Nokea
After a child undergoes a craniotomy for an infratentorial brain tumor, the nurse should place the child in which of the following positions to prevent undue strain on the sutures?
- A. Prone.
- B. Semi-Fowler's.
- C. Side-lying.
- D. Trendelenburg.
Correct Answer: C
Rationale: Side-lying position minimizes pressure on infratentorial sutures while maintaining airway and reducing intracranial pressure.
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When developing the plan of care for a child diagnosed with phenylketonuria (PKU), the nurse should establish which of the following goals?
- A. Meeting the child's nutritional needs for optimal growth.
- B. Ensuring that the special diet is started at age 3 weeks.
- C. Permitting serum phenylalanine level higher than 12 mg/100 mL.
- D. Maintaining serum phenylalanine level lower than 2 mg/100 mL.
Correct Answer: A
Rationale: The goal is to meet nutritional needs via a phenylalanine-restricted diet for growth while preventing neurological damage. The diet starts at diagnosis, not 3 weeks, and phenylalanine levels should be 2-6 mg/100 mL.
A nurse is teaching a child with a food allergy about safe eating. Which instruction is most important?
- A. Eat only home-cooked meals.
- B. Read food labels carefully.
- C. Avoid all fruits.
- D. Use herbal supplements.
Correct Answer: B
Rationale: Reading food labels prevents accidental allergen exposure. Home cooking helps but isn't always feasible, fruits are safe unless allergenic, and supplements are irrelevant.
After the acute stage following an ingestion of drain cleaner by a child, the nurse should be alert for the development of which of the following as a likely complication?
- A. Tracheal stenosis.
- B. Tracheal varices.
- C. Esophageal strictures.
- D. Esophageal diverticula.
Correct Answer: C
Rationale: Corrosive ingestion can scar the esophagus, leading to strictures. Tracheal complications are less common unless the airway is directly affected, and diverticula are not typical.
An 8-year-old with newly diagnosed diabetes is in the hospital for regulation of diet and medications. The child is using an exchange method for the diet. The nurse should instruct the client that the American Diabetes Association's (ADA's) exchange method for dietary regulation includes:
- A. Choosing food from each exchange list.
- B. Using a scale to weigh all food.
- C. Selecting from lists that group food according to protein, fat, and carbohydrate content.
- D. Carbohydrate counting for each meal and snack.
Correct Answer: C
Rationale: The ADA exchange method groups foods by protein, fat, and carbohydrate content to balance macronutrients. It does not require weighing all food or exclusive carbohydrate counting, though lists are used.
Which of the following should the nurse expect to include in the plan of care for a child who is diagnosed with rheumatic fever and carditis and admitted to the hospital?
- A. Ensuring continuous parental presence at the child's bedside.
- B. Providing the child with periods of rest.
- C. Encouraging participation in age-appropriate activities.
- D. Advising the child to eat as much as possible.
Correct Answer: B
Rationale: Rest is essential in rheumatic fever with carditis to minimize cardiac workload and prevent further damage. Other options are supportive but not the priority.