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After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which of the following statements offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?
- A. Knowing that the prognosis is poor helps prepare relatives for the death of children.
- B. Relatives are especially grieved when a child does well at first but then declines rapidly.
- C. Trust in health care personnel is most often destroyed by a death that is considered untimely.
- D. It is more difficult for relatives to accept the death of an older child than that of a toddler.
Correct Answer: B
Rationale: A rapid decline after improvement is particularly devastating, guiding the nurse to provide extra emotional support.
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The nurse is preparing to administer the last dose of ceftriaxone (Rocephin) before discharge to a 1-year-old but finds the I.V. has occluded. The nurse should:
- A. Restart the I.V.
- B. Administer the medication intramuscularly.
- C. Arrange for early discharge.
- D. Ask the provider to request an order change.
Correct Answer: B
Rationale: Administering ceftriaxone intramuscularly is appropriate when the I.V. is occluded, ensuring the child receives the final dose before discharge.
A nurse is reviewing a hospital's protocol for managing pediatric ingestions. Which step should be prioritized in the protocol?
- A. Administer an antidote immediately.
- B. Obtain a detailed history of the ingestion.
- C. Perform a physical examination.
- D. Order laboratory tests.
Correct Answer: B
Rationale: A detailed history (substance, amount, time) guides management decisions. Antidotes, exams, or labs follow based on history findings.
The nurse discusses with the parents how best to raise the IQ of their child with Down syndrome. Which of the following would be most appropriate?
- A. Serving hearty, nutritious meals.
- B. Giving vasodilator medications as prescribed.
- C. Letting the child play with more able children.
- D. Providing stimulating, nonthreatening life experiences.
Correct Answer: D
Rationale: Stimulating, nonthreatening experiences promote cognitive development by encouraging exploration and learning within the child's capabilities.
Which of the following outcomes indicates that the activity restriction necessary for a 7 -year-old child with rheumatic fever during the acute phase has been effective?
- A. Joints demonstrate absence of permanent injury.
- B. The resting heart rate is between 60 and 100 bpm.
- C. The child exhibits a decrease in chorea movements.
- D. The subcutaneous nodules over the joints are no longer palpable.
Correct Answer: B
Rationale: A normal resting heart rate (60-100 bpm) indicates reduced cardiac strain, showing effective activity restriction. Other outcomes are relevant but less directly tied to activity restriction.
The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?
- A. Fitting the diaper under the straps.
- B. Leaving the harness off while the infant sleeps.
- C. Checking for skin redness under straps every other day.
- D. Putting powder on the skin under the straps every day.
Correct Answer: A
Rationale: Fitting the diaper under the straps ensures hygiene without disrupting the harness's corrective positioning.