A nurse is receiving change of shift report on four children. Which of the following children should the nurse assess first?

A toddler who has a concussion and an episode of forceful vomiting

An adolescent who was placed into halo traction 1 hr ago and rates his pain at a 6 on a 0 to 10 scale

A school-age child who has acute glomerulonephritis and brown-colored urine

An adolescent who has infective endocarditis and reports having a headache

Answer and Explanation

The Correct Answer is A

A. Forceful vomiting in a child with a concussion could indicate increased intracranial pressure (ICP), which is a medical emergency. Vomiting is a common symptom of ICP, and prompt assessment is necessary to determine the severity of the concussion and prevent further complications.

B. Pain following halo traction is expected, and a pain score of 6 is moderate. The pain can be managed with appropriate interventions, and it does not indicate an immediate life-threatening situation.

C. Brown-colored urine in acute glomerulonephritis is concerning for hematuria, but it typically develops over several days and is not an acute emergency.

D. A headache in a patient with infective endocarditis could indicate a potential complication such as embolism or increased intracranial pressure, but it is not as immediately life-threatening as the signs of a concussion.

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Correct Answer is A

Explanation

A. Clinicians should be involved in discussions about the child’s prognosis to ensure that the family receives clear, compassionate information for decision-making.

B. Palliative care can and should be introduced earlier in the course of the illness, not just when the child is expected to live less than 6 months.

C. Parents expressing hope for survival do not necessarily reject palliative care. Palliative care can focus on comfort and quality of life even when there is still hope for recovery.

D. Palliative care should be integrated with curative care, as it can improve the quality of life while still pursuing treatment options.

A. Low-protein, low-potassium diet B. Low-carbohydrate, low-protein diet C. Regular diet, no added salt D. Low-sodium, fluid-restricted

Correct Answer is D

Explanation

A. A low-protein, low-potassium diet is not indicated for acute glomerulonephritis; protein restriction is generally considered for chronic renal failure.

B. Low-carbohydrate and low-protein diets are not indicated for this condition.

C. A regular diet with no added salt is inappropriate due to the child’s edema and need for sodium and fluid restrictions.

D. A low-sodium, fluid-restricted diet is appropriate for a child with acute glomerulonephritis to manage edema and prevent fluid overload.

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A nurse is receiving change of shift report on four children. Which of the following children should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly hired nurse about the management of care for the terminal illness of a child. Which of the following statements by the newly hired nurse indicates an understanding of the teaching?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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