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When developing the teaching plan for the mother and a child with insulin-dependent diabetes about sick-day management, which of the following instructions should the nurse include?
- A. Adhere to the same schedule and type and amount of insulin.
- B. Immediately call the physician for information about what to do.
- C. Adjust insulin based on more frequent testing of blood glucose levels.
- D. Take the child to the emergency department for immediate care.
Correct Answer: C
Rationale: Sick-day management requires frequent glucose monitoring and insulin adjustments to prevent ketoacidosis. Fixed insulin schedules, immediate physician calls, or ER visits are less appropriate without monitoring.
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The parents of a neonate with hypospadias and chordee wish to have him circumcised. Which of the following explanations should the nurse incorporate into the discussion with the parents concerning the recommendation to delay circumcision?
- A. The associated chordee is difficult to remove during circumcision.
- B. The foreskin is used to repair the deformity surgically.
- C. The meatus can become stenosed, leading to urinary obstruction.
- D. The infant is too small to have a circumcision.
Correct Answer: B
Rationale: The foreskin is needed for surgical repair.
A child is started on a soft diet after having been on clear liquids following an episode of severe gastroenteritis. When helping the mother choose foods for her child, which of the following foods would be most appropriate?
- A. Muffins and eggs.
- B. Bananas and rice.
- C. Bran cereal and a bagel.
- D. Pancakes and sausage.
Correct Answer: B
Rationale: Bananas and rice are gentle on the gut, suitable for a soft diet.
A parent asks why it is recommended that the second dose of the measles, mumps, and rubella (MMR) vaccine be given at 4 to 6 years of age? The nurse should explain to the parent that the second dose is given at this age for what reason?
- A. If the child has not developed immunity and becomes pregnant when receiving the vaccine, the risks to the fetus are high.
- B. The chance of contracting the disease is much lower at this age.
- C. The dangers associated with a strong reaction to the vaccine are increased at this age.
- D. A serious complication from the vaccine is swelling of the joints.
Correct Answer:
Rationale: The second MMR dose ensures long-term immunity, as some children may not respond fully to the first dose.
The physician orders carbamazepine extended release (Tegretol-XR) for a client with cerebral palsy who also has a seizure disorder. The client has a gastrostomy feeding tube. What should the nurse do?
- A. Crush the medication and administer through the tube.
- B. Request an immediate-release formulation.
- C. Withhold the medication and notify the physician.
- D. Administer the medication orally.
Correct Answer: C
Rationale: Extended-release formulations like Tegretol-XR should not be crushed; the nurse should notify the physician to adjust the order.
To assess the development of a 1-month-old, the nurse asks the parent if the infant is able to:
- A. Smile and laugh out loud.
- B. Roll from back to side.
- C. Hold a rattle briefly.
- D. Turn the head from side to side.
Correct Answer: D
Rationale: A 1-month-old can turn their head side to side, a basic motor milestone.