NUR 102 Exam 3

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A 4½-year-old is ordered to receive 25 mL/hour of IV solution. The nurse is using a pediatric microdrip chamber to administer the medication. For how many drops per minute should the microdrip chamber be set? Record your answer using a whole number.

25 drops/minute

A nurse on the pediatric unit is caring for a group of preschool children. Which situation takes priority? A. a child who develops a fever during a blood transfusion B. a child admitted from the postanesthesia care unit who has a blood-saturated surgical dressing C. a physician waiting on the telephone to give the nurse a verbal order D. a child with asthma who is wheezing with an oxygen saturation level of 96%

A. a child who develops a fever during a blood transfusion

A 3-year-old child with Down syndrome, admitted to the pediatric unit with asthma, does not enunciate words well and holds on to furniture when walking. What question would be appropriate for the nurse to ask the parent? A. "How long has your child has been like this?" B. "Is your child able to walk without holding on to furniture?" C. "How does your child's condition today differ from their normal condition?" D. "Does your child always drool?"

C. "How does your child's condition today differ from their normal condition?"

The nurse suspects that a child, age 4, is being neglected physically. To best collect data on the child's nutritional status, the nurse should ask the parents which question? A. "Has your child always been so thin?" B. "Is your child a picky eater?" C. "What did your child eat for breakfast?" D. "Do you think your child eats enough?"

C. "What did your child eat for breakfast?"

A child, age 5, is diagnosed with mycoplasma pneumonia and has a persistent productive cough. When monitoring the child's respirations, the nurse should keep in mind that children normally use which muscles to breathe? A. Accessory B. Thoracic C. Abdominal D. Intercostal

C. Abdominal

If a drug is available in suspension in a container, how should the nurse prepare the drug before administration? A. By diluting it with normal saline solution B. By diluting it with 5% dextrose solution C. By shaking or rolling the container so all drug particles are dispersed uniformly D. By filtering for undissolved particles and crushing them with a mortar and pestle

C. By shaking or rolling the container so all drug particles are dispersed uniformly

A mother of a 5-year-old child who was admitted to the hospital has a Protection from Abuse order for the child against his father. A copy of the order is kept on the pediatric medical surgical unit where the child is being treated. The order prohibits the father from having any contact with the child. One night, the father approaches the nurse at the nurses' station, politely but insistently demanding to see his child, and refusing to leave until he does so. What should the nurse do first? A. Firmly tell the father he must leave. B. Notify the nursing coordinator on duty. C. Notify the nurse-manager. D. Notify hospital security or the local authorities.

D. Notify hospital security or the local authorities.

A nurse manager of the pediatric unit discovers that she is overbudget on supplies. How could each nurse assigned to the unit help with cost containment? A. Order only brand-name supplies instead of the generic equivalent. B. Use the supply closet at work to stock personal medicine cabinets because the supplies are free. C. Order supplies that are soon to be expired. D. Use care pathways to specify care and identify daily outcomes.

D. Use care pathways to specify care and identify daily outcomes.

The nurse is reinforcing anticipatory guidance on safety topics to a group of parents who have preschool-age children. When reinforcing education, what is appropriate to cover for the preschool level? Select all that apply. A. bathtub safety B. bike helmet use C. information on drugs and alcohol D. peer pressure E. water safety

A. bathtub safety B. bike helmet use E. water safety

The nurse is teaching the mother of an ill child about childhood immunizations. The nurse should tell the mother that live virus vaccines shouldn't be administered to children with: A. diabetes. B. leukemia. C. asthma. D. cystic fibrosis.

B. leukemia.

A 4-year-old child had a subungual hemorrhage of the toe after a jar fell on the foot. Which statement regarding the rationale for using electrocautery to treat the injury is most accurate? A. It's used to prevent loss of nail growth. B. It's used to prevent loss of the nail. C. It's used to relieve pain and reduce the risk of infection. D. It's used to prevent permanent discoloration of the nail bed.

C. It's used to relieve pain and reduce the risk of infection.

The nurse has just administered a drug to a child. Which organ is most responsible for drug excretion in children? A. Heart B. Lungs C. Kidneys D. Liver

C. Kidneys

A child, age 5, is brought to the pediatrician's office for a routine visit. When inspecting the child's mouth, the nurse expects to find how many teeth? A. Up to 10 B. Up to 15 C. Up to 20 D. Up to 32

C. Up to 20

A nurse is reinforce educating the parents of a 5-year-old child admitted to the pediatric unit with cystic fibrosis. Which statement concerning steatorrheic stools is most accurate? A. They're black and tarry. B. They're frothy, foul-smelling, and fatty. C. They're clay-colored. D. They're orange or green.

B. They're frothy, foul-smelling, and fatty.

A 4-year-old girl has a urinary tract infection (UTI). When teaching the parents how to help her avoid recurrent UTIs, the nurse should emphasize which preventive measure? A. Wiping her perineum from back to front after she uses the toilet B. Administering prophylactic antibiotics C. Giving her a warm bath for 15 minutes daily D. Making sure she avoids bubble baths

D. Making sure she avoids bubble baths

The nurse is caring for a 4-year-old child who is near death. Which statement by the family best indicates to the nurse that the family may be ready to consider organ donation? A. "I would do anything to have no other family go through this." B. "How long can the child live this way? It is so hard to watch." C. "No one should have to watch their child die." D. "We talked to the doctor about removing life support."

A. "I would do anything to have no other family go through this."

A previously toilet-trained 4-year-old child begins wetting the bed after being hospitalized. Which statement should a nurse make to the parents? A. "It is normal for a child to start wetting the bed again when hospitalized." B. "Your child must not have been fully potty trained." C. "It is not uncommon for 4-year-olds to still have accidents." D. "Try not to worry. We can just cut back on fluids at night."

A. "It is normal for a child to start wetting the bed again when hospitalized."

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis? A. Avoid making noise when in the child's room. B. Rock the child frequently. C. Let the child's 2-year-old sibling stay in the room. D. Keep the lights on brightly so that the child can see the parent.

A. Avoid making noise when in the child's room.

When telling a 4-year-old child about an upcoming procedure, the nurse's most important consideration is to: A. use simple terms. B. speak loudly and clearly. C. offer a toy to keep the child happy. D. include every detail.

A. use simple terms.

A nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider? A. inappropriate parental concern for the degree of injury B. absence of parents to question about the injury C. inappropriate response of the child to the injury D. incompatibility between the child's history and the injury

D. incompatibility between the child's history and the injury

When collecting data on a child with impetigo, the nurse expects which findings? A. Small, brown, benign lesions B. Honey-colored, crusted lesions C. Linear, threadlike burrows D. Circular lesions that clear centrally

B. Honey-colored, crusted lesions

After receiving education about the treatment plan for acute lymphocytic leukemia (ALL) for a preschooler, the caregiver asks the nurse, "I saw a movie where a baby born to the parents was able to be a donor for stem cell transplant for the sibling with leukemia. Is that something we could do?" What is the nurse's best response? A. "If this is something you are considering, I recommend you speak to the health care provider about a consult to a genetic counselor." B. "As is often the case when medical treatments are represented in movies, this is not something that is really done in practice." C. "The time it will take for you to have another baby coupled with the possibility that that child will not be a match makes this impractical." D. "I saw that movie too. I thought it was unfair for the younger sibling to have to undergo all those invasive medical procedures."

A. "If this is something you are considering, I recommend you speak to the health care provider about a consult to a genetic counselor."

A 20-kg (44-lb) preschooler is being transferred to the unit from a pediatric post-anesthesia care unit after undergoing an inguinal hernia repair. For which prescription from the health care provider will the nurse seek clarification? A. 5% dextrose in water at 50 ml/hr intravenously B. monitor intake and output C. ibuprofen 100 mg orally every 6 hours PRN D. leave dressing intact for 5 days

A. 5% dextrose in water at 50 ml/hr intravenously

The nurse is caring for a preschooler who was just diagnosed with an allergy to wheat. When teaching the mother about dietary restrictions, the nurse should tell her to eliminate which food from the child's diet? A. Hot dogs B. Milk C. Gelatin D. French fries

A. Hot dogs

The nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement? A. Increased urine output B. Increased appetite C. Increased energy level D. Decreased diarrhea

A. Increased urine output

The nurse is caring for a 5-year-old with several tiny blisters near the mouth, several of which are draining clear fluid and others which have a yellowish crust. Which teaching will the nurse provide to the client's parent? A. Keep the child home from school until antibiotic therapy has been administered for 24 hours. B. Wash the area with isopropyl alcohol to attempt to dry the drainage faster. C. Recognize that this is a normal finding that will run its course without intervention. D. Plan to administer antiviral therapy for at least seven days.

A. Keep the child home from school until antibiotic therapy has been administered for 24 hours.

A boy, age 4, begins to use foul language. Concerned about this behavior, his parents ask the nurse how to stop it. Which advice should the nurse offer? A. "Just ignore it. He'll grow out of it." B. "Tell him it isn't acceptable and he'll be disciplined if he continues to do it." C. "Tell him that good little boys don't use bad words." D. "Tell him that his behavior makes you angry."

B. "Tell him it isn't acceptable and he'll be disciplined if he continues to do it."

The grandmother of a preschool-age child calls the clinic to report that the child has had a fever, has been fussy, and now has a rash that started on the neck and has spread to the rest of the child's body. The child was exposed to chickenpox about 3 weeks ago. What advice would be most important to give to the grandmother? A. "Bring the child to the clinic immediately so we can confirm the diagnosis." B. "You can help relieve the child's itching by giving him oatmeal baths." C. "Make sure the child stays calm and limit the amount of time he spends watching television." D. "The child should stay home until his fever is gone, then he can return to daycare."

B. "You can help relieve the child's itching by giving him oatmeal baths."

A child with a fractured left femur receives a cast. A short time later, the nurse notices that the toes on the child's left foot are edematous. Which nursing action would be most appropriate? A. Apply ice to the toes and foot. B. Contact the orthopedic surgeon. C. Elevate the foot of the bed. D. Utilize a traction sling to raise the extremity.

C. Elevate the foot of the bed.

A 4-year-old child has a tick embedded in the scalp. Which method should the nurse use to remove the tick? A. Burn the tick at the skin surface. B. Surgically remove the tick. C. Grasp the tick with tweezers and apply slow, outward pressure. D. Grasp the tick with tweezers and quickly pull the tick out.

C. Grasp the tick with tweezers and apply slow, outward pressure.

The nurse is caring for a 4-year-old with a full-thickness burn. Before sending the child to hydrotherapy for a scheduled wound debridement, which nursing action is a priority? A. Administer a fluid bolus of 500 ml B. Initiate antibiotics as prescribed C. Implement pain control measures D. Provide high-protein drinks

C. Implement pain control measures

The estranged parent of a preschool-age child comes to the hospital to visit the child. The child's medical record contains a restraining order that restricts the parent from visiting. When approached by the nurse, the parent becomes argumentative. What is the priority action by the nurse? A. Contact the health care provider. B. Contact the unit manager. C. Contact the local police. D. Contact the security department.

D. Contact the security department.

A preschool-age child underwent a tonsillectomy 4 hours ago. Which data collection finding would make the nurse suspect postoperative hemorrhage? A. Vomiting of dark brown emesis B. Refusal to drink clear fluids C. Decreased heart rate D. Frequent swallowing

D. Frequent swallowing

A child is diagnosed with Wilms' tumor. During data collection, the nurse expects to detect: A. gross hematuria. B. dysuria. C. nausea and vomiting. D. an abdominal mass.

D. an abdominal mass.

When collecting data on a child's cultural background, the nurse should keep in mind that: A. cultural background usually has little bearing on a family's health practices. B. physical characteristics mark the child as part of a particular culture. C. heritage dictates cultural values. D. behavioral patterns are learned within a culture.

D. behavioral patterns are learned within a culture.

A nurse is working on the pediatric unit. Which assignment best demonstrates primary care nursing? A. caring for the same child from admission to discharge B. caring for different children each shift to gain nursing experience C. taking vital signs for every child hospitalized on the unit D. assuming the charge nurse role instead of participating in direct child care

A. caring for the same child from admission to discharge

A 4-year-old child is admitted to the burn unit with a circumferential burn to the left forearm. Which finding would alert the nurse to a potential complication that should be reported to the health care provider? A. numbness of fingers B. +2 radial and ulnar pulses C. full range of motion and no pain D. bilateral capillary refill less than 2 seconds

A. numbness of fingers

Which method is most reliable for confirming a preschooler's identity before administering a medication? A. Check the name on the bed. B. Check the hospital identification bracelet. C. Ask the child his name. D. Ask the parents at the bedside.

B. Check the hospital identification bracelet.

A parent tells the nurse that the parent's preschool-aged child with spina bifida sneezes and gets a rash when playing with brightly colored balloons, and that recently the child had an allergic reaction after eating kiwi fruit and bananas. Based on the parent's report, the nurse suspects that the child may have an allergy to A. bananas. B. latex. C. kiwi fruit. D. color dyes.

B. latex.

When assisting in developing a plan of care for a hospitalized child, the nurse knows that children in which age-group are most likely to view illness as a punishment for misdeeds? A. infancy B. preschool age C. school age D. adolescence

B. preschool age

A nurse is finishing a shift on the pediatric unit. Because the shift is ending, which intervention takes priority? A. checking client pain levels for report to the next shift nurse B. checking to see that client orders have been transcribed C. documenting the care provided during the shift D. completing input and output recording for the shift

C. documenting the care provided during the shift

Parents report to the nurse that their 4-year-old child often lies and makes up wild stories. What is the most appropriate response by the nurse? A. "Let your child know that there will be punishment for lying." B. "Ask your child why the child isn't telling the truth." C. "Your child's lying is probably due to a vivid imagination and creativity." D. "Acknowledge your child by saying, 'That's a pretend story.'"

D. "Acknowledge your child by saying, 'That's a pretend story.'"

Tepid sponge baths effectively reduce hyperthermia in children. The best way to give such a bath is by: A. leaving the bathroom door open to increase air movement. B. waiting until the child has chills to give the bath. C. adding isopropyl alcohol to the bath water. D. continuing the bath for 20 to 30 minutes.

D. continuing the bath for 20 to 30 minutes.

A preschooler is returned to the pediatric department following surgery. Postoperative pain management orders include meperidine 25 mg I.M. every 6 hours. When administering this injection, which nursing action is best? A. Speak quietly and administer the injection while the child is groggy. B. Ask the child if the injection should be given now. C. Let the child choose which leg will receive the injection. D. State that the nurse will return in a few minutes to give the injection.

C. Let the child choose which leg will receive the injection.

The mother of a preschooler recently diagnosed with type 1 diabetes mellitus makes an urgent call to the pediatrician's office. She says her child had an uncontrollable temper tantrum while playing and now is lethargic and hard to arouse. The nurse should instruct the mother to take which action first? A. Obtain a urine sample and measure the glucose level. B. Force the child to drink orange juice. C. Measure the child's blood glucose level. D. Call 911 because this is an emergency.

C. Measure the child's blood glucose level.

A child who tests positive for the human immunodeficiency virus (HIV) is placed in foster care. The foster parents ask the nurse how to prevent HIV transmission to other family members. How should the nurse respond? A. "Make sure the child uses disposable plates and utensils." B. "Use isopropyl alcohol to clean surfaces contaminated with the child's blood or body fluids." C. "Don't let the child share toys with other children." D. "Wear gloves when you're likely to come into contact with the child's blood or body fluids."

D. "Wear gloves when you're likely to come into contact with the child's blood or body fluids."

The nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider? A. Inappropriate parental concern for the degree of injury B. Inability to question the parents about the injury because they aren't present C. Inappropriate response of the child to the injury D. Incompatibility between the history and the injury

D. Incompatibility between the history and the injury

Encouraging children to engage in fantasy play and participate in their own care is a useful developmental approach for which pediatric age-group? A. Preschool age (3 to 5 years) B. Adolescence (10 to 19 years) C. School age (5 to 10 years) D. Toddler (1 to 3 years)

A. Preschool age (3 to 5 years)

A 4-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Upon morning nursing rounds, which assessment finding indicates the client is in fluid overload? A. Rales noted on lung auscultation and worsening dyspnea B. Abdominal palpation indicating gastric distention C. Client states nausea with morning vomiting. D. A temperature of 102° F (38.9° C)

A. Rales noted on lung auscultation and worsening dyspnea

The nurse is caring for a preschooler with a fractured humerus and is observing for evidence of possible child abuse in the home. Which finding(s) does the nurse document as evidence of possible abuse? Select all that apply. A. The caregiver states, "I request that no one speaks to my child in my absence." B. The preschooler says, "Daddy gets mad more than Mommy does." C. The caregiver's account of how the injury occurred is inconsistent. D. The caregiver asks the nurse numerous questions about the plan of care. E. The preschooler says, "Sometimes there is a scary monster in my bedroom."

A. The caregiver states, "I request that no one speaks to my child in my absence." C. The caregiver's account of how the injury occurred is inconsistent.

When gathering data on a preschool-age child, the nurse finds multiple contusions over the body. Which statement indicates the findings that should be documented? A. Contusions confined to one body area are typically suspicious. B. All lesions, including location, shape, and color, should be documented. C. Natural injuries usually have straight linear lines, while injuries from abuse have multiple curved lines. D. The depth, location, and amount of bleeding that initially occurs is constant, but the sequence of color change is variable.

B. All lesions, including location, shape, and color, should be documented.

A parent asks the nurse for advice on setting limits and disciplining a 4-year-old child. During the teaching session, which fact should the nurse emphasize? A. Children younger than age 5 rarely need to be punished. B. Parents should set firm, consistent limits. C. Parents should always use a "timeout" seat. D. Parents should enforce rules rigidly.

B. Parents should set firm, consistent limits.

For a child with hemophilia, what is the most important nursing goal? A. Enhancing tissue perfusion B. Preventing bleeding episodes C. Promoting tissue oxygenation D. Controlling pain

B. Preventing bleeding episodes

A 4-year-old girl is admitted to the hospital to rule out a diagnosis of leukemia. Which would be the best room assignment for the nurse to select for this child? A. 4-year-old girl who has rheumatoid arthritis B. 5-year-old boy who is having a tonsillectomy C. 4-year-old girl who has leukemia D. alone in a private room

D. alone in a private room

The nurse is obtaining the history of a pediatric client, age 4. Which area usually takes longer to evaluate in a child than in an adult? A. Past health status B. Family health status C. Developmental status D. Review of physiologic systems

C. Developmental status

The nurse is caring for a preschool-age child who sustained burns in a house fire. The child is prescribed morphine every 4 hours for pain. Which assessment parameter is most important when monitoring a child who's receiving morphine? A. Pulse B. Respirations C. Temperature D. Blood pressure

B. Respirations

After collecting data on a newly admitted 5-year-old child, the nurse assists in making the nursing diagnosis of Parental role conflict related to child's hospitalization. Which defining characteristic would most suggest this diagnosis? A. Supportive child-parent interaction (speaking, listening, touching, and eye-to-eye contact) B. Parents' active participation in child's physical or emotional care C. Parents' failure to use available support systems or agencies to assist in coping D. Evidence of adaptation to parental role changes

C. Parents' failure to use available support systems or agencies to assist in coping

The licensed practical nurse (LPN) is assigned to care for a 4-year-old child who had a Harrington rod inserted the day before and notices the client is receiving antibiotics by a syringe pump. The nurse is IV certified, but uncomfortable because they are unfamiliar with the equipment. What would be the best course of action? A. Request another assignment. B. Refuse the assignment for safety reasons. C. Request in-service education for use of the syringe pump. D. Read through the unit policy and procedure manual.

C. Request in-service education for use of the syringe pump.

The parent of an 8-year-old client tells the nurse that when the child plays with other children, the child does not seem to interact with them, but simply plays alongside. What does the nurse determine about the child? A. This is solitary play typical of infants, not preschool children. B. This is a parallel play typical of toddlers, not school-aged children. C. This is associative play typical of preschool children, not school-aged children. D. This is cooperative play typical of adolescents, not school-aged children.

B. This is a parallel play typical of toddlers, not school-aged children.

When collecting data on a child with muscular dystrophy, the nurse expects which finding? A. Pain B. Waddling gait C. Joint swelling D. Limited range of motion (ROM)

B. Waddling gait

A preschooler has vomiting, diarrhea, and a potassium level of 3.0 mEq/L. The physician prescribes an I.V. infusion of dextrose 5% in water and half-normal saline solution with 10 mEq of potassium chloride. The nurse knows that a child with vomiting and diarrhea needs fluids and potassium chloride to: A. eliminate the cause of diarrhea. B. meet physiologic needs. C. avoid hyperglycemia. D. promote normal stool elimination.

B. meet physiologic needs.

The nurse realizes she's 1 hour late in administering a dose of medication for her 4-year-old client. She gives the medication immediately and assesses the client. The client isn't harmed by the delay. Which action should the nurse take next? A. No further action is necessary. B. The nurse should notify the physician of the error. C. The nurse should follow facility procedures for reporting an error. D. The nurse should document a medication error in the client's chart.

C. The nurse should follow facility procedures for reporting an error.

The nurse is preparing a child, age 4, for cardiac catheterization. Which explanation of the procedure is most appropriate? A. "Don't worry. It won't hurt." B. "The test usually takes an hour." C. "You must sleep the whole time that the test is being done." D. "The special medicine will feel warm when it's put in the tubing."

D. "The special medicine will feel warm when it's put in the tubing."

A 5-year-old arrives in the clinic for a physical to enter school. Which potential child abuse findings should be brought to the health care provider's attention? Select all that apply. A. The child has abrasions on the knee. B. A patterned bruise is noted on the back. C. Parental description of accident does not match injury. D. The child clings to favorite blanket. E. Injuries in various stages of healing are documented.

B. A patterned bruise is noted on the back. C. Parental description of accident does not match injury. E. Injuries in various stages of healing are documented.

The physician diagnoses leukemia in a child, age 4, who reports being tired and sleeps most of the day. Which nursing diagnosis reflects the nurse's understanding of the pathophysiology behind leukemia? A. Ineffective airway clearance related to fatigue B. Activity intolerance related to anemia C. Imbalanced nutrition: More than body requirements related to lack of activity D. Ineffective cerebral tissue perfusion related to central nervous system infiltration by leukemic cells

B. Activity intolerance related to anemia

A nurse is caring for a 4-year-old child with end-stage leukemia. The child's physician has ordered a lumbar puncture. His mother, who has legal custody, has refused to give consent for the child to undergo the procedure. However, the child's father is demanding that the procedure be performed. What should the nurse do first? A. Prepare the child for the lumbar puncture because the father wants the procedure to be performed. B. Inform the father that the procedure won't be performed because the mother didn't consent. C. Ask the child if he would like to have the procedure. D. Contact social services and the child's physician.

B. Inform the father that the procedure won't be performed because the mother didn't consent.

Which documentation is most important when preparing a preschool-age child for surgery? A. Vital signs B. Informed consent C. Preoperative teaching D. Preoperative medication administration

B. Informed consent

A 3-year-old child is admitted with pneumonia and exhibits a productive cough and difficulty breathing. The parents inform the nurse of a poor appetite and inactivity. Which interventions would be included in the care plan to improve airway clearance? Select all that apply. A. Restrict fluid intake. B. Perform chest physiotherapy as ordered. C. Encourage coughing and deep breathing. D. Keep the head of the bed flat. E. Perform postural drainage. F. Maintain humidification with a cool mist humidifier.

B. Perform chest physiotherapy as ordered. C. Encourage coughing and deep breathing. E. Perform postural drainage. F. Maintain humidification with a cool mist humidifier.

A 4-year-old is hospitalized following alleged sexual abuse. The child is withdrawn and exhibits poor eye contact. Which nursing strategies encourage client communication? Select all that apply. A. Use touch by rubbing the shoulders or back. B. Provide paper and crayons and encourage coloring. C. Provide a videotape on sexual abuse. D. Engage in play with toys and dolls. E. Read a book to establish a rapport.

B. Provide paper and crayons and encourage coloring. D. Engage in play with toys and dolls. E. Read a book to establish a rapport.

A nurse is performing a Denver Developmental Screening Test II on a 4½-year-old child. What behaviors should the nurse expect the child to demonstrate? Select all that apply. A. The child balances on each foot for at least 6 seconds. B. The child copies a circle that is closed or very nearly closed. C. The child speaks clearly. D. The child draws a person with at least three body parts.

B. The child copies a circle that is closed or very nearly closed. C. The child speaks clearly. D. The child draws a person with at least three body parts.

A school nurse is conducting a seminar for parents of preschool children on the prevention of head injuries. What is the most appropriate information for the nurse to give the parents? A. Children should always be supervised by an adult when playing. B. Safety gates should be installed at staircases at home. C. Children should always wear helmets when riding bicycles. D. Children should be accompanied by an adult when crossing the street.

C. Children should always wear helmets when riding bicycles.

A 4-year-old child is seen in the pediatrician's office. The child is due for immunizations and the provider discusses with the caregiver the need for the immunizations. The nurse returns to the room to administer the immunizations and the caregiver refuses to sign the paperwork for the administration of the immunizations. What is the most appropriate action by the nurse? A. The nurse listens to the caregiver's concerns and discusses the risks of nonimmunization. B. The nurse documents the interaction and escorts the caregiver and child out of the office. C. The nurse states the child must have vaccinations for preschool and injects the child without permission. D. The nurse asks the provider to return to discuss the risks of nonimmunization.

A. The nurse listens to the caregiver's concerns and discusses the risks of nonimmunization.

A nurse is collecting data on a 3-year-old who has ingested toilet bowl cleaner. What is the priority when gathering data from this child? A. observing skin integrity around the mouth B. evaluating the airway patency and respiratory status C. obtaining the name of the product ingested from the parents D. evaluating the stool for blood

B. evaluating the airway patency and respiratory status


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