The nurse is conducting teaching for an adolescent being discharged to home after a renal transplant. The adolescent needs further teaching if which statement is made?

Correct Answer: B

Rationale: The statement "I am glad I only have to take the immunosuppressant medication for two weeks" indicates a misunderstanding about the long-term nature of immunosuppressant therapy following a renal transplant. In reality, individuals who undergo a renal transplant need to take immunosuppressant medications for the rest of their lives to prevent rejection of the donor kidney. Failure to adhere to this medication regimen can result in rejection of the transplanted kidney. Therefore, this statement indicates a need for further teaching to ensure the adolescent understands the importance of lifelong immunosuppressant therapy.

Correct Answer: B

Rationale: Hypoparathyroidism is a condition characterized by decreased levels of parathyroid hormone, which can lead to low levels of calcium in the blood (hypocalcemia). Profound neuromuscular irritability is a significant complication of hypocalcemia and is a key concern for clients with hypoparathyroidism. Symptoms can include muscle cramps, tetany, seizures, and decreased cardiac contractility. Monitoring for neuromuscular irritability and promptly addressing low calcium levels are essential in the care of clients with hypoparathyroidism.

Correct Answer: D

Rationale: The most appropriate nursing intervention in this situation would be to get the newborn, wrap in a blanket, and rewarm in a radiant warmer so parents can hold their deceased infant. This is known as a "cold cuddle" technique, where the infant is gently rewarmed for a short period of time to allow the parents to hold and say goodbye to their baby. This practice has been shown to help parents in the grieving process and is a compassionate way to support them during this difficult time. It allows the parents to have a physical connection with their child and provides them with some closure and the opportunity to create lasting memories.

Correct Answer: B

Rationale: A hydrocele presents as a fluid-filled sac surrounding the testes within the scrotum. In newborns, it is a common finding due to the open connection between the peritoneal cavity and the scrotum that may allow fluid to accumulate. This can result in a large, edematous, and pendulous scrotum. Hydroceles are usually benign and tend to resolve on their own within the first year of life. In contrast, the absence of testes (cryptorchidism) would be identified as the inability to palpate the testes in the scrotum or inguinal canal. An inguinal hernia would present as a bulge in the inguinal area caused by a loop of intestine protruding through a weak spot in the abdominal wall.

Correct Answer: A

Rationale: Separation anxiety is the major stressor of hospitalization for these young patients. Toddlers and preschoolers are at a critical stage of development where they are developing close attachments to their primary caregivers. Being separated from their parents or primary caregivers when admitted to the hospital can lead to feelings of fear, distress, and insecurity. This separation can significantly impact their emotional well-being and overall hospital experience. Loss of control, fear of bodily injury, and fear of pain are also stressors associated with hospitalization, but separation anxiety is the primary concern for these young patients due to their developmental stage.

Correct Answer: A

Rationale: Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is essential for the absorption of vitamin B12 in the intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is absorbed in the ileum of the small intestine. Without intrinsic factor, vitamin B12 absorption is significantly impaired, leading to conditions like pernicious anemia, which is a type of megaloblastic anemia caused by vitamin B12 deficiency. By administering cyanocobalamin (Betalin-12) intramuscularly, the need for intrinsic factor in the absorption process is bypassed, which is necessary in cases where intrinsic factor production or function is disrupted.

Correct Answer: C

Rationale: Successful breastfeeding is most dependent on the mother's desire to breastfeed. A mother who is committed and motivated to breastfeed is more likely to overcome any challenges that may arise, such as difficulty latching, low milk supply, or lack of support. The mother's determination and willingness to persevere through any difficulties play a significant role in the success of breastfeeding. Additionally, a positive attitude and mindset can greatly impact the mother's breastfeeding experience and enhance the bond between the mother and baby.

Correct Answer: C

Rationale: In the case of Mr. Dela Isla, who suffered a CVA, one of the most important discharge teachings would be drug compliance. Following a stroke, patients are often prescribed medications to help manage their condition and reduce the risk of further complications. It is crucial for Mr. Dela Isla to understand the importance of taking his medications as prescribed by his healthcare provider. Non-compliance with medication regimens can have serious consequences and may increase the likelihood of recurrent strokes or other health issues. Therefore, ensuring that Mr. Dela Isla understands the purpose of his medications, how to take them correctly, and the potential side effects is essential for his recovery and ongoing health management. While emergency numbers, relaxation techniques, and dietary prescriptions are important aspects of care, ensuring drug compliance is critical for the immediate and long-term well-being of a patient who has experienced a stroke.

Correct Answer: C

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