The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond?

"Tell me about the circumstances when this occurs."

"Is there a family history of diabetes?"

"Suddenly having accidents can be a sign of diabetes."

"That's normal: don't worry about it."

Answer and Explanation

The Correct Answer is A

A. "Tell me about the circumstances when this occurs.": This response allows the nurse to gather more information about the child's toileting habits and potential triggers for the accidents.

Understanding the context can help identify possible underlying causes and guide appropriate interventions.

B. "Is there a family history of diabetes?": While diabetes can be a cause of increased urination, asking about a family history of diabetes is premature and may unnecessarily alarm the parent before further assessment.

C. "Suddenly having accidents can be a sign of diabetes.": Jumping to conclusions about a serious medical condition like diabetes without further assessment or evidence can cause unnecessary anxiety for the parent. It's important to gather more information and consider other potential causes before suggesting a diagnosis.

D. "That's normal: don't worry about it.": While occasional daytime wetting accidents can be common in young children, dismissing the concern without further assessment may overlook potential underlying issues that could benefit from intervention or support.

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Correct Answer is D

Explanation

A. TympaniC. Tympanic temperature measurement using an ear thermometer is a convenient and accurate method for assessing temperature in children, including toddlers.

B. Oral: Oral temperature measurement using a digital thermometer placed under the tongue is a commonly used method for children who can cooperate with the procedure and keep the

thermometer in their mouth.

C. Axillary: Axillary temperature measurement using a thermometer placed in the armpit is a non-invasive method suitable for children who cannot cooperate with oral or tympanic

measurements or when rectal measurement is contraindicated.

D. Rectal: Rectal temperature measurement is generally considered the most accurate method for assessing temperature in infants and young children, especially when accuracy is critical.

However, it may be less appropriate in the emergency department setting due to its invasive nature and potential discomfort for the child, especially in cases of diarrhea or vomiting where rectal temperature measurement may be difficult or impractical.

A. Use quick deliberate gestures to get your point across. B. Allow the child to control the pace and order of the health history. C. Do not make physical contact with the child during the interview. D. Wear a white examination coat when conducting the interview.

Correct Answer is B

Explanation

A. Use quick deliberate gestures to get your point across.

Using quick gestures may intimidate or overwhelm the child, potentially hindering communication. It's essential to approach the child with patience and attentiveness.

B. Allow the child to control the pace and order of the health history.

Allowing the child to dictate the pace and sequence of the health history empowers them and helps build trust. It allows the child to express themselves comfortably and share relevant

information at their own pace.

C. Do not make physical contact with the child during the interview.

While respecting the child's personal space is important, appropriate physical contact, such as a reassuring touch or handshake, can help establish rapport and comfort during the interview.

D. Wear a white examination coat when conducting the interview.

Wearing a white coat may create a sense of formality and authority that could intimidate the child. Opting for attire that is approachable and friendly can help put the child at ease and facilitate open communication.

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The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond?

Nursing Test Bank

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