A nurse is teaching a class on breastfeeding to expectant parents. Which are contraindications for breastfeeding? (Select all that apply.)
- A. Human immunodeficiency virus (HIV) in mother
- B. Mastitis
- C. Inverted nipples
- D. Maternal cancer therapy
Correct Answer: A
Rationale: Human immunodeficiency virus (HIV) in mother: Breastfeeding is contraindicated in mothers with HIV because the virus can be transmitted to the infant through breast milk.
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a school-age child is admitted in vaso-occlusive sickle cell crisis. the child's care should include which of the following?
- A. correction of acidosis.
- B. adequate hydration, pain management.
- C. pain management, administration of heparin.
- D. adequate oxygenation, replacement of factor viii
Correct Answer: B
Rationale: In a vaso-occlusive sickle cell crisis, it is crucial to focus on adequate hydration and pain management. Hydration is essential to prevent further sickling of red blood cells, which can exacerbate tissue damage and pain. Pain management is a key aspect of care as vaso-occlusive crises often cause severe pain that requires prompt and effective treatment. Administering heparin is not indicated in a vaso-occlusive sickle cell crisis as it is primarily used for conditions like deep vein thrombosis. Correcting acidosis and replacing factor VIII are also not typically part of the management of a vaso-occlusive sickle cell crisis.
The MOST common cause of obstructive sleep apnea in children is
- A. obesity
- B. allergies
- C. adenotonsillar hypertrophy
- D. pharyngeal reactive edema due to gastroesophageal reflux
Correct Answer: C
Rationale: Adenotonsillar hypertrophy is the leading cause of obstructive sleep apnea in children.
A child is brought to your clinic for a routine exam. She can dress with help, can ride a tricycle, knows her own age, and can speak in short sentences. She had difficulty in copying a square. The age of this child is most likely:
- A. 1 year
- B. 2 years
- C. 3 years
- D. 4 years
Correct Answer: C
Rationale: At 3 years, children typically have the ability to dress with assistance, ride a tricycle, know their age, and speak in short sentences. Copying a square usually occurs later, around 4 years of age.
A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant is currently up to date on all previously recommended immunizations. Which immunizations will the nurse prepare to administer? (Select all that apply.)
- A. Measles, mumps, and rubella (MMR)
- B. Rotavirus (RV)
- C. Diphtheria, tetanus, pertussis (DTaP)
- D. Varicella
Correct Answer: B
Rationale: A 4-month-old infant who is up to date on routine immunizations would not need the Measles, mumps, and rubella (MMR), Varicella, or Haemophilus influenzae type b (HIB) vaccines at this time. These vaccines are typically administered at older ages based on the recommended immunization schedule.
When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence?
- A. The acne has not responded to other treatments.
- B. The adolescent is or may become pregnant.
- C. The adolescent is unable to give up foods causing acne.
- D. Frequent washing with antibacterial soap has been unsuccessful.
Correct Answer: A
Rationale: Isotretinoin (Accutane) is a potent medication used for severe acne that has not responded to other treatments, such as topical medications or antibiotics. It is typically considered as a last resort due to its potential side effects and risks. Adolescents with resistant, severe acne who have not seen improvement with other therapies may be good candidates for isotretinoin treatment. It is important for the prescribing healthcare provider to carefully assess the severity of the acne and weigh the benefits against the potential risks before initiating isotretinoin therapy.