Nokea
The health care team has noticed an increase in I.V. infiltrations on the pediatric floor. As part of a Plan, Do, Study, Act quality improvement plan the team should do the following in which order?
- A. Analyze the data.
- B. Decide to monitor I.V. gauges.
- C. Perform chart audits.
- D. Write a new I.V. insertion policy.
Correct Answer: B,C,A,D
Rationale: The PDSA cycle involves planning (deciding to monitor), doing (chart audits), studying (analyzing data), and acting (writing a new policy).
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The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that myelomeningocele is commonly associated with which disorder?
- A. Excessive cerebrospinal fluid within the cranial cavity.
- B. Generally small head.
- C. Congenital absence of the cranium vault.
- D. Overriding of the cranial sutures.
Correct Answer: A
Rationale: Myelomeningocele is often associated with hydrocephalus, characterized by excessive cerebrospinal fluid in the cranial cavity, due to impaired cerebrospinal fluid circulation.
An adolescent complains of chest pain and goes to the school nurse. The nurse determines that the teenager has a history of asthma but has had no problems for years. Which of the following should the nurse do next?
- A. Call the adolescent's parent.
- B. Have the adolescent lie down for 30 minutes.
- C. Obtain a peak flow reading.
- D. Give two puffs of a short-acting bronchodilator.
Correct Answer: C
Rationale: Obtaining a peak flow reading is the next step to objectively assess the adolescent's respiratory status, given the history of asthma and new chest pain, which could indicate an asthma exacerbation.
Nonsteroidal anti-inflammatory drugs are the first choice in treating a child with juvenile idiopathic arthritis. Which adverse effects should the nurse include in the teaching plan for the parents? Select all that apply.
- A. Weight gain.
- B. Abdominal pain.
- C. Blood in the stool.
- D. Folic acid deficiency.
- E. Reduced blood clotting ability.
Correct Answer: B,C,E
Rationale: NSAIDs can cause gastrointestinal issues like abdominal pain and blood in the stool, and they may reduce blood clotting ability due to their effect on platelet function.
When taking a diet history from the mother of a 7-year-old child with phenylketonuria, a report of which of the following foods indicates a need for further teaching?
- A. Low-protein bread.
- B. Special PKU formula.
- C. Fresh apples.
- D. Chicken nuggets.
Correct Answer: D
Rationale: Chicken nuggets are high in phenylalanine, contraindicated in PKU. Low-protein bread, PKU formula, and apples are appropriate for a PKU diet.
When obtaining a history from the parents of a child diagnosed with diarrhea due to Salmonella, the nurse should ask the parents if the child has been exposed to which of the following possible sources of infection?
- A. Nonrefrigerated custard.
- B. A pet canary.
- C. Undercooked eggs.
- D. Unwashed fruit.
Correct Answer: C
Rationale: Undercooked eggs are a common source of Salmonella infection.