythema and edema of the affected auricle
- C. Increase in appetite
- D. Tugging on the affected ear lobe
Correct Answer: D
Rationale: Bluish-green discharge from the ear canal is not a typical finding in otitis media. This could suggest a different condition, such as an external ear infection or a ruptured eardrum. Erythema and edema of the affected auricle (outer part of the ear) are not typical findings in otitis media. These symptoms are more commonly associated with conditions affecting the external ear, such as otitis externa. An increase in appetite is not typically associated with otitis media. In fact, children with otitis media may have a decreased appetite due to discomfort or pain while swallowing. Tugging on the affected ear lobe is a common sign of otitis media in infants and young children. This is often due to the pain and discomfort caused by the infection.
A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following home care actions should the nurse recommend? (Select all that apply)
- A. Use cold compresses for joint pain.
- B. Take ibuprofen on an empty stomach.
- C. Perform range of motion exercises.
- D. Consider homeschooling.
- E. Provide extra time for completion of ADLs.
Correct Answer: A,C,E
Rationale: Choice A rationale: Cold compresses can help relieve joint pain associated with juvenile idiopathic arthritis. Cold therapy can reduce inflammation and numb the affected area, providing temporary relief. Choice B rationale: This is incorrect. Ibuprofen should not be taken on an empty stomach because it can cause stomach upset or even lead to ulcers or bleeding. It is generally recommended to take ibuprofen with food or milk. Choice C rationale: Performing range of motion exercises can help maintain joint flexibility and muscle strength in children with juvenile idiopathic arthritis. Regular exercise can also improve overall physical function and well-being. Choice D rationale: While homeschooling may be a consideration for some families, it is not a general recommendation for all children with juvenile idiopathic arthritis. Many children with this condition can attend regular school with some accommodations as needed. Choice E rationale: This is correct. Providing extra time for completion of activities of daily living (ADLs) can help children with juvenile idiopathic arthritis manage their symptoms and maintain their independence. It is important to allow children to perform tasks at their own pace to avoid causing unnecessary pain or fatigue.
A nurse is providing instructions about methylphenidate (Ritalin) to the parents of a school-age child who has ADHD. Which of the following instructions should the nurse include?
- A. You will need to give your child the medication after meals.
- B. You will need to have your child's blood glucose level checked monthly.
- C. You should not give your child the medication on weekends.
- D. You should give your child's last daily dose of the medication before 6 o'clock in the evening.
Correct Answer: D
Rationale: Methylphenidate (Ritalin) is a medication used to treat attention-deficit hyperactivity disorder (ADHD). It is not necessary to give the medication after meals. The medication can be taken with or without food. However, some people find that taking it with food can help prevent stomach upset. Regular blood glucose level checks are not typically required when a child is taking methylphenidate. This medication does not have a significant impact on blood sugar levels. It is not generally recommended to skip doses of methylphenidate on weekends. Consistent medication administration is important for managing ADHD symptoms. However, the prescribing doctor may sometimes recommend a 'drug holiday' or break from the medication. This should only be done under the guidance of a healthcare professional. This is the correct answer. Methylphenidate is a stimulant, and taking it later in the day can cause insomnia or trouble sleeping. Therefore, it is often recommended that the last dose of the medication be given before 6 o'clock in the evening to minimize sleep disturbances.
A nurse is caring for a child who has tinea pedis. The child's parent asks the nurse what this infection is commonly called. The nurse should respond with which of the following common names?
- A. Shingles
- B. Athlete's foot
- C. Fever blister
- D. Pinworms
Correct Answer: B
Rationale: Shingles, also known as herpes zoster, is a viral infection that causes a painful rash and is caused by the varicella-zoster virus, the same virus that causes chickenpox. Tinea pedis is a foot infection due to a dermatophyte fungus. It is the most common dermatophyte infection and is particularly prevalent in hot, tropical, urban environments. Interdigital involvement is most commonly seen (this presentation is also known as athlete's foot, although some people use the term for any kind of tinea pedis). Fever blister, also known as cold sores, are caused by the herpes simplex virus. They are small, fluid-filled blisters that develop on the lips or around the mouth. Pinworms are a type of parasite that lives in the lower intestine of humans. They are tiny, narrow worms. They are white and less than a half-inch long.
A nurse is collecting data from a child and notes the presence of bruises on her arms and legs. Which of the following actions should the nurse take first?
- A. Tell the child what will happen to her when the abuse is reported.
- B. Request a social services referral.
- C. Report the suspected abuse to the authorities.
- D. Obtain a detailed history.
Correct Answer: D
Rationale: Telling the child what will happen when the abuse is reported is not the first action a nurse should take. It is important to first gather all necessary information and report the suspected abuse to the appropriate authorities. Requesting a social services referral is an important step when abuse is suspected, but it should come after obtaining a detailed history and reporting the suspected abuse. Reporting the suspected abuse to the authorities is crucial when child abuse is suspected. However, it is important to first obtain a detailed history to provide as much information as possible to the authorities. When a nurse notes the presence of bruises on a child's arms and legs, the first action should be to obtain a detailed history. This can provide important context for the bruises and help determine whether they are likely the result of accidental injury or possible abuse.