Nokea
The nurse is caring for a 10-year-old with sickle cell anemia who is experiencing a vaso-occlusive crisis. Which intervention should the nurse prioritize?
- A. Administering antibiotics as prescribed.
- B. Encouraging ambulation to improve circulation.
- C. Providing hydration and pain management.
- D. Applying cold packs to painful joints.
Correct Answer: C
Rationale: Hydration and pain management are critical in vaso-occlusive crises to reduce blood viscosity and alleviate pain, improving outcomes.
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The nurse talks to an adolescent about how she can tell her friends about her new diagnosis of diabetes. Which of the following behaviors by the adolescent indicates that the adolescent has responded positively to the discussion?
- A. She asks the nurse for material on diabetes for a school paper.
- B. She introduces the nurse to her friends as the nurse to the taught me all about my diabetes.
- C. She says, 'I'll try to tell my friends, but they'll probably quit hanging out with me.'
- D. She asks her friends what they think about someone who has a lifelong illness.
Correct Answer: A
Rationale: Requesting materials indicates proactive engagement and willingness to share knowledge, reflecting a positive response. Other options show hesitation or indirect approaches.
When assessing a 3-month-old with Hirschsprung's disease, which finding should the nurse report immediately?
- A. Soft, formed stools.
- B. Abdominal distension.
- C. Regular feeding patterns.
- D. Mild fussiness.
Correct Answer: B
Rationale: Abdominal distension may indicate obstruction, requiring urgent intervention.
Which of the following medication orders to help relieve discomfort in a child with leukemia should the nurse question?
- A. Acetaminophen (Tylenol).
- B. Acetaminophen with codeine (Tylenol with Codeine).
- C. Ibuprofen (Motrin).
- D. Propoxyphene hydrochloride (Darvon).
Correct Answer: C
Rationale: Ibuprofen increases bleeding risk in leukemia due to its antiplatelet effects, which is dangerous with low platelets. Other medications are safer.
Parents bring their child to the emergency department because the child has stopped breathing. A nurse obtains a brief history of events occurring before and after the parents found the infant not breathing. Which of the following questions should the nurse ask the parents first?
- A. Was the infant sleeping while wrapped in a blanket?
- B. Was the infant lying on his stomach?
- C. What did the infant look like when you found him?
- D. When had you last checked on the infant?
Correct Answer: B
Rationale: Asking if the infant was lying on his stomach is critical, as prone sleeping is a major risk factor for SIDS and could explain the cessation of breathing.
The nurse is caring for a child with leukemia who reports mouth sores. Which intervention should the nurse implement?
- A. Encourage spicy foods to stimulate appetite.
- B. Provide a soft toothbrush and mild mouth rinse.
- C. Administer aspirin for pain relief.
- D. Avoid oral care until sores heal.
Correct Answer: B
Rationale: A soft toothbrush and mild mouth rinse prevent irritation and infection in mouth sores, common in leukemia due to chemotherapy. Aspirin and spicy foods worsen sores.