Maybe Peds FINAL

One nursing diagnosis for juvenile idiopathic arthritis (JIA) is impaired physical mobility. Select all that apply. 1. Give pain medication prior to ambulation. 2. Assist with range-of-motion activities. 3. Encourage the child to eat a high-fat diet. 4. Provide oxygen as necessary. 5. Use nonpharmacological methods, such as heat.

1. Give pain medication prior to ambulation. 2. Assist with range-of-motion activities. 5. Use nonpharmacological methods, such as heat.

The parents of a child just diagnosed with juvenile idiopathic arthritis (JIA) tell the nurse that the diagnosis frightens them because they know nothing about the prognosis. What should the nurse include when teaching the parents about the disease? 1. Half of affected children recover without joint deformity. 2. Many affected children go into long remissions but have severe deformities. 3. The disease usually progresses to crippling rheumatoid arthritis. 4. Most affected children recover completely within a few years

1. Half of affected children recover without joint deformity.

What are the serum and urinalysis/urine output findings for a child with acute renal failure? [3]

1. Hyperkalemia (>5.2) 2. Hyponatremia (<135) 3. Hypocalcemia (<8.5mg/dl or <2.15mmol/L)

Which would the nurse teach a patient when NSAIDs are prescribed for treating juvenile idiopathic arthritis (JIA)? 1. Take with food. 2. Take on an empty stomach. 3. Blood levels are required for drug dosages. 4. Good oral hygiene is needed.

1. Take with food.

Why are chemotherapeutic agents such as methotrexate (Trexall) and cyclophosphamide (Cytoxan) sometimes used to treat juvenile idiopathic arthritis (JIA)? 1. Are effective against cancer-like JIA. 2. Suppress the immune system. 3. Are similar to NSAIDs. 4. Are absorbed into the synovial fluid.

2. Suppress the immune system.

The mother of a 4-year-old child with juvenile idiopathic arthritis (JIA) is worried that her child will have to stop attending preschool because of the illness. Which of the following responses by the nurse would be most appropriate? 1."It may be difficult for your child to attend school because of the side effects of the medications he will be prescribed." 2."Your child should be encouraged to attend school, but he'll need extra time to work out early morning stiffness." 3."You should keep your child at home from school whenever he experiences discomfort or pain in his joints." 4."Your child will probably need to wear splints and braces so that his joints will be supported properly."

2."Your child should be encouraged to attend school, but he'll need extra time to work out early morning stiffness."

Nonsteroidal anti-inflammatory drugs are the first choice in treating a child with juvenile idiopathic arthritis. Which adverse effects should the nurse include in the teaching plan for the parents? Select all that apply. 1.Weight gain. 2.Abdominal pain. 3.Blood in the stool. 4.Folic acid deficiency. 5.Reduced blood clotting ability.

2.Abdominal pain. 3.Blood in the stool. 5.Reduced blood clotting ability.

Which would the nurse teach an adolescent is a complication of corticosteroids used in the treatment of juvenile idiopathic arthritis (JIA)? 1. Fat loss. 2. Adrenal stimulation. 3. Immune suppression. 4. Hypoglycemia.

3. Immune suppression.

What should the nurse include when developing the teaching plan for the parents of a child with juvenile idiopathic arthritis who is being treated with naproxen (Naprosyn)? 1. Anti-inflammatory effect will occur in approximately 8 weeks. 2. Within 24 hours, the child will have anti-inflammatory relief. 3. The nurse should be called before giving the child any over-the-counter medications. 4. If a dose is forgotten or missed, that dose is not made up.

3. The nurse should be called before giving the child any over-the-counter medications.

The nurse is teaching the parent of a child newly diagnosed with juvenile idiopathic arthritis (JIA). The nurse would evaluate the teaching as successful when the parent is able to say that the disorder is caused by the: 1. Breakdown of osteoclasts in the joint space causing bone loss. 2. Loss of cartilage in the joints. 3. Buildup of calcium crystals in joint spaces. 4. Immune-stimulated inflammatory response in the joint.

4. Immune-stimulated inflammatory response in the joint.

The father of a preschool-age child with a tentative diagnosis of juvenile idiopathic arthritis (JIA) asks about a test to definitively diagnose JIA. The nurse's response is based on knowledge of which of the following? 1. The latex fixation test is diagnostic. 2. An increased erythrocyte sedimentation rate is diagnostic. 3. A positive synovial fluid culture is diagnostic. 4. No specific laboratory test is diagnostic.

4. No specific laboratory test is diagnostic.

A preschool-age child with juvenile idiopathic arthritis (JIA) has become withdrawn, and the mother asks the nurse what she should do. Which of the following suggestions by the nurse would be most appropriate? 1.Introduce the child to other children her age who also have JIA. 2.Tell the mother to spend extra time with the child and less time with her other children. 3.Recommend that the mother send the child to see a counselor for therapy. 4.Encourage the mother to be supportive and understanding of the child.

4.Encourage the mother to be supportive and understanding of the child.

1. Which heart defect causes narrowing of the aortic valve? a. Aortic stenosis b. Atrial septal defect c. Coarctation of the aorta d. Patent ductus arteriosus

a. Aortic stenosis

1. What are nursing interventions for an infant requiring Digoxin?

a. Count apical heart rate for a full minute. b. Hold if HR lower than 90-110 for infants/young children; 70 for older children; adults 60. Infants rarely receive more than 1ml (50mcg or 0.05mg). c. Most common signs of digoxin toxicity in infants and children are bradycardia, anorexia, nausea, and vomiting.

1. A 2 week old (born at 36 weeks gestation) with patent ductus arteriosus (PDA) is admitted for initial placement of a nasogastric tube to begin NG feeds due to FTT related to this congenital defect. The child's cardiac status is stable. The nurse was reassigned to work on the cardiac unit; therefore, the nurse has not cared for a patient with a cardiac defect. What is a PDA?

a. Failure of the fetal ductus arteriosus (artery connecting the aorta and pulmonary artery) to close.

1. The nurse, preparing to give digoxin to a 9-month-old infant, checks the dosage and sees that 4 mL of the drug is to be administered. Which action by the nurse is correct? a. Mix the dose with juice to disguise its taste. b. Refrain from drawing up the dose because there is an error in the dosage. c. Check the heart rate and administer the dose by letting the infant suck it through a nipple. d. Check the heart rate and administer the dose by placing it at the back and side of the mouth.

a. Refrain from drawing up the dose because there is an error in the dosage.

1. The nurse is caring for a 14-year-old child with juvenile idiopathic arthritis (JIA). What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Erythema over joints b. Soft tissue contractures c. Swelling in multiple joints d. Morning stiffness of the joints e. Loss of motion in the affected joints

a. Soft tissue contractures b. Swelling in multiple joints c. Morning stiffness of the joints d. Loss of motion in the affected joints

1. Which of these statements accurately describes Duchenne muscular dystrophy (DND)? Select all that apply. a. The absence of dystrophin leads to muscle fiber degeneration b. DMD is inherited as a X-linked recessive trait c. Cognitive and intellectual impairment are rare in children with DMD d. Affected children have a waddling gait and lordosis and fall frequently e. Ambulation usually becomes impossible by 12 years old, and affected children are confined to a wheelchair f. Affected children must be hospitalized when ambulation becomes impossible.

a. The absence of dystrophin leads to muscle fiber degeneration b. DMD is inherited as a X-linked recessive trait d. Affected children have a waddling gait and lordosis and fall frequently e. Ambulation usually becomes impossible by 12 years old, and affected children are confined to a wheelchair

1. Adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following? Select all that apply a. Believing that thoughts are all powerful b. Thinking in abstract terms c. Thinking about hypotheses d. Using a future time perspective e. Thinking In the here and now

a. Thinking in abstract terms b. Thinking about hypotheses c. Using a future time perspective

1. What teaching should the nurse give to the principal caregiver of a child about the administration of digoxin? Select all that apply. a. Mix the drug with some food or fluids. b. Administer the drug every 12 hours. c. Report frequent vomiting or poor feeding. d. Give a second dose if the child vomits. e. Give water after administering the drug.

b. Administer the drug every 12 hours. c. Report frequent vomiting or poor feeding. d. Give a second dose if the child vomits.

1. A child, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following? a. This type of fracture is inconsistent with a fall. b. Bone growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. Healing is usually delayed in this type of fracture.

b. Bone growth can be affected by this type of fracture.

1. Urinary system distress (neurogenic bladder) in children with spina bifida (SB) is managed by: a. DDAVP b. Clean intermittent catheterization (CIC) c. Continuous urinary catheterization d. Mitrofanoff procedure

b. Clean intermittent catheterization (CIC)

1. A nurse confers with the nutritionist about the diet of a 4-year-old child with spina bifida who spends many hours in a wheelchair. What should the nurse encourage the mother to increase in her child's diet? Select all that apply. a. Fat b. Fiber c. Protein d. Calories e. Carbohydrates

b. Fiber c. Protein

1. A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses should the nurse make? a. "The Pavlik harness is used for children with scoliosis, not hip dysplasia." b. "The Pavlik harness is used for school‑age children." c. "The Pavlik harness cannot be used for your child because her condition is too severe." d. "The Pavlik harness is used for infants less than 6 months of age."

d. "The Pavlik harness is used for infants less than 6 months of age."

1. How should the nurse administer a digitalizing dosage to a child prescribed digoxin? a. Administer divided doses orally over 12 hours. b. Administer the medication orally twice a day. c. Administer the medication orally once a day. d. Administer divided doses intravenously over 24 hours.

d. Administer divided doses intravenously over 24 hours.

1. A nurse is caring for a child who is in a plaster spica cast. Which of the following actions should the nurse take? a. Use a heat lamp to facilitate drying. b. Avoid turning the child until the cast is dry. c. Assist the client with crutch walking after the cast is dry. d. Apply moleskin to the edges of the cast.

d. Apply moleskin to the edges of the cast.

1. What factors should the nurse consider when interviewing an adolescent patient? a. Begin with sensitive issues then proceed with less sensitive topics b. Assume you understand the adolescent by including your own experiences c. Interview the adolescent with the parents to ensure accuracy d. Ask open ended questions

d. Ask open ended questions

1. Which congenital heart defect is described as the incomplete fusion of the endocardial cushions? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Atrioventricular canal defect

d. Atrioventricular canal defect

1. A 5-month-old infant with Down Syndrome and a ventricular septal defect (VSD) is admitted for surgical repair of this congenital defect. a. The nurse works on the surgical unit; however, the nurse has not cared for a patient with a cardiac defect. What is a VSD?

i. Abnormal opening between the right and left ventricle

1. A 5-month-old infant with Down Syndrome and a ventricular septal defect (VSD) is admitted for surgical repair of this congenital defect. a. Due to this defect, how does this impact cardio-respiratory blood flow?

i. Left to right shunt caused by the flow of blood from the higher pressure left ventricle to the lower pressure right ventricle ii. Increased pulmonary blood flow results