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The nurse is providing discharge instructions to the parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism. Which statement by the parents indicate that further teaching is necessary?
- A. I give him medication so he'll be comfortable.
- B. I check his voiding to be sure there's no problem.
- C. I check his temperature.
- D. I'll let him decide when to return to his play activities.
Correct Answer: D
Rationale: I give him medication so he'll be comfortable.' - This statement indicates that the parents are providing medication to ensure the child's comfort after the procedure, which is an appropriate action. It suggests that the parents are attentive to the child's needs postoperatively. 'I check his voiding to be sure there's no problem.' - Checking the child's voiding is important postoperatively to ensure there are no urinary retention issues or other complications related to urination. This statement reflects appropriate postoperative care and monitoring. 'I check his temperature.' - Monitoring the child's temperature is also a good practice postoperatively to watch for signs of infection or other complications. This statement indicates that the parents are attentive to signs of potential postoperative issues. 'I'll let him decide when to return to his play activities.' - This statement suggests that the parents plan to let the child decide when to resume play activities after the surgery. However, after a surgical procedure like orchiopexy, it's important for parents to follow specific guidelines provided by healthcare providers regarding activity restrictions and return to normal activities. Allowing the child to decide may not align with the recommended postoperative care plan.
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A nurse is checking a school-age child for pediculosis capitis. Which of the following findings is a definitive indication of this condition?
- A. Firmly attached white particles on the hair
- B. Itching and scratching of the head
- C. Thick, yellow-crusted lesions on a red base
- D. Patchy areas of hair loss
Correct Answer: A
Rationale: Firmly attached white particles on the hair: Firmly attached white particles on the hair are characteristic of nits, which are the eggs of lice. While this finding supports the diagnosis of pediculosis capitis, it is not a definitive indication on its own. Itching and scratching of the head: Itching and scratching of the head are common symptoms of pediculosis capitis. However, they are also common symptoms of various other scalp conditions, so they are not definitive indications. Thick, yellow-crusted lesions on a red base: This description is more characteristic of impetigo, a bacterial skin infection, rather than pediculosis capitis. Impetigo typically presents with yellow-crusted lesions on a red base, but it does not involve lice infestation. Patchy areas of hair loss: Patchy areas of hair loss are not typically associated with pediculosis capitis. This finding is more suggestive of conditions like alopecia areata or fungal infections.
A school-age child in an emergency department has a 2-day history of nausea and vomiting and reports severe right lower quadrant pain. A nurse is preparing the child for an appendectomy. Which of the following statements by the child should the nurse find most concerning?
- A. My belly doesn't hurt anymore.
- B. I am hungry and thirsty.
- C. I'm tired and want to take a nap.
- D. I am scared and I want to go home.
Correct Answer: A
Rationale: My belly doesn't hurt anymore.' - This statement is concerning because sudden relief from severe right lower quadrant pain in a child with a history of nausea, vomiting, and suspected appendicitis may indicate a rupture or perforation of the appendix. When the appendix ruptures, there may be a temporary alleviation of pain due to the release of pressure. However, this situation is critical and requires immediate medical attention to prevent further complications such as peritonitis or sepsis.
A nurse is preparing to administer vaccines to a 4-month-old infant. Which of the following vaccines should the nurse plan to administer?
- A. Influenza
- B. Rotavirus
- C. Measles, mumps, rubella (MMR)
- D. Varicella (VAR)
Correct Answer: B
Rationale: Influenza: The influenza vaccine is typically administered annually starting at 6 months of age. It helps protect against seasonal influenza viruses and is usually recommended during the fall or winter months. Rotavirus: The rotavirus vaccine is routinely administered to infants starting at 2 months of age, with additional doses given at 4 and 6 months of age. It helps prevent rotavirus infection, which can cause severe diarrhea and vomiting in infants and young children. Measles, mumps, rubella (MMR): The MMR vaccine is typically administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps protect against measles, mumps, and rubella, which are contagious viral infections that can cause serious complications. Varicella (VAR): The varicella vaccine, also known as the chickenpox vaccine, is usually administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps prevent chickenpox, a highly contagious viral infection characterized by a rash and fever.
A nurse is caring for a child who is experiencing a seizure. Which of the following actions should the nurse take?
- A. Place the child in a side-lying position.
- B. Restrain the child's arms.
- C. Elevate the child's legs on a pillow.
- D. Insert a padded tongue blade into the child's mouth.
Correct Answer: A
Rationale: Place the child in a side-lying position. This is the correct action to take during a seizure to prevent aspiration and maintain an open airway. Placing the child in a side-lying position helps to prevent choking or aspiration if vomiting occurs and allows saliva or other fluids to drain out of the mouth instead of being inhaled into the lungs. Restrain the child's arms. Restraining the child's arms is not recommended during a seizure. It can potentially cause injury to the child or the person trying to restrain them. It may also exacerbate muscle spasms and increase the risk of injury during the seizure. Elevate the child's legs on a pillow. Elevating the child's legs on a pillow is not necessary during a seizure and is not a recommended intervention. It does not address the immediate needs of the child during a seizure, such as maintaining an open airway and preventing injury. Insert a padded tongue blade into the child's mouth. Inserting anything into the child's mouth during a seizure, including a tongue blade, is strongly discouraged. It can cause injury to the child's teeth, gums, or oral tissues and increase the risk of choking or aspiration. It may also result in the nurse getting bitten during the seizure. Maintaining a clear airway and ensuring the child's safety are the priorities during a seizure, and inserting objects into the mouth can interfere with these goals.
A nurse is reinforcing teaching about lice with the parents of a school-age child at a well-child visit. Which of the following information should the nurse include?
- A. Lice do not survive away from the host.
- B. Washing your child's hair daily will prevent lice.
- C. Encourage your child to avoid sharing hats with other children.
- D. Lice can jump from one child to another.
Correct Answer: C
Rationale: Lice do not survive away from the host.' - This statement is incorrect. Lice can survive away from the host (human scalp) for a limited period, usually up to 1-2 days. They may be found on items such as bedding, clothing, hats, or hair accessories. Therefore, proper cleaning and disinfection of these items are essential to prevent the spread of lice. 'Washing your child's hair daily will prevent lice.' - This statement is incorrect. While maintaining good hygiene is important, washing hair daily does not necessarily prevent lice infestation. Lice infestations occur through direct head-to-head contact with an infested person, not due to uncleanliness. Additionally, lice are more commonly found in clean hair rather than dirty hair. 'Encourage your child to avoid sharing hats with other children.' - This statement is correct. Sharing personal items such as hats, scarves, brushes, or hair accessories can facilitate the spread of lice from one person to another. Therefore, it's important to advise children not to share these items to reduce the risk of lice transmission. 'Lice can jump from one child to another.' - This statement is incorrect. Lice do not have the ability to jump or fly. They spread through direct contact with the hair or scalp of an infested person. However, they can crawl quickly from one person to another, especially when there is close contact, such as during play or when sharing personal items.