Nokea
The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?
- A. Most boys in the United States can be toilet trained at age 3 years.
- B. Training can begin when he has sufficient bladder capacity.
- C. Additional surgery may be necessary to achieve continence.
- D. They should begin now because he will require additional time.
Correct Answer: B
Rationale: Toilet training should begin when the child has sufficient bladder capacity and control, which may be delayed in children who have undergone surgical repairs for conditions like bladder exstrophy. Premature training can lead to frustration and setbacks.
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The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?
- A. A three-year-old girl of Mediterranean descent.
- B. A ten-year-old boy of Hispanic descent.
- C. A young girl of African descent.
- D. A baby of European descent.
Correct Answer: A
Rationale: Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.
What should the nurse include in the discharge instructions for the parents of an infant diagnosed with acute otitis media?
- A. Keep the baby in an elevated position during sleep
- B. Administer an antibiotic
- C. Place the baby to sleep with a bottle
- D. Administer acetaminophen (Tylenol) to relieve discomfort
Correct Answer: D
Rationale: Acetaminophen (Tylenol) is recommended to help relieve the discomfort associated with acute otitis media, such as pain and fever. Elevating the baby's head during sleep can also help with drainage and relieve pressure, making choice A incorrect. Administering an antibiotic may be necessary for bacterial otitis media but is not usually the first-line treatment for acute otitis media, so choice B is incorrect. Placing the baby to sleep with a bottle can increase the risk of ear infections due to the pooling of milk around the Eustachian tube, so choice C is incorrect.
The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
- A. Gastrointestinal perforation may have occurred.
- B. The object may have been aspirated.
- C. The object may be lodged in the esophagus.
- D. The object may be embedded in the stomach wall.
Correct Answer: C
Rationale: The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.
A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?
- A. Bacteriuria and hematuria
- B. Hematuria and proteinuria
- C. Bacteriuria and increased specific gravity
- D. Proteinuria and decreased specific gravity
Correct Answer: B
Rationale: Hematuria (blood in the urine) and proteinuria (protein in the urine) are common findings in acute glomerulonephritis due to inflammation of the glomeruli. Bacteriuria and changes in specific gravity are not as directly associated with this condition.
A teen with asthma asks the nurse why it is hard to breathe during an asthma attack. The nurse explains that exposure to a "trigger" results in which of these manifestations?
- A. Bronchodilation, muscle relaxation, and decreased mucus production
- B. Air trapping and hypo-inflation of the alveoli
- C. Air trapping and decreased blood flow to the upper airway
- D. Bronchoconstriction, airway inflammation, and excess mucus production
Correct Answer: D
Rationale: The correct answer is D. Asthma triggers cause bronchoconstriction, airway inflammation, and increased mucus production, leading to difficulty breathing. This combination of manifestations results in narrowing of the airways, making it hard for the individual to breathe effectively. Choices A, B, and C are incorrect because during an asthma attack, bronchodilation, muscle relaxation, and decreased mucus production do not occur. Instead, the airways constrict, become inflamed, and produce excess mucus, contributing to the breathing difficulties experienced by individuals with asthma.