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When assessing an infant with suspected inguinal hernia, which of the following findings would be most significant?
- A. The inguinal swelling is reddened, and the abdomen is distended.
- B. The infant is irritable, and a thickened spermatic cord is palpable.
- C. The inguinal swelling can be reduced, and the infant has a stool in the diaper.
- D. The infant's diaper is wet with urine, and the abdomen is nontender.
Correct Answer: B
Rationale: Irritability and a thickened spermatic cord suggest a hernia, indicating possible incarceration.
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The nurse is discharging an 8-month-old who weighs 15 lb from the hospital. The parents have put the child in the back seat of the car with the car seat facing the front. The nurse should:
- A. Ask the parents to wait while obtaining the correct car seat.
- B. Complete the discharge with the child sitting facing the front seat.
- C. Give the parents a manual on proper car seat placement.
- D. Explain the need for the rear-facing position and request assistance from a car seat technician.
Correct Answer: D
Rationale: Rear-facing car seats are recommended for infants under 2 years to protect their neck and spine.
An 8-year-old with diabetes is placed on neutral and immune Hagedorn (NPH) and regular insulin before breakfast and before dinner. She will receive a snack of milk and cereal at bedtime. The snack will:
- A. Help her regain lost weight.
- B. Provide carbohydrates for immediate use.
- C. Prevent late night hypoglycemia.
- D. Help her stay on her diet.
Correct Answer: C
Rationale: A bedtime snack with NPH insulin prevents late-night hypoglycemia by providing carbohydrates during peak insulin action. It is not primarily for weight gain, immediate use, or diet adherence.
An infant diagnosed with Hirschsprung's disease is scheduled to receive a temporary colostomy. When initially discussing the diagnosis and treatment with the parents, which of the following would be most appropriate?
- A. Assessing the adequacy of their coping skills.
- B. Reassuring them that their child will be fine.
- C. Encouraging them to ask questions.
- D. Giving them printed material on the procedure.
Correct Answer: C
Rationale: Encouraging questions promotes understanding and engagement with the treatment plan.
A nurse is teaching an obese child about portion control. Which strategy should be included?
- A. Eat only prepackaged meals.
- B. Use smaller plates.
- C. Skip breakfast daily.
- D. Drink soda with meals.
Correct Answer: B
Rationale: Smaller plates help control portion sizes visually. Prepackaged meals may be unhealthy, skipping breakfast can increase hunger, and soda adds empty calories.
After teaching the family of a child with scoliosis who wears a Boston brace, which of the following activities, if stated by the child and family as occasions appropriate for removal of the brace, indicates successful teaching?
- A. When bathing, for about 1 hour per day.
- B. While eating, for a total of 3 hours a day.
- C. During school, for about 8 hours a day.
- D. When sleeping, for a total of 10 hours a day.
Correct Answer: A
Rationale: The Boston brace can be removed for short periods, such as during bathing, typically limited to about 1 hour per day, to maintain treatment efficacy.