Nokea
Which playroom activities should the nurse organize for a small group of 7 year-old hospitalized children?
- A. Sports and games with rules
- B. Finger paints and water play
- C. Dress-up clothes and props
- D. Chess and television programs
Correct Answer: A
Rationale: Sports and games with rules. The purpose of play for the 7 year-old is developing cooperation. Rules are very important. Logical reasoning and social skills are developed through play.
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A client is receiving a nitroglycerin infusion for unstable angina. What assessment would be a priority when monitoring the effects of this medication?
- A. Blood pressure
- B. Cardiac enzymes
- C. ECG analysis
- D. Respiratory rate
Correct Answer: A
Rationale: Since an effect of this drug is vasodilation, the client must be monitored for hypotension.
The nurse is caring for a 1 year-old child who has 6 teeth. What is the best way for the nurse to give mouth care to this child?
- A. Using a moist soft brush or cloth to clean teeth and gums
- B. Swabbing teeth and gums with flavored mouthwash
- C. Offering a bottle of water for the child to drink
- D. Brushing with toothpaste and flossing each tooth
Correct Answer: A
Rationale: Using a moist soft brush or cloth to clean teeth and gums. The nurse should use a soft cloth or soft brush to do mouth care so that the child can adjust to the routine of cleaning the mouth and teeth.
According to Erickson's stage of growth and development, the developmental task associated with middle childhood is:
- A. Trust
- B. Initiative
- C. Independence
- D. Industry
Correct Answer: D
Rationale: Middle childhood (ages 6-12) is associated with the developmental task of industry, where children focus on competence and achievement.
The mother of a 10-year-old boy with IDDM (insulin-dependent diabetes mellitus) calls to discuss the child’s self-monitoring blood glucose (SMBG) home readings. He is being tightly regulated with a combination of NPH and regular insulin before breakfast and supper. The past two mornings his blood sugar readings were 220 mg/dL and 210 mg/dL. The nurse should advise the mother to
- A. continue with his medication regime.
- B. check his blood sugar during the night.
- C. give his NPH insulin later in the evening.
- D. serve his bedtime snack earlier in the evening.
Correct Answer: B
Rationale: High morning blood sugars suggest rebound hyperglycemia (Somogyi effect) from nocturnal hypoglycemia, requiring nighttime glucose checks. Options A, C, and D are premature: continuing the regimen ignores the issue, and adjusting insulin or snack timing requires confirmation.
A 3-year-old child who is up to date with all immunizations is seen at clinic. The child has a fever of 102°F and a pruritic rash with fluid-filled vesicles that began on the trunk. The physician says the child has varicella. The child's mother says to the nurse, 'I thought my child couldn't get this because she had all her shots.' What is the best response for the nurse to make?
- A. You child probably did not respond to the vaccine as most children do.
- B. The nurse must not have administered it correctly.
- C. It is still possible to contract the illness, but your child will most likely have a less severe case.
- D. The vaccine is only effective after the child has received two doses.
Correct Answer: C
Rationale: The varicella vaccine reduces severity but does not guarantee immunity; breakthrough cases are milder, as indicated by the child's symptoms.