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An adolescent patient with chronic asthma, who has been hospitalized several times during the winter with severe asthmatic exacerbations, confides, 'I wish I could stay here in the hospital because every time I go home, I get sick again!' What is the pediatric nurse's best response?
- A. Let's talk about preventing and managing your asthma on a daily basis at home.
- B. Why don't I speak with your parents about what they are doing at home to help control your asthma?
- C. We can arrange for you to stay in the hospital longer.
- D. none of the above.
Correct Answer: A
Rationale: Discussing strategies to manage asthma at home empowers the patient and addresses the root cause of recurrent exacerbations.
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A 4-month old infant who has a congenital heart defect develops heart failure and is exhibiting marked dyspnea at rest . The nurse is aware this finding can be attributed to:
- A. Anemia
- B. Hypovolemia
- C. Pulmonary edema
- D. Metabolic acidosis blood specimen is obtained. The child's color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?
Correct Answer: C
Rationale: The nurse would first assess for an irregular heart rate and rhythm. In a 4-month old infant with a congenital heart defect experiencing marked dyspnea at rest, the sudden onset of cyanosis (blue coloration) and increased respiratory rate can indicate worsening heart failure and potential arrhythmias. Assessing for any abnormal heart rhythms is a priority to determine if immediate intervention is required to stabilize the infant's condition and prevent further deterioration.
For a 14-month-old whose cleft palate was repaired 12 hours ago, which should be included in the plan of care?
- A. Allow familiar comfort items (e.g., favorite stuffed animal) and a 'sippy' cup (avoid suction items).
- B. Once liquids are tolerated, encourage a bland diet (e.g., soup, Jell-O, saltine crackers).
- C. Administer scheduled pain medication rather than PRN only.
- D. Use a Yankauer suction catheter to decrease aspiration risk.
Correct Answer: A
Rationale: Providing comfort items and avoiding suction items helps reduce distress and supports healing.
As the surgical incision is closed, who are the personnel in-charge in counting the needles, sponges, and instruments?
- A. the surgeon and anesthesiologist
- B. the surgeon and the registered
- C. the circulating and scrub nurse nurse first assistant
- D. the anesthesiologist and anesthetist
Correct Answer: C
Rationale: During the surgical procedure, the circulating nurse, scrub nurse, and nurse first assistant are responsible for keeping track of all instruments, needles, and sponges used. As the surgical incision is being closed, the circulating nurse and the scrub nurse/nurse first assistant conduct a final count of all needles, sponges, and instruments to ensure that nothing is accidentally left inside the patient's body. This is a critical step in preventing retained surgical items (RSI), which can lead to serious complications for the patient. It is part of the standard protocol in the operating room to have these specific personnel take charge of counting and verifying all items before the procedure is concluded.
Which of the following blood types would the nurse identify as the rarest?
- A. A
- B. AB
- C. B
- D. O
Correct Answer: B
Rationale: Blood type AB is the rarest of all the blood types. This is because individuals with AB blood type have both A and B antigens on their red blood cells, making it less common than other blood types. In the ABO blood group system, the distribution of blood types in the general population is approximately 45% type O, 40% type A, 11% type B, and only about 4% type AB. Therefore, blood type AB would be identified as the rarest in the given options.
A nurse plans therapeutic play time for a hospitalized child. What are the benefits of play? (Select all that apply.)
- A. Serves as method to assist disturbed children
- B. Allows the child to express feelings
- C. The nurse can gain insight into the child's feelings.
- D. The child can deal with concerns and feelings.
Correct Answer: A
Rationale: Play serves as a method to assist disturbed children by providing them with a therapeutic outlet to express themselves and work through their emotions in a safe and constructive manner.