A mother calls the school nurse to report that her preschool-aged child was bitten by a tick during a school outing last week. The mother removed the tick and flushed it down the toilet. What action should the school nurse take?

Correct Answer: D

Rationale: In this scenario, the correct action for the school nurse to take is D) Schedule a test for Lyme disease if a rash appears. This is the most appropriate response because tick bites can potentially transmit Lyme disease, which is caused by the bacterium Borrelia burgdorferi. By scheduling a test for Lyme disease if a rash appears, the nurse is following best practice guidelines to ensure early detection and treatment if necessary. Option A) Refer the mother to the Centers for Disease Control and Prevention is not the most immediate or practical step to take in this situation. The school nurse should first assess the child's symptoms and provide appropriate care before considering external referrals. Option B) Report the incident to the school principal is not the most urgent action needed. While it is important to document incidents, the immediate concern is the child's health and potential risk of Lyme disease. Option C) Culture the bite site when the child returns to school is not a recommended course of action. Lyme disease testing involves blood tests, not culturing the bite site, and waiting for the child to return to school may delay necessary testing and treatment. In an educational context, it is crucial for school nurses to be knowledgeable about common health risks, like tick bites and Lyme disease, especially in areas where these are prevalent. Prompt and appropriate actions can help prevent complications and ensure the well-being of students under their care. It is essential for school nurses to stay updated on best practices for managing various health concerns that may arise in a school setting.

Correct Answer: D

Rationale: To calculate the amount of terbutaline to administer, first convert the dose to the same unit. 250 mcg = 0.25 mg. Next, set up a proportion: 20 mg is to 1000 mL as 0.25 mg is to X mL. Cross multiply and solve for X: 20 X = 0.25 1000. X = (0.25 1000) / 20 = 12.5 mL. Therefore, the nurse should administer 13 mL of the solution.

Correct Answer: B

Rationale: Chorea, or sudden aimless movements associated with rheumatic fever, is temporary in nature and will eventually disappear on its own. It is important for the nurse to reassure the parents that these movements are part of the condition and typically resolve over time without the need for permanent lifestyle changes or strict discipline. Providing accurate information and reassurance to the parents can help alleviate concerns and promote understanding of the condition's course.

Correct Answer: A

Rationale: In this scenario, the highest priority action for the nurse caring for a one-year-old child following surgical correction of hypospadias is to monitor urinary output (Option A). This is because hypospadias repair surgery can lead to complications such as urinary retention, infection, or obstruction, which can impact the child's recovery and overall health. Monitoring urinary output is crucial in assessing renal function, fluid status, and the effectiveness of the surgical intervention. Changes in urinary output can indicate dehydration, renal complications, or issues with the surgical site. Early detection of these problems through monitoring urinary output allows for prompt intervention and prevents potential complications. The other options are not the highest priority in this situation. Auscultating bowel sounds (Option B) is important for assessing gastrointestinal function but is not as critical as monitoring urinary output in this postoperative period. Observing the appearance of stool (Option C) and recording the percent of diet consumed (Option D) are also important aspects of care but are not as immediate and essential as monitoring urinary output in this specific context. In an educational context, understanding the rationale behind prioritizing nursing actions based on the patient's condition and the potential complications of a surgical procedure is crucial for providing safe and effective care. Developing critical thinking skills to prioritize care based on the patient's needs and the clinical situation is a fundamental aspect of nursing practice in any specialty, including maternity care.

Correct Answer: D

Rationale: In this scenario, option D is the best choice as it promotes family-centered care and empowers the family members to make decisions together. Allowing the family to decide among themselves who will stay with the child during the procedure respects their autonomy and fosters a sense of control in a potentially stressful situation. This approach also encourages communication within the family and ensures that their preferences and needs are taken into account. Option A is incorrect because limiting the number of family members who can stay with the child may cause distress and disrupt family dynamics. It is essential to involve and support the family as a whole during times of medical intervention to provide emotional comfort and reassurance. Option B is inappropriate as it separates the child from their family members during a vulnerable moment, which can heighten the child's anxiety and feelings of isolation. Family presence has been shown to have positive effects on patient outcomes and satisfaction. Option C is not ideal as it isolates the sibling from the rest of the family without considering their emotional needs or the potential benefits of having familiar support nearby during the procedure. In an educational context, teaching healthcare providers about the importance of family-centered care and involving families in decision-making processes can enhance patient outcomes and satisfaction. By respecting and including families in care decisions, healthcare providers can create a supportive environment that promotes trust, collaboration, and positive health outcomes.