Nokea
At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. Which of the following statements regarding crowning is true?
- A. Crowning represents the end of the second stage of labor.
- B. Crowning always occurs immediately after the amniotic sac has ruptured.
- C. It is safe to transport the patient during crowning if the hospital is close.
- D. Gentle pressure should be applied to the baby's head during crowning.
Correct Answer: D
Rationale: During crowning, it is essential to apply gentle pressure to the baby's head to prevent rapid delivery, which can lead to potential injuries to both the mother and the baby. Choice A is incorrect because crowning signifies the beginning, not the end, of the second stage of labor. Choice B is incorrect as crowning can occur before or after the amniotic sac ruptures. Choice C is incorrect as transporting the patient during crowning, even if the hospital is close, can be unsafe due to the risk of rapid delivery and complications.
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The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?
- A. Instructing the parents to report adverse reactions to the growth hormone treatment
- B. Teaching the parents how to administer desmopressin acetate
- C. Informing the parents that treatment stops when puberty begins
- D. Educating the parents to report signs of acute adrenal crisis
Correct Answer: B
Rationale: In a child with a disorder of the posterior pituitary gland, desmopressin acetate is commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents to administer desmopressin acetate correctly is essential for the child's treatment. The other options are incorrect because growth hormone treatment, stopping treatment at puberty, and reporting signs of acute adrenal crisis are not directly related to managing a disorder of the posterior pituitary gland.
A parent asks the nurse what they can do to help their child who is experiencing night terrors. What should the nurse suggest?
- A. Encourage the child to talk about the dream
- B. Establish a bedtime routine
- C. Allow the child to sleep with the parents
- D. Wake the child during the night
Correct Answer: B
Rationale: Establishing a bedtime routine is the most appropriate suggestion for a child experiencing night terrors. Consistent bedtime routines help create a sense of security and predictability, reducing the likelihood of night terrors. Encouraging the child to talk about the dream (Choice A) may not be effective as night terrors occur during non-REM sleep, and the child may not remember the dreams. Allowing the child to sleep with the parents (Choice C) can reinforce dependency and may not address the underlying causes of night terrors. Waking the child during the night (Choice D) can disrupt their sleep cycle and worsen the occurrence of night terrors.
A child with a diagnosis of diabetes insipidus is admitted to the hospital. What is the priority nursing intervention?
- A. Administering insulin
- B. Monitoring fluid balance
- C. Administering diuretics
- D. Monitoring vital signs
Correct Answer: B
Rationale: The correct priority nursing intervention for a child diagnosed with diabetes insipidus is to monitor fluid balance. Diabetes insipidus is a condition characterized by excessive urination and thirst, which can lead to dehydration. Monitoring fluid balance is essential to prevent dehydration and ensure the child's hydration status remains stable. Administering insulin (Choice A) is not indicated in diabetes insipidus because it is a disorder of the posterior pituitary gland, not the pancreas. Administering diuretics (Choice C) would exacerbate fluid loss in a child already at risk for dehydration. Monitoring vital signs (Choice D) is important but not the priority when compared to maintaining fluid balance in a child with diabetes insipidus.
The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?
- A. Most childhood cancers affect tissues rather than organs.
- B. Childhood cancers are usually localized when found.
- C. Unlike adult cancers, childhood cancers are less responsive to treatment.
- D. The majority of childhood cancers can be prevented.
Correct Answer: A
Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers may not always be localized when found. Choice C is incorrect as childhood cancers can be responsive to treatment, although treatment approaches may differ from adult cancers. Choice D is incorrect as the majority of childhood cancers cannot be prevented; however, certain risk factors can be managed to reduce the risk of developing cancer.
The nurse caring for families in crisis assesses the affective function of an immigrant family consisting of a father, mother, and two school-age children. Based on Friedman's structural functional theory, what defines this family component?
- A. Meeting the love and belonging needs of each member
- B. Teaching children how to function and assume adult roles in society
- C. Ensuring the family has necessary resources with appropriate allocation
- D. Involving the provision of physical care to keep the family healthy
Correct Answer: A
Rationale: In Friedman's structural functional theory, the affective function of a family involves meeting the love and belonging needs of each member. This includes emotional support, care, and connections that contribute to the overall well-being of the family unit. Choice B is incorrect as it pertains more to the socialization function of the family, where children learn societal roles. Choice C relates to the economic function of the family, ensuring resources are available and allocated appropriately. Choice D focuses on the instrumental function of the family, which involves meeting the physical needs and health of its members.