Nokea
Which assessment finding best indicates that a child taking methylphenidate hydrochloride (Ritalin) is experiencing undesirable side effects?
- A. The child has altered elimination patterns.
- B. The child develops intolerance to certain foods.
- C. The child has an elevated blood pressure.
- D. The child has evidence of skin breakdown.
Correct Answer: C
Rationale: Elevated blood pressure is a concerning side effect of Ritalin.
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When caring for a newborn experiencing opioid withdrawal, the nurse frequently puts the baby in the crib when crying.
- A. Reduce environmental stimuli.
- B. Touch the newborn frequently.
- C. Stroke the newborn's skin gently.
- D. Leave the newborn unwrapped.
Correct Answer: A
Rationale: Reducing stimuli helps calm the newborn and manage withdrawal symptoms.
Which statement regarding hospital admittance is most accurate?
- A. The client cannot be committed involuntarily unless the client is uncooperative at this time.
- B. The client cannot be committed involuntarily unless the client poses harm to self or others.
- C. The client cannot be committed involuntarily unless the client cancels office appointments.
- D. The client cannot be committed involuntarily unless the client refuses to take medications.
Correct Answer: B
Rationale: Involuntary commitment requires evidence of harm to self or others.
Which suggestion is most appropriate for the nurse to offer the parents in this situation?
- A. Avoid controlling the child.
- B. Praise accomplishments as deserved.
- C. Avoid discussing peer comments.
- D. Show disapproval of negative labels.
Correct Answer: B
Rationale: Praising accomplishments boosts self-esteem and counters ridicule.
During the initial physical examination, the nurse is most likely to detect which finding related to anorexia?
- A. Growth of fine body hair
- B. Bruises over the upper torso
- C. Hyperactive bowel sounds
- D. Club-shaped fingertips
Correct Answer: A
Rationale: Lanugo (fine body hair) develops in anorexia due to malnutrition.
Which strategy is most appropriate for developing a positive, therapeutic relationship with the injured child at the time of assessment?
- A. The nurse should make an effort to have prolonged eye contact with the child.
- B. The nurse should maintain a body position at the same level as the child.
- C. The nurse should separate the child from the parent during the interview.
- D. The nurse should ask the child direct questions about the parent.
Correct Answer: B
Rationale: A non-threatening posture at the child's level builds trust.