Peds Practice Questions-CH 38, 39, 44, 46-#4
An infant is diagnosed with a congenital cataract. What would the nurse expect to assess? A) Absent red reflex B) Rapid irregular eye movement C) Misalignment of the eyes D) Enlarged eye appearance
A) Absent red reflex
A 4-year-old boy has a history of seizures and has been started on a ketogenic diet. Which food selection would be most appropriate for his lunch? A. Fried eggs, bacon, and iced tea B. A hamburger on a bun, French fries, and milk C. Spaghetti with meatballs, garlic bread, and a cola drink D. A grilled cheese sandwich, potato chips, and a milkshake
A. Fried eggs, bacon, and iced tea
The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding? A. Indications of increased intracranial pressure B. An increase in the blood glucose level C. A decrease in the liver enzymes D. A presence of protein in the urine
A. Indications of increased intracranial pressure
A group of students are reviewing information about head injuries in children. The students demonstrate understanding of this information when they identify what as the most common type of skull fracture in children? A. Linear B. Depressed C. Diastatic D. Basilar
A. Linear
The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents? A. Monitor their child's level of sedation. B. Watch for fever indicating infection. C. Gradually reduce the dosage as seizures stop. D. Monitor for an allergic reaction to the medication.
A. Monitor their child's level of sedation.
A child with a seizure disorder will be discharged home from the hospital on the drug levetiracetam. What discharge instruction is the most important for the nurse to provide the parent? A. Notify the health care provider if child experiences poor coordination B. Notify the health care provider if the number of seizures increases after 4 weeks C. Return to the clinic in 3 weeks for laboratory test to determine therapeutic level of the drug D. Do not to take two doses together if one dose is missed
A. Notify the health care provider if child experiences poor coordination
An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A. Notifying the doctor immediately B. Applying ice C. Elevating the arm D. Giving additional pain medication as ordered
A. Notifying the doctor immediately
A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect to position the child in which manner? A. On her side with the head flexed forward and knees flexed to the abdomen B. Sitting upright with the head flexed forward to the chest C. Supine with arms and legs pronated and extended D. Prone with the arms flexed under the chest
A. On her side with the head flexed forward and knees flexed to the abdomen
A child with increased intracranial pressure is being treated with hyperventilation. The nurse understands that after this treatment: A. PaCO2 levels decrease, causing vasoconstriction. B. drainage of cerebrospinal fluid occurs. C. activity is controlled via a stimulator. D. hyperexcitability of the nerves is reduced.
A. PaCO2 levels decrease, causing vasoconstriction.
The parents of a 10-year-old girl with a refractive error ask the nurse about the possibility of laser surgery to correct the vision. Which statement by the nurse would be most appropriate? A) "As she gets older, her vision will begin to correct itself." B) "Laser surgery typically is not done until she's 18 years old." C) "She looks so cute in her glasses; why put her through surgery?" D) "She can use contact lenses soon, so surgery isn't necessary."
B) "Laser surgery typically is not done until she's 18 years old."
A child is diagnosed with bacterial conjunctivitis and is prescribed topical antibiotic therapy. The child's mother asks when he can return to school. Which response by the nurse would be most appropriate? A) "You need to wait until you finish the entire prescription of antibiotic." B) "Once the drainage is gone, he can go back to school." C) "You can send him to school this afternoon after his first dose of antibiotic." D) "He needs to be symptom-free for at least 72 hours."
B) "Once the drainage is gone, he can go back to school."
A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A. Growth plate B. Epiphysis C. Physis D. Metaphysis
B. Epiphysis
The nurse is assessing a newborn who was delivered after a prolonged labor due to an abnormal presentation. The newborn sustained a cranial nerve injury. The nurse would most likely expect to assess deficits related to which cranial nerve? A. Optic B. Facial C. Acoustic D. Trigeminal
B. Facial
The nurse knows that children have larger heads in relation to the body and a higher center of gravity. When developing a teaching plan for parents, the nurse includes information about an increased risk for which problem? A. Febrile seizures B. Head trauma C. Caput succedaneum D. Posterior plagiocephaly
B. Head trauma
The nurse is taking a health history for a 9-year-old girl. Which finding would alert the nurse to a possible risk factor specifically associated with visual impairment? A) Being born at 39 weeks' gestation B) Having several hours of homework daily C) Being of African American heritage D) Being active in sports
C) Being of African American heritage
The nurse is examining a 7-year-old boy with blepharitis. What would the nurse least likely expect to assess? A) Redness B) Scaling C) Pain D) Edema
C) Pain
After teaching a group of new parents about their newborns' eyes and vision, which statement by the group indicates effective teaching? A) "Our newborn can see at distances of about 1 to 2 feet." B) "We won't know the baby's eye color until he's at least 6 months old." C) "A baby can easily distinguish colors, but they must be bright colors." D) "A newborn can focus with both eyes at the same time shortly after birth."
B) "We won't know the baby's eye color until he's at least 6 months old."
A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid? A. Semi-Fowler B. Supine C. High Fowler D. Side-lying
D. Side-lying
The nurse has developed a teaching plan for the family of a 2-year-old boy who holds his breath when he gets frustrated. What will be most important to include in this plan? A. Provide cuddle time whenever the child begins to act out. B. Explain the child's behavior to the parents. C. Encourage the parents to interact more with the child. D. Stay close to prevent injury when he gets frustrated.
D. Stay close to prevent injury when he gets frustrated.
A 16-year-old boy reports to the school nurse with headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis? A. Fixed and dilated pupils B. Frequent urination C. Sunset eyes D. Sunlight is "too bright"
D. Sunlight is "too bright"
The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: A. Decorticate posturing B. Nystagmus C. Doll's eye D. Sunsetting
D. Sunsetting
The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator? A. Lack of spontaneous movement B. Point tenderness C. Bruising D. Inability to bear weight
B. Point tenderness
A nurse is examining a 7-year-old boy with hordeolum. Which would the nurse expect to find? A) Redness B) Scaling C) Pain D) Edema
C) Pain
The nurse is caring for a 10-year-old with allergic conjunctivitis. The nurse would be alert to the child's increased risk for what issue? A) Atopic dermatitis B) Insect bite sensitivity C) Acute otitis media D) Frequent sore throats
A) Atopic dermatitis
A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply. A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands C) Touching the child on his shoulder before letting the child know someone is there D) Using the child's body parts to refer to the area where he may have postoperative pain E) Speaking to the child in a voice that is slightly louder than the usual tone of voice
A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands D) Using the child's body parts to refer to the area where he may have postoperative pain
An infant is diagnosed with infantile glaucoma. When developing the plan of care for the infant, for what would the nurse expect to prepare the infant and family? A) Goniotomy B) Antibiotic therapy C) Contact lenses D) Patching of affected eye
A) Goniotomy
The nurse is developing a plan of care for a 5-year-old child with a severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed? A) Immature emotional behavior B) Self-stimulatory actions C) Inattention and vacant stare D) Head tilt or forward thrust
A) Immature emotional behavior
The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A. "I will help you become comfortable in caring for your daughter." B. "You must learn how to care for your daughter at home." C. "You will need to learn to collaborate with all the caregivers." D. "There is a lot to learn, and you need a positive attitude."
A. "I will help you become comfortable in caring for your daughter."
The nurse is caring for a 14-month-old boy with rickets who was recently adopted from overseas. His condition was likely a result of a diet very low in milk products. The nurse is providing teaching regarding treatment. Which response by the parents indicates a need for further teaching? A. "We must give him calcium and phosphorus with food every morning." B. "He must take vitamin D as prescribed and spend some time in the sunlight." C. "He must take calcium at breakfast and phosphorus at bedtime." D. "We should encourage him to have fish, dairy, and liver if he will eat it."
A. "We must give him calcium and phosphorus with food every morning."
A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A. "We should give this drug before he eats anything." B. "We need to watch carefully for possible infection." C. "The drug should not be stopped suddenly." D. "He might gain some weight with this drug."
A. "We should give this drug before he eats anything."
A 10-month-old infant is brought to the emergency department by the parents after they found the infant face down in the bathtub. The parent states, "I just left the bathroom to answer the phone. When I came back, I found my infant." Which nursing action is priority? A. Assess the client's respiratory rate B. Start cardiopulmonary resusitative measures C. Determine how long the client was face down in the water D. Apply a heart monitor to the client
A. Assess the client's respiratory rate
A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply. A. Complaints of stiff neck B. Photophobia C. Absent headache D. Negative Brudzinski sign E. Vomiting
A. Complaints of stiff neck B. Photophobia E. Vomiting
Phenytoin IV has been prescribed by health care provider for a child who has experienced a seizure. Before administering the drug what should the nurse do? A. Determine the IV fluid infusing is normal saline B. Assess the child's vital signs C. Monitor the electrolyte levels D. Start another IV with a large bore needle
A. Determine the IV fluid infusing is normal saline
A hospitalized child is scheduled for magnetic resonance imaging (MRI) with contrast. What nursing intervention(s) will the nurse complete to ensure safety during the examination? Select all that apply. A. Place child in clothing with no metal B. Connect the child to a heart monitor C. Assess the IV site for patency D. Review any prescriptions for sedation E. Assess for a latex allergy
A. Place child in clothing with no metaL C. Assess the IV site for patency D. Review any prescriptions for sedation
The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse take first? A. Reposition the child's foot on a pressure-reducing device. B. Apply lotion to his foot to maintain skin integrity. C. Make sure the skin is clean and dry. D. Gently massage his foot to promote circulation.
A. Reposition the child's foot on a pressure-reducing device.
The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis? A. Risk for impaired skin integrity due to cast and location B. Deficient knowledge related to cast care C. Risk for delayed development related to immobility D. Self-care deficit related to immobility
A. Risk for impaired skin integrity due to cast and location
When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A. Skeletal traction B. Physical therapy C. Orthotics D. Occupational therapy
A. Skeletal traction
The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? A. Sluggish deep tendon reflexes B. Full range of motion in extremities C. Absence of hypotonia D. Lack of purposeful muscular control
A. Sluggish deep tendon reflexes
A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists the following causes: Streptococcus group B Haemophilus influenzae type B Streptococcus pneumoniae Neisseria meningitidis What would the nurse highlight as the most common cause of meningitis in newborns? A. Streptococcus group B B. Haemophilus influenzae type B C. Streptococcus pneumoniae D. Neisseria meningitidis
A. Streptococcus group B
The school nurse has performed scoliosis screening. Based on this assessment, which children require the nurse to implement a referral to the healthcare provider? Select all that apply. A. The child with asymetric shoulder elevation B. The child with a limb length discrepancy C. The child with a lateral curve of the spine D. The child with a one-sided hump upon bending over E. The child who's sibling had scoliosis surgically corrected F. The child who has uneven balance
A. The child with asymetric shoulder elevation B. The child with a limb length discrepancy C. The child with a lateral curve of the spine D. The child with a one-sided hump upon bending over
A child is in the emergency department with a head injury obtained in a motor vehicle crash. The glascow coma scale assessment is rated at 10 (3 eye opening, 3 motor, 4 verbal). How should the nurse interpret these findings? A. The child's eyes open to verbal stimuli, is confused and flexes with painful stimuli B. The child's eyes open spontaneously, able to localize pain and uses inappropriate words C. The child's eyes open to speech, is able to obey commands but is confused D. The child's eyes open to pain, opens to extension and says incomprehensible words
A. The child's eyes open to verbal stimuli, is confused and flexes with painful stimuli
A mother brings her child to the healthcare clinic because she thinks that the child has conjunctivitis. Which assessment findings would lead the nurse to suspect bacterial conjunctivitis? Select all that apply. A) Itching of the eyes B) Inflamed conjunctiva C) Stringy discharge D) Photophobia E) Mild pain F) Tearing
B) Inflamed conjunctiva E) Mild pain
The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5°C. Which action will be taken? A) Obtain a culture of the middle ear fluid. B) Instruct the parents to watch for worsening symptoms. C) Administer antibiotics. D) Administer antivirals.
B) Instruct the parents to watch for worsening symptoms.
A nurse is reviewing the medical record of a child with hearing loss and notes that the child's hearing loss is in the range 40 to 60 decibels (dB). The nurse interprets this as indicating what level of hearing loss? A) Mild loss B) Moderate loss C) Severe loss D) Profound loss
B) Moderate loss
Assessment of a child leads the nurse to suspect viral conjunctivitis based on what finding? A) Mild pain B) Photophobia C) Itching D) Watery discharge
B) Photophobia
The nurse assesses a child's level of consciousness, noting that the child falls asleep unless he is stimulated. What is the child's level of consciousness? A. Confusion B. Obtunded C. Stupor D. Coma
B. Obtunded
The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement? A) Being careful to prevent spread of infection B) Teaching the parents how to gently massage the duct C) Applying hot, moist compresses to the affected eye D) Referring the child to an ophthalmologist
B) Teaching the parents how to gently massage the duct
The nurse is caring for a newborn and knows that his vision, unlike his hearing, is not fully developed. Which aspect of the child's vision would the nurse expect to be similar to his father's vision? A) Adequate color detection B) Visual acuity of 20/100 C) Nearsightedness D) Monocular vision
B) Visual acuity of 20/100
What would the nurse include when teaching parents how to prevent otitis externa? A) Daily ear cleaning with cotton swabs B) Wearing earplugs when swimming C) Using a hair dryer on high to dry the ear canals D) Using hydrogen peroxide to dry the canal skin
B) Wearing earplugs when swimming
The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching? A. "I need to avoid pushing or pulling on an arm or leg." B. "I must carefully lift the baby from under the armpits." C. "I should not bend an arm or leg into an awkward position." D. "We must avoid lifting the legs by the ankles to change diapers."
B. "I must carefully lift the baby from under the armpits."
A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occurred. Which response by the nurse would be most appropriate? A. "This condition is due to a genetic defect in the bones." B. "It's most likely from how the baby was positioned in utero." C. "They really don't know what causes this condition." D. "There is probably an underlying deformity of the baby's hip."
B. "It's most likely from how the baby was positioned in utero."
A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions? A. "Expect his headache to get worse initially and then disappear." B. "Wake him every 2 hours to check his movement and responses." C. "Call your medical provider if he vomits more than five times." D. "Any watery fluid draining from his ears is normal."
B. "Wake him every 2 hours to check his movement and responses."
A nurse is providing instructions to the parents of a 3-month-old infant with developmental dysplasia of the hip who is being treated with a Pavlik harness. Which statement(s) by the parents demonstrates understanding of the instructions? Select all that apply. A. "We need to adjust the straps so that they are snug but not too tight." B. "We should change the diaper without taking our infant out of the harness." C. "We need to check the area behind our infant's knees for redness and irritation." D. "We need to send the harness to the dry cleaners to have it cleaned." E. "We need to call the health care provider if our infant is not able to actively kick the legs."
B. "We should change the diaper without taking our infant out of the harness." C. "We need to check the area behind our infant's knees for redness and irritation." E. "We need to call the health care provider if our infant is not able to actively kick the legs."
The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis? A. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis). B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers. C. A high-pitched "click" is heard with hip flexion or extension. D. The thigh and gluteal folds are symmetric.
B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers.
When teaching a group of parents about the skeletal development in children, what information is most helpful? A. The growth plate is made up of the epiphysis. B. A young child's bones commonly bend instead of break with an injury. C. The infant's skeleton has undergone complete ossification by birth. D. Children's bones have a thin periosteum and limited blood supply.
B. A young child's bones commonly bend instead of break with an injury.
The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations? A. Spastic B. Athetoid C. Ataxic D. Mixed
B. Athetoid
When assessing a child for slipped capital femoral epiphysis, what would the nurse identify as possible risk factors? Select all that apply. A. Age younger than 8 years B. Black race C. History of cystic fibrosis D. Excessive activity E. Obesity
B. Black race E. Obesity
What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A. Positioning supine with a pillow under the buttocks B. Covering the sac with saline-soaked nonadhesive gauze C. Wrapping the infant snugly in a blanket D. Applying a diaper to prevent fecal soiling of the sac
B. Covering the sac with saline-soaked nonadhesive gauze
A nurse is caring for a 14-year-old girl following myelography. What is the priority nursing action? A. Monitoring for a decrease in spasticity B. Observing for signs of meningeal irritation C. Assessing motor function D. Observing for mental confusion or hallucinations
B. Observing for signs of meningeal irritation
The nurse is teaching a group of students about myelinization in a child. Which statement by the students indicates that the teaching was successful? A. Myelinization is completed by 4 years of age. B. The process occurs in a head-to-toe fashion. C. The speed of nerve impulses slows as myelinization occurs. D. Nerve impulses become less specific in focus with myelinization.
B. The process occurs in a head-to-toe fashion.
During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve? A. Olfactory B. Trigeminal C. Facial D. Accessory
B. Trigeminal
The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A. Deep-breathing exercises B. Upright positioning C. Coughing D. Chest percussion
B. Upright positioning
A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA). When describing type 2 SMA, which information would the instructor include? Select all that apply. A. Onset before 6 months of age B. Weakness most severe in shoulders and hips C. Difficulty with swallowing D. Slowly progressing condition E. Genetic disease with autosomal recessive inheritance
B. Weakness most severe in shoulders and hips D. Slowly progressing condition E. Genetic disease with autosomal recessive inheritance
The nurse is instructing a 7-year-old child and his parents about using his prescribed corrective lenses. What would the nurse include in these instructions? A) "Make sure to take your glasses off from time to time to allow your eyes to rest." B) "Remove your glasses with both hands and lay them with the lens upright on the surface." C) "Clean the glasses every day with a mild soap and water or commercial cleaning agent." D) "Use paper towels or tissues to dry and periodically clean the lenses."
C) "Clean the glasses every day with a mild soap and water or commercial cleaning agent."
A child with persistent otitis media with effusion is to undergo insertion of pressure-equalizing tubes via a myringotomy. The child is to be discharged later that day. After teaching the parents about caring for their child after discharge, which statement indicates that the teaching was successful? A) "The tubes will stay in place for about a month and then fall out on their own." B) "His chances for ear infections now have dramatically decreased." C) "He should wear earplugs when swimming in a pool or a lake." D) "We should keep the ears protected with cotton balls for the first 24 hours."
C) "He should wear earplugs when swimming in a pool or a lake."
The parents of a 5-year-old bring their son to the emergency department because of significant eyelid edema. The mother states, "He scratched himself near his eye a couple of days ago while playing outside in the yard." The nurse suspects periorbital cellulitis based on which finding? A) Evidence of discharge B) Reddened conjunctiva C) Purplish discoloration of eyelid D) Altered visual acuity
C) Purplish discoloration of eyelid
After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify what as the most common cause of visual difficulties in children? A) Astigmatism B) Strabismus C) Refractive errors D) Nystagmus
C) Refractive errors
After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful? A) Infants with congenital deformities have an increased risk for ear infections. B) Ear infections typically increase as the child gets older. C) The shorter and wider eustachian tubes of an infant increase the risk. D) Adenoids shrink as the child grows, allowing more bacteria to enter.
C) The shorter and wider eustachian tubes of an infant increase the risk.
The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? A) Show him the stethoscope. B) Describe the examination room. C) Use his name before touching him. D) Allow him to explore the exam room.
C) Use his name before touching him.
The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has developed a sensitivity to latex. Which response from his mother indicates a need for further teaching? A. "He needs to get a medical alert identification." B. "I will need to discuss this with his caregivers." C. "A product's label indicates whether it is latex-free." D. "He must avoid all contact with latex."
C. "A product's label indicates whether it is latex-free."
A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement? A. "Having the shunt put in decreases his risk for developmental problems." B. "If he doesn't get an infection in the first week, the risk is greatly reduced." C. "He will need more surgeries to replace the shunt as he grows." D. "The shunt will help to prevent any further complications from his disease."
C. "He will need more surgeries to replace the shunt as he grows."
The nurse is caring for a 14-year-old client in traction prior to surgery. The client has been in the hospital for 2 weeks and will require an additional 10 days in the hospital following surgery. The client states, "I feel isolated and I am refusing any more treatment." Which response by the nurse is most appropriate? A. "I know it is boring here, but the best place for you to remain immobile is the hospital." B. "I will see if you can have friends come spend a few nights with you." C. "Let's come up with things for you to do and see if your friends can come visit." D. "If you refuse further treatment, your condition will only get worse."
C. "Let's come up with things for you to do and see if your friends can come visit."
The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? A. "If you wear your brace properly, you may not need surgery." B. "The good news is that you have very minimal curvature of your spine." C. "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." D. "Let's talk to the doctor about your treatment options."
C. "Let's talk to another boy with scoliosis, who is winning trophies for his swim team."
The nurse is caring for a female infant with torticollis and is providing instructions to the parents about how to help their daughter. Which statement by the parents indicates a need for further teaching? A. "We must encourage our daughter to turn her head both ways." B. "Flatness on one side of the head is a common side effect." C. "We must apply firm pressure and stretching every other day." D. "We will do a daily stretching regimen with multiple sessions."
C. "We must apply firm pressure and stretching every other day."
The nurse is caring for a 2-year-old girl in a bilateral brace with tibia vara. Her parents are upset by their toddler's limited mobility. Which response by the nurse would be most appropriate? A. "If you don't follow the therapy, your daughter could develop severe bowing of her legs." B. "It's important to use the brace or your daughter may need surgery." C. "You are doing a great job. Let's put our heads together on how to keep her busy." D. "You'll need to accept this since treatment may be required for several years."
C. "You are doing a great job. Let's put our heads together on how to keep her busy."
A 6-year-old child with cerebral palsy has been admitted to the hospital for some tests. The child's condition is stable. A parent remains with the child, but the parent is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A. "Would you like me to bring you a blanket and pillow?" B. "You are doing such a wonderful job with your child." C. "Your child is in good hands; consider going home to get some sleep." D. "Are you planning to spend the night or to go home?"
C. "Your child is in good hands; consider going home to get some sleep."
A group of nursing students are reviewing information about types of skin traction and skeletal traction. The students demonstrate understanding of this information when they identify which of these as a type of skeletal traction? A. Russell traction B. Bryant traction C. Buck traction D. Side arm 90-90 traction
C. Buck traction
As a result of seizure activity, a computed tomography (CT) scan was performed and showed that an 18-month-old child has intracranial arteriovenous malformation. When developing the child's plan of care, what would the nurse expect to implement actions to prevent? A. Drug interactions B. Developmental disabilities C. Hemorrhagic stroke D. Respiratory paralysis
C. Hemorrhagic stroke
A nurse is preparing a program for a group of parents about injury prevention. What would the nurse include as an important contributing factor for cervical spine injury in a child? A. Exposure to teratogens while in utero B. Immaturity of the central nervous system C. Increased mobility of the spine D. Incomplete myelinization
C. Increased mobility of the spine
When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of what condition? A. Neonatal conjunctivitis B. Facial deformities C. Intracranial hemorrhage D. Incomplete myelinization
C. Intracranial hemorrhage
A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A. Oral B. Subcutaneous injection C. Intramuscular injection D. Intravenous infusion
C. Intramuscular injection
Hydrocephalus is suspected in a 4-month-old infant. Which would the nurse expect to assess? A. Sunken fontanels B. Diminished reflexes C. Lower extremity spasticity D. Skull symmetry
C. Lower extremity spasticity
The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include? A. Dislocated radial head B. Transient synovitis of the hip C. Osgood-Schlatter disease D. Scoliosis
C. Osgood-Schlatter disease
The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include? A. Applying petroleum jelly to the dry skin B. Rubbing the skin vigorously to remove the dead skin C. Soaking the area in warm water every day D. Washing the skin with dilute peroxide and water
C. Soaking the area in warm water every day
An 18-month-old was brought to the emergency department by her mother, who states, "I think she broke her arm." The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal? A. Plastic deformity B. Buckle fracture C. Spiral fracture D. Greenstick fracture
C. Spiral fracture
The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition? A. Multiple corrective surgeries to slowly remove diseased parts of his brain B. Physical, occupational, and speech therapy to maximize his potential C. Support for maintaining self-esteem because of his altered lifestyle D. Hyperventilation therapy to counteract the periods of decreased oxygenation
C. Support for maintaining self-esteem because of his altered lifestyle
An 8-year-old boy with a fractured forearm is to have a fiberglass cast applied. What information would the nurse include when teaching the child about the cast? A. The cast will take a day or two to dry completely. B. The edges will be covered with a soft material to prevent irritation. C. The child initially may experience a very warm feeling inside the cast. D. The child will need to keep his arm down at his side for 48 hours.
C. The child initially may experience a very warm feeling inside the cast.
A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? A) Astigmatism B) Hyperopia C) Myopia D) Amblyopia
D) Amblyopia
The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which condition would the nurse explain as resolving by itself without the use of antibiotics? A) Blepharitis B) Hordeolum C) Corneal abrasion D) Chalazion
D) Chalazion
A nurse is examining a child who has sustained blunt trauma to the eye area. The nurse suspects a simple contusion based on what finding? A) Pain in the eye B) Impaired visual acuity C) Blurred vision D) Intact extraocular movements
D) Intact extraocular movements
The nurse is caring for a 3-year-old boy with amblyopia. Which intervention would be most appropriate to include in the child's plan of care? A) Rinsing the eye with cool water B) Educating the family about the disease C) Encouraging frequent hand washing D) Promoting eye safety
D) Promoting eye safety
A group of students are reviewing information about the differences in the hearing and vision capabilities of a child when compared to an adult. The students demonstrate a need for additional study when they identify what as one of the differences? A) Hearing is completely developed at the time of birth. B) Visual acuity develops from birth throughout childhood. C) Binocular vision is usually achieved by 2 months of age. D) The ability to discriminate colors is completed by birth.
D) The ability to discriminate colors is completed by birth.
A pediatric client diagnosed with Duchenne muscular dystrophy is prescribed a corticosteriod. Which statement by the caregiver indicates additional education by the nurse is needed? A. "I will monitor my child for signs of infection." B. "My child should take this medicine with food." C. "I will call the primary health care provider if my child develops a moon-face." D. "If I notice my child gain weight, I will stop the medication."
D. "If I notice my child gain weight, I will stop the medication."
A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which instruction would the nurse include when teaching the parents about caring for their child? A. Wait 48 hours before allowing the child to take a tub bath. B. Do not allow the child to sleep on the left side for about 4 weeks. C. Call the helath care provider if the child's temperature is over 100.5°F (38°C). D. Discourage the child from stretching or bending forward for 4 weeks.
D. Discourage the child from stretching or bending forward for 4 weeks.
A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion? A. The child's risk for cognitive problems is greatly increased. B. Structural damage occurs with febrile seizure. C. The child's risk for epilepsy is now increased. D. Febrile seizures are benign in nature.
D. Febrile seizures are benign in nature.
During class, a student states, "I didn't think children could have strokes. I thought this only occurred in older adults." When responding to the student, what would be most important for the instructor to integrate into the response? A. Strokes in children often have an identifiable cause. B. The signs and symptoms in children are different from an adult. C. Research has identified specific treatments for children. D. Ischemic strokes are more common than hemorrhagic strokes.
D. Ischemic strokes are more common than hemorrhagic strokes.
A group of nursing students are reviewing information related to seizures that occur in infants and children. The students demonstrate a need for additional review when they identify which type as common in neonates? A. Tonic B. Focal clonic C. Multifocal clonic D. Myoclonic
D. Myoclonic
What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? A. Bradycardia B. Cheyne-Stokes respirations C. Fixed, dilated pupils D. Projectile vomiting
D. Projectile vomiting
A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? A. Hyperextending the child's head while placing him on his side B. Using a tongue blade to pry open the child's jaw C. Loosening the child's clothing to ensure a patent airway D. Protecting the child from harm during the seizure
D. Protecting the child from harm during the seizure
The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? A. Recommend the bed's side rails be raised throughout the day and night. B. Suggest a caregiver be present continuously to prevent falls from bed. C. Encourage a loose restraint to be used when he is in bed. D. Recommend raising the bed's side rails when a caregiver is not present.
D. Recommend raising the bed's side rails when a caregiver is not present.
