Following a motor vehicle collision, a 3-year old girl has a spica cast applied. Which toy is best for the nurse for this 3 year old child?

Correct Answer: C

Rationale: In pediatric nursing, selecting appropriate toys for children with specific conditions or needs is crucial for promoting their well-being and aiding in their development. In the case of a 3-year-old child in a spica cast following a motor vehicle collision, the best toy option is a set of cloth and hand puppets (Option C). The rationale behind choosing hand puppets is that they allow for imaginative play and interaction, which can be beneficial for a child confined to a spica cast. Hand puppets can engage the child's attention, provide a means for self-expression, and facilitate social interaction even in limited physical conditions. Option A (Duck that squeaks) may not offer the same level of interaction and creative play as hand puppets. Option B (Fashion doll and clothes) might be challenging for a child in a spica cast to manipulate due to physical restrictions. Option D (Handheld video game) may not promote the same level of social interaction and creative engagement as hand puppets do. By choosing the hand puppets, the nurse can support the child's emotional well-being, cognitive development, and social skills even during a challenging time of physical confinement. This educational rationale underscores the importance of selecting toys that not only entertain but also support the holistic development of pediatric patients in various healthcare settings.

Correct Answer: C

Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being.

Correct Answer: A

Rationale: To calculate the dose for each administration, multiply the child's weight (25 kg) by the dose (300 mg/kg/24 hours) and divide by the number of doses per day (6, as doses are every 4 hours). This gives us (25 kg * 300 mg/kg / 24 hours) / 6 doses = 1875 mg. Therefore, the nurse should administer 1875 mg for each dose.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) BP 70/40, which should be reported immediately to a healthcare provider. A significant decrease in heart rate in a child with a congenital heart defect could indicate worsening cardiac function, which may lead to inadequate cardiac output and subsequent hypotension, reflected in the blood pressure reading. This finding is critical as it signals a potential cardiac decompensation and the need for immediate medical intervention. Option A) Oxygen saturation 94% is within the normal range for a pediatric patient and does not indicate an acute issue requiring immediate attention. Option B) RR of 25 breaths/minute is also within the normal range for a 3-year-old child and is not a concerning finding in isolation. Option C) Urine output 20 mL/hr is slightly on the lower side but may not be an immediate cause for concern in the absence of other critical symptoms or abnormal vital signs. Educationally, this question highlights the importance of recognizing subtle changes in vital signs in pediatric patients, especially those with underlying cardiac conditions. It emphasizes the need for prompt assessment and intervention when there is a significant deviation from baseline parameters, particularly in high-risk populations like children with congenital heart defects. Regular monitoring and early detection of deteriorating conditions can help prevent adverse outcomes in pediatric patients with complex health needs.

Correct Answer: C

Rationale: In a scenario where a 6-month-old infant is unresponsive and not breathing after the airway is open, giving two breaths that make the chest rise is the appropriate action. This helps deliver oxygen to the infant's lungs and can help initiate breathing. Chest compressions are not recommended for infants as the first step in resuscitation. Checking pulses like the femoral or carotid pulse is not the priority when an infant is not breathing, as providing oxygen through breaths is essential.