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A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?
- A. Verbally explain what will be done
- B. Have the child watch a video on dressing change
- C. Demonstrate a dressing change on a doll
- D. Explain the importance of keeping the burn area clean
Correct Answer: C
Rationale: The correct answer is C: Demonstrate a dressing change on a doll. This strategy is most appropriate because children with cognitive impairment often benefit from visual aids and hands-on experiences. By demonstrating the dressing change on a doll, the nurse can provide a clear and concrete example for the child to understand what will happen during the procedure. This approach can help reduce anxiety and fear by making the process more tangible and relatable for the child.
Other choices are incorrect:
A: Verbally explaining may not be as effective for a child with cognitive impairment who may struggle to understand complex verbal instructions.
B: Watching a video may be overwhelming or confusing for the child with cognitive impairment.
D: Explaining the importance of keeping the burn area clean is important but may not adequately prepare the child for the procedure itself.
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A 4-year-old, 44-pound Autistic patient is admitted to the ED with concerns of dehydration. He has been ordered to receive a 20ml/kg fluid bolus of normal saline over 30 minutes. At what rate would you set the IV pump?
- A. 880 ml/hour
- B. 800 ml/hour
- C. 440 ml/hour
- D. 400 ml/hour
Correct Answer: A
Rationale: The correct answer is A: 880 ml/hour. To calculate the IV pump rate, first, determine the total volume to be infused: 20 ml/kg x 44 lbs = 880 ml. Next, divide the total volume by the total time in hours: 880 ml / 1 hour = 880 ml/hour. This rate ensures the patient receives the prescribed fluid bolus over 30 minutes. Choice B is incorrect as it does not account for the specific weight of the patient. Choices C and D are incorrect as they do not follow the correct calculation based on the patient's weight.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test
- B. It is necessary to be completely asleep during the test
- C. The test is short, usually taking less than 1 hour
- D. When the procedure is done, you will have to keep your leg straight until after dinnertime
Correct Answer: D
Rationale: The correct answer is D because preschool children may not fully understand the importance of keeping still after cardiac catheterization. Keeping the leg straight helps prevent bleeding at the insertion site. Choice A is incorrect as postural drainage is not related to cardiac catheterization. Choice B is incorrect as sedation, not complete sleep, is usually used. Choice C is incorrect as the procedure can take longer than an hour.
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
- A. 63 ml/hr
- B. 64 ml/hr
- C. 65 ml/hr
- D. 107 ml/hr
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option A).
The other choices are incorrect because
When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?
- A. Diabetes insipidus
- B. Pyloric stenosis
- C. Congenital heart disease
- D. Congenital hip dysplasia
Correct Answer: C
Rationale: The correct answer is C: Congenital heart disease. Down syndrome is commonly associated with congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. This is important for the nurse to be aware of because these heart anomalies can impact the newborn's health and require monitoring or intervention.
Choice A: Diabetes insipidus is not a common congenital anomaly associated with Down syndrome.
Choice B: Pyloric stenosis is not typically associated with Down syndrome.
Choice D: Congenital hip dysplasia is not a common anomaly seen with Down syndrome.
In summary, the nurse should prioritize monitoring for congenital heart disease in a newborn with Down syndrome due to its high prevalence and potential impact on the baby's health.
A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.