Nokea
In an initial screening for lead poisoning, a 2-year-old child is found to have a lead level of 12 mcg/dL. The nurse should:
- A. Arrange a follow-up appointment in 6 months.
- B. Initiate chelation therapy.
- C. Refer to a neurologist.
- D. Test siblings for lead exposure.
Correct Answer: A
Rationale: A lead level of 12 mcg/dL requires follow-up in 3-6 months per CDC guidelines. Chelation is for levels >45 mcg/dL, neurology referral is premature, and sibling testing depends on shared exposure risk.
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A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following should the nurse try first?
- A. Ask another nurse to assist.
- B. Allow a parent to assist.
- C. Wait until the child calms down.
- D. Restrain the child's arms.
Correct Answer: B
Rationale: Parental involvement can comfort the child and improve cooperation.
At a follow-up appointment after being hospitalized, an adolescent with a history of cystic fibrosis (CF) describes his stools to the nurse. Which of the following descriptions should the nurse interpret as indicative of continued problems with malabsorption?
- A. Soft with little odor.
- B. Large and foul-smelling.
- C. Loose with bits of food.
- D. Hard with streaks of blood.
Correct Answer: B
Rationale: Large, foul-smelling stools indicate malabsorption in cystic fibrosis, suggesting inadequate pancreatic enzyme replacement or ongoing pancreatic insufficiency.
An infant diagnosed with Hirschsprung's disease undergoes surgery with the creation of a temporary colostomy. Which of the following statements by the parent regarding the colostomy indicates the need for further teaching?
- A. The colostomy is only temporary.
- B. The colostomy will give time for the nerves to return to normal.
- C. The colostomy may include two separate abdominal openings.
- D. Right after the procedure the stoma may appear purple.
Correct Answer: B
Rationale: The colostomy allows the affected bowel to rest, but nerves do not regenerate.
As part of a health education program, the nurse teaches a group of parents CPR. The nurse determines the teaching has been effective when a parent states:
- A. If I am by myself, I should call for help before starting CPR.
- B. I should compress the chest using 2-3 fingers.
- C. I should deliver chest compression at a rate of 100 per minute.
- D. If I can't get the breaths to make the chest rise, I should administer abdominal thrusts.
Correct Answer: A
Rationale: Calling for help before starting CPR when alone ensures timely emergency response, which is critical for improving outcomes.
When developing the plan of care for a newly admitted 2-year-old child with the diagnosis of Kawasaki disease, which of the following should be the priority?
- A. Taking vital signs every 6 hours.
- B. Monitoring intake and output every hour.
- C. Minimizing skin discomfort.
- D. Providing passive range-of-motion exercises.
Correct Answer: B
Rationale: Monitoring intake and output hourly is critical in Kawasaki disease to assess for fluid balance and potential cardiac complications like coronary artery involvement.