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Which intervention is best to prevent complications associated with traction and immobility?
- A. Offer the child fluids on a frequent basis.
- B. Assist the child to select low-fiber foods.
- C. Assist the child to select low-fiber foods daily.
- D. Reposition the child onto the side every 2 hours.
Correct Answer: A
Rationale: Frequent fluid intake prevents urinary stasis and constipation, common complications of immobility in traction, supporting hydration and kidney function.
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The nurse is concerned that a newborn may have congenital hydrocephalus. Which finding did the nurse likely observe on assessment?
- A. Bulging anterior fontanel
- B. Head and chest circumference equal
- C. A narrowed posterior fontanel
- D. Low-set ears
Correct Answer: A
Rationale: A bulging anterior fontanel suggests hydrocephalus due to increased intracranial pressure. Equal head/chest circumferences narrow posterior fontanel and low-set ears are normal or unrelated.
The parents of the child with juvenile rheumatoid arthritis (JRA) ask the nurse why the child cannot have aspirin. The parents further explain that they have heard that aspirin is used in the elderly for arthritis and the use of the patients. The nurse correctly explains that children with JRA are given different medications than adults with arthritis and explains that the toxic effects of aspirin include which manifestations?
- A. Constipation, weight gain, and fluid retention
- B. Ringing in the ears, nausea, and vomiting
- C. Anorexia, weight loss, and double vision
- D. Headache, dry mouth, and dental cavities
Correct Answer: B
Rationale: Aspirin in children can cause toxicity, including ringing in the ears (tinnitus), nausea, and vomiting, and is avoided due to the risk of Reye's syndrome, especially in children with viral infections.
18 years old P1 presents in outpatient department ten days after delivery with tender hot painful swelling in right breast. She also complains of fever with rigors. What will be the most likely management:
- A. Antibiotics.
- B. Analgesics.
- C. Incision & drainage.
- D. Conservative management.
- E. Lactation inhibition.
Correct Answer: C
Rationale: The symptoms suggest a breast abscess which requires incision and drainage for effective treatment especially with systemic symptoms like fever. Antibiotics alone are insufficient for an abscess and other options are inappropriate.
The nurse reviews the labor and delivery record of the 2-hour-old male newborn and sees this notation: “40 weeks’ gestation,large for gestational (LGA) age.” In response to this information it is most important for the nurse to plan to assess the infant carefully for which condition?
- A. Acrocyanosis
- B. Undescended testicles
- C. Intact clavicles
- D. Hypothermia
Correct Answer: C
Rationale: LGA infants risk birth trauma like fractured clavicles due to macrosomia. Acrocyanosis is normal testicles are typically descended at term and LGA infants are less prone to hypothermia.
Of the following methods,the safest,most precise and simplest for placental localization is:
- A. Auscultation.
- B. Ultrasonography.
- C. Radioisotope study.
- D. Abdominal palpation.
- E. Soft tissue radiography.
Correct Answer: B
Rationale: Ultrasonography is the safest most precise and simplest method for placental localization offering real-time imaging without radiation. Other methods are less accurate or involve risks.