Nokea
The mother of a 6-month-old states that she started her infant on 2% milk. The nurse should first ask the mother:
- A. Do you think your baby will be fine with this milk?
- B. Is it possible for you to switch your baby to whole milk?
- C. Can you tell me more about the reason you switched your baby to 2% milk?
- D. You cannot switch to 2% milk right now. Did your pediatrician tell you to do this?
Correct Answer: C
Rationale: Understanding the reason for the switch helps address misconceptions and provide education.
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Initiation of which of the following immunizations is recommended prior to the adolescent entering college?
- A. Diphtheria, tetanus, and acellular pertussis (DTaP).
- B. Varicella.
- C. Meningococcal.
- D. Pneumococcal conjugate vaccine (PCV).
Correct Answer: C
Rationale: Meningococcal vaccine is recommended before college due to increased risk in dormitories.
A 10-year-old child who is 5'4' (138 cm) tall with a history of asthma uses an inhaled bronchodilator only when needed. He takes no other medications routinely. His best peak expiratory flow rate is 270 L/minute. The child's current peak flow reading is 180 L/minute. The nurse interprets this reading as indicating which of the following?
- A. The child's asthma is under good control, so the routine treatment plan should continue.
- B. The child needs to start a short-acting inhaled beta-agonist medication.
- C. This is a medical emergency requiring a trip to the emergency department for treatment.
- D. The child needs to begin treatment with inhaled cromolyn sodium (Intal) for asthma control.
Correct Answer: B
Rationale: A peak flow reading of 180 L/minute is 66.7% of the child's best (270 L/minute), placing it in the yellow zone (50-80% of personal best), indicating an asthma exacerbation. A short-acting inhaled beta-agonist is needed to relieve symptoms.
A nurse walks into the room just as a 10-month-old infant places an object in his mouth and starts to choke. After opening the infant's mouth, which of the following should the nurse do next to clear the airway?
- A. Use blind finger sweeps.
- B. Deliver back slaps and chest thrusts.
- C. Apply four subdiaphragmatic abdominal thrusts.
- D. Attempt to visualize the object.
Correct Answer: B
Rationale: For a 10-month-old choking, delivering back slaps and chest thrusts is the recommended method to dislodge a foreign body, as per pediatric guidelines.
A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger snaps to help control the nausea. The nurse should tell the parent:
- A. I will need to get an order.'
- B. Your child needs medication for the vomiting.'
- C. We discourage the use of home remedies in children.'
- D. Ginger snaps are safe and may help with nausea.'
Correct Answer: D
Rationale: Ginger snaps are a safe, non-medicinal option that may help alleviate nausea in children.
A 7-year-old has had an appendectomy on November 12. He has had pain for the last 24 hours. There is an order to administer Tylenol with Codeine every 3 to 4 hours as needed. The nurse is beginning the shift and reviews the chart below for pain history. Based on the information in the chart, what should the nurse do next?
- A. Administer the Tylenol with Codeine.
- B. Distract the child by giving him breakfast.
- C. Instruct the child to take deep breaths and blow his pain away.
- D. Assess the child again in 1 hour.
Correct Answer: A
Rationale: The FACES score of 4 at 7:00 am indicates pain, and it's been 6 hours since the last dose, warranting medication.