An 18-month-old was brought to the emergency department by her mother, who states, 'I think she broke her arm.' The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?
- A. Plastic deformity
- B. Buckle fracture
- C. Spiral fracture
- D. Greenstick fracture
Correct Answer: C
Rationale: A spiral fracture is a type of fracture often associated with twisting injuries and can raise suspicion of child abuse. This type of fracture is caused by a twisting force applied to a bone. Plastic deformity is not typically associated with fractures but refers to the ability of a material to change shape and retain that shape. A buckle fracture, also known as a torus fracture, is an incomplete break in a bone commonly seen in children. A greenstick fracture is an incomplete fracture where the bone is bent and partially broken, more commonly seen in children due to their bone flexibility.
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A nurse is caring for an infant born with exstrophy of the bladder. What does the nurse determine is the greatest risk for this infant?
- A. Infection
- B. Dehydration
- C. Urinary retention
- D. Intestinal obstruction
Correct Answer: A
Rationale: Infection is the greatest risk for an infant with exstrophy of the bladder due to the exposure of the bladder and surrounding tissues. The bladder mucosa and adjacent tissues being exposed increase the susceptibility to infections. Dehydration (Choice B) is not the primary concern in this condition. Urinary retention (Choice C) is less likely as exstrophy of the bladder usually presents with constant dribbling of urine. Intestinal obstruction (Choice D) is not directly related to exstrophy of the bladder.
A nurse is discussing the care of an infant with colic with the parents. What should the nurse explain is the cause of colicky behavior?
- A. Inadequate peristalsis
- B. Paroxysmal abdominal pain
- C. An allergic response to certain proteins in milk
- D. A protective mechanism designed to eliminate foreign proteins
Correct Answer: B
Rationale: The correct answer is B: Paroxysmal abdominal pain. Colic in infants is characterized by paroxysmal abdominal pain, leading to excessive crying and fussiness. It is not caused by inadequate peristalsis (Choice A), an allergic response to certain proteins in milk (Choice C), or a protective mechanism designed to eliminate foreign proteins (Choice D). Understanding that colic is primarily associated with abdominal pain helps healthcare providers provide appropriate care and support to parents dealing with colicky infants.
The nurse is implementing care for a school-age child admitted to the pediatric intensive care unit with diabetic ketoacidosis (DKA). Which prescribed intervention should the nurse implement first?
- A. Begin 0.9% saline solution intravenously as prescribed
- B. Administer regular insulin intravenously as prescribed
- C. Place the child on a cardiac monitor
- D. Place the child on a pulse oximetry monitor
Correct Answer: A
Rationale: The correct first intervention when managing a child with diabetic ketoacidosis is to begin intravenous saline solution to address dehydration and restore electrolyte balance. Rehydration is essential to improve perfusion and correct electrolyte imbalances. Administering insulin without addressing dehydration can potentially lead to further complications. Placing the child on a cardiac monitor or pulse oximetry monitor is important but not the initial priority in managing DKA.
The parents of a 1-month-old girl with Down syndrome are being taught by the nurse on how to maintain the child's good health. Which instruction would the nurse be least likely to include?
- A. Getting cervical radiographs between 3 and 5 years of age
- B. Adhering to the special dietary needs of the child
- C. Getting an echocardiogram before 3 months of age
- D. Monitoring for symptoms of respiratory infection
Correct Answer: B
Rationale: The correct answer is B. While special dietary needs may be important, they are not typically a primary concern for a 1-month-old with Down syndrome compared to monitoring for congenital issues. Getting cervical radiographs, an echocardiogram, and monitoring for respiratory infections are more crucial in the early care of a child with Down syndrome. Cervical radiographs help in assessing for atlantoaxial instability, an echocardiogram is important for detecting congenital heart defects common in Down syndrome, and monitoring for respiratory infections is vital due to the increased risk in these children.
A healthcare provider is discussing the care of an infant with colic with the parents. What should the healthcare provider explain is the cause of colicky behavior?
- A. Inadequate peristalsis
- B. Paroxysmal abdominal pain
- C. An allergic response to certain proteins in milk
- D. A protective mechanism designed to eliminate foreign proteins
Correct Answer: B
Rationale: Colicky behavior in infants is primarily characterized by paroxysmal abdominal pain, resulting in excessive crying and fussiness. The pain episodes are often unpredictable and can be distressing for both the infant and the parents. Inadequate peristalsis (Choice A) refers to weak or ineffective bowel movements and is not the typical cause of colic. While some infants may experience colic due to an allergic response to certain proteins in milk (Choice C), this is not the primary cause of colic behavior in all infants. Choice D, a protective mechanism designed to eliminate foreign proteins, is not a recognized cause of colic. Therefore, the correct explanation for the cause of colicky behavior in infants is paroxysmal abdominal pain.