Nokea
When interacting with the mother of a child who has Duchenne's muscular dystrophy, the nurse observes behavior indicating that the mother may feel guilty about her child's condition. The nurse interprets this behavior as guilt stemming from which of the following?
- A. The terminal nature of the disease.
- B. The dependent behavior of the child.
- C. The genetic mode of transmission.
- D. The sudden onset of the disease.
Correct Answer: C
Rationale: The genetic mode of transmission (X-linked recessive) often leads to maternal guilt, as the mother may feel responsible for passing the gene.
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A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening?
- A. Has no interest in peek-a-boo games.
- B. Does not turn front to back.
- C. Does not babble.
- D. Continues to have head lag.
Correct Answer: D
Rationale: Head lag at 4 months suggests delayed motor development, requiring further evaluation.
An 8-year-old child does well after infratentorial tumor removal and is transferred back to the pediatric unit. Although she had been told about having her head shaved, she becomes upset. After exploring the child's feelings, which action should the nurse take?
- A. Ask the child if she'd like to wear a hat.
- B. Reassure the child that her hair will grow back.
- C. Explain to the child's parents that her reaction is normal.
- D. Suggest that the parents buy the child a wig as a surprise.
Correct Answer: A
Rationale: Offering a hat empowers the child to cope with her appearance change, addressing her distress directly.
A 10-year-old has 5 lb of Buck's extension traction on his left leg. The nurse should assess the child for which of the following? Select all that apply.
- A. Dryness of the skin, by removing the foam wraps and boot.
- B. Alignment of the shoulder, hips, and knees.
- C. Frayed rope near pulleys.
- D. Correct amount of traction weight on fracture.
- E. Pressure on the coccyx.
Correct Answer: B,C,D,E
Rationale: The nurse should check alignment, rope condition, weight accuracy, and pressure points to ensure effective and safe traction.
Which of the following would indicate that an infant with a tracheoesophageal fistula (TEF) needs suctioning?
- A. Brassy cough.
- B. Substernal retractions.
- C. Decreased activity level.
- D. Increased respiratory rate.
Correct Answer: B
Rationale: Substernal retractions indicate respiratory distress, often due to mucus accumulation in TEF, necessitating suctioning.
When teaching the child with scoliosis being treated with a Boston brace about exercises, the nurse explains that the exercises are performed primarily for which of the following purposes?
- A. To decrease back muscle spasms.
- B. To improve the brace's traction effect.
- C. To prevent spinal contractures.
- D. To strengthen the back and abdominal muscles.
Correct Answer: D
Rationale: Exercises for scoliosis in a Boston brace focus on strengthening back and abdominal muscles to support spinal alignment and improve posture.