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What should the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings?
- A. Decrease daytime feedings.
- B. Allow child to go to sleep with a bottle.
- C. Offer last feeding as late as possible at night.
- D. Put infant to bed after asleep from rocking.
Correct Answer: C
Rationale: The nurse should suggest to the parents to offer the last feeding as late as possible at night for an infant who has a prolonged need for middle-of-the-night feedings. By ensuring that the infant gets a full feeding closer to bedtime, it can potentially help the baby stay fuller for a longer period during the night, reducing the need for frequent nighttime feedings. This approach can help the parents establish a bedtime routine that supports longer stretches of sleep for both the infant and themselves. It is important to note that decreasing daytime feedings, allowing the child to go to sleep with a bottle, and putting the infant to bed after they are already asleep from rocking are not recommended strategies for addressing prolonged middle-of-the-night feedings.
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Which nursing diagnosis is most appropriate for a client with Addison's disease?
- A. Risk for infection
- B. Urinary retention
- C. Excessive fluid volume
- D. Hypothermia
Correct Answer: C
Rationale: Addison's disease is a condition characterized by adrenal insufficiency, resulting in a deficiency of aldosterone and cortisol. Without aldosterone, the body is unable to regulate fluid and electrolyte balance properly, leading to sodium loss and potassium retention. This imbalance can result in excessive fluid volume, as the kidneys retain water and sodium. Symptoms of excessive fluid volume in Addison's disease can include edema, weight gain, and hypertension. Therefore, the most appropriate nursing diagnosis for a client with Addison's disease would be Excessive Fluid Volume.
The nurse is taking vital signs of a pregnant woman during her first prenatal visit. The patient asks the nurse if she has to have an HIV test. Which of the following is the nurse's best response?
- A. "Yes, all pregnant women must have the test."
- B. "If you do not have multiple sex partners or inject drugs, it is not necessary."
- C. "Governmental guidelines require an HIV test for all pregnant woman."
- D. "After voluntary pretest counseling, you decide whether HIV testing should be done."
Correct Answer: D
Rationale: The nurse's best response is D, "After voluntary pretest counseling, you decide whether HIV testing should be done." It is important for the pregnant woman to make an informed decision about HIV testing after receiving pretest counseling. The decision should be based on her individual risk factors, concerns, and preferences. The nurse should provide information about the importance of HIV testing during pregnancy, the benefits of knowing one's HIV status, and the available treatment options if the test is positive. Ultimately, the decision should be made by the pregnant woman after considering all the information provided.
Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?
- A. A
- B. C
- C. Niacin
- D. Folic acid
Correct Answer: D
Rationale: Folic acid is the correct answer. All women of childbearing age are recommended to take folic acid to reduce the risk of neural tube defects such as spina bifida in their offspring. Neural tube defects occur in the early stages of pregnancy, often before a woman even knows she is pregnant, which is why it is important for all women of childbearing age to ensure they have adequate folic acid intake. Folic acid is a B vitamin that helps the body make new cells and plays a crucial role in the development of the baby's neural tube, which eventually becomes the brain and spinal cord. Adequate folic acid intake before and during pregnancy can significantly reduce the risk of neural tube defects. That's why it is recommended for all women of childbearing age to take a daily folic acid supplement or consume foods fortified with folic acid.
The nurse is caring for a very low birth weight (VLBW) newborn with a peripheral intravenous infusion. Which statement describes nursing considerations regarding infiltration?
- A. Infiltration occurs infrequently because VLBW newborns are inactive.
- B. Continuous infusion pumps stop automatically when infiltration occurs.
- C. Hypertonic solutions can cause severe tissue damage if infiltration occurs.
- D. Infusion site should be checked for infiltration at least once per 8-hour shift.
Correct Answer: C
Rationale: Infiltration of intravenous fluids in VLBW newborns can lead to serious complications, especially if hypertonic solutions are being administered. Hypertonic solutions have a higher osmolarity than the body's fluids, which can cause severe tissue damage if there is infiltration. It is crucial for the nurse to monitor the infusion site closely for signs of infiltration and take prompt action to prevent further harm to the newborn's delicate skin and tissues. The other options are not directly related to the risk and consequences of infiltration in VLBW newborns.
Which strategies should the school nurse recommend implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)? (Select all that apply.)
- A. Schedule heavier subjects to be taught in the afternoon.
- B. Accompany verbal instructions by written format.
- C. Limit number of breaks taken during instructional periods.
- D. Allow more time for testing.
Correct Answer: B
Rationale: Accompany verbal instructions by written format: Children with ADHD may have difficulty retaining verbal instructions due to their distractibility and impulsivity. Providing written instructions alongside verbal ones can help reinforce the information and improve comprehension.