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After completing diagnostic testing, the surgeon has scheduled a newborn with the diagnosis of an imperforate anus for surgery the next day. The infant's parents are Catholic and do not want the surgery to take place unless the infant has first been baptized. The nurse asks the parents:
- A. Are you worried your baby might die?
- B. Do you want me to help arrange the baptism?
- C. Do you want to speak with the social worker?
- D. Would you prefer to wait for the surgery?
Correct Answer: B
Rationale: Offering to arrange the baptism respects the parents' religious beliefs and facilitates timely surgery.
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A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:
- A. An 18-month-old with RSV.
- B. A 9-year-old 8 hours post-appendectomy.
- C. A 1-year-old with a heart defect.
- D. A 6-year-old with sickle cell crisis.
Correct Answer: C
Rationale: Assigning the same nurse to a child with RSV and a 1-year-old with a heart defect should be avoided due to the risk of transmitting RSV, which can be particularly severe in children with cardiac conditions.
A nurse is counseling parents of an obese child. Which lifestyle change should be emphasized?
- A. Eliminate all carbohydrates.
- B. Increase physical activity.
- C. Restrict meals to twice daily.
- D. Use meal replacement shakes.
Correct Answer: B
Rationale: Increased physical activity promotes weight control and health. Eliminating carbohydrates, restricting meals, or using shakes are not sustainable or appropriate for children.
A male adolescent who underwent repair of an inguinal hernia earlier today and is getting ready to go home receives instructions about resuming physical activities. Which of the following statements would indicate that he has understood the instructions?
- A. I can start riding my bike next week.
- B. I have to skip physical education classes for 2 weeks.
- C. I can start wrestling again in 3 weeks.
- D. I can return to my weight-lifting class in 2 weeks.
Correct Answer: B
Rationale: Avoiding strenuous activities like PE for 2 weeks prevents strain on the surgical site.
After teaching the parents of an infant with clubfoot about the condition and its management, which of the following statements by a parent indicates a need for additional teaching?
- A. My child will need several casts over a period of weeks to months.'
- B. Surgery may be needed if casting does not fully correct the foot.'
- C. The cast should be kept clean and dry at all times.'
- D. I should adjust the cast if it seems too tight.'
Correct Answer: D
Rationale: Parents should not adjust the cast themselves, as this could disrupt treatment; they should contact a healthcare provider if the cast seems too tight.
A 7-year-old has had an appendectomy on November 12. He has had pain for the last 24 hours. There is an order to administer Tylenol with Codeine every 3 to 4 hours as needed. The nurse is beginning the shift and reviews the chart below for pain history. Based on the information in the chart, what should the nurse do next?
- A. Administer the Tylenol with Codeine.
- B. Distract the child by giving him breakfast.
- C. Instruct the child to take deep breaths and blow his pain away.
- D. Assess the child again in 1 hour.
Correct Answer: A
Rationale: The FACES score of 4 at 7:00 am indicates pain, and it's been 6 hours since the last dose, warranting medication.