4410 Final

A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement?

"He will need more surgeries to replace the shunt as he grows."

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?

"I hate to think that I will need to be worried about his having seizures for the rest of his life."

The nurse is educating the parents of a client newly diagnosed with type 1 diabetes. Which statement by the parents indicates additional teaching is needed?

"Our child should not participate in sports or physical activity."

A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching?

"Pale, cool, or blue skin coloration is to be expected."

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be:

"These make a smooth edge on the cast so the skin is better protected."

The nurse is caring for a newborn client newly diagnosed with developmental dysplasia of the hip. Which response by the nurse educates the parents on the correct plan of treatment for this diagnosis?

"Treatment will begin immediately."

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction?

"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

A 2-year-old has a history of fever and fussiness. Which additional symptoms would make the nurse suspect a urinary tract infection?

Abdominal pain

A 6-year-old child with hydrocephalus had a ventriculoperitoneal (VP) shunt placed 6 weeks ago and now has experienced a seizure, vomiting, and loss of appetite. Which intervention will target the child's priority need?

Administer intravenous antibiotics as prescribed.

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

Administration of levothyroxine indefinitely

A nurse is performing a physical examination of a child with a suspected fracture. Which assessment technique would the nurse assume would not be used?

Auscultation

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

Color Sensation Pulse Capillary refill

The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:

Complete

The nurse is caring for a child who fractured the arm in an accident. A cast has been applied to the child's right arm. Which actions should the nurse implement? Select all that apply.

Document any signs of pain. Check radial pulse in the both arms. Monitor the color of the nail beds in the right hand.

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?

Escherichia coli

A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion?

Febrile seizures are benign in nature.

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?

Greenstick

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess or glean from chart review?

Hemolytic anemia, thrombocytopenia, and acute renal failure

The nurse is caring for a neonate in the newborn nursery with congenital talipes equinovarus (bilateral clubfoot). If nonsurgical treatment is chosen, which nursing action is anticipated?

Holding feet/ankles in position for casting

The student nurse is developing a care plan for a child who suffered a fractured tibia and will have a cast on his lower leg for approximately 6 weeks. Which nursing diagnosis would be the priority for this client?

Impaired physical mobility related to a cast on the leg

A 7-year-old child who has type 1 diabetes mellitus is at school reporting a headache and dizziness. The school nurse notices sweat on the child's face. What should the nurse do first?

Offer the child 8 ounces of juice or soda

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?

Regular insulin

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

Risk for infection

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority?

Risk for injury

An 18-month-old was brought to the emergency department by her mother, who states, "I think she broke her arm." The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

Spiral fracture

The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?

Sudden onset of severe scrotal pain with significant hemorrhagic swelling

The young boy has fractured his left leg and has had a cast applied. The nurse educates the boy and his parents prior to discharge from the hospital. The parents should call the physician when which incidents occur? Select all that apply.

The boy has had a fever of greater than 102° F (38.9°C) for the last 36 hours. New drainage is seeping out from under the cast. The boy's toes are light blue and very swollen.

The nurse is assessing a 5-year-old boy whose mother says he has been vomiting lately, has no appetite and has had an extreme thirst. Labwork for diabetes mellitis is being completed. Which symptom would differentiate between type 1 diabetes mellitus over type 2 diabetes mellitus?

The child has lost weight recently.

In caring for a child in traction, which intervention is the highest priority for the nurse?

The nurse should monitor for decreased circulation every 4 hours.

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?

This medication must be given by injection.

Which instruction should a nurse give to a client who has a history of urinary tract infection to prevent recurrence?

Wipe from front to back. Encourage fluids throughout the day. Finish all antibiotic prescribed.

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition?

acute glomerulonephritis

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child:

feels increasing severe pain.

A type of traction sometimes used in the treatment of the child with scoliosis is called:

halo traction.

A 5-year-old child has frequent visits to the school nurse's office. Which assessment data should alert the nurse that this child may be a victim of physical neglect?

malnourished with frequent absences from school

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as:

significant bending without actual breaking.

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is:

skeletal traction.

The charge nurse is observing a student nurse perform skeletal traction pin care. What action by the student nurse would indicate a need for intervention by the charge nurse?

unhooking a weight while providing pin care

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?

A classroom with a plan of study that is followed each day

A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client?

Bracing

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply.

Oxygen gauge and tubing Suction at bedside Padding for side rails

The nurse is caring for a 12-year-old boy diagnosed with acute glomerulonephritis. When reviewing the boy's health history, which finding will likely be noted?

Recent history of an upper respiratory infection

The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?

Risk for impaired skin integrity due to cast and location

A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which as an indicator of possible child abuse?

Sexual behavior that correlates with the child's developmental age