Question 1

A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention?

Accepted Answer

A)  Recommend allergy testing. 
B)  Provide a latex-free environment. 
C)  Use only powder-free latex gloves. 
D)  Limit use of latex products as much as possible. 
A)  Recommend allergy testing. 
B)  Provide a latex-free environment. 
C)  Use only powder-free latex gloves. 
D)  Limit use of latex products as much as possible. B

Question 2

A mother tells the clinic nurse that she often puts honey on her infant's pacifier to soothe the infant. What response should the nurse make to the mother?

Accepted Answer

A)  "That is a good way to soothe your baby." 
B)  "Honey does not have any soothing effects." 
C)  "There is still a risk for infant botulism from honey." 
D)  "Honey is OK, but it should not be put on the pacifier." 
A)  "That is a good way to soothe your baby." 
B)  "Honey does not have any soothing effects." 
C)  "There is still a risk for infant botulism from honey." 
D)  "Honey is OK, but it should not be put on the pacifier." C

Question 3

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate?

Accepted Answer

A)  Prone with the head turned to the side 
B)  On the side 
C)  Supine in an infant carrier 
D)  Supine, with defect supported with rolled blankets 
A)  Prone with the head turned to the side 
B)  On the side 
C)  Supine in an infant carrier 
D)  Supine, with defect supported with rolled blankets A

Question 4

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?

Accepted Answer

A)  It has an autosomal dominant inheritance pattern. 
B)  Onset occurs in later childhood and adolescence. 
C)  It is characterized by presence of Gower sign, a waddling gait, and lordosis. 
D)  Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years. 
A)  It has an autosomal dominant inheritance pattern. 
B)  Onset occurs in later childhood and adolescence. 
C)  It is characterized by presence of Gower sign, a waddling gait, and lordosis. 
D)  Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years.

Question 5

The nurse is teaching the family of an infant with cerebral palsy how to administer a diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session?

Accepted Answer

A)  The pill should be crushed and mixed with a small amount of water. 
B)  The pill should be crushed and mixed with the infant's formula. 
C)  After administering the medication, flush the tube with air. 
D)  Before administering the medication, check the placement of the tube. 
A)  The pill should be crushed and mixed with a small amount of water. 
B)  The pill should be crushed and mixed with the infant's formula. 
C)  After administering the medication, flush the tube with air. 
D)  Before administering the medication, check the placement of the tube.

Question 6

The health care provider has prescribed diazepam (Valium) 0.8 mg/kg/day PO divided q 6 hours for a child with cerebral palsy. The child weighs 110 lb. The nurse is preparing to administer the 1200 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_______

Accepted Answer

10
The correct calculation is:

Question 7

A recommendation to prevent neural tube defects (NTDs) is the supplementation of what?

Accepted Answer

A)  Vitamin A throughout pregnancy 
B)  Folic acid for all women of childbearing age 
C)  Folic acid during the first and second trimesters of pregnancy 
D)  Multivitamin preparations as soon as pregnancy is suspected 
A)  Vitamin A throughout pregnancy 
B)  Folic acid for all women of childbearing age 
C)  Folic acid during the first and second trimesters of pregnancy 
D)  Multivitamin preparations as soon as pregnancy is suspected

Question 8

The nurse is preparing to admit a 7-year-old child with an upper motor neuron syndrome. What clinical manifestations of an upper motor neuron syndrome should the nurse expect to observe? (Select all that apply.)

Accepted Answer

A)  No flexor spasms 
B)  Babinski reflex present 
C)  No wasting of muscle mass 
D)  Marked atrophy of atonic muscle 
E)  Hyperreflexia with tendon reflexes exaggerated 
A)  No flexor spasms 
B)  Babinski reflex present 
C)  No wasting of muscle mass 
D)  Marked atrophy of atonic muscle 
E)  Hyperreflexia with tendon reflexes exaggerated

Question 9

The health care provider has prescribed valproic acid (Depakene) 30 mg/kg/day divided bid for a child with cerebral palsy having seizures. The child weighs 22 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
__________

Accepted Answer

165
The correct calculation is

Question 10

What functional goal should the nurse expect for a child who has a C7 spinal cord injury? (Select all that apply.)

Accepted Answer

A)  Able to drive automobile with hand controls 
B)  Complete independence within limitations of a wheelchair 
C)  Can roll over in bed, sit up in bed, and eat independently 
D)  Requires some assistance in transfer and lower extremity dressing 
E)  Ambulation with bilateral long braces using four-point or swing-through crutch gait 
A)  Able to drive automobile with hand controls 
B)  Complete independence within limitations of a wheelchair 
C)  Can roll over in bed, sit up in bed, and eat independently 
D)  Requires some assistance in transfer and lower extremity dressing 
E)  Ambulation with bilateral long braces using four-point or swing-through crutch gait

Question 11

An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which psychosocial state?

Accepted Answer

A)  Normal phase of adolescent development 
B)  Severe depression that will require long-term counseling 
C)  Normal response to her situation that can be redirected in a healthy way 
D)  Denial response to her situation that makes rehabilitative efforts more difficult 
A)  Normal phase of adolescent development 
B)  Severe depression that will require long-term counseling 
C)  Normal response to her situation that can be redirected in a healthy way 
D)  Denial response to her situation that makes rehabilitative efforts more difficult

Question 12

A feeding technique the nurse can teach to parents of a child with cerebral palsy to improve use of the lips and the tongue to facilitate speech is which?

Accepted Answer

A)  Feeding pureed foods 
B)  Placing food on the tongue 
C)  Placing food at the side of the tongue 
D)  Placing food directly into the mouth with a spoon 
A)  Feeding pureed foods 
B)  Placing food on the tongue 
C)  Placing food at the side of the tongue 
D)  Placing food directly into the mouth with a spoon

Question 13

The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training?

Accepted Answer

A)  Children with dyskinetic CP have a wide-based gait and repetitive movements. 
B)  Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus. 
C)  Children with hemiplegia CP have mouth muscles and one lower limb affected. 
D)  Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria. 
A)  Children with dyskinetic CP have a wide-based gait and repetitive movements. 
B)  Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus. 
C)  Children with hemiplegia CP have mouth muscles and one lower limb affected. 
D)  Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria.

Question 14

The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what?

Accepted Answer

A)  Playing "pat-a-cake" with the child 
B)  None so the child does not become overstimulated 
C)  Putting a colorful mobile with music on the bed 
D)  Giving the child a coloring book and crayons 
A)  Playing "pat-a-cake" with the child 
B)  None so the child does not become overstimulated 
C)  Putting a colorful mobile with music on the bed 
D)  Giving the child a coloring book and crayons

Question 15

What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease? (Select all that apply.)

Accepted Answer

A)  Noticeable scoliosis 
B)  Absent deep tendon reflexes 
C)  Abnormal tongue movements 
D)  Failure to thrive 
E)  Prominent pectus excavatum
F) Significant leg involvement 
A)  Noticeable scoliosis 
B)  Absent deep tendon reflexes 
C)  Abnormal tongue movements 
D)  Failure to thrive 
E)  Prominent pectus excavatum
F) Significant leg involvement

Question 16

The health care provider has prescribed carbamazepine (Tegretol) 20 mg/kg/day divided bid for a child with cerebral palsy having seizures. The child weighs 44 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

200
The correct calculation is

Question 17

What most accurately describes bowel function in children born with a myelomeningocele?

Accepted Answer

A)  Incontinence cannot be prevented. 
B)  Enemas and laxatives are contraindicated. 
C)  Some degree of fecal continence can usually be achieved. 
D)  Colostomy is usually required by the time the child reaches adolescence. 
A)  Incontinence cannot be prevented. 
B)  Enemas and laxatives are contraindicated. 
C)  Some degree of fecal continence can usually be achieved. 
D)  Colostomy is usually required by the time the child reaches adolescence.

Question 18

The health care provider has prescribed gabapentin (Neurontin) 30 mg/kg/day divided q 8 hours for a child with cerebral palsy having seizures. The child weighs 110 lb. The nurse is preparing to administer the 1200 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

500
The correct calculation is

Question 19

What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury? (Select all that apply.)

Accepted Answer

A)  May be braced for standing 
B)  Able to drive automobile with hand controls 
C)  Can manage adapted public transportation 
D)  Some able to use regular public transportation 
E)  Ambulates well, often with short leg braces with or without cane 
A)  May be braced for standing 
B)  Able to drive automobile with hand controls 
C)  Can manage adapted public transportation 
D)  Some able to use regular public transportation 
E)  Ambulates well, often with short leg braces with or without cane

Question 20

The health care provider has prescribed oxybutynin (Ditropan) 0.2 mg/kg/day divided bid for a child with myelomeningocele. The child weighs 33 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer below using one decimal place.
_______

Accepted Answer

1.5
The correct calculation is

Exam 35: The Child with Neuromuscular or Muscular Dysfunction

A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention?

A mother tells the clinic nurse that she often puts honey on her infant's pacifier to soothe the infant. What response should the nurse make to the mother?

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate?

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?

The nurse is teaching the family of an infant with cerebral palsy how to administer a diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session?

A recommendation to prevent neural tube defects (NTDs) is the supplementation of what?

The nurse is preparing to admit a 7-year-old child with an upper motor neuron syndrome. What clinical manifestations of an upper motor neuron syndrome should the nurse expect to observe? (Select all that apply.)

What functional goal should the nurse expect for a child who has a C7 spinal cord injury? (Select all that apply.)

An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which psychosocial state?

A feeding technique the nurse can teach to parents of a child with cerebral palsy to improve use of the lips and the tongue to facilitate speech is which?

The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training?

The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what?

What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease? (Select all that apply.)

What most accurately describes bowel function in children born with a myelomeningocele?

What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury? (Select all that apply.)

Perspectives of Pediatric Nursing

Social, Cultural, Religious, and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, Physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child with Chronic Illness or Disability

Family-Centered Palliative Care

The Child with Cognitive, Sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child with Fluid and Electrolyte Imbalance

The Child with Renal Dysfunction

The Child with Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child with Respiratory Dysfunction

The Child with Cardiovascular Dysfunction

The Child with Hematologic or Immunologic Dysfunction

The Child with Cancer

The Child with Cerebral Dysfunction

The Child with Endocrine Dysfunction

The Child with Musculoskeletal or Articular Dysfunction

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