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An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth, but fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?
- A. No treatment is necessary, the fluid is reabsorbing normally
- B. Keeping the infant in a flat, supine position until the fluid is gone
- C. Referral to a surgeon for repair
- D. Massaging the groin area twice a day until the fluid is gone.
Correct Answer: A
Rationale: No treatment is necessary, the fluid is reabsorbing normally: - This option suggests that the hydrocele is resolving spontaneously, which is often the case in infants. The physician may choose to observe the hydrocele over time as it is likely to resolve without intervention. Keeping the infant in a flat, supine position until the fluid is gone: - This option does not address the underlying cause of the hydrocele and is not a standard treatment recommendation. Additionally, positioning changes are unlikely to affect the resolution of the hydrocele. Referral to a surgeon for repair: - Surgical repair may be considered if the hydrocele persists beyond a certain age or if it causes discomfort or complications. However, it is typically not recommended in infants unless the hydrocele persists beyond infancy or causes other issues. Massaging the groin area twice a day until the fluid is gone: - Massaging the groin area is not a recommended treatment for hydrocele and may not be effective in resolving the condition. Additionally, manipulating the scrotum may cause discomfort or injury to the infant.
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A nurse is caring for a child who has Hirschsprung disease. Which of the following findings should the nurse expect?
- A. Ridged abdomen
- B. Ribbonlike, foul-smelling stools
- C. Projectile vomiting
- D. Chronic hunger
Correct Answer: B
Rationale: Ridged abdomen - This finding is not typically associated with Hirschsprung disease. Instead, the abdomen may appear distended or bloated due to the accumulation of stool in the colon. Ribbonlike, foul-smelling stools - This is a characteristic finding in Hirschsprung disease. Because the affected portion of the colon lacks nerve cells (ganglion cells) responsible for peristalsis, stool movement is impaired, leading to the passage of narrow, ribbonlike stools. These stools may also have a foul odor due to bacterial overgrowth in the affected area. Projectile vomiting - Projectile vomiting is not a common finding in Hirschsprung disease. It is more commonly associated with conditions such as pyloric stenosis or gastroesophageal reflux. Chronic hunger - Chronic hunger is not a typical finding in Hirschsprung disease. Instead, affected infants may experience feeding difficulties, constipation, and failure to thrive due to the obstruction of stool in the colon. They may also exhibit symptoms such as abdominal distention, vomiting, and refusal to feed.
A nurse is contributing to the plan of care for a school-age child who has moderate partial-thickness burns on both lower extremities. Which of the following interventions should the nurse include?
- A. Administer pain medication 30 min before physical therapy.
- B. Allow the child to set her own schedule for care.
- C. Provide low-calorie snacks.
- D. Maintain medical asepsis during dressing changes
Correct Answer: A
Rationale: Pain management is critical for burn care, especially before activities like physical therapy that can be painful. Administering pain medication 30 minutes before therapy helps ensure the child is more comfortable and able to participate effectively in rehabilitation. This is a recommended intervention. While involving the child in decisions about their care can promote autonomy and improve adherence, the schedule for burn care and therapy should be based on medical needs and healing processes rather than the child's preference. Care schedules should be designed to optimize healing and manage pain effectively. Burn patients typically have increased nutritional needs due to the high metabolic demands of healing. High-calorie, protein-rich snacks are usually recommended to support wound healing and overall recovery, rather than low-calorie options. Maintain medical asepsis during dressing changes: For burn care, maintaining sterile technique is critical to prevent infection. Medical asepsis is generally not sufficient; sterile technique is required for dressing changes to reduce the risk of infection.
A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority?
- A. Move the child into a side-lying position.
- B. Place a pillow under the child's head.
- C. Time the seizure.
- D. Remove the child's eyeglasses.
Correct Answer: A
Rationale: Move the child into a side-lying position: This action is crucial during a seizure with vomiting to prevent aspiration. Placing the child on their side helps ensure that any vomit can easily exit the mouth and reduces the risk of choking or aspiration into the lungs. Place a pillow under the child's head: While providing comfort is important, it is not the priority during a seizure with vomiting. Placing a pillow under the child's head might elevate the head slightly, but it doesn't address the risk of aspiration, which is the primary concern. Time the seizure: Timing the seizure is important for documentation and to monitor the duration of the seizure. However, it is not the priority during the active phase of the seizure, especially when vomiting is occurring. Remove the child's eyeglasses: Removing the child's eyeglasses is not a priority during a seizure with vomiting. While it's important to prevent injury, particularly to the eyes, during a seizure, the immediate concern is addressing the risk of aspiration caused by vomiting.
A nurse is reviewing discharge instructions with a client who has pruritus following treatment for scabies. Which of the following instructions should the nurse include?
- A. Take a hot shower daily to relieve itching.
- B. Wear loose fitting clothing while you are experiencing itching.
- C. Add fabric softener to linens when they are washed.
- D. Use a soft bristle brush to gently rub the affected areas.
Correct Answer: B
Rationale: Take a hot shower daily to relieve itching.' This instruction is not recommended because hot water can exacerbate itching and worsen the condition. Hot showers can strip the skin of its natural oils, leading to further dryness and irritation, which may aggravate the itching associated with scabies. 'Wear loose fitting clothing while you are experiencing itching.' This instruction is appropriate because loose-fitting clothing can help minimize friction and irritation on the skin affected by scabies. Tight clothing can exacerbate itching and discomfort, so wearing loose clothing can provide relief and allow the skin to breathe. 'Add fabric softener to linens when they are washed.' This instruction is not recommended because fabric softeners may contain chemicals or fragrances that can irritate the skin, especially for someone with pruritus or scabies. It's best to use gentle, fragrance-free laundry detergent to wash linens and clothing to minimize potential irritation. 'Use a soft bristle brush to gently rub the affected areas.' This instruction is not recommended because using a brush, even if it has soft bristles, can further irritate the skin and potentially spread the scabies mites to other areas of the body. It's best to avoid any abrasive or vigorous rubbing of the affected areas and instead focus on gentle cleansing and moisturizing techniques.
The nurse knows further education is needed about reye syndrome when a mother states:
- A. Children with Reye syndrome are admitted to the hospital
- B. I will have my children immunized against varicella and influenza
- C. I will give aspirin to my child to treat a headache
- D. I will make sure not to give my child any products containing aspirin
Correct Answer: C
Rationale: Children with Reye syndrome are admitted to the hospital: This statement is accurate. Children with Reye syndrome often require hospital admission for monitoring and supportive care. Therefore, it does not indicate a need for further education. I will have my children immunized against varicella and influenza: This statement is also accurate. Vaccination against varicella (chickenpox) and influenza is recommended to prevent these illnesses. It does not indicate a need for further education. I will give aspirin to my child to treat a headache: This statement is concerning because giving aspirin to a child with Reye syndrome can worsen their condition. Aspirin use is contraindicated in children with viral illnesses due to the risk of Reye syndrome. Therefore, this statement indicates a need for further education. I will make sure not to give my child any products containing aspirin: This statement is accurate. Avoiding products containing aspirin is essential to prevent the risk of Reye syndrome in children. It does not indicate a need for further education.