NSG PN 223 OB & PEDS Final exam (Questions & Answer)

1. A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. administer an analgesic 2. release the skin traction 3. apply ice to the extremity 4. notify the HCP 2. A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1. ensure that all ropes are outside the pulleys 2. ensure that the weights are resting lightly on the floor 3. restrict diversional and play activities until the child is out of traction 4. check the HCP's prescriptions for the amount of weight to be applied 3. The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? 1. "I will encourage my child to perform prescribed exercises." 2. "I will have my child wear soft fabric clothing under the brace." 3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the use of powder because it will cake under the brace." 3. "I should apply lotion under the brace to prevent skin breakdown." 4. Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1. "Treatment needs to be started as soon as possible." 2. "I realize my infant will require follow-up care until fully grown." 3. "I need to bring my infant back to the clinic in 1 month for a new cast." 4. "I need to come to the clinic every week with my infant for the casting." Clubfoot is a complex deformity of the ankle and foot that includes forefoot adduction, midfoot supination, hindfoot varus, and ankle equinus; the defect may be unilateral or bilateral. Treatment for clubfoot is started as soon as possible after birth. Serial manipulation and casting are performed at least weekly. If sufficient correction is not achieved in 3 to 6 months, surgery usually is indicated. Because clubfoot can recur, all children with clubfoot require long-term interval follow-up until they reach skeletal maturity to ensure an optimal outcome. 5The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? SATA A. Use the fingertips to lift the cast while it is drying B. Keep small toys and sharp objects away from the cast C. Use a paddle ruler or another padded object to scratch the skin under the cast if it itches D. Place a heating pad on the lower end of the cast and over the fingers if the finders feel cool E. Elevate the extremity on pillows for the first 24-48 hours after casting to prevent swelling F. Contact the HCP if the child complains of numbness or tingling in the extremity 6, A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies would the nurse implement to promote the infant's growth and development? A. Tie colorful latex balloons to the side of the crib. B. Provide a small electronic toy. C. Change the infant's diaper as soon as soiling occurs. D. Allow infant to stand in the crib. D. Allow infant to stand in the crib. Rationale: The infant should not be restricted from normal activities. The infant can be held and allowed to walk in a cast or orthotic device. Allowing the child to participate in normal developmental activities will promote growth and development. 7, A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make? Normal bone growth can be affected 8, A home health nurse is developing a plan of care for a child who has hemiplegic cerebral palsy. which of the following goals is the priority for the nurse to include in the plan of care? A. provide respite services for the parents B. improve the clients communication skills C. foster self-care activities D. modify the environment Correct answer: D. modify the environment 9, A nurse is caring for a school-age client who possibly has Reye syndrome. Which of the following is a risk factor for developing Reye syndrome? A. Recent history of infectious cystitis caused by Candida B. Recent history of bacterial otitis media C. Recent episode of gastroenteritis D. Recent episode of Haemophilus influenzae meningitis 10, A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions by the nurse is appropriate? A. Place the client on NPO status. B. Prepare the client for a liver biopsy. C. Position the client dorsal recumbent. D. Put the client in a protective environment 10, A nurse is caring for a child who has increased intracranial pressure. Which of the following are appropriate actions by the nurse? (Select all that apply.) A. Suction the endotracheal tube every 2 hr. B. Maintain a quiet environment. C. Use two pillows to elevate the head. D. Administer a stool softener. E. Maintain body alignment.