The nurse completed discharge education to the Native American parents of a 48-hour-old,full-term infant. The nurse concludes that the mother needs additional teaching about jaundice when she makes which statement?
- A. “I know keeping my baby warm will help to decrease jaundice.”
- B. “I know the jaundice should start to decrease after about 3 days.”
- C. “The bilirubin causing the jaundice is eliminated in my baby’s stools.”
- D. “Feeding my baby frequently will help to decrease the jaundice.”
Correct Answer: B
Rationale: In Native American infants jaundice persists longer than in Caucasians with peak bilirubin at 3–5 days. Keeping warm frequent feeding and stool elimination of bilirubin are correct.
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A 30 years old G5P4 is admitted in labor room with H/O 32 weeks gestation,mild vaginal bleeding and abdominal pain. O/E her blood pressure 140/100 mm Hg abdomen is tense tender and hard. Fetal heart sounds are not audible. What is the most likely diagnosis:
- A. Placenta praevia.
- B. Abruptio placenta.
- C. Preterm labour.
- D. Urinary tract infection.
- E. Vasa praevia.
Correct Answer: B
Rationale: Abruptio placenta presents with vaginal bleeding abdominal pain a tense uterus and fetal distress (absent heart sounds) often with hypertension. Placenta previa typically causes painless bleeding and other options do not match the clinical picture.
Which of the following statements made by the adolescent best supports the nurse's suspicion of scoliosis?
- A. My friends are getting taller faster than I am.
- B. One of my sleeves is always shorter than the other.
- C. I have a difficult time sleeping on my side at night.
- D. I have a difficult time sleeping on my side at night.
Correct Answer: B
Rationale: Uneven sleeve length suggests shoulder asymmetry, a common sign of scoliosis due to lateral spinal curvature affecting posture.
Which dietary recommendation should the nurse provide to the parents of a child with iron deficiency anemia?
- A. Increase intake of red meat and leafy greens.
- B. Offer more dairy products like milk and cheese.
- C. Provide high-sugar snacks to boost energy.
- D. Limit consumption of whole grains.
Correct Answer: A
Rationale: Red meat and leafy greens are rich in iron, which is essential for correcting iron deficiency anemia by boosting hemoglobin production.
Which statement by the nurse would best help the parents cope with their feelings?
- A. You'll feel better if you visited your child for shorter periods of time.
- B. Don't worry. You're doing a great job, and everything will work out for the best.
- C. This is painful for you. Let's identify things you can do to help make your child feel good.
- D. It's sad that you feel helpless. What do you usually do to take your mind off your worries?
Correct Answer: C
Rationale: Acknowledging the parents' pain and suggesting actionable ways to help their child empowers them, addressing helplessness constructively and fostering coping.
The nurse advises the parents that, in most cases, children who have had an appendectomy usually return to school within what time frame?
- A. 5 days
- B. 2 weeks
- C. 4 weeks
- D. 6 weeks
Correct Answer: B
Rationale: Most children recover from an uncomplicated appendectomy within 1-2 weeks, allowing a return to school in about 2 weeks, depending on individual healing.
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