A nurse is caring for a 4-year-old child who is postoperative following abdominal surgery. Which of the following statements should the nurse make to encourage the child to take deep breaths?

"This will not be painful, just a little uncomfortable."

"Let's play a game of blowing cotton balls across your table."

"Do you want to take deep breaths for me now?"

"You can't go to the playroom until you finish doing your deep breathing."

Answer and Explanation

The Correct Answer is B

A. "This will not be painful, just a little uncomfortable." While this statement might provide some reassurance, it does not actively engage the child or make the task of taking deep breaths more enjoyable.

B. "Let's play a game of blowing cotton balls across your table." This is the best choice as it makes deep breathing fun and engaging for the child, encouraging them to participate without feeling like it’s a chore.

C. "Do you want to take deep breaths for me now?" This approach is too passive and doesn't engage the child actively or make the activity interesting.

D. "You can't go to the playroom until you finish doing your deep breathing." This approach can create negative reinforcement and might make the child associate deep breathing with punishment or coercion, which is not desirable.

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Correct Answer is A

Explanation

A. Rotavirus: The rotavirus vaccine is recommended for infants at 2, 4, and possibly 6 months of age, depending on the vaccine formulation. It helps protect against rotavirus, which can cause severe diarrhea and dehydration in infants.

B. Measles, mumps, rubella (MMR): The MMR vaccine is not given until 12-15 months of age. It is not part of the vaccination schedule for a 4-month-old infant.

C. Varicella (VAR): The varicella vaccine is typically administered at 12-15 months of age. It is not appropriate for a 4-month-old infant.

D. Influenza: The influenza vaccine is recommended annually starting at 6 months of age. A 4-month-old is too young to receive the influenza vaccine.

A. "Give her acetaminophen, not aspirin." B. "You'll have to call your physician." C. "Follow the directions on the aspirin bottle for her age and weight." D. "Give her no more than three baby aspirin every 4 hours."

Correct Answer is A

Explanation

A. "Give her acetaminophen, not aspirin." This is the appropriate response. Acetaminophen is commonly recommended for treating fever in children as it is safer and does not carry the risk of Reye's syndrome, a rare but serious condition associated with aspirin use in children and adolescents, particularly when they have viral infections. This response provides a safe alternative and addresses the immediate concern of fever treatment.

B. "You'll have to call your physician." While consulting a physician is generally good advice, this response does not provide immediate guidance or address the potential risks of giving aspirin to a toddler. It leaves the parent without immediate and necessary information to prevent harm.

C. "Follow the directions on the aspirin bottle for her age and weight." This response is inappropriate and potentially harmful. Aspirin should not be given to children, especially without a physician's guidance, due to the risk of Reye's syndrome. Following dosage directions on an aspirin bottle is unsafe for a toddler, as aspirin is not recommended for children in this age group for fever treatment.

D. "Give her no more than three baby aspirin every 4 hours." This is incorrect and dangerous advice. Giving any amount of aspirin to a toddler is not recommended because of the risk of Reye's syndrome. Suggesting a specific dosage implies that it's safe to give aspirin to a child, which it is not in this context.

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A nurse is caring for a 4-year-old child who is postoperative following abdominal surgery. Which of the following statements should the nurse make to encourage the child to take deep breaths?

Nursing Test Bank

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