A nurse is assessing a 5 year old with a history of heart failure. Which finding indicates that the child has adequate cardiac output?

Correct Answer: A

Rationale: Adequate cardiac output is a measure of how well the heart is able to pump blood effectively to meet the body's metabolic demands. An adequate cardiac output ensures sufficient oxygen and nutrients are delivered to the tissues and organs. One of the most reliable indicators of adequate cardiac output is urine output. A urine output of at least 1 mL/kg/hour, which translates to around 30 mL/hour in a 5-year-old child, indicates adequate perfusion and renal function. In heart failure, decreased cardiac output may lead to decreased renal perfusion, resulting in a decreased urine output, so a stable or increased urine output suggests adequate cardiac output.

Correct Answer: B

Rationale: When planning education for the parents of a child with type 1 diabetes mellitus, the nurse should include rotating insulin injection sites. This is important to prevent lipohypertrophy, which is the buildup of fat under the skin, and to ensure consistent absorption of insulin. Rotating injection sites helps to maintain healthy tissue and promotes better insulin effectiveness in managing blood sugar levels. It is a key component of proper diabetes care and helps to reduce the risk of complications associated with continuous injection in the same area.

Correct Answer: D

Rationale: The primary therapeutic management of children with beta-thalassemia major involves frequent blood transfusions. This is necessary because beta-thalassemia major is a severe form of thalassemia where there is a significant reduction in the production of hemoglobin. Blood transfusions help to increase the levels of normal hemoglobin in the body, improving symptoms related to anemia and preventing complications such as growth failure and organ damage. Other treatments such as iron chelation therapy to manage iron overload and supportive measures like adequate hydration are also important, but frequent blood transfusions are the cornerstone of managing beta-thalassemia major.

Correct Answer: D

Rationale: Type 1 diabetes mellitus is characterized by the body's inability to produce insulin. Therefore, the mainstay of treatment for type 1 diabetes is insulin therapy. Insulin injections are necessary to replace the insulin that the body is unable to produce on its own. While physical exercise and dietary management are important components of managing diabetes, in the case of type 1 diabetes, insulin is an essential part of the treatment plan to control blood glucose levels effectively and prevent complications. Oral hypoglycemic agents, on the other hand, are typically used in the treatment of type 2 diabetes, where the body's insulin production may be insufficient or ineffective.

Correct Answer: C

Rationale: The described reflex involving stroking the newborn's cheek along the side of the mouth causing the newborn to turn the head toward that side and begin to suck is known as the rooting reflex. This reflex is essential for newborns to find the nipple and start breastfeeding. Stroking the cheek triggers the baby to turn towards the stimulus, helping them locate the source of food for feeding.