Nokea
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.
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When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:
- A. nondisjunction.
- B. X-linked recessive inheritance.
- C. genomic imprinting.
- D. autosomal dominant inheritance.
Correct Answer: A
Rationale: The correct answer is A: nondisjunction. Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division leading to an extra copy of chromosome 21. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. Choices B, C, and D are incorrect. X-linked recessive inheritance refers to genetic disorders carried on the X chromosome, genomic imprinting involves gene expression based on parental origin, and autosomal dominant inheritance relates to disorders caused by a dominant gene on one of the non-sex chromosomes. In the case of trisomy 21, the cause is specifically related to the error in chromosome division, making nondisjunction the most appropriate answer.
A 12-month-old infant has become immunosuppressed during a course of chemotherapy. When preparing the parents for the infant's discharge, what information should the nurse give concerning the measles, mumps, and rubella (MMR) immunization?
- A. It should not be given until the infant reaches 2 years of age.
- B. Infants who are receiving chemotherapy should not be given these vaccines.
- C. It should be given to protect the infant from contracting any of these diseases.
- D. The parents should discuss this with their healthcare provider at the next visit.
Correct Answer: B
Rationale: Live vaccines, like the measles, mumps, and rubella (MMR) vaccine, should not be administered to immunosuppressed infants, such as those undergoing chemotherapy. The weakened immune system of these infants may not be able to handle live vaccines safely, potentially leading to severe complications. Therefore, it is crucial to avoid giving live vaccines like MMR to infants receiving chemotherapy. Choice A is incorrect as delaying the MMR vaccine until the infant reaches 2 years of age is not the main concern in this scenario. Choice C is incorrect because although MMR vaccination is important for disease prevention, it should not be given to immunosuppressed infants. Choice D is incorrect as immediate action is needed to prevent potential harm from live vaccines in immunosuppressed infants.
A child is admitted to the hospital with pneumonia. What is the priority need that must be included in the nursing plan of care for this child?
- A. Rest
- B. Exercise
- C. Nutrition
- D. Elimination
Correct Answer: A
Rationale: The correct answer is A: Rest. When a child is admitted to the hospital with pneumonia, the priority need in the nursing plan of care is to ensure adequate rest. Rest is crucial as it allows the child's body to fight the infection and recover. Choice B, Exercise, would not be appropriate as the child needs rest to conserve energy and promote healing. Choice C, Nutrition, is important for overall health but may not be the immediate priority when the child is acutely ill with pneumonia. Choice D, Elimination, is important but is not the priority need in this scenario compared to ensuring rest to aid recovery from pneumonia.
Which observation made of the exposed abdomen is most indicative of pyloric stenosis?
- A. abdominal rigidity
- B. substernal retraction
- C. palpable olive-like mass
- D. marked distention of lower abdomen
Correct Answer: C
Rationale: The correct answer is C: palpable olive-like mass. In pyloric stenosis, a palpable olive-like mass can often be felt in the abdomen due to the hypertrophied pyloric muscle. This mass is a key characteristic finding in infants with pyloric stenosis. Choice A, abdominal rigidity, is more commonly associated with conditions like peritonitis. Choice B, substernal retraction, is not typically seen in pyloric stenosis but can be a sign of respiratory distress. Choice D, marked distention of the lower abdomen, is not specific to pyloric stenosis and can be present in various abdominal conditions.
What is one of the most important factors that a healthcare professional must consider when parents of a toddler request to be present at a procedure occurring on the hospital unit?
- A. Type of procedure to be performed
- B. Individual assessment of the parents
- C. Whether the toddler wants the parents present
- D. Probable reaction to the toddler's response to pain
Correct Answer: B
Rationale: When parents of a toddler request to be present during a procedure, an individual assessment of the parents is crucial. This assessment helps healthcare professionals understand the parents' ability to cope with the situation, provide support to their child, and ensure a conducive environment for the procedure. Choice A is not as critical because the focus is on the parents' readiness rather than the specific procedure. Choice C, considering the toddler's desire, is important but not as crucial as assessing the parents. Choice D, anticipating the toddler's response to pain, is relevant but secondary to assessing the parents' readiness and support capabilities.