Ch 44
Chapter 44
1. The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has
developed a sensitivity to latex. Which response from his mother indicates a need for further
teaching?
A. "He needs to get a medical alert identification."
B. "I will need to discuss this with his caregivers."
C. "A product's label indicates whether it is latex-free."
D. "He must avoid all contact with latex."
Answer: C
3. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan
of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention
would the nurse implement to best promote maximum chest expansion?
A. Deep-breathing exercises
B. Upright positioning
C. Coughing
D. Chest percussion
Answer: B
6. The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was
recently injured when he fell out of bed at home. Which intervention would the nurse suggest
to
prevent further injury?
A. Recommend the bed's side rails be raised throughout the day and night.
B. Suggest a caregiver be present continuously to prevent falls from bed.
C. Encourage a loose restraint to be used when he is in bed.
D. Recommend raising the bed's side rails when a caregiver is not present.
Answer: D
8. The nurse is teaching a group of students about myelinization in a child. Which statement by
the students indicates that the teaching was successful?
A. Myelinization is completed by 4 years of age.
B. The process occurs in a head-to-toe fashion.
C. The speed of nerve impulses slows as myelinization occurs.
D. Nerve impulses become less specific in focus with myelinization.
Answer: B
9. When developing the plan of care for a child with cerebral palsy, which treatment would the
nurse expect as least likely?
A. Skeletal traction
,B. Physical therapy
C. Orthotics
D. Occupational therapy
Answer: A
11. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment
plan. After teaching the child's parents about this drug, which statement by the parents
indicates
the need for additional teaching?
A. "We should give this drug before he eats anything."
B. "We need to watch carefully for possible infection."
C. "The drug should not be stopped suddenly."
D. "He might gain some weight with this drug."
Answer: A
12. What information would the nurse include in the preoperative plan of care for an infant with
myelomeningocele?
A. Positioning supine with a pillow under the buttocks
B. Covering the sac with saline-soaked nonadhesive gauze
C. Wrapping the infant snugly in a blanket
D. Applying a diaper to prevent fecal soiling of the sac
Answer: B
17. A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA).
When describing type 2 SMA, which information would the instructor include? Select all that
apply.
A. Onset before 6 months of age
B. Weakness most severe in shoulders and hips
C. Difficulty with swallowing
D. Slowly progressing condition
E. Genetic disease with autosomal recessive inheritance
Answer: B, D, E
18. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m.
The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m.
her mother brings her back to the emergency department due to unrelenting pain that has not
been relieved by the prescribed narcotics. Which action would be the priority?
A. Notifying the doctor immediately
B. Applying ice
C. Elevating the arm
D. Giving additional pain medication as ordered
, Answer: A
26. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on
how to reduce the risk of injury. Which response from the mother indicates a need for further
teaching?
A. "I need to avoid pushing or pulling on an arm or leg."
B. "I must carefully lift the baby from under the armpits."
C. "I should not bend an arm or leg into an awkward position."
D. "We must avoid lifting the legs by the ankles to change diapers."
Answer: B
27. The nurse is developing a teaching plan for a child who is to have his cast removed. What
instruction would the nurse most likely include?
A. Applying petroleum jelly to the dry skin
B. Rubbing the skin vigorously to remove the dead skin
C. Soaking the area in warm water every day
D. Washing the skin with dilute peroxide and water
Answer: C
29. The school nurse is presenting a class to a group of students about common overuse
disorders. Which disorder would the school nurse include?
A. Dislocated radial head
B. Transient synovitis of the hip
C. Osgood-Schlatter disease
D. Scoliosis
Answer: C
30. The nurse is assessing a child with a possible fracture. What would the nurse identify as the
most reliable indicator?
A. Lack of spontaneous movement
B. Point tenderness
C. Bruising
D. Inability to bear weight
Answer: B
32. A child has undergone surgery using steel bar placement to correct pectus excavatum. What
position would the nurse instruct the parents to avoid?
A. Semi-Fowler
B. Supine
C. High Fowler
D. Side-lying
Answer: D
33. A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this
Chapter 44
1. The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has
developed a sensitivity to latex. Which response from his mother indicates a need for further
teaching?
A. "He needs to get a medical alert identification."
B. "I will need to discuss this with his caregivers."
C. "A product's label indicates whether it is latex-free."
D. "He must avoid all contact with latex."
Answer: C
3. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan
of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention
would the nurse implement to best promote maximum chest expansion?
A. Deep-breathing exercises
B. Upright positioning
C. Coughing
D. Chest percussion
Answer: B
6. The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was
recently injured when he fell out of bed at home. Which intervention would the nurse suggest
to
prevent further injury?
A. Recommend the bed's side rails be raised throughout the day and night.
B. Suggest a caregiver be present continuously to prevent falls from bed.
C. Encourage a loose restraint to be used when he is in bed.
D. Recommend raising the bed's side rails when a caregiver is not present.
Answer: D
8. The nurse is teaching a group of students about myelinization in a child. Which statement by
the students indicates that the teaching was successful?
A. Myelinization is completed by 4 years of age.
B. The process occurs in a head-to-toe fashion.
C. The speed of nerve impulses slows as myelinization occurs.
D. Nerve impulses become less specific in focus with myelinization.
Answer: B
9. When developing the plan of care for a child with cerebral palsy, which treatment would the
nurse expect as least likely?
A. Skeletal traction
,B. Physical therapy
C. Orthotics
D. Occupational therapy
Answer: A
11. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment
plan. After teaching the child's parents about this drug, which statement by the parents
indicates
the need for additional teaching?
A. "We should give this drug before he eats anything."
B. "We need to watch carefully for possible infection."
C. "The drug should not be stopped suddenly."
D. "He might gain some weight with this drug."
Answer: A
12. What information would the nurse include in the preoperative plan of care for an infant with
myelomeningocele?
A. Positioning supine with a pillow under the buttocks
B. Covering the sac with saline-soaked nonadhesive gauze
C. Wrapping the infant snugly in a blanket
D. Applying a diaper to prevent fecal soiling of the sac
Answer: B
17. A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA).
When describing type 2 SMA, which information would the instructor include? Select all that
apply.
A. Onset before 6 months of age
B. Weakness most severe in shoulders and hips
C. Difficulty with swallowing
D. Slowly progressing condition
E. Genetic disease with autosomal recessive inheritance
Answer: B, D, E
18. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m.
The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m.
her mother brings her back to the emergency department due to unrelenting pain that has not
been relieved by the prescribed narcotics. Which action would be the priority?
A. Notifying the doctor immediately
B. Applying ice
C. Elevating the arm
D. Giving additional pain medication as ordered
, Answer: A
26. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on
how to reduce the risk of injury. Which response from the mother indicates a need for further
teaching?
A. "I need to avoid pushing or pulling on an arm or leg."
B. "I must carefully lift the baby from under the armpits."
C. "I should not bend an arm or leg into an awkward position."
D. "We must avoid lifting the legs by the ankles to change diapers."
Answer: B
27. The nurse is developing a teaching plan for a child who is to have his cast removed. What
instruction would the nurse most likely include?
A. Applying petroleum jelly to the dry skin
B. Rubbing the skin vigorously to remove the dead skin
C. Soaking the area in warm water every day
D. Washing the skin with dilute peroxide and water
Answer: C
29. The school nurse is presenting a class to a group of students about common overuse
disorders. Which disorder would the school nurse include?
A. Dislocated radial head
B. Transient synovitis of the hip
C. Osgood-Schlatter disease
D. Scoliosis
Answer: C
30. The nurse is assessing a child with a possible fracture. What would the nurse identify as the
most reliable indicator?
A. Lack of spontaneous movement
B. Point tenderness
C. Bruising
D. Inability to bear weight
Answer: B
32. A child has undergone surgery using steel bar placement to correct pectus excavatum. What
position would the nurse instruct the parents to avoid?
A. Semi-Fowler
B. Supine
C. High Fowler
D. Side-lying
Answer: D
33. A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this
