Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A school-age child diagnosed with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
A. Administer an antiemetic at least 30 minutes before chemotherapy begins.
Administering an antiemetic at least 30 minutes before chemotherapy begins is correct because prevention is more effective than treatment after symptoms appear. Administering antiemetics prophylactically helps reduce the severity and incidence of chemotherapy-induced nausea and vomiting, improving patient comfort and adherence to treatment.
B. Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.
Encouraging the child to remain NPO until nausea subsides is incorrect because prolonged fasting does not prevent chemotherapy-induced nausea and may contribute to dehydration and nutritional deficits, especially important in children undergoing cancer treatment.
C. Encourage drinking large amounts of favorite fluids.
Encouraging drinking large amounts of fluids is incorrect because forcing large volumes may worsen nausea or vomiting. Fluid intake should be adequate but balanced to prevent discomfort.
D. Administer an antiemetic as soon as child has nausea.
Administering an antiemetic after the child has nausea is incorrect because reactive treatment is less effective than prophylactic administration. Once severe nausea and vomiting have occurred, they are harder to control and can impact hydration, nutrition, and overall treatment tolerance.
This question is an excerpt from Nurse Dive's nursing test bank - Ati dmmsn 650 OB/Pediatrics Proctored Exams. Take the full exam now
Full Explanation
A. Administering an antiemetic at least 30 minutes before chemotherapy begins is correct because prevention is more effective than treatment after symptoms appear. Administering antiemetics prophylactically helps reduce the severity and incidence of chemotherapy-induced nausea and vomiting, improving patient comfort and adherence to treatment.
B. Encouraging the child to remain NPO until nausea subsides is incorrect because prolonged fasting does not prevent chemotherapy-induced nausea and may contribute to dehydration and nutritional deficits, especially important in children undergoing cancer treatment.
C. Encouraging drinking large amounts of fluids is incorrect because forcing large volumes may worsen nausea or vomiting. Fluid intake should be adequate but balanced to prevent discomfort.
D. Administering an antiemetic after the child has nausea is incorrect because reactive treatment is less effective than prophylactic administration. Once severe nausea and vomiting have occurred, they are harder to control and can impact hydration, nutrition, and overall treatment tolerance.
Similar Questions
A nurse is providing anticipatory guidance about child development to the parents of a preschooler. Which of the following developmental tasks should the nurse include as being expected of a preschooler?
A. Develops object permanence
Develops object permanence is incorrect because object permanence is typically achieved by 8–12 months of age, during the sensorimotor stage of infancy, not during the preschool years.
B. Participates in imaginary play
Participates in imaginary play is correct because preschoolers (ages 3–5 years) engage in imaginative or pretend play, which is a hallmark of this developmental stage. Imaginary play supports cognitive, social, and emotional development and is consistent with Piaget’s preoperational stage.
C. Builds a collection of cards
Builds a collection of cards is incorrect because collecting items is more typical of school-age children (around 6–12 years), who are developing organizational skills and a sense of classification.
D. Learns to tell time
Learns to tell time is incorrect because this skill generally develops later in the school-age period, as it requires a more advanced understanding of abstract concepts and numerical sequencing.
Full Explanation
A. Develops object permanence is incorrect because object permanence is typically achieved by 8–12 months of age, during the sensorimotor stage of infancy, not during the preschool years.
B. Participates in imaginary play is correct because preschoolers (ages 3–5 years) engage in imaginative or pretend play, which is a hallmark of this developmental stage. Imaginary play supports cognitive, social, and emotional development and is consistent with Piaget’s preoperational stage.
C. Builds a collection of cards is incorrect because collecting items is more typical of school-age children (around 6–12 years), who are developing organizational skills and a sense of classification.
D. Learns to tell time is incorrect because this skill generally develops later in the school-age period, as it requires a more advanced understanding of abstract concepts and numerical sequencing.
A nurse is assessing a 9-month-old infant who has shown minimal weight gain. The parent reports the baby eats less than usual and tires easily during play. Both parents are of average height. Which factor is most likely affecting the infant's growth?
A. Psychosocial environment
Psychosocial environment is incorrect because while a stimulating and supportive environment can influence growth indirectly, the primary concern for minimal weight gain and fatigue in an infant is related to intake and nutritional status rather than parental interaction or emotional factors alone.
B. Genetics
Genetics is incorrect because both parents are of average height, suggesting that hereditary factors are unlikely to explain poor weight gain in this infant. Genetic potential affects height and weight trends but would not typically cause sudden minimal weight gain and fatigue.
C. Daycare setting
Daycare setting is incorrect because while meal patterns and activity level at daycare could influence intake, the report of decreased appetite and fatigue suggests a direct nutritional or health issue rather than environmental influence alone.
D. Nutrition
Nutrition is correct because insufficient caloric or nutrient intake is the most likely cause of poor weight gain, low energy, and fatigue in a 9-month-old. At this age, infants rely on adequate nutrition from breast milk, formula, or complementary foods to support rapid growth and development.
Full Explanation
A. Psychosocial environment is incorrect because while a stimulating and supportive environment can influence growth indirectly, the primary concern for minimal weight gain and fatigue in an infant is related to intake and nutritional status rather than parental interaction or emotional factors alone.
B. Genetics is incorrect because both parents are of average height, suggesting that hereditary factors are unlikely to explain poor weight gain in this infant. Genetic potential affects height and weight trends but would not typically cause sudden minimal weight gain and fatigue.
C. Daycare setting is incorrect because while meal patterns and activity level at daycare could influence intake, the report of decreased appetite and fatigue suggests a direct nutritional or health issue rather than environmental influence alone.
D. Nutrition is correct because insufficient caloric or nutrient intake is the most likely cause of poor weight gain, low energy, and fatigue in a 9-month-old. At this age, infants rely on adequate nutrition from breast milk, formula, or complementary foods to support rapid growth and development.
A nurse is educating the parents of a pediatric patient who recently had a ventriculoperitoneal (VP) shunt placed to treat hydrocephalus. Which statement by the parents indicates the most critical understanding about care and potential complications?
A. We should limit physical activity and keep the child in bed to prevent dislodging the shunt.
Limiting physical activity and keeping the child in bed is incorrect because children with VP shunts do not need prolonged bed rest. Normal activity is encouraged as long as it is safe; the shunt is designed to withstand routine movement.
B. If the child develops a fever, we can give over-the-counter fever reducers and only call the doctor if it persists more than 3 days.
Managing fever with over-the-counter medications and waiting 3 days to call the provider is incorrect because fever may indicate a shunt infection, which is a medical emergency. Prompt assessment is essential for early intervention.
C. We will need to flush the shunt regularly at home to keep it from clogging.
Flushing the shunt at home is incorrect because VP shunts should never be flushed by caregivers; doing so could cause serious injury or infection. Shunt function is monitored by observing for signs of malfunction, not by manual flushing.
D. We will watch closely for sudden vomiting headache, or changes in behavior and notify the provider immediately if these occur.
Watching for sudden vomiting, headache, or changes in behavior and notifying the provider immediately is correct because these are key signs of shunt malfunction or increased intracranial pressure, which can be life-threatening. Early recognition and prompt medical evaluation are critical for preventing complications such as brain damage or infection.
Full Explanation
A. Limiting physical activity and keeping the child in bed is incorrect because children with VP shunts do not need prolonged bed rest. Normal activity is encouraged as long as it is safe; the shunt is designed to withstand routine movement.
B. Managing fever with over-the-counter medications and waiting 3 days to call the provider is incorrect because fever may indicate a shunt infection, which is a medical emergency. Prompt assessment is essential for early intervention.
C. Flushing the shunt at home is incorrect because VP shunts should never be flushed by caregivers; doing so could cause serious injury or infection. Shunt function is monitored by observing for signs of malfunction, not by manual flushing.
D. Watching for sudden vomiting, headache, or changes in behavior and notifying the provider immediately is correct because these are key signs of shunt malfunction or increased intracranial pressure, which can be life-threatening. Early recognition and prompt medical evaluation are critical for preventing complications such as brain damage or infection.