UNWORLD PEDIATRICS EXAM AND
CORRECT ANSWERS.
The clinic nurse supervises a graduate nurse who is teaching the parents of
a 2-year-old with acute diarrhea about home management. The nurse
would need to intervene when the graduate nurse provides which
instruction?
The clinic nurse supervises a graduate nurse who is teaching the parents of
a 2-year-old with acute diarrhea about home management. The nurse
would need to intervene when the graduate nurse provides which
instruction?
1.
"Do not administer antidiarrheal medications to your child."
2.
"Follow the bananas, rice, applesauce, and toast diet for the next few days."
3.
"Record the number of wet diapers and return to the clinic if you notice a
decrease."
4.
"Use a skin barrier cream such as zinc oxide in the diaper area until
diarrhea subsides." - CorreCt Answers -2.
Hospitalization for toddlers (ie, 12-36 months) is particularly difficult due
to separation anxiety and a limited ability to cope with stress. Toddlers
thrive on home rituals and routines, which bring stability and reassurance.
,Hospitalization can severely disrupt these routines, triggering frustration
and temper tantrums. Caregivers should maintain as many home routines
as possible (eg, sleeping, eating) to help the child cope with unfamiliar
hospital surroundings and procedures (Option 1). Parents should also stay
with the child as much as possible, including overnight (ie, rooming-in), to
provide consistency and alleviate separation anxiety (Option 3).
Play, an important part of a child's emotional and social well-being, is an
effective coping mechanism for children of all ages to deal with the stress of
being away from home. The playroom is a safe place for children to act out
their fears and anxieties related to illness and hospitalization (Option 4).
(Option 2) A visit from friends is not likely to provide much comfort to a
toddler and may actually cause additional stress. Adolescents, who are
driven by peer interaction, would be more likely to benefit from this
strategy.
(Option 5) Preschool-aged children (3-5 years) have egocentric and magical
thinking, which may cause them to think that their illness is due to
something they have done or thought. Toddlers do not think this way.
The clinic nurse reviews teaching provided to the parent of a child being
considered for growth hormone replacement therapy at home. Which
statement by the parent indicates that teaching has been effective?
"Treatment will be considered a success when my child grows at a rate
equal to peers."
"Treatment will be required throughout my child's life."
"Treatment will begin when my child becomes an adolescent."
"Treatment will require a daily injection under my child's skin." - CorreCt
Answers -4. daily injection
,A child who demonstrates a slow growth pattern will undergo diagnostic
evaluation to determine the cause. If the cause is found to be growth
hormone deficiency, the child may undergo growth hormone replacement
therapy. The biosynthetic hormone is administered via subcutaneous
injection on a daily basis. Despite replacement therapy, the child may still
have a final height less than "normal." Treatment is most successful when
diagnosis and replacement therapy begin early in the child's life. When to
stop therapy is decided by the client, family, and provider. However, growth
less than 1 inch (2.5 cm) per year and bone age of 14 years in girls and 16
years in boys are the criteria often used to stop therapy.
(Option 1) Growth hormone replacement does not guarantee that a child
will grow at a rate equal to peers. Treated children often remain shorter
than their peers.
(Option 2) Replacement therapy is not continued throughout a child's life.
It is stopped when bone growth begins to cease or when the child, parents,
and provider make the decision.
(Option 3) Replacement therapy is most successful when treatment begins
early, as soon as growth delays are noted.
A nurse is reviewing the laboratory values for a 3-year-old client with
nephrotic syndrome. The nurse interprets the results to most clearly reflect
which physiologic process related to nephrotic syndrome? Click on the
exhibit button for additional information.
Glomerular injury
, Hepatic impairment
Inherited hypercholesterolemia
Malnutrition - CorreCt Answers -glomerular injury
Nephrotic syndrome is a collection of symptoms resulting from various
causes of glomerular injury. Below are the 4 classic manifestations of
nephrotic syndrome:
Massive proteinuria - caused by increased glomerular permeability
Hypoalbuminemia - resulting from excess protein loss in the urine
Edema - specifically periorbital and peripheral edema and ascites; caused
by low serum protein and albumin as fluid is pulled into interstitial spaces
and body cavities
Hyperlipidemia - related to increased compensatory protein and lipid
production by the liver
Additional symptoms include decreased urine output, fatigue, pallor, and
weight gain.
4 manifestations of nephrotic syndrom - CorreCt Answers -massive
proteinurea
hypoalbuminemis
edema
CORRECT ANSWERS.
The clinic nurse supervises a graduate nurse who is teaching the parents of
a 2-year-old with acute diarrhea about home management. The nurse
would need to intervene when the graduate nurse provides which
instruction?
The clinic nurse supervises a graduate nurse who is teaching the parents of
a 2-year-old with acute diarrhea about home management. The nurse
would need to intervene when the graduate nurse provides which
instruction?
1.
"Do not administer antidiarrheal medications to your child."
2.
"Follow the bananas, rice, applesauce, and toast diet for the next few days."
3.
"Record the number of wet diapers and return to the clinic if you notice a
decrease."
4.
"Use a skin barrier cream such as zinc oxide in the diaper area until
diarrhea subsides." - CorreCt Answers -2.
Hospitalization for toddlers (ie, 12-36 months) is particularly difficult due
to separation anxiety and a limited ability to cope with stress. Toddlers
thrive on home rituals and routines, which bring stability and reassurance.
,Hospitalization can severely disrupt these routines, triggering frustration
and temper tantrums. Caregivers should maintain as many home routines
as possible (eg, sleeping, eating) to help the child cope with unfamiliar
hospital surroundings and procedures (Option 1). Parents should also stay
with the child as much as possible, including overnight (ie, rooming-in), to
provide consistency and alleviate separation anxiety (Option 3).
Play, an important part of a child's emotional and social well-being, is an
effective coping mechanism for children of all ages to deal with the stress of
being away from home. The playroom is a safe place for children to act out
their fears and anxieties related to illness and hospitalization (Option 4).
(Option 2) A visit from friends is not likely to provide much comfort to a
toddler and may actually cause additional stress. Adolescents, who are
driven by peer interaction, would be more likely to benefit from this
strategy.
(Option 5) Preschool-aged children (3-5 years) have egocentric and magical
thinking, which may cause them to think that their illness is due to
something they have done or thought. Toddlers do not think this way.
The clinic nurse reviews teaching provided to the parent of a child being
considered for growth hormone replacement therapy at home. Which
statement by the parent indicates that teaching has been effective?
"Treatment will be considered a success when my child grows at a rate
equal to peers."
"Treatment will be required throughout my child's life."
"Treatment will begin when my child becomes an adolescent."
"Treatment will require a daily injection under my child's skin." - CorreCt
Answers -4. daily injection
,A child who demonstrates a slow growth pattern will undergo diagnostic
evaluation to determine the cause. If the cause is found to be growth
hormone deficiency, the child may undergo growth hormone replacement
therapy. The biosynthetic hormone is administered via subcutaneous
injection on a daily basis. Despite replacement therapy, the child may still
have a final height less than "normal." Treatment is most successful when
diagnosis and replacement therapy begin early in the child's life. When to
stop therapy is decided by the client, family, and provider. However, growth
less than 1 inch (2.5 cm) per year and bone age of 14 years in girls and 16
years in boys are the criteria often used to stop therapy.
(Option 1) Growth hormone replacement does not guarantee that a child
will grow at a rate equal to peers. Treated children often remain shorter
than their peers.
(Option 2) Replacement therapy is not continued throughout a child's life.
It is stopped when bone growth begins to cease or when the child, parents,
and provider make the decision.
(Option 3) Replacement therapy is most successful when treatment begins
early, as soon as growth delays are noted.
A nurse is reviewing the laboratory values for a 3-year-old client with
nephrotic syndrome. The nurse interprets the results to most clearly reflect
which physiologic process related to nephrotic syndrome? Click on the
exhibit button for additional information.
Glomerular injury
, Hepatic impairment
Inherited hypercholesterolemia
Malnutrition - CorreCt Answers -glomerular injury
Nephrotic syndrome is a collection of symptoms resulting from various
causes of glomerular injury. Below are the 4 classic manifestations of
nephrotic syndrome:
Massive proteinuria - caused by increased glomerular permeability
Hypoalbuminemia - resulting from excess protein loss in the urine
Edema - specifically periorbital and peripheral edema and ascites; caused
by low serum protein and albumin as fluid is pulled into interstitial spaces
and body cavities
Hyperlipidemia - related to increased compensatory protein and lipid
production by the liver
Additional symptoms include decreased urine output, fatigue, pallor, and
weight gain.
4 manifestations of nephrotic syndrom - CorreCt Answers -massive
proteinurea
hypoalbuminemis
edema
