Nokea
You are meeting parents of a 1.5-year-old boy who has suboptimal growth. He has been delivered prematurely at the gestational age of 32 weeks. Examination reveals a healthy child with growth parameters below normal for age. You reassure the parents that their child will catch his normal growth with time. Of the following, the growth parameter that should be corrected at this age is
- A. weight
- B. height
- C. body mass index
- D. head circumference
Correct Answer: A
Rationale: Premature infants often experience suboptimal weight gain initially due to their early birth. However, they tend to 'catch up' in weight over time as they mature, making weight the most relevant parameter to correct.
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Lily , age 5, with an intelligence quotient of 65 is admitted to the hospital for evaluation. When planning care, the nurse should keep in mind that this child is:
- A. Within the lower range of normal intelligence
- B. Mildly retarded but educable
- C. Moderately retarded but trainable
- D. Completely dependent on others for care
Correct Answer: C
Rationale: Lily, with an intelligence quotient of 65, falls into the category of moderate intellectual disability, which typically ranges from IQ 35-49 to 50-69. Children with moderate intellectual disability have limitations in intellectual functioning that result in difficulties with adaptive behaviors, learning, and social skills. They can benefit from training, therapies, and educational interventions to improve their functional abilities and quality of life. While they may require support and supervision in various aspects of daily living, they are not completely dependent on others for care like individuals with severe or profound intellectual disability. Therefore, the nurse should consider Lily as moderately retarded but trainable when planning care for her in the hospital.
What is the best initial action for the nurse to take?
- A. Try to have the client breathe slower or
- B. Give O2 via nasal cannula into the paper bag
- C. Administer sodium bicarbonate
- D. Monitor the client's fluid balance
Correct Answer: A
Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.
When a patient participates in a research study, the pediatric nurse's primary concern is to ensure that the:
- A. parent or guardian has given verbal consent for the patient's participation.
- B. quality of care that the patient receives will not be affected if the patient chooses to withdraw from the study.
- C. research meets the developmental needs of the patient.
- D. research will directly benefit the patient.
Correct Answer: B
Rationale: Ensuring that the quality of care remains unaffected regardless of the patient's participation status is paramount to ethical research practices.
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: Widening pulse pressure is indicative of increasing intracranial pressure (ICP) and must be reported immediately. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. An increasing pulse pressure can suggest a rise in ICP due to factors like cerebral edema or hemorrhage. This change indicates increased pressure exerted on blood vessels within the brain, potentially leading to serious consequences like brain herniation. Thus, recognizing and promptly reporting a widening pulse pressure is crucial to prevent further complications and enable appropriate interventions for the patient.
A 10-month-old child can do all the following EXCEPT
- A. says mama or dada
- B. follows one-step command without gesture
- C. points to objects or real first word
- D. speaks inhibition word 'no'
Correct Answer: D
Rationale: Speaking inhibition words like 'no' typically occurs later.