A 5-year-old child is scheduled for a venipuncture and is anxious about pain. Which intervention BEST reduces procedural pain at the insertion site?

Applying EMLA cream 30-60 minutes before the procedure under an occlusive dressing

Giving the child a sugar solution after the procedure

Placing a cold pack on the site immediately before the needle

Distracting the child with toys during the procedure

Answer and Explanation

The Correct Answer is A

A. EMLA cream (a eutectic mixture of local anesthetics) applied 30–60 minutes before a procedure under an occlusive dressing provides effective topical anesthesia, reducing pain at the venipuncture site. This is evidence-based practice for minimizing procedural pain in children and is particularly effective for needle insertions.

B. Administering a sugar solution (sucrose) is effective primarily for infants under 12 months and is most beneficial when given before or during painful procedures, not after. In a 5-year-old, it has minimal analgesic effect.

C. Applying a cold pack can provide some temporary numbing, but it is less effective than topical anesthetic creams for reducing pain during venipuncture. Additionally, short-duration cold application may not penetrate deep enough to anesthetize the vein adequately.

D. Distraction with toys can reduce anxiety and perceived pain but does not directly numb the insertion site. While helpful as a complementary measure, it is not as effective as topical anesthesia in reducing procedural pain.

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Correct Answer is A

Explanation

A. Tonsils are part of the lymphatic system, which is most active in early childhood to help the body respond to infections and build immunity. It is common for tonsils to appear large in healthy children between ages 3 and 6. This is a normal physiological finding and usually does not indicate illness unless accompanied by symptoms such as fever, difficulty breathing, or recurrent infections.

B. While significantly enlarged tonsils causing airway obstruction, sleep apnea, or recurrent infections may require evaluation, tonsillar enlargement alone in an otherwise healthy child is typically normal and does not require urgent referral.

C. Enlarged tonsils in this age group indicate a normally active immune system, not underdevelopment. They help the body recognize and respond to antigens, supporting healthy immune function.

D. Chronic or acute infections may cause tonsillar enlargement, but in the absence of symptoms such as fever, redness, or exudate, there is no evidence of infection, and antibiotics are not indicated.

A. "Your baby is demonstrating proximal-to-distal development, gaining control from the center outward" B. Your baby should use both hands equally at this age" C. "This is a sign of delayed fine motor development" D. "Your baby is skipping developmental milestones"

Correct Answer is A

Explanation

A. Infant motor development follows a proximal-to-distal pattern, meaning control develops from the center of the body outward. At 7 months, infants first gain control of shoulders and arms, allowing them to reach with the whole hand. Later, fine motor skills like the pincer grasp (using thumb and forefinger) develop around 9–12 months, enabling the child to pick up small objects. This progression is typical and expected.

B. At 7 months, infants are still developing bilateral coordination. It is normal for a baby to favor one hand or alternate hands inconsistently. Expecting equal use of both hands at this stage reflects a misunderstanding of normal motor development.

C. Fine motor skills, such as using the thumb and forefinger to grasp small objects, emerge later. Reaching with the whole hand at 7 months is part of normal development. Labeling it as delayed is incorrect and may cause unnecessary concern.

D. The infant is following the typical developmental sequence, progressing from gross motor to fine motor control. Reaching with one hand before using the pincer grasp does not indicate skipped milestones. Developmental milestones are achieved in a predictable order, and this behavior is within normal limits.

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A 5-year-old child is scheduled for a venipuncture and is anxious about pain. Which intervention BEST reduces procedural pain at the insertion site?

Nursing Test Bank

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During a routine checkup, a nurse observes that a 4-year-old child has noticeably enlarged tonsils but is otherwise healthy with no signs of infection. The child's parents express concern. Which statement BEST explains this finding?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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