NLOA-LT3Ratio PDF Past Paper

NLOA 1: LT 3 — PEDIATRICS 4. A 7-year-old child has been prescribed penicillin V D.1: Respiratory Disorders [Abang] for streptococcal pharyngitis. Which of the following...

NLOA 1: LT 3 — PEDIATRICS 4. A 7-year-old child has been prescribed penicillin V D.1: Respiratory Disorders [Abang] for streptococcal pharyngitis. Which of the following information should the nurse teach the parents 1. The mother of an 11-month-old remarks to a nurse at regarding the medication? the pediatric clinic, “We are so lucky. Our daughter has never had an ear infection!” Which of the following A. Once the child starts the medication, he will no factors can the nurse tell the mother to have protected longer be contagious her daughter from the disease? Select all that apply B. The child must take all the medication C. The child’s fever may persist until all of the 1. The family owns no pets. medicine has been taken 2. No one in the family smokes. D. If given with food, the medicine will be 3. The mother breastfeeds her daughter. ineffective 4. Child attends day care only two mornings a week. 5. The family lives in the southern part of the country. B. This statement is correct. In order to prevent the child from developing rheumatic fever or acute A. 1,2,3,4,5 glomerulonephritis, he or she must complete the full B. 2,3,4 course of antibiotics. C. 2,3,4,5 D. 1,2,3,4 5. The throat culture of an 8-year-old child grew out 4 B. Cigarette smoke places children at high risk for ear bacteria. The nurse should request the primary infections. Breastfeeding has been shown to have a health-care provider to prescribe an antibiotic for the protective effect on the incidence of ear infections. child to treat which of the following bacteria? Day-care attendance places children at high risk for ear infections. A. Haemophilus influenzae B. Streptococcus pyogenes 2. The mother of a 3-year-old child who has been C. Streptococcus pneumoniae diagnosed with an ear infection states, "I can't D. Mycoplasma pneumoniae understand why you won't give my child antibiotics. Can't you see that she is sick?" Which of the following B. A child would be treated if his or her throat responses by the nurse is appropriate at this time? culture grew out S. pyogenes. A. "I know how you feel, but the best medicine for 6. A child is being sent home after a tonsillectomy. your daughter right now is acetaminophen." Which of the following actions should the nurse B. "Your child will get better on her own in a few educate the parents to perform? days." A. Monitor the child for excessive swallowing. C. "I am also very surprised that the pediatrician B. Place warm compresses around the child's didn't order antibiotics." neck. C. Encourage the child to drink cold D. "It is likely that the ear infection is caused by a citrus juices. D. Position the child supine for virus and antibiotics do not kill the next six hours D. The nurse should provide the patient with a clear A. The parents should be taught to monitor the child rationale for the health-care provider's treatment plan. for excessive swallowing (may indicate bleeding) Letter D is an appropriate statement for the nurse to make. 7. A 10-year-old child who is receiving pre-op teaching from the surgical nurse states, "My friend told me that I 3. A child has had tympanostomy tubes inserted. will be given lots of ice cream right after the surgery. I Before discharging the child from the hospital, which can't wait!" Which of the following responses by the of the following should be included in the nurse's nurse is appropriate? discharge teaching? A. "You are right. You are going to have to come A. Elevate the head of the child's bed 30 degrees to the hospital for surgery, but at least we for the next week. will give you a big treat afterwards." B. Bright-red bleeding may drain from the ears for B. "Your friend is correct that you will be able to the remainder of the day. eat shortly after the surgery. We will let you C. Administer narcotic analgesic every 4 hours for eat ice pops, but no ice cream for a day or the next two days. two." D. Not to allow the child's head to be submerged C. "I'm afraid that your friend wasn't correct. in bath or pool water. We don't want you to eat or drink anything D. The child's head should not be allowed to cold for at least a week." submerge in bath or pool water. D. "I bet your friend watched an old movie  about children having their tonsils out. I'm C. Rotavirus afraid these days we won't let you eat or D. Neisseria meningitidis drink for two whole days." B. H. influenzae type b vaccine prevents upper B. This statement is correct, the child will be given respiratory infections, including bacterial croup. ice pops on the day of surgery, but no ice cream for 11. A newborn baby has been diagnosed with cystic a day or two. fibrosis (CF). Regarding which of the following 8. The parent of an 18-month-old-child calls the characteristics of the disease should the nurse child's primary health-care provider and states, "My forewarn the parents? child coughed all night long. She doesn't seem to A. Chronic conjunctivitis be too sick, and she has no temperature. What can B. Rapid weight gain I do to help her and the rest of us to sleep tonight?" C. Recurrent vomiting Which of the following responses is appropriate for D. Thick respiratory mucus the nurse to make? D. Thick respiratory mucus is seen in children with CF. A. "It often helps to promote sleep by putting a steam vaporizer right next to the head of 12. The parents of a child, who has had multiple the baby's crib." respiratory infections since birth, tell the nurse, "When B. "There are a number of very good we kiss our child, all we can taste is salt." It would be nonprescription cough and cold appropriate for the nurse to suggest to the primary medications at the pharmacy." health-care provider that the child be assessed for C. "You could try raising the head of the baby's which of the following illnesses? crib by putting books under the crib's front feet." A. Cystic fibrosis D. "The baby probably needs antibiotics so let's B. Asthma make an appointment for her this afternoon." C. Bronchitis D. Pharyngitis C. : Raising the head of the bed can be helpful for children who are likely suffering from spasmodic A. There is a high concentration of salt in the sweat of croup. children with CF. 9. A child is seen in the emergency department. D.2: Cardiovascular Disorders [Baguio] The nurse hears a high-pitched squeal every time 1. A 5-year-old with Tetralogy of Fallot experiences a the child inhales. The parent states that the child's sudden onset of cyanosis and labored breathing while fever is very high and, in addition, the child is playing. What should be the nurse’s priority action? gasping for breath and sitting in the tripod position. Which of the following actions would be A. Administer oxygen via mask. appropriate for the nurse to perform at this time? B. Position the child in a knee-chest position. C. Notify the healthcare provider immediately. D. Give A. Provide the child with warm liquids to drink. morphine as prescribed. B. Inspect the throat with a flashlight and B. The knee-chest position increases systemic vascular tongue blade. resistance, reducing the right-to-left blood shunting C. Check the child's vital signs and lung fields. and improving oxygenation during tet spells. Oxygen D. Get immediate medical attention for the and other treatments are secondary interventions child. once the child is in the correct position. Option A: Administering oxygen is important by: batak mag beg (migel `★) & batak mag rugby during cyanosis, but it will not address the (krez ౨ৎ) underlying cause of the cyanotic episode in D. The nurse should obtain immediate medical Tetralogy of Fallot, which is due to a attention for the child right-to-left shunt caused by the structural 10. A nurse is educating a group of parents regarding heart defect. the rationales for the administration of vaccinations. Option C: Notifying the healthcare provider is The nurse should advise the parents that the vaccine important but not the immediate priority that prevents infections from which of the following during an acute cyanotic episode. Immediate diseases has helped to reduce the numbers of children action is needed to improve the child’s diagnosed with bacterial croup? oxygenation and circulation. Option D: Morphine can reduce oxygen demand A. Hepatitis A by calming the child and decreasing B. Haemophilus influenzae type b respiratory effort; however, it is not the first-line  treatment. The priority is to improve blood flow months after IVIG due to interference with and oxygenation by using the knee-chest the immune response. position. Option B: Correct, as continued aspirin therapy is crucial for reducing 2. An 8-month-old infant diagnosed with heart inflammation and preventing coronary failure due to a ventricular septal defect shows artery aneurysms and thrombus formation signs of feeding intolerance and fatigue. What complications. would be the most appropriate nursing Option C: Monitoring the child’s temperature intervention to ensure adequate nutrition? daily is important, especially during the acute phase and after IVIG therapy, to A. Allow unrestricted breastfeeding detect any recurrent fever or B. Provide high-calorie formula and small, complications. frequent feedings C. Restrict fluid intake to lessen cardiac 4. A four-year-old child with a history of rheumatic workload D. Feed the infant in a supine fever is on penicillin prophylaxis. Which statement position from the parents suggests they understand the treatment plan? B. High-calorie formulas provided in small, frequent feedings help infants with heart failure A. “We will give penicillin only if our child has a meet their energy needs without becoming overly sore throat.” fatigued. B. “We will continue penicillin until our child Option A: Unrestricted breastfeeding can turns 21.” lead to fatigue in infants with heart failure C. “We will stop the penicillin if our child no due to a ventricular septal defect, as they longer has symptoms.” tire easily. Smaller, more frequent feedings D. “We’ll give the penicillin orally if we miss an with higher caloric content are preferable injection.” to meet their nutritional needs without overwhelming their energy reserves. B. Long-term penicillin prophylaxis is needed to Option C: Fluid restriction is not typically prevent recurrence of rheumatic fever, often used to manage heart failure in infants extending into adulthood for preventative care unless specifically ordered due to fluid rather than symptom management. overload concerns. The primary goal here is by: batak mag beg (migel `★) & batak mag rugby adequate nutrition. (krez ౨ৎ) Option D: Feeding in a supine position can Option A: Incorrect, as prophylaxis is to prevent increase the risk of aspiration and does not streptococcal infections that could trigger support the infant's heart condition. It is another episode of rheumatic fever, not to better to feed in an upright position to treat an existing / active infection. reduce aspiration risk and aid digestion. Option C: Incorrect, as prophylaxis should be 3. A child with Kawasaki disease is being treated maintained regardless of symptom presence with intravenous immunoglobulin (IVIG) and to prevent future episodes. aspirin. During discharge teaching, which Option D: Incorrect, as switching between oral statement by the parents would require further and injectable forms should only be done clarification? under healthcare provider guidance, as it may impact treatment effectiveness. A. “We will avoid giving live vaccines for 11 months.” B. “We will continue the aspirin 5. A child with coarctation of the aorta is awaiting therapy as prescribed.” surgery. Which preoperative finding should the nurse C. “We will check our child’s temperature daily immediately report to the health care provider? for the next week.” A. Blood pressure in the arms higher than in the D. “We should stop the aspirin once the fever is legs gone.” B. Diminished femoral pulses C. Headache and nosebleeds D. Aspirin therapy continues even after fever resolution to prevent thrombus formation, a D. Sudden severe abdominal pain and distension complication of Kawasaki disease. Parents should D. Acute abdominal pain and distension may indicate understand the importance of adhering to the serious complications, such as mesenteric ischemia, aspirin regimen until discontinued by the requiring urgent intervention. healthcare provider. Option A: Blood pressure differences between Option A: Correct, as live vaccines like MMR arms and legs are common in coarctation of and varicella should be delayed for about 11  the aorta due to reduced blood flow to the Option D: A helmet is not necessary unless lower body. Although significant, this is not an engaging in activities where head immediate emergency. protection is usually advised such as biking Option B: Diminished femoral pulses are or skateboarding. The main precaution is expected with this condition, as the narrowed to avoid direct trauma to the chest area. aorta restricts blood flow to the lower body. This is not an emergency finding. 8. A 10-year-old child with a history of endocarditis presents with fever, fatigue, and petechiae. Which Option C: Headache and nosebleeds can result from upper body hypertension associated with assessment should the nurse prioritize? coarctation. These symptoms should be A. Respiratory rate and oxygen saturation monitored but are not as critical as sudden B. Blood pressure and heart sounds abdominal pain. C. Temperature and capillary refill D. Auscultation of bowel sounds 6. A pediatric patient with heart failure is prescribed digoxin. What is the nurse’s priority before B. The child’s history of endocarditis and administering the medication? symptoms such as fever, fatigue, and petechiae suggest a potential recurrence or worsening heart A. Monitor potassium levels function. Assessing heart sounds for new or B. Measure the child’s apical pulse for a full minute worsening murmurs and monitoring blood C. Monitor for signs of toxicity such as nausea and pressure is crucial to detect signs of heart failure or vomiting shock. D. Record the child’s blood pressure Option A: Although monitoring respiratory B. Digoxin can cause bradycardia, so the apical pulse function is important, the priority is the must be checked before administration. If the pulse is heart and circulatory system as too low, the medication should be withheld. endocarditis primarily affects the heart Option A: Although potassium levels are valves which can lead to heart failure or important due to the risk of digoxin toxicity shock. with hypokalemia, this is not the immediate Option C: Temperature and capillary refill are action before every dose. useful for general assessment but are not Option C: Monitoring for toxicity signs is essential as directly informative for cardiac status. but is not the first action before administering Option D: Bowel sounds are not a priority in each dose; checking the pulse is more urgent. this case as gastrointestinal involvement is Option D: Blood pressure monitoring is not indicated. important in cardiovascular assessment, but digoxin primarily affects heart rate, making 9. A school-age child with a history of aortic apical pulse monitoring the priority. stenosis reports dizziness during exercise. What should the nurse do next? 7. The parents of a 2-year-old with a new pacemaker ask about physical activities. What advice should the A. Document that the child’s exercise tolerance nurse give? is normal B. Examine the surgical scar for signs of A. Your child should avoid all physical activities. infection C. Reassure the child that dizziness is common after surgery B. Your child can participate in typical toddler D. Investigate further, as this may indicate a activities with precautions. serious issue C. Your child should only play indoors to prevent D. Dizziness during exercise in a child with a history damage to the pacemaker. of aortic stenosis could signal a significant D. Your child should wear protective gear like a cardiovascular problem, such as decreased blood helmet during play. flow, arrhythmia, or worsening stenosis. Further B. Children with pacemakers can engage in most evaluation is necessary to determine the cause and age-appropriate activities, but precautions should be prevent possible complications. taken to avoid direct impacts to the chest. It strikes a Option A: Dizziness during exercise is not a balance between safety and normal toddler behavior. sign of normal exercise tolerance in a child Option A: Incorrect, as complete physical with this condition and should not be restriction is unnecessary and could hinder documented as such. physical and social development. Option B: While monitoring for surgical site Option C: Limiting the child to indoor play is infections is important, focusing on the not required. Outdoor activities are surgical scar would overlook the pressing permissible with precautions. cardiovascular concern suggested by the  dizziness. arise post-repair. Option C: Reassuring the child without investigating could result in missing a 12. A newborn with transposition of the great arteries serious complication; dizziness during (TGA) is awaiting surgery. What is the most urgent physical activity warrants further preoperative intervention? evaluation. A. Administer prostaglandin E1 as prescribed B. Track intake and output regularly 10. A 3-year-old child is recovering from patent ductus C. Provide continuous oxygen supplementation D. arteriosus (PDA) closure. Which postoperative Maintain a neutral thermal environment complication should the nurse monitor closely for? A. Administering prostaglandin E1 is essential to A. Pulmonary hypertension maintain ductal patency, allowing for mixing of B. Reduced urine output oxygenated and deoxygenated blood, which improves C. Hypothermia oxygenation until surgery. D. Bradycardia Option B: While monitoring fluid balance is important, it is not the most urgent A. The closure of a PDA can lead to significant intervention compared to ensuring adequate changes in blood flow dynamics, potentially causing oxygenation through ductal patency. increased pressure in the pulmonary arteries. Option C: Oxygen supplementation is helpful, Monitoring for signs of pulmonary hypertension is but the primary issue in TGA is the separation crucial in the postoperative period. of systemic and pulmonary circulation, making Option B: Although monitoring urine output is prostaglandin E1 more critical. important to assess renal function and fluid Option D: Maintaining a neutral thermal status, decreased urine output is not a specific environment is beneficial but less urgent than complication directly related to PDA closure. ensuring blood flow and oxygenation through Option C: Hypothermia may occur due to ductal patency with prostaglandin E1. anesthesia and exposure but is not specifically D.3: Immune Disorders [Abang] associated with PDA closure. Option D: Bradycardia can result from 1. A child has been exposed to a viral illness. The anesthesia or certain medications but is less child's B cells have been activated. The nurse directly related to PDA closure than pulmonary determines that the child's body has undergone hypertension. which of the following physiological responses? 11. A 7-year-old with a repaired atrial septal defect A. Red blood cells have increased in number. (ASD) is being discharged. Which long-term precaution should the nurse mention? B. Platelets are migrating to the respiratory tract. A. Frequent echocardiograms will be needed throughout life. C. Lymphocytes have begun to produce B. Your child no longer needs follow-up care after antibodies recovery. D. Interferon and enzyme production is C. Antibiotics may be required before dental inhibited procedures. D. Physical activities will need to be limited C.: It is correct that lymphocytes have begun to permanently. produce antibodies. C. Antibiotic prophylaxis may be recommended for 2. A 10-month-old infant has been exposed to certain patients with a history of congenital heart chickenpox. The nurse would expect the baby's defects, including those with repaired ASDs, to prevent primary health-care provider to order which of the bacterial endocarditis during dental procedures. following interventions to prevent the baby from Option A: Incorrect, as ongoing follow-up care is contracting the illness? usually required to monitor for potential complications like arrhythmias or residual A. Intravenous antibiotics defects. B. Varicella zoster immune globulin C. Varicella immunization Option B: Permanent physical activity limitations are typically unnecessary for children with D. Nothing because the baby is protected by repaired ASDs, as they can engage in typical the mother antibodies activities without long-term restrictions. B. The nurse would expect the primary health-care Option D: Frequent echocardiograms may not provider to order varicella zoster immune globulin be required for life unless specific concerns (VZIG), which contains antibodies against the  varicella virus. earlier. When the nurse suggests that the patient have an HIV test, he states, "Why, I'm fine. I don't have any 3. 27. A nurse is coordinating an educational symptoms at all." Which of the following responses by session for middle school students regarding the nurse would be appropriate to make? human immunodeficiency virus (HIV). The nurse should advise students that which of the following A. "You are probably correct because unless you behaviors place them at high risk of contracting had gastrointestinal symptoms after you had HIV? Select all that apply. intercourse, you are probably not infected B. "You are probably correct because having 1. Eating food prepared by an individual with HIV. intercourse with an infected woman is much more dangerous than with a man." 2. Engaging in oral intercourse with an individual with HIV. C. "I understand that there is virtually no chance that you are infected but it is recommended 3. Sharing marijuana cigarettes with an that all who are 13 and older be tested." individual w/ HIV. D. "You should be tested anyway, because it can take up to 10 years before any symptoms of the 4. Using natural skin condoms while having sex disease are detected." with an individual with HIV. D. This statement is correct. It can take up to 10 years 5. Drinking alcoholic beverages out of the same after becoming infected with HIV to exhibit any container as an individual with HIV. symptoms of the disease. A. 1,2,3,4,5 6. The nurse is providing HIV education to a group of B. 3,4,5 individuals. During the session, the nurse discusses C. 2,3,4,5 actions that have been shown to reduce the D. 2,4 transmission of HIV. Which of the following information did the nurse include in her discussion? D. Although an individual is less likely to acquire HIV when engaging in oral intercourse with an A. Circumcised men are less likely to contract and individual with HIV than during vaginal or anal transmit HIV than are uncircumcised men. intercourse, it is possible. Using natural skin B. HIV is eradicated from the body when 2 to 3 condoms while having sex with an individual with different antiretroviral medications are taken HIV is a high-risk behavior. for at least one year. C. The HIV vaccination has been approved for men 4. A young woman is being seen in the women's and women between the ages of 16 and 26 health clinic. She states that she had unprotected years of age. intercourse about one month earlier, and she is D. Babies born to HIV positive mothers are less worried that she may have contracted HIV. Which likely to contract HIV if they are exclusively of the following signs/symptoms would indicate breastfed. that her worries may be correct? A. This statement is true. Circumcised men are less A. Maculopapular rash covering her thorax likely to contract and transmit HIV than are B. Severe abdominal cramps accompanied by uncircumcised men. diarrhea 7. A nurse, caring for a client in the emergency C. Exhaustion accompanied by muscle aches department, is stuck by a and pains contaminated needle. Which of the following actions should the nurse perform? The nurse should: D. Abnormally heavy menstrual period A. Advise the client that a law requires that an HIV C. Exhaustion accompanied by muscle aches and test be performed on the client as soon as pains may indicate that she is HIV positive. possible. B. Wait at least 7 days before having HIV baseline testing performed. C. Be prepared to receive an intravenous infusion of HIV immune globulin in the emergency department. D. Begin post exposure prophylactic treatment within 72 hours of the HIV exposure. ) 5. An 18-year-old man reports to a nurse that he had D. The nurse should begin post exposure prophylactic unprotected anal intercourse with a man 3 years treatment within 72 hours of HIV exposure.  C. Pets D. Plants 8. A nurse is providing a teaching session for adolescents and their parents regarding HIV. Which of B. Foods are the most common childhood the following information should the nurse include in allergens. the teaching session? Select all that apply. 11. The nurse is providing education to pregnant 1. It is recommended that all individuals aged 18 and women who have a family history of severe older be tested for HIV. allergies. Which of the following information 2. The potential for contracting HIV increases when a should the nurse convey regarding actions the person has intercourse with multiple partners. 3. A women should take to minimize their children's person can contract more than one strain of HIV, potential for developing allergies? increasing the likelihood of the disease progressing to AIDS. A. Remove high-allergy foods from their diet 4. Although HAART helps to delay the onset of AIDS, all during their pregnancy and while patients with HIV will die within approximately 20 breastfeeding. years of the time of the initial infection. B. If they decide not to breastfeed their baby, 5. Anyone who is diagnosed with hepatitis B or to feed the baby a soy-based rather than a hepatitis C is at high risk for also being infected with cow's milk-based formula. HIV. C. Delay feeding their infant any solid foods until the infant is seven to eight months of age. A. 1,2,3,4,5 D. When they begin to feed their infant solid B. 2,3,4,5 foods, to begin serving high-allergy foods C. 2,3,5 shortly after low-allergy foods have been D. 2,3,4 introduced C.: It is true that the potential for contracting HIV D. It is recommended that when solid foods are increases when a person has intercourse with introduced into infants' diets, that high-allergy multiple partners. It is true that a person can foods be introduced shortly after low-allergy foods contract more than one strain of HIV, increasing have been introduced. the likelihood of the disease progressing to AIDS. This statement is true. Anyone who is diagnosed 12. A child, weighing 80 lb, has been prescribed an with hepatitis B or hepatitis C is at high risk for also EpiPen. Which of the following information should being infected with HIV. the nurse include in the medication teaching for the parents and the child? 9. A 12-year-old girl has just been diagnosed with systemid lupus erythematosus (SLE). Which of the A. To keep the medication in a refrigerator at all following information should the nurse include times. when educating her and her parents regarding the B. Inject the medication at a 45 degree angle disease? to the body surface. C. Administer the medication into the A. The cure rate for SLE is between 90% and dorsogluteal muscle 95%. B. SLE is caused by a virus that permeates D. Continue to inject the medication for at 100% of the cells of the kidneys and liver. least 10 seconds duration. C. The pain of SLE arthritis will likely be controlled with nonsteroidal D. The medication should continue to be injected anti-inflammatories. for at least a 10-see duration. D. SLE antibodies were triggered by pubertal changes. C. This statement is true. The pain of SLE arthritis 13. A school nurse is called to a third-grade classroom likely will be controlled with nonsteroidal because a child, with no previous history, is in anti-inflammatories, anaphylaxis. Which of the following actions should the nurse perform? 10. A nurse is providing education to parents of young children regarding the children's potential A. Notify the parents to pick up their child as soon for developing allergies. The nurse informs the as possible. parents that which are the most common allergies B. Take the AED to the classroom, and begin of childhood? emergency intervention. C. Have the child lie quietly in the nurse's office for A. Medicines the next 30 minutes. B. Foods D. Inform the health department that the child has  a reportable illness. contagiousness of rubella. The nurse should explain that the child is most contagious: B. The nurse should take the AED to the classroom and begin emergency intervention. A. Before the rash appears B. After the rash resolves D.4: Infectious Disorders [Baguio] C. During the fever stage D. When the rash is at its peak 1. A 7-year-old child is diagnosed with mumps. The A. Rubella is most contagious in the period before nurse notices that the child is complaining of severe the rash appears, starting approximately seven ear pain and is refusing to eat. Which complication is days prior. the nurse most concerned about? Option B: Incorrect, as rubella is no longer A. Otitis media considered contagious after the rash has resolved. B. Pancreatitis Option C: Although fever may occur, the C. Orchitis contagious period is primarily before and D. Parotitis during the rash, not specifically related to the fever. A. Severe ear pain in a child with mumps suggests a Option D: While the child is still contagious risk of otitis media, which can develop due to when the rash appears, the highest risk of inflammation associated with the viral infection. transmission occurs before the rash Option B: Pancreatitis can occur as a mumps manifests. complication but is less common in young children compared to older adolescents and 4. A four-year-old child is brought to the clinic with adults. a history of fever, fatigue, and a rash that developed Option C: Orchitis (inflammation of the testes) is after receiving antibiotics for a sore throat. Upon a potential complication of mumps but is examination, the nurse notes a fine red rash on the more common in post-pubertal boys, making child's chest and a "strawberry-like" tongue. What it less likely for this child. is the likely diagnosis? Option D: Parotitis, the classic presentation of A. Scarlet fever mumps, causes swelling of the parotid glands B. Kawasaki disease and could explain ear pain; however, otitis C. Measles media presents a more immediate concern D. Hand, foot, and mouth disease due to potential secondary infection. A. The presentation of fever, a fine red rash, and a 2. A 2-year-old child presents with a high fever, sore strawberry tongue is characteristic of scarlet fever, throat, and a thick, grayish membrane covering the often associated with a streptococcal infection. throat. The child is suspected of having diphtheria. Option B: Kawasaki disease can cause fever What is the nurse's priority action? and rash, but it typically presents with A. Administer diphtheria antitoxin additional signs such as prolonged fever, B. Initiate airborne precautions conjunctival injection, and oral mucosal C. Prepare the child for a tracheostomy changes (cracked lips). A strawberry D. Start IV antibiotics tongue may occur but is not specific to Kawasaki disease. A. Administering the diphtheria antitoxin is the priority Option C: Measles presents with a high fever, to neutralize the toxins, addressing the immediate runny nose, and conjunctivitis, with a threat of the disease. distinctive rash that starts at the hairline Option B: Airborne precautions are necessary to and spreads downward. The rash in prevent transmission but come after ensuring measles is not typically fine and red like in the patient receives the antitoxin. scarlet fever. Option C: Preparing for a tracheostomy is Option D: Hand, foot, and mouth disease important if severe airway obstruction occurs usually presents with sores in the mouth but is not the immediate priority over antitoxin and a rash on the hands and feet, not with administration. a fine red rash on the chest or a strawberry Option D: IV antibiotics, such as penicillin or tongue. erythromycin, are crucial in managing diphtheria; however, the immediate priority is 5. A 3-month-old infant is admitted with to administer the antitoxin. bronchiolitis caused by respiratory syncytial virus (RSV). The nurse observes nasal flaring and 3. A 5-year-old child with rubella presents with a retractions. What is the priority intervention? fine pink rash that started on the face and spread to the body. The child's mother asks about the A. Administer a bronchodilator  B. Suction the infant's airway C. Apply oxygen via nasal cannula C. Avoiding scratching and keeping nails short are D. Position the infant in a prone position effective in reducing the risk of secondary infections and scarring by minimizing trauma to the skin. C. Applying oxygen via nasal cannula is critical as it Option A: Topical antihistamines may help addresses the infant’s immediate need for reduce itching but do not directly prevent oxygenation in the context of respiratory distress. scarring and could cause irritation or allergic Option A: Although bronchodilators may be reactions. used for wheezing, they are not Option B: Pressure bandages are inappropriate consistently effective for RSV bronchiolitis for chickenpox lesions, as they can cause and are not the priority. irritation and may worsen infection. Option B: Suctioning can help clear Option D: Covering lesions with antibiotic secretions but is not the immediate priority ointment is generally not recommended when there are signs of significant unless there is clear evidence of a secondary respiratory distress. bacterial infection. Overuse of antibiotics can Option D: The preferred position for an infant lead to resistance and does not address the with respiratory distress is typically primary issue of avoiding scratching. semi-upright, not prone, to facilitate breathing. However, ensuring oxygenation 8. A nurse is caring for a 6-year-old child with severe takes precedence over repositioning. chickenpox lesions. The child develops a new onset of severe headache, vomiting, and confusion. Which condition is the nurse most concerned about? 6. A 9-year-old child with infectious mononucleosis develops abdominal pain and tachycardia. The nurse A. Encephalitis suspects a splenic rupture. What is the priority action? B. Reye’s syndrome C. Meningitis A. Place the child in a high Fowler’s position D. Septic shock B. Prepare the child for a blood transfusion B. Reye’s syndrome is more specifically associated with C. Notify the healthcare provider immediately recent viral infections and the use of aspirin. Symptoms of severe headache, vomiting, and D. Administer IV fluids for shock confusion align with Reye syndrome, making it the primary concern. C. Immediate notification of the healthcare Option A: Encephalitis can cause similar provider is essential for timely assessment and symptoms, but Reye syndrome is more intervention, as splenic rupture is a critical strongly associated with viral infections and emergency. aspirin use. by: batak mag beg (migel `★) & batak mag rugby Option C: Meningitis could cause headache, (krez ౨ৎ) vomiting, and confusion, but other signs like Option A: High Fowler's position may improve neck stiffness, photophobia and altered respiratory comfort, but it is not the immediate mental status are typically present, which are action needed in suspected splenic rupture. not mentioned here. Option B: While a blood transfusion may be Option D: Septic shock could lead to symptoms necessary if there is significant blood loss, the such as fever, chills, tachycardia, hypotension, nurse should first notify the provider for and altered mental status, but Reye syndrome evaluation and further orders. is more likely given the context of a recent viral Option D: IV fluids are essential in managing illness. shock, but this should follow after notifying the healthcare provider for a complete 9. A child with hand, foot, and mouth disease is assessment. refusing to drink fluids due to painful mouth ulcers. What is the nurse's best recommendation to the 7. A child with varicella (chickenpox) is admitted due to parents to ensure hydration? secondary bacterial skin infections. The parents are anxious about how to prevent scarring. What is the A. Offer frequent sips of warm tea nurse's best advice? B. Encourage cold, bland fluids C. Administer ibuprofen before meals A. Use topical antihistamines to stop itching B. D. Offer citrus juices to numb the pain Apply pressure bandages to lesions C. Avoid scratching lesions and keep nails short D. B. Cold, bland fluids provide comfort and relief for Cover lesions with antibiotic ointment painful ulcers while helping to maintain hydration. Option A: Warm tea may aggravate mouth ulcers due to its heat, whereas cold fluids are more effective. hypotension. What complication should the nurse Option C: Ibuprofen may relieve pain but suspect? does not directly address hydration. Additionally, ibuprofen may irritate the A. Sepsis with disseminated intravascular stomach if gastrointestinal discomfort is coagulation (DIC) present. B. Septic arthritis C. Secondary meningitis infection Option D: Citrus juices are acidic and can further irritate mouth ulcers, discouraging fluid D. Allergic reaction to antibiotics intake. A. The combination of petechiae and hypotension following bacterial meningitis is concerning for 10. A nurse is caring for a 10-year-old child with Lyme sepsis with DIC, a severe, life-threatening condition disease who presents with arthritis-like joint pain. requiring immediate evaluation. What is the priority intervention? Option B: Septic arthritis may occur after A. Administer analgesics bacterial infections but would typically B. Monitor the child’s renal function present with joint pain and swelling rather C. Encourage increased physical activity than systemic signs like petechiae and D. Continue the prescribed antibiotics hypotension. Option C: A secondary meningitis infection D. Ensuring that the child completes the antibiotic could present with central nervous course is the priority to address the underlying Lyme symptoms but not necessarily petechiae disease infection and prevent further complications. and hypotension. Option A: Analgesics can help manage pain Option D: Allergic reactions to antibiotics but do not address the root cause, which is may cause rash and anaphylaxis but are the infection. less likely to result in petechiae and Option B: Monitoring renal function is hypotension without other allergic important, especially if certain antibiotics symptoms. are used, but it is not the primary action in the context of joint pain and treatment by: batak mag beg (migel `★) & batak mag rugby continuation. (krez ౨ৎ) Option C: Increased physical activity could D.5: Hematologic Disorders [Baluran] exacerbate joint pain and discomfort, so 1. A 7-year-old child with sickle cell disease is brought rest is more appropriate during recovery. to the emergency room experiencing severe chest and 11. A 4-year-old child with a history of rheumatic fever abdominal pain, along with noticeable difficulty in limb presents with a new onset of chest pain and shortness movement. The physician explains to the concerned of breath. What is the nurse's priority action? parents that the child’s symptoms are related to complications stemming from the disease. Which of A. Administer anti-inflammatory medications the following mechanisms is responsible for the child's B. Auscultate heart sounds for a murmur symptoms? C. Notify the healthcare provider D. Obtain an ECG A. A general inflammatory response due to an autoimmune reaction from hypoxia. C. Immediate notification of the healthcare provider is B. Respiratory issues resulting in alkalosis due to necessary for assessment and potential intervention, the presence of deoxygenated red blood cells. as chest pain and shortness of breath in a child with a C. Local tissue damage with ischemia and necrosis history of rheumatic fever may indicate cardiac due to obstructed circulation. involvement. D. Central nervous system sensitivity influenced by Option A: Anti-inflammatory medications elevated serum bilirubin may be part of treatment but should not be administered without provider orders C. Characteristic sickle cells tend to clump, which and evaluation. results in poor circulation to tissue, local tissue Option B: While auscultation is essential, the damage, and eventual ischemia and necrosis. In sickle symptoms indicate a need for prompt cell anemia, damage is not due to an inflammatory assessment and potential intervention by a response. Respiratory issues resulting in alkalosis due healthcare provider. to the presence of deoxygenated red blood cells are Option D: An ECG may be ordered for further not present. The CNS effects result from ischemia. evaluation, but this should be done under 2. A nurse is developing an education program for the direction of the provider. families of children with sickle cell disease. During a 12. A 12-year-old child recovering from bacterial community health fair, she meets a concerned parent meningitis develops sudden petechiae and who wants to know how to best support their child's health and prevent complications. The nurse considers A. Long-term complications result from various topics to include in the program. Which of the hemochromatosis, excessive iron deposits collecting in following subjects should she prioritize for effective the tissues and causing destruction. Cellular damage client education? from hemochromatosis may lead to splenomegaly, A. The importance of proper hand washing and growth retardation, skeletal complications, cardiac strategies to avoid infections problems, gallbladder disease, hepatomegaly, and skin B. Recommendations for a high-iron protein diet changes. Anemia is a sign of this disorder. C. Guidelines for limiting fluid intake to 1 liter per 5. A nurse is caring for a child with thalassemia who day has been prescribed desferoxamine. During the D. The benefits of aerobic exercises to improve treatment, the nurse closely monitors the child for any oxygenation adverse effects or unusual symptoms. As she reviews A. Prevention of infection is an important measure in the child's condition, she encounters a specific sign the prevention of sickle cell crisis. A high-iron, that prompts her to consider notifying the physician. high-protein diet would have no effect on the disease Which of the following findings should raise her or prevention of a crisis. Proper hydration should be concern? encouraged to prevent crisis secondary to dehydration. A. Decreased hearing Strenuous exercise and activity should be avoided to B. Vomiting reduce the risk of increased tissue ischemia. C. Red urine 3. A nurse is creating a comprehensive care plan for a D. Hypertension 10-year-old child recently diagnosed with sickle cell A. Desferoxamine is ototoxic. Therefore, any hearing disease. During a team meeting, the nurse discusses problem should be promptly reported. Vomiting is not potential interventions that could be beneficial in an emergency with this drug. Red urine is an expected managing the child's condition and preventing occurrence with this drug. Hypotension, not complications. Which intervention should be included hypertension, is a possible adverse effect in the care plan to support the child's health and well-being? 6. A 9-year-old boy is being evaluated for possible hemophilia after experiencing frequent nosebleeds A. Administering an anticoagulant to prevent and easy bruising. The healthcare team decides to sickling episodes conduct several tests to confirm the diagnosis. During B. Providing health education aimed at reducing the discussion, the nurse considers which test would the frequency of sickling crises provide the most definitive information regarding the C. Monitoring and enforcing fluid intake child's condition. Which test should the nurse prioritize restrictions D. Recommending avoidance of opioid in this situation to aid in the diagnosis of hemophilia? medications for pain management A. Bleeding time B. Because there is no cure for sickle cell disease, B. Partial thromboplastin time prevention is one of the main goals of therapeutic C. Platelet count management. Thus, health teaching to help reduce D. Complete blood count sickling crises is key. Anticoagulants do not prevent sickling. Fluids are encouraged to increase the fluid B. In hemophilia, partial thromboplastin time is volume and prevent sickling. Opioids usually are abnormal. Thus, this test would be most helpful in needed for pain control. diagnosing the disorder. Bleeding time and platelet count are normal in hemophilia. The complete blood count is not affected in hemophilia. 4. A 12-year-old child with thalassemia major is undergoing regular check-ups to monitor their health. 7. A nurse is providing guidance to the parents of a During one visit, the healthcare team discusses child diagnosed with hemophilia following an injury potential long-term complications associated with the that resulted in bleeding. Which of the following condition. The parents express concern about what actions would the nurse instruct the parents of a child specific issues they should be aware of as their child with hemophilia to avoid? grows. Which underlying factor related to thalassemia A. Applying pressure major is most likely to contribute to these long-term B. Applying cold to the area complications? C. Immobilizing the joint A. Hemochromatosis D. Lowering the injured area B. Splenomegaly D. Typically, with any bleeding area, but especially with C. Anemia hemophilia-associated bleeding, the injured area must D. Growth retardation be elevated, not lowered. Applying pressure or cold to the area and immobilizing the joint are appropriate thrombocytopenic purpura who has been measures to control bleeding. experiencing severe bleeding episodes. During the pre-administration assessment, the nurse considers several factors to ensure the child's safety and 8. A nurse is reviewing the medication regimen for a effectiveness of the treatment. child diagnosed with idiopathic thrombocytopenic Which of the following considerations should the purpura. During a follow-up appointment, the child's nurse prioritize while administering IVIG? parents' express concerns about managing pain and fever, particularly regarding which medications might A. Monitoring for signs of an allergic reaction and be safe to use. The nurse considers various options but ensuring adequate hydration. knows that one specific medication could pose risks B. Observing the child for increased blood for their child's condition. Which medication should pressure and administering antihypertensive the nurse advise the parents to avoid? medication as needed. C. Checking for recent vaccinations and ensuring A. Aspirin the child is up to date on immunizations. B. Acetaminophen D. Assessing the child for signs of infection and C. Codeine ensuring a sterile environment. during D. Morphine administration. A. Aspirin exerts an antiplatelet action and therefore A. When administering IVIG, it's crucial to monitor for may increase platelet destruction in idiopathic potential allergic reactions due to the infusion and to thrombocytopenic purpura. Acetaminophen, codeine, ensure the child is well-hydrated to help prevent and morphine have no effect on platelets and, complications, such as renal issues therefore, are not contraindicated. 9. When administering a steroid to a child with idiopathic thrombocytopenia purpura, the nurse 12. A 10-year-old child is brought to the clinic by their should monitor the child for which of the following? parents, who report increasing fatigue, frequent infections, and easy bruising. After a comprehensive A. Anemia evaluation, the healthcare provider suspects aplastic B. Bleeding anemia. As part of the diagnostic workup, the provider C. Bruising reviews various laboratory findings. Which of the D. Infection following results would be most indicative of aplastic anemia for this child? D. Steroids may promote immunosuppression, making the child more susceptible to infections. Anemia is not A. Decreased production of T-helper cells associated with the disorder or medication. Bleeding B. Increased levels of white blood cells, red and bruising are seen as a result of the disorder, not blood cells, and platelets the steroid therapy C. Decreased levels of white blood cells, red blood cells, and platelets 10. A nurse is preparing to administer elemental iron therapy to a 6-year-old child diagnosed with iron D. Presence of Reed-Sternberg cells and lymph deficiency anemia. The physician has prescribed a node enlargement dosage of 6 mg/kg/day, which should be divided into C. In aplastic anemia, there is a failure of the bone three doses. The child weighs 44 Ibs. As the nurse marrow to produce sufficient blood cells, leading to calculates the appropriate dose for each decreased levels of white blood cells, red blood cells, administration, how many milligrams of iron should and platelets the child receive per dose? 13. A nurse is caring for a toddler who has been A. 40 mg/dose admitted to the hospital during a vaso-occlusive crisis B. 30 mg/dose related to sickle cell disease. As the nurse assesses the C. 50 mg/dose situation, she must determine which nursing diagnosis D. 60 mg/dose should take priority in the care plan for this child. A.: The child weighs 44 Ibs, which equals 20 kg (1 kg = Considering the child's condition, which diagnosis 2.2 lbs; 44/2.2 = 20 kg). Elemental iron therapy is should the nurse identify as the most critical at this ordered at 6mg/kg/day in three doses. Therefore, the time? child receives 120 mg/day (6 mg/20 kg/day = 120), A. Ineffective coping related to the presence of divided into three doses (120/3), which equals 40 a life-threatening disease mg/dose B. Decreased cardiac output related to 11. A nurse is preparing to administer intravenous abnormal hemoglobin formation immunoglobulin (IVIG) to a child with idiopathic C. Pain related to tissue anoxia  D. Excess fluid volume related to infection developing celiac disease because a maternal aunt has this. If Yna were developing this, you would assess her C. During a vaso-occlusive sickle cell crisis, the priority specifically for symptoms of: nursing diagnosis is pain due to tissue anoxia. Managing the child's pain is crucial to improve comfort A. Rickets and overall well-being. B. Polycythemia C. Obesity D.6: Gastrointestinal Disorders [Batar] D. Blindness 1. Baby Yna was born prematurely at 34 weeks and was A. Because children with celiac disease are unable to hospitalized in the NICU for 3 weeks due to developing absorb fat and fat-soluble vitamin, such as vitamin D, necrotizing enterocolitis (NEC) shortly after birth. rickets may occur Necrotizing enterocolitis is: Option B: Polycythemia - refers to an increased A. A volvulus of the intestine that leads to number of red blood cells in the blood. It is not death of tissue. associated with celiac disease. B. A congenital short bowel syndrome that Option C: Obesity - not a symptom of celiac limits digestion. disease. C. The lack of pancreatic enzymes so fat cannot Option D: Blindness - unrelated to celiac disease. be digested. 4. Yna also has a cleft lip. When evaluating the ability D. Necrotic patches of the intestine that of her mother to care for her, which maternal behavior interfere with absorption. would indicate to the nurse that the mother needs D. With NEC, portions of the bowel become necrotic, teaching? decreasing the surface for absorption and possibly A. Supports Yna in a low fowler's position to feed. leading to bowel perforation. Option A: Volvulus - complete twisting of a B. Burps Yna frequently during feeding. loop of intestine around its mesenteric attachment site. C. States that weight gain will have to be carefully monitored. Option B: Congenital Short Bowel Syndrome - an absorptive disorder in w/c there is not D. Feeds small amounts slowly. sufficient bowel surface area in the small intestine for proper nutrient absorption. A. The infant's head should be held upright for feeding Option C: Lack of pancreatic Enzymes - therefore option "A" is an incorrect behavior which describes a condition more typical of cystic indicates the mother needs more teaching. fibrosis or exocrine pancreatic insufficiency, Options B, C, & D: all are correct care for cleft lip. where the pancreas does not produce The infant with cleft lip should be fed small enough enzymes to digest fats that can amounts slowly & for a short time; burp lead to poor absorption of nutrients, frequently to help prevent regurgitation & weight loss, & shortage of vitamins.. aspiration; & weight needs to be monitored to determine if the infant is getting sufficient 2. One of the first symptoms of necrotizing enterocolitis you would expect to see is: 5. Yna underwent cleft lip repair. Which is a priority nursing goal, specific for her? A. Fresh blood in stools B. Pain under the sternum A. Decrease crying. C. Sweating & liver pain B. Keep nares patent. D. Abdominal distention C. Protect from exposure to cold. by: batak mag beg (migel `★) & batak mag rugby D. Prevent dehydration. (krez ౨ৎ) A. Crying increases tension on the suture line & can D. Abdominal distention and tenseness of the disrupt it. abdomen are usually the first indications of NEC. Option B: Keeping nares patent is not specific Option A: Fresh blood in stools - can be a sign of NEC, for an infant with cleft-lip repair because all it typically occurs later in the disease progression. It neonates are nose breathers so keeping nose indicates damage to the bowel and potential patent is important for all. perforation, but it is not considered an early symptom. Option C: Similarly all neonates need to be Option B: Pain under the sternum - not protected from cold & from dehydration, not associated with NEC. just those with cleft-lip repair. Option C: Sweating & liver pain - not relevant Option D: While maintaining adequate symptoms of NEC. hydration is always important, there are more 3. Yna's mother is concerned that Yna may be immediate post-surgical concerns specific to  cleft lip surgery. passage from the stomach to the small intestine) becomes abnormally narrow, leading to vomiting and feeding difficulties. Surgery (pyloromyotomy) is required to relieve the obstruction by widening the pylorus. Option A: No blockage in the intestine but in 6. Nurse Yuri is caring for a neonate of 38 weeks the pylorus. gestation when he observes marked peristaltic waves Option B: Pyloric stenosis does not require on a neonate's abdomen, and identifies olive-shaped organ repositioning. mass at the right upper quadrant. After these Option D: Incorrectly implies that the observations, the neonate exhibits projectile vomiting. surgery's primary goal is to regulate acid Nurse Yuri notifies the pediatrician because these production, which is not typically the signs are indicative of which of the following? objective of the surgery. It's not relevant to the question. A. GERD B. Pyloric stenosis 8. Another infant cared for by Nurse Yuri is Ydu, a C. Diaphragmatic Hernia 3-week-old infant who is brought to the E.R with a D. Hiatal hernia history of difficulty passing stools. The parents report that baby Ydu has not had a bowel movement in the B. The hallmark signs of pyloric stenosis include last 48 hours, and when they do occur, the stools are projectile vomiting, palpable olive-shaped mass in the ribbon-like. The infant appears irritable and has a abdomen, and dehydration (fewer wet diapers). The distended abdomen. Which condition is most likely infant's continued hunger after vomiting is another causing these symptoms? classic symptom of this condition. Option A: GERD can cause vomiting or A. Pyloric stenosis spitting up in infants but is typically B. Intussusception associated with non-projectile vomiting or C. Hirschsprung's disease regurgitation after feeding. There are no D. Gastroesophageal reflux characteristic peristaltic waves or a palpable olive-shaped mass with GERD. The projectile vomiting and mass are not C. Hirschsprung's disease is characterized by a lack of consistent with GERD, making it the wrong nerve cells in parts of the colon, leading to bowel choice. obstruction. Symptoms include constipation, Option C: DH - while a diaphragmatic hernia ribbon-like stools, abdominal distention, and irritability. presents with severe respiratory issues, it These signs are distinct from conditions like pyloric does not cause the specific gastrointestinal stenosis and gastroesophageal reflux. symptoms described in the question Option A: It typically presents in infants with Option D: A hiatal hernia involves the forceful projectile vomiting. dehydration, and a protrusion of a part of the stomach palpable olive-shaped mass in the abdomen. It through the diaphragm into the chest. It is not characterized by difficulty passing stools may cause reflux and vomiting, but it does or ribbon-like stools. not cause the distinct olive-shaped mass Option B: Symptoms include severe, or the severe projectile vomiting typical of Intermittent abdominal pain, a pyloric stenosis. "sausage-shaped" mass in the abdomen, and "currant jelly" stools (blood and mucus in the 7. The neonate taken cared of by nurse Yuri is stool). Intussusception does not usually cause scheduled for surgery. The parents ask why surgery is chronic constipation or ribbon-like stools. necessary. Which of the following explanations should Option D: Involves the backflow of stomach nurse Yuri provide? contents into the esophagus, leading to A. "Surgery is performed to widen the symptoms like vomiting, irritability, and intestines and improve digestion." sometimes poor weight gain, It doesn't cause B. "Surgery is required to reposition the constipation, abdominal distension, or stomach in the abdominal cavity." ribbon-like stools. C. "Surgery is necessary to remove the 9. Supposed, the condition of baby Yu is only a mild blockage caused by the narrowing of the case, which is a primary goal of care for him? pylorus." D. "Surgery will help regulate stomach acid A. Promote parent-child bonding. production and prevent future vomiting." B. Teach colostomy care. C. Avoid exposure to gluten products. C. Pyloric stenosis occurs when the pylorus (the  D. Relieve constipation. infants and would typically present with right lower quadrant pain, fever, nausea, D. Mild defects only require measures to prevent and vomiting rather than intermittent constipation. More severe defects, which are the crying and bloody stools. While majority, require surgical removal of the affected area appendicitis can cause lethargy and of the intestine. Occasionally, a temporary colostomy is irritability in infants, the classic "currant created. Parent-child bonding is important for all jelly" stools are not seen. children & the child with mild Hirschsprung's disease does not present a significant risk for impaired 11. Yodel is scheduled for a diagnostic and therapeutic bonding. Avoidance of gluten products is essential for enema. The mother asks how this procedure will help. the child with celiac disease, not Hirschsprung's Which of the following is the best explanation? disease. Option A: Bonding is crucial for emotional, A. "The enema will help detect any blockage in social, and cognitive development but this is the intestines." just the 2nd best answer next to relieving B. "The enema can push the folded section of constipation. the intestine back into place." Option B: Colostomy care is relevant only if the C. "The enema will clear out the intestines and baby has had a colostomy. Since the scenario allow normal bowel movements." describes a mild condition, it is unlikely that D. "The enema will remove any excess gas baby Ydu has undergone such an invasive causing discomfort in the abdomen." procedure, making this an inappropriate goal B. Intussusception occurs when a part of the intestine in this context. telescopes into itself, causing obstruction. A Option C: Avoiding gluten is specific to therapeutic enema (air or barium enema) is used not conditions like celiac disease, where gluten only for diagnosis but can also be effective in reducing causes harmful reactions in the body. Without (unfolding) the intussusception, avoiding the need for any indication that baby Yu has a condition surgery in some cases. like celiac disease, avoiding gluten is not Option A: is partially correct but not the best relevant to his care. answer. An enema, specifically a contrast 10. Another infant is brought to the emergency enema (air or barium), can indeed help department with intermittent episodes of severe visualize blockages during a diagnostic crying and drawing the legs up to the abdomen. The procedure. However, the main purpose of a mother reports that the baby passes "currant jelly" therapeutic enema for intussusception is stools and seems lethargic between episodes of pain. not just detection but also treatment. What is the most likely diagnosis? Option C: While enemas are often used to relieve constipation or cleanse the A. Hirschsprung's disease intestines, the purpose of an enema in this B. Intussusception context (for intussusception) is not to clear C. Pyloric Stenosis the intestines but to correct the D. Appendicitis obstruction caused by the telescoping segment. B. Intussusception is characterized by intermittent Option D: Although some enemas are used episodes of severe abdominal pain, often causing the to relieve gas, this is not the goal of a infant to draw their legs up. The presence of "currant therapeutic enema for intussusception. jelly" stools, which contain blood and mucus, is a The procedure's aim is to reduce the classic sign. Lethargy between painful episodes is also intussusception, not to manage gas. common in intussusception. Option A: Hirschsprung's disease typically 12. Which finding indicates that the therapeutic presents as a failure to pass meconium in enema (hydrostatic reduction) was successful? the first 48 hours of life, chronic constipation, and abdominal distension A. Presence of bowel sounds. rather than acute, intermittent pain or B. Absence of abdominal distention. currant jelly stools. C. Passage of normal stool. Option C: Pyloric stenosis usually presents in D. Cessation of abdominal pain. infants aged 2-6 weeks with projectile, C. Passage of normal stool beyond the point of non-bilious vomiting after feeding, weight intussusception is impossible. Once the loss, dehydration, & a palpable intussusception is reduced the bowel is no longer "olive-shaped" mass in the abdomen. It obstructed so normal stool can pass. ) does not cause bloody stools or abdominal Option A: Not the best indicator of success. pain with leg drawing. While bowel sounds suggest active intestinal Option D: Appendicitis is less common in  movement, they do not specifically indicate that the intussusception has been successfully D.7: Genitourinary Disorders [Echeveria] reduced. Bowel sounds may be present even if 1. When planning educational strategies for a client the telescoping section of the intestine has not with chronic renal failure, the nurse must consider the been fully corrected. neurological effects of uremia. Which teaching Option B: Not the best indicator. The absence of strategy is most appropriate? abdominal distention can suggest improvement in certain gastrointestinal A. Provide all necessary teaching in one extended conditions, but it's not a definitive sign that the session. intussusception has been reduced. Abdominal B. Conduct a one-on-one session with the client. distention can vary based on other factors, C. Use videotapes to reinforce the material as such as gas or fluid accumulation. needed. Option D: An important finding but not the best D. Frequently validate the client’s understanding indicator of successful reduction. While a of the material. reduction in abdominal pain suggests that the D. Uremia can cause decreased alertness, so the acute problem (intussusception) may be nurse must frequently validate the client's resolving, pain cessation could occur even comprehension and assess the extent of before the intussusception is fully corrected. impairment in thinking ability, memory, and Therefore, while it's a positive sign, it is not as orientation. Uremic syndrome can start with minor definitive as the passage of normal stool. confusion and irritability, progressing to altered personality, which makes frequent validation 13. Yodel has also been diagnosed with lactose essential. intolerance, and her mother asks how to manage her child's diet. Which of the following would be your best 2. When teaching a 9-year-old child with acute advice? glomerulonephritis about their prescribed diet, the nurse should explain that appropriate food choices A. "Your child must avoid all dairy products include: permanently." B. "Give your child small amounts of dairy products A. Corn in a cup, baked chicken, rice, apple, and to help their body adjust." milk. C. "You can use lactose-free dairy products or B. Baked potato, ground beef, canned carrots, lactase supplements when giving your child banana, and buttermilk. dairy." C. Canned green beans, baked ham, bread D. "Sw