Nokea
A toddler is being sent to the operating room for surgery at 9 AM. As the nurse prepares the child, what is the priority intervention?
- A. Administering preoperative antibiotic
- B. Verifying that the child and procedure are correct
- C. Ensuring that the toddler has been NPO since midnight
- D. Informing the parents where they can wait during the procedure
Correct Answer: B
Rationale: Verifying the correct child and procedure is the priority to ensure safety and prevent errors. Administering antibiotics is secondary, clear liquids can be given up to 2 hours before surgery, and informing parents about waiting areas is important but not the priority.
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A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions?
- A. Droplet
- B. Contact
- C. Airborne
- D. Standard
Correct Answer: B
Rationale: MRSA is spread by direct contact, requiring contact precautions with gowns, gloves, and meticulous hand washing, in addition to a private room. Droplet and airborne precautions are for different pathogens, and standard precautions alone are insufficient.
A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?
- A. Use an 18-gauge needle if possible.
- B. Show the child the equipment to be used before the procedure.
- C. If not successful after four attempts, have another nurse try.
- D. Restrain the child completely.
Correct Answer: B
Rationale: Showing the child the equipment before the procedure reduces fear and supports atraumatic care. An 18-gauge needle is too large, a two-try policy (four attempts total) is preferred, and full restraint is unnecessary, favoring therapeutic hugging instead.
A 4-year-old girl is admitted to outpatient surgery for removal of a cyst on her back. Her mother puts the hospital gown on her, but the child is crying because she wants to leave on her underpants. What is the most appropriate nursing action at this time?
- A. Allow her to wear her underpants.
- B. Discuss with her mother why this is important to the child.
- C. Ask her mother to explain to her why she cannot wear them.
- D. Explain in a kind, matter-of-fact manner that this is hospital policy.
Correct Answer: A
Rationale: Allowing the child to keep her underpants on provides a sense of control and comfort, and they can be removed later if needed for anesthesia. Discussing with the mother or citing hospital policy doesn?t address the child?s distress, and asking the mother to explain may escalate the situation.
The nurse needs to take the blood pressure of a preschool boy for the first time. What action would be best in gaining his cooperation?
- A. Tell him that this procedure will help him get well faster.
- B. Take his blood pressure when a parent is there to comfort him.
- C. Explain to him how the blood flows through the arm and why the blood pressure is important.
- D. Permit him to handle the equipment and see the cuff inflate and deflate before putting the cuff in place.
Correct Answer: D
Rationale: Allowing a preschooler to handle the blood pressure equipment and see the cuff in action reduces fear of bodily harm by familiarizing him with the procedure. Explaining complex blood flow is too advanced, claiming it aids recovery is inaccurate, and while parental presence helps, it?s less effective than hands-on engagement.
Using knowledge of child development, what approach is best when preparing a toddler for a procedure?
- A. Avoid asking the child to make choices.
- B. Plan for a teaching session to last about 20 minutes.
- C. Demonstrate on a doll how the procedure will be done.
- D. Show the necessary equipment without allowing child to handle it.
Correct Answer: C
Rationale: Demonstrating the procedure on a doll engages a toddler?s preoperational thinking through play, reducing fear. Avoiding choices limits participation, 20-minute sessions are too long for a toddler?s attention span, and showing equipment without handling increases anxiety.