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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is C
Explanation
Choice A reason: This response is not correct because a faster heart rate does not necessarily imply respiratory compromise. A child's heart rate is normally faster than an adult's due to the smaller size and higher metabolic rate of the child.
Choice B reason: This response is not correct because a greater body surface area does not directly affect the respiratory system. A child's body surface area is larger than an adult's in proportion to their body weight, which means they lose heat more easily and are more prone to hypothermia.
Choice C reason: This response is correct because a narrower airway diameter makes the child more susceptible to airway obstruction, inflammation, and edema. A child's airway is about one-third the size of an adult's, which means that even a small amount of swelling or secretions can significantly reduce the airway caliber and cause respiratory distress.
Choice D reason: This response is not correct because the ability to verbalize is not a factor that contributes to respiratory compromise. However, the inability to verbalize may make it harder for the child to communicate their symptoms and needs, which may delay the recognition and treatment of respiratory problems.
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