Nokea
The parents of a newborn with a cleft lip are concerned and ask the nurse when the lip will be repaired. With which statement should the nurse respond?
- A. Cleft lip cannot be repaired.
- B. Cleft-lip repair is usually performed by 6 months of age.
- C. Cleft-lip repair is usually performed during the first months of life.
- D. Cleft-lip repair is usually performed between 6 months and 2 years.
Correct Answer: C
Rationale: Cleft-lip repair is typically performed during the first few months of life to address functional and cosmetic concerns at an early stage. Early repair can enhance bonding and facilitate feeding. While revisions may be necessary later on, addressing the cleft lip early is essential. Option A is incorrect as cleft lip repair is a common surgical procedure. Option B is incorrect as repair is typically done earlier than 6 months for better outcomes. Option D is incorrect as the usual timing for repair is within the first months of life, not between 6 months and 2 years.
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A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first?
- A. Prepare the child for an X-ray of the upper airways
- B. Examine the child's throat
- C. Collect a sputum specimen
- D. Notify the healthcare provider of the child's status
Correct Answer: D
Rationale: The correct initial action is to notify the healthcare provider of the child's status. The presenting symptoms described, such as irritability, thick muffled voice, croaking on inspiration, being hot to the touch, sitting leaning forward, tongue protruding, drooling, and suprasternal retractions, are indicative of epiglottitis, a potentially life-threatening condition. Immediate medical attention is crucial in such cases. While preparing for an X-ray or examining the throat may be necessary, the priority is to ensure prompt evaluation and intervention by the healthcare provider. Collecting a sputum specimen is not relevant in this situation and would cause unnecessary delay. Therefore, the nurse should prioritize communication with the healthcare provider to expedite appropriate management and treatment.
A child diagnosed with Hepatitis A is under the care of a healthcare provider. Which of the following precautions would be most important to take to prevent the transmission of this infectious disease?
- A. Encourage the Hepatitis A vaccine for family members and siblings
- B. Use needleless systems if possible; otherwise, use careful needle precautionary measures
- C. Teach the child and enforce strict and frequent hand washing
- D. Teach the child and family about the dangers of contaminated food and water
Correct Answer: C
Rationale: The most crucial precaution to prevent the transmission of Hepatitis A is to emphasize strict and frequent hand washing. Hepatitis A is a virus that spreads through the oral-fecal route and can survive on human hands. Hand washing is the most effective measure to reduce the risk of transmission. Encouraging the Hepatitis A vaccine for family members and siblings (Choice A) is beneficial for prevention but not as directly impactful as hand washing. While needle precautions (Choice B) are important in healthcare settings, they are not directly relevant to preventing the spread of Hepatitis A. Teaching about the dangers of contaminated food and water (Choice D) is important for general hygiene but may not be as effective as emphasizing hand hygiene in preventing the spread of Hepatitis A.
A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse expects to provide teaching about which client problem?
- A. Odor
- B. Nausea
- C. Malaise
- D. Diarrhea
Correct Answer: A
Rationale: Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal consistency in places not appropriate for that purpose according to the individual's own sociocultural setting. Signs of encopresis include evidence of soiled clothing, scratching or rubbing the anal area due to irritation, fecal odor without apparent awareness by the child, and social withdrawal. Teaching about odor is essential to address the issue of encopresis. Choices B, C, and D are incorrect because encopresis is not typically associated with nausea, malaise, or diarrhea. Therefore, teaching about these symptoms would not be relevant in the context of encopresis.
Which of the following is TRUE about shock?
- A. A patient with severe shock does not always have an abnormally low blood pressure.
- B. Confusion and deteriorating mentation are indicative of hypotensive shock.
- C. Patients with compensated shock may not be able to maintain a normal blood pressure.
- D. A normal blood pressure does not imply that the patient is stable.
Correct Answer: B
Rationale: Confusion and deteriorating mentation are indeed indicative of hypotensive shock. It is important to note that a patient with hypotensive shock will likely exhibit deteriorating mental status. Choice A is incorrect because a patient in severe shock may not always have an abnormally low blood pressure, making it an unreliable indicator of shock severity. Choice C is incorrect because patients with compensated shock may present with normal blood pressure but still have inadequate tissue perfusion. Choice D is incorrect because a normal blood pressure does not guarantee the patient's stability, especially in cases of shock where tissue perfusion may be compromised despite normal blood pressure readings.
The mother of a child with hepatitis A tells the home care nurse that she is concerned because the child's jaundice seems worse. What is the nurse's best response?
- A. You need to change the child's diet.
- B. The child probably is infectious again.
- C. The jaundice may worsen before it resolves.
- D. You need to call the primary health care provider.
Correct Answer: C
Rationale: The best response for the nurse in this situation is to explain to the mother that jaundice may seem to worsen before it eventually gets better. This is a common occurrence in hepatitis A. Option A about changing the child's diet is irrelevant to the concern raised by the mother and not supported by evidence. Option B suggesting the child is infectious again is incorrect and may cause unnecessary alarm as jaundice does not indicate reinfection. Option D, advising the mother to call the primary health care provider, is premature as the nurse can first provide education and reassurance regarding the expected course of jaundice in hepatitis A.