The nurse is teaching parents of a preschool child strategies to implement when the child delays going to bed. What strategy should the nurse recommend?
- A. Use consistent bedtime rituals.
- B. Give in to attention-seeking behavior.
- C. Take the child into the parents bed for an hour.
- D. Allow the child to stay up past the decided bedtime.
Correct Answer: A
Rationale: For children who delay going to bed, a recommended approach involves a consistent bedtime ritual and emphasizing the normalcy of this type of behavior in young children. Parents should ignore attention-seeking behavior, and the child should not be taken into the parents bed or allowed to stay up past a reasonable hour.
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A child is admitted to the hospital with lesions on his abdomen that appear like cigarette burns. What should accurate documentation by the nurse include?
- A. Two unhealed lesions are on the childs abdomen.
- B. Two round 4-mm lesions are on the childs lower abdomen.
- C. Two round symmetrical lesions are on the childs lower abdomen.
- D. Two round lesions on the childs abdomen that appear to be cigarette burns.
Correct Answer: B
Rationale: Burn documentation should include the location, pattern, demarcation lines, and presence of eschar or blisters. The option that includes the size of the lesions is the most accurate.
The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurses recommendation should be based on remembering what?
- A. This is an expected behavior at this age.
- B. This is a warning sign of a serious problem.
- C. This is harmless venting of anger and frustration.
- D. This is common in children who are physically abused.
Correct Answer: B
Rationale: Cruelty to family pets is not an expected behavior. Hurting animals can be one of the earliest symptoms of a conduct disorder. Abusing animals does not dissipate violent emotions; rather, the acts may fuel the abusive behaviors. Referral for evaluation is essential. This behavior may be seen in emotional abuse or neglect, not physical abuse.
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
- A. Unintentional injury
- B. Shaken baby syndrome
- C. Congenital neurologic problem
- D. Sudden infant death syndrome (SIDS)
Correct Answer: B
Rationale: Shaken baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. With unintentional injuries, external signs are usually present. Congenital neurologic problems would usually have signs of abnormal neurologic anatomy. SIDS does not usually have identifiable injuries.
What is a clinical manifestation of acetaminophen poisoning?
- A. Hyperpyrexia
- B. Hepatic involvement
- C. Severe burning pain in stomach
- D. Drooling and inability to clear secretions
Correct Answer: B
Rationale: Hepatic involvement is the third stage of acetaminophen poisoning. Hyperpyrexia is a severe elevation in body temperature and is not related to acetaminophen poisoning. Acetaminophen does not cause burning pain in stomach and does not pose an airway threat.
An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?
- A. Giving half of the solution and then repeating the other half in 1 hour
- B. Mixing with a flavorful beverage in an opaque container with a straw
- C. Serving it in a clear plastic cup so the child can see how much has been drunk
- D. Administering it through a nasogastric tube because the child will not drink it because of the taste
Correct Answer: B
Rationale: Although activated charcoal can be mixed with a flavorful sugar-free beverage, it will be black and resemble mud. When it is served in an opaque container, the child will not have any preconceived ideas about its being distasteful. The ability to see the charcoal solution may affect the childs desire to drink the solution. The child should be encouraged to drink the solution all at once. The nasogastric tube would be traumatic. It should be used only in children who cannot be cooperative or those without a gag reflex.
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