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On finding a child who is not breathing, which of the following should the nurse do first?
- A. Clear the airway.
- B. Begin mouth-to-mouth resuscitation.
- C. Initiate oxygen therapy.
- D. Start chest compressions.
Correct Answer: A
Rationale: Clearing the airway is the first step in CPR to ensure no obstructions prevent effective ventilation.
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The nurse is caring for a child in Bryant’s traction (see fi gure). The nurse should:
- A. Adjust the weights on the legs until the buttocks rest on the bed.
- B. Provide frequent skin care.
- C. Place a pillow under the buttocks.
- D. Remove the elastic leg wraps every 8 hours for 10 minutes.
Correct Answer: B
Rationale: The traction is positioned correctly; the nurse should provide frequent skin care to the back and shoulder areas. The hips and buttocks should be lifted off the bed to provide counter traction; the nurse should not adjust the weights. The nurse should not place a pillow under the buttocks as this would prevent counter traction. The elastic wraps should remain on the legs unless permitted by the physician.
A nurse administers ranitidine (Zantac) instead of cetirizine (Zyrtec) to an 8-year-old with asthma. The client has suffered no adverse effects. The nurse tells the charge nurse of the incident but fears disciplinary action. The charge nurse should tell the nurse:
- A. If you do not report the error, I will have to.
- B. Reporting the error helps to identify system problems to improve client safety.
- C. Notify the client's physician to see if she wants this reported.
- D. This is not a serious mistake so reporting it will not affect your position.
Correct Answer: B
Rationale: Reporting the error helps identify system problems to improve client safety, promoting a culture of transparency and quality improvement.
An 8-year-old with diabetes is placed on neutral and immune Hagedorn (NPH) and regular insulin before breakfast and before dinner. She will receive a snack of milk and cereal at bedtime. The snack will:
- A. Help her regain lost weight.
- B. Provide carbohydrates for immediate use.
- C. Prevent late night hypoglycemia.
- D. Help her stay on her diet.
Correct Answer: C
Rationale: A bedtime snack with NPH insulin prevents late-night hypoglycemia by providing carbohydrates during peak insulin action. It is not primarily for weight gain, immediate use, or diet adherence.
The family of a 5-year-old, only child has just moved to a rural setting where the father has started a dental practice. At the well-child visit, the father expresses concern that his child seems prone to minor accidents such as skinning his elbow and knees or falling off his scooter. The nurse tells the father:
- A. Only children use accidents as a way to seek parents' attention.
- B. Children who live in the suburbs typically have more accidents.
- C. Children frequently have more accidents when families experience change.
- D. We see a relationship between accidents and parental education.
Correct Answer: C
Rationale: Changes like moving can increase accidents due to stress or unfamiliar environments.
The nurse is preparing to administer furosemide (Lasix) to a 3-year-old with a heart defect. The nurse verifies the child's identity by checking the arm band and:
- A. Asking the child to state her name.
- B. Checking the room number.
- C. Asking the child to tell her birth date.
- D. Asking the parent the child's name.
Correct Answer: D
Rationale: Asking the parent is appropriate for a 3-year-old, who may not reliably state their name or birth date. Room numbers are not reliable identifiers.