Which child does not need a urinalysis to evaluate for a UTI?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) An 8-year-old male with a history of ureteral reimplantation but no current symptoms, who does not need a urinalysis to evaluate for a UTI. This is because the child is asymptomatic and his history of ureteral reimplantation is likely the reason for routine follow-up. Option A) is incorrect as the 4-month-old female presents with symptoms suggestive of a UTI, making a urinalysis necessary. Option B) is incorrect as the 4-year-old female's symptoms of dysuria and frequent urination warrant further evaluation with a urinalysis. Option D) is incorrect as the 12-year-old female's symptoms of lower right back pain and fever also indicate the need for a urinalysis to rule out a UTI or other urinary issues. Educationally, understanding when to order diagnostic tests like a urinalysis is crucial in pediatric nursing practice. It is essential to differentiate between symptomatic and asymptomatic patients, considering their history and current presentation to provide appropriate care and interventions.

Correct Answer: C

Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. The other options are not recommended practices: placing the child in a prone position is not ideal for immunization administration, it is beneficial to have the caregiver present for support, and aspirating before administering the immunization is not required for intramuscular injections in current practice.

Correct Answer: C

Rationale: In this scenario, the correct action for the school nurse to take first when a school-age child experiences a tonic-clonic seizure while seated in a chair is to assist the child to a side-lying position on the floor (Option C). This is because placing the child in a side-lying position helps prevent aspiration and ensures an open airway, reducing the risk of injury during the seizure. Option A (Clear the immediate area around the child of hazardous objects) is important but not the first priority when a child is actively seizing, as the immediate safety and well-being of the child take precedence. Option B (loosen the child’s restrictive clothing) may be helpful after the child is in a safe position, but it is not the priority during an ongoing seizure. Option D (apply an oxygen mask to the child) is not necessary during a seizure unless respiratory distress occurs after the seizure ends. Educationally, it is crucial for nurses to prioritize actions during emergency situations like seizures, ensuring the safety and well-being of the child. Understanding the correct sequence of interventions can prevent complications and promote optimal outcomes for pediatric patients.

Correct Answer: B

Rationale: In preparing an adolescent for a lumbar puncture, the correct action for the nurse to take is to apply topical analgesic cream to the site one hour prior to the procedure (Option B). This is because the application of topical analgesic cream helps to numb the area, reducing the pain and discomfort the adolescent may experience during the procedure. It promotes a more comfortable experience and can help alleviate anxiety in the adolescent. Option A, placing a cardiac monitor on the adolescent prior to the procedure, is incorrect as a cardiac monitor is not typically required for a lumbar puncture in this context. Option C, keeping the adolescent in a semi-Fowler's position for 4 hours following the procedure, is also incorrect as maintaining a supine position is usually recommended to prevent complications post-procedure. Option D, restricting fluids for 2 hours following the procedure, is incorrect as maintaining hydration is important to prevent complications such as post-lumbar puncture headache. In an educational context, understanding the rationale behind each action is crucial for pediatric nurses to provide safe and effective care to their patients. Teaching the importance of proper preparation, including pain management strategies like applying topical analgesic cream, helps nurses optimize the patient experience and outcomes during procedures like lumbar punctures.

Correct Answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis.