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After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child:
- A. Fears another procedure.
- B. Does not understand body integrity.
- C. Is expressing pain.
- D. Is attempting to regain control.
Correct Answer: B
Rationale: Preschoolers may fear loss of body integrity, believing blood will leak out without a bandage.
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The mother of a child with chronic renal failure who is receiving peritoneal dialysis at home asks the nurse what she can do if both inflow and drain times are increased. Which of the following instructions would be most appropriate for the nurse to include when responding to the mother?
- A. Assess the child for constipation.
- B. Decrease the amount of dialysate infused for each dwell.
- C. Incorporate the increased inflow and drain times into the dialysis schedule.
- D. Monitor the child for shoulder pain during inflow and drain times.
Correct Answer: A
Rationale: Constipation can affect dialysis flow.
After teaching a group of parents about temper tantrums, the nurse knows the teaching has been effective when one of the parents states which of the following?
- A. I will ignore the temper tantrum.
- B. I should pick up the child during the tantrum.
- C. I'll talk to my daughter during the tantrum.
- D. I should put my child in time out.
Correct Answer: A
Rationale: Ignoring temper tantrums reduces attention-seeking behavior and is an effective strategy.
Which sign should lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?
- A. Hemorrhagic skin rash.
- B. Edema.
- C. Cyanosis.
- D. Dyspnea on exertion.
Correct Answer: A
Rationale: A hemorrhagic rash, such as petechiae or purpura, is a hallmark of disseminated intravascular coagulation in meningitis, indicating clotting abnormalities.
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 should the nurse assess in a newborn diagnosed with an anorectal malformation? Select all that apply.
- A. Abdominal distension.
- B. Loose stools.
- C. Vomiting.
- D. Meconium in the urine.
- E. Meconium stools.
Correct Answer: A,C,D
Rationale: Anorectal malformations can cause abdominal distension, vomiting, and meconium in the urine due to obstruction or fistulas.