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The nurse is caring for a child with Down syndrome. Which characteristics are commonly found in the child with Down syndrome?
- A. Fragile bones, blue sclera, and brittle teeth
- B. Epicanthal folds, broad hands, and transpalmar creases
- C. Low posterior hairline, webbed neck, and short stature
- D. Developmental regression and cherry-red macula
Correct Answer: B
Rationale: Down syndrome is characterized by epicanthal folds, broad hands, and transpalmar creases.
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A client with Crohn's disease requires TPN to provide adequate nutrition. The nurse finds the TPN bag empty. What fluid would the nurse select to hang until another bag is prepared in the pharmacy?
- A. Lactated Ringers
- B. Normal saline
- C. D10W
- D. Normosol R
Correct Answer: C
Rationale: D10W provides dextrose to prevent hypoglycemia, a risk when TPN (high in glucose) is abruptly stopped. Saline or other fluids don't provide necessary glucose.
A 6-month-old client is admitted with possible intussuception. Which question during the nursing history is least helpful in obtaining information regarding this diagnosis?
- A. Tell me about his pain.
- B. What does his vomit look like?
- C. Describe his usual diet.
- D. Have you noticed changes in his abdominal size?
Correct Answer: C
Rationale: The usual diet is less directly related to diagnosing intussusception compared to symptoms like pain, vomiting, or abdominal changes.
A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?
- A. Place the client in a sitting position.
- B. Administer acetaminophen (Tylenol).
- C. Pinch the soft lower part of the nose.
- D. Apply ice packs to the forehead.
Correct Answer: C
Rationale: Pinching the soft lower part of the nose is the most effective way to control a nosebleed in a client with hemophilia, as it applies direct pressure to the bleeding site.
A student nurse is precepting on the unit and caring for a client with a Dobbhoff nasoenteric tube. Which statement by the student nurse indicates the need for further teaching on caring for a client with this tube? Select all that apply.
- A. I should wait for X-ray confirmation before using the tube.
- B. I can confirm placement by auscultating over the epigastric area.
- C. I can mix liquid medications in with the tube feeding for administration.
- D. I will flush the tube with 20 to 30 mL of water every 4 hours during continuous tube feeding.
- E. I will observe the client for diarrhea, abdominal distention, nausea and vomiting, and tube dislodgement.
Correct Answer: B, C
Rationale: Auscultation is not a reliable method for confirming tube placement; X-ray is required. Mixing medications with feedings can cause clogs or interactions. The other statements are correct.
The patient is prescribed metronidazole (Flagyl) for adjunct treatment for a duodenal ulcer. When teaching about this medication, the nurse would include:
- A. This medication should be taken only until you begin to feel better.'
- B. This medication should be taken on an empty stomach to increase absorption.'
- C. While taking this medication, you do not have to be concerned about being in the sun.'
- D. While taking this medication, alcoholic beverages and products containing alcohol should be avoided.'
Correct Answer: D
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol, so avoidance is critical.