An adolescent with a chronic illness expresses frustration in managing the unceasing
treatment regimen. Which of the following suggestions is MOST appropriate to discuss
with the child and caregiver?
A) explain to the adolescent the potential consequences of non-adherence
B) encourage the caregiver to assume primary control of disease management
C) encourage shifting the responsibility from the child to the caregiver on occasion
D) allow a short-term holiday from treatment while maintaining contact with the health
care provider
,Give this one a try later!
C) encourage shifting the responsibility from the child to the caregiver on
occasion
Rationale: Ongoing motivation to adhere to a regimen is difficult. Encouraging
temporary shifting of responsibility is a strategy that provides an important
respite. Foregoing treatment options, even for a short time, is not acceptable
as this places the child's health at risk. Although the child does need to
understand the implications of the disease, explaining the consequences of
non-adherence does not typically foster compliance in adolescents. The
adolescent's independence in self-management is the key to close control
and should be encouraged with appropriate support.
For a school-age child who is dying, which approach BEST encourages the child to
convey emotional needs?
A) arrange for peer visits to promote opening up to friends
B) ask straightforward questions regarding how the child is feeling
C) provide opportunities for the child to express feelings through play and art
D) have caregiver discuss feelings and share the child's responses with the healthcare
team
Give this one a try later!
C) provide opportunities for the child to express feelings through play and art
Rationale: For many children, talking about their feelings is difficult. Direct
questions regarding their emotions often prove to be more stressful than
therapeutic for children. Instead, use of books, games, art, play and music
provide a means of stimulating dialog and is an effective technique to
communicate with a dying child. For example, asking a child to draw a self-
portrait can be especially enlightening as it enables the child to express
feelings in a nonverbal format and may open up conversation as the child
explains the drawing. It's important to be accepting of whatever emotion is
expressed. Any questions asked by the child should be answered honestly
and accurately at the child's developmental level. Communicating with
, caregivers and encouraging peer visits are appropriate interventions, but not
the best approach for determining the child's emotional needs.
When caring for a child following a head injury, which of the following findings is of
MOST concern?
A) bruising behind the ear
B) episode of vomiting
C) frontal hematoma
D) somnolence
Give this one a try later!
A) bruising behind the ear
Any child who sustains a head injury should receive a medical evaluation to
rule out a skull fracture, brain injury, or other complications. After initial
physical exam, if there was no loss of consciousness with the head injury, the
child can typically be observed at home. It is imperative to be able to
recognize signs and symptoms of severe injury and those requiring follow-up
evaluation. Periauricular bruising is typically not a result of direct injury to the
ear. Instead, it is often indicative of a basilar skull fracture. Other signs of skull
fracture include periorbital ecchymoses (raccoon eyes) and clear rhinorrhea
or otorrhea. Clear drainage from the nose or ears may be cerebrospinal fluid
(CSF) leakage from the fractured skull. CSF can be differentiated from mucus
by its high glucose content determined by test strip analysis. However,
glucose testing of bloody drainage is not effective for determining the
presence of CSF since blood also contains glucose. Frank blood can be
differentiated from drainage containing both blood and CSF through a halo
test. When blood is dropped onto a gauze or a cloth sheet, if it contains CSF,
a halo of clear fluid will form around the
drop of blood. Determination of the presence of a basilar skull fracture is
imperative, since this injury places a child at high risk for meningitis and
cerebrovascular accident. A frontal hematoma is a superficial collection of
blood following injury to the forehead. It can be treated with ice and
elevation of the head. Somnolence and a single episode of vomiting are to be
expected following acute head trauma and are consistent with minor injury.
The child should be monitored for signs of increasing intracranial pressure,
, which would warrant concern. These include deterioration in level of
consciousness, bulging fontanel, high-pitched cry, or changes in vital signs.
You are bathing a 2-year-old when you notice a red area on their back that resembles a
bulls-eye with a red outer ring, a central area of clearing, and a red center. You know that
this is caused by:
A) Tick bite
B) Black widow spider
C) Mosquito
D) Brown recluse spider
Give this one a try later!
A) Tick bite
Rationale: A painless red rash that starts as a red macule or papule and
expands over days or weeks. It may have a bull's eye appearance or it may
look like a bruise in a darker skin person
(Ball, Bindle, & Cowan, 2015). Domain: Infectious Disease
When an infant is admitted for failure to thrive, which is the PRIORITY family assessment?
A) current housing status
B) family financial situation
C) educational level of the primary caregiver
D) family member who has the most authority
Give this one a try later!
treatment regimen. Which of the following suggestions is MOST appropriate to discuss
with the child and caregiver?
A) explain to the adolescent the potential consequences of non-adherence
B) encourage the caregiver to assume primary control of disease management
C) encourage shifting the responsibility from the child to the caregiver on occasion
D) allow a short-term holiday from treatment while maintaining contact with the health
care provider
,Give this one a try later!
C) encourage shifting the responsibility from the child to the caregiver on
occasion
Rationale: Ongoing motivation to adhere to a regimen is difficult. Encouraging
temporary shifting of responsibility is a strategy that provides an important
respite. Foregoing treatment options, even for a short time, is not acceptable
as this places the child's health at risk. Although the child does need to
understand the implications of the disease, explaining the consequences of
non-adherence does not typically foster compliance in adolescents. The
adolescent's independence in self-management is the key to close control
and should be encouraged with appropriate support.
For a school-age child who is dying, which approach BEST encourages the child to
convey emotional needs?
A) arrange for peer visits to promote opening up to friends
B) ask straightforward questions regarding how the child is feeling
C) provide opportunities for the child to express feelings through play and art
D) have caregiver discuss feelings and share the child's responses with the healthcare
team
Give this one a try later!
C) provide opportunities for the child to express feelings through play and art
Rationale: For many children, talking about their feelings is difficult. Direct
questions regarding their emotions often prove to be more stressful than
therapeutic for children. Instead, use of books, games, art, play and music
provide a means of stimulating dialog and is an effective technique to
communicate with a dying child. For example, asking a child to draw a self-
portrait can be especially enlightening as it enables the child to express
feelings in a nonverbal format and may open up conversation as the child
explains the drawing. It's important to be accepting of whatever emotion is
expressed. Any questions asked by the child should be answered honestly
and accurately at the child's developmental level. Communicating with
, caregivers and encouraging peer visits are appropriate interventions, but not
the best approach for determining the child's emotional needs.
When caring for a child following a head injury, which of the following findings is of
MOST concern?
A) bruising behind the ear
B) episode of vomiting
C) frontal hematoma
D) somnolence
Give this one a try later!
A) bruising behind the ear
Any child who sustains a head injury should receive a medical evaluation to
rule out a skull fracture, brain injury, or other complications. After initial
physical exam, if there was no loss of consciousness with the head injury, the
child can typically be observed at home. It is imperative to be able to
recognize signs and symptoms of severe injury and those requiring follow-up
evaluation. Periauricular bruising is typically not a result of direct injury to the
ear. Instead, it is often indicative of a basilar skull fracture. Other signs of skull
fracture include periorbital ecchymoses (raccoon eyes) and clear rhinorrhea
or otorrhea. Clear drainage from the nose or ears may be cerebrospinal fluid
(CSF) leakage from the fractured skull. CSF can be differentiated from mucus
by its high glucose content determined by test strip analysis. However,
glucose testing of bloody drainage is not effective for determining the
presence of CSF since blood also contains glucose. Frank blood can be
differentiated from drainage containing both blood and CSF through a halo
test. When blood is dropped onto a gauze or a cloth sheet, if it contains CSF,
a halo of clear fluid will form around the
drop of blood. Determination of the presence of a basilar skull fracture is
imperative, since this injury places a child at high risk for meningitis and
cerebrovascular accident. A frontal hematoma is a superficial collection of
blood following injury to the forehead. It can be treated with ice and
elevation of the head. Somnolence and a single episode of vomiting are to be
expected following acute head trauma and are consistent with minor injury.
The child should be monitored for signs of increasing intracranial pressure,
, which would warrant concern. These include deterioration in level of
consciousness, bulging fontanel, high-pitched cry, or changes in vital signs.
You are bathing a 2-year-old when you notice a red area on their back that resembles a
bulls-eye with a red outer ring, a central area of clearing, and a red center. You know that
this is caused by:
A) Tick bite
B) Black widow spider
C) Mosquito
D) Brown recluse spider
Give this one a try later!
A) Tick bite
Rationale: A painless red rash that starts as a red macule or papule and
expands over days or weeks. It may have a bull's eye appearance or it may
look like a bruise in a darker skin person
(Ball, Bindle, & Cowan, 2015). Domain: Infectious Disease
When an infant is admitted for failure to thrive, which is the PRIORITY family assessment?
A) current housing status
B) family financial situation
C) educational level of the primary caregiver
D) family member who has the most authority
Give this one a try later!
