Question 1

Which intervention should the nurse use when collecting a urine specimen from an 8-month-old patient?&#10;A) Place a urine collector on the baby just prior to feeding.&#10;B) Wait an hour after a feeding and then apply a collection bag.&#10;C) Wait until the baby voids and attempt to obtain a clean-catch specimen.&#10;D) Place a diaper on the baby; when it is wet then send the diaper to the laboratory.

Accepted Answer

An infant who has not been toilet trained cannot be expected to urinate on command so a collecting device must be attached to the genitalia to collect their next voiding. Most infants void shortly after a feeding, so if the collector is applied just before a regular feeding, voiding will probably result soon afterward. Remove the collector as soon as the infant voids and transfer the specimen to a specimen cup by cutting a bottom corner of the bag. Waiting an hour after a feeding might not produce the needed urine for the specimen. It would be difficult to obtain a clean-catch specimen from a baby. It is inappropriate to send a saturated diaper to the laboratory for a urine specimen.

Question 2

The nurse needs to obtain a blood sample from a 7-year-old child. How should the nurse explain this procedure to the patient?&#10;A) &#34;The doctor needs some of your blood; trust me, it won't hurt.&#34;&#10;B) &#34;I need to draw some blood from you. Will you hold still for me?&#34;&#10;C) &#34;The technician will draw your blood; it will just hurt for a minute.&#34;&#10;D) &#34;The doctor needs to look at your blood to see why you are sick; it will hurt for a second.&#34;

Accepted Answer

The nurse should offer the child a simple explanation of the procedure such as, "The doctor needs to look at your blood to see why you are sick; it will only hurt for a second." The nurse needs to let the child know you understand how difficult it is to agree to the procedure. Saying that the procedure does not hurt is not being truthful. Asking the patient to hold still does not provide enough of an explanation about the venipuncture. Saying that the technician is going to draw the blood and that it will only hurt for a minute does not explain why the blood is needed.

Question 3

The nurse is preparing a community program for parents and children that focus on the 2020 National Health Goals to reduce the number of diagnostic or therapeutic procedures. Which topics should the nurse include in this program? (Select all that apply.)

A) Explain the importance of good nutrition.
B) Emphasize the importance of avoiding unintentional injuries.
C) Include interventions to help prevent children from becoming ill.
D) Discuss the value of having diagnostic testing completed annually.
E) Relate how immunizations continue to be controversial for children.

Explain the importance of good nutrition.
Emphasize the importance of avoiding unintentional injuries.
Include interventions to help prevent children from becoming ill.

Accepted Answer

Nurses can help the nation achieve the 2020 National Health Goals to reduce the number of diagnostic or therapeutic procedures for children by providing health counseling to both parent and child on ways to prevent children from becoming ill and subsequently requiring hospitalization, such as teaching sound nutrition and instructing on practices on avoiding unintentional injury. The goal is to reduce the number of diagnostic tests and not encourage them to be done annually. Focusing on the controversy with immunizations will not support the 2020 National Health Goals.

Question 4

The nurse is caring for an infant recovering from surgery for a cleft palate. Which type of restraint would be appropriate for the nurse to use when caring for this infant?&#10;A) Elbow&#10;B) Jacket&#10;C) Mummy&#10;D) Clove hitch

Accepted Answer

The elbow restraint is indicated to prevent children from touching the head or face after facial surgery. The jacket restraint is to restrain children younger than 6 months in a supine position. This will not prevent the baby from touching the face. The mummy restraint temporarily immobilizes young children for a procedure involving the head, neck, or throat. This might be the restraint used for the surgery but not for the postoperative care. The clove hitch restraint is used to secure one arm or leg for a procedure, such as an intravenous infusion.

Question 5

The nurse needs to assess the temperature of a 12-month-old infant. Which site should the nurse use for this assessment?&#10;A) Axilla&#10;B) Mouth&#10;C) Rectum&#10;D) Tympanic membrane

Accepted Answer

Thermometers that assess tympanic membrane temperature are ideal for assessment in children because they register within 2 seconds and therefore cause less fear because a child only has to be restrained for a few seconds. The axilla is the preferred site for temperature assessment for a newborn. The baby is too young to be able to keep an oral thermometer in the mouth. It is not necessary to use the rectum to measure the temperature on this child. This approach is too intrusive.

Question 6

The nurse is planning to instruct a school-age child on a barium swallow. What should the nurse do before beginning this instruction?&#10;A) Encourage the parents to participate in the teaching.&#10;B) Contact the lab to find out when the test is scheduled.&#10;C) Ask the child about ever having a test where something was swallowed.&#10;D) Check the child's medical record for reports of previous diagnostic tests.

Accepted Answer

Before moving forward with preparation for a diagnostic test, the nurse needs to determine the child's knowledge about a test or similar tests. Pointing out a child's past experience with similar procedures can lay a foundation for increased cooperation. The parents do not necessarily have to participate in this teaching. Learning the time of the test can be done later. Checking the child's medical record will not help with the child's learning needs at this present time.

Question 7

What action should the nurse take after collecting a stool specimen for ova and parasites from a preschool-age child?&#10;A) Refrigerate the specimen.&#10;B) Add alcohol to the specimen container.&#10;C) Have the specimen taken to the laboratory immediately.&#10;D) Discard the specimen if the color is not yellow or green.

Accepted Answer

If a stool specimen is for ova and parasites, do not refrigerate it because refrigeration destroys the organisms to be analyzed. The specimen needs to arrive in the laboratory in less than 1 hour after collection so the parasites can be readily detected. Alcohol should not be added to the specimen container. The color of the stool sample is of no consequence.

Question 8

A nasogastric tube for enteral feedings has just been inserted in a 6-month-old infant. What should the nurse do to assess if the tube is in the patient's stomach?&#10;A) Aspirate the tube for stomach contents.&#10;B) Administer 1 ml of fluid and observe for coughing.&#10;C) Listen at the distal end of the tube for bowel sounds.&#10;D) Lower the end of the tube and observe for drainage.

Accepted Answer

It is necessary to use a syringe to aspirate the tube for any stomach residual before a feeding because it confirms the tube's placement in the stomach. Fluid should not be introduced through the nasogastric tube until placement has been confirmed. Listening for bowel sound and lowering the tube for drainage are not appropriate techniques to assess for nasogastric tube placement in an infant.

Question 9

A preschool-age child has not been able to eat for several days until all diagnostic tests are complete to determine the cause of chronic diarrhea. Which nursing diagnosis should the nurse identify as being appropriate for the patient at this time?

A) Risk for injury related to intrusive procedures
B) Fear related to new and strange surroundings of procedure rooms
C) Deficient diversionary activity related to hospitalization and frequent procedures
D) Imbalanced nutrition, less than body requirements, related to food restriction for procedures

Accepted Answer

Because the child has not been able to eat for several days, the risk for imbalanced nutrition is high. This is the appropriate diagnosis for the nurse to select at this time. There is no enough information to determine if the child is at risk for injury, fearful of procedure rooms, or experiencing a deficiency in diversionary activities.

Question 10

The nurse instructs the mother of a toddler on the appropriate way to apply heat and cold to the child's ankle injury. Which statement indicates that instruction has been effective?&#10;A) &#34;I should apply the ice for 30 minutes followed by an hour of heat.&#34;&#10;B) &#34;I will keep the ice on the child's ankle longer after providing with pain medication.&#34;&#10;C) &#34;I will spend time with my child and read or play a game while the heat or cold is applied.&#34;&#10;D) &#34;I will apply the heat to the child's ankle after waiting 10 minutes for the heating pad to warm.&#34;

Accepted Answer

One guideline for the application of heat or cold is to supply a special activity for the child to enjoy while a hot or cold application is in place, such as reading a story or playing a game, so that the procedure is not viewed as a chore but as a pleasant time in which to look forward. Ice or heat should not be applied for longer than 20 minutes.
Pain medication can alter the perception of heat or cold, and the child could receive an injury from the application. To be certain that a heat application is not too hot, it should be tested with the inner wrist or the dorsal surface of the hand before applying it to the child.

Question 11

A 13-month-old child is having a dressing changed on a packed leg wound. Which action from the parents should be encouraged by the nurse during the treatment?&#10;A) Encourage the father to talk quietly to the child.&#10;B) Make sure the father is sitting on a chair near the door.&#10;C) Ask the father to wait outside until the treatment is complete.&#10;D) Have the father hold the child's legs still during the treatment.

Accepted Answer

The answer of A 13-month-old child is having a dressing...

Question 12

Which process should the nurse use to assess the heart rate of a school-age child?&#10;A) Apical pulse for 1 full minute&#10;B) Radial pulse for 1 full minute&#10;C) Femoral pulse for 1 full minute&#10;D) Brachial pulse for 1 full minute

Accepted Answer

The answer of Which process should the nurse use to...

Question 13

A school-age child is prescribed an enema in preparation for a colonoscopy. Which type of solution and amount should the nurse prepare for the child?&#10;A) 150 ml normal saline&#10;B) 350 ml normal saline&#10;C) 100 ml tap water enema&#10;D) 250 ml milk and molasses

Accepted Answer

The answer of A school-age child is prescribed an enema...

Question 14

The nurse is providing instructions to the parent of a school-age child who received conscious sedation for a bronchoscopy. What should the nurse include in this teaching? (Select all that apply.)&#10;A) Provide an antiemetic if vomiting occurs.&#10;B) Provide the child with something to eat if hungry.&#10;C) Encourage the child to engage in physical activity such as riding a bicycle.&#10;D) Expect to stay with the child for at least 4 hours to ensure dizziness does not occur.&#10;E) Determine that the child is able to swallow without choking before providing solid food.

Accepted Answer

The answer of The nurse is providing instructions to the...

Question 15

The nurse instructs the mother of a preschool-age child on the use of ibuprofen (Pediaprofen) prescribed for a temperature. Which statement indicates that the teaching has been effective?&#10;A) &#34;I should give this medication with food.&#34;&#10;B) &#34;I should measure out the dosage using a kitchen teaspoon.&#34;&#10;C) &#34;I should limit the child's fluids while taking this medication.&#34;&#10;D) &#34;I should expect the child to complain of a stomach ache with this medication.&#34;

Accepted Answer

The answer of The nurse instructs the mother of a...

Deck 37: Nursing Care of a Family When a Child Needs Diagnostic or Therapeutic Modalities