The healthcare provider is preparing to suture a 10-year-old with a lacerated forehead. Both parents and the 12-year-old sibling are at the child's bedside. Which instruction best supports the family?

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.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Assess bilirubin level. Neonatal jaundice is a common condition in newborns due to the breakdown of fetal red blood cells and the immature liver's inability to effectively process bilirubin. Assessing the bilirubin level is crucial to determine the severity of jaundice and guide appropriate interventions. Option B) Administer phototherapy is a common treatment for neonatal jaundice, but it should not be the first step without assessing the bilirubin level first. Option C) Encouraging feeding to help reduce bilirubin levels is not the immediate action needed in this case. While breastfeeding can help with the elimination of bilirubin, it is not the primary intervention when jaundice is already present. Option D) Performing a bilirubin test every hour is excessive and not necessary. Monitoring bilirubin levels is important, but the frequency of testing should be based on the healthcare provider's assessment. Educationally, understanding the pathophysiology of neonatal jaundice, the importance of timely assessment, and appropriate interventions is crucial for nurses caring for newborns. This case highlights the significance of prioritizing assessments and interventions based on the clinical situation to provide safe and effective care for neonates.

Correct Answer: A

Rationale: Encouraging parents to help the child with homework is beneficial as it fosters independence and academic skills. This involvement allows the child to receive the necessary support and guidance while still actively participating in their academic responsibilities, promoting a sense of accomplishment and skill development.

Correct Answer: A

Rationale: When preparing to measure the fundal height of a pregnant client, it is crucial to have the client empty her bladder before the procedure. This is the correct action because a full bladder can impede accurate fundal height measurement by pushing the uterus upwards, leading to an incorrect assessment. Option B is incorrect because lying on the left side is not necessary for fundal height measurement. Option C, performing Leopold's maneuvers first, is also incorrect as these maneuvers are used to determine fetal position and presentation, not for fundal height measurement. Option D, giving the client cold juice to drink, is incorrect as it is not relevant to the fundal height measurement process. In an educational context, students must understand the importance of preparing the client appropriately for fundal height measurement to ensure accurate assessment of fetal growth and development. Emphasizing the significance of a standardized procedure, including bladder emptying, can help students develop the necessary skills for effective maternity care.

Correct Answer: D

Rationale: The correct answer to this question is D) Do you have a history of rheumatic fever? This is the most important question for the LPN/LVN to ask the client because the symptoms described - pedal edema, dyspnea, fatigue, and a moist cough - are indicative of cardiac issues, specifically heart failure. Rheumatic fever is a known risk factor for the development of rheumatic heart disease, which can lead to heart failure during pregnancy. Option A) Which symptom did you experience first? While understanding the progression of symptoms can provide some insight, it is not as crucial as identifying a potential underlying cardiac condition. Option B) Are you eating large amounts of salty foods? While dietary habits can contribute to edema and other symptoms, in this case, the symptoms presented are more likely related to a cardiac issue rather than dietary choices. Option C) Have you visited a foreign country recently? This question is not relevant to the symptoms described and does not address the immediate concern of cardiac involvement. In an educational context, it is essential for healthcare providers to be able to recognize and assess symptoms that may indicate serious conditions during pregnancy. Understanding the significance of a client's medical history and risk factors is crucial in providing appropriate care and interventions to ensure the well-being of both the mother and the baby.