EXAM #4

A nurse is caring for a child who has Addison's Dx. Which action should the nurse take? A. Teach the parents about cortisol replacement therapy B. Place the child on a low Na+ diet C. Monitor the child for fluid volume excess D. Discuss the manifestation of hypoglycemia with the parents

A. Cortisol replacement therapy

A nurse is assessing a school-age child whose blood glucose level is 280. Which of the following should the nurse expect? A. Lethargy B. Pallor C. Tremors D, Shallow respirations

A. Lethargy

A nurse is caring for a 6 month old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which fluid should a nurse select for the infant? A. Oral electrolyte solution B. Half-strength infant formula C. Half-strength orange juice D. Sterile water

A. Oral electrolyte solution

A nurse is caring for a child with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child's appendix is perforated? A. Sudden decrease in abdominal pain B. Absent Rovsing's sign C. Flaccid Abdomen D. Low grade fever

A. Sudden decrease in abd pain

A nurse is caring for an infant who has GERD. The nurse should recognize that which of the following findings are associated with this condition? A. vomiting B. Wt loss C. Rigid abdomen D. Wheezing E. Fever

A. Vomiting B. Wt loss D. Wheezing

A nurse is caring for a child who has acute appendicitis. Which result should the nurse anticipate when reviewing this clients lab values? A. WBC 17,000 B. Neutrophils 3,000C. RBC C. 4.2 Million D. Lymphocytes 3,000

A. WBC 17,000

A nurse is providing teaching to the parent of an infant who has GERD. Which of the following indicates understanding of the teaching? A. " I will keep my baby in an upright position after feedings" b. "My baby formula can be thickened with oatmeal" c. "I will have to feed my baby formula rather than breast milk" D. I should position my baby side-lying during sleep"

A. baby should be upright for 1 hr after feeding

A nurse is teaching a school-age child who has type 1DM and his parents about illness management. Which instructions should the nurse include? A. Withhold insulin dose if feeling nauseous B. Notify the provider if blood glucose levels are over 350 C. Test the urine for ketones D. Limit fluid intake during meal time

B. Test urine for ketones

A nurse is caring for a 6 week old infant who has a pyloric stenosis. Which of the following clinical manifestations should the nurse expect? A. Red currant jelly stools B. Distended neck veins C. Projectile vomiting D. Ridged Abdomen

C. Projectile vomiting

A nurse is providing discharge teaching to the parents of a child with a new diagnosis of DM. Which statement by the parents indicates an understanding of the teaching? A. "The onset of low blood glucose usually occurs slowly" B. "My son might complain of feeling shaky when he has a low blood glucose level" C. "sweating can occur with hyperglycemia" D. "My son might have nausea and vomiting with hypoglycemia"

B Feeling shaky with hypoglycemia

A nurse is caring for an infant who has GERD. The nurse should place the infant in which of the following position following feedings? A. Prone B. In car seat C. Left side D. Right Side

B In car seat

A nurse is providing teaching to an adolescent who has type 1 DM. Which should the nurse include in the teaching? A. Admin glucagon for hyperglycemia b. Obtain an influenza vaccine annually c. Inject insulin in the deltoid muscled. Take glyburide with breakfast

B. Annual flu vaccine

A nurse is providing teaching to a school-age child who has a new diagnosis of DM. Which of the following statement indicates an understanding of the teaching? A. "My morning blood glucose should be between 90-130" B. " I should eat a snack half an hour before playing soccer" C. "I should not take my regular insulin when I am sick" D. " I can store unopened bottles of insulin in the freezer"

B. Snack before soccer

A nurse is providing nutritional teaching to the mother of a preschooler and is recommending food options to provide 1 oz of grains. Which should the nurse recommend? A. 1 cup of ready to eat cereal flakes B. 1/2 slice whole wheat bread D. 1/2 flour totilla

A. 1 cup of ready to eat cereal flakes

A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new DM. Which of the following indicates a need for further teaching? A. "I will be sure my child aspirates before injuries the insulin" B. "The insulin can be injected anywhere there is adipose tissue" C. "I will be sure my child rotates sites after 5 injects in one area" D. "The insulin should be injected at a 90 degree angle"

A. Aspirate before injecting insulin

A parent calls a clinic and reports to a nurse that has 2 month old infant is hungry more than usually but has projectile vomiting immediately after eating. Which of the following responses should the nurse make? A. "bring your baby in to the clinic today" B. "Burp your baby more frequently during feedings" C. "Give your infant an oral rehydration solution" D. " Try switching to a different formula"

A. Bring the baby in to the clinic

The parents of a toddler are concerned about their childs finicky eating habits. While counseling the parents, which statements by the nurse are the most appropriate? Standard Text: Select all that apply. 1. The child is experiencing physiologic anorexia, which is normal for this age group. 2. A general guideline for food quantity at a meal is one-quarter cup of each food per year of age. 3. It is more appropriate to assess a toddlers nutritional demands over a 1-week period rather than a 24-hour one. 4. Nutritious foods should be made available at all times of the day so that she is able to graze whenever she is hungry. 5. The toddler should drink 16 to 24 ounces of milk daily.

Correct Answer: 1,3,5 Rationale 1: Physiologic anorexia is caused when the extremely high metabolic demands of infancy slow to keep pace with the slower growth of toddlerhood, and it is a very normal finding at this age. It is not unusual for toddlers to have food jags during which they only want one or two food items for that day. So it is more helpful to look at what their intake has been over a week instead of a day. Two to three cups of milk per day are sufficient for a toddler, and more than that can decrease the childs desire for other foods and lead to dietary deficiencies. The correct general guideline for food quantity is one tablespoon of each food per year of age. Food should only be offered at meal and snack times, and children should sit at the table while eating to encourage their socialization skills.

The mother of a toddler is concerned because her child does not seem interested in eating. The child is drinking five to six cups of whole milk per day and one cup of fruit juice. When the weight-to-height percentile is calculated, the child is in the 90th to 95th percentile. What is the best advice the nurse can provide to the mother? 1. Eliminate the fruit juice from the childs diet. 2. Offer healthy snacks, presented in a creative manner, and let the child choose what he wants to eat without pressure from the parents. 3. Change from whole milk to 2 percent milk and decrease milk consumption to three to four cups per day and the fruit juice to a half cup per day, offering water if the child is still thirsty in between. 4. Make sure that the child is getting adequate opportunities for exercise, as this will increase his appetite and help lower the childs weight-to-height percentile.

Correct Answer: 3 Rationale 1: Toddlers require a maximum of about one liter of milk per day. This toddler is consuming most of his or her calories from the milk and thus is not hungry. The high fat content of the milk and the high sugar content of the fruit juice are also contributing to the childs higher weight-to-height percentile. Decreasing the amount and fat content of the milk and decreasing the intake of fruit juice will decrease calories and thus make the child hungry for other foods. The other advice is also appropriate but did not address the problem of excessive milk consumption.

A nurse is caring for a child who has suspected appendicitis. Which of the provider prescription should the nurse clarify? A. Maintain NPO status B. Monitor oral temp ever 4 hrs C. Medicate the client for pain every 4 hrs as needed D. Admin sodium biphosphate/sodium phosphate

D. Admin sodium biphosphate

A nurse is caring for a 7 year old child who has an upper respiratory infection and type 1 DM. Which statement by the mother indicates a need for further instruction? A. " I will encourage her to drink half a cup of water or sugar-free fluids every 30 min" B. " I will report a change in her breathing or any signs of confusion" C. "I will notify the doctor if her temp is not controlled with acetaminophen" D. I will continue to check his blood sugar two times every day"

D. Check BG twice a day to avoid developing DKA

A nurse is assessing an adolescent who has an exacerbation of Graves Dx. Which of the following findings should the nurse expect? A. Wt gain B. Bradycardia C. Lethargy D. Heat intolerance

D. Heat intolerance

A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders? A. Encopresis B. Enterocolitis C. Pyloric stenosis D. Hirschsprung's dx

D. Hirschsprung's dx