Nokea
When developing the plan of care for a child with cystic fibrosis (CF) who is scheduled to receive postural drainage, the nurse should anticipate performing postural drainage at which of the following times?
- A. After meals.
- B. Before meals.
- C. After rest periods.
- D. Before inhalation treatments.
Correct Answer: B
Rationale: Postural drainage should be performed before meals to avoid discomfort and reduce the risk of vomiting, as it involves positioning to facilitate mucus clearance.
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A child with hemophilia presents with a burning sensation in the knee and reluctance to move the body part. The nurse collaborates with the care team to provide the treatment and
- A. Administer an aspirin-containing compound.
- B. Institute Rest, Ice, Compression, and Elevation (RICE).
- C. Begin physical therapy with active range of motion.
- D. Initiate skin traction.
Correct Answer: B
Rationale: RICE reduces swelling and bleeding in hemophilic joint bleeds. Aspirin worsens bleeding, active motion is harmful, and traction is inappropriate.
The nurse is assisting another member of the health care team who is placing a peripherally inserted catheter in a 10-year-old with peritonitis from a ruptured appendix. The family is present in the treatment room to support the child. The nurse observes the other team member has contaminated a sterile glove. The nurse should:
- A. Discuss the incident with the team member after the event.
- B. Report the incident to the nursing unit manager.
- C. Tell the team member the glove is contaminated.
- D. Ask the family to leave before confronting the team member.
Correct Answer: C
Rationale: Immediately addressing the contamination maintains sterility and patient safety.
A 10-year-old with leukemia is taking immunosuppressive drugs. To maintain health the nurse should instruct the child and parents to:
- A. Continue with immunizations.
- B. Not receive any live attenuated vaccines.
- C. Receive vitamin and mineral supplements.
- D. Stay away from peers.
Correct Answer: B
Rationale: Live attenuated vaccines are contraindicated in immunosuppression due to infection risk. Other options are unnecessary or overly restrictive.
The nurse is evaluating a child’s skills in self-administering insulin (see fi gure). The nurse should:
- A. Have the child use both hands on the syringe.
- B. Ask the child to place the needle at a 45 degreeangle
- C. Tell the child to use a site lower on her thigh.
- D. Remind the child to rotate sites.
Correct Answer: D
Rationale: The child is using correct injection technique, and the nurse can remind the child to rotate sites. The nurse should also reinforce that the child has used correct technique and praise the child for doing so. If the child can manipulate the plunger of the syringe with one hand, this is appropriate. Insulin is administered at a 90 degree angle as shown. The child should identify appropriate sites on the thighs as one handbreadth below the hip and above the knee; the child is using appropriate sites.
A nurse is teaching an 8-year-old with diabetes and her parents about managing diabetes during illness. The nurse determines the parents understand the instruction when they indicate that, when the child is ill, they will provide:
- A. More calories.
- B. More insulin.
- C. Less insulin.
- D. Less protein and fat.
Correct Answer: B
Rationale: Illness increases insulin resistance, often requiring more insulin to manage elevated blood glucose. Calorie, protein, or fat adjustments are secondary to insulin needs.