Nokea
A nurse is developing a plan of care with the parents of a 6-year-old girl diagnosed with a seizure disorder. To promote growth and development, the nurse should instruct the parents that:
- A. The child will need activity limitation and will be unable to perform as well as her peers.
- B. There is potential for a learning disability and the child may need tutoring to reach her grade level.
- C. The child will likely have normal intelligence and be able to attend regular school.
- D. There will be problems associated with social stigma and parents should consider home schooling.
Correct Answer: C
Rationale: Most children with seizure disorders have normal intelligence and can attend regular school with appropriate management, promoting normal development.
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The nurse is giving care to an infant with a brain tumor. The nurse observes the infant arch the back (see figure). The nurse should:
- A. Notify the physician
- B. Stroke the back to release the arching
- C. Pad the side rails of the crib
- D. Place the child prone
Correct Answer: A
Rationale: The infant has opisthotonos, an indication of brain stem herniation; the nurse should notify the physician immediately and have resuscitation equipment ready. Stroking the back will not relieve the herniation or release the arching. Although the infant may also have a seizure, and padded side rails will prevent injury, the fi rst action is to notify the physician. Placing the child in a prone position will not relieve the herniation or release the arching.
Which development is necessary for toilet training readiness for a 2-year-old? Select all that apply.
- A. Adequate neuromuscular development for sphincter control.
- B. Appropriate chronological age.
- C. Ability to communicate the need to use the toilet.
- D. Desire to please the parents.
- E. Ability to play with other 2-year-olds.
Correct Answer: A,C,D
Rationale: Neuromuscular control, communication, and motivation are key for toilet training readiness.
Which of the following questions should the nurse ask first when obtaining a history from the mother of a 10-year-old child with a fever, complaints of not feeling well, and swelling around the eyes?
- A. Has the child had a sore throat recently?
- B. Is the child playing with friends as usual?
- C. Does the child urinate as much as usual?
- D. Is the urine pale in color?
Correct Answer: A
Rationale: Sore throat could indicate streptococcal infection.
An adolescent with insulin-dependent diabetes is being taught the importance of rotating the sites of insulin injections. The nurse should judge that the teaching was successful when the adolescent identifies which of the following as a result of using the same site?
- A. Unstruction of the fat tissue and poor absorption.
- B. Destruction of nerves and painful neuritis.
- C. Destruction of the tissue and too-rapid insulin uptake.
- D. Development of resistance to insulin and need for increased amounts.
Correct Answer: A
Rationale: Repeated injections at the same site cause lipodystrophy, leading to poor insulin absorption. Nerve damage, rapid uptake, or insulin resistance are not primary consequences.
The nurse is planning care with the parents of a child who requires continuous peritoneal dialysis. Which finding should be discussed with the physician?
- A. The family lives a long distance from the medical facility.
- B. The child attends a large public school.
- C. The child reports having a previous surgery for a ruptured appendix.
- D. The family feels the child cannot self-regulate to wake at night and change bags.
Correct Answer: C
Rationale: Previous surgery might impact current care.