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Which approach would be best to use to ensure a positive response from a toddler?
- A. Assume an eye-level position and talk quietly.
- B. Call the toddler's name while picking him or her up.
- C. Call the toddler's name and say, "I'm your nurse."
- D. Stand by the toddler, addressing him or her by name.
Correct Answer: A
Rationale: The approach that would be best to use to ensure a positive response from a toddler is to assume an eye-level position and talk quietly (Option A). This approach is effective because it demonstrates respect and consideration for the toddler's perspective. By being at the child's eye level, you are showing that you are engaging with them on their level, which can help them feel more comfortable and respected. Additionally, talking quietly can help create a calm and soothing environment, which is often more conducive to getting a positive response from a toddler. This approach shows empathy and understanding towards the toddler's needs and can help in building a positive relationship with them.
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A client is admitted for a spelenectomy. What problem is the nurse aware that could develop?
- A. Infection
- B. Urinary retention
- C. Congestive heart failure
- D. Viral hepatitis
Correct Answer: A
Rationale: Following a splenectomy (spleen removal), patients are at an increased risk of developing infections, particularly those caused by encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. The spleen plays a vital role in the immune system by filtering and clearing bacteria and viruses from the bloodstream. Without a functioning spleen, patients are more vulnerable to bacterial infections. Therefore, the nurse should be aware of the potential for infection and provide appropriate education to the client regarding infection prevention strategies, such as vaccinations and prompt medical treatment for any signs of infection.
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
Airborne isolation is required for a child who is hospitalized with:
- A. mumps.
- B. chickenpox.
- C. exanthema subitum (roseola).
- D. erythema infectiosum (fifth disease).
Correct Answer: B
Rationale: Airborne isolation is needed for a child hospitalized with chickenpox (varicella) because the virus causing chickenpox spreads easily through the air when an infected person coughs or sneezes. The virus can also be transmitted through direct contact with the rash or fluid from the blisters. By implementing airborne precautions, healthcare providers aim to prevent the spread of the virus to other patients, staff, and visitors in the healthcare setting. In contrast, mumps, exanthema subitum (roseola), and erythema infectiosum (fifth disease) are generally not transmitted through airborne routes; therefore, they do not require airborne isolation in a hospital setting.
A 52-year old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- A. Eversion of the right nipple and mobile
- B. Mobile mass that is soft and easily mass delineated
- C. Non-mobile mass with irregular edges
- D. Non palpable right axillary lymph nodes
Correct Answer: C
Rationale: A non-mobile mass with irregular edges is a strong indicator of a cancerous lump in the breast. Cancerous lumps often feel fixed or attached to the surrounding tissue and may have irregular shapes rather than smooth, round contours. The lack of mobility and irregular edges increase suspicion for malignancy and warrant further investigation, such as imaging studies and biopsies. It is important for this patient to follow up with a healthcare provider promptly for further evaluation and appropriate management.
All the following are true about infant sleep between 2-6 months EXCEPT
- A. total sleep hours are about 14-16 hr/24 hr
- B. sleeps about 9-10 hr concentrated at night
- C. sleeps 2 naps/day
- D. the sleep cycle time is similar to that of adults
Correct Answer: D
Rationale: Infant sleep cycles differ significantly from adult patterns.