A nurse is providing care to children on a general pediatric unit. Which of the following children should the nurse identify as a potential victim of abuse?

A child whose parents answer questions for the child.

A child who has frequent visitors

A child who uses the call light frequently

A child who has a BMI indicating obesity

Answer and Explanation

The Correct Answer is A

A. A child whose parents answer questions for the child. This behavior may indicate that the child's parents are controlling or dominating, possibly preventing the child from expressing their own thoughts or feelings. It could be a sign of emotional or psychological abuse, where the child's autonomy and voice are suppressed.

B. A child who has frequent visitors: While frequent visitors may raise concerns about the child's social environment, it does not necessarily indicate abuse. Further assessment would be needed to determine the nature of these visits and their impact on the child's well-being.

C. A child who uses the call light frequently: Frequent use of the call light may indicate physical discomfort, illness, or anxiety, but it does not inherently suggest abuse. It could be related to the child's medical condition or emotional state.

D. A child who has a BMI indicating obesity: Obesity alone is not indicative of abuse. While it may raise concerns about the child's health and well-being, it does not directly point to abuse unless there are additional signs or symptoms suggestive of neglect or mistreatment.

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Correct Answer is D

Explanation

A. Increased intracranial pressurE. Pulsation and bulging of the fontanel may be signs of

increased intracranial pressure in infants. However, it is important to differentiate between normal fontanel characteristics and abnormal signs of elevated intracranial pressure. In this case, the pulsation and bulging are likely normal responses to crying and changes in intracranial pressure during the newborn period.

B. Dehydration: Dehydration typically presents with sunken fontanels rather than pulsation and bulging. Dehydration is a serious condition that requires prompt assessment and intervention, but it is not indicated by the findings described in the scenario.

C. Overhydration: Overhydration is not typically associated with pulsation and bulging of the fontanel. Overhydration may lead to fluid overload and edema but does not directly affect fontanel characteristics.

D. These are normal findings: Pulsation and brief bulging of the fontanel in response to crying are considered normal findings in newborns. Fontanels allow for the flexibility of the skull bones during childbirth and provide space for brain growth during infancy. Pulsation and bulging may occur temporarily during crying or changes in intracranial pressure and are not necessarily

indicative of pathology.

A. The nurse checks the documented time of the last dosage administered. B. The nurse calculates the dosage according to the child's weight. C. The nurse makes sure the medication is given within the hour of the ordered time. D. The nurse explains the therapeutic effects of the medication to the child and parents. The nurse administers the medication even though the child is adamant about not taking it.

Correct Answer is ["A","B"]

Explanation

A. The nurse checks the documented time of the last dosage administereD. This action ensures that the medication is given at the appropriate frequency and prevents overdosing or underdosing.

B. The nurse calculates the dosage according to the child's weight: Pediatric medication dosages are often calculated based on the child's weight to ensure safe and effective administration.

C. The nurse makes sure the medication is given within the hour of the ordered timE. While

timely administration of medication is important, the specific time interval within which a PRN medication should be given may vary depending on the medication and the healthcare provider's orders. This statement does not necessarily reflect the rules of pediatric medication

administration.

D. The nurse explains the therapeutic effects of the medication to the child and parents. The nurse administers the medication even though the child is adamant about not taking it: Administering medication against the child's wishes without proper explanation or consent does not adhere to the principles of pediatric medication administration. It is important to provide education about the medication and involve the child and parents in the decision-making process whenever possible.

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A nurse is providing care to children on a general pediatric unit. Which of the following children should the nurse identify as a potential victim of abuse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?

Correct Answer is D

Explanation

The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric ward of the hospital. Which answers reflect nursing actions that follow the rules of the rights of pediatric medication administration? Select all that apply.

Correct Answer is ["A","B"]

Explanation

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