A nurse is caring for three toddlers and one preschooler. Which represents the major stressor of hospitalization for these four patients?

Fear of bodily injury

Fear of pain

Separation anxiety

Loss of control

Answer and Explanation

The Correct Answer is C

A. Fear of bodily injury is a concern but may not be as prominent as separation anxiety, particularly in younger children.

B. Fear of pain is significant but often secondary to the anxiety of being separated from parents.

C. Separation anxiety is the most prominent stressor for toddlers and preschoolers, as they struggle with being away from their caregivers.

D. Loss of control can contribute to stress but is more relevant in older children who understand their environment more clearly.

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Correct Answer is ["A","C","E"]

Explanation

2100: Child brought into the emergency department by their guardians. The child has Acute Lymphoblastic Leukemia (ALL) and is currently in the induction phase of treatment for standard risk. The child received chemotherapy with vincristine 8 days ago and is taking daily oral steroids. Child is alert, crying, and clinging to guardian. Guardians report the child has not had a bowel movement for 5 days.

2100:

Pulse 120/min

Respiratory rate 25/min

Temperature 38.8° C (101.9° F) tympanic

SaO2 96% on room air

2120: Child now asleep in guardian's arms. Respirations unlabored, heart rate regular. Child has a double-lumen central line catheter in the left chest wall. Insertion site is erythematous with a scant amount of purulent drainage.

Rationale:

Temperature of 38.8°C (101.9°F) tympanic: Fever in a child with leukemia is concerning as it may indicate an infection, especially since the child is immunocompromised due to chemotherapy. This needs immediate follow-up and potentially blood cultures to determine the source of infection.

Erythema and purulent drainage at central line insertion site: Purulent drainage and erythema at the central line insertion site suggest a possible infection, such as a catheter-associated bloodstream infection. This requires prompt follow-up, possibly including antibiotic therapy and further investigations to prevent sepsis.

Child has not had a bowel movement for 5 days: Constipation is a common side effect of chemotherapy and oral steroids, but a delay in bowel movements could indicate bowel obstruction or other gastrointestinal issues. This needs to be addressed, and the child may require laxatives or further investigation.

A. Decreased attention span B. Hyperactivity C. Tachycardia D. Hypotension

Correct Answer is A

Explanation

A. Decreased attention span is a common manifestation of increased intracranial pressure, as pressure on the brain can affect cognitive function.

B. Hyperactivity is not typically associated with increased intracranial pressure. It would be more common for the child to exhibit lethargy or irritability.

C. Tachycardia is not a primary symptom of increased intracranial pressure. Typically, bradycardia (slow heart rate) is seen in cases of severe intracranial pressure.

D. Hypotension is not usually associated with increased intracranial pressure. In fact, increased intracranial pressure often leads to elevated blood pressure and a widening pulse pressure.

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A nurse is caring for three toddlers and one preschooler. Which represents the major stressor of hospitalization for these four patients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","E"]

Explanation

A nurse is assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?

Correct Answer is A

Explanation

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