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The nurse is caring for an immobilized preschool child. What intervention is helpful during this period of immobilization?
- A. Encourage wearing pajamas.
- B. Let the child have few behavioral limitations.
- C. Keep the child away from other immobilized children if possible.
- D. Take the child for a walk by wagon outside the room.
Correct Answer: D
Rationale: Transporting the child by wagon outside the room provides social and environmental stimulation, aiding psychosocial health. Street clothes, not pajamas, reduce illness perception; appropriate behavioral limits are needed; and isolation from other children isn?t necessary.
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What measure is important in managing hypercalcemia in a child who is immobilized?
- A. Provide adequate hydration.
- B. Change position frequently.
- C. Encourage a diet high in calcium.
- D. Provide a diet high in calories for healing.
Correct Answer: A
Rationale: Vigorous hydration (3000-4000 ml/day for adolescents) with diuretics helps manage hypercalcemia by promoting calcium excretion. Frequent position changes address skin and respiratory issues, calcium intake is restricted, and high-protein, not just high-calorie, diets aid healing.
What is the recommended drink for athletes during practice and competition?
- A. Sports drinks to replace carbohydrates
- B. Cold water for gastrointestinal tract rapid absorption
- C. Carbonated beverages to help with acid-base balance
- D. Enhanced performance carbohydrate-electrolyte drinks
Correct Answer: B
Rationale: Cold water, consumed 4-8 oz every 15-20 minutes, promotes rapid gastric and intestinal absorption for hydration. Sports drinks may cause gastrointestinal upset, carbonated beverages are discouraged, and enhanced drinks lack evidence of performance benefits.
A young girl has just injured her ankle at school. In addition to notifying the childs parents, what is the most appropriate, immediate action by the school nurse?
- A. Apply ice.
- B. Observe for edema and discoloration.
- C. Encourage child to assume a position of comfort.
- D. Obtain parental permission for administration of acetaminophen or aspirin.
Correct Answer: A
Rationale: Applying ice immediately reduces swelling and pain in soft tissue injuries, followed by rest, elevation, and compression. Observing edema, finding a comfortable position, and administering medication are secondary to ice application.
What is a physiologic effect of immobilization on children?
- A. Metabolic rate increases.
- B. Venous return improves because the child is in the supine position.
- C. Circulatory stasis can lead to thrombus and embolus formation.
- D. Bone calcium increases, releasing excess calcium into the body (hypercalcemia).
Correct Answer: C
Rationale: Immobilization reduces muscle contraction, causing venous stasis, which increases the risk of thrombus and embolus formation. Metabolic rate decreases, venous return diminishes, and bone demineralization leads to hypercalcemia, not increased bone calcium.
A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?
- A. No restrictions of activity are indicated.
- B. Elevate casted arm when both upright and resting.
- C. The shoulder should be kept as immobile as possible to avoid pain.
- D. Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hours.
Correct Answer: B
Rationale: Elevating the casted arm during rest and in a sling when upright promotes venous return and reduces swelling. Strenuous activity is limited initially, shoulder movement is encouraged, and finger swelling requires immediate reporting to prevent neurovascular damage.