The nurse is giving instructions to the mother of a 10-year-old boy who is newly diagnosed with type 1 diabetes mellitus (DM). When attempting to teach the mother how to administer subcutaneous insulin injections to the child, the mother tells the nurse that she is afraid of needles and cannot perform the procedure.
Which intervention should the nurse implement?

Determine if the child can administer the insulin.

Assess the mother's parenting skills.

Encourage the mother to handle the needles.

Ask if the father can help with the injections.

Answer and Explanation

The Correct Answer is D

Choice A rationale

This choice suggests assessing if the child can administer the insulin. While it's important for children with diabetes to learn self-care skills, a 10-year-old may not yet be ready to take on the responsibility of injecting insulin regularly. The child might still rely on parental or caregiver support for this task. Moreover, it does not address the immediate issue of the mother's fear of needles.

Choice B rationale

This choice focuses on assessing the mother's parenting skills. It is not directly related to solving the issue of insulin administration. The mother's fear of needles does not necessarily reflect her overall parenting skills. Assessing parenting skills would not provide a practical solution to the child's need for insulin administration.

Choice C rationale

Encouraging the mother to handle the needles could help overcome her fear, but it might not be effective in the short term. The mother might need time and professional help to deal with her fear of needles. This choice does not provide an immediate solution for the child's need for insulin injections.

Choice D rationale

Asking if the father can help with the injections is a practical and immediate solution. If the father is available and comfortable with handling needles, he can take on the responsibility of administering insulin to the child. This ensures that the child's medical needs are met while giving the mother time to overcome her fear of needles.

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Correct Answer is A

Explanation

Choice A rationale

The child’s symptoms suggest epiglottitis, a medical emergency requiring readiness for intubation or tracheotomy to secure the airway. Immediate preparation for these procedures is crucial to prevent airway obstruction and respiratory arrest.

Choice B rationale

Although imaging can provide diagnostic information, it is not the immediate priority. The priority is to secure the airway to prevent acute respiratory failure, making this choice less appropriate.

Choice C rationale

Nebulizer treatments can help with lower airway obstructions but are ineffective for upper airway conditions like epiglottitis. The child’s symptoms indicate upper airway obstruction, making this choice less appropriate.

Choice D rationale

While antibiotics are essential for treating infections causing epiglottitis, the immediate priority is to ensure the airway is not compromised. Securing the airway takes precedence over initiating antibiotic therapy in this acute situation.

A. Request extra staff to help with the nursing assessments. B. Explain to the child the reasons an examination is needed. C. Talk to the mother and gradually focus on the child's toy. D. Complete the assessment while allowing the child to cry.

Correct Answer is C

Explanation

Choice A rationale

Requesting extra staff to help with the nursing assessments may not be the most effective approach. It could increase the child's anxiety due to the presence of more unfamiliar people in the room. The primary goal is to create a calm environment that helps the child feel safe and more cooperative.

Choice B rationale

Explaining the reasons for the examination to the child may not be effective for a preschooler who may not fully understand or be comforted by such explanations. Young children often require more tangible and immediate means of reassurance and distraction.

Choice C rationale

Talking to the mother and gradually focusing on the child's toy is a practical approach. This strategy helps build rapport with both the mother and the child, and using the toy as a focal point can distract and comfort the child, making the examination process less intimidating and more cooperative.

Choice D rationale

Completing the assessment while allowing the child to cry may not be ideal. It can increase the child's distress and make the assessment more challenging. Addressing the child's emotional needs by providing comfort and distraction can lead to a more successful and less stressful examination.

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Naxlex Comprehensive Predictor Exams

A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents.The child is anxious, has a temperature of 102.8°F (39.3°C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?

Correct Answer is A

Explanation

A mother brings her male preschooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to cry and cling to his mother when the nurse enters the examination room. Which action should the nurse implement to get the child to cooperate?

Correct Answer is C

Explanation

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