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When working with a couple at risk of bearing a child with a genetic abnormality, what is most important for the nurse to incorporate into the plan of care?
- A. Gathering information from at least three generations
- B. Informing the couple of the need for a wide range of information
- C. Maintaining the confidentiality of the information
- D. Presenting the information in a nondirective manner
Correct Answer: D
Rationale: When counseling a couple at risk of genetic abnormalities, it is crucial to present information in a nondirective manner. This approach allows the couple to make informed decisions without feeling pressured or influenced. Gathering information from at least three generations (Choice A) may be relevant for genetic counseling but is not the most critical aspect in this scenario. Informing the couple of the need for a wide range of information (Choice B) is too general and does not address the specific approach needed in this situation. Maintaining the confidentiality of the information (Choice C) is important but not the top priority compared to presenting information in a nondirective manner.
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During a primary survey of a child with partial thickness burns over the upper body areas, what action should the nurse take first?
- A. Inspect the child's skin color.
- B. Assess for a patent airway.
- C. Observe for symmetric breathing.
- D. Palpate the child's pulse.
Correct Answer: B
Rationale: The correct answer is B: Assess for a patent airway. When dealing with a child who has sustained partial thickness burns, the priority is ensuring a patent airway due to the risk of respiratory compromise. Checking the child's skin color (choice A) may be important but is secondary to assessing the airway. While observing for symmetric breathing (choice C) is crucial, assessing the airway takes precedence in this situation. Palpating the child's pulse (choice D) is not the initial priority when managing burns and potential airway compromise.
A 10-year-old girl is living with a foster family. Which intervention is the priority for the child in this family structure?
- A. Determining if the child is being bullied at school
- B. Dealing with mixed expectations of parents
- C. Establishing who is the child's actual caretaker
- D. Performing a comprehensive health assessment
Correct Answer: D
Rationale: Performing a comprehensive health assessment is crucial for a child living with a foster family as they may have moved between different homes, leading to incomplete medical records. This assessment helps identify any existing health issues, ensure appropriate care, and address any unmet health needs. While addressing issues like bullying or parental expectations is important, the immediate priority should be ensuring the child's overall health and well-being. Establishing the actual caretaker is also important but may not be as urgent as addressing potential health concerns.
When counseling a couple who suspect they could have a child with a genetic abnormality, what would be most important for the nurse to incorporate into the plan of care when working with this family?
- A. Gathering information from at least three generations
- B. Informing the family of the need for a wide range of information
- C. Maintaining the confidentiality of the information
- D. Presenting the information in a nondirective manner
Correct Answer: D
Rationale: When counseling a couple about the possibility of having a child with a genetic abnormality, it is vital for the nurse to present information in a nondirective manner. This approach empowers the couple to make decisions based on their values and preferences, respecting their autonomy. Gathering information from three generations (Choice A) may not be necessary and might overwhelm the couple with unnecessary data. Informing the family about the need for a wide range of information (Choice B) is not as critical as supporting their decision-making process through a nondirective approach. While maintaining confidentiality (Choice C) is crucial, it is not the most important aspect compared to ensuring the couple can make informed choices that align with their beliefs and wishes.
A group of students is reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state:
- A. Endocrine glands begin developing during gestation.
- B. Endocrine glands are fully functional at birth.
- C. Infants may have difficulty regulating glucose and electrolytes.
- D. A child's endocrine system plays a significant role in growth and development.
Correct Answer: C
Rationale: The correct answer is C. Infants may have difficulty regulating glucose and electrolytes due to their immature endocrine systems. This can lead to issues such as hypoglycemia and electrolyte imbalances. Choice A is incorrect because endocrine glands actually begin developing early in gestation, not just in the third trimester. Choice B is incorrect as endocrine glands are not fully functional at birth; they continue to mature and develop after birth. Choice D is incorrect as a child's endocrine system has a significant impact on growth and development through the secretion of hormones that regulate various processes in the body, but it does not specifically address the difficulty in regulating glucose and electrolytes seen in infants.
A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn't believe me.' Legally, who should the nurse notify?
- A. Police regarding a potential sex crime
- B. Health care provider to confirm the pregnancy
- C. Child Protective Services for immediate intervention
- D. The girl's mother about the positive pregnancy test result
Correct Answer: C
Rationale: In cases of child abuse and ongoing molestation, as described in the scenario, the primary concern is the safety and well-being of the child. Child Protective Services should be notified immediately for intervention to protect the girl and other children in the household from further harm. The police may be involved later to investigate the criminal aspect of the abuse. Notifying the healthcare provider solely to confirm the pregnancy or informing the girl's mother about the positive test result does not address the urgent need for intervention and protection from abuse. Child Protective Services are trained to handle such cases and provide the necessary support and protection for the child and other vulnerable individuals in the family. Immediate action is crucial to ensure the girl's safety and prevent further harm.