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A nurse is making an initial visit to a family with a 3-year-old child with early Duchenne's muscular dystrophy. Which of the following findings is expected with the missing child?
- A. Contractures of the large joints.
- B. Enlarged calf muscles.
- C. Difficulty riding a tricycle.
- D. Small, weak muscles.
Correct Answer: B
Rationale: Enlarged calf muscles due to pseudohypertrophy are a hallmark of early Duchenne's muscular dystrophy, caused by fatty infiltration of muscle tissue.
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A 4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse should anticipate that the infant's vomitus would contain gastric contents and which of the following?
- A. Bile and streaks of blood.
- B. Mucus and bile.
- C. Mucus and streaks of blood.
- D. Stool and bile.
Correct Answer: C
Rationale: Pyloric stenosis causes vomiting of gastric contents, mucus, and sometimes blood due to irritation, but not bile.
A nurse walks into the room just as a 10-month-old infant places an object in his mouth and starts to choke. After opening the infant's mouth, which of the following should the nurse do next to clear the airway?
- A. Use blind finger sweeps.
- B. Deliver back slaps and chest thrusts.
- C. Apply four subdiaphragmatic abdominal thrusts.
- D. Attempt to visualize the object.
Correct Answer: B
Rationale: For a 10-month-old choking, delivering back slaps and chest thrusts is the recommended method to dislodge a foreign body, as per pediatric guidelines.
After teaching the parents of a preschooler who has undergone a tonsillectomy and adenoidectomy about appropriate foods to give the child after discharge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching?
- A. Meat loaf and uncooked carrots.
- B. Pork and noodle casserole.
- C. Cream of chicken soup and orange sherbet.
- D. Hot dog and potato chips.
Correct Answer: C
Rationale: Cream of chicken soup and orange sherbet are soft, non-irritating foods suitable for a child post-tonsillectomy, as they are easy to swallow and unlikely to irritate the surgical site. Meat loaf, uncooked carrots, pork, noodles, hot dogs, and potato chips are harder or crunchier foods that could irritate or cause discomfort.
A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger snaps to help control the nausea. The nurse should tell the parent:
- A. I will need to get an order.'
- B. Your child needs medication for the vomiting.'
- C. We discourage the use of home remedies in children.'
- D. Ginger snaps are safe and may help with nausea.'
Correct Answer: D
Rationale: Ginger snaps are a safe, non-medicinal option that may help alleviate nausea in children.
A child diagnosed with Wilms' tumor undergoes successful surgery for removal of the diseased kidney. When the child returns to the room, the nurse should place the child in which position?
- A. Modified Trendelenburg.
- B. Sims'.
- C. Semi-Fowler's.
- D. Supine.
Correct Answer: C
Rationale: Semi-Fowler's aids breathing.