Nokea
Which statement by the parents indicates they understand the home care instructions given by the nurse?
- A. We've made arrangements for a homebound teacher.
- B. We'll use ice packs on our child's joints during episodes of inflammation.
- C. We'll serve meals that prevent excess weight gain.
- D. We'll keep our child in bed most of the time.
Correct Answer: C
Rationale: Maintaining a healthy weight reduces stress on inflamed joints in JRA. Serving meals that prevent excess weight gain shows understanding of home care instructions to support joint health.
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Which nursing action should be avoided when giving care to a child diagnosed with Wilms' tumor?
- A. Palpating the child's abdomen
- B. Collecting a catheterized urine sample
- C. Assessing pupillary reflex with a penlight
- D. Eliciting a patellar reflex with a reflex hammer
Correct Answer: A
Rationale: Palpating the abdomen in a child with Wilms' tumor risks dislodging tumor cells, potentially causing metastasis, and should be avoided to ensure safety.
The postpartum client (G2P2) asks the nurse for suggestions to help facilitate her 3-year-old’s attachment and acceptance of their newborn. Which action should the nurse suggest?
- A. Provide a doll for the 3-year-old to care for and nurture.
- B. Avoid bringing the 3-year-old to the “scary” hospital.
- C. Plan that dad cares for the 3-year-old and mom cares for the baby.
- D. Encourage the child to be “grown up” and accept the newborn.
Correct Answer: A
Rationale: Providing a doll encourages the 3-year-old to mimic parental care reducing jealousy. Hospital visits shared parental attention and accepting regression promote bonding.
For the teenager recovering from an appendectomy, which nursing measure is most appropriate to prevent respiratory complications during the postoperative period?
- A. Administer a bronchodilator by inhalation.
- B. Administer oxygen by nasal cannula.
- C. Give the child a corticosteroid.
- D. Have the child use an incentive spirometer.
Correct Answer: D
Rationale: Using an incentive spirometer encourages deep breathing, preventing atelectasis and pneumonia, common respiratory complications post-surgery due to immobility and anesthesia.
Which nursing action is most appropriate at this time?
- A. Recognize that the fluid is cerebrospinal fluid (CSF) and remove the dressing, observing for the source of the leakage.
- B. Recognize that the fluid is CSF and call the chaplain because death of the child is imminent.
- C. Recognize that the fluid is CSF and notify the operating room because additional surgery will be necessary.
- D. Recognize that the fluid is CSF and reinforce the dressing until the physician can change it.
Correct Answer: D
Rationale: Clear drainage on a head dressing post-craniotomy is likely CSF, indicating a leak. Reinforcing the dressing prevents infection and maintains a sterile barrier until the physician assesses the leak.
A child is prescribed 10 mg/kg of a medication, and the child weighs 15 kg. The medication is available as 50 mg/mL. How many milliliters should the nurse administer?
Correct Answer: 3 mL
Rationale: Calculation: 15 kg × 10 mg/kg = 150 mg. Volume = 150 mg ÷ 50 mg/mL = 3 mL. Since no options are provided, the calculated volume is noted for accuracy.