Nokea
A school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?
- A. Varicella (Chickenpox)
- B. Scarlet fever
- C. Poliomyelitis
- D. Whooping cough
Correct Answer: A
Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.
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A 7-year-old child with a history of seizures is being discharged from the hospital. What should the nurse include in the discharge teaching for the parents?
- A. Administer antiepileptic medication as prescribed, not just when a seizure occurs
- B. Ensure the child gets adequate sleep
- C. Restrict the child's activities to prevent seizures
- D. Teach seizure first aid to family members
Correct Answer: D
Rationale: The correct answer is to teach seizure first aid to family members. This is crucial because family members need to know how to appropriately respond during a seizure to ensure the child's safety. Choice A has been corrected to emphasize that antiepileptic medication should be administered as prescribed, not just when a seizure occurs, to effectively manage the condition. Choice B, while important for overall health, is not directly related to seizure management. Choice C is not recommended as restricting activities may not prevent seizures and may hinder the child's quality of life.
What intervention best meets a major developmental need of a newborn in the immediate postoperative period?
- A. Giving a pacifier to the newborn
- B. Putting a mobile over the newborn's crib
- C. Providing the newborn with a soft, cuddly toy
- D. Warming the newborn's formula before feeding
Correct Answer: A
Rationale: The correct answer is giving a pacifier to the newborn. Sucking is a natural reflex and a source of comfort for newborns, especially postoperatively. A pacifier can help meet their developmental needs by providing soothing comfort. Choices B, C, and D do not directly address the major developmental need related to the newborn's comfort and reflexes postoperatively. Putting a mobile over the crib, providing a cuddly toy, or warming formula, although potentially beneficial in other contexts, do not specifically target the developmental need of sucking for comfort. Offering a pacifier is a safe and effective way to address this developmental need in newborns.
One principle to be followed for children with type 1 diabetes is to provide for the variability of the child's activity. What should the nurse teach the child about how to compensate for increased physical activity?
- A. Eat more food when planning to exercise more than usual.
- B. Take oral, not injectable insulin, on days of heavy exercise.
- C. Take insulin in the morning when extra exercise is anticipated.
- D. Eat foods that contain sugar to compensate for the extra exercise.
Correct Answer: A
Rationale: The correct answer is to eat more food when planning to exercise more than usual. Increased physical activity requires more energy, so additional food intake is necessary to compensate for the increased energy expenditure. This helps maintain blood sugar levels within the target range. Choice B is incorrect because the mode of insulin administration does not change based on physical activity; the type and dose of insulin remain the same unless adjusted by a healthcare provider. Choice C is incorrect because insulin timing should not be adjusted solely based on anticipated exercise; consistent timing of insulin doses is crucial for stable blood sugar control. Choice D is incorrect because consuming foods with sugar may lead to unstable blood sugar levels and is not the recommended way to compensate for extra exercise, as it can result in sudden spikes and drops in blood glucose levels, affecting overall diabetes management.
Which of the following parameters would be LEAST reliable when assessing the perfusion status of a 2-year-old child with possible shock?
- A. distal capillary refill
- B. systolic blood pressure
- C. skin color and temperature
- D. presence of peripheral pulses
Correct Answer: B
Rationale: Systolic blood pressure is the least reliable parameter when assessing the perfusion status of a 2-year-old child with possible shock. In pediatric patients, especially young children, blood pressure may not decrease until significant shock has already occurred, making it a late indicator of inadequate perfusion. Depending solely on systolic blood pressure to evaluate perfusion status in this age group can lead to a delay in appropriate interventions. Distal capillary refill time, skin color, and temperature changes, and the presence of peripheral pulses are more sensitive and early indicators of perfusion status in pediatric patients. Monitoring distal capillary refill provides information on peripheral perfusion, while changes in skin color and temperature can signal circulatory compromise. Evaluating the presence or absence of peripheral pulses offers insights into vascular perfusion. These parameters offer more reliable and prompt feedback on a child's perfusion status compared to systolic blood pressure.
When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'
- A. keep medications in a medicine cabinet.
- B. have secured gates at entrances to staircases.
- C. move our child to a regular bed by the appropriate age.
- D. buy shoes that close with Velcro rather than laces.
Correct Answer: C
Rationale: Moving a child to a regular bed by the appropriate age is not recommended as it can increase the risk of falls. Toddlers should transition to a regular bed only when developmentally ready to prevent accidents. Keeping medications in a medicine cabinet (Choice A) promotes safety by preventing accidental ingestion. Securing gates at entrances to staircases (Choice B) helps prevent falls down stairs. Buying shoes that close with Velcro rather than laces (Choice D) is a good practice to prevent tripping and falling.