Nokea
Which intervention would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis?
- A. Wearing splints at night to prevent extension contractures
- B. Applying moist heat packs upon awakening
- C. Taking a warm tub bath the evening before
- D. Sleeping with two pillows under the head
Correct Answer: B
Rationale: Moist heat packs upon awakening reduce morning stiffness associated with juvenile rheumatoid arthritis.
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Approximately how old does the nurse assess a large green bruise on the thigh of a 4-year-old to be?
- A. 2 days
- B. 4 days
- C. 6 days
- D. 8 days
Correct Answer: C
Rationale: A green bruise typically appears 5 to 7 days after injury, indicating it is about 6 days old.
What type of juvenile rheumatoid arthritis do these findings suggest?
- A. Psoriatic
- B. Enthesitis
- C. Systemic
- D. Acute febrile
Correct Answer: C
Rationale: Systemic juvenile rheumatoid arthritis presents with fever, joint swelling, warmth, tenderness, abdominal pain, and elevated inflammatory markers.
Which nursing diagnosis takes highest priority for this child?
- A. Pain resulting from tissue trauma
- B. High risk for impaired skin integrity resulting from immobility
- C. Altered growth and development related to separation from family
- D. Altered urinary elimination related to immobility and traction
Correct Answer: A
Rationale: Pain from tissue trauma and muscle spasm is the highest priority due to its immediate impact on the child's comfort.
What nursing action will significantly decrease the risk of serious complications for a child in Bryant's traction?
- A. Neurovascular checks are done frequently.
- B. Bandages are wrapped tightly.
- C. The child is restrained from rolling over.
- D. The child's buttocks are resting on the bed.
Correct Answer: A
Rationale: Frequent neurovascular checks help detect Volkmann's ischemia, reducing the risk of circulatory complications.
Which observation requires a nursing intervention?
- A. Child's heels are placed firmly against the foot of the bed.
- B. Head of bed is elevated 20 degrees.
- C. Weights are hanging freely.
- D. Ropes are on pulleys.
Correct Answer: A
Rationale: Heels against the bed disrupt Buck traction's counterweight mechanism, requiring intervention to elevate them.