Nokea
What observation in an emergency department should lead a nurse to suspect child abuse in a child with a fractured arm?
- A. Lack of parental concern for the severity of the injury
- B. The child not answering questions concerning the injury
- C. Parents not asking about the child's condition
- D. Inconsistency between the injury and the parents' explanation of it
Correct Answer: D
Rationale: Special attention must be paid to injuries that are inconsistent with the parents' explanation.
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When the newly admitted 2-year-old who was potty-trained before admission begins to wet the bed, the mother is frightened. What statement by the nurse will be most helpful to the mother?
- A. Don't be concerned. Accidents happen.
- B. Let's put a diaper on your child until this gets better.
- C. The stress of hospitalization makes children regress a little.
- D. Your child will relearn 'potty-training' if you are patient.
Correct Answer: C
Rationale: It is not unusual for children to regress when hospitalized. Explaining that regression is normal during hospitalization will help allay the mother's anxiety.
What should be done before initiating a gavage feeding?
- A. Hold the feeding tube under water to check for bubbling.
- B. Check for gastric distention.
- C. Aspirate stomach contents.
- D. Ensure the sterility of feeding equipment.
Correct Answer: C
Rationale: Aspirating stomach contents and aspirating a small amount of air while listening for stomach gurgling are the best ways to ensure correct tube placement. Holding the feeding tube under water to check for bubbling is not an effective method to check tube placement. Gastric distention would be important following the feeding. A gavage feeding is not a sterile procedure.
What is the preferred IM injection site for a 2-year-old?
- A. Deltoid muscle
- B. Upper thigh
- C. Vastus lateralis
- D. Gluteus
Correct Answer: C
Rationale: The preferred site for an IM injection for a 2-year-old is the vastus lateralis.
An 8-year-old child asks how a blood pressure is taken. What would be the most appropriate response?
- A. This small machine will measure your systolic and diastolic pressure.
- B. The armband will hug your arm and tell me how well your blood is going through your arm.
- C. The armband will cut off your circulation for a while and then we can hear when it comes back.
- D. When you are ill we need to know if your blood is still moving in your body.
Correct Answer: B
Rationale: Because children are upset by unfamiliar procedures, it is best to explain each step in simple terms. It is best not to mention anything that may increase anxiety.
What should be included in the teaching plan for the parents of a 3-year-old child who has been prescribed an opioid analgesic?
- A. The opioid is likely to cause significant respiratory depression.
- B. The medicine is prescribed with the knowledge that addiction may occur.
- C. The opioid is very effective as a pain control method.
- D. The opioid is only to be given in cases of severe pain.
Correct Answer: C
Rationale: It is an effective type of analgesia. When administered to children, opioid analgesics do not have any greater respiratory depression than when given to an adult, and the risk of addiction is virtually nonexistent in children.