A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping.
Which intervention should the nurse implement?
Ask the boy to describe a typical day at school.
Compare the child's vital signs over the past three weeks.
Conduct a complete neurological assessment.
Counsel the parents to pay more attention to the child.
The Correct Answer is A
The boy's reported symptoms may indicate stress or anxiety related to his school experience. By asking the boy to describe a typical day at school, the nurse can gather information about the child's interactions with teachers and peers, academic performance, and any other potential sources of stress. This information can be used to develop an appropriate plan of care that addresses the child's emotional and physical needs.
Comparing vital signs or conducting a neurological assessment may not provide useful information in this case, and counseling the parents to pay more attention to the child is not a recommended intervention without first identifying the underlying cause of the child's symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
When caring for a child in balanced suspension skeletal traction, the most important intervention for the nurse to implement is monitoring peripheral pulses and sensation in the affected leg to detect any compromise in circulation or nerve function. This is crucial because the traction places tension on the bones, which can result in nerve or vascular damage.
Changing positions every 2 hours is important to prevent pressure injuries, but it is not the most critical intervention.
Cleansing pin sites and assessing skin for redness and signs of tissue breakdown are also important, but they are not as urgent as monitoring peripheral pulses and sensation.
Correct Answer is B
Explanation
Albuterol is a beta-adrenergic agonist agent that is used to open the airways in people with bronchial asthma. The mother's use of this medication to open her son's airway when he is having trouble breathing is appropriate. Overuse of the drug may cause side effects, but it does not cause chronic bronchitis (A)
Albuterol helps to relax the muscles in the airways, but it does not reduce airway inflammation (C)There is no indication that the child needs immediate evaluation (D)
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