What is the appropriate method for measuring the temperature of a 2-day-old neonate?
- A. Tympanic
- B. Oral
- C. Axillary
- D. Rectal
Correct Answer: C
Rationale: For a 2-day-old neonate, the most suitable method to measure temperature is the axillary method. This approach is considered safe and appropriate for neonates, minimizing the risk of injury. Tympanic temperature measurement may not be as accurate in neonates due to their small ear canals. Oral temperature measurement is not recommended for neonates as they may not be able to hold a thermometer properly in their mouths. Rectal temperature measurement is invasive and carries a higher risk of injury and should be avoided unless absolutely necessary.
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A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?
- A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
- B. Reschedule the treatment for a later time
- C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
- D. Show the respiratory therapist to the playroom
Correct Answer: C
Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.
When auscultating an infant's lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?
- A. Suggestive of chronic pulmonary disease
- B. Suggestive of impending respiratory failure
- C. An abnormal finding warranting investigation
- D. A normal finding in infants younger than 1 year of age
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a non-English-speaking child and family. Which should the nurse consider when using an interpreter?
- A. Pose several questions at a time
- B. Use medical jargon when possible
- C. Communicate directly with family members when asking questions
- D. Carry on some communication in English with the interpreter about the family's needs
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Where in the health history does a record of immunizations belong?
- A. History
- B. Present illness
- C. Review of systems
- D. Physical assessment
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
According to Freud's developmental theory, infancy is a stage of:
- A. Orality
- B. Latency
- C. Genitality
- D. Anality
Correct Answer: A
Rationale: In Freud's psychosexual development theory, the oral stage is the first stage and occurs during infancy. It focuses on activities involving the mouth, such as sucking and feeding. This stage is crucial for the child's development as it forms the basis for trust and attachment. Choices B, C, and D are incorrect as latency refers to the stage during middle childhood where sexual impulses are suppressed, genitality refers to the final stage focusing on mature sexual relationships, and anality refers to the stage occurring during the toddler years where toilet training plays a significant role.
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