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The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider immediately?
- A. Jaundice
- B. Swelling in the hands or feet
- C. Ulcers on the legs
- D. Chest pain
Correct Answer: D
Rationale: Chest pain may indicate acute chest syndrome, a life-threatening complication requiring immediate reporting.
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The nurse is evaluating a preschool-aged child who is presenting with symptoms of flank pain, dysuria, and a low-grade fever. What additional information should the nurse obtain from the parent to determine if the child might have a urinary tract infection?
- A. Frequency of urination
- B. Any recent changes in diet
- C. Presence of any unusual odors in the urine
- D. Any changes in the color of the urine
Correct Answer: A
Rationale: Increased urination frequency is a common UTI symptom in children, aiding diagnosis.
A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
- A. Urine specific gravity is 1.011
- B. White blood cell count of 10,000/mm³
- C. Weight gain of 2 pounds (0.91 kg) since birth
- D. Red blood cell count of 2.3 x 10²/L
Correct Answer: D
Rationale: A low red blood cell count indicates anemia, a surgical risk requiring preoperative attention.
The nurse is caring for a child with hypoparathyroidism who exhibits a carpal spasm when pressure is applied to the upper arm. Which laboratory value should the nurse review?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Chloride
Correct Answer: B
Rationale: Carpal spasm (Trousseau's sign) indicates hypocalcemia, common in hypoparathyroidism.
The nurse is providing education to parents about preventing otitis media recurrence in their infant. Which instruction should the nurse include?
- A. Position prone after feeding.
- B. Breastfeed frequently.
- C. Avoid smoke exposure.
- D. Inspect the infant's ears daily.
Correct Answer: C
Rationale: Avoiding smoke exposure reduces eustachian tube irritation, lowering otitis media risk.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
- A. The diaper area shows severe skin breakdown
- B. The mother states the baby is irritable during feedings
- C. The mother is a single parent and lives with her parents
- D. The infant's formula has been changed twice
Correct Answer: A
Rationale: Severe diaper dermatitis causes discomfort, impacting sleep and requiring immediate care.