Nokea
After teaching the mother of a child with severe burns about the importance of specific nutritional support in burn management, which of the following, if chosen by the mother from the child's diet menu, indicates the need for further teaching?
- A. Bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks.
- B. Cheeseburger, cottage cheese and pineapple salad, chocolate milk, and a brownie.
- C. Chicken nuggets, orange and grapefruit sections, and a vanilla milkshake.
- D. Beef, bean, and cheese burrito; a banana; fruit-flavored yogurt; and skim milk.
Correct Answer: A
Rationale: Burn patients require high-protein, high-calorie diets. Option A is low in protein and calories compared to options B, C, and D, which include protein-rich foods like cheese, chicken, and beans.
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The mother of a 2-year-old is concerned because the child's right eye seems to turn in toward his nose when he is tired. The nurse should:
- A. Assure the mother that this is a normal event when the child is tired.
- B. Advise the mother to continue to watch his eyes closely and if the problem persists to call the clinic.
- C. Test the child with the cover-uncover test and refer to an ophthalmologist if the test is abnormal.
- D. Explain to the mother that the child will probably outgrow the weakness and she need not be concerned.
Correct Answer: C
Rationale: The cover-uncover test can detect strabismus, which requires referral if confirmed.
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.
Which of the following should the nurse include when teaching the father of an infant just admitted with gastroenteritis about initial treatment for his infant?
- A. The infant will receive no liquids by mouth.
- B. Intravenous antibiotics will be started.
- C. The infant will be placed in a mist tent.
- D. An iron-fortified formula will be used.
Correct Answer: A
Rationale: NPO status is common initially to rest the gut during rehydration.
The nurse talks to an adolescent about how she can tell her friends about her new diagnosis of diabetes. Which of the following behaviors by the adolescent indicates that the adolescent has responded positively to the discussion?
- A. She asks the nurse for material on diabetes for a school paper.
- B. She introduces the nurse to her friends as the nurse to the taught me all about my diabetes.
- C. She says, 'I'll try to tell my friends, but they'll probably quit hanging out with me.'
- D. She asks her friends what they think about someone who has a lifelong illness.
Correct Answer: A
Rationale: Requesting materials indicates proactive engagement and willingness to share knowledge, reflecting a positive response. Other options show hesitation or indirect approaches.
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.