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A nurse is caring for a toddler. Which of the following statements should the nurse use when preparing to obtain the child's vital signs?

A.

"I am going to listen to your heart."

B.

"Can I listen to your lungs?"

C.

"I am going to take your blood pressure now."

D.

"Can you stand very still while I feel how warm you are?"

Answer and Explanation

The Correct Answer is A

A. “I am going to listen to your heart.”: This is the correct answer. It is a clear, simple statement that informs the child about what is going to happen. It is important to use language that is appropriate for the child’s age and development.
B. “Can I listen to your lungs?”: While this is a polite way to ask for consent, it might confuse a toddler who may not understand what “lungs” are.
C. “I am going to take your blood pressure now.”: This statement might be too complex for a toddler to understand. It’s better to use simpler language.
D. “Can you stand very still while I feel how warm you are?”: This statement might be confusing for a toddler. It’s better to use clear and direct language.
 


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Related Questions

Correct Answer is A

Explanation

A. Position the child laterally: This is the correct action. During a seizure, positioning the child on their side (lateral position) can help prevent aspiration of saliva or vomit.

B. Use a padded tongue blade: This is not recommended. Inserting anything into the mouth of a person having a seizure can cause injury to the teeth or jaw.

C. Restrain the child’s arms: This is not recommended. During a seizure, it’s important not to restrain the child as it can lead to injury.

D. Attempt to stop the seizure: This is not possible. Seizures usually need to run their course. It’s important to keep the child safe during the seizure and seek medical attention if necessary.

Correct Answer is C

Explanation

A. “Place your child in a sitting position with her head tilted back.”: This is not recommended because it can cause the blood to flow down the back of the throat, which can lead to gagging or choking.
B. “Apply ice at the base of the nose for 5 min and then check for bleeding.”: While applying ice can help constrict the blood vessels and slow the bleeding, it’s not the most effective initial step in managing a nosebleed.
C. “Have your child sit with her head tilted forward and hold pressure on her nose for 10 minutes.”: This is the correct answer. Tilting the head forward prevents the blood from flowing down the back of the throat, and applying pressure to the nostrils can help stop the bleeding.
D. “Place your child in a supine position with a pillow under her back.”: Lying down can increase blood pressure in the veins of the nose, which can make the nosebleed worse. It’s better to keep the head elevated.

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