Several children are seen in the ER for treatment of illnesses and injuries daily. The situation that would cause the nurse to have a high suspicion of child abuse would be:

a 1-year-old child who has a dislocated shoulder from arm swinging.

several visits of the same child with varied injuries.

a 5-year-old child who broke his arm and clings to mother crying

repeated visits of the same child with middle ear infections.

Answer and Explanation

The Correct Answer is B

B. Multiple visits of the same child with different injuries could be a significant red flag for possible child abuse. Patterns of repeated injuries or injuries inconsistent with the child's developmental stage or reported activities may indicate a pattern of maltreatment.
A. While accidental injuries can occur, a dislocated shoulder in a 1-year-old child from arm swinging seems unlikely and may warrant further investigation.
C. Breaking a bone, such as an arm, can occur accidentally during childhood play or activities and the behavior of the child clinging to the mother is expected in moments of pain.
D. Middle ear infections are common in childhood and typically do not raise suspicion of abuse on their own.

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Correct Answer is C

Explanation

C. Digoxin toxicity is a serious condition that can occur when there is too much digoxin in the body. It can lead to life-threatening cardiac dysrhythmias. One of the risk factors for digoxin toxicity is low blood levels of potassium, or hypokalemia.
A. Electrolyte imbalances, including hyponatremia (low sodium levels), can contribute to digoxin toxicity. However, a sodium level of 133 mg/dl alone does not directly indicate digoxin toxicity.
B. Blood glucose levels within the normal range (80-120 mg/dl) would not directly indicate digoxin toxicity.
D. Calcium levels within the normal range (8.5-10.5 mg/dl) do not directly indicate digoxin toxicity.

A. Encourage dividing tasks into smaller, attainable steps and reward successful completion. B. Remove privileges if homework is not completed within a 2-hour period. C. Seek a physician's order to discontinue the stimulant methylphenidate. D. Mandate that the client remains in his room until all homework is complete.

Correct Answer is A

Explanation

A. Dividing tasks into smaller, attainable steps and reward successful completion aligns with the principles of behavioral therapy and is likely to be effective for improving the task performance of an adolescent with ADHD. Breaking tasks into smaller, manageable steps can help reduce overwhelm and improve focus.
B. Removing privileges if homework is not completed within a 2-hour period is punitive and may not be effective for improving the task performance of an adolescent with ADHD. Negative consequences, such as removing privileges, can lead to feelings of frustration, demotivation, and resistance to task completion.
C. Methylphenidate is a commonly prescribed stimulant medication for ADHD, and discontinuing it abruptly without medical supervision can lead to withdrawal symptoms and worsening of ADHD symptoms.
D. Mandating isolation in the room is overly restrictive and can lead to feelings of frustration, isolation, and resentment, which can further impact task performance and exacerbate ADHD symptoms.

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Several children are seen in the ER for treatment of illnesses and injuries daily. The situation that would cause the nurse to have a high suspicion of child abuse would be:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse should monitor the client for signs and symptoms of digoxin toxicity if the laboratory report reflects a serum:

Correct Answer is C

Explanation

An adolescent diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) is having difficulty maintaining concentration in the inpatient milieu. Which nursing intervention would help improve the client's task performance?

Correct Answer is A

Explanation

A father brings his preschool son to the Emergency Department (ED) with multiple bruises and a fractured arm. Which statement by the father would cause the nurse to suspect child abuse? "He is:

An 11-year-old, who is diagnosed with oppositional defiant disorder, becomes angry and disruptive over the rules of the day treatment program. The nurse should de-escalate the situation by:

The nurse believes that a client being admitted for a surgical procedure may have a drinking problem. Which screening tool should the nurse use to further evaluate this possibility?

The best action for the nurse to take with a 5-year-old who runs over to another child in the waiting room and slaps her is to:

A physician mentions to the nurse that a child with Attention Deficit-Hyperactivity Disorder (ADHD) will begin medication therapy. The nurse should prepare a plan to teach the family about:

When assessing the client diagnosed with schizotypal personality disorder, the nurse expects to identify which characteristic behavior?

The nurse in the Emergency Department (ED) assesses a 17-year-old client exhibiting symptoms of opiate intoxication. Which of the following should be the nurse's priority action?