Nokea
The nurse is assessing a child with suspected appendicitis. Which physical finding supports this diagnosis?
- A. Rebound tenderness in the right lower quadrant.
- B. Soft, non-tender abdomen.
- C. Frequent bowel movements.
- D. Generalized abdominal bloating.
Correct Answer: A
Rationale: Rebound tenderness is a key sign of appendicitis due to peritoneal irritation.
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A father brings his 4-week-old son to the clinic for a checkup, stating that he believes his son's testicle is missing. Which of the following explanations would be most appropriate?
- A. Although the testes should have descended by now
- B. it is not a cause for worry.
- C. The testes often do not descend until age 6 months
- D. but let's check to see whether the testes are present.
- E. The testes are present in the scrotal sac at birth
- F. but surgery can remedy the situation.
- G. Although the testes normally descend by 1 year of age
Correct Answer: B
Rationale: Testes often descend by 6 months of age; however, if they haven't, surgical intervention may be necessary.
To encourage autonomy in a 4-year-old, the nurse should instruct the mother to:
- A. Discourage the child's choice of clothing.
- B. Button the child's coat and blouse.
- C. Praise the child's attempts to dress herself.
- D. Tell the child when the combination of clothes is not appropriate.
Correct Answer: C
Rationale: Praising efforts fosters autonomy by encouraging independence.
A 2-year-old child returns to the clinic after completing a 10-day course of amoxicillin prescribed to relieve an infection in his right ear. After completing the medication, the child has become fussy and has a low-grade fever. On physical examination, his right tympanic membrane is bulging and he is tugging at his ear. The nurse should:
- A. Suggest to the mother that a decongestant be used.
- B. Tell the mother the health care provider will probably repeat the 10-day course of amoxicillin.
- C. Suggest that the child should see an ear, nose, and throat specialist for myringotomy tubes.
- D. Report the assessment to the health care provider with the probability that another antibiotic will be used for a 10-day course.
Correct Answer: D
Rationale: Persistent symptoms like fussiness, fever, a bulging tympanic membrane, and ear tugging after completing amoxicillin suggest treatment failure, possibly due to resistant bacteria. The nurse should report these findings to the health care provider, who may prescribe a different antibiotic for another 10-day course.
Twelve hours after cardiac surgery, the nurse is assessing a 3-year-old who weighs 15 kg. The nurse should notify the surgeon about which of the following clinical finding?
- A. A urine output of 60 mL in 4 hours.
Correct Answer: A
Rationale: urine output of 60 mL in 4 hours is adequate (1 mL/kg/hr for a 15-kg child is 15 mL/hr, or 60 mL in 4 hours). No other findings are provided, so no notification is needed.
After teaching the mother of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, the mother indicates that she understands her child's prognosis when she states which of the following?
- A. My child will need to wear protective pads until puberty.
- B. My child will need extra fluids to prevent constipation.
- C. My child will probably always need a high-fiber diet.
- D. My child has a good chance of being potty trained.
Correct Answer: D
Rationale: Low anorectal anomalies often have a good prognosis for continence with proper management.