Nokea
The father is being taught by a nurse how to stimulate his 7-year-old son who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?
- A. Telling him to read stories to the child about famous athletes
- B. Suggesting he take the child to watch him play softball
- C. Urging him to sign the child up for little league football
- D. Proposing wrestling with the child and letting him win
Correct Answer: A
Rationale: For a child with a 'slow-to-warm-up' temperament, it is important to choose activities that are less intense and allow for gradual engagement. Reading stories to the child about famous athletes would be the most successful approach as it is less active and more likely to be acceptable to the child's temperament. Choice B and C involve more active and potentially overwhelming activities, which may not suit the child's temperament. Choice D, proposing wrestling and letting the child win, might create a competitive environment that could be counterproductive for a 'slow-to-warm-up' child.
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The nurse is assessing an infant and notes that the infant's urine has a mousy or musty odor. What would the nurse suspect?
- A. Maple syrup urine disease
- B. Tyrosinemia
- C. Phenylketonuria
- D. Trimethylaminuria
Correct Answer: C
Rationale: The correct answer is C: Phenylketonuria (PKU). PKU is suggested by a mousy or musty odor of the urine, which is caused by the inability to metabolize phenylalanine. Choice A, Maple syrup urine disease, is characterized by a sweet-smelling urine. Choice B, Tyrosinemia, typically presents with cabbage-like odor in the urine. Choice D, Trimethylaminuria, is associated with a fishy odor in the urine, breath, and sweat.
A child with a fever is prescribed acetaminophen. What should the nurse teach the parents about administering this medication?
- A. Administer the medication with food
- B. Measure the dose with a household spoon
- C. Measure the dose with a proper measuring device
- D. Administer the medication only when the child has a high fever
Correct Answer: C
Rationale: The correct answer is to measure the dose with a proper measuring device. Using a proper measuring device ensures accurate dosing, which is crucial to avoid under or overdosing. Administering the medication with food (Choice A) is not necessary for acetaminophen. Using a household spoon (Choice B) can lead to inaccurate dosing due to variations in spoon sizes. Administering the medication only when the child has a high fever (Choice D) is not appropriate as acetaminophen can be used for fever management regardless of the fever intensity.
A major developmental milestone of a toddler is the achievement of autonomy. What should the parents do to enhance their toddler's need for autonomy?
- A. Teach the child to share with others.
- B. Help the child learn society's roles.
- C. Teach the child to accept external limits.
- D. Help the child develop internal controls.
Correct Answer: D
Rationale: Toddlers striving for autonomy need to develop internal controls to foster their independence. Teaching the child to share (Choice A) focuses more on social skills rather than autonomy. Helping the child learn society's roles (Choice B) is important but not directly related to enhancing autonomy. Teaching the child to accept external limits (Choice C) is contrary to promoting autonomy as it emphasizes conformity to external rules rather than internal self-regulation.
At 7 AM, a healthcare professional receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?
- A. Encourage the adolescent to start exercising.
- B. Ask the adolescent to obtain an immediate glucometer reading.
- C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
- D. Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.
Correct Answer: D
Rationale: The correct priority nursing action in this situation is to administer the prescribed dose of rapid-acting insulin. Rapid-acting insulin is necessary to help lower the elevated blood glucose level quickly, thereby preventing potential complications of hyperglycemia. Encouraging exercise, obtaining a glucometer reading, or suggesting consumption of complex carbohydrates like cheese may not address the immediate need to bring down the high blood glucose level effectively. Exercise could potentially raise blood glucose levels, obtaining a glucometer reading may delay necessary treatment, and consuming complex carbohydrates can further elevate blood glucose levels in this scenario.
When teaching a class of new parents about positioning their infants during the first few weeks of life, which position is safest?
- A. On the back, lying flat
- B. On either side, lying flat
- C. Head slightly elevated on the left side
- D. Head slightly elevated on the right side
Correct Answer: A
Rationale: The correct answer is A: 'On the back, lying flat'. Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position helps ensure the baby's airway remains clear and reduces the likelihood of suffocation. Choices B, C, and D are not as safe as placing the infant on their back, as they may increase the risk of accidental suffocation or SIDS.