Nokea
Why is it recommended that closure of the palate should be done before the age of 2 for an 11-month-old infant with a cleft palate?
- A. "After the age of 2, surgery becomes frightening and should be avoided if possible."
- B. "The eruption of the 2-year molars often complicates the surgical procedure."
- C. "As your child grows older, the palate widens, making repair more challenging."
- D. "Surgery should be performed before your child begins to use faulty speech patterns."
Correct Answer: D
Rationale: It is recommended to perform palate closure surgery before the child starts using faulty speech patterns to prevent the development of speech issues that may be harder to correct later. Delaying surgery until after the age of 2 can lead to the child forming incorrect speech habits, which can be challenging to correct. Choices A, B, and C are incorrect because they do not address the specific concern related to speech development in children with cleft palates.
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A nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit for it to be most productive?
- A. When the husband is out of the home.
- B. At a time when the mother is feeding the infant.
- C. At a time that is convenient for the family.
- D. When the nurse can spend time with the family.
Correct Answer: C
Rationale: Scheduling the visit at a time that is convenient for the family is the most appropriate choice. This ensures that the family is receptive and available, making the visit more productive. Choice A is incorrect because the presence of the husband may be important for support and decision-making. Choice B focuses solely on the mother and the infant's feeding time, which may not align with the family's overall availability. Choice D is incorrect as it emphasizes the nurse's convenience rather than the family's, which may not lead to an effective visit.
A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?
- A. Avoid triggers that cause flare-ups
- B. Apply topical corticosteroids as prescribed
- C. Use a soft toothbrush for oral care
- D. Avoid contact with sick individuals
Correct Answer: B
Rationale: The correct answer is to apply topical corticosteroids as prescribed. Atopic dermatitis is a chronic inflammatory skin condition that can be managed with topical corticosteroids to reduce inflammation and itching. While avoiding triggers that cause flare-ups is important in managing atopic dermatitis, the primary treatment approach involves using prescribed medications like corticosteroids. Using a soft toothbrush for oral care and avoiding contact with sick individuals are not directly related to managing atopic dermatitis and are not the priority discharge teachings in this case.
You are called to a residence for a 'sick' 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of
- A. 100% oxygen via a non-rebreathing mask and rapid transport
- B. positive pressure ventilations with a BVM device and rapid transport
- C. chest compressions, artificial ventilations, and rapid transport
- D. back blows and chest thrusts while attempting artificial ventilations
Correct Answer: C
Rationale: In a 5-year-old child who is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min, the priority is to initiate chest compressions, artificial ventilations, and rapid transport. These vital interventions are crucial in cases of severe respiratory and cardiovascular compromise. Choice A is incorrect because administering 100% oxygen alone may not address the underlying issues of inadequate ventilation and circulatory support. Choice B is not the most appropriate initial intervention in this scenario; chest compressions should precede positive pressure ventilations. Choice D is incorrect as back blows and chest thrusts are indicated in choking emergencies, not in this case of respiratory and cardiovascular compromise.
You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation?
- A. Inform the parents of your suspicions.
- B. Call the police so the parents can be arrested.
- C. Advise the parents that the child needs to be transported.
- D. Transport the child to the hospital regardless of the parents' wishes.
Correct Answer: C
Rationale: In cases where child abuse is suspected, it is crucial to prioritize the safety and well-being of the child. Advising the parents that the child needs to be transported allows for the child to receive necessary medical care without immediate confrontation. Calling the police to have the parents arrested (Choice B) may escalate the situation and should only be done after ensuring the child's safety. Informing the parents of suspicions (Choice A) may potentially place the child at further risk if the parents are the abusers. Transporting the child to the hospital regardless of the parents' wishes (Choice D) could lead to legal and ethical complications; it is important to involve the appropriate authorities and handle the situation with sensitivity and care.
The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct Answer: B
Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. The decreased aldosterone results in impaired sodium reabsorption and potassium excretion, leading to hyperkalemia. Hypernatremia (Choice A) is unlikely because sodium reabsorption is impaired. Hyperglycemia (Choice C) is not a typical lab finding in Addison's disease. Hypercalcemia (Choice D) is not associated with Addison's disease; rather, it can be seen in conditions like hyperparathyroidism.