Nokea
Which of the following findings would indicate altered mental status in a small child?
- A. Recognizing the parents
- B. Showing fright at the EMT-B's presence
- C. Displaying a lack of attention to the EMT-B's presence
- D. Maintaining consistent eye contact with the EMT-B
Correct Answer: C
Rationale: In a small child, displaying a lack of attention to the EMT-B's presence would indicate altered mental status. This behavior suggests a diminished level of consciousness or awareness, which is concerning. Recognizing the parents (Choice A) is a normal and expected behavior for a child. Showing fright at the EMT-B's presence (Choice B) may indicate fear or anxiety but not necessarily altered mental status. Maintaining consistent eye contact with the EMT-B (Choice D) may indicate engagement or curiosity rather than altered mental status.
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The nurse is teaching the parents of a 1-month-old girl with Down syndrome how to maintain good health for the child. Which instruction would the nurse be least likely to include?
- A. Getting cervical radiographs between 3 and 5 years of age
- B. Adhering to the special dietary needs of the child
- C. Getting an echocardiogram before 3 months of age
- D. Monitoring for symptoms of respiratory infection
Correct Answer: B
Rationale: The correct answer is B. While special dietary needs may be important for a child with Down syndrome, they are typically not the primary concern for a 1-month-old. The nurse would be least likely to focus on this aspect as immediate issues such as monitoring for congenital heart defects (echocardiogram), cervical spine abnormalities (radiographs), and respiratory infections are more critical in the early months. Adhering to dietary needs is important, but it is usually addressed as the child grows older and is not the priority during the infant stage.
A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for
- A. vomiting
- B. seizures
- C. combativeness
- D. respiratory distress
Correct Answer: B
Rationale: Seizures are a common complication in children with high fever and altered mental status, indicating a risk of febrile seizures. While vomiting can occur with altered mental status, seizures are of higher concern due to the association with febrile illnesses in children. Combativeness may be a concern in some altered mental status cases but is not as common as seizures. Respiratory distress, although important, is not the primary concern in this scenario given the symptoms presented.
A nurse is caring for an infant born with exstrophy of the bladder. What does the nurse determine is the greatest risk for this infant?
- A. Infection
- B. Dehydration
- C. Urinary retention
- D. Intestinal obstruction
Correct Answer: A
Rationale: Infection is the greatest risk for an infant with exstrophy of the bladder due to the exposure of the bladder and surrounding tissues. The exposed bladder increases the risk of infection as it lacks the protective covering of the skin. Dehydration (Choice B) may occur but is not the greatest risk compared to infection. Urinary retention (Choice C) is less likely due to the nature of the condition. Intestinal obstruction (Choice D) is not directly associated with exstrophy of the bladder.
A healthcare professional is reviewing the laboratory report of a child with tetralogy of Fallot that indicates an elevated RBC count. What does the professional identify as the cause of the polycythemia?
- A. Low tissue oxygen needs
- B. Tissue oxygen needs
- C. Diminished iron level
- D. Hypertrophic cardiac muscle
Correct Answer: B
Rationale: The correct answer is B: Tissue oxygen needs. Polycythemia occurs as the body's response to chronic hypoxia by increasing RBC production to enhance oxygen delivery. In tetralogy of Fallot, a congenital heart defect, the heart's structure causes reduced oxygen levels in the blood. This chronic hypoxia stimulates the bone marrow to produce more red blood cells, leading to an elevated RBC count. Choice A is incorrect as low blood pressure is not directly related to polycythemia in this context. Choice C, diminished iron level, is not the cause of polycythemia in tetralogy of Fallot. Choice D, hypertrophic cardiac muscle, is not the primary cause of the elevated RBC count in this case.
The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include?
- A. Applying petroleum jelly to the dry skin.
- B. Rubbing the skin vigorously to remove the dead skin.
- C. Soaking the area in warm water every day.
- D. Washing the skin with diluted peroxide and water.
Correct Answer: C
Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the child to soak the area in warm water every day. Soaking the area in warm water helps to gently remove dead skin without causing irritation, facilitating the safe and comfortable removal of the cast. Applying petroleum jelly (Choice A) may not be necessary and could interfere with the cast removal process. Rubbing the skin vigorously (Choice B) can lead to skin damage and should be avoided. Washing the skin with diluted peroxide and water (Choice D) is not recommended as peroxide can be irritating to the skin and may not aid in cast removal.