Nokea
A nurse working in the nursery identifies a goal for a mother of a newborn to demonstrate positive attachment behaviors upon discharge. Which intervention would be least effective in accomplishing this goal?
- A. Provide opportunities for the mother to hold and examine the newborn.
- B. Engage the mother in the newborn's care.
- C. Create an environment that fosters privacy for the mother and newborn.
- D. Identify strategies to prevent difficulties in parenting.
Correct Answer: D
Rationale: Preventing parenting difficulties is less directly related to fostering immediate attachment.
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An 18-month-old with a congenital heart defect is to receive digoxin twice a day. The nurse should instruct the parents about which of the following?
- A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
- B. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances.
- C. Digoxin is absorbed better if taken with meals.
- D. If the child vomits within 15 minutes of administration, the dosage should be repeated.
Correct Answer: A
Rationale: Digoxin improves heart function by increasing contractility and regulating rhythm. Toxicity signs are correct but not the focus here, absorption is not meal-dependent, and repeating a vomited dose risks overdose.
The parents of an infant with myelomeningocele ask the nurse about their child's future mental ability. What is the nurse's best response?
- A. About one-third are mentally retarded, but it's too early to tell about your child.'
- B. About two-thirds are significantly retarded, and you'll know soon if this will occur.'
- C. Your child will probably be of normal intelligence since he demonstrates signs of it now.'
- D. You'll need to talk with the doctor about that, but you can ask later.'
Correct Answer: D
Rationale: Referring parents to the physician for detailed prognostic discussions ensures accurate information and avoids premature or speculative statements about mental ability.
A nurse administers ranitidine (Zantac) instead of cetirizine (Zyrtec) to an 8-year-old with asthma. The client has suffered no adverse effects. The nurse tells the charge nurse of the incident but fears disciplinary action. The charge nurse should tell the nurse:
- A. If you do not report the error, I will have to.
- B. Reporting the error helps to identify system problems to improve client safety.
- C. Notify the client's physician to see if she wants this reported.
- D. This is not a serious mistake so reporting it will not affect your position.
Correct Answer: B
Rationale: Reporting the error helps identify system problems to improve client safety, promoting a culture of transparency and quality improvement.
When developing the plan of care for a school-age child with acute poststreptococcal glomerulonephritis who has a fluid restriction of 1,000 mL/day, which of the following fluids should the nurse consider as most appropriate for the client's condition and effective for preventing excessive thirst?
- A. Diet cola.
- B. Ice chips.
- C. Lemonade.
- D. Tap water.
Correct Answer: B
Rationale: Ice chips help manage thirst.
A 12-year-old with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet?
- A. High-residue.
- B. Low-residue.
- C. Low-fat.
- D. High-calorie.
Correct Answer: D
Rationale: A high-calorie diet supports energy needs during leukemia treatment, especially with vincristine, which doesn't require dietary restrictions.