Nokea
Which of the following questions should the nurse ask first when obtaining a history from the mother of a 10-year-old child with a fever, complaints of not feeling well, and swelling around the eyes?
- A. Has the child had a sore throat recently?
- B. Is the child playing with friends as usual?
- C. Does the child urinate as much as usual?
- D. Is the urine pale in color?
Correct Answer: A
Rationale: Sore throat could indicate streptococcal infection.
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A child with a lead level of 20 mcg/dL is prescribed oral chelation therapy. The nurse should monitor for which side effect?
- A. Hypertension.
- B. Renal toxicity.
- C. Hypoglycemia.
- D. Seizures.
Correct Answer: B
Rationale: Oral chelators like succimer can cause renal toxicity, requiring monitoring of kidney function. Hypertension, hypoglycemia, and seizures are not common side effects.
A recent history of which of the following should alert the nurse to gather additional information about the possibility of a urinary tract infection in a 2-year-old child who is exhibiting fever and fussiness?
- A. Abdominal pain.
- B. Swollen lymph glands.
- C. Skin rash.
- D. Back pain.
Correct Answer: A
Rationale: Abdominal pain can indicate UTI.
In planning the discharge for a newborn diagnosed with torticollis (wry neck), the nurse should:
- A. Teach the parent the side effects of botulinum toxin (BOTOX).
- B. Coordinate outpatient physical therapy.
- C. Verify the date for corrective surgery.
- D. Demonstrate the use of positioning wedges for sleep.
Correct Answer: B
Rationale: Physical therapy is the most important part of the child's plan of care. Most cases of torticollis respond to gentle stretching exercises, which can be taught to parents and continued at home.
A 7-year-old has had an appendectomy on November 12. He has had pain for the last 24 hours. There is an order to administer Tylenol with Codeine every 3 to 4 hours as needed. The nurse is beginning the shift and reviews the chart below for pain history. Based on the information in the chart, what should the nurse do next?
- A. Administer the Tylenol with Codeine.
- B. Distract the child by giving him breakfast.
- C. Instruct the child to take deep breaths and blow his pain away.
- D. Assess the child again in 1 hour.
Correct Answer: A
Rationale: The FACES score of 4 at 7:00 am indicates pain, and it's been 6 hours since the last dose, warranting medication.
After teaching the parents of an infant with clubfoot about the condition and its management, which of the following statements by a parent indicates a need for additional teaching?
- A. My child will need several casts over a period of weeks to months.'
- B. Surgery may be needed if casting does not fully correct the foot.'
- C. The cast should be kept clean and dry at all times.'
- D. I should adjust the cast if it seems too tight.'
Correct Answer: D
Rationale: Parents should not adjust the cast themselves, as this could disrupt treatment; they should contact a healthcare provider if the cast seems too tight.