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A nurse who witnesses an accident involving an adolescent riding a motorcycle, hitting a tree, and being thrown 30 feet into a field stops to help. The adolescent reports that he is now unable to move his legs. While waiting for the emergency medical service to arrive, what should the nurse do?
- A. Flex the adolescent's knees to relieve stress on his back.
- B. Leave the adolescent as he is, staying close by.
- C. Remove the adolescent's helmet as soon as possible.
- D. Assess the adolescent for abdominal trauma.
Correct Answer: B
Rationale: Immobilizing the adolescent by leaving him undisturbed prevents further spinal cord damage until EMS arrives.
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The nurse manager on a pediatric floor is reviewing national sentinel event alerts and preparing recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply.
- A. Eliminate the pediatric satellite pharmacy.
- B. Increase the steps in the medication administration procedure.
- C. Utilize only oral syringes to administer oral medication.
- D. Limit the size of I.V. fluid bags that can be hung on small children.
- E. Reduce the available concentrations or dose strengths to the minimum.
Correct Answer: C,D,E
Rationale: Oral syringes ensure accurate dosing, smaller IV bags prevent fluid overload, and fewer concentrations reduce dosing errors.
After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetes still has a fasting blood glucose level of 140 mg/dL. The primary care provider has decided to begin metformin (Glucophage). The adolescent asks how the medication works. The nurse should tell the client that the medicine decreases the glucose production and:
- A. Replaces natural insulin.
- B. Helps the body make more insulin.
- C. Increases insulin sensitivity.
- D. Decreases carbohydrate adsorption.
Correct Answer: C
Rationale: Metformin reduces hepatic glucose production and increases insulin sensitivity in peripheral tissues, improving glucose uptake. It does not replace insulin, stimulate insulin production, or affect carbohydrate absorption.
What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of diphenylhydantoin (Dilantin)?
- A. Drinking plenty of fluids.
- B. Brushing teeth after each meal.
- C. Having someone be with the child during waking hours.
- D. Reporting signs of infection.
Correct Answer: B
Rationale: Dilantin can cause gingival hyperplasia; brushing after meals promotes oral hygiene to mitigate this side effect.
A nurse is planning care for a 12-year-old with rheumatic fever. The nurse should teach the parents to:
- A. Observe the child closely.
- B. Allow the child to participate in activities that will not tire him.
- C. Provide for adequate periods of rest between activities.
- D. Encourage someone in the family to be with the child 24 hours a day.
Correct Answer: C
Rationale: Rest is critical in rheumatic fever to reduce cardiac strain and prevent complications like carditis. Observation and limited activities are important, but rest is the priority.
Which of the following meals would be most appropriate for a 15-year-old with glomerulonephritis with severe hypertension?
- A. Egg noodles, hamburger, canned peas, milk.
- B. Baked ham, baked potato, pear, canned carrots, milk.
- C. Baked chicken, rice, beans, orange juice.
- D. Hot dog on a bun, corn chips, pickle, cookie, milk.
Correct Answer: C
Rationale: Low-sodium diet is recommended.