Nokea
The parents of an infant with myelomeningocele ask the nurse about their child's future mental ability. What is the nurse's best response?
- A. About one-third are mentally retarded, but it's too early to tell about your child.'
- B. About two-thirds are significantly retarded, and you'll know soon if this will occur.'
- C. Your child will probably be of normal intelligence since he demonstrates signs of it now.'
- D. You'll need to talk with the doctor about that, but you can ask later.'
Correct Answer: D
Rationale: Referring parents to the physician for detailed prognostic discussions ensures accurate information and avoids premature or speculative statements about mental ability.
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The family of a 5-year-old, only child has just moved to a rural setting where the father has started a dental practice. At the well-child visit, the father expresses concern that his child seems prone to minor accidents such as skinning his elbow and knees or falling off his scooter. The nurse tells the father:
- A. Only children use accidents as a way to seek parents' attention.
- B. Children who live in the suburbs typically have more accidents.
- C. Children frequently have more accidents when families experience change.
- D. We see a relationship between accidents and parental education.
Correct Answer: C
Rationale: Changes like moving can increase accidents due to stress or unfamiliar environments.
A 14-year-old girl with sickle cell disease has her fourth hospitalization for sickle cell crisis. Her family is planning a ski vacation in the mountains. What should the nurse tell the parents?
- A. Encourage them to go on the trip.
- B. Go on the trip, but find a sitter for the 14-year-old.
- C. Suggest the trip be postponed until next year.
- D. Explain that the high altitude may cause a crisis.
Correct Answer: D
Rationale: High altitudes reduce oxygen availability, increasing the risk of sickle cell crisis due to hypoxia. This is a critical consideration for the child's safety.
Which of the following statements obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure?
- A. The child has had a low-grade fever for several weeks.
- B. The family history is negative for convulsions.
- C. The seizure occurred with a necessary arrest.
- D. The seizure occurred when the child had a respiratory infection.
Correct Answer: D
Rationale: Febrile seizures are associated with acute fever, often during infections like respiratory infections, in young children.
A nurse administers ranitidine (Zantac) instead of cetirizine (Zyrtec) to an 8-year-old with asthma. The client has suffered no adverse effects. The nurse tells the charge nurse of the incident but fears disciplinary action. The charge nurse should tell the nurse:
- A. If you do not report the error, I will have to.
- B. Reporting the error helps to identify system problems to improve client safety.
- C. Notify the client's physician to see if she wants this reported.
- D. This is not a serious mistake so reporting it will not affect your position.
Correct Answer: B
Rationale: Reporting the error helps identify system problems to improve client safety, promoting a culture of transparency and quality improvement.
The charge nurse on the pediatric floor has assigned a 6-year-old girl of Arab-American ethnicity with newly diagnosed type 1 diabetes and an 8-year-old girl recovering from ketoacidosis to the same semi-immune treatment. The 6-year-old's mother is upset because the parent staying with the other child is the father. The nurse should:
- A. Explain to the parents that this room arrangement facilitates teaching.
- B. Reassign the children to different rooms.
- C. Offer the Arab-American parent another place to sleep.
- D. Refer the parent to the customer service representative.
Correct Answer: B
Rationale: Cultural sensitivity requires addressing the mother's discomfort, likely due to gender norms. Reassigning rooms respects her concerns while maintaining care. Teaching convenience, alternative sleeping, or customer service do not address cultural needs.