Nokea
Which is an important nursing consideration when suctioning a young child who has had heart surgery?
- A. Perform suctioning at least every hour.
- B. Suction for no longer than 30 seconds at a time.
- C. Administer supplemental oxygen before and after suctioning.
- D. Expect symptoms of respiratory distress when suctioning.
Correct Answer: C
Rationale: If suctioning is indicated, supplemental oxygen is administered with a manual resuscitation bag before and after the procedure to prevent hypoxia. Suctioning should be done only as indicated, not on a routine basis. The child should be suctioned for no more than 5 seconds at one time. Symptoms of respiratory distress are avoided by using appropriate technique.
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The differential in a 5-year old with a 2-week history of painful joints is all the following except:
- A. Viral polyarthritis
- B. Rheumatoid arthritis
- C. Lyme disease
- D. Rheumatic fever
Correct Answer: B
Rationale: rheumatoid arthritis is rare in a 5-year-old with a 2-week history of joint pain. The other options (a-d) are more likely differentials.
Paediatric HIV infection:
- A. Is similar to adult HIV infection except for the mode of transmission
- B. Antenatal screening of pregnant women is not of proven benefit
- C. Developmental delay is a recognised presentation
- D. In an infant, the diagnosis is established first before any management steps are undertaken
Correct Answer: C
Rationale: Developmental delay is a recognized presentation of paediatric HIV infection, reflecting the impact of the virus on the developing nervous system.
Toddler's diarrhoea is characterised by:
- A. Onset over 18 months
- B. Failure to thrive
- C. Excessive consumption of cow's milk
- D. Undigested food particles in the stool
Correct Answer: D
Rationale: The correct answer is D because undigested food particles in the stool are a hallmark of toddler's diarrhoea. The other options (a, b, c, e) are less specific.
Benign Rolandic seizures:
- A. Usually occurs at night
- B. Are difficult to control with drugs
- C. Centrotemporal spikes in EEG are a recognised feature
- D. Are more common than petit mal
Correct Answer: C
Rationale: Centrotemporal spikes on EEG are a hallmark feature of benign Rolandic epilepsy, a common childhood epilepsy syndrome.
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
- A. “I should avoid tub baths but may shower.â€
- B. “I have to stay on strict bed rest for 3 days.â€
- C. “I should remove the pressure dressing the day after the procedure.â€
- D. “I may attend school but should avoid exercise for several days.â€
Correct Answer: B
Rationale: The child does not need to be on strict bed rest for 3 days. Showers are recommended; children should avoid a tub bath. The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean. Strenuous activity must be avoided for several days, but the child can return to school.