#1
A teenage has been placed in a brace for the treatment of scoliosis. The family asks what they can do to be more supportive. What suggestion of the nurse is the most appropriate?
A. Spending most of their time with them
B. Taking them to the mall in a wheelchair
C. Purchasing clothes to disguise the cast
D. Enrolling them in a health club
C. Purchasing clothes to disguise the cast
Rationale:
The adolescent is trying to fit in with peers and has concerns about body image.
The health care provider is treating a child with meningitis with a course of antibiotic therapy. When should the nurse expect the child to be out of isolation?
A. When the child has no symptoms of the disease
B. When the course of antibiotics is complete
C. When a negative CNS culture is obtained
D.When the antibiotics have been initiated for at least 24 hours
D.When the antibiotics have been initiated for at least 24 hours
Rationale:
The child with bacterial meningitis is isolated for at least 24 hours until antibiotic therapy has been administered.
When caring for a 7-week-old infant with hypothyroidism, the nurse explains that the prevention of what complication is dependent on the administration of oral thyroid replacement therapy and is critical for the child?
B. Cognitive impairment
Rationale:
The treatment of choice for congenital and acquired hypothyroidism is oral thyroid hormone replacement therapy. Prompt treatment is especially critical in the infant with congenital hypothyroidism to avoid permanent cognitive impairment.
What should the therapeutic management of iron deficiency anemia include?
D. Ferrous sulfate
Rationale:
Therapeutic management of iron deficiency anemia is iron (ferrous sulfate) supplementation, nutritional counseling, and treatment of any underlying condition.
A child with a Wilms tumor is admitted. Which action should the nurse avoid?
A. Measuring abdominal circumference.
B. Monitoring B/P
C. Palpating the abdomen
D. Monitoring the urine output
C. Palpating the abdomen
When conducting a class for parents about sudden infant death syndrome (SIDS), the nurse instructs the class that the infant should be placed in which position to sleep?
A. Supine
B. Right side-lying
C. Left side-lying
D. Prone
A. Supine
The American Academy of Pediatrics recommends placing the infant on its back, or supine, to sleep.
Following a bout of diarrhea, which foods should be offered to the school-age child?
D. Bananas and rice
Rationale:
When rehydration has been completed, foods that are nonirritating to the bowel should be offered to the child. Bananas and rice would be the least irritating to the bowel, as fruits and milk could cause GI irritation.
Recurrent abdominal pain (RAP) is most often seen in school-age or adolescent children. The nurse should assess closely for what potential problems?
Rationale:
RAP is often related to emotional factors in the child.
Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse?
A. "Are you sure your child has iron deficiency anemia?"
B. "The child may not have had it for a long time."
C. "This anemia is caused by blood loss."
D. "This happens when the maternal stores of iron are depleted at about 6 months."
D. "This happens when the maternal stores of iron are depleted at about 6 months."
Rationale:
Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant, when maternal stores of iron are depleted.
A child with hemophilia has a swollen painful knee. What does the nurse suspect?
A. Infection
B. Hemarthrosis
C. Dehydration
D. Fracture
B. Hemarthrosis
What is the priority patient problem for the parents of a newborn born with cleft lip and palate?
C. Risk for impaired attachment
Rationale:
Parents of a child with cleft lip and palate may have difficulty bonding with their child due to the appearance of the child. The priority patient problem is risk for impaired attachment. A goal is to promote bonding between parents and infant.
Which laboratory results should the nurse anticipate to be abnormal in a child with hemophilia?
B. Partial thromboplastin time
Rationale:
Expected laboratory findings for a child with hemophilia include a prolonged partial thromboplastin time. The prothrombin time, bleeding time, and platelet count are typically normal.
The parents of a child with acute lymphoblastic leukemia ask about the best approach for maintaining remission of the disease. What would be the most effective therapy?
Rationale:The treatment of choice is methotrexate, a chemotherapeutic agent, to produce remission.
What other congenital defects are common in children with Down syndrome?
B. Heart defects
Rationale:
Many children with Down syndrome have congenital heart defects.
Which finding after tonsillectomy requires immediate attention?
A. Bad breath
B. White patches in the throat
C. Ear pain
D. Frequent swallowing
D. Frequent swallowing
What is the hallmark sign of intussusception?
C.Currant jelly–like stools
Rationale:
The hallmark sign of intussusception is currant jelly stools.
Which additional congenital malformation is present in the majority of infants with a myelomeningocele?
B. Hydrocephalus
Rationale:
Depending on the level of the defect, affected infants usually have flaccid paralysis and sensory deficits of the lower extremities, bowel and bladder incontinence, talipes equinovarus defects, and a subluxated hip (a partial or incomplete dislocation of the hip). Hydrocephalus is present in most affected infants.
What assessment findings should lead the nurse to suspect Down syndrome in a newborn?
B. Low-set ears and a simian crease
Rationale:
Manifestations of the Down syndrome infant include low-set ears, simian crease, protruding tongue, and hypotonic extremities.
An infant has been diagnosed with cradle cap. What is the correct intervention to treat the scalp?
B. Mineral oil
Rationale:
Crusty patches can be removed with the application of mineral oil.
Which food should the nurse recommend with oral iron?
A. Milk
B. Orange juice
C. Cheese
D. Yogurt
B. Orange juice
How is the infant with gastroesophageal reflux (GERD) typically treated?
C.By thickening the formula or breast milk with cereal
Rationale:
GERD is treated with small feedings thickened with cereal. The infant should not be made NPO or switched to cow's milk. Infants should only be placed on the back to sleep due to the risk of SIDS.
What is the best time to administer pancreatic enzyme replacement?
Rationale:
Pancreatic enzymes are administered before meals and snacks to digest carbohydrates, fats, and proteins.
A new parent asks the clinic nurse if they must continue giving their baby nystatin for thrush since the white tongue lesions have disappeared. What response by the nurse is most appropriate?
Rationale:
Nystatin should be given for the full 7 days even if the lesions are no longer present.
A 2-year-old child with laryngotracheobronchitis (LTB) is fussy and restless in the oxygen tent. The oxygen level in the tent is 25%, and blood gases are normal. What would be the correct action by the nurse?
D. Increase the oxygen concentration in the tent.
Rationale:
The child with LTB should be placed in the mist tent with 30% oxygen. Restlessness is caused by poor oxygenation. The child should not be taken out of the oxygenated tent. While the mother could be asked to help comfort the child, and the health care provider may be notified, the priority is to set the oxygen at the correct level.
Which Intervention is most important for a child with cystic fibrosis?
A. Restrict fluids
B. Limit proteins
C. Promote airway clearance
D. Restrict salt
C. Promote airway clearance
What should the nurse assess in an infant who has been diagnosed with hypertrophic pyloric stenosis?
B. An olive-shaped mass right of the abdomen's midline
Rationale:
Examination of the abdomen may assist in the diagnosis and reveal key signs of hypertrophic pyloric stenosis. Visible peristaltic waves that move from left to right across the epigastric region may be evident, and palpation may reveal an olive-shaped mass in this area to the right of the midline. None of the other options are associated with this condition.
The nurse is caring for a child who has been diagnosed as having an attention deficit hyperactivity disorder (ADHD). What is the most important intervention for the nurse?
Rationale:
It is most important to allay any feelings of guilt the parents may have so that the child can receive the medical and family attention they need.
The nurse anticipates that the cerebrospinal fluid (CSF) taken from a child with bacterial meningitis would have a low level of which component?
Rationale:The glucose level in the CSF of a child with bacterial meningitis is low because the bacteria in the fluid have digested the glucose.
The nurse educates the family of a newly admitted child with cystic fibrosis that the treatment will be centered on what therapy?
A. Prevention of diarrhea
B. Insulin therapy
D. Chest physiotherapy
Rationale:
Chest physiotherapy and aerosol medications are the center of treatment for cystic fibrosis. None of the other options are relevant to this situation.
Which activity is important for a toddler?
A. Competitive team sports
B. Parallel play
C. Abstract board games
D. Cooperative group projects
B. Parallel play