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When obtaining a history from the parents of a child diagnosed with diarrhea due to Salmonella, the nurse should ask the parents if the child has been exposed to which of the following possible sources of infection?
- A. Nonrefrigerated custard.
- B. A pet canary.
- C. Undercooked eggs.
- D. Unwashed fruit.
Correct Answer: C
Rationale: Undercooked eggs are a common source of Salmonella infection.
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Which of the following findings should lead the nurse to decide that spinal shock was resolving in the adolescent with a spinal cord injury?
- A. Atonic urinary bladder.
- B. Flaccid paralysis.
- C. Hyperactive reflexes.
- D. Widened pulse pressure.
Correct Answer: C
Rationale: Hyperactive reflexes indicate the resolution of spinal shock, as the nervous system begins to recover from initial flaccidity.
Which of the following outcome criteria would the nurse develop for a child with cystic fibrosis who has a nursing diagnosis of Ineffective airway clearance related to increased pulmonary secretions and inability to expectorate?
- A. Respiratory rate and rhythm within expected range.
- B. Absence of chills and fever.
- C. Ability to engage in age-related activities.
- D. Ability to tolerate usual diet without vomiting.
Correct Answer: A
Rationale: A respiratory rate and rhythm within the expected range is an appropriate outcome for ineffective airway clearance, indicating improved mucus clearance and respiratory function.
Which of the following structures should be closed by the time the child is 2 months old?
- A. A.
- B. B.
- C. C.
- D. D.
Correct Answer: C
Rationale: posterior fontanelle closes by 2 months.
A school-age client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with acute poststreptococcal glomerulonephritis. Which of the following actions should receive the highest priority?
- A. Assessing vital signs every 4 hours.
- B. Monitoring intake and output every 12 hours.
- C. Obtaining daily weight measurements.
- D. Obtaining serum electrolyte levels daily.
Correct Answer: C
Rationale: Weight reflects fluid status.
The mother tells the nurse that her 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of?
- A. Inadequate parental attention.
- B. Mastery of language ambiguities.
- C. Inappropriate peer influence.
- D. Excessive television watching.
Correct Answer: B
Rationale: Telling jokes and riddles reflects cognitive development and understanding of language nuances.