Verified Answers
1. Which response about safety measures is the most appropriate advice for
the 2 year old's mother who had her older home remodeled to reduce the lead
level? Select all that apply.
1. Wash & dry the child's hands and face before he eats.
2. it is best to use cold water to prepate the child's food to decrease lead level.
3. diet does not matter in reduce lead levels in the child.
4. Drinking two cups of milk per day helps decrease lead levels.: 1 & 3. Washing and
drying hands and face especially before eating, decreases lead ingestion. Hot water absorbs more lead readily than
hot water. Diet does matter; regular meals, adequate iron and calcium, and less fat help the child absorb less lead.
Drinking 2 cups of milk per day is important for children but does not help decrease lead level.
2. Which would be the priority intervention for a child suspected of having
varicella (chickenpox)?
1. Contact Precautions
2. Contact and Droplet Respiratory Precautions?
3. Droplet respiratory precautions?
4. Universal Precautions and standard precautions.: 2. Varicella (Chickenpox) is highly
contagious. Contact & Droplet respiratory precautions should be started immediately because the primary source of
transmission is secretions of the respiratory tract (droplet) and also by contaminated objects.
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4. Caladryl: A lotion containing diphenhydramine. Should not be applied if child has already been given benadryl
(diphenhydramine) because it can cause toxicity.
5. Which s&s would the nurse expect with rheumatic fever?
1. Ankle and Knee Joint Pain.
2. Negative group A beta strep culture.
3. Large, red "bulls eye" - appearing rash.
,4. stiff neck with photophobia.: Ankle and knee joint pain.
, 6. The parents of a 12-month old with HIV are concerned about him receiving
routine immunizations. What will the nurse tell them about immunizations?: -
"You are concerned about your child receiving immunizations. Let me explain why your child will NOT receive routine
immunizations today"
The nurse acknowledges a client's fears and then discusses the concerns to clarify any misconceptions. Immunizations
and influenza vaccine are recommended to prevent infection. Immunocompromised HIV-infected children should not
receive MMR and varicella live vaccines.
7. Nursing Assessment suspects the newborn has cystic fibrosis. Which inter-
ventions would the nurse begin.
1. Observe frequency and nature of stools.
2. Provide Chest PT
3. Observe for weight gain.
4. Assess parent's compliance with fluid restrictions.
5. Assess respiratory system frequently.: 1 & 3
Cystic fibrosis is an inherited autsomal trait, causing exocrien gland dysfunction. 7-10% present meconium ileus, so
assessing stool frequency and consistency is important.
Assessing weight is important in newborns because they lose up to 10% of their birth weight, and can take 2 weeks for
them to regain their birth weight.
Assessing the newborn's respiratory system frequently would be monitored as frequently as other infants if the newborn
has no respiratory symptoms. Chest PT would not be initiated in a newborn without a definitive diagnosis.
8. Can a mother breastfeed their infant if they have PKU?: Yes. Breast milk has low amounts
of phenylalanine, so the mother can breast as long as the infants phenylalanine level is monitored.
9. Vaccines given routinely at 15 months.: Hib & DTaP
10. Which priority intervention for the newborn of a mother positive for hepatitis
antigen?: The newborn should receive both hepatitis B vaccine and hepatitis B immune globulin within 12 hours
of birth to prevent hepatitis B infection.