Nokea
An adolescent client reports to the nurse of walking with a limp due to pain localized in the right knee which worsens at night but denies any recent injury or trauma. The nurse observes swelling and tenderness in the right lower thigh, and imaging results reveal radial ossification in the soft tissues. Which condition should the nurse consider as the probable cause of the findings?
- A. Osteosarcoma
- B. Growing pains
- C. Rhabdomyolysis
- D. Hemosiderosis
Correct Answer: A
Rationale: Pain, swelling, tenderness, and radial ossification suggest osteosarcoma, a common bone tumor in adolescents, unlike the other conditions.
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The nurse is providing education to parents about preventing otitis media recurrence in their infant. Which instruction should the nurse include?
- A. Avoid smoke exposure.
- B. Inspect the infant's ears daily.
- C. Position prone after feeding.
- D. Breastfeed frequently.
Correct Answer: A
Rationale: Avoiding smoke exposure reduces the risk of otitis media recurrence, a known risk factor.
The parents of a 14-month-old child who is hospitalized due to febrile seizures tell the nurse that they fear their child will have lifelong seizures. Which information should the nurse convey to these parents?
- A. Ibuprofen should be used prophylactically to prevent febrile seizures.
- B. Provide the child with a sponge bath for temperatures over 100.6°F (38.1°C)
- C. Reassure the parents that febrile seizures decrease as the child grows older.
- D. Avoid excessive visual stimuli because it can precipitate seizure activity.
Correct Answer: C
Rationale: Most children outgrow febrile seizures by age 5, reducing parental concerns about lifelong seizures.
A 9-week-old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
- A. White blood cell count of 10,000/mm (10x 10/L).
- B. Weight gain of 2 pounds (0.91 kg) since birth.
- C. Red blood cell count of 2.3 cell/mcl or (2.3 x 10/L).
- D. Urine specific gravity is 1.011.
Correct Answer: C
Rationale: A low red blood cell count indicates anemia, increasing surgical risks, making it critical to report to the surgeon.
The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic anti-infective ointment. Which instruction should the nurse provide the child's caregivers during discharge education?
- A. Discontinue the ointment once drainage resolves.
- B. Prepare the child for blurry vision after ointment application.
- C. Use a disposable moist wipe to remove eye crusts.
- D. Remove secretions by wiping toward the opposite eye.
Correct Answer: B
Rationale: Ophthalmic ointment can cause temporary blurry vision, and preparing the child for this effect is important.
The nurse is assessing a preschool-aged child who presents with flank pain, dysuria, and low-grade fever. To determine a possible urinary tract infection, which additional information should the nurse gather from the parent?
- A. Pale urine.
- B. Increased fluid intake.
- C. New onset bedwetting.
- D. Voiding every 4 hours.
Correct Answer: C
Rationale: New onset bedwetting in a preschool-aged child can indicate a urinary tract infection, as it may reflect irritation or loss of bladder control.