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A nurse is assessing the growth and development of a 10-year-old. What is the expected behavior of this child?
- A. Enjoys physical demonstrations of affection.
- B. Is selfish and insensitive to the welfare of others.
- C. Is uncooperative in play and school.
- D. Has a strong sense of justice and fair play.
Correct Answer: D
Rationale: A 10-year-old typically develops a sense of fairness and justice in social interactions.
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The nurse observes an 18 month old who has been admitted with a respiratory tract infection (see figure). The nurse should fi rst:
- A. Position the child supine
- B. Call the rapid response team
- C. Offer the child a carbonated drink
- D. Place the child in a croup tent
Correct Answer: D
Rationale: The child is in respiratory distress and is sitting in a position to relieve the airway obstruction; the nurse should provide a humidifi ed environment with a croup tent with cool mist to facilitate breathing and liquefy secretions. The child should remain sitting to facilitate breathing; the nurse should allow the child to determine the most comfortable position. After the child is breathing normally, the nurse can offer fl uids; the physician also may order intravenous fluids. The nurse can call the rapid response team if the respiratory distress is not relieved by using a croup tent or other vital signs changes indicate further distress.
When providing intermittent nasogastric feedings to an infant with failure to thrive, which method is preferred to confirm tube placement before each feeding?
- A. Obtain a chest X-ray.
- B. Verify that the gastric pH is less than 5.5.
- C. Auscultate the stomach while instilling an air bolus.
- D. Compare the tube insertion length to a standardized chart.
Correct Answer: B
Rationale: Gastric pH <5.5 confirms stomach placement non-invasively. X-rays are impractical for each feeding, auscultation is unreliable, and length comparison doesn't verify placement.
A transfusion of packed red blood cells has been ordered for a 1-year-old with sickle cell anemia. The infant has a 25 gauge I.V. infusing dextrose with sodium and potassium. Using the Situation, Background, Assessment, Recommendation (SBAR) method of communication, the nurse contacts the physician and recommends:
- A. Starting a second I.V. with a 22 gauge catheter to infuse normal saline with the blood.
- B. Using the existing I.V., but changing the fluids to normal saline for the transfusion.
- C. Replacing the I.V. with a 22 gauge catheter to infuse the ordered fluids.
- D. Starting a second I.V. with a 25 gauge catheter to infuse normal saline with the transfusion.
Correct Answer: A
Rationale: A second I.V. with a larger 22-gauge catheter ensures safe blood transfusion, as dextrose is incompatible and a 25-gauge is too small.
A mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following?
- A. Little is known about iron deficiency anemia and its relationship to infection.
- B. Children with iron deficiency anemia are more susceptible to infection than are other children.
- C. Children with iron deficiency anemia are less susceptible to infection than are other children.
- D. Children with iron deficiency anemia are equally as susceptible to infection as are other children.
Correct Answer: B
Rationale: Iron deficiency impairs immune function, increasing infection susceptibility. This is well-documented in pediatric care.
A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following should the nurse try first?
- A. Ask another nurse to assist.
- B. Allow a parent to assist.
- C. Wait until the child calms down.
- D. Restrain the child's arms.
Correct Answer: B
Rationale: Parental involvement can comfort the child and improve cooperation.