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Pediatrics > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What do you assess for a fracture?

A

temperature
color
pulse

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2
Q

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?

A.) Perform a neurovascular assessment
B.) Explain the discharge instructions to the clients and parents
C.) Provide reassurance to the clients and parents
D.) Apply an ice pack to the casted leg

A

A.) Perform a neurovascular assessment

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3
Q

What is included in a neurovascular assessment?

A

sensation
skin temp
skin color
cap refill
pulses
movement

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4
Q

What do you need to watch out for when you have a fracture that compresses muscle?

A

compartment syndrome

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5
Q

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)

a. Palpable distal pulse
b. Capillary refill to extremity less than 3 seconds
c. Severe pain not relieved by analgesics
d. Tingling of extremity
e. Inability to move extremity

A

c. Severe pain not relieved by analgesics
d. Tingling of extremity
e. Inability to move extremity

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6
Q

What is a complication for compartment syndrome in a joint or extremity?

A

Volkmann’s contracture

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7
Q

What is volkmann’s contracture? What are the causes?

A

permanent contracture of the forearm and hand

CAUSES: tight dressing or cast, hemorrhage, burns, surgery, massive IV infiltration

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8
Q

A 13-year-old child is diagnosed with Ewing’s sarcoma of the femur. After a course of radiation and chemotherapy, it has been decided that leg amputation is necessary. After the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. Which nursing statement would be appropriate to assist in alleviating the child’s fear?

a) “This aching and cramping is normal and temporary and will subside.”
b) “This normally occurs after the surgery, and we will teach you ways to deal with it.”
c) “The pain medication I will give you will take the feelings away.”
d) “The pain is not real pain, and relaxation exercises will help it go away.”

A

a) “This aching and cramping is normal and temporary and will subside.”

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9
Q

For a child with Ewing’s sarcoma tumor on the femur who just had an amputation is complaining about feeling pain. What should the nurse do?

A

this is normal
teach ways to help understand

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10
Q

A nurse is assessing a 3 year old child who stands with their knees together and feet apart, what should the nurse do?

A

report to doctor because this is not normal

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11
Q

Which screening tests should the school nurse perform for the adolescent? (Select all that apply.)

a. Glucose
b. Vision
c. Hearing
d. Cholesterol
e. Scoliosis

A

b. Vision
c. Hearing
e. Scoliosis

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12
Q

What is scoliosis?

A

abnormal lateral curvature of the spine

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13
Q

Who is affected by scoliosis? When is it diagnosed?

A

adolescents
females

screening during preadolescence

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14
Q

What is the treatment for scoliosis?

A

surgical intervention

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15
Q

What should be monitored after scoliosis surgery?

A

change in body image for pt

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16
Q

A client who has sustained a crush injury to the right lower leg reports numbness and tingling of the affected extremity. The skin of the right leg appears pale. Which is the nurse’s first intervention?

a. Assess pedal pulses.
b. Apply oxygen by nasal cannula.
c. Increase the IV flow rate.
d. Document the finding.

A

a. Assess pedal pulses.

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17
Q

Which is an appropriate nursing intervention when caring for a child in traction?

a. Remove adhesive traction straps daily to prevent skin breakdown.
b. Assess for tightness, weakness, or contractures in uninvolved joints and muscles.
c. Provide active range-of-motion exercises to affected extremity three times a day.
d. Keep the child in one position to maintain good alignment.

A

b. Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

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18
Q

A nurse is caring for a toddler who has a fractured right femur and is in Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following?

A. Skin straps maintain the leg in an extended position.
B. Weights are attached to a pin that is inserted into the femur.
C. A padded sling is under the knee of the affected leg.
D. The buttocks is elevated slightly off of the bed.

A

D. The buttocks is elevated slightly off of the bed.

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19
Q

A child with developmental dysplasia of the hip has a spica cast applied. Which action(s) specific to the spica cast should be taken? (Select all that apply)

A. Check for cracks or breaks in the cast.
B. Ensure the child’s head is higher than his feet.
C. Assess for circulation, movement, and sensation.
D. Measure the blood pressure frequently.
E. Auscultate the bowel sounds.
F. Use the rod between the child’s legs to lift and turn the child.
G. Check for swelling and tightness.
H. Position with feet elevated above heart level.
I. Place a disposable diaper inside the edges of the rear part of the cast.

A

A. Check for cracks or breaks in the cast.
B. Ensure the child’s head is higher than his feet.
C. Assess for circulation, movement, and sensation.
E. Auscultate the bowel sounds.
G. Check for swelling and tightness.
I. Place a disposable diaper inside the edges of the rear part of the cast.

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20
Q

A patient has a hip fracture (dysplasia) with a spica cast, what should the nurse assess?

A

circulation
sensation
movement

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21
Q

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

a. Healing is usually delayed in this type of fracture.
b. Growth can be affected by this type of fracture.
c. This is an unusual fracture site in young children.
d. This type of fracture is inconsistent with a fall.

A

b. Growth can be affected by this type of fracture.

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22
Q

What is the goal of treating septic arthritis?

A

eradicating the infection

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23
Q

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included?

a. Apply lotion or powder to minimize skin irritation.
b. Remove harness several times a day to prevent contractures.
c. Return to clinic every 1 to 2 weeks.
d. Place diaper over harness, preferably using a superabsorbent disposable diaper that
is relatively thin.

A

c. Return to clinic every 1 to 2 weeks.

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24
Q

What should the nurse teach for a patient who has hip dysplasia being sent home with pavlik harness?

A

it can be removed once a day for one hour

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25
Q

Which type of croup is always considered a medical emergency?

a. Laryngitis
b. Epiglottitis
c. Spasmodic croup
d. Laryngotracheobronchitis (LTB)

A

b. Epiglottitis

26
Q

What is another name for laryngotracheobronchitis?

A

croup

27
Q

What kind of cough does croup make?

A

barking cough

28
Q

What is the diet for a child with croup?

A

NPO

29
Q

A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following findings indicates that the treatment has been effective?

A. Barking cough
B. Improved hydration
C. Decreased stridor
D. Decreased temperature

A

C. Decreased stridor

30
Q

A nurse is caring for a pre-school age child who has epiglottitis with a barking cough. Which of the following actions should the nurse take?

A. Initiate airborne precautions.
B. Obtain a throat culture.
C. Use a tongue depressor to observe the epiglottis.
D. Monitor oxygen saturation.

A

D. Monitor oxygen saturation.

31
Q

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?

a.Tell the mother that the child must stay in the tent.
b.Place a toy in the tent to make the child feel more comfortable.
c.Call the health care provider and obtain a prescription for a mild sedative.
d.Let the mother hold the child and direct the cool mist over the child’s face.

A

d.Let the mother hold the child and direct the cool mist over the child’s face.

32
Q

What is the respiratory treatment for a child with croup?

A

cool mist for oxygen

racemic epi nebulizer (decreases mucosal edema)

33
Q

How will you know if the respiratory treatment is effective for croup?

A

cough or stridor subsides

34
Q

The nurse is caring for a child in the emergency department who presents with a low-grade fever, a barking cough, and inspiratory stridor. Which actions does the nurse anticipate performing?

A

Encourage the child to be held and comforted by parents
Closely monitor respiratory status.
Ensure emergency equipment is available at the bedside.

35
Q

What should be at the bedside for a patient with croup?

A

intubation
ambu bag
suction

36
Q

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. The nurse’s rationale for this action is described primarily in which statement?

a. Mothers of hospitalized toddlers often experience guilt.
b. The mother’s presence will reduce anxiety and ease the child’s respiratory efforts.
c. Separation from the mother is a major developmental threat at this age.
d. The mother can provide constant observations of the child’s respiratory efforts.

A

b. The mother’s presence will reduce anxiety and ease the child’s respiratory efforts.

37
Q

How will you know that respiratory treatment is effective for a 2 year old who has respiratory distress?

What will be heard upon auscultation?

A

RR regular
HR <140
O2 sats >95%
decreased cough
decreased nasal flaring
decreased retractions

ausc: clear breath sounds

38
Q

The nurse is assessing a child with acute epiglottitis. Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition?

a. Inspiratory stridor
b. Complete obstruction
c. Sore throat
d. Respiratory tract infection

A

b. Complete obstruction

39
Q

A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?

A. Obtain a throat culture.
B. Place the child in an upright position.
C. Transport the child to radiology for a throat x-ray.
D. Visualize the epiglottis with a tongue depressor.

A

B. Place the child in an upright position.

40
Q

A 3 year old arrives to the ER. The child has a temperature of 102.4 ‘F, respiratory rate of 45, and is agitated. The child is diagnosed with epiglottitis. You note the child is sitting up, positioned forward with chin in the air and the tongue is protruding with the mouth open. Which nursing intervention below is NOT appropriate for this patient?

A. Assist the patient in a supine position.
B. Keep the child on the parent’s lap during treatments.
C. Keep the child nothing by mouth.
D. Avoid taking a temperature on the patient orally.

A

A. Assist the patient in a supine position.

41
Q

A nurse is assessing a patient who has pneumonia. The mom says he has not been eating, what will the nurse expect to see?

A

dehydration
low grade temp
high electrolytes
high BUN and sodium
bilateral crackles

42
Q

The nurse is concerned that a​ 9-month-old client being treated for bronchiolitis caused by respiratory syncytial virus​ (RSV) is developing respiratory distress. Which assessment finding supports this​ concern? (Select all that​ apply.)

A. Onset of expiratory grunting
B. Visible intercostal retractions with ventilations
C. Respiratory rate increased from 30 to 48​ breaths/min
D. Systolic blood pressure 10 mmHg less than previous measurement
E. Femoral pulse weak and 120​ beats/min

A

A. Onset of expiratory grunting
B. Visible intercostal retractions with ventilations
C. Respiratory rate increased from 30 to 48​ breaths/min

43
Q

What will a nurse expect to see for a patient with RSV?

A

retractions (not active)
it is a virus
high RR

44
Q

A nurse is caring for a child who has a suspected diagnosis of cystic fibrosis. Which of the following diagnostic tests will confirm the diagnosis?

A. Sweat chloride test
B. A sputum culture
C. A stool fat content analysis
D. Pulmonary function tests

A

A. Sweat chloride test

45
Q

A nurse is planning care for a child who has cystic fibrosis and a prescription to receive chest physiotherapy (CPT). Which of the following actions should the nurse plan to take?

A. Percuss each lung segment for 15 min.
B. Perform CPT immediately after the child eats.
C. Administer albuterol prior to CPT.
D. Perform vibration during the client’s inspirations.

A

C. Administer albuterol prior to CPT.

46
Q

A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?

a. Sweat chloride test, stool for fat, chest radiograph films
b. Stool test for fat, gastric contents for hydrochloride, chest radiograph films
c. Sweat chloride test, bronchoscopy, duodenal fluid analysis
d. Sweat chloride test, stool for trypsin, biopsy of intestinal mucosa

A

a. Sweat chloride test, stool for fat, chest radiograph films

47
Q

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

a. Before chest physiotherapy (CPT)
b. After CPT
c. Before receiving 100% oxygen
d. After receiving 100% oxygen

A

a. Before chest physiotherapy (CPT)

48
Q

Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included?

a. Do not administer pancreatic enzymes if the child is receiving antibiotics.
b. Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools.
c. Administer pancreatic enzymes between meals if at all possible.
d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

A

d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

49
Q

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

a. Diet should be high in carbohydrates and protein
b. Diet should be high in easily digested carbohydrates and fats
c. Most fruits and vegetables are not well tolerated.
d. Fats and proteins must be greatly curtailed.

A

a. Diet should be high in carbohydrates and protein

50
Q

A nurse is providing discharge teaching about nutrition to the parents of a child who has cystic fibrosis (CF). Which of the following responses by the parents indicates an understanding of the teaching?

a) “We will give our child pancreatic enzymes with snacks and meals.”
b) “We will restrict the amount of salt in our child’s food.”
c) “I will limit my child’s fluid intake.”
d) “I will prepare low-fat meals with limited protein for my child.”

A

a) “We will give our child pancreatic enzymes with snacks and meals.”

51
Q

How would you describe the secretions of cystic fibrosis?

A

thick

52
Q

A nurse is caring for a child who has a tracheostomy. After suctioning the tracheostomy, the nurse should use which of the following findings to determine that the procedure was effective?

A. Increased respiratory rate
B. Stable oxygen saturation
C. Clear breath sounds
D. Brisk capillary refill

A

C. Clear breath sounds

53
Q

What is another name for pertussis?

A

whooping cough

54
Q

If a patient is experiencing a severe prolonged asthma attack and is not responding to treatment, what is this called?

A

status asthmaticus

55
Q

A nurse is providing teaching to a parent of a child who has acute group A ß-hemolytic streptococci. Which of the following information should the nurse include in the teaching?

A. Avoid the use of warm compresses around the head or neck.
B. Intramuscular injections will be required monthly.
C. Replace the child’s toothbrush after 24 hr on antibiotics.
D. Keep the child home from school for at least 1 week.

A

C. Replace the child’s toothbrush after 24 hr on antibiotics.

56
Q

A nurse is providing teaching to the parents of a child who has streptococcal pharyngitis about ways to prevent disease transmission. Which of the following responses by the parents indicates an understanding of the teaching?

A. “We’ll continue to encourage him to drink lots of fluids.”
B. “We’ll take his temperature every 4 hours.”
C. “We’ll give him Tylenol for the pain.”
D. “We’ll discard his toothbrush and buy another.”

A

D. “We’ll discard his toothbrush and buy another.”

57
Q

A nurse is teaching an assistive personnel to measure a newborn’s respiratory rate. Which of the following statements indicates an understanding of why the respiratory rate should be counted for a complete minute?

A. “Newborns are abdominal breathers.”
B. “Newborns do not expand their lungs fully with each respiration.” C. “Activity will increase the respiratory rate.”
D. “The rate and rhythm of breath are irregular in newborns.”

A

D. “The rate and rhythm of breath are irregular in newborns.”

58
Q

The nurse reviews the assessment findings and determines they are consistent with which of the following disease processes?For each assessment finding, click to specify if the finding is consistent with acute viral nasopharyngitis, acute epiglottitis, or acute laryngotracheobronchitis. Each finding may support more than one disease process.

A

acute viral nasopharyngitis
- body temp

acute epiglottitis
- child’s appearance
- oral secretions
- positioning of body
- retractions
- body temp
- reported pain

acute laryngotracheobronchitis
- retractions
- body temp

59
Q

What category of pediatric patients are considered undertreated for pain?

A

cognitively impaired

60
Q

Nonpharmacologic strategies for pain management:

a. may reduce pain perception.
b. make pharmacologic strategies unnecessary.
c. usually take too long to implement.
d. trick children into believing they do not have pain.

A

a. may reduce pain perception.

61
Q

What pain scale would be used for a 1 year old after surgery?

A

FLACC

62
Q

How would you observe an infant for increased pain?

A

increase in body movements

Pediatrics (6 decks)

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