A nurse is planning to change the dressings on a school-age child who has sustained multiple burns. Which of the following actions should the nurse plan to take?

Explain long term consequences of the procedure to the child.

Remove the dressings while explaining the procedure to the child.

Keep equipment out of the child's sight.

Allow the child to help remove the dressings.

Answer and Explanation

The Correct Answer is D

A. Explain long term consequences of the procedure to the child. This level of detail is not developmentally appropriate for a school-age child. It may increase anxiety without helping the child understand or cope with the immediate situation.
B. Remove the dressings while explaining the procedure to the child. While it is important to explain procedures, it should be done before starting to allow time for questions and emotional preparation. Explaining during may cause confusion or distraction.
C. Keep equipment out of the child's sight. Hiding equipment can actually increase fear and mistrust. School-age children benefit from open, age-appropriate communication and preparation about what to expect.
D. Allow the child to help remove the dressings. This is the most appropriate action. Allowing the child to participate in their care provides a sense of control, reduces anxiety, and helps build trust. It also aligns with the developmental need of school-age children to take on increasing responsibility and be involved in decision-making.

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Correct Answer is A

Explanation

A. "I will hang a new bag of TPN and IV tubing every 24 hours." This is the correct action. TPN solutions are high in glucose and lipids, which create an ideal environment for bacterial growth. Changing the bag and tubing every 24 hours reduces the risk of infection and sepsis, especially in clients with central lines.
B. "I will obtain the client's weight every other day." Weight should be monitored daily in clients receiving TPN to assess for fluid status, nutritional progress, and potential complications like fluid overload or retention.
C. "I will monitor the client's blood glucose level every 8 hours." Clients receiving TPN require more frequent glucose monitoring, typically every 4 to 6 hours, especially when therapy is initiated, due to the high dextrose content that can cause hyperglycemia.
D. “I will increase the rate of the TPN infusion to ensure the correct amount is given." TPN infusion rates should never be adjusted independently by a nurse. Changes must be made only with a provider’s order, as improper rate adjustments can lead to electrolyte imbalances, hyperglycemia, or fluid overload.

A. Platelet count B. OPIT C. Fibrinogen level D. INR

Correct Answer is D

Explanation

A. Platelet count. While important for evaluating bleeding risk, platelet count is not directly used to adjust or determine daily warfarin dosing. Warfarin affects the coagulation cascade, not platelet function.
B. aPTT. The activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin. It assesses the intrinsic pathway of coagulation and is not sensitive to warfarin’s effects on the clotting factors.
C. Fibrinogen level. Fibrinogen is involved in clot formation, but its measurement is not part of routine warfarin management. It is more relevant in evaluating bleeding disorders or disseminated intravascular coagulation (DIC).
D. INR. The international normalized ratio (INR) is the primary lab value used to monitor the effectiveness and safety of warfarin therapy. It helps guide daily dosing by reflecting how long it takes blood to clot, with therapeutic ranges typically between 2.0 and 3.0 for most conditions.

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A nurse is planning to change the dressings on a school-age child who has sustained multiple burns. Which of the following actions should the nurse plan to take?

Nursing Test Bank

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