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A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse's most appropriate response?
- A. Praise the parent for the decision and encourage the plan.
- B. Ask for more specific information related to the developmental delays.
- C. Advise the parent to have the healthcare provider help choose an appropriate program.
- D. Explain that this may be a premature action and the developmental delays could disappear.
Correct Answer: B
Rationale: The most appropriate response for the nurse in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the situation, offer appropriate support, and provide guidance tailored to the child's specific needs. Praising the parent or encouraging the plan without understanding the full context may not be beneficial. Advising the parent to have the healthcare provider help choose a program assumes the parent has not already involved the healthcare provider, which may not be the case. Explaining that the developmental delays could disappear is not appropriate as it may give false hope or minimize the parent's concerns.
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After corrective surgery for hypertrophic pyloric stenosis (HPS), what should the nurse teach a parent to do immediately after a feeding to limit vomiting?
- A. Rock the infant.
- B. Place the infant in an infant seat.
- C. Place the infant flat on the right side.
- D. Keep the infant awake with sensory stimulation.
Correct Answer: B
Rationale: After corrective surgery for hypertrophic pyloric stenosis (HPS), placing the infant in an infant seat is the correct action to take immediately after feeding to limit vomiting. This position helps keep the head elevated, reducing the risk of vomiting. Rocking the infant (Choice A) may agitate the stomach and increase the likelihood of vomiting. Placing the infant flat on the right side (Choice C) is not recommended as it does not encourage proper digestion and may increase the risk of vomiting. Keeping the infant awake with sensory stimulation (Choice D) does not address the positioning concern related to vomiting in this specific post-operative scenario.
The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?
- A. Dislocated radial head
- B. Transient synovitis of the hip
- C. Osgood-Schlatter disease
- D. Scoliosis
Correct Answer: C
Rationale: The correct answer is C: Osgood-Schlatter disease. This condition is a common overuse injury that affects the knee. Osgood-Schlatter disease typically occurs in children and adolescents who are involved in activities that require frequent running, jumping, and kicking. It is characterized by pain, swelling, and tenderness at the tibial tuberosity, where the patellar tendon inserts into the tibia.
Choice A, Dislocated radial head, is not an overuse disorder but rather a form of elbow injury where the head of the radius bone is displaced from its normal position.
Choice B, Transient synovitis of the hip, is a self-limiting condition that causes hip pain and limping in children. It is not typically considered an overuse disorder.
Choice D, Scoliosis, is a condition characterized by an abnormal lateral curvature of the spine. While it may be related to certain activities or postures, it is not primarily classified as an overuse disorder.
The instructor is educating a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?
- A. Myelination continues into adolescence.
- B. The process occurs in a head-to-toe fashion.
- C. Myelination speeds up nerve impulses.
- D. Myelination increases the specificity and efficiency of nerve impulses.
Correct Answer: B
Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect because myelination continues beyond 4 years of age and into adolescence. Choice C is incorrect as myelination speeds up nerve impulses rather than slowing them down. Choice D is incorrect because myelination increases the specificity and efficiency of nerve impulses, making them more focused and precise.
Parents of a sick infant talk with a nurse about their baby. One parent says, "I am so upset; I didn't realize our baby was ill." What major indication of illness in an infant should the nurse explain to the parent?
- A. Grunting respirations
- B. Excessive perspiration
- C. Longer periods of sleep
- D. Crying immediately after feedings
Correct Answer: C
Rationale: Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it may indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, excessive perspiration (choice B) may indicate overheating or fever, and crying immediately after feedings (choice D) can be a sign of gastrointestinal discomfort, such as colic or reflux. However, in this scenario, the emphasis is on changes in sleep patterns as a potential indicator of illness.
When assessing the perfusion status of a 2-year-old child with possible shock, which of the following parameters would be LEAST reliable?
- A. distal capillary refill
- B. systolic blood pressure
- C. skin color and temperature
- D. presence of peripheral pulses
Correct Answer: B
Rationale: The correct answer is B: systolic blood pressure. In young children, systolic blood pressure is the least reliable parameter for assessing perfusion status. Factors such as anxiety, crying, and fear can significantly affect blood pressure measurements, leading to inaccuracies. Distal capillary refill, skin color and temperature, and presence of peripheral pulses are more reliable indicators of perfusion status in pediatric patients. Distal capillary refill assesses peripheral perfusion, skin color, and temperature reflect tissue perfusion, and the presence of peripheral pulses indicates blood flow to the extremities. Therefore, when evaluating a 2-year-old child with possible shock, focusing on parameters other than systolic blood pressure is crucial for an accurate assessment of perfusion status.