Nokea
The nurse is assessing the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?
- A. Speaks in simple sentences with four or more words.
- B. Recognizes most letters and numbers.
- C. Uses gestures with 1-to-2-word sentences.
- D. Uses 1-word sentences.
Correct Answer: A
Rationale: Speaking in simple sentences with four or more words is a normal milestone for a 3-year-old.
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A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
- A. The TSH is high because of the low production of T4 by the thyroid.
- B. The thyroxine level is low because the TSH level is high.
- C. The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
- D. High thyroxine levels normally occur in breastfeeding infants.
Correct Answer: A
Rationale: High TSH levels are a compensatory response to low T4 production, indicating congenital hypothyroidism, which requires prompt treatment to prevent developmental delays.
A 9-week-old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
- A. White blood cell count of 10,000/mm (10x 10/L).
- B. Weight gain of 2 pounds (0.91 kg) since birth.
- C. Red blood cell count of 2.3 cell/mcl or (2.3 x 10/L).
- D. Urine specific gravity is 1.011.
Correct Answer: C
Rationale: A low red blood cell count indicates anemia, increasing surgical risks, making it critical to report to the surgeon.
The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic anti-infective ointment. Which instruction should the nurse provide the child's caregivers during discharge education?
- A. Discontinue the ointment once drainage resolves.
- B. Prepare the child for blurry vision after ointment application.
- C. Use a disposable moist wipe to remove eye crusts.
- D. Remove secretions by wiping toward the opposite eye.
Correct Answer: B
Rationale: Ophthalmic ointment can cause temporary blurry vision, and preparing the child for this effect is important.
The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?
- A. Have the child blow a cotton ball and have the parent catch it.
- B. Place a toy in the child's hands while listening to the breath sounds.
- C. Offer the child bubbles before the stethoscope is placed.
- D. Allow the child to use a stethoscope on a stuffed animal.
Correct Answer: D
Rationale: Allowing the child to use a stethoscope on a stuffed animal familiarizes them with the procedure, increasing cooperation.
The nurse is providing nutrition education to the parents of an infant with failure to thrive (FTT). Which statement made by the parent should the nurse recognize as an appropriate understanding of interventions?
- A. Breast milk provides adequate calories for the child.
- B. Regular syringe feedings promote rapid weight gain.
- C. High-calorie formula encourages increased growth.
- D. Fruit juice increases the child's daily vitamin intake.
Correct Answer: C
Rationale: High-calorie formula provides the increased caloric intake needed to promote growth in infants with FTT.