Nokea
After teaching the mother of a young child with a peritoneal catheter about the signs and symptoms of peritonitis, the nurse determines that the mother has understood the teaching when she identifies which of the following as an important sign?
- A. Cloudy dialysate drainage return.
- B. Distended abdomen.
- C. Shortness of breath.
- D. Weight gain of 3 lb in 2 days.
Correct Answer: A
Rationale: Cloudy drainage indicates infection.
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A 12-year-old with rheumatic fever has a history of long-term aspirin use. Which statement by the client indicates that the nurse should notify the health care provider?
- A. I hear ringing in my ears.
- B. Is it alright to put lotion on my itchy skin?
- C. My stomach hurts after I take that medicine.
- D. These pills make me cough.
Correct Answer: A
Rationale: Ringing in the ears (tinnitus) is a sign of aspirin toxicity, requiring immediate notification. Stomach pain is common but less urgent, and other symptoms are unrelated.
A child with a peanut allergy is prescribed an epinephrine auto-injector. The nurse should teach the parents to administer it in which situation?
- A. Mild itching after eating peanuts.
- B. Swelling of the lips and tongue.
- C. Upset stomach after exposure.
- D. Fatigue after a meal.
Correct Answer: B
Rationale: Lip and tongue swelling indicates anaphylaxis, requiring immediate epinephrine. Itching, upset stomach, or fatigue are less severe and managed differently.
When observing the parent instilling prescribed ear drops ordered twice a day for a toddler, the nurse decides that the teaching about positioning of the pinna for instillation of the drops is effective when the parent pulls the toddler's pinna in which of the following directions?
- A. Up and forward.
- B. Up and backward.
- C. Down and forward.
- D. Down and backward.
Correct Answer: D
Rationale: In children under 3, the pinna is pulled down and back to straighten the ear canal.
The physician orders carbamazepine extended release (Tegretol-XR) for a client with cerebral palsy who also has a seizure disorder. The client has a gastrostomy feeding tube. What should the nurse do?
- A. Crush the medication and administer through the tube.
- B. Request an immediate-release formulation.
- C. Withhold the medication and notify the physician.
- D. Administer the medication orally.
Correct Answer: C
Rationale: Extended-release formulations like Tegretol-XR should not be crushed; the nurse should notify the physician to adjust the order.
Which of the following should the nurse include in the discharge teaching for a parent of an infant with a repaired cleft lip to promote healing?
- A. Avoid pacifier use for 2 weeks.
- B. Apply antibiotic ointment daily.
- C. Keep the infant in a supine position.
- D. Offer large, frequent feedings.
Correct Answer: A
Rationale: Avoiding pacifier use prevents stress on the suture line, promoting healing.