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When developing a recreational therapy plan of care for a 3-year-old child hospitalized with pneumonia and cystic fibrosis, which of the following toys would be appropriate?
- A. 100-piece jigsaw puzzle.
- B. Child's favorite doll.
- C. Fuzzy stuffed animal.
- D. Scissors, paper, and paste.
Correct Answer: B
Rationale: A child's favorite doll is appropriate for a 3-year-old, providing comfort and familiarity without posing a risk of irritation or infection, unlike fuzzy stuffed animals which can harbor dust or bacteria.
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After teaching a group of school teachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizure. Which of the following actions, when performed first, indicates that the nurse's teaching has been successful?
- A. Asking the other children what happened before the seizure.
- B. Moving the child to the nurse's office for privacy.
- C. Removing any nearby objects that could harm the child.
- D. Placing a padded tongue blade between the child's teeth.
Correct Answer: C
Rationale: Removing harmful objects first ensures the child's safety during a seizure, reflecting effective teaching.
A 12-year-old child has had a traumatic head injury from playing in a football game. He is admitted to the emergency department and transferred to the pediatric intensive care unit. He has an I.V. of dextrose 5% in water at a 'keep-open' rate and nasal oxygen at 2 L/minute. The nurse is assessing the child at the beginning of the shift (11:00 p.m.) and reviews the Glasgow Coma Scale flow sheet. The nurse notes that the child responds to pain, is making incomprehensible sounds, and has abnormal flexion of the limbs. What should the nurse do first?
- A. Notify the physician.
- B. Administer pain medication.
- C. Increase oxygen flow.
- D. Document the findings.
Correct Answer: A
Rationale: A Glasgow Coma Scale score indicating pain response, incomprehensible sounds, and abnormal flexion (approximately 6-8) suggests severe neurological impairment, warranting immediate physician notification.
The parents of a neonate born with congenital clubfoot express feelings of helplessness and guilt, exhibiting anxiety about how the neonate will be treated. Which of the following actions by the nurse would be most appropriate initially?
- A. Ask them to share these concerns with the physician.
- B. Arrange a meeting with other parents whose infants have clubfoot to discuss their feelings.
- C. Suggest that they make an appointment to talk things over with a counselor.
- D. Encourage the parents to express their feelings and listen attentively.
Correct Answer: D
Rationale: Encouraging expression of feelings and listening attentively is the most appropriate initial step to address emotional concerns and build trust.
Which of the following client actions should the nurse judge to be a healthy coping behavior for a male adolescent after an appendectomy?
- A. Insisting on wearing a T-shirt and gym shorts rather than pajamas.
- B. Avoiding interactions with other adolescents on the nursing unit.
- C. Refusing to fill out the menu, and allowing the nurse to do so.
- D. Not taking telephone calls from friends so he can rest.
Correct Answer: A
Rationale: Choosing preferred clothing reflects autonomy and positive coping.
When teaching the parents of a child with a ventricular septal defect who is scheduled for a cardiac catheterization, the nurse explains that this procedure involves the use of which of the following?
- A. Ultra-high-frequency sound waves.
- B. Catheter placed in the right femoral vein.
- C. Cutdown procedure to place a catheter.
- D. General anesthesia.
Correct Answer: B
Rationale: Cardiac catheterization involves inserting a catheter, typically through the femoral vein, to assess heart structures. Ultra-high-frequency sound waves are used in echocardiography, a cutdown is not standard, and general anesthesia is not always required.