Nurse Kim is teaching a group of parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
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Solution
Eustachian tubes
In a child, Eustachian tubes are short and lie in a horizontal plane, promoting entry of nasopharyngeal secretions into the tubes and thus setting the stage for otitis media.
Options B, C, and D: The nasopharynx, tympanic membrane, external ear canal have no unusual features that would predispose a child to otitis media.
Nurse Walter should expect a 3-year-old child to be able to perform which action?
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Solution
Ride a tricycle
At age 3, gross motor development and refinement in eye-hand coordination enable a child to ride a tricycle.
Options B, C, and D: The fine motor skills required to tie shoelaces and the gross motor skills require for roller-skating and jumping rope develop around age 5.
When performing a physical examination on an infant, the nurse in charge notes abnormally low-set ears. This finding is associated with:
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Solution
Renal anomalies
Normally the top of the ear aligns with an imaginary line drawn across the inner and outer canthus of the eye. Ears set below this line are associated with renal anomalies or mental retardation.
Options A, B, and C: Low-set ears do not accompany otogenous tetanus, tracheoesophageal fistula, or congenital heart defects.
Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is least effective?
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Solution
Providing age-appropriate reading materials
Because adolescents absorb less information through reading, providing age-appropriate reading materials is the least effective way to teach parenting skills to an adolescent.
Options A, B, and C: The other options engage more than one of the senses and therefore serve as effective teaching strategies.
A 1-year-and 2-month-old child weighing 26 lb (11.8 kg) is admitted for traction to treat congenital hip dislocation. When preparing the patient’s room, the nurse anticipates using which traction system?
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Solution
Bryant’s traction
Bryant’s traction is used to treat femoral fractures of congenital hip dislocation in children under age 2 who weigh less than 30 lb (13.6 kg).
Option B: Buck’s extension traction is skin traction used for short-term immobilization or to correct bone deformities or contractures.
Option C: Overhead suspension traction is used to treat fractures of the humerus; and
Option D: 90-90 traction is used to treat femoral fracture in children over age 2.
To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation, succinylcholine (Anectine) is used with which of the following agents?
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Solution
Atropine sulfate
Succinylcholine is an ultra-short-acting depolarizing agent used for rapid-sequence intubation. Bradycardia can occur, especially in children. Atropine is the drug of choice in treating succinylcholine-induced bradycardia.
Options A and B: Epinephrine bolus and isoproterenol are not used in rapid-sequence intubation because of their profound cardiac effects.
Option D: Lidocaine is used in adults only.
During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first?
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Solution
Rice cereal
Rice cereal is the first solid food an infant should receive because it is easy to digest and is associated with few allergies. Next, the infant can receive pureed fruits, such as bananas, applesauce, and pears, followed by pureed vegetables, egg yolks, cheese, yogurt, and finally, meat.
Option B: Egg whites should not be given until age 9 months because they may trigger a food allergy.
A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child’s vision, the nurse should ask:
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Solution
“How are you doing in school?”
A child’s poor progress in school may indicate a visual disturbance. The other options are more appropriate questions to ask when assessing vision in a geriatric patient.
A mother asks the nurse how to handle her 5-year-old child, who recently started wetting the pants after being completely toilet trained. The child just started attending nursery school 2 days a week. Which principle should guide the nurse’s response?
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Solution
The child returns to a level of behavior that increases the sense of security.
The stress of starting nursery school may trigger a return to a level of successful behavior from earlier stages of development.
Option A: A child’s skills remain intact, although increased stress may prevent the child from using these skills.
Option B: Growth occurs when the child does not regress.
Option C: Parents rarely desire less mature behaviors.
A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?
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Solution
Heart rate, respiratory rate, and blood pressure
The most important data to obtain on a child’s arrival in the emergency department are vital sign measurements. The nurse should gather the other data later.