Nokea
During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond?
- A. Ask for a demonstration of these exercises
- B. Explain that coughing should be avoided
- C. Review the client’s previous surgical history
- D. Document the client's understanding of teaching
Correct Answer: A
Rationale: Asking for a demonstration ensures that the client understands the proper technique for coughing and deep breathing exercises.
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All of the following are true about a small VSD EXCEPT
- A. spontaneous closure is more common in muscular vs. membranous defects
- B. closure usually occurs in the first 2 years of life
- C. there is no risk of endocarditis
- D. pulmonary pressures are normal
Correct Answer: C
Rationale: Even small VSDs carry a risk of endocarditis until they close.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child’s parent asks the nurse, “How does Kawasaki disease affect my child’s heart and blood vessels?†On what understanding is the nurse’s response based?
- A. Inflammation weakens blood vessels, leading to aneurysm.
- B. Increased lipid levels lead to the development of atherosclerosis.
- C. Untreated disease causes mitral valve stenosis.
- D. Altered blood flow increases cardiac workload with resulting heart failure.
Correct Answer: A
Rationale: Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
A psychiatric referral is warranted in a preschool child with the following:
- A. Night terrors
- B. Separation anxiety
- C. Scared of ghosts
- D. Masturbation
Correct Answer: B
Rationale: Separation anxiety in a preschool child, especially if it is severe and persistent, may warrant a psychiatric referral to assess for anxiety disorders.
A 2-year-old child should be able to:
- A. Name three colours correctly
- B. Use plurals
- C. Build a tower of five blocks
- D. Kick a ball on request
Correct Answer: C
Rationale: A 2-year-old can typically build a tower of five blocks. Naming colors and using plurals are more advanced skills, and kicking a ball is variable.
Concerning insulin-dependent diabetes mellitus in children:
- A. Microangiopathic changes are rare before puberty
- B. Isophane is shorter acting than soluble insulin
- C. Lipohypertrophy is more common than lipo-atrophy
- D. Fructosamine can be used to monitor glucose control
Correct Answer: A
Rationale: Microangiopathic changes are indeed rare before puberty in children with insulin-dependent diabetes mellitus. Isophane is not shorter acting than soluble insulin, and fructosamine is used to monitor glucose control.