Medical Surgical nursing Questions And Answers2024

Medical Surgical nursing Questions And Answers2024 The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD ) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunch time dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond? A. "He will need to learn to ignore the children, he needs this medication." B. "I can have the teacher speak with the other children." C. "You may want to talk to your physician about an extended release medication." D. "Remind him that his schoolwork may deteriorate." C. "You may want to talk to your physician about an extended release medication." A nurse is providing a routine wellness examination and follow-up for a 3-year-old recently diagnosed with autism spectrum disorder (ASD). Which response indicates a need for additional referral or followup? A. "We have recently completed his individualized education plan." B. "We really like the treatment plan that has been created by his school." C. "We try to be flexible and change his routine from day to day." D. "We have a couple of baby sitters who know how to handle his needs." C. "We try to be flexible and change his routine from day to day." The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which complications that signal refeeding syndrome? A. Cardiac arrhythmias, confusion, seizures B. Orthostatic hypotension and hypothermia C. Hypothermia and irregular pulse D. Bradycardia with ectopy and seizures A. Cardiac arrhythmias, confusion, seizures A nurse is conducting a physical examination of an adolescent girl with suspected bulimia. Which assessment finding should the nurse expect? A. Eroded dental enamel B. Dry sallow skin C. Soft sparse body hair D. Thinning scalp hair A. Eroded dental enamel Alteration in Oxygenation: Pediatric Considerations Promote oxygenation Provide rest Parent education Evaluation and monitoring from pulmonologist Reassessment Listen to parental concerns Meet growth and development needs Newborns are nose breathers until _________ weeks old? 4 Frontal sinuses develop by age? 6-8 years Infants and children under the age of ______ are diaphragmatic breathers. 6 years What is a complication associated with placenta accreta? Postpartum hemorrhage Hemorrhage is determined by type of accreta. This rise in cardiac output is due to a ______ to ______ increase in blood volume (stroke volume) and a ______ increase in heart rate. 30%; 50%; 30% What is mental health? A sense of personal well-being, physical health, and psychological stability. What are risk factors for childhood mental disorders? Parental use of drugs/alcohol Separation from parents Children with inappropriate roles Learning disabilities Abuse PTSD Children of teenage parents Low income homes Intellectual disability Childhood schizophrenia How are mental health disorders diagnosed? Mental health screenings. Children often do not display the usual developmental milestones at the appropriate times. What a treatment options for childhood mental disorders? Individual therapy, group therapy, family therapy, play therapy, art therapy, cognitive/behavioral therapy, behavior modification, visualization and guided imagery, hypnosis What does the nursing assessment focus on in those with childhood mental disorders? Child behaviors, developmental progression, treatment for mental health or cognitive condition. Make sure child is safe at all times. What are the expected outcomes of nursing care in those with childhood mental disorders? Behavioral symptoms effectively managed, child performs elements of self-care, child remains free from injury, consistent developmental progression is observed, and the child develops successful communication strategies. Conduct disorder A group of behavioral and emotional issues in children/adolescents. What is seen on assessment for those with conduct disorder? Difficulty following rules and behaving in a socially acceptable way, often viewed as "bad" or "delinquent", breaking rules without reason, cruel/aggressive behavior towards people/animals, truancy, alcohol/illicit drug use, intentionally setting fires, lying to achieve a goal, vandalizing How is conduct disorder diagnosed? Based on criteria presented. What are contributing factors to conduct disorder? Child abuse, neglect, genetic vulnerability, school failure, traumatic life experiences What is nursing management focused on for those with conduct disorder? Therapy sessions (individual/family), medication, psychotherapy, remind parents the follow up care will be needed and to follow instructions of any medications as indicated, teaching parenting skills, offer community resources (i.e., respite care, support and therapy groups) Adjustment Disorder The development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of the onset of the stressor. (DSM-5) What is seen on assessment for those with adjustment disorder? Anxiety (including separation anxiety), depression/sadness, withdrawn, poor eye contact, loss of interest in usual activities, sleep disturbances, truancy, vandalism, fighting, reckless driving How is adjustment disorder diagnosed? Based on s/s and thorough psychological evaluation. Specific criteria based on DSM-5. What is nursing management focused on for those with adjustment disorder? Therapy session (i.e., individual, group, family), pharmacotherapy with goal of reducing debilitation symptoms (i.e., anti-depression, anti-anxiety), activity, reminds parents the follow up care will be needed and to follow instructions of any medication as indicated. Anorexia Nervosa Refusal to maintain normal body weight. What is commonly seen in those with anorexia nervosa? Morbid fear of obesity Disturbed body image Some binge/purge behavior Food restrictions Individuals learn to suppress hunger Anorexia nervosa cases are seen 90% in _____________? Females What is the death rate for those diagnosed with anorexia nervosa? 8-18% What are the causes of anorexia nervosa? Biological factors and psychological factors What psychological factors contribute to the development of anorexia nervosa? Obsession related to control, rule driven, inflexibility, disturbed body image, cannot interpret internal stimuli, low self-esteem, overprotective, smothering, intrusive parenting, sexual abuse. What biological factors contribute to the development of anorexia nervosa? Hypothalamus regulates eating, serotonin and norepinephrine are decreased causing depression.