A single woman brings her 10-year-old daughter in for the first well-child visit at the clinic. The nurse discovers they recently relocated to that area due to the mother’s job, the child is now attending a “tough” school and she is home, scared and alone, for several hours after school. Which action should the nurse prioritize to assist this family?

Discuss concerns about anxiety and depression.

Provide information for preventing drug and alcohol use among teens.

Provide a list of emergency contact numbers.

Provide a list of local after-school programs.

Answer and Explanation

The Correct Answer is D

Choice A reason: Discussing anxiety and depression is relevant but premature without addressing the immediate issue of the child being alone and scared after school. After-school programs provide supervision and safety, making this less urgent and incorrect compared to resolving the primary concern of unsupervised time for the child.

Choice B reason: Preventing drug and alcohol use is important but not the priority for a 10-year-old scared and alone after school. After-school programs address immediate safety and social needs, making this secondary and incorrect compared to tackling the child’s current unsupervised and fearful situation at home.

Choice C reason: Emergency contact numbers are useful but do not resolve the ongoing issue of the child being alone and scared daily. After-school programs offer structured supervision, directly addressing the primary concern, making this less critical and incorrect for the nurse’s priority action for this family.

Choice D reason: Providing a list of after-school programs addresses the child’s fear and isolation by offering supervised, engaging activities, reducing unsupervised time at home. This prioritizes safety and emotional well-being, aligning with pediatric nursing goals for supporting relocated families, making it the correct action to assist them.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A reason: Perianal itching is the hallmark symptom of enterobiasis, caused by pinworms laying eggs at night, irritating the skin. This aligns with pediatric infectious disease evidence, making it the most likely history in a child admitted with pinworm infection, accurately reflecting the condition’s presentation.

Choice B reason: Malnutrition is not typically associated with pinworms, which cause localized irritation rather than systemic nutrient loss. Perianal itching is the primary symptom, making this incorrect, as it does not reflect the usual clinical history of a child with enterobiasis in a hospital setting.

Choice C reason: Bedwetting is unrelated to pinworm infection, which primarily causes perianal itching due to nocturnal egg-laying. Itching is the expected history, making this incorrect, as bedwetting does not correlate with the typical presentation of enterobiasis in a young admitted child.

Choice D reason: Restlessness may occur due to itching but is less specific than perianal itching, the defining symptom of pinworms. Itching directly ties to the diagnosis, making this less precise and incorrect compared to the primary history expected in a child with enterobiasis infection.

A. The caregiver should use tweezers to carefully remove the tick without crushing it. B. The caregiver should hold a gauze pad beneath the tick to catch the blood and carefully crush the tick. C. The caregiver should have another adult hold the child still, light a match and let it burn for 1 second, then blow out the match and quickly hold it on the tick. D. The caregiver should take the child to a healthcare facility where the tick can be removed aseptically.

Correct Answer is A

Explanation

Choice A reason: Using tweezers to gently remove a tick without crushing it minimizes infection risk and ensures complete removal, reducing Lyme disease transmission. This aligns with pediatric infectious disease guidelines for tick removal, making it the best action for the caregiver to follow for the 4-year-old.

Choice B reason: Crushing the tick risks releasing pathogens into the bite site, increasing infection risk. Gentle tweezer removal is the standard, as it avoids dispersing tick contents, making this unsafe and incorrect for the proper method of removing a swollen tick from the child’s arm.

Choice C reason: Using a hot match to remove a tick is ineffective and risks burning the child or driving pathogens deeper. Tweezers ensure safe, complete removal, making this dangerous and incorrect compared to the recommended technique for tick removal in a child in a wooded area.

Choice D reason: Taking the child to a healthcare facility is unnecessary for a routine tick removal, which caregivers can perform with tweezers. This delays action and increases inconvenience, making it incorrect compared to the effective, immediate tweezer method for tick removal in this scenario.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A young child has been admitted with a diagnosis of enterobiasis (pinworm infection). This child will most likely have a history of:

Correct Answer is A

Explanation

The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. What would be the best action for the caregiver to follow in removing the tick?

Correct Answer is A

Explanation

The pediatric nurse recognizes that what statement is true regarding medications administered via the intravenous route?

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

A child diagnosed with allergic rhinitis is rubbing his nose upward and backward. Which response is the child exhibiting?

A first-time mother calls the pediatrician’s office to ask the nurse about her baby’s tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby’s dentition?

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system?

The daughter of a divorced couple is hospitalized for injuries received in an automobile accident. The custodial father is at work when the mother arrives extremely agitated and demanding to see her daughter immediately. Which action will be most appropriate for the nurse to take at this time?

The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?