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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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The nurse is caring for a school aged child in sickle cell crisis. Which interventions are appropriate for this patient? (Select all that apply)
- A. Application of a heating pad to the painful areas
- B. Start a Morphine PCA to provide pain relief for this patient
- C. Encourage patient to ambulate often to prevent pneumonia
- D. Hydrate patient with one-and-a-half-time maintenance fluid
Correct Answer: A,B,D
Rationale: Correct Answer: A, B, D
Rationale:
A: Application of a heating pad to the painful areas helps to relieve vaso-occlusive pain in sickle cell crisis by promoting vasodilation and increasing blood flow.
B: Starting a Morphine PCA is appropriate for pain management in sickle cell crisis as it provides controlled analgesia for the patient.
D: Hydrating the patient with one-and-a-half-time maintenance fluid helps prevent dehydration and maintain adequate blood flow, reducing the risk of vaso-occlusive episodes.
Incorrect Choices:
C: Encouraging the patient to ambulate often may not be suitable during a sickle cell crisis as it can increase the risk of pain and further complications.
E, F, G: No additional choices given, but typically options not directly related to pain management, hydration, or symptom relief would be incorrect in this scenario.
The nurse is caring for a preschool age child who just received chemotherapy. The child's mother asks the nurse when it is safe for the child to attend his cousin's birthday party. Which is the correct response:
- A. The best time to attend the party is 7 to 10 days from now.
- B. Any time is a good time, especially if it makes him happy.
- C. About three weeks from today would be the safest time for him to attend a party.
- D. He may need to wait until he's completely finished with chemotherapy.
Correct Answer: C
Rationale: The correct response is C: About three weeks from today would be the safest time for him to attend a party. This answer is correct because chemotherapy can weaken the child's immune system, making him more susceptible to infections. Attending a party with a large number of people increases the risk of exposure to germs. Waiting for about three weeks allows the child's immune system to recover to a safer level before being exposed to a potentially infectious environment.
Choice A is incorrect because 7 to 10 days may not provide enough time for the child's immune system to recover adequately. Choice B is incorrect as it disregards the child's health and safety by prioritizing immediate happiness over well-being. Choice D is incorrect as it may be too restrictive; attending a party may be possible before completing chemotherapy if the child's immune system has recovered sufficiently.
A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?
- A. Pale and a 24-hr fluid deficit of 30 mL
- B. Sunken fontanels and dry mucous membranes
- C. Decreased appetite and irritability
- D. Temperature 38° C (100.4° F) and pulse rate 124/min
Correct Answer: B
Rationale: The correct answer is B: Sunken fontanels and dry mucous membranes. These findings indicate severe dehydration in the infant with gastroenteritis. Sunken fontanels suggest significant fluid loss, while dry mucous membranes also indicate dehydration. Dehydration in infants can lead to serious complications, so it is crucial for the nurse to report these findings to the provider promptly.
The other choices are not as concerning as choice B. Choice A indicates a fluid deficit but does not suggest severe dehydration. Choice C could be expected in a sick infant and does not require immediate provider notification. Choice D shows signs of fever and tachycardia, which are common in gastroenteritis and may not be as urgent as severe dehydration.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations of ADHD are typically so bizarre that the diagnosis is easy
- B. Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom
- C. Manifestations of ADHD such as learning disabilities eventually disappear by adulthood
- D. Manifestations of ADHD must always be present and are required to receive a positive diagnosis
Correct Answer: B
Rationale: Correct Answer: B
Rationale: Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom. ADHD symptoms impact academic performance, social interactions, and behavior in various settings. Children with ADHD often struggle with impulse control, hyperactivity, and inattention, leading to challenges in the classroom environment. This choice acknowledges the pervasive nature of ADHD symptoms while highlighting the prominent impact on the child's educational experience.
Summary of other choices:
A: Incorrect - Manifestations of ADHD are not necessarily bizarre, and the diagnosis is often complex due to overlapping symptoms with other conditions.
C: Incorrect - Learning disabilities and ADHD are separate conditions, and ADHD symptoms may persist into adulthood without necessarily disappearing.
D: Incorrect - While consistent manifestations are a key diagnostic criterion, ADHD symptoms can fluctuate in intensity and may still be present without being constant.
The nurse is caring for a child with frostbite would expect the patient to display:
- A. Redness and swelling of the hands
- B. Blisters that appear 24 to 48 hours after rewarming
- C. Itching and burning that persists after rewarming
- D. Fever
Correct Answer: B
Rationale: The correct answer is B because blisters appearing 24 to 48 hours after rewarming is a common symptom of frostbite. This occurs due to damage to the blood vessels and tissues. A: Redness and swelling are more indicative of mild frostbite. C: Itching and burning are not typical symptoms of frostbite. D: Fever is not a common symptom of frostbite.