A nurse is caring for a child who has had diarrhea for 3 days. Which of the following actions should the nurse take?
Weigh the child weekly.
Keep the child NPO for the next 12 hr.
Collect a stool culture.
Offer the child 120 mL (4 oz) of apple juice every 2 hr.
The Correct Answer is C
A. Weighing the child weekly is not an appropriate intervention for managing acute diarrhea, as it does not address the immediate concern of dehydration or infection.
B. Keeping the child NPO for 12 hours is generally not recommended unless the child is severely dehydrated or vomiting, as it could lead to further dehydration. Hydration and appropriate refeeding are important in managing diarrhea.
C. A stool culture can help determine the cause of diarrhea (such as bacterial infection) and guide appropriate treatment. This is a priority in determining the underlying cause of the child's symptoms.
D. Offering apple juice is not recommended for diarrhea, as high fructose content can worsen diarrhea. Oral rehydration solutions (ORS) or clear fluids are more appropriate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A 9-month-old infant is expected to demonstrate a crude pincer grasp, which involves picking up small objects between the thumb and forefinger. This is a developmental milestone for this age.
B. While infants may shake their heads by this age, it is typically not used in the context of saying "no." This action is usually a sign of exploration or reaction to stimulation.
C. A 9-month-old typically does not use two-word phrases. By this age, infants are usually babbling and may say single words like "mama" or "dada."
D. A 9-month-old is not expected to build a tower of four blocks. By 12-15 months, infants may begin to stack blocks.
Correct Answer is B
Explanation
A. Neck flexion when bending forward is not a typical indicator of scoliosis. Scoliosis is identified by abnormal curvature of the spine, not by the neck.
B. Uneven shoulders when standing erect are a key indicator of scoliosis. This asymmetry can be identified when the child bends forward at the waist, which is a standard test for scoliosis during a physical examination.
C. Toes that point inward when bending forward is not a sign of scoliosis. This could be indicative of a different musculoskeletal issue such as hip or leg alignment problems, but it is not related to scoliosis.
D. Knees that bow outward when standing erect indicate bow-leggedness (genu varum), not scoliosis. Scoliosis specifically affects the spine's curvature.
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