A nurse has been assigned to care for a 12-year-old child who will likely die from his illness. The child asks the nurse, “Do you think I am going to die?” Which of the following responses would be appropriate for the nurse to make?

“Don’t talk like that. You are going to get better very soon.”

“It would be best if you were to ask your doctor about that.”

“Some children who have been diagnosed with your illness do die.”

“It’s hard for me to talk about death. It would be best if you were to ask your parents.”

Answer and Explanation

The Correct Answer is C

When caring for children with life-threatening or terminal illnesses, nurses often face difficult questions about death. School-age children, around 12 years old, understand that death is final and irreversible, and they seek honest, empathetic answers.

Rationale for correct answer:

C. “Some children who have been diagnosed with your illness do die.” This response is honest, developmentally appropriate, and empathetic. At age 12, children in the concrete–formal operational stage (Piaget) understand that death is permanent and universal. They deserve truthful answers. The nurse’s role is to provide open, supportive communication, allowing the child to express fears, feelings, and questions while fostering trust.

Rationale for incorrect answers:

A. “Don’t talk like that. You are going to get better very soon.” This is false reassurance and invalidates the child’s feelings and undermines trust.

B. “It would be best if you were to ask your doctor about that.” This avoids the child’s question, shuts down communication, and conveys that the nurse is uncomfortable discussing important concerns.

D. “It’s hard for me to talk about death. It would be best if you were to ask your parents.” This focuses on the nurse’s feelings instead of the child’s. This avoidance leaves the child unsupported and isolated with their fears.

Take home points

Children around 10–12 years old understand the permanence of death and may ask direct questions.
The nurse should respond with honesty, empathy, and openness, validating the child’s feelings while providing comfort.
Avoid false reassurance or deflection, these erode trust and increase anxiety.
Facilitating discussions with parents, providers, and chaplains may also help, but the nurse should not avoid the child’s direct questions.

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Free Nursing Study Resources

Correct Answer is ["B","C","D","E"]

Explanation

Postoperative care for toddlers requires close monitoring of safety, fluid balance, pain control, and equipment management. Since 18-month-old children are active and curious, they may try to pull at tubes or IV lines, so nurses must anticipate needs and prevent complications.

Rationale for correct answers:

B. Accurate I&O monitoring is essential for a post-op child with IV fluids and an NG tube to assess hydration, kidney function, and fluid balance.

C. An elbow restraint prevents the child from pulling out the NG tube or IV line or interfering with the abdominal dressing. Always requires a provider’s order. A nurse cannot apply it independently.

D. At 18 months, the child cannot use a numeric scale. The nurse should use a validated tool such as the FLACC (Face, Legs, Activity, Cry, Consolability) scale to assess pain.

E. Safe practice requires verification of IV solution and rate against the provider’s orders before continuing infusion. This prevents medication or fluid errors.

Rationale for incorrect answers:

A. NSAIDs are not typically first-line in immediate post-op care for an 18-month-old with abdominal surgery due to risk of bleeding and gastric irritation. Stronger analgesics (opioids, acetaminophen IV/PO) are often ordered instead.

Take home points

Post-op care for toddlers focuses on safety (verify orders), comfort (age-appropriate pain assessment), and monitoring (I&O, vital signs, wound care).
Pain assessment tools must be developmentally appropriate (e.g., FLACC scale for infants and toddlers).
NSAIDs are not routine post-op measures and require careful consideration of risks and alternatives.
Nurses should always double-check IV solutions against provider orders to prevent errors.

A. Usually 2ml is the maximum volume that should be administered in a single site to small children and older infants. B. New evidence suggests that immunizations at the ventrogluteal site have been found to have fewer local reactions and fever. C. Distraction and prevention of unexpected movement may be more easily achieved by placing the child supine on a parent’s lap for ventrogluteal site use. D. The deltoid muscle advantages are less pain and fewer side effects from the injectate compared with the vastus lateralis. E. Aspiration during intramuscular vaccine administration is always recommended.

Correct Answer is ["B","C","D"]

Explanation

Intramuscular (IM) injections are a method of delivering medication directly into a muscle, where it’s absorbed quickly into the bloodstream due to the muscle’s rich vascular supply.

Rationale for correct answers:
B. Studies show that vaccines given at the ventrogluteal site have fewer local reactions such as redness and swelling, and systemic side effects such as fever, making it a safe and effective site.
C. Having the child supine on a parent’s lap provides comfort, distraction, and physical control, reducing the risk of sudden movements that could cause injury.
D. In older children, the deltoid muscle may be associated with less pain and fewer side effects compared with vastus lateralis, though it is not typically used in infants due to limited muscle mass.

Rationale for incorrect answers:

A. For small infants, volumes should actually be lower such as 0.5–1 mL. Thus, this option is less universally correct in pediatrics compared to the chosen answers.

E. Aspiration is not recommended during vaccine administration. It causes unnecessary pain and is not needed since recommended injection sites for children do not have large blood vessels at risk.

Take home Points

Ventrogluteal site is increasingly supported for vaccines due to fewer reactions and good muscle depth.
Parent lap positioning is both comforting and a safety measure to prevent movement.
Deltoid site is appropriate for older children/adolescents and may cause less discomfort than vastus lateralis in some cases.
Injection volumes must always be adjusted to the child’s age and muscle size (infants ≤1 mL, older children up to 2 mL per site).

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A nurse has been assigned to care for a 12-year-old child who will likely die from his illness. The child asks the nurse, “Do you think I am going to die?” Which of the following responses would be appropriate for the nurse to make?

Nursing Test Bank

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Correct Answer is ["B","C","D","E"]

Explanation

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Explanation

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