To determine if a blood pressure reading is normal, the nurse must know which information about the child? Select all that apply.
- A. Age.
- B. Body mass index (BMI).
- C. A secret.
- D. Height.
- E. Occipital frontal circumference (OFC).
- F. Weight.
Correct Answer: A,D,F
Rationale: Age, height, and weight are key factors in determining normal blood pressure ranges.
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A mother states that she thinks her 9-month-old 'is developing slowly.' When assessing the infant's development, the nurse is also concerned because the infant should be demonstrating which of the following characteristics?
- A. Vocalizing single syllables.
- B. Standing alone.
- C. Building a tower of two cubes.
- D. Drinking from a cup with little spilling.
Correct Answer: C
Rationale: Building a tower of two cubes is expected by 9 months; failure to do so suggests developmental delay.
When developing the discharge teaching plan for a child with chronic renal failure and the family, the nurse should emphasize restriction of which of the following nutrients?
- A. Ascorbic acid.
- B. Calcium.
- C. Magnesium.
- D. Phosphorus.
Correct Answer: D
Rationale: Phosphorus restriction is important.
A child with meningitis is to receive 1,000 mL of dextrose 5% in normal saline over 12 hours. At what rate in milliliters per hour should the nurse set the pump? Round your answer to the nearest whole number.
- A. 83 mL/hour
Correct Answer: A
Rationale: Calculate: 1,000 mL ÷ 12 hours = 83.33 mL/hour, rounded to 83 mL/hour, ensuring accurate fluid administration.
A 14-year-old is being screened for scoliosis. Which of the following statements about scoliosis screening is true?
- A. Teenagers ages 14 to 16 should be screened yearly.
- B. A shirt and shorts are worn for screening.
- C. The girl is assessed standing and bending forward.
- D. The girl should refrain from eating 8 hours before the examination.
Correct Answer: C
Rationale: Assessing the girl standing and bending forward is the standard method to detect spinal asymmetry during scoliosis screening.
Which of the following actions indicates that the parents of a 12-month-old with iron deficiency anemia understand how to administer iron supplements?
- A. They administer iron supplements in combination with fruit juice.
- B. They administer iron supplements with meals.
- C. They report dark stools.
- D. They brush the child's teeth after administering the iron supplements.
- E. They decrease dietary intake of foods fortified with iron.
Correct Answer: A,C,D
Rationale: Iron with fruit juice enhances absorption, dark stools are expected, and brushing teeth prevents staining. Iron with meals reduces absorption, and fortified foods should not be decreased.
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