Nokea
A child who limps and has pain has been found to have Legg-Calvé-Perthes disease. What should the nurse expect to include in the child's plan of care?
- A. Initiation of pain control measures, especially at night when acute.
- B. Promotion of ambulation despite child's discomfort in the affected hip.
- C. Prevention of flexion in the affected hip and knee.
- D. Advance of weight bearing on the head of the affected femur.
Correct Answer: A
Rationale: Pain control is essential in Legg-Calvé-Perthes disease, as pain is a common symptom, especially at night, due to inflammation and muscle spasms.
You may also like to solve these questions
The nurse is caring for a 5-year-old boy who is taking prednisolone for nephrotic syndrome. The child is at the 75th percentile for height and has a blood pressure of 114/73. The nurse compares the reading to the below blood pressure levels for boys age and height percentiles. The nurse determines that the blood pressure represents a change and notifies the primary care provider of the assessment of:
- A. Hypotension.
- B. Prehypertension.
- C. Hypertension.
- D. Hypertension stage II.
Correct Answer: C
Rationale: BP indicates hypertension.
The health care team has noticed an increase in I.V. infiltrations on the pediatric floor. As part of a Plan, Do, Study, Act quality improvement plan the team should do the following in which order?
- A. Analyze the data.
- B. Decide to monitor I.V. gauges.
- C. Perform chart audits.
- D. Write a new I.V. insertion policy.
Correct Answer: B,C,A,D
Rationale: The PDSA cycle involves planning (deciding to monitor), doing (chart audits), studying (analyzing data), and acting (writing a new policy).
The parents of a child with a serious head injury ask the nurse if the child is going to be all right. Which of the following responses by the nurse would be most appropriate?
- A. Children usually don't do very well after head injuries like this.'
- B. Children usually recover rapidly from head injuries.'
- C. It's hard to tell this early, but we'll keep you informed of the progress.'
- D. That's something you'll have to talk to the doctor about.'
Correct Answer: C
Rationale: Acknowledging uncertainty while promising updates provides honest, supportive communication without false reassurance.
The nurse is assessing a 9-year-old child who has third-degree burns as shown below. Using the 'Rule of Nines' adapted for children, the nurse estimates that the extent of burns for this child is:
- A. 9%.
- B. 14%.
- C. 18%.
- D. 24%.
Correct Answer: C
Rationale: In children, the Rule of Nines assigns 18% to each arm (including forearm and hand). A third-degree burn on one forearm approximates 18%, assuming the burn covers the entire forearm as implied.
Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin (Lanoxin) should include which of the following?
- A. Give the medication at regular intervals.
- B. Mix the medication with a small volume of breast milk or formula.
- C. Repeat the dose one time if the child vomits immediately after administration.
- D. Notify the primary care provider of poor feeding or vomiting.
- E. Make up any missed doses as soon as realized.
- F. Notify the primary care provider if more than 2 consecutive doses are missed.
- G. Keep medication in a safe place, preferably a locked cabinet.
Correct Answer: A,C,D,F,G
Rationale: Digoxin requires regular dosing, safe storage, and monitoring for side effects like vomiting or poor feeding. Vomiting doses should not be repeated due to toxicity risks, and missed doses should not be made up.