FA Davis Ch 32 and 33

The parent of a pediatric patient diagnosed with type 2 diabetes mellitus asks how the child "caught" the disease. Which response by the nurse would be appropriate?

"It develops because of insulin resistance."

The parent of a 5-year-old patient with a fractured femur asks how long it will take for the break to heal. Which response by the nurse would be appropriate?

"It will take about 5 weeks."

The parents of a pediatric patient with type 2 diabetes mellitus feel overwhelmed with the amount of information needed to care for their child properly. Which response by the nurse would be appropriate?

"Perhaps you can attend support groups in your area."

The parent of a pediatric patient with type 1 diabetes mellitus calls for direction when the child's morning fasting glucose level is 45 mg/dL (2.5 mmol/L). Which direction would the nurse provide to the parent?

"Take your child to the nearest emergency department."

The parent of a newborn with a clubfoot is concerned that the baby is in pain. Which response would the nurse provide to the parent?

"The disorder is painless, so the baby is not suffering."

An adolescent patient with type 2 diabetes mellitus asks why there is no medication to cure the disease. Which response by the nurse would be appropriate to offer the patient?

"There is no cure, but it can be controlled with diet and weight loss."

The LPN/LVN reinforces teaching previously provided by the RN to the parent of a pediatric patient with type 1 diabetes mellitus. Which statement made by the parent would the LPN/LVN be required to address?

"We will increase the insulin dose if ketones are present in our child's urine."

A preadolescent patient who has been prescribed corticosteroids for years as part of asthma treatment wishes to discontinue the medication. Which response by the nurse would be appropriate?

"Your health care provider will need to prescribe tapering doses."

The LPN/LVN is reinforcing teaching provided by the RN to the parents of a pediatric patient with hypothyroidism. Which statements would indicate that the parents understand the teaching? Select all that apply.

-"Our child will need thyroid medication for life." -"We will not give our child any iron supplements." -"We can crush the medication and give it in a small amount of formula."

The nurse is reinforcing teaching provided by the RN to a parent of a child in a hip spica cast. Which statements would indicate that teaching has been effective? Select all that apply.

-"We bought a special car seat for our child." -"A disposable diaper is placed under the edges of the cast." -"We will wrap the cast with plastic and tape before bathing." -"The edges of the cast are petaled to prevent the skin from being scratched."

The parent of a pediatric patient with type 1 diabetes mellitus asks why the child's blood glucose level is frequently less than 70 mg/dL. Which responses by the nurse would be appropriate? Select all that apply.

-"Your child is eating too little food." -"Your child is eating later than usual." -"Your child is getting more exercise than usual."

The parent of an adolescent patient is concerned because the patient's hands and feet are growing unusually large. Which additional findings would lead the nurse to suspect a diagnosis of gigantism? Select all that apply.

-Acne -Obesity -Sweating -Headaches

The nurse is caring for a pediatric patient with diabetic ketoacidosis (DKA). Which prescriptions would the nurse question before administration? Select all that apply.

-Administer regular insulin 10 units subcutaneously every hour. -Provide intravenous normal saline with potassium chloride at 100 mg per hour. -Titrate insulin infusion so that blood glucose level drops 100 mg/dL per hour.

The nurse is helping create a teaching tool about the pediatric musculoskeletal system. Which structures would the nurse include? Select all that apply.

-Bones -Joints -Muscles -Hematopoiesis

The nurse is caring for a pediatric patient demonstrating signs of juvenile arthritis. Which laboratory test values would the nurse expect to be altered in this patient? Select all that apply.

-C-reactive protein -Rheumatoid factor -Antinuclear antibodies

The nurse is helping to create a teaching tool about traction for the pediatric patient. Which components would the nurse recommend be included in this tool? Select all that apply.

-Friction -Trapeze -Forward force -Counter traction

The nurse is caring for a pediatric patient with a thyroid disorder. Which physiological functions would the nurse anticipate being affected by this disorder? Select all that apply?

-Heart rate -Basal metabolic rate -Processing of nutrients -Blood calcium concentration

The nurse is assisting in the data collection for a newborn. Which tests would the nurse anticipate being prescribed to determine whether the baby has developmental dysplasia/dislocation of the hip (DDH)? Select all that apply.

-Measure leg length -Barlow's maneuver -Ortolani's maneuver -Analyze gluteal skin folds

The nurse is caring for a pediatric patient with hyperthyroidism and exophthalmos. Which interventions would the nurse anticipate being added to the plan of care by the primary health care provider? Select all that apply.

-Measure weight daily. -Provide five meals per day. -Provide with protective eyewear. -Instill artificial tears into eyes every 4 hours while awake.

The nurse is caring for a pediatric patient who is demonstrating signs of Duchenne's muscular dystrophy. Which diagnostic tests would the nurse anticipate being prescribed to confirm the diagnosis? Select all that apply.

-Muscle biopsy -Serum aldolase level -Myoglobin level -Creatinine kinase level

Which clinical data noted by the nurse during the shift assessment indicate that the pediatric client may be experiencing compartment syndrome? (Select all that apply.)

-Pain not relieved by pain medication -Prolonged capillary refill time -Paresthesia of the leg

A mother brings her school-aged daughter to the pediatrician. Upon hearing the daughter's symptoms, the health-care provider prescribes a test for type 1 DM. Which data collected during the nursing assessment support the diagnosis of type 1 diabetes? (Select all that apply.)

-Polyuria -Polyphagia -Polydipsia -Enuresis

The nurse is caring for a pediatric patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which treatments would the nurse anticipate being prescribed for the patient? Select all that apply.

-Restrict fluids -Provide furosemide as prescribed -Monitor 0.3% normal saline intravenous infusion

The nurse is assisting in the creation of a teaching tool about the care of a pediatric patient with type 1 diabetes mellitus. Which complications would the nurse recommend be added to this tool? Select all that apply.

-Retinopathy -Nephropathy -Heart disease -Atherosclerosis

The nurse is caring for a pediatric patient with an adrenal gland disorder. Which clinical manifestations would the nurse observe if the patient's glands produce too much adrenaline? Select all that apply.

-Tremors -Tachycardia -Hypertension

The nurse is caring for a preschool-age patient who has grown 1 inch since age 3. Which diagnostic tests would the nurse anticipate to determine whether the patient has pituitary dwarfism? Select all that apply.

-X-ray of the wrists -Serum growth hormone level

A pediatric patient has 90 g of carbohydrates on the breakfast tray. How many units of a rapid-acting insulin would the nurse anticipate being prescribed for this patient? Record your answer as a range, using whole numbers. Enter the numerals only.

3/6

The nurse is reviewing laboratory test data for a 10-year-old patient with type 1 diabetes mellitus. Which hemoglobin A1c value would the nurse document as within normal limits?

7.3%

The nurse is caring for a newborn patient. At which time would the test for phenylketonuria (PKU) be completed?

After the baby is 24 hours old and breastfeeds

The nurse is caring for a school-age patient with osteomyelitis. Which treatment would the nurse anticipate being prescribed immediately for this patient?

Antibiotics

The nurse is caring for a newborn diagnosed with developmental dysplasia/dislocation of the hip (DDH). For which treatment would the nurse prepare this patient?

Application of a Pavlik harness

The nurse is caring for a pediatric patient with a fractured femur. Which complication would the nurse suspect is occurring if the child has an abnormal complete blood count?

Bleeding

A pediatric patient is being tested for pancreatic malfunction. Which result would the nurse closely monitor in this patient?

Blood glucose level

The parent of a pediatric patient asks why the skin around the child's neck is thicker and darker than anywhere else on the body. Which diagnostic test would the nurse anticipate for this patient?

Blood glucose level

A 4-year-old patient in traction is demonstrating signs of pulmonary congestion. Which action would the nurse suggest to improve this patient's respiratory status?

Blowing bubbles

The nurse is caring for an adolescent patient recovering from surgery to correct scoliosis. Which action would the nurse take when turning this patient?

Carefully logroll the patient.

A parent brings a pediatric patient to the emergency department after the child fell while climbing a tree. Which area would most likely be injured?

Clavicle

The nurse is caring for a school-age child who is newly diagnosed with slipped capital femoral epiphysis. Which treatment would the nurse anticipate for this patient?

Complete bedrest

A pediatric patient has a fractured rib that punctures the left lung. For which type of fracture would the nurse provide interventions to this patient?

Complicated

The parent of a child with Duchenne's muscular dystrophy feels overwhelmed with the care that the child requires and the ultimate outcome. Which information would the nurse offer the parent?

Contact a national muscular dystrophy foundation

Which type of childhood injury is best described as an impact injury that causes hemorrhaging in the soft tissue?

Contusion

A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms?

Daily growth hormone

The nurse is caring for a pediatric patient who is experiencing dehydration and weight loss. Which observation would cause the nurse to suspect that the patient has type 1 diabetes mellitus?

Deep fast respirations

The parent of a pediatric patient with Legg-Calve-Perthes disease does not want the child to have surgery. Which possible complication would the nurse remind the parent could occur if the disorder is not treated?

Degenerative arthritis

The nurse is caring for a pediatric patient in traction due to a fractured femur. Which condition would the nurse suspect is occurring when the thigh muscle of the affected limb is smaller in size?

Disuse atrophy

The nurse observes a preschool-age child having difficulty standing after sitting on the floor. For which health problem would the nurse anticipate collecting data from this patient?

Duchenne's muscular dystrophy

The nurse notes that a female adolescent patient is lacking expected physical signs of sexual maturity for her age. Which hormone would the nurse anticipate being measured in this patient?

Estrogen

An interprofessional team is meeting to discuss the care that a preschool-age patient with osteogenesis imperfecta requires. Which suggestion would the nurse offer the team?

Handle the patient gently when performing physical care.

The parent of a 12-month-old pediatric patient reports that the child cries, vomits, and has diarrhea when given apple and orange juice. Which inborn error of metabolism would the nurse suspect the patient is experiencing?

Hereditary fructose intolerance

The nurse is caring for a school-age child in long-term traction. Which developmental activity would be most beneficial to suggest to this patient?

Homework completion

A pediatric patient is diagnosed with hypothyroidism. Which dietary supplement would the nurse anticipate being prescribed for this patient?

Iodine

The LPN/LVN is caring for a pediatric patient with an undiagnosed metabolic disorder. For which reason would the nurse anticipate testing that includes the pituitary gland?

It is the master gland.

The nurse is caring for a school-age child who reports painful and swollen knees and ankles. The nurse would anticipate providing care for which health problem?

Juvenile idiopathic arthritis (JIA)

While collecting data, the nurse suspects that a school-age patient has Legg-Calve-Perthes disease. Which finding would cause the nurse to make this clinical determination?

Limp hip joint that causes pain

A pediatric patient falls from a structure on a playground and sustains an arm injury. Which diagnostic test would this child need to have performed to visualize the exact location and severity of the injury?

Magnetic resonance imaging (MRI)

The nurse is preparing a dose of insulin for a pediatric patient with type 1 diabetes mellitus. Which insulin would the nurse note to be cloudy in appearance?

Neutral protamine Hagedorn (NPH)

A pediatric patient with a cast on the right lower extremity reports an increase in pain and pressure. Which action by the nurse would be appropriate?

Notify the health care provider.

A parent brings a 3-day-old newborn who was born at home to the emergency department for vomiting after ingesting formula since birth. Which action would be a priority for this patient?

Obtain a newborn screening specimen

The nurse is assisting in the care of a newborn who sustained several fractures during birth. For which health problem would the nurse anticipate care being planned for this patient?

Osteogenesis imperfecta

Which nursing action is appropriate when providing care to a 7-year-old child with a right femur fracture who is placed in Bryant traction while recovering?

Perform frequent repositioning.

The nurse provides a pediatric patient with type 1 diabetes mellitus a prescribed morning dose of insulin. Which action would the nurse take to ensure that the child does not develop hypoglycemia?

Permit the patient to finish breakfast before going for a test.

The nurse is caring for a preadolescent patient recovering from surgery to correct scoliosis. Which goal of care would the nurse identify as a priority for this patient?

Prevent postoperative spinal injury

The LPN/LVN is caring for an adolescent patient with gigantism. Which intervention would be the priority for this patient's care?

Psychological support

A school-age patient with Duchenne's muscular dystrophy is experiencing progressive weakness. Which intervention would the nurse anticipate being prescribed to address this patient's needs?

Referral for occupational therapy

The nurse notes that a pediatric patient has a fasting blood glucose level of 140 mg/dL. Which intervention would the nurse anticipate to validate that this patient has type 1 diabetes mellitus?

Repeat the fasting blood glucose level the next day.

The nurse is preparing a dose of desmopressin for a pediatric patient with hemophilia. Which action would the nurse perform when providing this medication?

Restrict oral fluids for 6 hours after the dose

A pediatric patient with type 1 diabetes mellitus has a morning blood glucose level of 55 mg/dL. Which action would the LPN/LVN take after providing the child with 15 g of orange juice?

Retest the blood glucose level in 15 minutes.

The nurse is caring for a pediatric patient with type 1 diabetes mellitus. Which action would the nurse take when preparing the morning dose of insulin?

Rotate the vial of insulin before withdrawing the dose.

The parent of a preadolescent patient is concerned because the child's clothing is not fitting properly. For which health problem would the nurse prepare to collect data from this patient?

Scoliosis

The nurse is caring for a pediatric patient with maple syrup urine disease (MSUD). For which complication would the nurse plan if the child is not treated with decarboxylase?

Seizures

The nurse is caring for a pediatric patient with maple syrup urine disease (MSUD). For which complication would the nurse plan if the child is not treated?

Seizures

The nurse is asked for suggestions for the care plan of a pediatric patient who will be in long-term traction. Which concern would the nurse identify as being the greatest for this patient?

Skin integrity

A school-age child with a body mass index of 30 is experiencing significant hip pain and a limp. For which potential health problem would the nurse collect data from this patient?

Slipped femoral capital epiphysis

A parent with a newborn diagnosed with galactosemia is concerned about the cost to purchase Nutramigen for the baby. Which other formula would the nurse recommend to the parent?

Soy milk

The nurse is caring for a newborn who is diagnosed with galactosemia. Which feeding would be recommended for the mother to use for this patient?

Soy-based formula

The nurse is caring for a pediatric patient with a fractured humerus. Which type of fracture would raise the greatest suspicion of child abuse?

Spiral

A pediatric patient pulls a muscle during physical education class in school. For which type of injury would the school nurse provide care?

Strain

The nurse is assisting in the creation of a teaching tool about the endocrine system. Which functional unit would the nurse identify as where the chemical messenger acts?

Target cell