Peds exam 2
A nurse is teaching a child who has type 1 diabetes mellitus about self care. Which of the following statements by the child indicates understanding of the teaching? A. "I should skip breakfast when I am not hungry. "B. "I should increase my insulin with exercise." C. "I should drink a glass of milk when I am feeling irritable." D. "I should draw up the NPH insulin into the syringe before the regular insulin."
C C. An early clinical manifestation of hypoglycemia is irritability. Therefore, drinkinga glass of milk, which is approximately 15 g of carbohydrates, indicates understanding ofthe teaching.
A newly admitted client is diagnosed with Hodgkin's disease undergoes an excisional cervical lymph node biopsy under local anesthesia. What does the nurse assess first after the procedure? A) Vital signs B) Incision site C) Airway D) LOC
C) Airway Assessing for an open airway is the priority. The procedure involves the neck, the anesthesia may have affected the swallowing reflex or the inflammation may have closed in on the airway leading to ineffective air exchange.
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take? a. place a cardiac monitor on the adolescent prior to the procedure b. apply topical analgesic cream to the site 1hr prior to the procedure c. keep the adolescent in a semi-fowler's position for 4hrs following the procedure d. restrict fluids for 2hrs following procedure
b
A nurse is teaching a school age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching? a. "I will puncture the pad of my finger when I am testing my blood glucose." b. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast." c. "I will eat a snack of 5 grams of carbohydrates if my blood glucose is low." d. "I will decrease the amount of fluids I drink when I am sick."
b
A nurse is caring for a child following an above-the-knee left-leg amputation. Which of the following is an appropriate action for the nurse to take? A. Avoid discussing the amputation. B. Administer aspirin for phantom pain. C. Prepare the child for a prosthesis fitting. D. Maintain the affected limb in the dependent position.
c C. Temporary prostheses are fitted soon after surgery. Therefore, preparing the child for aprosthesis is an appropriate action for the nurse to take.
A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG).Which of the following should be included in the teaching? A. "Decaffeinated beverages should offered on the morning of the procedure." B. "Do not wash your child's hair the night before the procedure." C. "Withhold all foods the morning of the procedure."D. " Give your child an analgesic the night before the procedure."
A A. Caffeine can alter the results of an EEG and should be avoided prior to the test.
A nurse is providing teaching about the management of epistaxis to a child and his family. Which of the following positions should the nurse instruct the child to take when experiencing a nosebleed? A. Sit up and lean forward. B. Sit up and tilt the head up. C. Lie in a supine position. D. Lie in a prone position.
A A. The nurse should instruct the child to sit up and lean to prevent aspiration when experiencing a nosebleed.
A nurse is caring for a child who just experienced a generalized seizure. Which of the following is thepriority action for the nurse to take? A. Maintain in a side-lying position. B. Monitor vital signs. C. Reorient the child to the environment. D. Assess for injuries.
A A. Using the airway, breathing, circulation priority-setting framework, the first action is toplace the child in a side-lying position to maintain a patent airway and prevent aspiration of secretions.
A nurse is caring for a school-age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction? a. laryngeal edema b. flank pain c. distended neck veins d. muscular weakness
b
A nurse is teaching a parent of a child who is receiving chemotherapy for bone cancer. Which of the following should be included in the teaching? (Select all that apply.) A. Signs of infection B. Bleeding precautions C. Hand hygiene D. Home schooling E. Nutritional requirements
A B C E A. Chemotherapy destroys healthy WBCs, which increases the risk of infection. Therefore,signs of infection should be included in the teaching. B. Chemotherapy destroys healthy platelets, which increases the risk of bleeding.Therefore, bleeding precautions should be included in the teaching. C. Chemotherapy destroys healthy WBCs, which increases the risk of infection. Therefore,hand hygiene should be included in the teaching. E. Chemotherapy destroys healthy blood cells. Therefore, nutritional requirements shouldbe included in the teaching.
A diagnosis of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease? 1. Elevated vanillylmandelic acid urinary levels 2. The presence of blast cells in the bone marrow 3. The presence of Epstein-Barr virus in the blood 4. The presence of Reed-Sternberg cells in the lymph nodes
4-Hodgkin's disease (a type of lymphoma) is a malignancy of the lymph nodes. The presence of giant, multinucleated cells (Reed-Sternberg cells) is the classic characteristic of this disease. Elevated levels of vanillylmandelic acid in the urine may be found in children with neuroblastoma. The presence of blast cells in the bone marrow indicates leukemia. Epstein-Barr virus is associated with infectious mononucleosis.
A child with sickle cell anemia is being discharged after tx of a crisis. Which instructions for avoiding future crises would the nurse provide for the child and family. Select all that apply. A) Drink plenty of fluids B) Use cold packs to relieve joint pain C) Report sore throat to an adult immediately D) Restrict activity to quiet board games E) Wash hands before meals and after playing
A,C,E
An 11 year old diagnosed with hemophilia A is in the emergency room after experiencing a fall on the school playground. Which of the following laboratory data would the nurse expect to see? A) Leukocyte count 15,000 cells/mm3 B) Platelet count 75,000 cells/mm3 C) Partial prothrombin time (PTT) is 90 seconds D) Prothrombin time (PT) is 9 seconds
C
The nurse is teaching a group of parents whose children have sickle cell anemia. When a parent asks the cause of the symptoms, the nurse responds with which of the following?
"Sickled cells clump in the smaller blood vessels and obstruct blood flow." Rationale:All the symptoms of sickle cell are a result of the clumping of the sickled cells in the microvasculature, causing obstruction of blood flow. The other statements are inaccurate.
A nurse is teaching a parent about posttraumatic stress disorder (PTSD). Which of the following shouldbe included in the teaching? (Select all that apply.) A. Children who have PTSD require psychotherapy. B. A clinical manifestation of PTSD is phobias. C. Depression is seen within 1 day after the incident. D. PTSD develops following a traumatic event. E. There are six stages of PTSD.
A B D A. Children who have PTSD should be referred to psychotherapy to assist with resolutionof the traumatic event.B. The child who is experiencing PTSD often has new phobias that can be related to thetraumatic event.D. PTSD develops following a traumatic event such as assault, serious injury, or alife‑threatening episode.
A nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. Which of the following are clinical manifestations of this disorder? (Select all that apply.) A. Enlarged neck lymph nodes B. Pain C. Vomiting D. Epistaxis E. Diplopia
A B D A. Palpable neck lymph nodes is a clinical manifestation of rhabdomyosarcoma of the nasopharynx. B. Pain is a clinical manifestation of rhabdomyosarcoma of the nasopharynx. D. CORRECT: Epistaxis is a clinical manifestation of rhabdomyosarcoma of the nasopharynx.
A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following results indicate viral meningitis? (Select all that apply.) A. Negative gram stain B. Normal glucose content C. Cloudy color D. Decreased WBC count E. Normal protein content
A B E A. A negative gram stain indicates viral meningitis.B. Normal glucose content indicates viral meningitis.E. Normal protein content indicates viral meningitis.
A nurse is caring for a child who has depression. Which of the following findings are associated with this diagnosis? (Select all that apply.) A. Prefers being with peers B. Weight loss C. Report of low self-esteem D. Sleeping more than usual E. Hyperactivity
A C D B. Weight loss or gain are findings associated with depression.C. Low self-esteem is a finding associated with depression.D. Sleeping more than usual is a finding associated with depression.
After receiving the change-of-shift report, which client will you assess first? A) A 20-year-old with possible acute myelogenous leukemia who has just arrived on the medical unit B) A 38-year-old with aplastic anemia who needs teaching about decreasing infection risk prior to discharge C) A 40-year-old with lymphedema who requests help to put on compression stockings before getting out of bed D) A 60-year-old with non-Hodgkin's lymphoma who is refusing the ordered chemotherapy regimen
A) A 20-year-old with possible acute myelogenous leukemia who has just arrived on the medical unit The newly admitted client should be assessed first, because the baseline assessment and plan of care need to be completed. The other clients also need assessments or interventions, but do not need immediate nursing care. Focus: Prioritization
A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness.Which of the following actions by the nurse is appropriate? A. Place the client on NPO status. B. Prepare the client for a liver biopsy. C. Position the client dorsal recumbent. D. Put the client in a protective environment.
A. Due to the client's decreased level of consciousness, placing the client on NPO status isan appropriate action by the nurse.
Which of the following foods would the nurse encourage the client in sickle cell crisis to eat? --A. Peaches --B. Cottage cheese --C. Popsicles --D. Lima beans
C
A nurse is caring for an adolescent who has been diagnosed with osteosarcoma. Which of the following actions should the nurse take? A. Ensure that the adolescent has a referral for a psychiatrist visit. B. Prepare a teaching plan to educate the adolescent in detail about what he should know regarding his diagnosis and treatment. C. Spend time with the adolescent to answer any questions he may have. D. Perform a mental status examination to assess the adolescent's thought patterns.
C C. The nurse should be available to answer the client's questions and to listen as he talksabout his feelings.
A 14 year old girl has been hospitalized with Sickle Cell Anemia in vasoocclusive crisis. Which of these Nursing diagnoses should receive priority in the Nursing plan of care? -- A. Impaired social interaction - -B. Alteration in body image - -C. Pain - -D. Alteration in tissue perfusion
D
A 3-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use? A. Body temperature of 99°F or less B. Toes moved in active range of motion C. Sensation reported when soles of feet are touched D. Capillary refill of < 3 seconds
D
The male client with sickle cell anemia comes to the emergency room with a temperature of 101.4 F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency room doctor ordering for the client? --A. Spinal tap. -- B. Hemoglobin electrophoresis. C. Sickle-turbidity test (Sickledex). - D. Blood cultures.
D
A nurse is caring for a 4-month-old infant who has meningitis. Which of the following findings is associated with this diagnosis? A. Depressed anterior fontanel B. Constipation C. Presence of the rooting reflex D. High-pitched cry
D D. A high-pitched cry is a finding associated with meningitis in a 4-month-old infant.
A nurse is providing teaching to the parent of a child who has a new prescription for liquid oral iron supplements. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should take my child to the emergency department if his stools become dark." B. "My child should avoid eating citrus fruits while taking the supplements." C. "I should give the iron with milk to help prevent an upset stomach." D. "My child should take the supplement through a straw."
D D. The child should take the supplement through a straw to prevent or minimize staining ofthe teeth.
You have developed the nursing diagnosis Risk for Impaired Tissue Integrity related to effects of radiation for a client with Hodgkin's lymphoma who is receiving radiation to the groin area. Which nursing activity is best delegated to a nursing assistant caring for the client? A) Check the skin for signs of redness or peeling. b) Apply alcohol-free lotion to the area after cleaning. C) Explain good skin care to the client and family. D) Clean the skin over daily with a mild soap.
D) Clean the skin over daily with a mild soap Skin care is included in nursing assistant education and job description. Assessment and client teaching are more complex tasks that should be delegated to registered nurses. Use of lotions to the irradiated area is usually avoided during radiation therapy. Focus: Delegation
The nurse is caring for a child who is in the hospital experiencing sickle cell crisis. The parents are asking the nurse which treatment will help cure the child. The nurse responds with which of the following?
Treatment is aimed at pain control, oxygen therapy, and hydration, but does not provide a cure.Rationale:Treatment for sickle cell crisis is pain control, oxygenation, and fluid resuscitation. There is no cure for sickle cell disease. The nurse teaches families how to prevent sickle cell crisis.
A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 89. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. a. Adjust the room temperature b. Give a bolus of IV fluids c. Start O2 d. Administer meperidine (Demerol) 75mg IV push
c
A nurse is caring for a 15 year old client following a head injury. Which of the following should the nurse identify as an indication that the child is developing syndrome of inappropriate antidiuretic hormone secretion (SIADH)? a. sodium 148 mEq/L b. urine specific gravity 1.020 c. mental confusion d. weak peripheral pulses
c
A nurse is caring for a school age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions should the nurse take? a. use surgical asepsis when providing routine care for the child b. administer the measles, mumps, and rubella (MMR) vaccine to the child c. screen the child's visitors for indications of infection d. infuse packed RBCs
c
A nurse is reviewing the lumbar puncture results of a school-age child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? a. decreased cerebrospinal fluid pressure b. decreased WBC count c. increased protein concentration d. increased glucose level
c
How to manage Sickle Crisis?
Give fluids because of dehydration
What to assess for with Sickle Cell crisis?
Pain
The nurse is caring for a 16 year old client with myelogenous leukemia whose platelet count is 26,000/mcl. Which nursing intervention would be included in the plan of care? Select all that apply: a. Instruct the patient not to use a razor for shaving b. Plan to infuse packed red blood cells c. Encourage the patient to eat fluids high in iron d. Assess the patient for pain in the joints e. Encourage vigorous exercise to muscle strength
A, D
A 12 year old boy with a history of sickle cell anemia and a diagnosis of vasooclussive crisis is being assessed by the admitting nurse in the emergency department. Which of the following signs and symptoms would the nurse expect to see? Select all that apply A) Priapism B) pain level 2/10 c) Hematuria D) elevated liver enzymes E) Hematocrit 39%
A,C,D
A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply: a. Tetracaine-adrenaline-cocaine (TAC) 15 minutes before procedure. b. Transdermal fentanyl (Duragesic) patch immediately before procedure. c. Eutectic mixture of local anesthetics (EMLA) 1 hour before procedure. d. EMLA 30 minutes before procedure.
ANS: C EMLA is an effective analgesic agent when applied to the skin 60 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin. The gel can be placed on the wound for suturing. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain control. For maximal effectiveness EMLA must be applied approximately 60 minutes in advance.
A nurse is developing an in-service about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? (Select all that apply.) A. Inactivated polio vaccine (IPV) B. Pneumococcal conjugate vaccine (PCV) C. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) D. Haemophilus influenzae type B (Hib) vaccine E. Trivalent inactivated influenza vaccine (TIV)
B B. The introduction of the PCV decreased the incidence of bacterial meningitis in children, as it provides immunity against bacteria that causes the illness.
A nurse is preparing to administer iron dextran (Proferdex) IM to a school-age child who has iron deficiency anemia. Which of the following actions by the nurse is appropriate? A. Administer the dose in the deltoid muscle. B. Use the Z-track method when administering the dose. C. Avoid injecting more than 2 mL with each dose. D. Massage the injection site for 1 min after administering the dose.
B B. The nurse should use the Z-track method when administering the dose.
Lisa is 6 year old receiving chemotherapy through a central line to treat childhood malignancy. Her Hemoglobin and Hematocrit is currently 7 and 22 and she is to receive packed cells. Which of the following should be priority in her plan of care? a. Start a secondary large bore IV b. Administer Zofran prior to administration of the blood c. Administer O2 via nasal cannula d. Anticipate the need for protective isolation
C
You have just received a change of shift report about the following pediatrics patients. Which patient will you assess first? A) A one year old with hemophilia B who was admitted because of decreased responsiveness. B) A 3 year old Von Willibrand disease who has a dose of DDAVP scheduled C) A 7 year old with acute lymphocytic leukemia who has chemotherapy induced thrombocytopenia D) A 16 year old with sickle cell disease who is complaining of acute right lower quadrant pain
A
A nurse is teaching a group of parents about the risk factors for seizures. Which of the following shouldbe included in the teaching? (Select all that apply.) A. Febrile episodes B. Hypoglycemia C. Sodium imbalances D. Low serum lead levels E. Presence of diphtheria
A B C A. Febrile episodes can cause general tonic-clonic seizures in infants and young children.B. Seizure activity is a late manifestation of hypoglycemia.C. Seizure activity is a manifestation of hyponatremia and hypernatremia.
A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect?(Select all that apply.) A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects D. Falling to the floor E. Having a piercing cry
A B C A. Loss of consciousness for 5 to 10 seconds is a clinical manifestation of an absence seizure.B. Behavior that resembles daydreaming is a clinical manifestation of an absence seizure.C. A child who is having absence seizures may drop a held object.
The nurse is caring for a 9-year-old child with leukemia who is hospitalized for the administration of chemotherapy. The nurse would monitor the child specifically for central nervous system involvement by checking which item? 1. Pupillary reaction 2. Level of consciousness 3. The presence of petechiae in the sclera 4. Color, motion, and sensation of the extremities
2
The nursing student is presenting a clinical conference and discusses the cause of β-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1. A child of Mexican descent 2. A child of Mediterranean descent 3. A child whose intake of iron is extremely poor 4. A breast-fed child of a mother with chronic anemia
2
A 15-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client? A. Taking hourly blood pressures with mechanical cuff B. Encouraging fluid intake of at least 200mL per hour C. Position in high Fowler's with knee gatch raised D. Administering Tylenol as ordered
B
The nurse is caring for 3 year old Amanda. The nurse has calculated the absolute neutrophil count (ANC) to be 325. The nurse knows that Amanda: a. Has severe infection b. Is at severe risk for infection c. Is at moderate risk for infection d. Is at low risk for infection
B
A nurse is providing teaching to the parent of a child who has attention-deficit/hyperactivity disorder.The nurse should include which of the following as a characteristic of impulsivity? A. Loses things B. Frequently interrupts C. Is easily distracted D. Talks excessively
B B. Frequently interrupting is a characteristic of impulsivity.
A nurse is caring for an infant whose screening test reveals that he may have sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease? A. Sickle solubility test (Sickledex) B. Hemoglobin electrophoresis C. Complete blood count D. Transcranial Doppler
B B. The hemoglobin electrophoresis test should be performed to distinguish if the infanth as the trait or the disease.
A nurse is caring for a school-age child who has experienced a tonic-clonic seizure. Which of the following actions should the nurse take during the immediate postictal period? a. place the child in a side-laying position b. delay documentation until the child is fully alert c. give the child a high-carb snack d. administer an oral sedative to the child
a
A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse see first? a. a school age child who has sickle cell anemia and reports decreased vision in the left eye b. a school age child who has cystic fibrosis and a frequent nonproductive cough c. a preschooler who has asthma and a peak flow meter reading in the green zone d. an adolescent who has meningitis and reports a sensitivity to lights and noise
a
A nurse is reviewing the laboratory report of a 7-year-old child who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider? a. hgb 8.5g/dL b. WBC 9500/mm^3 c. prealbumin 18mg/dL d. platelets 300000/mm^3
a
A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority for the nurse to report to the provider? a. reports a headache as 6 on a 0-10 pain scale b. petechiae on the lower extremities c. nuchal rigidity d. positive Kernig's sign
b
A nurse is providing instruction to the teacher of a child who has attention-deficit/hyperactivitydisorder (ADHD). Which of the following classroom strategies should be included in the teaching?(Select all that apply.) A. Eliminate testing. B. Allow for regular breaks. C. Combine verbal instruction with visual cues. D. Establish consistent classroom rules. E. Decrease stimuli in the environment.
B C D E B. Allowing for regular breaks will assist the client who has ADHD to focus on therequired tasks.C. Combining verbal instruction with visual cues will assist the client who has ADHD withlearning information.D. Providing consistent classroom rules will assist the client who has ADHD to becomesuccessful.E. Stimuli in the environment distract the client who has ADHD, so they should bedecreased.
A nurse is creating a plan of care for an infant who has an epidural hematoma form a head injury. Which of the following interventions should the nurse include in the plan? a. position the infant side-lying with their head at a )-5 degree angle b. perform a neurological assessment Q4hrs c. suction the infant's nares to remove secretions d. implement seizure precautions for the infant
d
A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 meq/L. Which of the following interventions should the nurse include in the plan? a. administer ibuprofen to the child for a temperature greater than 38 degrees C (100.4 degrees F) b. assess the child's blood pressure every 8hr c. weigh the child weekly at a various times of the day d. initiate seizure precautions for the child
d
A nurse is providing teaching about epistaxis to the parent of a school-age child. Which of the following should the nurse include as an appropriate action to take when managing an episode of epistaxis?(Select all that apply.) A. Press the nares together at least 10 min. B. Breathe through the nose until bleeding stops. C. Pack cotton or tissue into the naris that is bleeding. D. Apply a warm cloth across the bridge of the nose. E. Insert petroleum into the naris after the bleeding stops.
A C E A. Pressing the nares together for at least 10 min is an appropriate action to take when managing an episode of epistaxis. C. Packing cotton or tissue into the naris that is bleeding is an appropriate action when managing an episode of epistaxis. E. Inserting petroleum into the naris after the bleeding stops is an appropriate action when managing an episode of epistaxis.
A hospice nurse is caring for a preschooler who has a terminal illness. One of the preschooler's parents tells the nurse that they cannot cope anymore and are thinking about moving out of the house. Which of the following statements should the nurse make? a. "it is important that you provide emotional support for your family at this time." b. "You have to do what you feel is best. Everything will turn out fine." c. "I know how you feel. This is an extremely stressful time for your family." d. "Let's talk about some of the ways you have handled previous stressors in your life."
d
A nurse is caring for a child who has type 1 diabetes. Which of the following is a clinical manifestation of diabetic ketoacidosis? (Select all that apply.) A. Blood glucose 58 mg/dL B. Weight gain C. Dehydration D. Mental confusionE. Fruity breath
C D E C. Clients who have diabetic ketoacidosis experience osmotic diuresis because of theelectrolyte shift. D. Clients who have diabetic ketoacidosis experience mental confusion because of theelectrolyte shift. E. Clients who have diabetic ketoacidosis experience fruity breath because of the body'sattempt to eliminate ketones.
A client admitted with newly diagnosed with Hodgkin's disease. Which of the following would the nurse expect the client to report? A) Lymph node pain b) Weight gain C) Night sweats D) Headache
C) Nightsweats Assessment of a client with Hodgkin's disease most often reveals enlarged, painless lymph node, fever, malaise and night sweats.
A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which ofthe following should be included in the discussion? (Select all that apply.)A. Vagal nerve stimulatorB. Additional antiepileptic medicationsC. Corpus callosotomyD. Focal resectionE. Radiation therapy
A B C D A. The implantation of a vagal nerve stimulator is an option to provide seizure control.B. Additional antiepileptic medication can be added to the current medication regime tocontrol seizures.C. A corpus callosotomy can be performed for uncontrolled seizures.D. A focal resection can be performed for uncontrolled seizures.
A nurse is assessing a child who has rhabdomyosarcoma of an extremity. Which of the following are clinical manifestations of this condition? (Select all that apply.) A. Pain B. Discoloration of the skin C. Lymph node enlargement D. Moveable mass E. Palpable mass
A C E A. Pain is a clinical manifestation of rhabdomyosarcoma of an extremity. C. Lymph node enlargement is a clinical manifestation of rhabdomyosarcoma of an extremity. E. Palpable mass is a clinical manifestation of rhabdomyosarcoma of an extremity.
A nurse is reviewing sick day management with a parent of a child who has type 1 diabetes mellitus.Which of the following should the nurse include in the teaching? (Select all that apply.) A. Monitor blood glucose levels every 3 hr. B. Discontinue taking insulin until feeling better. C. Drink 8 oz of fruit juice every hour. D. Test urine for ketones.E. Call the health care provider if blood glucose is greater than 240 mg/dL.
A D E A. A client who is experiencing illness can have waning blood glucose levels. Therefore,frequent monitoring of blood glucose levels is done to identify hyper- or hypoglycemic episodes. D. A client who is experiencing an illness should test her urine for ketones to assist in earlydetection of ketoacidosis. E. A client who is experiencing illness should notify the provider of blood glucose levelsgreater than 240 mg/dL to obtain further instructions in caring for the hyperglycemia.
A nurse is teaching an adolescent who has diabetes about clinical manifestations of hypoglycemia.Which of the following should be included in the teaching? (Select all that apply.) A. Increased urination B. Hunger C. Signs of dehydration D. Irritability E. Sweating and pallor F. Kussmaul respirations
B D E B. Hunger is a clinical manifestation of hypoglycemia because of the increased adrenergicnervous system activity. D. Irritability is a clinical manifestation of hypoglycemia because of the depleted glucosein the CNS. E. Sweating and pallor is a clinical manifestation of hypoglycemia because of the increasedadrenergic nervous system activity.
A nurse is caring for a school-age client who possibly has Reye syndrome. Which of the following is arisk factor for developing Reye syndrome? A. Recent history of infectious cystitis caused by Candida B. Recent history of bacterial otitis media C. Recent episode of gastroenteritis D. Recent episode of Haemophilus influenzae meningitis
C C. A recent episode of gastroenteritis, a viral illness, is a risk factor for Reye syndrome.Reye syndrome typically follows a viral illness, such as influenza, gastroenteritis, or varicella.
A nurse is teaching an adolescent who has diabetes about foot care. Which of the following should thenurse include in the teaching?A. "You should inspect your feet once a week." B. "You should cut your toe nails in a rounded fashion." C. "You can use cornstarch on your feet. "D. "You can use over-the-counter callus removers."
C C. Clients who have diabetes can use cornstarch to aid in moisture absorption
A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia? a. hematocrit 28% b. hemoglobin 13.5 g/dL c. WBC count 8000mm^3 d. platelets 250000/mm^3
a
