Question 1

A 2-year-old child is diagnosed with lead poisoning caused by eating paint chips from a windowsill. What measure should the nurse instruct the parents to prevent this from occurring in the future?

Accepted Answer

Active interventions need to begin to prevent further lead exposure such as removal of the child from the environment containing the lead source or removal of the source of lead from the child's environment. Removal of the lead source is not an easy task in homes because simple repainting or wallpapering does not necessarily remove the source of peeling paint adequately. After some months, the new paint will begin to peel because of the defective paint underneath. The walls must therefore be covered by paneling or dry wall or other solid protective material. The child is 2 years old and will not understand that paint is not edible. Milk products will not prevent future episodes of lead poisoning. Syrup of ipecac will not help with the metabolism of lead from paint chips.

Question 2

A child with a head injury is demonstrating signs of cognitive deficits. The parents are concerned about how well the child will recover. Which nursing diagnosis should the nurse identify as the most appropriate for the family at this time?

Accepted Answer

The parents are concerned if the child will recover. The most appropriate nursing diagnosis would be parental fear related to outcome after head injury. The parents are not demonstrating anxiety related to the hospitalization. Even though the child is demonstrating cognitive deficits at this time, this can change. The recovery from a head injury is unpredictable so deficits can resolve. The parents are not providing care to the child at this time, so there is no evidence of ineffective coping related to the care of a child with a head injury.

Question 3

An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?

Accepted Answer

In the emergency department, acetylcysteine, a mucolytic agent and also the specific antidote for acetaminophen poisoning, will be administered. Acetylcysteine prevents hepatotoxicity by binding with the breakdown product of acetaminophen so that it will not bind to liver cells. Iron, deferoxamine, and dexamethasone are not used as antidote for acetaminophen poisoning.

Question 4

The nurse is completing the health history for the parents of school-age child admitted with a ruptured spleen. For which activity should the nurse assess as the possible cause for this child's injury?

Accepted Answer

In children, the spleen is the most frequently injured organ when there is abdominal trauma. Frequent causes of injury include skateboard accidents. Injuries to the spleen are not associated with shooting pool or playing baseball or basketball.

Question 5

Before discharging a school-age child being treated for a snake bite, the nurse instruct ways to prevent additional bites in the future. Which statement indicates that teaching provided to this child has been effective?

Accepted Answer

Common safety rules to avoid snake bites include being aware that snakes like to sit in the sun on warm rocks. The child should look at a rock before touching it to prevent a snake bite. Wearing long pants will not necessarily prevent snake bits. Snakes should not be poked or sprayed with water. Snakes should be identified in underbrush and under rocks. Snakes should also be identified by sound and markings.

Question 6

A school-age child comes into the emergency clinic complaining of knee pain that started while playing soccer. What will the nurse most likely observe when assessing this child's knee?

Accepted Answer

Participation in sports such as soccer is a frequent cause of knee injuries in children and usually involves the ligaments surrounding the knee. Immediately after the injury, the child reports severe pain in the knee, and localized edema becomes evident. Erythema, contusions, and mottled skin are not associated with a knee injury caused by participation in a sport.

Question 7

A preadolescent child sprains the right ankle while inline skating. What should the nurse instruct the child and parents about the care that the child will need at home? (Select all that apply.)

Accepted Answer

Interventions to help with a sprain include applying ice pack for 20-minute intervals, applying ice pack on the site for 4 to 7 days, wrapping with an elastic bandage, and using crutches to walk for 3 to 4 days after the injury. Heat is not applied to a sprain.

Question 8

A child with extensive burns is permitted to eat. Which nutrient should the nurse ensure is of a high amount when the child's meals are being prepared?

Accepted Answer

To supply adequate calories for increased metabolic needs and spare protein for repair of cells after a burn injury, the diet is high in calories and protein. The diet does not need to be high in fat, minerals, or carbohydrates.

Question 9

The nurse calculates that a child with a burn injury is to receive 3,600 ml of intravenous fluid over the next 24 hours. How much of this fluid should the nurse provide to the patient during the first 8 hours?

Accepted Answer

Fluid is administered rapidly for the first 8 hours after the injury or half of the 24-hour load and then more slowly for the next 16 hours or the second half. If the child is to receive 3,600 ml of fluid over 24 hours, half of the amount, or 1,800 ml, should be infused over the first 8 hours. The remaining 1,800 ml should be infused over the next 16 hours.

Question 10

The nurse notes that a child with a burn injury is prescribed daily debridement. What should the nurse instruct the child and parents about the purpose of this treatment?

Accepted Answer

Debridement is the removal of necrotic tissue on which microorganisms could thrive from a burned area to reduce the possibility of infection. Debridement does not relieve pain but rather is a very painful procedure. Debridement does not influence extremity mobility. The need for skin grafts depends on the depth of the burned tissue.

Question 11

The school nurse is planning a presentation to be given during the next parent/teacher conference to include the 2020 National Health Goals to prevent unintentional injuries in children. What should the nurse include in this presentation? (Select all that apply.)

Accepted Answer

Nurses can help the nation achieve the 2020 National Health Goals to prevent unintentional injuries in children by providing counseling on safety precautions to parents and children and always help assess whether injuries were unintentional or could be child maltreatment or self-injury. The legal aspects of child abuse would not be appropriate for this presentation.

Question 12

The nurse is preparing to administer activated charcoal to a 4-year-old child who accidentally ingested a family member's heart medication. What should the nurse do to reduce the discomfort from this treatment?

Accepted Answer

Activated charcoal absorbs toxic substances that have been swallowed to prevent them from being absorbed by the stomach. The drug is provided as a powder that must be mixed with water, and not milk, and administered orally or through a nasogastric tube. The solution feels gritty and tastes disagreeable, so it may be difficult to swallow. A nasogastric tube will help decrease the child's discomfort when taking the medication. This medication does not require an indwelling urinary catheter or intravenous infusion for fluid replacement.

Question 13

A school-age child is brought to the emergency department after being hit in the mouth with a baseball bat during Little League. The child has lost two deciduous teeth, and one permanent front tooth is loose. What care should the nurse prepare to provide to this patient? (Select all that apply.)

Accepted Answer

With dental fractures, deciduous teeth may not be replaced. If the blow to the teeth was extensive, an X-ray may be done to ensure that the upper or lower jaw is not fractured. The patient will be prescribed an oral antibiotic. The jaw does not need to be wired shut unless it is fractured. A chest X-ray would be done if the missing teeth are unaccountable.

Question 14

The nurse is caring for a preschool-age child who survived near drowning. Which interventions should the nurse plan to promote optimum respiratory functioning for this patient? (Select all that apply.)

Accepted Answer

After a near drowning, the child should be turned every 2 hours. The child is usually prescribed prophylactic antibiotic therapy to prevent pneumonia. Lung sounds should be auscultated frequently for adventitious sounds. Deep breathing and incentive spirometry should be encouraged every hour help to aerate the lungs fully and prevent the accumulation of fluid, which promotes infection. Monitoring cardiac rhythm and blood pressure are not interventions specifically for respiratory functioning.

Question 15

A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time?

Accepted Answer

Objects that do not digest such as batteries need to be removed by endoscopy as soon as possible because they can lead to bowel perforation or volvulus from the acid within the object. Activated charcoal is used for accidental poisoning. The child is not demonstrating signs of respiratory distress and will not need oxygen or emergency intubation.

Quiz 52: Nursing Care of a Family When a Child Has an Unintentional Injury