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Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
- A. Codeine sulfate (Codeine)
- B. Morphine (Roxanol)
- C. Methadone (Dolophine)
- D. Meperidine (Demerol)
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A thorough systemic physical assessment is necessary in the extremely low-birth-weight (ELBW) infant to detect what?
- A. Weight gain reflective of fluid retention
- B. Difficulties in maternal-child attachment
- C. Subtle changes that may be indicative of an underlying problem
- D. Changes in Apgar score over the first 24 hours of life
Correct Answer: C
Rationale: In extremely low-birth-weight (ELBW) infants, a thorough systemic physical assessment is crucial to detect subtle changes that may indicate an underlying problem. These infants are highly vulnerable and may show signs of stress through changes in feeding behavior, activity, color, oxygen saturation, or vital signs. Monitoring weight in ELBW infants primarily reflects genitourinary function rather than fluid retention. Difficulties in maternal-child attachment are important but are usually assessed during parental visits and are not the primary focus of a systemic physical assessment. Changes in the Apgar score are used immediately after birth to assess the transition to extrauterine life and are not as relevant in the following 24 hours to detect ongoing subtle issues.
The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
- A. Lightly brush the palate with a cotton swab
- B. Perform the examination in front of a mirror
- C. Let the child examine someone else's mouth first
- D. All of the above
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?
- A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
- B. Reschedule the treatment for a later time
- C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
- D. Show the respiratory therapist to the playroom
Correct Answer: C
Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.
The parents of a school-age child ask the nurse if she thinks that their child has attention deficit hyperactivity disorder (ADHD). Which statement regarding the child's behavior at school is most indicative of ADHD?
- A. He finishes his work on time in order to go to recess.
- B. He occasionally gets into trouble for talking.
- C. He enjoys math but does not like reading.
- D. He cannot sit still in his seat and constantly moves his legs.
Correct Answer: D
Rationale: The most indicative behavior of ADHD is the inability to sit still and constant movement, known as hyperactivity. This behavior is a hallmark symptom of ADHD, making option D the correct choice. Options A, B, and C do not specifically reflect the characteristic hyperactivity associated with ADHD, making them less indicative of the disorder. While option B suggests impulsivity, it is not as specific to ADHD as the hyperactivity described in option D.
Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?
- A. Palpate another area simultaneously
- B. Ask the child not to laugh or move
- C. Begin with deeper palpation and gradually progress to superficial palpation
- D. Have the child help with palpation by placing his or her hand over the palpating hand
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.