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What is an appropriate screening test for hearing that can be administered by the nurse to a 5- year-old child?
- A. The Rinne test
- B. The Weber test
- C. Conventional audiometry
- D. Eliciting the startle reflex
Correct Answer: C
Rationale: Conventional audiometry is the appropriate screening test for hearing that can be administered by a nurse to a 5-year-old child. This test involves using specialized equipment to measure the child's ability to hear sounds at various frequencies and volumes. It is a comprehensive and reliable test that can accurately assess the child's hearing abilities across the auditory spectrum. The other options listed (A. Rinne test, B. Weber test, and D. Eliciting the startle reflex) are not suitable for screening the hearing of a 5-year-old child as they are either more applicable to adults or not as comprehensive and reliable as conventional audiometry when assessing hearing in children.
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The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. What is most likely the cause of the diaper rash?
- A. Impetigo
- B. Candida albicans
- C. Urine and feces
- D. Infrequent diapering
Correct Answer: B
Rationale: The presentation of perianal inflammation with satellite lesions that cross the inguinal folds is highly suggestive of a Candida albicans (yeast) diaper rash. Yeast diaper rash is characterized by redness, swollenness, and usually involves the skin folds. The warm, moist environment created by a diaper provides an ideal setting for Candida albicans to grow and cause a rash. The presence of satellite lesions that cross the inguinal folds further supports the diagnosis of a yeast infection rather than other causes like impetigo, irritation from urine and feces, or infrequent diapering. Treatment for yeast diaper rash typically involves antifungal creams or ointments.
The pediatric nurse advises a parent how to best convey the circumstances surrounding the sudden death of an 18-month-old patient to a four-year-old sibling. The nurse anticipates that the sibling:
- A. may feel guilty about the patient's death.
- B. may mistrust the parent.
- C. understands the permanence of death.
- D. will role-play the patient's death.
Correct Answer: A
Rationale: Young children often struggle with understanding death and may internalize feelings of guilt, believing they had a role in the event.
The initial neurological symptom of Guilain-Barre Syndrome is:
- A. Absent tendon reflex
- B. Paresthesia of the legs
- C. Dysrhythmias
- D. Transient hypertension
Correct Answer: B
Rationale: The initial neurological symptom of Guillain-Barre Syndrome (GBS) is typically paresthesia, which is a tingling or numbness sensation in the legs. GBS is an autoimmune disorder that affects the peripheral nervous system, leading to muscle weakness and paralysis. As the condition progresses, symptoms may worsen and may include absent tendon reflexes, weakness in the arms and legs, and difficulty breathing. However, paresthesia is often one of the earliest and most common symptoms of GBS.
During the physical examination of a client for a possible neurologic disorder, how can the nurse examine the client for stiffness and rigidity of the neck?
- A. By positioning the client flat on bed for at least 3 hrs
- B. By moving the head and chin of the client toward the chest
- C. By asking the client to bend and pick up small and large objects on the floor
- D. By introducing a painful stimulus on the neck
Correct Answer: B
Rationale: The nurse can examine the client for stiffness and rigidity of the neck by moving the head and chin of the client toward the chest. This maneuver, known as neck flexion, assesses the resistance and presence of stiffness in the neck muscles. Stiffness and rigidity of the neck muscles may suggest conditions such as meningitis, cervical dystonia, or other neurologic disorders. It is important for the nurse to perform this examination maneuver carefully to avoid causing discomfort or injury to the client.
In children with asthma, which of the following preoperative preparations is LEAST likely to be necessary?
- A. Increase in beta-agonist dosage
- B. Addition of systemic steroids
- C. Bronchodilator therapy
- D. None of the above
Correct Answer: D
Rationale: In stable asthmatic patients, additional interventions like systemic steroids or increased beta-agonist doses are not always necessary unless there are signs of exacerbation.