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?
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.
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.
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.
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.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Walking then running is a gross motor sequence, not proximodistal, which progresses from central to peripheral control. Arm waving to foot grasping shows this pattern, making this incorrect, as it does not illustrate the infant’s proximodistal development in the instructor’s class.
Choice B reason: Rolling over precedes eye tracking, but proximodistal development involves motor control from trunk to extremities. Arm waving to foot grasping better illustrates this, making this incorrect, as it does not reflect the central-to-peripheral progression of infant motor development in the lesson.
Choice C reason: Imitating sounds to speaking is linguistic, not proximodistal, which focuses on motor control from core to limbs. Arm waving to foot grasping demonstrates this pattern, making this incorrect, as it does not represent the physical developmental sequence taught in the infant development class.
Choice D reason: Kicking and arm waving involve trunk and proximal muscles, while grasping the foot uses distal control, illustrating proximodistal development. Students choosing this show understanding, aligning with infant motor development principles, making it the correct example for a successful class on infant development.
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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