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The parents of a child with a serious head injury ask the nurse if the child is going to be all right. Which of the following responses by the nurse would be most appropriate?
- A. Children usually don't do very well after head injuries like this.'
- B. Children usually recover rapidly from head injuries.'
- C. It's hard to tell this early, but we'll keep you informed of the progress.'
- D. That's something you'll have to talk to the doctor about.'
Correct Answer: C
Rationale: Acknowledging uncertainty while promising updates provides honest, supportive communication without false reassurance.
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When assessing for pain in a toddler, which of the following methods should be the most appropriate?
- A. Ask the child about the pain.
- B. Observe the child for restlessness.
- C. Use a numeric pain scale.
- D. Assess for changes in vital signs.
Correct Answer: B
Rationale: Toddlers cannot reliably verbalize pain, so observing behavior like restlessness is most appropriate.
A nurse is teaching the parents of a preschooler about the possibility of post-operative hemorrhage after a tonsillectomy and adenoidectomy. The nurse should explain that the risk is greatest at which of the following times?
- A. 1 to 3 days after surgery.
- B. 4 to 6 days after surgery.
- C. 7 to 10 days after surgery.
- D. 11 to 14 days after surgery.
Correct Answer: C
Rationale: The risk of post-operative hemorrhage after a tonsillectomy is greatest 7 to 10 days after surgery, as this is when the eschar (scab) typically sloughs off, potentially exposing blood vessels and leading to bleeding.
A child who limps and has pain has been found to have Legg-Calvé-Perthes disease. What should the nurse expect to include in the child's plan of care?
- A. Initiation of pain control measures, especially at night when acute.
- B. Promotion of ambulation despite child's discomfort in the affected hip.
- C. Prevention of flexion in the affected hip and knee.
- D. Advance of weight bearing on the head of the affected femur.
Correct Answer: A
Rationale: Pain control is essential in Legg-Calvé-Perthes disease, as pain is a common symptom, especially at night, due to inflammation and muscle spasms.
A child has just ingested about 10 adult-strength acetaminophen (Tylenol) pills. The mother brings the child to the emergency department. What should the nurse do? Place the interventions in the order of priority from first to last.
- A. Administer activated charcoal.
- B. Assess the airway.
- C. Reassure the mother.
- D. Check serum acetaminophen levels.
- E. Obtain information about how the child obtained the pills.
- F. Complete a physical examination.
Correct Answer: B,A,D,C,F,E
Rationale: 1. Assess the airway to ensure patency and stability. 2. Administer activated charcoal to reduce acetaminophen absorption. 3. Check serum acetaminophen levels to guide treatment. 4. Reassure the mother to reduce anxiety. 5. Obtain information about how the child obtained the pills for safety education. 6. Complete a physical examination to assess for other effects.
Which of the following structures should be closed by the time the child is 2 months old?
- A. A.
- B. B.
- C. C.
- D. D.
Correct Answer: C
Rationale: posterior fontanelle closes by 2 months.