Nokea
A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is what?
- A. Hepatic dysfunction
- B. Dehydration secondary to vomiting
- C. Esophageal stricture and shock
- D. Bronchitis and chemical pneumonia
Correct Answer: D
Rationale: Lighter fluid is a hydrocarbon. The immediate danger is aspiration. Acetaminophen overdose, not hydrocarbons, causes hepatic dysfunction. Dehydration is not the primary danger. Esophageal stricture is a late or chronic consequence of hydrocarbon ingestion.
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The nurse is teaching parents of a preschool child strategies to implement when the child delays going to bed. What strategy should the nurse recommend?
- A. Use consistent bedtime rituals.
- B. Give in to attention-seeking behavior.
- C. Take the child into the parents bed for an hour.
- D. Allow the child to stay up past the decided bedtime.
Correct Answer: A
Rationale: For children who delay going to bed, a recommended approach involves a consistent bedtime ritual and emphasizing the normalcy of this type of behavior in young children. Parents should ignore attention-seeking behavior, and the child should not be taken into the parents bed or allowed to stay up past a reasonable hour.
A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child?
- A. Monitoring the parents whenever they are with the child
- B. Reassuring the parents that the cause of the disorder will be found
- C. Teaching the parents how to obtain necessary specimens
- D. Supporting the parents as they cope with diagnosis of a chronic illness
Correct Answer: A
Rationale: MSBP refers to an illness that one person fabricates or induces in another. The child must be continuously observed for development of symptoms to determine the cause. MSBP is caused by an individual harming the child for the purpose of gaining attention. Nursing staff should obtain all specimens for analyzing. This minimizes the possibility of the abuser contaminating the sample. The child must be supported through the diagnosis of MSBP. The abuser must be identified and the child protected from that individual.
What is probably the most important criterion on which to base the decision to report suspected child abuse?
- A. Inappropriate response of child
- B. Inappropriate parental concern for the degree of injury
- C. Absence of parents for questioning about childs injuries
- D. Incompatibility between the history and injury observed
Correct Answer: D
Rationale: Conflicting stories about the accident are the most indicative red flags of abuse. The child or caregiver may have an inappropriate response, but this is subjective. Parents should be questioned at some point during the investigation.
A child is admitted to the hospital with lesions on his abdomen that appear like cigarette burns. What should accurate documentation by the nurse include?
- A. Two unhealed lesions are on the childs abdomen.
- B. Two round 4-mm lesions are on the childs lower abdomen.
- C. Two round symmetrical lesions are on the childs lower abdomen.
- D. Two round lesions on the childs abdomen that appear to be cigarette burns.
Correct Answer: B
Rationale: Burn documentation should include the location, pattern, demarcation lines, and presence of eschar or blisters. The option that includes the size of the lesions is the most accurate.
The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurses recommendation should be based on remembering what?
- A. This is an expected behavior at this age.
- B. This is a warning sign of a serious problem.
- C. This is harmless venting of anger and frustration.
- D. This is common in children who are physically abused.
Correct Answer: B
Rationale: Cruelty to family pets is not an expected behavior. Hurting animals can be one of the earliest symptoms of a conduct disorder. Abusing animals does not dissipate violent emotions; rather, the acts may fuel the abusive behaviors. Referral for evaluation is essential. This behavior may be seen in emotional abuse or neglect, not physical abuse.