Nokea
An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?
- A. We should be sure to start our daughter on birth control pills.'
- B. Sexual maturity differences between my daughter and her peers will disappear within a few years.'
- C. Our daughter will be on this hormone treatment the rest of her life.'
- D. We should encourage her to dress in clothing that suits her sexual maturity level.'
Correct Answer: B
Rationale: LHRH therapy delays premature puberty, allowing physical maturity to align with peers over time, with treatment stopping at an appropriate age.
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An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg PO daily and metronidazole 500 mg IV piggy back (IVBP) twice daily (BID). She asks the nurse, 'Why do I have to be in the hospital? Why can't I get my treatment at home?' Which purpose should the nurse provide that supports an effective outcome?
- A. Detection of early symptoms of Jarisch-Herxheimer reaction.
- B. Collection of serial anaerobic cultures of vaginal discharge.
- C. Implementation of contact precautions to prevent spread of infection.
- D. Administration of a supervised parenteral antibiotic protocol.
Correct Answer: D
Rationale: Hospitalization ensures supervised IV antibiotics for severe PID unresponsive to outpatient therapy, preventing complications like tubo-ovarian abscess.
The nurse is giving instructions to the mother of a 10-year-old boy who is newly diagnosed with type 1 diabetes mellitus (DM). When attempting to teach the mother how to administer subcutaneous insulin injections to the child, the mother tells the nurse that she is afraid of needles and cannot perform the procedure. Which intervention should the nurse implement?
- A. Determine if the child can administer the insulin.
- B. Ask if the father can help with the injections.
- C. Assess the mother's parenting skills.
- D. Encourage the mother to handle the needles.
Correct Answer: D
Rationale: Gradual exposure to needles through practice builds the mother's confidence, ensuring effective insulin administration for diabetes management.
History and Physical
Nurses' Notes
Flow Sheet
Laboratory Results
38-year-old primiparous client is seen in the outpatient obstetric office 2 weeks postpartum after a spontaneous vaginal birth of a full-term infant after rupture of membranes for 16 hours. The client was discharged on day 2, exclusively breastfeeding.
Which education by the nurse will help resolve the issue for the client? Select all that apply.
- A. Wear an underwire bra around the clock.
- B. Apply warm compresses to affected area before feeding.
- C. Pump breasts if feeding will be missed, due to absence from the infant.
- D. Pump breastmilk and feed it to infant instead of nursing.
- E. Finish antibiotics even if symptoms improve.
- F. Maintain activity due to the risk of blood clots with extra rest.
- G. Wash hands before handling the breast.
Correct Answer: B,C,E,G
Rationale: Warm compresses, pumping to prevent milk stasis, completing antibiotics, hand hygiene, starting on the unaffected side, and varying positions promote milk flow, reduce infection risk, and ensure effective breastfeeding. Underwire bras and avoiding rest are not recommended.
A child who weighs 25 kg receives a prescription for isoniazid 10 mg/kg/day by mouth once a day. The bottle is labeled 'Isoniazid Oral Solution, USP 50 mg per 5 mL.' How many mL should the nurse administer?
- A. 25 mL
Correct Answer: A
Rationale: For a 25 kg child, the dose is 250 mg/day (25 kg × 10 mg/kg). With a concentration of 50 mg/5 mL (10 mg/mL), the volume is 250 mg ÷ 10 mg/mL = 25 mL.
A mother brings her male preschooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to cry and cling to his mother when the nurse enters the examination room. Which action should the nurse implement to get the child to cooperate?
- A. Complete the assessment while allowing the child to cry.
- B. Explain to the child the reasons an examination is needed.
- C. Talk to the mother and gradually focus on the child's toy.
- D. Request extra staff to help with the nursing assessments.
Correct Answer: C
Rationale: Engaging the mother and using the child's toy as a distraction builds trust, reducing anxiety and encouraging cooperation.