peds exam 3

Nursing care of the child with Kawasaki disease is challenging because of which occurrence? a. The child's irritability b. Predictable disease course c. Complex antibiotic therapy d. The child's ongoing requests for food

a. The child's irritability

The primary health care provider diagnoses a client with slipped capital femoral epiphysis and instructs the nurse to prepare the client for surgery immediately. What is the rationale for this instruction? a. To prevent avascular necrosis

a. To prevent avascular necrosis

Which should the nurse recommend to prevent urinary tract infections in young girls? a. Wear cotton underpants b. Limit bathing as much as possible c. Increase fluids; decrease salt intake d. Cleanse perineum with water after voiding

a. Wear cotton underpants

Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? a. Wheezing b. Increased blood pressure c. Increased urine output d. Decreased heart rate

a. Wheezing

A priority nursing responsibility in the care of a child with a cast or in traction is. a. performing neurovascular assessments or checks

a. performing neurovascular assessments or checks

After a cardiac catheterization, the nurse monitors the child's fluid balance closely based on the understanding that: a. the contrast material used has a diuretic effect b. the prolonged preprocedure fasting state places the child at risk for dehydration c. blood loss during the procedure can be significant d. the insertion of the catheter into the heart stimulates a diuretic response

a. the contrast material used has a diuretic effect

Nursing students are reviewing information about the different types of congenital heart defects. They demonstrate understanding of the information when they identify which of these as disorders with increased pulmonary blood flow? Select all that apply. a.Ventricular septal defect b. Atrioventricular canal defect c. Patent ductus arteriosus d. Pulmonary stenosis e. Coarctation of the aorta

a.Ventricular septal defect b. Atrioventricular canal defect c. Patent ductus arteriosus

A client's newborn is diagnosed with Tetralogy of Fallot. When explaining this condition to the client, which of the following defects would the nurse's description include? a. Atrial septal defect b. Overriding of the aorta c. Stenosis of the aorta d. Left ventricular hypertrophy

b. Overriding of the aorta

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? a. Fever b. Polyarthritis c. Osler nodes d. Janeway spots

b. Polyarthritis

Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy? a. Tremulous movements at rest and with activity b. Positive Babinski reflex c. Writhing, uncontrolled, involuntary movements d. Clumsy, uncoordinated movements

b. Positive Babinski reflex

The caregiver of a 2-year-old who has a polyurethane resin cast on her arm calls the clinic to report that her child is crying and says that the cast has sand in it. The caregiver states that she has had casts of her own and knows how badly they can itch. She says she always used a hanger to scratch but is worried that it will be too sharp for the child. Which of the following statements would be appropriate for the nurse to make to this caregiver? a. "Since the child's cast is synthetic, she could soak it with cool water." b. "A plastic ruler is less likely than a hanger to cut the child's skin." c. "You could give the child an extra dose of acetaminophen and see if that helps." d. "Nothing should be put into the cast. You can blow cool air into it with a hair dryer."

d. "Nothing should be put into the cast. You can blow cool air into it with a hair dryer."

You take an infant's apical pulse before administering digoxin. What is the usually accepted level of pulse rate considered safe for administering digoxin to an 8-month-old infant? a. 150 beats per minute b. 60 beats per minute c. 80 beats per minute d. 100 beats per minute

d. 100 beats per minute

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? a. A capillary refill of greater than three seconds b. A palpable dorsalis pedis pulse but a weak posterior tibial pulse c. A decrease in sensation with a weakened dorsalis pedis pulse d. A capillary refill of less than three seconds with palpable warmth

d. A capillary refill of less than three seconds with palpable warmth

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity? a. Lowered blood pressure b. Tinnitus c. Ataxia d. A change in heart rhythm

d. A change in heart rhythm

Which nursing assessment is appropriate for determining neurovascular competency? a. Degree of motion and ability to position the extremity b. Length, diameter, and shape of the extremity c. Amount of swelling noted in the extremity and pain intensity d. Skin color, temperature, movement, sensation, and capillary refill of the extremity

d. Skin color, temperature, movement, sensation, and capillary refill of the extremity

A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating distress? a. Reduced respiratory rate during feeding b. Perspiration on body after feeding c. Feeding lasting for 15-20 minutes d. Subcostal retraction at the time of feeding

d. Subcostal retraction at the time of feeding

A newborn has been diagnosed with a congenital heart disease. Which of the following congenital heart diseases is associated with cyanosis? a. Coarctation of aorta b. Pulmonary stenosis c. Aortic stenosis d. Tetralogy of Fallot

d. Tetralogy of Fallot

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? a. Aspirin is contraindicated b. The principal area of involvement is the joints c. The child's fever is usually responsive to antibiotics within 48 hours d. Therapeutic management includes administration of gamma globulin and salicylates

d. Therapeutic management includes administration of gamma globulin and salicylates

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 patient's limb balanced d. To avoid indenting the cast

d. To avoid indenting the cast

A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what? a. Tetralogy of Fallot b. Coarctation of the aorta c. Pulmonary stenosis d. Ventricular septal defect

d. Ventricular septal defect

The nurse, assessing the neurovascular status of a child in Russell traction should report immediately the finding of: a. skin that's warm to the touch b. capillary refill less than 3 seconds c. ability to wiggle toes d. bluish coloration of skin

d. bluish coloration of skin

Which should the nurse stress to the parents of an infant in a pavlik harness for treatment of DDH a. put socks on over the foot pieces of the harness to help stabilize it b. use lotions or powder on the skin to prevent rubbing of straps c. remove harness during diaper changes for ease of cleaning diaper area d. check under the straps at least 2-3x/day for red areas

d. check under the straps at least 2-3x/day for red areas

When a child is scheduled for a cardiac catheterization, an important health teaching point for parents is that the a. Child will have to remain NPO for 6 to 8 hours after the procedure to prevent vomiting b. procedure is noninvasive and not frightening for children c. Child will require a general anesthetic and needs to be prepared for this d. child will return with a bulky pressure dressing over the catheter insertion area

d. child will return with a bulky pressure dressing over the catheter insertion area

A 4-year-old who had a broken arm is preparing to have the cast removed after 4 weeks. The child's parent states, "I had a cast on my arm a lot longer than that for it to heal. Are you sure the cast has been on long enough?" Which is the best response to the parent? a. "Children's bones heal faster than adults, so they don't need to wear a cast as long as an adult." b. "Children's bones are different, but the cast should be on about as long as yours was." c. "You're right. The cast hasn't been on nearly as long as an adult. I'll recheck with the health-care provider." d. "We don't worry about children's bones as much; they will remodel well on their own."

a. "Children's bones heal faster than adults, so they don't need to wear a cast as long as an adult."

The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching? a. "It is acceptable to take frequent bubble baths"

a. "It is acceptable to take frequent bubble baths"

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? a. A high hemoglobin b. A low hematocrit c. A high white blood cell count d. A low platelet count

a. A high hemoglobin

What cardiovascular defect results in obstruction to blood flow? a. Aortic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries

a. Aortic stenosis

Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage? a. Apply a sterile dressing moistened in a warm, sterile saline solution b. Cover the sac with petroleum jelly and a dry sterile dressing c. Allow the sac to dry out to "toughen" it d. Cover the sac with a water-soluble lubricant and a dry sterile dressing

a. Apply a sterile dressing moistened in a warm, sterile saline solution

The nurse is caring for a 10-year-old boy following a cardiac catheterization. Four hours after the procedure, the nurse notes some minor bleeding at the site. Which action would be most appropriate? a. Apply pressure 1 inch above the site b. Change the dressing c. Contact the physician d. Ensure that the child's leg is kept straight

a. Apply pressure 1 inch above the site

Which instruction(s) should the nurse give the parents of an adolescent with slipped capital femoral epiphysis (SCFE)? Select all that apply. a. Continue upper body exercises to limit loss of muscle strength b. Do not turn the teen in bed when complaining of pain c. Provide homework, computer games, and other activities to decrease boredom d. Do most activities of daily living for the teen e. Expect expressions of anger and hostility f. Continue setting limits on behavior

a. Continue upper body exercises to limit loss of muscle strength c. Provide homework, computer games, and other activities to decrease boredom e. Expect expressions of anger and hostility f. Continue setting limits on behavior

What are uneven folds in the back of an infant's legs indicative of? a. DDH - developmental dysplasia of the hip

a. DDH - developmental dysplasia of the hip

The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which of the following should be reported if they occur or are seen related to this child? (Select all that apply) a. Drainage from under the cast b. Any pink color in the fingers or toes of casted extremity c. A foul odor under the cast d. Any area on the cast that is warm to the touch e. Any itching under or around the edges of the cast f. Looseness of the cast on the extremity

a. Drainage from under the cast c. A foul odor under the cast d. Any area on the cast that is warm to the touch f. Looseness of the cast on the extremity

Tetralogy of Fallot consists of the following four anomalies: aortic stenosis, atrial septal defect, dextroposition (overriding) of the aorta, and hypertrophy of the left ventricle. a. False b. True

a. False

A nurse is performing an assessment on a child. Which of the following would be indicative of a potential for a urinary tract infection? a. Holding urine while at school b. Not using cleansing towelettes routinely c. Washing the genital area with water daily d. Not using soap when cleaning the urethral area

a. Holding urine while at school

Spastic cerebral palsy is characterized by what presentation? 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

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate? a. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow b. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect c. Acute Pain Related to the Effects of a Congenital Heart Defect d. Hypothermia Related to Decreased Metabolic State

a. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow

General cast care considerations would include which of the following? a. Keep cast clean and dry, monitor integrity of cast materials, and elevate the involved extremity for 24 to 48 hours as recommended. Monitor neurovascular status per doctors orders and shower as instructed. b. Allow the cast to get wet and follow up in 4 to 6 weeks for cast removal. c. Spray the cast with Febreze if a foul smell occurs. d. All of the above

a. Keep cast clean and dry, monitor integrity of cast materials, and elevate the involved extremity for 24 to 48 hours as recommended. Monitor neurovascular status per doctors orders and shower as instructed.

The nurse is caring for a client with a slipped capital femoral epiphysis. Which clinical manifestations does the nurse observe in the client? Select all that apply. a. Loss of abduction b. Limp on affected side c. shortening of lower extremity

a. Loss of abduction b. Limp on affected side c. shortening of lower extremity

You meet a child with a slipped femoral epiphysis. In what type of child does this usually occur? a. Obese adolescent boys b. Active school-aged children c. Tall, thin girls d. Preadolescent girls

a. Obese adolescent boys

Which factor(s) is/are associated with slipped capital femoral epiphysis (SCFE)? Select all that apply. a. Obesity b. Female gender c. African descent d. Age of 5 to 10 years e. Pubertal hormonal changes f. Endocrine disorders

a. Obesity e. Pubertal hormonal changes f. Endocrine disorders

The nurse cares for the newborn diagnosed with developmental dysplasia of the hip (DDH). The nurse expects which treatment to be used with the newborn? a. Palvik harness

a. Palvik harness

An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply. a. Place the child in knee-chest position b. Draw blood for a serum hemoglobin c. Administer oxygen d. Administer morphine and propranolol intravenously as ordered e. Administer Benadryl as ordered

a. Place the child in knee-chest position c. Administer oxygen d. Administer morphine and propranolol intravenously as ordered

The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? a. Pulmonary hypertension b. Right-to-left shunt of blood c. Pulmonary embolism d. Left ventricular hypertrophy

a. Pulmonary hypertension

What structural defects constitute tetralogy of Fallot? a. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c. Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy d. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

a. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). Which of the following would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply. a. Sensation b. Capillary refill c. Color d. Vital signs e. Pulse

a. Sensation b. Capillary refill c. Color e. Pulse

A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports he will not stop crying even after taking Tylenol with codeine. He also will not straighten the fingers on his right arm. The nurse tells the mother to do which? a. Take him to the emergency department b. Put ice on the injury c. Avoid letting him get so tired d. Wait another hour. If he is still crying, call back

a. Take him to the emergency department

The child has returned to the nurse's unit following a cardiac catheterization. The insertion site is located at the right groin. Peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. Which finding should be reported to the child's physician? a. The child is reporting nausea b. The child has a runny nose c. The right groin is soft without edema d. The child's right foot is cool with a pulse assessed only with the use of a Doppler e. The child has a temperature of 102.4° F (39.1° C)

a. The child is reporting nausea d. The child's right foot is cool with a pulse assessed only with the use of a Doppler e. The child has a temperature of 102.4° F (39.1° C)

Which statement by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections (UTIs)? a. "I always wear cotton underwear." b. "I really enjoy taking a bubble bath." c. "I go to the bathroom every 3 to 4 hours." d. "I drink four to six glasses of fluid every day."

b. "I really enjoy taking a bubble bath."

The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? a. "My child should not attend school for the next 5 days." b. "I should change the bandage every day for the next 2 days." c. "My child can take a tub bath but should avoid taking a shower for the next 4 days." d. "I should expect the site to be red and swollen for the next 3 days."

b. "I should change the bandage every day for the next 2 days."

A child is being treated with a hip Spica cast and preparing to be discharged home. Which statement by the parents demonstrates effective education and readiness to care for the child? a. "We will turn our daughter every day and watch for skin irritation." b. "Placing the absorbent part of the diaper toward the skin is best." c. "We will let our daughter chose her own snacks to help her be happy." d. "If our daughter is in pain, we will use only oxycodone to treat pain."

b. "Placing the absorbent part of the diaper toward the skin is best."

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate? a. 60 beats/min b. 90 beats/min c. 100 beats/min d. 120 beats/min

b. 90 beats/min

An examiner who discovers unequal movement or uneven gluteal skinfolds during the Ortolani maneuver does what? a. Tells the parents that one leg may be longer than the other, but they will equal out by the time the infant is walking b. Alerts the health care provider that the infant has a dislocated hip c. Informs the parents and health care provider that molding has not taken place d. Suggests that if the condition does not change, surgery to correct vision problems might be needed

b. Alerts the health care provider that the infant has a dislocated hip

When caring for a child that has just had a cardiac catheterization, which of the following would indicate a sign of hypotension? a. Diaphoresis and tachycardia b. Cold clammy skin and increased heart rate c. Syncope and tachypnea d. Decreased heart rate and dizziness

b. Cold clammy skin and increased heart rate

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

A child is recovering from Kawasaki disease (KD). The child should be monitored for which? a. Anemia b. Electrocardiograph (ECG) changes c. Elevated white blood cell count d. Decreased platelets

b. Electrocardiograph (ECG) changes

Which of the following would be included in the care of an infant in heart failure? a. Begin formulas with increased calories b. Encourage larger, less frequent feedings c. Maintain the child in the supine position d. Administer digoxin even if the infant is vomiting

b. Encourage larger, less frequent feedings

The nurse is providing care to a preschool-aged child who has been placed in a hip Spica cast for treatment of a femur fracture. The child is given narcotic pain medication for the first 48 hours before being sent home. When providing discharge instructions to the child's parents, which is the most important? a. Assist the child to find ways to play while in the cast b. Ensure the cast is not too tight around the abdomen c. Keep the cast clean by using absorbent pads when toileting d. Avoid giving the child sugary snacks while being treated

b. Ensure the cast is not too tight around the abdomen

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

During discharge planning the parents of an infant with spina bifida express concern about skin care and ask the nurse what can be done to avoid problems. What is the best response by the nurse? a. Diapers should be changed at least every 4 hours b. Frequent diaper changes with cleansing are needed c. Medicated ointment should be applied six times a day d. Powder may be used in the perineal area when it becomes wet

b. Frequent diaper changes with cleansing are needed

The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Select all that apply. a. Allow the infant to feed for 60 minutes b. Hold the infant at a 45 degree angle c. Encourage frequent hand hygiene d. Notify the health care provider for fever e. Pump the breasts and feed with a bottle if weight gain is an issue

b. Hold the infant at a 45 degree angle c. Encourage frequent hand hygiene d. Notify the health care provider for fever e. Pump the breasts and feed with a bottle if weight gain is an issue

What blood flow pattern occurs in a ventricular septal defect? a. Mixed blood flow b. Increased pulmonary blood flow c. Decreased pulmonary blood flow d. Obstruction to blood flow from ventricles

b. Increased pulmonary blood flow

When developing a teaching plan for the parents of a child diagnosed with tricuspid atresia, the nurse would integrate knowledge of what factor as the major mechanism involved? a. Narrowing of the major vessel b. Obstruction of blood flow to the lungs c. Mixing of well-oxygenated and poorly oxygenated blood d. Increased pulmonary blood flow

b. Obstruction of blood flow to the lungs

A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? a. Preoperative teaching should be directed at his parents because he is too young to understand b. Preoperative teaching should be adapted to his level of development so that he can understand c. Preoperative teaching should be done several days before the procedure so he will be prepared d. Preoperative teaching should provide details about the actual procedures so he will know what to expect

b. Preoperative teaching should be adapted to his level of development so that he can understand

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk? a. Minimize seizures b. Prevent dehydration c. Promote cardiac output d. Reduce energy expenditure

b. Prevent dehydration

During painful episodes of juvenile arthritis, a plan of care should include which nursing intervention? a. A weight-control diet to decrease stress on the joints b. Proper positioning of the affected joints to prevent musculoskeletal complications c. Complete bed rest to decrease stress to joints d. High-resistance exercises to maintain muscular tone in the affected joints

b. Proper positioning of the affected joints to prevent musculoskeletal complications

A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? a. Serum sodium b. Serum potassium c. Serum glucose d. Serum chloride

b. Serum potassium

A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents' discharge teaching? a. Turn every 8 hours b. Specially designed car restraints are necessary c. Diapers should be avoided to reduce soiling of the cast d. Use an abduction bar between the legs to aid in turning

b. Specially designed car restraints are necessary

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? a. Teach her to take frequent tub baths to clean her perineal area b. Teach her to wipe her perineum front to back after voiding c. Suggest she drink less fluid daily to concentrate urine d. Encourage her to be more ambulatory to increase urine output

b. Teach her to wipe her perineum front to back after voiding

What clinical manifestation is a common sign of digoxin toxicity? a. Seizures b. Vomiting c. Bradypnea d. Tachycardia

b. Vomiting

The nurse is caring for an infant with a myelomeningocele. the parents ask the nurse why they keep measuring the babys head circumference. select the nurses best response a. babies heads are measured to ensure growth is on track b. babies with a myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size c. because your baby has an opening on the spinal cord, your infant is at risk for meningitis, which can show up as an increase in head size d. many infants with myelomeningocele have microcephaly, which can show up as a decrease in head size

b. babies with a myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? a. "We need to avoid a tub bath for the next 3 days." b. "Strenuous activity should be limited for the next 3 days." c. "The feeling of the heart skipping a beat is common." d. "We need to watch for changes in skin color or difficulty breathing."

c) "The feeling of the heart skipping a beat is common."

After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds? a. 15 b. 30 c. 60 d. 120

c. 60

A mother with a child with Juvenile Idiopathic Arthritis calls the clinic nurse because the child is having a pain exacerbation. The mother asks the nurse if the child can continue with her range of motion exercises at the time. The appropriate nursing response is: a. Range of motion exercises should be done every day b. Have the child do isometric exercises during this time c. Administer additional pain medication before doing the exercises d. Avoid exercises during this time

c. Administer additional pain medication before doing the exercises

The nurse is caring for a child after a cardiac catheterization. What is the nursing priority? a. Allow early ambulation to encourage activity participation b. Check pulses above the catheter insertion site for strength and quality c. Assess extremity distal to the insertion site for temperature and color d. Change the dressing to evaluate the site for infection

c. Assess extremity distal to the insertion site for temperature and color

Which should be included in teaching a family about post-surgical care for slipped capital femoral epiphysis (SCFE)? Select all that apply. a. The patient will receive help with weight-bearing ambulation 24 to 48 hours after surgery b. Monitoring of pain medication to prevent drug dependence c. Instruction on pin site care d. Offering low-calorie meals to encourage weight loss e. Correct use of crutches by the patient f. Outpatient physical therapy for 6 to 8 weeks

c. Instruction on pin site care e. Correct use of crutches by the patient

The nurse performing a neurovascular check on a limb in traction would report and document which finding(s) as indicative of altered circulation? Select all that apply. a. Pulse is equal to uncasted limb b. Patient is aware of touch and warm and cold application c. Limb is cool to the touch d. Capillary refill is 5 seconds e. Distal limb can flex and extend

c. Limb is cool to the touch d. Capillary refill is 5 seconds

After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? a. Elevate the affected extremity b. Notify the practitioner of the observation c. Record data on the assessment flow record d. Apply warm compresses to the insertion site

c. Record data on the assessment flow record

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child? a. Weight loss b. Bradycardia c. Tachycardia d. Increased blood pressure

c. Tachycardia

At 3 years of age, a child has a cardiac catheterization. After the procedure, which of the following interventions would be most important? a. Allowing the child to talk about the procedure b. Allowing the child to adapt to the light room gradually c. Taking pedal pulses for the first 4 hours d. Assuring the child that the procedure is now over

c. Taking pedal pulses for the first 4 hours

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

The nurse should tell the parents of a child with Duchenne muscular dystrophy that some of the progressive complications include: a. dry skin, hirsutism, protruding tongue, and mental retardation b. anorexia, gingival hyperplasia, and dry skin and hair c. contractures, obesity, and pulmonary infections d. trembling, frequent loss of consciousness, and slurred speech

c. contractures, obesity, and pulmonary infections

The nurse caring for a child with Duchenne's muscular dystrophy notes a characteristic manifestation, which is that the child: a. ambulates by holding onto furniture b. exhibits atrophy of the calf muscles c. falls frequently and is clumsy d. has delayed fine-motor development

c. falls frequently and is clumsy

Which would the nurse assess in a 4wo infant who has DDH and is wearing a pavlik harness a. diaper dermatitis b. talipes equinovarus c. leg shortening and limited abduction d. Pain

c. leg shortening and limited abduction

Which should be included in the plan of care for a newborn with myelomeningocele who will have a surgical repair tomorrow a. offer formula every 3 hours b. turn the infant back to front every 2 hours c. place a wet dressing on the sac d. provide pain medication every 4 hours

c. place a wet dressing on the sac

A 5-year-old boy presents to the emergency department with a history of a motor vehicle accident. He was restrained in the backseat, and the car was hit head on. He has a swollen and deformed left thigh. He is in extreme pain. He has frequent muscle spasms. X-rays reveal a midshaft femur fracture. As you prepare the child prior to surgery, you will assist with anticipatory guidance as well as show and discuss a spica cast. What information will be helpful to this young boy? a. A hard cast from your waist to your toes will protect your leg so it can heal b. We can put a cast like yours on your bear c. The IV will give you medicine to make you sleep, wake up, and help with the pain d. All of the above

d. All of the above

Keyanna, a 7-year-old girl, has been placed in a leg spica case because of injuries she sustained in a motor vehicle accident. The nurse has created a plan of care for Keyanna while she is an inpatient on the pediatric floor. The plan of care should address: a. Neurovascular checks b. Checking to make sure two fingers can be inserted along the abdomen of the cast to make sure that it is not too tight c. Constipation prevention d. All of the above should be in the plan of care

d. All of the above should be in the plan of care

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially? a. Notify the physician b. Place the child in Trendelenburg position c. Apply a new bandage with more pressure d. Apply direct pressure above the catheterization site

d. Apply direct pressure above the catheterization site

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

Patient and parent education for the child who has a synthetic cast should include which information? a. Apply a heating pad to the cast if the child has swelling in the affected extremity b. Wrap the outer surface of the cast with an Ace bandage c. Split the cast if the child complains of numbness or pain d. Cover the cast with plastic and waterproof tape to keep it dry while bathing or showering

d. Cover the cast with plastic and waterproof tape to keep it dry while bathing or showering

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

A nurse admits an infant with a possible diagnosis of congestive heart failure. Which of the following signs and symptoms would the infant most likely be exhibiting? a. Rapid weight gain b. Yellowish color c. Bradycardia d. Feeding problems

d. Feeding problems

A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? a. Gallop and rales b. Blood pressure discrepancies in the extremities c. Right ventricular hypertrophy on ECG d. Heart murmur

d. Heart murmur

An 8-month-old has a ventricular septal defect. Which nursing diagnosis below would best apply? a. Impaired skin integrity related to poor peripheral circulation b. Impaired gas exchange related to a right-to-left shunt c. Ineffective airway clearance related to altered pulmonary status d. Ineffective tissue perfusion related to inefficiency of the heart as a pump

d. Ineffective tissue perfusion related to inefficiency of the heart as a pump

A 7-year-old is having on and off knee, ankle, wrist, and hip pain. The family history is positive for rheumatoid arthritis. No injury has taken place, and the child has occasional swelling of joints. Pain resolves with rest, ice, and NSAIDs. The primary care physician ran labs with positive rheumatoid factor ANA and ESR. This child is a soccer player and a violinist. Your differential diagnosis would be: a. Juvenile Idiopathic Arthritis (JIA), septic arthritis, osteomyelitis, and fracture b. Juvenile Idiopathic Arthritis (JIA), toxic synovitis, osteomyelitis, and Developmental Dislocated Hips (DDH) c. Juvenile Idiopathic Arthritis (JIA), chronic inflammatory arthritis, chronic osteomyelitis, and Developmental Dislocated Hips (DDH) d. Juvenile Idiopathic Arthritis (JIA) only

d. Juvenile Idiopathic Arthritis (JIA) only

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)

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which of the following symptoms? a. Pallor b. Pain c. Paralysis d. Paresthesia

d. Paresthesia

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority? a. Use a calm, comforting approach b. Administer propranolol (0.1 mg/kg IV) c. Provide supplemental oxygen d. Place the child in a knee-to-chest position

d. Place the child in a knee-to-chest position

A 3-month-old infant has a hypercyanotic spell. What should be the nurse's first action? a. Assess for neurologic defects b. Prepare the family for imminent death c. Begin cardiopulmonary resuscitation d. Place the child in the knee-chest position

d. Place the child in the knee-chest position

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury? a. Place petroleum jelly gauze on the spinal sac to keep it moist b. Place a urine collection bag on newborn for the continuous leakage c. Delay the parents from holding the newborn d. Place the newborn in a prone or lateral position

d. Place the newborn in a prone or lateral position

Which is included in the plan of care for a newborn who has myelomeningocele a. place the child in the prone position with a sterile dry dressing over the defect. slowly begin oral gastric feeds to prevent the development of nectrozing enterocolitis b. place the child in the prone position with a sterile dry dressing over the defect. begin IV fluids to prevent dehydration c. place the child in the prone position with a sterile most dressing over the defect. slowly begin oral gastric feeds to prevent the development of necrotizing enterocolitis d. place the child in the prone position with a sterile most dressing over the defect. begin IV fluids to prevent dehydrations

d. place the child in the prone position with a sterile most dressing over the defect. begin IV fluids to prevent dehydrations