Nokea
The parents report that their 1-day-old is drooling and having choking episodes with excessive amounts of mucus and color changes, especially during feedings. When contacting the physician about these symptoms the nurse should request:
- A. A referral to a lactation consultant.
- B. That the physician further assess the client.
- C. An order for an x-ray with orogastric catheter placement.
- D. A serum blood glucose level per laboratory.
Correct Answer: C
Rationale: These symptoms suggest tracheoesophageal fistula, and an x-ray with orogastric catheter placement can confirm the diagnosis by visualizing the anatomy.
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When developing the discharge teaching plan for the parents of a child who has undergone a cardiac catheterization for ventricular septal defect, which of the following should the nurse expect to include?
- A. Restriction of the child's activities for the next 3 weeks.
- B. Use of sponge baths until the stitches are removed.
- C. Use of prophylactic antibiotics before receiving any dental work.
- D. Maintenance of a pressure dressing until a return visit with the physician.
Correct Answer: C
Rationale: Prophylactic antibiotics are recommended before dental procedures for children with ventricular septal defects to prevent endocarditis. Activity restrictions are typically shorter, stitches are not always used, and pressure dressings are removed sooner.
The nurse assesses the child with chronic renal failure who is receiving peritoneal dialysis for edema. Which finding is expected for this child?
- A. Absence of pulmonary crackles.
- B. Increased dialysate outflow.
- C. Normal blood pressure.
- D. Pallor.
Correct Answer: D
Rationale: Pallor is common in chronic conditions.
A nurse is teaching a child with a food allergy about safe eating. Which instruction is most important?
- A. Eat only home-cooked meals.
- B. Read food labels carefully.
- C. Avoid all fruits.
- D. Use herbal supplements.
Correct Answer: B
Rationale: Reading food labels prevents accidental allergen exposure. Home cooking helps but isn't always feasible, fruits are safe unless allergenic, and supplements are irrelevant.
A 10-year-old has just spilled hot liquid on his arm, and a 4-inch area on his forearm is severely burned. His mother calls the emergency department. What should the nurse advise the mother to do?
- A. To the child warm.
- B. Cover the burned area with an antibiotic cream.
- C. Apply cool water to the burned area.
- D. Call 911 to transport the child to the hospital.
Correct Answer: C
Rationale: Applying cool (not cold) water for 10-15 minutes reduces burn depth and pain. Keeping the child warm is secondary, antibiotic cream is not immediate, and 911 is unnecessary for a localized burn unless systemic symptoms appear.
Which development is necessary for toilet training readiness for a 2-year-old? Select all that apply.
- A. Adequate neuromuscular development for sphincter control.
- B. Appropriate chronological age.
- C. Ability to communicate the need to use the toilet.
- D. Desire to please the parents.
- E. Ability to play with other 2-year-olds.
Correct Answer: A,C,D
Rationale: Neuromuscular control, communication, and motivation are key for toilet training readiness.