A nurse is collecting a health history from the guardian of a 4year old child. Which of the following statements by the guardian is the priority for the nurse to address?

I have a difficult time getting my child to eat green vegetables

My child continually asks me the same questions

My child still wets the bed at least two times per week

I have noticed that my child is withdrawn since we switched day care providers

Answer and Explanation

The Correct Answer is D

A) I have a difficult time getting my child to eat green vegetables: While it’s common for preschoolers to be selective about food, especially vegetables, this issue does not represent an immediate concern for the child’s health or development. This issue can often be addressed with strategies to encourage healthy eating, but it is not as urgent as other concerns.

B) My child continually asks me the same questions: Repetitive questioning is a normal part of preschool development, as children at this age are curious and often seek reassurance. It reflects their cognitive development as they try to understand the world around them. While it may be tiring for the guardian, it is not an immediate concern.

C) My child still wets the bed at least two times per week: Bedwetting (enuresis) is common among preschool-aged children, and many children do not gain full bladder control until after age 5. This issue is typically addressed if it continues past the age of 5, but it is not a priority at this time.

D) I have noticed that my child is withdrawn since we switched day care providers: This statement indicates a potential emotional or behavioral issue that requires immediate attention. Changes in behavior, such as withdrawal, can be a sign of stress, anxiety, or difficulty adjusting to a new environment. The nurse should prioritize this concern, as it may indicate that the child is having difficulty coping with the transition and may need additional support or evaluation. Addressing emotional well-being is a priority for the nurse.

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Correct Answer is B

Explanation

A) Place the client in Sims' position for catheter insertion: Sims' position (side-lying position) is not typically used for central venous catheter insertion. The client is usually placed in a supine or Trendelenburg position to help facilitate insertion and decrease the risk of air embolism during the procedure.

B) Prepare the client for a chest x-ray to verify catheter placement: After the insertion of a central venous catheter, a chest x-ray is routinely performed to verify the correct placement of the catheter in the superior vena cava or right atrium. This is essential to ensure the catheter is properly positioned and to check for complications like pneumothorax or inadvertent placement in the lung.

C) Use clean technique when changing the catheter dressing: When changing the dressing for a central venous catheter, sterile technique is required, not clean technique. Sterile technique minimizes the risk of infection, which is a major concern when caring for central venous access devices.

D) Verify the amount of TPN solution the client is receiving every 4 hr: While it is important to monitor the amount of TPN being infused and assess for complications, verifying the exact amount every 4 hours is not a standard procedure. Typically, TPN is managed and adjusted by the healthcare provider based on lab results, weight, and clinical status, but constant monitoring of the solution is not required.

A. The client's meal tray includes ice cream with fresh fruit. B. The client is assigned to a room with negative airflow. C. The client has artificial flowers in the room. D. The client's meal tray contains hard boiled eggs.

Correct Answer is A

Explanation

A) The client's meal tray includes ice cream with fresh fruit: Fresh fruit poses a risk to a neutropenic client because it may harbor harmful bacteria or fungi, which could lead to an infection. Neutropenic clients have a weakened immune system and are more vulnerable to infections, so it is essential to avoid raw or unwashed fruits that can carry harmful pathogens.

B) The client is assigned to a room with negative airflow: A room with negative airflow is a precautionary measure used to prevent the spread of airborne pathogens, particularly for clients with compromised immune systems. This would help reduce the risk of infection by keeping potentially harmful microorganisms from circulating into the room.

C) The client has artificial flowers in the room: While artificial flowers may not pose an immediate risk for infection, they can accumulate dust and other particles that may contribute to a less clean environment. However, they are not as significant a risk factor as the presence of fresh fruits, which can carry live microorganisms capable of causing infections in neutropenic patients.

D) The client's meal tray contains hard boiled eggs: Hard boiled eggs are generally considered safe for neutropenic clients as long as they are properly cooked and stored. Eggs are not a known source of infection in this context, especially when they are cooked and handled properly.

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A nurse is collecting a health history from the guardian of a 4year old child. Which of the following statements by the guardian is the priority for the nurse to address?

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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