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The physician has ordered intravenous mannitol (Osmitrol) for a child with a head injury. The best indicator that the drug has been effective is:
- A. Increased urine output.
- B. Improved level of consciousness.
- C. Decreased intracranial pressure.
- D. Decreased edema.
Correct Answer: C
Rationale: Mannitol reduces intracranial pressure by osmotic diuresis; decreased intracranial pressure is the primary indicator of its effectiveness.
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When developing the teaching plan for the parents of a 12-month-old infant with hypospadias and chordee repair, which of the following should the nurse expect to include as most important?
- A. Assisting the child to become familiar with his dressings so he will leave them alone.
- B. Encouraging the child to ambulate as soon as possible by using a favorite push toy.
- C. Forcing fluids to at least 2,500 mL/day by offering his favorite juices.
- D. Preventing the child from disrupting the catheters by using soft restraints.
Correct Answer: D
Rationale: Restraining prevents dislodgment of catheters.
The mother asks the nurse whether her child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which of the following responses by the nurse would be most appropriate?
- A. Ask the doctor what he thinks at your next appointment.'
- B. Maybe, maybe not. How old were you when you first walked?'
- C. It's difficult to predict, but his ability to bear weight is a positive factor.'
- D. If he really wants to walk, and works hard, he probably will eventually.'
Correct Answer: C
Rationale: The ability to bear weight is a positive sign, but predicting normal walking is challenging due to the variability in cerebral palsy outcomes.
The mother of a toilet-trained toddler who was admitted to the hospital for severe gastroenteritis and subsequent dehydration and is now at home asks the nurse why the child still wets the bed. Which of the following should be the nurse's best response?
- A. Hospitalization is a traumatic experience for children, regression is common and it takes time for them to return to their former behavior.
- B. The stress of hospitalization is hard for many children, but usually they have no problems when they return home.
- C. After returning home from being hospitalized, children still feel they should be the center of attention.
- D. Children do not feel comfortable in their home surroundings once they return home from being hospitalized.
Correct Answer: A
Rationale: Regression, like bedwetting, is common after hospitalization due to stress.
To determine if a blood pressure reading is normal, the nurse must know which information about the child? Select all that apply.
- A. Age.
- B. Body mass index (BMI).
- C. A secret.
- D. Height.
- E. Occipital frontal circumference (OFC).
- F. Weight.
Correct Answer: A,D,F
Rationale: Age, height, and weight are key factors in determining normal blood pressure ranges.
The nurse begins CPR on a 5-year-old unresponsive client. When the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 with cyanotic legs. The team should next:
- A. Discontinue compressions but continue administering breaths with a bag-mask device.
- B. Establish an intravenous line with a large bore needle while preparing the defibrillator.
- C. Begin 2-person CPR at a ratio of 2 breaths to 15 compressions.
- D. Begin 2-person CPR at a ratio of 2 breaths to 30 compressions.
Correct Answer: C
Rationale: For a 5-year-old with a heart rate of 50 (bradycardia) and no respiratory effort, 2-person CPR with a ratio of 2 breaths to 15 compressions is appropriate to optimize oxygenation and circulation.