Nokea
Which of the following should the nurse include in the teaching plan for a child with iron deficiency anemia to increase iron absorption?
- A. Administer iron supplements with milk.
- B. Take iron supplements between meals.
- C. Avoid eating green leafy vegetables.
- D. Limit intake of citrus fruits.
Correct Answer: B
Rationale: Taking iron supplements between meals enhances absorption, as food, especially milk, can interfere. Citrus fruits and leafy greens support absorption.
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A child undergoes rehydration therapy after having severe gastroenteritis. After teaching the parents about dietary management, the nurse understands that the teaching plan has been successful when the parents tell the nurse that they will follow which type of diet?
- A. Regular.
- B. Clear liquid.
- C. Full liquid.
- D. Soft.
Correct Answer: D
Rationale: A soft diet is appropriate post-rehydration to ease digestion.
The nurse is planning care with the parents of a child who requires continuous peritoneal dialysis. Which finding should be discussed with the physician?
- A. The family lives a long distance from the medical facility.
- B. The child attends a large public school.
- C. The child reports having a previous surgery for a ruptured appendix.
- D. The family feels the child cannot self-regulate to wake at night and change bags.
Correct Answer: C
Rationale: Previous surgery might impact current care.
The nurse is assessing a neonate with suspected tracheoesophageal fistula. Which of the following findings would be most concerning?
- A. Excessive drooling.
- B. Mild cyanosis during feeding.
- C. Heart rate of 140 bpm.
- D. Temperature of 37°C.
Correct Answer: B
Rationale: Mild cyanosis during feeding indicates potential airway compromise, a critical concern in TEF.
During assessment of an adolescent who has sustained a recent thoracic spinal injury, the nurse auscultates the adolescent's abdomen. The nurse explains to the parents that this is necessary because clients with spinal cord injury often develop which of the following?
- A. Abdominal cramping.
- B. Hyperactive bowel sounds.
- C. Paralytic ileus.
- D. Profuse diarrhea.
Correct Answer: C
Rationale: Paralytic ileus is common in spinal cord injury due to autonomic disruption, necessitating abdominal assessment for bowel sounds.
While assessing a 3-year-old child who has had an injury to the leg, has pain, and refuses to walk, the nurse notes that the child's left thigh is swollen. What should the nurse do next?
- A. Assess the neurologic status of the toes.
- B. Determine the circulatory status of the upper thigh.
- C. Obtain the child's vital signs.
- D. Notify the physician immediately.
Correct Answer: D
Rationale: Swelling, pain, and refusal to walk suggest a serious injury, possibly a fracture, requiring immediate physician notification.