Which nursing actions are appropriate when providing care to a toddler-aged patient who is restrained to protect an incision after a surgical procedure? Select one that does not apply.

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Question 1 of 5

Which nursing actions are appropriate when providing care to a toddler-aged patient who is restrained to protect an incision after a surgical procedure? Select one that does not apply.

Correct Answer: C

Rationale: Least restrictive methods , proper orders , activities , and hygiene checks ensure safety and development. Removal every 4 hours is too infrequent; every 2 hours is standard.

Question 2 of 5

Which form of CAM therapy can easily be mistaken for child abuse because of the lingering marks on the skin after treatment?

Correct Answer: C

Rationale: Coin rubbing (C), or 'Cao-gio,' leaves skin marks that mimic abuse. Reflexology (A), Ayurveda (B), and acupressure (D) don’t typically mark skin. Document: 'Coin rubbing… can easily be mistaken for child abuse because of the lingering marks.'

Question 3 of 5

Lori weight at birth was 7lbs. Now she is 14lbs. She can sit alone and completely turn over. She often bangs her rattler on the table. Lori can pull to a sitting position and tolerate solid food.

Correct Answer: C

Rationale: At 6 months (C), infants double birth weight (7 to 14 lbs), sit briefly, roll over, bang objects, pull to sit, and start solids. Too early for 2 months (A), too late for 11/18 months (B, D). Document: 'At 6 months… double in birth weight… Sits alone momentarily… First solid food is introduced.'

Question 4 of 5

Because young children cannot express themselves well, the nurse uses the therapeutic intervention that allows children to act out their feelings, which is:

Correct Answer: B

Rationale: Play therapy (B) lets young children express feelings through play. Art (A), music (C), and bibliotherapy (D) are less suited for preverbal kids. Document: 'Play therapy allows a young child to act out… concerns.'

Question 5 of 5

The parents of a newborn are concerned that their son's scrotum is enlarged and swollen on one side. The nurse's best response would be:

Correct Answer: C

Rationale: A hydrocele (C), fluid in the scrotum, often resolves by 1 year. Size difference (A) is normal but not swollen, bruising (B) or blood (D) suggest hematoma, not fluid. Document: 'These signs are indicative of a hydrocele… [that] usually corrects itself in a year.'

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