Nokea
The pediatric nurse charts that the parents of a 4-year-old child are very anxious. Which observation would indicate to the nurse unhealthy coping by these parents:
- A. Discussing their needs with the nursing staff
- B. Discussing their needs with other family members
- C. Seeking support from their minister
- D. Refusing to participate in the child's care
Correct Answer: D
Rationale: (A, B, C) These methods are healthy ways of dealing with anxiety. Participation minimizes feelings of helplessness and powerlessness. It is important that parents have accurate information and that they seek support from sources available to them.
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The nurse is performing discharge teaching on a client at high risk for the development of skin cancer. Which instruction should be included in the client teaching?
- A. "You should see the doctor every six months."
- B. "Sunbathing should be done between the hours of noon and 3 p.m."
- C. "If you have a mole, it should be removed and biopsied."
- D. "You should wear sunscreen when going outside."
Correct Answer: D
Rationale: Wearing sunscreen protects against UV radiation, a key skin cancer risk factor. Regular checkups (A) are less specific, sunbathing at peak hours (B) increases risk, and routine mole removal (C) is excessive.
The nurse is checking the client's central venous pressure. The nurse should place the zero of the manometer at the:
- A. Phlebostatic axis
- B. Point of maximal impulse
- C. Erb's point
- D. Tail of Spence
Correct Answer: A
Rationale: The phlebostatic axis (located at the fourth intercostal space mid-axillary line) is the standard reference point for zeroing the manometer to accurately measure central venous pressure. The other options are incorrect anatomical landmarks.
A client with a history of breast cancer is receiving tamoxifen (Nolvadex). Which adverse effect should the nurse monitor for?
- A. Weight loss
- B. Endometrial hyperplasia
- C. Hypotension
- D. Hair loss
Correct Answer: B
Rationale: Tamoxifen increases the risk of endometrial hyperplasia, a serious adverse effect due to its estrogenic effects on the uterus. Weight loss (A), hypotension (C), and hair loss (D) are not typical.
The nurse is caring for a client with a history of a hiatal hernia who is receiving Propulsid (cisapride). The nurse should monitor the client for:
- A. Arrhythmias
- B. Hypotension
- C. Constipation
- D. Weight gain
Correct Answer: A
Rationale: Cisapride can prolong the QT interval, risking arrhythmias, requiring cardiac monitoring. Hypotension, constipation, and weight gain are not primary side effects.
Which toys are suited to the developmental skills of the 2-3 year old?
- A. Soap bubbles
- B. Skates
- C. Riding toys
- D. Bicycle
- E. Talking toys
Correct Answer: A, C, E
Rationale: For 2-3-year-olds, soap bubbles (A), riding toys (C), and talking toys (E) match gross motor and imaginative play skills. Skates (B) and bicycles (D) require advanced coordination.