Chapter 32: Care of the Child with a Physical and Mental or Cognitive Disorder

A child has developed a diaper rash, and the parents are using zinc oxide to treat it. What does the nurse suggest to aid in the removal of the zinc oxide? a. Mild soap and water b. A cotton ball c. Mineral oil d. Alcohol swabs

c. Mineral oil To completely remove ointment, especially zinc oxide, mineral oil should be used. p. 1043, Box 31-12

Which is a priority nursing intervention for the cognitively impaired child? a. The family will provide good nutrition. b. The family will provide loving interactions. c. Stimulation will improve. d. There will be contact with peers.

b. The family will provide loving interactions. Nursing interventions focus on promoting optimal development and loving interactions with family. p. 1056

What most influences the severity of respiratory distress syndrome (RDS)? a. Poor cough and gag reflex b. The gestational age at birth c. Administering high concentrations of oxygen d. The sex of the infant

b. The gestational age at birth RDS is caused by a deficiency of surfactant and it occurs almost exclusively in preterm, low-birth-weight infants. p. 994

What is the main characteristic of cystic fibrosis? a. Multiple upper respiratory infections b. An underproduction of exocrine glands c. Excessive, thick mucus d. An overproduction of thin mucus

c. Excessive, thick mucus The pathophysiology of cystic fibrosis includes excessive, thick mucus. p. 1002

What other congenital defects are common in children with Down syndrome? a. Hypospadias b. Pyloric stenosis c. Heart defects d. Hip dysplasia

c. Heart defects Many children with Down syndrome have congenital heart defects. p.s 1056-1057

An infant has been diagnosed with cradle cap. What is the correct intervention to treat the scalp? a. Alcohol b. Mineral oil c. Calamine d. A&D ointment

b. Mineral oil Crusty patches can be removed with the application of mineral oil. p. 1044

A teenage girl has been placed in a brace for the treatment of scoliosis, the most common skeletal deformity of adolescence. The family asks what they can do to be more supportive. What suggestion of the nurse is the most appropriate? a. Enrolling her in a health club b. Taking her to the mall in a wheelchair c. Purchasing clothes to disguise the cast d. Spending a majority of their time with her

c. Purchasing clothes to disguise the cast The adolescent is trying to fit in with peers and has concerns about body image. p. 1027

How should the nurse measure urinary output for an infant with dehydration? a. Attaching a urine collecting bag b. Wringing out the diaper c. Weighing the diaper d. Inserting a catheter

c. Weighing the diaper Wet diapers are weighed to assess the amount of output. p. 1008

When interacting with the parents of a SIDS infant, the nurse should attempt to assist the parents with: a. encouraging the parents to have another baby. b. encouraging the parents to remain stoic. c. allaying feelings of guilt and blame. d. learning how the event could have been prevented.

c. allaying feelings of guilt and blame. As parents try to cope, they have feelings of guilt and blame. p. 997

The parents of a child suffering from depression ask the nurse what causes depression in children. Which answer is an appropriate response by the nurse? a. The causes of major depression are unknown. b. Major affective disorders in parents increase depression in children. c. Boys are more likely than girls to be depressed. d. The prevalence rate is higher in prepubescent children.

a. The causes of major depression are unknown. The causes of depression have not been established. However, many studies have shown that children have a three times greater rate of suffering from depression if their parents have a major affective disorder. p. 1061

When the nurse performs the initial assessment of an adolescent with depression, what is the most important question to ask? a. "What is making you depressed?" b. "Have you ever thought about suicide?" c. "What could we do to make you happy?" d. "Would you like your friends to visit?"

b. "Have you ever thought about suicide?" Ask direct questions about suicidal thoughts. The discovery of whether the person has an actual plan is an indicator of the seriousness of the situation. p. 1063

Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse? a. "Are you sure your child has iron deficiency anemia?" b. "This happens when the maternal stores of iron are depleted at about 6 months." c. "This anemia is caused by blood loss." d. "The child may not have had it for a long time."

b. "This happens when the maternal stores of iron are depleted at about 6 months." Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant, when maternal stores of iron are depleted. p. 983

A new mother asks the clinic nurse if she must continue giving her baby nystatin for thrush since the white lesions on his tongue have disappeared. What response by the nurse is most appropriate? a. "No. When the lesions have gone you may stop the nystatin." b. "Yes. You should continue it for the full 7 days." c. "No. Thrush is a self-limiting disorder and nystatin is given for comfort only." d. "Yes. The medication should be refilled for a second week of therapy."

b. "Yes. You should continue it for the full 7 days." Nystatin should be given for the full 7 days even if the lesions are no longer present. p. 1048

The nurse is caring for a child who has been diagnosed as having an attention deficit hyperactivity disorder (ADHD). What is the most important intervention for the nurse? a. Have the child enrolled in a special education class. b. Allay any feelings of guilt the parents may have. c. Counsel the parents that the medications are lifelong. d. Teach the parents to set limits.

b. Allay any feelings of guilt the parents may have. It is most important to allay any feelings of guilt the parents may have. p. 1061

When speaking to young parents, the nurse states that lead poisoning is one of the most common preventable health problems affecting children. What condition occurs when the level of lead ingested exceeds the amount that can be absorbed by the bone? a. Malnutrition b. Anemia c. Bone pain d. Diarrhea

b. Anemia When the amount of lead ingested exceeds the amount that can be absorbed by the bone, it leads to anemia. p. 1040

How is the infant with gastroesophageal reflux (GER) typically treated? a. By making the infant NPO b. By thickening the formula or breast milk with cereal c. By placing the infant to sleep on the side d. By switching the infant to cow's milk

b. By thickening the formula or breast milk with cereal GER is treated with small feedings thickened with cereal. The infant should not be made NPO or switched to cow's milk. Infants should only be placed on the back to sleep due to the risk of SIDS. p. 1011

When caring for a 7-week-old infant with hypothyroidism, the nurse explains that the prevention of what complication is dependent on the administration of oral thyroid replacement therapy and is critical for the child? a. Excessive growth b. Cognitive impairment c. Damage to the nervous system d. Damage to the urinary system

b. Cognitive impairment The treatment of choice for congenital and acquired hypothyroidism is oral thyroid hormone replacement therapy. Prompt treatment is especially critical in the infant with congenital hypothyroidism to avoid permanent cognitive impairment. p. 1021

What are early signs of varicella disease? a. High fever over 101° F b. General malaise c. Increased appetite d. Crusty sores

b. General malaise Early signs of varicella will develop during the prodromal period and are mainly low-grade fever, malaise, and anorexia. Lesions do not appear until later. p. 1051, Table 31-7

What assessment findings should lead the nurse to suspect Down syndrome in a newborn? a. Hypertonia and dark skin b. Low-set ears and a simian crease c. Inner epicanthal folds and a high, domed forehead d. Long, thin fingers and excessive hair

b. Low-set ears and a simian crease Manifestations of the Down syndrome infant include low-set ears, simian crease, protruding tongue, and hypotonic extremities. p. 1056

What is the most common method of attempted suicide? a. Hanging b. Medication ingestion c. Gunshot d. Slashing the wrists

b. Medication ingestion Ingesting medication is the most common method of attempted suicide. p. 1062

The parents of a child recently diagnosed with sickle cell anemia ask what can be done to avoid a sickle cell crisis. What should be included in the medical management of sickle cell crisis? a. Information for the parents including home care b. Provisions for adequate hydration and pain management c. Pain management and administration of iron supplements d. Adequate oxygenation and factor VIII

b. Provisions for adequate hydration and pain management Medical management of sickle cell crisis includes palliative analgesics, hydration, and oxygen. p. 986

An adolescent female asks the nurse about taking retinoic acid (Accutane). What guidance should be provided by the nurse? a. The medication should be used only for 10 weeks b. The medication requires that sexually active females use contraception c. The medication lowers hemoglobin very quickly d. The medication has few side effects

b. The medication requires that sexually active females use contraception Accutane has many side effects and can produce birth defects. Effective contraception is necessary during treatment and for 1 month after the 20 weeks it is to be taken. p. 1046

What are the clinical manifestations of otitis media? a. Earache, wheezing, vomiting b. Coughing, rhinorrhea, headache c. Fever, irritability, pulling on ear d. Wheezing, cough, drainage in ear canal

c. Fever, irritability, pulling on ear Clinical manifestations of otitis media include fever, irritability, and pulling on the ear. p. 1053

What are priority nursing interventions designed to do for a 4-year-old child with cerebral palsy? a. Assist with referral to specialized education b. Support the child with independent toileting c. Assist the child to develop effective communication d. Encourage the child to ambulate independently

d. Encourage the child to ambulate independently A child with cerebral palsy is usually in need of support with communication, locomotion, and self-help. p. 1035

When conducting a class for parents about sudden infant death syndrome (SIDS), the nurse instructs the class that the infant should be placed in which position to sleep? a. Right side-lying b. Left side-lying c. Prone d. Supine

d. Supine The American Academy of Pediatrics recommends placing the infant on its back, or supine, to sleep. p. 997

The mother of a child who has been diagnosed with varicella asks the nurse when the child can return to school. When is the child no longer contagious? a. When the fever dissipates b. After the incubation period c. When the lesions have healed d. When the lesions are crusted over

d. When the lesions are crusted over Varicella is no longer contagious when the lesions are dry. p. 1051, Table 31-7