. A nurse is assisting with the collection of a bone marrow specimen from a preschooler. Which of the following actions should the nurse take?

Place the child in prone position to expose the posterior iliac crest.

Position the child side-lying to expose the vertebrae.

Place the child supine with legs flexed outward into a frog-like position.

Position the child sitting with their buttocks at the edge of the table.

Answer and Explanation

The Correct Answer is A

A. The posterior iliac crest is the typical site for bone marrow aspiration in children. Placing the child in the prone position allows for proper access to the site while ensuring the child remains safe and stable during the procedure.

B. Positioning the child side-lying would expose the vertebrae but is not an optimal position for accessing the iliac crest for bone marrow aspiration.

C. The frog-like position (supine with legs flexed outward) is not an appropriate position for a bone marrow aspiration, as it does not provide the best access to the iliac crest or posterior iliac crest.

D. Sitting with the buttocks at the edge of the table would not adequately expose the posterior iliac crest, making it unsuitable for bone marrow aspiration.

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Correct Answer is B

Explanation

A. A decreased white blood cell (WBC) count in the cerebrospinal fluid (CSF) would not support the diagnosis of bacterial meningitis. Bacterial infections typically cause an increased WBC count, specifically neutrophils.

B. Elevated total protein in the CSF is a classic finding in bacterial meningitis, as the infection leads to increased permeability of the blood-brain barrier and results in an increase in protein content.

C. Elevated glucose in the CSF is not consistent with bacterial meningitis. In bacterial meningitis, glucose levels are usually decreased due to the consumption of glucose by bacteria.

D. Decreased pressure in the CSF is not typical in bacterial meningitis. Increased intracranial pressure often results in elevated CSF pressure.

A. "It is not your fault that this happened." B. "You should have told someone about this sooner." C. "I promise I won't tell anyone about this." D. "This should not have happened to you."

Correct Answer is A

Explanation

A. This response reassures the child that they are not to blame for the abuse and provides emotional support. It also establishes a sense of safety for the child to express their feelings.

B. Telling the child that they should have spoken up earlier may cause shame or guilt, which can further harm the child’s emotional well-being.

C. Promising not to tell anyone would be unethical because it is necessary to report suspected abuse to the appropriate authorities for the child's safety.

D. While this response acknowledges the injustice of the situation, it doesn't validate the child's feelings of fear or confusion in a way that encourages trust and healing.

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