Nokea
When positioning a neonate with an unrepaired myelomeningocele, which of the following positions is most appropriate?
- A. Supine with the hips at 90-degree flexion.
- B. Right side-lying position with the knees flexed.
- C. Prone with hips in abduction.
- D. Supine in semi-Fowler's position with chest and abdomen elevated.
Correct Answer: C
Rationale: The prone position protects the myelomeningocele sac from pressure and rupture before surgical repair, with hips in abduction to maintain alignment and prevent strain on the defect.
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A toddler is scheduled to have tympanostomy tubes inserted. When approaching the toddler for the first time, which of the following should the nurse do?
- A. Talk to the mother first so that the toddler can get used to the new person.
- B. Hold the toddler so that the toddler becomes more comfortable.
- C. Walk over and pick the toddler up right away so that the mother can relax.
- D. Pick up the toddler and take the child to the play area so that the mother can rest.
Correct Answer: A
Rationale: Talking to the mother first allows the toddler to observe the nurse from a safe distance, helping the child become accustomed to the new person without causing immediate distress. This approach respects the toddler's developmental need for gradual introduction to strangers.
The nurse determines that interventions for decreasing fluid retention have been effective when the child with nephrotic syndrome demonstrates evidence of which of the following?
- A. Decreased abdominal girth.
- B. Increased caloric intake.
- C. Increased respiratory rate.
- D. Decreased heart rate.
Correct Answer: A
Rationale: Decreased girth indicates reduced edema.
A 13-year-old has been admitted with a diagnosis of rheumatic fever and is on bed rest. He complains of a sore throat. His joints are painful and swollen. He has a red rash on his trunk and is experiencing aimless movements of his extremities. Use the chart below to determine what the nurse should do first.
- A. Report the heart rate to the physician.
- B. Apply lotion to the rash.
- C. Splint the joints to relieve the pain.
- D. Request an order for medication to treat the elevated temperature.
Correct Answer: A
Rationale: Rheumatic fever can cause carditis, and an elevated heart rate may indicate cardiac involvement, requiring immediate reporting. Other symptoms are managed after assessing cardiac status.
While preparing to examine a 6-week-old infant's scrotal sac and testes for possible undescended testes, which of the following would be most important for the nurse to do?
- A. Check the diaper for recent urination.
- B. Give the infant a pacifier.
- C. Ensure that the room is kept warm.
- D. Tap lightly on the left inguinal ring.
Correct Answer: C
Rationale: Ensuring the room is warm helps relax the cremaster muscle, facilitating examination.
The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, 'I hate you.' Which of the following would be most appropriate:
- A. Tell the parents they will need to wait out in the lobby.
- B. Ask the charge nurse to assign this client to another nurse.
- C. Reassure the parents that this is a normal behavior under the circumstances.
- D. Ask the parents to discipline the child so that the physician can treat her.
Correct Answer: C
Rationale: Such behavior is a normal stress response in a young child experiencing pain and fear in an emergency setting.