Nokea
The parents of a 12-month-old child ask the nurse whether the child can eat hot dogs. The nurse's reply should be based on which statement?
- A. Child is too young to digest hot dogs.
- B. Child is too young to eat hot dogs safely.
- C. Hot dogs must be sliced into sections to prevent aspiration.
- D. Hot dogs must be cut into small, irregular pieces to prevent aspiration.
Correct Answer: D
Rationale: The correct statement to guide the parents on feeding their 12-month-old child hot dogs is that the hot dogs must be cut into small, irregular pieces to prevent aspiration. Hot dogs are a high-risk choking hazard for young children due to their shape and texture. Cutting them into small, irregular pieces decreases the risk of choking as compared to slicing them into sections. It is essential to always supervise young children while they are eating to prevent choking incidents. So, the nurse should advise the parents to cut the hot dogs into small, irregular pieces to ensure the child's safety.
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A client with Hashimoto's thyroiditis and a history of two myocardial infarctions and coronary artery disease is to receive levothyroxine (Synthroid). Because of the client's cardiac history, the nurse would expect that the client's initial dose for the thyroid replacement would be which of the following?
- A. 25 g/day, initially
- B. Delayed until after thyroid surgery
- C. 100 g/day, initially
- D. Initiated before thyroid surgery
Correct Answer: A
Rationale: In a client with a history of two myocardial infarctions and coronary artery disease, initiating levothyroxine therapy with a low starting dose of 25 mcg/day is recommended. Thyroid hormone replacement therapy can potentially worsen underlying cardiac conditions, so a cautious approach is necessary. The dose may be gradually titrated upwards based on thyroid function tests and the client's response. Delaying treatment until after thyroid surgery (option B) is not necessary in this scenario if the client requires thyroid hormone replacement. Initiating levothyroxine before thyroid surgery (option D) is not relevant to the given clinical situation. Starting with a higher dose of 100 mcg/day (option C) may pose a higher risk of cardiac complications in this client with a cardiac history.
A few minutes after beginning a blood transfusion, the nurse notes that the client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem?
- A. A hemolytic reaction to mismatched blood
- B. A hemolytic reaction to Rh-incompatible blood
- C. A hemolytic allergic reaction caused by bacterial contamination of donor blood
- D. None of the above
Correct Answer: A
Rationale: The client is likely experiencing a hemolytic reaction to mismatched blood due to the symptoms of chills, dyspnea, and urticaria occurring shortly after beginning the blood transfusion. These symptoms are classic signs of a transfusion reaction, especially a hemolytic reaction where the recipient's immune system attacks the transfused red blood cells. This can happen if the donor blood is not compatible with the recipient's blood type, leading to a severe reaction. It is crucial to report this immediately to the physician to halt the transfusion and provide appropriate treatment to the client.
Which of the ff factors makes it important for the nurse to provide special care to older clients with an immune system disorder?
- A. Age-related changes
- B. Use of multiple drugs (Polypharmacy)
- C. Poor diet
- D. Reduced activity levels
Correct Answer: A
Rationale: Age-related changes contribute significantly to the vulnerability of older clients with an immune system disorder. As people age, their immune system undergoes various alterations that can compromise its effectiveness in fighting off infections and diseases. These changes include thymic involution (decrease in thymus size and function), decrease in T-cell production, impaired immune response to infections, and decline in overall immune function. Older individuals are more susceptible to infections due to these age-related changes, which makes it essential for nurses to provide special care tailored to their specific needs. By understanding and considering these age-related immune system changes, nurses can develop appropriate care plans to support the health and well-being of older clients with immune system disorders.
The nurse has given medication instruction to the client receiving phenyton (Dilantin). The nurse determines that the client has an adequate understanding if the client states that:
- A. "Alcohol is not contraindicated while taking this medication."
- B. "Good oral hygiene is needed, including brushing and flossing."
- C. "The medication dose may be self-adjusted depending on side effects."
- D. "The morning dose of the medication should be taken before a serum drug level is drawn."
Correct Answer: B
Rationale: Phenytoin (Dilantin) can cause gingival hyperplasia, a side effect manifested by overgrowth of the gums. To help prevent this side effect, patients taking phenytoin should maintain good oral hygiene practices, including regular brushing and flossing. This statement shows an understanding of the importance of oral care while on phenytoin therapy, making it the correct answer choice.
What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?
- A. Provide for privacy
- B. Encourage parents to room in
- C. Explain procedures and routines
- D. Encourage contact with children the same age
Correct Answer: B
Rationale: Encouraging parents to room in with the hospitalized toddler is an appropriate nursing intervention to minimize separation anxiety. This allows the child to maintain a sense of security and familiarity by having their primary caregivers close by. Having parents present can provide comfort, reassurance, and emotional support for the child during their hospital stay, which can help alleviate separation anxiety. Additionally, parents can continue to provide their usual care and routines for the child, further promoting a sense of stability and security.