Nursing Care of Children (Easy)

A nurse is caring for a 10-year-old child who would reduce his fat intake. Which of the following menu choices should the nurse suggest? A. A hot dog on a whole-wheat bun B. 3 oz of baked chicken on a whole-wheat roll C. 1/2 cup of diced potatoes with scrambled egg D. medium blueberry muffin

B. 3 oz of baked chicken on a whole-wheat roll RATIONALE: A baked chicken sandwich on a whole-wheat bun has the lowest fat content at 6.2 g.

A nurse is observing the behavior of a 2-year-old child. Which of the following actions should the nurse expect to observe when the child is in an activity room with other toddlers? A. Playing a simple game with another child B. Engaging in play near other children C. Sharing crayons with another toddler D. Jumpin on 1 foot without help

B. Engaging in play near other children RATIONALE: The nurse should identify that toddler play happens in parallel to that of other children. As socialization begins, the child plays alongside other children, not with them.

A nurse is assessing a 12-year-old child during a well-child checkup. Which of the following physical findings should the nurse report to the provider? A. 5 cm (2 in) of growth in the past year B. Hyperopia C. Presence of pubic hair D. Weight gain of 3 kg (6.6 lb) in the last year

B. Hyperopia RATIONALE: The nurse should report hyperopia in a 12-year-old child to the provider. Hyperopia, or farsightedness, is an unexpected finding after the age of 7.

A nurse is taking the history of and performing a physical on a school-age child who has ADHD. Which of the following findings in the child's medical record should the nurse identify as a risk factor for ADHD? A. The child's family has a middle-class socioeconomic background B. The child had prenatal exposure to alcohol on a regular basis C. Both siblings of the child show moderate activity levels in school and play activities D. The child's mother currently had diabetes mellitus

B. The child had prenatal exposure to alcohol on a regular basis RATIONALE: Prenatal exposure to alcohol on a regular basis is a contributing factor to ADHD, along with prenatal nicotine exposure and exposure to lead or mercury.

A nurse is assessing a 6-year-old child who is immediately postoperative following a tonsillectomy. Which of the following findings should the nurse report to the provider? A. the child has a small amount of dark brown blood between the teeth B. the child is swallowing frequently C. the child has a heart rate of 118/min D. the child refuses the application of an ice collar

B. the child is swallowing frequently RATIONALE: The nurse should identify that frequent swallowing is a manifestation of hemorrhage. Therefore, the nurse should immediately notify the provider of this finding.

A nurse is teaching a school-aged child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements should the nurse make? A. "If you take too much insulin, drink a sugar-free cola" B. "You will need to decrease your insulin dosage when you become a teenager" C. "You can use a vial of insulin for up to 30 days" D. "Stop taking insulin if you are vomiting"

C. "You can use a vial of insulin for up to 30 days" RATIONALE: The child can use an opened vial of insulin for 28-30 days stored at room temperature or in the refrigerator

A nurse is caring for a 15-month-old client who requires droplet precautions. Which of the following actions should the nurse take? A. Have the toddler wear a disposable gown when in the unit's playroom B. Wear sterile gloves when changing the toddler's diapers C. Wear a mask when assisting the toddler with meals D. Ask visitors to wear an N-95 mask when entering the toddler's room

C. Wear a mask when assisting the toddler with meals RATIONALE: The nurse should wear a mask within 3-6 feet of the toddler to prevent the transmission of infections that are spread via large-droplet particles expelled in the air.

A nurse is teaching a school-age child with asthma how to use a metered-dose inhaler. In which order should the nurse instruct the child to perform the following steps and evaluate the return demonstration? A. Slowly inhale the medication. B. Position the mouthpiece in the mouth. C. Hold the breath for 5-10 sec. D. Shake the inhaler while holding it upright.

D, B, A, C

A nurse is teaching a school-age child and his parents how to self-administer insulin. Which of the following actions should the nurse take first? A. Allow a parent to administer an injection to the nurse B. Have the child teach the injection technique to the parents C. Have a parent administer the insulin injection to the child D. Demonstrate the injection technique on an orange

D. Demonstrate the injection technique on an orange RATIONALE: Demonstrating the injection technique on an orange poses no risk to the client and is the first action the nurse should take.

A nurse is providing education for a family of a 6-month-old infant about ways to stimulate language development. Which of the following instructions should the nurse include? A. "Explain what you are doing to the infant while providing care." B. "Promote fine-motor development of the tongue by offering a pacifier several times each day" C. "Exercise jaw muscles with foods that require chewing, such as hot dogs and carrots" D. "Leave a television playing in the child's room during nap time"

A. "Explain what you are doing to the infant while providing care." RATIONALE: The nurse should instruct the family that exposing the infant to expressive speech is the foundation for the development of expressive skills (the ability to make others understand needs and thoughts) and receptive skills (the ability to understand spoken words)

A nurse is providing teaching about home care to the guardian of an adolescent who has hemophilia. Which of the following pieces of information should the nurse provide? A. Encourage the adolescent to participate in non-contact sports B. Provide the adolescent with a firm-bristled toothbrush C. Administer aspirin to the adolescent for episodes of pain D. Provide disposable razors to the adolescent for shaving

A. Encourage the adolescent to participate in non-contact sports RATIONALE: The nurse should instruct the guardian that the adolescent should be allowed to participate in non-contact sports such as walking, bowling, and golf. Contact sports may be allowed if the adolescent wears protective gear and receives routine recombinant factor VIII infusions.

A nurse is providing teaching about home safety to the parent of a 2-month-old infant. Which of the following information should the nurse include? A. Remove bibs before the infant goes to sleep B. Cover the infant with a lightweight blanket at bedtime C. Place the infant in direct sunlight for at least 10 minutes each day D. Set the hot water heater to 60 C (140F)

A. Remove bibs before the infant goes to sleep RATIONALE: The nurse should instruct the parents to remove bibs prior to the infant sleeping to decrease the risk of strangulation.

A nurse is caring for a 2-year-old child who has frequent UTIs. When educating the parents about the prevention of UTIs, which of the following instructions should the nurse include? A. Teach the child to wipe from front to back B. Give the child frequent bubble baths C. Urge the child to urinate every 6 hrs D. Administer oxybutynin daily

A. Teach the child to wipe from front to back RATIONALE: The child should be taught to wipe from front to back in order to prevent contamination from the anal area entering the urethra.

A nurse is assessing an infant who develops respiratory distress, absence of breath sounds on one side, and deviation of the trachea away from the affected side. Based on these manifestations, which of the following conditions is the infant experiencing? A. Tension pneumothorax B. Flail Chest C. Pulmonary contusion D. Fractured Rib

A. Tension pneumothorax RATIONALE: The nurse should identify these manifestations as an indication that the infant is developing a tension pneumothorax. The infant might also become cyanotic and show asymmetry of the thorax.

A nurse is p preparing to assess a 2-year-old toddler. Which of the following should the nurse expect during the examination? A. The child prefers to sit on the parent's lap during the examination B. The child is interested in how the examination equipment work C. The child asks specific questions about body functions D. The child questions how her development compares to other children at the same age

A. The child prefers to sit on the parent's lap during the examination RATIONALE: Toddlers and infants whoa re able to sit typically prefer to sit in their parents' lap throughout the examination

A nurse is preparing to administer an intramuscular injection to a 2-month-old infant. In which of the following sites should the nurse plan to administer the injection? A. Vatus lateralis B. Dorsogluteal C. Deltoid D. Abdomen 5 cm (2 in) from the umbilicus

A. Vatus lateralis RATIONALE: The vatus lateralis is a large developed muscle, even in an infant. The muscle can tolerate the volume of the injection, and there is no important nerves or blood vessels in this muscle.

A nurse is providing teaching to the parent of an infant who has heart failure and a new prescription for digoxin elixir. Which of the following pieces of information should the nurse include? A. Withhold the medication if the infant's heart rate is less than 110/min B. Mix the medication in 120 mL (4 oz) of infant formula C. Expect the infant to vomit frequently while taking this medication D. Double the dose if the infant has increased edema

A. Withhold the medication if the infant's heart rate is less than 110/min RATIONALE: The parent should withhold the medication and notify the provider if the infant's heart rate is less than 110/min

A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask? A. "Does your child wear a hat outdoors in cold weather?" B. "Does anyone smoke around or in the same house as your child?" C. "Have you given your child any aspirin recently?" D. "Is your child's diet high in gluten?"

B. "Does anyone smoke around or in the same house as your child?" RATIONALE: Otitis media is an infection of the middle ear. Passive smoking promotes adherence fo respiratory pathogens to the lining of the middle ear space and prolonged the inflammation that impedes drainage of the ear

A nurse on a pediatric mental health unit is caring for a school-age child. Which of the following questions or statements should the nurse provide to foster a rapport and encourage conversations? A. "Do you like school?" B. "Tell me about your favorite video game." C. "We have another child your age on the unit." D. "Would you like your friends to visit you?"

B. "Tell me about your favorite video game." RATIONALE: The nurse should use the therapeutic communication technique of exploring to encourage the child to respond with more than just the name of the game. This type of communication fosters rapport and encourages communication.

A nurse is providing teaching to the guardian of a 9-month-old infant who has a new prescription of an oral liquid medication. Which of the following points should the nurse include in the teaching? A. "Mix the medication into a small amount of your infant's formula to disguise the taste." B. "Use an oral syringe to measure your infant's medicine accurately" C. "Position your infant supine when administering the medication." D. "Assist your infant with drinking the medicine from a small paper cup."

B. "Use an oral syringe to measure your infant's medicine accurately" RATIONALE: An oral syringe is the best method for accurately measuring small amounts of liquid medications. Additionally, the syringe allows the caregiver to deposit small amounts of the medication along the side of the infant's tongue to decrease the risk of aspiration.

A nurse is teaching the parents of a 3-year-old child who had persistent otitis media about prevention. Which of the following statements by the parents indicates an understanding of the teaching? A. "My child should not play around others who have ear infections" B. "We should not smoke around our child" C. "My child should not swim this summer" D. "I will encourage m child to blow his nose forcefully when he has a cold"

B. "We should not smoke around our child" RATIONALE: Preventing exposure to tobacco smoke at home can prevent further episodes of ear infections because tobacco smoke can cause inflammation of the respiratory tract

A nurse is teaching an adolescent client who has type 1 diabetes mellitus about managing hypoglycemia. Which of the following statements should the nurse include in the teaching? A. "You should drink 8 oz of regular soft drink if you experience hypoglycemia" B. "You should drink 4 oz of orange juice if you experience hypoglycemia" C. "You should take 2 glucose tablets if you experience hypoglycemia" D. "You should take 3 tsp of sugar if you experience hypoglycemia"

B. "You should drink 4 oz of orange juice if you experience hypoglycemia" RATIONALE: The nurse should tell the client to drink 4 oz of orange juice if hypoglycemia occurs

A nurse is teaching the parents of a toddler who has enterobiasis about managing this parasitic disease. Which of the following pieces of information should the nurse include in the teaching? A. "You should encourage your child to take a tub bath daily" B. "You should keep your child's fingernails trimmed short" C. "You should dress your child in a 2-piece outfit at bedtime" D. "You should expect your child not to have a recurrence of the parasitic disease.

B. "You should keep your child's fingernails trimmed short" RATIONALE: The nurse should instruct the parents to keep their child's fingernails trimmed short to minimize the collection of ova under the nails.

A nurse is preparing to administer a liquid medication to an infant. Which of the following actions should the nurse take? A. Administer the medication while the infant is supine B. Give the medication at the side of the infant's mouth C. Add the medication to a full bottle of the infant's formula D. Administer the medication slowly while holding the nares closed

B. Give the medication at the side of the infant's mouth RATIONALE: When administering medications to an infant, a needless oral syringe or medicine dropper is placed in the side of the mouth (i.e. in the buccal cavity alongside the tongue) to prevent gagging and aspiration

A nurse is caring for a 4-year-old child who has superficial partial-thickness burns over 50% of his body. To meet the nutritional needs of the child, which of the following actions should the nurse plan to take? A. Administer pancrelipase to the child prior to each meal B. Supplement the child's feedings with enteral feedings C. Provide the child with a low-protein meal D. Perform dressing changes 10 min prior to the child's meals

B. Supplement the child's feedings with enteral feedings RATIONALE: A child who has burns in excess of 25% of total body surface area requires enteral supplementation to consume enough calories to heal

The nurse is preparing to administer an oral medication to an 8-month-old infant. Which of the following actions should the nurse take? A. Mix the medication with 1 tsp of honey to sweeten the taste for the infant B. Use an oral syringe to place the medication alongside the infant's tongue C. Add the medication to the infant's bottle of formula D. Place the infant in a supine position to administer the medication

B. Use an oral syringe to place the medication alongside the infant's tongue RATIONALE: The nurse should use an oral syringe to administer the medication slowly alongside the infant's tongue or at the side of the mouth. The nurse should give the child time to swallow between deposits.

A nurse is caring for a child who is in the emergency department after ingesting a bottle of acetaminophen. Which of the following medications should the nurse plan to administer? A. digoxin immune fab B. acetylcysteine C. naloxone D. vitamin k

B. acetylcysteine RATIONALE: Acetylcysteine is the antidote for acetaminophen overdosing or poisoning.

A nurse is caring for a newborn who has spina bifidia. The newborn's parents are upset by the diagnosis. Which of the following actions should the nurse take? A. discuss placement options for the newborn B. encourage the parents to touch and care for the newborn C. reassure the parents that everything will be fine D. avoid talking about the newborn's defect until the parents bring up the subject

B. encourage the parents to touch and care for the newborn RATIONALE: Touching and caretaking will help the parents bond with the newborn

A nurse in a provider's office is assessing a client. The nurse determines the client's BMI is 21.2. This finding is classified as which of the following? A. underweight B. healthy weight C. overweight D. obese

B. healthy weight RATIONALE: BMI is a measure of an individual's weight relative to height. A BMI from 18.5-24.9 is in the healthy range. Therefore, this client's weight is considered healthy.

A nurse is discussing play activities with a group of parents of toddlers. Which of the following should the nurse recommend for this age group? A. jumping rope B. pushing a toy lawn mower C. sorting colored marbles D. playing a board game

B. pushing a toy lawn mower RATIONALE: The nurse should recommend pushing a toy lawn mower as a play activity for a toddler. Toddlers are developmentally ready for push-pull toys, and they enjoy play activities that allow imitation of adults.

A nurse is providing teaching to the family of a child who has autism spectrum disorder. Which of the following statement indicates that the family understands the teaching? A. "Donepezil might slow the progression of the disorder" B. "My child will prefer group therapy with other children" C. "We can help our child by structuring our daily routine" D. "Our child probably has this condition as a result of prematurity "

C. "We can help our child by structuring our daily routine" RATIONALE: Children who have autism spectrum disorder benefit from a structured routine. This environment can minimize the anxiety the child might have with sudden schedule changes and socialization requirements and satisfy a preference for ritualistic behavior.

A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 mmHg and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hot dog, 22 potato chips, and 120 mL (4 oz) of orange juice B. 1 sandwich with lettuce, tomato, and 4 slices of bacon; a small apple; and 240 mL (8 oz) of milk C. 3 oz grilled chicken, 1 cup of pear slices, and 120 mL (4 oz) of apple juice D. 1 cup of cottage cheese, a small banana, and 240 mL (8 oz) of soda

C. 3 oz grilled chicken, 1 cup of pear slices, and 120 mL (4 oz) of apple juice RATIONALE: A child who has glomerulonephritis has moderate sodium restriction, and further restriction is given to foods that are high in potassium for children who have decreased urinary output. These restrictions are because the kidneys of these children are not functioning appropriately. This menu option consists of 571 g of potassium and 268 g of sodium.

A nurse is teaching the guardian of a school-age child who has Diabetes Mellitus how to recognize diabetic ketoacidosis (DKA). Which of the following findings should the nurse identify as a manifestation of this complication? A. Slow heart rate B. Protruding eyeballs C. Deep, rapid respirations D. Decreased urinary output

C. Deep, rapid respirations RATIONALE: Deep and rapid respirations are known as Kussmaul respirations, which is a manifestation of DKA. This respiratory pattern is caused by the body's attempt to rid itself of the excess carbon dioxide that results from the presence of ketones. The child's breath can be sweet smelling due to the body's attempt to eliminate ketones through the respiratory system.

A nurse is caring for a 6-year-old child who is experiencing encopresis. Which of the following actions should the nurse take? A. Instruct the child's guardian to limit stool softener use to no more than twice per week B. Encourage the child to attempt to have a bowel movement 4 times per day C. Determine if there are any recent stressors in the child's environment D. Urge the child's guardian to provide negative consequences when the child has a bowel accident

C. Determine if there are any recent stressors in the child's environment RATIONALE: Encopresis can be caused by stress or changes in the child's environment

A nurse is admitting a child who has Wilms' tumor. Which of the following actions should the nurse take? A. Initiate contact precautions for the child B. Explain to the child's parents that chemotherapy will start 3 months after surgery C. Put a "no abdominal palpation" sign over the child's bed D. Prepare the child for a spinal tap

C. Put a "no abdominal palpation" sign over the child's bed RATIONALE: The nurse should place a sign over the child's bed stating "no abdominal palpation" because palpation is not necessary to confirm the diagnosis and could prompt metastasis.

A nurse is obtaining a urine sample from a 5-month-old infant by applying a urine collection bag. Which of the following actions should the nurse take first? A. Apply the collection bag to the skin at the area of the symphysis pubis B. Apply the collection bag to the skin of the perineum C. Wash and dry the genitalia, perineum, and surrounding skin D. Stroke the muscles on either side of the infant's spine

C. Wash and dry the genitalia, perineum, and surrounding skin RATIONALE: The first action the nurse should take is to wash and dry the genitalia, perineum, and the skin in the area to which the collection bag will be secured.

A nurse is caring for a 1-year-old infant who has chronic otitis media. The nurse should identify that which of the following areas is at risk of a delay in development? A. fine motor skills B. visual acuity C. speech patterns D. hand-to-eye coordination

C. speech patterns RATIONALE: Speech patterns are developed through auditory experiences. Chronic otitis media is a common cause of hearing impairment, which can delay the development of speech.

A nurse is teaching the parents of an infant who has congenital hypothyroidism. Which of the following directions should the nurse provide? A. "Your child will need to take estrogen daily when she reaches puberty" B. "Your child will need monthly blood coagulation studies" C. "Your child will need surgery to remove the diseased thyroid" D. "Your child will need to take thyroid hormone replacement for her entire life"

D. "Your child will need to take thyroid hormone replacement for her entire life" RATIONALE: In congenital hyperthyroidism, the child does not manufacture an adequate amount of thyroid hormone to maintain the appropriate metabolic rate. The child will require lifelong thyroid hormone replacement to support normal growth and development.

A nurse is performing an annual physical assessment of a preschooler. The parent expresses concern about the child's 1.8 kg (4 lb) weight gain over the past year. Which of the following responses should the nurse make? A. "This amount of weight gain could likely indicate a serious problem." B. "This weight change seems to be the result of poor eating habits" C. "Your child should have gained double this amount in a year." D. "Your child's weight change is expected for this age group."

D. "Your child's weight change is expected for this age group." RATIONALE: A preschooler should gain about 2-3 kg (4.4-6.6 lb) each year. Therefore, the nurse should reassure the parent that this child's weight gain is an expected finding for the age group.

A nurse is caring for a child who adheres to a vegetarian diet and has sustained superficial partial-thickness burns. The nurse should recommend which of the following food choices due to the high protein content? A. Medium baked potato B. Wheat bagel with 1 tbsp of apricot jam C. Large orange D. 1/2 cup of peanut butter with apple slices

D. 1/2 cup of peanut butter with apple slices RATIONALE: Peanut butter and apple slices have a total of 28.91 g of protein. This is a good choice for this client because peanut butter is high in protein, which promotes the healing process.

A nurse is assessing an adolescent who has sustained a broken tibia. Following the application of a fiberglass cast, the adolescent reports pain and a tingling feeling in the limb. Which of the following actions should the nurse take first? A. Give the adolescent ibuprofen B. Elevate the adolescent's leg on pillows C. Place an ice pack on the cast D. Assess for manifestations of circulatory impairment

D. Assess for manifestations of circulatory impairment RATIONALE: The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning. An alteration in any of these can indicate a threat to life and is therefore the nurse's priority concern.

A nurse in the emergency department is assessing a preschooler for indications of child maltreatment. The nurse should identify that which of the following findings is a manifestation of physical abuse? A. Multiple dental caries B. Malnutrition C. Frequent urinary tract infections D. Bruises at various stages of healing

D. Bruises at various stages of healing RATIONALE: The nurse should recognize that bruises at various stages of healing are a manifestation of physical abuse.

A nurse is caring for a 2-year-old child who has cystic fibrosis. The nurse is planning to take the child to the playroom. Which of the following activities would be appropriate for the child? A. Cutting figures from colored paper B. Drawing stick figures using crayons C. Riding a tricycle D. Building towers with blocks

D. Building towers with blocks RATIONALE: Building towers with blocks is an appropriate activity for a 2-year-old child and promotes fine-motor development. Also, knocking blocks down provides a means of dealing with the stress of hospitalization.

A nurse is providing teaching about home care to the parents of an infant who has diaper dermatitis. Which of the following instructions should the nurse include? A. Dry the affected area with a hair dryer on the low setting twice per day B. Use cloth diapers washed in a low-residue detergent C. Wash the genital area vigorously with each diaper change D. Leave the zinc oxide ointment intact and reapply as necessary during diaper changes

D. Leave the zinc oxide ointment intact and reapply as necessary during diaper changes RATIONALE: Zinc oxide can be applied as a barrier ointment to areas that are reddened or open and moist. While removing the waste material, zinc oxide should be left in place as much as possible during a diaper change. More ointment can be applied as needed. The ointment can be removed, if necessary, by applying mineral oil to the area and gently wiping.

A nurse is reviewing the morning laboratory results of an infant who is receiving digoxin and furosemide for the treatment of heart failure. Which o the following findings should the nurse report to the provider? A. Sodium 140 mEq/L B. Calcium 10.2 mg/dL C. Chloride 100 mEq/L D. Potassium 3.2 mEq/L

D. Potassium 3.2 mEq/L RATIONALE: The nurse should identify that a potassium level of 3.2 mEq/L is below the expected reference range of 4.1 to 5.3 mEq/L for an infant. Therefore, the nurse should report this finding to the provider.

A nurse is caring for an adolescent who is receiving pain medication via a PCA pump. When the nurse assesses the client's pain at 0800, the client describes the pain as a 3 on a scale of 1 to 10. At 1000, the client describes the pain as a 5. The nurse discovers that the client has not pushed the button to deliver medication in the past 2 hr. Which of the following actions should the nurse take? A. Ask the provider to discontinue the PCA pump so the nurse can administer PRN pain medication B. Suggest the client's parent push the button for the client if the parent thinks the adolescent is having pain C. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to 10 D. Reinforce teaching with the client about how to push the button to deliver the medication

D. Reinforce teaching with the client about how to push the button to deliver the medication RATIONALE: The appropriate action at this time is to reinforce client's teaching about the PCA. The nurse should remind the client about the availability of the medication, verify that the client knows how to use the equipment, and emphasize the importance of using it regularly to manage pain effectively.

A nurse is preparing to administer acetaminophen 240 mg PO daily to a child who has a temperature of 38.9 C (102 F). The amount available is acetaminophen oral solution 160 mg/5 mL. How many mL should the nurse administer per dose?

7.5 mL

A nurse is caring for a child who has possible intussusception. The parents of the child ask the nurse how the diagnosis is determined. Which of the following responses should the nurse make? A. "An abdominal ultrasound will confirm the pocket in the intestine" B. "Genotyping will be done to identify this condition" C. "A biopsy will be done on a small amount of tissue from the colon" D. "An upper GI series should identify the area involved"

A. "An abdominal ultrasound will confirm the pocket in the intestine" RATIONALE: Intusscusception is the invasion of a part of the intestine into another, creating a pocket. The presence of an intussusception is confirmed by an abdominal X-ray, ultrasound, or CT scan.

The nurse is teaching the parent of a toddler about home safety. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will lock my medications in the medicine cabinet." B. "I will keep my child's crib mattress at the highest level." C. "I will turn pot handles to the side of my stove while cooking." D. "I will give my child syrup of ipecac if she swallows something poisonous."

A. "I will lock my medications in the medicine cabinet." RATIONALE: Locking up medications and other potential poisons prevent access. Toddlers have improved gross and fine motor skills that allow further explorations of the environment and possible access to hazardous substances.

A nurse is talking with a parent of a preschooler. The parent reports that she struggles to get their child to go to bed at a consistent time. She explains that the child gets out of bed, enters his parents' room, and cries when they tell him to stay in his own bed. Which of the following instructions should the nurse give the parent? A. "Use a stable, relaxing routine like a bath and story time before bed" B. "Make sure the room is completely dark when placing your child in bed" C. "Let your child go to sleep in your lab and then put him in his bed" D. "Respond consistently if your child cries out for you after putting him to bed"

A. "Use a stable, relaxing routine like a bath and story time before bed" RATIONALE: Routines are reassuring to preschoolers because they allow them to anticipate their environment and adapt appropriately. These actions help the child settle down prior to bedtime and allow parental-child interaction prior to bed.

A nurse is planning to assess an 8-year-old child who was brought to the clinic by a parent. The patient reports the child has missed school for 3 weeks and refuses to go back due to "not feeling well." Which of the following actions should the nurse perform during the initial interview with the child? A. Ask the child to describe what things were right before not wanting to go to school B. Use a direct question and ask the child why going to school is no longer fun C. Tell the child it is okay to not like school, but she has to go back D. Reassure the child that things might not be going well right now, but they will soon improve

A. Ask the child to describe what things were right before not wanting to go to school RATIONALE: The nurse should ask the child to describe what things were right before not wanting to go to school to help determine whether this behavior is related to a long-term issue or a critical incident that caused intense discomfort.

A nurse is providing teaching to the parents of a 4-year-old child about fine motor development. Which of the following tasks should the nurse include as an expected finding for this age group? A. Copying a circle B. Cutting foods using a table knife C. Beginning to write in cursive D. Printing the first and last name clearly

A. Copying a circle RATIONALE: The nurse should explain that copying a circle is a skill achieved by the age of 4 years.

A nurse is planning care for a preschool-age child who has autism and is being admitted to the facility. Which of the following actions should the nurse plan to take? A. Encourage the parents to bring the child's stuffed animal B. Give the child choices when planning daily activities C. Administer phenytoin 3 times per day D. Provide a shared room with another child his age

A. Encourage the parents to bring the child's stuffed animal RATIONALE: Encouraging parents to bring in a child's favorite stuffed animal may lessen the disruptiveness of hospitalization.

A nurse is planning preoperative teaching for a preschooler who is scheduled for a tonsillectomy. Which of the following interventions should the nurse plan to include? A. Encourage the preschooler to bring a favorite toy to the hospital B. Spend 30 minutes teaching the preschooler about what to expect C. Schedule the teaching session for the morning of the preschooler's procedure D. Reassure the preschooler that medicine will prevent pain after the procedure

A. Encourage the preschooler to bring a favorite toy to the hospital RATIONALE: The nurse should encourage the preschooler to bring a favorite toy or blanket to the hospital on the day of the procedure. A familiar object provides comfort and relieves fear.

A nurse teaching the parent of a 3-year-old toddler about promoting sleep. Which of the following pieces of information should the nurse include? A. Follow a nightly routine and established bedtime B. Encourage active play prior to bedtime C. Let the child remain awake until tired enough to go to sleep D. Reward the child with a food treat just before sleep if the child goes to bed on time

A. Follow a nightly routine and established bedtime RATIONALE: Preschool-age children test limits. A consistent approach to bedtime is important. Bedtime is more likely to be pleasant for everyone if a routine is established and followed every night.

A nurse is providing teaching to an adolescent who has a fiberglass arm cast. Which of the following instructions should the nurse include in the teaching? A. Place a plastic bag over the cast when showering B. Insert a dull knitting needle into the cast to rub itchy skin C. Exercise fingers every 8 hr for the first 24 hrs D. Draw on the cast using magic markers

A. Place a plastic bag over the cast when showering RATIONALE: The nurse should instruct the adolescent to keep the cast dry by placing a plastic bag over it while showering

A nurse is caring for a 4-month-old infant who has tetralogy of Fallot and experiences a hypercyanotic spell. Which of the following actions should the nurse take? A. Place the infant in knee-chest position B. Begin CPR C. Prepare to intubatete the infant D. Administer IV adenosine

A. Place the infant in knee-chest position RATIONALE: The nurse should identify that a hypercyanotic spell occurs when a vascular spasm reduces pulmonary blood flow and forces blood to shunt from the right ventricle to the left ventricle through the ventricular septal defect. The nurse should place the infant in a knee-chest position to increase systemic vascular resistance, which will help force more blood through the pulmonary artery.

A nurse is providing teaching to the guardian of an adolescent. The guardian reports that the adolescent sleeps about 10 hr on weekend nights. Which of the following responses should the nurse provide? A. "Your child should have a blood test to check for anemia" B. "Adolescents need more sleep due to rapid growth" C. "Your child should not be staying up so late at night" D. "If your child eats properly, this should not happen"

B. "Adolescents need more sleep due to rapid growth" RATIONALE: The nurse should identify that sleeping 10 hours on weekend nights is an expected finding in adolescents, who need more sleep time rather than other age groups Common reasons for the increased need for sleep includes stress, busy schedules, and rapid physical growth.

A nurse is performing a nutritional screening for a 12-year-old client who weighs 41 kg (90 lb) and has a height of 1.5 m (60 in). Which of the following values is the client's body mass index (BMI)? A. 1.5 B. 3.6 C. 18.2 D. 27.3

C. 18.2 RATIONALE: To calculate the client's BMI, the nurse should divide the client's weight in kg by the square of the client's height in meters. Therefore, 41 kg divided by the square of 1.5 m gives a correct BMI of 18.2.

A nurse is providing teaching to a 13-year-old client who has type 1 diabetes mellitus. Which of the following client statements indicates an understanding of diabetes mellitus management? A. "I will need to avoid snacks between meals" B. "I should check my blood glucose levels more often when I am sick" C. "I will need to limit my exercise to 1 hour per day" D. "I should consume 30 g of simple carbohydrates if I feel shaky"

B. "I should check my blood glucose levels more often when I am sick" RATIONALE: Blood glucose levels should be checked every 3 hrs during illness for a client who has DM 1, even if the client consumes fewer calories than usual. Hyperglycemia often occurs with an infection, requiring additional doses of insulin.

A nurse is teaching the parents of a 10-year-old child who has iron-deficiency anemia. Which of the following statements by a parent indicates an understanding of the teaching? A. "I will give my child an iron tablet once each day at bedtime." B. "I will administer the iron tablet with orange juice." C. "I will encourage my child to take an antacid with the iron tablet." D. "I will crush the iron tablet prior to giving it to my child."

B. "I will administer the iron tablet with orange juice." RATIONALE: The intake of citrus juice with the iron will increase the iron's absorption.

A nurse is instructing a group of parents and guardians about child development. Which of the following recommendations should the nurse make to promote the developmental task of industry in the school-age child? A. Have an after-school snack ready for the child each day B. Assign the child several small chores C. Talk with the child about what future goals as an adult D. Talk openly about the family's value system

B. Assign the child several small chores RATIONALE: The nurse should recommend assigning the child several small chores. The completion of each chore in a short amount of time offers he child a sense of accomplishment and promotes the achievement of the developmental task of industry.

A nurse is caring for a child who has been in Buck's traction for 2 days. Which of the following actions should the nurse take to prevent complications? A. Manually move the weights to the floor when the child is experiencing pain B. Check for pulses in the affected leg every 4 hr C. Cleanse the pins every 12 hr D. Inform parents to discourage visitors for the child

B. Check for pulses in the affected leg every 4 hr RATIONALE: Traction might lead to neurovascular compromise. The nurse should assess for edema, pulses, pain, color, and temperature of the extremity every 4 hr

A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and holding a container of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action by the nurse? A. Remove the child's contaminated clothing. B. Check the child's respiratory status. C. Administer an antidote to the child. D. Establish IV access for the child.

B. Check the child's respiratory status. RATIONALE: The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning. An alteration in any of these can indicate a threat to life and is therefore the nurse's priority concern.

A nurse is assessing a child who has stage I Hodgkin disease. Which of the following findings should the nurse expect? A. Generalized petechiae B. Enlarged lymph nodes C. Chronic vomiting D. Dependent edema

B. Enlarged lymph nodes RATIONALE: Manifestations of stage I Hodgkins disease include painless enlargement of lymph nodes.

A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations and is planning to attend college. The nurse should recommend which of the following immunizations prior to moving to a campus dormitory? A. Pneumococcal polysaccharide B. Meningococcal polysaccharide C. Rotavirus D. Herpes zoster

B. Meningococcal polysaccharide RATIONALE: The meningococcal polysaccharide immunization is used to prevent infection by certain groups of meningococcal bacteria. Meningococcal infection can cause life-threatening illnesses, such as meningococcal meningitis and meningococcemia.

A nurse is assessing a 9-month-old infant. Which of the following findings should the nurse report to the provider as a delay in development? A. Using a pincer grasp to pick up blocks B. Requiring support to sit for prolonged periods C. Turning the head toward the parent's voice D. Reaching for the mother and saying "mama"

B. Requiring support to sit for prolonged periods RATIONALE: An infant should be able to sit unsupported by the age of 8 months. The nurse should report this finding to the provider because it is an indication of a delay in gross development.

A nurse is assessing a child who is postoperative. Which of the following findings should the nurse identify as an indication that naloxone should be administered? A. Crackles in the lung bases B. Respiratory depression C. Nausea and vomiting D. Tachycardia

B. Respiratory depression RATIONALE: The nurse should monitor the child's respiratory status postoperatively and plan to administer naloxone if respiratory depression is present. naloxone is an opioid antagonist used to reverse the effects of opioids administered preoperatively.

A nurse is assessing a school-age child who has celiac disease. Which of the following findings should the nurse expect? A. Elevated sweat chloride B. Steatorrhea C. Clubbing of the fingers D. Jaundice

B. Steatorrhea RATIONALE: Foul, fatty frothy stools known as steatorrhea are a manifestation of celiac disease, which is a malabsorption syndrome.

A nurse is assessing the dynamics of a family in which child maltreatment is suspected. Which of the following findings should the nurse report to the provider? A. The parents provide emotional support to the child during the assessment process B. The child has several unexplained scars and bruises C. The child cries and appears afraid of the healthcare provider D. The parents offer consistent, detailed stories about the child's injuries

B. The child has several unexplained scars and bruises RATIONALE: The nurse should suspect child maltreatment when the child has multiple unexplained scars and bruises. The nurse should report this finding to the provider.

A nurse is assessing a school-aged child who is 30 minutes postoperative following a cardiac catheterization using the left femoral artery. Which of the following findings should the nurse identify as the priority to report to the provider? A. The child rouses to verbal stimuli B. The pulse strength of the child's left popliteal artery site is decreased C. The child's respiratory rate is 20/min D. The child rates his pain at the catheter insertion site at a 7 on a scale of 0 to 10

B. The pulse strength of the child's left popliteal artery site is decreased RATIONALE: When using the greatest risk framework, the nurse should identify that the greatest risk to the child is a decrease or loss of circulation below the catheter insertion site. This can indicate hemorrhage or a thrombus at the site and can result in neurovascular impairment

A nurse is providing postoperative teaching to the parent of a 3-month-old infant who is recovering from an umbilical hernia repair. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will expect the site to bulge when my baby cries." B. "I will place a belly band around my baby's abdomen" C. "I will fold my baby's diaper away from the incision." D. "I will bathe my child in the bathtub daily."

C. "I will fold my baby's diaper away from the incision." RATIONALE: To prevent infection, the parent should be able to describe and demonstrate proper folding of the diaper to protect the surgical incision from contamination.

A nurse is providing discharge teaching to the parent of a school-aged child who has leukemia and is receiving chemotherapy. Which of the following statements b the parent indicates an understanding of the teaching? A. "I will take my child's rectal temperature daily" B. "I will make sure my child gets his MMR vaccine this week" C. "I will inspect my child's mouth every day for sores" D. "I will allow my child to ride his bicycle tomorrow"

C. "I will inspect my child's mouth every day for sores" RATIONALE: A child who has leukemia is at an increased risk form mucositis; therefore, the parent should inspect the child's mouth daily for lesions or ulcerations

A nurse is talking with the parent of a 4-month-old infant about growth and development. Which of the following statements indicates that the parent needs further teaching? A. "I need to remind my older kids to keep small objects out of the baby's reach" B. "I let my baby play on her stomach when she is awake and I am watching" C. "My baby loves to play with the pillows in her crib" D. "I put my baby in a rear-facing car seat in the back seat of the car"

C. "My baby loves to play with the pillows in her crib" RATIONALE: Parents should never place pillows in their infant's crib since they pose a suffocation hazard.

A nurse is providing teaching about oxycodone to an adolescent who is experiencing a vaso-occlusive crisis. Which of the following pieces of information should the nurse include? A. "This medication can cause diarrhea" B. "This medication can cause an increase in blood pressure" C. "This medication might cause nausea" D. "This medication can cause an increase in salivation"

C. "This medication might cause nausea" RATIONALE: The nurse should instruct the adolescent that nausea is an adverse effect of oxycodone. Other adverse effects include dizziness, sedation, and confusion.

A nurse is providing discharge teaching to the guardian of an infant following a hypospadias repair. Which of the following instructions should the nurse include? A. Clamp the infant's catheter for 30 minutes each day B. Give the infant a tub bath once per day C. Apply antibacterial ointment to the infant's penis each day D. Decrease the infant's fluid intake for 3 days

C. Apply antibacterial ointment to the infant's penis each day RATIONALE: The nurse should instruct the guardian to apply an antibacterial ointment to the infant's penis once daily to decrease the risk of infection

A nurse is caring for a child who has epistaxis. Which of the following actions should the nurse perform? A. Apply a warm cloth to the bridge of the child's nose B. Tilt the child's head back C. Apply continuous pressure to the child's nose for at least 10 min D. Administer aspirin for the child's pain

C. Apply continuous pressure to the child's nose for at least 10 min RATIONALE: The nurse needs to apply continuous pressure for at least 10 minutes to help stop bleeding.

A nurse is providing anticipatory guidance about the accidental ingestion of a toxic substance to the parents of a toddler. The nurse should instruct the parents to take which of the following actions first if the child ingests a hazardous substance? A. Give the toddler milk. B. Go to an emergency department. C. Call the poison control center. D. Induce vomiting.

C. Call the poison control center. RATIONALE: According to EBP, the nurse should instruct the parents to call the poison control center, which will then identify what further actions the parents should take.

A nurse is assessing the vital signs of a 1-month-old infant. Which of the following actions should the nurse perform? A. Use a cuff to auscultate blood pressure B. Determine heart rate by taking the radial pulse C. Count respirations before taking other vital signs D. Measure temperature by placing the thermometer in the infant's ear

C. Count respirations before taking other vital signs RATIONALE: It is best to count the infant's respirations while the infant is calm and before being disturbed. The pulse should be taken next, followed by temperature, which is the most disruptive assessment to an infant.

A nurse is assessing the pain level of a 3-year-old child who is postoperative following abdominal surgery. Which of the following pain scales should the nurse use? A. Word graphic rating scale B. Color tool C. FACES pain rating scale D. Numeric scale

C. FACES pain rating scale RATIONALE: The FACES scale includes various faces, which represent various levels of pain. A 3-year-old child is able to identify faces that represent different pain levels.

A nurse is caring for a child who is postoperative following a tonsillectomy. Which of the following findings is the nurse's priority? A. Nausea B. Hoarse voice C. Frequent swallowing D. Sore throat

C. Frequent swallowing RATIONALE: Frequent swallowing can be an indication of bleeding and must be addressed.

A nurse is assessing a 24-month-old toddler who has a new diagnosis of ASD. Which of the following findings should the nurse expect? A. Wanting to be held frequently B. Ability to build a tower of 10 cubes C. Impaired language skills D. Ability to stand on 1 foot

C. Impaired language skills RATIONALE: The nurse should expect a 24-month-old toddler who has ASD to exhibit impaired language skills (e.g., failing to respond to his/her name, pointing to objects instead of speaking)

A nurse is observing a mother who is playing peek-a-boo with her 8-month-old child. The mother asks if this game has any developmental significance. The nurse should reply that peek-a-boo helps develop which of the following concepts in the child? A. Hand-eye coordination B. Sense of trust C. Object permanence D. Egocentrism

C. Object permanence RATIONALE: Object permanence refers to the cognitive skill of knowing an object still exists even when out of sight. By discovering a hidden object while playing peek-a-boo, the infant experiences validation of this concept.

A nurse is caring for an adolescent who has end-stage renal disease and is scheduled for peritoneal dialysis. Which of the following actions should the nurse take? A. Position the adolescent supine during the procedure B. Have the adolescent drink 240 mL (8 oz) of fluid prior to the procedure C. Obtain the adolescent's weight prior to the procedure D. Monitor the adolescent's vital signs every 4 hrs during the procedure

C. Obtain the adolescent's weight prior to the procedure RATIONALE: The nurse should obtain a baseline weight prior to the initiation of the procedure and again following the procedure.

A nurse is providing nutritional teaching to an adolescent client who has celiac disease. Which of the following breakfast foods should the nurse recommend? A. Plain flour pastry B. Wheat cereal C. Scrambled eggs D. Rye toast

C. Scrambled eggs RATIONALE: A client who has celiac diseases should be on a gluten-free diet and should avoid foods containing barley, oat, rye, and wheat

A nurse is providing teaching to the guardian of a school-age child who has hearing loss. Which of the following techniques should the nurse recommend to facilitate communication with the child? A. Exaggerate the pronunciation of each word B. Keep hands still when speaking C. Speak at the child's eye level D. Avoid using facial expressions when speaking

C. Speak at the child's eye level RATIONALE: The nurse should instruct the guardian to speak at the child's eye level and ensure there is adequate lighting on the speaker's face to facilitate lip-reading and communication.

A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings indicates the need for further assessment? A. The infant is grabbing the feet and pulling them to the mouth B. The infant has a closed posterior fontanel C. The infant's legs remain crossed and extended when supine D. The infant's birth weight has doubled

C. The infant's legs remain crossed and extended when supine RATIONALE: Legs that are crossed and extended when supine is an unexpected finding and require further assessment. At 6 months of age, the infant's legs flex at the knees when the infant is supine. Crossed and extended legs when supine is associated with cerebral palsy.

A nurse is reviewing the laboratory report of a child with acute nephrotic syndrome who has been receiving prednisone by mouth for the past week. Which of the following findings should the nurse report to the provider? A. serum sodium 142 mEq/L B. serum potassium 4 mEq/L C. WBC count 3,000/mm^3 D. platelet count 298,000/mm^3

C. WBC count 3,000/mm^3 RATIONALE: The nurse should understand that the use of corticosteroids suppresses the child's immune system and increases the risk of infection. The nurse should identify that a WBC count of 3,000/mm^3 is below the expected range for a child and should report this finding to the provider.

A nurse is providing teaching about home care to the guardian of a school-aged child who has seizures. Which of the following statement by the guardian indicates an understanding of the teaching? A. "I will call an ambulance if my child's seizure lasts more than 10 minutes" B. "I will offer my child clear liquids immediately following a seizure" C. "I will tightly hold my child to restrain her during a seizure" D. "I will turn my child onto her side when a seizure begins"

D. "I will turn my child onto her side when a seizure begins" RATIONALE: To reduce the risk of aspiration and to improve oxygenation, the guardian should place the child in a side-lying position.

A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child's parents ask the nurse to explain the purpose of the test. Which of the following responses should the nurse provide? A. "The test determines the level of antibiotics in your child's blood" B. "The test tells us if your child ever had measles" C. "The test verifies the amount of albumin in your child's blood" D. "The test shows if your child had a recent strep infection"

D. "The test shows if your child had a recent strep infection" RATIONALE: An ASO titer indicates the child had a recent strep infection. When determining a definitive diagnosis for acute glomerulonephritis, this must be documented because the condition is usually the result of this type of infection.

A nurse is teaching a group of parents of toddlers about growth and development. A parent asks, "Why does my child's abdomen stick out?" Which of the following replies should the nurse provide? A. "You should give your child a stool softener daily" B. "Toddlers gain weight at a rapid pace" C. "You should have your child assessed for spinal deformity" D. "Toddlers do not have well-developed abdominal muscles"

D. "Toddlers do not have well-developed abdominal muscles" RATIONALE: The abdominal muscles are immature and minimally developed at this stage; giving the a "potbellied" appearance

A nurse on a pediatric unit has just received reports for 4 newly admitted clients. For which of the following children should the nurse plan to initiate droplet precautions? A. A child who has Rocky Mountain spotted fever B. A child who has roseola C. A child who has Molluscum contagiosum D. A child who has pertussis

D. A child who has pertussis RATIONALE: The nurse should initiate droplet precautions for the child who has pertussis to decrease the risk of transmitting the infection to others on the unit. Pertussis, or whooping cough, is a bacterial infection that is transmitted via exposure or direct contact with the respiratory secretions from an infected person. Manifestations include a fever, sneezing, and a severe productive cough that generally becomes worse before getting better.

A school nurse is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse plan to administer to the child? A. Zafirlukast B. Budesonide C. Montelukast D. Albuterol

D. Albuterol RATIONALE: The nurse should plan to administer albuterol o a child who is experiencing an acute exacerbation of asthma. This is considered a rescue medication due to its paid onset of action. Albuterol is a beta-adrenergic agonist that promotes bronchodilators and suppresses histamine release in the lungs.

A nurse is caring for a child who has epistaxis. Which of the following actions should the nurse take? A. Administer aspirin B. Tilt the child's head back and apply pressure C. Have the child lie down and rest D. Apply continuous pressure to the lower part of the child's nose

D. Apply continuous pressure to the lower part of the child's nose RATIONALE: With the child sitting up and breathing through the mouth, the nurse should apply continuous pressure with the thumb and forefinger to the soft area of the nose for 10 minutes. Most bleeding from the nose stops within this period.

A nurse is providing teaching to the parents of an infant who is breastfeeding. When should the nurse instruct the parents to introduce solid foods in the infant's diet? A. After the rooting reflex disappears B. At 2 to 3 months of age C. After the infant's first tooth erupts D. At 4 to 6 months of age

D. At 4 to 6 months of age RATIONALE: The nurse should identify that infants are developmentally ready for solid foods at 4 to 6 months of age

A nurse in an emergency department is caring for a 4-year-old child who has burns to the neck and face following a house fire. Which of the following actions should the nurse take first? A. Cover the child's wounds with a clean, dry cloth B. Establish IV access with a large-bore catheter C. Provide reassurance to the child's parents D. Determine the child's breathing pattern

D. Determine the child's breathing pattern RATIONALE: The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning. An alteration in any of these can indicate a threat to life and is therefore the nurse's priority concern.

A nurse is assessing the pain level of a 3-year-old child following a tonsillectomy. Which of the following rating scales should the nurse use to determine the child's pain? A. Word graphic rating scale B. Color tool C. Poker Chip Tool D. FACES pain rating scale

D. FACES pain rating scale RATIONALE: The FACES scale includes various faces, which represent various levels of pain. A 3-year-old child is able to identify faces that represent different pain levels.

A nurse is caring for a child with cystic fibrosis who has a pulmonary infection. Which of the following findings is the nurses' priority? A. Blood streaking of the septum B. Dry mucous membranes C. Constipation D. Inability to clear secretions

D. Inability to clear secretions RATIONALE: The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning. An alteration in any of these can indicate a threat to life and is therefore the nurse's priority concern.

A nurse is caring for a 5-year-old child who has a fever and begins to have a seizure. Which of the following actions should the nurse take? A. Give acetaminophen 240 mg PO immediately following a seizure B. Sponge the child's skin with a mixture of cold water and rubbing alcohol C. Administer rectal diazepam if the seizure lasts longer than 2 minutes D. Place the child in a side-lying position

D. Place the child in a side-lying position RATIONALE: The nurse should place the child in a side-lying position to facilitate drainage of oral secretions, which decreases the risk of aspiration.

A nurse is creating a plan of care for a preschooler who was admitted for the treatment of measles. Which of the following activities should the nurse include in the client's care plan? A. constructing a model airplane B. playing a video game in the playroom C. pulling a wagon with toys in the hallway D. putting together a puzzle with large pieces

D. putting together a puzzle with large pieces RATIONALE: The nurse should recommend putting together a puzzle with large pieces for a hospitalized preschooler. Other recommended activities for preschoolers on airborne precautions include playing pretend and dress up, painting, and looking at illustrated books.