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During her sports physical examination, 15-year-old female requests oral contraceptives. She explains that she is sexually active and does not want her parents to know. Which action should the nurse take?
- A. Encourage the client to discuss her need for contraceptives with her parents.
- B. Counsel the client about the risks and benefits of using oral contraceptives.
- C. Explain that she needs parental approval to receive contraceptives.
- D. Tell the client how to receive a variety of free oral contraceptives from the clinic.
Correct Answer: B
Rationale: Providing counseling about the risks and benefits of oral contraceptives ensures the client is informed and respects her autonomy and privacy while ensuring she receives necessary information.
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The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?
- A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
- B. Metal clips are surgically applied at the tumor site for exact marking for radiation.
- C. Surgery is necessary to stage the tumor and determine metastasis to other sites.
- D. The surgery provides a visualization of other pathology and dysfunction of the kidney.
Correct Answer: A
Rationale: Biopsy risks rupturing the encapsulated Wilms tumor, potentially spreading cancer cells, making surgery the preferred initial approach.
The nurse is caring for an infant who was recently diagnosed with a congenital heart defect. Which assessment finding is most important for the nurse to report to the healthcare provider?
- A. Audible heart murmur.
- B. Heart rate of 162 beats/minute.
- C. Poor oral intake and suckling effort.
- D. Weight gain of 2.2 lbs. (1 kg) in the last 48 hours.
Correct Answer: C
Rationale: Poor oral intake and suckling effort indicate feeding difficulties, which can lead to dehydration and poor weight gain, requiring immediate reporting.
The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic anti-infective ointment. Which instruction should the nurse provide the child's caregivers during discharge education?
- A. Discontinue the ointment once drainage resolves.
- B. Prepare the child for blurry vision after ointment application.
- C. Use a disposable moist wipe to remove eye crusts.
- D. Remove secretions by wiping toward the opposite eye.
Correct Answer: B
Rationale: Ophthalmic ointment can cause temporary blurry vision, and preparing the child for this effect is important.
The nurse is caring for an adolescent with scoliosis who is recovering after a surgical spinal instrumentation. Which technique should the nurse use when moving this client?
- A. Cross the arms and legs.
- B. Perform a log roll.
- C. Raise the hips.
- D. Flex the knees.
Correct Answer: B
Rationale: The log roll technique maintains spinal alignment, critical after surgical spinal instrumentation.
The parents of a 14-month-old child who is hospitalized due to febrile seizures tell the nurse that they fear their child will have lifelong seizures. Which information should the nurse convey to these parents?
- A. Ibuprofen should be used prophylactically to prevent febrile seizures.
- B. Provide the child with a sponge bath for temperatures over 100.6°F (38.1°C)
- C. Reassure the parents that febrile seizures decrease as the child grows older.
- D. Avoid excessive visual stimuli because it can precipitate seizure activity.
Correct Answer: C
Rationale: Most children outgrow febrile seizures by age 5, reducing parental concerns about lifelong seizures.