A. Administering the insulin injection quickly to minimize discomfort. Administering an injection quickly may reduce discomfort, but it does not address the emotional and psychological aspects of atraumatic care. The goal is to minimize fear and distress, not just physical pain.

B. Explaining the procedure in simple terms to the client before administering the insulin. Providing a clear, age-appropriate explanation helps reduce anxiety and fosters trust between the child and the nurse. Understanding what to expect allows the child to feel a sense of control, which is a key principle of atraumatic care.

C. Asking the client to look away during the injection to reduce anxiety. While looking away may help some children, it does not promote understanding or involvement in their care. Instead, explaining the procedure allows the child to develop coping strategies and feel more secure.

D. Using a larger needle to ensure accurate insulin delivery. Insulin is administered using a small-gauge needle to minimize pain. A larger needle is unnecessary and could increase discomfort, contradicting the principles of atraumatic care.

A. "Since ADHD is genetic, we need to know if other family members have been diagnosed to determine if your child has it." While ADHD has a genetic component, a family history alone is not sufficient to diagnose the condition. A proper diagnosis requires a comprehensive evaluation, not just genetic predisposition.

B. "Your child will need a comprehensive evaluation, based on specific criteria including a detailed history and behavior assessment." ADHD diagnosis is based on clinical criteria from the DSM-5, which includes a thorough history, observation of symptoms in multiple settings, and standardized behavior assessments. This ensures an accurate and well-supported diagnosis.

C. "If your child shows symptoms of ADHD at home but not at school, they can still be diagnosed with ADHD." ADHD symptoms must be present in at least two different settings, such as home and school, to meet diagnostic criteria. If symptoms are only seen in one setting, another cause may be responsible for the child’s behavior.

D. "ADHD can be confirmed with a blood test, so we should schedule one for your child." There is no laboratory test, imaging, or biomarker that can diagnose ADHD. Diagnosis is based on behavioral criteria and clinical evaluation rather than medical testing.

A. Collect data on physical examination. The first priority in managing a suspected head injury is assessing the adolescent's neurological status, airway, breathing, circulation, and level of consciousness. A physical examination helps determine the severity of the injury and guides further interventions.

B. Administer pain medication to the adolescent. While pain management is important, administering medication before assessing neurological status could mask symptoms of worsening intracranial pressure, making it difficult to monitor changes in the adolescent’s condition.

C. Notify the adolescent's primary care provider. Informing the provider is necessary, but it should be done after an initial assessment to provide accurate information about the adolescent’s condition and guide appropriate interventions.

D. Collect a detailed past medical history. While medical history is valuable, it is not the immediate priority in an emergency. The primary concern is assessing the adolescent’s current condition to determine if there are signs of increased intracranial pressure or other serious complications.

A. Pyloric stenosis. Pyloric stenosis is a condition that affects infants, causing projectile vomiting due to the narrowing of the pyloric sphincter. It is not a complication of appendicitis and is unrelated to this child's condition.

B. Celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to malabsorption and gastrointestinal symptoms. It is a chronic condition and is not associated with appendicitis or its complications.

C. Gastroenteritis. Gastroenteritis involves inflammation of the stomach and intestines, usually due to viral or bacterial infection. While it can cause abdominal pain, it is not a direct complication of appendicitis but rather a separate condition with similar symptoms.

D. Peritonitis. Peritonitis is the most serious complication of appendicitis and occurs when the inflamed appendix ruptures, leading to infection of the peritoneal cavity. It presents with severe abdominal pain, fever, rigidity, and signs of systemic infection, requiring urgent medical intervention.

A. "Tetralogy of Fallot is a group of four heart defects that impact circulation of blood in your child's body. These are pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and an overriding aorta." This is the correct definition of Tetralogy of Fallot. The four defects result in decreased oxygenation of blood, leading to cyanosis and other circulatory problems that require medical intervention.

B. "Tetralogy of Fallot is a heart defect that impacts circulation in your child's body due to the atypical placement of the aorta." While an overriding aorta is one of the four defects in Tetralogy of Fallot, it is not the sole cause of circulatory problems. The condition results from a combination of four structural abnormalities, not just aortic malposition.

C. "Tetralogy of Fallot is a group of heart defects that impact the circulation of blood in your child's body. These are aortic stenosis, atrial septal defect, and left ventricular hypertrophy." This statement describes different congenital heart defects but does not accurately define Tetralogy of Fallot. Aortic stenosis and atrial septal defects are not components of this condition.

D. "Tetralogy of Fallot is a heart defect that impacts circulation in your child's body due to an opening in the wall between the ventricles, causing mixing of oxygenated and deoxygenated blood." While a ventricular septal defect (VSD) is one of the four components, it is not the only issue affecting circulation. The combination of all four defects contributes to the condition's severity.

A. Amenorrhea. Anorexia nervosa is associated with severe weight loss and malnutrition, leading to hormonal imbalances that disrupt the menstrual cycle. Decreased estrogen levels result in amenorrhea, which is a hallmark symptom of the disorder and a significant reproductive health concern.

B. Increased fertility. Anorexia nervosa typically leads to hormonal imbalances, including decreased levels of gonadotropins and estrogen, which suppress ovulation and reduce fertility rather than increasing it.

C. Early onset of puberty. Malnutrition and low body fat delay puberty rather than accelerating it. Adolescents with anorexia nervosa may experience delayed menarche and stunted growth due to inadequate nutrition.

D. Pelvic inflammatory disease (PID). PID is usually caused by sexually transmitted infections and is not directly associated with anorexia nervosa. The primary reproductive concern in anorexia is hormonal disruption leading to menstrual irregularities.

A. Weight gain. Corticosteroids cause fluid retention and increased appetite, leading to significant weight gain. In a 6-year-old, this can affect self-esteem and social interactions, potentially leading to body image concerns and difficulty fitting in with peers.

B. Irritability. Mood changes, including irritability, anxiety, and mood swings, are common side effects of corticosteroids. These emotional changes can impact relationships with family and friends, affecting the child's psychosocial well-being.

C. Osteoporosis. While long-term corticosteroid use can lead to osteoporosis, it is primarily a physical concern rather than a psychosocial one. Bone health issues typically become more evident later in life rather than in early childhood.

D. Hypertension. Elevated blood pressure is a physiological side effect of corticosteroids but does not directly impact the child’s psychosocial development. It is more of a medical concern requiring monitoring rather than a factor affecting social interactions.

E. Nausea. Although nausea can cause discomfort, it does not have a significant impact on the child's psychosocial development compared to mood changes and body image issues caused by corticosteroid therapy.

A. The child is able to answer simple questions. By the age of 3, children develop basic language skills, allowing them to respond to simple questions. Their vocabulary expands significantly, and they begin to form short sentences, making communication more interactive.

B. The child engages in conversation. While 3-year-olds can communicate basic needs and thoughts, true conversational skills, including back-and-forth exchanges with complex sentences, typically develop later, around age 4 to 5.

C. The child knows to stay away from danger. At 3 years old, children have limited understanding of danger and often require close supervision to ensure safety. Their impulse control is still developing, making them prone to risky behaviors.

D. The child adheres to rules. While toddlers begin to understand rules, they may not consistently follow them. At this stage, they still need reminders and reinforcement, as their self-regulation skills are not yet fully developed.

Calculate the total drops needed:

Total drops (gtt) = Total volume (mL) x Drop factor (gtt/mL)

=100 mL x 15 gtt/mL

= 1500 gtt

Calculate the infusion time in minutes:

1 hour x 60 minutes/hour = 60 minutes

Calculate the drops per minute (gtt/min)

Total drops per min (gtt/min) = Total drops (gtt) / Total minutes (min)

=1500 gtt / 60 min

= 25 gtt/min

The nurse should set the manual IV infusion to deliver 25 gtt/min.

A. "Adolescents may feel responsible for the illness." While younger children may engage in magical thinking and believe they caused their illness, adolescents typically have a more developed understanding of disease processes and are less likely to blame themselves.

B. "Adolescents may feel frustrated for being dependent on others." Adolescents value independence and autonomy, so a terminal illness that forces them to rely on caregivers can lead to frustration, anger, and emotional distress. This struggle with dependency is a common psychosocial challenge in adolescent patients.

C. "Children 3 to 5 years old are too young to understand the difference between life and death." Preschool-aged children may not fully grasp the permanence of death, but they do have some awareness of it. They often see death as temporary or reversible, influenced by their limited cognitive development and exposure to media or stories.

D. "Children around 5 or 6 years old may try to be brave and shield loved ones from distress." While school-aged children may begin to understand the finality of death, the tendency to "be brave" and protect loved ones is more common in older children and adolescents, who have a stronger sense of emotional responsibility.