Nokea
What is the most appropriate method to use when drawing blood from a child with hemophilia?
- A. Use finger punctures for lab draws.
- B. Be prepared to administer platelets for prolonged bleeding.
- C. Apply heat to the extremity before venipunctures.
- D. Schedule all labs to be drawn at one time.
Correct Answer: D
Rationale: Scheduling labs together minimizes venipunctures, reducing bleeding risk in hemophilia. Finger punctures and heat increase bleeding, and platelets are not standard.
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The nurse is caring for a 5-year-old boy who is taking prednisolone for nephrotic syndrome. The child is at the 75th percentile for height and has a blood pressure of 114/73. The nurse compares the reading to the below blood pressure levels for boys age and height percentiles. The nurse determines that the blood pressure represents a change and notifies the primary care provider of the assessment of:
- A. Hypotension.
- B. Prehypertension.
- C. Hypertension.
- D. Hypertension stage II.
Correct Answer: C
Rationale: BP indicates hypertension.
The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate?
- A. I can understand why you feel guilty, but these things happen.'
- B. Tell me a little bit more about your feelings of guilt.'
- C. You should not have taken your eyes off of your child.'
- D. You really shouldn't feel guilty; you're lucky because your child will be all right.'
Correct Answer: B
Rationale: Encouraging parents to express their feelings facilitates therapeutic communication and supports emotional processing.
The mother of a child with chronic renal failure who is receiving peritoneal dialysis at home asks the nurse what she can do if both inflow and drain times are increased. Which of the following instructions would be most appropriate for the nurse to include when responding to the mother?
- A. Assess the child for constipation.
- B. Decrease the amount of dialysate infused for each dwell.
- C. Incorporate the increased inflow and drain times into the dialysis schedule.
- D. Monitor the child for shoulder pain during inflow and drain times.
Correct Answer: A
Rationale: Constipation can affect dialysis flow.
The nurse is monitoring an infant receiving IV fluids for gastroenteritis. Which finding suggests the infant is responding well to treatment?
- A. Dry mucous membranes.
- B. Weight gain of 50 grams daily.
- C. Urine output of 1 mL/kg/hour.
- D. Heart rate of 180 bpm.
Correct Answer: C
Rationale: Adequate urine output indicates effective rehydration.
The nurse reads the new medications orders for a 4-year-old child with nephrotic syndrome on the chart below: Orders D/C prednisolone 40 mg PO Daily Prednisolone 30 mg PO QOD The nurse should:
- A. Discontinue the prednisolone 40 mg and give the 30 mg dose today.
- B. Check the medication record first to see when the last dose of prednisolone was given.
- C. Start the 30 mg dose tomorrow.
- D. Contact the prescriber for clarification.
Correct Answer: D
Rationale: Clarification ensures correct dosing.