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The parents of a 3-year-old boy who has Duchenne muscular dystrophy (DMD) ask, 'how can our son have this disease? We are wondering if we should have any more children.' What information should the nurse provide these parents?
- A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family.
- B. The male infant had a viral infection that went unnoticed and untreated, leading to muscle damage.
- C. The lack of the protein dystrophin in the mother can impact the muscle groups of males.
- D. Damage to the spinal cord due to birth trauma from a breech vaginal birth weakens the muscles.
Correct Answer: A
Rationale: The nurse should inform the parents that Duchenne muscular dystrophy is an X-linked recessive disorder, which primarily affects male children in the family. This genetic condition is caused by a mutation in the dystrophin gene located on the X chromosome. Females are usually carriers of the gene mutation and may pass it on to their sons. Daughters of carrier mothers have a 50% chance of being carriers themselves. Understanding the genetics of DMD can help the parents make informed decisions about family planning and genetic counseling.
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The healthcare provider is providing postoperative care to a 7-year-old child who had surgery for appendicitis. The child is experiencing pain at the surgical site. What is the healthcare provider's priority action?
- A. Administer the prescribed pain medication
- B. Encourage the child to take deep breaths
- C. Apply a warm compress to the surgical site
- D. Reposition the child to a more comfortable position
Correct Answer: A
Rationale: Administering the prescribed pain medication is crucial to effectively manage the child's postoperative pain. Pain management is a priority to ensure the child's comfort and promote healing following surgery. Encouraging deep breaths, applying warm compresses, or repositioning the child may help, but addressing the pain with medication is the initial and most vital intervention.
Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children?
- A. Carefully recording the height and weight of children to detect inappropriate growth.
- B. Performing head circumference measurements on infants under one year of age.
- C. Assessing for behavioral problems at home and school by interviewing the parents.
- D. Noting tracked weight gain without a gain in height on a growth chart.
Correct Answer: A
Rationale: Recording the height and weight of children is crucial in detecting growth abnormalities like hypopituitarism and hyperpituitarism. Inappropriate growth patterns, such as disproportionate weight gain or stunted height, can be indicative of these conditions. Regular monitoring of height and weight is a fundamental nursing intervention that can aid in the early identification and management of pituitary-related disorders in children.
When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents?
- A. High protein.
- B. Low sodium.
- C. Low fat.
- D. High carbohydrate.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky, and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child's plan of care?
- A. Obtain vital signs to monitor for fluid overload
- B. Change IV site dressing every 3 days and as needed
- C. Monitor for signs of facial swelling or urticaria
- D. Assess for abdominal pain and vomiting
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.