In the pediatric emergency department, the nurse must prioritize patient care. Which patient should the nurse assess first?

The 1-month-old infant who has developed colic and is crying.

The 14-year-old adolescent whose mother suspects her child is sexually active.

The 2-year-old toddler who was bitten by another child at the day-care center.

The 6-year-old school-aged child who was hit by a car while riding a bicycle.

Answer and Explanation

The Correct Answer is D

Choice A reason: While colic can be distressing, it is not life-threatening and does not require immediate assessment over more critical conditions.
Choice B reason: Suspicions of sexual activity in an adolescent are a concern but do not constitute an emergency that requires immediate assessment.
Choice C reason: A bite from another child, although potentially serious, is less urgent than a trauma case and can be assessed after more critical patients.
Choice D reason: This is the correct choice. A child hit by a car may have life-threatening injuries and requires immediate assessment and intervention.

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Correct Answer is D

Explanation

Choice A reason: Asking the client to choose the medication is not appropriate as the nurse should use clinical judgment to select the medication based on effectiveness and onset of action.
Choice B reason: Documentation is important but should not precede the administration of pain relief.
Choice C reason: Comparing the pain scale rating with prescribed dosing is part of pain management, but the immediate concern is to relieve the pain as quickly as possible.
Choice D reason: This is the correct choice. The nurse should determine which medication will provide the quickest relief from pain, which is the client's immediate need.

A. Explain the body changes that will take place. B. Maintain the child's normal routines. C. Allow the child to talk about the illness. D. Encourage friends to visit.

Correct Answer is B

Explanation

Choice A reason: Explaining body changes to a toddler may not be effective due to their limited understanding at this developmental stage.

Choice B reason: Maintaining normal routines provides a sense of security and normalcy, which is crucial for a toddler's emotional well-being, especially during a serious illness.

Choice C reason: Allowing the child to talk about the illness can be therapeutic, but toddlers may not have the verbal skills to express complex emotions or understand their condition.

Choice D reason: While encouraging friends to visit can provide social support, it is not as fundamental as maintaining daily routines that offer stability in the child's life. Maintaining normal routines is the most comforting and beneficial intervention for a toddler in this situation.

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In the pediatric emergency department, the nurse must prioritize patient care. Which patient should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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