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Which of the following techniques help prepare a child for surgery by utilising role playing or hands on activities (eg, starting an IV on a teddy bears)?
- A. Onlooker play
- B. Therapeutic play
- C. Cooperative play
- D. Play therapy
Correct Answer: B
Rationale: The correct answer is B: Therapeutic play. Therapeutic play involves using various activities like role-playing or hands-on tasks to help children understand and cope with medical procedures. It allows them to express emotions, reduce anxiety, and gain a sense of control. Onlooker play (A) involves observing others play without actively participating. Cooperative play (C) involves playing together towards a common goal. Play therapy (D) is a form of psychotherapy using play to help children express feelings. Since the question specifically mentions preparing a child for surgery through role-playing and hands-on activities, therapeutic play is the most appropriate choice.
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A 9-year-old child for an IV catheter insertion
A nurse is preparing a 9-year-old child for an IV catheter insertion. Which of the following actions should the nurse take first?
- A. Allow the child to see and touch IV tubing and supplies.
- B. Explain to the child's parents what role they will have during the procedure.
- C. Describe the procedure using visual aids.
- D. Ask the child what he knows about the procedure.
Correct Answer: D
Rationale: The correct answer is D, asking the child what he knows about the procedure first. This step is crucial as it helps assess the child's understanding, address any misinformation, and tailor the explanation to the child's knowledge level. It also promotes trust and cooperation. Option A may increase anxiety as seeing the supplies without understanding can be intimidating. Option B involves parents before addressing the child directly. Option C may overwhelm the child with too much information at once.
A child who has spina bifida occulta
A nurse is collecting data from a child who has spina bifida occulta. Which of the following findings should the nurse expect?
- A. Flaccid paralysis of lower extremities
- B. Hip dislocation
- C. Hydrocephalus
- D. Dimple in sacral area
Correct Answer: D
Rationale: The correct answer is D: Dimple in sacral area. In spina bifida occulta, there is a small gap in the spine but no protrusion of the spinal cord or meninges. A dimple in the sacral area is a common physical finding. Flaccid paralysis of lower extremities (A) is more characteristic of myelomeningocele, not occulta. Hip dislocation (B) is not typically associated with spina bifida occulta. Hydrocephalus (C) is more commonly seen with myelomeningocele as well. The presence of a dimple in the sacral area is a key indicator of spina bifida occulta due to the incomplete closure of the spinal column.
An infant who has Tetralogy of Fallot and is easily fatigued when eating
A nurse is caring for an infant who has Tetralogy of Fallot and notes that the infant is easily fatigued when eating. Which defect is not present in this cardiac congenital malformation?
- A. Overriding aorta
- B. Pulmonary stenosis
- C. Left ventricular hypertrophy
- D. Ventricular septal defect
Correct Answer: C
Rationale: The correct answer is C: Left ventricular hypertrophy is not present in Tetralogy of Fallot. In Tetralogy of Fallot, the four main defects are pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Left ventricular hypertrophy is not part of the condition. The infant's fatigue during feeding is likely due to decreased oxygen levels in the blood caused by the pulmonary stenosis and right-to-left shunting at the ventricular septal defect. Choices A, B, and D are all components of Tetralogy of Fallot, making them incorrect options.
A child who is to receive percussion, vibration, and postural drainage
A nurse is caring for a child who is to receive percussion, vibration, and postural drainage. Which of the following actions should the nurse take first?
- A. Instruct the client to cough
- B. Perform vibration while the client exhales slowly through the nose.
- C. Percuss the upper posterior chest.
- D. Administer albuterol by nebulizer.
Correct Answer: D
Rationale: The correct answer is D: Administer albuterol by nebulizer. This should be done first to help open up the airways and facilitate the effectiveness of the subsequent treatments. Albuterol is a bronchodilator that helps to relax the muscles in the airways, making it easier for the child to breathe. Administering albuterol before percussion, vibration, and postural drainage will help optimize the child's lung function and overall response to the respiratory therapy.
Choice A: Instruct the client to cough - This can be done after administering albuterol to help clear any loosened secretions.
Choice B: Perform vibration while the client exhales slowly through the nose - This can be done after administering albuterol to further aid in loosening and mobilizing secretions.
Choice C: Percuss the upper posterior chest - This can be done after administering albuterol to assist in clearing secretions from the lungs.
A toddler who is scheduled to have a lumbar puncture
A nurse is caring for a toddler who is scheduled to have a lumbar puncture. Which of the following actions should the nurse take?
- A. Restrain the toddler for 1 hr after the procedure.
- B. Swaddle the toddler in a warm blanket.
- C. Ask another nurse to assist with holding the toddler in a prone position.
- D. Place the toddler in a side-lying knee-chest position
Correct Answer: D
Rationale: The correct answer is D: Place the toddler in a side-lying knee-chest position. This position helps to open up the spaces between the vertebrae, making it easier for the healthcare provider to perform the lumbar puncture. Restraint is not recommended as it can cause distress and increase the risk of complications. Swaddling in a warm blanket may not provide the necessary positioning for the procedure. Asking another nurse to assist with holding the toddler in a prone position may not be as effective in achieving the optimal positioning needed for a lumbar puncture.