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 D

Explanation

Choice A reason: Increasing protein calories doesn’t address malabsorption causing constipation and diarrhea in cystic fibrosis. Pancreatic enzymes improve nutrient absorption, making this irrelevant and incorrect compared to the need to correct digestive issues due to enzyme deficiency in the child’s dietary management.

Choice B reason: Saturated fat doesn’t resolve malabsorption-related constipation and diarrhea in cystic fibrosis and may worsen symptoms. Pancreatic enzymes correct enzyme deficiency, making this inappropriate and incorrect compared to the dietary adjustment needed to manage the child’s gastrointestinal symptoms effectively.

Choice C reason: Iodized salt supports hydration in cystic fibrosis but doesn’t address malabsorption causing diarrhea and constipation. Pancreatic enzymes target digestive issues, making this incorrect, as it fails to correct the underlying enzyme deficiency responsible for the child’s gastrointestinal symptoms.

Choice D reason: Pancreatic enzymes improve fat and nutrient absorption in cystic fibrosis, reducing constipation and diarrhea due to malabsorption. This aligns with pediatric cystic fibrosis management, making it the correct substance to increase in the child’s diet to address the reported gastrointestinal symptoms.

A. “The purpose of this form of suctioning is to remove secretions from the nose and mouth.” B. “If possible, the child should be asked to cough before suctioning.” C. “Sterile normal saline drops are used to loosen the dried secretions prior to nasal suctioning.” D. “Such suctioning is only done with a bulb syringe.”

Correct Answer is D

Explanation

Choice A reason: Suctioning removes secretions from the nose and mouth, a correct purpose. This statement reflects accurate understanding of the procedure’s goal, making it correct and not requiring further instruction, unlike the misconception about exclusive bulb syringe use in suctioning discussed in the seminar.

Choice B reason: Asking a child to cough before suctioning clears airways and is appropriate when feasible, showing correct knowledge. This does not indicate a need for instruction, making it incorrect compared to the incorrect limitation of suctioning to bulb syringes only in the student’s statement.

Choice C reason: Using sterile saline drops to loosen secretions is a standard practice in nasal suctioning, reflecting accurate technique. This statement is correct, making it incorrect for needing further instruction, unlike the erroneous restriction of suctioning to bulb syringes alone in the seminar discussion.

Choice D reason: Suctioning is not limited to bulb syringes; catheter or mechanical suction is used in clinical settings for deeper secretions. This statement reflects a misunderstanding, requiring further instruction on suctioning methods, aligning with pediatric nursing standards, making it the correct choice for additional teaching.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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?

Correct Answer is D

Explanation

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