Nokea
Which of the following statements by the mother of an 18-month-old child should indicate to the nurse that the child needs laboratory testing for lead levels?
- A. My child does not always wash after playing outside.
- B. My child drinks 2 cups of milk every day.
- C. My child has more temper tantrums than other kids.
- D. My child is smaller than other kids of the same age.
Correct Answer: A
Rationale: Not washing after outdoor play increases lead exposure risk from contaminated soil or dust, warranting testing. Milk intake, tantrums, and size are not specific indicators.
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Which one of the following children is at most risk for sudden infant death syndrome (SIDS)?
- A. Infant who is 3 months old.
- B. 2-year-old who has apnea lasting up to 5 seconds.
- C. First-born child whose parents are in their 40s.
- D. 6-month-old who has had two bouts of pneumonia.
Correct Answer: A
Rationale: A 3-month-old infant is at the highest risk for SIDS, as the peak incidence occurs between 2 and 4 months of age.
The nurse is administering gastrostomy feedings to an infant after surgery to correct a tracheoesophageal fistula (TEF). To prevent air from entering the stomach once the syringe barrel is attached to the gastrostomy tube the nurse should:
- A. Unclamp the tube after pouring the complete amount of formula to be administered into the syringe barrel.
- B. Pour all of the formula to be administered into the syringe barrel after opening the clamp.
- C. Maintain a continuous flow of formula down the side of the syringe barrel once the clamp is opened.
- D. Move small amount of formula to enter the stomach before pouring more formula into the syringe barrel.
Correct Answer: D
Rationale: Allowing small amounts of formula to enter before adding more prevents air from being trapped in the tube.
The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and its management. Which of the following statements by the mother indicates successful teaching?
- A. My son will probably be unable to walk independently by the time he is 9 to 11 years old.'
- B. Muscle relaxants are effective for some children; I hope they can help my son.'
- C. When my son is a little older, he can have surgery to improve his ability to walk.'
- D. I need to help my son be as active as possible to prevent progression of the disease.'
Correct Answer: A
Rationale: Children with Duchenne's muscular dystrophy typically lose the ability to walk independently by ages 9 to 11 due to progressive muscle weakness.
While preparing to examine a 6-week-old infant's scrotal sac and testes for possible undescended testes, which of the following would be most important for the nurse to do?
- A. Check the diaper for recent urination.
- B. Give the infant a pacifier.
- C. Ensure that the room is kept warm.
- D. Tap lightly on the left inguinal ring.
Correct Answer: C
Rationale: Ensuring the room is warm helps relax the cremaster muscle, facilitating examination.
The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, 'I hate you.' Which of the following would be most appropriate:
- A. Tell the parents they will need to wait out in the lobby.
- B. Ask the charge nurse to assign this client to another nurse.
- C. Reassure the parents that this is a normal behavior under the circumstances.
- D. Ask the parents to discipline the child so that the physician can treat her.
Correct Answer: C
Rationale: Such behavior is a normal stress response in a young child experiencing pain and fear in an emergency setting.