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The parents of a neonate born with congenital clubfoot express feelings of helplessness and guilt, exhibiting anxiety about how the neonate will be treated. Which of the following actions by the nurse would be most appropriate initially?
- A. Ask them to share these concerns with the physician.
- B. Arrange a meeting with other parents whose infants have clubfoot to discuss their feelings.
- C. Suggest that they make an appointment to talk things over with a counselor.
- D. Encourage the parents to express their feelings and listen attentively.
Correct Answer: D
Rationale: Encouraging expression of feelings and listening attentively is the most appropriate initial step to address emotional concerns and build trust.
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A child with Kawasaki disease is receiving low dose aspirin. The mother calls the clinic and states that the child has been exposed to influenza. Which recommendations should the nurse make?
- A. Increase fluid intake.
- B. Stop the aspirin.
- C. Keep the child home from school.
- D. Watch for fever.
- E. Weigh the child daily.
Correct Answer: B,C,D
Rationale: Aspirin should be stopped due to the risk of Reye's syndrome with influenza. Keeping the child home and monitoring for fever help manage infection risk.
The nurse is evaluating a child's skills in self-administering insulin (see figure). The nurse should:
- A. Have the child use both hands on the syringe.
- B. Ask the child to place the needle at a 45 degree angle.
- C. Tell the child to use a site lower on her thigh.
- D. Remind the child to rotate sites.
Correct Answer: D
Rationale: Rotating insulin injection sites prevents lipodystrophy and ensures consistent absorption. Both hands are typically used, a 90-degree angle is standard for children, and site location depends on rotation.
A nasogastric tube inserted during surgery to correct an infant's intussusception is no longer freely removing gastric secretions. Which of the following should the nurse do next?
- A. Aspirate the tube with a syringe.
- B. Irrigate the tube with distilled water.
- C. Increase the level of suction.
- D. Rotate the tube.
Correct Answer: A
Rationale: Aspirating with a syringe checks for blockages and attempts to restore function safely.
Which statements by the mother of a toddler should lead the nurse to suspect that the child is at risk for iron deficiency anemia?
- A. He drinks over three cups of milk per day.
- B. I can't keep enough apple juice in the house; he must drink over 10 oz per day.
- C. He refuses to eat more than two different kinds of vegetables.
- D. He doesn't like meat; I don't think that he will eat small amounts of it.
- E. He sleeps 12 hours every night and takes a 2-hour nap.
Correct Answer: A,C,D
Rationale: Excess milk, limited vegetables, and low meat intake reduce iron intake, increasing anemia risk. Apple juice and sleep patterns are unrelated.
A 16-month-old child is seen in the clinic for a checkup for the first time. The nurse notices that the toddler limps when walking. Which of the following would be appropriate to use when assessing this toddler for developmental dysplasia of the hip?
- A. I couldn'ts maneuver.
- B. Barlow's maneuver.
- C. Adam's position.
- D. Trendelenburg's sign.
Correct Answer: B
Rationale: Barlow's maneuver is used to assess for hip instability in infants and toddlers, appropriate for detecting developmental dysplasia of the hip.