Which assessment finding in an infant with colic should the nurse prioritize?
- A. Frequent spitting up.
- B. Crying for 3 hours daily.
- C. Weight gain below average.
- D. Fever of 100.4°F.
Correct Answer: D
Rationale: Fever suggests an underlying illness, requiring urgent evaluation. Prolonged crying is typical of colic, but spitting up and slow weight gain are less acute concerns.
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The parents of a 12-year-old girl ask why their non-sexually active daughter should receive the human papillomavirus (HPV) vaccine. The nurse should tell the parents:
- A. The vaccine is most effective against cervical cancer if given before becoming sexually active.
- B. Parents are never sure when their child might become sexually active.
- C. HPV is most common in teens and women in their late twenties.
- D. If your daughter is sexually assaulted, she may be exposed to HPV.
Correct Answer: A
Rationale: The HPV vaccine is most effective when given before potential exposure to the virus.
The stool culture of a child with profuse diarrhea reveals Salmonella bacilli. After teaching the mother about Salmonella, which of the following statements by the mother indicates effective teaching?
- A. Some people become carriers and stay infectious for a long time.
- B. After the acute stage passes, the organism is usually not present in the stool.
- C. Although the organism may be alive indefinitely, in time it will be of no danger to anyone.
- D. If my child continues to have the organism in the stool, an antitoxin can help destroy the organism.
Correct Answer: A
Rationale: Salmonella can lead to a carrier state with prolonged infectiousness.
A 10-year-old with scoliosis has to wear a brace. The nurse should develop a teaching plan with the client to include which of the following instructions?
- A. Wear the brace during waking hours.
- B. Wear the brace only during sleep.
- C. Wear a form-fitting, sleeveless T-shirt under the brace.
- D. Bathe the skin under the brace once per week.
Correct Answer: A,C
Rationale: The brace should be worn during waking hours for maximum effectiveness, and a form-fitting T-shirt helps protect the skin and improve comfort.
When preparing the teaching plan for the mother of a child with asthma, which of the following should the nurse include as signs to alert the mother that her child is having an asthma attack?
- A. Secretion of thin, copious mucus.
- B. Tight, productive cough.
- C. Wheezing on expiration.
- D. Temperature of 99.4°F (37.4°C).
Correct Answer: C
Rationale: Wheezing on expiration is a hallmark sign of an asthma attack, indicating airway narrowing. The mother should be taught to recognize this to initiate prompt treatment.
A mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following?
- A. Little is known about iron deficiency anemia and its relationship to infection.
- B. Children with iron deficiency anemia are more susceptible to infection than are other children.
- C. Children with iron deficiency anemia are less susceptible to infection than are other children.
- D. Children with iron deficiency anemia are equally as susceptible to infection as are other children.
Correct Answer: B
Rationale: Iron deficiency impairs immune function, increasing infection susceptibility. This is well-documented in pediatric care.
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