A nurse is assessing a school-age child immediately postoperative following a perforated appendix. Which of the following finding should the nurse expect?

A WBC of 6,000/mm3

Purulent nasogastric drainage

Passage of dark red stool with mucus

Absence of peristalsis

Answer and Explanation

The Correct Answer is D

A. A WBC of 6,000/mm³ is within the normal range (4,500-11,000/mm³), and a postoperative infection is more likely to result in an elevated WBC count.

B. Purulent nasogastric drainage is more suggestive of a gastrointestinal issue unrelated to a perforated appendix and is not a common finding post-surgery.

C. Passage of dark red stool with mucus could suggest gastrointestinal bleeding or infection, but it is not typical postoperatively after a perforated appendix.

D. After surgery for a perforated appendix, peristalsis may be absent initially due to the effects of anesthesia, bowel manipulation, or inflammation from the infection. This is a normal postoperative finding.

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Correct Answer is []

Explanation

Potential Condition: Child maltreatment

Actions to take:

Interview the child separately from the parents

Ask a parent, away from the child

Parameters to monitor:

Signs of fear or apprehension from the child when either parent is present

Negative comments about child from either parent.

Rationale:

Potential Condition: Child Maltreatment

The client’s history of multiple injuries (bloody nose, sutures from hitting cabinet, and spiral fracture) in the context of the parent’s alcohol intoxication, slurring, and aggressive behavior raises concern for possible child maltreatment. The child’s statement about being "clumsy" and the observed scars also support the need for further investigation into possible abuse.

Actions to Take

Interview the child separately from the parents: To ensure the child can speak freely and report any concerns without the influence or presence of the parents, especially when maltreatment is suspected.

Ask a parent, away from the child: The parent should be interviewed privately to assess their behavior and any possible stressors or issues that could indicate abuse or neglect, especially considering their appearance and actions when visiting the child.

Parameters to Monitor

Signs of fear or apprehension from the child when either parent is present: This could indicate emotional distress or fear related to the parent’s behavior. It is important to observe how the child reacts to the presence of each parent during assessments.

Negative comments about the child from either parent: Verbal abuse or negative comments can be a red flag for emotional abuse or neglect. Careful attention should be paid to any signs of verbal maltreatment.

Potential Diagnoses: Incorrect Choices

Muscular Dystrophy: While this could explain a pattern of injury due to muscle weakness, it does not align with the history of multiple injuries caused by trauma or the current family dynamics.

Constipation: No evidence or symptoms supporting constipation were observed in the current assessment.

Strabismus: No direct evidence to suggest strabismus in the child’s history or exam.

A. Place infant supine in the crib. B. Mix medication with formula. C. Position the syringe to the side of the infant's tongue. D. Measure elixir using a medicine cup.

Correct Answer is C

Explanation

A. Placing the infant supine in the crib is not a recommended position for administering oral medication as it may cause choking or aspiration.

B. Mixing medication with formula is not recommended, as it may alter the effectiveness of the medication or lead to incomplete dosing.

C. Positioning the syringe to the side of the infant's tongue is the best method to prevent choking and allow the infant to swallow the medication effectively.

D. A medicine cup is not appropriate for measuring medication for an infant due to the small volume and potential for spillage.

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A nurse is assessing a school-age child immediately postoperative following a perforated appendix. Which of the following finding should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Correct Answer is []

Explanation

A nurse is preparing to administer oral medication to a 3-month-old infant. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

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