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After a discussion with the healthcare provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?
- A. The diameter of the aorta is enlarged.
- B. The wall between the right and left ventricles is open.
- C. It is a narrowing of the entrance to the pulmonary artery.
- D. It is a connection between the pulmonary artery and the aorta.
Correct Answer: D
Rationale: Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta. In a fetus, the ductus arteriosus is a normal connection between these two vessels, allowing blood to bypass the lungs. However, it should close shortly after birth. When it remains open (patent), it leads to PDA. Choices A, B, and C do not accurately describe PDA. Choice A describes an enlarged aorta, choice B describes a ventricular septal defect, and choice C describes pulmonary stenosis, which are different cardiac conditions.
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Which of the following findings would indicate altered mental status in a small child?
- A. Recognition of the parents
- B. Fright at the EMT-B's presence
- C. Lack of attention to the EMT-B's presence
- D. Consistent eye contact with the EMT-B
Correct Answer: C
Rationale: In small children, altered mental status can manifest as a lack of attention to the presence of unfamiliar individuals, such as the EMT-B. This lack of engagement may indicate confusion, disorientation, or impaired cognitive function. Choices A, B, and D are incorrect as recognizing parents, exhibiting fear, or maintaining consistent eye contact do not necessarily indicate altered mental status. Recognizing parents is a normal response, fear can be a typical reaction to unfamiliar situations, and making eye contact may be a sign of curiosity or comfort rather than a reflection of mental status.
The nurse is teaching the parents of a 1-month-old girl with Down syndrome how to maintain good health for the child. Which instruction would the nurse be least likely to include?
- A. Getting cervical radiographs between 3 and 5 years of age
- B. Adhering to the special dietary needs of the child
- C. Getting an echocardiogram before 3 months of age
- D. Monitoring for symptoms of respiratory infection
Correct Answer: B
Rationale: The correct answer is B. While special dietary needs may be important for a child with Down syndrome, they are typically not the primary concern for a 1-month-old. The nurse would be least likely to focus on this aspect as immediate issues such as monitoring for congenital heart defects (echocardiogram), cervical spine abnormalities (radiographs), and respiratory infections are more critical in the early months. Adhering to dietary needs is important, but it is usually addressed as the child grows older and is not the priority during the infant stage.
A child with a diagnosis of bronchiolitis is admitted to the hospital. What is the most important nursing intervention?
- A. Administering bronchodilators
- B. Providing respiratory therapy
- C. Monitoring oxygen saturation
- D. Encouraging fluid intake
Correct Answer: B
Rationale: The most important nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention helps to maintain airway patency and improve breathing by assisting with mucus clearance and ventilation. Administering bronchodilators (Choice A) may be considered in some cases, but it is not the most crucial intervention for bronchiolitis. Monitoring oxygen saturation (Choice C) is important but is not as directly impactful as providing respiratory therapy. Encouraging fluid intake (Choice D) is important for hydration but does not directly address the respiratory distress associated with bronchiolitis.
A 6-year-old with muscular dystrophy was recently injured falling out of bed at home. What intervention should the nurse suggest to prevent further injury?
- A. Recommend raising the bed's side rails when a caregiver is not present.
- B. Suggest a caregiver be present continuously to prevent falls from bed.
- C. Encourage the use of loose restraints while in bed.
- D. Recommend raising the bed's side rails throughout the day and night.
Correct Answer: A
Rationale: In this scenario, the most appropriate intervention to prevent further injury is to raise the bed's side rails when a caregiver is not present. This measure helps in preventing falls without the need for constant supervision. Choice B is not practical as continuous caregiver presence may not always be feasible. Choice C is unsafe as loose restraints can pose a strangulation risk. Choice D does not address the need for intervention when a caregiver is absent, potentially leading to an increased risk of falls.
A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?
- A. Acidosis
- B. Alkalosis
- C. Hyperkalemia
- D. Hypernatremia
Correct Answer: B
Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.