A nurse is assisting with the care of a group of pediatric clients. Which of the following actions should the nurse take first?
Deliver a breakfast tray to a child who has been administered regular insulin.
Complete pin site care for a child who is in skeletal traction.
Provide clear liquids to a child who is 4 hr postoperative following a laparoscopic appendectomy.
Administer acetaminophen to a child who has a temperature of 101.2°F (38.4°C).
The Correct Answer is A
If a nurse is assisting with the care of a group of pediatric clients, the first action the nurse should take is to deliver a breakfast tray to a child who has been administered regular insulin. This is because regular insulin is a fast-acting insulin that begins to lower blood sugar levels within 15 minutes of administration. It is important for the child to eat shortly after receiving regular insulin to prevent hypoglycemia.
Option B is incorrect because completing pin site care for a child who is in skeletal traction is not as time-sensitive as delivering a breakfast tray to a child who has been administered regular insulin.
Option C is incorrect because providing clear liquids to a child who is 4 hr postoperative following a laparoscopic appendectomy is not as time-sensitive as delivering a breakfast tray to a child who has been administered regular insulin.
Option D is incorrect because administering acetaminophen to a child who has a temperature of 101.2°F (38.4°C) is not as time-sensitive as delivering a breakfast tray to a child who has been administered regular insulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
If an assistive personnel (AP) refuses to take a specimen to the laboratory, the nurse should first discuss the incident with the AP. This allows the nurse to understand the reasons for the refusal and to address any concerns or issues that may have led to the refusal.
Option B may be necessary at some point, but it should not be the first response.
Option C may also be necessary to ensure that the specimen is delivered to the laboratory in a timely manner, but it does not address the underlying issue.
Option D may also be necessary at some point, but it should not be the first response.
Correct Answer is A
Explanation
The first action the nurse should take is to collect data on the client. This includes assessing the client's condition and vital signs to determine if they require immediate medical attention.
Option b may not be appropriate without first assessing the client's condition.
Option c may be necessary after collecting data on the client, but it should not be the first action taken.
Option d may also be necessary, but it should not be the first action taken.
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