pets 3
Major goals for the therapeutic management of juvenile idiopathic arthritis include:
control pain; preserve joint function
a nurse is assessing an infant who has congenital heart disease. Which of the following should the nurse recognize as manifestations of heart failure? (select all)
cool extremities; nasal flaring; peripheral edema
A 4 year old child is admitted with a tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, the nurse suspects that the child has:
correction of the aorta
a 7 year old has had a cast applied for a fractured arm with the wrist and elbow immobilized. Which of the following should be included in the home care instructions?
elevate casted arm when both upright and resting
a nurse is completing preoperative teaching with an adolescent client who is going to receive spinal instruments for scoliosis. which of the following information should the nurse include in the teaching
"you may need to receive blood"
A child with leukemia has mucosal ulceration in his mouth and throat due to neutropenia. Which of the following actions should the nurse take? (select all)
encourage gargling with warm saline mouthwash; use a soft, disposable toothbrush for oral care; offer soft foods
A nurse is caring for a 3 year old client with neuroblastoma who has been receiving chemotherapy for the last 4 weeks. His laboratory test results indicate a hbg of 12.5; HCT of 36.8%; WBC of 2000 mm3; platelet of 150,000. Based on the child's values what is the highest priority of nursing intervention?
encourage meticulous handwashing by client and visitors
The nurse is caring for a child with fractured femur in traction. Which action will the nurse complete while caring for this client?
ensure traction weights are hanging freely, not touching the bed or floor
The primary intervention for beta- thalassemia is a chronic transfusion program of packed WBC with iron chelation
false
A recommendation to prevent neural tube defects is the supplementation of which of the following?
folic acid for all women of childbearing age
The therapeutic management of children with b-thalassemia major consists primarily of which of the following?
frequent blood transfusion
The child with thalassemia may be given which of the following classifications of medications to prevent one of the complications frequently seen with this disorder?
iron-chelating drugs
The nurse is caring for a term neonate who is diagnosed with patent ductus arterioles. While performing a physical assessment of the neonate, the nurse anticipates that the neonate will exhibit which of the following?
loud machine-hum like cardiac murmurs through systole and diastole
a school-aged child is admitted to the hospital with a vasoocclusive sickle cell crisis. Which measure in his care should be given priority?
maintaining a fluid IV line
Nursing considerations related to the administration of chemotherapeutic drugs include which of the following?
many chemotherapeutic agents are vesicants that can cause severe cellular damage if drug infiltrates
In addition to Childs history, symptoms, and blood studies, which of the following helps to confirm the diagnosis of leukemia
Bone marrow aspiration
A mother who just delivered a newborn who has congenital clubfoot, talipes equinovarus, asks what treatment is available for her baby. The nurse's best response would be:
serial castings will be implemented very shortly
A nurse is giving a talk to high school students about preventing the spread of HIV. What does the nurse identify as ways it can be spread?
sharing contaminated needles; perinatally from mother to fetus; transfusion of contaminated blood; exposure to blood and body fluids through sexual contact
A woman who has sickle cell anemia asks you if her infant will develop sickle cell disease. The nurse would base the answer on which of the following?
sickle cell anemia is recessively inherited
A nurse is teaching a parent of a child who is receiving chemotherapy for bone cancer. Which of the following should be included in the teaching? (Select all)
signs of infection; hand hygiene; nutritional requirements; bleeding precautions
a 2 year old child is receiving digoxin. The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?
90
A toddler is diagnosed with chronic benign neutropenia. The parents are being taught about caring for their child. Which of the following is important to include?
Avoid large indoor crowds and people who are ill
A young child with leukemia has decrease oral intake and severe stomatitis. The nurse should suggest that the parents try which of the following?
Avoid placing pressure on the child to eat
The school nurse is informed that a child with HIV will be attending school soon. Which of the following is an important nursing intervention?
Carefully follow unierveral precautions
Which of the following would the nurse include in the preop plan of care for an infant with myleomengiocele
Covering the sac with saline-soaked nonadhesive sterile gauze
The parents of a child with sickle cell anemia are concerned about subsequent children having the disease. The nurse should know the that:
Each child has a chance of having SCA
When examining school-aged and adolescent children, the nurse routinely screens for scoliosis. Which statement accurately summarizes how to perform this screening?
Have the child stand firmly on both feet and bend forward at the hips, with the trunk exposed
A school-age child with vasooclusive sickle cell crisis. The child's care should include which of the following?
Hydratino and pain management
during a developmental screening, the nurse finds that a 3 year old child with cerebral palsy has arrested social and language development. Then nurse tells the family:
I need to refer you for more developmental testing
The clinical manifestations of SCA are primarily the result of which of the following?
Increased RBC destruction
The nurse is caring for a 12 year old client during a follow up visit for an ulnar fracture that required a cast. During the visit, the client asks why it is not recommended to scratch the itchy skin under the cast. How should the nurse respond?
It can lead to skin irritation, open areas of skin and infection
a nurse is providing teaching to the mother of an infant who is to start taking digoxin. Which of the following instructions should the nurse include?
It is important to administer the correct amount at regularly scheduled times
When developing the plan of care for a newly admitted 2-year-old child with the diagnosis of Kawasaki disease. Which of the following should be the priority?
Monitoring the I and o every hour
A 4 year old is placed in buck extension traction. He is crying with pain as the nurse assesses the skin on his right foot and sees that it is pale. What should the nurse do first?
Notify the practitioner of the changes noted
The parents of a young child with congestive heart failure (CHF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which of the following?
Parents need to learn specific, important guidelines for administration of digoxin
Which of the following heart defects causes hypoxemia and cyanosis because desaturated venous blood is entering the systemic circulation?
Tetralogy of fallot
An 11 year old client has been complaining of severe pain since surgery two days ago. The client is currently in the play room, avidly playing video games and shows no evidence of pain. When the nurse has the client return to bed, the client begins complaining of severe pain again. Which of the following is probably true about this pain?
The distraction of playing video games in an important adjunct to other pain-management techniques
Which of the following is descriptive of most cases of hemophilia
X-linked recessive inherited disorder in which a blood clotting factor is deficient
The mother of a 4 year old child with juvenile idiopathic arthritis is worried that her child will have to stop attending school because of the illness. Which of the following responses by the nurse would be appropriate?
Your child should be encouraged to attend school, but he'll need extra time to work out early morning stiffness
Therapeutic management of the child with rheumatic fever include:
administration of penicillin
an adolescent is schedule for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include which of the following?
answer questions with straightforward honesty
Decresing the demands on the heart is a priority in care for the infant with CHF. In evaluating the infant's status, Which of the following is most indicative of achieving this goal?
appropriate weight gain for this age
A 10 month old infant is being assessed for dysplasia of the hip. The nurse concludes that positive signs and symptoms of that indicate this disorder include : (Select all)
asymmetric thigh and gluteal folds; shortening of the affected leg; ortalni sign; Barlow sign
Parents of a preschooler with cerebral palsy ask the nurse what the suregeon plans to implant in their child's body to control spasticity. What is the nurse's answer?
baclofen pump
children in the US with HIV can acquire the disease: (Select all)
by using IV drugs; from a blood transfusion' through sexual contact; perinatally from their mothers
which of the following would make you, as the admission nurse, suspect Duchenne's muscular dystrophy before obtaining the patients history?
gower's sign
The nurse is explaining blood components to an 8 year old.The nurse's best description of platelets is that they do which of the following?
help your body stop bleeding by forming a clot (scab) over the area
The nurse performing a focused health history on a newborn asks the parents if there are any heredity disorders affecting musculoskeletal function in the family history, These disorders include what? (Select all
hip dysplasia; clubfoot
a parent of a 7 year old girl with ventricular septal defect calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 degrees and now her muscles and joints ache. Based on this info you advise the mother to:
immediately bring the child to clinic for evaluation
Which of the following statements best describes b- thalassemia?
increased incidence occurs in families of mediterranenan extraction
The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure, The nurse documents this finding as:
petechiae
A 16 month old child diagnosed with Kawasaki disease is very irritable, refuses to ear, and exhibits peeling skin on the hands and feet. The nurse should do which of the following?
place the toddler in a quiet environment
An infant born to a mother who has HIV positive was tested at birth and found to be negative. The infant is scheduled for follow-up testing. Which test would the nurse expect to be performed?
polymerase chain reaction (PCR) test
A goal for children with spina bifida is to reduce the chance of allergy development.A priority nursing intervention is to:
provide latex-free environment
Which of the following structural defects constitute tetraology of fallot?
pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
The physician suggests that surgery be performed for patent ductus arterioles to prevent which of the following complications?
pulmonary vascular congestion
The nurse uses the 5 P's to assess ischemia in a child with a fracture. Which of the following findings is considered a late and ominous sign?
pulselessness
The major goals of therapy for children with cerebral palsy (CP) include which of the following?
recognize the disorder early and promote optimum development
The nurse should recognize that CHF is which of the following?
result of diminished workload imposed on an abnormal myocardium
The mother of an infant tells the nurse that sometimes there is a whitish "glow' in the pupil of his eye. The nurse should suspect which of the following?
retinoblastoma
Which of the nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with myelomeningocele?
risk for infection
The nurse has completed a physical assessment of an infant and has notice of cutaneous dimple with dark tufts of hair between L5 and S1. Which of the following medical conditions should the nurse suspect?
spina bifida occulta
A nurse is caring for a child who has AIDS. Which of the following isolation precautions should the nurse implement?
standard
The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which of the following is the most appropriate nursing action?
stop drug infusion immediately
