Nokea
A nurse is teaching the parents of a preschooler about the possibility of post-operative hemorrhage after a tonsillectomy and adenoidectomy. The nurse should explain that the risk is greatest at which of the following times?
- A. 1 to 3 days after surgery.
- B. 4 to 6 days after surgery.
- C. 7 to 10 days after surgery.
- D. 11 to 14 days after surgery.
Correct Answer: C
Rationale: The risk of post-operative hemorrhage after a tonsillectomy is greatest 7 to 10 days after surgery, as this is when the eschar (scab) typically sloughs off, potentially exposing blood vessels and leading to bleeding.
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The health care team has noticed an increase in I.V. infiltrations on the pediatric floor. As part of a Plan, Do, Study, Act quality improvement plan the team should do the following in which order?
- A. Analyze the data.
- B. Decide to monitor I.V. gauges.
- C. Perform chart audits.
- D. Write a new I.V. insertion policy.
Correct Answer: B,C,A,D
Rationale: The PDSA cycle involves planning (deciding to monitor), doing (chart audits), studying (analyzing data), and acting (writing a new policy).
A child has just ingested about 10 adult-strength acetaminophen (Tylenol) pills. The mother brings the child to the emergency department. What should the nurse do? Place the interventions in the order of priority from first to last.
- A. Administer activated charcoal.
- B. Assess the airway.
- C. Reassure the mother.
- D. Check serum acetaminophen levels.
- E. Obtain information about how the child obtained the pills.
- F. Complete a physical examination.
Correct Answer: B,A,D,C,F,E
Rationale: 1. Assess the airway to ensure patency and stability. 2. Administer activated charcoal to reduce acetaminophen absorption. 3. Check serum acetaminophen levels to guide treatment. 4. Reassure the mother to reduce anxiety. 5. Obtain information about how the child obtained the pills for safety education. 6. Complete a physical examination to assess for other effects.
After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child:
- A. Fears another procedure.
- B. Does not understand body integrity.
- C. Is expressing pain.
- D. Is attempting to regain control.
Correct Answer: B
Rationale: Preschoolers may fear loss of body integrity, believing blood will leak out without a bandage.
The nurse reads the new medications orders for a 4-year-old child with nephrotic syndrome on the chart below: Orders D/C prednisolone 40 mg PO Daily Prednisolone 30 mg PO QOD The nurse should:
- A. Discontinue the prednisolone 40 mg and give the 30 mg dose today.
- B. Check the medication record first to see when the last dose of prednisolone was given.
- C. Start the 30 mg dose tomorrow.
- D. Contact the prescriber for clarification.
Correct Answer: D
Rationale: Clarification ensures correct dosing.
The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?
- A. Fitting the diaper under the straps.
- B. Leaving the harness off while the infant sleeps.
- C. Checking for skin redness under straps every other day.
- D. Putting powder on the skin under the straps every day.
Correct Answer: A
Rationale: Fitting the diaper under the straps ensures hygiene without disrupting the harness's corrective positioning.