A nurse is assisting with the care of a school-age child who has shigella. Which of the following actions should the nurse take?

Maintain oral rehydration therapy.

Provide a diet high in sodium.

Administer antiviral medication.

Give antidiarrheal agents every 4 hours.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Maintaining oral rehydration therapy is a crucial nursing action when caring for a child with shigella, which is a bacterial infection that causes severe diarrhea. Oral rehydration therapy helps prevent dehydration and electrolyte imbalances caused by fluid loss from diarrhea. It involves giving the child oral rehydration solutions containing electrolytes and fluids to replace those lost through diarrhea.
Choice B rationale:
Providing a diet high in sodium is not recommended for a child with shigella. Shigella is associated with diarrhea and gastrointestinal symptoms, and a high-sodium diet can worsen fluid imbalances and dehydration.
Choice C rationale:
Shigella is a bacterial infection, not a viral infection, so administering antiviral medication would not be effective or appropriate. Antiviral medications are used to treat viral infections, not bacterial ones like shigella.
Choice D rationale:
Giving antidiarrheal agents every 4 hours is not recommended for a child with shigella. Antidiarrheal agents can slow down the gastrointestinal tract and inhibit the body's natural mechanism for expelling harmful substances, such as bacteria. It's important to allow the body to eliminate the bacteria and toxins causing the infection through diarrhea, while simultaneously providing rehydration support.

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Correct Answer is C

Explanation

Choice A rationale:
Sun protection is necessary even when using self-tanning creams. Self-tanning creams do not provide protection against the harmful effects of ultraviolet (UV) radiation. Adolescents should be educated about the importance of using sunscreen to prevent skin damage and reduce the risk of skin cancer.
Choice B rationale:
The risk of injury from firearms does not necessarily decrease as children enter adolescence. Adolescents may still lack proper judgment and decision-making skills, making them susceptible to accidents and injuries related to firearms. Educating adolescents about firearm safety and promoting responsible firearm storage is essential.
Choice C rationale:
(Correct Choice) Driving skills can indeed be impaired when friends are present. Teenagers often face distractions while driving, especially when friends are in the car. Peer pressure and social interactions can divert their attention from the road, leading to an increased risk of accidents. Educating adolescents about the importance of focused and responsible driving can help reduce this risk.
Choice D rationale:
Medroxyprogesterone, a form of hormonal contraception, does not provide protection against gonorrhea. It offers contraception by preventing ovulation and altering the cervical mucus to impede sperm penetration. However, it does not offer any protection against sexually transmitted infections (STIs). Adolescents should be educated about safe sex practices to prevent STIs.

A. 8.6 to 9.5 kg (19 to 21 lb). B. 4.1 to 5 kg (9 to 11 lb). C. 6.8 to 7.7 kg (15 to 17 lb). D. 10.4 to 11.3 kg (23 to 25 lb).

Correct Answer is C

Explanation

The correct answer is choice C. 6.8 to 7.7 kg (15 to 17 lb).

Choice A rationale:

This weight range is above the average for a 6-month-old infant. According to growth charts, the 50th percentile weight for a 6-month-old male is approximately 7.9 kg (17 lb 8 oz), and for a female, it’s about 7.3 kg (16 lb 1 oz). Therefore, 8.6 to 9.5 kg would be considered above average and not the anticipated weight for most infants.

Choice B rationale:

This weight range is below the average for a 6-month-old infant. The average weight at 6 months is significantly higher than 4.1 to 5 kg, as infants are expected to double their birth weight by 5 months of age. Therefore, an infant weighing between 9 to 11 lb at 6 months would be considered underweight.

Choice C rationale:

This weight range is within the average for a 6-month-old infant. As mentioned, the 50th percentile weights for 6-month-old infants are approximately 7.9 kg for males and 7.3 kg for females. This choice falls within the expected weight gain trajectory where an infant is anticipated to double their birth weight by 5 months and then gain an additional pound or so by 6 months.

Choice D rationale:

This weight range is significantly above the average for a 6-month-old infant. It is well above the 95th percentile for this age group and would be considered unusual without underlying health conditions that could contribute to such a weight at this age. An infant weighing between 23 to 25 lb at 6 months would be exceptionally rare and likely indicative of an abnormal growth pattern.

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A nurse is assisting with the care of a school-age child who has shigella. Which of the following actions should the nurse take?

Nursing Test Bank

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