Nokea
While caring for the small-for-gestational-age newborn (SGA),the nurse notes slight tremors of the extremities a high-pitched cry and an exaggerated Moro reflex. In response to these assessment findings what should be the nurse’s first action?
- A. Assess the infant’s blood sugar level.
- B. Document the findings in the infant’s medical record.
- C. Immediately inform the pediatrician of the symptoms.
- D. Assess the infant’s axillary temperature.
Correct Answer: A
Rationale: SGA infants risk hypoglycemia due to low glycogen stores causing tremors high-pitched cry and exaggerated reflexes. Checking blood sugar is the priority action.
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If the physician orders a magnetic resonance imaging (MRI) study for the child with a brain tumor, which statement by the nurse would best prepare the child for the diagnostic test?
- A. MRI machines differ with some being tunnel-like and others open.
- B. Pain may occur when the dye is injected into the vein.
- C. You'll be given medicine that will make you sleep during the test.
- D. You'll have little electrodes placed on your head with a special gel.
Correct Answer: A
Rationale: Explaining that MRI machines vary (tunnel-like or open) prepares the child for the procedure by addressing potential fears about the machine's appearance, ensuring they know what to expect.
Which statement by the client indicates that teaching has been effective?
- A. My partner should use a condom when lesions are present to prevent transmission.
- B. I should douche after intercourse to prevent becoming infected.
- C. I should apply acyclovir to lesions before intercourse to prevent transmission.
- D. I should avoid sexual contact, especially when lesions or symptoms are present.
Correct Answer: D
Rationale: Avoiding sexual contact when lesions or symptoms are present is the most effective way to prevent herpes transmission, indicating successful teaching.
18 years old P1 presents in outpatient department ten days after delivery with tender hot painful swelling in right breast. She also complains of fever with rigors. What will be the most likely management:
- A. Antibiotics.
- B. Analgesics.
- C. Incision & drainage.
- D. Conservative management.
- E. Lactation inhibition.
Correct Answer: C
Rationale: The symptoms suggest a breast abscess which requires incision and drainage for effective treatment especially with systemic symptoms like fever. Antibiotics alone are insufficient for an abscess and other options are inappropriate.
Which activity is most appropriate for the child with juvenile rheumatoid arthritis?
- A. Skipping rope
- B. Softball
- C. Swimming
- D. Running
Correct Answer: C
Rationale: Swimming is a low-impact activity that promotes joint mobility and muscle strength without stressing inflamed joints, making it ideal for a child with JRA.
Which explanation by the nurse is most accurate?
- A. Your child's condition, which involves a 35-degree curvature, may improve without treatment.
- B. Your child may develop problems with bladder control without treatment.
- C. Your child may develop problems with bowel control without treatment.
- D. Your child may develop breathing problems without treatment.
Correct Answer: D
Rationale: A 35-degree scoliosis curvature is significant and, without treatment, may progress, potentially compressing the lungs and causing breathing difficulties.