An infant who is developmentally delayed has a ventricular peritoneal (VP) shunt for hydrocephalus. The nurse makes a postoperative home visit to assess the child's progress. During the visit, the mother tells the nurse, "When the shunt is removed, the pressure in my baby's head will be gone." Which response should the nurse provide?

"Many infants outgrow the need for a shunt after the neonatal period."

"The shunt will be replaced as your child grows to reduce pressure in the brain."

"Other pathways in the brain will drain fluid after the shunt is removed."

"The shunt will have to be reinserted only if an infection or blockage develops."

Answer and Explanation

The Correct Answer is B

Choice A reason: "Many infants outgrow the need for a shunt after the neonatal period." is not a correct response that the nurse should provide. This statement is false, as most infants with hydrocephalus will need a shunt for life. Only a small percentage of infants with post-hemorrhagic hydrocephalus may outgrow the need for a shunt .

Choice B reason: "The shunt will be replaced as your child grows to reduce pressure in the brain." is the correct response that the nurse should provide. This statement is true, as the shunt will need to be adjusted or replaced as the child grows to accommodate the changes in the size and shape of the head and the amount of fluid drainage. The nurse should educate the mother about the signs and symptoms of shunt malfunction and the need for regular follow-up visits.

Choice C reason: "Other pathways in the brain will drain fluid after the shunt is removed." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that bypasses the blocked or impaired pathways in the brain and allows the fluid to drain into the abdomen. Without the shunt, the fluid will accumulate in the brain and cause increased pressure and damage.

Choice D reason: "The shunt will have to be reinserted only if an infection or blockage develops." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed and reinserted unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that stays in place unless it malfunctions or becomes infected. The nurse should educate the mother about the signs and symptoms of shunt infection and the need for prompt treatment.

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Correct Answer is B

Explanation

Choice A reason: Luteinizing hormone (LH) levels are not relevant for the diagnosis of congenital hypothyroidism. LH is a hormone that regulates the reproductive system and is not affected by thyroid function.

Choice B reason: Thyroxine (T4) is the main hormone produced by the thyroid gland and is essential for growth and development. Low levels of T4 indicate hypothyroidism and require treatment with thyroid hormone replacement. High levels of T4 indicate hyperthyroidism and require treatment with anti-thyroid drugs.

Choice C reason: Growth hormone (GH) levels are not relevant for the diagnosis of congenital hypothyroidism. GH is a hormone that stimulates growth and metabolism and is not affected by thyroid function.

Choice D reason: Follicle stimulating hormone (FSH) levels are not relevant for the diagnosis of congenital hypothyroidism. FSH is a hormone that regulates the reproductive system and is not affected by thyroid function.

A. Recommend that the parent bring the child in for immediate evaluation. B. Advise the parent that over-use of the medication may cause chronic bronchitis. C. Confirm that the medication helps to reduce airway inflammation. D. Assure the parent that they are using the medication correctly.

Correct Answer is D

Explanation

Choice A reason: Recommending that the parent bring the child in for immediate evaluation is not the best response by the nurse. This may cause unnecessary anxiety and expense for the parent and the child. Albuterol is a bronchodilator that relaxes the muscles in the airways and increases air flow to the lungs. It is used to treat or prevent bronchospasm, or narrowing of the airways, in people with asthma or chronic obstructive pulmonary disease (COPD). It is also used to prevent exercise-induced bronchospasm. It is a quick-relief medication that can be used as needed when the child has difficulty breathing.

Choice B reason: Advising the parent that over-use of the medication may cause chronic bronchitis is not the best response by the nurse. This is not true and may discourage the parent from giving the medication to the child when needed. Chronic bronchitis is a type of COPD that causes inflammation and mucus production in the airways. It is usually caused by smoking or exposure to air pollution, not by albuterol. Albuterol does not cause chronic bronchitis, but it can help relieve the symptoms of bronchospasm in people who have it.

Choice C reason: Confirming that the medication helps to reduce airway inflammation is not the best response by the nurse. This is not accurate and may confuse the parent. Albuterol does not reduce airway inflammation, but it relaxes the muscles around the airways so that they open up and the child can breathe more easily. Albuterol is not an anti-inflammatory medication, but a bronchodilator. Anti-inflammatory medications, such as corticosteroids, are used to prevent or reduce inflammation in the airways, but they are not quick-relief medications like albuterol.

Choice D reason: Assuring the parent that they are using the medication correctly is the best response by the nurse. This shows that the nurse understands the purpose and the proper use of albuterol and that the nurse supports the parent's decision to give the medication to the child when needed. The nurse should also educate the parent on how to use the inhaler device correctly, how to monitor the child's symptoms and peak flow, and when to seek medical attention if the child's condition worsens.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a one-month-old infant admitted for suspected congenital hypothyroidism. Which diagnostic test results should the nurse report to the healthcare provider?

Correct Answer is B

Explanation

A school-age child with bronchial asthma has a prescription for albuterol. The child's parent tells the nurse that the medication is used when the child is having difficulty breathing. Which is the best response by the nurse?

Correct Answer is D

Explanation

The nurse is teaching the parents about important dietary changes for their child who is newly diagnosed with celiac disease. Which foods should the nurse include in the list of allowed foods for this child?

The nurse observes a mother giving her 11-month-old ferrous sulfate (iron drops), followed by 2 ounces (60 mL) of orange juice. What should the nurse do next?

The nurse is performing a routine assessment of a 3-year-old at a community health center. Which behavior by the child should alert the nurse to request a follow-up for a possible autism spectrum disorder (ASD)?

A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping. Which intervention should the nurse implement?

The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?

The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

A preschool-age boy in a daycare facility scratches his head frequently, and the nurse confirms the presence of head lice. The nurse washes the child's hair with permethrin shampoo and calls his parents. Which instruction should the nurse provide to the parents about treatment for head lice?