Nokea
After teaching the mother of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, the mother indicates that she understands her child's prognosis when she states which of the following?
- A. My child will need to wear protective pads until puberty.
- B. My child will need extra fluids to prevent constipation.
- C. My child will probably always need a high-fiber diet.
- D. My child has a good chance of being potty trained.
Correct Answer: D
Rationale: Low anorectal anomalies often have a good prognosis for continence with proper management.
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A nurse is teaching an 8-year-old with diabetes and her parents about managing diabetes during illness. The nurse determines the parents understand the instruction when they indicate that, when the child is ill, they will provide:
- A. More calories.
- B. More insulin.
- C. Less insulin.
- D. Less protein and fat.
Correct Answer: B
Rationale: Illness increases insulin resistance, often requiring more insulin to manage elevated blood glucose. Calorie, protein, or fat adjustments are secondary to insulin needs.
A mother brings her 18-month-old to the clinic because the child 'eats ashes, crayons, and paper.' Which of the following information about the toddler should the nurse assess first?
- A. Evidence of eruption of large teeth.
- B. Amount of attention from the mother.
- C. Any changes in the home environment.
- D. Intake of a soft, low-roughage diet.
Correct Answer: C
Rationale: Changes in the home environment may contribute to pica, which requires immediate assessment.
When teaching the child with scoliosis being treated with a Boston brace about exercises, the nurse explains that the exercises are performed primarily for which of the following purposes?
- A. To decrease back muscle spasms.
- B. To improve the brace's traction effect.
- C. To prevent spinal contractures.
- D. To strengthen the back and abdominal muscles.
Correct Answer: D
Rationale: Exercises for scoliosis in a Boston brace focus on strengthening back and abdominal muscles to support spinal alignment and improve posture.
A 15-year-old has been diagnosed with acute glomerulonephritis and has been in the hospital for 1 day. Which of the following findings requires immediate action?
- A. Large amount of generalized edema.
- B. Urine specific gravity of 1.030.
- C. Large amount of albumin in the urine.
- D. 24-hour output of 1,500 mL.
Correct Answer: A
Rationale: Severe edema could indicate worsening condition.
A 2-year-old child returns to the clinic after completing a 10-day course of amoxicillin prescribed to relieve an infection in his right ear. After completing the medication, the child has become fussy and has a low-grade fever. On physical examination, his right tympanic membrane is bulging and he is tugging at his ear. The nurse should:
- A. Suggest to the mother that a decongestant be used.
- B. Tell the mother the health care provider will probably repeat the 10-day course of amoxicillin.
- C. Suggest that the child should see an ear, nose, and throat specialist for myringotomy tubes.
- D. Report the assessment to the health care provider with the probability that another antibiotic will be used for a 10-day course.
Correct Answer: D
Rationale: Persistent symptoms like fussiness, fever, a bulging tympanic membrane, and ear tugging after completing amoxicillin suggest treatment failure, possibly due to resistant bacteria. The nurse should report these findings to the health care provider, who may prescribe a different antibiotic for another 10-day course.