While checking the vital signs of a 10-year-old child who underwent a tonsillectomy earlier in the day, the nurse notices the child swallowing every 2 to 3 minutes. What action should the nurse take next?

Check for signs of teeth clenching or grinding

Inspect the back of the throat

Stimulate the gag reflex by touching the tonsillar pillars

Ask the child to speak to assess for any changes in voice tone .

Answer and Explanation

The Correct Answer is B

Choice A rationale
Checking for signs of teeth clenching or grinding is not typically necessary in a child who has undergone a tonsillectomy and is swallowing frequently. These signs are not typically associated with post-tonsillectomy complications.
Choice B rationale
Inspecting the back of the throat is an appropriate action for the nurse to take next. Frequent swallowing can be a sign of bleeding in the throat, which is a potential complication of tonsillectomy. By inspecting the back of the throat, the nurse can assess for signs of bleeding.
Choice C rationale
Stimulating the gag reflex by touching the tonsillar pillars is not typically necessary in a child who has undergone a tonsillectomy and is swallowing frequently. This action could potentially cause discomfort or induce vomiting.
Choice D rationale
Asking the child to speak to assess for any changes in voice tone is not typically necessary in a child who has undergone a tonsillectomy and is swallowing frequently. Changes in voice tone are not typically associated with post-tonsillectomy complications.

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Correct Answer is C

Explanation

Choice A rationale
While a list of achievement timeline for developmental milestones can provide useful information about the child’s overall development, it may not be the most critical information when planning care for an umbilical hernia repair.
Choice B rationale
The mother’s use of alcohol, drugs, or cigarettes during pregnancy can have long-term effects on the child’s health, but it may not be the most relevant information for planning care for an umbilical hernia repair.
Choice C rationale
Knowing how the child reacted to any previous hospitalizations can provide valuable insight into the child’s previous healthcare experiences. This information can help the nurse plan care that is appropriate for the child’s emotional and developmental needs during the hospitalization for an umbilical hernia repair.
Choice D rationale
A history of rubella, rubeola, or chicken pox is important for the child’s medical history, but it may not be the most critical information when planning care for an umbilical hernia repair.

A. Rice B. Barley C. Rye D. Oats

Correct Answer is A

Explanation

Choice A rationale
Rice is a gluten-free grain and is safe for individuals with celiac disease to consume.
Choice B rationale
Barley contains gluten, a protein that triggers an immune response in people with celiac disease, damaging the lining of the small intestine. Therefore, barley should be avoided.
Choice C rationale
Rye also contains gluten and should be avoided by individuals with celiac disease.
Choice D rationale
Oats are often cross-contaminated with gluten-containing grains and should be consumed with caution. Only oats labeled as gluten-free are safe for individuals with celiac disease.

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While checking the vital signs of a 10-year-old child who underwent a tonsillectomy earlier in the day, the nurse notices the child swallowing every 2 to 3 minutes. What action should the nurse take next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A six-year-old girl is being admitted to the hospital for repair of an umbilical hernia. Which information, collected by the admitting nurse, is particularly helpful in planning care for this child?

Correct Answer is C

Explanation

A nurse is educating parents about essential dietary modifications for their child, who has recently been diagnosed with celiac disease. Which foods should the nurse include in the list of permissible foods for this child?

Correct Answer is A

Explanation

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