Nokea
The mother asks the nurse for advice about discipline for her 18-month-old. Which of the following should the nurse suggest that the mother use?
- A. Structured interactions.
- B. Spanking.
- C. Reasoning.
- D. Time out.
Correct Answer: D
Rationale: Time out is an effective, age-appropriate discipline method for an 18-month-old.
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An adolescent with chronic renal failure is scheduled to go home with a peritoneal dialysis catheter in place. When developing the discharge teaching plan for the client and family focusing on psychosocial needs, which of the following areas should be a top priority to include?
- A. Advantages of limiting social activities and contacts for the first few months.
- B. Not disclosing information about the peritoneal dialysis to people outside the family.
- C. Possible effect on body image of the presence of an abdominal catheter.
- D. Importance of relying on parents to do the dialysis and dressing changes.
Correct Answer: C
Rationale: Body image concerns are significant.
The parents report that their 1-day-old is drooling and having choking episodes with excessive amounts of mucus and color changes, especially during feedings. When contacting the physician about these symptoms the nurse should request:
- A. A referral to a lactation consultant.
- B. That the physician further assess the client.
- C. An order for an x-ray with orogastric catheter placement.
- D. A serum blood glucose level per laboratory.
Correct Answer: C
Rationale: These symptoms suggest tracheoesophageal fistula, and an x-ray with orogastric catheter placement can confirm the diagnosis by visualizing the anatomy.
Which procedures can the nurse working on a pediatric floor safely delegate to the licensed practical nurse (LPN). Select all that apply.
- A. Refilling a baclofen pump.
- B. Administering gastrostomy tube feedings.
- C. Administering gastrostomy medications.
- D. Giving an IV push medication.
- E. Calling the AM blood sugars to the physician.
Correct Answer: B,C,E
Rationale: LPNs can safely administer gastrostomy feedings and medications and report blood sugar results, as these tasks are within their scope of practice.
A 10-year-old has just spilled hot liquid on his arm, and a 4-inch area on his forearm is severely burned. His mother calls the emergency department. What should the nurse advise the mother to do?
- A. To the child warm.
- B. Cover the burned area with an antibiotic cream.
- C. Apply cool water to the burned area.
- D. Call 911 to transport the child to the hospital.
Correct Answer: C
Rationale: Applying cool (not cold) water for 10-15 minutes reduces burn depth and pain. Keeping the child warm is secondary, antibiotic cream is not immediate, and 911 is unnecessary for a localized burn unless systemic symptoms appear.
After teaching a group of parents of preschoolers attending a well-child clinic about oral hygiene and tooth brushing, the nurse determines that the teaching has been successful when the parents state that children can begin to brush their teeth without help at which of the following ages?
- A. 3 years.
- B. 5 years.
- C. 7 years.
- D. 9 years.
Correct Answer: C
Rationale: Children can brush their teeth independently around 7 years, when fine motor skills are developed.