Nokea
The nurse is giving an intramuscular injection of an antibiotic to a 16-month-old toddler with pneumonia. The toddler does not have any known allergies and has been walking without assistance for one month. Which technique should the nurse select for administration?
- A. Divide the gluteal area into quarters and give IM into the upper outer quadrant.
- B. Administer the injection into the middle of the lateral aspect of the thigh.
- C. Use a needle length of 1/2 inch (1.25 cm) to avoid deep tissue damage.
- D. Give in the arm, one to 2 inches (2.5 to 5.0 cm) below the acromion process.
Correct Answer: B
Rationale: The vastus lateralis in the thigh is the preferred IM site for toddlers, ensuring safe delivery.
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When advising a new mother on caring for a child with croup, which symptom should be a priority concern for the telephone triage nurse?
- A. Fever 101.0° F (38.3°C)
- B. Barking cough, worse at night
- C. Frequent crying during nursing
- D. Difficulty swallowing secretions .
Correct Answer: D
Rationale: Difficulty swallowing secretions suggests severe airway swelling, requiring urgent attention.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
- A. The diaper area shows severe skin breakdown
- B. The mother states the baby is irritable during feedings
- C. The mother is a single parent and lives with her parents
- D. The infant's formula has been changed twice
Correct Answer: A
Rationale: Severe diaper dermatitis causes discomfort, impacting sleep and requiring immediate care.
While checking the vital signs of a 10-year-old child who underwent a tonsillectomy earlier in the day, the nurse notices the child swallowing every 2 to 3 minutes. What action should the nurse take next?
- A. Check for signs of teeth clenching or grinding
- B. Inspect the back of the throat
- C. Stimulate the gag reflex by touching the tonsillar pillars
- D. Ask the child to speak to assess for any changes in voice tone .
Correct Answer: B
Rationale: Frequent swallowing may indicate post-tonsillectomy bleeding, requiring throat inspection.
Which snack choice by a school-aged child with gastroesophageal reflux indicates to the nurse that the child understands the dietary restrictions?
- A. Chocolate milkshake
- B. Sugar cookies
- C. Tacos
- D. Pizza
Correct Answer: B
Rationale: Sugar cookies are less likely to trigger GERD symptoms compared to high-fat or acidic foods.
A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?
- A. Apply lotion to hands and feet.
- B. Encourage the parents to rest when possible.
- C. Make a list of foods that the child likes.
- D. Place the child in a quiet environment.
Correct Answer: D
Rationale: Placing the child in a quiet environment reduces stimulation and promotes rest, addressing irritability, a primary symptom of Kawasaki disease.