A 5-month-old infant presents to the ED with right upper arm swelling, and a fracture is suspected. The mother first told the triage nurse that the infant rolled off the changing table during a diaper change, and later said the infant rolled off the couch when the doorbell rang. What knowledge guides the nurse in planning the next steps?

Infant bones are prone to fractures.

The focus should be on the injury not how it occurred.

Inconsistencies in how injury occurred may indicate child maltreatment.

Parents don't remember details when they are under stress.

Answer and Explanation

The Correct Answer is C

Choice A reason: This is not the correct answer because infant bones are not prone to fractures. They are more flexible and resilient than adult bones, and require more force to break.

Choice B reason: This is not the correct answer because the focus should not be only on the injury, but also on how it occurred. The nurse should assess the mechanism of injury and the history of the child and the family for any signs of abuse or neglect.

Choice C reason: This is the correct answer because inconsistencies in how injury occurred may indicate child maltreatment. The nurse should be alert for any discrepancies or changes in the story, or any explanations that do not match the type or severity of the injury.

Choice D reason: This is not the correct answer because parents don't necessarily forget details when they are under stress. They may be anxious or emotional, but they should still be able to provide a consistent and coherent account of what happened.

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Correct Answer is D

Explanation

Choice A reason: This is not a good intervention because it disregards the parent's and the child's religious beliefs and values. It may also imply that the nurse knows better than the parent what is best for the child.

Choice B reason: This is not a necessary intervention because it does not address the immediate issue of the child's nutrition. It may also suggest that the nurse thinks the parent needs spiritual guidance or counseling.

Choice C reason: This is not a respectful intervention because it violates the parent's and the child's right to follow their dietary rules. It may also cause the parent and the child to feel guilty or conflicted.

Choice D reason: This is the best intervention because it honors the parent's and the child's preferences and practices. It also ensures that the child receives adequate and appropriate nutrition.

A. Parents are shocked when their child is diagnosed with a malignant bone tumor. The orthopedic surgeon discusses the options of limb amputation and a limb-salvage procedure. The parents are asked to consider each option. B. A child in end-stage renal failure is placed on the renal transplant list. The parents are asked to sign permission for surgery after a cadaver kidney is located. One parent is out of town and gives telephone consent. C. After initial therapies have failed, a child with leukemia is evaluated for a new cancer protocol. The child, age 8 years, gives assent for the new treatment, and his parents give their consent. D. The physician recommends that a young child be taken off the ventilator. The parents, who are divorced and have joint custody of the child, have differing views about whether to discontinue the ventilator.

Correct Answer is D

Explanation

Choice A reason: This situation does not require the involvement of the hospital ethics committee, as the parents are not refusing or requesting any treatment that is contrary to the standard of care. The surgeon is providing them with information and options, and the parents are free to make their own decision.

Choice B reason: This situation does not involve any ethical dilemma, as the parents are giving their permission for the surgery, and the telephone consent is legally valid. The hospital ethics committee is not needed to resolve any conflict or uncertainty.

Choice C reason: This situation is an example of ethical research involving children, as the child is giving assent and the parents are giving consent for the new protocol. The hospital ethics committee is not required to intervene, as the research protocol has already been approved by the institutional review board.

Choice D reason: This situation is an appropriate case for the hospital ethics committee, as it involves a life-and-death decision that affects the child's best interests and the parents' rights. The hospital ethics committee can help to mediate the conflict, provide guidance, and facilitate a resolution.

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Naxlex Comprehensive Predictor Exams

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." The nurse's best intervention is to:

Correct Answer is D

Explanation

Which situation would be appropriate to refer to the hospital ethics committee?

Correct Answer is D

Explanation

The nurse discovers welts on the back of a child whose parents identify as 1st generation Vietnamese. The mother states she rubbed the edge of a coin on her child's oiled back. The nurse should recognize that this is:

A thirteen-year-old female is admitted for abdominal pain. Her parents state that their daughter is not sexually active. As the health care provider, you:

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply).

Over half of all violent offenders in prison were physically or sexually abused as children.

While caring for a 4-year-old, the nurse uses which tool to assess pain?

You enter a two-year-old patient's room and see the pulse oximeter reading 55% oxygen saturation. Your first action would be to:

The nurse is using the FLACC scale to evaluate pain in a preverbal child. The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming, tense; Cry: no cry; Consolability: content, relaxed. The nurse records the patient's pain using the FLACC assessment as: