The nurse working in the ER is admitting a toddler to the orthopedic unit. The parents and grandparents are at bedside. What should the nurse use as the best source of data for this client?

Grandparents

Admitting provider

Parents

Medical record

Answer and Explanation

The Correct Answer is C

A. Grandparents: While grandparents can provide valuable information, parents are typically the primary source of information about a child’s medical history, current symptoms, and behavioral changes.
B. Admitting provider: The admitting provider's role is to assess and diagnose the client. While they provide essential clinical information, they are not the primary source for personal and historical data about the client.
C. Parents: Parents are the most reliable source of information regarding the toddler's medical history, current condition, and any changes in behavior or health. They are most familiar with the child’s day-to-day health and medical background.
D. Medical record: Although the medical record contains important information, it may not have the most recent updates or contextual details that parents can provide. It is important to corroborate the information in the medical record with input from the parents.

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Correct Answer is A

Explanation

A. Financial difficulties: Correct. Financial difficulties are a psychological stressor as they impact mental and emotional well-being, contributing to stress.
B. Hypothermia: This is a physiological stressor, as it involves a physical condition affecting the body's health rather than psychological aspects.
C. Burn injury: This is also a physiological stressor resulting from physical harm rather than a psychological impact.
D. Wrist fracture: This is a physical stressor due to injury, not a psychological one, as it affects physical health rather than mental well-being.

A. Use soap and water to clean the client's perineum. B. Use the same section of washcloth for each area cleaned. C. Allow the client's perineum to air dry. D. Start at the client's rectum and clean to the client's perineum.

Correct Answer is A

Explanation

A. Use soap and water to clean the client's perineum: Correct. Using soap and water is the standard method for cleaning the perineum to ensure it is effectively cleaned while maintaining hygiene.
B. Use the same section of washcloth for each area cleaned: Incorrect. To prevent cross-contamination, the nurse should use a clean section of the washcloth or a new washcloth for each area cleaned.
C. Allow the client's perineum to air dry: Incorrect. The perineum should be gently patted dry with a clean towel to prevent irritation and ensure proper drying.
D. Start at the client's rectum and clean to the client's perineum: Incorrect. The proper technique is to clean from the perineum to the rectum to prevent the spread of bacteria from the rectal area to the vaginal area.

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The nurse working in the ER is admitting a toddler to the orthopedic unit. The parents and grandparents are at bedside. What should the nurse use as the best source of data for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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Correct Answer is A

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