Peds Exam 3
A 15 yr female had a scoliosis surgery 5 days ago. This morning she is c/o severe back pain, 10/10. State 2 nursing interventions you would perform.
- Analgesia - Check temp - severe pain 5 days post op might indicate an infection
List three interventions for the infant having a hyper cyanotic spell
- administer 100% oxygen by face - Place in knee-chest position - administer morphine SQ or IV if IV route is available - comfort and soothe the infant
The most painful part of cardiac surgery for the child is usually the: A) thoracotomy incision site B) graft site on the leg C) sternotomy incision site D) intravenous insertion site
A) thoracotomy incision site
J had a unilateral clubfoot repair today and was given a caudal injection for pain control at the end of his surgery. He is awake and crying 5 hours later. J continues to cry despite the maximum dosage of morphine IV at the most frequent interval. His N-V status has worsened (increased capillary refill time, slightly dusky toes). A) What do you suspect is the cause? B) What do you do?
A) Compartment Syndrome B) Call someone ASAP
A nurse is teaching a parent of an infant about GERD. Which of the following should the nurse include in the teaching? (Select all that apply) A) Offer frequent feedings B) Thicken formula with rice feedings C) Use a bottle with a one-way valve D) Position baby upright after feedings E) Use a wide-based nipple for feedings
A) Offer frequent feedings B) Thicken formula with rice feedings D) Position baby upright after feedings
Which of the following usually indicates that the intussusception has reduced itself? A) Passage of a normal brown stool B) Increase in appetite C) Hyperactive bowel sounds D) Normal complete blood count
A) Passage of a normal brown stool
A nurse is assessing an infant who has hypertrophic pyloric stenosis. Which of the following findings should the nurse expect? (Select all that apply) A) Projectile vomiting B) Dry mucus membranes C) Currant jelly stools D) Sausage-shaped abdominal mass E) Constant Hunger
A) Projectile vomiting B) Dry mucus membranes E) Constant Hunger
Malcolm has been admitted to the hospital for closed reduction of his fracture. The suspected child abuse has been reported to the state welfare department and a caseworker has been assigned. Which one of the following is the most appropriate nursing intervention for Malcolm at this time? A) Provide consistent caregiver during hospitalization B) Educate Malcolm's mother on the physical and emotional needs of Malcolm C) Treat Malcolm as a child who is a victim of specific physical abuse D) Promise Malcolm that what he tells you is a secret and you will not tell anyone.
A) Provide consistent caregiver during hospitalization
Which one of the following patterns is indicative of infection in the postoperative period following cardiac surgery? A) Temp of 38.6 C 72 hours after surgery B) Temp of 37.7 C 36 hours after surgery C) Hypothermia in the early postoperative period
A) Temp of 38.6 C 72 hours after surgery
A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply) A) Weak femoral pulses B) Cool skin of lower extremities C) Severe cyanosis D) Clubbing of the fingers E) Heart Failure
A) Weak femoral pulses B) Cool skin of lower extremities E) Heart Failure
One of the most important factors in preventing BE in high risk patients is: A) administration of prophylactic antibiotic therapy B) surgical repair of the defect C) administration of routine childhood immunizations D) administration of antibiotics after dental work
A) administration of prophylactic antibiotic therapy
The standard treatment for Kawasaki disease is: A) aspirin and immune globulin B) aspirin and cryoprecipitate C) meperidine hydrochloride and immune globulin D) meperidine hydrochloride and cryoprecipitate
A) aspirin and immune globulin
Major consequences of immobility in the pediatric patient include which one of the following? A) bone demineralization leading to osteoporosis B) orthostatic hypertension C) dependent edema in the lower extremities D) decrease in the metabolic rate
A) bone demineralization leading to osteoporosis
If failure to thrive has been a longstanding problem, the infant will show evidence of A) both weight and heigh being decreased B) weight restriction only C) height restriction only D) increased head circumference
A) both weight and heigh being decreased
Al, age 5 months, is suspected of having intussusception. What clinical manifestations would he most likely have? A) crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools B) fever; diarrhea; vomiting; lowered WBC count; and tender, distended abdomen C) Weight gain, constipation, refusal to eat, and rebound tenderness D) Abdominal distention, periodic pain, hypotension, and lethargy
A) crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools
Nursing interventions aimed at preventing problems associated with immobility include which one of the following? A) encouraging self-care B) restricting fluids with strict intake and output C) limiting active range-of-motion exercises to once per day D) Decreasing sensory stimulation to allow adequate rest
A) encouraging self-care
In fetal circulation, the majority of the oxygenated blood is pumped through the: A) foramen ovale B) lungs C) liver D) coronary sinus
A) foramen ovale
Based on the above physical findings, documentation should include: i. location and detailed description of arm injury, including asymmetry of injury and pain degree ii. color, size and location of all bruising, including distinguishing characteristics such as shape iii. location, pattern, demarcation lines, and presence of escar, blisters or scarring for burns iv. photographs of the injuries using a measurement tool A) i, ii, iii, and iv B) ii and iii C) i, ii, and iv D) ii, iii, and iv
A) i, ii, iii, and iv
An invagination of one portion of the intestine into another is called: A) intussusception B) pyloric stenosis C) tracheoesophageal fistula D) Hirschsprung disease
A) intussusception
Nursing care directed toward nonsurgical management in a teenager with scoliosis primarily includes: A) promoting self-esteem and positive body image B) preventing immobility C) promoting adequate nutrition D) preventing infection
A) promoting self-esteem and positive body image
The best approach for the nurse to use in advising parents about how to discipline the child with a congenital defect is to: A) provide the parents with anticipatory guidance B) teach the parents to overcompensate C) help the parents focus on the child's defect D) teach the parents to use benevolent overreaction
A) provide the parents with anticipatory guidance
Physical assessment for child physical abuse: A) should identify all injuries B) should always begin with rapid assessment of airway, breathing, circulation and neurologic systems C) should recognize that all forms of physical abuse have obvious signs D) should occur only after legal authorities have been notified
A) should identify all injuries
Coarctation of the aorta should be suspected when: A) the blood pressure in the arms is different from the blood pressure in the legs B) the blood pressure in the right arm is different from the blood pressure in the left arm C) apical pulse is stronger than the radial pulse D) point of maximum impulse is shifted to the left
A) the blood pressure in the arms is different from the blood pressure in the legs
A nurse is caring for a 2-year old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A) Place on NPO status for 12 hr prior to the procedure B) Check for iodine or shellfish allergies prior to procedure C) Elevate the affected extremity following the procedure D) Limit fluid intake following the procedure
B) Check for iodine or shellfish allergies prior to procedure
A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply) A) Bradycardia B) Cool extremities C) Peripheral edema D) Increased urinary output E) Nasal flaring
B) Cool extremities C) Peripheral edema E) Nasal flaring
The diagnostic test that requires intravenous sedation and has been used increasingly in recent years to confirm the diagnosis of a congenital heart defect without a cardiac catheterization is the: A) ECG B) echocardiogram C) transesophageal echocardiagram D) two-dimensional echocardiogram
C) transesophageal echocardiagram
Sam, age 5, is being started on bowel retraining program for chronic constipation. Instructions to the family should include: A) Decrease the water and increase the milk in Sam's diet B) Establish a regular toilet time twice a day after meals when Sam will sit on the toilet for 5-10 minutes C) Withhold Sam's playtime if he does not have a daily bowel movement D) Have Sam sit on the toilet each day until he has a bowel movement
B) Establish a regular toilet time twice a day after meals when Sam will sit on the toilet for 5-10 minutes
In preparing the parents of a child with cleft palate, the nurse includes which of the following in the long-term family teaching plan? A) Explanation that tooth development will be delayed B) Guidelines to use for speech development C) Use of decongestants and acetaminophen to care for frequent upper respiratory tract symptoms D) All of the above
B) Guidelines to use for speech development
After fecal impaction is removed, maintenance therapy for constipation may include laxative use. Why is polyethylene glycol considered safe to use for pediatric patients? A) Decreases fluid in the colon B) Increases fluid in the colon C) Increases peristaltic stimulation D) Increases osmotic pressure and acidification of the colon contents
B) Increases fluid in the colon
A nurse is caring for an infant who is postoperative following cleft lip and palate repair. Which of the following actions should the nurse take? A) Remove the packing from the mouth B) Place the infant in an upright position C) Offer a pacifier with sucrose D) Assess the mouth with a tongue blade
B) Place the infant in an upright position
A nurse is caring for a child who has Hirschsprung's disease. Which of the following actions should the nurse take? A) Encourage a high-fiber, low-protein, and low-calorie diet B) Prepare the family for surgery C) Place an NG tube for decompression D) Initiate bed rest
B) Prepare the family for surgery
Justin age 1 month is brought to the clinic by his mother. The nurse suspects pyloric stenosis. Which of the following symptoms would support this theory? A) Diarrhea B) Projectile vomiting C) Fever and dehydration D) Abdominal distention
B) Projectile vomiting
A 4 mo. old with TOF... When blood is drawn, he becomes acutely cyanotic with rapid shallow respirations. What should you do? A) Call the rapid response team. B) Stop the procedure, calm the infant, place in the knee-chest position, and administer blow-by oxygen, and call for assistance. C) Continue the procedure; this is expected. D) Stop, and wait for his color to improve before completing the procedure.
B) Stop the procedure, calm the infant, place in the knee-chest position, and administer blow-by oxygen, and call for assistance.
Sally, age 5, has been diagnosed with chronic constipation. Management includes: A) decreasing the water and increasing the milk in Sally's diet B) an organized approach of at least 6-12 months of treatment to be effective C) daily use of rectal stimulation to promote stool passage D) having Sally sit on the toilet each day until she has a bowel movement
B) an organized approach of at least 6-12 months of treatment to be effective
When obtaining a history from the parents of an infant suspected of having altered cardiac function, the nurse would expect: A) specific concerns related to palpitations the infant is having B) feeding difficulty, sweating with activity, and poor weight gain C) specific concerns about the infant's shortness of breath D) concerns related to the infant's lack of crying
B) feeding difficulty, sweating with activity, and poor weight gain
The process of the formation of the heart's atrial septum results in a temporary flap called the: A) truncus arteriosus B) foramen ovale C) sinus venosus D) ductus venosus
B) foramen ovale
The nurse is suspicious of child abuse (non accidental injury) when: i. there is a delay in seeking medical assistance for the injury ii. the parent's history of the injury is not congruent with the actual injury iii. x-ray studies demonstrate previous fractures in different stages of healing iv. the child is crying and fearful of separation from the parent A) i, ii, iii, and iv B) i, ii and iii C) ii and iii D) ii, iii, and iv
B) i, ii and iii
Tetralogy of Fallot consists of these defects: i. VSD ii. ASD iii. Right ventricular hypertrophy iv. Pulmonic stenosis v. overridding aorta vi. patent ductus arteriosus A) ii, iii, iv, and vi B) i, iii, iv, and v C) ii, iv, v, and vi
B) i, iii, iv, and v
Emergency treatment for the child with a fracture includes: A) moving the child to allow removal of clothing from the area of injury B) immobilization of the limb, usually including joints above and below the injury site C) pushing the protruding bone under the skin D) keeping the area of injury in a dependent position
B) immobilization of the limb, usually including joints above and below the injury site
Prostaglandin is administered to the newborn with a congenital heart defect to: A) close the ductus arteriosus B) keep the ductus arteriosus open C) keep the foramen ovale open D) close the foramen ovale
B) keep the ductus arteriosus open
Constipation in infancy A) may be due to normal developmental changes B) may be related to dietary practices C) is found more often in breast-fed infants D) may be due to environmental stressors
B) may be related to dietary practices
In children, the usual approach to the left ventricle of the heart in a cardiac catheterization is through the: A) left side of the heart B) right side of the heart
B) right side of the heart
The peak age for the incidence of Kawasaki disease in the: A) infant age-group B) toddler age-group C) school-age group D) adolescent age-group
B) toddler age-group
Surgical intervention is usually necessary in the first few months of life when an infant is born with: A) atrial septal defect B) ventricular septal defect C) transposition of the great vessels D) patent ductus arteriosus
C) transposition of the great vessels
A nurse is providing teaching to the mother of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A) "Do not offer your baby fluids after giving this medication." B) "Digoxin increases your baby's heart rate." C) "Give the correct dose of med at regularly scheduled times." D) "If your baby vomits a dose, you should repeat the dose to ensure the he gets the correct amount."
C) "Give the correct dose of med at regularly scheduled times."
Which one of the following defects has the best prognosis? A) Tetralogy of Fallot B) Ventricular septal defect C) Arial septal defect D) Hypoplastic left heart syndrome
C) Arial septal defect
Julie, age 10, has just returned from surgery for repair of an open fracture she has a dressing and elastic bandage wrap on her leg from upper thigh to mid-calf. The nurse immediately notifies the physician if assessment findings include which of the following? A) appearance of blood-stained area the size of a dime on the dressing B) 2+ pedal pulse C) Inability to move the toes D) Report pain level of 4/10 on Wong-Baker Faces Pain Rating Scale
C) Inability to move the toes
Joey, 3 yrs, has just returned from the cath lab. He has vomited, and his mom calls you to tell you that he is bleeding. You find him in his bed, crying and sitting up in a puddle of blood. What is the FIRST thing you should do? A) Increase the rate of his IV fluids. B) Give an antiemetic and keep him NPO. C) Lie Joe down and apply direct pressure slightly above (1 finger above) the catheter site. D) Call the cardiologist.
C) Lie Joe down and apply direct pressure slightly above (1 finger above) the catheter site.
The recommended treatment for DDH in an infant 2 months old is: A) surgical fixation B) hip spica cast C) Pavlik harness D) hip abduction orthosis
C) Pavlik harness
A 2 month old is admitted with failure to thrive 2º VSD. VS: HR 170; RR 84; BP 76/40, O2 96%. Upon assessment he is: fussy, with mild retractions; no edema, has been feeding poorly. In planning fluid & nutritional needs for the next 12 hrs, you would expect which of the following orders? A) Push bottle feedings q 3 hrs. B) Make NPO and run IV fluids at ½ maintenance. C) Place an NG tube and po / tube feed every 2-3 hours to meet fluid restriction D) Begin on high calorie formula and bottle feed q 4-5 hrs.
C) Place an NG tube and po / tube feed every 2-3 hours to meet fluid restriction
To confirm the diagnosis of Hirschsprung disease, the nurse prepares the child for which one of the following tests? A) Barium enema B) Upper GI series C) Rectal biopsy D) Esophagoscopy
C) Rectal biopsy
Your patient has presented to the hospital with chronic constipation, abdominal distention, and vomiting. Hirschprung's disease is suspected. You anticipate completing some patient teaching related to: A) Barium swallow B) Esophagoscopy C) Rectal biopsy D) CBC and differential
C) Rectal biopsy
Because of the medication used for long-term therapy, children with Kawasaki disease are at increased risk for: A) chickenpox B) influenza C) Reye syndrome D) myocardial infarction
C) Reye syndrome
Which feeding practices should be used for the infant with a cleft lip or palate? A) Use a large, hard nipple with a large hole B) Use a normal nipple and position it sideways in the mouth C) Use a special nipple, positioned so it is compressed by the infant's tongue and existing palate D) Withhold breastfeeding until after surgical correction of the defect
C) Use a special nipple, positioned so it is compressed by the infant's tongue and existing palate
One of the strategies the nurse can use to progressively increase a child's activity in the postoperative period after cardiac surgery is to: A) ambulate on the first day B) keep the child on strict bedrest C) ambulate after analgesic medication
C) ambulate after analgesic medication
When children develop heart failure from a congenital heart defect, the failure is usually A) right-sided only B) left-sided only C) both right and left sided
C) both right and left sided
Evaluation of the infant for edema is different from that of the older child in that: A) weight is not reliable as an early sign B) pedal edema is most pronounced in the newborn C) edema is usually generalized and difficult to detect D) distended neck veins are the most reliable sign
C) edema is usually generalized and difficult to detect
The calories are usually increased for an infant with heart failure by: A) increasing the number of feedings B) introducing solids into the diet C) increasing the caloric density of the formula D) gastrostomy feeding
C) increasing the caloric density of the formula
In fetal circulation, the umbilical vein divides and sends blood directly to the inferior vena cava by way of the ductus venosus. This division occurs at the: A) heart B) lungs C) liver D) Placenta
C) liver
One important strategy for feeding a child with failure to thrive would be to: A) avoid having the same nurse feed the child B) distract the child during meals with television and toys C) maintain a clam, even temperament during feedings D) vary the feeding routines to make the feeding time more interesting
C) maintain a clam, even temperament during feedings
For parents using the Internet to obtain information about their child's cardiac diagnosis, it is important for the nurse to remind them that: A) information is difficult to access B) most information found will not be helpful C) not all websites offer accurate information D) information on the Internet is usually reliable
C) not all websites offer accurate information
Al's intussusception is reduced without surgery. The nurse should expect care for Al after reduction to include: A) administration of antibiotics B) enema administration to remove remaining stool C) observation of stools D) rectal temperatures every 4 hours
C) observation of stools
An important assessment for the nurse to perform in identifying the cleft palate is to: A) assess sucking ability of infant B) assess color of lips C) palpate the palate with a gloved finger D) do all of the above
C) palpate the palate with a gloved finger
The electrolyte that is usually depleted with most diuretic therapy and is most likely to cause dehydration is: A) sodium B) chloride C) potassium D) magnesium
C) potassium
The priority nursing goal in the immediate care of a postoperative infant after repair of a cleft lip is to: A) keep the infant well hydrated B) prevent vomiting C) prevent trauma to operative site D) administer medications to prevent drooling
C) prevent trauma to operative site
To increase the caloric intake of an infant with failure to thrive, the nurse might recommend A) using developmental stimulation by a specialist during feedings B) avoiding solids until after the bottle is well accepted C) restricting juice intake D) varying the schedule for routine activities on a daily basis
C) restricting juice intake
L.R. is an 8 yo female status post proximal tibial osteotomy following a fracture. There is bright red staining on her cast in the area of surgery that is increasing rapidly. What should you do?
Call the provider Mark on the cast unless it is rapidly bleeding Make them NPO in anticipation they may go to surgery Give her IV fluids Take vital signs and put them on monitor
The nurse is counseling the mother of 12-month-old Brian on methods to prevent constipation. Which one of the following methods would be contraindicated for Brian? A) Add bran to Brian's cereal B) Increase Brian's intake of water C) Add prune to Brian's diet D) Add popcorn to Brian's diet
D) Add popcorn to Brian's diet
Which of the following is a congenital anomaly that results in mechanical obstruction form inadequate motility of part of the intestine? A) Intussusception B) Short-bowel syndrome C) Crohn disease D) Hirschsprung disease
D) Hirschsprung disease
The nurse would expect to see what clinical manifestations in the child diagnosed with Hirschsprung disease? A) History of bloody diarrhea, fever and vomiting B) Irritability, severe abdominal cramps, fecal soiling C) Decreased hemoglobin, increased serum lipids, and positive stool for O&P D) History of constipation, abdominal distention and passage of ribbonlike, foul-smelling stools
D) History of constipation, abdominal distention and passage of ribbonlike, foul-smelling stools
Which of the following defects has the worst prognosis? A) Tetralogy of Fallot B) Ventricular septal defect C) Arial septal defect D) Hypoplastic left heart syndrome
D) Hypoplastic left heart syndrome
Malcolm is a 4-year-old brought to the E.R. by his mother. Malcolm's mother tells the nurse that Malcolm was being swung around by his old brother, who accidentally hurt Malcolm's arm. During the interview process, the mother says that Malcolm has not stopped complaining and crying about his arm and will not use it. The mother tells Malcolm that he needs to "stop crying. It's all your fault." When the mother leaves to fill out admission paperwork, Malcolm tells the nurse, "My mom hurt my arm." On physical exam, the nurse views that Malcolm's left arm is deformed and painful when moved. The nurse notes that Malcolm's legs are covered with bruises and there appears to be an old healing burn on Malcolm's back. Based on the information provided, the nurse suspects that Malcolm is being physically abused. Which one of the following best supports this theory? A) Malcom's mother is distant and angry with Malcolm about his injuries B) Malcolm's mother blames his older brother for Malcolm's injuries C) Malcolm tells the nurse, "My mom hurt my arm." D) Malcolm has physical evidence of previous injuries that are in various stages of healing
D) Malcolm has physical evidence of previous injuries that are in various stages of healing
Which of the following parental behavioral responses should alert the nurse to the possibility of maltreatment of the child? A) Parent displays extreme care for the child, not wanting to leave the child's side B) Parent displays signs of guilt, not being able to eat or sleep C) Parent displays abnormal interest in the incident, going over each detail repeatedly D) Parent displays anger at the child for being injured
D) Parent displays anger at the child for being injured
Which of the following is acceptable in providing postoperative care for the infant with a cleft lip or palate? A) Use of tongue depressor in the mouth to assess surgical site B) Continuous elbow restraints to prevent injury C) Placement of infant in the prone position after cleft lip repair D) Position the infant in the side-lying position after cleft palate repair
D) Position the infant in the side-lying position after cleft palate repair
Diagnostic evaluation is important for early recognition of scoliosis. Which of the following is the correct procedure for the school nurse conducting this examination? A) View the child, who is standing and walking fully clothed, to look for uneven hanging of clothing B) View all children from the left and right side to look mainly for asymmetry of the hip height. C) Completely undress all children before the examination D) View the child who is wearing underpants from behind when the child bends forward at the hips
D) View the child who is wearing underpants from behind when the child bends forward at the hips
After cardiac surgery, fluid intake calculations for a child would include: A) intravenous fluids B) arterial and CVP line flushes C) fluid used to dilute mechanisms D) all of the above
D) all of the above
Chronic hypoxemia is manifested clinically by which of the following signs? A) fatigue B) polycythemia C) clubbing D) all of the above
D) all of the above
Parents of the child with a congenital heart defect should know the signs of heart failure, which include: A) poor feeding B) sudden weight gain C) increased efforts to breathe D) all of the above
D) all of the above
Pulmonary congestion in an infant may be identified by: A) inability to feed B) mild cyanosis C) costal retractions D) all of the above
D) all of the above
Fluids are especially important to monitor after cardiac surgery, because during surgery: A) the cardiopulmonary pump uses a large volume of extra fluid B) the patient's blood is diluted by the use of the pump C) there is total body edema D) all of the above may occur
D) all of the above may occur
In obtaining a history pertaining to an incident of abuse, the nurse should: A) expect the child to betray the parents by admitting to the abuse received B) expect the child to defend the parents out of a sense of loyalty C) recognize that the child will have a sense of relief after telling someone about the abuse D) avoid biasing the child's retelling of the events
D) avoid biasing the child's retelling of the events
The nutritional needs of the infant with heart failure are usually: A) the same as an adult's B) Less than a healthy infant's C) the same as a healthy infant's D) greater than a healthy infant's
D) greater than a healthy infant's
Preop, the nursing plan for suspected pyloric obstruction should include which of the following? i. Observation for dehydration ii. Keeping body temperature below 37.7 C iii. Parental support and reassurance iv. Observation for coughing and gagging after feeding v. Observation of quality of stool A) i, ii, iii, iv, and v B) i, iii and iv C) iii, iv, and v D) i, iii, and v
D) i, iii, and v
The nurse working with the abused child and family: i. should view the parent and child as victims ii. should teach the parents through demonstration and example rather than lecture iii. recognizes that parents need to correct abnormal behavior in the child- for example, "We told you not to go with strangers." iv. recognizes that the goal of the nurse-child relationship is to provide a role model for the parents in helping them to relate positively to their child A) i, ii, iii, and iv B) ii, iii, and iv C) i and iii D) ii and iv
D) ii and iv
In identification of the abused child, the nurse knows: A) physical abuse can be readily identified during the physical examination B) specific behavioral problems can be seen in the abused child C) maltreated children easily admit to the abuse they received from their parents D) incompatibility between the history and injury is probably the most important criterion on which to base the decision to report suspected abuse
D) incompatibility between the history and injury is probably the most important criterion on which to base the decision to report suspected abuse
When suctioning an infant after cardiac surgery, the nurse should: A) hyperoxygenate before suctioning B) suction for no more than 5 seconds C) provide supplemental oxygen D) perform all of the above
D) perform all of the above
If bleeding occurs at the insertion site after a cardiac catheterization, the nurse should apply A) warmth to the unaffected extremity B) pressure 1 inch below the insertion site C) warmth to the affected extremity D) pressure 1 inch above the insertion site
D) pressure 1 inch above the insertion site
The best nursing goal for Malcolm at this time is: A) identification of all injuries B) identification of abuse pattern C) reassuring Malcolm that everything is . going to be fine D) protecting Malcolm from further abuse
D) protecting Malcolm from further abuse
A clue in the mother's history that is important in the diagnosis of congenital heart disease is: A) rheumatoid arthritis B) rheumatic fever C) streptococcal infection D) rubella
D) rubella
The primary diagnostic tool used in developmental dysplasia of the hip (DDH) in a newborn is: A) a radiograph B) an ultrasound C) magnetic resonance imaging D) the Barlow and Ortolani maneuvers
D) the Barlow and Ortolani maneuvers
The prognosis for children with short-bowel syndrome has improved as a result of: A) dietary supplement of vitamin B12 B) improvement in surgical procedures to correct the defect C) improved home care availability D) total parenteral nutrition and enteral feeding
D) total parenteral nutrition and enteral feeding
An appropriate nursing intervention for the care of a child with an extremity in a new cast is to: A) keep the cast covered with a sheet B) use the fingertips when handling the cast to prevent pressure areas C) use heated fans or dryers to circulate air and speed the cast-drying process D) turn the child at least every 2 hours to help dry the cast evenly
D) turn the child at least every 2 hours to help dry the cast evenly
You are working in NICU. The resident stops by to say that he will be reducing the Silo on your patient with gastroschisis. Your nursing priorities include: A) Sedate the patient B) Watch for respiratory distress following the reduction C) Document how the patient tolerated the procedure D) All of the above E) B and C only
E) B and C only patient should already be sedated since they are on a vent
J had a unilateral clubfoot repair today and was given a caudal injection for pain control at the end of his surgery. He is awake and crying 5 hours later. Name 2 nursing interventions you would implement.
FLACC pain assessments See if nerve block has worn off - re-analgesic
R.J. is a 15 yo male > 97 percentile for height and weight who had a fracture repair with an external pin fixation yesterday. He received 4 mg morphine IV for pain 3 hours ago and c/o severe pain now. Patient's weight = 90 kg. Morphine typical dose = 0.1 mg/kg Nursing Interventions?
Morphine dose is less than half what it should Advocate for order change Careful pain assessments
