A nurse is preparing to perform a dressing change on a preschooler. Which of the following actions should the nurse take to prepare the child for the procedure?

Limit teaching sessions about the procedure to 20 min.

Ask the parents to wait outside the room during the procedure.

Instruct the child in deep-breathing methods prior to the procedure.

Explain in simple terms how the procedure will affect the child.

Answer and Explanation

The Correct Answer is D

Rationale:
A. Limit teaching sessions about the procedure to 20 min: While preschoolers have limited attention spans, the focus should be on using age-appropriate language and explanations rather than strictly timing the teaching session. The quality and clarity of instruction are more important.

B. Ask the parents to wait outside the room during the procedure: Preschoolers often feel safer and more cooperative when a parent is present. Removing parents can increase anxiety and resistance, so parental presence is encouraged.

C. Instruct the child in deep-breathing methods prior to the procedure: Deep-breathing exercises can help with relaxation, but preschoolers may have difficulty understanding or performing them effectively. Simple explanations and reassurance are more appropriate.

D. Explain in simple terms how the procedure will affect the child: Providing a clear, age-appropriate explanation helps the preschooler understand what to expect, reduces fear, and promotes cooperation. Using simple terms tailored to the child’s developmental level is the most effective preparation.

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Correct Answer is C

Explanation

Rationale:
A. "I should clean my stoma with moisturizing soap.": Moisturizing soaps can leave a residue that interferes with the adhesive seal of the ostomy pouch. The stoma and surrounding skin should be cleaned gently with mild, non-moisturizing soap and water to maintain skin integrity and pouch adhesion.

B. "I should expect my stoma to be blistered.": A healthy stoma should appear pink to red and moist. Blistering indicates trauma, irritation, or infection, which requires assessment and intervention, so this expectation is incorrect.

C. "I should cut my pouch opening 1/8 inch larger than my stoma.": Proper pouch sizing ensures a secure fit around the stoma while protecting the surrounding skin from effluent. Cutting the opening slightly larger than the stoma prevents pressure and irritation.

D. "I should change my stoma pouch 30 minutes after meals.": Ostomy pouch changes should be scheduled when effluent is minimal, typically every 3–7 days or when the pouch is leaking. Timing changes specifically after meals is unnecessary.

A. "I will ask your provider to discuss options for discontinuing treatment with you." B. "You cannot legally discontinue treatment unless you have a living will." C. "You must continue with these treatments because they are lifesaving." D. "I know your provider thinks these treatments are necessary for you."

Correct Answer is A

Explanation

Rationale:
A. "I will ask your provider to discuss options for discontinuing treatment with you.": This response supports the client’s autonomy and right to refuse treatment while ensuring that the provider is informed to discuss the medical and ethical aspects of stopping therapy. It reflects respect for the client’s wishes and promotes shared decision-making.

B. "You cannot legally discontinue treatment unless you have a living will.": A living will is not required for a client to refuse or discontinue treatment. Competent clients have the legal and ethical right to make decisions about their own care, including the choice to stop therapy, regardless of advance directives.

C. "You must continue with these treatments because they are lifesaving.": This statement disregards the client’s autonomy and imposes the nurse’s opinion on the client’s decision. Even if the treatment is potentially lifesaving, the client has the right to decline it based on their personal values and quality-of-life considerations.

D. "I know your provider thinks these treatments are necessary for you.": This response shifts focus away from the client’s preferences and reinforces the provider’s opinion instead. It fails to acknowledge the client’s emotional and ethical right to choose.

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A nurse is preparing to perform a dressing change on a preschooler. Which of the following actions should the nurse take to prepare the child for the procedure?

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