Nokea
The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state:
- A. I should call if I see changes in the color of the toes under the cast.'
- B. I should use a pillow to elevate my child's foot as he sleeps.'
- C. My baby will need a series of casts to fix her foot.'
- D. Having a cast should not prevent me from holding my baby.'
Correct Answer: B
Rationale: Using a pillow to elevate the foot may alter the cast's corrective positioning, requiring additional teaching to avoid this practice.
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In an initial screening for lead poisoning, a 2-year-old child is found to have a lead level of 12 mcg/dL. The nurse should:
- A. Arrange a follow-up appointment in 6 months.
- B. Initiate chelation therapy.
- C. Refer to a neurologist.
- D. Test siblings for lead exposure.
Correct Answer: A
Rationale: A lead level of 12 mcg/dL requires follow-up in 3-6 months per CDC guidelines. Chelation is for levels >45 mcg/dL, neurology referral is premature, and sibling testing depends on shared exposure risk.
When obtaining the nursing history from the mother of an infant with suspected intussusception, which of the following questions would be most helpful?
- A. What do the stools look like?
- B. When was the last time your child urinated?
- C. Is your child eating normally?
- D. Has your child had any episodes of vomiting?
Correct Answer: A
Rationale: Stool appearance (e.g., currant jelly stools) is a hallmark of intussusception, aiding diagnosis.
A 5-year-old child brought to the clinic with several superficial sores on the front of the left leg is diagnosed with impetigo. Which of the following instructions should the nurse give the parent?
- A. Wash the child's legs gently three times per day with a mild soap.
- B. Cover the sores with loose gauze.
- C. Add the child to go back to school after 24 hours of treatment.
- D. Have the child return to the clinic the next week for a follow-up examination.
Correct Answer: C
Rationale: Impetigo is contagious until treated for 24 hours with antibiotics, after which the child can return to school. Gentle washing is helpful but not the primary instruction, gauze may trap moisture, and follow-up timing depends on response.
Shortly after an infant is returned to his room following hydrocele repair, the infant's mother tells the nurse that the child's scrotum looks swollen and bruised. Which of the following responses by the nurse would be most appropriate?
- A. Let me see if the doctor has ordered aspirin for him. If he did
- B. I'll get it right away.
- C. Why don't you wait in his room? Then you can ask me any questions when I get there.
- D. What you are describing is unusual after this type of surgery. I'll let the doctor know.
- E. This is normal after this type of surgery. Let's look at it together just to be sure.
Correct Answer: D
Rationale: Swelling and bruising post-surgery are common.
The breast-feeding mother of a 1-month-old diagnosed with cow's milk sensitivity asks the nurse what she should do about feeding her infant. Which of the following recommendations would be most appropriate?
- A. Continue to breast-feed but eliminate all milk products from your own diet.
- B. Discontinue breast-feeding and start using a predigested formula.
- C. Limit breast-feeding to once per day and begin feeding an iron-fortified formula.
- D. Change to a soy-based formula exclusively and begin solid foods.
Correct Answer: A
Rationale: Eliminating dairy from the mother's diet prevents milk proteins from passing to the infant via breast milk, allowing breastfeeding to continue. Formula or solids are less appropriate at this age.