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After emphasizing to an adolescent with renal failure the importance of maintaining a positive self-concept, which of the following behaviors by the adolescent should the nurse identify as an indicator that the plan is working?
- A. Reports of headaches, abdominal pain, and nausea.
- B. Insistence on making diet choices even if the foods chosen are restricted.
- C. Verbalization of plans to quit all after-school activities when returning home.
- D. Demonstration of desire to do the dressing changes and take care of the medications.
Correct Answer: D
Rationale: Self-care indicates positive adjustment.
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The breast-feeding mother of a 1-month-old diagnosed with cow's milk sensitivity asks the nurse what she should do about feeding her infant. Which of the following recommendations would be most appropriate?
- A. Continue to breast-feed but eliminate all milk products from your own diet.
- B. Discontinue breast-feeding and start using a predigested formula.
- C. Limit breast-feeding to once per day and begin feeding an iron-fortified formula.
- D. Change to a soy-based formula exclusively and begin solid foods.
Correct Answer: A
Rationale: Eliminating dairy from the mother's diet prevents milk proteins from passing to the infant via breast milk, allowing breastfeeding to continue. Formula or solids are less appropriate at this age.
A three-year-old is brought into the emergency department in her mother's arms. The child's mouth is open and she is drooling and lethargic. Her mother states that she became ill suddenly within the past 2 hours. What should the nurse do first?
- A. Draw blood cultures for complete blood count.
- B. Start an intravenous line.
- C. Inspect the child's throat with a tongue blade.
- D. Maintain the child in an undisturbed, upright position.
Correct Answer: D
Rationale: The symptoms suggest possible epiglottitis, a medical emergency. Maintaining the child in an undisturbed, upright position prevents airway obstruction and is the priority action.
A 2-year-old tells his mother he is afraid to go to sleep because 'the monsters will get him.' The nurse should tell his mother to:
- A. Allow him to sleep with his parents in their bed whenever he is afraid.
- B. Increase his activity before he goes to bed, so he eventually falls asleep from being tired.
- C. Give him a favorite cuddly animal or a blanket.
- D. Allow him to stay up an hour later with the family until he falls asleep.
Correct Answer: C
Rationale: A comfort object helps a toddler feel secure and supports self-soothing.
The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following?
- A. Allow the child to stay up later one or two nights a week.
- B. Establish a set bedtime and follow a routine.
- C. Encourage active play before bedtime.
- D. Give the child a cookie if bedtime is pleasant.
Correct Answer: B
Rationale: A consistent bedtime routine promotes healthy sleep habits.
A father asks the nurse how he would know if his child had developed mononucleosis. The nurse explains that in addition to fatigue, which of the following would be most common?
- A. Liver tenderness.
- B. Enlarged lymph glands.
- C. Persistent nonproductive cough.
- D. A blush-like generalized skin rash.
Correct Answer: B
Rationale: Enlarged lymph glands, especially in the neck, are a hallmark symptom of mononucleosis.