The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?
- A. Advise bed rest until 1 week after the icteric phase.
- B. Teach infection control measures to family members.
- C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
- D. Reassure the mother that hepatitis A cannot be transmitted to other family members.
Correct Answer: B
Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.
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In pediatric patients, what is the primary concern with untreated vesicoureteral reflux (VUR)?
- A. Recurrent UTIs
- B. Chronic renal failure
- C. Hypertension
- D. Bladder dysfunction
Correct Answer: B
Rationale: The primary concern with untreated vesicoureteral reflux (VUR) in pediatric patients is chronic renal failure. Untreated VUR can lead to this complication due to recurrent urinary tract infections and kidney damage. While recurrent UTIs (Choice A) are a common consequence of VUR, the ultimate worry is the development of chronic renal failure. Hypertension (Choice C) may occur as a result of renal damage but is not the primary concern. Bladder dysfunction (Choice D) is not the most significant consequence of untreated VUR in terms of long-term outcomes compared to chronic renal failure.
A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?
- A. Pizza
- B. Pretzels
- C. Popcorn
- D. Oatmeal cookies
Correct Answer: C
Rationale: Popcorn is a safe snack for a child with celiac disease as it is naturally gluten-free. Other options like pizza, pretzels, and oatmeal cookies typically contain gluten unless specifically made with gluten-free ingredients, which can exacerbate celiac symptoms. Therefore, popcorn is the best option to suggest to the child to avoid any adverse effects on their condition.
What information should the nurse include when teaching an adolescent with Crohn disease (CD)?
- A. How to cope with stress and adjust to chronic illness
- B. Preparation for surgical treatment and cure of CD
- C. Nutritional guidance and prevention of constipation
- D. Prevention of spread of illness to others and principles of high-fiber diet
Correct Answer: A
Rationale: Teaching about coping with stress and adjusting to chronic illness is crucial for adolescents with Crohn disease. CD is a chronic condition with no cure, so focusing on managing the disease, stress, and diet is essential for improving the adolescent's quality of life. Choice B is incorrect because Crohn disease cannot be cured surgically. Choice C is relevant but not as essential as coping with stress and chronic illness. Choice D is not a priority in teaching an adolescent with Crohn disease as it mainly focuses on preventing the spread of illness to others, which is not a significant concern with CD, and high-fiber diets may not always be suitable for individuals with this condition.
What is typically the first sign of puberty in females?
- A. Breast development
- B. Menarche
- C. Pubic hair growth
- D. Axillary hair growth
Correct Answer: A
Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.
An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
- A. A low-fiber diet is not always required.
- B. Stress management may be helpful.
- C. Milk products may or may not be a contributing factor.
- D. Pantoprazole (a proton pump inhibitor) is not a first-line treatment.
Correct Answer: B
Rationale: The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.
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