A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?

An hour before meals and at bedtime.

Every six hours around the clock.

Upon awakening and within an hour after meals.

Evenly spaced when the patient is awake.

Answer and Explanation

The Correct Answer is A

An hour before meals and at bedtime.

Choice A rationale:

Scheduling chest physiotherapy an hour before meals and at bedtime is optimal. This timing helps prevent aspiration during meals and aids in clearing secretions before sleep. It complements the patient's meal schedule and sleep routine.

Choice B rationale:

Every six hours around the clock could disrupt the patient's sleep and meal times. Chest physiotherapy might not align well with the patient's daily activities, potentially affecting treatment compliance and effectiveness.

Choice C rationale:

Performing chest physiotherapy upon awakening and after meals might increase the risk of aspiration during meals. Clearing airways before meals is safer, and performing it right after meals could cause discomfort.

Choice D rationale:

Evenly spaced physiotherapy when awake lacks synchronization with meal and sleep times. This approach might not optimize treatment effects and patient convenience.

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Correct Answer is B

Explanation

Choice A rationale:

Neck vein distention might be seen in conditions affecting venous return to the heart, such as heart failure, but it's not a specific symptom of closed head injury.

Choice B rationale:

Fixed, dilated pupils are a classic sign of increased intracranial pressure. The pressure can compress the cranial nerves, leading to changes in pupillary size and reactivity.

Choice C rationale:

Shortness of breath is more related to respiratory issues and might not be directly linked to a closed head injury.

Choice D rationale:

Glycosuria, the presence of glucose in the urine, is not a primary symptom of closed head injury. It could be related to diabetes or other metabolic conditions.

A. The patient ties his shoelaces. B. The patient gives his first and last name. C. The patient can tell time. D. The patient draws a stick figure with six parts.

Correct Answer is D

Explanation

Choice A rationale:

The patient ties his shoelaces. This choice is incorrect as most 3-year-olds lack the fine motor skills required to tie shoelaces independently.

Choice B rationale:

The patient gives his first and last name. This choice is also incorrect, as most 3-year-olds might not have developed language skills to provide their full name accurately.

Choice C rationale:

The patient can tell time. This choice is unrealistic for a 3-year-old, as telling time involves cognitive and conceptual abilities that are not yet developed at this age.

Choice D rationale:

The patient draws a stick figure with six parts. This choice is correct. Around age 3, children usually start drawing simple figures with a head, arms, legs, and possibly facial features, totaling around six parts. This reflects appropriate developmental milestones for a child of this age.

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A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 15-year-old patient with a closed head injury is admitted to the pediatric intensive care unit and is intubated. The nurse should monitor the patient for which symptom?

Correct Answer is B

Explanation

A nurse is caring for a 3-year-old patient. Which behavior is developmentally appropriate for this patient?

Correct Answer is D

Explanation

A patient newly diagnosed with insulin-dependent diabetes mellitus comes to the clinic one month after diagnosis. The mother tells the nurse, "My child is getting better. The glucose levels are almost normal and my child requires less insulin.". What is the most appropriate response by the nurse?

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A nurse takes all of these actions when caring for a 13-year-old who just returned from a cardiac catheterization. Which action is incorrect and requires further discussion?

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