Nokea
The nurse is collecting data from a client with primary adrenal insufficiency (Addison disease). Which of the following findings is consistent with the condition?
- A. Bronze pigmentation of the skin
- B. Increased body and facial hair
- C. Purple or red striae on the abdomen
- D. Supraclavicular fat pad
Correct Answer: A
Rationale: Bronze skin pigmentation (A) is a hallmark of Addison disease due to increased ACTH stimulating melanocytes. Increased hair (B) and supraclavicular fat pad (D) are associated with Cushing syndrome, while striae (C) are nonspecific but not typical of Addison disease.
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The school nurse is conducting an educational session for middle school teachers that is designed to heighten awareness of school bullying. The nurse recognizes that further instruction is needed when one of the teachers makes which comment?
- A. Bullying is a normal part of childhood growth and development.
- B. Children with physical disabilities are more vulnerable to bullying.
- C. Most children who are victims of a school bully do not tell an adult about it.
- D. The most common form of bullying is verbal aggression, such as insults and intimidation.
Correct Answer: A
Rationale: Bullying is not a normal part of development (A) and requires intervention. Vulnerability of disabled children (B), underreporting (C), and verbal aggression (D) are accurate.
A client who is 2 days post-operative from an appendectomy requests medication for pain. The client's vital signs are as follows: pulse 96, respirations 30, BP 130/92. The nurse should:
- A. Ask whether the client is anxious.
- B. Give the pain medication.
- C. Check the dressing for bleeding.
- D. Recheck the client's vital signs.
Correct Answer: B
Rationale: Pain medication is appropriate for a post-op client with pain and stable vitals. Anxiety may contribute, but pain should be addressed first. Bleeding checks or rechecking vitals are unnecessary without specific indicators.
The nurse is caring for a 12 year-old with an acute illness. Which of the following indicates the nurse understands common sibling reactions to hospitalization?
- A. Younger siblings adapt very well
- B. Visitation is helpful for both
- C. The siblings may enjoy privacy
- D. Those cared for at home cope better
Correct Answer: B
Rationale: Visitation is helpful for both. Contact with the ill child helps siblings understand hospitalization and maintain relationships.
The nurse is caring for a toddler with atopic dermatitis. The nurse should instruct the parents to
- A. Dress the child warmly to avoid chilling
- B. Keep the child away from other children for the duration of the rash
- C. Clean the affected areas with tepid water and detergent
- D. Wrap the child's hand in mittens or socks to prevent scratching
Correct Answer: D
Rationale: Wrap the child's hand in mittens or socks to prevent scratching. This prevents worsening of lesions and secondary infections.
The nurse is reinforcing teaching to the parents of a 6-month-old child who has been given a new prescription for a liquid iron supplement. Which statements by the parents indicate a need for further teaching? Select all that apply.
- A. Our child might become constipated while taking this medication.
- B. Our child's stools might become black and tarry.
- C. We can give the dose with milk to prevent gastric irritation.
- D. We will administer the dose into the back of our child's cheek.
- E. We will administer the dose with meals to increase absorption.
Correct Answer: C,E
Rationale: Giving iron with milk (C) reduces absorption and should be avoided. Administering with meals (E) also decreases absorption; iron is best given between meals with vitamin C. Statements A, B, and D are correct regarding side effects and administration.