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When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct Answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies.
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As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?
- A. Increased PCO2 and respiratory acidosis
- B. Decreased PCO2 and respiratory alkalosis
- C. Low pH and low PCO2
- D. High pH and high PCO2
Correct Answer: A
Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood.
Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?
- A. Headache, hematuria, and vertigo
- B. Foul-smelling urine, elevated blood pressure (BP), and hematuria
- C. Urgency, dysuria, and fever
- D. Severe flank pain, nausea, and headache
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse provides dietary teaching to the guardian of a school-age child with cystic fibrosis. Which statement should the nurse make?
- A. You should offer your child high-protein meals and snacks throughout the day.
- B. You should decrease your child's dietary fat intake to less than 10% of their caloric intake.
- C. You should restrict your child's calorie intake to 1,200 per day.
- D. You should give your child a multivitamin once weekly.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?
- A. WBC of 3200 units/L
- B. RR of 26 breaths/min
- C. Temp of 38°C
- D. BP of 70/50
Correct Answer: D
Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.
A school nurse is assessing a school-age child’s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child’s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.