The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child’s caregiver that the child may:

Be given ice cream and milk the first postoperative day because these foods make swallowing easier.

Have a painful earache around the third day postoperatively but the earache will be gone by the fourth day.

Vomit dark old blood but the caregiver should call the clinic if the child has bleeding between the fifth and seventh days postoperatively.

Have severe throat pain for up to 2 weeks postoperatively; this is not a concern.

Answer and Explanation

The Correct Answer is C

Choice A reason: Ice cream and milk may coat the throat, increasing mucus and infection risk post-tonsillectomy. Vomiting dark blood is normal, but new bleeding requires attention, making this incorrect, as dairy is not recommended for easing swallowing in the immediate postoperative period for the child.

Choice B reason: Earache from referred pain is common post-tonsillectomy but may persist beyond the fourth day. Vomiting old blood with guidance on new bleeding is more accurate, making this incorrect, as it underestimates the duration and management of ear pain in the recovery period.

Choice C reason: Vomiting dark old blood is normal post-tonsillectomy due to swallowed blood, but fresh bleeding between days 5-7 indicates potential complications, requiring clinic contact. This aligns with pediatric postoperative care, making it the correct explanation for caregivers during discharge teaching for the child.

Choice D reason: Severe throat pain for 2 weeks is expected but should be monitored, not dismissed, as it may signal complications. Guidance on bleeding is more critical, making this incorrect, as it downplays the need for vigilance regarding pain in the postoperative recovery period.

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Correct Answer is D

Explanation

Choice A reason: Explaining differential treatment to siblings fosters resentment and doesn’t teach the impaired child. Time-out after repetition reinforces boundaries, making this unhelpful and incorrect compared to a direct discipline strategy addressing the cognitively impaired preschooler’s continued behavior effectively.

Choice B reason: Taking away privileges like movies is too abstract for a cognitively impaired preschooler to connect to behavior. Immediate time-out is clearer, making this ineffective and incorrect compared to a concrete, immediate consequence tailored to the child’s cognitive limitations in discipline.

Choice C reason: Ignoring behavior and cleaning up avoids teaching consequences, reinforcing unwanted actions in a cognitively impaired child. Time-out provides structure, making this counterproductive and incorrect compared to a strategy that directly addresses and corrects the preschooler’s behavior with appropriate discipline.

Choice D reason: Waiting for a second occurrence and using immediate time-out provides clear, consistent consequences, suitable for a cognitively impaired preschooler’s understanding. This aligns with pediatric behavioral strategies, making it the correct statement reflecting effective discipline for the child’s continued behavior issues.

A. The child has a fractured bone. B. The child is hyperactive and angry. C. The child has bruises on the knees and elbows. D. The child has a burn that has not been treated.

Correct Answer is D

Explanation

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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The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child’s caregiver that the child may:

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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?

Correct Answer is D

Explanation

The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year-old will be best suited to work on which activity?

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?

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The parents and their child with a chronic illness have been seen by the nurse in the pediatrician’s office since birth. Which situation is appropriate for instruction by the nurse?

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