Nokea
When caring for a 2-year-old girl who is wheezing and has difficulty breathing, which interview question would provide the most useful information related to the symptoms of the child?
- A. Inquiring about child safety in the home
- B. Asking about the temperament of the child
- C. Asking about the child's diet
- D. Asking the parents if they smoke in the home
Correct Answer: D
Rationale: Asking the parents if they smoke in the home is the most relevant question as exposure to secondhand smoke can exacerbate respiratory symptoms like wheezing and difficulty breathing in children. This information is crucial for identifying potential triggers for the child's symptoms. Inquiring about child safety in the home, asking about the child's temperament, and inquiring about the child's diet, while important aspects of care, may not directly address the respiratory symptoms the child is experiencing.
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When working with a couple at risk of bearing a child with a genetic abnormality, what is most important for the nurse to incorporate into the plan of care?
- A. Gathering information from at least three generations
- B. Informing the couple of the need for a wide range of information
- C. Maintaining the confidentiality of the information
- D. Presenting the information in a nondirective manner
Correct Answer: D
Rationale: When counseling a couple at risk of genetic abnormalities, it is crucial to present information in a nondirective manner. This approach allows the couple to make informed decisions without feeling pressured or influenced. Gathering information from at least three generations (Choice A) may be relevant for genetic counseling but is not the most critical aspect in this scenario. Informing the couple of the need for a wide range of information (Choice B) is too general and does not address the specific approach needed in this situation. Maintaining the confidentiality of the information (Choice C) is important but not the top priority compared to presenting information in a nondirective manner.
A child with a cardiac malformation associated with left-to-right shunting. What does this type of congenital disorder lead to primarily?
- A. Elevated hematocrit
- B. Severe growth retardation
- C. Clubbing of the fingers and toes
- D. Increased blood flow to the lungs
Correct Answer: D
Rationale: Left-to-right shunting in a cardiac malformation results in increased blood flow to the lungs. This increased blood flow can lead to pulmonary hypertension and heart failure if left untreated. Elevated hematocrit (Choice A) is not a characteristic directly associated with left-to-right shunting. Severe growth retardation (Choice B) is not a typical manifestation of this type of congenital disorder. Clubbing of the fingers and toes (Choice C) is more commonly seen in conditions like chronic respiratory or cardiac diseases, not specifically with left-to-right shunting and associated cardiac malformations.
A school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?
- A. Varicella (Chickenpox)
- B. Scarlet fever
- C. Poliomyelitis
- D. Whooping cough
Correct Answer: A
Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.
The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?
- A. Shortened prothrombin time
- B. Increased fibrinogen level
- C. Positive fibrin split products
- D. Increased platelets
Correct Answer: C
Rationale: Positive fibrin split products indicate disseminated intravascular coagulation (DIC), a condition characterized by the widespread formation of blood clots throughout the body. In DIC, clotting factors are consumed, leading to increased fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster blood clotting, which is not consistent with the pathophysiology of DIC. An increased fibrinogen level (Choice B) is also not a characteristic finding in DIC, as fibrinogen levels may be decreased due to consumption in the formation of clots. Increased platelets (Choice D) are not typically observed in DIC; instead, thrombocytopenia (decreased platelet count) is more common due to their consumption in clot formation.
Parents of a sick infant talk with a nurse about their baby. One parent says, "I am so upset; I didn't realize our baby was ill." What major indication of illness in an infant should the nurse explain to the parent?
- A. Grunting respirations
- B. Excessive perspiration
- C. Longer periods of sleep
- D. Crying immediately after feedings
Correct Answer: C
Rationale: The correct answer is C. Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it can indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, not just an indication of illness. Excessive perspiration (choice B) can occur due to various reasons and is not a specific major indication of illness. Crying immediately after feedings (choice D) is a common behavior in infants and not necessarily a major indication of illness.