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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.
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When caring for a child with moderate burns from the waist down, which of the following should the nurse do when positioning the child?
- A. Place the child in a position of comfort.
- B. Allow the child to lie on the abdomen.
- C. Ensure the application of leg splints.
- D. Have the child flex the hips and knees.
Correct Answer: D
Rationale: Flexing hips and knees prevents contractures and promotes circulation in lower extremity burns. Comfort is secondary, lying on the abdomen may cause pressure, and splints are not routinely needed.
The nurse is evaluating a child's skills in self-administering insulin (see figure). The nurse should:
- A. Have the child use both hands on the syringe.
- B. Ask the child to place the needle at a 45 degree angle.
- C. Tell the child to use a site lower on her thigh.
- D. Remind the child to rotate sites.
Correct Answer: D
Rationale: Rotating insulin injection sites prevents lipodystrophy and ensures consistent absorption. Both hands are typically used, a 90-degree angle is standard for children, and site location depends on rotation.
An 8-year-old has a body mass index (BMI) for age at the 90th percentile, but has no other risk factors. The nurse should:
- A. Refer for a weight management program.
- B. Prescribe a low-calorie diet.
- C. Order fasting glucose levels.
- D. Initiate daily exercise logs.
Correct Answer: A
Rationale: A BMI at the 90th percentile indicates overweight. A weight management program promotes healthy habits. Diet prescription, glucose testing, or exercise logs are premature without further risk assessment.
A nurse is assessing a child who is mildly mentally retarded. The best indication of how a mentally retarded child is progressing can be obtained by observing him:
- A. At school with his teacher.
- B. At home with his family.
- C. In the clinic with his mother.
- D. Playing soccer with his friends.
Correct Answer: B
Rationale: Observing the child at home provides insight into daily functioning and adaptive behavior in a familiar environment, reflecting progress accurately.
When developing the teaching plan for the mother and a child with insulin-dependent diabetes about sick-day management, which of the following instructions should the nurse include?
- A. Adhere to the same schedule and type and amount of insulin.
- B. Immediately call the physician for information about what to do.
- C. Adjust insulin based on more frequent testing of blood glucose levels.
- D. Take the child to the emergency department for immediate care.
Correct Answer: C
Rationale: Sick-day management requires frequent glucose monitoring and insulin adjustments to prevent ketoacidosis. Fixed insulin schedules, immediate physician calls, or ER visits are less appropriate without monitoring.