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The parent of a 17-year-old boy, who is hospitalized for complications related to type I diabetes, requests to review the adolescent's medical record. The client reported receiving mental health counseling during the admission history, but did not want his parent to know. The nurse, who is uncertain of how to protect the adolescent's privacy and accommodate the parent's request, should consult:
- A. The unit nurse manager.
- B. The primary care provider.
- C. The organization's privacy officer.
- D. The customer service representative.
Correct Answer: C
Rationale: The privacy officer is trained to handle HIPAA and confidentiality issues, ensuring the adolescent's privacy (e.g., mental health records) is protected while addressing parental rights.
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The nurse should instruct the family of a child with newly diagnosed hyperthyroidism to:
- A. Keep their home warmer than usual.
- B. Encourage twenty or outdoor activities.
- C. Promote interactions with one friend instead of groups.
- D. Limit bathing to prevent skin irritation.
Correct Answer: C
Rationale: Hyperthyroidism causes irritability and hyperactivity, so limiting social interactions to one friend reduces overstimulation. Warmer homes, excessive activity, and limited bathing are inappropriate.
A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We don't want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best?
- A. I sympathize with your difficulties
- B. but just ignore the behavior for now.
- C. I understand it's hard to discipline a child who is ill
- D. but things need to be kept as normal as possible.
- E. I understand that things are difficult for you right now
- F. but your child is ill and deserves special treatment.
- G. I understand your concern
Correct Answer: B
Rationale: Maintaining routines is essential.
The parents of a child with occasional generalized seizures want to send the child to summer camp. The parents contact the nurse for advice on planning for the camping experience. Which of the following activities should the nurse and family decide the child should avoid?
- A. Rock climbing.
- B. Hiking.
- C. Swimming.
- D. Tennis.
Correct Answer: C
Rationale: Swimming poses a drowning risk during a seizure; it should be avoided unless closely supervised.
The health care team has noticed an increase in I.V. infiltrations on the pediatric floor. As part of a Plan, Do, Study, Act quality improvement plan the team should do the following in which order?
- A. Analyze the data.
- B. Decide to monitor I.V. gauges.
- C. Perform chart audits.
- D. Write a new I.V. insertion policy.
Correct Answer: B,C,A,D
Rationale: The PDSA cycle involves planning (deciding to monitor), doing (chart audits), studying (analyzing data), and acting (writing a new policy).
The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?
- A. Fitting the diaper under the straps.
- B. Leaving the harness off while the infant sleeps.
- C. Checking for skin redness under straps every other day.
- D. Putting powder on the skin under the straps every day.
Correct Answer: A
Rationale: Fitting the diaper under the straps ensures hygiene without disrupting the harness's corrective positioning.