Nokea
When caring for a child after a tonsillectomy, what intervention should the nurse do?
- A. Watch for continuous swallowing.
- B. Encourage gargling to reduce discomfort.
- C. Apply warm compresses to the throat.
- D. Position the child on the back for sleeping.
Correct Answer: A
Rationale: Continuous swallowing, especially during sleep, signals bleeding from the tonsillectomy site, requiring immediate attention. Gargling may irritate the site, ice compresses are preferred to reduce inflammation, and side or abdominal positioning aids drainage, not back sleeping.
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An infants parents ask the nurse about preventing otitis media (OM). What information should be provided?
- A. Avoid tobacco smoke.
- B. Use nasal decongestants.
- C. Avoid children with OM.
- D. Bottle- or breastfeed in a supine position.
Correct Answer: A
Rationale: Avoiding tobacco smoke reduces the risk of otitis media and other childhood illnesses. Nasal decongestants don?t prevent OM, it?s not contagious unless other symptoms are present, and feeding in a semivertical position, not supine, helps prevent OM.
A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition?
- A. Allergies
- B. Acute pharyngitis
- C. Foreign body in the nose
- D. Acute nasopharyngitis
Correct Answer: C
Rationale: A unilateral foul-smelling nasal discharge with sneezing suggests a foreign body causing local irritation and obstruction. Allergies cause bilateral clear discharge, pharyngitis lacks nasal discharge, and nasopharyngitis produces bilateral mucous discharge.
An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent?
- A. Administer all of the prescribed medication.
- B. Continue medication until all symptoms subside.
- C. Immediately stop giving medication if hearing loss develops.
- D. Stop giving medication and come to the clinic if fever is still present in 24 hours.
Correct Answer: A
Rationale: Completing the full course of amoxicillin prevents recurrence of resistant bacteria. Stopping when symptoms subside risks incomplete treatment, hearing loss requires evaluation but not stopping antibiotics, and fever may persist for 24-48 hours despite treatment.
A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner?
- A. Make her lie down and rest quietly.
- B. Examine her oral pharynx and report to the physician.
- C. Auscultate her lungs and prepare for placement in a mist tent.
- D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.
Correct Answer: D
Rationale: The symptoms suggest epiglottitis, a medical emergency requiring immediate physician notification and preparation for airway support like tracheostomy or intubation. Lying down worsens breathing, examining the throat risks obstruction, and mist tents are ineffective for epiglottitis.
What statement best represents infectious mononucleosis?
- A. Herpes simplex type 2 is the principal cause.
- B. A complete blood count shows a characteristic leukopenia.
- C. A short course of ampicillin is used when pharyngitis is present.
- D. Clinical signs and symptoms and blood tests are both needed to establish the diagnosis.
Correct Answer: D
Rationale: Diagnosing infectious mononucleosis requires both clinical symptoms (e.g., sore throat, lymphadenopathy) and blood tests (heterophil antibody, monospot), as symptoms mimic other diseases. Epstein-Barr virus, not herpes simplex, causes it; lymphocytosis, not leukopenia, is typical; and penicillin, not ampicillin, is used due to rash risks.