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The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse?
- A. Explain that it will not be painful.
- B. Suggest to him that he not worry about losing just a little bit of blood.
- C. Discuss with him how his body is always in the process of making blood.
- D. Tell the child that he will not even need a Band-Aid afterward because it is a simple procedure.
Correct Answer: C
Rationale: Explaining that the body continuously makes blood addresses the child?s fear of loss using age-appropriate scientific terms. Claiming it won?t hurt is inaccurate, dismissing worry doesn?t reassure, and minimizing the need for a Band-Aid trivializes the child?s concern.
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A 6-year-old child needs to drink 1 L of GoLYTELY in preparation for a computed tomography scan of the abdomen. To encourage the child to drink, what should the nurse do?
- A. Give him a large cup with ice so it tastes better.
- B. Restrict him to his room until he drinks the GoLYTELY.
- C. Use little cups and make a game to reward him for each cup he drinks.
- D. Tell him that if he does not finish drinking by a set time, the practitioner will be angry.
Correct Answer: C
Rationale: Using small cups and making a game with rewards makes the large volume of GoLYTELY less daunting and encourages compliance. A large cup with ice increases the volume, restriction is punitive, and threats about the practitioner are ineffective and inappropriate.
The nurse needs to take the blood pressure of a preschool boy for the first time. What action would be best in gaining his cooperation?
- A. Tell him that this procedure will help him get well faster.
- B. Take his blood pressure when a parent is there to comfort him.
- C. Explain to him how the blood flows through the arm and why the blood pressure is important.
- D. Permit him to handle the equipment and see the cuff inflate and deflate before putting the cuff in place.
Correct Answer: D
Rationale: Allowing a preschooler to handle the blood pressure equipment and see the cuff in action reduces fear of bodily harm by familiarizing him with the procedure. Explaining complex blood flow is too advanced, claiming it aids recovery is inaccurate, and while parental presence helps, it?s less effective than hands-on engagement.
A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include?
- A. Massaging reddened bony prominences
- B. Teaching the parents to turn the child every 4 hours
- C. Ensuring that nutritional intake meets requirements
- D. Minimizing use of extra linens, which can irritate the childs skin
Correct Answer: C
Rationale: Adequate nutrition prevents skin breakdown by supporting tissue health, especially in NPO children. Massaging bony prominences risks tissue damage, turning should occur every 2 hours by the nurse, and linens don?t typically cause irritation if managed properly.
Using knowledge of child development, what approach is best when preparing a toddler for a procedure?
- A. Avoid asking the child to make choices.
- B. Plan for a teaching session to last about 20 minutes.
- C. Demonstrate on a doll how the procedure will be done.
- D. Show the necessary equipment without allowing child to handle it.
Correct Answer: C
Rationale: Demonstrating the procedure on a doll engages a toddler?s preoperational thinking through play, reducing fear. Avoiding choices limits participation, 20-minute sessions are too long for a toddler?s attention span, and showing equipment without handling increases anxiety.
A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen?
- A. Establish a contract with her, including rewards.
- B. Suggest time-outs when she forgets her medicine.
- C. Discuss with her mother the damaging effects of her rescuing the child.
- D. Ask the child to bring her medicine containers to each appointment so they can be counted.
Correct Answer: A
Rationale: Establishing a behavioral contract with rewards encourages adherence by addressing barriers like side effects or scheduling and motivates the child. Time-outs are punitive, discussing maternal rescuing is less effective, and checking containers monitors but doesn?t promote self-responsibility.