Nokea
During a well-child visit, a 10-year-old child is found to be above the 95th percentile for weight and reports watching more than two hours of television daily. An appropriate nursing diagnosis for this child is:
- A. Imbalanced Nutrition: More than body requirements
- B. Altered Growth and Development
- C. Ineffective Coping
- D. Altered Family Processes
Correct Answer: A
Rationale: The correct nursing diagnosis for a 10-year-old child who is above the 95th percentile for weight and watches more than two hours of television daily would be 'Imbalanced Nutrition: More than body requirements.' This diagnosis reflects the excessive intake of nutrients compared to the child's energy expenditure, which can contribute to weight gain. 'Altered Growth and Development' (choice B) is not the most appropriate diagnosis in this scenario, as the primary concern is related to nutrition and sedentary behavior rather than developmental issues. 'Ineffective Coping' (choice C) and 'Altered Family Processes' (choice D) are also not relevant to the child's weight status and television habits. Monitoring and addressing the child's dietary habits and sedentary behavior are essential to promote a healthier lifestyle and prevent further weight-related issues.
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A 6-year-old male is hospitalized in stable condition with multiple fractures following a car accident. The child's parents tell the nurse that their 7-year-old daughter is very upset about the accident and is concerned that her brother will die. Which suggestion by the nurse is most appropriate?
- A. Encourage the parents to phone the sister frequently with updates on her brother's condition.
- B. Suggest that the sister come to the hospital for a visit.
- C. Suggest that one parent leave the hospital to spend extra time with their daughter at home.
- D. Remind the parents that it is normal for children to be upset when their sibling is hospitalized.
Correct Answer: B
Rationale: In situations where a sibling is upset about a family member being hospitalized, suggesting that the sister come to the hospital for a visit can help alleviate her concerns. This allows the sister to see her brother, ask questions, and receive reassurance from seeing him in stable condition. Direct contact and interaction can often provide more comfort and understanding than phone calls or staying at home. Encouraging phone calls (Choice A) might not provide the same level of comfort as a physical visit. While spending extra time with the daughter at home (Choice C) is important, in this scenario, facilitating a visit to the hospital can address the daughter's immediate concerns better. Reminding the parents that it is normal for children to be upset (Choice D) is not as proactive as arranging for the sister to visit her brother.
In counseling the parents of a child with hypopituitarism, Nurse Gyimah is asked about their child's condition. Which of the following phrases, if stated by the nurse, best describes the condition?
- A. Linear growth retardation with skeletal proportions normal for chronologic age
- B. A complete normal growth pattern, but with the onset of precocious puberty
- C. Normal growth for the first five years, followed by progressive linear growth retardation
- D. Growth retardation in which height and weight are equally affected
Correct Answer: A
Rationale: Hypopituitarism is characterized by linear growth retardation with skeletal proportions normal for chronologic age. This means that although the child experiences growth retardation, their skeletal proportions are appropriate for their age, which distinguishes it from other conditions like precocious puberty or equal height and weight affectation. Choice B is incorrect as hypopituitarism does not involve precocious puberty. Choice C is wrong as it describes a different growth pattern not typical of hypopituitarism. Choice D is also incorrect as in hypopituitarism, height and weight are not equally affected, rather the focus is on linear growth retardation with normal skeletal proportions.
In the Integrated Management of Neonatal and Childhood Illnesses, one of the things to look for is danger signs. Which of the following will you consider a danger sign in a child?
- A. The child vomits everything
- B. A child with diarrhea
- C. A child with headache
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: 'The child vomits everything.' Vomiting everything is considered a danger sign in a child as it can lead to dehydration and other serious complications. Recognizing this sign early can help in timely intervention and management of the child's condition. Choices B and C are incorrect as diarrhea and headache, while concerning, are not specific danger signs highlighted in the Integrated Management of Neonatal and Childhood Illnesses.
How will a ventricular septal defect affect blood flow?
- A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
- B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
- C. No shunting occurs due to high pressure in the left ventricle.
- D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.
Correct Answer: A
Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.
A group of nursing students is discussing trends that influence pediatric health care today. The students' discussion focuses on which trends?
- A. Family-centered care
- B. Evidenced-based practice
- C. Nursing traditions
- D. A and B
Correct Answer: D
Rationale: In pediatric health care, family-centered care and evidenced-based practice are crucial trends that impact care delivery. Family-centered care involves involving the family in decision-making and care planning, recognizing their role in the child's well-being. Evidenced-based practice ensures nursing interventions are based on the best available evidence to provide high-quality care to pediatric patients. Nursing traditions, though important, may not encompass the latest advancements in pediatric care. Therefore, choices A and B are correct as they represent current influential trends in pediatric health care.