Nokea
At a follow-up appointment after being hospitalized, an adolescent with a history of cystic fibrosis (CF) describes his stools to the nurse. Which of the following descriptions should the nurse interpret as indicative of continued problems with malabsorption?
- A. Soft with little odor.
- B. Large and foul-smelling.
- C. Loose with bits of food.
- D. Hard with streaks of blood.
Correct Answer: B
Rationale: Large, foul-smelling stools indicate malabsorption in cystic fibrosis, suggesting inadequate pancreatic enzyme replacement or ongoing pancreatic insufficiency.
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The mother brings her child to the clinic after discharge from the hospital for Guillain-Barré syndrome. Which of the following statements by the mother indicates that she is following the discharge plan?
- A. She and her sister argue all day.'
- B. I have to bribe her to get her to do her exercises.'
- C. I take her to the pool where she can exercise with other children.'
- D. She's missed a few of her therapy sessions because she often sleeps.'
Correct Answer: C
Rationale: Exercising in the pool indicates adherence to the rehabilitation plan, promoting recovery through low-impact activity.
After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetes still has a fasting blood glucose level of 140 mg/dL. The primary care provider has decided to begin metformin (Glucophage). The adolescent asks how the medication works. The nurse should tell the client that the medicine decreases the glucose production and:
- A. Replaces natural insulin.
- B. Helps the body make more insulin.
- C. Increases insulin sensitivity.
- D. Decreases carbohydrate adsorption.
Correct Answer: C
Rationale: Metformin reduces hepatic glucose production and increases insulin sensitivity in peripheral tissues, improving glucose uptake. It does not replace insulin, stimulate insulin production, or affect carbohydrate absorption.
A 2-year-old tells his mother he is afraid to go to sleep because 'the monsters will get him.' The nurse should tell his mother to:
- A. Allow him to sleep with his parents in their bed whenever he is afraid.
- B. Increase his activity before he goes to bed, so he eventually falls asleep from being tired.
- C. Give him a favorite cuddly animal or a blanket.
- D. Allow him to stay up an hour later with the family until he falls asleep.
Correct Answer: C
Rationale: A comfort object helps a toddler feel secure and supports self-soothing.
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.
A parent asks which nutrient deficiency is common in children with celiac disease. The nurse should respond:
- A. Vitamin C.
- B. Iron.
- C. Vitamin A.
- D. Magnesium.
Correct Answer: B
Rationale: Iron deficiency is common in celiac disease due to malabsorption in the small intestine. Other deficiencies (e.g., vitamin D, B vitamins) may occur, but iron is most frequent.