Nokea
The nurse is planning for a 5-month-old with gastroesophageal reflux disease whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instructions should the nurse provide this mother?
- A. Give small amounts of baby food with each feeding.
- B. Thicken formula with cereal for each feeding.
- C. Dilute the child's formula with equal parts of water.
- D. Offer 10% dextrose in water between most feedings.
Correct Answer: B
Rationale: Thickening formula with cereal is a recommended intervention for infants with gastroesophageal reflux disease (GERD) to help reduce vomiting and increase caloric intake. This modification can help the infant keep the food down better, reducing reflux symptoms while providing adequate nutrition. Giving small amounts of baby food with each feeding (Choice A) is not recommended for a 5-month-old with GERD as it may exacerbate symptoms. Diluting the child's formula with equal parts of water (Choice C) can lead to inadequate nutrition and is not advisable. Offering 10% dextrose in water between most feedings (Choice D) is not appropriate for managing GERD in infants and does not address the underlying issue of reflux.
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When obtaining the nursing history of a 7-year-old child admitted to the hospital with acute glomerulonephritis (AGN), which finding should the nurse expect to obtain?
- A. High blood cholesterol level on routine screening.
- B. Increased thirst and urination.
- C. A recent strep throat infection.
- D. A recent DPT immunization.
Correct Answer: C
Rationale: When assessing a child with acute glomerulonephritis (AGN), a common trigger to expect in the nursing history is a recent strep throat infection. AGN can be triggered by a streptococcal infection, leading to the deposition of immune complexes in the glomeruli. This finding is crucial as it helps identify a potential cause for the development of AGN in the child. Choices A, B, and D are incorrect as high blood cholesterol levels, increased thirst and urination, and recent DPT immunization are not directly associated with triggering acute glomerulonephritis in children.
When a mother of a 3-year-old boy gives birth to a baby girl and the boy asks why his baby sister is breastfeeding from their mother, how should the nurse respond? Select the option that is not appropriate.
- A. Remind him that his mother breastfed him too
- B. Clarify that breastfeeding is the mother's choice
- C. Reassure the older brother that it does not hurt his mother
- D. Explain that newborns get milk from their mothers in this way
Correct Answer: B
Rationale: Choice B is not the appropriate response in this scenario. The correct answer is choice A, which normalizes the situation for the child by reminding him that his mother breastfed him too. This response helps the older brother understand that breastfeeding is a natural and common practice for newborns, including his baby sister, just as it was for him when he was a baby. Choice B, while true, does not directly address the child's question and may not provide the same level of reassurance and normalization as choice A. Choices C and D also do not directly answer the child's question and do not provide the same level of connection and understanding as choice A.
A 4-year-old child with a history of asthma is brought to the clinic with a complaint of cough and wheezing. The nurse notes that the child has been using a rescue inhaler more frequently over the past week. What should the nurse do next?
- A. Review the child's asthma action plan
- B. Administer a dose of the rescue inhaler
- C. Instruct the parents to increase the dose of the controller medication
- D. Schedule a follow-up appointment in one week
Correct Answer: A
Rationale: In this scenario, the best course of action for the nurse is to review the child's asthma action plan. By doing so, the nurse can assess the current asthma management, ensure that the child is using the rescue inhaler correctly, and make any necessary adjustments to the treatment plan. Reviewing the asthma action plan helps in identifying triggers, proper use of medications, and when to seek medical help. Administering a dose of the rescue inhaler without assessing the current management plan may not address the underlying issue. Instructing the parents to increase the dose of the controller medication without proper evaluation can lead to inappropriate medication adjustments. Scheduling a follow-up appointment in one week is not the immediate action needed to address the child's current symptoms.
A 12-year-old child with type 1 diabetes is under the nurse's care. The child's parent asks how to prevent hypoglycemia during physical activity. What is the nurse's best response?
- A. Give your child extra insulin before exercise
- B. Make sure your child eats a snack before exercise
- C. Limit your child's physical activity to avoid hypoglycemia
- D. Monitor your child's blood glucose levels after exercise
Correct Answer: B
Rationale: The most effective way to prevent hypoglycemia during physical activity in a child with type 1 diabetes is to ensure they eat a snack before exercising. Eating a snack before exercise helps maintain blood glucose levels by providing additional glucose for energy during physical activity, reducing the risk of hypoglycemia. Giving extra insulin before exercise (Choice A) can increase the risk of hypoglycemia as it lowers blood glucose levels further. Limiting physical activity (Choice C) is not recommended as exercise is important for overall health. Monitoring blood glucose levels after exercise (Choice D) is essential but does not directly prevent hypoglycemia during physical activity.
A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents?
- A. Permanent lifestyle changes need to be made to promote safety in the home
- B. The chorea or movements are temporary and will eventually disappear
- C. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged
- D. Consistent discipline is needed to help the child control the movements
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.