Introduction to Maternity and Pediatric Nursing Test Bank

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The nurse is assisting the family of a child with a history of encopresis. Which should be included in the nurse's discussion with this family?

  • A. Instruct the parents to sit the child on the toilet at twice-daily routine intervals.
  • B. Instruct the parents that the child will probably need to have daily enemas.
  • C. Suggest the use of stimulant cathartics weekly.
  • D. Reassure the family that most problems are resolved successfully, with some relapses during periods of stress.
Correct Answer: D

Rationale: The most appropriate response for the nurse to include in the discussion with the family of a child with a history of encopresis is to reassure them that most problems are resolved successfully, with some relapses during periods of stress. Encopresis is a common disorder in childhood, characterized by the repeated passage of feces in inappropriate places. It is often related to chronic constipation and fecal impaction. Treatment for encopresis includes addressing the underlying constipation through interventions like dietary changes, behavioral therapies, and possibly medications. It is important for the nurse to educate the family that although it may take time and effort, most children improve with treatment. Reassuring the family that relapses during periods of stress are to be expected can help to alleviate some of their anxiety and encourage them to continue with the treatment plan.

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A client is admitted to the ICU, which laboratory result must be reported immediately to the physician?

  • A. Hematocrit 48%
  • B. paCO2 38 mm Hg
  • C. platelets 18,000
  • D. WBC count 8000
Correct Answer: C

Rationale: A platelet count of 18,000 is significantly low, indicating a condition known as thrombocytopenia, which can lead to a risk of bleeding. In a critical care setting like the ICU, low platelet counts need to be addressed urgently to prevent serious complications such as hemorrhage. This result must be reported immediately to the physician so that appropriate interventions, such as transfusion of platelets, can be initiated promptly to manage the patient's condition effectively. Hematocrit, paCO2, and WBC count may also be important parameters to monitor in an ICU patient, but the critically low platelet count poses the most immediate threat to the patient's well-being and requires urgent attention.

Which is the nurse's best interpretation of this?

  • A. Resuscitation is likely to be needed.
  • B. Adjustment to extrauterine life is adequate.
  • C. Additional scoring in 5 more minutes is needed.
  • D. Maternal sedation or analgesia contributed to the low score.
Correct Answer: B

Rationale: The nurse's best interpretation is that the adjustment to extrauterine life is adequate. This can be determined by the Apgar score, which assesses a newborn's well-being shortly after birth. A score of 7-10 indicates that the newborn is adjusting well to life outside the womb, while a score of 4-6 may indicate some difficulties that may require intervention. In this case, the nurse's interpretation suggests that the newborn is doing well in adapting to the new environment.

. A client with a suspected left sided heart failure is scheduled to undergo a multigated acquisition scan. Which of the following actions is required before undergoing the test?

  • A. Diuretics are administered
  • B. Client should avoid fluid intake 6 hours
  • C. Client is medicated to relieve cough before the test
  • D. Client is administered analgesics
Correct Answer: C

Rationale: Before undergoing a multigated acquisition scan, a client with suspected left sided heart failure should be medicated to relieve cough. Coughing can disrupt the accuracy of the scan results by affecting the heart's movement and leading to motion artifacts. Therefore, it is essential to address any coughing issues before the test to ensure reliable and accurate imaging of the heart's function. The other options, such as administering diuretics, avoiding fluid intake, and administering analgesics, are not directly related to optimizing the imaging quality of the multigated acquisition scan for a client with suspected left sided heart failure.

When instructing the client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of which of the following?

  • A. Restricting fluids
  • B. Forcing fluids
  • C. Restricting sodium
  • D. Restricting potassium
Correct Answer: C

Rationale: For clients diagnosed with hyperparathyroidism, it is important to restrict sodium in the diet. High sodium intake can worsen calcium loss from the bones and increase the risk of kidney stones, both of which are concerns for individuals with hyperparathyroidism. Therefore, it is crucial to advise the client to limit their sodium intake to help manage their condition effectively.

The nurse is teaching parents about prevention of urinary tract infections in children. Which factor predisposes the urinary tract to infection?

  • A. Increased fluid intake
  • B. Short urethra in young girls
  • C. Prostatic secretions in males
  • D. Frequent emptying of the bladder
Correct Answer: B

Rationale: One of the factors that predisposes the urinary tract to infection is a short urethra in young girls. The shorter urethra compared to boys makes it easier for bacteria to travel up the urinary tract and cause infections. This anatomical difference in young girls increases their susceptibility to urinary tract infections compared to boys. In boys, the longer length of the urethra provides a natural barrier for bacteria to enter the bladder, reducing the risk of infection.

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