Nokea
A nurse is reinforcing teaching with the parent of a child who has diabetes mellitus. The parent asks the nurse how to minimize the child's pain when monitoring blood glucose levels. Which of the following statements by the parent indicates an understanding of the teaching?
- A. My child should use their index finger to obtain blood samples.
- B. My child should hold their finger under warm water before obtaining a sample.
- C. My child should puncture the center of their finger pad when obtaining a sample.
- D. My child should hold their finger against a table when obtaining a sample.
Correct Answer: B
Rationale: Warm water increases blood flow, reducing pain during glucose monitoring. Index finger use, central punctures, or table pressure do not specifically minimize discomfort.
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A nurse is reinforcing teaching with the parent of a 15-month-old toddler about nutritional guidelines. Which of the following statements by the parent indicates an understanding of the teaching?
- A. My child will be constipated if they drink more than 6 ounces of juice a day.
- B. My child's intake of calcium should average 500 milligrams every day.
- C. My child should consume 1,500 to 1,800 calories each day by the time they turn 2.
- D. My child's appetite will increase suddenly when they turn 18 months old.
Correct Answer: B
Rationale: A 15-month-old toddler needs about 500 milligrams of calcium per day to support bone growth and development. Excessive juice does not cause constipation but can reduce appetite for other foods. Toddlers need approximately 1,000 to 1,300 calories per day, so 1,500-1,800 calories is excessive. There is no specific age-related sudden appetite increase at 18 months.
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.
A nurse is preparing to obtain a blood pressure reading from a school-age child. Which of the following actions should the nurse take?
- A. Record the diastolic value as the first Korotkoff sound (K1).
- B. Release the cuff pressure at a rate of about 5 mm Hg/second.
- C. Position the child's arm at the level of the heart.
- D. Select a cuff with a bladder size that is approximately 20% of the child's upper arm circumference.
Correct Answer: C
Rationale: Positioning the arm at heart level ensures accuracy. Diastolic is K5, cuff release should be 2-3 mm Hg/second, and cuff size is ~40% of arm circumference.
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 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.