Nokea
A young child is admitted for treatment of lead poisoning. The nurse recognizes that the most serious effect of chronic lead poisoning is
- A. Central nervous system damage
- B. Moderate anemia
- C. Renal tubule damage
- D. Growth impairment
Correct Answer: A
Rationale: Corrected Rationale: Chronic lead poisoning can lead to severe and irreversible damage to the central nervous system, including cognitive and developmental delays. Central nervous system damage is the most serious effect of chronic lead poisoning because it can have long-lasting consequences on a child's cognitive function and overall development. Moderate anemia (Choice B), renal tubule damage (Choice C), and growth impairment (Choice D) can also occur due to lead poisoning, but they are not as severe or potentially irreversible as the damage to the central nervous system.
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Which of the following behaviors is influenced by cultural expectations?
- A. talking openly about the details of the illness
- B. deciding whether to 'feed a cold' or 'starve a fever'
- C. taking herbal supplements to boost the immune system
- D. all of the above
Correct Answer: D
Rationale: Cultural expectations can influence all the listed behaviors. Talking openly about the details of an illness may be culturally acceptable or taboo. The decision to 'feed a cold' or 'starve a fever' is often influenced by cultural beliefs and practices. Additionally, the use of herbal supplements to boost the immune system can also be shaped by cultural norms and traditions. Therefore, all the behaviors listed can be influenced by cultural expectations, making option D the correct answer. Choices A, B, and C are incorrect because cultural expectations can impact each of these behaviors.
An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?
- A. "Feedings can begin in 5 to 7 days."
- B. "The use of the feeding tube can begin immediately."
- C. "The stomach contents and air must be drained first."
- D. "The incision healing must be complete before feeding."
Correct Answer: C
Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.
A 14-month-old had cleft palate surgical repair several days ago. The parents ask the nurse about feedings after discharge. Which lunch is the best example of an appropriate meal?
- A. Hot dog, carrot sticks, gelatin, milk
- B. Soup, blenderized soft foods, ice cream, milk
- C. Peanut butter and jelly sandwich, chips, pudding, milk
- D. Baked chicken, applesauce, cookie, milk
Correct Answer: B
Rationale: Choice B, 'Soup, blenderized soft foods, ice cream, milk,' is the correct answer. After cleft palate repair, it is essential to provide soft and blenderized foods to prevent trauma to the surgical site and promote proper healing. Choices A, C, and D contain foods that may be difficult for the child to consume comfortably and safely after a cleft palate surgical repair. A hot dog, carrot sticks, chips, and hard cookies could potentially cause injury or discomfort to the surgical area. Peanut butter and jelly sandwich might be too difficult to swallow or may stick to the surgical site. Baked chicken could be too challenging to chew. Therefore, the best choice for an appropriate meal post cleft palate repair is soft, blenderized foods like soup, along with other soft options like ice cream and milk.
Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?
- A. ''I may experience seizures if I stop the medication abruptly.''
- B. ''I may experience an increase in my heart rate for a few weeks.''
- C. ''I can expect to feel nervousness the first few weeks.''
- D. ''I can have a heart attack if I stop this medication suddenly.''
Correct Answer: D
Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.
The school nurse is called to the playground for an episode of mouth trauma. The nurse finds that the front tooth of a 9-year-old child has been avulsed (knocked out). After recovering the tooth, the initial response should be to
- A. Rinse the tooth in water before placing it in the socket
- B. Place the tooth in a clean plastic bag for transport to the dentist
- C. Hold the tooth by the roots until reaching the emergency room
- D. Ask the child to replace the tooth even if the bleeding continues
Correct Answer: A
Rationale: The correct immediate action after recovering an avulsed tooth is to rinse it with water and place it back in the socket. This helps preserve the tooth and increases the chances of successful re-implantation. Placing the tooth in a clean plastic bag for transport to the dentist (choice B) is not ideal as immediate re-implantation is preferred. Holding the tooth by the roots until reaching the emergency room (choice C) can further damage the tooth. Asking the child to replace the tooth even if bleeding continues (choice D) is incorrect and may lead to improper re-implantation.