Nokea
To meet the emotional needs of a 10-year-old patient who is dying, the most appropriate nursing action is to:
- A. answer questions honestly and frankly.
- B. avoid interruptions by coordinating nursing actions.
- C. encourage the patient to write in a journal.
- D. provide opportunities for the patient to interact with children of the same age.
Correct Answer: A
Rationale: Answering questions honestly and frankly helps build trust and provides clarity for the child during this difficult time.
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When caring for Mr. Reyes, the nurse should assess for
- A. Decreased carotid pulses
- B. Altered level of consciousness
- C. Bleeding from oral cavity
- D. Absence of deep tendon-reflexes
Correct Answer: B
Rationale: When caring for Mr. Reyes, the nurse should assess for an altered level of consciousness as it is a crucial indicator of his overall neurological status. Changes in consciousness can signify multiple underlying issues such as neurological, metabolic, or circulatory problems. It is important for the nurse to monitor Mr. Reyes closely for any signs of confusion, disorientation, agitation, drowsiness, or changes in behavior that could indicate a decline in his neurological function. Assessing and addressing alterations in consciousness promptly is essential for providing appropriate care and preventing further complications.
A newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained sebaceous secretions. When charting this observation, the nurse identifies it as:
- A. Milia
- B. Lanugo
- C. Whiteheads
- D. Mongolian spots
Correct Answer: A
Rationale: Milia are small, whitish, pinpoint spots that commonly occur in newborns due to retained sebaceous secretions in the skin. They are commonly seen on the nose and can also appear on the cheeks and chin. Milia are not indicative of any illness and tend to disappear on their own without any treatment. They are a benign and temporary skin condition in newborns.
A nurse has determined that a newborn's respiratory breathing is within a normal range. How should the nurse document this finding?
- A. Irregular, abdominal, 30 to 60 breaths/min
- B. Regular, abdominal, 25 to 35 breaths/min
- C. Regular, noisy, 35 to 45 breaths/min
- D. Irregular, quiet, 45 to 55 breaths/min
Correct Answer: B
Rationale: A newborn with normal respiratory breathing would typically exhibit regular breathing patterns, with abdominal movements indicating effective diaphragmatic breathing. The normal respiratory rate for a newborn is considered to be 25 to 35 breaths per minute. Therefore, documenting the newborn's respiratory breathing as "Regular, abdominal, 25 to 35 breaths/min" would accurately represent a normal finding.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action?
- A. Teach parents appropriate exercises.
- B. Recheck head control at next visit.
- C. Refer child for further evaluation.
- D. Refer child for further evaluation if anterior fontanel is still open. TestBankWorld.org
Correct Answer: C
Rationale: Significant head lag in an 8-month-old infant can be a concerning sign indicating potential developmental delays or muscle weakness. The most appropriate action for the nurse in this situation is to refer the child for further evaluation by a healthcare provider, such as a pediatrician or developmental specialist, to assess and address the underlying cause of the head lag. It is important to rule out any potential developmental issues early on to provide the necessary interventions and support for the infant's optimal growth and development.