A client has just given birth to her second child and will breastfeed. Although she wants 'lots of kids,' she does not want to become pregnant again until her second child is at least 2 years old. The nurse would counsel her to start using birth control at what point?

Correct Answer: D

Rationale: The correct answer is D) As soon as she resumes sexual activity. This recommendation is based on the fact that ovulation can occur before the first postpartum menstrual period, making it possible for the client to conceive even before menstruation resumes. It is crucial for the client to start using birth control as soon as she becomes sexually active again to prevent unintended pregnancies. Option A) Within 6 weeks is incorrect because the client can resume ovulation before this time frame, so waiting until 6 weeks postpartum may not provide adequate protection against pregnancy. Option B) Within 18 months is incorrect as this timeframe does not align with the client's desire to wait until her second child is at least 2 years old before becoming pregnant again. Option C) As soon as she stops breastfeeding is incorrect because the resumption of ovulation can occur even while breastfeeding, especially as the frequency and duration of breastfeeding decrease over time. Educationally, this question highlights the importance of understanding postpartum contraception and the potential for ovulation to resume before the return of menstruation. It emphasizes the need for healthcare providers to counsel clients effectively on the appropriate timing to initiate birth control to meet their reproductive goals.

Correct Answer: D

Rationale: The correct answer is D: "Encourage your child to lie on their left side with elevated head of the bed." Rationale: Lying on the left side with an elevated head of the bed helps to improve lung expansion and ventilation in the right lower lobe, which is affected by pneumonia. This position allows for better drainage of secretions and promotes optimal oxygenation. Option A: "Place child in Trendelenberg position" is incorrect because this position, where the bed is tilted with the head lower than the feet, is not recommended for pneumonia as it can cause increased pressure on the lungs and compromise breathing. Option B: "Place the child in prone position" is not ideal for pneumonia as it can increase the risk of aspiration and may not provide adequate lung expansion in the affected area. Option C: "Encourage your child to lie on the right side with elevated head of the bed" is incorrect because lying on the right side may further compromise the right lower lobe affected by pneumonia and hinder effective lung aeration. Educational Context: Understanding the optimal positioning for improved lung aeration in pediatric patients with pneumonia is crucial for nurses caring for these children. By knowing the rationale behind the correct positioning, nurses can educate parents on how to support their child's respiratory function and recovery effectively. This knowledge is essential for providing safe and evidence-based care to pediatric patients with respiratory conditions.

Correct Answer: D

Rationale: The correct answer is D: "You should administer five back blows followed by five chest thrusts." This response is the most appropriate because for a child under 1 year old, the recommended first aid technique for choking is a series of five back blows followed by five chest thrusts. This technique is specifically designed for infants to dislodge the obstructing object and clear the airway without causing harm. Option A suggests administering abdominal thrusts, which are not recommended for infants as they can cause harm to their delicate bodies. Option B advises trying to retrieve the object manually, which can potentially push the object further down the airway. Option C mentions the Heimlich maneuver, which is suitable for conscious adults or older children but not recommended for infants due to the risk of injury. In an educational context, it is crucial for nurses to be well-versed in pediatric first aid techniques, especially for common emergencies like choking. By understanding and correctly applying the appropriate interventions, nurses can help save lives and prevent further complications in pediatric patients. Training and regular practice of these skills are essential for healthcare professionals working with pediatric populations.

Correct Answer: D

Rationale: The correct answer is option D: "Let's talk about your questions and concerns. We also have a parent support group that you may be interested in." This response is the best choice because it demonstrates empathy, active listening, and a patient-centered approach. It acknowledges the parents' emotional state, offers to address their questions and concerns, and provides additional support through a parent support group. This response shows the nurse's commitment to holistic care, considering not just the medical aspect but also the emotional and social needs of the family. Option A is incorrect because while it is true that the life expectancy for CF patients has improved, it does not directly address the parents' current emotional concerns. Option B is incorrect because it dismisses the parents' worries by implying that their child may not follow the same course as the cousin who died of CF, which may come across as insensitive. Option C is incorrect because it shifts the responsibility to the physician without addressing the immediate emotional needs of the parents. It is important for the nurse to provide support and guidance to the family during this difficult time. In an educational context, this question highlights the importance of effective communication, empathy, and support in pediatric nursing. Nurses play a crucial role in providing not only medical care but also emotional support to families dealing with chronic illnesses like CF. Building rapport, addressing concerns, and offering resources for additional support are essential skills for pediatric nurses to ensure comprehensive care for both the patient and the family.

Correct Answer: C

Rationale: In pediatric nursing, understanding the symptoms of heart failure in children is crucial for providing effective care. The correct answer, option C, "Weight gain," is not typically seen in children with heart failure. This is because heart failure in children often presents with symptoms such as poor feeding (option A), rapid breathing (option B), and fatigue (option D). Poor feeding is common in children with heart failure due to increased metabolic demands and decreased cardiac output, leading to reduced appetite. Rapid breathing occurs as the body compensates for the heart's inability to pump effectively by increasing respiratory rate to improve oxygenation. Fatigue is a result of the heart’s decreased ability to pump blood efficiently, leading to decreased energy levels in children with heart failure. Understanding these symptoms is essential for nurses caring for pediatric patients with heart failure as early recognition and intervention can significantly impact outcomes. Educating nurses on these manifestations equips them to provide timely and appropriate care, such as monitoring intake and output, administering medications, and collaborating with the healthcare team to optimize the child's cardiac function. This knowledge ensures safe and effective nursing practice in managing pediatric patients with heart failure.