A nurse is preparing to administer an intramuscular (IM) injection to a toddler. Which intervention should the nurse implement first?

Restrain the toddler to prevent movement during the injection.

Gather all necessary supplies for the injection.

Explain the procedure to the toddler using simple language.

Assess the toddler's vital signs prior to the injection.

Answer and Explanation

The Correct Answer is C

A.   While some form of restraint may be necessary, explaining the procedure first is important for reducing anxiety and helping the toddler understand what is going to happen.
B.   Gathering supplies is essential but should come after preparing the child and ensuring they are mentally ready.
C.   Explaining the procedure to the toddler helps ease anxiety and ensures they are informed, even at a young age.
D.   Routine vital sign assessment is not necessary for a simple IM injection unless the child has a specific medical condition.

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Correct Answer is C

Explanation

A. Thickening the formula with cereal is generally not recommended for infants with a cleft lip and palate as it can cause additional feeding difficulties.
B. Positioning the infant laying back can increase the risk of aspiration and is not recommended. An upright position helps reduce the risk of aspiration.
C. Positioning the infant upright during feedings helps reduce the risk of aspiration and facilitates better feeding for infants with cleft lip and palate.
D. A nasogastric tube may be needed if the infant is unable to feed orally due to the severity of the cleft, but this is not a routine part of feeding education.

A. 2 to 3 days after surgery B. 7 to 10 days after surgery C. 4 to 6 days after surgery D. 11 to 14 days after surgery

Correct Answer is B

Explanation

A. The first few days after surgery can involve some bleeding as part of normal healing, but the greatest risk for hemorrhage occurs later.
B. The greatest risk for post-operative hemorrhage after a tonsillectomy is typically 7 to 10 days post- surgery when the scabs formed in the throat start to fall off.
C. The 4 to 6-day window does not correlate with the peak risk for hemorrhage, which is typically observed later in the healing process.
D. The 11 to 14-day period is past the time when hemorrhage is most likely to occur.

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A nurse is preparing to administer an intramuscular (IM) injection to a toddler. Which intervention should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education about feedings to the parents of a newborn with a cleft lip and palate. The education includes the use of a specialized bottle/nurser, offering frequent short feedings, and burping more frequently. What other education should the nurse include?

Correct Answer is C

Explanation

A nurse is providing post-operative tonsillectomy instructions to the parents of a child. The nurse informs the parents that the greatest risk for postoperative hemorrhage can occur during which of the following time frames?

Correct Answer is B

Explanation

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