Latasha, age 8 years, is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which will help her most in her adjustment to the hospital?

Correct Answer: A

Rationale: Explaining hospital schedules to Latasha, such as mealtimes, will help her most in adjusting to the hospital environment. Providing her with a sense of routine and structure can help reduce her anxiety and uncertainty during her stay. By knowing when things like meals will happen, Latasha can feel more in control of her surroundings and what to expect, which can be comforting for a child in a new and potentially scary situation like being in the hospital.

Correct Answer: A

Rationale: Methylphenidate (Ritalin) is a stimulant medication commonly used in the treatment of ADHD. One of the possible side effects of methylphenidate is an increase in nervousness or jitteriness. This side effect is more common at the beginning of treatment or when the dosage is increased. It is important for parents to be aware of this potential side effect and to inform the healthcare provider if it becomes bothersome for the child. Other common side effects of methylphenidate may include decreased appetite, insomnia, and stomach upset.

Correct Answer: C

Rationale: Creatinine is a waste product produced by muscle metabolism that is normally filtered by the glomerulus in the kidneys and excreted in urine. The level of creatinine in the urine is a direct reflection of the glomerular filtration rate (GFR). As GFR decreases in conditions such as acute renal failure, the amount of creatinine excreted in the urine also decreases. Therefore, measuring creatinine levels in the urine is a useful clinical indication of the glomerular filtration rate and kidney function. pH, osmolality, and protein level may provide additional information but are not as directly linked to GFR as creatinine levels.

Correct Answer: D

Rationale: Hyperkalemia is a condition characterized by elevated levels of potassium in the blood. This can have serious effects on the heart, leading to cardiac arrhythmias which can be life-threatening. In acute renal failure, the kidneys are not able to properly regulate potassium levels in the blood, leading to a potential buildup of potassium, resulting in hyperkalemia. The nurse should recognize cardiac arrhythmias as a critical sign of hyperkalemia in a child with acute renal failure and take prompt action to address this electrolyte imbalance. Dyspnea, seizure, and oliguria are not typically directly correlated with hyperkalemia.

Correct Answer: D

Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.