Nokea
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities?
- A. Give large push-pull toys for kinetic stimulation.
- B. Place cradle gym across crib to facilitate fine motor skills.
- C. Provide child with finger paints to enhance fine motor skills.
- D. Provide stick horse to develop gross motor coordination.
Correct Answer: A
Rationale: At 12 months of age, children are generally starting to become more mobile and interested in exploring their surroundings. Large push-pull toys are a great option for encouraging physical activity and helping with gross motor skills development. These toys can help the child practice walking, crawling, and hand-eye coordination. Push-pull toys also provide kinetic stimulation which is important for the child's overall physical development at this age. Other play activities mentioned in the options, such as finger paints or cradle gym, may be suitable for older children as they require more fine motor skills and coordination. Stick horse, on the other hand, is more appropriate for older children who have better developed gross motor coordination.
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The nurse answers a call bell and finds a frightened mother whose child, the patient, is having a seizure. Which of these actions should the nurse take?
- A. The nurse should insert a padded tongue blade in the patient's mouth to prevent the child from swallowing or choking on his tongue.
- B. The nurse should help the mother restrain the child to prevent him from injuring himself.
- C. The nurse should call the operator to page for seizure assistance.
- D. The nurse should clear the area and position the client safely.
Correct Answer: D
Rationale: In this situation, the nurse's priority is to provide a safe environment for the patient during the seizure. Inserting a padded tongue blade (Option A) is not recommended as it can cause more harm than good, such as dental injury. Restraint of the patient (Option B) during a seizure is also not recommended as it can lead to injury. Calling the operator to page for seizure assistance (Option C) may delay immediate intervention. The best course of action is for the nurse to clear the area of any objects that may injure the patient during the seizure and position the client safely. This will help prevent injury and ensure the patient's safety until the seizure subsides.
The patient is dangling at the bedside and states, "Oh, my stomach is tearing open." Which of the following actions should the nurse immediately take when dehiscence occurs?
- A. Have patient sit upright in a chair.
- B. Have patient lie down.
- C. Slow IV fluids.
- D. Obtain a sterile suture set.
Correct Answer: B
Rationale: When dehiscence, which is the separation of the layers of a surgical incision, occurs in a patient, it is important to have the patient lie down. This position will help decrease intra-abdominal pressure and reduce the risk of further complications. Having the patient sit upright in a chair can increase intra-abdominal pressure, worsening the dehiscence. Slowing IV fluids may be necessary to prevent fluid overload in certain situations, but it is not the immediate action required when dehiscence occurs. Obtain a sterile suture set may eventually be needed, but the priority in this situation is to stabilize the patient by having them lie down.
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
- A. Social isolation
- B. Level of stress
- C. Degree of depression
- D. Desire to punish others
Correct Answer: D
Rationale: The most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats is the desire to punish others. Individuals who commit suicide often exhibit behaviors or thought patterns indicating a desire to cause harm or guilt to others. This desire to punish others may drive them to take their own lives as a way to make others feel responsible or suffer the consequences of their actions. On the other hand, individuals who make suicidal attempts or threats may not have the same level of intent to harm others through their actions, and their motivations may stem from different underlying issues such as social isolation, stress, or depression. Therefore, the desire to punish others is a crucial factor that sets those who commit suicide apart from those who make attempts or threats.
The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
- A. It decreases edema.
- B. It decreases cardiac output.
- C. It increases heart size.
- D. It increases venous pressure.
Correct Answer: A
Rationale: Digoxin is a medication commonly used in the treatment of heart failure (HF) because of its positive inotropic effect, which means it strengthens the heart muscle. While digoxin does not directly decrease edema, its ability to increase the strength of the heart muscle allows the heart to pump more effectively. When the heart is pumping blood more efficiently, it can help reduce fluid accumulation in the body, including edema.
Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:
- A. avoidance of eye contact.
- B. an associated malabsorption defect.
- C. weight that falls below the 15th percentile.
- D. normal achievement of developmental landmarks.
Correct Answer: C
Rationale: Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories may include weight that falls below the 15th percentile on growth charts. Weight falling below the 15th percentile may indicate poor nutrition intake leading to inadequate growth and development. Other signs such as avoidance of eye contact, an associated malabsorption defect, and normal achievement of developmental landmarks may not be specific indicators of failure to thrive due to behavioral problems with inadequate calorie intake.