Nokea
When instilling ear drops in a 2-year-old child, how should the practical nurse (PN) position the earlobe to straighten the external auditory canal?
- A. Up and back.
- B. Down and back.
- C. Up and forward.
- D. Down and forward.
Correct Answer: B
Rationale: When administering ear drops to a child under three years old, it is essential to pull the earlobe down and back. This positioning helps straighten the external auditory canal, facilitating the proper administration of the ear drops. Pulling the earlobe down and back in young children aims to ensure that the medication reaches the intended area for optimal effectiveness.
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When caring for a 4-year-old child diagnosed with celiac disease, the parent asks about foods to avoid. Which response by the nurse is correct?
- A. Avoid all dairy products
- B. Avoid foods containing wheat, barley, and rye
- C. Avoid all foods high in sugar
- D. Avoid foods with artificial coloring
Correct Answer: B
Rationale: Celiac disease is managed with a strict gluten-free diet, necessitating the avoidance of foods containing wheat, barley, and rye. Gluten is found in these grains and can trigger an immune response in individuals with celiac disease, leading to damage to the small intestine. Therefore, it is essential for individuals with celiac disease, including children, to carefully avoid gluten-containing foods to maintain their health and well-being.
A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (ProAir) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky, and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct Answer: D
Rationale: The most crucial information for the nurse to obtain in this scenario is how often the metered-dose inhaler (MDI) is used daily. This information will help assess if the symptoms of insomnia, shakiness, and palpitations are potentially related to overuse of the inhaler, which can cause side effects such as tremors and palpitations. Monitoring the frequency of MDI usage is essential in managing asthma and ensuring appropriate medication administration.
What advice should be provided by the practical nurse to the mother of a school-age child with acute diarrhea and mild dehydration who is occasionally vomiting despite being given an oral rehydration solution (ORS)?
- A. Continue to give ORS frequently in small amounts.
- B. Alternate between ORS and carbonated beverages.
- C. Take the child to the hospital for intravenous fluids.
- D. Place the child NPO for the next eight to nine hours.
Correct Answer: A
Rationale: The practical nurse should advise the mother to continue providing the oral rehydration solution (ORS) frequently in small amounts. It is essential to continue ORS administration to prevent dehydration, even if the child is occasionally vomiting. Small, frequent amounts of ORS help maintain hydration levels in children with acute diarrhea and mild dehydration.
During a follow-up clinical visit, a mother tells the nurse that her 5-month-old son, who had surgical correction for tetralogy of Fallot, has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held, and his growth is in the expected range. Which intervention should the nurse implement?
- A. Stimulate the infant to cry to produce cyanosis
- B. Auscultate the heart and lungs while the infant is held
- C. Evaluate the infant for failure to thrive
- D. Obtain a 12-lead electrocardiogram
Correct Answer: B
Rationale: Auscultating the heart and lungs while the infant is held can provide important diagnostic information in assessing the cardiac and respiratory status of the infant who had surgical correction for tetralogy of Fallot. This intervention can help the nurse identify any abnormal heart or lung sounds, which may indicate complications or issues that need further evaluation or intervention.
A 6 year old who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a 35% of personal best peak expiratory flow rate (PEFR). Based on these findings, what actions should the nurse take first?
- A. Administer a prescribed bronchodilator.
- B. Encourage the child to cough and deep breath.
- C. Report findings to the health care provider.
- D. Determine what triggers precipitated this attack.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.