A nurse is caring for a school-age child who has conduct disorder and requires wrist restraints. Which of the following actions should the nurse take?

Monitor the child's vital signs every 15 min.

Have the child perform range-of-motion exercises every 3 hr.

Ensure three fingers will fit between the child's wrist and the restraint.

Obtain a prescription for the restraints within 2 hr of initiating them.

Answer and Explanation

The Correct Answer is D

The nurse should obtain a prescription for the restraints within 2 hr of initiating them, as this is a legal requirement and ensures that the restraints are used appropriately and safely. The other options are also important, but they are not the priority action in this situation.

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Correct Answer is C

Explanation

This question helps the nurse to evaluate the client's personal coping skills and identify their strengths and weaknesses. Asking about the impact of the situation, the current feelings, or the future outlook are not directly related to coping skills, although they might provide some useful information.

A. Report suspected abuse to Child Protective Services. B. Determine the immediate safety needs of the child. C. Ask the child how the injury occurred. D. Request that the parent leave the room while interviewing the child.

Correct Answer is B

Explanation

The nurse's priority is to ensure that the child is safe and protected from further harm. A spiral fracture is a type of fracture that occurs when a bone is twisted, and it is often associated with child abuse. The nurse should assess if there are any other signs of abuse, such as bruises, burns, or cuts, and if there are any threats to the child's well-being at home or elsewhere. The nurse should also provide emotional support and comfort to thechild. The other options are important steps to take, but they are not as urgent as ensuring safety.

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A nurse is caring for a school-age child who has conduct disorder and requires wrist restraints. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client's personal coping skills?

Correct Answer is C

Explanation

A nurse in a provider's office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

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