NUR2262 - 1: Care of Women and Pediatric Client
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A nurse is teaching the parents of a toddler how to prevent accidental poisoning. Which of the following should be included in the teaching? (Select all that apply.)
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Keep Poison Control's number readily available
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Store medications in locked cabinets
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Tell children that medicine is candy so that they'll take it
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Ensure the caps stay on the medication bottles by adhering them with super glue
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Keep medications in their original containers
Explanation
Effective poison prevention teaching includes having emergency resources on hand, securing medications out of a toddler's reach in locked cabinets, and keeping medications in their original, labeled containers to avoid confusion or accidental ingestion of mislabeled substances.
Why the other options are incorrect:
C. Tell children that medicine is candy so that they'll take it: This is dangerous teaching, as it encourages children to view medication as a treat, increasing the risk they will seek out and ingest medications on their own.
D. Ensure the caps stay on the medication bottles by adhering them with super glue: Gluing caps shut would prevent access in a true emergency and does not represent standard or safe childproofing practice; child-resistant caps used correctly are the appropriate method.
A nurse in the emergency department is caring for a 3-year-old child whose parent reports finding an open bottle of drain cleaner next to the child. The child is drooling and refuses to swallow. Which action should the nurse take first?
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Induce vomiting with syrup of ipecac
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Assess the child's airway and prepare for possible airway compromise
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Offer the child milk to dilute the substance
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Administer activated charcoal as prescribed
Explanation
Drain cleaner is a caustic substance, and drooling with refusal to swallow suggests oropharyngeal or esophageal burns/swelling, which can rapidly compromise the airway. Following the ABC priority framework, the nurse's first action must be to assess and protect the airway.
Why the other options are incorrect:
A. Induce vomiting with syrup of ipecac — Inducing vomiting with a caustic substance is contraindicated, as it causes re-exposure of the esophagus to the corrosive agent and increases risk of aspiration and further tissue damage.
C. Offer the child milk to dilute the substance — Diluting a caustic ingestion is generally not recommended in current practice, especially before the airway is assessed and secured.
D. Administer activated charcoal as prescribed — Activated charcoal is not effective for and is contraindicated in caustic/corrosive ingestions; it also does not address the immediate airway threat.
Correct Answer Is:
B
The nurse is planning activities for an 8-year-old child hospitalized for pneumonia. Which activity is most appropriate?
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Playing with a musical mobile
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Reading a picture book with the parents
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Playing a board game with the parents
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Finger painting
Explanation
School-age children (6-12 years) are in Erikson's stage of industry versus inferiority and benefit from activities that involve rules, strategy, and cooperative or competitive play, such as board games, which match their cognitive and social developmental level.
Why the other options are incorrect:
A. Playing with a musical mobile is appropriate for an infant, not an 8-year-old, as mobiles are designed to stimulate visual and auditory senses in babies.
B. Reading a picture book with the parents is more suited to toddlers or preschoolers; an 8-year-old would benefit more from age-appropriate books or activities that engage their developing skills.
D. Finger painting is a sensory activity best suited to toddlers and preschoolers, not a school-age child who is capable of more complex, rule-based activities.
A nurse is preparing to administer 100 mg of gentamycin to an adolescent client. The pharmacy prepares the 100 mg of gentamycin in a 100 mL bag of fluid. The physician's order states to infuse the gentamycin over 30 minutes. What rate should the nurse set the IV pump at?
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200 mL/hr
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100 mL/hr
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50 mL/hr
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400 mL/hr
Explanation
Using the formula: Rate = Volume ÷ Time. The volume is 100 mL, and the time is 30 minutes (0.5 hours). Dividing 100 mL by 0.5 hours gives 200 mL/hr, which is the correct pump rate to infuse the full volume in 30 minutes.
Why the other options are incorrect:
B. 100 mL/hr — This rate would infuse the 100 mL bag over 60 minutes, not the ordered 30 minutes.
C. 50 mL/hr — This rate would take 2 hours to infuse the full bag, far exceeding the ordered infusion time.
D. 400 mL/hr — This rate would infuse the bag in only 15 minutes, which is faster than the ordered 30-minute infusion time.
Correct Answer Is:
A
A nurse is preparing to administer ceftriaxone 75 mg/kg/day IV divided into two equal doses to a child who weighs 44 lb. The pharmacy supplies ceftriaxone 1 g in 10 mL. How many mL should the nurse administer per dose? Round to the nearest tenth.
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15 mL
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7.5 mL
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150 mL
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75 mL
Explanation
Step 1: Convert weight to kg — 44 lb ÷ 2.2 = 20 kg Step 2: Calculate total daily dose — 75 mg/kg/day × 20 kg = 1,500 mg/day Step 3: Divide into two equal doses — 1,500 mg ÷ 2 = 750 mg per dose Step 4: Convert to volume using the concentration (1,000 mg/10 mL) — 750 mg ÷ 1,000 mg × 10 mL = 7.5 mL
The nurse should administer 7.5 mL per dose.
Why the other options are incorrect:
A. 15 mL — This would be the volume for the full daily dose (1,500 mg), not the divided per-dose amount.
C. 150 mL — This is significantly too high and does not correspond to a correct calculation based on the given concentration.
D. 75 mL — This would incorrectly represent 7,500 mg, far exceeding both the total daily dose and per-dose amount.
A nurse in the emergency department is assessing a 2-year-old child for suspected physical abuse. Which of the following findings should the nurse identify as possible indicators of maltreatment? (Select all that apply)
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Child appearing fearful of the nurse
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Small, nonuniform bruises on the shin
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Bruising on the torso in various stages of healing
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Caregiver reporting delay in seeking care for a serious injury
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Spiral fracture of the humerus with an inconsistent history
Explanation
These findings are recognized red flags for physical abuse: a fearful demeanor toward caregivers/providers, bruising on well-protected areas (torso) in multiple healing stages (suggesting repeated injury over time), delayed care-seeking for serious injuries, and fracture patterns (like spiral fractures) inconsistent with the reported mechanism of injury are all classic indicators used in abuse screening.
Why the other options are incorrect:
B. Small, nonuniform bruises on the shin — Bruising on the shins is common in active toddlers from normal accidental falls and bumps, and is not typically concerning for abuse on its own.
Correct Answer Is:
A, C, D, E
A nurse is caring for a school-aged child who begins having a tonic-clonic seizure upon returning to the hospital room from the playroom. Which action should the nurse take first?
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Time the length of the seizure
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Ease the child to the floor
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Obtain a portable suction machine
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Notify the child's parents
Explanation
The nurse's first priority is to ensure the child's immediate physical safety by easing them to the floor to prevent injury from a fall, before proceeding with other important but secondary actions.
Why the other options are incorrect:
A. Time the length of the seizure — Timing is important and should begin as soon as possible, but ensuring physical safety by getting the child safely to the floor takes precedence.
C. Obtain a portable suction machine — Suction equipment may be needed if the child vomits or has excess secretions, but is not the very first action when a seizure begins mid-fall risk.
D. Notify the child's parents — Notification is important but is not the priority over ensuring the child's immediate physical safety.
Two children arrive simultaneously to the emergency department.
Child 1: Barking cough, inspiratory stridor while crying, hoarse voice, temperature 38°C (100.4°F), drinking fluids
Child 2: Temperature 40°C (104°F), sitting upright leaning forward, drooling, muffled voice, inspiratory stridor at rest, refuses to swallow
Which child should the nurse assess first?
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Either child can be assessed first as neither is a priority
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Using a tongue blade, have both children simultaneously open their mouths to see which appears more swollen
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Child 2 because of the possible airway obstruction
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Child 1 because of the barking cough and inspiratory stridor
Explanation
Child 2's presentation — high fever, tripod positioning, drooling, muffled ("hot potato") voice, stridor at rest, and refusal to swallow — is classic for epiglottitis, a life-threatening airway emergency that can rapidly progress to complete airway obstruction. This child requires immediate assessment and airway management, taking priority over Child 1.
Why the other options are incorrect:
A. Either child can be assessed first as neither is a priority — This is incorrect, as Child 2's presentation represents an acute, life-threatening airway emergency requiring immediate priority.
B. Using a tongue blade, have both children simultaneously open their mouths to see which appears more swollen — Using a tongue blade to examine the throat in a child with suspected epiglottitis is contraindicated, as it can trigger complete airway obstruction/laryngospasm.
D. Child 1 because of the barking cough and inspiratory stridor — Child 1's symptoms (barking cough, stridor only with crying, mild fever, tolerating fluids) are consistent with croup, a less acutely dangerous condition compared to Child 2's presentation of suspected epiglottitis.
Which of the following is a milestone for a 5-year-old child?
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Tie shoelaces
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Feed self
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Ride a tricycle
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Walk along furniture
Explanation
Tying shoelaces is a fine motor milestone typically achieved around 5 years of age, reflecting the more advanced hand-eye coordination and dexterity developed by this age.
Why the other options are incorrect:
B. Feed self — This is achieved much earlier, typically around 12-18 months of age.
C. Ride a tricycle — This milestone is typically achieved earlier, around 3 years of age.
D. Walk along furniture (cruising) — This is an early gross motor milestone typically achieved around 9-12 months of age.
A nurse is preparing to administer an injection to a 4-year-old preschooler. Which action best supports Erikson's developmental stage?
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Allow the child to inject themselves.
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Ask the parent to leave the room.
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Tell the child to remain still so that it won't hurt.
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Allow the child to help place the bandage after the injection.
Explanation
The preschool age (3-6 years) corresponds to Erikson's stage of initiative versus guilt, during which children develop a sense of purpose through taking initiative in tasks. Allowing the child to participate by placing the bandage gives them a sense of control and accomplishment, supporting healthy development at this stage.
Why the other options are incorrect:
A. Allow the child to inject themselves: This is developmentally inappropriate and unsafe for a 4-year-old, as young children lack the fine motor skills and understanding to safely self-administer an injection.
B. Ask the parent to leave the room: Removing the parent can increase a preschooler's fear and anxiety; parental presence is generally supportive and recommended during procedures for this age group.
C. Tell the child to remain still so that it won't hurt: This does not support the child's developmental need for initiative and can increase fear rather than promote a sense of accomplishment or control.
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