Extract:

Question 1 of 5

A child has had a cast placed on his left arm following a diagnosed fracture. Which actions should the nurse take? (Select all that apply)

A. Smooth the rough edges of the cast to maintain skin integrityB. Wear sterile gloves when touching or removing the castC. Monitor capillary refill and color of nail beds of the left-handD. Monitor for signs of painE. Assess for numbness, tingling, or decreased sensation of the left hand.

Correct Answer: A,C,D,E

Rationale:
Choice A rationale: Smoothing the rough edges of the cast can help maintain skin integrity and prevent skin irritation or injury.
Choice C rationale: Monitoring capillary refill and color of nail beds of the left hand is important to assess the circulation to the hand and ensure that the cast is not too tight.
Choice D rationale: Monitoring for signs of pain can help detect complications such as compartment syndrome, which is a serious condition that can occur if pressure within the muscles builds to dangerous levels.
Choice E rationale: Assessing for numbness, tingling, or decreased sensation of the left hand is important as these can be signs of nerve damage or compression.
Choice B rationale: Wearing sterile gloves when touching or removing the cast is not typically necessary. The outside of a cast is not a sterile environment, and healthcare providers do not usually wear sterile gloves when handling it.

Question 2 of 5

A nurse is preparing a 4-year-old child for discharge following a bilateral myringotomy with tympanostomy tube placement. The mother asks what to do if the tubes fall out. Which of the following instructions should the nurse give the parent?

A. Gently reinsert the tubes.B. Call the health care clinic to report that the tubes have fallen out.C. Reassure the mother that the tubes will not fall out.D. Take the child to an emergency department.

Correct Answer: B

Rationale: It is not advisable for a parent to attempt to reinsert the tubes if they fall out. This could potentially cause harm to the child's ear. If the tubes fall out, the parent should call the healthcare clinic to report this. The healthcare provider can then decide on the appropriate next steps. It is not accurate to reassure the mother that the tubes will not fall out. Tympanostomy tubes are designed to fall out on their own after a certain period of time. Taking the child to an emergency department is not necessary unless there are signs of infection or other complications.

Question 3 of 5

A nurse in an urgent care clinic is assisting with the care of a toddler who ingested 30 tablets of aspirin. Which of the following substances should the nurse administer to the toddler?

A. Activated charcoalB. A chelating agentC. AcetylcysteineD. Digoxin immune FAB

Correct Answer: A

Rationale: Activated charcoal is often used in cases of drug overdose or poisoning, including aspirin ingestion. It works by binding to the drug or toxin in the stomach, preventing it from being absorbed into the body. This makes activated charcoal an effective treatment for aspirin overdose in a toddler. A chelating agent is a substance that can bind to heavy metals in the body, helping to remove them. While useful in cases of heavy metal poisoning, it would not be the first choice for an aspirin overdose. Acetylcysteine is an antidote for acetaminophen (Tylenol) overdose, not aspirin. It works by replenishing glutathione, a substance that helps to detoxify the liver. Digoxin immune FAB is used to treat digoxin toxicity. Digoxin is a medication used to treat heart conditions, and it is not related to aspirin.

Question 4 of 5

A nurse is caring for a 2-year-old child who has been diagnosed with nephrotic syndrome. The nurse collects data knowing that a common characteristic associated with nephrotic syndrome is:

A. HypotensionB. Generalized edemaC. Increased urinary outputD. Bright red blood in urine

Correct Answer: B

Rationale: Hypotension, or low blood pressure, is not typically associated with nephrotic syndrome. In fact, some patients with nephrotic syndrome may experience high blood pressure. Generalized edema, or swelling, is a common characteristic of nephrotic syndrome. It occurs due to the loss of proteins in the urine, which leads to a decrease in the amount of protein in the blood. This decrease in blood protein levels causes fluid to move from the blood vessels into the tissues, leading to swelling. Increased urinary output is not typically associated with nephrotic syndrome. In fact, some patients may experience decreased urine output. Bright red blood in the urine is not a typical symptom of nephrotic syndrome. Hematuria, or blood in the urine, when present in nephrotic syndrome, is usually microscopic and not visible to the naked eye.

Question 5 of 5

A nurse at a pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. Which of the following statements by the nurse is an appropriate response?

A. Follow the directions on the aspirin bottle for her age and weight.'B. She should be given acetaminophen, not aspirin.'C. Just be sure you administer the medication with food.'D. Give her no more than three baby aspirin every 4 hours.'

Correct Answer: B

Rationale: It's not advisable to follow the directions on the aspirin bottle for her age and weight. Aspirin is not recommended for use in children due to the risk of Reye's syndrome, a rare but serious condition that can affect the liver and brain. This is the correct response. Acetaminophen is a safer alternative to aspirin for managing fever in children. While it's generally a good idea to administer medication with food to prevent stomach upset, this advice does not address the specific risks associated with giving aspirin to a toddler. Giving a toddler three baby aspirin every 4 hours is not recommended due to the risk of Reye's syndrome.