Nokea
After receiving an immunization for pediatric diphtheria, tetanus, and acellular pertussis (DTaP), a patient develops swelling and tenderness at the injection site, a low-grade fever, and malaise. The pediatric nurse informs the patient's parents that:
- A. they should delay future immunizations until the patient sees an allergist.
- B. this is a mild reaction, and teaches them how to manage it.
- C. this is an appropriate reaction, and instructs them to do nothing.
- D. none of the above.
Correct Answer: B
Rationale: Mild reactions like swelling, tenderness, low-grade fever, and malaise are common after DTaP vaccination and can be managed with supportive care.
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Which of the ff should a client with auto immune disorder be advised to avoid?
- A. Resting during the periods of severe exacerbation
- B. Regular exercise during the periods of remission
- C. Being in crowds during the periods of immunosuppression
- D. Humid environment during the periods of remission
Correct Answer: C
Rationale: Clients with autoimmune disorders often experience periods of immunosuppression, where their immune system is compromised and less effective at fighting off infections. Being in crowded places increases the risk of exposure to infectious agents, which can pose a greater threat to individuals with weakened immune systems. It is important for clients with autoimmune disorders to avoid crowds during periods of immunosuppression to reduce the risk of infections and other complications.
The developmental age of a child who continues to search for a hidden subject has achieved
- A. 7 months
- B. 9 months
- C. 11 months
- D. 13 months
Correct Answer: B
Rationale: Object permanence is typically achieved around 9 months.
The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)
- A. Warm flushed extremities
- B. Weight loss
- C. Decreased urinary output
- D. Sweating (inappropriate)
Correct Answer: C
Rationale: C. Decreased urinary output: This can be a sign of fluid retention, which is a common symptom of heart failure. Infants with heart failure may have decreased urine output as the body tries to retain fluid to help compensate for the heart's decreased ability to pump effectively.
The first thing to do for a nurse when an accident occurs is to find out if patient is conscious so that she could:
- A. Reassure the patient
- B. Call relatives
- C. Bring patient immediately to the hospital
- D. Call a doctor
Correct Answer: A
Rationale: The first thing a nurse should do when an accident occurs is to assess the patient's level of consciousness. This is important to determine the patient's immediate medical needs and to ensure the patient's safety. By checking if the patient is conscious, the nurse can assess the patient's alertness and responsiveness, which will help in providing appropriate care. Reassuring the patient is crucial to help calm them down and provide comfort in a stressful situation. Once the nurse has established the patient's level of consciousness, they can then proceed with necessary medical interventions such as contacting a doctor or bringing the patient to the hospital if needed.
According to Piaget, the 6-month-old infant should be in which developmental stage?
- A. Use of reflexes
- B. Primary circular reactions
- C. Secondary circular reactions
- D. Coordination of secondary schemata
Correct Answer: B
Rationale: According to Piaget's theory of cognitive development, the 6-month-old infant would typically be in the stage known as primary circular reactions. This stage occurs from around 1 to 4 months of age up to about 1 year old. During this stage, infants begin to repeat actions that bring them pleasure or interesting results, such as sucking their thumb or repeating simple movements like kicking. These repetitive actions are circular in nature because they involve the infant's own body, and they serve as the building blocks for more complex interactions and understanding of the world. This stage is characterized by the infant's increasing ability to coordinate sensory information with motor actions, laying the foundation for further cognitive development.