Nokea
The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?
- A. Fitting the diaper under the straps.
- B. Leaving the harness off while the infant sleeps.
- C. Checking for skin redness under straps every other day.
- D. Putting powder on the skin under the straps every day.
Correct Answer: A
Rationale: Fitting the diaper under the straps ensures hygiene without disrupting the harness's corrective positioning.
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A 6-month-old child is discharged with a urinary stent after a procedure to repair a hypospadias. The nurse should tell the parents to:
- A. Avoid tub baths until the stent is removed.
- B. Measure output in the urinary bag.
- C. Avoid drinking fruit juice.
- D. Clean the tip of the penis 3 times a day with soap and water.
Correct Answer: A
Rationale: Avoiding tub baths prevents infection.
After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which of the following statements offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?
- A. Knowing that the prognosis is poor helps prepare relatives for the death of children.
- B. Relatives are especially grieved when a child does well at first but then declines rapidly.
- C. Trust in health care personnel is most often destroyed by a death that is considered untimely.
- D. It is more difficult for relatives to accept the death of an older child than that of a toddler.
Correct Answer: B
Rationale: A rapid decline after improvement is particularly devastating, guiding the nurse to provide extra emotional support.
The mother tells the nurse that her 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of?
- A. Inadequate parental attention.
- B. Mastery of language ambiguities.
- C. Inappropriate peer influence.
- D. Excessive television watching.
Correct Answer: B
Rationale: Telling jokes and riddles reflects cognitive development and understanding of language nuances.
Which of the following should the nurse include when completing discharge instructions for the parents of a 12-month-old child diagnosed with Kawasaki disease (KD) and being discharged to home?
- A. Offer the child extra fluids every 2 hours for 2 weeks.
- B. Take the child's temperature daily for several days.
- C. Check the child's blood pressure daily until the follow-up appointment.
- D. Call the physician if the irritability lasts for 2 more weeks.
Correct Answer: B
Rationale: Monitoring temperature daily helps detect persistent fever, a sign of ongoing inflammation in Kawasaki disease. Other options are less critical or impractical at home.
The parent of a 17-year-old boy, who is hospitalized for complications related to type I diabetes, requests to review the adolescent's medical record. The client reported receiving mental health counseling during the admission history, but did not want his parent to know. The nurse, who is uncertain of how to protect the adolescent's privacy and accommodate the parent's request, should consult:
- A. The unit nurse manager.
- B. The primary care provider.
- C. The organization's privacy officer.
- D. The customer service representative.
Correct Answer: C
Rationale: The privacy officer is trained to handle HIPAA and confidentiality issues, ensuring the adolescent's privacy (e.g., mental health records) is protected while addressing parental rights.