The nurse is assessing a child who is lying quietly on the bed. Which action should the nurse take?

Pick up the child from the environment.

Leave the child in a flexed position on the bed.

Check the child’s level of consciousness and pain scale.

Assume the child is quietly sleeping on the parent’s lap.

Answer and Explanation

The Correct Answer is C

Choice A reason: Picking up the child without assessment risks disrupting a potentially critical condition, as quiet lying may indicate pain or altered consciousness. Checking consciousness and pain ensures safety, making this premature and incorrect compared to prioritizing a thorough evaluation of the child’s quiet state.

Choice B reason: Leaving the child in a flexed position assumes no issue without assessing consciousness or pain, which quiet behavior may mask. Evaluating the child’s status is critical, making this passive and incorrect compared to actively checking for underlying issues in the child’s quiet presentation on the bed.

Choice C reason: Checking the level of consciousness and pain scale determines if the child’s quietness indicates distress, pain, or neurological issues, ensuring appropriate care. This aligns with pediatric assessment protocols, making it the correct action to address the child’s condition lying quietly on the bed.

Choice D reason: Assuming the child is sleeping on the parent’s lap is incorrect, as the child is on the bed, and quietness may indicate distress. Assessing consciousness and pain is essential, making this inaccurate and incorrect compared to evaluating the child’s true condition in this scenario.

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Correct Answer is B

Explanation

Choice A reason: Socializing with healthy peers may motivate but doesn’t directly teach self-care skills for chronic illness. A contract with rewards engages the child actively, making this less focused and incorrect compared to a structured strategy ensuring school-aged children achieve treatment goals effectively.

Choice B reason: Co-writing a contract with rewards engages the child in setting and achieving self-care goals, fostering responsibility and motivation. This aligns with pediatric chronic illness management, making it the most effective strategy to help school-aged children master treatment goals with caregiver involvement.

Choice C reason: Reinforcing the importance of goals educates but lacks active engagement compared to a reward-based contract. Contracts promote accountability, making this less effective and incorrect for directly helping chronically ill children achieve self-care treatment goals in a structured, motivating way.

Choice D reason: A sticker chart tracks progress but is less collaborative than a contract, which involves the child in goal-setting. Contracts better foster ownership, making this less engaging and incorrect compared to the co-written contract strategy for achieving self-care goals in school-aged children.

A. A 9-year-old with a compound fracture of the tibia, which the caregiver reports as having been caused when the child attempted a flip on a skateboard. B. A 10-year-old with a simple fracture of the femur, which the caregiver reports as having been caused when the child fell down a set of stairs. C. A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate. D. A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports as having been caused when the child fell while ice-skating.

Correct Answer is C

Explanation

Choice A reason: A compound tibia fracture from a skateboard flip is plausible, as high-impact activities can cause such injuries in active 9-year-olds. A spiral fracture with an inconsistent story raises more suspicion, making this less concerning and incorrect for prioritizing abuse investigation in the unit.

Choice B reason: A simple femur fracture from falling down stairs aligns with common childhood accidents, especially in a 10-year-old. The spiral fracture’s implausible bat story is more suspicious, making this less indicative and incorrect compared to the need to investigate potential abuse in another case.

Choice C reason: A spiral humerus fracture suggests twisting force, inconsistent with a bat swing by a peer, raising abuse concerns in a 7-year-old. This warrants further data collection, aligning with child maltreatment protocols, making it the correct situation for exploring possible mistreatment on the pediatric unit.

Choice D reason: A greenstick wrist fracture from ice-skating is typical in a 6-year-old, as falls cause such incomplete breaks in flexible bones. The spiral fracture’s questionable explanation is more concerning, making this plausible and incorrect for prioritizing abuse investigation among the children.

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The nurse is assessing a child who is lying quietly on the bed. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is working with a group of chronically ill school-aged children and their caregivers. Which strategy would be most effective in helping the children reach their self-care treatment goals?

Correct Answer is B

Explanation

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse (child mistreatment) in which situation?

Correct Answer is C

Explanation

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