NURS 6551 FINAL EXAM 2 PEDIATRICS ACUTE
AND CHRONIC CONDITIONS REVIEW 2026
◉ Which critical element should be included in a plan of care for a
pediatric patient who has to be immobilized as part of the course of
therapeutic intervention? Answer: Asking the patient to help
organize individual care into a schedule.
Rationale:
One of the critical elements for a pediatric patient is to allow them to
participate in scheduling their care. This allows for the patient to
have "self-care" choices which provides for more control over their
environment. Antiemetic therapy and restriction of visitors may not
be required and are related to the patient's immediate medical
diagnosis. The Braden scale should be implemented but it is
typically done once a shift and not every 4 hours.
◉ Which statement is true concerning osteogenesis imperfecta (OI)?
Answer: OI is an inherited disorder.
Rationale:
OI is an autosomal dominant inherited disorder and presents as a
lifelong problem as a result of defective bone mineralization,
abnormal bone architecture and increased susceptibility to
fractures. OI has a predictable course that is determined by the
,pathophysiologic processes, not the time of onset. Lightweight
braces and splints can help support limbs and fractures.
◉ What are considered major goals of the therapeutic management
of juvenile rheumatoid arthritis (JRA)? Answer: Prevent physical
deformity; preserve joint function.
Rationale:
The goals of treatment for JRA include the prevention of physical
deformity, the preservation of joint function, and the control of pain.
Once the joint is damaged from the physiologic processes of JRA, it
may not be possible to regain proper alignment. Children with JRA
may be cured of the disease. Skin breakdown is usually not an issue
in JRA.
◉ Basic treatment of musculoskeletal soft tissue injuries involves
the use of RICE modalities during the first 12 to 24 hours. Which
option would be included in RICE? Answer: The extremity should be
maintained in proper alignment and activity should be limited.
Rationale:
R refers to rest and the involved extremity should be maintained in
proper alignment with activity (range of motion) limited in order to
prevent further damage. Reusing chemical ice packs is not
acceptable. Ice should be applied for no more than 30 minutes at a
time. Pillows can be used to elevate the extremity but it should be
,done above the level of the heart. To facilitate venous return and
prevent fluid accumulation.
◉ What is a secondary effect when a child experiences decreased
muscle strength, tone, and endurance from immobilization? Answer:
Decreased exercise tolerance
Rationale:
Muscle disuse leads to tissue breakdown and loss of muscle mass or
muscle atrophy. It may take weeks or months to recover. Metabolism
decreases during periods of immobility. There is decreased venous
return due to decreased muscle activity secondary to immobility.
There is decreased cardiac output secondary to immobility.
◉ Therapeutic management of the patient with systemic lupus
erythematosus (SLE) includes: Answer: administration of
corticosteroids to control inflammation.
Rationale:
Corticosteroid administration is the primary mode of therapy
currently for SLE. The application of cold salts will not affect the
inflammatory process associated with SLE. A balanced diet without
exceeding caloric expenditures is recommended. Exercise should be
done in moderation
, ◉ What is an appropriate nursing intervention when caring for the
child with chronic osteomyelitis? Answer: Move and turn the child
carefully and gently to minimize pain.
Rationale:
Osteomyelitis is extremely painful. Movement is carried out only as
needed and then carefully and gently. Active range-of-motion
exercises are contraindicated until pain has subsided. Pain
medication should be administered as needed. Ambulation is
contraindicated until pain has subsided.
◉ A pediatric patient has been diagnosed with Type I Osteogenesis
Imperfecta (OI). The nurse understands that this specific type of OI:
Answer: is the most common form of the disease.
Rationale:
Type 1 is the most common form of OI. In terms of stature, bone loss
and fractures it presents with the fewest clinical symptoms and
occurs before puberty. The most severe form of OI is type II. Type III
presents at birth and is associated with multiple fractures.
◉ Which measure is important in managing hypercalcemia in a child
who is immobilized? Answer: Promote adequate hydration
Rationale:
AND CHRONIC CONDITIONS REVIEW 2026
◉ Which critical element should be included in a plan of care for a
pediatric patient who has to be immobilized as part of the course of
therapeutic intervention? Answer: Asking the patient to help
organize individual care into a schedule.
Rationale:
One of the critical elements for a pediatric patient is to allow them to
participate in scheduling their care. This allows for the patient to
have "self-care" choices which provides for more control over their
environment. Antiemetic therapy and restriction of visitors may not
be required and are related to the patient's immediate medical
diagnosis. The Braden scale should be implemented but it is
typically done once a shift and not every 4 hours.
◉ Which statement is true concerning osteogenesis imperfecta (OI)?
Answer: OI is an inherited disorder.
Rationale:
OI is an autosomal dominant inherited disorder and presents as a
lifelong problem as a result of defective bone mineralization,
abnormal bone architecture and increased susceptibility to
fractures. OI has a predictable course that is determined by the
,pathophysiologic processes, not the time of onset. Lightweight
braces and splints can help support limbs and fractures.
◉ What are considered major goals of the therapeutic management
of juvenile rheumatoid arthritis (JRA)? Answer: Prevent physical
deformity; preserve joint function.
Rationale:
The goals of treatment for JRA include the prevention of physical
deformity, the preservation of joint function, and the control of pain.
Once the joint is damaged from the physiologic processes of JRA, it
may not be possible to regain proper alignment. Children with JRA
may be cured of the disease. Skin breakdown is usually not an issue
in JRA.
◉ Basic treatment of musculoskeletal soft tissue injuries involves
the use of RICE modalities during the first 12 to 24 hours. Which
option would be included in RICE? Answer: The extremity should be
maintained in proper alignment and activity should be limited.
Rationale:
R refers to rest and the involved extremity should be maintained in
proper alignment with activity (range of motion) limited in order to
prevent further damage. Reusing chemical ice packs is not
acceptable. Ice should be applied for no more than 30 minutes at a
time. Pillows can be used to elevate the extremity but it should be
,done above the level of the heart. To facilitate venous return and
prevent fluid accumulation.
◉ What is a secondary effect when a child experiences decreased
muscle strength, tone, and endurance from immobilization? Answer:
Decreased exercise tolerance
Rationale:
Muscle disuse leads to tissue breakdown and loss of muscle mass or
muscle atrophy. It may take weeks or months to recover. Metabolism
decreases during periods of immobility. There is decreased venous
return due to decreased muscle activity secondary to immobility.
There is decreased cardiac output secondary to immobility.
◉ Therapeutic management of the patient with systemic lupus
erythematosus (SLE) includes: Answer: administration of
corticosteroids to control inflammation.
Rationale:
Corticosteroid administration is the primary mode of therapy
currently for SLE. The application of cold salts will not affect the
inflammatory process associated with SLE. A balanced diet without
exceeding caloric expenditures is recommended. Exercise should be
done in moderation
, ◉ What is an appropriate nursing intervention when caring for the
child with chronic osteomyelitis? Answer: Move and turn the child
carefully and gently to minimize pain.
Rationale:
Osteomyelitis is extremely painful. Movement is carried out only as
needed and then carefully and gently. Active range-of-motion
exercises are contraindicated until pain has subsided. Pain
medication should be administered as needed. Ambulation is
contraindicated until pain has subsided.
◉ A pediatric patient has been diagnosed with Type I Osteogenesis
Imperfecta (OI). The nurse understands that this specific type of OI:
Answer: is the most common form of the disease.
Rationale:
Type 1 is the most common form of OI. In terms of stature, bone loss
and fractures it presents with the fewest clinical symptoms and
occurs before puberty. The most severe form of OI is type II. Type III
presents at birth and is associated with multiple fractures.
◉ Which measure is important in managing hypercalcemia in a child
who is immobilized? Answer: Promote adequate hydration
Rationale:
