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The nurse is evaluating a child’s skills in self-administering insulin (see fi gure). The nurse should:
- A. Have the child use both hands on the syringe.
- B. Ask the child to place the needle at a 45 degreeangle
- C. Tell the child to use a site lower on her thigh.
- D. Remind the child to rotate sites.
Correct Answer: D
Rationale: The child is using correct injection technique, and the nurse can remind the child to rotate sites. The nurse should also reinforce that the child has used correct technique and praise the child for doing so. If the child can manipulate the plunger of the syringe with one hand, this is appropriate. Insulin is administered at a 90 degree angle as shown. The child should identify appropriate sites on the thighs as one handbreadth below the hip and above the knee; the child is using appropriate sites.
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While assessing a preschooler brought by her parents to the emergency department after ingestion of kerosene, the nurse should be alert for which of the following?
- A. Uremia.
- B. Hepatitis.
- C. Carditis.
- D. Pneumonitis.
Correct Answer: D
Rationale: Kerosene ingestion often causes chemical pneumonitis due to aspiration risk. Uremia, hepatitis, and carditis are not common complications.
The nurse judges that the mother has understood the teaching about care of an infant with colic when the nurse observes the mother doing which of the following?
- A. Holding the infant prone while feeding.
- B. Holding the infant in her lap to burp.
- C. Placing the infant prone after the feeding.
- D. Burping the infant during and after the feeding.
Correct Answer: D
Rationale: Burping during and after feeding reduces air swallowing, easing colic symptoms. Prone positioning during or after feeding increases aspiration risk, and lap burping is less effective.
After teaching the mother of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, the mother indicates that she understands her child's prognosis when she states which of the following?
- A. My child will need to wear protective pads until puberty.
- B. My child will need extra fluids to prevent constipation.
- C. My child will probably always need a high-fiber diet.
- D. My child has a good chance of being potty trained.
Correct Answer: D
Rationale: Low anorectal anomalies often have a good prognosis for continence with proper management.
A 10-year-old has 5 lb of Buck's extension traction on his left leg. The nurse should assess the child for which of the following? Select all that apply.
- A. Dryness of the skin, by removing the foam wraps and boot.
- B. Alignment of the shoulder, hips, and knees.
- C. Frayed rope near pulleys.
- D. Correct amount of traction weight on fracture.
- E. Pressure on the coccyx.
Correct Answer: B,C,D,E
Rationale: The nurse should check alignment, rope condition, weight accuracy, and pressure points to ensure effective and safe traction.
When interacting with the mother of a child who has Duchenne's muscular dystrophy, the nurse observes behavior indicating that the mother may feel guilty about her child's condition. The nurse interprets this behavior as guilt stemming from which of the following?
- A. The terminal nature of the disease.
- B. The dependent behavior of the child.
- C. The genetic mode of transmission.
- D. The sudden onset of the disease.
Correct Answer: C
Rationale: The genetic mode of transmission (X-linked recessive) often leads to maternal guilt, as the mother may feel responsible for passing the gene.