Nokea
Which of the following measures would be most effective in helping the infant with a cleft lip and palate to retain oral feedings?
- A. Burp the infant at frequent intervals.
- B. Feed the infant small amounts at one time.
- C. Place the end of the nipple far to the back of the infant's tongue.
- D. Maintain the infant in a lying position while feeding.
Correct Answer: B
Rationale: Feeding small amounts at a time reduces the risk of aspiration and helps the infant manage feedings despite the cleft, promoting retention.
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What is the most appropriate method to use when drawing blood from a child with hemophilia?
- A. Use finger punctures for lab draws.
- B. Be prepared to administer platelets for prolonged bleeding.
- C. Apply heat to the extremity before venipunctures.
- D. Schedule all labs to be drawn at one time.
Correct Answer: D
Rationale: Scheduling labs together minimizes venipunctures, reducing bleeding risk in hemophilia. Finger punctures and heat increase bleeding, and platelets are not standard.
The nurse reads the new medications orders for a 4-year-old child with nephrotic syndrome on the chart below: Orders D/C prednisolone 40 mg PO Daily Prednisolone 30 mg PO QOD The nurse should:
- A. Discontinue the prednisolone 40 mg and give the 30 mg dose today.
- B. Check the medication record first to see when the last dose of prednisolone was given.
- C. Start the 30 mg dose tomorrow.
- D. Contact the prescriber for clarification.
Correct Answer: D
Rationale: Clarification ensures correct dosing.
The nurse observes as a child with Duchenne's muscular dystrophy attempts to use from a sitting position on the floor. After attaining a kneeling position, the child 'walks' his hands up his legs to stand. The nurse documents this as which of the following?
- A. Galeazzi's sign.
- B. Goodell's sign.
- C. Goodenough's sign.
- D. Gower's sign.
Correct Answer: D
Rationale: Gower's sign is characteristic of Duchenne's muscular dystrophy, indicating proximal muscle weakness as the child uses their hands to 'walk' up their legs to stand.
Which complication is the nurse most concerned about in an obese child?
- A. Asthma.
- B. Type 2 diabetes.
- C. Seasonal allergies.
- D. Iron deficiency.
Correct Answer: B
Rationale: Obesity increases the risk of type 2 diabetes due to insulin resistance. Asthma and allergies may occur, but diabetes is a more significant concern. Iron deficiency is unrelated.
The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?
- A. Fitting the diaper under the straps.
- B. Leaving the harness off while the infant sleeps.
- C. Checking for skin redness under straps every other day.
- D. Putting powder on the skin under the straps every day.
Correct Answer: A
Rationale: Fitting the diaper under the straps ensures hygiene without disrupting the harness's corrective positioning.