Nokea
Which statements made by a parent indicate that appropriate care is being provided for a 4-year-old with spastic-type CP?
- A. "I perform range of motion (ROM) exercises every 4 hours to help prevent contractures."
- B. "I give my child a therapeutic massage after the stretching exercises to help manage pain."
- C. "I minimize the calories I provide with meals because my child is more prone to obesity."
- D. "I have my child wear a helmet during the day because of chronic tonic-clonic seizures."
- E. "Using utensils with large, padded handles makes it easier for my child to feed himself."
Correct Answer: A,B,D,E
Rationale: ROM exercises, therapeutic massage, helmet use for seizures, and adaptive utensils indicate appropriate care for spastic CP.
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The nurse is caring for a client with a fractured left tibia and fibula. Which data should the nurse report to the health-care provider immediately?
- A. Localized edema and discoloration occurring hours after the injury.
- B. Generalized weakness and increasing sensitivity to touch.
- C. Dorsalis pedal pulse cannot be located with a Doppler and increasing pain.
- D. Pain relieved after taking four (4) mg hydromorphone, a narcotic analgesic.
Correct Answer: C
Rationale: Absent pulses and increasing pain suggest compartment syndrome or arterial occlusion, requiring urgent HCP notification. Edema is expected, weakness is nonspecific, and pain relief is positive.
How should the nurse explain the purpose of methotrexate in treating a child with juvenile arthritis?
- A. Improves functional ability
- B. Controls the febrile response
- C. Minimizes the effects of uveitis
- D. Decreases the inflammatory response
Correct Answer: D
Rationale: Methotrexate is a disease-modifying antirheumatic drug that reduces inflammation in juvenile arthritis.
The client, who is diagnosed with CA, tells the clinic nurse about the inability to ambulate and about staying on bedrest due to hip stiffness. In addition to teaching the client measures to reduce joint stiffness, which referral for the client should the nurse plan to discuss with the HCP?
- A. Psychiatrist
- B. Social worker
- C. Physical therapist
- D. Arthritis Foundation
Correct Answer: C
Rationale: C. The nurse should plan to discuss a referral to a physical therapist (PT). The PT can assist the client in adopting self-management strategies and teach isometric, postural, and aerobic exercises that prevent joint overuse.
The client is now over an acute episode of gout. He is to be discharged on allopurinol (Zyloprim). What instruction must the nurse give to this client?
- A. Take your medicine on an empty stomach.'
- B. Report any nausea to your physician at once.'
- C. Drink two to three quarts of fluids daily.'
- D. Do not take over-the-counter cold medicine.'
Correct Answer: C
Rationale: Drinking 2-3 quarts of fluids daily prevents uric acid stone formation, a key instruction for clients on allopurinol.
Which is the best technique for the nurse to use when applying the elastic bandage to the client's lower extremity?
- A. Making figure-eight turns with the bandage
- B. Making spiral-reverse turns with the bandage
- C. Making recurrent turns with the bandage
- D. Making spica turns with the bandage
Correct Answer: A
Rationale: The figure-eight technique provides even compression and support around the ankle joint, stabilizing it while allowing some flexibility. Spiral-reverse turns are better for cylindrical limbs, recurrent turns are used for stumps, and spica turns are typically for larger joints like the hip or shoulder.