Nokea
The parents of a child, age 6, who will begin school in the fall ask the nurse for anticipatory guidance. The nurse should explain that a child of this age:
- A. Still depends on the parents
- B. Rebels against scheduled activities
- C. Is highly sensitive to criticism
- D. Loves to tattle
Correct Answer: C
Rationale: A 6-year-old child is typically highly sensitive to criticism as they are developing self-esteem and are influenced by feedback from adults and peers.
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The following are true of vitamin K:
- A. It is a water-soluble vitamin
- B. It is found mainly in red meat
- C. After infancy most is synthesised by the gut flora
- D. Low levels after birth may lead to intracerebral haemorrhage
Correct Answer: C
Rationale: Vitamin K is synthesized by gut flora after infancy. It is a fat-soluble vitamin, and low levels after birth can lead to hemorrhagic disease of the newborn.
The nurse is monitoring an infant with a congenital heart disease closely for signs of heart failure. Which early sign should the nurse be most concerned about?
- A. Pallor
- B. Cough
- C. Tachycardia
- D. Slow and shallow breathing
Correct Answer: C
Rationale: Tachycardia is an early sign of heart failure in infants because the heart attempts to compensate for decreased cardiac output by increasing the heart rate.
The patient most probably has
- A. severe aortic stenosis
- B. patent ductus arteriosus
- C. Williams syndrome
- D. none of the above
Correct Answer: A
Rationale: The clinical features suggest severe aortic stenosis with left ventricular hypertrophy.
A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. What action should the nurse take first?
- A. Notify the healthcare provider
- B. Assure the client that such feelings occur with wound infections
- C. Visualize the abdominal incision
- D. Obtain sterile towels soaked in saline
Correct Answer: C
Rationale: Visualizing the incision helps determine if dehiscence or evisceration has occurred, which requires immediate intervention.
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
- A. “I should avoid tub baths but may shower.â€
- B. “I have to stay on strict bed rest for 3 days.â€
- C. “I should remove the pressure dressing the day after the procedure.â€
- D. “I may attend school but should avoid exercise for several days.â€
Correct Answer: B
Rationale: The child does not need to be on strict bed rest for 3 days. Showers are recommended; children should avoid a tub bath. The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean. Strenuous activity must be avoided for several days, but the child can return to school.