Deck 31: Care of the Child with a Physical Disorder

Question 1

The nurse educates the family of a newly admitted child with cystic fibrosis that the therapy will be centered on:

A) chest physiotherapy.
B) mucus-drying agents.
C) prevention of diarrhea.
D) insulin therapy.

Answer 1

chest physiotherapy.

Question 2

The nurse teaches parents that the severity of infant respiratory distress syndrome (RDS)is most influenced by:

A) poor cough and gag reflex.
B) the gestational age at birth.
C) administering high concentrations of oxygen.
D) the sex of the infant.

Answer 2

the gestational age at birth.

Question 3

A 2-year-old child with laryngotracheobronchitis (LTB)is fussy and restless in the oxygen tent.The oxygen level in the tent is 25%,and blood gases are normal.The nurse should:

A) restrain the child in the tent and notify the physician.
B) increase the oxygen concentration in the tent.
C) take the child out of the tent and into the playroom.
D) ask the mother for help in comforting the child.

Answer 3

increase the oxygen concentration in the tent.

Question 4

Following surgical repair of a cleft palate,when soft food is introduced,the nurse modifies the care plan to include feeding safety based on the knowledge that to avoid injury to the suture line,it is best to avoid the use of a:

A) feeding dropper.
B) spoon.
C) syringe.
D) cup.

Question 5

Parents of a 6-month-old child who has just been diagnosed with iron deficiency anemia ask why it was not diagnosed earlier.The nurse's best response is:

A) "Are you sure your child has iron deficiency anemia?"
B) "This happens when the maternal stores of iron are depleted at about 6 months."
C) "This anemia is caused by blood loss."
D) "The child may not have had it for a long time."

Question 6

The nurse is assisting the parents of a child born with a cleft lip and palate to deal with the deformity.An appropriate nursing diagnosis for the parents is:

A) parental role conflict.
B) risk for delayed growth and development.
C) risk for impaired attachment.
D) anticipatory grieving.

Question 7

Therapeutic management of iron deficiency anemia includes administration of what?

A) Multivitamins
B) Calcium
C) Ferrous sulfate
D) Iodine

Question 8

When reviewing laboratory results for a child with hemophilia,the nurse anticipates finding an abnormal:

A) prothrombin time.
B) bleeding time.
C) platelet count.
D) partial thromboplastin time.

Question 9

The mother of a child with acute laryngotracheobronchitis (LTB)asks why her child must be kept NPO.The nurse explains that:

A) the epinephrine given causes nausea and vomiting.
B) the child is being hydrated with IV fluids.
C) swollen respiratory passages make eating difficult.
D) the child's rapid respirations pose a risk for aspiration.

Question 10

The parents of a child with acute lymphoblastic leukemia ask about the best approach for maintaining remission of the disease.The nurse informs them that the most effective therapy would be:

A) surgery to remove enlarged lymph nodes.
B) long-term chemotherapy.
C) nutritional supplements to enhance blood cell production.
D) blood transfusions to replace ineffective red cells.

Question 11

When interacting with the parents of a SIDS infant,one of the things the nurse attempts to assist with is:

A) referring the parents to a psychologist.
B) encouraging the parents to remain stoic.
C) allaying feelings of guilt and blame.
D) learning how the event could have been prevented.

Question 12

The nurse teaches the parents of a child with acute epiglottitis that the child could suddenly suffer:

A) increased carbon dioxide levels.
B) airway obstruction.
C) inability to swallow.
D) bronchial collapse.

Question 13

The parents of a child who has been diagnosed with sickle cell anemia ask why their child experiences pain.The nurse explains that the child's pain is caused by:

A) inflammation of the vessels.
B) obstructed blood flow.
C) overhydration.
D) stress-related headaches.

Question 14

When reviewing the pathophysiology of cystic fibrosis,the nurse recognizes that it is characterized by:

A) multiple upper respiratory infections.
B) an underproduction of exocrine glands.
C) excessive,thick mucus.
D) an overproduction of thin mucus.

Question 15

The nurse selects which time as the best to administer the pancreatic enzyme replacement?

A) Before meals and snacks
B) Before bedtime
C) Early in the morning
D) After meals and snacks

Question 16

The mother of a child who has pneumonia is asking what could have been done to prevent the infection.The nurse teaches the mother that children older than 2 years:

A) are still protected by antibodies from the mother.
B) can be inoculated against pneumococcal pneumonia.
C) may have nutritional deficits that make them vulnerable.
D) are frequently sedentary,which makes them susceptible to infections.

Question 17

The parents of a child diagnosed with sickle cell anemia ask what to do to avoid a sickle cell crisis.The nurse explains that the medical management of sickle cell crisis includes:

A) information for the parents including home care.
B) providing adequate hydration and pain management.
C) pain management and administration of iron supplements.
D) adequate oxygenation and factor VIII.

Question 18

When conducting a class for parents about sudden infant death syndrome (SIDS),the nurse instructs the class that new information suggests not placing the infant in which position?

A) Right side-lying
B) Left side-lying
C) Prone
D) Supine

Question 19

When caring for a child with coarctation of the aorta,the nurse assesses for the most common clinical manifestation,which is:

A) clubbing of the digits.
B) upper extremity hypertension.
C) pedal edema and portal congestion.
D) loud systolic ejection murmur.

Question 20

The nurse uses a diagram to show that tetralogy of Fallot involves a combination of which four congenital defects?

A) Aortic stenosis,atrial septal defect,overriding aorta,left ventricular hypertrophy
B) Pulmonary stenosis,ventricular septal defect,overriding aorta,right ventricular hypertrophy
C) Aortic stenosis,atrial septal defect,overriding aorta,right ventricular hypertrophy
D) Pulmonary stenosis,ventricular septal defect,aortic hypertrophy,left ventricular hypertrophy

Question 21

The nurse caring for a 6-year-old child with acute glomerulonephritis anticipates that the most difficult part of the care will be implementing:

A) forced fluids.
B) increased feedings.
C) bed rest.
D) frequent position changes.

Question 22

A teenage girl has been placed in a body cast for the treatment of scoliosis,the most common skeletal deformity of adolescence.When the family asks what they can do to be more supportive,the nurse suggests:

A) enrolling her in a health club.
B) taking her to the mall in a wheelchair.
C) purchasing clothes to disguise the cast.
D) spending a majority of their time with her.

Question 23

A child with Duchenne's muscular dystrophy rises from the floor by walking up the thighs with the hands.The nurse records this observation as:

A) hand-assistance.
B) leg crawling.
C) Gowers' sign.
D) Bright's sign.

Question 24

The nurse measures intake and output for an infant with dehydration by:

A) attaching a urine collecting bag.
B) wringing out the diaper.
C) weighing the diaper.
D) inserting a catheter.

Question 25

The nurse is caring for a newborn with a myelomeningocele.Before surgery,the nursing interventions should include:

A) leaving the lesion uncovered and placing the infant supine.
B) covering the lesion with a sterile,saline-soaked gauze.
C) applying lotion to the lesion to keep it moist.
D) covering the lesion with a dry,sterile gauze.

Question 26

When caring for a 7-week-old infant with hypothyroidism,the nurse explains that the administration of oral thyroid replacement therapy is critical for this child to prevent:

A) excessive growth.
B) cognitive impairment.
C) damage to the nervous system.
D) damage to the urinary system.

Question 27

The nurse explains that gastroesophageal reflux (GER)usually begins within the first week of life in infants and is usually treated by:

A) making the infant NPO.
B) thickening the food with cereal.
C) placing the infant in an upright position.
D) feeding the infant in a car seat.

Question 28

The nurse assessing an infant who has been diagnosed with hypertrophic pyloric stenosis anticipates:

A) a history of diarrhea following each feeding.
B) gastric pain evidenced by vigorous crying.
C) poor appetite due to a poor sucking reflex.
D) an olive-shaped mass at the midline.

Question 29

When a 2-year-old child is admitted with a diagnosis of Hirschsprung's disease,the nurse explains that the causative factor of this disease is:

A) frequent evacuation of solids,liquid,and gases.
B) excessive peristaltic movement.
C) the absence of parasympathetic ganglion cells in a portion of the colon.
D) one portion of the bowel telescoping into another.

Question 30

When discussing long-term complications of a child with cleft lip and palate,the nurse tells the parents that one of the complications is:

A) cognitive impairment.
B) altered growth and development.
C) faulty dentition.
D) physical abilities.

Question 31

A school-age child has been rehydrated following a bout of diarrhea.The nurse offers foods that are nonirritating to the bowel,including:

A) apricots and peaches.
B) chocolate milk.
C) applesauce and milk.
D) bananas and rice.

Question 32

When assessing a child for classical signs of meningeal irritation,the nurse records:

A) positive Kernig's sign,diarrhea,and headache.
B) negative Brudzinski's sign,positive Kernig's sign,and irritability.
C) positive Brudzinski's and Kernig's signs and photophobia.
D) negative Kernig's sign,vomiting,and fever.

Question 33

When selecting nursing diagnoses for the 4-year-old child with nephrosis,the nurse places priority on risk for:

A) impaired body image.
B) skin impairment.
C) nutritional deficit.
D) injury.

Question 34

Which additional congenital malformation is expected in 80% of infants with a myelomeningocele?

A) Cerebral palsy
B) Hydrocephalus
C) Meningitis
D) Neuroblastoma

Question 35

When speaking to young parents,the nurse states that lead poisoning is one of the most common preventable health problems affecting children.When lead levels exceed the amount that can be absorbed by the bones,it leads to:

A) malnutrition.
B) anemia.
C) bone pain.
D) diarrhea.

Question 36

The physician is treating a child with meningitis with a course of antibiotic therapy.The nurse assures the parents that the child will be out of isolation when:

A) the course of antibiotics is complete.
B) a negative CNS culture is obtained.
C) the antibiotics have been initiated for 24 hours.
D) the child has no symptoms of the disease.

Question 37

The nurse explains to the parents of a child with developmental hip dysplasia that the application of a Pavlik harness will hold the child's femurs in:

A) abduction.
B) adduction.
C) flexion.
D) extension.

Question 38

A newborn has talipes and has been casted.The nurse explains that the casts must be changed:

A) daily.
B) weekly.
C) bi-weekly.
D) monthly.

Question 39

The nurse caring for a 4-year-old child with cerebral palsy recognizes that the priority nursing interventions are designed to:

A) assist with referral to specialized education.
B) support the child with independent toileting.
C) assist the child to develop effective communication.
D) encourage the child to ambulate independently.

Question 40

When assessing a child admitted with intussusception,the nurse discovers the hallmark sign of intussusception,which is:

A) mucus-like stools.
B) currant jelly-like stools.
C) tarry,black stools.
D) green,soft stools.

Question 41

The nurse instructs the mother of a child with a ventricular septal defect that she can expect the child to become cyanotic when the child does what?

A) Experiences an elevation in temperature
B) Sleeps on the left side
C) Cries vigorously
D) Is held upright
E) Eats

Question 42

The mother of a child who has been diagnosed with varicella asks the nurse when the child can return to school.The nurse states that the child is no longer contagious:

A) when the fever dissipates.
B) after the incubation period.
C) when the lesions have healed.
D) when the lesions are crusted over.

Question 43

The mother brings the child to the nurse because of exposure to varicella.The nurse explains that early signs of the disease are:

A) high fever over 101° F.
B) general malaise.
C) increased appetite.
D) crusty sores.

Question 44

An infant has been diagnosed with cradle cap.The nurse recognizes that the intervention to treat the scaly patches on the scalp is to apply:

A) alcohol.
B) mineral oil.
C) calamine.
D) A&D ointment.

Question 45

A child has developed a diaper rash,and the parents are using zinc oxide to treat it.The nurse is instructing the parents about removal of the ointment and suggests using:

A) mild soap and water.
B) a cotton ball.
C) mineral oil.
D) alcohol swabs.

Question 46

The nurse instructs the parents of a child who has had a myringotomy to position the child:

A) supine.
B) on the affected side.
C) on the unaffected side.
D) in a Trendelenburg position.

Question 47

A new mother asks the clinic nurse if she must continue giving her baby nystatin for thrush since the white lesions on his tongue have disappeared.The nurse replies:

A) "No.When the lesions have gone you may stop the nystatin."
B) "Yes.You should continue it for the full 7 days."
C) "No.Thrush is a self-limiting disorder and nystatin is given for comfort only."
D) "Yes.The medication should be refilled for a second week of therapy."

Question 48

The nurse anticipates that the cerebrospinal fluid (CSF)taken from a child with bacterial meningitis would have a low __________ level.

Question 49

An adolescent female asks the nurse about taking retinoic acid (Accutane).The nurse instructs that the medication:

A) should be used only for 10 weeks.
B) requires that sexually active females use contraception.
C) lowers hemoglobin very quickly.
D) has few side effects.

Question 50

When assessing the laboratory values of a child with nephrosis,the nurse anticipates which result(s)? (Select all that apply.)

A) High levels of protein in the urine
B) High serum lipid levels
C) Low serum protein levels
D) Low hemoglobin
E) High white blood cell count

Question 51

When the mother of a child with gastroesophageal reflux calls the clinic nurse to report that her baby is vomiting small amounts of blood,the nurse explains that the esophagus has been irritated by _______ ________.

Question 52

The nurse instructs parents about the signs of otitis media,which include:

A) earache,wheezing,vomiting.
B) coughing,rhinorrhea,headache.
C) fever,irritability,pulling on ear.
D) wheezing,cough,drainage in ear canal.

Question 53

The nurse reassures the anxious mother of a child with pyloric stenosis who is to have surgery that the surgical procedure,called a __________,is quickly done and the child recovers almost immediately.