which of the following is a sign of an altered mental status in a small child

ATI LPN

LPN Pediatrics

1. Which of the following is a sign of altered mental status in a small child?

A. Fear of the EMT's presence.
B. Recognition of the parents.
C. Inattention to the EMT's presence.
D. Consistent eye contact with the EMT.

Correct answer: C

Rationale: Inattention to the EMT's presence is a sign of altered mental status in a small child. When a child is not responsive or does not acknowledge the presence of the EMT, it could indicate a change in their mental status. This lack of attention or awareness may signify a neurological issue or other medical condition affecting the child's cognitive function.

2. You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:

A. provide supportive care and transport.
B. give him acetaminophen or ibuprofen.
C. begin rapid cooling measures at once.
D. allow the mother to take her child to the doctor.

Correct answer: A

Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.

3. A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?

A. Always store insulin vials in the refrigerator
B. Adjust insulin dosage before exercise
C. Presence of ketones in urine indicates a need for less insulin
D. Systematically rotate injection sites

Correct answer: D

Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.

4. Which of the following is not a clinical type of diarrhea?

A. Acute diarrhea
B. Bloody diarrhea
C. Persistent diarrhea
D. Secretory diarrhea

Correct answer: B

Rationale: Bloody diarrhea is not typically classified as a clinical type of diarrhea. The clinical types of diarrhea commonly include acute, persistent, and secretory diarrhea, which are characterized by different mechanisms and durations. Bloody diarrhea usually indicates the presence of blood in the stool, which can be a sign of various underlying conditions but is not a specific clinical type of diarrhea.

5. Jaundice in children can be either pathological or physiological. Which of these will you consider as more serious?

A. Jaundice seen within 24 hours of life
B. Jaundice seen at the palms and soles
C. Jaundice appearing after 24 hours of life
D. Jaundice seen after 14 days of life

Correct answer: A

Rationale: Jaundice seen within 24 hours of life is considered more serious in children as it can indicate pathological causes such as hemolytic disease or sepsis, which require prompt evaluation and management to prevent complications. Jaundice appearing within 24 hours of life is concerning due to the higher likelihood of severe conditions, while jaundice seen at the palms and soles is more likely due to physiological causes such as breast milk jaundice. Jaundice appearing after 24 hours or after 14 days of life may still require evaluation but is less urgent compared to jaundice within the first 24 hours.