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A nasogastric tube is ordered to be inserted for a child with severe head trauma. Diagnostic testing reveals that the child has a basilar skull fracture. What should the nurse do next?
- A. Ask for the order to be changed to oral gastric tube.
- B. Attempt to place the tube into the duodenum.
- C. Test the gastric aspirate for blood.
- D. Use extra lubrication when inserting the nasogastric tube.
Correct Answer: A
Rationale: Basilar skull fractures contraindicate NG tube insertion due to the risk of cranial penetration; an oral gastric tube is safer.
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A child with a nut allergy is admitted with a severe reaction for the third time in three months. The parent says, 'I am having trouble with the food labels.' The nurse should first:
- A. Assess the parent's ability to read.
- B. Refer the client to the dietician.
- C. Notify the primary care provider.
- D. Obtain a social service consult.
Correct Answer: B
Rationale: A dietician can provide expert guidance on reading labels to avoid allergens. Reading assessment, provider notification, or social services may follow but are not the priority.
A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:
- A. An 18-month-old with RSV.
- B. A 9-year-old 8 hours post-appendectomy.
- C. A 1-year-old with a heart defect.
- D. A 6-year-old with sickle cell crisis.
Correct Answer: C
Rationale: Assigning the same nurse to a child with RSV and a 1-year-old with a heart defect should be avoided due to the risk of transmitting RSV, which can be particularly severe in children with cardiac conditions.
The mother of a toddler who has just been admitted with severe dehydration secondary to gastroenteritis says that she cannot stay with her child because she has to take care of her other children at home. Which of the responses by the nurse would be most appropriate?
- A. You really shouldn't leave right now. Your child is very sick.
- B. I understand, but feel free to visit or call anytime to see how your child is doing.
- C. It really isn't necessary to stay with your child. We'll take very good care of him.
- D. Can you find someone to stay with your children? Your child needs you here.
Correct Answer: B
Rationale: This response acknowledges the mother's constraints while encouraging involvement.
A nurse is counseling parents of an obese child. Which lifestyle change should be emphasized?
- A. Eliminate all carbohydrates.
- B. Increase physical activity.
- C. Restrict meals to twice daily.
- D. Use meal replacement shakes.
Correct Answer: B
Rationale: Increased physical activity promotes weight control and health. Eliminating carbohydrates, restricting meals, or using shakes are not sustainable or appropriate for children.
Which of the following questions should the nurse ask first when obtaining a history from the mother of a 10-year-old child with a fever, complaints of not feeling well, and swelling around the eyes?
- A. Has the child had a sore throat recently?
- B. Is the child playing with friends as usual?
- C. Does the child urinate as much as usual?
- D. Is the urine pale in color?
Correct Answer: A
Rationale: Sore throat could indicate streptococcal infection.