The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse (child maltreatment). Which finding might alert the nurse to this possibility that the child may have been abused?

The child has a fractured bone.

The child is hyperactive and angry.

The child has bruises on the knees and elbows.

The child has a burn that has not been treated.

Answer and Explanation

The Correct Answer is D

Choice A reason: A fractured bone can occur from accidents or abuse, but alone, it is not specific to maltreatment without inconsistent history or pattern. An untreated burn is more suggestive of neglect or abuse, as it indicates failure to seek care, making this less definitive and incorrect compared to a clear neglect indicator.

Choice B reason: Hyperactivity and anger are behavioral responses that may occur in abused children but are nonspecific and common in other conditions. An untreated burn is a clearer physical sign of potential neglect or abuse, making this behavioral finding less indicative and incorrect for alerting to possible child maltreatment.

Choice C reason: Bruises on knees and elbows are typical in active children from play, not necessarily indicative of abuse. An untreated burn raises stronger suspicion of neglect or intentional injury, making this common finding less concerning and incorrect for identifying potential child maltreatment in a clinical setting.

Choice D reason: An untreated burn is highly suggestive of child abuse or neglect, as it indicates failure to seek medical care for a serious injury. This finding, especially if unexplained or inconsistent with history, aligns with child maltreatment indicators, making it the most alerting sign for the nurse to investigate further.

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Correct Answer is C

Explanation

Choice A reason: Red meat, poultry, and fish are animal products excluded from a vegan diet, which is plant-based. Students identifying these correctly understand veganism excludes them, making this incorrect, as it does not indicate a need for more information about vegan dietary restrictions in the presentation.

Choice B reason: Red meat and poultry are not part of a vegan diet, which avoids all animal products. Students listing these show understanding of vegan exclusions, making this incorrect, as it does not reflect a misunderstanding requiring further education about vegan diet principles for the students.

Choice C reason: Vegan diets exclude dairy, meat, poultry, fish, and eggs, as they are animal-derived. Identifying these as included indicates a misunderstanding, as vegans consume only plant-based foods, making this the correct choice for needing more information, per nutritional education standards for high schoolers.

Choice D reason: Meat, poultry, fish, and eggs are excluded from vegan diets, and students listing them understand this restriction. This does not indicate a knowledge gap, making it incorrect compared to including dairy, which reflects a common misconception about veganism among the student group.

A. Use the “shortcut” scale because this child is average. This will show the nurse the percentage of the adult dosage appropriate for this child. Use this percentage to calculate the dosage. B. Locate the child’s height and weight on the nomogram. Use a straight edge to align these numbers with the scale indicating percentage of adult dosage and multiply the adult dosage by this number. C. Locate the child’s height and weight on the scale, multiply those two numbers, and divide the adult dosage by the resulting number. D. Use the scale to locate the child’s height and weight. Use a straight edge to align these numbers with the scale indicating the surface area, divide that by the average adult body surface area, and multiply the resulting number by the adult dose.

Correct Answer is D

Explanation

Choice A reason: The “shortcut” scale is not a standard method for the West nomogram, which calculates body surface area (BSA) for precise dosing. Using BSA ensures accuracy for a 76-lb, 50-inch child, making this simplified approach incorrect for calculating a safe pediatric medication dosage in clinical practice.

Choice B reason: Aligning height and weight to a percentage of adult dosage is not how the West nomogram works; it calculates BSA. The correct method uses BSA relative to adult BSA, making this incorrect, as it skips the critical step of surface area calculation for accurate pediatric dosing.

Choice C reason: Multiplying height and weight and dividing the adult dosage is not a nomogram method. The West nomogram uses BSA to adjust doses, comparing child and adult surface areas, making this mathematically incorrect and inappropriate for calculating a safe pediatric medication dose for the child.

Choice D reason: The West nomogram calculates a child’s BSA using height (50 inches) and weight (76 lb), then divides by the average adult BSA (1.7 m²) to find the proportion of the adult dose (300 mg). This method ensures accurate pediatric dosing, making it the correct choice for safe administration.

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The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse (child maltreatment). Which finding might alert the nurse to this possibility that the child may have been abused?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The school nurse is presenting information to a group of high school students who are asking about vegetarian diets. The nurse determines that the group needs more information when they identify which foods as being included in a vegan diet?

Correct Answer is C

Explanation

Using the West nomogram scale, the nurse needs to calculate the safe dosage of a medication for a child. The child is 50 inches tall and weighs 76 lb. The normal dosage of the medication for an adult is 300 mg. Which of the following is the correct way to use the West nomogram scale?

Correct Answer is D

Explanation

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The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse (child maltreatment). Which finding might alert the nurse to this possibility that the child may have been abused?

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