The nurse is assessing a child with celiac disease. Which symptom should the nurse expect?
- A. Constipation.
- B. Abdominal distension.
- C. Fever.
- D. Joint pain.
Correct Answer: B
Rationale: Abdominal distension is a common symptom of celiac disease due to malabsorption and gas. Diarrhea is more typical than constipation, and fever or joint pain are less specific.
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A child is to receive I.V. antibiotics for osteomyelitis. Before the initial dose of antibiotics can be given, the nurse confirms that a blood sample for which of the following tests has been drawn?
- A. Creatinine.
- B. Culture.
- C. Hemoglobin.
- D. White blood count.
Correct Answer: B
Rationale: A blood culture is essential before starting antibiotics to identify the causative organism in osteomyelitis.
A nurse evaluates discharge teaching as successful when the parents of a school-age child with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt?
- A. Decreased urine output with stable intake.
- B. Tense fontanel and increased head circumference.
- C. Elevated temperature and reddened incisional site.
- D. Irritability and increasing difficulty with eating.
Correct Answer: D
Rationale: Irritability and difficulty eating are early signs of shunt blockage due to increased intracranial pressure, which parents should recognize for timely intervention.
The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, 'I hate you.' Which of the following would be most appropriate:
- A. Tell the parents they will need to wait out in the lobby.
- B. Ask the charge nurse to assign this client to another nurse.
- C. Reassure the parents that this is a normal behavior under the circumstances.
- D. Ask the parents to discipline the child so that the physician can treat her.
Correct Answer: C
Rationale: Such behavior is a normal stress response in a young child experiencing pain and fear in an emergency setting.
The mother of a 4-year-old expresses concern that her child may be hyperactive. She describes the child as always in motion, constantly dropping and spilling things. Which of the following actions would be appropriate at this time?
- A. Determine whether there have been any changes at home.
- B. Explain that this is not unusual behavior.
- C. Explore the possibility that the child is being abused.
- D. Assess that the child be seen by a pediatric neurologist.
Correct Answer: A
Rationale: Assessing home changes helps identify triggers for the behavior before assuming pathology.
A 14-year-old has just had a plaster cast placed on his lower left leg. To provide safe cast care, the nurse should?
- A. Petal the cast as soon as it is put on.
- B. Keep the child in the same position for 24 hours until the cast is dry.
- C. Use only the palms of the hand when handling the cast.
- D. Notify the physician if the client complains of heat.
Correct Answer: C
Rationale: Using only the palms prevents indentations in the wet cast, which could cause pressure points or alter the cast's shape.
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