Nokea
After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?
- A. A balance of rest and exercise is important.
- B. I can apply lotion or powder to the incision if it is itchy.
- C. Activities in which falling could occur need to be avoided for two to four weeks.
- D. Large crowds of people need to be avoided for at least two weeks after the surgery.
Correct Answer: B
Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.
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What is the aim of Integrated Management of neonatal and Childhood Illnesses?
- A. Improved case management
- B. Improved family and community practices
- C. None of the above
- D. A & B
Correct Answer: D
Rationale: The aim of the Integrated Management of neonatal and Childhood Illnesses is to enhance both case management and family and community practices. By improving case management, healthcare providers can ensure appropriate treatment and care, leading to better outcomes for neonates and children. Enhancing family and community practices can contribute to the prevention, early detection, and overall well-being of children. Choice A is incorrect as the aim is not solely focused on improved case management. Choice B is incorrect as the aim goes beyond just improving family and community practices. Choice C is incorrect as the correct aim involves both improved case management and family/community practices, making choice D the most comprehensive and accurate answer.
A 3-month-old is hospitalized with a fractured femur. The pain assessment tool most appropriate for this child is the:
- A. FLACC scale.
- B. Poker chip tool.
- C. Number scale.
- D. Visual analog scale.
Correct Answer: A
Rationale: The FLACC scale is a validated pain assessment tool suitable for infants and young children, including 3-month-olds. It assesses pain based on five categories: Face, Legs, Activity, Cry, and Consolability. Since infants cannot communicate their pain verbally, the FLACC scale is effective in evaluating pain by observing these behavioral indicators. The other options, such as the Poker chip tool, Number scale, and Visual analog scale, are not specifically designed for infants and may not provide accurate pain assessment in this age group.
A 6-year-old male is hospitalized in stable condition with multiple fractures following a car accident. The child's parents tell the nurse that their 7-year-old daughter is very upset about the accident and is concerned that her brother will die. Which suggestion by the nurse is most appropriate?
- A. Encourage the parents to phone the sister frequently with updates on her brother's condition.
- B. Suggest that the sister come to the hospital for a visit.
- C. Suggest that one parent leave the hospital to spend extra time with their daughter at home.
- D. Remind the parents that it is normal for children to be upset when their sibling is hospitalized.
Correct Answer: B
Rationale: In situations where a sibling is upset about a family member being hospitalized, suggesting that the sister come to the hospital for a visit can help alleviate her concerns. This allows the sister to see her brother, ask questions, and receive reassurance from seeing him in stable condition. Direct contact and interaction can often provide more comfort and understanding than phone calls or staying at home. Encouraging phone calls (Choice A) might not provide the same level of comfort as a physical visit. While spending extra time with the daughter at home (Choice C) is important, in this scenario, facilitating a visit to the hospital can address the daughter's immediate concerns better. Reminding the parents that it is normal for children to be upset (Choice D) is not as proactive as arranging for the sister to visit her brother.
What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?
- A. Insert the needle and aspirate before injecting
- B. Inject insulin into the extremity to be exercised to improve absorption
- C. The muscles in the abdomen and thigh are the easiest for self-administration
- D. Clean the injection site with soap and water and avoid alcohol
Correct Answer: C
Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.
When drawing blood from the diabetic patient for a glycosylated hemoglobin (HBA1c) test, the nurse explains to the woman that the test is used to determine:
- A. The highest glucose level in the past week.
- B. Her insulin levels.
- C. Glucose levels over the past three months.
- D. Her usual fasting glucose level.
Correct Answer: C
Rationale: The glycosylated hemoglobin (HBA1c) test reflects the average blood sugar levels over the past three months. It provides a more comprehensive view of the individual's glucose control compared to a single point-in-time measurement like a fasting glucose level or the highest glucose level in the past week. Choice A is incorrect because it focuses on a single high glucose level rather than the overall control over a period. Choice B is incorrect as HBA1c is not a test for insulin levels. Choice D is incorrect as the HBA1c test does not reflect a single fasting glucose level but rather an average over a more extended period.