Nokea
A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen?
- A. Establish a contract with her, including rewards.
- B. Suggest time-outs when she forgets her medicine.
- C. Discuss with her mother the damaging effects of her rescuing the child.
- D. Ask the child to bring her medicine containers to each appointment so they can be counted.
Correct Answer: A
Rationale: Establishing a behavioral contract with rewards encourages adherence by addressing barriers like side effects or scheduling and motivates the child. Time-outs are punitive, discussing maternal rescuing is less effective, and checking containers monitors but doesn?t promote self-responsibility.
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A child, age 7 years, has a fever associated with a viral illness. She is being cared for at home. What is the principal reason for treating fever in this child?
- A. Relief of discomfort
- B. Reassurance that illness is temporary
- C. Prevention of secondary bacterial infection
- D. Avoidance of life-threatening complications
Correct Answer: A
Rationale: Treating fever primarily relieves discomfort using antipyretics and environmental measures. It doesn?t reassure temporariness, prevent bacterial infections, or significantly reduce rare complications like febrile seizures.
A 6-year-old boy is hospitalized for intravenous antibiotic therapy. He eats very little on his regular diet trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. What nursing action is the most appropriate?
- A. Request these favorite foods for him.
- B. Identify healthier food choices that he likes.
- C. Explain that he needs fruits and vegetables.
- D. Reward him with ice cream at the end of every meal that he eats.
Correct Answer: A
Rationale: Requesting the child?s favorite foods encourages nutritional intake during illness, which can be supplemented with healthier options. Explaining nutritional needs or rewarding with ice cream is less effective, and focusing only on healthier foods may discourage eating.
A 16-year-old girl comes to the pediatric clinic for information on birth control. The nurse knows that before this young woman can be examined, consent must be obtained from which source?
- A. Herself
- B. Her mother
- C. Court order
- D. Legal guardian
Correct Answer: A
Rationale: Contraceptive advice is considered a medically emancipated condition, allowing the 16-year-old to provide her own informed consent. Parental or guardian consent is not required, and a court order is unnecessary for this routine care.
An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restraints can be removed. What nurses response is best?
- A. Restraints need to be kept on all the time.
- B. That is fine as long as you are with him.
- C. That is fine if we have his parents consent.
- D. The restraints can be off only when the nursing staff is present.
Correct Answer: B
Rationale: Removing restraints when a responsible adult, like the grandmother, is present to supervise protects the IV site while promoting comfort. Keeping restraints on constantly, requiring parental consent, or limiting removal to staff presence is overly restrictive.
A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?
- A. Use an 18-gauge needle if possible.
- B. Show the child the equipment to be used before the procedure.
- C. If not successful after four attempts, have another nurse try.
- D. Restrain the child completely.
Correct Answer: B
Rationale: Showing the child the equipment before the procedure reduces fear and supports atraumatic care. An 18-gauge needle is too large, a two-try policy (four attempts total) is preferred, and full restraint is unnecessary, favoring therapeutic hugging instead.