N165 Pediatrics Sherpath Week 1

The parents of a young child who is hospitalized appear nervous and state that they have had terrible past experiences in the hospital. What is the most appropriate nursing action to help promote comfort to this patient and family?

• Offer clear information on the patient’s hospitalization and allow the family opportunities to ask questions.

The nurse observes that a 4-year-old patient on the pediatric unit is anxious and appears scared. Which actions can the nurse take to help relieve the fear of hospitalization?

Select all that apply:

• Encourage involvement of family members. 

• Remove the child from family during procedures. 

• Demonstrate procedures and treatments with toys. 

• Explain procedures and treatments to family members. 

• Reassure the patient that he or she has nothing to be afraid of.

• Encourage the involvement of family members. 

• Demonstrate procedures and treatments with toys. 

A young child admitted to the emergency department starts to cry when separated from her mother. How can the nurse help reduce the anxiety of the child?

• Allow the child an outlet for her feelings. 

A 4-year-old patient is afraid of a blood pressure cuff and the nurse would like to find a way to help decrease the child’s fear. Which actions can the nurse take to help comfort to the child?

Select all that apply:

• Show the child the blood pressure equipment. 

• Permit the child to handle the blood pressure equipment. 

• Educate the child on the purpose of blood pressure readings. 

• Wait until the child is less stressed to take her blood pressure. 

• Allow the child to apply the blood pressure cuff to a family members arm to demonstrate it’s not painful.

• Permit the child to handle the blood pressure equipment.

• Allow the child to apply the blood pressure cuff to a family members arm to demonstrate it’s not painful.

The nurse brings a hospitalized pediatric patient to the unit playroom. Upon walking into the playroom the child starts crying and yells, “I’m not staying here. I want to go back to my room.” What is the nurse’s most appropriate response?

Select all that apply:

• Comfort the child and ask him why he is crying. 

• Explain to the child that procedures are not performed in the playroom. 

• Encourage the child to look at the other children playing in the playroom. 

• Explain to the child that he has no choice and he must stay in the playroom.

• Explain to the child that procedures are not performed in the playroom.

The nurse notices that a pediatric patient, diagnosed with depression, is not engaging in unstructured play. What is the nurse’s initial action?

Select all that apply:

• Allow the child extra time in the playroom. 

• Encourage the child to play with another patient’s toys. 

• Ask the child what activities she would like to engage in. 

• Ask the child to draw you a picture of how they are feeling. 

• Ask the child what activities she would like to engage in. 

The parent of a patient diagnosed with cancer denies the illness and states, “My child is not sick.” What will be the immediate nursing action?

• Assess the parent’s knowledge pertaining to the child’s illness

The sibling of a pediatric patient would like to see his sister but refuses to go into the patient’s room. Which intervention should the nurse consider to decrease the sibling’s anxiety?

• Allow the sibling to assist with holding the thermometer while obtaining the patient’s temperature.

The nurse is providing care for a patient who has been in the hospital for the past three weeks. The nurse has become acquainted with family members and notices a close relationship between the patient and the patient’s sibling. Which negative actions, by the patient’s sibling, could the nurse possibly witness?

Select all that apply:

• Refusing to share a portable video game. 

• Leaving the room because of feelings of jealousy. 

• Teasing the ill child for looking abnormal in the hospital. 

• Crying for not receiving as much attention as the sick child. 

• Anger toward the sibling for causing the parents pain and strife.

• Leaving the room because of feelings of jealousy.

• Crying for not receiving as much attention as the sick child. 

• Anger toward the sibling for causing the parents pain and strife.

A patient has had an extended hospital stay and is demonstrating symptoms of low self-esteem. Which action by the nurse would allow the child to gain a sense of autonomy?

Select all that apply:

• Provide the child instruction on his wound care

• Allow the child to decide on times of medication administration.

• Discourage the child from using social media to keep in touch with his family and friends.

• Encourage the patient to discuss feelings about low self-esteem and personal experiences in the hospital.

• Provide structured visiting hours for the child to help reduce a feeling of being overwhelmed

• Provide the child instruction on his wound care

• Allow the child to decide on times of medication administration.

• Encourage the patient to discuss feelings about low self-esteem and personal experiences in the hospital.

Organize the stages of separation anxiety in a 9-month-old patient.

• Parents exit the room and the child becomes angry and upset

• The child begins crying and rejecting the nurse

• The child’s crying decreases and the child becomes apathetic

• The child is happy and begins playing with the nurse

A 4-year-old patient starts expressing fear whenever she needs to get her blood drawn. Which action can a nurse take to help the pediatric patient cope during an uncomfortable procedure?

Select all that apply:

• Assess the child’s fears. 

• Perform procedures early during the day. 

• Avoid procedures until the child is comfortable.

• Allow the parents to participate in the procedure. 

• Instruct the patient in performing breathing exercises. 

• Allow the parents to participate in the procedure. 

• Instruct the patient in performing breathing exercises. 

A patient draws a picture of her parents with anger expressed in their faces. What is the priority nursing action?

• Ask the child what the drawing means

A patient admitted to the pediatric unit is upset because she misses playing with her sister, who’s at home. What is the most appropriate action by the nurse?

• Encourage the sibling to visit and to engage in activities with the patient.

During a procedure in the pediatric outpatient center, the nurse notices the patient’s sibling is looking on with both concern and curiosity. Which action by the nurse would be most appropriate?

Select all that apply:

• Explain the procedure to the sibling

• Disregard the sibling as the focus should be on the patient. 

• Avoid performing the procedure until the sibling is comfortable. 

• Ask the sibling if she has any questions pertaining to the procedure. 

• Ask family members to take the sibling to the waiting room area to provide a more focused and uninterrupted environment. 

• Explain the procedure to the sibling

• Ask the sibling if she has any questions pertaining to the procedure. 

The nurse is providing discharge instructions to the parent of the pediatric patient and states, “your child may resume regular activities after discharge.” Which statement by the parent indicates a need for further teaching?

Select all that apply:

• “I will assist the child with daily hygiene needs.”

• “I will allow the child to attend school tomorrow.”

• “I will continue to allow the child to play with siblings.”

• “I will try to avoid bathing the child until the child feels better.”

• “I will not allow my child to attend his gymnastics class tomorrow.”

• “I will try to avoid bathing the child until the child feels better.”

• “I will not allow my child to attend his gymnastics class tomorrow.”

A nurse has been working with a patient in the therapeutic-play setting for two weeks and notices an improvement in the child’s ability to cope with painful procedures. Which is the next effective strategy to continuing improving the child’s ability to tolerate painful procedures?

• Begin to incorporate more unstructured play.

A non-English speaking family member of a child is having difficulty understanding the child’s diagnosis. What is the most appropriate action by the nurse?

• Allow an interpreter to translate for the family members.

Which finding will the nurse expect to see in a 5-year-old child whom the mother suspects to have ingested the acetaminophen 3 hours ago?

• Malaise, pallor, weakness

Which clinical manifestations are likely to develop in a 3-year-old child after initial stabilization for bleach ingestion?

Select all that apply:

• Development of metabolic acidosis

• Development of esophageal strictures

• Development of liver necrosis and jaundice

• Development of hypokalemia and dehydration

• Development of organ perforation and vascular complications

• Development of esophageal strictures

• Development of organ perforation and vascular complications

Which type of poisoning might the nurse expect for a 6-year-old who has presented with a cherry-red mucosa and a history of altered mental status after playing in the garage with the car running?

• Carbon monoxide

A nurse is teaching a group of parents about assessing the ABCDE’s in children with toxic exposure. Which two assessment components should the nurse discuss in addition to the traditional ABC’s of CPR?

Select all that apply:

• Diuresis

• Disability

• Exposure

• Exudates

• Diaphoresis

• Disability

• Exposure

In order to terminate ocular exposure, which interventions should the nurse provide to a patient who has experienced exposure to a powdered poison?

Select all that apply:

• Administer a chelating agent

• Remove contaminated clothing

• Irrigate the eyes with warm water or saline

• Induce vomiting to reduce absorbed poison levels

• Eliminate powder from skin and clothing; wash skin

• Remove contaminated clothing

• Irrigate the eyes with warm water or saline

• Eliminate powder from skin and clothing; wash skin

A mother calls the nurse and reports that her child has ingested a toxin. Which statement by the nurse explains why inducing vomiting is contraindicated?

• “Vomiting may cause additional damage to the esophagus.”

A mother brings in her 4-year-old child to the health care provider, stating that the child has marked constipation and describing the child as “sluggish.” Which patient’s social history is most significant?

• The family has recently moved into a historic house.

The nurse is caring for a child with a rapid breathing, headache, and the smell of wintergreen on the skin and clothes. Which additional signs and symptoms would the nurse assess for?

Select all that apply:

• Bleeding

• Vomiting

• Confusion

• Diaphoresis

• Hyperglycemia

• Peripheral edema

• Bleeding

• Vomiting

• Confusion

• Diaphoresis

A child accidentally aspirated lighter fluid after playing with a lighter. Which roles does the nurse have in managing this patient?

Select all that apply:

• The nurse will administer IV fluids.

• The nurse will utilize measures to prevent emesis.

• The nurse will administer oxygen and support ventilation.

• The nurse will administer chelators and anti-coagulant medications.

• The nurse will monitor vital signs and observe for signs of CNS depression.

• The nurse will administer IV fluids.

• The nurse will utilize measures to prevent emesis.

• The nurse will administer oxygen and support ventilation.

• The nurse will monitor vital signs and observe for signs of CNS depression.

A 6-year-old child comes to the emergency department and presents with respiratory distress from gasoline skin exposure. Which action should the nurse take if the child becomes unconscious?

• Assess and support cardiorespiratory function

A 2-year-old child comes to the emergency department with a substantial acetaminophen overdose. Which drug-specific medication should the nurse anticipate administering to this patient?

• N-acetylcysteine

A 5-year-old child presents to the emergency department and begins to exhibit neurological side effects after ingesting an unknown poison at home. Which action should the nurse take after assessing that the airway is stable?

• Prepare for seizure precautions

A child is brought to the emergency department with a fever. The caregiver becomes anxious and tells the nurse he had a family member die from a high-fever and sore throat 30 years ago. Which statement is the appropriate response by the nurse?

• “That must have been very traumatic; now let’s get your son assessed so we can begin his care.”

Which action would the nurse perform to help the parents understand a 5-year-old’s needs during IV insertion?

• Ensure that she communicates honestly about procedures

A 15-year-old boy has been admitted to the emergency department and is recovering from ethanol intoxication. When questioned about his behavior, the adolescent becomes upset, fearful, and anxious. What should the nurse do in this situation?

Select all that apply:

• Ensure the child’s privacy is maintained

• Encourage the child to discuss emotions

• Contact authorities to report the child’s alcohol use

• Remind the child of the dangers of drinking ethanol

• The nurse should justify the necessity of providing treatment for an impeding alcohol problem

• Ensure the child’s privacy is maintained

• Encourage the child to discuss emotions

A 12-month-old infant is brought into the emergency department with difficulty breathing. Which action would the nurse perform first?

• Observe the infant for respiratory rate and effort

The nurse is conducting a primary assessment on a toddler with a respiratory rate of 40, supraclavicular retractions, and nasal flaring. Which is the next appropriate action for the nurse to take?

• Assess lung sounds

A 10-year-old, tearful patient presents to the emergency department with a burn on the left foot. The nurse notes a partial thickness burn and erythema. After vitals are assessed and the child is provided with comfort measures, which are the next appropriate actions to take?

Select all that apply:

• Monitor the surface of the injury

• Assess range of motion in all extremities

• Obtain information on past hospitalizations

• Carefully monitor the patient’s temperature

• Pain management primarily through nonpharmacologic measures

• Monitor the surface of the injury

• Assess range of motion in all extremities

• Obtain information on past hospitalizations

• Carefully monitor the patient’s temperature

Match the equipment with its use in a pediatric emergency.

• Endotracheal tube

  • Support the failed airway

• Fluid warmer

  • Heat blood before transfusion

• Capnometer

  • Measure exhaled CO2

• Bag-valve mask

  • Support ventilation

• Intraosseous device

  • Peripheral vascular access

Pediatric airways utilized in an emergency are classified into different categories. What are the names of the airways that may be utilized in a pediatric emergency?

Select all that apply:

• Laryngeal

• Chest tube

• Oropharyngeal

• Nasoesophageal

• Nasopharyngeal

• Laryngeal

• Oropharyngeal

• Nasopharyngeal

Which medication is utilized to reverse the effects of opiate narcotics?

• Naloxone hydrochloride

The nurse is caring for an infant in the emergency department. The nurse must be careful of all the patient’s IV lines, but also recognizes that to provide developmentally appropriate care she should perform which actions in caring for the infant?

Select all that apply:

• Swaddle the infant

• Touch and rock the infant

• Allow the use of a pacifier

• Leave infant in crib at all times

• Talk in normal volume and tone to infant

• Swaddle the infant

• Touch and rock the infant

• Allow the use of a pacifier

A nurse in the unit receives a prescription to obtain a urine sample via catheterization. The first attempt was not successful, and the infant starts crying. What should be the nurse’s next action because the baby is crying?

• Let the infant have a rest period

Which factors make it possible to have two patients that are both at the same age yet behave very differently in an emergency setting?

Select all that apply:

• Maturity levels

• Past experiences

• Health care agency

• Cultural differences

• Health care provider

• Maturity levels

• Past experiences

• Cultural differences

Which factors are most frequently associated with pediatric cardiopulmonary arrest?

Select all that apply:

• Shock

• Choking

• Cardiac arrest

• Lethal arrhythmia

• Respiratory failure

• Shock

• Respiratory failure

The nurse is performing cardiopulmonary resuscitation (CPR) on a 9-month-old patient and needs to obtain the baby’s pulse. Where is the best place to locate a pulse on a 9-month-old infant during CPR?

• The ventral surface of the arm near the cubital fossa

Which technique would the nurse utilize to perform chest compressions on an infant?

• two fingers

The nurse is preparing a 7-year-old boy with a lower leg fracture for emergency surgery. The child asks, “Will I be able to play baseball in 2 weeks?” Which response by the nurse is most appropriate?

“I know you will want to play baseball in 2 weeks. Because of your injury, you may be able to watch the game and support your team, but it is unlikely that you will be able to play in the game.”

Which behaviors would a nurse demonstrate to patients and parents that would build a trusting relationship for effective communication?

Select all that apply:

• Make eye contact

• Call the child by name

• Avoid fearful subjects

• Provide updates when available

• Offer silence as much as possible

• Make eye contact

• Call the child by name

• Provide updates when available

The nurse is caring for a 5-year-old patient after a motor vehicle collision. The child’s parents were killed on impact. One of the family members who has arrived at the bedside is emotional, crying, and getting louder. Which action would the nurse take to maintain effective communication with the patient and the family?

• The nurse knows she must encourage the person in crisis to move to a quiet place.

A child has just presented to the emergency department. Which three factors must a triage nurse first assess in a young infant?

Select all that apply:

• Skin color

• Temperature

• Level of arousal

• Hydration status

• Respiratory rate and effort

• Skin color

• Level of arousal

• Respiratory rate and effort

A 3-year-old child is brought to the emergency department unconscious, and the nurse notes a very abnormal skin color. Based on this observation, which factors must be addressed immediately since they indicate a great threat to the child’s life?

Select all that apply:

• Hypertension

• Hypoventilating

• Abdominal distention

• Respiratory distress or failure

• Inadequate tissue perfusion (shock)

• Respiratory distress or failure

• Inadequate tissue perfusion (shock)

The nurse is caring for a 9-year-old child brought to the emergency department by ambulance after a motor vehicle collision. The patient is not accompanied by any family. Which assessment finding would be obtained during the secondary assessment?

• Family presence

A patient is diagnosed with torsades de pointes. What medication can the nurse anticipate the health care provider prescribing as part of the care plan for this patient?

• Magnesium sulfate

Which medication is commonly used to treat pulseless ventricular tachycardia?

• Lidocaine

Which aspect of adenosine administration is most important for the nurse to remember?

The nurse understands that the priority of the emergency situation is addressing the adolescent’s physical problems. After physical problems have been addressed, the nurse should complete which step next?

• Ensure the patient’s modesty is preserved

The nurse is caring for a 9-year-old with an abdominal wound. Which factor is mostimportant to consider when teaching the child about care of the wound?

• Nine-year-olds have extensive vocabularies, and they can understand simple explanations of procedures.

The emergency department nurse is caring for a 7-year-old child who presents with frequent abdominal pain. The child reports bullying at school and poor test grades. Which factors are most important for the nurse consider when providing care?

Select all that apply:

• Grade level

• Height and weight

• Child’s developmental level

• Child’s abdominal discomfort

• How the child responds to bullying

• Child’s developmental level

• Child’s abdominal discomfort

• How the child responds to bullying

The nurse is caring for a 12-year-old child who was found unresponsive and requires cardiopulmonary resuscitation. Which aspect of a child’s medical history would the nurse suspect to be involved in the child’s emergency condition?

Select apply:

• Bee sting allergy

• History of asthma

• Tension headaches

• Greenstick fracture

• Low blood pressure

• Bee sting allergy

• History of asthma

• Low blood pressure

The nurse is caring for a 3-month-old in respiratory arrest. Upon assessment, the nurse notes the child is apneic and pulseless. Which is the appropriate next action to take?

• Begin CPR

The nurse is caring for a 2-year-old in respiratory distress related to epiglottitis who has a patent airway. The child is sitting in the mother’s lap and appears calm. Which is the appropriate action for the nurse to take?

Select all that apply:

• Place the child in a supine position

• Administer supplemental oxygen via blow by

• Allow the mother to continue to hold the infant

• Use a tongue depressor to assess airway patency

• Contact anesthesiology as this is a medical emergency

• Administer supplemental oxygen via blow by

• Allow the mother to continue to hold the infant

• Contact anesthesiology as this is a medical emergency

What evidence would the nurse use to distinguish a human bite from a dog bite?

• The shape of the bite can help determine the origin.

The nurse is caring for a child after a snake bite. Which assessment findings can indicate that the bite was from a venomous species?

Select all that apply:

• Decreased breathing rate

• Mild erythema develops at the site of the bite

• Piercing marks of the bite look like fang-marks

• Onset of nausea, vomiting, sweating and/or salivation

• Pain, numbness, or increasing edema near the bite location

• Piercing marks of the bite look like fang marks

• Onset of nausea, vomiting, sweating and/or salivation

• Pain, numbness, or increasing edema near the bite location

A mother brings her child to the emergency department after being stung by a wasp. What is the next appropriate step for the nurse to take in caring for the child?

• The stinger should be carefully removed to avoid injecting more venom

The nurse is caring for a child after a submersion injury. An artificial airway is in place, and the patient’s breathing is mildly labored. Which additional assessments should the nurse perform?

Select all that apply:

• Gait testing

• Pupillary response

• Level of consciousness

• Reflexes and vital signs

• Movement of extremities

• Pupillary response

• Level of consciousness

• Reflexes and vital signs

• Movement of extremities

The nurse is caring for a patient who was submerged in a freshwater pond for several minutes and who progressively shows signs of cerebral edema. Which finding would alert the nurse to take immediate action?

• Low serum sodium

The nurse is caring for a child who was submerged in a warm lake for 10 minutes. Which finding would be most concerning and require prompt monitoring by the nurse?

• Posturing

The nurse is caring for a toddler brought in after a sibling’s baseball game who is tachycardic and tachypneic with a rectal temperature of 105° F. In which heat-related injury category should the nurse classify this patient?

• Heat stroke

Which actions should the nurse take to stabilize a child with a heat-related injury?

Select all that apply:

• Loosen or remove clothing

• Offer oral fluids or use IV rehydration

• Monitor vital signs and respond accordingly

• Set up dialysis to quickly reestablish electrolyte balance

• Maintain a cool environment, including cool, moist cloths and fans

• Loosen or remove clothing

• Offer oral fluids or use IV rehydration

• Monitor vital signs and respond accordingly

• Maintain a cool environment, including cool, moist cloths and fans

Which environmental risk factors should the nurse inform parents about that would increase the possibility of heat-related injury among their children?

Select all that apply:

• Asthma

• Obesity

• High humidity

• High temperature

• Skin prone to sunburn

• High body-surface-area to mass ratio

• High humidity

• High temperature

A child presents to the emergency department 24 hours after a human bite to the left shoulder by another child. The nurse notes a small, open, bite-shaped wound with minimal bleeding. Which intervention by the nurse is a priority?

• Irrigate the wound

A 4-year-old child is seen in the ER with a black widow spider bite to the lower back with reports of abdominal pain and muscle spasms. Which interventions would the nurse perform?

Select all that apply:

• Administer antivenin

• Administer antihistamines

• Administer muscle relaxant

• Clean the wound with antiseptic

• Use cool compresses on the wound

• Apply a paste of water and baking soda

• Administer antivenin

• Administer muscle relaxant

• Clean the wound with antiseptic

• Use cool compresses on the wound

The nurse reviews the health care provider’s prescriptions for a child that was bitten by a brown recluse spider. Which prescription would the nurse question?

• Administer antivenin

A child is brought to the ER after sustaining a submersion injury after falling into a frozen lake. Which assessment findings is the nurse likely to see?

Select all that apply:

• Rectal temp 96.1° F

• Radial heart rate 47

• Capillary refill > 5 seconds

• Supraventricular tachycardia

• Compensated metabolic alkalosis

• Rectal temp 96.1° F

• Radial heart rate 47

• Capillary refill > 5 seconds

Which action by the nurse is important when speaking with the family of a critically ill child with a submersion injury?

• Be honest about the severity of the injury

The nurse arrives at the scene to begin treating a child who has experienced a submersion injury. Upon arriving at the scene, which actions are appropriate? And after CPR is initiated, which next actions are appropriate?

Select all that apply:

• Monitor vitals

• Stabilize the spine

• Maintain lung hyperinflation

• Start CPR and ensure a patent airway

• Suction the oropharynx or remove

• Monitor vitals

• Stabilize the spine

• Start CPR and ensure a patent airway

• Suction the oropharynx or remove

The nurse is caring for a 10-year-old brought in after a syncopal episode during a football game in which the outside temperature was 103° F. Which assessment finding would be most concerning to the nurse?

• Dry skin

The nurse is discussing with parents the prevention of heat-related injuries in preschoolers. Which information should the nurse provide?

Select all that apply:

• Discuss the importance of fluid and electrolyte intake

• Explain wearing loose-fitting, light-colored clothes to keep cool

• Discuss the importance of proper nutrition to prevent weight gain

• Discuss never leaving a child in a vehicle alone, even in cool temperatures

• Tell the parents to monitor the weather and adjust activities if high temperature or humidity is expected

• Discuss the importance of fluid and electrolyte intake

• Explain wearing loose-fitting, light-colored clothes to keep cool

• Discuss never leaving a child in a vehicle alone, even in cool temperatures

• Tell the parents to monitor the weather and adjust activities if high temperature or humidity is expected

The nurse is caring for a child with an episode of dizziness during a soccer game and reports having muscle cramps and nausea but no vomiting. The nurse notes diaphoresis and mild tachycardia. Which action should the nurse take?

• Encourage oral fluids

The nurse is performing an initial assessment on a 4-year-old child. Before beginning the assessment, what should the nurse do?

• Have the child sit beside the parent

The nurse is assessing a 2-month-old patient. The nurse conducts which part of the assessment first?

• Auscultation of the heart and lungs

When examining a 15-month-old, which assessment would the nurse perform last?

• Otoscopic ear examination

Place the steps of the chest examination in the order in which they are performed.

1. Inspection

2. Palpation

3. Percussion

4. Auscultation

The nurse is performing an assessment on a 3-year-old with a fever and a sore throat. Which part of the hand would the nurse use to palpate cervical lymph nodes?

• Fingertips

The nurse is assessing a patient who reports shortness of breath, wheezing, and chest tightness. Which assessment technique(s) will help the nurse assess the severity of the patient’s condition?

Select all that apply:

• Palpation

• Inspection

• Percussion

• Auscultation

• Inspection

• Auscultation

The nurse is assessing a 7-year-old. List the body systems in the order in which they would likely be assessed.

• face

• neck

• chest

• abdomen

• extremities

• genitals

The nurse is assessing a 4-year-old child with a cough. After noting the child’s vital signs, which action would the nurse take?

• Obtaining a throat culture is uncomfortable

An 8-year-old is seen in a clinic for a sore throat and cough. The nurse has orders to assess vital signs, auscultate lung sounds, assess the child’s weight, and obtain a throat culture. Why would the nurse perform the culture last?

• Inspect the chest

Why should the nurse auscultate the abdomen before palpation during an abdominal assessment?

• Palpation changes bowel sounds

The nurse percusses the chest of a 7-year-old patient with asthma and notes a dull area over the lower left quadrant. How would the nurse describe this finding?

• Percussion over a high-density organ or mass

The nurse is performing a thorough examination of a 5-year-old child. When assessing the warmth of the child’s skin, the nurse uses which aspect of the hand?

• Back surface