Chapter 31 Care of the Child With a Physical and Mental or Cognitive Disorder

26. The mother of a child with Down syndrome expresses concerns about her child's physical health. Which response by the nurse would be the most appropriate? 1."Children with Down syndrome are prone to upper respiratory infections." 2."Congenital heart defects are uncommon in children with Down syndrome." 3."Your child will probably need to be institutionalized before the age of 18." 4."Most children with Down syndrome develop leukemia."

"Congenital heart defects are uncommon in children with Down syndrome."

16. In a discussion about an 11-month-old patient's diet, which statement by her mother indicates a possible cause for iron-deficiency anemia? 1."Formula is so expensive. We switched to regular milk early on." 2."She almost never drinks water." 3."She doesn't really like peaches or pears, so we stick to bananas for fruit." 4."I give her a piece of bread now and then. She likes to chew on it."

"Formula is so expensive. We switched to regular milk early on."

18. Which statement made by a 12-year-old patient with type 1 diabetes indicates a need for more teaching? 1."My pancreas is sick and needs insulin until it gets better." 2."I will need to take my insulin every day." 3."I need to keep a piece of candy in my pocket in case I start to feel shaky." 4."My mom has to give me insulin shots twice a day."

"My pancreas is sick and needs insulin until it gets better."

27. The health care provider has diagnosed depression in a 16-year-old patient. Which statement by the parents indicates that they have a proper understanding of the diagnosis? 1."My child will need to be placed in an inpatient mental health facility." 2."My child will have to take antidepressive medications for life." 3."The recovery process for my child is likely to be a slow, lengthy process." 4."Depression is nothing to worry about in a child of this age."

"The recovery process for my child is likely to be a slow, lengthy process."

2. The student nurse is preparing a community presentation on urinary tract infections. What should the student include as risk factors? (Select all that apply.) 1.A short urethra in young girls 2.Frequent emptying of the bladder 3.Increased fluid intake 4.Ingestion of highly acidic juices 5.Cleaning the perineal area from back to front

A short urethra in young girls Cleaning the perineal area from back to front

8. How is Hirschsprung disease best described? 1.Absence of parasympathetic ganglion cells in a segment of the colon 2.Passage of excessive amounts of meconium by the newborn 3.Results in excessive peristaltic movements within the GI tract 4.Results in frequent evacuation of solids, liquids, and gas

Absence of parasympathetic ganglion cells in a segment of the colon

11. A 5-year-old patient is admitted to the pediatric unit in sickle cell crisis. Which nursing intervention will be included in the plan of care? (Select all that apply.) 1.Strenuous exercise of the extremities to increase oxygen to the area 2.Administration of IV fluids to improve circulation and hydration 3.Administration of analgesics as ordered 4.Administration of oxygen as ordered 5.Applying ice packs to the affected areas

Administration of IV fluids to improve circulation and hydration Administration of analgesics as ordered Administration of oxygen as ordered Applying ice packs to the affected areas

1. The nurse is caring for a patient with nephrotic syndrome. What assessment finding does the nurse expect to find? 1.Gross hematuria, albuminuria, temperature of 101° F (38.3° C) to 103° F (39.4° C) 2.Elevated blood pressure, weight loss, hematuria 3.Albuminuria, edema, puffiness of face 4.Edema, albuminuria, hypotension

Albuminuria, edema, puffiness of face

28. The nurse is assessing a newly admitted patient. What clinical manifestations would probably indicate that the child has autism? (Select all that apply.) 1.Avoidance of body contact with other people 2.Speech and language delays 3.Deficits in social development 4.Good eye contact with the nurse during the assessment 5.Increased sensitivity to stimuli

Avoidance of body contact with other people Speech and language delays Deficits in social development Increased sensitivity to stimuli

6. In an assessment of a newborn, what findings are suggestive of hydrocephalus? 1.Bulging fontanelle, dilated scalp veins 2.Depressed fontanelle, decreased blood pressure 3.Constant low-pitched cry, restlessness 4.Closed fontanelle, high-pitched cry

Bulging fontanelle, dilated scalp veins

10. A 6-month-old patient is suspected of having cystic fibrosis. What diagnostic tests does the nurse expect to be ordered for this patient? (Select all that apply.) 1.Bronchoscopy, with pulmonary washings 2.Chest x-ray study 3.Upper GI series 4.Sweat test 5.Pulmonary function tests

Chest x-ray study, Sweat test, Pulmonary function tests

5. The LPN/LVN is assisting in preparing a care plan for a patient who has received a diagnosis of a seizure disorder. What is an important nursing intervention that should be included in caring for a child who is experiencing a seizure? 1.Describe and record the seizure activity observed. 2.Restrain the child when seizures occur to prevent bodily harm. 3.Place a tongue blade between the teeth if they become clenched. 4.Suction the child during a seizure to prevent aspiration.

Describe and record the seizure activity observed.

22. The parents of a 12-year-old patient are concerned about the child's recent diagnosis of school avoidance. Which response by the nurse would be the most appropriate? 1.Emphasize that the child is sick and needs to stay home from school. 2.Discuss the importance of the child's returning to school. 3.Ignore any somatic complaints the child may have. 4.Instruct them that this is a psychiatric disorder.

Discuss the importance of the child's returning to school.

7. A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The health care provider explained the plan of therapy and its expected good results; however, the mother refuses to see or hold her baby. What is the most therapeutic initial approach to the mother? 1.Restate what the health care provider has told her about plastic surgery. 2.Encourage her to express her feelings. 3.Emphasize the normal characteristics of her baby and the baby's need for mothering. 4.Keep the baby and mother apart until the lip has been repaired.

Encourage her to express her feelings.

25. A 3-year-old patient has received a diagnosis of a cognitive impairment. Which intervention is most important in dealing with the patient and her family? 1.Encourage the family to enroll the child in an early intervention program. 2.Discourage play with "normal" children to prevent feelings of inadequacy. 3.Instruct the family not to discuss their feelings in front of the child. 4.Educate the family that they should treat the child in a special manner because she is "slow."

Encourage the family to enroll the child in an early intervention program.

24. A 7-year-old patient has a diagnosis of recurrent abdominal pain (RAP). What nursing interventions would be most appropriate to include in the plan of care? (Select all that apply.) 1.Encourage the parents to maintain a normal schedule for their child with regard to school. 2.Support the parents in deemphasizing their child's complaints. 3.Educate the parents to contact the health care provider if symptoms worsen. 4.Help the parents choose appropriate exercise for the child. 5.Discourage the parent from allowing the child to play with other children until symptoms subside.

Encourage the parents to maintain a normal schedule for their child with regard to school. Support the parents in deemphasizing their child's complaints. Educate the parents to contact the health care provider if symptoms worsen. Help the parents choose appropriate exercise for the child.

23. A 14-year-old patient has a positive test result for human immunodeficiency virus (HIV) and expresses a desire to kill herself. What would be the most appropriate initial response of the nurse? 1.Tell her that they are very close to discovering a cure for HIV. 2.Encourage her to talk to her pastor. 3.Arrange a visit with another adolescent who is HIV positive. 4.Immediately report the threat to a mental health care provider.

Immediately report the threat to a mental health care provider.

15. The nurse is educating a new mother about infectious diseases. The mother demonstrates understanding of teaching by identifying which disorders as being contagious? (Select all that apply.) 1.Impetigo 2.S. aureus infection 3.Infantile eczema (atopic dermatitis) 4.Pediculosis 5.Cystic fibrosis

Impetigo, S. aureus infection, Pediculosis

3. The nurse is answering questions from a parent whose child has acute glomerulonephritis. Which explanation of the disease is most accurate? 1.It is a syndrome in which there is reabsorption of bicarbonate or in which excretion of hydrogen ions is impaired. 2.It occurs after an antecedent streptococcal infection. 3.It is a disorder manifested by gross bacteria. 4.It is a disorder associated with a defect in the ability to concentrate urine.

It occurs after an antecedent streptococcal infection.

19. The nurse is discussing possible causes of a 4-year-old child's cognitive impairment with his mother. Which causes would the nurse be correct in including in the discussion? 1.Metabolic disorders, perinatal anoxia, hyperthyroidism 2.Perinatal infection, metabolic disorders, and postmaturity 3.Lead poisoning, prematurity, perinatal anoxia 4.Iron supplementation, toxoplasmosis, maternal drug use

Lead poisoning, prematurity, perinatal anoxia

17. When caring for a 9-month-old patient who underwent surgery to repair a cleft palate, what is the priority intervention? 1.Referral to a parent support group. 2.Maintaining adequate nutrition. 3.Keeping an IV line open. 4.Keeping the patient sedated.

Maintaining adequate nutrition.

9. The nurse is caring for a 4-month-old patient with severe infantile diarrhea. What condition is this patient most likely to experience as a result? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic acidosis

14. When caring for a patient who is 2½ years old and has Wilms tumor, what assessment is most likely to reveal clinical manifestations of the disease? 1.Auscultation of lung sounds 2.Palpation of the abdomen 3.Assessment of skin turgor 4.Palpation of femoral and dorsalis pedis pulses

Palpation of the abdomen

13. When interviewing parents of an infant with hypertrophic pyloric stenosis, the nurse expects the parents to report which symptom? 1.Diarrhea 2.Projectile vomiting 3.Poor appetite 4.Constipation

Projectile vomiting

20. A 2-month-old infant receives a diagnosis of Down syndrome. Which clinical manifestation supports this diagnosis? 1.Pointed nose 2.Small, rounded skull with flat occiput; simian crease 3.Small tongue 4.Downward-slanting eyes

Small, rounded skull with flat occiput; simian crease

4. A pediatric patient has received a diagnosis of Wilms tumor. Which statement regarding Wilms tumor is true? 1.The tumor manifests as a firm, nontender, intra-abdominal mass. 2.The tumor is sometimes difficult to distinguish from the spleen. 3.The tumor usually crosses the midline. 4.If the surgeon successfully removes the tumor without a tear in its capsule, no chemotherapy is needed.

The tumor manifests as a firm, nontender, intra-abdominal mass.

12. The nurse is caring for a child with nephrotic syndrome. The nurse is correct in questioning the health care provider's order of which class of medications? (Select all that apply.) 1.Antibiotics 2.Diuretics 3.Vitamins 4.Corticosteroids 5.Antifungals

Vitamins, Antifungals

21. When a child is beginning antidepressant medications, it is important for parents to be alert for signs of _______________ _______________ for the first 2 weeks of treatment.

suicidal thoughts