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What is the best response for a two-year-old boy who begins to cry when the mother starts to leave?
- A. Let's wave bye-bye to mommy.
- B. Two-year-olds usually stop crying the minute the parent leaves.
- C. Now be a big boy. Mommy will be back soon.
- D. Let's wave bye-bye to mommy.
Correct Answer: D
Rationale: The best response for a two-year-old boy who begins to cry when the mother starts to leave is to wave bye-bye to mommy. This action helps the child understand that the separation is temporary and gives him a sense of closure. Choice A is the correct answer. Choice B is incorrect as it generalizes the behavior of two-year-olds. Choice C may invalidate the child's feelings by telling him to 'be a big boy' instead of acknowledging his emotions and providing comfort.
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The healthcare provider is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant's clinical picture?
- A. Metabolic alkalosis.
- B. Respiratory acidosis.
- C. Metabolic acidosis.
- D. Respiratory alkalosis.
Correct Answer: A
Rationale: Pyloric stenosis leads to obstruction at the outlet of the stomach, causing frequent vomiting and loss of stomach acids. This results in a loss of hydrochloric acid and hydrogen ions, leading to metabolic alkalosis due to an increase in serum bicarbonate levels. Therefore, the correct answer is metabolic alkalosis. Choice B, respiratory acidosis, is incorrect as it is not typically associated with pyloric stenosis. Choice C, metabolic acidosis, is incorrect because the loss of stomach acids in pyloric stenosis leads to metabolic alkalosis, not acidosis. Choice D, respiratory alkalosis, is also incorrect as it is not the usual consequence of pyloric stenosis.
The child is 3 years old and is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding indicates arterial obstruction?
- A. Blood pressure is decreasing, and the pulse is rapid and irregular.
- B. The right foot feels cool to the touch and appears pale and blanched.
- C. The pulse distal to the femoral artery is weaker in the left foot than the right foot.
- D. The pressure dressing at the right femoral area is damp and oozing blood.
Correct Answer: B
Rationale: A cool, pale, and blanched foot is indicative of arterial obstruction, leading to poor blood flow. This finding requires immediate intervention to prevent further complications such as tissue damage or necrosis. Monitoring for signs of arterial compromise, such as color changes, temperature, and capillary refill, is crucial in detecting and managing vascular complications post-cardiac catheterization. Choices A, C, and D do not directly indicate arterial obstruction. While a decreasing blood pressure and rapid, irregular pulse may suggest compromise, these findings are more nonspecific. A weaker pulse distal to the femoral artery indicates reduced perfusion but not necessarily arterial obstruction. Finally, a damp, oozing pressure dressing suggests a dressing issue rather than arterial obstruction.
A 10-year-old child is brought to the emergency department after falling from a bicycle and hitting their head. The nurse notes that the child is drowsy and has a headache. What is the nurse's priority action?
- A. Perform a full neurological assessment
- B. Administer pain medication
- C. Allow the child to rest quietly
- D. Check the child's immunization status
Correct Answer: A
Rationale: In a child who has fallen and hit their head, presenting with drowsiness and headache, the priority action for the nurse is to perform a full neurological assessment. This is crucial to evaluate the extent of the head injury and monitor for signs of increased intracranial pressure, which could indicate a more severe traumatic brain injury. Administering pain medication or allowing the child to rest quietly are not appropriate initial actions without first assessing the neurological status. Checking the child's immunization status is important for overall health but is not the priority in this acute situation.
The parents of a 2-month-old infant, who is being discharged after treatment for pyloric stenosis, are being educated by the healthcare provider. Which statement by the parents indicates a need for further teaching?
- A. We should feed our baby in an upright position
- B. We should avoid feeding our baby solid foods until at least 6 months of age
- C. We will lay our baby on their stomach to sleep
- D. We will burp our baby frequently during feedings
Correct Answer: C
Rationale: The correct answer is C. Placing babies on their stomach to sleep increases the risk of sudden infant death syndrome (SIDS). The safest sleep position for infants is on their back to reduce the risk of SIDS. Teaching parents about safe sleep practices is crucial in preventing potential harm to the infant. Choices A, B, and D are all correct statements that promote the well-being of the infant. Feeding the baby in an upright position helps prevent reflux, delaying solid foods until 6 months of age is recommended for proper growth and development, and burping the baby frequently during feedings helps prevent gas buildup and colic.
The caregiver is providing discharge instructions to the parents of a 6-month-old infant who was hospitalized for bronchiolitis. Which statement by the parents indicates a correct understanding of the instructions?
- A. We should keep our baby away from people with colds
- B. We should continue giving the prescribed medication even if our baby seems better
- C. We should avoid giving solid foods to help with recovery
- D. We can place our baby to sleep on their back to help with breathing
Correct Answer: A
Rationale: Keeping the infant away from people with colds is crucial to prevent the spread of respiratory infections, especially for infants recently hospitalized with bronchiolitis. This precaution helps protect the baby from further illnesses and promotes recovery. The other choices are incorrect because it is important to complete the prescribed medication course even if the baby seems better to ensure the infection is fully treated (Choice B). Solid foods are usually introduced around six months of age, so avoiding them entirely may not be necessary (Choice C). Placing the baby to sleep on their back is a safe sleep practice to prevent sudden infant death syndrome (SIDS) but may not directly help with breathing in the context of bronchiolitis (Choice D).