N212 ATI RN Nursing Care of Children
1. Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The nurse
... [Show More] should identify that which of the following statements by the parents indicates an understanding of the teaching?
a) my child will have a cast until healing is complete.
b) My child will receive antibiotics for several weeks.
c) My child can return to playing sports once he is discharged.
d) My child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4 weeks. Surgery might be indicated if the antibiotics are not successful. A - incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain.
Therefore, it will be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
the sound
2. A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify as which of the following? Click the audio button to listen.
a) Biots respiration
b) Chaney Stokes respiration
c) Tackypnea
d) Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid, regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic acidosis, or severe anemia.
A- Biot's respirations are periods of apnea alternating with two or three shallow breaths. B- Cheyne-Stokes respirations are periods of apnea alternating with periods of hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
3. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?
a) Elevate the head of the child's bed
b) insert a large-bore IV catheter for the child
c) determine the allergen that caused the child's reaction
d) administer IM epinephrine to the child
Answer- d
When using the urgent vs nonurgent approach to client care, the nurse determines that the priority action is administering IM epinephrine to the child. During an anaphylactic reaction, histamine release causes bronchoconstriction and vasodilation. This is an emergency because ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child's bed is important to facilitate breathing and circulation.
However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child's reaction is important to prevent any additional episodes of anaphylaxis. However, it is not the priority action the nurse should take. [Show Less]