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An adolescent is on the football team and practices in the morning and afternoon before school starts for the year. The temperature on the field has been high. The school nurse has been called to the practice field because the adolescent is now reporting that he has muscle cramps, nausea, and dizziness. Which of the following actions should the school nurse do first?
- A. Administer cold water with ice cubes.
- B. Take the adolescent's temperature.
- C. Have the adolescent go to the swimming pool.
- D. Move the adolescent to a cool environment.
Correct Answer: D
Rationale: The symptoms suggest heat exhaustion, and the first priority is to move the adolescent to a cool environment to prevent further heat-related complications.
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The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following?
- A. Allow the child to stay up later one or two nights a week.
- B. Establish a set bedtime and follow a routine.
- C. Encourage active play before bedtime.
- D. Give the child a cookie if bedtime is pleasant.
Correct Answer: B
Rationale: A consistent bedtime routine promotes healthy sleep habits.
What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of diphenylhydantoin (Dilantin)?
- A. Drinking plenty of fluids.
- B. Brushing teeth after each meal.
- C. Having someone be with the child during waking hours.
- D. Reporting signs of infection.
Correct Answer: B
Rationale: Dilantin can cause gingival hyperplasia; brushing after meals promotes oral hygiene to mitigate this side effect.
A father asks the nurse how he would know if his child had developed mononucleosis. The nurse explains that in addition to fatigue, which of the following would be most common?
- A. Liver tenderness.
- B. Enlarged lymph glands.
- C. Persistent nonproductive cough.
- D. A blush-like generalized skin rash.
Correct Answer: B
Rationale: Enlarged lymph glands, especially in the neck, are a hallmark symptom of mononucleosis.
The father of a neonate scheduled for gastrointestinal surgery asks the nurse how newborns respond to painful stimuli. Which of the following should be the nurse's best response?
- A. Newborns cry and cannot be distracted to stop crying.
- B. When faced with a pain, newborns try to roll away from it.
- C. Newborns typically move their whole body in response to pain.
- D. Pain causes the newborn to withdraw the affected part.
Correct Answer: C
Rationale: Newborns exhibit a generalized body response to pain, such as squirming or thrashing.
The nurse manager on a pediatric floor is reviewing national sentinel event alerts and preparing recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply.
- A. Eliminate the pediatric satellite pharmacy.
- B. Increase the steps in the medication administration procedure.
- C. Utilize only oral syringes to administer oral medication.
- D. Limit the size of I.V. fluid bags that can be hung on small children.
- E. Reduce the available concentrations or dose strengths to the minimum.
Correct Answer: C,D,E
Rationale: Oral syringes ensure accurate dosing, smaller IV bags prevent fluid overload, and fewer concentrations reduce dosing errors.