Nokea
When taking a diet history from the mother of a 7-year-old child with phenylketonuria, a report of which of the following foods indicates a need for further teaching?
- A. Low-protein bread.
- B. Special PKU formula.
- C. Fresh apples.
- D. Chicken nuggets.
Correct Answer: D
Rationale: Chicken nuggets are high in phenylalanine, contraindicated in PKU. Low-protein bread, PKU formula, and apples are appropriate for a PKU diet.
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A child who limps and has pain has been found to have Legg-Calvé-Perthes disease. What should the nurse expect to include in the child's plan of care?
- A. Initiation of pain control measures, especially at night when acute.
- B. Promotion of ambulation despite child's discomfort in the affected hip.
- C. Prevention of flexion in the affected hip and knee.
- D. Advance of weight bearing on the head of the affected femur.
Correct Answer: A
Rationale: Pain control is essential in Legg-Calvé-Perthes disease, as pain is a common symptom, especially at night, due to inflammation and muscle spasms.
An adolescent complains of chest pain and goes to the school nurse. The nurse determines that the teenager has a history of asthma but has had no problems for years. Which of the following should the nurse do next?
- A. Call the adolescent's parent.
- B. Have the adolescent lie down for 30 minutes.
- C. Obtain a peak flow reading.
- D. Give two puffs of a short-acting bronchodilator.
Correct Answer: C
Rationale: Obtaining a peak flow reading is the next step to objectively assess the adolescent's respiratory status, given the history of asthma and new chest pain, which could indicate an asthma exacerbation.
After teaching the parents of a child newly diagnosed with leukemia about the disease, which of the following descriptions given by the mother best indicates that she understands the nature of leukemia?
- A. The disease is an infection resulting in increased white blood cell production.
- B. The disease is a type of cancer caused by an increase in immature white blood cells.
- C. The disease is an inflammation associated with enlargement of the lymph nodes.
- D. The disease is an allergic disorder involving increased circulating antibodies in the blood.
Correct Answer: B
Rationale: Leukemia is a cancer characterized by excessive immature white blood cells. Other descriptions are incorrect.
A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We don't want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best?
- A. I sympathize with your difficulties
- B. but just ignore the behavior for now.
- C. I understand it's hard to discipline a child who is ill
- D. but things need to be kept as normal as possible.
- E. I understand that things are difficult for you right now
- F. but your child is ill and deserves special treatment.
- G. I understand your concern
Correct Answer: B
Rationale: Maintaining routines is essential.
Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin (Lanoxin) should include which of the following?
- A. Give the medication at regular intervals.
- B. Mix the medication with a small volume of breast milk or formula.
- C. Repeat the dose one time if the child vomits immediately after administration.
- D. Notify the primary care provider of poor feeding or vomiting.
- E. Make up any missed doses as soon as realized.
- F. Notify the primary care provider if more than 2 consecutive doses are missed.
- G. Keep medication in a safe place, preferably a locked cabinet.
Correct Answer: A,C,D,F,G
Rationale: Digoxin requires regular dosing, safe storage, and monitoring for side effects like vomiting or poor feeding. Vomiting doses should not be repeated due to toxicity risks, and missed doses should not be made up.