In preparing a preschool-aged patient for an injection, the most appropriate nursing intervention is to:

Correct Answer: A

Rationale: The most appropriate nursing intervention for preparing a preschool-aged patient for an injection is option A) allow the patient to administer an injection to a doll. This technique, known as therapeutic play, helps the child understand and become familiar with the procedure in a non-threatening way. Through play, the child can gain a sense of control and mastery over the situation, reducing anxiety and fear associated with the injection. Option B) arranging for the patient to watch a peer receive an injection may inadvertently increase the child's anxiety by witnessing another child in distress. This approach lacks the hands-on involvement and active participation that therapeutic play provides. Option C) having the parents explain the process to the patient may not be as effective as the direct experiential learning gained from administering an injection to a doll. While parental support and education are important, they may not address the child's emotional and psychological needs in the same way that therapeutic play does. Option D) suggesting diversionary activities like singing may help momentarily distract the child, but it does not actively involve the child in the preparation process or address their underlying fears and anxieties about the injection. In an educational context, understanding the rationale behind using therapeutic play in pediatric nursing is crucial for creating a supportive and effective care environment for young patients. By engaging children in hands-on learning experiences that are developmentally appropriate and non-threatening, nurses can help alleviate anxiety, build trust, and empower children to cope with medical procedures in a positive way.

Correct Answer: D

Rationale: The correct answer is D) sleep-onset association disorder. At 4 months old, babies start to develop sleep associations, such as needing to be rocked to sleep. This association can become a behavioral sleep disorder if the baby cannot fall asleep without being rocked. This disorder is common in infants and can lead to sleep disturbances. Option A) early signs of ADHD is incorrect because needing to be rocked to sleep at this age is more likely due to a sleep association issue rather than a sign of ADHD. ADHD typically presents with symptoms of inattention, hyperactivity, and impulsivity, not related to sleep habits. Option B) primary restless legs syndrome is incorrect as this condition is characterized by an uncomfortable sensation in the legs causing an urge to move them, usually worsened at rest and at night. It is not typically associated with needing to be rocked to sleep. Option C) sleep terrors is incorrect as sleep terrors usually occur during non-REM sleep and are more common in older children. Sleep terrors are characterized by sudden awakening with intense fear and confusion, not related to needing to be rocked to sleep. Educationally, understanding common pediatric sleep disorders is crucial for pediatric nurses as they play a vital role in assessing and supporting children's sleep patterns. Recognizing sleep-onset association disorder in infants is important for providing appropriate guidance to parents on sleep hygiene and promoting healthy sleep habits from an early age.

Correct Answer: B

Rationale: The correct answer is B) intelligence. The Denver II is a developmental screening tool used to assess children from birth to 6 years of age. It evaluates four domains: language, gross motor skills, fine motor skills, and personal-social skills. The exclusion of intelligence from the Denver II assessment is based on the fact that intelligence is a complex and multifaceted construct that cannot be reliably assessed through a brief developmental screening tool like the Denver II. Option A) language is included in the Denver II because language development is a critical aspect of a child's overall development and can indicate potential delays or issues. Option C) gross motor skills and Option D) personal-social skills are also included in the Denver II as they are essential for evaluating a child's physical and social development. In an educational context, understanding the domains assessed by tools like the Denver II is crucial for healthcare professionals working with pediatric populations. By recognizing what each domain evaluates, practitioners can better identify areas of concern, provide appropriate interventions, and support children's overall development. It also helps in collaborating with families to address any developmental delays or issues early on, enhancing the child's well-being and long-term outcomes.

Correct Answer: E

Rationale: In this question, the correct answer is E, which is not listed among the provided options. Antivenins should be used in the treatment of envenomations from rattlesnakes, scorpions, black widows, and stonefish. Antivenin is a specific treatment for venomous bites or stings. Rattlesnake envenomations can lead to serious tissue damage and systemic effects that require antivenin therapy. Scorpion envenomations can cause neurotoxic effects that may be effectively treated with antivenin. Black widow envenomations can result in severe muscle pain and cramping, which can be alleviated with antivenin. Stonefish envenomations can lead to intense pain and systemic symptoms requiring antivenin. Educationally, understanding the use of antivenins in treating various envenomations is crucial for healthcare providers, especially pediatric nurses, who may encounter these cases in their practice. Being able to differentiate which envenomations require antivenin therapy is essential for providing prompt and effective care to pediatric patients who have been exposed to venomous bites or stings.

Correct Answer: B

Rationale: The correct answer is B) colic. In the first 2 months of life, colic is the most common cause of sleeping difficulty in infants. Colic leads to excessive crying, fussiness, and difficulty in soothing the baby, which can disrupt sleep patterns. Colic typically peaks around 6 weeks of age and can cause sleep disturbances during this period. Option A) gastro-esophageal reflux can also cause sleep disturbances in infants, but it is not as common in the first 2 months of life compared to colic. Reflux symptoms often worsen when lying down, leading to discomfort during sleep. Option C) formula intolerance can lead to gastrointestinal issues and discomfort, but it is less likely to be the primary cause of sleeping difficulties in the first 2 months unless there are other significant symptoms present. Option D) developmentally self-resolving sleeping behavior is not a common cause of sleeping difficulties in the first 2 months of life. While infants do go through various sleep patterns as they develop, persistent sleeping difficulties are more likely due to underlying issues like colic. In an educational context, understanding the common causes of sleeping difficulties in infants is crucial for pediatric nurses. By recognizing the symptoms and causes, nurses can provide appropriate support and guidance to parents in managing these challenges. Educating parents on strategies to soothe a colicky baby can significantly impact both the infant's sleep patterns and the overall well-being of the family.