Questions for CA Exam 7

The pediatric nurse knows that an over-the-counter topical preparation such as docosanol (Abreva) can be safely used by children over the age of 12 for local relief of symptoms and potentially to limit the length of an outbreak of ______ _______ _.

herpes simplex virus

During the assessment of a child, the nurse notices the presence of vesicles on the lip and mouth that are oozing clear fluid. Which term will the nurse use when documenting this finding in the medical record? 1) Bullae 2) Pustule 3) Wheal 4) Nodule

1) Bullae

When presenting information to a group of nursing students regarding musculoskeletal childhood disorders, which location will the nurse educator state as the most common location of these disorders? 1) Long bones 2) Short bones 3) Flat bones 4) Irregular bones

1) Long bones

The pediatric nurse is assessing a wound on a preschool-age child's leg and notes that the site is pink with the formation of new epithelial cells. Based on this data, which term will the nurse use to describe the current stage of healing? 1) Proliferation 2) Inflammation 3) Restoration 4) Remodeling

1) Proliferation

The nurse is providing care to a child diagnosed with impetigo. The child's parents ask what caused this to occur. Which organism will the nurse include when educating the parents about impetigo? 1) Staphylococcus aureus 2) Human papilloma virus 3) Pseudomonas aeruginosa 4) Escherichia coli

1) Staphylococcus aureus

The nurse is teaching the parents of an infant diagnosed with candidiasis in the diaper area how to treat this occurrence and decrease the risk for future occurrences. Which teaching points will the nurse include in the teaching session? SELECT ALL THAT APPLY. 1) Finishing all of the antiviral medication as prescribed 2) Keeping the diaper area as dry as possible 3) Using a moisture barrier cream 4) Changing to a lactose-free formula 5) Administering an oral antifungal liquid for prevention of future occurrences

2) Keeping the diaper area as dry as possible 3) Using a moisture barrier cream

During the physical examination of a child's skin, the nurse notes that there is hypertrophic scar tissue from a previous surgery. When documenting this finding in the child's medical record, which term will the nurse use? 1) Lichenification 2) Keloids 3) Ulcers 4) Scaling

2) Keloids

The pediatric nurse explains to the parents of a child diagnosed with muscular dystrophy that pseudohypertrophic muscular dystrophy (________) is the most common type of muscular dystrophy.

Duchenne

The pediatric nurse is educating novice nurses about the types of skeletal traction used on patients. Crutchfield tongs are used in the treatment of cervical and thoracic fracture, 90/90 femoral traction is used to treat femur fractures, and ____________ traction is used in the treatment of a supracondylar fracture of the humerus.

Dunlop

When assessing a child, the nurse expects a nonpainful lateral __________ of the spine for a child who is diagnosed with scoliosis.

curvature

The nurse is collecting a blood sample specimen for an adolescent who has received a prescription for isotretinoin (Accutane) for acne. This weekly or biweekly blood test monitors which item? 1) Bone mineral density 2) Liver enzymes 3) Platelet count level 4) Follicle-stimulating hormone levels

2) Liver enzymes

The nurse is assisting the health-care provider to apply a spica cast on a child following hip surgery. Which recommended nursing measures would the nurse perform for this patient? SELECT ALL THAT APPLY. 1) Monitor the patient for compartment syndrome that occurs when the hip is compressed. 2) Prevent cast syndrome through frequent repositioning, fluids, and increased fiber in the diet. 3) Use the five Ps to perform a cast nursing assessment. 4) Facilitate drying of the cast by using a hairdryer. 5) Tell the parents the cast can be immersed in water

2) Prevent cast syndrome through frequent repositioning, fluids, and increased fiber in the diet. 3) Use the five Ps to perform a cast nursing assessment.

An orthopedic surgeon diagnoses a pediatric patient with a type IV fracture of the femur. When providing education to the child's parents regarding this type of fracture, which information will the nurse include? SELECT ALL THAT APPLY. 1) Does not affect physical growth and long-term development 2) Requires open reduction and internal fixation 3) Is a fracture through the epiphysis into the joint and the metaphysis 4) Results in premature closure of the epiphyseal plate 5) Circulation not affected

2) Requires open reduction and internal fixation 3) Is a fracture through the epiphysis into the joint and the metaphysis

The pediatric nurse understands that which classification of fracture has the most potential to affect growth? a. Type III b. Type V c. Closed d. Open

b. Type V

A school-age child is brought to the pediatric clinic for a consultation. During the nursing interview, the child's parents tell the pediatric nurse that their child has been complaining of groin pain all week. When assessing the right hip, the nurse finds that the hip does not fully rotate internally and abduction is limited. Based on this data, which condition might the nurse suspect? 1) Slipped femoral capital epiphysis 2) Left hip and femur fracture 3) Legg-Calvé-Perthes disease 4) Osgood-Schlatter disease

1) Slipped femoral capital epiphysis

The nurse performs a neuromuscular assessment of a child who is in Russell's traction. Which assessment findings would indicate the need for further intervention? SELECT ALL THAT APPLY 1) The child reports a pain rating of 6 on an age-appropriate numeric pain rating scale. 2) The child feels the distal part of the extremity when touched by the nurse. 3) The child does not have a significant amount of edema in the extremity. 4) The child has a capillary refill time of more than 3 seconds. 5) The child's toes are cold and appear dusky.

1) The child reports a pain rating of 6 on an age-appropriate numeric pain rating scale. 4) The child has a capillary refill time of more than 3 seconds. 5) The child's toes are cold and appear dusky.

The pediatric nurse is providing a preschool-age child's mother with information regarding impetigo. The mother is concerned about the possibility of passing the infection on to her other toddler-age child. Which response by the nurse is the most appropriate in this situation? 1) "I know that you are concerned about the health of both of your children. Your child has been prescribed 7 days of antibiotic therapy. After 24 hours of antibiotic therapy you will not need to worry about the transmission of bacteria to your other child." 2) "Caring for both of your children right now will take more time than usual. Do you have anyone who can come and help you with their care?" 3) "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well." 4) "You only need to concern yourself with the child who has impetigo. It will be important to ensure that all of the medication is taken and that all toys and linens are washed in the next 24 hours."

3) "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well."

The nurse is providing care to several children on a medical-surgical pediatric unit. When providing culturally appropriate care, which child would you touch when providing verbal praise? 1) A Caucasian school-age child diagnosed with muscular dystrophy 2) An African American infant diagnosed with RSV 3) A Hispanic American adolescent who is diagnosed with juvenile arthritis 4) An Asian American preschool-age child who is in traction due to a fracture

3) A Hispanic American adolescent who is diagnosed with juvenile arthritis

The pediatric nurse explains home care measures to the parents of a child who is in a leg cast due to an injury sustained in a sporting match. When educating the child and parents, which actions will the nurse recommend as preventing complications and restoring function to the limb? SELECT ALL THAT APPLY. 1) Apply warm compresses to the leg for the first 24 hours after the injury. 2) Provide a well-balanced diet consisting mostly of carbohydrates. 3) Administer acetaminophen (Tylenol) with codeine as prescribed. 4) Elevate the casted extremity on pillows for at least the first 24 hours. 5) Apply cold packs to the leg 24 hours after the injury.

3) Administer acetaminophen (Tylenol) with codeine as prescribed. 4) Elevate the casted extremity on pillows for at least the first 24 hours.

The pediatric nurse knows that which imaging test visualizes hard and soft tissue along with bone marrow without the use of radiation? 1) Bone scan 2) Computed tomography 3) Magnetic resonance imaging 4) Fluoroscopy

3) Magnetic resonance imaging

An orthopedic surgeon orders diagnostic blood tests to determine the levels of calcium and phosphate for a child with a musculoskeletal disorder. When reviewing the results, the calcium level is below 8.5 mg and the phosphorus level is below 3 mg. Based on this data, which condition does the nurse suspect? 1) Bacterial infection 2) Juvenile arthritis 3) Rickets 4) Osteomyelitis

3) Rickets

The pediatric nurse is providing health promotion teaching to the family of a preschool-age child following a diagnosis of herpes simplex I. Which topic is important for the nurse to include in the teaching for this child and family? 1) Encouraging the child to practice personal hygiene by bathing twice a day 2) Encouraging the child's understanding of information about the condition 3) Encouraging the child's diet planner to prevent excessive carbohydrate and iron intake 4) Encouraging the child to wash the hands by singing along during the process

4) Encouraging the child to wash the hands by singing along during the process

A child has lice. The parent wants to know what to do with the child's stuffed animals. Which response by the nurse is most appropriate? a. Seal in a plastic garbage bag for 2 weeks b. spray with an anti-lice fumigating product c. throw them away; they cannot be cleaned d. wash in hottest water possible and line dry

a. Seal in a plastic garbage bag for 2 weeks

The pediatric nurse is caring for a 5-year-old child in traction related to broken femur. What action by the nurse takes priority? a. assess neurovascular status every 4 hours b. provide diversional activities for the child c. educate parents on the principles of traction d. provide high-protein, high-fiber menu items

a. assess neurovascular status every 4 hours

The mother of a 3-year-old child arrives at a clinc and tells the nurse that the child has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? a. fine grayish red lines b. purple-colored lesions c. thick, honey-colored crusts d. clusters of fluid-filled vesicles

a. fine grayish red lines

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? a. limited range of motion in the affected hip b. an apparent lengthened femur on the affected side c. asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed d. symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

a. limited range of motion in the affected hip

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? a. the child is 18 months old b. the child is being bottle-fed c. a sibling is using lindane for the treatment of scabies d. the child has a history of frequent respiratory infections

a. the child is 18 months old

The pediatric nurse is aware that a critical first step in the assessment of a systemic allergic reaction from a medication is assessment of the ______ for obstruction or edema.

airway

The student nurse studying the musculoskeletal system of children learns that juvenile arthritis is a(n) __________ inflammatory process with unknown origin that is thought to be triggered by an infection.

autoimmune

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. the nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? a. "the cast may feel warm as the cast dries" b. "I can use lotion or powder around the cast edges to relieve itching" c. " a small amount of white shoe polish can touch up a soiled white cast" d. "if the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast"

b. "I can use lotion or powder around the cast edges to relieve itching"

The nurse is preparing a 7-year-old child to have a cast removed from his leg. Which statement would be most appropriate to prepare the child for the procedure? a. "As soon as the cast comes off, you can get up and move around" b. "The sound of the cast saw is very loud and may be a little scary" c. "You must sit very still so we don't accidentally hurt your leg" d. "Don't worry; you will be asleep during the cast removal"

b. "The sound of the cast saw is very loud and may be a little scary"

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply: a. scarring is less severe in a child than in an adult b. a delay in growth may occur after a burn injury c. an immature immune system presents an increased risk of infection for infants and young children d. fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area e. the lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems f. infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults

b. a delay in growth may occur after a burn injury c. an immature immune system presents an increased risk of infection for infants and young children f. infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults

Which explanation by the pediatric nurse is most appropriate for a child with ankylosis? a. ROM restrictions in the vertebrae b. adhesions causing joint immobility c. curvature of the cervical spine d. bowed legs caused by low calcium

b. adhesions causing joint immobility

A nurse visiting a day care notices a boy trying to get up off the floor by kneeling, rising, to his feet while keeping his hands on the floor, then walking his hands up hid legs until he is standing. Which assessment finding does this nurse document? a. positional instability b. gowers' maneuver c. kernig's sign d. grey turner's sign

b. gowers' maneuver

The pediatric nurse is aware that which is the precipitating cause of Legg-Calve-Perthes disease? a. genetic abnormality b. interruption in blood flow c. birth trauma d. dietary deficiency

b. interruption in blood flow

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? Select all that apply: a. use the fingertips to lift the cast while it is drying b. keep small toys and sharp objects away from the cast c. use a padded ruler or another padded object to scratch the skin under the cast if it itches d. place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold e. elevate the extremity on pillows for the first 24 to 48 after casting to prevent swelling f. contact the health care provider if the child complains of numbness or tingling in the extremity

b. keep small toys and sharp objects away from the cast e. elevate the extremity on pillows for the first 24 to 48 after casting to prevent swelling f. contact the health care provider if the child complains of numbness or tingling in the extremity

An adolescent is experiencing severe acne and has recently been diagnosed with prediabetes. Which medication does the nurse educate the adolescent about? a. clindamycin (Cleocin) b. metformin (Fortamet) c. tetracycline (Sumycin) d. trenitoin (Retin A)

b. metformin (Fortamet)

The nurse consults the child life specialist to help plan care for a child who is immobilized and is increasingly anxious. Which is the priority intervention for this child? a. allowing the school to provide a tutor b. providing diversional activities c. consulting a social worker d. administering pain medication

b. providing diversional activities

A nurse reads the diagnosis of neurogenic clubfoot on an infant's chart. Which other diagnosis does the nurse expect to find when reviewing the medical record? a. osteogenesis imperfecta b. spina bifida c. muscular dystrophy d. no associated diagnosis

b. spina bifida

The nurse is providing care to a child diagnosed with lordosis. Which common term might the parents have heard to describe this condition? a. hunchback b. swayback c. spinal curvature d. flat feet

b. swayback

Parents bring their 2-week-old infant to a clinic for a treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? a. "treatment needs to be started as soon as possible" b. "I realize my infant will require follow-up care until fully grown" c. "I need to bring my infant back to the clinic in 1 month for a new cast" d. "I need to come to the clinic every week with my infant for the casting"

c. "I need to bring my infant back to the clinic in 1 month for a new cast"

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? a. "I will encourage my child to perform prescribed exercises" b. "I will have my child wear soft fabric clothing under the brace" c. "I should apply lotion under the brace to prevent skin breakdown" d. "I should avoid the use of powder because it will cake under the brace."

c. "I should apply lotion under the brace to prevent skin breakdown"

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? a. "avoid all exercise during painful periods" b. "range-of-motion exercises must be performed every day" c. "have the child perform simple isometric exercises during this time" d. "administer additional pain medication before performing range-of-motion exercises"

c. "have the child perform simple isometric exercises during this time"

The school nurse has provided an instructional session about impetigo to parent of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? a. "it is extremely contagious" b. "it is most common in humid weather" c. "lesions most often are located on the arms and chest" d. "it might show up in an area of broken skin, such as an insect bite"

c. "lesions most often are located on the arms and chest"

The nurse provides anticipatory guidance to parents telling them the maximum water temperature for bathing children is which temperature? a. 100 b. 110 c. 120 d. 140

c. 120

The nurse is assisting a health care provider examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? a. babinski's sign b. the moro reflex c. Ortolani's maneuver d. the palmar-plantar grasp

c. Ortolani's maneuver

The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid restriction? a. skin turgor b. level of edema at burn site c. adequacy of capillary filling d. amount of fluid tolerated in 24 hours

c. adequacy of capillary filling

A teen is prescribed griseofulvin (Grifulvin V). What teaching does the nurse provide the child and parents? a. apply this medication only at night b. avoid sun exposure and tanning beds c. have liver enzymes checked every 6 weeks d. use two forms of birth control if you have sex

c. have liver enzymes checked every 6 weeks

The emergency department nurse knows that which type of bite has the highest risk of infection? a. cat b. dog c. human d. squirrel

c. human

The nursing instructor is explaining the layers of skin to students. Which layer is inconsistent with knowledge of this topic? a. dermis b. epidermis c. intradermis d. subcutaneous fatty layer

c. intradermis

A mother reports seeing "burrows" on her child's hands. Which medication does the nurse teach the mother about? a. lindane (Kuell) b. malathion (Ovide) c. permethrin 5% (Elimite) d. spinosad (Natroba)

c. permethrin 5% (Elimite)

The pediatric nurse understands that benzathine penicillin G (Pfizerpen), prescribed for cellulitis, causes ______ _______ by binding to the cellular wall.

cell death

A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? a. Apply the cream over the entire body b. apply a thick layer cream to affected areas only c. avoid cleansing the area before application of the cream d. apply a thin layer of cream and rub it into the area thoroughly

d. apply a thin layer of cream and rub it into the area thoroughly

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? a. apply the lotion to area of the rash only b. apply the lotion and leave it on for 6 hours c. avoid putting clothes on the child over the lotion d. apply the lotion to cool, dry skin at least 30 minutes after bathing

d. apply the lotion to cool, dry skin at least 30 minutes after bathing

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? a. ensure that all ropes are outside the pulleys b. ensure that the weights are resting lightly on the floor c. restrict diversional and play activities until the child is out of traction d. check the HCP's prescriptions for the amount of weight to be applied

d. check the HCP's prescriptions for the amount of weight to be applies

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? a. administer an antiemetic b. increases the intravenous fluids c. place the child in a Sims' position d. notify the HCP

d. notify the HCP

The child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? a. administer an analgesic b. release the skin traction c. apply the ice to the extremity d. notify the health care provider

d. notify the health care provider

A parent calls the clinic to ask about signs and symptoms of impetigo. Which information does the nurse provide? a. erythema and swelling of the fingers b. groups of small flesh colored or pink papules c. painful, watery blisters often near the nose d. pustules that have honey-colored exudate

d. pustules that have honey-colored exudate

A nurse admitting a child to the intensive care unit is told the child has risus sardonicus. Which disease process does the nurse suspect the child has? a. scoliosis b. osteogenesis imperfecta c. duchenne's muscular dystrophy d. tetanus

d. tetanus

The nurse working with children knows that which burn is the most common type of burn in the pediatric population? a. contact b. flame c. scald d. thermal

d. thermal

When assessing for primary skin lesions on children, what does the nurse specifically look for? a. crusts b. keloids c. scales d. wheals

d. wheals

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check? a. maculopapular lesions behind the ears b. lesions in the scalp that extend to the hairline or neck c. white flaky particles throughout the entire scalp region d. whites sacs attached to the hair shafts in the occipital area

d. whites sacs attached to the hair shafts in the occipital area

The nurse educator teaches the student nurse that there is a classification of fractures according to the type of break that occurred. The nurse explains that in a spiral fracture, a diagonal line coils around the bone; in a(n) ___________ fracture, the bone is bent, but not broken; and in a comminuted fracture, the bone becomes wider and more flat.

greenstick

The pediatric nurse is aware that the thin skin of an infant makes the infant particularly susceptible to _______ ________ and difficulty with thermoregulation.

heat loss

The pediatric nurse is aware that mupirocin (Bactroban) is the appropriate topical ointment for the child diagnosed with ________ that is confined to a small area on the trunk.

impetigo

The pediatric nurse is aware that _______ _______ is performed by an allergist to determine the presence of specific allergens.

patch testing

Following an assessment, the pediatric nurse correctly documents ______ to describe the patient's skin condition, which manifests as slightly oily keratinized irregularly shaped cells.

scales

The pediatric nurse tells the parents of a patient diagnosed with a muscular disorder that muscular dystrophies are a group of muscle disorders that cause the gradual wasting of ___________ groups of skeletal muscle. The nurse notes that they are the most common group of muscle disorders found in childhood.

symmetrical