Nokea
An adolescent girl with a seizure disorder controlled with phenytoin (Dilantin) and carbamazepine (Tegretol) asks the nurse about getting married and having children. Which of the following responses by the nurse would be most appropriate?
- A. You probably shouldn't consider having children until your seizures are cured.'
- B. Your children won't necessarily have an increased risk of seizure disorder.'
- C. When you decide to have children, talk to the doctor about changing your medication.'
- D. Women with seizure disorders commonly have a difficult time conceiving.'
Correct Answer: C
Rationale: Consulting a doctor about medication adjustments before pregnancy ensures safety for mother and fetus, addressing teratogenic risks.
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A mother states that she thinks her 9-month-old 'is developing slowly.' When assessing the infant's development, the nurse is also concerned because the infant should be demonstrating which of the following characteristics?
- A. Vocalizing single syllables.
- B. Standing alone.
- C. Building a tower of two cubes.
- D. Drinking from a cup with little spilling.
Correct Answer: C
Rationale: Building a tower of two cubes is expected by 9 months; failure to do so suggests developmental delay.
A nurse evaluates discharge teaching as successful when the parents of a school-age child with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt?
- A. Decreased urine output with stable intake.
- B. Tense fontanel and increased head circumference.
- C. Elevated temperature and reddened incisional site.
- D. Irritability and increasing difficulty with eating.
Correct Answer: D
Rationale: Irritability and difficulty eating are early signs of shunt blockage due to increased intracranial pressure, which parents should recognize for timely intervention.
An adolescent male client scheduled for an emergency appendectomy is to be transferred directly from the emergency room to the operating room. Which of the following statements by the client should the nurse interpret as most significant?
- A. I'm scared about the surgery.
- B. I need to call my parents first.
- C. My pain is getting worse.
- D. I don't want to have a scar.
Correct Answer: C
Rationale: Worsening pain may indicate perforation, requiring urgent attention.
The mother asks the nurse whether her child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which of the following responses by the nurse would be most appropriate?
- A. Ask the doctor what he thinks at your next appointment.'
- B. Maybe, maybe not. How old were you when you first walked?'
- C. It's difficult to predict, but his ability to bear weight is a positive factor.'
- D. If he really wants to walk, and works hard, he probably will eventually.'
Correct Answer: C
Rationale: The ability to bear weight is a positive sign, but predicting normal walking is challenging due to the variability in cerebral palsy outcomes.
The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, 'I hate you.' Which of the following would be most appropriate:
- A. Tell the parents they will need to wait out in the lobby.
- B. Ask the charge nurse to assign this client to another nurse.
- C. Reassure the parents that this is a normal behavior under the circumstances.
- D. Ask the parents to discipline the child so that the physician can treat her.
Correct Answer: C
Rationale: Such behavior is a normal stress response in a young child experiencing pain and fear in an emergency setting.