Nokea
Parents report that they have been giving a multivitamin to their 1-year-old infant. The nurse counsels the parents that which vitamin can cause a toxic reaction at a low dose?
- A. Niacin
- B. B
- C. D
- D. C
Correct Answer: C
Rationale: Vitamin D is a fat-soluble vitamin that can be toxic in high doses, leading to hypercalcemia. Infants are particularly vulnerable to vitamin D toxicity because they have a lower ability to excrete excess vitamin D. Symptoms of vitamin D toxicity include nausea, vomiting, weakness, and kidney problems. Therefore, it is important for parents to avoid giving high doses of vitamin D to infants and always follow healthcare provider recommendations for supplementation.
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The single parent of a 3-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which is the most appropriate nursing intervention?
- A. Reassure the parent that it is not necessary to stay home with the child.
- B. Explain that no medication will shorten the course of the illness.
- C. Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox.
- D. Explain the advantages of the medication VCZ immune globulin (VariZIG) to treat chickenpox.
Correct Answer: B
Rationale: The most appropriate nursing intervention in this scenario is to explain to the parent that no medication will shorten the course of chickenpox. Chickenpox is a viral illness caused by the varicella-zoster virus, and there is no specific treatment to shorten its duration. Antiviral medications like acyclovir are typically reserved for severe cases or for individuals with compromised immune systems. VCZ immune globulin (VariZIG) is used for post-exposure prophylaxis in susceptible individuals who have been exposed to chickenpox and are at high risk for severe disease.
An infant has been diagnosed with cow's milk allergy. What are the clinical manifestations the nurse expects to assess? (Select all that apply.)
- A. Pink mucous membranes
- B. Vomiting
- C. Rhinitis
- D. Abdominal pain
Correct Answer: B
Rationale: Pink mucous membranes are not a typical clinical manifestation of cow's milk allergy. Allergies often present with symptoms affecting the gastrointestinal tract, respiratory system, skin, or a combination of these systems.
Which of the ff precautions must a nurse take while caring for clients with HIV/AIDS to reduce occupational risks?
- A. Transport specimens of body fluid in leakproof containers
- B. Seek prescription for a fusion inhibitor to reduce risk of infection
- C. Avoid administering IV drugs
- D. Avoid cleaning the clients room, esp cleaning urine, stool, or vomit
Correct Answer: A
Rationale: When caring for clients with HIV/AIDS to reduce occupational risks, a nurse must take precautions to minimize the risk of exposure to body fluids that may contain the HIV virus. Transporting specimens of body fluid in leakproof containers helps prevent accidental spills or leakages that could lead to exposure. Proper handling and containment of body fluids are essential to reducing the risk of transmission of HIV to healthcare workers. This precaution is in line with standard infection control practices to ensure the safety of healthcare providers and minimize the risk of occupational exposure to bloodborne pathogens like HIV.
A nurse is preparing to assess a 3-year-old child. What communication technique should the nurse use for this child?
- A. Focus communication on child.
- B. Explain experiences of others to child.
- C. Use easy analogies when possible.
- D. Assure child that communication is private.
Correct Answer: A
Rationale: When assessing a young child, it is important for the nurse to focus communication on the child by using simple language, asking direct questions, and using play-based approaches to facilitate communication. By engaging the child directly and adapting communication techniques to their developmental level, the nurse can establish rapport, gain the child's trust, and obtain accurate information during the assessment process. This approach helps create a positive and supportive environment for the child, making them feel comfortable and understood.
While caring for a critically ill child, the nurse observes that respirations are gradually increasing in rate and depth, with periods of apnea. What pattern of respiration will the nurse document?
- A. Dyspnea
- B. Tachypnea
- C. Cheyne-Stokes respirations
- D. Seesaw (paradoxic) respirations
Correct Answer: C
Rationale: Cheyne-Stokes respirations are characterized by alternating periods of deep, rapid breathing followed by periods of apnea. This cyclic pattern of respiration is often seen in critically ill patients and can be a sign of serious neurological or cardiac dysfunction. The nurse should document Cheyne-Stokes respirations when observing this specific breathing pattern in the child described in the scenario.