Question

A nurse is caring for a school-age child who has cystic fibrosis.

Answer 1

Correct Answers:

Water-soluble vitamins
Dornase alfa
Pancreatic lipase

Rationale :

🧪Cystic fibrosis impairs the absorption of fat-soluble vitamins (A, D, E, K) due to pancreatic insufficiency, so water-soluble forms of these vitamins are required to enhance absorption.

🌬️Dornase alfa is a mucolytic agent that reduces the viscosity of pulmonary secretions, improving airway clearance and respiratory function in children with chronic obstructive pulmonary disease caused by CF.

🍽️Pancreatic lipase is essential for children with CF who have pancreatic enzyme deficiency. Supplementation with enzymes helps with the digestion of fats and proteins, improving nutrient absorption and weight gain.

🧴Medications like acetaminophen and meperidine are not specific to CF management and do not address the underlying disease complications like malabsorption or thickened mucus.

📌core message

Children with cystic fibrosis often require vitamin supplementation, mucolytics, and pancreatic enzymes to manage malabsorption and pulmonary complications.

Answer 2

Correct Answers:

Instruct the parent to ensure the pneumococcal vaccine is current.
Administer folic acid as prescribed.
Monitor oxygen saturation continuously.
Place the client on strict bed rest.
Give oral hydroxyurea.

Rationale :

🦠Pneumococcal vaccination is critical for individuals with sickle cell disease due to their increased infection risk from splenic dysfunction.

💊Folic acid supplementation supports red blood cell production and counters chronic hemolysis.

📈Continuous oxygen monitoring is necessary during a vaso-occlusive crisis because hypoxia can worsen sickling.

🧪Hydroxyurea is a disease-modifying therapy that increases fetal hemoglobin and reduces the frequency of crises.

🛌Strict bed rest is recommended to decrease oxygen demand and prevent further sickling episodes during acute crises.

📌core message

Management of vaso-occlusive crisis in sickle cell includes hydration, rest, oxygen monitoring, folic acid, and preventive immunizations.

Answer 3

Correct Answers:

Decreased platelet count

Rationale :

🩸Disseminated intravascular coagulation (DIC) is a condition involving widespread clotting and subsequent bleeding due to consumption of platelets and clotting factors.

🔬A decreased platelet count (thrombocytopenia) is a hallmark laboratory feature, reflecting excessive use during abnormal clot formation.

⚠️Other findings include elevated PT, aPTT, D-dimer, and decreased fibrinogen, not increased Hgb or RBCs.

🧫The drop in platelets contributes to increased bleeding risk, which is a critical concern in DIC.

📌core message

DIC is marked by decreased platelet count due to consumption during abnormal systemic clotting.

Answer 4

Correct Answers:

An 18-month-old toddler who has a heart rate of 68/min

Rationale :

❤️The normal heart rate for an 18-month-old ranges between 80 to 130 beats per minute. A heart rate of 68/min is bradycardic and abnormal.

🛑This finding could indicate hypoxia, increased intracranial pressure, or cardiac dysfunction, requiring immediate evaluation.

🌡️A temperature of 37.3°C, a BP of 132/82 in an adolescent, and a respiratory rate of 30/min in a 3-month-old are all within normal parameters for their respective age groups.

📞Bradycardia in toddlers is a priority reportable finding due to the potential for rapid decompensation.

📌core message

A heart rate of 68/min is abnormally low in a toddler and may indicate cardiac or systemic compromise.

Answer 5

Correct Answers:

Check clothing for loose buttons.

Rationale :

🧵Toddlers are at high risk for choking, and loose buttons on clothing pose a hazard if detached and ingested.

🚫Safety measures should prioritize prevention of aspiration and choking, making button checks an important intervention.

🔥Setting the water heater to 54°C (129.2°F) is too high and increases the risk of burn injuries—it should be set no higher than 49°C (120°F).

🎈Balloons are also a known choking hazard for toddlers and should be avoided.

👉Screens on windows can prevent insect entry but do not reliably prevent falls, thus not a primary injury prevention method.

📌core message

Choking prevention in toddlers includes checking for small removable objects like buttons.

Answer 6

Correct Answers:

"Notify the provider if your child is swallowing frequently."

Rationale :

🩸Frequent swallowing after a tonsillectomy can be an early sign of postoperative bleeding, even if no visible blood is present.

🧃Using a straw or encouraging throat clearing increases the risk of irritating the surgical site, which can dislodge clots and promote bleeding.

🧼Dark brown blood may be old, but active bleeding often presents subtly, hence any signs should be reported promptly.

📞Early recognition of complications like bleeding is crucial for preventing hemorrhage in pediatric post-tonsillectomy patients.

📌core message

Frequent swallowing after tonsillectomy may signal bleeding and should be reported immediately.

Answer 7

Correct Answers:

"Your child can rest on your lap during the procedure."

Rationale :

👩‍👧Allowing the toddler to sit in the parent's lap promotes security and cooperation during the ECG, aligning with atraumatic care principles.

📉ECGs are painless and noninvasive, so comfort positioning is preferred to avoid unnecessary distress.

🩺ECG leads are placed on the chest, arms, and legs, not on the back, and no alarms will sound during the test—it simply records electrical activity.

⏱️The procedure takes only a few minutes, not 30, making a brief, comforting setup ideal.

📌core message

ECGs are noninvasive, and using parental presence enhances comfort during the procedure.

Answer 8

Correct Answers:

Check the pH of the gastric secretions.

Rationale :

🧪Verifying NG tube placement is the priority before administering any enteral feeding to prevent the risk of aspiration or misplacement.

📉Gastric aspirate should have a pH of 1 to 5, confirming stomach placement.

🚫Attaching tubing or flushing before checking placement can deliver fluids or feeds into the lungs if the tube is misplaced.

✅Checking tube placement is a critical safety step in all types of enteral feeding.

📌core message

Checking gastric pH is essential to verify NG tube placement before feeding.

Answer 9

Correct Answers:

Provide an infant with a one-piece pacifier for non-nutritive sucking.

Rationale :

👶A one-piece pacifier minimizes the risk of choking or aspiration compared to multi-piece designs that could separate.

🪑Feeding a 5-month-old in a high chair is unsafe because they lack adequate trunk and head control.

🛏️Infants should sleep on a firm mattress, not a soft one, to prevent SIDS.

🚗Car seats should never be placed behind active airbags, which can cause fatal injury in an accident.

📌core message

A one-piece pacifier ensures safe soothing and minimizes choking risk in infants.

Answer 10

Correct Answers:

Place intubation equipment at the bedside.

Rationale :

🗣️Epiglottitis is a life-threatening emergency marked by sudden airway obstruction, so preparation for intubation or tracheostomy is the highest priority.

⚠️Any agitation or invasive procedures like x-rays can worsen airway obstruction, so airway management preparation comes first.

🛑IV antibiotics and precautions are important but are secondary to securing the airway.

🚨Placing emergency equipment readily available ensures rapid intervention if airway compromise occurs.

📌core message

In epiglottitis, the top priority is securing the airway, so intubation readiness is critical.

1 :
A nurse is caring for a school-age child who has cystic fibrosis.

Answer Options

📌core message

2 :
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Answer Options

📌core message

3 :
A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

📌core message

DIC is marked by decreased platelet count due to consumption during abnormal systemic clotting.

4 :
A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

📌core message

5 :
A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

📌core message

6 :
A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

📌core message

Frequent swallowing after tonsillectomy may signal bleeding and should be reported immediately.

7 :
A nurse is providing teaching to the parent of a toddler who isscheduled for an electrocardiogram. Which of the following statements should the nurse make?

📌core message

8 :
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

📌core message

Checking gastric pH is essential to verify NG tube placement before feeding.

9 :
A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

📌core message

10 :
A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?

📌core message

1 : A nurse is caring for a school-age child who has cystic fibrosis.

Answer Options

📌core message

2 : A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Answer Options

📌core message

3 : A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

📌core message

DIC is marked by decreased platelet count due to consumption during abnormal systemic clotting.

4 : A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

📌core message

5 : A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

📌core message

6 : A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

📌core message

Frequent swallowing after tonsillectomy may signal bleeding and should be reported immediately.

7 : A nurse is providing teaching to the parent of a toddler who isscheduled for an electrocardiogram. Which of the following statements should the nurse make?

📌core message

8 : A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

📌core message

Checking gastric pH is essential to verify NG tube placement before feeding.

9 : A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

📌core message

10 : A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?

📌core message

1 :
A nurse is caring for a school-age child who has cystic fibrosis.

2 :
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

3 :
A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

4 :
A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

5 :
A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

6 :
A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

7 :
A nurse is providing teaching to the parent of a toddler who isscheduled for an electrocardiogram. Which of the following statements should the nurse make?

8 :
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

9 :
A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

10 :
A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?