Nokea
The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following?
- A. Allow the child to stay up later one or two nights a week.
- B. Establish a set bedtime and follow a routine.
- C. Encourage active play before bedtime.
- D. Give the child a cookie if bedtime is pleasant.
Correct Answer: B
Rationale: A consistent bedtime routine promotes healthy sleep habits.
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After a plaster cast has been applied to the arm of a child with a fractured right humerus, the nurse completes discharge teaching. The nurse should evaluate the teaching as successful when the mother agrees to seek medical advice if the child experiences which of the following?
- A. Inability to extend the fingers on the right hand.
- B. Vomiting after the cast is applied.
- C. Coolness and dampness of the cast after 5 hours.
- D. Fussiness with complaints that the cast is heavy.
Correct Answer: A
Rationale: Inability to extend fingers suggests possible nerve or circulatory compromise, requiring immediate medical attention.
When teaching an adolescent with a seizure disorder who is receiving valproic acid (Depakene), which sign or symptom should the nurse instruct the client to report to the health care provider?
- A. Three episodes of diarrhea.
- B. Loss of appetite.
- C. Jaundice.
- D. Sore throat.
Correct Answer: C
Rationale: Jaundice indicates potential liver toxicity, a serious side effect of valproic acid, requiring immediate reporting.
After teaching the mother of a child with severe burns about the importance of specific nutritional support in burn management, which of the following, if chosen by the mother from the child's diet menu, indicates the need for further teaching?
- A. Bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks.
- B. Cheeseburger, cottage cheese and pineapple salad, chocolate milk, and a brownie.
- C. Chicken nuggets, orange and grapefruit sections, and a vanilla milkshake.
- D. Beef, bean, and cheese burrito; a banana; fruit-flavored yogurt; and skim milk.
Correct Answer: A
Rationale: Burn patients require high-protein, high-calorie diets. Option A is low in protein and calories compared to options B, C, and D, which include protein-rich foods like cheese, chicken, and beans.
Which of the following medication orders to help relieve discomfort in a child with leukemia should the nurse question?
- A. Acetaminophen (Tylenol).
- B. Acetaminophen with codeine (Tylenol with Codeine).
- C. Ibuprofen (Motrin).
- D. Propoxyphene hydrochloride (Darvon).
Correct Answer: C
Rationale: Ibuprofen increases bleeding risk in leukemia due to its antiplatelet effects, which is dangerous with low platelets. Other medications are safer.
A nurse is planning care for a 12-year-old with rheumatic fever. The nurse should teach the parents to:
- A. Observe the child closely.
- B. Allow the child to participate in activities that will not tire him.
- C. Provide for adequate periods of rest between activities.
- D. Encourage someone in the family to be with the child 24 hours a day.
Correct Answer: C
Rationale: Rest is critical in rheumatic fever to reduce cardiac strain and prevent complications like carditis. Observation and limited activities are important, but rest is the priority.