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A child with Duchenne muscular dystrophy rises from the floor by walking up the thighs with the hands. How should the nurse record this observation?
- A. Hand assistance
- B. Leg crawling
- C. Gowers sign
- D. Bright sign
Correct Answer: C
Rationale: Using the hands to walk up the thighs is known as the Gowers sign.
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The nurse educates the family of a newly admitted child with cystic fibrosis that the treatment will be centered on what therapy?
- A. Chest physiotherapy
- B. Mucus-drying agents
- C. Prevention of diarrhea
- D. Insulin therapy
Correct Answer: A
Rationale: Chest physiotherapy and aerosol medications are the center of treatment for cystic fibrosis.
The parents of a child who has been diagnosed with sickle cell anemia ask why their child experiences pain. What is the most likely cause of the pain?
- A. Inflammation of the vessels
- B. Obstructed blood flow
- C. Overhydration
- D. Stress-related headaches
Correct Answer: B
Rationale: The signs and symptoms of sickle cell anemia include the sickle-shaped cells clumping and obstructing blood flow, which causes severe tissue hypoxia and necrosis leading to pain.
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. What would be the correct action by the nurse?
- A. Restrain the child in the tent and notify the health care provider.
- 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.
Correct Answer: B
Rationale: The child with LTB should be placed in the mist tent with 30% oxygen. Restlessness is caused by poor oxygenation. The child should not be taken out of the oxygenated tent. While the mother could be asked to help comfort the child, and the health care provider may be notified, the priority is to set the oxygen at the correct level.
The parents of a child suffering from depression ask the nurse what causes depression in children. Which answer is an appropriate response by the nurse?
- A. The causes of major depression are unknown.
- B. Major affective disorders in parents increase depression in children.
- C. Boys are more likely than girls to be depressed.
- D. The prevalence rate is higher in prepubescent children.
Correct Answer: A
Rationale: The causes of depression have not been established. However, many studies have shown that children have a three times greater rate of suffering from depression if their parents have a major affective disorder.
What is the most common clinical manifestation of coarctation of the aorta?
- A. Clubbing of the digits
- B. Upper extremity hypertension
- C. Pedal edema and portal congestion
- D. Loud systolic ejection murmur
Correct Answer: B
Rationale: Coarctation of the aorta results in hypertension in the upper extremities. The pressure in the arms is typically 20 mm Hg higher than in the legs.