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Which dietary recommendation should the nurse include for a child with lead poisoning to enhance lead excretion?
- A. High-protein diet.
- B. Calcium-rich diet.
- C. Low-fat diet.
- D. High-fiber diet.
Correct Answer: B
Rationale: Calcium-rich foods reduce lead absorption by competing for intestinal binding sites. Protein, fat, or fiber diets have less direct impact on lead excretion.
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Which sign should lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?
- A. Hemorrhagic skin rash.
- B. Edema.
- C. Cyanosis.
- D. Dyspnea on exertion.
Correct Answer: A
Rationale: A hemorrhagic rash, such as petechiae or purpura, is a hallmark of disseminated intravascular coagulation in meningitis, indicating clotting abnormalities.
The mother of a child with chronic renal failure who is receiving peritoneal dialysis at home asks the nurse what she can do if both inflow and drain times are increased. Which of the following instructions would be most appropriate for the nurse to include when responding to the mother?
- A. Assess the child for constipation.
- B. Decrease the amount of dialysate infused for each dwell.
- C. Incorporate the increased inflow and drain times into the dialysis schedule.
- D. Monitor the child for shoulder pain during inflow and drain times.
Correct Answer: A
Rationale: Constipation can affect dialysis flow.
A 14-year-old is using glargine (Lantus) and lispro (Humolog) to manage type I diabetes. The order for sliding scale lispro reads: Lispro subcutaneous give units according to sliding scale: Blood glucose: 70-150 mg/dL = 0 units, 151-200 mg/dL = 1 unit, 201-250 mg/dL = 2 units, 251-300 mg/dL = 3 units, 301-350 mg/dL = 4 units, Call for Blood glucose >350. In addition give 1 unit for every 15 grams of carbohydrate. The morning blood glucose is $202 \mathrm{mg} / \mathrm{dL}$ and the client is going to eat 2 carbohydrate exchanges. The nurse has the client administer how many units of lispro?
Correct Answer: 4
Rationale: Blood glucose of 202 mg/dL requires 2 units (sliding scale). Two carbohydrate exchanges (30 g) require 2 units (1 unit/15 g). Total: 2 + 2 = 4 units of lispro.
The nurse judges that the mother understands the term cerebral palsy when she describes it as a term applied to impaired movement resulting from which of the following?
- A. Injury to the cerebrum caused by viral infection.
- B. Malformed blood vessels in the ventricles caused by inheritance.
- C. Nonprogressive brain damage caused by injury.
- D. Inflammatory brain disease caused by metabolic imbalances.
Correct Answer: C
Rationale: Cerebral palsy is characterized by nonprogressive brain damage from injury, often occurring before, during, or shortly after birth, leading to impaired movement.
An adolescent complains of chest pain and goes to the school nurse. The nurse determines that the teenager has a history of asthma but has had no problems for years. Which of the following should the nurse do next?
- A. Call the adolescent's parent.
- B. Have the adolescent lie down for 30 minutes.
- C. Obtain a peak flow reading.
- D. Give two puffs of a short-acting bronchodilator.
Correct Answer: C
Rationale: Obtaining a peak flow reading is the next step to objectively assess the adolescent's respiratory status, given the history of asthma and new chest pain, which could indicate an asthma exacerbation.