Nokea
The camp nurse provides instructions regarding skin protection from the sun to the parents who are preparing their children for a camping adventure. Which statement by a parent indicates a need for further instructions?
- A. A protective sunscreen is best to prevent sunburn.
- B. My child won't need the sunscreen on cloudy, hazy days.
- C. I need to pack a hat, long-sleeved shirts, and long pants for my child to wear.
- D. My child should wear clothes that have a tightly woven material for greater protection from the sun's rays.
Correct Answer: B
Rationale: The sun's rays are as damaging to the skin on cloudy, hazy days as they are on sunny days. Sunscreens are recommended and should be applied before exposure to the sun and reapplied frequently and liberally at least every 2 hours. A hat, long-sleeved shirt, and long pants should be worn when out in the sun. Tightly woven materials provide greater protection from the sun's rays.
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A mother brings her 6-month-old child to the clinic for a wellness checkup. The nurse anticipates that the health care provider will order which vaccinations for this client?
- A. DTaP and MMR
- B. Hib and varicella
- C. hepatitis B and DTaP
- D. hepatitis A and MMR
Correct Answer: C
Rationale: At 6 months, hepatitis B and DTaP are scheduled. MMR, varicella, and hepatitis A are given later (12-15 months).
The nurse provides dietary instruction to the parents of a child with a diagnosis of cystic fibrosis. The nurse should tell the parents that which diet plan should be followed?
- A. Fat free
- B. Low in protein
- C. Low in sodium
- D. High in calories
Correct Answer: D
Rationale: Children with cystic fibrosis are managed with a high-calorie, highprotein diet; pancreatic enzyme replacement therapy; fat-soluble vitamin supplements; and if nutritional problems are severe, nighttime gastrostomy feedings or parental nutrition. Fats are not restricted unless steatorrhea cannot be controlled by increased pancreatic enzymes. Sodium intake is unrelated to this disorder.
A client is being discharged to home after prostatectomy for treatment of benign prostatic hyperplasia. Which point should the nurse plan to teach the client as part of the discharge teaching?
- A. Mowing the lawn is allowed after 1 week.
- B. Avoid lifting more than 50 pounds for 4 to 6 weeks after surgery.
- C. Drink at least 15 glasses of water a day to minimize clot formation.
- D. Notify the primary health care provider if fever, increased pain, or an inability to void occurs.
Correct Answer: D
Rationale: Notifying the primary health care provider about fever, increased pain, or inability to void is critical to detect complications like infection or urinary obstruction. Mowing the lawn is too strenuous too soon, lifting more than 20 pounds is prohibited, and 15 glasses of water daily is excessive; 6 to 8 glasses are sufficient.
The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which statement by the client indicates an understanding of the nurse's instructions?
- A. I will definitely have to continue taking antithyroid medication after this surgery.
- B. I need to place my hands behind my neck when I have to cough or change positions.
- C. I need to turn my head and neck front, back, and side to side every hour for the first 12 hours after surgery.
- D. I will immediately report to the emergency room if I experience tingling of my toes, fingers, and lips after surgery.
Correct Answer: B
Rationale: One way of reducing incisional tension is to teach the client how to support the neck when coughing or being repositioned. The removal of the thyroid does not mean that the client will be taking antithyroid medications postoperatively. The client is taught that after thyroidectomy tension needs to be avoided on the suture line because hemorrhage may develop. Likewise, during the postoperative period, the client should avoid any unnecessary movement of the neck; that is why sandbags and pillows are frequently used to support the head and neck. If a client experiences tingling in the fingers, toes, and lips, it is probably a result of injury to the parathyroid gland during surgery, resulting in hypocalcemia. These signs and symptoms need to be reported immediately.
The community health nurse teaches a group of females how to prevent pelvic inflammatory disease (PID). What instruction should the nurse include?
- A. To douche monthly
- B. To avoid unprotected intercourse
- C. To use only ultra-low dose oral contraceptive pills
- D. To consult with a gynecologist regarding the placement of an intrauterine device (IUD)
Correct Answer: B
Rationale: PID is an infection of the pelvis. The primary prevention of PID includes avoiding unprotected intercourse. Douching leads to a higher risk for PID. It is believed that high hormonal doses may decrease risk of PID, but ultra-low doses will not. The use of an IUD may also increase the risk for PID.