Parents tell the nurse that their child keeps scratching the areas where he has bed bugs. The nurse's response would be based on which statement?

Correct Answer: D

Rationale: In this scenario, the correct response is option D: "Scratching the lesions may cause them to become secondarily infected." This answer is correct because when a child scratches the areas where they have bed bugs, it can lead to breaks in the skin, creating openings for bacteria to enter and cause a secondary infection. This is a common concern in pediatric patients with skin conditions exacerbated by scratching. Option A is incorrect because scratching can indeed cause problems such as skin breakdown and infection. Option B is incorrect as bed bug bites can cause itching due to the body's reaction to the bug's saliva. Option C is incorrect as scratching the lesions will not cause the bed bugs to spread; however, it can lead to complications like infection. In an educational context, it is crucial for nurses to understand the implications of scratching on skin integrity, especially in pediatric patients. Teaching parents about the risks associated with scratching can help prevent further complications and promote proper wound care practices. Nurses play a vital role in educating families on how to manage skin conditions effectively to prevent secondary infections and promote healing.

Correct Answer: B

Rationale: The correct answer is B) An opportunity for regression. In the context of a hospitalized preschool child in isolation, it is developmentally appropriate for children of this age to regress when faced with stress or changes in their environment. Isolation can disrupt their routine, causing them to revert to behaviors from an earlier stage of development as a way to cope with the unfamiliar situation. This regression can manifest as clinginess, bedwetting, or seeking more comfort from caregivers. Option A) Loss of companionship with friends may cause distress, but it is not the most expected reaction in this scenario. Preschoolers are more focused on their immediate environment and caregivers. Option C) A threat to the child's self-image is more relevant to older children who have a more developed sense of self. Preschoolers are still in the process of forming their self-concept. Option D) Seeing isolation as a punishment requires a higher level of cognitive understanding and may be more common in older children who can link their behavior to consequences. Educationally, understanding typical responses of preschoolers to stressors like hospitalization and isolation is crucial for pediatric nurses to provide appropriate care and support. Recognizing regression as a common coping mechanism can help nurses tailor their approach to meet the child's emotional needs effectively.

Correct Answer: B

Rationale: The most appropriate nursing action when a parent reports that their child has a temperature of 101°F (38.3°C) is to encourage the child to rest and increase fluid intake, which is option B. This response aligns with the initial management of a low-grade fever in a child. Encouraging rest helps the body conserve energy to fight off the infection causing the fever, while increasing fluid intake helps prevent dehydration, which is common with fevers. By following this approach, the child's body can better regulate its temperature and aid in the recovery process. Option A is not the best choice as waiting for 24 hours without taking any action may lead to the child's condition worsening if there is an underlying infection. Administering acetaminophen (Option C) should only be done if the child is uncomfortable or if the fever is high. Suggesting a visit to the emergency department (Option D) is premature for a low-grade fever without any other concerning symptoms. Educationally, it is crucial for nurses to understand the initial management of fevers in pediatric patients. Teaching parents about home care measures can empower them to support their child's recovery and know when further medical intervention is necessary. It is essential for nurses to provide evidence-based guidance to promote the well-being of pediatric patients.

Correct Answer: C

Rationale: In pediatric respiratory assessment nursing, understanding the underlying pathophysiology of conditions like type 1 diabetes is crucial for providing comprehensive care. The correct answer is C) Autoimmune destruction of the insulin-producing cells in the pancreas. Type 1 diabetes is an autoimmune condition where the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This results in a lack of insulin production, leading to high blood sugar levels. Option A) Insulin resistance is more commonly seen in type 2 diabetes, where the body's cells do not respond effectively to insulin. Option B) Impaired glucose production is not characteristic of type 1 diabetes, as the primary issue lies in the destruction of insulin-producing cells rather than impaired glucose production. Option D) Insulin overproduction is not a feature of type 1 diabetes, as the condition is characterized by insulin deficiency. Educationally, understanding the specific pathophysiology of type 1 diabetes is essential for nurses to provide appropriate education to pediatric patients and their families. By explaining the autoimmune nature of the disease, nurses can emphasize the importance of insulin therapy and monitoring to manage blood sugar levels effectively and prevent complications. This knowledge also informs nursing interventions and helps tailor care plans to meet the unique needs of children with type 1 diabetes.

Correct Answer: C

Rationale: In caring for a child diagnosed with meningitis, an altered level of consciousness (Option C) would be the most concerning assessment finding for the nurse. Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. When a child with meningitis experiences an altered level of consciousness, it can indicate increased intracranial pressure or neurological compromise, which can be life-threatening and require immediate intervention. Option A, headache, is a common symptom of meningitis but may not be as concerning as an altered level of consciousness. Option B, nausea and vomiting, can also occur with meningitis but are more general symptoms. Option D, neck stiffness, is another classic sign of meningitis (meningismus) but, while important, may not be as immediately alarming as a change in level of consciousness. Educationally, this question highlights the critical assessment skills required when caring for pediatric patients with meningitis. Nurses need to prioritize and recognize the most severe symptoms that require prompt intervention to prevent complications and ensure the best outcomes for their patients.