Nokea
When teaching the parents of an infant how to perform back slaps to dislodge a foreign body, which of the following should the nurse tell the parents to use to deliver the blows?
- A. Palm of the hand.
- B. Heel of the hand.
- C. Fingertips.
- D. Entire hand.
Correct Answer: B
Rationale: The heel of the hand is used to deliver back slaps in infants to effectively dislodge a foreign body without causing injury.
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Assessment of a school-age child with Guillain-Barré syndrome reveals absent gag and cough reflexes. Which of the following nursing diagnoses should receive the highest priority during the acute phase?
- A. Risk for infection due to altered immune system.
- B. Ineffective breathing pattern related to neuromuscular impairment.
- C. Impaired swallowing related to neuromuscular impairment.
- D. Total urinary incontinence related to fluid losses.
Correct Answer: B
Rationale: Absent gag and cough reflexes increase the risk of respiratory compromise, making ineffective breathing pattern the highest priority.
When explaining to the parents of a child with a hydrocele about the possible cause of the condition, the nurse bases this explanation on the interpretation that a hydrocele is most likely the result of which condition?
- A. Blockage in the inguinal canal that allows fluid to accumulate in epididymis and ductus deferens.
- B. Failure of the upper part of the processus vaginalis to atrophy, allowing accumulation of fluid in the testicle and the peritoneal cavity.
- C. A patent processus vaginalis that results in the collection of fluid along the spermatic cord or tunica vaginalis of the testicle.
- D. An obliterated processus vaginalis that allows fluid to accumulate in the scrotal sac.
Correct Answer: C
Rationale: Patent processus vaginalis leads to fluid collection.
The parent of a child with spastic cerebral palsy and a communication disorder tells the nurse, 'He seems so restless. I think he is in pain.' The nurse should:
- A. Assess the child for pain using the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.
- B. Assess the child using the pediatric FACES scale.
- C. Administer the pain medication which is ordered to be given as needed and assess the response.
- D. Notify the primary care provider of the change in behavior.
Correct Answer: A
Rationale: The FLACC scale is appropriate for assessing pain in children with communication disorders, as it relies on observable behaviors rather than verbal reports.
The nurse is teaching the parents of a child with sickle cell disease. To instruct them on how to prevent sickle cell crisis, she should include which instruction?
- A. Restrict the child's fluid intake to less than 1 quart per day.
- B. Start up a 1½ quarts of fluids per day.
- C. Stay away from other teenagers.
- D. Avoid physical activity.
Correct Answer: B
Rationale: Adequate hydration (1½ quarts daily) prevents blood viscosity, reducing the risk of sickle cell crisis. Other options are incorrect or overly restrictive.
Twelve hours after cardiac surgery, the nurse is assessing a 3-year-old who weighs 15 kg. The nurse should notify the surgeon about which of the following clinical finding?
- A. A urine output of 60 mL in 4 hours.
Correct Answer: A
Rationale: urine output of 60 mL in 4 hours is adequate (1 mL/kg/hr for a 15-kg child is 15 mL/hr, or 60 mL in 4 hours). No other findings are provided, so no notification is needed.