Nokea
A healthcare provider is preparing a 2-year-old child for surgery. What preoperative teaching should be provided to this child?
- A. Explaining the procedure in simple terms
- B. Using a doll to demonstrate the procedure
- C. Showing pictures of the hospital environment
- D. Allowing the child to play with medical equipment
Correct Answer: B
Rationale: Using a doll to demonstrate the procedure is the most appropriate preoperative teaching method for a 2-year-old child. It helps them understand what to expect in a non-threatening way by providing a visual representation of the upcoming surgery. Explaining the procedure in simple terms may be too abstract for a child of this age, as they may not fully comprehend verbal explanations. Showing pictures of the hospital environment may not be as effective as using a doll, as it may not provide a concrete understanding of the actual procedure. Allowing the child to play with medical equipment is unsafe and does not adequately prepare them for the surgery, as it may lead to misunderstandings or fear regarding the equipment's actual use during the surgery.
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When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?
- A. Skeletal traction
- B. Physical therapy
- C. Orthotics
- D. Occupational therapy
Correct Answer: A
Rationale: When caring for a child with cerebral palsy, skeletal traction is the least likely treatment intervention. Cerebral palsy primarily involves motor function impairments, and skeletal traction is not a typical intervention for this condition. Physical therapy is commonly used to improve movement and function, orthotics help with posture and mobility, and occupational therapy addresses activities of daily living. These interventions are more aligned with the needs of a child with cerebral palsy compared to skeletal traction, making it the least likely treatment option.
During a clinical conference with a group of nursing students, the instructor is describing burn classifications. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?
- A. Skin that is reddened, dry, and slightly swollen
- B. Skin appearing wet with significant pain
- C. Skin with blistering and swelling
- D. Skin that is leathery and dry with some numbness
Correct Answer: D
Rationale: Full-thickness burns, also known as third-degree burns, are characterized by a leathery, dry appearance with numbness due to nerve damage. This type of burn extends through all layers of the skin, affecting nerve endings. Choice A describes characteristics of superficial partial-thickness burns, which involve the epidermis and part of the dermis. Choice B describes characteristics of superficial burns, or first-degree burns, which only affect the epidermis. Choice C describes characteristics of superficial to mid-dermal burns, also known as second-degree burns, which involve the epidermis and part of the dermis but do not extend through all skin layers. Therefore, the correct answer is D.
A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?
- A. Cannot stand on one foot
- B. Builds a tower of 7 blocks
- C. Uses echolalia when speaking
- D. Colors outside the lines of a picture
Correct Answer: C
Rationale: The correct answer is C. Using echolalia, which is the repetition of words or phrases, is not typical for a 2-year-old child and may indicate the need for further evaluation. Choices A, B, and D are all within the expected developmental skills for a 2-year-old. While most 2-year-olds may not be able to stand on one foot, it is not a cause for concern at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both appropriate for a 2-year-old's developmental skills.
The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?
- A. Interrupted family process related to the child's diagnosis
- B. Deficient knowledge related to the genetic disorder
- C. Grieving related to the child's poor prognosis
- D. Ineffective coping related to stress from providing care
Correct Answer: C
Rationale: The correct nursing diagnosis would be 'Grieving related to the child's poor prognosis.' Trisomy 18 is associated with a poor prognosis, and families often experience feelings of grief and loss when dealing with such a diagnosis. The choice 'Interrupted family process' does not directly address the emotional response to the prognosis. 'Deficient knowledge' may be a concern but does not address the emotional aspect of dealing with a poor prognosis. 'Ineffective coping related to stress from providing care' focuses more on the caregiver's ability to cope rather than the family's response to the child's condition.
A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse's best response?
- A. "Attempt to distract the child by offering a toy to the child."
- B. "Say nothing and allow the tantrum to continue until it ends."
- C. "Have a babysitter stay with the child at home until the child outgrows this behavior."
- D. "Give the child the item while in the store, and when the child loses interest, return the item to the shelf."
Correct Answer: B
Rationale: The nurse's best response is to allow the tantrum to continue until it ends without giving in to the child's demands. By not rewarding the child with the desired item during a tantrum, the child learns that this behavior is not effective in getting what they want. Offering a toy to distract the child (Choice A) may reinforce the idea that tantrums lead to rewards. Leaving the child with a babysitter (Choice C) does not address the issue at hand, which is teaching the child appropriate behavior in public places. Giving the child the item temporarily (Choice D) may encourage the child to have tantrums in the future to obtain desired items.