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A nurse is collecting data from a child who has nephrotic syndrome. Which of the following manifestations should the nurse expect?
- A. Orange-tinged urine
- B. Hypertension
- C. Periorbital edema
- D. Polyuria
Correct Answer: C
Rationale: Orange-tinged urine - This manifestation is not typically associated with nephrotic syndrome. Orange-tinged urine may indicate other conditions such as dehydration, liver disease, or the presence of certain medications or foods. Hypertension - Hypertension is not a common manifestation of nephrotic syndrome. However, it can occur in some cases due to the retention of sodium and water, which can lead to fluid overload and increased blood pressure. Periorbital edema - This is a classic manifestation of nephrotic syndrome. Periorbital edema, or swelling around the eyes, is often one of the initial signs observed in children with nephrotic syndrome due to the loss of protein in the urine, leading to fluid accumulation in the tissues. Polyuria - Polyuria, or increased urine output, is not typically associated with nephrotic syndrome. Instead, children with nephrotic syndrome may experience oliguria or normal urine output, depending on the severity of renal involvement and fluid balance.
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A nurse is reviewing discharge instructions with a client who has pruritus following treatment for scabies. Which of the following instructions should the nurse include?
- A. Take a hot shower daily to relieve itching.
- B. Wear loose fitting clothing while you are experiencing itching.
- C. Add fabric softener to linens when they are washed.
- D. Use a soft bristle brush to gently rub the affected areas.
Correct Answer: B
Rationale: Take a hot shower daily to relieve itching.' This instruction is not recommended because hot water can exacerbate itching and worsen the condition. Hot showers can strip the skin of its natural oils, leading to further dryness and irritation, which may aggravate the itching associated with scabies. 'Wear loose fitting clothing while you are experiencing itching.' This instruction is appropriate because loose-fitting clothing can help minimize friction and irritation on the skin affected by scabies. Tight clothing can exacerbate itching and discomfort, so wearing loose clothing can provide relief and allow the skin to breathe. 'Add fabric softener to linens when they are washed.' This instruction is not recommended because fabric softeners may contain chemicals or fragrances that can irritate the skin, especially for someone with pruritus or scabies. It's best to use gentle, fragrance-free laundry detergent to wash linens and clothing to minimize potential irritation. 'Use a soft bristle brush to gently rub the affected areas.' This instruction is not recommended because using a brush, even if it has soft bristles, can further irritate the skin and potentially spread the scabies mites to other areas of the body. It's best to avoid any abrasive or vigorous rubbing of the affected areas and instead focus on gentle cleansing and moisturizing techniques.
A nurse is collecting data from an infant who has gastroesophageal reflux. Which of the following findings should the nurse expect? (Select the 3 that apply.)
- A. Wheezing
- B. Rigid abdomen
- C. Pallor
- D. Weight loss
- E. Vomiting
Correct Answer: A,D,E
Rationale: A. Wheezing: Wheezing is a common symptom associated with asthma, which can be exacerbated by gastroesophageal reflux (GER) in infants. GER occurs when stomach contents flow back into the esophagus, leading to irritation and inflammation of the airways. This inflammation can cause wheezing sounds during breathing, especially if the refluxed material reaches the lower respiratory tract. B. Rigid abdomen: While gastroesophageal reflux (GER) primarily affects the upper gastrointestinal tract, it typically does not cause a rigid abdomen. A rigid abdomen may indicate other underlying gastrointestinal issues such as bowel obstruction, intussusception, or peritonitis. These conditions are not typically associated with GER in infants. C. Pallor: Pallor, or paleness of the skin, is not a common symptom of gastroesophageal reflux (GER) in infants. GER primarily affects the upper gastrointestinal tract and is characterized by symptoms such as spitting up, regurgitation, and irritability. Pallor may be indicative of other health issues such as anemia or circulatory problems but is not directly related to GER. D. Weight loss: Weight loss can occur in infants with gastroesophageal reflux (GER) if frequent vomiting leads to inadequate intake of nutrients. However, it is not a direct symptom of GER itself. Infants with GER may experience feeding difficulties, irritability, and discomfort associated with feeding, which can contribute to poor weight gain over time if not managed effectively. E. Vomiting: Vomiting is a common symptom of gastroesophageal reflux (GER) in infants. It occurs when stomach contents flow back up into the esophagus and sometimes out of the mouth. Infants with GER may spit up or vomit frequently after feeding or during burping, which can lead to discomfort and irritability. Vomiting may also contribute to poor weight gain and nutritional deficiencies if not managed effectively.
A nurse is preparing to administer vaccines to a 4-month-old infant. Which of the following vaccines should the nurse plan to administer?
- A. Influenza
- B. Rotavirus
- C. Measles, mumps, rubella (MMR)
- D. Varicella (VAR)
Correct Answer: B
Rationale: Influenza: The influenza vaccine is typically administered annually starting at 6 months of age. It helps protect against seasonal influenza viruses and is usually recommended during the fall or winter months. Rotavirus: The rotavirus vaccine is routinely administered to infants starting at 2 months of age, with additional doses given at 4 and 6 months of age. It helps prevent rotavirus infection, which can cause severe diarrhea and vomiting in infants and young children. Measles, mumps, rubella (MMR): The MMR vaccine is typically administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps protect against measles, mumps, and rubella, which are contagious viral infections that can cause serious complications. Varicella (VAR): The varicella vaccine, also known as the chickenpox vaccine, is usually administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps prevent chickenpox, a highly contagious viral infection characterized by a rash and fever.
Which of the following activities are appropriate for a child who is recovering from orchiopexy?
- A. Baseball games
- B. Running around the playground
- C. Horseback riding
- D. Puzzle games
Correct Answer: D
Rationale: Baseball games: Participating in baseball games may involve running, jumping, and sudden movements that could potentially strain the surgical area or cause discomfort. It's best to avoid strenuous physical activities like baseball until the child has fully recovered from orchiopexy. Running around the playground: Running around the playground may also involve vigorous physical activity that could potentially affect the surgical site. It's advisable to limit activities that involve running or jumping until the child's healthcare provider gives clearance. Horseback riding: Horseback riding involves sitting on a horse and may put pressure on the groin area, where the surgical site is located. It's generally recommended to avoid activities like horseback riding until the child has fully healed from orchiopexy. Puzzle games: Puzzle games are typically low-impact activities that do not involve physical exertion or strain on the surgical area. Engaging in quiet, seated activities like puzzle games can be suitable for a child who is recovering from orchiopexy and may help keep them entertained during the recovery period.
12-month-old boy weighed 8 lb 2 oz at birth. Understanding developmental milestones, what should the nurse caring for the child expect the current weight to be?
- A. 24 lb 6 oz
- B. 20 lb 5oz
- C. 32 lb 8 0z
- D. 16 lb 4 oz
Correct Answer: A
Rationale: The nurse should expect the 12-month-old boy to weigh approximately 24 lb 6 oz (since 0.375 lb ≈ 6 oz).
So, around 24 lbs 6 oz is a normal expected weight at 12 months for a baby born at 8 lb 2 oz.