A 5-year-old boy is brought to the emergency room with a possible broken arm. His 18-year-old sister, who is also his primary caregiver, has come with him. The boy is relatively calm, but his sister is so upset she is nearly hysterical. The nurse notes that as her behaviors show more anxiety, the boy is getting more upset and his anxiety is also increasing. What initial action would be best for the nurse to take in this situation?

While attending to the child, reassure the sister and suggest interventions she can help with.

Ask the sister if she prefers to leave the exam room.

Reassure the child that he is going to be fine and that his sister is just nervous.

Ask his sister to calm down so that she can help her brother remain calm as well.

Answer and Explanation

The Correct Answer is A

Choice A reason: Reassuring the sister while attending to the child and involving her in interventions reduces her anxiety, stabilizing the 5-year-old’s emotional state. This aligns with pediatric emergency care principles, making it the best initial action to manage the escalating anxiety in the emergency room.

Choice B reason: Asking the sister to leave may increase her distress and isolate the child, worsening his anxiety. Reassuring and involving her is more supportive, making this counterproductive and incorrect compared to the nurse’s role in calming both the caregiver and child effectively.

Choice C reason: Reassuring the child about his sister’s nerves doesn’t address her anxiety, which is escalating his distress. Involving the sister in care reduces both anxieties, making this insufficient and incorrect compared to the nurse’s priority of stabilizing the emotional environment in the ER.

Choice D reason: Asking the sister to calm down may heighten her distress, as she’s already hysterical, and doesn’t offer support. Reassuring and involving her helps both, making this ineffective and incorrect compared to the nurse’s action to reduce anxiety for the child and caregiver.

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Correct Answer is C

Explanation

Choice A reason: Ice cream and milk may coat the throat, increasing mucus and infection risk post-tonsillectomy. Vomiting dark blood is normal, but new bleeding requires attention, making this incorrect, as dairy is not recommended for easing swallowing in the immediate postoperative period for the child.

Choice B reason: Earache from referred pain is common post-tonsillectomy but may persist beyond the fourth day. Vomiting old blood with guidance on new bleeding is more accurate, making this incorrect, as it underestimates the duration and management of ear pain in the recovery period.

Choice C reason: Vomiting dark old blood is normal post-tonsillectomy due to swallowed blood, but fresh bleeding between days 5-7 indicates potential complications, requiring clinic contact. This aligns with pediatric postoperative care, making it the correct explanation for caregivers during discharge teaching for the child.

Choice D reason: Severe throat pain for 2 weeks is expected but should be monitored, not dismissed, as it may signal complications. Guidance on bleeding is more critical, making this incorrect, as it downplays the need for vigilance regarding pain in the postoperative recovery period.

A. “The highest incidence of this disease is seen in children who are adolescents.” B. “The cause of this disease can be treated very simply.” C. “It is important to increase the intake of protein for these children.” D. “These children have a severe deficiency of vitamin D.” E. “These children have a severe deficiency of vitamin D.”

Correct Answer is C

Explanation

Choice A reason: Kwashiorkor primarily affects young children, not adolescents, due to protein deficiency during critical growth periods. Increasing protein intake is the key treatment, making this inaccurate, as it misidentifies the age group most impacted by this nutritional disorder in the in-service discussion.

Choice B reason: Treating Kwashiorkor is complex, requiring gradual protein reintroduction and management of complications, not a simple fix. Increasing protein is central, but the process is intricate, making this incorrect compared to the accurate focus on protein supplementation for recovery in affected children.

Choice C reason: Kwashiorkor results from severe protein deficiency, and increasing protein intake is critical for treatment, restoring growth and tissue repair. This aligns with pediatric nutritional deficiency management, making it the most accurate statement about addressing Kwashiorkor in children during the in-service program.

Choice D reason: Kwashiorkor is caused by protein deficiency, not vitamin D deficiency, which is linked to rickets. Protein supplementation is the primary intervention, making this incorrect, as it misattributes the nutritional cause of Kwashiorkor to a vitamin deficiency in the context of the discussion.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child’s caregiver that the child may:

Correct Answer is C

Explanation

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?

Correct Answer is C

Explanation

The caregiver of an infant keeps removing the pulse oximetry sensor claiming it’s too tight on the baby. Which response should the nurse prioritize in addressing this situation?

A young child has been admitted with a diagnosis of enterobiasis (pinworm infection). This child will most likely have a history of:

The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child?

The nurse is presenting a post-conference seminar to a group of nursing students on the topic of suctioning of a child. Which statement made by a student demonstrates a need for further instruction on this procedure?

The nurse is working with a group of chronically ill school-aged children and their caregivers. Which strategy would be most effective in helping the children reach their self-care treatment goals?