Everything but endocrine

A child has a basilar skull fracture. Which primary health care provider's prescription should the nurse question? 1. Restrict fluid intake 2. Insert an indwelling urinary catheter 3. Keep an intravenous (IV) line patent. 4. Suction via the nasotracheal route as needed

ans: 4 - suction via the nasotracheal route

A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body 2. Apply a thick layer over the entire body 3. Avoid cleansing the area before application of the cream 4. Apply a thin layer of cream and rub it into the area thoroughly

ans: D

A child who limps and has pain has been found to have Legg-Calve-Perthes disease. What should the nurse expect to include in the child's plan of care? a. initiation of pain control measures, especially at night when acute b. promotion of ambulation despite the child's discomfort in the affected hip c. prevention of flexion in the affected hip and knee d. avoidance of weight bearing on the head of the affected femur

ans: D avoid weight bearing on the head of the affected femur

A 4 year old child sustains a fall at home injuring the right arm and is brought to the emergency department by the mother. The nurse should perform which emergency actions in the care of the child? (select all that apply) 1. elevate the right arm 2. Apply warm packs to the right arm 3. check the neurovascular status of the right extremity 4. check the range of motion of the right arm and shoulder 5. determine the level of pain using a pediatric pain assessment tool

1 - elevate the right arm 3 - check neurovascular status of the extremity 5 - determine pain level with an appropriate tool Rationale: elevation helps reduce swelling, obtaining a pain level helps evaluate the extent of the injury and neurovascular status is important to pick up on early signs of compartment syndrome or other circulation impairments

A mother of a 3-year-old child tells the nurse that the child has been continuously scratching the skin and has developed a rash. On data collection, which finding indicates that the child may have scabies? 1. Fine, grayish-red lines 2. Purple-colored lesions 3. Thick, honey-colored crusts 4. Clusters of fluid-filled vesicles

1 - fine, grayish-red lines Rationale: Scabies appears as burrows or fine, grayish-red lines. They may be difficult to see if they are obscured by excoriation and inflammation. Purple-colored lesions may be indicative of various disorders, including systemic conditions. Thick, honey-colored crusts are characteristic of impetigo. Clusters of fluid-filled vesicles are seen in clients with herpesvirus.

A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox? 1. Macular rash on the trunk and scalp 2. Pseudomembrane formation in the throat 3. Maculopapular or petechial rash on the extremities 4. Small, red spots with a bluish-white center and red base

1 - macular rash on trunk and scalp

The nurse is reinforcing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by a parent indicates the need for further teaching? 1. "I need to have my child wear a soft fabric under the brace." 2. "I will apply lotion under the brace to prevent skin breakdown." 3. "I will need to encourage my child to perform the prescribed exercises." 4. "I will need to avoid applying powder under the brace, because it will cake."

2 - "I will apply lotion under the brace to prevent skin breakdown." Rationale: The use of either lotions or powders should be avoided, because they can become sticky or cake under the brace, thus causing irritation. Options 1, 3, and 4 are appropriate statements regarding the care of a child with a brace.

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected, and a nurse is monitoring the child continuously for signs of increased intracranial pressure (ICP). Which of the following is a late sign of increased ICP in this child? 1. Nausea 2. Bradycardia 3. Bulging fontanel 4. Dilated scalp veins

2 - bradycardia Rationale: Late signs of increased ICP include a significant decrease in the level of consciousness, bradycardia, and fixed and dilated pupils. Nausea is an early sign of increased ICP. A bulging fontanel and dilated scalp veins are early signs of increased ICP and would be noted in an infant rather than in a 5-year-old child.

A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? (select all that apply) 1. Enteric 2. Contact 3. Airborne 4. Protective 5. Neutropenic

2 - contact 3 - airborne Rationale: Rubeola is transmitted via airborne particles or direct contact with infectious droplets. Respiratory precautions are required, and a mask is worn by those who come in contact with the child. Gowns and gloves are not indicated. Articles that are contaminated should be bagged and labeled. Options 1, 2, and 3 are not indicated for rubeola.

A nurse is assigned to care for a child with a compound (open) fracture of the arm that occurred as a result of a fall. The nurse plans care, knowing that this type of fracture involves: 1. The entire bone fractured straight across 2. A greater risk of infection than a simple fracture 3. One side of the bone being broken and the other side being bent 4. The bone being fractured but not producing a break in the skin

2 - greater risk of infection Rationale: In a compound (open) fracture, a wound in the skin leads to the broken bone, and there is an added danger of infection. Option 1 describes a transverse fracture. Option 3 describes a greenstick fracture. Option 4 describes a closed or simple fracture.

The nurse is reviewing the postoperative prescriptions for an infant with hydrocephalus, who came back from surgery with a ventriculoperitoneal shunt. Which of the primary health care provider's prescriptions does the nurse question? 1. Position the infant on the inoperative side 2. Keep the head of the bed elevated 45 degrees 3. Monitor for signs of infection and check dressings for drainage 4. Observe for irritability, a high shrill cry, lethargy, and poor feeding

2 - keep HOB 45 degrees rationale: initial post op care includes keeping HOB flat or < 20 degrees to prevent rapid depressurization of the ventricles. the question is asking "which of these is wrong as hell"

The nurse provides information to the parent of a 2 week old infant who was diagnosed with clubfoot at the time of birth. Which statement by the parent indicates the need for further teaching regarding this disorder? 1. "I understand treatment need to be started as soon as possible." 2. "I realize my child will require follow-up care until full grown." 3. "I need to bring my child back to the clinic in 1 month for a new cast." 4. "I need to come to the clinic every week with my child for the casting."

3 - "I need to bring my child back to the clinic in one month for a new cast" in nonsurgical treatment of clubfoot, the child gets a new cast weekly, not monthly, to gradually reposition the foot. treatment should be started asap to prevent complications such as inability to wear shoes and pain when walking.

The nurse reinforces home care instructions to the parents of a child with a brace for scoliosis. Which statement by a parent indicates a need for further teaching? 1. "I will insect the skin under the brace for redness or breakdown." 2. "I will encourage my child to do their exercises to maintain strength." 3. "I understand that my child needs to wear this brace for 12 hours a day." 4. "I understand that this brace is not a cure for scoliosis, it only slows the progression of the curvature."

3 - "I understand that my child needs to wear this brace for 12h a day" rationale: successful outcomes with bracing are more likely when the brace fits properly and is worn 16-23h/d

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. During data collection about the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities 2. Adduction of the arms at the shoulders 3. Rigid extension and pronation of the arms and legs 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3 - Rigid extension and pronation of the arms and legs

The nurse assists in planning care for a child who sustained a burn injury based on which of the following accurate statements? 1. Scarring is not as severe in a child as in an adult. 2. Children are at a lower risk of infection than adults because of their strong immune systems. 3. Lower burn temperatures and shorter exposure to heat can cause a more severe burn in a child than an adult because a child's skin is thinner. 4. Infants and children are at decreased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

3 - lower burn temps and shorter exposure to heat can cause a more severe burn in children than adults because a child's skin is thinner Rationale: Lower burn temperatures and shorter exposure to heat can cause a more severe burn in a child than an adult because a child's skin is thinner. Scarring is more severe in a child; additionally, disturbed body image will be a distinct issue for a child or adolescent, especially as growth continues. An immature immune system presents an increased risk of infection for infants and young children. Infants and children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

A nurse is assigned to care for a child after a spinal fusion for the treatment of scoliosis. The child complains of abdominal discomfort and begins to have episodes of vomiting. On data collection, the nurse notes abdominal distention. Which action should the nurse take? 1. Administer an antiemetic. 2. Increase the intravenous fluids. 3. Notify the registered nurse (RN). 4. Place the child in a side-lying Sims' position.

3 - notify the RN Rationale: A complication after the surgical treatment of scoliosis is superior mesenteric artery syndrome. This disorder is caused by mechanical changes in the position of the child's abdominal contents that result from the lengthening of the child's body. It results in a syndrome of emesis and abdominal distention that is similar to that which occurs with intestinal obstruction or paralytic ileus. Postoperative vomiting among children with body casts or among those who have undergone spinal fusion warrants attention because of the possibility of superior mesenteric artery syndrome. Therefore, the remaining options are incorrect.

The nurse is performing a neurovascular check on a hospitalized child who had a cast applied to the lower leg. The child complains of a tingling in the toes distal to the fracture site. Which action should the nurse take? 1. Elevate the extremity 2. Document the findings 3. Notify the registered nurse (RN) 4. Ambulate the child with crutches

3 - notify the RN elevation would further restrict blood flow to the extremity, documenting the findings needs to happen regardless and is not the priority, and the child should not ambulate until compartment syndrome can be ruled out. The best option is to notify the RN.

The nurse is assigned to care for a child who is in skeletal traction. The nurse needs to avoid which action when caring for the child? 1. Keeping the weights hanging freely. 2. Ensuring that the ropes are in the pulleys 3. Placing the bed linens on the traction ropes 4. Ensuring that the weights are out of the child's reach

3 - placing bed linens on the traction ropes Rationale: ensuring weights hang freely, are out of the child's reach, and the ropes are in the pulleys are all recommended nursing care for a child in traction

the nurse provides instructions regarding respiratory precautions to the mother of a child with mumps. The mother asks the nurse about the length of time required for the respiratory precautions. Which response by the nurse is accurate? 1. Respiratory isolation is not necessary. 2. Mumps is not transmitted by the respiratory system. 3. Respiratory precautions are indicated during the period of communicability. 4. Respiratory precautions are indicated for 18 days after the onset of parotid swelling.

3 - respiratory precautions are indicated during the period of communicability Rationale: Mumps is transmitted via direct contact or droplets spread from an infected person and possibly by contact with urine. Respiratory precautions are indicated during the period of communicability. Options 1, 2, and 4 are incorrect.

A day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which of the following observations may be indicative of this condition? 1. The child has difficulty hearing. 2. The child does not respond when spoken to. 3. The child consistently tilts his or her head to see. 4. The child consistently turns his or her head to see.

3 - the child consistently tilts his/her head to see Rationale: The nurse may suspect strabismus in a child when the child complains of frequent headaches, squints, or tilts the head to see. Options 1, 2, and 4 are not indicative of this condition. option 4 is indicative of nystagmus, not strabismus

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurse bases the response on the understanding that cerebral palsy is which type of condition? 1. An infectious disease of the central nervous system 2. An inflammation of the brain as a result of a viral illness 3. A congenital condition that results in moderate to severe retardation 4. A chronic disability characterized by impaired muscle movement and posture

4 - A chronic disability characterized by impaired muscle movement and posture

The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease? 1. Skin rash caused by a virus 2. Skin rash caused by a bacteria 3. Respiratory disease caused by virus involving the lymph nodes 4. Respiratory disease caused by a virus involving the parotid gland

4 - Respiratory disease caused by a virus involving the parotid gland

The nurse is assisting a primary health care provider (PHCP) during an examination of an infant with hip dysplasia. The PHCP performs the Ortolani maneuver. Which data should the nurse expect to note during the examination? 1. Full range of motion of the legs 2. Marked asymmetry on the affected side 3. The unstable femoral head pops out of the acetabulum 4. The dislocated femoral head pops back into the acetabulum

4 - The dislocated femoral head pops back into the acetabulum there should be an audible or palpable clunk when the hip pops back in

Permethrin 5% (Elimite) is prescribed for a 4-year-old child with a diagnosis of scabies. The nurse instructs the mother regarding the use of this treatment. Which instruction is appropriate? 1. Apply the lotion and leave it on for 4 hours. 2. Apply the lotion to the hair, the face, and the entire body. 3. The child should wear no clothing while the lotion is in place. 4. Apply the lotion to cool, dry skin at least half an hour after bathing.

4 - apply the lotion to cool, dry skin at least 1/2 h after bathing Rationale: Permethrin is applied from the neck downward, with care taken to ensure that the soles of the feet, the areas behind the ears, and the areas under the toenails and fingernails are covered. The lotion should be kept on for 8 to 14 hours, and then the child should be given a bath. The lotion should be applied at least 30 minutes after bathing, and it should be applied only to cool, dry skin. The child should be clothed during treatment.

A nurse is preparing to perform a neurovascular check for tissue perfusion in the child with an arm cast. Which of the following is the priority when performing this procedure? 1. Taking the temperature 2. Taking the blood pressure 3. Checking the apical heart rate 4. Checking the peripheral pulse in the affected arm

4 - checking peripheral pulse in the affected arm Rationale: The neurovascular check for tissue perfusion is performed on the toes or fingers distal to an injury or cast and includes checking peripheral pulse, color, capillary refill time, warmth, motion, and sensation. Options 1, 2, and 3 may be components of care, but they are not the priority in this situation.

A nurse is assisting with data collection from an infant who has been diagnosed with hydrocephalus. If the infant's level of consciousness diminishes, a priority intervention is: 1. Taking the apical pulse 2. Taking the blood pressure 3. Testing the urine for protein 4. Palpating the anterior fontanel

4 - palpating the anterior fontanelle Rationale: A full or bulging anterior fontanel indicates an increase in cerebrospinal fluid collection in the cerebral ventricle. Apical pulse and blood pressure changes and proteinuria are not specifically associated with increasing cerebrospinal fluid in the brain tissue in an infant.

The nurse is reinforcing home-care instructions to the parents of a 3 year old child with scabies. Which statement by a parent indicates the need for further teaching? (select all that apply) 1. "I understand that I need to leave the scabicide on for 4 hours before washing it off." 2. "I will need to seal up all my child's nonwashable toys in a plastic bag for at least 4 days." 3. "I realize that everyone who has come in contact with my child will need to be treated for scabies." 4. "I know I need to wash all the clothing and bedding in hot water with detergent and dry in a hot dryer."

A. "I understand that I need to leave the scabicide on for 4 hours before washing it off."

The nurse caring for a child who sustained a burn injury plans care based on which pediatric consideration associated with this injury? (select all that apply) 1. Scarring is less severe in a child than in an adult 2. A delay in growth may occur after a burn injury 3. An immature immune system presents an increased risk of infection for infants and young children 4. Fluid resuscitation is unnecessary unless the burned are is more than 25% of the total body surface area 5. The proportion of body fluid to body mass in a child increases the risk of cardiovascular problems 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults

A. A delay in growth may occur after a burn injury B. An immature immune system presents an increased risk of infection for infants and young children C. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults

The school nurse prepares a list of home care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which should be included in the list? (select all that apply) 1. Siblings may also need treatment 2. Use anti-lice sprays on all bedding and furniture 3. Use a pediculicide shampoo and repeat treatment in 14 days 4. Grooming items such as combs and brushes should not be shared 5. Launder all the bedding and clothing in hot water and dry on high heat 6. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.

A. Siblings may also need treatment B. Grooming items such as combs and brushes should not be shared C. Launder all the bedding and clothing in hot water and dry on high heat D. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.

The nurse is assigned to care for a child after a myringotomy with the insertion of tympanostomy tubes. The nurse notes a small amount of reddish drainage from the child's ear after the surgery. On the basis of this finding, which action should the nurse take? 1. Document the findings 2. Notify the registered nurse immediately 3. Change the ear tubes so that the do not become blocked 4. Check the ear drainage for the presence of cerebrospinal fluid

Ans: 1 - document the findings Serosanguineous drainage after surgery is an expected finding

The nurse is monitoring for bleeding in a child after surgery to remove a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which nursing action is appropriate? 1. Reinforce the dressing 2. Notify the registered nurse (RN) 3. Document the findings and continue to monitor 4. Circle the area of drainage and continue to monitor.

Ans: 2. notify the RN Rationale: That's a halo sign and is indicative of CSF leakage

The nurse has provided instructions to the mother of a child who has been diagnosed with bacterial conjunctivitis. Which statement by the mother would indicate the need for further teaching? 1. "I need to wash my hands frequently." 2. "I need to clean the eye, as prescribed." 3. "I need to give the eye drops, as prescribed." 4. "I need to use hot compresses to relieve the eye irritation."

Ans: 4 - "I need to use hot compresses to relieve the eye irritation" Rationale: bacterial conjunctivitis is treated with topical antibiotic drops and/or ointments. cleaning the eye as prescribed, giving eye drops as prescribed, and frequent hand washing are all recommended in the treatment of bacterial conjunctivitis. a warm compress can be used for allergic or viral conjunctivitis to relieve discomfort

The nurse is instructing a mother of a 1 year old child with strabismus about the treatment options. Which statement by the mother would indicate the need for further teaching? 1. "My child will outgrow this by the time he is 2 years old and be able to see just fine." 2. "I will have my child wear an eye patch over the good eye to help strengthen the weak eye." 3. "If this eye patch does not work I know that we will have to do surgery to correct my child's crossed eyes." 4. "There are a few causes of this condition and they tell me my child has crossed eyes because of a muscle imbalance."

Ans: A Children do not grow out of strabismus without treatment. If left untreated, the child's brain suppresses the image from the deviated eye to prevent double vision and the visual pathway doesn't develop correctly in the "bad" eye

The nurse is proving postoperative care for an infant who had a ventriculoperitoneal shunt placed to correct hydrocephalus. Which clinical finding warrants immediate intervention? a. abdominal distention b. lethargy c. facial edema d. headache

Ans: A Rationale: abdominal distention may indicate peritonitis and requires intervention

When planning home care for the child with Legg-Calve-Perthes disease, what should be the PRIMARY focus for family teaching? a. need for intake of protein-rich foods b. gentle stretching exercises for both legs c. management of the corrective appliance d. relaxation techniques for pain control

Ans: C Rationale: braces or traction may be necessary to immobilize the affected leg

The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the GREATEST need of emergency medical treatment? a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling b. a 3-year-old with a fever of 100 F (37.8 C), a barky cough, and mild intercostal retractions c. a 4-year-old with a fever of 101 F (38.3 C), a hoarse cough, inspiratory stridor, and restlessness d. a 12-year-old with a fever of 104 F (40 C), chills, and a cough with thick yellow secretions

Answer: a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling Rationale: this child is exhibiting signs and symptoms of epiglottitis, which is a medical emergency

A 3-month-old infant with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the HIGHEST priority? a. instituting droplet precautions b. administering acetaminophen c. obtaining history information from the parents d. orienting the parents to the pediatric unit

Answer: a. instituting droplet precautions

A child is admitted with a fracture of the femur and is placed in skeletal traction. What should the nurse assess FIRST? a. the pull of traction on the pin b. the Ace bandage c. the pin sites for signs of infection d. the dressings for tightness

Answer: a. the pull of traction on the pin

The nurse reports to the healthcare provider signs of increased ICP in an infant with myelomeningocele who has which finding? a. minimal lower extremity movement b. a high-pitched cry c. overflow voiding only d. a fontanelle that bulges with crying

Answer: b. a high-pitched cry

Before placement of a ventriculoperitoneal shunt for hydrocephalus, an infant is irritable, lethargic, and difficult to feed. To maintain the infant's nutritional status, which action would be MOST appropriate? a. feed the infant just before doing any procedures b. give the infant small, frequent feedings c. feed the infant in a horizontal position d. give large, less frequent feedings

Answer: b. give the infant small, frequent feedings

When teaching the family of an older infant who has had a spica cast applied for DDH, which information should the nurse include when describing the abduction stabilizer bar? a. it can be adjusted to a position of comfort b. it is used to lift the child c. it adds strength to the cast d. it is necessary to turn the child

Answer: c. it adds strength to the cast *the bar cannot be removed or adjusted unless the entire cast is taken off and replaced* If it has an abductor bar, do not use said bar to move the infant

A 14-year-old has just had a plaster cast placed on his lower left leg. To provide safe cast care, the nurse should: a. petal the cast as soon as it is put on b. keep the child in the same position for 24 hours until the cast is dry c. use only the palms of the hand when handling the cast d. notify the healthcare provider if the client feels heat

Answer: c. use only the palms of the hand when handling the cast Rationale: the wet plaster cast should be handled using only the palms of the hands to prevent indentation of the cast surface

A 16-month-old child is seen in the clinic for a checkup for the first time. The nurse notices that the toddler limps when walking. Which would be appropriate to use when assessing this toddler for developmental dysplasia of the hip (DDH)? a. Ortolani's maneuver b. Barlow's maneuver c. Adam's position d. Trendelenburg's sign

Answer: d. Trendelenburg's sign rationale: Older children who are walking have an unstable/limping gait (Trendelenburg gait)

A nurse evaluates discharge teaching as successful when the parents of a school-age child with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt? a. decreased urine output with stable intake b. tense fontanelle and increased head circumference c. elevated temperature and reddened incisional site d. irritability and increasing difficulty with eating

Answer: d. irritability and increasing difficulty with eating rationale: these are signs of increased ICP

Which assessment findings should lead the nurse to suspect that a toddler is experiencing respiratory distress? Select all that apply. a. coughing b. respiratory rate of 35 breaths/min c. heart rate of 95 beats/min d. restlessness e. malaise f. diaphoresis

Answers: a. coughing b. respiratory rate of 35 breaths/min d. restlessness f. diaphoresis

Parents bring a 10-month-old boy with myelomeningocele and hydrocephalus with a ventriculoperitoneal shunt to the ED. His symptoms include vomiting, poor feeding, lethargy, and irritability. What interventions by the nurse are the MOST appropriate? Select all that apply. a. weigh the child b. listen to bowel sounds c. palpate the anterior fontanelle d. obtain vital signs e. assess pinch and quality of the child's cry

Answers: a. weigh the child b. listen to bowel sounds d. obtain vital signs e. assess pinch and quality of the child's cry

A 10-year-old has a 5 lb. of Buck's extension traction on his left leg. What finding should the nurse assess the child for? Select all that apply. a. dryness of the skin, by removing the foam wraps and boot b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx

Answers: b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx

A child with cerebral palsy is to begin botulinum toxic type A injections. Which treatment goals should the healthcare team set for the child related to botulinum toxin? Select all that apply. a. improved nutritional status b. decreased pain from spasticity c. improved motor function d. enhanced self-esteem e. reduced caregiver strain and improved self-care f. decreased speech impediments

Answers: b. decreased pain from spasticity c. improved motor function d. enhanced self-esteem e. reduced caregiver strain and improved self-care

Which clinical manifestations would lead the nurse to suspect an infant has hydrocephaly? Select all that apply. a. depressed fontanelle b. headache c. vomiting d. low-pitched cry e. irritability f. pupillary changes g. bulging fontanelle

Answers: c. vomiting e. irritability f. pupillary changes Rationale: hydrocephaly is a block in the flow of cerebrospinal fluid

The nurse assists to create a nursing care plan for the child with an arm cast and should include which interventions in the plan? (select all that apply) 1. Instruct parents to keep the cast clean and dry 2. Monitor the extremity for circulatory impairment 3. Instruct the child not to stick objects down the cast 4. Ensure that rough cast materials are cut off to keep smooth 5. Notify the registered nurse (RN) immediately if circulatory impairment occurs

Answers: 1 - keep the cast clean and dry 2 - monitor the extremity for circulatory impairment 3 - instruct the child not to stick objects down the cast 5 - notify the RN immediately if circulatory impairment occurs Rationale: keep the cast clean and dry, and don't put objects inside the cast to prevent skin breakdown during wearing of the cast. monitor circulatory status and notify the RN immediately if circulatory impairment occurs because compartment syndrome can occur and is a medical emergency requiring prompt intervention.

The nurse is assisting in performing pediculosis capitis (head lice) checks. Which finding indicates that a child has a "positive" head check? 1. Maculopapular lesions behind the ears 2. Lesions in the scalp that extend to the hairline or neck 3. White flaky particles throughout the entire scalp region 4. White sacs attached to the hair shafts in the occipital area

White sacs attached to the hair shafts in the occipital area