Saving Grace

A parent of a school-aged child who was GH deficiency asks the nurse how long the child will need to take injections for growth delay. Which of the following responses should the nurse make?

"Injections should be continued until there is evidence of epiphyseal closure."

The parent of a pediatric patient diagnosed with type 2 diabetes mellitus asks how the child "caught" the disease. Which response by the nurse would be appropriate?

"It develops because of insulin resistance."

A newborn with developmental dysplasia/dislocation of the hip is going home with a Pavlik harness. Which parent statement would indicate to the nurse that teaching about the device has been effective?

"The harness must be kept in place 24 hours per day."

The parents of a child with a new diagnosis of JIA asks why the child has so much pain. What would a correct response from the nurse be?

"This disease destroys the joint tissues that normally lubricate the joint and make motion smooth and pain-free."

The parents ask the nurse why their child is in skeletal traction. The nurse knows that the parents understand the primary reason for skeletal traction when they give which response?

"To align the ends of the fractured bone."

The nurse is providing care to an infant diagnosed with congenital clubfoot. Which parental statement regarding the child's care indicates correct understanding of the information provided?

"We will need to undergo a series of casting procedures to stretch and move the deformity into alignment."

A 15 year old male asks the nurse why he has to learn how to inject insulin rather than take pills like his grandmother does for her diabetes. What is the best response by the nurse?

"You have a different type of diabetes that needs to be controlled with insulin injections."

A preadolescent patient who has been prescribed corticosteroids for years as part of asthma treatment wishes to discontinue the medication. Which response by the nurse would be appropriate?

"Your health care provider will need to prescribe tapering doses."

The nurse is reinforcing teaching provided by the RN to a parent of a child in a hip spica cast. Which statements would indicate that teaching has been effective? (Select all that apply.)

-"A disposable diaper is placed under the edges of the cast." -"We will wrap the cast with plastic and tape before bathing." -"We bought a special car seat for our child." -"The edges of the cast are petaled to prevent the skin from being scratched or breaking down."

The parent of an adolescent patient is concerned because the patient's hands and feet are growing unusually large. Which additional findings would lead the nurse to suspect a diagnosis of gigantism? (Select all that apply.)

-Acne -Obesity -Sweating -Headaches

A school-aged child sustained a soft tissue injury while playing soccer. What does the nurse suggest the parents do immediately? (Select all that apply.)

-Apply ice to the site of the injury. -Have the child lie down or sit down and rest the injured extremity. -Elevate the extremity. -Apply compression to the site to reduce the chance of swelling.

Which of the following are initial symptoms of a new diagnosis of type I diabetes? (Select all that apply.)

-Fruity, sweet odor on breath -Extreme thirst -Frequent urination -Increased appetite

Which clinical data noted by the nurse during the shift assessment indicate that the pediatric client may be experiencing compartment syndrome? (Select all that apply.)

-Prolonged capillary refill time -Paresthesia of the leg -Pain not relieved by pain medication

The nurse performs a neuromuscular assessment of a child who is in Russel's traction. Which assessment findings indicate the need for further intervention? (Select all that apply.)

-The child has a cap refill time of more than 3 seconds. -The child experiences a pain rating of 6 on an age appropriate numeric pain rating scale -The child's toes are cold and appear dusky.

For which patient would the nurse consider the diagnosis of juvenile idiopathic arthritis (JIA)?

6 year old with inflammation in more than one joint that lasts for at least 6 weeks

The nurse is providing care to a child with a fractured femur who has been in skeletal traction for 2 days. Which assessment finding indicates to the nurse that the patient has peripheral neurovascular impairment?

Absent pulses

The nurse is caring for a newborn patient. At which time would the test for phenylketonuria (PKU) be completed?

After the baby is 24 hours old and breastfeeds or formula fed

The nurse is caring for a school-age patient with osteomyelitis. Which treatment would the nurse anticipate being prescribed immediately for this patient?

Antibiotics

The nurse is performing an assessment of a newborn diagnosed with developmental dysplasia/dislocation of the hip (DDH). Which assessment finding supports this diagnosis?

Asymmetrical skinfolds in the gluteus

The nurse is caring for an adolescent patient recovering from surgery to correct scoliosis. Which action would the nurse take when turning this patient?

Carefully logroll the patient.

Which type of childhood injury is best described as an impact injury that causes hemorrhaging in the soft tissue?

Contusion

A child presents with a rounded face, muscle weakness, and poor wound healing. The nurse knows that these symptoms are consistent with what disorder?

Cushing's Syndrome

A nurse is collecting data from a child who has short stature. Which of the following findings would indicate a growth hormone deficiency?

Decreased height that is proportionally equal to weight

The overproduction and excretion of antidiuretic hormone (ADH) from the posterior pituitary results in which symptoms?

Decreased urine output

Which of the following is the correct method for mixing insulin?

Draw up clear insulin into a syringe, then draw up cloudy insulin.

Jacob, age 17, was diagnosed with type 2 diabetes 4 months ago and was instructed by the LPN to eat fewer carbs, lose weight and exercise more. Today is in for his follow-up appointment. What is the most accurate way to assess Jacob's compliance with his diet and exercise regimen?

Drawing blood for a HbA1c.

The nurse observes a preschool-age child having difficulty standing after sitting on the floor. For which health problem would the nurse anticipate collecting data from this patient?

Duchenne's muscular dystrophy

A nurse is discussing the best way to continue playing on the football team with a 16-year-old high school junior with type I diabetes. What should the nurse instruct the teen to do before exercising?

Eat a high protein snack of cheese, crackers and turkey slices.

The nurse notes that a female adolescent patient is lacking expected physical signs of sexual maturity for her age. Which hormone would the nurse anticipate being measured in this patient?

Estrogen

The parent of a 12-month-old pediatric patient reports that the child cries, vomits, and has diarrhea when given apple and orange juice. Which inborn error of metabolism would the nurse suspect the patient is experiencing?

Hereditary fructose intolerance

The nurse is collecting data on a pediatric patient with diabetes insipidus (DI). Which finding would the nurse anticipate in this patient?

Large urine output

While collecting data, the nurse suspects that a school-age patient has Legg-Calve-Perthes disease. Which finding would cause the nurse to make this clinical determination?

Limp hip joint that causes pain

A patient is diagnosed with hyperthyroidism. What medication does the nurse anticipate administering to this patient?

Methimazole

The nurse is providing education to a school-aged child recently diagnosed with type 1 diabetes mellitus (DM). Which item will the nurse include in the teaching plan regarding sick day management?

Monitoring for ketones after each void.

Which insulin type is intermediate acting and cloudy with an onset of 1-2 hours, a peak of 6-12 hours, and a duration of 18-26 hours?

NPH

A pediatric patient with a cast on the right lower extremity reports an increase in pain and pressure. Which action by the nurse would be appropriate?

Notify the health care provider.

The nurse is assisting in the care of a newborn who sustained several fractures during birth. For which health problem would the nurse anticipate care being planned for this patient?

Osteogenesis imperfecta

Which nursing action is appropriate when providing care to a 7-year-old child with a right femur fracture who is placed in Bryant traction while recovering?

Perform frequent positioning

The nurse is caring for a preadolescent patient recovering from surgery to correct scoliosis. Which goal of care would the nurse identify as a priority for this patient?

Prevent postoperative spinal injury

What is the priority in caring for a child with a newly placed hip spica cast?

Report any changes in circulation, sensation, and movement.

A pediatric patient with type 1 diabetes mellitus has a morning blood glucose level of 55 mg/dL. Which action would the LPN/LVN take after providing the child with 15 g of juice?

Retest the blood glucose level in 15 minutes.

Which finding does the LPN report to the charge nurse for an infant suspected of having unilateral developmental dysplasia/dislocation of the hip (DDH)?

Shortened leg on the affected side

The nurse is asked for suggestions for the care plan of a pediatric patient who will be in long-term traction. Which concern would the nurse identify as being the greatest for this patient?

Skin integrity

The nurse is assisting in the assessment of a school-aged patient who reports hip pain all week. When assessing the right hip, the nurse finds that the hip does not fully rotate internally, abduction is limited and the child is limping while ambulating. Based on these data findings, which condition might the nurse suspect?

Slipped capital femoral epiphysis

An infant is diagnosed with galactosemia. What formula should the parents be instructed to use when feeding this infant?

Soy milk

The nurse is caring for a pediatric patient with a fractured humerus. Which type of fracture would raise the greatest suspicion of child abuse?

Spiral

Which of the following endocrine glands is correctly paired with its location?

Thyroid - in the neck

Which topic is the priority for the nurse who is teaching family of an infant diagnosed with osteogenesis imperfecta?

Trunk and extremity support during everyday care

Alivia is a 3 month old and has phenylkeonuria (PKU). If this inherited error of metabolism is untreated she will develop:

mental retardation

A nurse is caring for a child newly diagnosed with type I diabetes. The nurse plans her care based on the understanding:

there is an absolute deficiency of insulin