Nokea
The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate?
- A. I can understand why you feel guilty, but these things happen.'
- B. Tell me a little bit more about your feelings of guilt.'
- C. You should not have taken your eyes off of your child.'
- D. You really shouldn't feel guilty; you're lucky because your child will be all right.'
Correct Answer: B
Rationale: Encouraging parents to express their feelings facilitates therapeutic communication and supports emotional processing.
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When assessing a female adolescent for scoliosis, what should the nurse ask the client to do?
- A. Bend forward at the waist with arms hanging freely.
- B. Lie flat on the floor and extend her legs straight from the trunk.
- C. Sit in a chair while lifting her feet and legs to a right angle with the trunk.
- D. Stand against a wall while pressing the length of her back against the wall.
Correct Answer: A
Rationale: Bending forward at the waist with arms hanging freely allows the nurse to observe for spinal asymmetry, a key sign of scoliosis.
After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which of the following statements offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?
- A. Knowing that the prognosis is poor helps prepare relatives for the death of children.
- B. Relatives are especially grieved when a child does well at first but then declines rapidly.
- C. Trust in health care personnel is most often destroyed by a death that is considered untimely.
- D. It is more difficult for relatives to accept the death of an older child than that of a toddler.
Correct Answer: B
Rationale: A rapid decline after improvement is particularly devastating, guiding the nurse to provide extra emotional support.
The nurse is caring for a 5-year-old boy who is taking prednisolone for nephrotic syndrome. The child is at the 75th percentile for height and has a blood pressure of 114/73. The nurse compares the reading to the below blood pressure levels for boys age and height percentiles. The nurse determines that the blood pressure represents a change and notifies the primary care provider of the assessment of:
- A. Hypotension.
- B. Prehypertension.
- C. Hypertension.
- D. Hypertension stage II.
Correct Answer: C
Rationale: BP indicates hypertension.
After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child:
- A. Fears another procedure.
- B. Does not understand body integrity.
- C. Is expressing pain.
- D. Is attempting to regain control.
Correct Answer: B
Rationale: Preschoolers may fear loss of body integrity, believing blood will leak out without a bandage.
What is the most appropriate method to use when drawing blood from a child with hemophilia?
- A. Use finger punctures for lab draws.
- B. Be prepared to administer platelets for prolonged bleeding.
- C. Apply heat to the extremity before venipunctures.
- D. Schedule all labs to be drawn at one time.
Correct Answer: D
Rationale: Scheduling labs together minimizes venipunctures, reducing bleeding risk in hemophilia. Finger punctures and heat increase bleeding, and platelets are not standard.