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 B

Explanation

A. While emotional support is important, this response may come across as directive and may not acknowledge the father's current emotional state.

B. Asking about how the father has handled previous stressors allows him to reflect on coping mechanisms and may provide insight into how he can manage the current situation.

C. While acknowledging the father's feelings is important, agreeing without further exploration may not help him address the emotional distress he is experiencing.

D. Dismissing the father’s feelings or emotions can invalidate his experience, which could prevent him from opening up about his struggles.

A. "I will prepare low-fat meals with limited protein for my child." B. "We will give our child pancreatic enzymes with snacks and meals." C. "I will limit my child's fluid intake." D. "We will restrict the amount of salt in our child's food."

Correct Answer is B

Explanation

A. A low-fat diet is inappropriate for children with cystic fibrosis; they require a high-fat, high-calorie diet.

B. Pancreatic enzymes must be taken with every meal and snack to help with nutrient absorption in children with cystic fibrosis.

C. Limiting fluid intake is not appropriate for children with cystic fibrosis; adequate hydration is important.

D. Salt intake should be increased, not restricted, in children with cystic fibrosis due to excessive salt loss in sweat.

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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

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