Prep U practice

The nurse is caring for an 8-year-old child in traction. The client has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. The client is showing signs of regression with thumb sucking and pleas for the now tattered baby blanket. What would be the most helpful intervention? "Would you like a coloring book? ""Let's ask your parents to bring your friends for a visit. ""You are too big to suck your thumb. ""Do you want a book to read?"

""Let's ask your parents to bring your friends for a visit.

The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education? "Because our child has scoliosis, treatment will include halo traction." "The treatment for our child's scoliosis is anticipated to last between 3 to 4 months." "Because our child is being treated by using braces, the braces will have to be worn almost all the time." "The most successful treatment for scoliosis is surgery before reaching adult age."

"Because our child is being treated by using braces, the braces will have to be worn almost all the time."

A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl? "Do you notice any wheezing when you breathe or a runny nose?" "Do you have any shoulder pain or abdominal tenderness?" "Have you noticed any new bruising or different color patterns on your skin?" "Have you noticed any hair loss or redness on your face?"

"Have you noticed any hair loss or redness on your face?" Alopecia and the characteristic malar rash (butterfly rash) on the face are common clinical manifestations of SLE.

The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education? "I guess my mom was right, she always put ice on our burns when we were kids." "If my child has a superficial burn, I will run cool water over it." "Mild soap can be used to clean a superficial burn." "For a superficial burn, I can cover it with a clean nonadherent dressing."

"I guess my mom was right, she always put ice on our burns when we were kids." Steps for providing burn care at home to a first-degree (superficial) burn includes running cool water, not ice, over the burn. Covering it with a nonadherent bandage after cleaning with a fragrance-fee mild soap. Other care includes not applying butter, ointments or creams, and administering acetaminophen or ibuprofen for pain.

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? "I brush my child's teeth once every day." "My child's stools are darker than usual." "I mix ferrous sulfate with milk in a bottle." "My child takes ferrous sulfate after meals."

"I mix ferrous sulfate with milk in a bottle." ferrous sulfate may not be absorbed if taken with milk or tea, and if the parent mixes the medicine with milk in a bottle, there is also concern that if the child does not drink the entire amount of medication. Ferrous sulfate may be taken after meals to prevent gastrointestinal irritation. Dark stools are a common side effect of ferrous sulfate. Parents should be encouraged to brush the child's teeth thoroughly to prevent teeth staining.

An adolescent client who has scoliosis and is wearing a Milwaukee brace tells the nurse that she is ugly and cannot wear the same clothing as her friends. Which response by the nurse best addresses this client's altered self-image? "You should not worry about what everyone else is wearing. You look fine." "Kids can be cruel sometimes. Has anyone told you that you look different?" "Let's look at some clothing that you can wear with the brace that will look like everyone else's clothes but cover it." "Just hold your head up and be confident in how you look. Look for some after-school activities you can do wearing your brace."

"Let's look at some clothing that you can wear with the brace that will look like everyone else's clothes but cover it." A positive self-image is very important for adolescents wearing a brace. They want to look like their peers and wear the same clothing, but often that is not possible when wearing a brace. Assisting the adolescent in selecting clothing that looks stylish but still hides the brace is one of the best ways to help this client. Telling her she looks fine, to be confident, or bringing up the times she has been embarrassed does not help the client.

A nurse is providing dietary interventions for a 5-year-old with an iron deficiency. Which response indicates a need for further teaching? "Red meat is a good option; he loves the hamburgers from the drive-thru." "He will enjoy tuna casserole and eggs." "There are many iron fortified cereals that he likes." "I must encourage a variety of iron-rich foods that he likes."

"Red meat is a good option; he loves the hamburgers from the drive-thru." While iron from red meat is the easiest for the body to absorb, the nurse must limit fast food consumption from the drive-thru as it is also high in fat, fillers, and sodium. The other statements are correct.

The nurse is caring for a child who has received significant partial-thickness burns to the lower body. What is the priority assessment in the first 24h after injury? 1. fluid balance 2. wound infection 3. respiratory arrest 4. separation anxiety

1. fluid balance

The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? 1. administer griseofulvin with a fatty meal 2. institute contact isolation precautions 3. apply topical antibiotic cream 4. apply topical antifungal cream

4. apply topical antifungal cream

A parent calls the pediatric oncology clinic about the child having headaches after chemotherapy. What is the nurse's best advice? Administer ibuprofen every 6 hours. Use an ice pack on the child's head. Administer acetaminophen as needed. Administer oral hydrocodone as needed.

Administer acetaminophen as needed. Caution parents, while children are receiving chemotherapy, not to give them nonsteroidal anti-inflammatory drugs because they may interfere with blood coagulation, a problem that may already be present because of lowered thrombocyte levels. Instead, suggest they use acetaminophen to relieve a headache. Ice packs are used to prevent hair loss and do not help with headaches. Hydrocodone is not needed for a headache.

The nurse is working with a child who is in sickle cell crisis. Treatment and nursing care for this child include which actions? Select all that apply. Administering oxygen Administering analgesics Maintaining fluid intake Promoting exercise and activity Administering platelets

Administering oxygen Administering analgesics Maintaining fluid intake

A school-aged child is brought to the office of the camp nurse with a small, superficial burn (first-degree burn). Which action by the nurse would be most appropriate to take first? Administer acetaminophen. Cover the area with a sterile bandage. Apply a topical anesthetic ointment. Apply cold compresses to the area.

Apply cold compresses to the area. Cool water is an excellent emergency treatment for burns involving small areas. The immediate application of cool compresses or cool water to burn areas appears to inhibit capillary permeability and thus suppress edema, blister formation, and tissue destruction.

A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode? Administer factor VIII replacement. Apply heat to the site of bleeding. Elevate the injured area such as a leg or arm. Apply direct pressure to the area.

Apply heat to the site of bleeding.

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer? Bladder Blood Brain Kidney

Bladder The most common sites for childhood cancer include the blood, lymph, brain, bone, kidney, and muscle. Bladder is a common site for adult cancer.

The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects? Drink a glass of milk Brush his or her teeth Remain in an upright position for at least 15 minutes Not eat or drink for one hour

Brush his or her teeth To prevent staining of the teeth, the child should brush the teeth after administration of iron preparations such as ferrous sulfate. There is no need to remain upright, drink milk or to refrain from eating or drinking for one hour.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply. Color Sensation Capillary refill Vital signs Pulse

Color Sensation Pulse Capillary refill A neurovascular assessment includes assessing for color, movement, sensation, edema, and quality of pulses. Vital signs are not a component of a neurovascular assessment.

A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family? Keep follow-up appointments Perform proper hand hygiene Complete the prescribed antibiotics Monitor for signs of worsening condition

Complete the prescribed antibiotics

The nurse is caring for a child with a fractured femur in traction. Which action will the nurse complete while caring for this client? Ensure traction weights are hanging freely, not touching the bed or floor. Remove traction weights once per shift for 30 minutes and then replace them. Plan to add additional weights as the fracture heals, usually once per day. Have the unlicensed assistive personnel remove the weights daily and encourage the child to move around in bed.

Ensure traction weights are hanging freely, not touching the bed or floor. Traction is used as a pulling force on an extremity or body part. For it to be effective, the weights need to hang freely at all times and the ropes need to remain in the pulley grooves. The weights are not replaced or removed during traction. The child can move all extremities except the affected one(s). The child remains in traction until healing occurs, a cast is applied, or surgical repair is performed.

A nurse is caring for an infant whose mother is human immunodeficiency (HIV) positive. The nurse knows that which diagnostic test result will be positive even if the child is not infected with the virus? Erythrocyte sedimentation rate Immunoglobulin electrophoresis Polymerase chain reaction test Enzyme-linked immunosorbent assay (ELISA)

Enzyme-linked immunosorbent assay (ELISA) The ELISA test will be positive in infants of HIV-infected mothers because of trans-placentally received antibodies. These antibodies may persist and remain detectable up to 24 months of age, making the ELISA test less accurate in detecting true HIV infection in infants and toddlers than the polymerase chain reaction (PCR).

While administering a blood transfusion to a child with a hematologic disorder, the nurse notes the child develops urticaria and wheezing. Which collaborative interventions will the nurse begin? Select all that apply. Apply oxygen as needed. Obtain a blood culture. Administer a diuretic. Give an antihistamine. Discontinue the transfusion.

Give an antihistamine. Apply oxygen as needed. Discontinue the transfusion The child is experiencing signs of an allergic reaction to the blood transfusion and would require discontinuation of the blood transfusion, administration of an antihistamine, and oxygen as needed. Diuretics would be needed for an anaphylactic or circulatory overload reaction related to the blood transfusion, whereas a blood culture would be needed if a contaminant in the blood was suspected.

A 5-year-old child is in traction and at risk for impaired skin integrity due to pressure. Which intervention is most effective? Apply lotion to dry skin. Gently massage the child's back to stimulate circulation. Inspect the child's skin for rashes, redness, irritation, or pressure sores. Keep the child's skin clean and dry.

Inspect the child's skin for rashes, redness, irritation, or pressure sores. It is important to be vigilant in inspecting the child's skin for rashes, redness, and irritation to uncover areas where pressure sores are likely to develop. Applying lotion is part of the routine skin care regimen. Applying lotion, gentle massage, and keeping skin dry and clean are part of the routine skin care regimen.

The nurse is caring for a child with HIV. The doctor will most likely order which test to monitor the child's progress? Lymphocyte immunophenotyping T-cell quantification Complement assay (C3 and C4) IgG subclasses Immunoglobulin electrophoresis

Lymphocyte immunophenotyping T-cell quantification Lymphocyte immunophenotyping T-cell quantification is for ongoing monitoring of progressive depletion of CD4 T lymphocytes in HIV disease. The nurse would expect the physician to order a complement assay (C3 and C4) for ongoing monitoring of systemic lupus erythematosus.

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority? Monitor the site dressing and vital signs. Evaluate pain and administer medication. Educate the family on proper handwashing. Allow the child to play with a doll and syringe.

Monitor the site dressing and vital signs.

The most accurate screening test for the presence of HIV antigen in young children is: a. ELISA b. Western Blot c. PCR d. CD4 count

PCR PCR tests directly for the HIV antigen. ELISA and the Western blot test detect the presence of HIV antibodies. The CD4 count is used as a measure of disease status and progression

The nurse is developing the plan of care for a 3-year-old child diagnosed with atopic dermatitis. Which client outcomes are common focuses for a child with this diagnosis? Select all that apply. a) Prevention of infection b) Promotion of skin hydration c) Pain management d) Maintenance of skin integrity e) Reduction in anxiety

Promotion of skin hydration• Maintenance of skin integrity• Prevention of infection

In caring for a child in traction, which intervention is the highest priority for the nurse? The nurse should record accurate intake and output. The nurse should clean the pin sites at least once every 8 hours. The nurse should monitor for decreased circulation every 4 hours. The nurse should provide age-appropriate activities for the child.

The nurse should monitor for decreased circulation every 4 hours.

A 14-year-old adolescent is suspected to have scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note? The angle of the iliac crest when bending forward The angle of the lower chest when sitting down The posterior spine when bending forward The posterior spine when bending sideways

The posterior spine when bending forward

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? a child with IgA deficiency reporting rhinitis a child reporting coughing, itching, and anxiety a child with HIV who reports feeling lethargic a child reporting a vesicular rash with yellow crusts

a child reporting coughing, itching, and anxiety The first child the nurse will see is the child showing signs and symptoms of an allergic reaction, which includes coughing, itching, and anxiety. Children with IgA deficiency are likely to experience rhinitis. Lethargy is a common symptom of HIV. A child with a vesicular rash with yellow crusts most likely has atopic dermatitis (eczema). Reference:

A girl with scoliosis is prescribed a body brace. The purpose of the brace is to a) improve spinal alignment. b) prevent torticollis. c) prevent herniation of a spinal disk. d) correct spinal curvature.

a) improve spinal alignment. Body bracing helps to hold the spine in alignment and prevent further curvature. The brace will not correct the problem. Herniation and torticollis are not associated with scoliosis.

The nurse is preparing an assessment guide for the emergency department staff regarding assessment of clients who are admitted with burn injuries. What should the nurse be sure to include in the assessment guide for primary emergency assessment of burns? airway assessment depth of the burns presence of edema percentage of body burned pulse strength

airway assessment presence of edema pulse strength

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 disorder? hemophilia otitis media rheumatoid arthritis asthma

asthma Infants who have atopic dermatitis (infantile eczema) tend to have allergic rhinitis or asthma later in life.

The nurse is providing education to the parents of a teenaged boy diagnosed with impetigo. Which of the following statements by the boy indicates the need for further education? a) "This condition is contagious." b) "I will need to cover my son's skin lesions with bandages until it has healed." c) "It is important to remove the crusts before applying any topical medications." d) "My son can continue to attend school while he is taking the prescribed antibiotics."

b) "I will need to cover my son's skin lesions with bandages until it has healed." Impetigo is an infectious bacterial infection. The crusts should be removed after soaking prior to applying topical medications. Leaving the lesions open to air is not contraindicated. Children diagnosed with impetigo may attend school during treatment.

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? a) Candidiasis b) Seborrheic dermatitis c) Impetigo d) Miliaria rubra

c) Impetigo Impetigo is a superficial bacterial skin infection.

Which mechanism is central to cancers in children? genetics environment cellular growth race

cellular growth

The nurse will select which meal as the best choice for a child with iron-deficiency anemia? cheeseburger, broccoli, and fresh strawberries chicken breast, French fries, and sweetened tea peanut butter sandwich, cheese stick, and applesauce two slices of pepperoni pizza and a glass of skim milk

cheeseburger, broccoli, and fresh strawberries Children with iron-deficiency anemia require diets rich in iron and vitamin C (vitamin C enhances iron absorption). Meats are excellent sources of iron. Broccoli is a good source of iron, and strawberries are a good source of vitamin C. To help the body absorb the most iron from the meal, tea and foods rich in calcium (such as milk and cheese) should be avoided.

The nurse is caring for a child admitted with partial thickness burns. What is most characteristic of this type of burn? a) Muscle damage occurs b) Skin is red and edematous c) Pain is minimal d) Blisters appear

d) Blisters appear (2nd degree)

The nurse is caring for a 1-year-old in a pediatric clinic. The child was brought to the clinic with symptoms of dry, itchy red patches of skin on the arms and legs. A diagnosis of atopic dermatitis (eczema) is made. What is a key element in the treatment regimen for this diagnosis? a) Daily oral cortisone b) Teaching the child not to scratch the "itchy" skin c) Applying topical antibiotics routinely d) Frequently rehydrating the skin

d) Frequently rehydrating the skin

The nurse is caring for a child admitted with Legg-Calvé-Perthes disease. Which clinical manifestation would likely have been noted in the child with this diagnosis? a) Poor posture and malformed vertebrae b) Difficulty standing and walking c) Inflammation of the joints d) Pain in the groin and a limp

d) Pain in the groin and a limp Symptoms first noticed in Legg-Calvé-Perthes disease are pain in the hip or groin and a limp accompanied by muscle spasms and limitation of motion.

A nurse is conducting a physical examination on an 11-year-old boy with Legg-Calvé-Perthes disease. Which assessment finding would be expected? a) Lordosis b) Loss of strength in ankle dorsiflexion c) Kyphosis d) Trendelenburg gait

d) Trendelenburg gait

The nurse is caring for a child with osteomyelitis. Which of the following is true regarding this diagnosis? Select all that apply. a) As abscess forms, ruptures and spreads infection in the metaphysis of the bone b) Corticosteroids are the treatment of choice c) Transmission-based precautions are followed in most cases d) Caused by Staphylococcus aureus e) Lab findings show a leukocyte count of 1,000 to 2,000 cells

d)Caused by Staphylococcus aureus c)Transmission-based precautions are followed in most cases a)As abscess forms, ruptures and spreads infection in the metaphysis of the bone Explanation: Osteomyelitis is caused by Staphylococcus aureus. The bacteria enter the bloodstream and are carried to the metaphysis, the growing portion of the bone, where an abscess forms, ruptures, and spreads the infection along the bone under the periosteum. Transmission-based precautions may be required if a wound is open and draining.

A nurse is caring for a newborn whose screening test result indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect the test result to be confirmed by which lab tests? reticulocyte count peripheral blood smear erythrocyte sedimentation rate hemoglobin electrophoresis

hemoglobin electrophoresis If the screening test result indicates the possibility of SCA or sickle cell trait, hemoglobin (Hgb) electrophoresis is performed promptly to confirm the diagnosis. While Hgb electrophoresis is the only definitive test for diagnosis of the disease, other laboratory testing that assists in the assessment of the disease include reticulocyte count (greatly elevated), peripheral blood smears (presence of sickle-shaped cells and target cells), and erythrocyte sedimentation rate (elevated).

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens. killer; bacterial humoral; viral killer; viral humoral; bacterial

humoral; bacterial B cells are also called humoral cells and typically attack bacterial organisms. Another term for T cells is killer cells, and they most commonly attack viral organisms.

Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for: platelets. leukemic cells. early meningitis. early development of septicemia.

leukemic cells. Acute lymphoblastic leukemia (ALL) is a rapidly progressive cancer affecting the undifferentiated or immature cells. It is the most common form of cancer in children

The nurse is providing care to a child and is to collect a 24-hour urine specimen for catecholamines. The nurse integrates knowledge of this testing as indicative of: neuroblastoma. Hodgkin disease. leukemia. osteosarcoma.

neuroblastoma. A 24-hour urine specimen for catecholamines (homovanillic acid [HVA] and vanillylmandelic acid [VMA]) is used to help diagnose neuroblastoma because this cancer produces catecholamines; thus, levels will be elevated. This test is not used to diagnose Hodgkin disease, leukemia, or osteosarcoma.

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as: significant bending without actual breaking. bone buckling due to compression. incomplete fracture. bone that breaks into two pieces.

significant bending without actual breaking. A plastic or bowing deformity is one in which there is significant bending of the bone without breaking. A buckle fracture is one in which the bone buckles rather than breaks. This is usually due to a compression injury. An incomplete fracture of the bone is a greenstick fracture. A complete fracture is one in which the bone breaks into two pieces.

A child is to receive oral iron therapy in liquid form three times per day. After teaching the parents about administering the iron, which statement indicates a need for additional teaching? "Our child's bowel movements will probably turn very dark." "We will try to give the medicine to our child in between meals." "We will have our child drink water or juice with the medicine." "Our child can drink the medicine from a medicine cup."

"Our child can drink the medicine from a medicine cup." Liquid iron can stain the teeth; therefore, the parents should give the liquid iron through a straw or syringe, placing it toward the back of the child's mouth. Iron turns stools dark. To maximize absorption, it is best to give the iron with water or juice between meals.

A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care? a) Maintaining intravenous antibiotic therapy b) Assisting the child with crutch walking c) Restricting fluid to encourage red cell production d) Keeping the child quiet while in skeletal traction

a) Maintaining intravenous antibiotic therapy Osteomyelitis is a serious infection. It is treated vigorously with intravenous antibiotics. It would not require traction. The stem does not indicate the location of the infection, so the child may not need crutches. Fluid restriction does not help red blood cell production.

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? a) Osteosarcoma b) Osteomyelitis c) Muscular dystrophy d) Juvenile rheumatoid arthritis

b) Osteomyelitis

The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time? a) Hepatitis A vaccine b) Tetanus toxoid vaccine c) Hepatitis B vaccine d) Haemophilus influenzae type B vaccine

b) Tetanus toxoid vaccine

When helping parents plan care for a child with Legg-Calvé-Perthes disease, the nurse would teach the parents that the usual therapy for children with this disorder is: a) passive range-of-motion exercises TID. b) surgery with supporting rods. c) a nonweight-bearing period. d) exercise to increase muscle strength of the knee joint.

c) a nonweight-bearing period. Resting the affected femoral epiphysis aids healing.

When caring for a child experiencing anaphylactic shock, the most important nursing action would be to a) counteract hypertension. b) enhance the action of histamine. c) facilitate breathing. d) reverse sympathetic nervous system responses.

c) facilitate breathing. The sudden release of histamine with an allergic reaction can cause severe bronchospasm, closing the airway.

A nurse is working with a 12-year-old girl with osteomyelitis who is recovering from surgery. Which of the following are nursing interventions that should be implemented in this case? *(Select all that apply.) a) Instituting infection-control precautions related to drainage tubes b) Instruction to the parents regarding the importance of the child maintaining bed rest c) Casting of the affected limb d) Instruction to the parents regarding how to care for an antibiotic IV line at home e) Administration of IV antibiotics at the hospital f) Instruction to the parents regarding proper traction of the limb

e)Administration of IV antibiotics at the hospital d)Instruction to the parents regarding how to care for an antibiotic IV line at home a)Instituting infection-control precautions related to drainage tubes b) Instruction to the parents regarding the importance of the child maintaining bed rest

A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important? Restricting the child's visitors Placing a "no abdominal palpation" sign above the child's bed Ensuring that the child be allowed nothing by mouth Preparing the child for chemotherapy Preventing weight-bearing activities

Placing a "no abdominal palpation" sign above the child's bed Nephroblastoma (Wilms tumor) metastasizes rapidly, so it is important that the child's abdomen not be palpated any more than necessary for diagnosis, because handling appears to aid metastasis. There is no need to restrict the child's visitors. Ensuring nothing by mouth would be appropriate prior to surgery. Preventing weight-bearing activities would be appropriate for a child with Ewing sarcoma.

The nurse is speaking with the parents of a child who has a cast. The parents state that the child reports itching in the area of the cast. What is the best response by the nurse? "Itching is common. It's nothing to worry about." "Blowing cool air with a fan or hair dryer may relieve the feeling." "You can put a pencil or coat hanger and scratch the area but don't let your child put anything down the cast without you there." "A small amount of lotion or baby oil can be poured in the cast to moisturize the area."

"Blowing cool air with a fan or hair dryer may relieve the feeling." Itching is a common report, but just stating this does not address the entire situation. The suggestion of blowing cool air is the best answer. Clients should never put anything in a cast to scratch. Lotion may be applied to the skin above or below a cast but should never be poured into a cast. Reference:

A nurse caring for a child wearing a brace to correct scoliosis provides patient and family teaching for home care of the brace. Which of the following is an accurate intervention for this situation? Select all that apply. a) Schedule brace wear for waking hours for best therapeutic results. b) Tell the patient to loosen the brace during meals if necessary. c) Gradually decrease wearing time so the skin can develop tolerance. d) Avoid sitting in one position for long periods of time. e) Recommend a shower instead of a bath to stimulate the skin. f) Wear a 100%-cotton T-shirt under the brace to absorb moisture.

b) Tell the patient to loosen the brace during meals if necessary. d) Avoid sitting in one position for long periods of time. f) Wear a 100%-cotton T-shirt under the brace to absorb moisture. The nurse should teach the patient to avoid sitting in one position for long periods of time and to loosen the brace during meals. The nurse should also encourage wearing the brace during sleep to use up the most hours and tell the family to increase wearing time gradually so that the skin can develop tolerance for the pressure of the brace. A 100%-cotton shirt should be worn under the brace, and a shower or bath should be taken daily.

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education? "Phagocytosis is the process in which phagocytes swallow up and break down microorganisms." "Humoral immunity is immunity mediated by antibodies secreted by B cells." "Cellular immunity is cell-mediated immunity controlled by T cells." "Humoral immunity is generally functional at birth."

"Humoral immunity is generally functional at birth." Normal immune function is a complex process involving phagocytosis (process by which phagocytes swallow up and break down microorganisms), humoral immunity (immunity mediated by antibodies secreted by B cells), cellular immunity (cell-mediated immunity controlled by T cells), and activation of the complement system. Cellular immunity is generally functional at birth, and as the infant is exposed to various substances over time, humoral immunity develops.

An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals? "It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms." "It is important to correct spinal curvature before it gets too bad, causing you problems." "It is important to prevent herniation of a spinal disk, which is painful." "It is important to prevent torticollis."

"It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms." It is important to have the adolescent understand the treatment and how the treatment will benefit him or her. Body bracing helps to hold the spine in alignment and prevent further curvature, decreasing the symptoms. The brace will not correct the problem. Adolescents have a hard time being compliant with the brace due to body image disturbance and peer reaction. The brace can also cause discomfort and be hot to wear. Torticollis is tightened neck muscles causing the head to tilt downward. A herniated disc is related to the disc space between the vertebrae. It has no affect on the curvature of the spine.

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? Plotting height and weight on a growth chart Assessing dietary intake by addressing "picky eating" and "food jags" Administering the measles, mumps, rubella (MMR) vaccine Teaching the importance of taking water safety measures

Administering the measles, mumps, rubella (MMR) vaccine Live vaccines (viral or bacterial) should not be administered to an immunosuppressed child because of the risk of causing disease. The other health maintenance activities are important for the health maintenance of the toddler and should be included during the well-child visit.

The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? Calling the doctor if the child gets a sore throat Keeping a written copy of the treatment plan Writing down phone numbers and appointments Using acetaminophen if the child needs an analgesic

Calling the doctor if the child gets a sore throat Calling the doctor if the child gets a sore throat is the priority. Because of the child's impaired immune system, any sign of potential infection, such as sore throat, must be evaluated by a physician. Using acetaminophen if the child needs an analgesic, writing down phone numbers and appointments, and keeping a written copy of the treatment plan are important teaching points—but secondary to guarding against infection.

The nurse is caring for a child who is beginning to show signs and symptoms of anaphylaxis. Which intervention would be the priority?a) Obtaining brief history of allergen exposure b) Assessing patency of the airway c) Administering IV diphenhydramine (Benadryl) d) Administering corticosteroids

b) Assessing patency of the airway The priority nursing intervention is to assess patency of the airway and breathing. If the child is stable, the next step would be to obtain a brief history of allergen exposure. If epinephrine is required, it would be administered prior to diphenhydramine. Corticosteroids would be used to prevent late-onset reactions

The nurse is caring for a preschooler with a greenstick fracture. Which statement by a parent indicates an understanding of this type of fracture? "This type of fracture only occurs in the leg." "My child may need the arm broken completely prior to putting a cast on it." "Crepitus (crackling) can be felt over this type of fracture." "I shouldn't have picked my child up by the arm. This fracture wouldn't have happened."

"My child may need the arm broken completely prior to putting a cast on it." Greenstick fractures are incomplete fractures. They commonly occur in young children. Sometimes greenstick fractures are broken completely before casting to prevent the bone from resuming its "bent" position in the cast. This fracture does not always occur in the leg. Crepitus (crackling) typically occurs over a clavicle fracture. A dislocation of the radial head is the typical injury that occurs when a child is picked up by one arm.

Which nursing intervention is priority when caring for a child with HIV? Assist the child with daily activities. Assess pain after invasive procedures. Administer prescribed medications. Review laboratory CD4 counts daily.

Administer prescribed medications. Although assisting with activities, assessing pain, and reviewing CD4 counts are all important, the priority when caring for a child with HIV is to administer prescribed medications. Prescribed medications prevent progressive deterioration of the immune system and provide prophylaxis against opportunistic infections.

The nurse is caring for a patient brought to a pediatric clinic for swelling in the lower extremities with reddened skin that has undefined borders and pits slightly when pressed. Which of the following is the most likely diagnosis of the patient's skin alteration? a) Cat scratch disease b) Cellulitis c) Impetigo d) Staphylococcal scalded skin syndrome

b) Cellulitis

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? a) The nurse applies elbow restraints to the infant. b) The nurse applies topical antibiotics to the lesions. c) The nurse follows contact precautions. d) The nurse soaks the skin with warm water.

c) The nurse follows contact precautions. Impetigo is highly contagious and can spread quickly. The nurse should follow contact (skin and wound) precautions, including wearing a cover gown and gloves. The nurse will soak the crusts with warm water, apply topical antibiotics, and apply elbow restraints, but these are not as high a priority as trying to prevent the spread of the infection by following contact precautions.

A 6-year-old child has been found to have a stage II brain tumor. The parent asks the nurse to explain what "stage II" means. Which information would the nurse provide? The cancer has spread in the brain itself but the chance of complete surgical removal is good. The tumor has not extended into the surrounding tissue and can be completely removed surgically. Cancer cells have spread to local lymph nodes. Tumors have spread systemically throughout the body.

The cancer has spread in the brain itself but the chance of complete surgical removal is good. Knowing the stage of a tumor helps the health care team design an effective treatment program, establish an accurate prognosis, and evaluate the progress or regression of the disease. In general, stage I refers to a tumor that has not extended into the surrounding tissue so can be completely removed surgically; stage II means there is some local spread but the chance for complete surgical removal is good. Stage III typically means cancer cells have spread to local lymph nodes; stage IV designates tumors that have spread systemically (metastasis).

The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe? a) Edema with dry or waxy-looking skin b) Edema with wet blistering skin c) Peeling skin with eschar d) Reddened and leathery skin

b) Edema with wet blistering skin (2nd degree)

A nurse is caring for a burn patient with second and third degree burns on 15% of the body. The patient is complaining of severe itching in and around the burn sites. Which of the following is the best nursing intervention to relieve this symptom? a) Diversional activities b) Turning the patient every two hours c) Medication d) Soaking in a colloidal bath

c) Medication