Practice Questions 2
A nurse is teaching a child's caregiver about spica cast care at home. Which of the following responses from the caregiver indicates further teaching is needed? Select all that apply. A. "If the cast gets wet, I should use a hair dryer to quickly dry the cast." B. "Small dents in the cast may happen, especially the longer the child has the cast. C. "Bivalving the cast will help prevent soiling of the cast in the perineal area." D. "I should place my child on their abdomen to promote their independence in feeding themselves." E. "If itching occurs under the cast, they should be sure to use a long device, so it does not get stuck under the cast."
A. "If the cast gets wet, I should use a hair dryer to quickly dry the cast." B. "Small dents in the cast may happen, especially the longer the child has the cast. E. "If itching occurs under the cast, they should be sure to use a long device, so it does not get stuck under the cast."
A 16-year-old post-op patient for scoliosis is getting ready to be discharged from the hospital. Which of the following statements indicates understanding of discharge patient teaching for the immediate recovery period? Select all that apply. A. "My parents will need to stay home with me at all times." B. "I can return to school in 1 week." C. "I will need to practice sitting up without the brace to improve muscle strength." D. "I should not have trouble breathing when wearing the brace." E. "I will use an elevated toilet seat."
A. "My parents will need to stay home with me at all times." D. "I should not have trouble breathing when wearing the brace." E. "I will use an elevated toilet seat."
A nursing instructor knows the student nurse needs further remediation when explaining the blood flow in the normal heart based on which statement? A. "The pulmonary artery carries oxygenated blood." B. "Blood leaves the left ventricle as oxygenated blood through the aortic valve and aorta, and goes to the rest of the body." C. "The venae cava carries unoxygenated blood from the body tissue to the right atrium." D. "The left atrium allows blood to flow down through the mitral valve into the left ventricle."
A. "The pulmonary artery carries oxygenated blood."
Which of the following statements is correct teaching for a nurse when speaking to a caregiver about their newly diagnosed infant with torticollis? A. "Treatment with botulinum toxin (Botox) may be effective." B. "Special care should be taken to limit cervical spine range of motion, so the condition does not worsen." C. "Do not place the infant on their stomach at any time as it puts the infant at risk for suffocation." D. "The main medical management of torticollis is having the child work with a child-life specialist to encourage developmentally appropriate play activities that encourage movement."
A. "Treatment with botulinum toxin (Botox) may be effective."
A nurse caring for a child diagnosed with an endocardial cushion defect knows the heart has what issues? Select all that apply. A. An opening on the atrial wall B. An opening on the ventricle wall C. The tricuspid and mitral valve from one large valve D. The aortic and pulmonary valve form one large valve E. Presence of a patent ductus arterioles
A. An opening on the atrial wall B. An opening on the ventricle wall C. The tricuspid and mitral valve from one large valve
Which of the following interventions would the nurse provide when providing care for a patient with juvenile rheumatoid arthritis that is impairing their mobility? A. Assist with active and passive ROM exercises B. Cold application to joints C. Apply oxygen before and during physical therapy D. Encourage a high-fiber diet E. Preambulation pain medication administration
A. Assist with active and passive ROM exercises E. Preambulation pain medication administration
Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include which action? A. Avoid using any latex product. B. Use only nonallergenic latex products. C. Administer medication for long-term desensitization. D. Teach family about long-term management of asthma.
A. Avoid using any latex product
The nurse is conducting discharge teaching to parents of a preschool child with myelomeningocele, repaired at birth, being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the childs genitourinary function? (Select all that apply.) A. Continue to perform the clean intermittent catheterizations (CIC) at home. B. Administer the oxybutynin chloride (Ditropan) as prescribed. C. Reduce fluid intake in the afternoon and evening hours. D. Monitor for signs of a recurrent urinary tract infection. E. Administer furosemide (Lasix) as prescribed.
A. Continue to perform the clean intermittent catheterizations (CIC) at home. B. Administer the oxybutynin chloride (Ditropan) as prescribed. E. Administer furosemide (Lasix) as prescribed.
The nurse is caring for a 15-year-old patient with scoliosis who just returned to his room after spinal fusion surgery. Priority nursing care for the child includes which of the following? Select all that apply. A. Continuous infusion of an opioid using a PCA. B. Obtain vital signs and perform neurological assessments every 4 hours. C. Ambulate the patient to the bathroom within 8-10 hours after surgery. D. Utilize the logrolling technique when moving the patient. E. Assess for signs and symptoms of pneumothorax from the chest-tube removal.
A. Continuous infusion of an opioid using a PCA. D. Utilize the logrolling technique when moving the patient.
A student nurse is performing an assessment on a child diagnosed with severe craniosynostosis. Which of the following treatments is most likely? A. Craniotomy B. Radiation C. Treatment is not needed unless severe D. Physical therapy to increase ROM
A. Craniotomy
A student nurse is learning about pediatric fractures and the healing process. Which of the following indicate understanding? Select all that apply. A. Fractures cause an inflammatory response. B. Callus formation takes up to a year. C. Osteoblasts activate within 24 hours of the fracture occurring. D. There are five types of diaphysis fractures. E. To heal correctly, the bones need to be perfectly aligned.
A. Fractures cause an inflammatory response. C. Osteoblasts activate within 24 hours of the fracture occurring.
A nurse admitting a child with the beginning stages of CHF due to increased preload would most likely expect the child to be receiving which medication? A. Furosemide B. Enalapril C. Dopamine D. Aspirin
A. Furosemide
You are the nurse assisting a health-care provider performing the Ortalani maneuver on an infant assessment of developmental dysplasia. The nurse understands that this maneuver is used to assess which of the following? A. Hip instability B. Movement of each femoral head in relation to the other C. Strength of hips D. Full range of motion
A. Hip instability
The nurse is conducting a staff in-service on common problems associated with myelomeningocele. Which common problem is associated with this defect? A. Hydrocephalus B. Craniosynostosis C. Biliary atresia D. Esophageal atresia
A. Hydrocephalus
A child presents to the pediatrician's office with an irregular heart rhythm. An ECG is obtained, and the child is found to have sinus dysrhythmia. The nurse knows which of the following are true about this irregular rhythm? Select all that apply. A. It has no adverse effect on cardiac output B. The heart rate increases with inspiration C. The heart rate decreases with inspiration D. The heart rate increases with expiration E. The heart rate decreases with expiration
A. It has no adverse effect on cardiac output B. The heart rate increases with inspiration E. The heart rate decreases with expiration
A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Nursing care for this child includes which action(s)? (Select all that apply.) A. Monitoring and maintaining systemic blood pressure B. Administering corticosteroids C. Minimizing environmental stimuli D. Discussing long-term care issues with the family E. Monitoring for respiratory complications
A. Monitoring and maintaining systemic blood pressure B. Administering corticosteroids E. Monitoring for respiratory complications
The nurse is teaching a group of nursing students about newborns born with the congenital defect of myelomeningocele. Which common problem is associated with this defect? A. Neurogenic bladder B. Mental retardation C. Respiratory compromise D. Cranioschisis
A. Neurogenic bladder
Four-year-old David is placed in Buck extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first? A. Notify the practitioner of the changes noted. B. Give the child medication to relieve the pain. C. Reposition the child and notify physician. D. Chart the observations and check the extremity again in 15 minutes.
A. Notify the practitioner of the changes noted.
Which can result from the bone demineralization associated with immobility? A. Osteoporosis B. Urinary retention C. Pooling of blood D. Susceptibility to infect
A. Osteoporosis
A home-health nurse caring for a 7-year-old diagnosed with osteogenesis imperfecta (OI) should focus care on which of the following long-term interventions? Select all that apply. A. Prevent deformities. B. Identify cause of a fracture. C. Ensure proper nutrition to prevent obesity. D. Multidisciplinary care coordination with physical therapists. E. Prevention of osteomyelitis.
A. Prevent deformities. C. Ensure proper nutrition to prevent obesity. D. Multidisciplinary care coordination with physical therapists.
At a 4-month well-child check, a caregiver expresses concern that the child is much smaller than their other child was at the same age. The caregiver also states the child seems to tire easily when breastfeeding and "doesn't seem to take a whole feeding." What other signs and symptoms would indicate concern for a ventricular septal defect (VSD)? Select all that apply. A. Puffy Eyes B. Sweating when breastfeeding C. Frequent respiratory infections D. Diarrhea E. Vomiting after feedings
A. Puffy Eyes B. Sweating when breastfeeding C. Frequent respiratory infections
A 4-year-old child has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. The management plan should include which action? A. Recommend genetic counseling. B. Explain that the disease is easily treated. C. Suggest ways to limit use of muscles. D. Assist family in finding a nursing facility to provide his care.
A. Recommend genetic counseling.
When teaching caregivers about their child with osteogenesis imperfecta, which of the following are appropriate nursing actions? Select all that apply. A. Refer the parents to a genetic counselor before having future children. B. Provide information about special care considerations for the child such as different positioning and diapering. C. Encourage the caregivers to not treat the child different than other children. D. Encourage nutritional support to increase intake of vitamin D. E. Teach the caregivers to watch for signs of a fracture.
A. Refer the parents to a genetic counselor before having future children. B. Provide information about special care considerations for the child such as different positioning and diapering. D. Encourage nutritional support to increase intake of vitamin D. E. Teach the caregivers to watch for signs of a fracture.
Which term is used to describe a type of fracture that does not produce a break in the skin? A. Simple B. Compound C. Complicated D. Comminuted
A. Simple
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. Which should the nurse suggest to remove this material? A. Soak in a bathtub. B. Vigorously scrub leg. C. Apply powder to absorb material. D. Carefully pick material off leg.
A. Soak in a bathtub.
The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant? (Select all that apply.) A. Temperature instability B. Irritability C. Lethargy D. Bradycardia E. Hypertension
A. Temperature instability B. Irritability C. Lethargy
A nurse is performing a newborn assessment on a child with congenital talipes equinovarus. Which of the following assessment findings are consistent with this diagnosis? A. The mother is obese and smokes during pregnancy. B. The foot is plantar flexed. C. The forefoot is abducted D. The foot can be manipulated to the 'neutral' position. E. The newborn has been diagnosed with spina bifida.
A. The mother is obese and smokes during pregnancy. B. The foot is plantar flexed. E. The newborn has been diagnosed with spina bifida.
Which of the following are frequent sites of subluxation? Select all that apply. A. Thumb B. Neck C. Toe D. Shoulder E. Hip
A. Thumb D. Shoulder E. Hip
Which assessment finding in a child is concerning after a cast is applied for an elbow fracture? Select all that apply. A. Unrelieved pain B. Weakness C. Paresthesia D. Pale in color E. Range of motion
A. Unrelieved pain C. Paresthesia D. Pale in color
A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is to: A. apply ice. B. observe for edema and discoloration. C. encourage child to assume a position of comfort. D. obtain parental permission for administration of acetaminophen or aspirin.
A. apply ice.
The nurse is planning a staff in-service on childhood spastic cerebral palsy. Spastic cerebral palsy is characterized by: A. hypertonicity and poor control of posture, balance, and coordinated motion. B. athetosis and dystonic movements. C. wide-based gait and poor performance of rapid, repetitive movements. D. tremors and lack of active movement
A. hypertonicity and poor control of posture, balance, and coordinated motion.
A student nurse is learning about the different types of traction. Which of the following statements indicates the nurse needs further teaching? Select all that apply. A. "Russell's traction is used on children younger than 2 to 3 years of age and less than 26.4 pounds." B. "Bryant's traction uses pull in only one direction." C. "Modified diapering should be used for a child with Bryant's traction." D. "Skeletal traction is used after open reduction of a fracture to keep the bones in proper position." E. "When Crutchfield tongs are used as traction, the child should only be moved by log-rolling."
B. "Bryant's traction uses pull in only one direction." C. "Modified diapering should be used for a child with Bryant's traction." E. "When Crutchfield tongs are used as traction, the child should only be moved by log-rolling."
A child is diagnosed with a fracture and a cast is applied. At discharge, the nurse is teaching the caregiver how to assess for poikilothermia. The nurse knows the caregiver understands by which of the following statements? A. "If I apply ice to the child's fractured leg and their body temperature decreases, I should be concerned." B. "If the child's fractured left leg begins to feel cooler in temperature than the other leg, I should notify the health-care provider." C. "If I am unable to feel pulses below the cast, I will notify the health-care provider." D. "If the pain is unrelieved by narcotics, I should begin to alternate Tylenol and Ibuprofen to help with pain."
B. "If the child's fractured left leg begins to feel cooler in temperature than the other leg, I should notify the health-care provider."
When explaining a 'Tet' spell and Tetralogy of Fallot (TOF) to the parents of a newly diagnosed child, the nurse should include which statements? Select all that apply. A. "It may help to lay the child completely flat during a 'spell' until it passes." B. "Spells may be exacerbated by crying, excitement, active playing, or during feeding." C. "Tet spells are caused by a rapid drop in the amount of oxygen in the blood." D. "TOF leads to left ventricular hypertrophy." E. "TOF causes mixing of oxygenated and deoxygenated blood."
B. "Spells may be exacerbated by crying, excitement, active playing, or during feeding." C. "Tet spells are caused by a rapid drop in the amount of oxygen in the blood." E. "TOF causes mixing of oxygenated and deoxygenated blood."
How much folic acid is recommended for women of childbearing age? A. 1.0 mg B. 0.4 mg C. 1.5 mg D. 2.0 mg
B. 0.4 mg
A student nurse is learning about the pediatric musculoskeletal system. The student correctly identifies the differences between children and adults to include which of the following? Select all that apply. A. A child with a fracture is more likely to have bone displacement than an adult. B. An epiphyses fracture can cause permanent bone length differences. C. Fractures in children younger than age 1 are uncommon. D. The posterior fontanelle closes last at 12 to 18 months of age. E. Children's bones grow in length and width.
B. An epiphyses fracture can cause permanent bone length differences. C. Fractures in children younger than age 1 are uncommon. E. Children's bones grow in length and width.
Which is an appropriate nursing intervention when caring for a child in traction? A. Remove adhesive traction straps daily to prevent skin breakdown. B. Assess for tightness, weakness, or contractures in uninvolved joints and muscles. C. Provide active range-of-motion exercises to affected extremity three times a day. D. Keep the child in one position to maintain good alignment.
B. Assess for tightness, weakness, or contractures in uninvolved joints and muscles.
The nurse is admitting a school-age child with suspected Guillain-Barr syndrome (GBS). Which is a priority in the care for this child? A. Monitoring intake and output B. Assessing respiratory efforts C. Placing on a telemetry monitor D. Obtaining laboratory studies
B. Assessing respiratory efforts
A nurse caring for an infant with early stages of right heart failure due to a congenital heart defect expects to find which of the following on assessment? Select all that apply. A. Ascites B. Bulging Fontanelles C. Edema in hands and feet D. Hyperactivity E. Poor feeding
B. Bulging Fontanelles C. Edema in hands and feet E. Poor feeding
A child with a diagnosis of developmental dysplasia of the hip has just returned from surgery with a spica cast. Which intervention is the nurse's priority for the child? A. Application of heat B. Circulatory assessment C. Administration of stool softeners D. Place pillows under the buttocks
B. Circulatory assessment
The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac? A. Open to air B. Covered with a sterile moist nonadherent dressing C. Reinforcement of the original dressing if drainage noted D. A diaper secured over the dressing
B. Covered with a sterile moist nonadherent dressing
The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status? A. Hypocalcemia B. Decreased metabolic rate C. Positive nitrogen balance D. Increased production of stress hormones
B. Decreased metabolic rate
The nurse is conducting a staff in-service on casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast? A. Cheaper B. Dries Rapidly C. Molds closely to body parts D. Smooth Exterior
B. Dries Rapidly
A nurse is caring for a child with a femur fracture in skeletal traction. Which interventions should be included in the nurse's plan of care during the shift? A. Ensure that all ropes are outside the pulleys. B. Ensure the amount of weight applied is correct and hanging freely. C. Limit diversional activities to allow for frequent change of positions. D. Ensure the wheels of the traction pulley remain locked.
B. Ensure the amount of weight applied is correct and hanging freely.
Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement? A. Healing is usually delayed in this type of fracture. B. Growth can be affected by this type of fracture. C. This is an unusual fracture site in young children. D. This type of fracture is inconsistent with a fall.
B. Growth can be affected by this type of fracture.
A nurse is caring for a 12-year-old in the hospital with osteomyelitis. The child was started on IV antibiotics 3 days ago. The child's current vital signs consist of an oral temperature of 102.4°F, blood pressure is 96/58, pulse is 102, and respiratory rate is 26. The physician has been notified and writes orders to prepare the child for surgery. The nurse understands the likely reason for surgical treatment is: A. To apply traction for stabilization of the bone. B. Lack of response to antibiotics with need for debridement. C. Removal of the infected bone. D. Application of internal fixator.
B. Lack of response to antibiotics with need for debridement.
A 10-year-old is being evaluated for systemic onset juvenile arthritis (JA). Which of the following findings might support this diagnosis? Select all that apply. A. Low grade fevers over last several weeks B. Macular rash on chest and thighs C. Rheumatoid factor is absent in blood D. Rheumatoid nodules on elbow E. Infection is present in the bone when biopsied
B. Macular rash on chest and thighs C. Rheumatoid factor is absent in blood
An adolescent with a fractured femur is in Russells traction. Surgical intervention to correct the fracture is scheduled for the morning. Nursing actions should include which action? A. Maintaining continuous traction until 1 hour before the scheduled surgery B. Maintaining continuous traction and checking position of traction frequently C. Releasing traction every hour to perform skin care D. Releasing traction once every 8 hours to check circulation
B. Maintaining continuous traction and checking position of traction frequently
Which of the following nursing interventions should the nurse include in the care of a child who has a spica cast? Select all that apply. A. Neurovascular checks as needed for complaints of pain B. Medication administration for pain C. Repositioning every 2 to 4 hours while the patient is awake D. Increasing fluid intake and adjusting diet to prevent constipation E. Removing traction every 2 hours to avoid pressure sores
B. Medication administration for pain C. Repositioning every 2 to 4 hours while the patient is awake D. Increasing fluid intake and adjusting diet to prevent constipation
Which should the nurse expect to find in the cerebral spinal fluid (CSF) results of a child with Guillain-Barr syndrome (GBS)? (Select all that apply.) A. Decreased protein concentration B. Normal glucose C. Fewer than 10 white blood cells (WBCs/mm3) D. Elevated red blood cell (RBC) count
B. Normal glucose C. Fewer than 10 white blood cells (WBCs/mm3)
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is which position? A. Prone and tube-fed B. Prone, head turned to side, and nipple-fed C. Supine in an infant carrier and nipple-fed D. Supine, with defect supported with rolled blankets, and nipple-fed
B. Prone, head turned to side, and nipple-fed
Priority safety interventions when caring for all patients with a congenital heart defect (CHD) must include which of the following? Select all that apply. A. Wrist Restraints B. Pulse Oximetry C. Cardiac Monitoring D. Fluid Resuscitation E. Bed Rest
B. Pulse Oximetry C. Cardiac Monitoring
A 14-year-old presents to the ER with a circular red rash with raised edges on their trunk. Upon taking a history, it is noted the child was diagnosed with strep pharyngitis 2 weeks ago. A diagnosis of rheumatic fever is likely. Which signs and symptoms support this diagnosis? Select all that apply. A. Recent tick bite B. Sydenham's chorea C. Prolonged QR interval D. Emotional outbursts E. Murmur over the mitral valve area.
B. Sydenham's chorea D. Emotional outbursts E. Murmur over the mitral valve area.
A caregiver asks the nurse how to care for their child's sprained wrist. Which of the following statements is not appropriate? A. "Sprains are more common in adolescents than young children." B. The acronym RICE will help you remember what to do." C. "Full ROM exercises need to be performed." D. "Wrap the area proximal to distal to provide compression."
B. The acronym RICE will help you remember what to do."
A nurse is caring for a 7-year-old who has a fracture of the femur along the epiphyseal plate of the femur. Which of the following should the nurse include when providing information to the caregiver? A. This type of fracture will require narcotic pain medication since it occurred on the growth plate. B. This type of fracture may cause a discrepancy in the child's leg lengths. C. The most common cause of fractures in children is bicycle crashes. D. The child will need to be interviewed alone to rule out maltreatment as a cause of the fracture.
B. This type of fracture may cause a discrepancy in the child's leg lengths.
In a normal heart of a pediatric patient, what is most responsible for the pumping work of the heart? A. Atria B. Ventricles C. Vessels D. Valves
B. Ventricles
A nurse is educating parents about the Pavlik harness for their 6-month-old infant with developmental dysplasia of the hip. Which of the following parent statements indicates understanding of the teaching? Select all that apply. A. "The brace should be applied and worn every night while the child sleeps." B. "As the hips have more ROM, we will adjust the harness as needed." C. "Frequent skin checks are important." D. "The diaper should be applied under the straps." E. "Cradling the infant should be minimized to not put pressure on the hips while harnessed."
C. "Frequent skin checks are important." D. "The diaper should be applied under the straps."
A nurse is teaching the mother of a child newly diagnosed with moderate to severe osteogenesis imperfecta about the disease. The nurse knows the mother needs further teaching when they make which of the following statements? A. "I will make regular appointments with an orthopedist, neurologist, and cardiologist for my child to be followed closely." B. "My child will likely be smaller than their peers." C. "The prescribed bisphosphonates will help with bone resorption to help make the bones stronger." D. "I understand if I have other children, they may also be diagnosed with this disease."
C. "The prescribed bisphosphonates will help with bone resorption to help make the bones stronger."
A nursing student is learning about application of a Pavlik harness to treat developmental dysplasia of the hip (DDH). The student shows correct understanding when they state that the Pavlik harness immobilizes the legs in what position? A. Extension and abduction B. Adduction and flexion C. Abduction and flexion D. Extension and adduction
C. Abduction and flexion
A caregiver brings their 9-year-old son to the health-care provider's office for a well-child check. The caregiver states, "I'm worried because I know he is overweight for his age and his father had a massive heart attack last year." They ask the nurse if the child needs blood tests to check cholesterol. The nurse knows all of the following indicate screening should be performed except: A. A family history of early heart disease B. Family history of diabetes C. Average intake of 150 mg of cholesterol per day D. Immunosuppressant drug use
C. Average intake of 150 mg of cholesterol per day
A child has just had a spica cast applied. Which of the following actions would most help prevent the complication of cast syndrome? A. Frequent assessment to rule out the 5 Ps B. Perform a neurovascular assessment C. Cut a 'belly hole' in the cast D. Monitor for vomiting and abdominal distention
C. Cut a 'belly hole' in the cast
A nurse is preparing a young child recently diagnosed with dilated cardiomyopathy for discharge. The nurse ensures the child and caregivers fully understand all of the following except: A. Activity restriction is important. B. Follow-up with regular ECGs is important. C. Fluid restriction is important. D. ACE inhibitors are necessary to help with muscular contractility.
C. Fluid restriction is important.
The nurse is reviewing prenatal vitamin supplements with an expectant client. Which supplement should be included in the teaching? A. Vitamin A throughout pregnancy B. Multivitamin preparations as soon as pregnancy is suspected C. Folic acid for all women of childbearing age D. Folic acid during the first and second trimesters of pregnancy
C. Folic acid for all women of childbearing age
A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation? A. Traction is tried first. B. Surgical intervention is needed. C. Frequent, serial casting is tried first. D. Children outgrow this condition when they learn to walk
C. Frequent, serial casting is tried first.
The nurse is caring for a child diagnosed with scoliosis with a spine curve of 30 degrees. Based on the suspected treatment for the child, the nurse develops a plan of care knowing the child is at risk for which problem? A. Immobility B. Delayed growth and development C. Impaired skin integrity D. Falls
C. Impaired skin integrity
A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which intervention should the nurse perform first? A. Place the adolescent in a flat right side-lying position. B. Place a cool washcloth on the adolescents forehead and continue to monitor the blood pressure. C. Implement a standing prescription to empty the bladder with a sterile in and out Foley catheter. D. Take a full set of vital signs and notify the health care provider.
C. Implement a standing prescription to empty the bladder with a sterile in and out Foley catheter.
The nurse is taking care of a 10-year-old child who has osteomyelitis. Which treatment plan is considered the primary method of treating osteomyelitis? A. Joint replacement B. Bracing and casting C. Intravenous antibiotic therapy D. Long-term corticosteroid therapy
C. Intravenous antibiotic therapy
Which clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease)? A. Hyperactive deep tendon reflexes B. Hypertonicity C. Lying in the frog position D. Motor deficits on one side of body
C. Lying in the frog position
The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease? A. Spinal muscular atrophy B. Neural atrophy of muscles C. Progressive weakness and wasting of skeletal muscle D. Pseudohypertrophy of certain muscle groups
C. Progressive weakness and wasting of skeletal muscle
A 39-week pregnant woman is being induced. During regular prenatal care, the fetus was diagnosed with tricuspid atresia. Upon birth, the newborn will be admitted to the neonatal intensive care nursery. The nurse admitting the newborn can expect what immediate initial treatment? A. Open heart surgery B. Fontan Procedure C. Prostaglandin administration D. Indomethacin administration
C. Prostaglandin administration
The nurse is caring for a patient who has just returned to the unit after a Nuss procedure. Postoperative care should focus on what priority? A. Assessment for signs and symptoms of infection B. Diversional activities for nonpharmacological pain relief C. Respiratory care to increase lung expansion D. Bowel movement
C. Respiratory care to increase lung expansion
The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included? A. Apply lotion or powder to minimize skin irritation. B. Remove harness several times a day to prevent contractures. C. Return to clinic every 1 to 2 weeks. D. Place diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin.
C. Return to clinic every 1 to 2 weeks.
A 14-year-old boy is being evaluated for Osgood-Schlatter disease. Which of the following activities would be least likely to contribute to this diagnosis? A. Gymnastics B. Basketball C. Swimming D. Soccer
C. Swimming
The nurse is caring for a school-age child diagnosed with juvenile idiopathic arthritis (JIA). Which intervention should be a priority? A. Apply ice packs to relieve stiffness and pain. B. Administer acetaminophen to reduce inflammation. C. Teach the child and family correct administration of medications. D. Encourage range-of-motion exercises during periods of inflammation.
C. Teach the child and family correct administration of medications.
A nurse is assessing an infant for developmental dysplasia of the hip (DDH). On exam, the nurse notes the child has a negative Barlow sign. Which of the following statements is true concerning this finding? A. The child has dislocation of the hip outside the acetabulum when abducting the leg inward and outward, which is evidence of DDH. B. The child has dislocation of the hip outside the acetabulum when adducting the leg inward and outward, which is evidence of DDH. C. The child does not have dislocation of the hip outside the acetabulum when adducting the leg inward and outward, which indicates no evidence of DDH. E. The child has dislocation of the hip outside the acetabulum when abducting the leg inward and outward, which indicates no evidence of DDH.
C. The child does not have dislocation of the hip outside the acetabulum when adducting the leg inward and outward, which indicates no evidence of DDH.
A 17-year-old football player is being seen by the health-care provider for an ankle injury and receives a diagnosis of a second-degree soft tissue injury. Which of the following are consistent with this diagnosis? A. On exam, the ankle joint is unstable. B. The child reports bruising and swelling almost immediately after the injury. C. The child's is unable to bear weight on their ankle. D. Due to the child's age, they are less likely to have a fracture than a younger child.
C. The child's is unable to bear weight on their ankle.
A child is being evaluated after a fainting episode while the parent was brushing their hair. Seizure disorder and Long QT syndrome have been ruled out as diagnoses. Knowing that the child fainting episode was due to neurally mediated syncope (NMS), what definitive diagnostic test does the nurse prepare the child for? A. ECG B. Cardiac Catherization C. Tilt Test D. Orthostatic Blood Pressure
C. Tilt Test
A child is born with the heart shown in the figure in which the aorta is attached to the right ventricle and the pulmonary artery is attached to the left ventricle. Identify the condition noted in the figure. A. Trunks arteriosus B. Patent ductus arteriosus C. Transposition of the great arteries D. Tetralogy of Fallot
C. Transposition of the great arteries
A nurse is providing discharge teaching to parents of a 9-month-old infant that just had open-heart surgery to correct a congenital heart defect. The infant will be discharged home on nasal cannula oxygen supplementation. What should the nurse include in the discharge teaching? Select all that apply. A. Restrict fluids to 24 ounces a day B. Remove the steri-strips within 7 days C. You must cradle the infant when picking up or carrying them D. The infant will need to be monitored with pulse oximetry while sleeping E. Only use sponge-baths until the surgical site is healed
C. You must cradle the infant when picking up or carrying them E. Only use sponge-baths until the surgical site is healed
The ER nurse is caring for a 4-year-old girl diagnosed with a fractured ulna. The child is crying, fearful, and resistant to having the cast applied. What is the most appropriate statement for the nurse to make to the child? A. "Don't be scared; I'll let you pick out the color for the cast." B. "Don't worry; applying the cast will not hurt." C. "I will give you some medicine if you are in pain." D. "Let's turn on some cartoons; what is your favorite show?"
D. "Let's turn on some cartoons; what is your favorite show?"
The nurse is caring for a newborn infant girl who has just been diagnosed with developmental dysplasia of the hip. The mother is very upset and blames herself stating "I caused this". Which statement by the nurse would best address the mother's immediate concerns? A. "I will show you how the Pavlik brace that she will need to wear should be applied." B. "Regular skin checks will help prevent the risk for skin breakdown when wearing the Pavlik harness." C. "This is a common diagnosis, and you should not worry about long-term effects." D. "Nothing you did caused this, and I will help you understand the treatment and plan ahead."
D. "Nothing you did caused this, and I will help you understand the treatment and plan ahead."
A caregiver brings their 1-week-old infant to an outpatient clinic for treatment of clubfoot diagnosed at birth. Which statement by the parents indicates a need for further teaching about this diagnosis? A. "The goal of treatment is overcorrection of the ligaments." B. "We will have to return weekly for recasting." C. "It is important to start the treatment as soon as possible." D. "We will make our next appointment for 1 month."
D. "We will make our next appointment for 1 month."
A student nurse is learning about the pediatric musculoskeletal system. The student correctly identifies which of the following true statements pertains to the pediatric musculoskeletal system? A. A head injury in a 30-month-old causing increased intracranial pressure may cause cranial sutures to separate. B. A newborn's muscles will increase as the child grows in the first several years. C. Skeletal growth in children ages 1 to 5 years of age is stimulated by growing epiphyses. D. A child with a broken femur will likely heal faster than an adult with the same injury.
D. A child with a broken femur will likely heal faster than an adult with the same injury.
The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing? A. Administer 250 mg botulism immune globulin intravenously (BIG-IV) one time. B. Provide total parenteral nutrition (TPN) at 25 ml/hr intravenously. C. Titrate oxygen to keep pulse oximetry saturations greater than 92. D. Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.
D. Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.
A nurse caring for a child diagnosed with Kawasaki disease on the pediatric care unit would expect all the following to be part of the treatment except: A. IV immunoglobulin B. High dose aspirin C. Steroids D. Diuretics
D. Diuretics
The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching? A. Swelling of the fingers is to be expected for the next 48 hours. B. Immobilize the shoulder to decrease pain in the arm. C. Allow the affected limb to hang down for 1 hour each day. D. Elevate casted arm when resting and when sitting up
D. Elevate casted arm when resting and when sitting up
The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy? A. Tonic neck reflex at 5 months of age B. Absent Moro reflex at 8 months of age C. Moro reflex at 3 months of age D. Extensor reflex at 7 months of age
D. Extensor reflex at 7 months of age
Which should cause a nurse to suspect that an infection has developed under a cast? A. Complaint of paresthesia B. Cold toes C. Increased respirations D. Hot spots felt on cast surface
D. Hot spots felt on cast surface
The parents of a child with cerebral palsy ask the nurse whether any drugs can decrease their childs spasticity. The nurses response should be based on which statement? A. Anticonvulsant medications are sometimes useful for controlling spasticity. B. Medications that would be useful in reducing spasticity are too toxic for use with children. C. Many different medications can be highly effective in controlling spasticity. D. Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.
D. Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.
A nurse caring for a 5-year-old boy notes he has symptoms consistent with Legg-Calvé-Perthes disease (LCPD). Which of the following would support this diagnosis? A. Pain that persists with rest B. Limited adduction and external hip rotation C. Stiff joints throughout body D. Muscle wasting in quadriceps and buttocks
D. Muscle wasting in quadriceps and buttocks
The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching? A. My child will have an allergic reaction if he comes in contact with yeast products. B. My child may have an upset stomach if he eats a food made with wheat or barley. C. My child will probably develop an allergy to peanuts. D. My child should not eat bananas or kiwis.
D. My child should not eat bananas or kiwis.
Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? A. Aspirin B. Corticosteroids C. Cytotoxic drugs such as methotrexate D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
A 4-year-old child is newly diagnosed with Legg-Calv-Perthes disease. Nursing considerations should include which action? A. Encouraging normal activity for as long as is possible B. Explaining the cause of the disease to the child and family C. Preparing the child and family for long-term, permanent disabilities D. Teaching the family the care and management of the corrective appliance
D. Teaching the family the care and management of the corrective appliance
The nurse uses the palms of the hands when handling a wet cast for which reason? A. To assess dryness of the cast B. To facilitate easy turning C. To keep the patients limb balanced D. To avoid indenting the cast
D. To avoid indenting the cast
The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status? A. Metabolic rate increases B. Increased joint mobility leading to contractures C. Bone calcium increases, releasing excess calcium into the body (hypercalcemia) D. Venous stasis leading to thrombi or emboli formation
D. Venous stasis leading to thrombi or emboli formation
The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborns defect? A. Fissure in the spinal column that leaves the meninges and the spinal cord exposed B. Herniation of the brain and meninges through a defect in the skull C. Hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elements D. Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves
D. Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves
Kayla is a 20-month-old child diagnosed with coarctation of the aorta that has not yet been corrected. The nurse assessing the child would most likely expect to find which of the following? A. Cyanotic episodes when crying B. Severe cyanosis at birth with low oxygen saturation C. Squatting posture D. absent or diminished pedal pulses
D. absent or diminished pedal pulses
Therapeutic management of a child with tetanus includes the administration of: A. nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation. B. muscle stimulants to counteract muscle weakness. C. bronchodilators to prevent respiratory complications. D. tetanus immunoglobulin therapy.
D. tetanus immunoglobulin therapy.
A 13-year-old is admitted to the hospital with a diagnosis of acute slipped capital femoral epiphysis (SCFE). The child is awaiting surgical correction. Which of the following is allowed when providing care to the child? A. Assistance with ambulation to the bathroom B. Regular range of motion exercises C. Manual reduction of the hip E. Split Russell's traction
E. Split Russell's traction
The nurse should monitor for which effect on the cardiovascular system when a child is immobilized? A. Venous stasis B. Increased vasopressor mechanism C. Normal distribution of blood volume D. Increased efficiency of orthostatic
Venous stasis
