A pre-school age child with a congenital heart defect is brought to the clinic by the parent because of a fever and an earache. During the assessment, the parent asks the nurse why the child is at the 5th percentile for weight and height for age. Which response is best for the nurse to provide?
"Haven't you been feeding according to recommended daily allowances for children?"
"Does your child seem mentally slower than his peers also?"
"You should not worry about the growth tables. They are only averages for children."
"The smaller size is probably due to the heart disease."
The Correct Answer is D
A. "Haven't you been feeding according to recommended daily allowances for children?": This response implies blame and lacks sensitivity. It doesn't acknowledge the child’s underlying medical condition that may affect growth.
B. "Does your child seem mentally slower than his peers also?": Intellectual development is unrelated to height/weight percentile in children with congenital heart disease unless there are neurological complications, which haven't been indicated.
C. "You should not worry about the growth tables. They are only averages for children.": While growth charts are averages, they are clinically significant, especially for identifying underdevelopment in children with chronic illnesses.
D. "The smaller size is probably due to the heart disease.": Chronic hypoxia and increased metabolic demands in congenital heart disease often contribute to poor weight gain and growth delay, making this the most informative and empathetic response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["75"]
Explanation
Dose per administration in milliliters = 15 mL.
Concentration of the medication = 12.5 mg/5 mL.
- Calculate the amount of medication in milligrams (mg) per administration.
Amount per administration (mg) = Dose per administration (mL) × (Concentration (mg) / Volume (mL))
= 15 mL × (12.5 mg / 5 mL)
= 15 mL × 2.5 mg/mL
= 37.5 mg.
- Determine the number of doses per day.
Doses are given every 12 hours, so Number of doses per day = 24 hours / 12 hours/dose
= 2 doses/day.
- Calculate the total daily dose in milligrams (mg).
Total daily dose (mg) = Amount per administration (mg) × Number of doses per day
= 37.5 mg × 2 doses
= 75 mg.
Correct Answer is B
Explanation
A. Notify the charge nurse the client will need assignment to the COVID-19 specified area of the facility: This is appropriate, but not the most immediate priority. Isolation must occur first to prevent viral spread before formal reassignment can be made.
B. Isolate the client from other clients, family, and healthcare workers not wearing proper PPE: This is the most urgent infection control measure. Isolation limits transmission risk while awaiting test results and is the first step in managing suspected COVID-19 cases.
C. Explain to the client to inform others that they may have been potentially exposed in the last 14 days: This is part of public health tracing but is not the nurse’s immediate clinical priority when caring for a symptomatic client.
D. Update the client and family regarding the COVID-19 vaccines that are available: Vaccine education is important for prevention but not urgent during symptomatic evaluation and isolation of a potentially infectious individual.
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