Nokea
Which actions by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings
- B. Conduct routine blood pressure screenings
- C. Refer children with sore throats for throat cultures
- D. Recommend aspirin instead of acetaminophen for minor discomforts
Correct Answer: C
Rationale: The correct answer is C: Refer children with sore throats for throat cultures. This is important in preventing rheumatic fever as it helps identify and treat streptococcal infections promptly, which can lead to rheumatic fever if left untreated. Encouraging routine cholesterol screenings (A) and conducting routine blood pressure screenings (B) are not directly related to preventing rheumatic fever. Recommending aspirin instead of acetaminophen (D) can actually be harmful in children with viral infections, increasing the risk of Reye's syndrome.
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When instructing the parents of a toddler with iron deficiency anemia about the importance of increasing iron in the toddler's diet, which of the following foods should the nurse instruct the parents to include in the toddler's diet?
- A. Pasta
- B. Vitamin D milk
- C. Dried fruits
- D. Green leafy vegetables
Correct Answer: C
Rationale: The correct answer is C: Dried fruits. Dried fruits are a good source of iron, which is essential for treating iron deficiency anemia in toddlers. They provide a concentrated amount of iron in a small serving size, making them convenient for toddlers. Pasta (A) does not contain significant amounts of iron. Vitamin D milk (B) is important for bone health but does not provide a substantial amount of iron. Green leafy vegetables (D) are a good source of iron, but they may be harder for toddlers to eat compared to dried fruits.
When preparing your pediatric patient for his cardiac assessment, which element would you start with for the assessment?
- A. Assess peripheral pulses
- B. Auscultate heart rate and rhythm
- C. Evaluate chest rise
- D. Palpate liver margins
Correct Answer: B
Rationale: The correct answer is B: Auscultate heart rate and rhythm. This is the first step in a pediatric cardiac assessment because it provides crucial information about the heart's function. Listening to the heart helps identify any abnormalities in heart sounds, such as murmurs or irregular rhythms, which can indicate underlying cardiac issues. Assessing peripheral pulses (choice A) may be important but comes after evaluating the heart. Evaluating chest rise (choice C) is important for respiratory assessment, not specifically for cardiac assessment. Palpating liver margins (choice D) is more relevant for assessing hepatomegaly, not typically the initial step in a cardiac assessment.
A nurse is caring for a school-age child who is postoperative and received morphine via IV bolus for pain 10 min ago. Which of the following findings is the nurse's priority?
- A. Constipation
- B. Sedation
- C. Bradypnea
- D. Euphoria
Correct Answer: C
Rationale: The correct answer is C: Bradypnea. This is the priority finding because morphine, an opioid, can cause respiratory depression leading to bradypnea or slow breathing. Monitoring the child's respiratory status is crucial to prevent respiratory compromise or arrest. A: Constipation is a common side effect but not an immediate concern. B: Sedation is expected after receiving morphine but not as critical as respiratory depression. D: Euphoria is a possible side effect but not as concerning as respiratory depression. Thus, the priority is to monitor for signs of respiratory depression to ensure the child's safety.
After receiving a stem cell transplant, the patient develops a rash and diarrhea. This most likely indicates:
- A. Neutropenia
- B. Radiation toxicity
- C. Gastroenteritis
- D. Graft Vs. Host disease
Correct Answer: D
Rationale: The correct answer is D: Graft Vs. Host disease. This occurs when donor immune cells attack the recipient's tissues, leading to symptoms like rash and diarrhea. Neutropenia (A) is low neutrophil count, not typically causing rash and diarrhea. Radiation toxicity (B) would cause different symptoms, not typically rash and diarrhea. Gastroenteritis (C) typically presents with nausea, vomiting, and abdominal pain, not necessarily rash.
Nurses’ Notes
0640:
Weight 4200 gm (9lb 4 oz), head circumference 35.5cm (14 in)
Respiratory rate 68/min, with mild grunting.
0650:
Respiratory rate 72/min, with mild grunting
0700:
Respiratory rate 76/min, with moderate grunting and mild intercostal retractions
A nurse is caring for a newborn. The client is at risk for developing ------- and --------
- A. hypoglycemia
- B. bronchopulmonary dysplasia
- C. transient tachypnea of the newborn
- D. tachycardia
Correct Answer: A,B
Rationale: The correct answer is A and B. Newborns are at risk for hypoglycemia due to immature glycogen stores and increased glucose utilization after birth. Bronchopulmonary dysplasia can occur in premature infants due to prolonged oxygen therapy and lung immaturity. Transient tachypnea of the newborn is a common self-limiting respiratory condition. Tachycardia can be a normal response to various stimuli in newborns. The other choices are not directly related to newborns' risk factors as stated in the question.