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A nurse is reinforcing teaching about injury prevention with the parents of a toddler. Which of the following instructions should the nurse include in the teaching?
- A. Install window guards on windows.
- B. Place scatter rugs over hardwood floors.
- C. Keep doors locked.
- D. Supervise at playgrounds.
- E. Turn pot handles toward the front of the stove.
Correct Answer: A,C,D
Rationale: Window guards prevent falls, locked doors limit access to hazards, and supervision at playgrounds ensures safety. Scatter rugs increase tripping risks, and pot handles should face inward to prevent burns.
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A nurse is reviewing the medical record of a school-age child who is current on recommended immunizations. Which of the following immunizations should the nurse plan to administer at the 11-year-old well-child visit?
- A. Tetanus, diphtheria, acellular pertussis (Tdap)
- B. Haemophilus influenzae type b (Hib)
- C. Inactivated poliovirus (IPV)
- D. Rotavirus (RV)
Correct Answer: A
Rationale: Tdap is recommended at 11-12 years as a booster. Hib, IPV, and RV are given in infancy, not at this age.
A nurse is collecting data from an 8-month-old infant. Which of the following findings indicates expected growth and development?
- A. Inability to hold a bottle
- B. Uses palmar grasp
- C. Sits unsupported
- D. Forces tongue outward when it is touched
Correct Answer: C
Rationale: Sitting unsupported by 8 months is expected. Bottle holding occurs earlier, palmar grasp fades by this age, and tongue thrust typically resolves by 6 months.
A nurse is reviewing the medical records of several children in an outpatient clinic. The nurse should identify that which of the following infections is included on the list of nationally notifiable conditions?
- A. Scarlet fever
- B. Rotavirus
- C. Erythema infectiosum (Fifth disease)
- D. Pertussis
Correct Answer: D
Rationale: Pertussis is nationally notifiable for public health surveillance. Scarlet fever, rotavirus, and fifth disease are not typically required to be reported.
A nurse is collecting data from a toddler who has heart failure. Which of the following findings should the nurse expect?
- A. Weight loss of 0.9 kg (2 lb)
- B. Heart rate 65/min
- C. Bounding peripheral pulses
- D. Decreased urine output
Correct Answer: D
Rationale: Decreased urine output is expected in heart failure due to poor renal perfusion. Weight gain, not loss, is typical, and heart rate is usually elevated, not normal. Pulses are often weak.
A nurse in a pediatric unit is assisting with providing care for multiple children. Which of the following physical findings and parental reports should cause the nurse to suspect child maltreatment?
- A. A toddler has a spiral fracture, and the parent reports a fall from a swing.
- B. A preschooler has bruises on the shins, and the parent reports a collision with furniture.
- C. An adolescent has a head injury, and the parent reports a fall from a bike.
- D. A school-age child has a black eye, and the parent reports a fight with a classmate.
Correct Answer: A
Rationale: Spiral fractures in toddlers are concerning for abuse, as they often result from twisting forces not typical in a fall from a swing. Bruises on shins, head injuries from biking, and a black eye from a fight are more consistent with common childhood injuries.