Nokea
After insertion of bilateral tympanostomy tubes in a toddler, which of the following instructions should the nurse include in the child's discharge plan for the parents?
- A. Insert ear plugs into the canals when the child bathes.
- B. Blow the nose forcibly during a cold.
- C. Administer the prescribed antibiotic while the tubes are in place.
- D. Disregard any drainage from the ear after 1 week.
Correct Answer: C
Rationale: Administering prescribed antibiotics as directed is crucial to prevent infection after tympanostomy tube insertion. Ear plugs are not typically recommended, as they can introduce bacteria. Forcibly blowing the nose can disrupt the tubes, and any drainage after 1 week should be reported, not disregarded.
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A nurse who witnesses an accident involving an adolescent riding a motorcycle, hitting a tree, and being thrown 30 feet into a field stops to help. The adolescent reports that he is now unable to move his legs. While waiting for the emergency medical service to arrive, what should the nurse do?
- A. Flex the adolescent's knees to relieve stress on his back.
- B. Leave the adolescent as he is, staying close by.
- C. Remove the adolescent's helmet as soon as possible.
- D. Assess the adolescent for abdominal trauma.
Correct Answer: B
Rationale: Immobilizing the adolescent by leaving him undisturbed prevents further spinal cord damage until EMS arrives.
A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time?
- A. Reading the child a story.
- B. Painting with watercolors.
- C. Pounding on a pegboard.
- D. Stacking a tower of blocks.
Correct Answer: C
Rationale: Pounding on a pegboard allows the child to express frustration physically, which is developmentally appropriate for a preschooler.
A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family the nurse should:
- A. Advise the family to bring the child to the hospital the night before.
- B. Explain that the child will need a large bandage after the procedure.
- C. Discourage bringing favorite toys that might become associated with pain.
- D. Explain that the child may get up as soon as the vital signs are stable.
Correct Answer: B
Rationale: The catheter insertion site will be covered with a bandage. This is important for preschool children to know as they are very concerned about bodily harm. Preparing the child the night before, bringing favorite toys, and explaining activity restrictions are also important but not the primary focus of this choice.
In an initial screening for lead poisoning, a 2-year-old child is found to have a lead level of 12 mcg/dL. The nurse should:
- A. Arrange a follow-up appointment in 6 months.
- B. Initiate chelation therapy.
- C. Refer to a neurologist.
- D. Test siblings for lead exposure.
Correct Answer: A
Rationale: A lead level of 12 mcg/dL requires follow-up in 3-6 months per CDC guidelines. Chelation is for levels >45 mcg/dL, neurology referral is premature, and sibling testing depends on shared exposure risk.
A 10-year-old with scoliosis has to wear a brace. The nurse should develop a teaching plan with the client to include which of the following instructions?
- A. Wear the brace during waking hours.
- B. Wear the brace only during sleep.
- C. Wear a form-fitting, sleeveless T-shirt under the brace.
- D. Bathe the skin under the brace once per week.
Correct Answer: A,C
Rationale: The brace should be worn during waking hours for maximum effectiveness, and a form-fitting T-shirt helps protect the skin and improve comfort.