NCLEX resp questions

After insertion of bilat tubes in a toddler, which instructions should the nurse include in the child's discharge plan for the parents? 1. insert ear plugs when the child baths 2. blow the nose forcibly during a cold 3. administer the prescribed antibiotics while the tubes are in place 4. disregard any drainage from the ear after 1 week

1. need to prevent contaminated bath water from entering the middle ear. Blowing the nose forcefully during a cold causes organisms to ascend through the eustachian tubes. No need to have cont antibiotics when tubes are in place. Drainage from the ear may be a sign of middle ear infection.

when preparing the teaching plan for the mother of a child with asthma, which of the following should the nurse include as signs to alert the mother that her child is having an asthma attack? 1. secretion of thin, copious mucus 2. tight, productive cough 3. wheezing on expiration 4. temperature of 99.4

3. wheezing on expiration pt may have tight, productive cough with asthma as well

After a tonsillectomy and adenoidectomy, which of the following findings should alert the nurse to suspect early hemorrhage in a 5-year-old child? 1. drooling of bright red secretions 2. pulse rate of 95 bpm 3. vomiting of 25 ml dark brown emesis 4. blood pressure of 95/56 mm Hg

1. because of discomfort in throat kids sometimes don't want to swallow so they may drool. bright red is always bad. freq

An 11 year old is admitted for treatment of an asthma attack. Which of the following indicates immediate intervention is needed? 1. thin, copious mucous secretions 2. productive cough 3. intercostal retractions 4. respiratory rate of 20 breaths/min`

3. intercostal retractions = respiratory distress thin secretions are not a problem productive cough may need to be addresses but not an immediate problem respiratory rate of 20 is normal

After teaching parents of a preschooler about post op tonsillectomy eating, which of the following statements indicates successful teaching? 1. meat loaf and uncooked carrots 2. pork and noodle casserole 3. cream of chicken soup and orange sherbert 4. hot dog and potato chips

3. soft foods needed, meatloaf is considered soft but carrots aren't, don't want food they have to chew to much because sometimes they don't chew well, so pork and noodles casserole and hot dog is out, potato chips have sharp edges

A nurse is teaching the parents of a preschooler about the possibility of postoperative hemorrhage after a tonsillectomy and adenoidectomy. The nurse should explain that the risk is greatest at which of the following times? 1. 1-3 days after surgery 2. 4-6 days after surgery 3. 7-10 days after surgery 4. 11-14 days after surgery

3. tissue begins sloughing and scabs fall off at 7-10 days, higher risk of bleeding at that time