A nurse is planning to change the dressings on a school-age child who has sustained multiple burns. Which of the following actions should the nurse plan to take?

Explain long term consequences of the procedure to the child.

Remove the dressings while explaining the procedure to the child.

Keep equipment out of the child's sight.

Allow the child to help remove the dressings.

Answer and Explanation

The Correct Answer is D

A. Explain long term consequences of the procedure to the child. This level of detail is not developmentally appropriate for a school-age child. It may increase anxiety without helping the child understand or cope with the immediate situation.
B. Remove the dressings while explaining the procedure to the child. While it is important to explain procedures, it should be done before starting to allow time for questions and emotional preparation. Explaining during may cause confusion or distraction.
C. Keep equipment out of the child's sight. Hiding equipment can actually increase fear and mistrust. School-age children benefit from open, age-appropriate communication and preparation about what to expect.
D. Allow the child to help remove the dressings. This is the most appropriate action. Allowing the child to participate in their care provides a sense of control, reduces anxiety, and helps build trust. It also aligns with the developmental need of school-age children to take on increasing responsibility and be involved in decision-making.

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Correct Answer is D

Explanation

A. Rubeola (measles). Rubeola is transmitted through airborne particles and requires airborne precautions, including the use of an N95 respirator and placement in a negative pressure room. Droplet precautions would not provide sufficient protection due to the small particle size and long-range transmission.
B. Varicella (chickenpox). Varicella requires both airborne and contact precautions because it spreads via airborne respiratory droplets and direct contact with lesions. A client with varicella must be isolated in a negative pressure room and healthcare workers should use full PPE.
C. Tuberculosis. Tuberculosis is caused by Mycobacterium tuberculosis and is spread through airborne droplet nuclei, which remain suspended in the air for extended periods. It requires airborne precautions, including an N95 respirator and isolation in a specialized room.
D. Pertussis (whooping cough). Pertussis is a highly contagious bacterial infection that spreads through large respiratory droplets during coughing or sneezing. Droplet precautions are required, which include wearing a surgical mask when within 3 feet of the client and practicing proper hand hygiene to prevent transmission.

A. The client calls the office multiple times per day to speak with their provider. B. The client states. "I only act this way because my partner makes me so angry." C. The client does not listen to the nurse during a discussion about their diagnosis. D. The client reports that they get upset with their family members for "no apparent reason."

Correct Answer is B

Explanation

A. The client calls the office multiple times per day to speak with their provider. This behavior may indicate anxiety or dependence, but it does not reflect rationalization, which involves making excuses to justify behavior.
B. The client states, "I only act this way because my partner makes me so angry." This is a clear example of rationalization, where the client is attempting to justify unacceptable behavior by blaming it on someone else rather than taking personal responsibility.
C. The client does not listen to the nurse during a discussion about their diagnosis. This may indicate denial or avoidance, not rationalization. The client may be overwhelmed and unwilling to accept the diagnosis.
D. The client reports that they get upset with their family members for "no apparent reason." This may suggest emotional dysregulation or projection, but it lacks the clear element of excuse-making that defines rationalization.

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A nurse is planning to change the dressings on a school-age child who has sustained multiple burns. Which of the following actions should the nurse plan to take?

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