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A nurse is reinforcing teaching with the parents of a preschooler who has atopic dermatitis. Which of the following information should the nurse include?
- A. You will need to take the entire prescription of antibiotics even if your symptoms improve.
- B. The doctor will remove the lesions with liquid nitrogen.
- C. The doctor might recommend an antihistamine to help control your symptoms.
- D. You can relieve your child's discomfort by applying warm compresses to the lesions.
Correct Answer: C
Rationale: You will need to take the entire prescription of antibiotics even if your symptoms improve.' Atopic dermatitis is not typically treated with antibiotics, as it is not caused by a bacterial infection. Therefore, this statement is not relevant and would not be included in the teaching. 'The doctor will remove the lesions with liquid nitrogen.' Liquid nitrogen is not typically used to remove lesions associated with atopic dermatitis. Atopic dermatitis lesions are usually managed with topical treatments and other measures to reduce inflammation and itching. Therefore, this statement is not accurate and would not be included in the teaching. 'The doctor might recommend an antihistamine to help control your symptoms.' Antihistamines may be prescribed to help relieve itching associated with atopic dermatitis. Itching is a common symptom of atopic dermatitis, and antihistamines can help reduce this symptom. Therefore, this statement is relevant and would be included in the teaching. 'You can relieve your child's discomfort by applying warm compresses to the lesions.' Warm compresses can exacerbate itching associated with atopic dermatitis by increasing blood flow.
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The nurse is caring for a 7-year-old child who fell off an ATV sustaining a flesh wound. The child is awaiting wound debridement. What nursing action best demonstrates the concept of atraumatic care?
- A. Allowing siblings to visit the client in the hospital
- B. Using a doll to demonstrate an invasive procedure
- C. Encouraging communication between the parents and nurse
- D. Arranging the room to accommodate religious practices
Correct Answer: B
Rationale: Allowing siblings to visit the client in the hospital - Allowing siblings to visit the client in the hospital is a compassionate gesture and promotes family-centered care. However, it may not directly address the concept of atraumatic care, which focuses on minimizing physical and psychological stress related to healthcare procedures. Using a doll to demonstrate an invasive procedure - Using a doll to demonstrate an invasive procedure is an example of atraumatic care. It allows the nurse to provide preparatory information to the child in a non-threatening and understandable manner. By visually demonstrating the procedure on a doll, the child can better understand what will happen, reducing anxiety and fear. Encouraging communication between the parents and nurse - Encouraging communication between the parents and nurse is important for providing holistic care and addressing the child's needs. While effective communication is essential, it may not directly demonstrate the concept of atraumatic care unless it involves discussing how to minimize stress and anxiety during procedures. Arranging the room to accommodate religious practices - Arranging the room to accommodate religious practices is a form of patient-centered care and respects the cultural and religious beliefs of the patient and family. While important for overall comfort and respect for the patient's values, it may not directly relate to the concept of atraumatic care, which specifically focuses on reducing stress and anxiety during healthcare procedures.
A nurse is collecting data from an infant who has otitis media. The nurse should expect which of the following findings?
- A. Increase in appetite
- B. Tugging on the affected ear lobe
- C. Erythema and edema of the affected auricle
- D. Bluish-green discharge from the ear canal
Correct Answer: B
Rationale: Increase in appetite: Otitis media, an infection or inflammation of the middle ear, typically causes discomfort and pain in infants. As a result, they may experience a decrease in appetite rather than an increase. Tugging on the affected ear lobe: Tugging or pulling on the affected ear lobe is a common sign of ear pain in infants with otitis media. It occurs because the pain from the middle ear extends to the outer ear canal. Erythema and edema of the affected auricle: Otitis media primarily affects the middle ear, so erythema (redness) and edema (swelling) are not typically observed on the outer ear (auricle). Instead, these symptoms are more commonly seen in external ear infections, such as otitis externa. Bluish-green discharge from the ear canal: Bluish-green discharge from the ear canal is not a typical finding in otitis media. It may suggest a secondary bacterial infection or another underlying condition, but it is not a characteristic feature of otitis media.
A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect:
- A. Gross hematuria
- B. Dysuria
- C. An abdominal mass
- D. Nausea and Vomiting
Correct Answer: C
Rationale: Gross hematuria: Gross hematuria refers to visible blood in the urine, which can present as pink, red, or cola-colored urine. While hematuria can be associated with various kidney conditions, including Wilms' tumor, it is not a consistent or defining symptom of this specific tumor. Additionally, because the tumor is typically confined within the kidney and does not usually invade the urinary tract, gross hematuria might not always be present. Dysuria: Dysuria is the medical term for painful or difficult urination. It is not a typical symptom of Wilms' tumor, as this tumor primarily affects the kidney and may not directly affect the urinary tract in a way that causes painful urination. An abdominal mass: This is the correct answer. Wilms' tumor often presents as a palpable abdominal mass, which may be felt during physical examination. The mass is usually firm, non-tender, and confined to one side of the abdomen. Detection of an abdominal mass should prompt further diagnostic evaluation to confirm the diagnosis and plan appropriate treatment. Nausea and vomiting: While some children with Wilms' tumor may experience nausea and vomiting, these symptoms are nonspecific and can be caused by various conditions. They are not considered characteristic or defining features of Wilms' tumor. The presence of nausea and vomiting would prompt further assessment to determine the underlying cause.
The nurse knows further education is needed about reye syndrome when a mother states:
- A. Children with Reye syndrome are admitted to the hospital
- B. I will have my children immunized against varicella and influenza
- C. I will give aspirin to my child to treat a headache
- D. I will make sure not to give my child any products containing aspirin
Correct Answer: C
Rationale: Children with Reye syndrome are admitted to the hospital: This statement is accurate. Children with Reye syndrome often require hospital admission for monitoring and supportive care. Therefore, it does not indicate a need for further education. I will have my children immunized against varicella and influenza: This statement is also accurate. Vaccination against varicella (chickenpox) and influenza is recommended to prevent these illnesses. It does not indicate a need for further education. I will give aspirin to my child to treat a headache: This statement is concerning because giving aspirin to a child with Reye syndrome can worsen their condition. Aspirin use is contraindicated in children with viral illnesses due to the risk of Reye syndrome. Therefore, this statement indicates a need for further education. I will make sure not to give my child any products containing aspirin: This statement is accurate. Avoiding products containing aspirin is essential to prevent the risk of Reye syndrome in children. It does not indicate a need for further education.
A nurse is caring for a child who has Hirschsprung disease. Which of the following findings should the nurse expect?
- A. Ridged abdomen
- B. Ribbonlike, foul-smelling stools
- C. Projectile vomiting
- D. Chronic hunger
Correct Answer: B
Rationale: Ridged abdomen - This finding is not typically associated with Hirschsprung disease. Instead, the abdomen may appear distended or bloated due to the accumulation of stool in the colon. Ribbonlike, foul-smelling stools - This is a characteristic finding in Hirschsprung disease. Because the affected portion of the colon lacks nerve cells (ganglion cells) responsible for peristalsis, stool movement is impaired, leading to the passage of narrow, ribbonlike stools. These stools may also have a foul odor due to bacterial overgrowth in the affected area. Projectile vomiting - Projectile vomiting is not a common finding in Hirschsprung disease. It is more commonly associated with conditions such as pyloric stenosis or gastroesophageal reflux. Chronic hunger - Chronic hunger is not a typical finding in Hirschsprung disease. Instead, affected infants may experience feeding difficulties, constipation, and failure to thrive due to the obstruction of stool in the colon. They may also exhibit symptoms such as abdominal distention, vomiting, and refusal to feed.