mc exam four

A 5 year-old sustained a concussion when she fell out of a tree. In preparation for discharge the nurse is discussing home care with her mother. Which statement made by the mother indicated a correct understanding of the teaching?

"I should expect my child to have some behavioral changes after the accident."

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching?

"If I notice sleep disturbances, I should contact the physician immediately."

A 3-year-old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse, "This seems unnecessary when he is perfectly fine." The nurse's best reply is:

"The reason for this is that complications could still occur."

A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurse's best response is:

"The seizure may or may not mean that your child has epilepsy."

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

"We're glad there is a cure for this disorder."

How should the nurse explain positioning for a lumbar puncture to a 5-year-old child?

"You will lie on your side & bend your knees so that they touch your chin."

Which information should the nurse give to a child who is to have magnetic resonance imaging (MRI) of the brain?

"Your head will be restrained during the procedure."

What would cause a nurse to suspect that an infection has developed under a cast?

"hot spots" felt on cast surface

The nurse is preparing a school-age child for a computed tomography (CT) scan to assess cerebral function. When preparing the child for the scan, which statement should the nurse include?

"the scan will not hurt"

A clinic nurse is conducting a staff in-service for other clinic staff regarding the signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session (Select all that apply)?

- abdominal mass - sore throat & ear pain - ecchymosis of conjuctiva

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased ICP in an infant (Select all that apply)?

- alteration in pupil size & reactivity - extension or flexion posturing - cheyne-stokes respirations

The nurse is caring for a neonate with suspected meningitis. Which clinical manifestations should the nurse prepare to assess if meningitis is confirmed (Select all that apply)?

- bulging anterior fontanel - weak cry - poor muscle tone

Clinical manifestations of increased intracranial pressure (ICP) in infants are (Select all that apply):

- diplopia & blurred vision - irritability - distended scalp veins

A nurse should expect which cerebrospinal fluid (CSF) laboratory results on a child diagnosed with bacterial meningitis (Select all that apply)?

- elevated WBC - decreased glucose - cloudy in color

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child (Select all that apply)?

- instructions to avoid exposure to sunlight - teaching about body changes associated with SLE

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the child's postoperative care (Select all that apply)?

- observe closely for signs of infection - maintain an accurate record of I/O - monitor for abdominal distention

The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe (Select all that apply)?

- positive ortolani sign - unequal gluteal folds

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome (Select all that apply)?

- severe pain not relieved by analgesics - tingling of extremity - inability to move extremity

The treatment of brain tumors in children consists of which therapies (Select all that apply)?

- surgery - chemotherapy - radiation

The nurse is performing a Glasgow Coma Scale (GCS) on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record?

15

The nurse has received report on four children. Which child should the nurse assess first?

A preschool child with a head injury & decreasing level of consciousness

Which neurologic diagnostic test gives a visualized horizontal and vertical cross section of the brain at any axis?

CT scan

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

NSAIDs

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Russell

A child has been seizure-free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. The nurse includes which intervention in the response?

a stepwise approach will be used to reduce the dosage gradually

Which type of seizure may be difficult to detect?

absence

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include:

answering questions with straightforward honesty

A young child's parents call the nurse after their child was bitten by a raccoon in the woods. The nurse's recommendation should be based on knowing that:

anti-rabies prophylaxis must be initiated

A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate immediate action by the school nurse is to:

apply ice

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy?

arrangements for tutoring & schoolwork

When infants are seen for fractures, which nursing intervention is a priority?

assess for child abuse. fractures in infants are often nonaccidental.

An appropriate nursing intervention when caring for a child in traction is to:

assess for tightness, weakness, or contractures in uninvolved joints & muscles

The nurse uses the palms of the hands when handling a wet cast to:

avoid indenting the cast

What action may be beneficial in reducing the risk of Reye's syndrome?

avoidance of aspirin & ibuprofen for children with varicella or those suspected of having influenza

Which statement is accurate concerning a child's musculoskeletal system and how it may be different from an adult's?

because soft tissues are resilient in children, dislocations & sprains are less common than in adults

Which statement best describes a subdural hematoma?

bleeding occurs between the dura & the cerebrum

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. What type of head injury should the nurse suspect?

brainstem

Which clinical manifestations would suggest hydrocephalus in a neonate?

bulging fontanel & dilated scalp veins

The nurse should recommend medical attention if a child with a slight head injury experiences:

confusion or abnormal behavior

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor?

decreased metabolic rate

An important nursing intervention when caring for a child who is experiencing a seizure is to:

describe & record the seizure activity observed

Which statement best describes a neuroblastoma?

diagnosis is usually made after metastasis occurs

Which type of fracture describes traumatic separation of cranial sutures?

diastatic

When assessing the child with osteogenesis imperfecta, the nurse should expect to observe:

discolored teeth

A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to:

discuss with the practitioner what analgesia can be safely administered

An advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast:

dries rapidly

When does idiopathic scoliosis become most noticeable?

during preadolescent growth spurt

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching?

elevate casted arm when resting & when sitting up

The priority nursing intervention when a child is unconscious after a fall is to:

establish an adequate airway

The Glasgow Coma Scale consists of an assessment of:

eye opening, verbal, & motor responses

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

femur

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that:

frequent, serial casting is tried first

Which type of seizure involves both hemispheres of the brain?

generalized

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

growth can be affected by this type of fracture

The most common clinical manifestation of brain tumors in children is:

headaches & vomiting

Which problem is most often associated with myelomeningocele?

hydrocephalus

The primary method of treating osteomyelitis is:

intravenous antibiotic therapy

Which statement is most descriptive of a concussion?

it is a transient, reversible neuronal dysfunction

Which term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

kyphosis

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests:

leaking of CSF

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is:

level of consciousness

The initial clinical manifestation of generalized seizures is:

losing consciousness

Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema?

mannitol

A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she "seems fine." The nurse should explain that the toddler:

may have a brain injury

An appropriate nursing intervention when caring for an unconscious child should be to:

monitor fluid intake & output carefully to avoid fluid overload & cerebral edema

When caring for the child with Reye's syndrome, the priority nursing intervention is to:

monitor intake & output

The vector reservoir for agents causing viral encephalitis in the United States is:

mosquitos & ticks

The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include?

nasogastric intubation & urinary catheter may be required

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as:

neurosurgical emergency

Four-year-old David is placed in Buck's extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. What should the nurse do first?

notify the practitioner of the changes noted

Which term is used to describe a child's level of consciousness when the child can be aroused with stimulation?

obtundation

Which test is never performed on a child who is awake?

oculovestibular response

Which condition can result from the bone demineralization associated with immobility?

osteoporosis

The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

periodic and irregular breathing

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included?

return to the clinic every 1 to 2 weeks

Discharge planning for the child with juvenile arthritis includes the need for:

routine ophthalmologic examinations to assess for visual problems

Which term is used to describe a type of fracture that does not produce a break in the skin?

simple

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material?

soak in a bathtub

A 10-year-old boy has been hit by a car while riding his bicycle in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be to:

stabilize the neck & spine

Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?

stupor

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to:

teach child & family the correct administration of medications

A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?

teaching the family the care & management of the corrective appliance

Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm?

the skin color, temperature, movement, sensation, & capillary refill of the extremity

What is most descriptive of the therapeutic management of osteosarcoma?

treatment usually consists of surgery & chemotherapy

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that:

vaccination to prevent haemophilus influenzae type B meningitis has decreased the frequency of this disease in children

When taking the history of a child hospitalized with Reye's syndrome, the nurse should not be surprised that a week ago the child had recovered from:

varicella

What effect does immobilization have on the cardiovascular system?

venous stasis