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A nurse is teaching a child with a food allergy about safe eating. Which instruction is most important?
- A. Eat only home-cooked meals.
- B. Read food labels carefully.
- C. Avoid all fruits.
- D. Use herbal supplements.
Correct Answer: B
Rationale: Reading food labels prevents accidental allergen exposure. Home cooking helps but isn't always feasible, fruits are safe unless allergenic, and supplements are irrelevant.
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During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute?
- A. Limiting conversation with the child.
- B. Keeping extraneous noise to a minimum.
- C. Allowing the child to play in the bathtub.
- D. Performing treatments quickly.
Correct Answer: B
Rationale: Minimizing noise reduces sensory stimulation, which can exacerbate irritability in a child with meningitis.
The mother of a toddler who has just been admitted with severe dehydration secondary to gastroenteritis says that she cannot stay with her child because she has to take care of her other children at home. Which of the responses by the nurse would be most appropriate?
- A. You really shouldn't leave right now. Your child is very sick.
- B. I understand, but feel free to visit or call anytime to see how your child is doing.
- C. It really isn't necessary to stay with your child. We'll take very good care of him.
- D. Can you find someone to stay with your children? Your child needs you here.
Correct Answer: B
Rationale: This response acknowledges the mother's constraints while encouraging involvement.
The nurse is planning care with the parents of a child who requires continuous peritoneal dialysis. Which finding should be discussed with the physician?
- A. The family lives a long distance from the medical facility.
- B. The child attends a large public school.
- C. The child reports having a previous surgery for a ruptured appendix.
- D. The family feels the child cannot self-regulate to wake at night and change bags.
Correct Answer: C
Rationale: Previous surgery might impact current care.
The nurse is giving care to an infant with a brain tumor. The nurse observes the infant arch the back (see figure). The nurse should:
- A. Notify the physician
- B. Stroke the back to release the arching
- C. Pad the side rails of the crib
- D. Place the child prone
Correct Answer: A
Rationale: The infant has opisthotonos, an indication of brain stem herniation; the nurse should notify the physician immediately and have resuscitation equipment ready. Stroking the back will not relieve the herniation or release the arching. Although the infant may also have a seizure, and padded side rails will prevent injury, the fi rst action is to notify the physician. Placing the child in a prone position will not relieve the herniation or release the arching.
A child with a lead level of 20 mcg/dL is prescribed oral chelation therapy. The nurse should monitor for which side effect?
- A. Hypertension.
- B. Renal toxicity.
- C. Hypoglycemia.
- D. Seizures.
Correct Answer: B
Rationale: Oral chelators like succimer can cause renal toxicity, requiring monitoring of kidney function. Hypertension, hypoglycemia, and seizures are not common side effects.