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ISPN考试练习题之妇儿

发表日期:2016-04-06 | 来源 :国际护士网 | 作者 :www.the-nurses.com |点击数: 次 收听:
 
1. The nurse discusses skateboard safety witha group of parents. It is MOST important for the nurse to include which of thefollowing statements?
(1)    “Ifyour children are younger than 5, always observe them while they areskateboarding.”
(2)    “Carefullycheck the surface where your child will be skateboarding.”
(3)    “Itdoes not matter what type of skateboard you get for your child.”
(4)    “Instructyour child to keep as close to the curb as possible.”

CORRECT:(2) 

1. Strategy: Determine the outcome of eachanswer. Is it desired?
1) childrenyounger than 5 should not skateboard; developmentally they have difficultyprotecting themselves from injury
2) checkfor holes, bumps, rocks, and debris
3) skateboardsare designed for various uses (slalom, freestyle, or speed); know how you childplans to use the skateboard
4) never ride askateboard in the street
 
2. The nurse in the outpatient clinic assesses a school-age childbrought to the clinic because of a skateboarding accident. Which of thefollowing questions should the nurse ask FIRST?
(1)     “When did the accident occur?”
(2)     “Were you wearing a helmet? 
(3)     “How long have you been skateboarding?”
(4)     “Did you hit your head?”

CORRECT:(4) 
Strategy: “FIRST” indicates priority.
1) appropriate question but not the firstquestion the nurse should ask
2) should wear helmets and protective padding;priority is assessing current injuries
3) not best question
4) injuries caused by skateboardinginclude wrist injuries and head injuries; priority is to assess for head injury
 
3. The nurse in the pediatric clinic makes a follow-up call to themother of a school-aged child diagnosed the previous day with rubella (Germanmeasles). The nurse should FIRST respond to which of the following statementsmade by the mother?
(1)     "My sister-in-law is coming to visit next week. She just foundout that she is pregnant."
(2)     "I have heard measles can cause serious complications. I do notknow how to protect my child."
(3)     "My child is so upset about missing the class trip. It is myfault for not having my child immunized."
(4)     "My child feels very warm. I am going to give my child someaspirin to decrease the temperature." 

CORRECT:(4) 
Strategy: "FIRST" indicates priority.
1) of great concern, but not the firststatement the nurse should respond to; rubella is contagious and can have ateratogenic effect on the fetus; notify sister-in-law not to come
2) reassure mother that complications are rare
3) psychosocial needs; vaccination preventsrubella, priority is responding to the statement about the aspirin
4) can cause Reye’s syndrome;acetaminophen is effective in reducing fever and is the preferred antipyreticfor children
 
4. A mother brings her 3-year-old to the pediatric clinic for awell-child visit. Which of the following comments by the mother to the nurse isMOST important for the nurse to address further?
(1)     "My child talks constantly, even when nobody is listening, isforever asking questions, and sometimes stutters."
(2)     "My mother-in-law is coming for a visit in 2 weeks and I amworried about the tension her visits generate. She spoils my child andcriticizes me."
(3)     "I am sorry we were a little late. There is so much renovationwork going on in the old house we live in that I almost lost track oftime."
(4)     "Lately my child has an imaginary friend named Peter and I amsupposed to set an extra plate at the table for him."

CORRECT:(3) 
Strategy: "MOST important" indicates that discrimination is requiredto answer the question.
1) may indicate that health teaching would beuseful regarding expected developmental behaviors; these are normal behaviorsfor a 3-year-old
2) psychosocial concern; further assessmentwould be useful in terms of mother’s feelings, husband’s role, andlimit-setting efforts already tried; may be useful to offer recommendations forlearning assertiveness, problem-solving skills, and perhaps seeking familycounseling
3) depending on the house’s age,renovation and remodeling can spread lead dust that child and others couldinhale and then develop lead poisoning; houses built before 1978 are ofconcern; if such houses are being remodeled, neither children nor pregnantwomen should be in them until the work is fully done and cleaning has occurred
4) normal 3-year-old behavior
 
5. The nurse cares for clients in labor anddelivery. A client in early labor complains of “not being able to hold myurine.” Which of the following actions should the nurse take FIRST?
   (1) Instruct the client to void more frequently.
   (2) Check the pH of the fluid. 
   (3) Assess the client for dilatation and effacement. 
   (4) Change the bed linens. 

CORRECT:(2) 
Strategy:Determine if it is appropriate to assess or implement.
1) a full bladdercan increase discomfort during the contraction and slow the descent of thefetus; encourage client to void every 1–2 hours
2) determineif the fluid is amniotic fluid (alkaline) or urine (acidic); assess beforeimplementing
3) when BOWruptures, assess fetal well being
4) keeping linendry promotes comfort during labor; priority is determining if the BOW hasruptured
 
6. The mother of a 2-year-old and a 4-year-oldbrings the children to the pediatric clinic for well-child checkups. Bothchildren will be having birthdays within the next 2 months. The mother appearstired and frustrated and says to the nurse, "I feel like I have been on awhirlwind for over a year. I never thought two children could be so much work.If I have to set limits one more time, I think I will scream." Which ofthe following responses by the nurse is BEST?
  (1) "Next year should be a more peaceful year for you."
  (2) "Have you though about preschool for your children?"
  (3) "When they get more involved away from home, you will miss thesedays."
  (4) "Do you and your husband agree on discipline?

CORRECT:(1) 
Strategy:"BEST" indicates that discrimination is required to answer thequestion.
1)provides opening for realistic anticipatory guidance; toddlerhood, withits negativism, temper tantrums, mood shifts, food issues, and short attentionspan, gives way to a period of relative equilibrium when the 2-year-old reachesage 3; the transition from the often aggressive, mood swings, rebelliousness,and drama of a 4-year-old to a period of calm tranquility at age 5 is a similarprocess; thus it is correct that this mother’s next year should be morepeaceful
2) closed-endedquestion that misses opportunity to talk of upcoming quieter time
3) discouragesfurther communication and is rather patronizing; may even convey that mothershould feel guilty about feeling the way she does
4) may be usefulto explore, but first need further expression of mother’s feelings
 
7. Thenurse on a pediatric unit prepares to admit a child diagnosed with nonorganicfailure to thrive. When caring for the child, the nurse should take which ofthe following actions?
  (1) Feed the child in the presence of other children.
  (2) Assign a consistent core group of staff to care for the child.
  (3Place the child in a room near the nurse’s station.
  (4Rotate the staff so that the parents can see a variety of feedingapproaches.

CORRECT:(2) 
Strategy:Determine the outcome of each answer. Is it desired?
1) may be easilydistracted; other children will be distracting; feeding environment should bequiet and nonstimulating
2)consistent team of nurses helps build trust; cycle of dissatisfactionand frustration causes difficulty between parent and child; feeding techniquesbest taught to parents by example and demonstration
3) quiet,nonstimulating atmosphere is best for feeding; controlled stimulation throughplanned program of play is important
4) consistency ofstaff priority in order to gain trust of child and parents
 
8. The nurse counsels the parents ofschool-age children. One of the parents asks the nurse how they should teachtheir children about human sexuality. Which of the following responses by thenurse is BEST?
  (1) “Find out what your children know before answering their questions.”
  (2) “Remember, your words have more influence than your actions.”
  (3) “Avoid correct anatomic terms because they are difficult for the childto comprehend.”
  (4) “Playing ‘ doctor’ satisfies the child’s curiosity.”

CORRECT:(1) 
Strategy:Determine the outcome of each answer.
1) firstassess; children often have misinformation about human sexuality; if themisinformation is not identified, child will incorporate the misinformationinto the parent’s answer
2) actions aremore influential than words
3) using correctterminology is appropriate
4) parents’responsibility to answer their child’s questions
 
9. A woman delivers an 8 lb, 1 oz,infant via spontaneous vaginal delivery. The nurse assists the patient with herfirst breast-feeding experience. Which of the following should be the priorityaction of the nurse?
  (1) Instruct the mother to use an antiseptic soap on her breasts.
  (2) Teach the mother how to position the baby. 
  (3) Allow the mother and the baby time alone. 
  (4) Include the infant’s father or other caregiver. 

CORRECT:(2) 
Strategy: Allthe answer choices are implementations. Determine the outcome of each answer.Is it desired?
1)implementation; should just use water on the breasts because soap can bedrying; dry thoroughly; expose to air
2) implementation; can use side-lying, sitting upright, or with infant facingmother (tailor position); rotate breast-feeding positions; position nipple sothat infant’s mouth covers a large portion of the areola and release infant’smouth from nipple by inserting finger to break suction
3)implementation; stay with the patient; should assess effectiveness of newborn’ssuck, swallow, gag reflex; instruct mother how to position baby and nipple
4) implementation;not highest priority
 
10. A 55-year-old woman comes to the outpatientclinic. The client has been receiving estrogenic substances, conjugated (PremPro), for 3 months. Which statement, if made by the client to the nurse,requires immediate follow-up?
  (1)  “Ifrequently have trouble falling asleep at night.”
  (2)  “Ihave gained 5 pounds since I have started taking this medication.”
  (3)  “Myleft leg is sore behind the knee.”
  (4)  “Iam still having hot flashes several times a week.” 

CORRECT:(3) 
Strategy:“requires immediate follow-up” indicates a complication.
1) assessment;insomnia is a common complaint during menopause
2) assessment;weight gain is a common side effect
3) assessment could indicate thrombophlebitis; other side effects include nausea,skin rashes, pruritus, breast secretion
4) assessment;symptoms of menopause may persist with use of ERT; symptoms related to hormonechanges: vasomotor instability, emotional disturbances, atrophy of genitalia,uterine prolapse.

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