Nokea
An adolescent is to receive radioactive iodine for Graves' diseases. Which statement by the client reflects the need for more teaching?
- A. I plan to talk on Facebook since I have to keep several feet from my friends for 3 days.
- B. Taking radioactive iodine will not affect my ability to have children in the future.
- C. The advantage of radioactive iodine is that I will not need future medication for my disease.
- D. I should try to use a separate bathroom from the rest of my family for several days.
Correct Answer: C
Rationale: Radioactive iodine often leads to hypothyroidism, requiring lifelong thyroid hormone replacement. Options A, B, and D reflect correct understanding of radiation precautions and fertility.
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A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:
- A. An 18-month-old with RSV.
- B. A 9-year-old 8 hours post-appendectomy.
- C. A 1-year-old with a heart defect.
- D. A 6-year-old with sickle cell crisis.
Correct Answer: C
Rationale: Assigning the same nurse to a child with RSV and a 1-year-old with a heart defect should be avoided due to the risk of transmitting RSV, which can be particularly severe in children with cardiac conditions.
In planning the discharge for a newborn diagnosed with torticollis (wry neck), the nurse should:
- A. Teach the parent the side effects of botulinum toxin (BOTOX).
- B. Coordinate outpatient physical therapy.
- C. Verify the date for corrective surgery.
- D. Demonstrate the use of positioning wedges for sleep.
Correct Answer: B
Rationale: Physical therapy is the most important part of the child's plan of care. Most cases of torticollis respond to gentle stretching exercises, which can be taught to parents and continued at home.
After the acute stage following an ingestion of drain cleaner by a child, the nurse should be alert for the development of which of the following as a likely complication?
- A. Tracheal stenosis.
- B. Tracheal varices.
- C. Esophageal strictures.
- D. Esophageal diverticula.
Correct Answer: C
Rationale: Corrosive ingestion can scar the esophagus, leading to strictures. Tracheal complications are less common unless the airway is directly affected, and diverticula are not typical.
A 1-year-old child is scheduled for surgery to correct hypospadias and chordee. The nurse explains to the parents that this is the preferred time for surgical repair based on which of the following?
- A. At this age, the child will experience less pain.
- B. The child is too young to have developed castration anxiety.
- C. The child will not remember the surgical experience.
- D. The repair is easier to perform after the child is toilet trained.
Correct Answer: C
Rationale: Younger children may not remember the experience.
The nurse is giving care to an infant with a brain tumor. The nurse observes the infant arch the back (see figure). The nurse should:
- A. Notify the physician
- B. Stroke the back to release the arching
- C. Pad the side rails of the crib
- D. Place the child prone
Correct Answer: A
Rationale: The infant has opisthotonos, an indication of brain stem herniation; the nurse should notify the physician immediately and have resuscitation equipment ready. Stroking the back will not relieve the herniation or release the arching. Although the infant may also have a seizure, and padded side rails will prevent injury, the fi rst action is to notify the physician. Placing the child in a prone position will not relieve the herniation or release the arching.