Nokea
What definitive diagnostic procedure does the nurse expect to be used to confirm the diagnosis of Hirschsprung disease in a 1-month-old infant?
- A. Colonoscopy
- B. Rectal biopsy
- C. Multiple saline enemas
- D. Fiberoptic nasoenteric tube
Correct Answer: B
Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. This procedure reveals the absence of ganglion cells in the affected bowel segment, which is a hallmark of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for diagnosing Hirschsprung disease due to the risk of not accurately reaching the affected segment. Multiple saline enemas (Choice C) are not used to confirm the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a standard diagnostic procedure for Hirschsprung disease and does not provide the necessary information to confirm the absence of ganglion cells in the affected bowel segment.
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When a child with a diagnosis of asthma is prescribed a peak flow meter, what should the nurse teach the child and parents about using this device?
- A. Use the device before taking medication
- B. Use the device during asthma attacks
- C. Record the best of three attempts
- D. Use the device after eating
Correct Answer: C
Rationale: The correct answer is to record the best of three attempts when using a peak flow meter. This method provides a more accurate measure of peak expiratory flow. Choice A is incorrect because using the device before taking medication may not reflect the actual peak flow, as medication can affect lung function. Choice B is incorrect as using the device during asthma attacks may not be feasible or safe, as the focus during an attack should be on managing symptoms rather than measuring peak flow. Choice D is incorrect because using the device after eating may not provide an accurate measurement of peak flow, as digestion can affect lung function temporarily.
One principle to be followed for children with type 1 diabetes is to provide for the variability of the child's activity. What should the nurse teach the child about how to compensate for increased physical activity?
- A. Eat more food when planning to exercise more than usual.
- B. Take oral, not injectable insulin, on days of heavy exercise.
- C. Take insulin in the morning when extra exercise is anticipated.
- D. Eat foods that contain sugar to compensate for the extra exercise.
Correct Answer: A
Rationale: The correct answer is to eat more food when planning to exercise more than usual. Increased physical activity requires more energy, so additional food intake is necessary to compensate for the increased energy expenditure. This helps maintain blood sugar levels within the target range. Choice B is incorrect because the mode of insulin administration does not change based on physical activity; the type and dose of insulin remain the same unless adjusted by a healthcare provider. Choice C is incorrect because insulin timing should not be adjusted solely based on anticipated exercise; consistent timing of insulin doses is crucial for stable blood sugar control. Choice D is incorrect because consuming foods with sugar may lead to unstable blood sugar levels and is not the recommended way to compensate for extra exercise, as it can result in sudden spikes and drops in blood glucose levels, affecting overall diabetes management.
A nurse is teaching the parents of a toddler about the signs and symptoms of lead poisoning. Which symptom should the nurse emphasize?
- A. Abdominal pain
- B. Constipation
- C. Irritability
- D. Frequent urination
Correct Answer: C
Rationale: Irritability is a significant symptom of lead poisoning in toddlers and should be emphasized to parents. Lead poisoning can manifest with various symptoms, but irritability is particularly common in children exposed to lead. Abdominal pain (Choice A) is not a typical symptom of lead poisoning in toddlers. While constipation (Choice B) can occur, it is less specific and less common than irritability. Frequent urination (Choice D) is not a typical symptom associated with lead poisoning in toddlers and is less relevant for parents to recognize in this context.
During a primary survey of a child with partial thickness burns over the upper body areas, what action should the nurse take first?
- A. Inspect the child's skin color.
- B. Assess for a patent airway.
- C. Observe for symmetric breathing.
- D. Palpate the child's pulse.
Correct Answer: B
Rationale: The correct answer is B: Assess for a patent airway. When dealing with a child who has sustained partial thickness burns, the priority is ensuring a patent airway due to the risk of respiratory compromise. Checking the child's skin color (choice A) may be important but is secondary to assessing the airway. While observing for symmetric breathing (choice C) is crucial, assessing the airway takes precedence in this situation. Palpating the child's pulse (choice D) is not the initial priority when managing burns and potential airway compromise.
When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'
- A. keep medications in a medicine cabinet.
- B. have secured gates at entrances to staircases.
- C. move our child to a regular bed by the appropriate age.
- D. buy shoes that close with Velcro rather than laces.
Correct Answer: C
Rationale: Moving a child to a regular bed by the appropriate age is not recommended as it can increase the risk of falls. Toddlers should transition to a regular bed only when developmentally ready to prevent accidents. Keeping medications in a medicine cabinet (Choice A) promotes safety by preventing accidental ingestion. Securing gates at entrances to staircases (Choice B) helps prevent falls down stairs. Buying shoes that close with Velcro rather than laces (Choice D) is a good practice to prevent tripping and falling.