A nurse is planning care for a child who has mumps. Which of the following instructions should the nurse include in the plan?

Initiate contact precautions.

Initiate standard precautions.

Initiate airborne precautions.

Initiate droplet precautions.

Answer and Explanation

The Correct Answer is D

Choice A: Contact precautions are not necessary for a child who has mumps, as mumps is not transmitted by direct or indirect contact with the infected person or their environment. Contact precautions are used for infections that are spread by contact with skin, wounds, body ﬂuids, or contaminated surfaces.

Choice B: Standard precautions are always used for any patient care, regardless of their diagnosis or infection status. Standard precautions include hand hygiene, use of personal protective equipment (PPE), safe injection practices, and proper disposal of waste and sharps. However, standard precautions alone are not sufficient for a child who has mumps, as mumps are transmitted by respiratory droplets.

Choice C: Airborne precautions are not necessary for a child who has mumps, as mumps are not transmitted by small particles that remain suspended in the air and can be inhaled by others. Airborne precautions are used for infections that are spread by airborne transmission, such as tuberculosis, measles, or chickenpox.

Choice D: Droplet precautions are required for a child who has mumps, as mumps are transmitted by large respiratory droplets that are expelled when the infected person coughs, sneezes, or talks. Droplet precautions include wearing a surgical mask when within 3 feet of the patient, placing the patient in a private room or cohorts with other patients with the same infection, and limiting visitors and staﬀ who are susceptible to the infection.

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Correct Answer is C

Explanation

Choice A: This statement indicates a lack of understanding of the teaching, as insulin should not be stored in the freezer, as freezing can damage the insulin and make it ineﬀective. Insulin should be stored in a cool and dry place, away from direct sunlight and heat sources. Unopened bottles of insulin can be stored in the refrigerator until their expiration date, but opened bottles of insulin can be kept at room temperature for up to 28 days.

Choice B: This statement indicates a lack of understanding of the teaching, as the morning blood glucose level for a child who has type 1 diabetes mellitus should be between 70 and 110 mg/dL, according to the American Diabetes Association. A blood glucose level between 90 and 130 mg/dL may indicate hyperglycemia, which is high blood sugar and can cause symptoms such as thirst, hunger, fatigue, or frequent urination. A blood glucose level below 70 mg/dL may indicate hypoglycemia, which is low blood sugar and can cause symptoms such as sweating, shaking, dizziness, or confusion.

Choice C: This statement indicates an understanding of the teaching, as eating a snack half an hour before playing soccer can help prevent hypoglycemia, which is low blood sugar, in a child who has type 1 diabetes mellitus. Physical activity can lower blood sugar levels by increasing the uptake of glucose by the muscles. Eating a snack that contains carbohydrates and protein can provide energy and prevent a sudden drop in blood sugar levels during or after exercise.

Choice D: This statement indicates a lack of understanding of the teaching, as regular insulin should not be skipped or stopped when a child who has type 1 diabetes mellitus is sick. In fact, insulin may need to be increased or adjusted when a child is sick, as illness can raise blood sugar levels by causing stress hormones or inﬂammation. The child should monitor their blood sugar levels more frequently when they are sick and follow their sick day plan that includes taking insulin, checking for ketones, staying hydrated, and contacting their provider if needed.

A. At the end B. Before auscultating the chest and abdomen C. At the beginning D. Before examining the head and neck

Correct Answer is A

Explanation

Choice A reason: This choice is correct because examining the child's tympanic membrane at the end of the physical examination is the best strategy to avoid upsetting or frightening the child. The tympanic membrane is the thin membrane that separates the outer ear from the middle ear, and it can be examined by using an otoscope, which is a device that has a light and a magnifying lens. Examining the tympanic membrane may be uncomfortable or painful for the child, especially if they have an ear infection or inﬂammation. Therefore, performing this procedure at the end of the examination can help to minimize the child's distress and resistance.

Choice B reason: This choice is incorrect because examining the child's tympanic membrane before auscultating the chest and abdomen is not a good strategy to avoid upsetting or frightening the child. Auscultating the chest and abdomen is a procedure that involves listening to the sounds of the heart, lungs, and bowel by using a stethoscope, which is a device that has a chest piece and earpieces. Auscultating the chest and abdomen may be soothing or relaxing for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to calm and distract the child.

Choice C reason: This choice is incorrect because examining the child's tympanic membrane at the beginning of the physical examination is not a good strategy to avoid upsetting or frightening the child. Examining the tympanic membrane at the beginning of the examination may cause anxiety or fear in the child, which can affect their cooperation and trust for the rest of the examination. Therefore, performing this procedure at the beginning of the examination can increase the child's distress and resistance.

Choice D reason: This choice is incorrect because examining the child's tympanic membrane before examining the
head and neck is not a good strategy to avoid upsetting or frightening the child. Examining the head and neck is a procedure that involves inspecting and palpating the scalp, hair, face, eyes, ears, nose, mouth, throat, lymph nodes, and thyroid gland. Examining the head and neck may be easy or pleasant for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to establish rapport and confidence with the child.

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A nurse is planning care for a child who has mumps. Which of the following instructions should the nurse include in the plan?

Nursing Test Bank

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