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60 Cards in this Set
- Front
- Back
Which of the following measures is important in managing hypercalcemia in a child who is immobilized?
- Promote adequate hydration - Change position frequently - Encourage diet high in calcium - Provide diet high in protein and calories |
Promote adequate hydration for flusihing out calcium.
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The nurse Is caring for a an immobilized preschool child. Which of the following is helpful during this period of immobilization?
1. Encourage wearing pajamas 2. Let child have few behaviorl limitations. 3. Keep child away from other immobilized children if possible. 4. Take a walk by wagon outside the room. |
Take child for a "walk" by wagon outside of room - important for activities outside of room if possible. Gives them opporutnities to meet their normal g and d needs.
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Which of the following is the rationale for elevating an extremity after a soft-tissue injury such as a sprined ankle?
. Elevation increases the pain threshold .Elevation increases metabolism in the tissues .Elevation produces deep tissue vasodilation. .Elevation reduces edema formation |
Elevation reduces edema formation. Uses gravity to facilitate venous return to reduce edema.
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Which of the following is characteristic of fractures in children?
.Fractures rearely occur at grwoth plate site , since it absorbs shock well. .Rapidity f healing is inversely related to the child's ages. Pliable bones of growing children are less porous than those of adults .Periosteum of a child's bone is thinner, is weaker and has less osteogenic potential compared with that of the adult. |
Rapidity of healing is inversely related to the child's age.
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The callus that develops at the fracture site is important because it provides which of the following?
Functional use of the injured part sufficient support for weight bearing means for adeuate blood supply Means for holding bone fragments together. |
Means for holding bone fragments together - New bone cells are formed in large numbers and stimulated to maximum activity. They are found at the site of the injury. In time, calcium salts are absorbed to form the callus.
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An younster has just retunred from surgery in a hip spica cast. The priority nursing intervention would be which of the following?
Elevate HOB Check circulation, sensation and motion of toes Turn child to right side, then left side every 4 hours offer sips of water |
Check circulation, sensation, and motion of toes. Chief concern is that the extremity may continue to swell. This must be assessed to ensure that the cast does not become a tourniquet and cause complications.
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Which of the following statements is true concerning osteogenesis imperfecta (OI)
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OI is an autosomal dominant inherited disorder. OI is a lifelong problem caused by defective bone mineralization, abnormal bone architecture, and increased susceptibility to fracture. OI has a predicatble course of disease that is determined by the pathophysiologic processes, not the time of onset. Lightweight braces and splints can help support limbs and fractures.
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Which of the following is characteristic of most neonatal seizures?
Generalized Tonic-Clonic Well organized Subtle and barely discernible |
Subtle and barely discernible. Signs of seizures in newborns are subtle. They include symptoms such as lip smacking, tongue thrusting, eye rolling, and arching of the back.
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Which of the following is a clnical manifestation of Increased ICP in infants?
Shrill, high pitched cry photophobia pulsating anterior fontanel Vomiting and diarrhea |
Shrill, high pitched cry. A shrill, high-pitched cry is common clin manifestation of IICP in infants. The characteristic cry occurs secondary to the pressure being placed on the miningeal nerves, causing pain. Photophobia is not indicative of IICP in infants. A pulsating anterior fonanel is normal in infants. Would see a bulging anterior fontanel in IICP. Vomiting is in children.
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The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. Which of the following is the priority assessment for this child?
Reactivity of pupils Doll's head maneuver Oculovestibular response Funduscopic exam to identify papilledema |
Reactivity of pupils - indication of neurologic health. Pupils shuld be assessed for no reaction, unilateral reaction, and rate of reactivity.
Dolls head maneuver should not be performed if there is a cervical spine injury. Assessing for oculosvestibular response is a painful test that should not be done on a child ho is having variable levels of consciousness. Papilledema does not develop for 24 - 48 hours in the course of unconsciousness. |
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The nurse is performing a neurologic assessment on a 2-month old infant after a car accident. Moro, tonic neck, wand withdrawal reflexes are present. The nurse should recognize that these reflexes suggest which of the following?
Neurologic health Severe brain damage Decorticate posturing Decerebrate posturing |
Neurologic Health
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The temperature of an adolescent who is unconscious is 105 degrees F. The priority nursing action is to:
Continue to monitor temperature Initiate a pain asessment NON Apply a hypothermia blanket Adminster aspirin stat |
Apply a hypothermia blanket - Brain damage can occur at temperatures as high as 105. It is extremely important to institute temperateure-lowering interventions such as hypothermia blankets and tepid baths immediately.
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The nurse is caring for a child with multiple injuries who is comatose. The nurse should recognize that pain:
cannot occur if child is comatose may occur if child regains consciousness requires astute nursing assessmetn and managemetn Is best assessed by family members who are familiar with child. |
Requires astute nursing assessment and management - Since the child cannot communicate pain through one of the standard pain rating scales, the nurse must focus on physiologic and behavioral manifestations to accurately assess pain.
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Which of the following is a nurinsg intervention used to prevent increased intracranial pressure (ICP) in an unconsious child?
Suction child frequently Provide enviornmental stimulation Turn head side to side every hour Avoid activities that cause pain or crying |
Avoid activities that cause pain or crying.
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The nurse is instructing a group of parents about head injuries in children. The nurse should explain that infants are particularly vulnerale to acceleration-decelearation head injuries because:
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Musculskeletal support of head is insufficient - The relatively large head size coupled with insufficient musculoskeltal support increases the risk to infants of accel-decel head injuries.
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The nusre is admitting a young child to the hospital b/c bacterial meningitis is suspected. Which of the following is the major priority of nursing care?
Initiate isolation precautions as soon as diagnosis confirmed. Initiate isolation precautions as soon as the causative agent is identified. Administered antibiotic therapy as soon as it is orderd Admin sedatives and analgesics on a preventive scheduled to manage pain. |
Admin Antibiotic therapy as soon as the causative agent is identified - Are begun as soon as possible to prevent death and to avoid resultant disabilities.
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The nurse is planning care for a school aged child with bacterial meningitis. Which of the following nursing interventions should be included?
Keep enviornment stimuli to a minimum. Avoid giving pain medications that could dull sensorium. Measure head circumference to assess developing complications Have child move head side to side at least every 2 hours. |
Children with meningitis are sensitive to noise, bright lights, and other extenral stimuli because of the irritation on the meningeal nerves. The nurse should keep the room as quite as possible with a minimum of external stimuli, including lighting. A school aged child will have closed sutures; thus head circum cannot change. Child should be placed on side-lying position with HOB slightly elevated. Should avoid measures such as lifting head that increases discomfort and puts tension on the neck.
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A young child is having a seizure that has lasted 35 minutes. There is a loss of consciousness. The nurse should recognize that this is:
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Status epilepticus
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The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt to correct hydrocephalus. Which of the following should the nurse include:
Parenteral protection is essential until child reaches adulthood. Mental retardation is to be expected with hydrocephalus Shunt malfunction or infection requires immediate treatment. Most usual childhood activities must be restricted |
Shunt malfunction or infection requires immediate treatment
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Cerebral Palsy (CP) may result from a variety of causes. It is now known that the most common cause of CP is which of the following?
Birth asphyxia Neonatal diseases Cerebral trauma Prenatal brain abnormalities |
Prenatal brain abnormalities: Most common currently identifiable cause of CP is exhisting brain abnormalities during the prenatal period.
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The major goals of therapy for children with CP include:
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Recognizing the disorder early and promoting optimal development.
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A 3 year old has CP, and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. Which of the following is the most appropriate nursing action related to feeding the boy?
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Stabilize his jaw with one hand (either from a front or side position) to facilitate swallowing
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An 8 year old has been diagnosed with moderate cerebral palsy (CP). She recently began participation in a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurse's response should be based on knowledge that:
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provides Opportunities for scoializtion and recreation.
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A neural tube defect that is not visible externally in the lumbosacral area would be called:
Meningocele Myelomeningocele Spina bifida Cystica Spina Bifida occulta |
Spina Bifida Occulta: often will not be noticed. A clue to the presence of this internal disorder will be a dimple or tuft of hair on the lumbosacral area.
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A woman who is 6 weeks pregnant tells the nurse that she is worried her baby might have spina bifida because of a family history. The nurses repsonse should be based on which of the following?
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Fetal ultrasound and elevated concentrations of a - fetoprotein in amniotic fluid many indicate the presence of anecephaly, myelominogecele or other neural tube defects. No chromosoma lstudies that currently diagnose SB
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A 6 year old girl born with a myelomeningocele has a neurogenic bladder. Her parents have been performing clean intermittent catheterization. The nurse should recommend which of the following?
Teach the child to do self cath Teach the child appropriate bladder control Continue having the parents do the cath Encourage the family to consider urinary diversion |
Teach the child to do self- cath _ At 6 years of age this child should have deterity to perform the intermittent cath herself. This will give her more control and master over her disability.
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Which of the following most accurately describes bowel function in children born with myelomeningocele?
Incontinence cannot be prevented Enemas and laxatives are contraindicated Some degree of fecal incontinence can usually be achieved A colostomy is usually required by the time the child reaches adolescence. |
Some degree of fecal continence can usually be achieved - With diet modification and regular toliet habits to prevent constipation and impaction,
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Which of the following is an important nursing intervention when caring for a child with myelomeningocele in preop stage?
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Measure head circum…Obstructive hydrocephalus is freqently associated with myelomeninogcele. Measure head circum and examine fontanels for signs that might indicating developing hydrocephalus
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A child with spina bifida has developed a latex allergy from numerous bladder cathertizations and surgeries. A priority nursing intervention is to:
Recommend allergy testing. Provide a latex-free enviornement Use only powder-free latex gloves Limit the use of latex products as much as possible |
Provide a latex-free environment. From birht on, limitation of exposure to latex is essnetial in an attempt to minmize sensitization.
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Which of the following factors predispose an infant to fluid imbalances?
Decreased surface area Lower metabolic rate Immature kidney functioning Decreased daily exchange of extracellular fluid |
Imature kidney Functioning - Infant's kidneys are unable to concentrate or dilute urine, to conserve or excrete sodium, and to acidify urine.
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When evaluating the extent of an infan'ts dehydration, the nurse should recognize that the symptoms of severe dehydration (15%) include:
Tachycardia, decreased tears, 5% weight loss Normal pulse and blood pressure, intesne thirst Irritability, moderate thirst, normal eyes and fontanels, Tachycardia, parched mucous membranes, sunken eyes and fontanels |
Symptoms of severe dehydration include tachycardia, parched mucous membranes and sunken eyes and fontanels. Severe = 15% weight loss,
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A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution (ORS). The child's mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which of the following?
Bring the child to the hospital for IV fluids Alternate giving ORS and carbonated drinks Continue to give ORS frequently in small amounts Institute NPO status for the child for 8 hours and resume ORS if vomiting has subsided. |
Continue to give ORS frequently in small amounts- Vomiting is not a contraindication to the use of ORS unless it is severe. The mother should continue to give ORS in small amounts at freq intervals.
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Which of the following urine tests would be considered abnormal?
pH: 4 SG: 1.020 Protein Level: absent Glucose level: absent |
pH 4 - expected pH of urine is 4.8-7.8
SG Range: 1.015 - 1.030 Protein - should not be present would indidcate abnormality in glomerular filtration Glucose - indicate DM, glomerulonephritis, or a response to infusion or fluids with high glucose concentrations |
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A young child is diagnosed with Vesicoureteral reflux. The nurse should know that this is usually associated with:
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Reccurent Kidney Infections: Refulx allows urine to flow back to the kidneys. When the urine is infected, this contributes to kidney infections.
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A 5 year old child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for which of the following?
School phobia Emotioanl causes Possible urinary tract infection Possible structural defects of urinary tract |
Incontinence in a previously toliet trained child can be an indication of a urinary tract infection.
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External defects of GI Tract such as hypospadias, are usually repaired as early as possible to ensure which of the following?
Prevention of urinary tract complications Prevention of seperation anxiety Acceptance of hospitalization Development of Normal body image |
Development of Normal body image: Promotion is extremely important. Surgery involving sexual organs can be upsetting to children, esspecialy prescholers who fear mutilation and castration. Surgical intervention for external defects of the genitourinary system should be done as soon as possible.
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Which of the following lab findings, in conjunction with the presenting symptoms indicates nephrosis?
Hypoalbuminemia Low specific gravity Decreased Hemoglobin Decreased Hematocrit |
Hypoalbuminemia: Result of large amounts of protein that leak through the glomerular membrane into the urine in a child with nephrosis
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In a non-potty trained child with nephrotic syndrome, the best way to detect fluid retention is which of the following?
Weigh child daily Test urine for hematuria Measure abdominal girth weekly Count the number of wet diapers |
Weight child daily: At same time in same clothing is most accurate way to determine fluid gains and losses.
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What is an appropriate nursing intervention while the child with nephrotic syndrome is confidned to bed?
Restrain child as necessary Discourage parents from holding child Do passive-range of motion exercises once a day Adjust activities to child's tolerance level |
Adjust activitiees to child's tolerance level: The child will have variable level of tolerance for activity. The activity tolerane will also be affected by labile moods associated with steroid admin. The nurs should assist the family in adjusting activities for the child that are age appropriate.
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The parent of a child hospitalized with acute glomerulonephritis (AGN) asks the nurse why blood pressure readings are being taken so often. The nurse's reply should be based on knowledge of which of the following?
BP flucturations are a common side effect of antibiotic therapy BP fluctuations are a sign that the condition has become chronic Acute hypertension must be anticipated and identified Hypotension leading to sudden shock can develop at any time |
Acute HTN must be anticipated and identified: Vital signs ,in particular BP, provide information about the severity of AGN and early signs of complications. Acute HTN is anticipated and requires frequent monitoring for ealry intervention.
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A 3 year old child is scheduled for surgery to remove Wilms Tumor from one kidney. The parents ask the nurse about what treamtents, if any will be necessary after recovery from surgery. The nurse's explanation should be based on knowledge that:
No additonal treatments are usually necessary. Chemo is usually not necessary Chemotherapy with or without radioatherapy is indicated Kidney transplant will be indicated within the year. |
Chemotherapy with or without radioterapy is indicated: Detemrination of chemo and / or radio therapy as tx modatlities will be made based on histologic pattern of the tumor.
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The nurse is caring for a child with Wilms tumor. Which of the following is the most important nursing intervetnion preoperatively?
Avoid abdominal palpation Closely monitor arterial blood gases Prepare child and family for long-term dialysis Prepare child and family for renal transplantation |
Avoid abdominal palpation: Wilms tumors are encapsulated. It is extremely important to avoid any palpation of the mass to minimize the risk of disemination of cancer cells to adjacent and other sites. A sign should be placed over the bed indicating that no abdominal palpation should be conducted.
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A toddler is hospitalized with acute renal failure secondary to severe dehydration. The nurse should assess the child for which of the following possible complications?
Hypotension Hypokalemeia Hypernatremia Water Intoxication |
Water Intoxication: child with ARF has tendency to develop water intoxication with hyponatremia. Control water balance requires careful monitoring of intake, output, body weight, and electrolytes.
Monitored for HTN not hypo, Hyponatremia not Hyper and HyperKalemia not Hypo |
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6 year old child with acute renal failure is being transferred out of the ICU. Which of the following children, considereing their diagnosis would be most appropriate roomate for this child?
6 year old child with pneumonia 4 year old child with gastroenteritis 5 year old child who has a fractured femur 7 year old child who had surgery for a ruptured appendix |
The 5 year old with fractured femur would be best, this child does not have an illness of viral or bacterial orgin.
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The newborn diagnosed with phenylketonuria (PKU) will require long-term follow-up to assess for the development of:
Obesity Diabetes Insipidus Resp distress Mental retardation |
Mental Retardation: PKU an inborn error of meatabolism, may lead to mental retardation if early intervetnion is not performed.
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Which of the following is the best way for the nurse to maintain adeuate fluid intake for a toddler with nausea, vomiting, and diarrhea?
Keep the patient NPO and give hypotnic solutions IV Force fluids and give hypertonic solutions IV Provide Jell-O and Popsicles to increase fluid intake Offere oral rehydration solutions (ORS) to rehydrate the patient |
Offer oral rehdyration solutions to rehydrate patient: Contain sodium potassium, choloride, citrate, and glucose; amount given determined by degree of dehydration and child's weight; if child vomiting give small amount of oral rehydration solution at frequent intervals.
Parenteral fluids are necessary only if toddler is severely dehydrated or in shock No longer recommended to give clear fluids such as fruit juices, carbonated soft drinks, geatin b/c therse are high in carbs, low in electrolytes and have high osmolarity. |
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The nurse cares for a newborn diagnosed with DDH. The nurse expects which of the following methods of treatment to be used for the newborn?
Pavlik harness Double diapering Placing a small pillow between the legs Bracing the affected leg |
Pavlik harness: during the early newborn period a harness is appllied to hold the hips in wide abduction; if tx does not achieve the correction in a few months then surgery is indicated and a postop spica hip bandage or body cast is applied.
Double diaper can cause hip extension Parents should ***** for skin breakdown when infant is in pavlik harness; put undershirt on infant under the chest straps nd knee socks on under the foot and leg pieces; check for skin breakdown 2-3 times per day; avoid lotions and powders; place diaper understraps. Gently massage skin under straps once per day to stimulate circulation. |
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When planning care for an infant diagnosed with a myelominocele, it is MOST important the nurse identifieds which of the following principles of nursince care is MOSt important to paply when caring for an infant with myelomingocele?
Asepsis Exercise Hygiene Rest |
Asepsis : infection may cause meningitis and damage the brain; the CNS is very delicate; asepsis is extremly important.
Infant placed in prone position; head turned to one side for feeding; gentle ROB may be restricted to foot, ankle, and knee joints, Diapering may be contraindicated until after surgical repair of defect; change paddening benath infant as needed Frequent stroking and caressing wil meet need for tactile stimulation |
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A brace is ordered for an adolescent to correct a scoliosis deformity. Which of the following statements, if made by the parent to the nurse, indicates teaching is succssful?
A bed board may replace the brace at night My child's diet should be low in calories Daily tub baths are preferred to showers The brace should be worn 23 hours a day. |
The brace should be worn 23 hours a day. Remove for bathing; ***** skin for signs of iritation; wear cotton T-shirt under brace to prevent irritation. Teach child how to prevent falls by using handrais and avoiding slippary surfaces.
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Home care monitors pediatric client diagnosed with chrnoic seizure disorder. The nurse should intervene if which of the following is observed?
The parent takes the child's temp using an oral electronic thermometer Parent encourages child to play with boats during bath time Child wears a helmet when riding a bicycle The child eats p nut buta and jelly sand. |
The parent takes the child's temp with oral electronic thermometer: Seizures can occur without warning ; its dangerous to have a thermometer in the mouth b/c the child may start seizing.
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The nurse performs a home care visit for a child diagnosed with cystic fibrosis. The nurse should intervene if which of the following is observed?
The child eats a high-protein, high cal diet The child has two to three stools per day The child swallows the pancreatic enzyme capsules whole. The child takes the pancreatic enzymes on hour after eating |
The child takes enzyme capusles one hour after eating: Should be taken at beginning of meal or with snacks or withing 30 min of eating; chewing or crushing beads destroys enteric coating.
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The nurse performs assessments in the well-baby clinic. The nurse identifies which of the following is a warning sign of CP?
The infant has poor head control after 3 months The infant sits with support by 8 months The infant uses arms and legs to crawl across the room The infant smiles at the mother by 3 months |
The infant has poor head control after 3 months
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Adolescent is evaluated for scoliosis. The client asks the nurse, "what is scoliosis?" Which of the following statements by the nurse BEST describes scoliosis?
It is inward curvature of the lower spine It is an exaggerated convexitity In the rhoracic region of the spine it is the herniation of an intervertebral disc it is a lateral curvature of a portion of the spine |
It is a lateral curvature of a portion of the spine: brace worn 23 hours a day.
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A 3 day old infant is born with a myelomeningocele. The nurse caring for the neonate should place the infant in which of the following positions?
Prone Fowler's Trendelenburg's Sidelying |
Prone: Neural tube fails to close and fuse during development: prone position helps prevent pressure on the fatlike protrusion on the back; pressure on the area may rsult in IICP and may also cause a rupture of the sac leading to infection
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An 18 mont old toddler diagnosed with cystic fibrosis is admitted to the hospital with a resp infection. The nurse should expect to see which of the following charateristic features of CF?
Absence of gastric enzymes An altered viscosity of mucous An absence of liver enzymes Poor ventilatory functioning |
An altered viscosity of Mucus:
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The nurse is asked to explain the major difference between a clubfoot and a postional deformity to a student nurse. Which of the following statements, if made by the nurse is appropriate?
A clubfoot can be passively corrected, but a postitional deformity must be corrected with surgery and casting A clubfoot is corrected with surgery and casting, but a postional defomrity can be passively corrected. A clubfoot is not correctable, but a positional deformity is correctable A clubfoot is correctable but a positional deformity is not correctable. |
A clubfoot is corrected with surgery and casting but a positional deformity can be passively corrected.
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Prior to surgery for myelomeningocele, which of the following actions should the nurse perform to care for the area of the defect?
Cleans the defect and leave the defect open to air Apply a dry steril dressing Apply a moist sterile dresing Apply antibiotic ointment and leave the area open to air |
Moist sterile dressing
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The nurse instructs the parents of a 7 year old child diagnosed with CF about required dietary modifications. Which of the following adjustments is likely to be made in a normal diet?
Increased protien Increased Fat Increased Carb Increased Potassium |
look this up
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The nurse cares for an infant immediately after insertion of a shunt due to hydrocephalus. Which of the folowing observations by the nurse should be reported to the physician immediately?
The infant is lying flat in bed The infan'ts pupils are dilated The suture is pink Bowel sounds are heard in all quadrants |
Pupils dilated = IICP
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A 3 year old child is brought to the ER with a Hx of vomiting and diarrhea for the past 3 days. Which of the following signs and symptoms is the nurse MOST likely to see?
Shorntess of breath Slow heart rate Sunken eyes Tremors |
Sunken Eyes
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