Articles Test 4

As opposed to type 1 diabetes, with type 2 diabetes: a. the beta cells in the pancreas are destroyed. b. the body is unable to use insulin. c. lifelong insulin replacement is necessary. d. the pancreas is unable to produce glucose.

b

Her mother should be taught that before Martha goes outside to play, her insulin should be adjusted to compensate for increased energy expenditure. a. True b. False

b

Hypoglycemia should be immediately treated with insulin, while hyperglycemia, with food. a. True b. False

b

If Martha's blood glucose level exceeds 180 mg/dL, once, diabetic ketoacidosis should immediately be suspected. a. True b. False

b

In children, femoral shaft fractures: a. typically occur after a fall from a bicycle. b. are one of the most common fractures. c. rarely produce complications. d. can result from minor twisting forces.

b

Lilly was a passenger in a motor vehicle accident and is diagnosed with a skull fracture. Which of the following types of fractures are nearly exclusively associated with child abuse? a. Compound b. Egg-shell c. Basilar d. Depressed

b

A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4

Lower extremity fractures do NOT include which of the following bones? a. Tibia b. Ulna c. Femur d. Fibula

b

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? 1. "I will encourage my child to perform prescribed exercises." 2. "I will have my child wear soft fabric clothing under the brace." 3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the use of powder because it will cake under the brace."

3

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities 2. Adduction of the arms at the shoulders 3. Rigid extension and pronation of the arms and legs 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? 1. An infectious disease of the central nervous system 2. An inflammation of the brain as a result of a viral illness 3. A chronic disability characterized by impaired muscle movement and posture 4. A congenital condition that results in moderate to severe intellectual disabilities

3

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? 1. Limited range of motion in the affected hip 2. An apparent lengthened femur on the affected side 3. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4. Symmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table

1

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1. Meningitis 2. Spinal cord injury 3. Intracranial bleeding 4. Decreased cerebral blood flow

1

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1. Time the seizure. 2. Restrain the child. 3. Stay with the child. 4. Place the child in a prone position. 5. Move furniture away from the child. 6. Insert a padded tongue blade in the child's mouth.

1, 3, 5

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? 1. "The cast may feel warm as the cast dries." 2. "I can use lotion or powder around the cast edges to relieve itching." 3. "A small amount of white shoe polish can touch up a soiled white cast." 4. "If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."

2

A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation? 1. It is positive. 2. It is negative. 3. It is inconclusive. 4. It requires rescreening at age 6 weeks.

2

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? 1. Test the urine for protein. 2. Reposition the infant frequently. 3. Provide a stimulating environment. 4. Assess blood pressure every 15 minutes

2

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? Select all that apply. 1. Use the fingertips to lift the cast while it is drying. 2. Keep small toys and sharp objects away from the cast. 3. Use a padded ruler or another padded object to scratch the skin under the cast if it itches. 4. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold. 5. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. 6. Contact the health care provider (HCP) if the child complains of numbness or tingling in the extremity.

2, 5, 6

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1. "Avoid all exercise during painful periods." 2. "Range-of-motion exercises must be performed every day." 3. "Have the child perform simple isometric exercises during this time." 4. "Administer additional pain medication before performing range-of-motion exercises."

3

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia

4

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears. 2. Urine specific gravity is 1.035. 3. Capillary refill is less than 2 seconds. 4. Urine output is less than 1 mL/kg/hour.

3

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level 2. Clear CSF, elevated protein, and decreased glucose levels 3. Cloudy CSF, elevated protein, and decreased glucose levels 4. Cloudy CSF, decreased protein, and decreased glucose levels

3

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1. "Treatment needs to be started as soon as possible." 2. "I realize my infant will require follow-up care until fully grown." 3. "I need to bring my infant back to the clinic in 1 month for a new cast." 4. "I need to come to the clinic every week with my infant for the casting."

3

The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquids. 4. Administer an additional dose of regular insulin.

3

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care provider's (HCP's) prescriptions and should contact the HCP to question which prescription? 1. Obtain daily weight. 2. Provide clear liquid intake. 3. Nasotracheal suction as needed. 4. Maintain a patent intravenous line.

3

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? 1. Administer an antiemetic. 2. Increase the intravenous fluids. 3. Place the child in a Sims' position. 4. Notify the health care provider (HCP).

4

The nurse is assisting a health care provider (HCP) examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? 1. Babinski's sign 2. The Moro reflex 3. Ortolani's maneuver 4. The palmar-plantar grasp

3 Rationale: In developmental dysplasia of the hip, the head of the femur is seated improperly in the acetabulum or hip socket of the pelvis. Ortolani's maneuver is a test to assess for hip instability and can be done only before 4 weeks of age. The examiner abducts the thigh and applies gentle pressure forward over the greater trochanter. A "clicking" sensation indicates a dislocated femoral head moving into the acetabulum. Babinski's sign is abnormal in anyone older than 2 years of age and indicates central nervous system abnormality. The Moro reflex is normally present at birth but is absent by 6 months; if still present at 6 months, there is an indication of neurological abnormality. The palmar-plantar grasp is present at birth and lessens within 8 months.

The nurse should implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply. 1. Administer regular insulin. 2. Encourage the child to ambulate. 3. Give the child a teaspoon of honey. 4. Provide electrolyte replacement therapy intravenously. 5. Wait 30 minutes and confirm the blood glucose reading. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

3, 6

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic. 2. Release the skin traction. 3. Apply ice to the extremity. 4. Notify the health care provider (HCP)

4

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? 1. Assessing hearing loss 2. Monitoring urine output 3. Changing body position every 2 hours 4. Providing a quiet atmosphere with dimmed lighting

4

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1. Ensure that all ropes are outside the pulleys. 2. Ensure that the weights are resting lightly on the floor. 3. Restrict diversional and play activities until the child is out of traction. 4. Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied

4

A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunchtime. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.

4

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen

4

The nurse has just administered ibuprofen to a child with a temperature of 102 °F (38.8 °C). The nurse should also take which action? 1. Withhold oral fluids for 8 hours. 2. Sponge the child with cold water. 3. Plan to administer salicylate in 4 hours. 4. Remove excess clothing and blankets from the child.

4

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric precautions. 2. Maintain neutropenic precautions. 3. No precautions are required as long as antibiotics have been started. 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

4

An 8 year old boy was hit with a baseball on the outside of his calf on his lower right leg. While sliding into home base his right leg bent under him significantly at the ankle. There is a high risk that he fractured his: a. tibia. b. fibula. c. radius. d. femur.

b

Child abuse is a primary cause of lower extremity fractures in newborns and infants. a. True b. False

a

Fat cells interfere with the body's ability to use insulin. a. True b. False

a

Hyperglycemia is often the presenting sign of type 1 diabetes in children. a. True b. False

a

Hyperglycemia results when there is insufficient: a. insulin. b. food intake. c. carbohydrates. d. growth.

a

If a child has an episode of severe hypoglycemia, nothing by mouth should be given. a. True b. False

a

In motor vehicle accidents, children less than 2 years old most commonly suffer TBI from being an unrestrained or improperly restrained passenger in a car. a. True b. False

a

Lilly has a depressed skull fracture, which means: a. one or more bone fragments have indented into the brain tissue. b. there is a simple or linear fracture of the skull. c. a laceration and contusion of the brain tissue has occurred. d. a break in the posterior-inferior portion of the skull.

a

SMA is characterized by all of the following EXCEPT: a. mental retardation. b. muscle weakness. c. atrophy of the arms, legs, neck, and chest muscles d. hypotonia.

a

Samantha's mother asks, "Does that mean we shouldn't have more children?" The correct response is to say: a. "A genetic counselor can best help you with the risks and options. I'll see about getting a referral if that's something you'd like to do." b. "Your next child, if they have SMA, may have Type ll or Type lll, and they're not as severe as the type Samantha has." c. "Since you are both carriers for SMA, I certainly wouldn't take my chances, but that's certainly up to you both." d. "I think you should consider adopting right away, so Matt will have a brother or sister."

a

The SMA type is determined by the severity of clinical manifestations, as well as the age of onset. a. True b. False

a

What places Lilly at high risk for a serious head injury related to falls? a. Her head is anatomically larger than the rest of her body. b. Being the youngest child, she is likely to be left unattended. c. She is mastering walking, so in the process she will fall occasionally. d. Her skull is pliable and not totally a closed system.

a

When a tibia fracture occurs due to a direct impact, it is one of the body's long bones most likely to break through the skin. a. True b. False

a

Which of the following does NOT contribute to type 2 diabetes in children? A/an: a. immune attack destroying all pancreatic beta cells. b. obesity. c. increase in insulin resistance. d. reduced physical activity.

a

Which of the following is the most frequent TBI, but the least serious? a. Concussion b. Simple fracture c. Contusion and laceration d. Subarachnoid hemorrhage

a

With type 2 diabetes and insulin resistance, hyperinsulemia may be present. a. True b. False

a

Young children are at risk for serious head injuries, related to being struck by a car, because the direct impact with the car bumper is most commonly the head. a. True b. False

a

Martha's mother wants to know what to do if Martha has a mild hypoglycemic reaction when she gets her home. The healthcare provider suggests: a. give her a bag of hard candy and let her eat it until her blood glucose is at least 200 mg/dL. b. give her a small glass of milk and repeat that in 10-15 minutes if she still has symptoms. c. check her glucose level then take her in immediately for emergency treatment. d. give her some nuts and cheese.

b

Samantha's mother asks, "How could this have happened? We have no history of SMA in our families. We have another child, Matt. He's 4 years old and healthy and so are we." The healthcare provider appropriately responds: a. "SMA tends to only affect females, so that's why your son doesn't have it." b. "With SMA both parents are carriers for it. I'll be glad to go over that with you." c. "DNA testing will probably be done to insure your husband is Samantha's father." d. "Since there's no family history, I'll have to check with Samantha's doctor."

b

Samantha, 2 months old, has Type 1 SMA. When assessing Samantha, which of the following findings is not commonly associated with Type 1 SMA? a. A frog-legged position b. Scoliosis c. A bell-shaped body d. Diaphragmatic breathing

b

Shaken baby syndrome is most commonly associated with which primary head injury? a. Concussion b. Diffuse axonal injury c. Subdural hematoma d. Cerebral contusion

b

Today, type 1 diabetes is more common in children than type 2 diabetes. a. True b. False

b

Which of the following laboratory findings is NOT consistent with a child suspected of having type 2 diabetes in children? a. Glucose in the urine b. A1C of 4% c. FBS >126 mg/dL d. Increased insulin levels

b

Which of the following statements made by Samantha's mother's pregnancy is often associated with Type 1 SMA? a. "I had nausea for most of my pregnancy. A couple of times I needed IV fluids." b. "I didn't feel her move very often during the last couple of months of my pregnancy." c. "I had gestational diabetes. She was a big baby and I had to have a c-section." d. "They couldn't tell her sex on the ultrasound I had."

b

Which of the following will most likely result in a "toddler fracture"? When the child: a. suffers abuse. b. trips over a toy. c. runs. d. falls down a flight of stairs

b

"Toddler's fracture" involves the: a. fibula. b. femur. c. tibia. d. tibia and femur.

c

A fasting glucose greater than which of the following values would suggest insulin resistance in a child? a. 60 mg/dL b. 86 mg/dL c. 100 mg/dL d. 156 mg/dL

c

All of the following may trigger a hyperglycemic reaction EXCEPT: a. illness. b. growth. c. incompletely consumed meals. d. emotional or physical stress.

c

Between the ages of 4 and 7 years, a common cause of femoral shaft fracture is: a. tripping. b. child abuse. c. motor vehicle-pedestrian accidents. d. skiing.

c

SMA is what kind of genetic trait? a. Chromosomal b. Autosomal dominant c. Autosomal recessive d. Y-linked

c

The healthcare professional knows Lilly, 11 months old, should be riding in a car safety seat placed: a. forward-facing in the front seat. b. rear-facing in the front seat. c. rear-facing in the back seat. d. forward-facing in the center of the back seat.

c

The next day, Martha is weepy and says, "I feel shaky and weak all over." Her mother has stepped outside to use her cell phone. Before any further assessment, the healthcare provider first suspects Martha is: a. having trouble dealing with her new diagnosis. b. trying to get some attention since her mother is not with her. c. having a hypoglycemic reaction. d. experiencing hyperglycemia.

c

What is the difference between an epidural and subdural hematoma? With an epidural hematoma: a. there is usually an underlying brain bruise, not found in subdural hematomas. b. loss of consciousness occurs in the majority of children. However, in subdural hematomas there may or may not be loss of consciousness. c. blood collects between the dural surface of the brain and the skull, as compared with a subdural hematoma in which the blood collects below the dural surface. d. confirmed fractures of the basal and temporal skull should alert the healthcare professional to a subdural hematoma.

c

With a "toddler fracture", the young child most often presents with: a. extensive swelling. b. severe bruising. c. noticeable limping. d. considerable deformity.

c

A difference between type 1 and type 2 diabetes is that: a. only type 1 involves the pancreas. b. with type 2, symptoms occur abruptly. c. too many beta cells are produced with type 1. d. insulin resistance occurs in type 2.

d

Assessment findings for a fractured femur include all of the following EXCEPT: a. an inability to walk. b. severe pain. c. noticeably deformed affected thigh. d. full range of motion of both extremities

d

Her older brother, Sam, 8 years old, is at highest risk for head injury from: a. child abuse. b. falling from an open window that doesn't have a secure screen. c. riding as a passenger in the back seat with his seat belt on. d. riding a bicycle without a helmet.

d

In SMA, the basic defect is mutated or absent: a. SMN2. b. exon 7. c. link on Chromosome 5. d. Survival Motor Neuron, SMA1 gene.

d

Samantha's father says, "We were planning on having four children. Since Samantha has SMA, and Matt doesn't, that means our others will only be carriers, right?" The healthcare provider responds: a. "That's exactly right. If you have 4 children, 1, or 25%, will have SMA." b. "Yes, they won't have SMA, but there's a 50% chance they'll be carriers." c. "Your chances are about the same as for anybody else." d. "Your risk for having a child with SMA is 25% for each pregnancy."

d

The healthcare provider looks for a history of what early cardinal signs and symptoms of hyperglycemia in Martha? a. blurred vision and sweating. b. shaky feelings, irritability and dizziness. c. dehydration and shallow respirations. d. increased thirst, hunger and voiding.

d

Which of the following is least likely to be evident in a newly diagnosed 11 year old with type 2 diabetes? a. Excessive thirst b. Night time bed-wetting c. Fatigue d. Significant weight loss

d

Which of the following maternal factors does NOT predispose a child to type 2 diabetes? His or her mother: a. had gestational diabetes while pregnant with the child. b. was obese when pregnant with the child. c. has type 2 diabetes. d. is Caucasian.

d

With Type ll SMA, the child, with or without bracing, is usually unable to: a. hold head up. b. sit up without support. c. crawl. d. walk.

d