Nokea
While the nurse is delivering abdominal thrusts to a 6-year old who is choking on a foreign body, the child begins to cry. Which of the following should the nurse do next?
- A. Tap or gently shake the shoulders.
- B. Deliver back slaps.
- C. Perform a blind finger sweep of the mouth.
- D. Observe the child closely.
Correct Answer: D
Rationale: If the child begins to cry, it indicates the airway is no longer obstructed, as crying requires airflow. The nurse should observe the child closely to ensure stability.
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The mother of a toilet-trained toddler who was admitted to the hospital for severe gastroenteritis and subsequent dehydration and is now at home asks the nurse why the child still wets the bed. Which of the following should be the nurse's best response?
- A. Hospitalization is a traumatic experience for children, regression is common and it takes time for them to return to their former behavior.
- B. The stress of hospitalization is hard for many children, but usually they have no problems when they return home.
- C. After returning home from being hospitalized, children still feel they should be the center of attention.
- D. Children do not feel comfortable in their home surroundings once they return home from being hospitalized.
Correct Answer: A
Rationale: Regression, like bedwetting, is common after hospitalization due to stress.
An adolescent tells the nurse that the area below his knee has been hurting for several weeks. The nurse should obtain history information about participation in which of the following?
- A. Soccer.
- B. Golf.
- C. Diving.
- D. Swimming.
Correct Answer: A
Rationale: Pain below the knee in adolescents is often associated with Osgood-Schlatter disease, which is common in sports like soccer that involve repetitive knee stress.
An overweight adolescent has been diagnosed with type 2 diabetes. To increase the client's self-efficacy to manage their disease, the nurse should:
- A. Provide the client with a written daily food and exercise plan.
- B. Discuss eliminating junk food in the home with the parents.
- C. Arrange for the school nurse to weigh the child weekly.
- D. Utilize a peer with type 2 diabetes to role model lifestyle changes.
Correct Answer: D
Rationale: Peer role modeling enhances self-efficacy by providing relatable examples of successful disease management. Plans, junk food elimination, and weigh-ins are less empowering without peer support.
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.
The nurse is assessing a child with sickle cell disease during a routine clinic visit. Which finding requires immediate follow-up by the nurse?
- A. Pallor of the nail beds and mucous membranes.
- B. A heart rate of 88 beats per minute.
- C. Intact and equal bilateral peripheral pulses.
- D. Normal vision and hearing reported by the parents.
Correct Answer: A
Rationale: Pallor of nail beds and mucous membranes indicates anemia or poor perfusion, a serious concern in sickle cell disease requiring immediate follow-up.