The nurse is providing car seat safety education to the parent of an 18-month-old.
Which statement by the parent requires the nurse to re-educate them about this topic?
A child less than 24 months of age should be in a rear-facing car seat.
The chest buckle should be at the level of the child's nipple line.
A child is switched to a forward-facing car seat at 12 months.
The car seat should be placed in the back seat.
The Correct Answer is C
Choice A rationale
AAP guidelines recommend rear-facing car seats for children under 24 months due to superior protection in a collision.
Choice B rationale
The chest buckle should be at armpit level to prevent injury in case of a crash.
Choice C rationale
Switching to a forward-facing car seat at 12 months contradicts safety recommendations; the child should remain rear-facing until at least 2 years old.
Choice D rationale
Car seats should always be placed in the back seat to minimize risk from front airbags during collisions.
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Correct Answer is D
Explanation
Choice A rationale
Examining the tympanic membrane at the beginning may cause distress to the child and make the rest of the exam difficult.
Choice B rationale
Before auscultating the chest and abdomen, the child needs to be calm and cooperative, which might not be the case if their ear is examined first.
Choice C rationale
Examining the tympanic membrane before the head and neck could lead to increased anxiety and uncooperativeness in the child during the rest of the exam.
Choice D rationale
Examining the tympanic membrane at the end allows for a more accurate and complete examination without causing the child to become distressed early in the process.
Correct Answer is A
Explanation
Choice A rationale
Giving the toddler a choice between two cups helps to decrease negativism by providing options that still achieve the desired outcome, thereby reducing the likelihood of refusal.
Choice B rationale
Asking the child to take medicine now offers no real choice and is likely to be met with resistance, which is characteristic of negativism in toddlers.
Choice C rationale
This question is too open-ended and can easily be refused, as it does not provide a sense of control or choice for the toddler.
Choice D rationale
Telling the child they "need" to take medicine is directive and authoritarian, which often triggers negativism and a refusal.