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What suggestion should the nurse provide to prevent diaper rash in a 4-month-old infant as requested by the mother?
- A. Generously powder the baby's diaper area with talcum powder at each diaper change to promote dryness.
- B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.
- C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.
- D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.
Correct Answer: C
Rationale: Using a barrier cream like zinc oxide forms a protective layer on the skin, creating a barrier against irritants and moisture, thus helping to prevent diaper rash. Unlike other options, barrier creams do not need to be completely removed at each diaper change, allowing the skin to remain protected between changes.
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An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response?
- A. Decreased urinary output
- B. Decreased periorbital edema
- C. Increased periods of rest
- D. Weight gain of 0.5 kg/day
Correct Answer: B
Rationale: In nephrotic syndrome treatment, decreased periorbital edema is a positive therapeutic response as it indicates a reduction in fluid retention. Periorbital edema is a common symptom of nephrotic syndrome due to fluid accumulation, so a decrease in this swelling signifies an improvement in the condition.
During a routine assessment of a 3-year-old at a community health center, the healthcare professional should be alert for signs of autism spectrum disorder. Which behavior by the child should prompt further evaluation for a possible autistic spectrum disorder?
- A. Engages in odd repetitive behaviors
- B. Shows indifference to verbal stimulation
- C. Strokes the hair of a hand-held doll
- D. Has a history of temper tantrums
Correct Answer: A
Rationale: Engaging in odd repetitive behaviors is a hallmark sign of autism spectrum disorder in children. These behaviors can include repetitive movements, insistence on sameness, or specific routines. Recognizing and addressing these behaviors early can help in providing appropriate interventions and support for the child.
The practical nurse (PN) is caring for an adolescent who has been diagnosed with mononucleosis. Which activity should the PN advise the adolescent to avoid?
- A. Playing video games.
- B. Drinking caffeinated beverages.
- C. Participating in contact sports.
- D. Eating spicy foods.
Correct Answer: C
Rationale: Contact sports should be avoided in mononucleosis due to the risk of spleen rupture, which is a serious complication of the disease. The spleen can enlarge in mononucleosis, making it more susceptible to injury from contact sports, potentially leading to a life-threatening situation if rupture occurs.
A 6 year old who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a 35% of personal best peak expiratory flow rate (PEFR). Based on these findings, what actions should the nurse take first?
- A. Administer a prescribed bronchodilator.
- B. Encourage the child to cough and deep breath.
- C. Report findings to the health care provider.
- D. Determine what triggers precipitated this attack.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 12-year-old child is admitted to the hospital with a diagnosis of osteomyelitis. Which finding should the nurse expect during the assessment?
- A. Localized pain and swelling
- B. Generalized joint stiffness
- C. Pain in the muscles
- D. Limited range of motion in the limbs
Correct Answer: A
Rationale: In osteomyelitis, an infection of the bone, patients typically present with localized pain, swelling, and warmth over the affected bone. This is due to the inflammatory response in the bone tissue. Generalized joint stiffness, pain in the muscles, and limited range of motion in the limbs are not specific to osteomyelitis and are more commonly associated with other conditions.