Nokea
An 18-month-old with a congenital heart defect is to receive digoxin twice a day. The nurse should instruct the parents about which of the following?
- A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
- B. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances.
- C. Digoxin is absorbed better if taken with meals.
- D. If the child vomits within 15 minutes of administration, the dosage should be repeated.
Correct Answer: A
Rationale: Digoxin improves heart function by increasing contractility and regulating rhythm. Toxicity signs are correct but not the focus here, absorption is not meal-dependent, and repeating a vomited dose risks overdose.
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When developing the plan of care for a child with early Duchenne's muscular dystrophy, which of the following nursing goals is the priority?
- A. Encouraging early wheelchair use.
- B. Fostering social interactions.
- C. Maintaining function of unaffected muscles.
- D. Prevent circulatory impairment.
Correct Answer: C
Rationale: Maintaining function of unaffected muscles is the priority to prolong mobility and independence in early Duchenne's muscular dystrophy.
An 8-month-old infant is seen in the well-child clinic for a routine checkup. The nurse should expect the infant to be able to do which of the following? Select all that apply.
- A. Say 'mama' and 'dada' with specific meaning.
- B. Feed self with a spoon.
- C. Play peek-a-boo.
- D. Walk independently.
- E. Stack two blocks.
- F. Transfer object from hand to hand.
Correct Answer: C,F
Rationale: Playing peek-a-boo and transferring objects are typical 8-month milestones; others occur later.
Which of the following statements obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure?
- A. The child has had a low-grade fever for several weeks.
- B. The family history is negative for convulsions.
- C. The seizure occurred with a necessary arrest.
- D. The seizure occurred when the child had a respiratory infection.
Correct Answer: D
Rationale: Febrile seizures are associated with acute fever, often during infections like respiratory infections, in young children.
The parents of an infant with myelomeningocele ask the nurse about their child's future mental ability. What is the nurse's best response?
- A. About one-third are mentally retarded, but it's too early to tell about your child.'
- B. About two-thirds are significantly retarded, and you'll know soon if this will occur.'
- C. Your child will probably be of normal intelligence since he demonstrates signs of it now.'
- D. You'll need to talk with the doctor about that, but you can ask later.'
Correct Answer: D
Rationale: Referring parents to the physician for detailed prognostic discussions ensures accurate information and avoids premature or speculative statements about mental ability.
When assessing an infant with suspected inguinal hernia, which of the following findings would be most significant?
- A. The inguinal swelling is reddened, and the abdomen is distended.
- B. The infant is irritable, and a thickened spermatic cord is palpable.
- C. The inguinal swelling can be reduced, and the infant has a stool in the diaper.
- D. The infant's diaper is wet with urine, and the abdomen is nontender.
Correct Answer: B
Rationale: Irritability and a thickened spermatic cord suggest a hernia, indicating possible incarceration.