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The health care team determines that the family of an infant with failure to thrive who is to be discharged will need follow-up care. Which of the following would be the most effective method of follow-up?
- A. Daily phone calls from the hospital nurse.
- B. Enrollment in community parenting classes.
- C. Twice-weekly clinic appointments.
- D. Weekly visits by a community health nurse.
Correct Answer: D
Rationale: Weekly in-home nurse visits provide direct monitoring and support for feeding and growth. Phone calls, classes, or clinic visits are less comprehensive.
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A nurse working in the nursery identifies a goal for a mother of a newborn to demonstrate positive attachment behaviors upon discharge. Which intervention would be least effective in accomplishing this goal?
- A. Provide opportunities for the mother to hold and examine the newborn.
- B. Engage the mother in the newborn's care.
- C. Create an environment that fosters privacy for the mother and newborn.
- D. Identify strategies to prevent difficulties in parenting.
Correct Answer: D
Rationale: Preventing parenting difficulties is less directly related to fostering immediate attachment.
When teaching an adolescent with facial acne about skin care, the nurse should instruct the adolescent.
- A. Wash the face twice a day with mild soap and water.
- B. Remove whiteheads and comedones after washing his face with antibacterial soap.
- C. Apply vitamin E ointment twice daily to the affected skin.
- D. Apply tretinoin (Retin-A) daily in the morning and expose the face to the sun.
Correct Answer: A
Rationale: Washing the face twice daily with mild soap and water helps remove excess oil and debris without irritating the skin. Removing whiteheads can cause scarring, vitamin E is not evidence-based for acne, and tretinoin should be applied at night due to photosensitivity.
A school-age boy with a spinal cord injury is moved to the rehabilitation unit. The nurse notes that the child tends to refuse to cooperate in care and is quiet. The nurse interprets this behavior as indicative of which of the following?
- A. A stage of grief reaction.
- B. A phase of rebellion.
- C. A reaction to sensory overload.
- D. A response to too much attention.
Correct Answer: A
Rationale: Refusal and withdrawal are consistent with grief, reflecting the child's adjustment to significant loss of function.
When developing the plan of care for a school-age child with a suspected diagnosis of appendicitis who is complaining of severe abdominal pain, which of the following measures should the nurse expect to include in the child's plan of care?
- A. Application of a heating pad.
- B. Insertion of a rectal tube.
- C. Application of an ice bag.
- D. Administration of an intravenous narcotic.
Correct Answer: C,D
Rationale: Ice and narcotics relieve pain without risking perforation, unlike heat or rectal tubes.
When teaching the parents of a child with Salmonella gastroenteritis about preventing recurrence, which instruction should the nurse include?
- A. Avoid sharing toys with other children.
- B. Cook poultry to an internal temperature of 165°F.
- C. Use hand sanitizers before meals.
- D. Limit fluid intake during meals.
Correct Answer: B
Rationale: Cooking poultry thoroughly prevents Salmonella contamination.