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A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents discharge teaching?
- A. Turn every 8 hours.
- B. Specially designed car restraints are necessary.
- C. Diapers should be avoided to reduce soiling of the cast.
- D. Use an abduction bar between the legs to aid in turning.
Correct Answer: B
Rationale: Specially designed car restraints ensure safe transport for a child in a hip spica cast. Turning should occur more frequently, diapers are needed to maintain cleanliness, and the abduction bar is not used for turning to avoid cast damage.
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The middle school nurse is speaking to parents about prevention of injuries as a goal of the physical education program. How should the goal be achieved?
- A. Use of protective equipment at the familys discretion
- B. Education of adults to recognize signs that indicate a risk for injury
- C. Sports medicine program to help student athletes work through overuse injuries
- D. Arrangements for multiple sports to use same athletic fields to accommodate more children
Correct Answer: B
Rationale: Educating adults to recognize fatigue, dehydration, and injury risk signs prevents sports injuries. Protective equipment is mandatory, working through overuse injuries is harmful, and shared fields increase distraction and injury risk.
A young girl has just injured her ankle at school. In addition to notifying the childs parents, what is the most appropriate, immediate action by the school nurse?
- A. Apply ice.
- B. Observe for edema and discoloration.
- C. Encourage child to assume a position of comfort.
- D. Obtain parental permission for administration of acetaminophen or aspirin.
Correct Answer: A
Rationale: Applying ice immediately reduces swelling and pain in soft tissue injuries, followed by rest, elevation, and compression. Observing edema, finding a comfortable position, and administering medication are secondary to ice application.
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material?
- A. Soak in a bathtub.
- B. Vigorously scrub the leg.
- C. Carefully pick material off the leg.
- D. Apply powder to absorb the material.
Correct Answer: A
Rationale: Soaking in a bathtub gently removes desquamated skin and secretions over days, avoiding skin damage. Scrubbing or picking risks excoriation, and powder is ineffective; oil or lotion may help comfort, not removal.
The nurse at a summer camp recognizes the signs of heatstroke in an adolescent girl. Her temperature is 40 C (104 F). She is slightly confused but able to drink water. Nursing care while waiting for transport to the hospital should include what intervention?
- A. Administer antipyretics.
- B. Administer salt tablets.
- C. Apply towels wet with cool water.
- D. Sponge with solution of rubbing alcohol and water.
Correct Answer: C
Rationale: Applying cool, wet towels and removing clothing cools the body in heatstroke, addressing thermoregulatory failure. Antipyretics are ineffective, salt tablets worsen dehydration, and rubbing alcohol is harmful and not used.
Immobilization causes what effect on metabolism?
- A. Hypocalcemia
- B. Decreased metabolic rate
- C. Positive nitrogen balance
- D. Increased levels of stress hormones
Correct Answer: B
Rationale: Immobilization reduces metabolic rate, slowing systems and food intake. It causes hypercalcemia, negative nitrogen balance from muscle atrophy, and decreased stress hormone production due to reduced coping capacity.