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 child is being admitted to the hospital for probable pneumonia. The nurse asks what the parents have done at home for this illness. The parent comments that they have given the child a tea made up of herbs that a neighbor recommended. The parents ask if that is a safe thing to do. The most appropriate response for the nurse is:
- A. Sure, if it doesn't make the child worse, it could help.
- B. Of course, teas are rarely harmful.
- C. It might be safe for adults, but research might not have been conducted on the effects on children.
- D. Absolutely not, herbal teas are not appropriate for children.
Correct Answer: C
Rationale: The most appropriate response is C: 'It might be safe for adults, but research might not have been conducted on the effects on children.' This response acknowledges the potential differences in the effects of herbal teas on adults versus children and highlights the importance of considering the lack of specific research on this topic when it comes to pediatric care. Choice A is incorrect because assuming something is safe without evidence can be risky in a pediatric setting. Choice B is also incorrect as it oversimplifies the safety of herbal teas. Choice D is too definitive and does not consider the possibility that herbal teas might have different effects on children than on adults.
A mother visited your facility with the complaint of her child passing watery stools for two days. This is the first time the child is having such an experience. How will you describe such a visit?
- A. Initial
- B. Follow-up
- C. Routine visit
- D. None of the above
Correct Answer: A
Rationale: The correct answer is 'Initial.' This visit is described as initial because it is the first time the child is experiencing these symptoms. It signifies the first encounter with healthcare professionals for this specific issue, distinguishing it from subsequent visits which would be follow-up appointments to monitor progress or routine visits for preventive care. Choice B, 'Follow-up,' is incorrect as it implies subsequent visits after the initial encounter. Choice C, 'Routine visit,' is also incorrect as it implies a scheduled visit for preventive care rather than a visit prompted by a new or acute issue. Choice D, 'None of the above,' is incorrect as one of the options accurately describes the situation, which is 'Initial.'
When working with a new adolescent patient, which greeting by the nurse indicates awareness of the needs of the adolescent client?
- A. I will talk with your parents first, and then you can tell me why you are here.
- B. Please let me know what your concerns are, and if you have any questions.
- C. Before we begin, I will need to know if you are sexually active.
- D. I will do the physical exam first, and then we will talk about your history.
Correct Answer: B
Rationale: The greeting 'Please let me know what your concerns are, and if you have any questions.' indicates awareness of the needs of the adolescent client. It encourages open communication, allows the adolescent to voice their concerns, and shows that their questions are welcomed and valued, fostering a trusting nurse-patient relationship. Choices A, C, and D do not prioritize the adolescent's perspective or promote open communication. Asking to talk to the parents first (Choice A) may hinder the adolescent's autonomy and trust. Inquiring about sexual activity (Choice C) may be necessary but should be approached with sensitivity and privacy. Doing the physical exam first (Choice D) before discussing the patient's history may not align with the adolescent's need for communication and understanding.
After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?
- A. A balance of rest and exercise is important.
- B. I can apply lotion or powder to the incision if it is itchy.
- C. Activities in which falling could occur need to be avoided for two to four weeks.
- D. Large crowds of people need to be avoided for at least two weeks after the surgery.
Correct Answer: B
Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.
Use this scenario to answer questions 70 to 72. Madam KK brought her two-month-old sick child to your facility. She complains that the child is having a fever, fast breathing, and is not eating anything. Using the IMNCI, what will be the steps to manage this child?
- A. i. Provide practical treatment instructions
- B. ii. Triage based on the severity of illness
- C. iii. Perform a head-to-toe assessment
- D. iv. Identify specific treatments
Correct Answer: D
Rationale: To manage the sick child using IMNCI, the correct steps are as follows: Triage based on the severity of illness, Perform a head-to-toe assessment, Identify specific treatments, Provide practical treatment instructions, and Assess feeding while providing counseling. The correct answer, 'D,' focuses on identifying specific treatments, which is crucial in addressing the child's condition effectively. Choice A ('Provide practical treatment instructions') is not the initial step and should come after identifying specific treatments. Choice B ('Triage based on the severity of illness') and Choice C ('Perform a head-to-toe assessment') are essential steps but should follow the identification of specific treatments in the IMNCI approach.