While admitting an uncircumcised 4-year-old, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; she is unable to replace it over the head of the penis. What should she do?

Correct Answer: B

Rationale: Paraphimosis (tight foreskin impeding blood flow) requires immediate physician notification (B) to prevent tissue damage. Forcing the skin (A), waiting (C), or warm compresses (D) delay critical intervention. Document: 'Notify the physician immediately of the occurrence of paraphimosis… [it] can impede the blood flow.'

Correct Answer: C

Rationale: Bubble baths (C) irritate the urethra, increasing UTI risk, indicating misunderstanding. Front-to-back wiping (A), cotton underwear (B), and fluids/frequent voiding (D) prevent UTIs. Document: 'Oils in bubble baths… are known to irritate the urethra.'

Correct Answer: C

Rationale: Opioid addiction is rare in children when used for pain (C), reassuring parents with evidence. A overcomplicates, B minimizes, D shifts focus. Document: 'Addiction is rare in children.'

Correct Answer: D

Rationale: Peeling palms and soles (D) is a hallmark of Kawasaki disease’s convalescent phase. Respiratory distress (A), hyperlipidemia (B), and GERD (C) are unrelated. Document: 'The child with Kawasaki disease has… desquamation (peeling) of palms and soles.'

Correct Answer: D

Rationale: Frequent swallowing (D) post-tonsillectomy suggests bleeding, needing urgent follow-up. Pulse (A), BP (B), and nausea (C) are less specific. Document: 'Frequent swallowing… is an early sign of bleeding.'