The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse?

Correct Answer: C

Rationale: The best approach by the nurse in this scenario is option C: Discuss with him how his body is always in the process of making blood. This response is the most appropriate because it addresses the child's fear of losing blood by providing education about the body's natural process of blood regeneration, which can help alleviate his concerns and anxiety. Option A (Explain that it will not be painful) is incorrect because it does not directly address the child's fear of losing blood, which is the primary issue at hand. Option B (Suggest to him that he not worry about losing just a little bit of blood) minimizes the child's feelings and does not provide adequate reassurance. Option D (Tell the child that he will not even need a Band-Aid afterward because it is a simple procedure) focuses on the aftermath of the procedure rather than addressing the child's fear beforehand. In an educational context, it is crucial for nurses to communicate effectively with pediatric patients to help them understand and cope with medical procedures. Providing age-appropriate explanations and reassurance can help build trust and cooperation with young patients, ultimately enhancing the quality of care provided.

Correct Answer: C

Rationale: The most appropriate method to collect small amounts of urine for frequent specific gravity tests on a 6-month-old infant is option C, which is to aspirate urine from cotton balls inside the diaper with a syringe without a needle. This method is preferred because it allows for a clean and uncontaminated sample to be obtained without interfering with the infant's normal diapering routine. Aspirating urine from cotton balls inside the diaper ensures that the sample is not diluted or contaminated by the diaper material. Option A, using a urine collection bag, may lead to contamination of the urine sample with the adhesive or other materials in the bag. Option B, taping a small medicine cup inside the diaper, may also contaminate the sample with the cup material or interfere with the diaper's function. Option D, using a syringe without a needle to aspirate urine from a superabsorbent disposable diaper, is not ideal as the superabsorbent material may interfere with the accuracy of the urine sample. Educationally, understanding the appropriate methods for collecting urine samples in infants is crucial for nurses caring for pediatric patients. It ensures accurate test results and minimizes the risk of contamination, leading to better clinical decision-making and patient care.

Correct Answer: C

Rationale: The correct answer is C) Withdraw a blood sample equal to the amount of fluid in the device, discard, and then withdraw the sample needed. This procedure is appropriate because it helps prevent dilution of the blood sample with IV fluids, which could lead to inaccurate test results. By discarding the initial sample equal to the device's volume, the subsequent sample obtained will provide an accurate representation of the child's blood composition. Option A is incorrect because performing a new venipuncture would not address the issue of potential dilution of the blood sample with IV fluids. Option B is incorrect as interrupting the IV fluid could also lead to inaccurate results due to changes in the child's fluid balance. Option D is incorrect because flushing the line with saline before aspirating the blood may still result in sample dilution. In an educational context, it is essential for nurses caring for pediatric patients with central venous access devices to understand the importance of obtaining accurate blood samples for diagnostic tests. Proper technique in blood sample collection ensures the reliability of test results, which directly impacts patient care and treatment decisions. This knowledge helps nurses deliver safe and effective care to children with complex medical needs.

Correct Answer: C

Rationale: In pediatric nursing, administering bitter medications to infants and small children can be challenging. The correct method of mixing the medication with something sweet-tasting, such as jam (Option C), is appropriate because it helps mask the bitter taste, making it more palatable for the child. Sweet tastes are generally more appealing to children, and mixing the medication with jam can help increase compliance with medication administration. Option A, mixing with a bottle of formula or milk, is not ideal as it may affect the absorption of the medication or alter the consistency of the feed, leading to potential feeding issues. Option B, mixing with any food the child is going to eat, may not effectively mask the bitter taste of the medication and can lead to aversion to that particular food in the future. Option D, mixing with a carbonated beverage over crushed ice, is not recommended as it may not effectively mask the bitterness and introduces unnecessary elements that could potentially cause gastrointestinal upset in children. Educationally, understanding the importance of appropriate medication administration techniques in pediatric patients is crucial for nursing care. It ensures effective treatment outcomes, minimizes medication aversion in children, and promotes safe and accurate medication administration practices in pediatric nursing settings.

Correct Answer: B

Rationale: The correct answer is B) Free of significant nerves and vascular structures. The ventrogluteal muscle is preferred as an injection site in young children because it is relatively free of major nerves and blood vessels, reducing the risk of accidental injury during the injection. This site provides a safe and effective option for administering medications to pediatric patients. Option A) Easily accessible from many directions is incorrect because while the ventrogluteal muscle is accessible, the primary advantage lies in its safety due to the absence of major nerves and vessels. Option C) Can be used until the child reaches a weight of 9 kg (20 lb) is incorrect because the suitability of the ventrogluteal site is not determined by the child's weight but rather by the muscle mass and development at the site. Option D) Increased subcutaneous fat, which provides sustained drug absorption is incorrect as the advantage of the ventrogluteal site is not related to fat thickness but rather to the safety of the muscle site for injections. Understanding the anatomical considerations of injection sites in pediatric patients is crucial for safe and effective nursing care. Educators should emphasize the importance of selecting appropriate injection sites based on anatomical landmarks to prevent complications and ensure optimal medication delivery in children.