m&p chapter 40 & 41

In discussing the treatment for children with scoliosis, a group of pediatric nurses makes the following statements. Which statement is most accurate related to the treatment of scoliosis?

"Children treated for scoliosis by using braces have to wear the brace almost all the time."

The nurse admits a 10-year-old who has just eaten lobster and has hives over much of her body. In collecting data regarding this child, which of the following would be the most important question to initially ask the child's caregiver?

"Has the child ever eaten shellfish before now?"

The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child's mouth and notes a white coating that looks like milk curds. Which of the following questions would be most important for the nurse to ask the caregiver?

"Has your child been treated for any type of infection recently?"

The nurse is reinforcing teaching with the caregivers of a child who has had a cast on the arm removed after the cast has been in place for six weeks. The caregiver makes the following statements. Which statement indicates an understanding of the teaching?

"He loves to play outside now that the weather is nice; I will have to remind him to use sunscreen."

The nurse is discussing skin disorders with a group of caregivers. The caregivers make the following statements. Which statement indicates an understanding of tinea capitis?

"I always tell my daughter to use her own hairbrush."

The nurse is discussing allergies with a group of caregivers of children who have food allergies. Which of the following statements made by the caregivers indicates the most concerning issue faced by the caregivers of children with food allergies?

"I read all the labels, but sometimes it is not easy to understand the ingredients."

The nurse is talking with the caregiver of a 13-year-old diagnosed with scoliosis. The child has come to the clinic to be fitted with a brace to begin her treatment. The child appears upset and angry and states, "I hate this brace; I hate it already." In an effort to support this child, which of the following statements would be the most appropriate for the nurse to make to this child's caregiver?

"If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."

The nurse is reinforcing teaching with the caregivers of a child who has been placed in an external fixation device for the treatment of an orthopedic condition. Which of the following statements made by the caregivers indicate an understanding of the external fixation device?

"It will be hard, but we know our child will be in this device for a long time."

The nurse is caring for a child diagnosed three months ago with juvenile rheumatoid arthritis (JRA). The caregiver reports that the child has recently complained of little pain and is not currently taking aspirin or NSAIDs. The caregiver also tells the nurse that just to be on the safe side, she is continuing to keep the child from doing physical exercise. The mother states, "I think we have beaten this disease." In working with this child and the caregiver, which of the following statements would be best for the nurse to say?

"Let's review some of the instructions. She does need to take an anti-inflammatory every day."

When doing teaching with a group of caregivers of infants the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash.

"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."

The nurse is presenting an in-service to a group of nursing students discussing atopic dermatitis. The following statements were made by the students. Which statement is most accurate related to atopic dermatitis?

"My sister never gives her 6-month-old eggs because her other kids have all had this disorder."

The caregiver of a 2-year-old who has a polyurethane resin cast on her arm calls the clinic to report that her child is crying and says that the cast has sand in it. The caregiver states that she has had casts of her own and knows how badly they can itch. She says she always used a hanger to scratch but is worried that it will be too sharp for the child. Which of the following statements would be appropriate for the nurse to make to this caregiver?

"Nothing should be put into the cast. You can blow cool air into it with a hair dryer."

The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris?

"Sometimes I get acne when I use my sister's makeup."

An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. Which of the following responses would be appropriate for the nurse to say to this caregiver?

"That's not an uncommon reaction, although it's hard on you and on your child."

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which of the following statements would be the most appropriate statement for the nurse to make to this mother?

"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life."

The nurse is reviewing the integumentary system during a presentation to a group of nurses. Which of the following statements made by the nurses is the most accurate regarding the integumentary system?

"The largest organ of the integumentary system helps regulate body temperature."

At an obstetric visit 28 weeks into her pregnancy, an expectant mother tells the nurse that her friend's newborn has a soft spot on his head. She is concerned that something is wrong with this baby and is worried the same thing could happen to her child. The best explanation the nurse could offer this expectant mother regarding the bones in the skull would be which of the following?

"The soft spot and unclosed sutures in the skull allow the bones to move as they need to so that the baby's head can move through the narrow birth canal."

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be which of the following?

"These make a smooth edge on the cast so the skin is better protected."

The nurse is working with the caregiver of a newborn. The caregiver states, "My first baby had a disorder they called seborrehic dermatitis; what can I do to prevent this baby from having that?" The most appropriate response by the nurse would be which of the following statements?

"You should wash your infant's hair every day to prevent this disorder."

Most children who are diagnosed with acquired immunodeficiency syndrome (AIDS) are within which of the follow age ranges?

1 to 4 years of age

The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which of the following should be reported if they occur or are seen related to this child? (Select all that apply)

1) Any area on the cast that is warm to the touch 2) A foul odor under the cast 3) Drainage from under the cast 4) Looseness of the cast on the extremity

A pediatric patient who has been seriously burned is being given IV fluid replacements. It has been determined that the patient will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received

12 ounces of IV fluid replacement by 6:00 PM

The musculoskeletal system is made up of various types of bones. Most bone growth is completed by which of the following ages?

20 years of age

The nurse is administering aspirin to an 8-year-old child with severe juvenile rheumatoid arthritis. The child weighs 35 pounds. The dosage is 120 mg/kg/day in two divided doses. The medication comes in chewable tablets 80mg/tab. How many tabs per day will this child receive? (round to the nearest whole number)

24 tabs

The nurse is monitoring the urinary output of 3-year-old child admitted with a severe burn. The child weighs 44 pounds. Which of the following would be a desirable and adequate urinary output for this child?

30 to 50 mL/hr

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations?

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

The nurse is caring for a child with a possible diagnosis of muscular dystrophy. The nurse explains to the parents that which of the following will likely be used to confirm this child's diagnosis?

A muscle biopsy

The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. Which of the following would be the best action for the nurse to take? The nurse should

Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is which of the following?

Acyclovir

The caregivers of a child with juvenile rheumatoid arthritis are asking the nurse about exercise for their child. The nurse explains to the caregivers that gentle daily exercise is needed to prevent which of the following from occurring?

Ankylosis

A school-age child is brought to the office of the camp nurse with a small, superficial burn. Which of the following actions by the nurse would be the most appropriate action for the nurse to do first?

Apply cold compresses to the area

The nurse is caring for a child with juvenile rheumatoid arthritis. Which of the following medications would the nurse most likely be administering to this child to manage the symptoms of this disorder?

Aspirin

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which of the following disorders?

Asthma

The nurse is presenting an in-service to a group of peers on the topic of traction. The nurse asks the group to give examples of types of skin traction. The following types were named by the nurses. Which of the following is an example of a type of skeletal traction?

Balanced suspension traction

The caregiver of a child with a recent puncture wound on the arm calls the pediatrician's office reporting that after seeming well at bedtime last night, the child now has a temperature of 101 degrees Fahrenheit, pain at the site of the injury, and is unable to fully bend the elbow of the arm which had been injured. The nurse recommends the child be brought in to see the care provider. Which of the following would likely be ordered for this child?

Blood work

In understanding the development of the musculoskeletal system, the nurse recognizes that which of the following is implanted in a gel-like substance during fetal life?

Cartilage

The nurse is working with a group of caregivers of school-age children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be which of the following?

Complete

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes a macule?

Discolored skin spot not elevated at the surface

The process of removing necrotic tissue in the treatment of burns is known as which of the following?

Débridement

The nurse is discussing fractures seen in children with a group of caregivers. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in which of the following?

Epiphyseal plate

Infectious mononucleosis ("mono") is caused which of the following?

Epstein-Barr virus

The nurse admits an 11-year-old boy who is complaining of lower leg pain after he was hit with a lacrosse stick during a game. The level of pain is not consistent with the description of the incident. With further questioning the nurse discovers the child has had pain in that spot off and on for several months. The child has a biopsy, a bone scan and a bone marrow aspiration ordered by the care provider. Which of the following is the most likely condition the care provider is looking for?

Ewing's sarcoma

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which of the following symptoms might be an early warning signal that the child has developed compartment syndrome? The child

Feels increasing severe pain

The caregivers of an 8-year-old child diagnosed with muscular dystrophy are discussing appropriate activities for their child. The nurse might suggest to these caregivers that they do which of the following in regard to their child's activities?

Find a Little League team that encourages participation of kids at all disability levels.

The term tinea is also called ringworm and it is applied to which of the following?

Fungal infections

The nurse is caring for a child diagnosed with Hepatitis B. Which of the following systems are most likely to have complications from this diagnosis?

Gastrointestinal

The child diagnosed with muscular dystrophy uses a method of rising from the floor which is referred to as which of the following?

Gowers sign

The nurse caring for children with fungal infections most often administers which of the following medications?

Griseofulvin

A type of traction sometimes used in the treatment of the child with scoliosis is called which of the following?

Halo traction

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in doing which of the following with this child?

Handling the cast with open palms when moving the arm.

Which of the following treatments will most likely be the best long-term benefit for the child with an allergic condition in which it is difficult to remove or avoid the allergen?

Hyposensitization

In understanding the body and its functions, the nurse recognizes that protecting the body from attacks by microorganisms and helping the body get rid of or resist invasion by foreign materials is a major role of which of the following body systems?

Immune System

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children. Which of the following disorders is the nurse most likely referring to?

Impetigo

The caregiver of a 17-year-old boy reports that her normally active son has a temperature of 101 degrees Fahrenheit, a sore throat, a headache, and seems completely exhausted. He has just had a nosebleed. The care provider sees the child and makes a diagnosis of infectious mononucleosis. The treatment most likely to be recommended for this child would include

Increased fluids, bed rest, analgesics

The nurse is caring for a child admitted with juvenile rheumatoid arthritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Inflammation of the joints

The school nurse is teaching a group of teachers about various skin disorders seen in children. One of the teachers asks what to look for if they think a child in their class has head lice. Which of the following signs is the most obvious symptom of head lice?

Itching of the scalp

In understanding the function of the musculoskeletal system, the nurse recognizes that which of the following allows for movement of the body parts?

Joints

The child diagnosed with muscular dystrophy often exhibits a forward curvature of the lumbar spine. This description is accurate regarding which of the following?

Lordosis

A group of camp nurses is discussing various types of tick bites. One of the nurses states that deer ticks are carried by white-footed mice and white-tailed deer, and can carry the organism that causes which of the following diseases?

Lyme disease

The immune system works to destroy pathogens by helping the body get rid of or resist the invasion of foreign materials The blood cells that surround, ingest and neutralize the pathogens are which of the following?

Macrophages

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. They are discussing various disorders related to the integumentary system. One of the nurses describes a disorder by telling the group that it is common in children during the summer when it is hot or when the child is overdressed. Which of the following disorders is the nurse most likely referring to?

Miliaria rubra

In understanding the physiology of the musculoskeletal system, the nurse recognizes that which of the following are stored in the bones?

Minerals

The nurse is caring for a child admitted with a severe burn. Which of the following nursing interventions will the nurse most likely perform in the first one to two days following the child's injury?

Monitor nasogastric suctioning

The nurse is discussing medications to be given to a child who has been diagnosed with Candidiasis. Which of the following medications would most likely be prescribed for the child?

Nystatin

The nurse working in a school-based clinic is gathering data on a 17-year-old girl who has come to the clinic. She is complaining of nausea and has not had a period in six weeks. She is found to be pregnant and to have gonorrhea as well. The girl is undecided as to whether she wishes to abort the pregnancy or have the baby. Which of the following medications will most likely be ordered for this adolescent? An injection of ceftriaxone followed by a

One-week course of oral erythromycin

A nursing student tells the staff nurse on the pediatric orthopedic unit that she has heard of a musculoskeletal disorder in which there is an infection of the bone. Which of the following disorders does this statement describe?

Osteomyelitis

The nurse is caring for a child admitted with Legg-Calvé-Perthes disease. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Pain in the groin and a limp

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which of the following symptoms?

Paresthesia

The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is which of the following?

Penicillin

A child diagnosed with AIDS comes to the clinic for routine immunizations. In giving immunizations to the child who has AIDS, the nurse can safely administer the injectable vaccine given for which of the following?

Poliomyelitis

The home health nurse is caring for a child with muscular dystrophy and is reinforcing teaching with the child's caregivers. The child now has developed kyphosis. Because of the development of kyphosis the nurse stresses with the caregivers that the child should be watched most closely for which of the following?

Possibility of respiratory infection

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). Which of the following goal has the highest priority for this child?

Preventing spread of infection

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes erythema?

Redness of the skin produced by congestion of the capillaries

The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at doing which of the following?

Reducing swelling and relieving itching

The nurse is caring for a 1-year-old hospitalized child who is in Bryant's traction. Which of the following nursing interventions would be the highest priority for this child?

Report continuous loud crying or irritability

The nurse is caring for an adolescent diagnosed with gonorrhea. The drug of choice for treating gonorrhea is which of the following?

Rocephin

The school nurse is doing a presentation to a group of caregivers of children diagnosed with scoliosis. One of the caregivers asks the nurse about structural scoliosis. The nurse explains that which of the following is involved with the diagnosis of structural scoliosis?

Rotated and malformed vertebrae

The caregiver of a fifth-grade boy calls the pediatrician's office and reports that her son has been scratching at his groin for a week or so. Despite his need for privacy, he's finally allowed the caregiver to look at the groin area. The caregiver describes the area to the nurse saying, "It looks like black pin dots that seem to have dark tails." The nurse suspects that the child may have which of the following?

Scabies

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is which of the following?

Skeletal traction

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes pustule?

Small elevation of epidermis filled with a viscous fluid

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes a papule?

Small, circumscribed, solid elevation of the skin

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which of the following forms of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

Spica cast

The nurse is collecting data on an adolescent admitted with a diagnosis of a sexually transmitted infection. The child has a hard, red, painless lesion on his penis. The nurse recognizes the lesion as a chancre which is a sign of which of the following infections?

Syphilis

An adolescent girl and her caregiver present at the pediatricians office. The adolescent complains of severe abdominal pain. A diagnosis of pelvic inflammatory disease is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which of the following actions by the nurse would be most appropriate?

Take the child to a private room and interview her regarding her sexual history and partners.

The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which of the following immunizations would the child most likely be given at this time?

Tetanus toxoid vaccine

The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. Which of the following would be the best action for the caregiver to follow in removing the tick?

The caregiver should apply isopropyl alcohol to the tick and the child's arm, then use sterilized tweezers to carefully remove the tick without crushing it.

One method of preventing communicable diseases in children is to administer vaccines to stimulate the development of antibodies. Which of the following best describes what occurs in the child when vaccines are given?

The child develops an active immunity.

The nurse is collecting data on a child admitted to the burn unit with a partial-thickness burn. Which of the following is most accurate regarding this type of burn?

The child will likely have blisters.

The nurse is collecting data on a 4-year-old child admitted to the burn unit. The nurse is concerned about the possibility of the child going into hypovolemic shock. Which of the following data would the nurse recognize as an indication that this may be occurring?

The child's apical pulse is 140 bpm

In caring for a child being treated for scoliosis, the highest priority goal is which of the following?

The child's will remain free of injury.

The nurse is collecting data on an adolescent admitted with diagnosis of a chlamydial infection. Which of the following is most accurate regarding chlamydial infections?

The male with the diagnosis may be sterile and unable to father a child

. The nurse is caring for an infant who has impetigo and is hospitalized. Which of the following nursing interventions is the highest priority for this child?

The nurse follows contact precautions

The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a care provider. Which of the following is the most appropriate action for the nurse to do with this child?

The nurse should apply ice to the affected area

The nurse is caring for a child with Osteomyelitis who has a leg wound. The highest priority nursing intervention for this child would be for the nurse to do which of the following?

The nurse should follow transmission-based precautions.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. Of the following nursing interventions, which would be most important for the nurse to include in working with this child and the child's caregivers?

The nurse should help the caregivers to understand and the child to effectively use the corrective devices.

The nurse is caring for a child diagnosed with Haemophilus Influenzae type B. Which of the following nursing interventions would be the highest priority in the prevention of complications seen with this disorder?

The nurse will administer antibiotics.

The nurse is caring for a child hospitalized with pertussis. Which of the following nursing interventions would be the highest priority for this child?

The nurse will administer oxygen.

The nurse is reinforcing teaching regarding the treatment for head lice with the caregiver of a child who has the disorder. Which of the following is most accurate related to the treatment for the child with an infection of head lice?

The treatment will need to be repeated in about two weeks.

The nurse is caring for a child who has had a cast applied to treat a fracture of the fibula. To monitor the pulse of the child's involved extremity the nurse will monitor which of the following?

Tibial pulse

Which of the following infections is often contracted by having contact with an infected dog or cat?

Tinea corporis

The disorder called Legg-Calvé-Perthes is more likely to be seen in which of the following ethnic groups of people?

White boys