Nokea
The clue to need help by age of 24 months, if the child
- A. speech is not understood by familiar listeners
- B. speech is not understood by unfamiliar listeners
- C. has not begun to ask questions (using where, what, why)
- D. is not using short sentences (e.g., 'Daddy went bye-bye')
Correct Answer: D
Rationale: By 24 months, children should begin using short sentences.
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The nurse is assessing a child with croup and a sore throat in the ED. The child is drooling and agitated. The nurse should know that examining the child's throat using a tongue depressor might precipitate which of the following?
- A. Profuse coughing
- B. Inspiratory stridor
- C. Complete obstruction
- D. Increased agitation
Correct Answer: C
Rationale: When assessing a child with croup who is drooling and agitated, the nurse should be aware that examining the throat using a tongue depressor can potentially precipitate a complete airway obstruction. Croup is characterized by upper airway inflammation, particularly around the larynx and trachea, leading to a barking cough, hoarseness, and respiratory distress. In a child with croup who is already showing signs of airway compromise such as drooling and agitation, any manipulation in the throat area can cause further swelling and lead to a complete obstruction of the airway. This can be a life-threatening emergency requiring immediate intervention to secure the airway and ensure adequate oxygenation. Therefore, utmost caution should be taken when performing any procedures that may exacerbate the child's respiratory distress in this situation.
A 1-year-old with acute renal failure (ARF) is edematous with minimal urine output. Vital signs: HR 146, BP 176/92, RR 42; the child has nasal flaring and retractions. Despite oral Kayexalate, serum potassium continues to rise. Which treatment will most benefit the child?
- A. Additional rectal Kayexalate.
- B. Intravenous furosemide.
- C. Endotracheal intubation and ventilatory assistance.
- D. Placement of a Tenckhoff catheter for peritoneal dialysis.
Correct Answer: D
Rationale: When ARF deteriorates and electrolyte imbalances worsen, peritoneal dialysis (via a Tenckhoff catheter) is indicated.
You are evaluating a 9-year-old boy child with ALL who recently develops relapse; an important statement that should be mentioned to his parents is
- A. testicular relapse occurs in the majority of boys with ALL
- B. such relapse occurs as painful swelling of one or both testes
- C. the diagnosis is confirmed by ultrasonography
- D. the majority of affected boys can be successfully retreated, and the survival rate is good
Correct Answer: D
Rationale: Most boys with testicular relapse can be successfully treated, and their overall survival remains favorable.
The birthweight usually quadruples by the age of
- A. 1.5 years
- B. 2 years
- C. 2.5 years
- D. 3 years
Correct Answer: B
Rationale: Birthweight typically quadruples by 2 years.
During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should include which statement?
- A. "The head of your bed must remain flat for 24 hours after surgery."
- B. "You should avoid deep breathing and coughing after surgery."
- C. "You won't be able to swallow for the first day or two."
- D. "You must avoid hyperextending your neck after surgery."
Correct Answer: D
Rationale: The correct statement to include during preoperative teaching for a client undergoing subtotal thyroidectomy is "You must avoid hyperextending your neck after surgery." This is important because hyperextending the neck can put strain on the suture line and may lead to dehiscence (wound opening). It is crucial for the client to avoid any activities or positions that could compromise the surgical site and hinder proper healing.