Wongs Essentials of Pediatric Nursing 11th Edition Test Bank

Wongs Essentials of Pediatric Nursing 11th Edition Test Bank Related

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Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which statement?

  • A. The child needs opportunities to play with peers.
  • B. The child needs to understand that peers' activities are too strenuous.
  • C. Parents can meet all of the child's needs.
  • D. Constant parental supervision is needed to avoid overexertion.
Correct Answer: A

Rationale: The nurse's reply should be based on the statement that "the child needs opportunities to play with peers." It is important for children to engage in play and social interactions with their peers for their overall development, including social, emotional, cognitive, and physical growth. By allowing the child with congenital heart disease to play with other children, under appropriate supervision, the child can still have enriching experiences while ensuring their safety and well-being. It is essential to strike a balance between enabling the child to participate in activities and managing any potential risks associated with their condition. A supportive environment that encourages play and socialization with peers can contribute positively to the child's development and quality of life.

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Which is the most appropriate nursing action when intermittently gavage-feeding a preterm newborn?

  • A. Allow formula to flow by gravity.
  • B. Insert tube through nares rather than mouth.
  • C. Avoid letting newborn suck on tube.
  • D. Apply steady pressure to syringe to deliver formula to stomach in a timely manner.
Correct Answer: C

Rationale: The most appropriate nursing action when intermittently gavage-feeding a preterm newborn is to avoid letting the newborn suck on the tube. Preterm infants are at risk for disorganized feeding patterns and can develop a non-nutritive sucking habit when the tube is in their mouth. Allowing them to suck on the tube can lead to difficulty transitioning to oral feeding once they are ready, as they may associate feeding with the tube rather than with proper suckling at the breast or bottle. Therefore, it is important to prevent non-nutritive sucking during gavage feedings to promote successful oral feeding later on.

Usually, how does the patient behave after his seizure has subsided?

  • A. Most comfortable walking and moving about
  • B. Sleeps for a period of time
  • C. Becomes restless and agitated
  • D. starts singing
Correct Answer: C

Rationale: After a seizure has subsided, it is common for the patient to experience restlessness and agitation. This may be due to confusion, disorientation, and fatigue following the seizure. Restlessness and agitation can also be caused by the brain's recovery process and the emotional impact of a seizure episode. It is important to provide a calm and supportive environment for the patient during this time and to ensure their safety until they fully recover from the seizure.

A nurse explains to a child's parents that the role of methotrexate (Rheumatrex®) in treating children with juvenile arthritis is to:

  • A. decrease the inflammatory response.
  • B. improve functional ability.
  • C. control the febrile response.
  • D. minimize the effects of uveitis.
Correct Answer: A

Rationale: Methotrexate, which is a disease-modifying antirheumatic drug (DMARD), is commonly used to treat juvenile arthritis by decreasing the inflammatory response in the joints. By suppressing the overactive immune response that causes inflammation in the joints, methotrexate helps reduce pain, swelling, and stiffness in children with juvenile arthritis. This ultimately helps to improve joint function and prevent joint damage. While methotrexate may indirectly contribute to improving functional ability and controlling febrile responses in some cases, its primary mechanism of action is to target and reduce inflammation in juvenile arthritis. The medication may also help in managing associated conditions like uveitis, but its main role lies in decreasing the inflammatory response in arthritis.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is

  • A. fibroblastic
  • B. chondroblastic
  • C. parosteal
  • D. periosteal
Correct Answer: D

Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.

Hindbrain herniation or the Chiari type II malformation is seen in which percent of individuals with myelomeningocele

  • A. 10-20%
  • B. 20-30%
  • C. 40-50%
  • D. 80-90%
Correct Answer: D

Rationale: Chiari type II malformation is strongly associated with myelomeningocele, occurring in approximately 80-90% of cases due to abnormal cerebellar development and cranial settling.

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