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If the physician orders a magnetic resonance imaging (MRI) study for the child with a brain tumor, which statement by the nurse would best prepare the child for the diagnostic test?
- A. MRI machines differ with some being tunnel-like and others open.
- B. Pain may occur when the dye is injected into the vein.
- C. You'll be given medicine that will make you sleep during the test.
- D. You'll have little electrodes placed on your head with a special gel.
Correct Answer: A
Rationale: Explaining that MRI machines vary (tunnel-like or open) prepares the child for the procedure by addressing potential fears about the machine's appearance, ensuring they know what to expect.
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Which instruction is most appropriate to give to the client regarding doxycycline?
- A. The medication normally causes a dark orange discoloration of urine.
- B. Take the medication 1 hour before or 2 hours after a meal.
- C. Don't drink water for at least 30 minutes after taking the medication.
- D. Report any symptoms of GI upset to the health care provider.
Correct Answer: B
Rationale: Doxycycline should be taken on an empty stomach (1 hour before or 2 hours after a meal) to ensure optimal absorption, making this the most appropriate instruction.
Which statement by the parents of a child with chickenpox indicates a need for further teaching?
- A. We'll keep our child out of school until the lesions are crusted over.
- B. We'll apply calamine lotion to relieve itching.
- C. We'll give our child aspirin to reduce fever.
- D. We'll ensure our child gets plenty of rest.
Correct Answer: C
Rationale: Aspirin should be avoided in children with chickenpox due to the risk of Reye's syndrome, a serious condition linked to aspirin use in viral infections, indicating a need for further teaching.
Which assessment finding should the nurse report immediately to the charge nurse or physician?
- A. Clear, watery nasal drainage
- B. Glasgow Coma Scale score of 15
- C. Child does not know the time of day
- D. Apical pulse of 80 beats/minute
Correct Answer: A
Rationale: Clear, watery nasal drainage may indicate cerebrospinal fluid (CSF) leakage, a serious complication of head injury requiring immediate reporting to prevent infection or neurological damage.
If the client asks the nurse for instructions on safe condom use, which information needs to be stressed?
- A. Condoms should be stored in a warm, dry place to prevent damage.
- B. Condoms are generally lubricated with mineral oil or petroleum jelly.
- C. A condom should be applied before the penis becomes erect.
- D. During application, a ½†space should be left at the end of the condom.
Correct Answer: D
Rationale: Leaving a ½†space at the condom's tip prevents breakage by allowing room for semen, a critical aspect of safe condom use to ensure effectiveness.
The nurse is concerned that a newborn may have congenital hydrocephalus. Which finding did the nurse likely observe on assessment?
- A. Bulging anterior fontanel
- B. Head and chest circumference equal
- C. A narrowed posterior fontanel
- D. Low-set ears
Correct Answer: A
Rationale: A bulging anterior fontanel suggests hydrocephalus due to increased intracranial pressure. Equal head/chest circumferences narrow posterior fontanel and low-set ears are normal or unrelated.