Nokea
The mother asks the nurse about her 9-year-old child's apparent need for between-meal snacks, especially after school. When developing a sound nutritional plan for the child with the mother, the nurse should advise the mother:
- A. The child does not need to eat between-meal snacks.
- B. The child should eat the snacks the mother thinks are appropriate.
- C. The child should help with preparing his or her own snacks.
- D. The child will instinctively select nutritional snacks.
Correct Answer: C
Rationale: Involving the child in snack preparation promotes healthy choices and responsibility.
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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.
When developing the plan of care for a school-age child with a suspected diagnosis of appendicitis who is complaining of severe abdominal pain, which of the following measures should the nurse expect to include in the child's plan of care?
- A. Application of a heating pad.
- B. Insertion of a rectal tube.
- C. Application of an ice bag.
- D. Administration of an intravenous narcotic.
Correct Answer: C,D
Rationale: Ice and narcotics relieve pain without risking perforation, unlike heat or rectal tubes.
The nurse is caring for a child in Bryant's traction (see figure). 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: Frequent skin care is essential in Bryant's traction to prevent pressure ulcers due to prolonged immobility.
A school-age boy with a spinal cord injury is moved to the rehabilitation unit. The nurse notes that the child tends to refuse to cooperate in care and is quiet. The nurse interprets this behavior as indicative of which of the following?
- A. A stage of grief reaction.
- B. A phase of rebellion.
- C. A reaction to sensory overload.
- D. A response to too much attention.
Correct Answer: A
Rationale: Refusal and withdrawal are consistent with grief, reflecting the child's adjustment to significant loss of function.
Which of the following initial physical findings indicate the development of carditis in a child with rheumatic fever?
- A. Heart murmur.
- B. Low blood pressure.
- C. Irregular pulse.
- D. Anterior chest wall pain.
Correct Answer: A
Rationale: A heart murmur is a hallmark of carditis in rheumatic fever, indicating valvular involvement. Other findings may occur but are less specific.