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When developing the discharge teaching plan for the parents of a child who has undergone a cardiac catheterization for ventricular septal defect, which of the following should the nurse expect to include?
- A. Restriction of the child's activities for the next 3 weeks.
- B. Use of sponge baths until the stitches are removed.
- C. Use of prophylactic antibiotics before receiving any dental work.
- D. Maintenance of a pressure dressing until a return visit with the physician.
Correct Answer: C
Rationale: Prophylactic antibiotics are recommended before dental procedures for children with ventricular septal defects to prevent endocarditis. Activity restrictions are typically shorter, stitches are not always used, and pressure dressings are removed sooner.
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Which of the following would be the best activity for the nurse to include in the plan of care for an infant experiencing severe diarrhea?
- A. Monitoring the total 8-hour formula intake.
- B. Weighing the infant each day.
- C. Checking the anterior fontanel every shift.
- D. Monitoring abdominal skin turgor every shift.
Correct Answer: B
Rationale: Daily weights provide an accurate measure of fluid loss in diarrhea.
When developing the ongoing plan of care for the parents whose infant died of sudden infant death syndrome (SIDS), the nurse should plan to accomplish which of the following on the second home visit?
- A. Allow the parents to express their feelings.
- B. Have the parents gain an understanding of the disease.
- C. Assess the impact of the infant's death on their other children.
- D. Deal with issues such as having other children.
Correct Answer: A
Rationale: On the second home visit, allowing parents to express their feelings supports their emotional processing of grief, which is a priority in early bereavement care.
An adolescent with insulin-dependent diabetes is being taught the importance of rotating the sites of insulin injections. The nurse should judge that the teaching was successful when the adolescent identifies which of the following as a result of using the same site?
- A. Unstruction of the fat tissue and poor absorption.
- B. Destruction of nerves and painful neuritis.
- C. Destruction of the tissue and too-rapid insulin uptake.
- D. Development of resistance to insulin and need for increased amounts.
Correct Answer: A
Rationale: Repeated injections at the same site cause lipodystrophy, leading to poor insulin absorption. Nerve damage, rapid uptake, or insulin resistance are not primary consequences.
Initiation of which of the following immunizations is recommended prior to the adolescent entering college?
- A. Diphtheria, tetanus, and acellular pertussis (DTaP).
- B. Varicella.
- C. Meningococcal.
- D. Pneumococcal conjugate vaccine (PCV).
Correct Answer: C
Rationale: Meningococcal vaccine is recommended before college due to increased risk in dormitories.
The nurse is assessing a neonate with suspected tracheoesophageal fistula. Which of the following findings would be most concerning?
- A. Excessive drooling.
- B. Mild cyanosis during feeding.
- C. Heart rate of 140 bpm.
- D. Temperature of 37°C.
Correct Answer: B
Rationale: Mild cyanosis during feeding indicates potential airway compromise, a critical concern in TEF.