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The nurse is planning discharge teaching for the parents of a child who sustained a head injury and who is now receiving tapering doses of dexamethasone. The nurse plans to make which statement to the parents?
- A. This medication decreases the chance of infection.
- B. This medication will be discontinued after two doses.
- C. If your child's face becomes puffy, the medication dose needs to be increased.
- D. This medication is tapered to decrease the chance of recurring swelling in the brain.
Correct Answer: D
Rationale: Dexamethasone sodium phosphate is a corticosteroid. The rebounding of cerebral edema is a side effect of dexamethasone sodium phosphate withdrawal if it is done abruptly. This medication decreases inflammation rather than infection. Facial edema is a common side effect that disappears when the medication is discontinued.
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A client is being discharged from the hospital after a bronchoscopy that was performed a day earlier. After the discharge teaching, the client makes the following statements to the nurse. Which statement should the nurse identify as indicating a need for further teaching?
- A. I will stop smoking my cigarettes.
- B. I can expect to cough up bright red blood.
- C. I will get help immediately if I start having trouble breathing.
- D. I will use the throat lozenges as directed by my doctor until my sore throat goes away.
Correct Answer: B
Rationale: After bronchoscopy, expectorated secretions are inspected for hemoptysis, and if the client expectorates bright red blood, the primary health care provider is to be notified. The client needs to avoid smoking. The client should be observed for signs/symptoms of respiratory distress, including dyspnea, changes in respiratory rate, the use of accessory muscles, and changes in or absent lung sounds. A sore throat is common, and lozenges would be helpful to alleviate it.
The nurse provides instructions regarding home care to a parent of a 3-year-old child who has been hospitalized with hemophilia. Which statement by the parent indicates the need for further teaching?
- A. I should not leave my child unattended.
- B. I need to pad table corners in my home.
- C. My child should not have any immunizations.
- D. I need to remove household items that can tip over.
Correct Answer: C
Rationale: Immunizations are important for children with hemophilia to prevent infections, and the parent's statement about avoiding them indicates a misunderstanding. Not leaving the child unattended, padding table corners, and removing tippable items are appropriate safety measures to prevent bleeding injuries.
The nurse provides home care instructions to a client diagnosed with Cushing's syndrome. The nurse determines that the client understands the hospital discharge instructions if the client makes which statement?
- A. I need to eat foods low in potassium.
- B. I need to check the color of my stools.
- C. I need to check the temperature of my legs twice a day.
- D. I need to take aspirin rather than acetaminophen for a headache.
Correct Answer: B
Rationale: Cushing's syndrome results in an increased secretion of cortisol. Cortisol stimulates the secretion of gastric acid, and this can result in the development of peptic ulcers and gastrointestinal bleeding. The client should be encouraged to eat potassium-rich foods to correct the hypokalemia that occurs with this disorder. Cushing's syndrome does not affect temperature changes in the lower extremities. Aspirin can increase the risk for gastric bleeding and skin bruising.
The clinic nurse provides home care instructions to a mother regarding the care of her child who is diagnosed with croup. Which statement by the mother indicates the need for further instructions?
- A. I will give Tylenol for the fever.
- B. I will give cough syrup every night at bedtime.
- C. Sips of warm fluids during a croup attack will help.
- D. I will place a cool-mist humidifier next to my child's bed.
Correct Answer: B
Rationale: The mother needs to be instructed that cough syrup and cold medicines should not be administered because they may dry and thicken secretions, worsening croup symptoms. Acetaminophen (Tylenol) is appropriate for reducing fever. Sips of warm fluids help relax the vocal cords and thin mucus. A cool-mist humidifier is recommended to keep the air moist and reduce airway irritation.
A 9-month-old child is registered to attend a local childcare clinic. Upon initial intake, the nurse discovers the child has received the first and second dose of the hepatitis B vaccine. What is the best course of action for the nurse to recommend to the parents?
- A. no action; a third dose of the vaccine is not recommended
- B. immediately inoculate the child given the high risk of not having a third vaccine
- C. wait until the child is 12 months to give the vaccine
- D. schedule the child for the third vaccine at the earliest convenience
Correct Answer: D
Rationale: The hepatitis B vaccine requires three doses, with the third typically given between 6-18 months. Scheduling the third dose at the earliest convenience ensures timely protection. Option A is incorrect, B is unnecessarily urgent, and C delays protection.