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RN Nursing Care of Children Online Practice 2019 A
1. A child with acetylsalicylic acid (aspirin) poisoning is being admitted to the emergency department. What early clinical manifestation does the nurse expect to assess on this child?
- A. Hematemesis
- B. Hematochezia
- C. Hyperglycemia
- D. Hyperventilation
Correct answer: D
Rationale: Early signs of aspirin poisoning include hyperventilation due to the stimulation of the respiratory center and the resultant respiratory alkalosis. Hematemesis, hematochezia, and hyperglycemia can occur later in the poisoning process or may not be directly related to aspirin toxicity.
2. Which distraction technique should be used for an adolescent child during a painful procedure?
- A. Blowing bubbles
- B. Guided imagery
- C. EMLA cream
- D. Sucrose solution
Correct answer: B
Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.
3. What is the recommended position for a child with epiglottitis to ease breathing?
- A. Supine
- B. Prone
- C. Tripod
- D. Semi-Fowler’s
Correct answer: C
Rationale: The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler’s) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler’s position do not facilitate optimal air exchange in these cases.
4. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?
- A. Give only an opioid analgesic at this time.
- B. Increase the dosage of analgesic until the child is adequately sedated.
- C. Plan a preventive schedule of pain medication around the clock.
- D. Give the child a clock and explain when they can have pain medications.
Correct answer: C
Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.
5. Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.)
- A. Disturbed concept of sexuality
- B. All are applicable
- C. Worry about themselves, parents, or siblings
- D. Expression of anger, sadness, shame, or embarrassment
Correct answer: B
Rationale: Adolescents may withdraw from social interactions, worry about the impact of the divorce, and express strong emotions such as anger or sadness.
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