The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?

Correct Answer: D

Rationale: The correct response, option D, is the best choice for the nurse to provide because it acknowledges the child's feelings of anger and helps the mother understand that this reaction is a common coping mechanism in response to a significant loss, such as an amputation. By validating the child's emotions and explaining that anger is a natural part of the grieving process, the nurse can help the mother support her child effectively during this challenging time. Option A is incorrect because immediately suggesting a psychiatric consult may not be necessary at this stage and could potentially escalate the situation. Option B is incorrect as it dismisses the child's feelings as just normal adolescent behavior, failing to address the underlying emotional distress. Option C is also incorrect as it overlooks the specific emotional response of anger and does not provide guidance on how to help the child cope with these feelings effectively. In an educational context, it is crucial for pediatric nurses to understand the emotional impact of medical interventions on children and adolescents. By recognizing and addressing their emotional responses, nurses can provide holistic care that supports not only their physical well-being but also their mental and emotional health during challenging times like dealing with an amputation.

Correct Answer: A

Rationale: In pediatric nursing, monitoring hydration status is crucial for managing conditions like dehydration. In this scenario, the best indicator that the child's dehydration is improving is option A) The child's urine output increases. When a child is dehydrated, their kidneys conserve water, leading to decreased urine output. As hydration improves, the kidneys start excreting more urine, indicating better fluid balance. Increased urine output is a reliable sign of improving hydration status in pediatric patients. Option B) The child's skin turgor is normal is not as reliable in children compared to adults. Skin turgor can be affected by various factors in children, making it a less specific indicator of hydration status. Option C) The child's weight increases may not be immediate and can fluctuate due to factors other than hydration, such as food intake or edema. Option D) The child's vital signs are stable is important but may not directly reflect hydration status. Vital signs can remain stable even in the presence of dehydration, especially in the early stages. Educationally, it's vital for pediatric nurses to understand the specific indicators of hydration status in children to provide optimal care. Emphasizing the significance of monitoring urine output as a key parameter in assessing hydration status can help nurses make informed clinical decisions and ensure positive patient outcomes.

Correct Answer: D

Rationale: A hemoglobin A1c of 10% indicates poor blood glucose control, reflecting an average blood sugar level over the past 2-3 months. To improve control, the plan of care should be comprehensive. Increasing the frequency of self-monitoring blood glucose helps track changes in blood sugar levels. Discussing dietary changes to reduce carbohydrate intake can aid in better blood sugar management. Reviewing the client's insulin administration technique ensures proper medication dosing. Therefore, all the options (increasing monitoring, discussing dietary changes, and reviewing insulin administration) are essential components of the plan of care to address the client's poor blood glucose control.

Correct Answer: A

Rationale: DTaP and IPV can be safely administered to a child with a mild illness like a cold, even if there is an immunocompromised family member, as these vaccines do not contain live viruses. It is important to ensure that the child is otherwise healthy and afebrile before administering the vaccines. The presence of a cold is not a contraindication for receiving DTaP and IPV vaccines.

Correct Answer: A

Rationale: By 6 months of age, infants typically achieve the milestone of rolling over completely. This ability demonstrates increasing strength and coordination. Creeping on all fours, pulling self to a standing position, and assuming a sitting position independently are skills that are usually developed at later stages of infancy.