Question 1 See full question
A 4-year-old girl has a urinary tract infection (UTI). Which statement by the mother
demonstrates understanding of preventing future UTIs?
You Selected:
"I shouldn't let my daughter take bubble baths."
Correct response:
"I shouldn't let my daughter take bubble baths."
Explanation:
Saying that the child shouldn't take bubble baths demonstrates effective teaching
because oils in the bubble bath preparation may irritate the urethra, contributing to UTIs.
Girls and women should wipe the perineum from front to back, not back to front, to
avoid contaminating the urinary tract with fecal bacteria. Although antibiotics are used to
treat UTIs, they aren't given prophylactically. No evidence suggests that warm baths
help prevent UTIs.
Question 2 See full question
A child, age 4, fell and broke his arm and had a cast applied. Which of these statements
by the child indicates an immediate risk for compartment syndrome?
You Selected:
"My arm hurts."
Correct response:
"I can't wiggle my fingers."
Explanation:
Signs and symptoms of compartment syndrome, such as motor weakness, reflect a
deficit or deterioration of neuromuscular status in the involved area. Inability to wiggle
fingers indicates an immediate risk for compartment syndrome because it could suggest
neurovascular pressure or damage caused by edema following the injury. The other
statements don't indicate risk for compartment syndrome.
Question 3 See full question
,A physician diagnoses leukemia in a child, aged 4, who complains of being tired and
sleeps most of the day. Which nursing diagnosis reflects the nurse's understanding of
the physiologic effects of leukemia?
You Selected:
Activity intolerance related to hypoxia and weakness
Correct response:
Activity intolerance related to hypoxia and weakness
Explanation:
A nursing diagnosis of Activity intolerance related to hypoxia and weakness reflects the
nurse's understanding of leukemia's physiologic effects because a child with leukemia
may experience weakness and lack of oxygen. The nurse's findings don't support the
other diagnoses of Ineffective airway clearance related to fatigue, Imbalanced nutrition:
More than body requirements related to lack of activity, or Ineffective cerebral tissue
perfusion related to central nervous system infiltration by leukemic cells.
Question 4 See full question
A 3-year old with dehydration has vomited three times in the last hour and continues to
have frequent diarrhea stools. The child was admitted 2 days ago with gastroenteritis
caused by rotavirus. The child weighs 22 kg, has a normal saline lock in his right hand,
and has had 30 mL of urine output in the last four hours. Using the SBAR (Situation-
Background-Assessment-Recommendation) technique for communication, the nurse
calls the health care provider (HCP) with the recommendation for:
You Selected:
establishing a Foley catheter.
Correct response:
starting a fluid bolus of normal saline.
Explanation:
The child is dehydrated, is not able to retain oral fluids, and continues to have diarrhea.
A normal saline bolus should be given followed by maintenance of IV fluids.
Antidiarrheal medications are not recommended for children and will prolong the illness.
The child has gastroenteritis caused by a viral illness. IV antibiotics are not indicated for
viral illnesses. Strict I&O;is important in all children with gastroenteritis.
Question 5 See full question
, The nurse is caring for a 5-year-old child who has a history of multiple admissions for
fractures and cuts. The mother explains that the child fractured the femur by falling, but
does not give any further details. The child indicates that the mother’s boyfriend was
present when the injury occurred, and the child’s recollection of the event conflicts with
the mother’s explanation. What is the nurse’s immediate responsibility?
You Selected:
Keep the child safe and assess for abuse.
Correct response:
Keep the child safe and assess for abuse.
Explanation:
The assessment for risk is the priority nursing action. This would include verbalizing
your concerns to the most immediate supervisor and involving hospital social workers
and the medical team. These initial steps need to be implemented, and then the
appropriate authorities must be alerted.
Question 1 See full question
A nurse is concerned about another nurse's relationship with the members of a family
and their ill preschooler. Which behavior should be brought to the attention of the nurse-
manager?
You Selected:
The nurse attempts to influence the family's decisions by presenting her own
thoughts and opinions.
Correct response:
The nurse attempts to influence the family's decisions by presenting her own
thoughts and opinions.
Explanation:
When a nurse attempts to influence a family's decision with her own opinions and
values, the situation becomes one of overinvolvement on the nurse's part, creating a
nontherapeutic relationship. When a nurse keeps communication channels open, works
with family members to decrease their dependence on health care providers, and
instructs family members so they can accomplish tasks independently, she has
developed an appropriate therapeutic relationship.
Question 2 See full question
A 4-year-old girl has a urinary tract infection (UTI). Which statement by the mother
demonstrates understanding of preventing future UTIs?
You Selected:
"I shouldn't let my daughter take bubble baths."
Correct response:
"I shouldn't let my daughter take bubble baths."
Explanation:
Saying that the child shouldn't take bubble baths demonstrates effective teaching
because oils in the bubble bath preparation may irritate the urethra, contributing to UTIs.
Girls and women should wipe the perineum from front to back, not back to front, to
avoid contaminating the urinary tract with fecal bacteria. Although antibiotics are used to
treat UTIs, they aren't given prophylactically. No evidence suggests that warm baths
help prevent UTIs.
Question 2 See full question
A child, age 4, fell and broke his arm and had a cast applied. Which of these statements
by the child indicates an immediate risk for compartment syndrome?
You Selected:
"My arm hurts."
Correct response:
"I can't wiggle my fingers."
Explanation:
Signs and symptoms of compartment syndrome, such as motor weakness, reflect a
deficit or deterioration of neuromuscular status in the involved area. Inability to wiggle
fingers indicates an immediate risk for compartment syndrome because it could suggest
neurovascular pressure or damage caused by edema following the injury. The other
statements don't indicate risk for compartment syndrome.
Question 3 See full question
,A physician diagnoses leukemia in a child, aged 4, who complains of being tired and
sleeps most of the day. Which nursing diagnosis reflects the nurse's understanding of
the physiologic effects of leukemia?
You Selected:
Activity intolerance related to hypoxia and weakness
Correct response:
Activity intolerance related to hypoxia and weakness
Explanation:
A nursing diagnosis of Activity intolerance related to hypoxia and weakness reflects the
nurse's understanding of leukemia's physiologic effects because a child with leukemia
may experience weakness and lack of oxygen. The nurse's findings don't support the
other diagnoses of Ineffective airway clearance related to fatigue, Imbalanced nutrition:
More than body requirements related to lack of activity, or Ineffective cerebral tissue
perfusion related to central nervous system infiltration by leukemic cells.
Question 4 See full question
A 3-year old with dehydration has vomited three times in the last hour and continues to
have frequent diarrhea stools. The child was admitted 2 days ago with gastroenteritis
caused by rotavirus. The child weighs 22 kg, has a normal saline lock in his right hand,
and has had 30 mL of urine output in the last four hours. Using the SBAR (Situation-
Background-Assessment-Recommendation) technique for communication, the nurse
calls the health care provider (HCP) with the recommendation for:
You Selected:
establishing a Foley catheter.
Correct response:
starting a fluid bolus of normal saline.
Explanation:
The child is dehydrated, is not able to retain oral fluids, and continues to have diarrhea.
A normal saline bolus should be given followed by maintenance of IV fluids.
Antidiarrheal medications are not recommended for children and will prolong the illness.
The child has gastroenteritis caused by a viral illness. IV antibiotics are not indicated for
viral illnesses. Strict I&O;is important in all children with gastroenteritis.
Question 5 See full question
, The nurse is caring for a 5-year-old child who has a history of multiple admissions for
fractures and cuts. The mother explains that the child fractured the femur by falling, but
does not give any further details. The child indicates that the mother’s boyfriend was
present when the injury occurred, and the child’s recollection of the event conflicts with
the mother’s explanation. What is the nurse’s immediate responsibility?
You Selected:
Keep the child safe and assess for abuse.
Correct response:
Keep the child safe and assess for abuse.
Explanation:
The assessment for risk is the priority nursing action. This would include verbalizing
your concerns to the most immediate supervisor and involving hospital social workers
and the medical team. These initial steps need to be implemented, and then the
appropriate authorities must be alerted.
Question 1 See full question
A nurse is concerned about another nurse's relationship with the members of a family
and their ill preschooler. Which behavior should be brought to the attention of the nurse-
manager?
You Selected:
The nurse attempts to influence the family's decisions by presenting her own
thoughts and opinions.
Correct response:
The nurse attempts to influence the family's decisions by presenting her own
thoughts and opinions.
Explanation:
When a nurse attempts to influence a family's decision with her own opinions and
values, the situation becomes one of overinvolvement on the nurse's part, creating a
nontherapeutic relationship. When a nurse keeps communication channels open, works
with family members to decrease their dependence on health care providers, and
instructs family members so they can accomplish tasks independently, she has
developed an appropriate therapeutic relationship.
Question 2 See full question
