Question

A nurse is caring for a school-age child who has cystic fibrosis.

Answer 1

Correct Answers:

Water-soluble vitamin
Dornase alfa

Rationale :

🫁Dornase alfa is a mucolytic agent specifically prescribed for clients with cystic fibrosis to thin and loosen thick pulmonary secretions, thereby improving airway clearance and reducing the risk of infections.

💊Clients with fat-soluble vitamin malabsorption (vitamins A, D, E, K) require water-soluble forms of these vitamins to improve absorption due to pancreatic enzyme deficiency and steatorrhea.

🔬The presence of Pseudomonas aeruginosa and elevated WBC count confirms infection, but acetaminophen is only symptomatic and not a CF-specific treatment, while meperidine is not recommended for children due to the risk of toxic metabolite accumulation.

🩻The child’s symptoms—paroxysmal cough, barrel chest, and clubbing—are classic signs of chronic hypoxia in cystic fibrosis, supporting the need for targeted pulmonary and nutritional therapies.

📌Core Message

Children with cystic fibrosis require airway clearance agents like dornase alfa and water-soluble vitamins to manage mucus build-up and fat-soluble vitamin deficiencies due to malabsorption.

Answer 2

Correct Answers:

Instruct the parent to ensure the pneumococcal vaccine is current.
Administer folic acid as prescribed.
Monitor oxygen saturation continuously
Apply cold compresses to the affected joints.
Give oral hydroxyurea.

Rationale :

💉Pneumococcal vaccination is essential for clients with sickle cell disease due to their increased risk for encapsulated bacterial infections from functional asplenia.

💊Folic acid is given to support erythropoiesis, as these clients experience chronic hemolysis and need help generating new red blood cells.

📈Oxygen saturation monitoring helps detect hypoxia, which can worsen sickling and vaso-occlusion, making it critical during crisis management.

🧊Cold compresses are effective for localized pain relief and reducing inflammation during joint pain episodes, which often accompany sickle cell crises.

💊Hydroxyurea is a disease-modifying drug that increases fetal hemoglobin (HbF) production, which reduces sickling episodes and the severity of crises.

📌Core Message

Care for clients in vaso-occlusive crisis includes pain control, oxygenation, infection prevention, and disease-modifying therapy such as hydroxyurea and folic acid supplementation.

Answer 3

Correct Answers:

Decreased platelet count

Rationale :

🧪Disseminated intravascular coagulation (DIC) is a coagulopathy marked by widespread clotting and simultaneous bleeding due to platelet and clotting factor consumption.

📉As a result, clients typically present with a decreased platelet count, prolonged bleeding time, and abnormal coagulation studies such as increased PT and aPTT.

🩸Hgb and RBC levels are often reduced, not increased, due to ongoing bleeding and hemolysis.

🔬The body’s inability to control bleeding in DIC leads to microvascular thrombi and hemorrhagic manifestations, making low platelets a key indicator.

📌Core Message

Disseminated intravascular coagulation causes consumption of platelets and clotting factors, leading to a decreased platelet count and abnormal coagulation profiles.

Answer 4

Correct Answers:

An 18-month-old toddler who has a heart rate of 68/min

Rationale :

❤️The normal heart rate for an 18-month-old ranges between 80–130/min, so a heart rate of 68/min is bradycardic and requires immediate evaluation.

🩺Bradycardia in children can be a late and critical sign of hypoxia or cardiac dysfunction, making it a priority finding to report.

🌡️The other findings, including rectal temperature of 99.1°F, BP of 132/82 in an adolescent, and RR of 30/min in a 3-month-old, fall within normal limits.

📞Prompt communication with the provider is essential when a vital sign deviates significantly from the expected pediatric range.

📌Core Message

A heart rate of 68/min in a toddler is below the expected range and may indicate cardiac or respiratory compromise, requiring prompt provider notification.

Answer 5

Correct Answers:

Check clothing for loose buttons.

Rationale :

🤱Toddlers are at high risk for choking, and loose buttons on clothing are a common aspiration hazard.

🚫Balloons are also choking risks, but offering them promotes danger rather than preventing it.

🌡️Setting the water heater at 54°C (129.2°F) exceeds safety recommendations — the recommended temperature is below 49°C (120°F) to prevent scald injuries.

🪟Window screens may give a false sense of security but do not prevent falls, so they are not a safe substitute for window guards or locked windows.

📌Core Message

Choking prevention in toddlers includes removing loose items like buttons that can be aspirated, as toddlers frequently explore by putting objects in their mouth.

Answer 6

Correct Answers:

"Notify the provider if your child is swallowing frequently."

Rationale :

🩸Frequent swallowing following a tonsillectomy is a red flag for bleeding, especially from the operative site at the back of the throat.

📞Early detection of post-tonsillectomy hemorrhage is critical because bleeding can be subtle yet life-threatening.

🚫Using a straw increases the risk of dislodging clots by creating negative pressure and should be avoided.

🚫Telling the child to clear their throat can also disturb healing tissue and promote bleeding.

📌Core Message

Frequent swallowing after tonsillectomy may signal postoperative bleeding and should be reported immediately to prevent complications.

Answer 7

Correct Answers:

"Your child can rest on your lap during the procedure."

Rationale :

🪑Allowing a toddler to rest on the parent's lap during an ECG helps reduce anxiety and movement, promoting cooperation and accurate results.

💓ECGs are painless and non-invasive, requiring only that electrodes be attached to the chest and limbs, not the back.

⏱️The procedure typically takes a few minutes, not 30, so informing the parent it takes longer could increase anxiety unnecessarily.

🚫Alarms are not part of a standard ECG — they are part of cardiac monitoring, not a static ECG recording.

📌Core Message

During an ECG, allowing the child to sit on the parent’s lap provides comfort and helps ensure accurate, motion-free results.

Answer 8

Correct Answers:

Check the pH of the gastric secretions.

Rationale :

🧪Verifying tube placement is always the first priority before initiating any enteral feeding, and checking the pH of gastric aspirate is a recommended method.

🚫Administering feeding without checking placement first poses a risk of aspiration or incorrect delivery, especially if the tube has migrated.

🚿Flushing the tube or setting the rate comes after confirming correct placement.

🔗Safety checks before feeding are essential for preventing complications in enteral nutrition delivery.

📌Core Message

Before delivering an enteral feeding, verify NG tube placement by checking gastric pH to prevent aspiration and ensure safety.

Answer 9

Correct Answers:

Provide an infant with a one-piece pacifier for non-nutritive sucking

Rationale :

🍼One-piece pacifiers are recommended because they reduce the risk of choking and aspiration if the pacifier breaks apart.

👶Non-nutritive sucking is beneficial for self-soothing and can improve feeding readiness and neurodevelopment in infants.

🚫Placing a 5-month-old in a high chair may not be safe unless the child has adequate trunk control, which typically develops closer to 6 months.

🛏️A soft mattress increases the risk of suffocation; infants should be placed supine on a firm mattress to reduce the risk of SIDS.

🚗Never place an infant car seat in front of an airbag, as it can lead to fatal injuries in the event of deployment.

📌Core Message

Use one-piece pacifiers to reduce the risk of choking and support safe, comforting habits in infants.

Answer 10

Correct Answers:

Place intubation equipment at the bedside.

Rationale :

🛑Epiglottitis is a medical emergency due to the risk of sudden airway obstruction, and the nurse must be prepared for immediate intubation.

🧑‍⚕️Having intubation equipment readily available is the first priority, even before diagnostic procedures or medication.

🚷Throat inspection or obtaining a neck x-ray could worsen airway obstruction if the child becomes agitated.

🦠Droplet precautions are necessary, but they are not the first action — airway management takes precedence in life-threatening situations.

📌Core Message

In suspected epiglottitis, always prioritize airway readiness by ensuring intubation equipment is immediately available.

1 :
A nurse is caring for a school-age child who has cystic fibrosis.

Answer Options

2 :
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Answer Options

3 :
A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

4 :
A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

5 :
A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

6 :
A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

7 :
A nurse is providing teaching to the parent of a toddler who is scheduled for an electrocardiogram. Which of the following statements should the nurse make?

8 :
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

9 :
A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

10 :
A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?

1 : A nurse is caring for a school-age child who has cystic fibrosis.

Answer Options

2 : A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Answer Options

3 : A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

4 : A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

5 : A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

6 : A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

7 : A nurse is providing teaching to the parent of a toddler who is scheduled for an electrocardiogram. Which of the following statements should the nurse make?

8 : A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

9 : A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

10 : A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?

1 :
A nurse is caring for a school-age child who has cystic fibrosis.

2 :
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

3 :
A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

4 :
A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider?

5 :
A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?

6 :
A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include?

7 :
A nurse is providing teaching to the parent of a toddler who is scheduled for an electrocardiogram. Which of the following statements should the nurse make?

8 :
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?

9 :
A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching?

10 :
A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first?