Nokea
The mother of an 8-year-old with diabetes tells the nurse that she does not want the school to know about her daughter's condition. The nurse should reply:
- A. I think that would be a good idea.'
- B. What is it that concerns you about having the school know about your daughter's condition?'
- C. It would be fine not to tell your daughter's friends, but the teacher must know.'
- D. In order to keep your daughter safe, it is necessary for all adults in the school to know her condition.'
Correct Answer: B
Rationale: Exploring concerns builds trust and allows the nurse to address fears while explaining the need for school awareness (e.g., for hypoglycemia management). Other responses dismiss or mandate without dialogue.
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The physician has ordered intravenous mannitol (Osmitrol) for a child with a head injury. The best indicator that the drug has been effective is:
- A. Increased urine output.
- B. Improved level of consciousness.
- C. Decreased intracranial pressure.
- D. Decreased edema.
Correct Answer: C
Rationale: Mannitol reduces intracranial pressure by osmotic diuresis; decreased intracranial pressure is the primary indicator of its effectiveness.
The nurse begins CPR on a 5-year-old unresponsive client. When the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 with cyanotic legs. The team should next:
- A. Discontinue compressions but continue administering breaths with a bag-mask device.
- B. Establish an intravenous line with a large bore needle while preparing the defibrillator.
- C. Begin 2-person CPR at a ratio of 2 breaths to 15 compressions.
- D. Begin 2-person CPR at a ratio of 2 breaths to 30 compressions.
Correct Answer: C
Rationale: For a 5-year-old with a heart rate of 50 (bradycardia) and no respiratory effort, 2-person CPR with a ratio of 2 breaths to 15 compressions is appropriate to optimize oxygenation and circulation.
A mother has heard that several children have been diagnosed with mononucleosis. She asks the nurse what ascendancy what precautions should be taken to prevent this from occurring in her child. The nurse should instruct the mother to:
- A. Take no particular precautionary measures.
- B. Sterilize the child's eating utensils before they are reused.
- C. Wash the child's linens separately in hot, soapy water.
- D. Wear masks when providing direct personal care.
Correct Answer: A
Rationale: Mononucleosis spreads through saliva, but routine hygiene is sufficient; no special precautions are needed.
The nurse caring for a 7 -year-old child who has undergone a cardiac catheterization 2 hours ago finds the dressing and bed saturated with blood. The nurse should first:
- A. Assess the vital signs.
- B. Reinforce the dressing.
- C. Apply pressure just above the catheter insertion.
- D. Notify the physician.
Correct Answer: C
Rationale: Direct pressure is the first measure that should be used to control bleeding. Taking the vital signs will not control the bleeding. This should be done while another person is being sent to notify the physician. The dressing can be reinforced after the bleeding has been contained.
When assessing a 2-year-old child brought by his mother to the clinic for a routine checkup, which of the following should the nurse expect the child to be able to do?
- A. Ride a tricycle.
- B. Tie his shoelaces.
- C. Kick a ball forward.
- D. Use blunt scissors.
Correct Answer: C
Rationale: Kicking a ball forward is a gross motor skill expected at 2 years.