The nurse should plan to include information about which common practice that can increase the risk for developmental dysplasia of the hip (DDH)?
- A. Carrying a child in a backpack
- B. Carrying a child in a frontpack
- C. Swaddling of a child
- D. Extended time in a car seat
Correct Answer: C
Rationale: Tight swaddling can restrict hip movement and increase the risk of DDH.
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On the basis of the nurse's knowledge of the client's culture and beliefs, which statement regarding the health-seeking behavior is probably most accurate?
- A. Home remedies have been unsuccessful, and the condition threatens the client's self-image.
- B. The power to cure comes from physicians and is passed to nurses.
- C. The client waited for symptoms to resolve spontaneously.
- D. The client sought care due to family encouragement.
Correct Answer: A
Rationale: Hispanic clients may try home remedies first, seeking care when self-image is impacted.
During a physical examination of the 1-month-old, the nurse notes that the infant has blue sclerae. The nurse should further assess for signs and symptoms of which disorder?
- A. Juvenile rheumatoid arthritis (JRA)
- B. Tay-Sachs disease
- C. Duchenne muscular dystrophy (DMD)
- D. Osteogenesis imperfecta (OI)
Correct Answer: D
Rationale: Blue sclerae are a hallmark of osteogenesis imperfecta due to thin connective tissue.
While the client is waiting for the ankle to be X-rayed, which nursing measure is most helpful for relieving the soft-tissue swelling?
- A. Place a heating pad on the ankle.
- B. Apply ice to the ankle.
- C. Exercise the client's foot.
- D. Immobilize the client's foot.
Correct Answer: B
Rationale: Applying ice is the most effective initial measure to reduce soft-tissue swelling by causing vasoconstriction, which decreases blood flow and fluid accumulation in the injured area. Heat may increase swelling, exercise could exacerbate the injury, and immobilization alone does not address swelling as directly.
What should the nurse do after noting serosanguineous drainage on the cast of a child with myelodysplasia post-TEV repair?
- A. Cut a window where the drainage is seeping through the cast.
- B. Petal the cast to minimize skin irritation and decrease leakage.
- C. Measure the area of drainage on the cast and document this.
- D. Telephone the surgeon to report the serosanguineous drainage.
Correct Answer: C
Rationale: Measuring and documenting the drainage allows monitoring without compromising the cast's integrity.
The nurse is to give the client with gout one tablet of colchicine every hour until relief or toxicity occurs. Which of the following is an indication for stopping the colchicine?
- A. Ringing in the ears
- B. Nausea and vomiting
- C. A rash on the client's hips
- D. A temperature of 101°F
Correct Answer: B
Rationale: Nausea and vomiting are signs of colchicine toxicity, indicating the need to stop the medication.