A nurse is assessing a 4-year-old child who is 2 days postoperative following insertion of a ventriculoperitoneal shunt. Which of the following findings is the nurse's priority?

Urine output of 50 mL in 2 hr

Lethargy

Respiratory rate 24/min

Absent Babinski reflex

Answer and Explanation

The Correct Answer is B

A. Urine output of 50 mL in 2 hr: This is within normal limits for a child and does not indicate an immediate concern.
B. Lethargy: Lethargy is a potential sign of increased intracranial pressure (ICP), which is a critical complication of VP shunt placement and requires immediate intervention.
C. Respiratory rate 24/min: This is within the normal range for a 4-year-old child.
D. Absent Babinski reflex: This is a normal finding in children over 2 years old, as the reflex typically disappears by that age.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. A 15-year-old client who requires an open reduction of a fracture. Minors generally require parental or guardian consent for surgical procedures unless emancipated.
B. A 6-month-old infant requiring IV antibiotics. Informed consent from the guardian is required for medical interventions like IV antibiotics in infants.
C. A 14-year-old client seeking prenatal care. Pregnant minors in many jurisdictions are allowed to consent for their own prenatal care without a guardian's approval.
D. A 5-year-old child requiring a chest x-ray. While routine x-rays require parental consent, in an emergency, consent may not be necessary if immediate care is required to stabilize the child.

A. "I will set the temperature of the hot water heater to 140 degrees." B. "I will turn pot handles towards the front of the stove when cooking." C. "I don't need to apply sunscreen to my child if he is outside after 3 p.m." D. “I will plug protective guards into my electrical outlets."

Correct Answer is D

Explanation

A. "I will set the temperature of the hot water heater to 140 degrees." The hot water heater should be set to 120°F (49°C) or lower to prevent scald injuries. A setting of 140°F significantly increases the risk of burns.
B. "I will turn pot handles towards the front of the stove when cooking." Pot handles should be turned toward the back of the stove to prevent a child from grabbing or knocking them over.
C. "I don't need to apply sunscreen to my child if he is outside after 3 p.m." Sunscreen is essential any time a child is outdoors during daylight, regardless of the time, to protect against harmful UV rays.
D. "I will plug protective guards into my electrical outlets." Installing protective guards helps prevent electrical burns by stopping toddlers from inserting objects into outlets.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is assessing a 4-year-old child who is 2 days postoperative following insertion of a ventriculoperitoneal shunt. Which of the following findings is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse on a pediatric unit is reviewing informed consent guidelines with a newly licensed nurse. For which of the following clients should the nurse obtain informed consent from a guardian?

Correct Answer is A

Explanation

A nurse is providing a presentation for parents of a toddler about preventing childhood burns. Which of the following statements by a parent indicates an understanding of the teaching?

Correct Answer is D

Explanation

The nurse is continuing to care for the infant. Exhibits The nurse has provided teaching to the parents about the prescribed medication. Which of the following statements by the parents indicate an understanding of the teaching? Select all that apply.

A nurse is assessing a 2-year-old child following a surgical procedure. Which of the following pain tools should the nurse use?

A nurse is caring for an infant who sustained critical injuries in a motor vehicle accident and is not expected to survive. Which of the following interventions should the nurse implement to support the infant's parents in anticipatory grieving?

A nurse is admitting a child who has pertussis. Which of the following isolation precautions should the nurse initiate for the child?

A nurse is assessing a child who has heart failure. Which of the following clinical manifestations should the nurse expect?

A nurse is providing discharge teaching to the parent of a school-age child who has juvenile idiopathic arthritis (JIA). The nurse should identify that which of the following responses by the parent indicates an understanding of the teaching?

A nurse is assessing a 9-month-old infant who has gastroenteritis. Which of the following findings should the nurse identify as a manifestation of severe fluid volume deficit?

A nurse is preparing to obtain a blood sample for an Hgb from a child who has hemophilia. Which of the following actions should the nurse plan to take?