As the new school year begins, the school nurse evaluates several ...

[joesmith1212]

As the new school year begins, the school nurse evaluates several children to determine their healthcare needs. Which child would the nurse consider to be medically fragile?
 
  1. The child with a casted right arm due to a fracture
  2. The child who wears hearing aids due to hearing loss secondary to meningitis as an infant
  3. The child requiring oxygen and tube feedings secondary to a congenital heart defect
  4. The child with a developmental delay

Question 2

The nurse is working with a child newly enrolled in an English as a Second Language class. The nurse wants to teach the child about the importance of hand washing before meals and to not eat food dropped on the exam room floor.
 
  The best way to evaluate the child's understanding of hygienic nutrition is to: 1. Have the child repeat his interpretation of the information that was taught.
  2. Schedule a medical interpreter to accompany the patient to his next visit.
  3. Provide written materials in English about hygiene and diet for the client to take home.
  4. Have the nurse model proper hand washing before examining the child, and throw out the dropped cookie.

[todom5090]

Answer to Question 1

3
Rationale 1: This is a temporary issue and does not constitute a significant health issue.
Rationale 2: This is a normal healthy skin with a sensory deficit, not a significant health issue.
Rationale 3: This child has current medical issues which require continued monitoring and care. This child would be considered medically fragile.
Rationale 4: This child may need special support in the classroom but is not considered medically fragile.
Global Rationale:

Answer to Question 2

1
Rationale 1: When an interpreter is not available, asking the client to repeat his understanding of what was taught reveals how he understood the concepts discussed.
Rationale 2: In working with families with limited English proficiency, it is optimal to have a medical interpreter present for the entire visit. When teaching has been done, the nurse has a responsibility to assess client understanding; thus, an interpreter at the next visit will not help the nurse or the client now.
Rationale 3: Written materials in English hold minimal value for clients with limited understanding.
Rationale 4: The purpose of modeled behavior could be misunderstood if it is not accompanied by an explanation.
Global Rationale: