Nokea
An infant diagnosed with Hirschsprung's disease undergoes surgery with the creation of a temporary colostomy. Which of the following statements by the parent regarding the colostomy indicates the need for further teaching?
- A. The colostomy is only temporary.
- B. The colostomy will give time for the nerves to return to normal.
- C. The colostomy may include two separate abdominal openings.
- D. Right after the procedure the stoma may appear purple.
Correct Answer: B
Rationale: The colostomy allows the affected bowel to rest, but nerves do not regenerate.
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The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state:
- A. I should call if I see changes in the color of the toes under the cast.'
- B. I should use a pillow to elevate my child's foot as he sleeps.'
- C. My baby will need a series of casts to fix her foot.'
- D. Having a cast should not prevent me from holding my baby.'
Correct Answer: B
Rationale: Using a pillow to elevate the foot may alter the cast's corrective positioning, requiring additional teaching to avoid this practice.
A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time?
- A. Reading the child a story.
- B. Painting with watercolors.
- C. Pounding on a pegboard.
- D. Stacking a tower of blocks.
Correct Answer: C
Rationale: Pounding on a pegboard allows the child to express frustration physically, which is developmentally appropriate for a preschooler.
Which assessment finding in an infant with colic should the nurse prioritize?
- A. Frequent spitting up.
- B. Crying for 3 hours daily.
- C. Weight gain below average.
- D. Fever of 100.4°F.
Correct Answer: D
Rationale: Fever suggests an underlying illness, requiring urgent evaluation. Prolonged crying is typical of colic, but spitting up and slow weight gain are less acute concerns.
The physician orders a urinalysis for a child who has undergone surgical repair of a hypospadias. Which of the following results should the nurse report to the physician?
- A. Urine specific gravity of 1.017.
- B. Ten red blood cells per high-powered field.
- C. Twenty-five white blood cells per high-powered field.
- D. Urine pH of 6.0.
Correct Answer: C
Rationale: High WBC count indicates infection.
When developing the plan of care for a newly admitted 2-year-old child with the diagnosis of Kawasaki disease, which of the following should be the priority?
- A. Taking vital signs every 6 hours.
- B. Monitoring intake and output every hour.
- C. Minimizing skin discomfort.
- D. Providing passive range-of-motion exercises.
Correct Answer: B
Rationale: Monitoring intake and output hourly is critical in Kawasaki disease to assess for fluid balance and potential cardiac complications like coronary artery involvement.