Nokea
The nurse is conducting a quality improvement audit on the pediatric unit. Which finding indicates a need for further staff education on IV catheter care?
- A. IV sites checked every 2 hours.
- B. Use of transparent dressings.
- C. Infiltration rates above 10%.
- D. Documentation of insertion dates.
Correct Answer: C
Rationale: High infiltration rates suggest improper technique or monitoring, requiring education.
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In an initial screening for lead poisoning, a 2-year-old child is found to have a lead level of 12 mcg/dL. The nurse should:
- A. Arrange a follow-up appointment in 6 months.
- B. Initiate chelation therapy.
- C. Refer to a neurologist.
- D. Test siblings for lead exposure.
Correct Answer: A
Rationale: A lead level of 12 mcg/dL requires follow-up in 3-6 months per CDC guidelines. Chelation is for levels >45 mcg/dL, neurology referral is premature, and sibling testing depends on shared exposure risk.
A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following should the nurse try first?
- A. Ask another nurse to assist.
- B. Allow a parent to assist.
- C. Wait until the child calms down.
- D. Restrain the child's arms.
Correct Answer: B
Rationale: Parental involvement can comfort the child and improve cooperation.
A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time?
- A. Reading the child a story.
- B. Painting with watercolors.
- C. Pounding on a pegboard.
- D. Stacking a tower of blocks.
Correct Answer: C
Rationale: Pounding on a pegboard allows the child to express frustration physically, which is developmentally appropriate for a preschooler.
Shortly after an infant is returned to his room following hydrocele repair, the infant's mother tells the nurse that the child's scrotum looks swollen and bruised. Which of the following responses by the nurse would be most appropriate?
- A. Let me see if the doctor has ordered aspirin for him. If he did
- B. I'll get it right away.
- C. Why don't you wait in his room? Then you can ask me any questions when I get there.
- D. What you are describing is unusual after this type of surgery. I'll let the doctor know.
- E. This is normal after this type of surgery. Let's look at it together just to be sure.
Correct Answer: D
Rationale: Swelling and bruising post-surgery are common.
After insertion of bilateral tympanostomy tubes in a toddler, which of the following instructions should the nurse include in the child's discharge plan for the parents?
- A. Insert ear plugs into the canals when the child bathes.
- B. Blow the nose forcibly during a cold.
- C. Administer the prescribed antibiotic while the tubes are in place.
- D. Disregard any drainage from the ear after 1 week.
Correct Answer: C
Rationale: Administering prescribed antibiotics as directed is crucial to prevent infection after tympanostomy tube insertion. Ear plugs are not typically recommended, as they can introduce bacteria. Forcibly blowing the nose can disrupt the tubes, and any drainage after 1 week should be reported, not disregarded.