Peds Quiz 3 lz
An 11-year-old has been diagnosed with idiopathic scoliosis and has been told that wearing a Boston brace will be necessary. What should the nurse tell the child and the mother about wearing this brace? A-"The goal of wearing this brace is to keep the curve in your back from getting worse." B-"You may need to wear the brace for a long time. It may be months or even years." C-"You may remove the brace only when you bathe or shower." D-"No one will know you have the brace on, so you can wear whatever you want to." E-"The brace should not interfere with your ability to play basketball."
A, B, C
Important items in the assessment of a newborn with a neural tube defect are: (SOA) A- Monitoring the integrity of the sac and for cerebrospinal fluid (CSF) leakage B-Assessing extremities for deformity C- Observing for signs of infection D- Keeping extremities in full extension postoperatively E- Performing the Glasgow neurologic assessmen
A, B, C
Parents and family of a child with hydrocephalus must show understanding of and proficiency with: (SOA) A- Signs and symptoms of shunt failure B- How to recognize and respond to the child's seizure C- Avoidance of latex and latex-containing products D-Strict hand hygiene for dressing changes only E- Restriction of the child's participation in sports
A, B, C
Which are true statements about disorders of the spine? (SOA) A-Lordosis manifests in excessive concave curvature of the lumbar spine. B-Scoliosis manifests in a curvature of the spine, often with a rotational deformity of the spine and ribs. C-Kyphosis manifests in excessive convex curvature of the cervical thoracic spine. D-All disorders of the spine are caused by injury at birth. E-Torticollis manifests in a rotation of the thoracic spine.
A, B, C
The nurse is caring for a child who has been diagnosed with complex partial seizures. Which clinical manifestations would the nurse expect to assess during the child's seizure activity (SOA)? A- posturing B- lip smacking C- twitching D- motor responses in one extremity E- impaired consciousness
A, B, C, E
A 6 year old child has been having seizures. The child's mother asks the nurse what she should do when a seizure occurs. Which responses by the nurse are appropriate? A-Call 911 if the seizure lasts more than 5 minutes B-Check your watch or clock when you see signs of a seizure starting C-Give oral antiepileptic medication D- Turn your child on his side E- Put a tongue depressor between your child's teeth
A, B, D
Providing nursing management for the child with torticollis, lordosis, and kyphosis includes several actions that are appropriate for all three disorders, including (SOA): A-Encouraging stretching exercises and physical conditioning B-Providing for education during long absences from school C-Supporting child and family as they work to accept altered body image D-Educating child and family about bracing, if ordered E-Preparing child and family for imminent surgery
A, C, D
Assessment data that may indicate a positive finding of scoliosis include (SOA): A-Unequal rib prominences B-Chest symmetry C-Unequal shoulder heights D-Unequal waist angles E-Unequal scapula prominences
A, C, D, E
Ventriculoperitoneal (VP) shunts used to treat communicating hydrocephalus (SOA): A- May become blocked or infected B-Are permanent once placed C-Terminate in the pleural space in some instances D-Can terminate in the peritoneal cavity E-Sometimes terminate in the atrium of the heart
A, C, D, E
Which are essential elements of child and family education for any child undergoing treatment for a disorder of the feet, legs, hips, spine, bones, or joints(SOA)? A-Importance of compliance to achieve desired outcomes B-Importance of extended restriction from school activities C-Promotion of normal growth and development with appropriate diversional activities D-The need for ambulation and weight bearing as ordered by the health care provider E-Signs and symptoms of infection
A, C, D, E
An adolescent who participates in several sports has been diagnosed with slipped capital femoral epiphysis (SCFE). When reviewing the assessment information, which symptoms does the nurse expect to see in this adolescent client?(SOA) -Increased hip flexibility -In-toeing -Limp -Knee pain -Increased internal rotation
Limp Knee pain
A child with a history of seizures arrives in the emergency department (ED) in status epilepticus. What is the nurse's initial response? -Maintain a patent airway -Perform a rapid neurologic assessment -Take vital signs -Establish an IV line
Maintain a patent airway
Surgery to close the defect associated with myelomeningocele (spina bifida) should occur: Within 3 to 4 days after birth Within 5 to 7 days after birth Within 24 to 48 hours after birth Within 72 to 84 hours after birth
Within 24-48 hours after birth
The nurse is teaching a mother of a young child with a newly diagnosed seizure disorder. The child has been put on valproic acid for control of seizures. The nurse knows that the mother does not understand the side effects of valproic acid when she states: -"I will not use carbonated beverages to dilute his medication." -"I will bring him to the health care provider's office for regular blood work to check bleeding times." -"I will not let him chew his tablet." -"So that he will absorb it better, I will give his medicine on an empty stomach."
"So that he will absorb it better, I will give his medicine on an empty stomach"
The nurse has completed parent education related to treatment for an infant with congenital clubfoot. What statement by the parents indicates to the nurse that further teaching is needed? "We're happy this is the only cast our baby will need." "We'll watch for any swelling of the feet while the casts are on." "We'll keep the casts dry." "We're getting a special car seat to accommodate the casts."
"We are happy this is the only cast our baby will need"
The nurse is caring for a 5-month-old infant recently diagnosed with developmental dysplasia of the hip. The infant's parents inquire about treatment for this condition. The nurse responds, knowing that the most common treatment for developmental dysplasia of the hip (DDH) in children under 6 months of age is what? -Serial casting and bracing -A pavlik harness worn 23 hr a day -Skin traction followed by surgery -Hip spica casting
A Pavlik harness worn 23 hr a day
The nurse is caring for a 7-year-old child who has been having intractable seizures. The nurse educates the family and the child a potential treatment option could include what? -Taking medium chain triglyceride oil -A second anti epileptic medication -A ketogenic diet -Surgery
A ketogenic diet
Prior to discharge from the hospital, the nurse provides a teaching session for parents of a child who recently had a tonic-clonic seizure. Which statement by the parent indicates a need for further teaching? "If my child has another seizure, there may not be an aura." "A tonicdash-clonic seizure causes a loss of consciousness for 30 min." "This type of seizure may be genetic, but most occur for no reason." "My child may be temporarily sleepy or confused following the seizure."
A tonic-clonic seizure causes a loss of consciousness for 30 min
The nurse is caring for a pediatric client with a history of seizure activity. The child is being treated with gabapentin. The nurse knows that gabapentin should not be given within 2 hrs of which class of medication? -NSAIDs -Oral contraceptives -Antibiotics -Antacids
Antacids
The nurse in the newborn nursery is doing the admission assessment on a neonate. Observation of what signs and symptoms would cause the nurse to suspect developmental dysplasia of the hip? -Lordosis -Telescoping -Trendelenburg sign -Asymmetry of the gluteal and thigh fat folds
Asymmetry of the gluteal and thigh fat folds
After the health department orthopedic health care provider examines Katiana, he informs the parents that casting will be used to correct the disorder, possibly followed by surgery. Once the doctor leaves the room, the family asks you what he meant. Your best response is: A- "Surgery is always needed for this disorder, regardless of the effect of casting." B- "The health care provider will use a cast to hold the foot in the desired position. The cast will be changed weekly until the deformity has been corrected and then an open-toed shoe attached to a bar will be used to keep the foot in that position. The health care provider will decide at that time if further treatment and possible surgery will be necessary." C- "Braces for bowlegs are worn at night, while those for knock-knees are worn day and night. The length of time in braces depends on the severity of the disorder. In some cases, surgery is also needed." D-"Sometimes this disorder can be corrected with exercises, but often it requires a series of casts. Depending on the results, casting may be followed with braces and orthopedic shoes."
B
Harvey Baker, who is 15 years old, has been living with generalized seizure disorder since age 6 years as a result of traumatic brain injury (TBI). His family has tried treatment with anticonvulsants, the ketogenic diet, and a surgically implanted vagus nerve stimulator. Harvey still experiences multiple generalized seizures daily as well as several episodes of status epilepticus monthly. Each episode has resulted in further brain damage. He is currently your client in the pediatric intensive care unit (PICU) after such an episode. He is stable and resting comfortably at this time. Your next focus of treatment is: A-Making plans for Harvey's discharge back home, which will be simple because his family has 9 years of experience B-Providing support to Harvey's family, including listening to their concerns and connecting them with community resources C-Asking the social worker to provide support to the family and investigate long-term care for Harvey D-Informing Harvey's family that it is time to make a decision about end-of-life treatment options for him
B
Types of neural tube defects include: (SOA) A-A vertebral defect that causes the spinal column to curve B-No brain development above the brainstem C-The protrusion of a cerebrospinal fluid (CSF)-filled meningeal sac through a vertebral defect D-A defect in the skull with protruding meningeal tissue or meningeal-covered brain E-A defect of the vertebral column in which the posterior arches fail to fuse
B, C, D, E
A nurse is called to an examining room where a young child is having a seizure. When the nurse arrives, the parent says the child has been in the seizure for about 2 min. As the seizure continues, the nurse suspects possible status epilepticus. While waiting for the health care provider to arrive, what emergency actions should the nurse implement? A- insert an NG tube B- Monitor vitals C- Manage thermoregulation D- Give supplemental oxygen E- Maintain a patent airway
B, D, E
Roscoe Sinter, who is 8 years old, is entering public school for the first time. Previously, he was home-schooled because of his generalized seizure disorder. As his seizures have been fully controlled and he has been seizure free for 12 months, his health care providers have given him permission to attend public school. As his school nurse, what are your priorities? A-Reviewing the documentation from the health care provider and submitting a request to deny Roscoe's entry into public school B-Contacting Roscoe's parents to request that they provide a family member to accompany him at school C-Formulating an individualized health plan for Roscoe and educating school personnel about how to respond to a seizure D-Explaining seizure disorders to the other students during an all-school assembly
C
Arrange the steps to apply a Pavlik harness in the correct order. A-Position the legs and feet in stirrups. Be sure the hips are flexed and abducted B-Fasten the legs with Velcro C- Position the chest halter at the nipple line and fasten with Velcro. D- Connect the chest halter and leg straps in the front then in the back
C, A, B, D
The nurse is teaching a family how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip (DDH). What is appropriate for the nurse to include in parental education in relation to the Pavlik harness? -Apply lotion or powder to minimize skin irritation. -Put all clothing over the harness for maximum effectiveness of the device. -Place the diaper over the harness, preferably using a thin, superabsorbent, disposable diaper. -Check at least two or three times a day for red areas under the straps.
Check at least two or three times a day for red areas under the straps
The nurse is caring for an infant who is experiencing seizures. The nurse correctly states that infantile seizures are caused by what? (SOA) -Congenital diseases -Perinatal hypoxia -Accidental drug ingestion -Infection -Lead toxicity
Congenital diseases, Perinatal hypoxia, Infection
The nurse is caring for a child who has a history of generalized seizures. Which clinical manifestations will the nurse be alert for when providing care for this child? -Crying or grunting -Tonic phase -Lip chewing -Drooling or foaming at the mouth -Clonic phase
Crying or grunting, Tonic phase, drooling or foaming at the mouth, clonic phase
Nathan Hollister, age 4 years, is being seen in the neurologist's office where you are employed. Nathan has been on a ketogenic diet for 6 months. His parents tell you they cannot continue on the diet because of the side effects. He is to enter kindergarten in 6 months, and they are desperate for another treatment for the 50 to 100 absence seizures Nathan experiences each day. Your best response to the parents is to: A-Offer the parents a chance to voice their frustration and offer empathy, and then emphasize their obligation to provide Nathan the best source of control for his seizures B-Offer information on community resources for families using the ketogenic diet, including family support groups, day cares, respite care, and financial assistance C-Offer information about a surgically implanted vagus nerve stimulator or brain surgery to remove part of Nathan's brain in order to control the seizures D-Offer additional treatments for the constipation and other side effects, and encourage the parents to continue with the diet for another 6 months for the greatest benefit to Nathan
D
The nurse is caring for a 3-year-old child who was previously diagnosed with febrile seizures. The nurse is teaching the mother how to calculate a proper acetaminophen dose for the child. The child's weight is 32 pounds (14.5 kg). The safe dose of acetaminophen is 10 to 15 mg/kg/dose. The nurse knows the mother has understood the teaching when she states the safe dose range as (round to the nearest whole number): A- 166-224 mg B- 120-200 mg C- 200-250 mg D- 145- 216 mg
D
Nursing management of genu varum and genu valgum does not include: -Reassuring parents these conditions are usually self-resolving -Determining in which parent the condition originated -Providing instructions for brace application and maintenance -Educating child and family about the condition and treatment
Determining in which parent the condition originated
A 16-year-old female with a seizure is being treated with valproic acid. The client tells you that she is sexually active. What is the most important teaching point the nurse will emphasize when she comes to the clinic for a routine exam? Encouraging her to keep a change of clothes in her backpack during school hours Discussing the need for contraception Asking if she is interested in getting a driver's license Encouraging exercise and physical activity
Discussing the need for contraception
A 13-year-old client who is undergoing surgery for scoliosis asks the nurse about possible activities after the spinal surgery. Following a spinal fusion, which activity should the nurse caution the adolescent against? Diving Stair climbing Swimming Walking
Diving
A 10-year-old female with epilepsy is being treated with valproic acid. The child has lost weight recently. What is the most important nursing intervention when she comes to the clinic for a routine exam? -Encouraging exercise and physical activity -Encouraging her to keep a change of clothes in her backpack during school hours -Asking if she is interested in getting a driver's license -Encouraging her to take the medication with food
Encouraging her to take the medication with food
Nursing management of clubfoot does not include: -Assessing child's physical condition, motor development, family coping -Facilitating recovery with only one or two complications -Maintaining child's skin integrity and normal developmental progression -Providing emotional support as well as care instruction to parents
Facilitating recovery with only one or two complications
Parents bring their 2-year-old child to the emergency department (ED), stating that the child "Just had her first seizure." They say that the seizure lasted less than 5 min and involved jerking movements over the entire body. Prior to the seizure, the child had been sick and was running a fever. Based on the description, the nurse suspects that the child experienced which type of seizure? -Generalized -Partial -Status epilepticus -Febrile
Febrile
You are a nurse in a pediatric emergency department (ED). Tommy Potts, a 7-year-old, arrives for evaluation of a biking injury that occurred a few days ago. Taking his admission history, you note all of his complaints are consistent with a diagnosis of osteomyelitis except: Increased joint mobility and weak muscles Constant pain in his leg and a pronounced limp Redness and edema over the injury site Recent trauma to the affected leg
Increased joint mobility and weak muscles
All of the following are characteristics of osteogenesis imperfecta except: Infrequent fractures, limb and spinal column deformities Blue sclera and skin bruises easily Autosomal dominant inheritance pattern; some types have a recessive pattern Biochemical defect in collagen production
Infrequent fractures, limb and spinal column deformities
A 5-year-old with a seizure disorder has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided back pain. The nurse tells the parents about what possible complication of the ketogenic diet? -Kidney stones -Urinary tract infection -Appendicitis -Bowel obstruction
Kidney stones
You are a pediatric nurse at the local health department. Katiana Allen, age 8 months, is brought in by her adoptive parents for evaluation of a birth defect. She was recently adopted from Russia. After examination, you document her clubfoot, as: -Midfoot directed downward, hindfoot turned inward, and the forefoot curled toward the heel and upward in partial supination -Knees close together, lower legs directed outward in a knock-knee appearance -Curvature of the lateral border of the foot, forefoot turned inward and out of alignment with the remainder of the foot -Knees widely separated, ankles close together, lower legs turned inward in bowlegged appearance
Midfoot directed downward, hindfoot turned inward, and the forefoot curled toward the heel and upward in partial supination
Non-communicating hydrocephalus results from -Trauma -Obstruction -Meningitis -Hemorrhage
Obstruction
A pediatric client has just been diagnosed with septic arthritis. The nurse is educating the child and family regarding treatment options. What should be included in this education (SOA)? -Open drainage and irrigation -Shunt insertion -Calcium and vitamin D administration -Joint aspiration -Intravenous (IV) antibiotics for 3 to 4 weeks
Open drainage, joint aspiration, IV abx for 3-4 weeks
You know that Jennifer's spinal curvature is greater than 40°. Because of this, you: -Prepare Jennifer and her mom for spinal fusion surgery -Encourage exercises and diligent brace wear -Reassure Jennifer and her mom that she will eventually outgrow the disorder -Encourage stretching exercises
Prepare Jennifer and her mom for spinal fusion surgery
A 2-year-old child arrives on the pediatric floor after being referred by a local pediatric health care provider. Upon arrival, the child has a seizure. How should the nurse administer the ordered anticonvulsants without an accessible intravenous (IV) line? -Via NG tube -Via inhaler -Orally -Rectally
Rectally
Assessment findings in toddlers and older children with hydrocephalus include all of the following except: -Split cranial sutures -Decreased LOC -Papilledema -Sunsetting eyes
Split cranial sutures
Nursing management of metatarsus adductus does not include: -Providing emotional support to the parents -Performing specific exercises at diaper change -Casting the affected foot -Surgical intervention with pin replacement
Surgical intervention with pin placement
A school health nurse is screening an adolescent female student for scoliosis. The nurse knows that which findings are indicative of scoliosis (SOA)? -Lordosis -Uneven shoulders and hips -A one-sided rib hump -Pain -Prominent scapula
Uneven shoulders and hips A one-sided rib hump Prominent scapula
Preoperative care for the child with hydrocephalus includes: -Monitoring child's vitals every 2 hours -Use of soft covering under the head to protect skin -Laying the child in bed with head lower than feet -Measuring head circumference every 4 hrs
Use of soft covering under the head to protect skin
A child has been admitted to the hospital with osteomyelitis. The child's parents inquire about treatment options. The nurse responds, including information about administering which intravenous (IV) antibiotic for this child? -Gentamycin and tobramycin -Vancomycin or clindamycin -Ampicillin or penicillin -Rifadin or rifampin
Vancomycin or clindamycin
Surgery to close the defect associated with myelomeningocele (spina bifida) should occur: -Within 3 to 4 days after birth -Within 5-7 days after birth -Within 24-48 hours after birth -WIthin 72-84 hours after birth
Within 24-48 hours after birth
An infant with developmental dysplasia of the hip (DDH) is in traction. Which nursing interventions are implemented to reduce the risk of alterations from immobility? -Change the child's position every hour. -Assess breathing and lung sounds frequently. -Decrease fluids to reduce soiling of the cast edges. -Perform skin and neurovascular assessment. -Use moleskin to reduce skin irritation.
-Assess breathing and lung sounds frequently -perform skin and neurovascular assessment -Use moleskin to reduce skin irritation
Which nursing interventions are appropriate for a family with an infant diagnosed with developmental dysplasia of the hip (DDH) (SOA)? -Counsel the parents to prepare for surgical correction of the hips when the baby is 2 to 3 months old. -Educate parents that an infant with DDH is usually hospitalized in skin traction until the age of 1 year. -While the infant is wearing a Pavlik harness, the parents should refrain from holding him/her. -Assess the client for risk factors for developmental dysplasia of the hip. -Have the parents demonstrate application of the Pavlik harness prior to the infant's discharge from the hospital.
-Assess the client for risk factors for developmental dysplasia of the hip. -Have the parents demonstrate application of the Pavlik harness prior to the infant's discharge from the hospital.
The nurse is caring for a child admitted to the hospital with osteomyelitis of the right foot. Based upon this diagnosis, which are appropriate nursing interventions for this child? (select all that apply) -Elevate the right foot -Administer medication for pain on a regular basis -Obtain culture of the wound prior to starting abx -Encourage a well-balanced diet -Encourage ambulation
-Elevate right foot -Administer medication for pain on a regular basis -Obtain culture of the wound prior to starting antibiotics -Encourage a well balanced diet
Which are true statements regarding disorders of the bones and joints? (SOA) A- A fracture is usually the first sign of osteoporosis and osteopenia. B- Girls who are at puberty are at greater risk of disorders of the bones and joints. C- Symptoms of osteomyelitis include constant pain, edema, redness, decreased mobility, and fever. D- Symptoms of septic arthritis include pain, local inflammation, joint tenderness, swelling, and loss of spontaneous movement. E-Symptoms of skeletal tuberculosis (TB) include pain, limp, severe muscle spasms, kyphosis, muscle atrophy, and "doughy" swelling of the joints
A, C, D, E
Comprehensive care for the child with myelomeningocele includes all of the following except: -Bowel and bladder program -Good nutrition -Safety and mobility using aids such as braces and walkers -Gradual elimination of latex allergy
Gradual elimination of latex allergy
The nurse is caring for a child who has recently been placed on a ketogenic diet. What does this diet include? -High amounts of carbohydrates -Meals based on a 1,500-calorie diabetic diet -High amounts of fat -Low amounts of protein
High amounts of fat
Jennifer Logan is an adolescent who has been treated for scoliosis since birth. You are the pediatric nurse at her pediatrician's office. Today she is being evaluated for a spinal fusion. Jennifer has obvious physical signs of this disorder, which include all of the following except: Hunchback or rounded shoulders Uneven shoulder and hip height Lateral "S" or "C" shaped curvature of the spine One-sided rib hump
Hunchback or rounded shoulders
Once the diagnosis of osteomyelitis is made, you call the pediatric unit to request a room for Tommy. His admission to the hospital is necessary because he will need: Intravenous (IV) fluids and antibiotics, with possible surgical aspiration Joint aspiration, open drainage and irrigation, and then intravenous (IV) antibiotics for 3 to 4 weeks followed by oral antibiotics Physical therapy; casting, bracing, or splinting; surgical stabilization; and nutritional management Antibiotic therapy using a combination of medications for 6 to 9 months after the site is immobilized
IV fluids and abx, with possible surgical aspiration
A nurse is performing a newborn assessment on a child born several hours ago. The nurse notes that the infant has blue sclera. Based on this assessment finding, for what disorder does the nurse anticipate the child will be checked? -Marfan syndrome -Muscular dystrophy -Osteogenesis imperfecta -Achondroplasia
Osteogenisis imperfecta
The nurse is caring for a pediatric client admitted to the medical-surgical unit with the diagnosis of osteomyelitis. What should be included in a focused nursing assessment for the child with osteomyelitis? -Bone deformity and fragility -Severe joint pain and significant signs of local inflammation -Pain, fever, and tenderness at the site -Red, raised rash over the extremity
Pain, fever, and tenderness at the site
An important part of preoperative care for the newborn with a neural tube defect is: -Providing tactile stimulation to the child -Maintaining the child in a supine position -Placing rolled towels under the child's knees -Covering the defect with dry, sterile gauze and tape
providing tactile stimulation to the child