A school nurse is assessing a school-age child’s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child’s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?
- A. The child with tachypnea and pulmonary congestion
- B. The child with hepatomegaly and normal respiratory rate
- C. The child with dependent and sacral edema and regular pulse
- D. The child with periorbital edema and normal respiratory rate
Correct Answer: A
Rationale: The child with tachypnea and pulmonary congestion should be seen first as these symptoms indicate a more severe form of fluid-volume excess that requires immediate attention. Tachypnea is an increase in respiratory rate, which could be a sign of respiratory distress, and pulmonary congestion indicates fluid accumulation in the lungs, posing a significant risk to the child's respiratory function.
A nurse is caring for a child who has a new diagnosis of osteomyelitis. Which of the following actions should the nurse take?
- A. Administer aspirin for pain.
- B. Apply ice to the affected area.
- C. Monitor the child’s weight daily.
- D. Limit the child's activity.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse provides dietary teaching to the guardian of a school-age child with cystic fibrosis. Which statement should the nurse make?
- A. You should offer your child high-protein meals and snacks throughout the day.
- B. You should decrease your child's dietary fat intake to less than 10% of their caloric intake.
- C. You should restrict your child's calorie intake to 1,200 per day.
- D. You should give your child a multivitamin once weekly.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 30-month-old apparently well child presented with stomping, hitting, head banging, and falling down for few minutes every few days.
- A. brain MRI
- B. serum ferritin
- C. skeletal survey
- D. EEG
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.