A caregiver who works in the hospital brings his 9-year-old son to the emergency room with a spiral fracture of the tibia. The caregiver reports that the injury occurred when the boy’s 5-year-old sister hit him with a wooden bat. The injury is inconsistent with an impact and with the sister’s strength. Which of the following would be appropriate for the nurse to do in this situation?

Leave the treatment area and call the police.

Tell the hospital administrator so that the hospital can take any necessary action.

Tell the caregiver that the story is not plausible and ask what really happened.

Leave the treatment area and call the social services department in the hospital.

Answer and Explanation

The Correct Answer is D

Choice A reason: Calling the police directly bypasses hospital protocol for suspected abuse. Contacting social services allows for a multidisciplinary evaluation of the inconsistent spiral fracture story, ensuring appropriate investigation, making this premature and incorrect compared to following hospital child protection procedures for the child.

Choice B reason: Informing the hospital administrator is less direct than contacting social services, which is trained to handle suspected abuse cases. The inconsistent injury story requires specialized assessment, making this less appropriate and incorrect for addressing the immediate concern of potential child maltreatment in the ER.

Choice C reason: Confronting the caregiver risks escalating the situation and may hinder investigation. Reporting to social services ensures a professional evaluation of the implausible injury explanation, aligning with child protection protocols, making this confrontational approach incorrect for managing suspected abuse in the hospital setting.

Choice D reason: Calling social services is the appropriate action for a spiral fracture with an inconsistent story, as it suggests possible abuse. Social services can investigate and coordinate with authorities, aligning with hospital protocols for child maltreatment, making this the correct response to ensure the child’s safety.

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Correct Answer is C

Explanation

Choice A reason: Stating vegetarian diets are unhealthy and teens are too immature dismisses the viability of well-planned vegetarianism, which can meet nutritional needs. Emphasizing diverse plant-based foods ensures balanced nutrition, making this overly restrictive and incorrect for addressing the parent’s concern about the adolescent’s vegetarian diet.

Choice B reason: Requiring lacto-ovo vegetarianism assumes eggs and dairy are essential, but vegan diets with soy substitutes can suffice. Recommending whole grains, legumes, and nuts addresses broader nutrient needs, making this less inclusive and incorrect compared to supporting a flexible, balanced vegetarian diet for the teen.

Choice C reason: Vegetarian diets, when including whole grains, legumes, nuts, seeds, and soy substitutes, provide adequate protein, vitamins, and minerals for teens. This response reassures the parent while offering practical guidance, aligning with pediatric nutrition guidelines, making it the prioritized choice for ensuring proper nutrition on a vegetarian diet.

Choice D reason: Suggesting protein drinks and megavitamins implies vegetarian diets are inherently deficient, which is unnecessary with proper food choices. Whole grains and legumes meet nutritional needs naturally, making this overly reliant on supplements and incorrect compared to promoting a balanced vegetarian diet for the adolescent.

A. Place the probe of the oximeter on the child’s chest and secure it with tape. B. Explain that pulse oximetry is done to detect respiratory retractions. C. Explain that pulse oximetry measures the oxygen saturation of arterial hemoglobin. D. Ensure the oximeter probe site is checked every 8 hours for possible reactions.

Correct Answer is C

Explanation

Choice A reason: Placing the probe on the chest is not a standard pulse oximetry site and yields inaccurate readings. Explaining the device’s purpose addresses the caregiver’s concern, making this ineffective and incorrect compared to educating about the sensor’s role in monitoring the infant’s oxygen levels.

Choice B reason: Pulse oximetry measures oxygen saturation, not respiratory retractions, which are observed visually. Explaining its true purpose reassures the caregiver, making this inaccurate and incorrect compared to clarifying the device’s function to address concerns about the sensor’s use on the infant.

Choice C reason: Explaining that pulse oximetry measures oxygen saturation clarifies its importance, reassuring the caregiver about its necessity and addressing tightness concerns. This aligns with pediatric nursing education principles, making it the prioritized response to ensure compliance with monitoring the infant’s respiratory status.

Choice D reason: Checking the probe site every 8 hours prevents skin issues but doesn’t address the caregiver’s concern about tightness. Explaining the device’s purpose promotes understanding, making this secondary and incorrect compared to educating to maintain the sensor’s use on the infant.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The parent of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this parent?

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?

Correct Answer is C

Explanation

In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia?

The caregiver of a child with sickle cell disease asks the nurse how much fluid her child should have each day after the child goes home. In response to the caregiver’s question, the nurse would explain that for the child with sickle cell disease, it is best that the child have:

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?

The parents and their child with a chronic illness have been seen by the nurse in the pediatrician’s office since birth. Which situation is appropriate for instruction by the nurse?

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?