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4 | Page 48. Mrs. Paula related that she oftentimes feel nauseated in the afternoon. Which of the following should Nurse Cynthia advise her to do? A. Eat sky flakes and follow it up with water B. Drink iced carbonated drinks C. Drink hot chocolate or coffee D. Eat frequent but small amount of foods. 49.Which of the following periods of pregnancy does organogenesis occur? A. Third B. First C. Second D. Fourth 50.What sign of pregnancy is morning sickness characterized by nausea? A. Probable, subjective B. Presumptive, subjective C. Probable, objective D. Presumptive, objective Situation 12 – A mother in her first trimester of pregnancy is asthmatic and has taken steroids. This resulted to her baby with cleft lip and cleft palate. 51. While assessing a newborn with cleft lip, the nurse should be alerted on which of the following that will MOST likely be compromised? A. Locomotion B. Respiratory status C. GI function D. Sucking ability 52. What is the MOST APPROPRIATE response of the nurse to the mother’s question as to when the child will be ready for a cleft palate repair? Cleft palate repair is usually done _______. A. When a large-holed feeding bottle is ineffective for his feeding B. When the child is completely weaned from bottle feeding C. Prior to the development of speech D. After the child has been toilet trained 53. Elbow restraints are the choice during the patient’s operation. When is the right time to introduce the use of these restraints? It should be during the _________ phase. A. Pre-operative B. Rehabilitative C. intra- operative D. post- operative 54. Before bringing the child to the operating room, what condition of the patient needs immediate notification of the surgeon by the nurse that will warrant suspension of surgery? A. Colic B. Atopic dermatitis C. nasopharyngitis D. eye deviation 55. Include in the post-op plan of care is collaboration and referral of the patient with cleft palate to which of the following APPROPRIATE health care provider? A. Speech therapist B. Dentist C. dietetian D. gynecologist Situation 13 – The giving of medication to a pediatric patient is a serious responsibility of a nurse. The need for accuracy in giving medication is greater than with adult patients. Nurse Yuuh has just been assigned to the Pediatric Wards. 56. Dosage, when giving medicine to pediatric patients, varies according to which of the following? Select all that apply 1. Size 2. Surface area 3. Age of child 4. Height A. 3 only B. 1 and 2 C. 1, 2, 3 D. 1, 2, 3, 4 57. Nurse Yuuh is being reviewed by her Headnurse on administering oral medication on pediatric patients. Which of the following statements below is CORRECT? A. The child should be told to place the tablet in the middle of his tongue and to drink water, fruit juice, milk in order to wash down the tablet. B. A child’s reaction to a dose ordered by a physician is not less predictable than adult’s reaction. C. When giving oral medication, the child as young as two years of age CANNOT be taught to swallow drugs. D. The possibility of error is greater in the giving of medication to children than to adults. 58. In children and infants, which part is often used for intramuscular injection to reduce the risk of vascular and peripheral nerve (sciatic) injuries? A. Deltoid muscle B. Gluteus maximus C. Dorsogluteal D. Vastus lateralis 59. Comprehensive surveys of research reports and case study literature about intramuscular injections revealed that administering medication intramuscularly can produce a variety of serious adverse effects. When asked by the Headnurse what possible complications can arise, Nurse Yuuh should include which of the following? 1. Skin and tissue trauma 2. Muscle fibrosis and contracture 3. Nerve palsies and paralysis 4. Infectious processes such as abscesses or gangrene A. 1, 3, and 4 B. 1, 2, 3, 4 C. 2, 3, 4 D. 1, 2, 3 60. Prior to administering the drugs ordered by the Pediatrician, Nurse Yuuh needs to know if she is giving the ordered medication to the right patient. The FIRST step is __________. A. Check patient’s identification bracelet. B. Compare medication to order to identification bracelet and patient’s stated name and birth date. C. Verify patient’s allergies with chart and with patient. D. Ask patient to state their name and birth date. Situation 14 – Nicole, 5 years of age, is admitted to the Pediatric Ward due to severe otalgia, fever and irritability. The mother informed Nurse Olive, who is assigned to Nicole that patient had upper respiratory infection three weeks prior to admission. The admission diagnosis is acute otitis media (AOM). 61. Nurse Olive makes her INITIAL assessment on Nicole. The patient keeps on crying and constantly pulls her right ear. What is her MOST APPROPRIATE action? A. Assess the description and frequency of pain. B. Take Karen’s vital signs. C. Request parent to carry the child. D. Refer to the attending physician. 62.Nurse Olive is preparing to administer ofloxacin eardrop on Nicole per Doctor’s order. She needs to hold the bottle with her hands to warm up the solution to prevent dizziness for _________. A. 10 minutes B. 5 minutes  C. 3-5 minutes D. 1 to 2 minutes 63. After washing her hands and gently cleaning any discharge that can be removed easily from the outer ear, Nurse Olive positions the child. Which of the following steps follows? A. Gently press the tragus of the ear four times in a pumping motion. B. Drop the medicine into the ear canal. C. Gently pull the outer ear D. Keep the up for five minutes 64. Based on her knowledge on otitis media, Nurse Romana recalls that children are predisposed to AOM due to their Eustachian tubes being, which of the following? Select all that apply.

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