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A 7-year-old child with a history of seizures is being discharged from the hospital. What should the nurse include in the discharge teaching for the parents?
- A. Administer antiepileptic medication as prescribed, not just when a seizure occurs
- B. Ensure the child gets adequate sleep
- C. Restrict the child's activities to prevent seizures
- D. Teach seizure first aid to family members
Correct Answer: D
Rationale: The correct answer is to teach seizure first aid to family members. This is crucial because family members need to know how to appropriately respond during a seizure to ensure the child's safety. Choice A has been corrected to emphasize that antiepileptic medication should be administered as prescribed, not just when a seizure occurs, to effectively manage the condition. Choice B, while important for overall health, is not directly related to seizure management. Choice C is not recommended as restricting activities may not prevent seizures and may hinder the child's quality of life.
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Which of the following parameters would be LEAST reliable when assessing the perfusion status of a 2-year-old child with possible shock?
- A. distal capillary refill
- B. systolic blood pressure
- C. skin color and temperature
- D. presence of peripheral pulses
Correct Answer: B
Rationale: Systolic blood pressure is the least reliable parameter when assessing the perfusion status of a 2-year-old child with possible shock. In pediatric patients, especially young children, blood pressure may not decrease until significant shock has already occurred, making it a late indicator of inadequate perfusion. Depending solely on systolic blood pressure to evaluate perfusion status in this age group can lead to a delay in appropriate interventions. Distal capillary refill time, skin color, and temperature changes, and the presence of peripheral pulses are more sensitive and early indicators of perfusion status in pediatric patients. Monitoring distal capillary refill provides information on peripheral perfusion, while changes in skin color and temperature can signal circulatory compromise. Evaluating the presence or absence of peripheral pulses offers insights into vascular perfusion. These parameters offer more reliable and prompt feedback on a child's perfusion status compared to systolic blood pressure.
What should the nurse include in the preoperative teaching for a 4-year-old child scheduled for a tonsillectomy?
- A. Explaining the procedure in detail
- B. Encouraging deep breathing exercises
- C. Discussing the importance of hydration
- D. Using play therapy to prepare the child
Correct Answer: B
Rationale: Encouraging deep breathing exercises is crucial preoperative teaching for a child scheduled for a tonsillectomy as it helps improve lung function and can prevent postoperative complications like pneumonia. Explaining the procedure in detail may heighten the child's anxiety, making it less ideal. While discussing hydration is important, it may not be the top priority for preoperative teaching for this specific procedure. Play therapy can reduce fear and anxiety, but encouraging deep breathing exercises directly contributes to better postoperative outcomes by enhancing respiratory function.
A child is brought to the clinic after tripping over a rock. The child states, 'I twisted my ankle,' and is given a diagnosis of a sprain. What intervention is most important for the nurse to include in the discharge instructions for this child?
- A. For the first 24 hours, apply ice for 20 minutes and remove for 60 minutes.
- B. Bed rest with the leg elevated for 36 hours.
- C. May take an NSAID for pain as prescribed.
- D. Use a compression dressing for 72 hours.
Correct Answer: A
Rationale: The correct answer is A. Applying ice in intervals helps to reduce swelling and pain in the first 24 hours after a sprain. This intervention is crucial in the initial management of a sprain to decrease inflammation and provide pain relief. Bed rest with the leg elevated for 36 hours (Choice B) is not recommended as prolonged immobilization can lead to stiffness and decreased range of motion. Allowing the child to take an NSAID for pain as prescribed (Choice C) is a supportive measure but not as essential as ice application in the acute phase. Using a compression dressing for 72 hours (Choice D) may assist in reducing swelling, but it is not as critical as the immediate application of ice to manage pain and inflammation effectively.
A 6-month-old infant is diagnosed with cystic fibrosis. What explanation should the nurse provide to the parents about this condition?
- A. It is a condition affecting the respiratory and digestive systems.
- B. It is an autoimmune disorder affecting multiple organs.
- C. It is a genetic disorder that can be managed with medication.
- D. It is a condition caused by prenatal exposure to toxins.
Correct Answer: A
Rationale: The correct answer is A: 'It is a condition affecting the respiratory and digestive systems.' Cystic fibrosis is a genetic disorder that primarily affects the respiratory and digestive systems. It is caused by a defective gene that leads to the production of thick and sticky mucus in these organs. This mucus can clog airways in the lungs and block the ducts in the pancreas, affecting digestion. Choice B is incorrect because cystic fibrosis is not an autoimmune disorder; it is a genetic condition. Choice C is partially correct in that cystic fibrosis is a genetic disorder, but merely managing it with medication oversimplifies the comprehensive care needed for individuals with cystic fibrosis. Choice D is incorrect as cystic fibrosis is not caused by prenatal exposure to toxins but is a genetic condition inherited from parents.
A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse's most appropriate response?
- A. Praise the parent for the decision and encourage the plan.
- B. Ask for more specific information related to the developmental delays.
- C. Advise the parent to have the healthcare provider help choose an appropriate program.
- D. Explain that this may be a premature action and the developmental delays could disappear.
Correct Answer: B
Rationale: The most appropriate response in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the child's needs and provide tailored guidance and support to the parent. Praising the parent (Choice A) before fully grasping the situation may not be beneficial. Advising the parent to involve the healthcare provider in selecting a program (Choice C) is premature without a comprehensive understanding of the child's developmental delays. Explaining that the delays might resolve on their own (Choice D) is inappropriate as it dismisses the parent's concerns and the necessity for timely and appropriate interventions.