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MATERNAL AND PEDIATRIC NURSING
EXAM ACTUAL EXAM 2025 |
COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS | ALREADY
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"What clinical manifestation is suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease) in an infant? a. Hyperactive deep tendon reflexes b. Hypertonicity c. Lying in the frog position
d. Motor deficits on one side of body - CORRECT ANSWER=> ANS: C
The infant lies in the frog position with the legs externally rotated abducted and flexed at knees. Deep tendon reflexes are absent. The child has hypotonia and inactivity as the most prominent features. Motor deficits are bilateral." "A young boy has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. What should the management plan include? a. Recommend genetic counselling. b. Explain that the disease is easily treated. c. Suggest ways to limit the use of his muscles.
d. Assist the family in finding a nursing facility to provide his care. - CORRECT ANSWER=> ANS: A
Pseudohypertrophic (Duchenne's) muscular dystrophy is inherited as an X-linked recessive gene. Genetic counselling is recommended for parents female siblings maternal aunts and their female offspring. No effective treatment exists at this time for childhood muscular dystrophy. Maintaining optimal function of all muscles for as long as possible is the primary goal. It has been found that children who remain as active as they possibly can are able to avoid wheelchair confinement for a longer time. Assisting the family in finding a nursing facility for the boy is inappropriate at the time of diagnosis. When the child becomes increasingly incapacitated the family may consider home-based care a skilled nursing facility or respite care to provide the necessary care." "A 14-year-old girl is in the critical care unit after a spinal cord injury 2 days ago. Which should be included in nursing care for this child?
a. Avoiding the use of diazepam. b. Administering methylprednisone. c. Minimizing environmental stimuli.
d. Discussing long-term care issues with the family. - CORRECT ANSWER=> ANS: B
Corticosteroids are administered to minimize the inflammation present at the injury site. Patients with spinal cord injury are physiologically labile so close monitoring is required. Diazepam is the medication of choice for seizure control and muscle relaxation therefore it should not be avoided. Minimizing environmental stimuli and discussing long-term care issues with the family actions do not apply to providing care for this patient." "When assessing a child for botulism which are clinical manifestations? Select all that apply. Express answer in small letters followed by a comma and a space—e.g. a b c. a. Scotoma b. Weakness c. Headache d. Vomiting e. Diarrhea
f. Exaggerated gag reflex - CORRECT ANSWER=> ANS: B C D
Clinical manifestations of botulism include weakness headache diplopia and vomiting. With infants they also experience constipation and a reduced gag reflex." "What effect does immobilization have on metabolism? a. It causes hypocalcemia. b. It causes a decreased metabolic rate. c. It causes a positive nitrogen balance.
d. It causes increased production of stress hormones. - CORRECT ANSWER=> ANS: B
Immobilization causes a decreased metabolic rate with the slowing of all systems and decreased food intake leads to hypercalcemia and causes a negative nitrogen balance secondary to muscle atrophy. The production of stress hormones decreases resulting in reduced physical and emotional coping capacity." "What effect does immobilization have on the cardiovascular system? a. Venous stasis b. Increased vasopressor mechanism c. Normal distribution of blood volume
d. Increased efficiency of orthostatic neurovascular reflexes - CORRECT ANSWER=> ANS: A
Because of the decreased muscle contraction the physiological effects of immobilization include venous stasis. This can lead to pulmonary emboli or thrombi. A decreased vasopressor mechanism results in orthostatic hypotension syncope hypotension decreased cerebral blood flow and tachycardia. The distribution of blood volume is altered with decreased cardiac workload and exercise tolerance. Immobilization causes a decreased efficiency in orthostatic neurovascular reflexes with an inability to adapt readily to the upright position and pooling of blood in the extremities in the upright position." "What can result from the bone demineralization associated with immobility? a. Osteoporosis
a. Swelling of the fingers is to be expected for the next 48 hours. b. Immobilize the shoulder to decrease pain in the arm. c. Allow the affected limb to hang down for 1 hour each day.
d. Elevate the casted arm when resting and sitting up. - CORRECT ANSWER=> ANS: D
The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return. Swelling of the fingers may indicate neurovascular damage and should be reported immediately since permanent damage can occur within 6 to 8 hours. Joints above and below the cast on the affected extremity should be moved. The child should not engage in strenuous activity for the first few days. Rest with the extremity elevated is encouraged." "Why does a nurse use the palms of his hands when handling a wet cast? a. To assess the dryness of the cast b. To facilitate easy turning c. To keep the patient's limb balanced
d. To avoid indenting the cast - CORRECT ANSWER=> ANS: D
Wet casts should be handled with the palms of the hands not the fingers to prevent the creation of pressure points. Assessing dryness facilitating easy turning or keeping the patient's limb balanced are not reasons for using the palms of the hand rather than the fingers when handling a wet cast." "What causes a nurse to suspect that an infection has developed under a cast? a. Complaint of paresthesia b. Cold toes c. Increased respirations
d. Hot spots on the cast's surface - CORRECT ANSWER=> ANS: D
If hot spots are felt on the cast surface they usually indicate infection beneath the area. This should be reported so a window can be made in the cast to observe the site. The five P's of ischemia from a vascular injury include pain pallor pulselessness paresthesia and paralysis. Paresthesia is an indication of vascular injury not infection. Cold toes may be indicative of a cast that's too tight and need further evaluation. Increased respirations may indicate a respiratory infection or pulmonary emboli. This should be reported and the child should be evaluated." "A child is upset because when the cast was removed from her leg the skin surface was caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material? a. Soak in a bathtub. b. Vigorously scrub the leg. c. Apply powder to absorb the material.
d. Carefully pick the material off of the leg. - CORRECT ANSWER=> ANS: A
Simply soaking in the bathtub is usually sufficient for the removal of the desquamated skin and sebaceous secretions. It may take several days to eliminate the accumulation completely. The parents and child should be advised not to scrub the leg vigorously or forcibly remove this material because it may cause excoriation and bleeding. Oil or lotion but not powder may provide comfort for the child's skin." "Which type of traction uses skin traction on the lower leg and a padded sling under the knee?
a. Dunlop b. Bryant c. Russell
d. Buck extension - CORRECT ANSWER=> ANS: C
Russell traction involves skin traction on the lower leg and a padded sling under the knee. The combination of longitudinal and perpendicular traction allows the lower extremity to be realigned and immobilizes the hips and knees in a flexed position. Dunlop traction is an upper extremity traction used for fractures of the humerus. Bryant traction is skin traction with the legs flexed at a 90-degree angle at the hip. Buck extension traction has the legs in an extended position and is used primarily for short-term immobilization before surgery with dislocated hips for correcting contractures or for bone deformities such as Legg-Calvé-Perthes disease." "Which is an appropriate nursing intervention when caring for a child in traction? a. Remove adhesive traction straps daily to prevent skin breakdown. b. Assess for tightness weakness or contractures in uninvolved joints and muscles. c. Provide active range-of-motion exercises to affected extremity three times a day.
d. Keep the child in one position to maintain good alignment. - CORRECT ANSWER=> ANS: B
Traction places stress on the affected bone joint and muscles. The nurse must assess for tightness weakness or contractures developing in the uninvolved joints and muscles. The adhesive straps should be released or replaced only when absolutely necessary. Active passive or active with resistance exercises should be carried out for the unaffected extremity only. Movement is expected with children— each time the child moves the nurse should check to ensure that proper alignment is maintained." "Which should be included when the nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip? a. Apply lotion or powder to minimize skin irritation. b. Remove the harness several times a day to prevent contractures. c. Return to the clinic every week for assessment. d. Place a diaper over the harness preferably using a superabsorbent disposable diaper that is relatively
thin. - CORRECT ANSWER=> ANS: C
Infants have a rapid growth pattern. The child needs to be assessed by the practitioner every week for possible adjustments. Lotions and powders should not be used with the harness. The harness should not be removed except as directed by the practitioner. A thin disposable diaper can be placed under the harness." "A newborn is born with mild clubfeet. What should the nurse explain to the parents when they ask how this will be corrected? a. Traction is tried first. b. Surgical intervention is needed. c. Frequent serial casting is tried first.
d. Children outgrow this condition when they learn to walk. - CORRECT ANSWER=> ANS: C
Serial casting the preferred treatment is begun shortly after birth and before discharge from the nursery. Successive casts allow for gradual stretching of the skin and tight structures on the medial side of the foot. Manipulation and casting of the leg are repeated frequently (every week) to accommodate the
c. Intensive irradiation is the primary treatment.
d. Bone marrow transplantation offers the best chance of long-term survival. - CORRECT ANSWER=>
ANS: A
The optimal therapy for osteosarcoma is a combination of surgery and chemotherapy. Amputation is frequently required. Intensive radiation and bone marrow transplantation are usually not part of the therapeutic management." "An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. How should the nurse approach this patient? a. Answer questions with straightforward honesty. b. Avoid discussing the seriousness of the condition. c. Explain that although the amputation is difficult it will cure the cancer. d. Assist the adolescent in accepting that the amputation as better than a long course of chemotherapy. -
CORRECT ANSWER=> ANS: A
Honesty is essential to gain the cooperation and trust of the child. The diagnosis of cancer should not be disguised with falsehoods. The adolescent should be prepared in advance for the surgery so that there is time for reflection about the diagnosis and subsequent treatment. This allows him to gain answers to his questions. To accept the need for radical surgery the child must be aware of the lack of alternatives for treatment. Amputation is necessary but it will not guarantee a cure. Chemotherapy is an integral part of the therapy with surgery. The child should be informed before surgery of the need for chemotherapy and its adverse effects." "Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? a. Aspirin b. Corticosteroids c. Cytotoxic drugs such as methotrexate
d. Nonsteroidal anti-inflammatory drugs (NSAIDs) - CORRECT ANSWER=> ANS: D
NSAIDs are the first drugs used in JIA. Naproxen ibuprofen indomethacin celecoxib meloxicam aspirin and tolmetin are approved for use in children. Aspirin once the drug of choice has been replaced by NSAIDs because they have fewer adverse effects and easier administration schedules. Corticosteroids are used for life-threatening complications incapacitating arthritis and uveitis. Methotrexate is a second-line therapy for JIA." "What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA)? a. Apply ice packs to relieve stiffness and pain. b. Administer acetaminophen to reduce inflammation. c. Teach the child and family the correct administration of medications.
d. Encourage range-of-motion exercises during periods of inflammation. - CORRECT ANSWER=> ANS: C
The management of JIA is primarily pharmacological. The family should be instructed on how to administer the medications and the value of a regular schedule of administration to maintain a satisfactory blood level in the body. They need to know that NSAIDs should not be given on an empty stomach and to be alert for signs of toxicity. Warm moist heat is best for relieving stiffness and pain.
Acetaminophen does not have anti-inflammatory effects. Range-of-motion exercises should not be done during periods of inflammation." "The nurse is caring for an infant with developmental dysplasia of the hip. What clinical manifestation should the nurse expect to observe? a. Positive Ortolani click b. Lordosis c. Negative Babinski sign
d. Telescoping of the affected limb - CORRECT ANSWER=> ANS: A
A positive Ortolani test and unequal gluteal folds are clinical manifestations of developmental dysplasia of the hip seen from birth to 2 to 3 months. Negative Babinski sign telescoping of the affected limb and lordosis are not clinical manifestations of developmental dysplasia of the hip." "Which would the nurse expect to find when assessing a child with slipped capital femoral epiphysis? Select all that apply. Express answer with small letters followed by a comma and a space—e.g. a b c. a. Pain in the hip b. External rotation deformity c. Restricted internal rotation on adduction d. Limp on the unaffected side e. Lengthening of lower extremity
f. No change in abduction - CORRECT ANSWER=> ANS: A B C
Clinical manifestation of slipped capital femoral epiphysis includes pain in the hip either continuous or intermittent external rotation deformity and restricted internal rotation on adduction. The child would limp on the affected side and there would be a shortening of the lower extremity. Abduction is lost as severity increases." "A child falls on the playground and has a small laceration on the forearm. What should the school nurse do to cleanse the wound? a. Slowly pour hydrogen peroxide over wound. b. Soak arm in warm water and soap for at least 30 minutes. c. Gently cleanse with sterile pad and a non stinging povidone-iodine solution.
d. Wash wound with mild soap and water or saline for several minutes. - CORRECT ANSWER=> ANS: D
Lacerations should be washed with mild soap and water or normal saline. A sterile pad is not necessary and hydrogen peroxide and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection. Soaking the arm does not effectively clean the wound." "A child steps on a nail and sustains a puncture wound in the foot. What is the most appropriate method for cleansing this wound? a. Wash wound thoroughly with chlorhexidine. b. Wash wound thoroughly with povidone-iodine. c. Soak foot in warm water and soap.
d. Soak foot in solution of 50% hydrogen peroxide and 50% water. - CORRECT ANSWER=> ANS: C
c. Parasite
d. Virus - CORRECT ANSWER=> ANS: D
Human warts are caused by the human papillomavirus. Infection with bacteria fungus and parasitic organisms does not result in warts." "What is the primary treatment for warts? a. Vaccination b. Local destruction c. Corticosteroids
d. Specific antibiotic therapy - CORRECT ANSWER=> ANS: B
Topical treatments include chemical cautery which is especially useful for the treatment of warts. Local destructive therapy is individualized according to the location type and number of warts. Surgical removal electrocautery curettage cryotherapy caustic solutions x-ray treatment and laser therapies are used. Vaccination is prophylaxis for warts and is not a treatment. Corticosteroids and specific antibiotic therapy are not effective in the treatment of warts." "Herpes zoster is caused by the varicella virus and has an affinity for which structure(s)? a. Sympathetic nerve fibres b. Parasympathetic nerve fibres c. Posterior root ganglia and the posterior horn of the spinal cord
d. Lateral and dorsal columns of the spinal cord - CORRECT ANSWER=> ANS: C
The herpes zoster virus has an affinity for posterior root ganglia the posterior horn of the spinal cord and skin and does not involve sympathetic or parasympathetic nerve fibres nor lateral and dorsal columns of the spinal cord." "What does treatment for herpes simplex virus (types 1 or 2) include? a. Corticosteroids b. Oral griseofulvin c. Oral antiviral agent
d. Topical and/or systemic antibiotic - CORRECT ANSWER=> ANS: C
Oral antiviral agents are effective for viral infections such as herpes simplex. Corticosteroids and antibiotics are not effective for viral infections. Griseofulvin is an antifungal agent and is not effective for viral infections." "Which is the cause of ringworm that is frequently found in schoolchildren? a. Virus b. Fungus c. Allergic reaction
d. Bacterial infection - CORRECT ANSWER=> ANS: B
Ringworm is caused by a group of closely related filamentous fungi that invade primarily the stratum corneum hair and nails. It is a superficial infection that lives on not in the skin. Viral and bacterial infections are not causative organisms for ringworm. Ringworm is not an allergic response."
"A young boy's mother tells the nurse that he keeps scratching the areas where he has poison ivy. How should the nurse respond? a. Poison ivy does not itch and needs further investigation. b. Scratching the lesions will not cause a problem. c. Scratching the lesions will cause the poison ivy to spread.
d. Scratching the lesions may cause them to become secondarily infected. - CORRECT ANSWER=> ANS:
D
Poison ivy is a contact dermatitis that results from exposure to the oil urushiol in the plant. Every effort must be made to prevent the child from scratching because the lesions can become secondarily infected. The poison ivy produces localized streaked or spotty oozing and painful impetiginous lesions. Itching is a common response. The lesions do not spread by contact with the blister serum or by scratching." "What is the primary clinical manifestation of scabies? a. Edema b. Redness c. Pruritus
d. Maceration - CORRECT ANSWER=> ANS: C
Scabies is caused by the scabies mite. The inflammatory response and intense itching occur after the host has become sensitized to the mite. This occurs approximately 30 to 60 days after initial contact. In a previously sensitized person the response occurs within 48 hours. Edema redness and maceration are not observed in scabies." "What is the only symptom of pediculosis capitis (head lice)? a. Itching b. Vesicles c. Scalp rash
d. Localized inflammatory response - CORRECT ANSWER=> ANS: A
Itching is generally the only manifestation of pediculosis capitis (head lice). Diagnosis is made by observation of the white eggs (nits) on the hair shaft. Vesicles scalp rash and localized inflammatory response are not symptoms of head lice." "The treatment of a child who has just been stung by a bee or wasp should include which intervention? a. Cool compresses b. Warm compresses c. Antibiotic cream
d. Corticosteroid cream - CORRECT ANSWER=> ANS: A
Bee or wasp stings are initially treated by carefully removing the stinger cleansing the site with soap and water applying cool compresses and using common household agents such as lemon juice or a paste made with aspirin and baking soda to address pain and swelling. Warm compresses are to be avoided. Antibiotic cream is unnecessary unless a secondary infection occurs. Corticosteroid cream is not part of the initial therapy. If a severe reaction occurs systemic corticosteroids may be indicated." "A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. What should the nurse advise the father to do?
a. Impetigo b. Candida albicans c. Urine and feces
d. Infrequent diapering - CORRECT ANSWER=> ANS: B
Candida albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds. Impetigo is a bacterial infection that spreads peripherally in sharply marginated irregular outlines. Eruptions involving the skin in contact with the diaper but sparing the folds are likely to be caused by chemical irritation especially urine and feces." "The nurse is teaching a class about preventing diaper rash in newborns to a group of new parents. Which statement made by one parent indicates he has a correct understanding of the teaching? a. "I should wash my infant's buttocks with soap and water every time I change the diaper." b. "I will wash my infant with a mild soap and water and dry her thoroughly after a bowel movement." c. "I should wash my infant's buttocks with soap before applying a thin layer of oil."
d. "I will apply baby oil and powder to the creases in my infant's buttocks." - CORRECT ANSWER=>
ANS: B
The diaper should be changed as soon as it becomes soiled. Stool should be wiped gently from skin with water and mild soap. Overwashing the skin should be avoided especially with perfumed soaps or commercial wipes which may be irritating. The skin should be thoroughly dried after washing. Application of oil does not create an effective barrier. Baby powder should not be used because of the danger of aspiration." "Which statement is true regarding atopic dermatitis (eczema) in the infant? a. It is easily cured. b. It is worse in humid climates. c. It is associated with upper respiratory tract infections.
d. It is associated with allergy with a hereditary tendency. - CORRECT ANSWER=> ANS: D
Atopic dermatitis is a type of pruritic eczema that usually begins during infancy and is associated with allergy with a hereditary tendency. It can be controlled but not cured. Manifestations of the disease are worse when environmental humidity is lower. Atopic dermatitis is not associated with respiratory infections." "Which is an appropriate nursing intervention when caring for an infant with atopic dermatitis? a. Feed a variety of foods. b. Keep lesions dry. c. Prevent infection.
d. Use fabric softener to avoid rough cloth. - CORRECT ANSWER=> ANS: C
The eczematous lesions of atopic dermatitis are intensely pruritic. Scratching can lead to new lesions and secondary infection. The infant's nails should be kept short and clean and have no sharp edges. During periods of irritability these children tend to have a decreased appetite. The restriction of hyperallergenic foods such as milk dairy products peanuts and eggs may make adequate nutrition a challenge with these children. Wet soaks and compresses are used to keep the lesions moist and minimize the pruritus. Fabric softener should be avoided because of the irritant effects of some of its components."
"Tretinoin (Retin-A) is a topical agent commonly used to treat acne. What advice should the nurse provide to patients prescribed this drug? a. Avoid using sunscreen agents. b. Use cosmetics with lanolin and petrolatum. c. Explain that medication should not be applied until at least 20 to 30 minutes after washing.
d. Explain that erythema and peeling are indications of toxicity. - CORRECT ANSWER=> ANS: C
The medication should not be applied for at least 20 to 30 minutes after washing to decrease the burning sensation. Avoiding the sun and using sunscreen agents must be emphasized because sun exposure can result in severe sunburn. Cosmetics with lanolin petrolatum vegetable oil lauryl alcohol butyl stearate and oleic acid can increase comedone production. Erythema and peeling are common local manifestations." "When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence? a. The acne has not responded to other treatments. b. The adolescent is or may become pregnant. c. The adolescent is unable to give up foods causing acne.
d. Frequent washing with antibacterial soap has been unsuccessful. - CORRECT ANSWER=> ANS: A
Accutane (isotretinoin) is reserved for severe cystic acne that has not responded to other treatments. Accutane has teratogenic effects and should never be used when there is a possibility of pregnancy. No correlation exists between foods and acne. Frequent washing with antibacterial soap is not a recommended therapy for acne." "A child experiences frostbite on the fingers after prolonged exposure to the cold. What intervention should the nurse use first? a. Rapidly rewarm the fingers by placing them in warm water. b. Place the hand in cool water. c. Slowly rewarm the fingers by wrapping them in a warm cloth.
d. Use an ice pack to keep fingers cold until medical intervention is possible. - CORRECT ANSWER=>
ANS: A
Rapid rewarming is recommended by immersing the affected part in well-agitated water at 37.8°C to 42.2°C and results in less tissue necrosis than slow thawing. The frostbitten area should be rewarmed as soon as possible to avoid further tissue damage." "Which best describes a full-thickness (third-degree) burn? a. Erythema and pain b. Skin showing erythema followed by blister formation c. Destruction of all layers of skin evident with extension into subcutaneous tissue
d. Destruction injury involving underlying structures such as muscle fascia and bone - CORRECT
ANSWER=> ANS: C
A third-degree or full-thickness burn is a serious injury that involves the entire epidermis and dermis and extends into the subcutaneous tissues. Erythema and pain are characteristic of a first-degree or superficial burn. Erythema with blister formation is characteristic of a second-degree or partial-thickness burn. A fourth-degree burn is a full-thickness burn that also involves underlying structures such as muscle fascia and bone."
b. Encourage her to drink clear liquids. c. Place her in a tub of cool water.
d. Remove her burned clothing and jewellery. - CORRECT ANSWER=> ANS: D
For major burns burned clothing should be removed to avoid further damage from smouldering fabric and hot beads of melted synthetic materials. Jewellery is also removed to eliminate the transfer of heat from the metal and constriction resulting from edema formation. The burns should be covered not wrapped with a clean cloth. A blanket can be used initially to stop the burning process. Fluids should not be given by mouth to avoid aspiration and water intoxication. The child should be kept warm. Placing her in a tub of cool water will further exacerbate heat loss." "A toddler sustains a minor burn on the hand from hot coffee. What is the first action to take in treating this burn? a. Apply ice to burned area. b. Hold the burned area under cool running water. c. Break any blisters with a sterile needle.
d. Clean the wound with soap and warm water. - CORRECT ANSWER=> ANS: B
For minor burns the best method to stop the burning process is to hold the burned area under cool running water. Ice is not recommended. Removal of blisters is not a generally accepted therapy unless the injury is from a chemical substance. Cooling is necessary to stop the burning process." "Why is a high-protein diet recommended for a child with major burns? a. It promotes growth. b. It improves appetite. c. It diminishes the risks of stress-induced hyperglycemia.
d. It helps prevent protein breakdown. - CORRECT ANSWER=> ANS: D
The diet must provide sufficient calories to meet the increased metabolic needs and enough protein to avoid protein breakdown. Healing not growth is the primary consideration. Many children have poor appetites and supplementation will be necessary. Hypoglycemia not hyperglycemia can occur from the stress of a burn injury because liver glycogen stores are rapidly depleted." "Fentanyl and midazolam (Versed) are given before debridement of a child's burn wounds. What is the purpose of these drugs? a. To promote healing b. To prevent infection c. To provide pain relief
d. To limit the amount of debridement that will be necessary - CORRECT ANSWER=> ANS: C
Fentanyl and midazolam provide excellent intravenous sedation and analgesia to control procedural pain in children with burns. They do not promote healing or prevent infection nor do they limit the amount of debridement needed." "A child with extensive burns requires debridement. What is the priority of this procedure? a. To promote healing b. To prevent bleeding c. To maintain the airway
d. To restore fluid balance - CORRECT ANSWER=> ANS: A
Partial-thickness burns require debridement of devitalized tissue to promote healing. The procedure is very painful and requires analgesia and sedation beforehand. Preventing bleeding maintaining the airway and restoring fluid balance are not goals of debridement." "Biological dressings are applied to a child with partial-thickness burns on both legs. Which nursing action is related to this procedure? a. Observe wounds for bleeding. b. Observe wounds for signs of infection. c. Monitor the child closely for signs of shock.
d. Splint the child's legs to prevent movement. - CORRECT ANSWER=> ANS: B
When applied early to a superficial partial-thickness injury biological dressings stimulate epithelial growth and faster wound healing. If the dressing covers areas of heavy microbial contamination infection occurs beneath it. In the case of partial-thickness burns such infection may convert the wound to a full- thickness injury. Infection is the primary concern when biological dressings are used." "What is one of the first signs of overwhelming sepsis in a child with burn injuries? a. Seizures b. Bradycardia c. Decreased level of consciousness
d. Decreased blood pressure - CORRECT ANSWER=> ANS: C
Decreasing level of consciousness in a burn patient is one of the first signs of overwhelming sepsis and may indicate inadequate hydration. Seizures bradycardia and decreased blood pressure are not initial manifestations of overwhelming sepsis." "Which is an effective strategy to reduce the stress of burn dressing procedures? a. Give the child as many choices as possible. b. Reassure the child that dressing changes are not painful. c. Explain to the child why analgesics cannot be used.
d. Encourage the child to master stress with controlled passivity. - CORRECT ANSWER=> ANS: A
Children who have an understanding of the procedure and some perceived control demonstrate less anxious behaviour. They respond well to participating in decisions and should be given as many choices as possible. The dressing-change procedure is very painful and stressful so the child should not be misinformed about it. Analgesia and sedation can and should be used. Encouraging the child to master stress with controlled passivity is not a positive coping strategy." "What is the most important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns? a. Apply topical medication with clean hands. b. Wash hands and forearms before and after changing the dressing. c. If dressings adhere to the wound soak in hot water before removal.
d. Apply the dressing so that movement is limited during the healing process. - CORRECT ANSWER=>
ANS: B
In children with hypopituitarism the skeletal proportions are normal. Growth is within normal limits for the first year of life. Height is usually more delayed than weight. Intelligence is not affected by hypopituitarism." "Which is a condition that can result if there is hypersecretion of growth hormone (GH) after epiphyseal closure? a. Dwarfism b. Acromegaly c. Gigantism
d. Cretinism - CORRECT ANSWER=> ANS: B
Excess GH after the closure of the epiphyseal plates results in acromegaly. Dwarfism is the condition of being abnormally small. Gigantism occurs when there is hypersecretion of GH before the closure of the epiphyseal plates. Cretinism is associated with hypothyroidism." "At what age is sexual development in boys and girls considered to be precocious? a. Boys 11 years girls 9 years b. Boys 12 years girls 10 years c. Boys 9 years girls 8 years
d. Boys 10 years girls 9.5 years - CORRECT ANSWER=> ANS: C
Manifestations of sexual development before age 9 in boys and 8 in girls are considered precocious and should be investigated. However recent research indicates that puberty is beginning early in girls and it is suggested that precocious puberty may be evident as young as 6 or 7 years of age. Boys older than 9 years of age and girls older than 8 years of age fall within the expected range of pubertal onset." "A child is starting treatment for precocious puberty. This involves injections of which synthetic substance? a. Thyrotropin b. Gonadotropins c. Somatotropic hormone
d. Luteinizing hormone-releasing hormone - CORRECT ANSWER=> ANS: D
Precocious puberty of central origin is treated with monthly subcutaneous injections of luteinizing hormone-releasing hormone. Thyrotropin gonadotropin and somatotropic hormone are not appropriate therapies for precocious puberty." "Diabetes insipidus is a disorder of which of structure? a. Anterior pituitary b. Posterior pituitary c. Adrenal cortex
d. Adrenal medulla - CORRECT ANSWER=> ANS: B
The principal disorder of posterior pituitary hypofunction is diabetes insipidus. The anterior pituitary produces growth hormones thyroid-stimulating hormones adrenocorticotropic hormones gonadotropin prolactin and melanocyte-stimulating hormone. The adrenal cortex produces aldosterone sex hormones and glucocorticoids. The adrenal medulla produces catecholamines."
"Which clinical manifestation would the nurse expect to observe when caring for a child with suspected diabetes insipidus? a. Oliguria b. Glycosuria c. Nausea and vomiting
d. Polyuria and polydipsia - CORRECT ANSWER=> ANS: D
Excessive urination accompanied by insatiable thirst is the primary clinical manifestation of diabetes. These symptoms may be so severe that the child does little other than drink and urinate. Oliguria is decreased urine production and is not associated with diabetes insipidus. Glycosuria is associated with diabetes mellitus. Nausea and vomiting are associated with inappropriate antidiuretic hormone secretion." "Which would the nurse expect when completing an assessment on a child with juvenile hypothyroidism? a. Insomnia b. Diarrhea c. Dry skin
d. Accelerated growth - CORRECT ANSWER=> ANS: C
Dry skin mental decline and myxedematous skin changes are associated with juvenile hypothyroidism. Children with hypothyroidism are usually sleepy. Constipation is associated with hypothyroidism and decelerated growth is common." "A goitre is an enlargement or hypertrophy of which gland? a. Thyroid gland b. Adrenal gland c. Anterior pituitary gland
d. Posterior pituitary gland - CORRECT ANSWER=> ANS: A
A goitre is an enlargement or hypertrophy of the thyroid gland. Goitre is not associated with the adrenals or the anterior and posterior pituitaries." "Which may cause exophthalmos? a. Hypothyroidism b. Hyperthyroidism c. Hypoparathyroidism
d. Hyperparathyroidism - CORRECT ANSWER=> ANS: B
Exophthalmos is manifested as protruding eyeballs and is a clinical manifestation of hyperthyroidism. Hypothyroidism hypoparathyroidism and hyperparathyroidism are not associated with exophthalmos." "The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of Graves' disease. Which statement indicates the parents' correct understanding of the teaching? a. "I expect my child to gain weight while taking this medication." b. "I expect my child to experience episodes of ear pain while taking this medication." c. "If my child develops a sore throat and fever I should contact the physician immediately."
d. "If my child develops the stomach flu he will need to be hospitalized." - CORRECT ANSWER=> ANS: C
