UPDATE FINAL
A nurse is reinforcing home safety instructions with the parents of a toddler.
Which of the following parent statements indicates an understanding of the
teaching? - ---✔✔✔ANSWER----"We will turn the pot handles toward the
back of the stove."
The nurse should instruct the parents to turn pot handles toward the back of the
stove to prevent the toddler from pulling a pot off the stove, resulting in a burn.
A nurse is caring for an adolescent client who is a practicing Jehovah's Witness
and is scheduled for surgery for a ruptured appendix. The adolescent tells the
nurse that based on her religious beliefs, she cannot receive a blood transfusion.
Which of the following responses should the nurse make? - ---
✔✔✔ANSWER----"Let's discuss the possibility of you needing a blood
transfusion with your parents."
The nurse should offer to involve the child's parents to understand the family's
beliefs about blood transfusions.
,A nurse is reviewing the laboratory report of a preschooler. Which of the following
laboratory results should the nurse report to the provider? - ---
✔✔✔ANSWER----Lead 14 mcg/dL
This lead level is above the expected reference range for a preschooler. Therefore,
the nurse should report this result to the provider.
A nurse is collecting data from a 12-month-old infant during a well-child visit. The
nurse should identify which of the following findings as a deviation from expected
growth and development? - ---✔✔✔ANSWER----Birth weight doubled
The nurse should identify this finding as a deviation from expected growth and
development. The infant's birth weight should triple by 12 months of age.
Therefore, the nurse should report this finding to the provider.
A nurse is reinforcing discharge teaching with the guardian of a school-age child
who has acute lymphocytic leukemia and an absolute neutrophil count of
450/mm3. Which of the following instructions should the nurse include? - ---
✔✔✔ANSWER----"Keep your child away from crowded areas."
The nurse should instruct the guardian to keep the child away from crowds and
visitors who have an illness to decrease the risk for infection.
A nurse in a clinic is collecting data from an adolescent who has received all
recommended immunizations through the age of 6 years. Which of the following
immunizations should the nurse plan to administer? - ---✔✔✔ANSWER----
Tetanus, diphtheria toxoids, and acellular pertussis (Tdap)
, The Tdap vaccine is recommended between the ages of 11 and 12 years.
Therefore, this adolescent should receive the Tdap vaccine now.
A nurse is reinforcing teaching with the parent of a child who has a new
prescription for ferrous sulfate. The nurse should reinforce that the parent should
administer the medication with which of the following fluids to enhance the
medication absorption? - ---✔✔✔ANSWER----Orange juice
The nurse should reinforce with the parent that administering ferrous sulfate with
orange juice will enhance medication absorption.
A nurse in a pediatric clinic is observing for an anaphylactic reaction after
administering an IM antibiotic to a child 5 min ago. Which of the following
manifestations should the nurse expect to observe first? - ---
✔✔✔ANSWER----Hives
The nurse should observe for hives first because this is an early manifestation of
an anaphylactic reaction.
A nurse is reinforcing dietary teaching about a low-sodium diet with the parents of
a child who is recovering from acute glomerulonephritis. Which of the following
food choices by the parents indicates an understanding of the teaching? - ---
✔✔✔ANSWER----Apples
The nurse should instruct the parents that apples are low in sodium and supply
the child with energy needed for recovery.