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A parent has asked the nurse about how her child can be tested for pinworms. The nurse responds by stating that which is the most common test for diagnosing pinworms in a child?
- A. Lower gastrointestinal (GI) series
- B. Three stool specimens, at intervals of 4 days
- C. Observation for presence of worms after child defecates
- D. Laboratory examination of a fecal smear
Correct Answer: D
Rationale: The most common test for diagnosing pinworms in a child is a laboratory examination of a fecal smear. This involves taking a sample of the child's feces and examining it under a microscope to look for pinworm eggs or actual adult worms. This test is more reliable and accurate compared to other methods for detecting pinworms. It is important to collect the sample in the morning before the child has a bowel movement or bath, as this increases the chances of finding the eggs.
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A patient with a history of endocarditis is undergoing a bowel resection. The nurse explains that the prophylactic antibiotics prevent which of the following?
- A. Endocarditis c.Vegetative emboli
- B. Peritonitis
- C. Inflammation
Correct Answer: A
Rationale: Prophylactic antibiotics are given to prevent the recurrence or complications of endocarditis in patients with a history of the condition. Endocarditis is an infection of the inner lining of the heart chambers and valves. One of the serious complications of endocarditis is the formation of vegetative emboli, which are clusters of bacteria and fibrin that can break off and travel through the bloodstream, potentially causing blockages in various organs. By preventing endocarditis, the antibiotics also help reduce the risk of vegetative emboli formation during surgical procedures or other situations where bacteria may enter the bloodstream. Therefore, the nurse's explanation to the patient about the prophylactic antibiotics is focused on preventing complications related to endocarditis, including the formation of vegetative emboli.
A client with autoimmune thrombocytopenia and a platelet count of 8,000/ul develops epistaxis and melena. Treatment with corticosteroids and immunoglobulins has been unsuccessful, and the physician recommends a splenectomy. The client states, "I don't need surgery-this will go away on its own". In considering her response to the client, the nurse must depend on the ethical principle of:
- A. Beneficence
- B. Advocacy
- C. Autonomy
- D. Justice
Correct Answer: C
Rationale: The ethical principle most relevant in this situation is autonomy. Autonomy refers to a person's right to make decisions about their own care and treatment. In this case, the client is expressing her wish to avoid surgery and believes her condition will improve on its own. It is important for the nurse to respect the client's autonomy and involve her in the decision-making process regarding her treatment. The nurse should provide information, support, and guidance to help the client make an informed decision that aligns with her values and preferences. While the nurse can provide education and encourage the client to consider the physician's recommendation, ultimately the decision should respect the client's autonomy.
The patient is having difficulty coping with her new diagnosis of lymphoma. Which response by the nurse is most helpful?
- A. "Don't worry. You'll be okay."
- B. "The treatments you are receiving will make you feel better very soon."
- C. "Who do you usually go to when you have a problem?"
- D. "Have you made end-of-life decisions?"
Correct Answer: C
Rationale: Option C, "Who do you usually go to when you have a problem?" is the most helpful response by the nurse in this situation. This response allows the patient to identify her support system and opens up a conversation about coping mechanisms and sources of emotional support. It helps the nurse understand who the patient leans on during difficult times and enables the nurse to involve these individuals in providing support and encouragement to the patient as she copes with her new diagnosis of lymphoma. By exploring the patient's typical sources of support, the nurse can assist in strengthening her coping mechanisms and emotional well-being during this challenging time.
An adolescent patient, who has pelvic inflammatory disease (PID), inquires about the effects of the disease on their ability to bear children. What is the pediatric nurse's best response?
- A. The occurrence of spontaneous abortion during pregnancy increases with PID.
- B. There is an increased risk for ectopic pregnancy or infertility.
- C. There is an increased risk of placenta previa.
- D. There should be no problems with your ability to conceive.
Correct Answer: B
Rationale: PID can lead to scarring of the fallopian tubes, increasing the risk of ectopic pregnancy or infertility.
Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is:
- A. 12 months.
- B. 15 months.
- C. 10 months.
- D. 14 months.
Correct Answer: A
Rationale: The Denver Developmental Screening Test states that the median age for walking is around 12 months. This means that about half of all typically developing children will begin to walk by this age. It is important to note that there is a wide range of normal development, and not all children will hit these milestones at the same time. If Cherry's 11-month-old daughter, Elizabeth, is not yet walking, it does not necessarily indicate a developmental delay as long as she is meeting other milestones within a reasonable timeframe.