The nurse would plan to use the Nipissing District Developmental Screen with a child who is:

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Question 1 of 9

The nurse would plan to use the Nipissing District Developmental Screen with a child who is:

Correct Answer: A

Rationale: The correct answer is A (3 years old) because the Nipissing District Developmental Screen is specifically designed for children aged 1 month to 6 years to assess their developmental milestones. It focuses on various areas of development appropriate for this age group, such as motor skills, language, social interaction, and cognitive abilities. Using this tool with a 3-year-old child allows for early identification of potential developmental delays or concerns. Incorrect choices: B (16 years old) - The Nipissing District Developmental Screen is not intended for children above 6 years old. C (8 years old with a developmental delay) - The tool is primarily for early screening, not for children already identified with developmental delays. D (Having difficulty with gross motor skills) - While this child may benefit from assessment, the Nipissing Screen is a comprehensive tool for overall development, not just specific skill deficits.

Question 2 of 9

What should be the nurse's first action when a client develops a fever after surgery?

Correct Answer: A

Rationale: The correct first action when a client develops a fever after surgery is to administer antipyretics (A). Fever post-surgery can indicate infection, and antipyretics help lower the body temperature. Administering pain medications (B) may mask the fever's underlying cause. Providing fluids (C) is essential but not the priority. Providing wound care (D) is important but comes after addressing the fever. Administering antipyretics promptly helps manage the fever and allows for further assessment and intervention if needed.

Question 3 of 9

A woman has noticed that her son, who has a new babysitter, has some blisters and scabs on his face and buttocks. On examination, the nurse notices moist, thin-roofed vesicles with a thin erythematous base and suspects:

Correct Answer: B

Rationale: The correct answer is B: impetigo. The characteristics of moist, thin-roofed vesicles with a thin erythematous base are classic features of impetigo, a bacterial skin infection commonly seen in children. Impetigo is highly contagious and commonly affects the face and buttocks. The presence of blisters and scabs further supports the diagnosis of impetigo. Explanation of other choices: A: Eczema typically presents as dry, itchy patches of skin with redness and scaling. It does not usually manifest as vesicles or blisters. C: Herpes zoster, also known as shingles, presents as a painful rash with grouped vesicles on one side of the body along a nerve pathway. It is uncommon in children and usually affects older individuals. D: Diaper dermatitis is a common rash in infants due to prolonged skin exposure to urine and feces. It typically presents as redness, irritation, and possibly skin breakdown in the diaper

Question 4 of 9

Which food should be avoided by clients prone to heartburn from GERD?

Correct Answer: C

Rationale: The correct answer is C: Chocolate. Chocolate is known to trigger heartburn in individuals with GERD due to its high fat content and caffeine. Fat relaxes the lower esophageal sphincter, allowing stomach acid to flow back up the esophagus, leading to heartburn. Caffeine can also relax the sphincter and trigger acid reflux. Lettuce (A) and eggs (B) are generally well-tolerated and do not commonly trigger heartburn. Butterscotch (D) may be high in fat and sugar, but it is less likely to cause heartburn compared to chocolate.

Question 5 of 9

When examining a patient's eyes, the nurse knows that stimulation of the sympathetic branch of the autonomic nervous system:

Correct Answer: C

Rationale: The correct answer is C because stimulation of the sympathetic branch of the autonomic nervous system results in the elevation of the eyelid (ptosis) and dilation of the pupil (mydriasis). This is due to the action of the dilator pupillae muscle and the superior tarsal muscle. Pupillary constriction (choice A) is controlled by the parasympathetic branch via the sphincter pupillae muscle. Adjusting the eye for near vision (choice B) is controlled by the ciliary muscle, which is under parasympathetic control, not sympathetic. Contraction of the ciliary body (choice D) is also controlled by the parasympathetic system for accommodation of near vision, not the sympathetic system.

Question 6 of 9

During a well-baby checkup, the nurse notices that a 1-week-old infant's face looks small, compared with an enlarged cranium. On further examination, the nurse also notes dilated scalp veins and downcast, or"setting sun," eyes. What condition does the nurse suspect?

Correct Answer: C

Rationale: The correct answer is C: Hydrocephalus. The nurse suspects hydrocephalus due to the symptoms presented by the infant: enlarged cranium, small face, dilated scalp veins, and "setting sun" eyes. Hydrocephalus is the abnormal accumulation of cerebrospinal fluid in the brain, leading to increased intracranial pressure and characteristic physical signs such as an enlarged head. Craniotabes (A) is softening of the skull bones, not associated with these symptoms. Microcephaly (B) is characterized by a smaller head size, opposite to what is described in the question. Caput succedaneum (D) is swelling of the soft tissues of the infant's scalp, which is unrelated to the symptoms mentioned.

Question 7 of 9

Which technique is most effective for assessing the patient's abdominal organ size?

Correct Answer: B

Rationale: The correct answer is B: Palpation. Palpation is the most effective technique for assessing the patient's abdominal organ size as it allows the healthcare provider to feel and evaluate the size, texture, and consistency of the abdominal organs through touch. This hands-on approach provides valuable information about any abnormalities or tenderness in the organs. Inspection (choice A) involves looking at the abdomen for any visible signs but does not provide information on organ size. Percussion (choice C) involves tapping on the abdomen to assess the density of underlying structures, not specifically organ size. Auscultation (choice D) involves listening to sounds within the abdomen and does not directly assess organ size. Palpation is the preferred method for accurately assessing abdominal organ size due to its tactile nature.

Question 8 of 9

The nurse is performing an assessment on a 21-year-old patient and notes that his nasal mucosa appears pale, grey, and swollen. What would be the most appropriate question to ask the patient?

Correct Answer: A

Rationale: The correct answer is A: "Are you aware of having any allergies?" This question is appropriate because the patient's symptoms of pale, grey, and swollen nasal mucosa suggest an allergic reaction. By asking about allergies, the nurse can gather important information to determine the cause of the symptoms. B: "Do you have an elevated temperature?" - This question is not directly related to the patient's nasal symptoms and does not address the likely allergic reaction. C: "Have you had any symptoms of a cold?" - While cold symptoms may present similarly to allergies, the patient's specific symptoms of pale, grey, and swollen nasal mucosa are more indicative of an allergic reaction. D: "Have you been having frequent nosebleeds?" - This question does not directly address the patient's current symptoms and is not likely related to the nasal mucosa appearance described.

Question 9 of 9

A nurse is teaching a patient with a history of stroke about reducing the risk of another stroke. Which of the following lifestyle changes should the nurse emphasize?

Correct Answer: D

Rationale: The correct answer is D: All of the above. This is the best choice because reducing the risk of another stroke requires a holistic approach. A: Limiting sodium and cholesterol intake helps manage blood pressure and cholesterol levels, reducing the risk of stroke. B: Increasing physical activity and managing weight can improve cardiovascular health and overall well-being, reducing the risk of stroke. C: Taking prescribed medications regularly, such as blood thinners or antihypertensives, is crucial in preventing another stroke. In summary, all three choices address key risk factors for stroke prevention, making them essential components of a comprehensive stroke prevention plan.

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