Nokea
A school-age child who has respiratory failure due to pneumonia
A nurse is assisting with the care of a school-age child who has respiratory failure due to pneumonia. Which of the following positions should the nurse encourage to allow maximal lung expansion?
- A. Upright
- B. Supine
- C. Prone
- D. Side-lying
Correct Answer: A
Rationale: The correct answer is A: Upright. In an upright position, gravity helps to maximize lung expansion by allowing the diaphragm to descend fully. This position promotes better ventilation and oxygenation by reducing the pressure on the lungs. Supine (B), prone (C), and side-lying (D) positions can limit lung expansion and compromise breathing mechanics. These positions may cause the abdominal contents to compress the lungs, reducing their ability to expand fully. Therefore, encouraging the child to sit upright will optimize lung function and promote effective gas exchange.
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A child who has cystic fibrosis
A nurse is reinforcing discharge instructions with a parent of a child who has cystic fibrosis. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I will restrict the amount of salt in my child's meals.
- B. I will put my child in daycare to ensure that she socializes with other children.
- C. I will make sure my child washes her hands before eating.
- D. I will provide low-fat meals for my child.
Correct Answer: C
Rationale: The correct answer is C: "I will make sure my child washes her hands before eating." This statement indicates an understanding of the teaching because proper handwashing is crucial in preventing infections in individuals with cystic fibrosis who are more susceptible to respiratory infections. By washing hands before eating, the child can reduce the risk of exposure to harmful pathogens.
Choice A is incorrect because restricting salt intake is not a priority in managing cystic fibrosis. Choice B is incorrect as the focus should be on hygiene and health rather than socialization. Choice D is incorrect as children with cystic fibrosis actually require a higher calorie and fat intake.
A child who is postoperative following the insertion of a ventriculoperitoneal shunt
A nurse is caring for a child who is postoperative following the insertion of a ventriculoperitoneal shunt. The nurse should place the child in which of the following positions?
- A. A 45 degree head elevation
- B. On the nonoperative side
- C. Prone
- D. Supine
Correct Answer: D
Rationale: The correct answer is D: Supine. Placing the child in a supine position promotes proper drainage and prevents obstruction of the ventriculoperitoneal shunt. Supine position helps maintain a neutral head position, reducing the risk of complications. A 45-degree head elevation (choice A) can increase intracranial pressure, which is contraindicated in this case. Placing the child on the nonoperative side (choice B) or prone (choice C) can potentially cause kinking or obstruction of the shunt tubing.
None
Which of the following techniques help prepare a child for surgery by utilising role playing or hands on activities (eg, starting an IV on a teddy bears)?
- A. Onlooker play
- B. Therapeutic play
- C. Cooperative play
- D. Play therapy
Correct Answer: B
Rationale: The correct answer is B: Therapeutic play. Therapeutic play involves using various activities like role-playing or hands-on tasks to help children understand and cope with medical procedures. It allows them to express emotions, reduce anxiety, and gain a sense of control. Onlooker play (A) involves observing others play without actively participating. Cooperative play (C) involves playing together towards a common goal. Play therapy (D) is a form of psychotherapy using play to help children express feelings. Since the question specifically mentions preparing a child for surgery through role-playing and hands-on activities, therapeutic play is the most appropriate choice.
A child who is postoperative following a tonsillectomy
A nurse is collecting data from a child who is postoperative following a tonsillectomy. Which of the following is a clinical manifestation of a hemorrhage?
- A. Drooling
- B. Continuous swallowing
- C. Poor fluid intake
- D. Increased pain
Correct Answer: B
Rationale: The correct answer is B: Continuous swallowing. This is a clinical manifestation of hemorrhage post-tonsillectomy as the child may be swallowing blood. Drooling (A) is more indicative of airway obstruction. Poor fluid intake (C) is a sign of dehydration. Increased pain (D) can be expected postoperatively but is not specific to hemorrhage.
A toddler who has laryngotracheobronchitis
A nurse is caring for a toddler who has laryngotracheobronchitis. For which of the following findings should the nurse monitor to detect airway obstruction?
- A. Decreased stridor
- B. Increased restlessness
- C. Decreased heart rate
- D. Decreased temperature
Correct Answer: B
Rationale: The correct answer is B: Increased restlessness. Restlessness is a common sign of airway obstruction in toddlers with laryngotracheobronchitis. As the airway becomes more obstructed, the toddler may feel increasingly anxious and agitated, leading to increased restlessness. Monitoring for this sign is crucial as it indicates worsening respiratory distress and the need for prompt intervention.
Decreased stridor (choice A) is not indicative of airway obstruction in this condition, as stridor is a high-pitched sound heard on inspiration and can be present in both mild and severe cases of laryngotracheobronchitis. Decreased heart rate (choice C) and decreased temperature (choice D) are not typically associated with airway obstruction and are less relevant in this context.