When the working mother of a toddler is preparing to take her child home after a prolonged hospitalization, she asks the nurse what type of behavior she should expect to be displayed. What is the nurse's most appropriate description of her child's probable behavior?
- A. Excessively demanding behavior
- B. Hostile attitude toward the mother
- C. Cheerful, with shallow attachment behaviors
- D. Withdrawn, without emotional ties to the mother
Correct Answer: A
Rationale: After a prolonged hospitalization, a toddler may exhibit excessively demanding behavior as they readjust to being home. This behavior can be a result of the child seeking extra attention and reassurance after a stressful experience. Choices B, C, and D are incorrect because hostility, cheerfulness with shallow attachment, and withdrawal without emotional ties are less likely outcomes in this situation and do not align with common reactions of toddlers after hospitalization.
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A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the nurse expect?
- A. Proteinuria
- B. Peripheral edema
- C. Elevated hematocrit
- D. Absence of pedal pulses
Correct Answer: C
Rationale: In a child with a congenital cardiac malformation causing right-to-left shunting of blood, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not a typical clinical finding related to right-to-left shunting. Peripheral edema (Choice B) is more commonly associated with conditions causing volume overload, such as left-sided heart failure. Absence of pedal pulses (Choice D) is not directly related to right-to-left shunting but may be seen in conditions affecting peripheral circulation.
What are general guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion?
- A. Examining the child in the parent's arms
- B. Palpating the painful area of the abdomen first
- C. Placing the child supine and palpating the abdomen
- D. Separating the child from the parent to ensure a reliable examination
Correct Answer: A
Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is important to examine the child in the parent's arms. This approach helps reduce the child's anxiety, provides comfort, and can facilitate a more accurate assessment. Palpating the painful area of the abdomen first (choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent to ensure a reliable examination (choice D) can further increase anxiety and hinder the assessment process. Therefore, examining the child in the parent's arms (choice A) is the most appropriate and effective approach in this scenario.
While performing a visual inspection of a 30-year-old woman in active labor, you can see the umbilical cord at the vaginal opening. After providing high concentration oxygen, you should next
- A. massage the uterus to facilitate delivery of the fetus
- B. relieve pressure from the cord with your gloved fingers
- C. place the mother on her left side and provide rapid transport
- D. elevate the mother's lower extremities and provide immediate transport
Correct Answer: B
Rationale: In the scenario described, when the umbilical cord is visible at the vaginal opening, the priority is to relieve pressure from the cord with gloved fingers. This action helps prevent cord compression and ensures continued oxygenation to the fetus, which is crucial for the baby's well-being. Massaging the uterus or elevating the mother's lower extremities is not the correct course of action in this situation and may potentially worsen the condition. Placing the mother on her left side and providing rapid transport is not the immediate step needed to address the visible umbilical cord; relieving pressure from the cord takes precedence to maintain fetal oxygen supply.
Which nursing intervention provides the most support to the parents of an infant with an obvious physical anomaly?
- A. Encourage them to express their concerns.
- B. Discourage them from talking about their baby.
- C. Assure them not to worry because the anomaly can be repaired.
- D. Show them postoperative photographs of infants who had a similar anomaly.
Correct Answer: A
Rationale: Encouraging parents to express their concerns is the most supportive intervention as it allows them to process their emotions and provides an opportunity for the nurse to offer appropriate support and information. This choice focuses on validating the parents' feelings and creating an open communication channel. Choices B and C are incorrect as they can hinder the parents' emotional processing and may provide false reassurance. Choice D, showing postoperative photographs, may not be appropriate at this stage as it might not address the parents' current emotional needs and could induce anxiety or unrealistic expectations.
When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school's Parent-Teachers Association?
- A. Rubella
- B. Rubeola
- C. Chickenpox
- D. Scarlet fever
Correct Answer: C
Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.