In a pediatric surgical unit, when discussing patient-controlled analgesia (PCA) in a preoperative parental meeting, which client would be the most appropriate candidate for PCA?

An 8-year-old, postoperative spinal fusion for scoliosis.

A 6-year-old who is 72 hours post-op.

A 10-year-old who has a fractured femur and concussion.

A 16-year-old postoperative bone surgery with Down Syndrome.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct choice. An 8-year-old is typically capable of understanding and using PCA effectively, especially after a major surgery like spinal fusion.
Choice B reason: A 6-year-old may not fully understand how to use PCA and could be at risk for under or overdosing.
Choice C reason: While a 10-year-old could use PCA, the presence of a concussion may impair their ability to use it properly.
Choice D reason: A 16-year-old with Down Syndrome may have cognitive impairments that could hinder the safe use of PCA.

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Correct Answer is C

Explanation

The correct answer is: c. In an emergency, a court order can be obtained for the patient to receive blood transfusions.

Choice A: The patient can only receive blood that has been donated by family members.

Jehovah’s Witnesses refuse blood transfusions, including those from family members, due to their religious beliefs. They believe that both the Old and New Testaments command them to abstain from blood (Genesis 9:4; Leviticus 17:10; Deuteronomy 12:23; Acts 15:28, 29). Therefore, this option is incorrect.

Choice B: Under no circumstances will the patient receive blood products.

While Jehovah’s Witnesses generally refuse blood transfusions, there are exceptional circumstances where medical professionals can seek a court order to administer blood transfusions, especially in life-threatening situations involving minors. Thus, this statement is not entirely accurate.

Choice C: In an emergency, a court order can be obtained for the patient to receive blood transfusions.

In life-threatening emergencies, especially involving minors, courts can intervene and issue orders to administer necessary medical treatments, including blood transfusions, despite parental objections based on religious beliefs. This ensures the child’s right to life and health is protected. Therefore, this is the correct answer.

Choice D: The patient can receive volume expanders.

Volume expanders can be used to increase blood volume and maintain circulation, but they do not carry oxygen or replace lost blood cells. While they are an option for managing blood loss, they are not a substitute for blood transfusions in severe cases of anemia or blood loss, which are common in leukemia patients. Thus, this option is not entirely correct.

A. Urinary tract infection. B. Emotional trauma. C. Sexual abuse. D. Structural defect of the urinary tract.

Correct Answer is A

Explanation

Choice A reason: This is the correct choice. A urinary tract infection is a common cause of urinary incontinence in children and should be evaluated first.
Choice B reason: While emotional trauma can cause changes in behavior, including incontinence, it is not the first complication to be evaluated in this scenario.
Choice C reason: Sexual abuse can result in behavioral changes, but there is no immediate indication of this being the cause without further assessment.
Choice D reason: A structural defect of the urinary tract could cause incontinence, but it is less likely to be the cause of a sudden onset of symptoms compared to a urinary tract infection.

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In a pediatric surgical unit, when discussing patient-controlled analgesia (PCA) in a preoperative parental meeting, which client would be the most appropriate candidate for PCA?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A four-year-old patient has been diagnosed with leukemia. The patient's parents, who follow the Jehovah's Witness faith, inform the physician that they will not approve any type of blood transfusions. The pediatric nurse is aware that:

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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