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During the course of treatment a toddler is to receive an intramuscular injection.
What is the priority nursing intervention that should be included in the plan of
care to comfort the child?
1
Distracting the toddler's attention with a toy car
2
Telling the parents exactly what will be done to the toddler
3
Giving the toddler the choice of having the injection now or later
4
Involving the parents in comforting the toddler after the injection ---------CORRECT
ANSWER-----------------4
The parents are the most significant people in the young child's life, and their
involvement in comforting the child is the most supportive intervention for the
toddler. Distraction does not provide an outlet for the toddler's feelings.
Explaining the procedure to the parents does not comfort the child. Offering
choices for the toddler is incorrect because this type of choice is not a viable
option; the medication must be administered as prescribed.
,A preterm newborn is admitted to the neonatal intensive care unit (NICU). Which
concern is most commonly expressed by NICU parents?
1
Fear of handling the infant
2
Delayed ability to bond with the infant
3
Prolonged hospital stay needed by the infant
4
Inability to provide breast milk for the infant ---------CORRECT ANSWER---------------
--1
Because these infants are so tiny and frail, parents most commonly fear
handling or touching them; they should be encouraged to do so by the NICU
staff. The primary concern is the infant's fragility, not bonding; however,
bonding should be encouraged. Although there may be concerns about a long
hospital stay, they are not commonly expressed by mothers. The primary
concern is the infant's fragility, not breast-feeding. Breasts may be pumped and
breast milk given in gavage feedings.
A father asks a nurse for strategies to convince his 5-year-old to wear a helmet
while bicycling. What should the nurse suggest to the father?
1
"You should forbid your child from riding a bicycle."
2
"You should wear your helmet while riding your bicycle."
3
,"You should limit your child's bicycling to a defined area."
4
"You should tell your child about the risks associated with not wearing a helmet."
---------CORRECT ANSWER-----------------2
The nurse should suggest the father to wear a helmet when he rides his bicycle.
This sets a positive example for the child to wear his or her helmet. Restricting
the child will interfere with the cognitive development. Limiting the child's
bicycling to a defined area may lead to conflicts between the father and the
child. Telling the child about the risks of not wearing a helmet may interfere
with the child's willingness to ride.
After a difficult labor a client gives birth to a 9-lb (4 kg) boy who expires shortly
afterward. That evening the client tearfully describes to the nurse her projected
image of her son and what his future might have been. What is the nurse's most
therapeutic response?
1
"I guess you wanted a son very much."
2
"It must be difficult to think of him now."
3
"I'm sure he would have been a wonderful child."
4
"If you dwell on this now, your grief will be harder to bear." ---------CORRECT
ANSWER-----------------2
Stating that it must be difficult to think of him now demonstrates empathy; the
nurse is attempting to show understanding of the client's feelings. Stating that
the patient must have wanted a son very much is nontherapeutic; the nurse has
, no way of knowing this. Stating the certainty that the infant would have been a
wonderful child switches the focus away from the client, whose needs should be
met at this time. Stating that dwelling on the death will make her grief harder to
bear denies the client's feelings and implies that the client should curb painful
emotions.
At 1 am a 28-month-old toddler is admitted to the pediatric unit with suspected
meningitis. At 3 am, after the child is settled in, the mother tells the nurse, "I have
to leave now, but whenever I try to go my child gets upset and then I start to cry."
What is the best action by the nurse?
1
Walking the mother to the elevator
2
Encouraging the mother to spend the night
3
Staying with the child while the mother leaves
4
Telling the mother to wait until the child falls asleep ---------CORRECT ANSWER-----
------------3
Staying with the child enables the mother to leave and reassures her and the
child that someone will be with and comfort the child. The mother has indicated
that she is upset when the child is upset; walking the mother to the elevator
meets neither the mother's nor the child's needs. The mother has said she must
leave; trying to persuade her to stay will make her feel guilty about having to
leave. Telling the mother to leave after the child is asleep is a dishonest
solution; the child should be aware that the mother is leaving and reassured in
terms that a toddler will understand that she will return.