Maternal and Child Practice Exam 3.

Maternal and Child Practice Exam 3. When providing postoperative care for the child with a cleft palate, the nurse should position the child in which of the following positions? A On the side B Prone C In an infant seat D Supine Postoperatively children with cleft palate should be placed on their abdomens to facilitate drainage. If the child is placed in the supine position, he or she may aspirate. Using an infant seat does not facilitate drainage. Side-lying does not facilitate drainage as well as the prone position. Which of the following would the nurse expect to assess in a child with celiac disease having a celiac crisis secondary to an upper respiratory infection? A Watery diarrhea B Respiratory distress C Weight gain D Lethargy Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged fasting, or exposure to anticholinergic drugs. Celiac crisis is typically characterized by severe watery diarrhea. Respiratory distress is unlikely in a routine upper respiratory infection. Irritability, rather than lethargy, is more likely. Because of the fluid loss associated with the severe watery diarrhea, the child's weight is more likely to be decreased. Which of the following would the nurse do first for a 3-year-old boy who arrives in the emergency room with a temperature of 105 degrees, inspiratory stridor, and restlessness, who is learning forward and drooling? A Auscultate his lungs and place him in a mist tent. B Have him lie down and rest after encouraging fluids. C Examine his throat and perform a throat culture D Notify the physician immediately and prepare for intubation. The child is exhibiting classic signs of epiglottitis, always a pediatric emergency. The physician must be notified immediately and the nurse must be prepared for an emergency intubation or tracheostomy. Further assessment with auscultating lungs and placing the child in a mist tent wastes valuable time. The situation is a possible life-threatening emergency. Having the child lie down would cause additional distress and may result in respiratory arrest. Throat examination may result in laryngospasm that could be fatal. Which of the following toys should the nurse recommend for a 5-month-old? A A colorful busy box B A big red balloon C A teddy bear with button eyes D A push-pull wooden truck A busy box facilitates the fine motor development that occurs between 4 and 6 months. Balloons are contraindicated because small children may aspirate balloons. Because the button eyes of a teddy bear may detach and be aspirated, this toy is unsafe for children younger than 3 years. A 5-month-old is too young to use a push-pull toy. When assessing a child with a cleft palate, the nurse is aware that the child is at risk for more frequent episodes of otitis media due to which of the following? A Plugging of the Eustachian tubes with food particles B Associated congenital defects of the middle ear. C Lowered resistance from malnutrition D Ineffective functioning of the Eustachian tubes Because of the structural defect, children with cleft palate may have ineffective functioning of their Eustachian tubes creating frequent bouts of otitis media. Most children with cleft palate remain well-nourished and maintain adequate nutrition through the use of proper feeding techniques. Food particles do not pass through the cleft and into the Eustachian tubes. There is no association between cleft palate and congenial ear deformities. Which of the following best describes parallel play between two toddlers? A Sharing crayons to color separate pictures B Sitting near each other while playing with separate dolls C Playing a board game with a nurse D Sharing their dolls with two different nurses Rationale: Toddlers engaging in parallel play will play near each other, but not with each other. Thus, when two toddlers sit near each other but play with separate dolls, they are exhibiting parallel play. Sharing crayons, playing a board game with a nurse, or sharing dolls with two different nurses are all examples of cooperative play. The adolescent's inability to develop a sense of who he is and what he can become results in a sense of which of the following? A Role diffusion B Guilt C Inferiority D Shame Role diffusion Rationale: According to Erikson, role diffusion develops when the adolescent does not develop a sense of identity and a sense or where he fits in. Toddlers develop a sense of shame when they do not achieve autonomy. Preschoolers develop a sense of guilt when they do not develop a sense of initiative. School-agechildren develop a sense of inferiority when they do not develop a sense of industry. ..................