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An 8-year-old with diabetes is placed on neutral and immune Hagedorn (NPH) and regular insulin before breakfast and before dinner. She will receive a snack of milk and cereal at bedtime. The snack will:
- A. Help her regain lost weight.
- B. Provide carbohydrates for immediate use.
- C. Prevent late night hypoglycemia.
- D. Help her stay on her diet.
Correct Answer: C
Rationale: A bedtime snack with NPH insulin prevents late-night hypoglycemia by providing carbohydrates during peak insulin action. It is not primarily for weight gain, immediate use, or diet adherence.
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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.
When developing the plan of care for a toddler who has taken an acetaminophen overdose, which of the following should the nurse expect to include as part of the initial treatment?
- A. Frequent blood level determinations.
- B. Gastric lavage.
- C. Tracheostomy.
- D. Electrocardiogram.
Correct Answer: A
Rationale: Frequent blood level monitoring guides acetylcysteine therapy. Gastric lavage is less effective than charcoal, and tracheostomy or ECG are not typically needed unless complications arise.
A 9-month-old is admitted because of dehydration. How should the nurse go about accurately monitoring fluid intake and output? Select all that apply.
- A. Weighing and recording all wet diapers.
- B. Obtaining a urine specific gravity measure.
- C. Obtaining an accurate daily weight.
- D. Restricting fluids prior to weighing the child.
- E. Obtaining an accurate stool count.
Correct Answer: A,C,E
Rationale: Weighing diapers, daily weights, and stool counts accurately track fluid balance.
A nurse identifies a medication error in a pediatric unit. Which action should the nurse take first?
- A. Administer the correct medication.
- B. Notify the prescribing physician.
- C. Complete an incident report.
- D. Inform the child's parents.
Correct Answer: C
Rationale: Completing an incident report ensures documentation and system improvement. Correcting the medication, notifying the physician, or informing parents follows after reporting.
A 13-month-old has a febrile seizure one month after the administration of the chickenpox vaccine. The nurse should:
- A. Recognize that the events are unrelated.
- B. Report the event through the Vaccine Adverse Event Reporting System.
- C. Explain to the parents that this is a rare but acceptable risk.
- D. Report the incident through the vaccine manufacturer's hotline.
Correct Answer: B
Rationale: Febrile seizures post-vaccination should be reported to VAERS for monitoring vaccine safety.