NURS 232 EXAM REVIEW QUESTIONS
WITH CORRECT ANSWERS
The nurse is assessing a 7-year-old child with trisomy 21 (Down syndrome). Which
| | | | | | | | | | | |
would the nurse be least likely to assess?
| | | | | | | |
1. Inspection finds the nasal passages clear and open.
| | | | | | | |
2. Auscultation reveals a definite heart murmur.
| | | | | |
3. Palpation indicates that the child may be constipated.
| | | | | | | |
4. The child is significantly underweight. - CORRECT ANSWER✔✔-1
| | | | | | | |
|Rationale: It is LEAST LIKELY that the nurse would find the child's nasal passages
| | | | | | | | | | | | | |
clear and open. Children with trisomy 21 (Down syndrome) have chronically
| | | | | | | | | | |
stuffy noses due to underdeveloped nasal bones. Typically, children with Down
| | | | | | | | | | |
syndrome are overweight. Children with Down syndrome often experience
| | | | | | | | |
digestive problems such as constipation. Children with Down syndrome often
| | | | | | | | | |
experience cardiac problems, such as a heart murmur.
| | | | | | |
Parents have just given birth to a child diagnosed with trisomy 21 (Down
| | | | | | | | | | | | |
syndrome). The couple are parents of three other children under the age of 8
| | | | | | | | | | | | | |
years old with no genetic disorders. What would be a priority nursing diagnosis at
| | | | | | | | | | | | |
this time?
| |
1. Decisional conflict
| |
2. Interrupted family processes
| | |
,3. Deficient knowledge regarding trisomy 21
| | | | |
4. Risk for delayed growth and development - CORRECT ANSWER✔✔-3
| | | | | | | | |
Rationale: Based on the child just being born and the parents dealing with three
| | | | | | | | | | | | | |
other children, the highest priority is Deficient knowledge regarding trisomy 21,
| | | | | | | | | | |
followed by interrupted family processes.
| | | |
A nurse is describing the underlying cause of trisomy 21 (Down syndrome) to a
| | | | | | | | | | | | | |
group of parents, integrating knowledge that the disorder is due to:
| | | | | | | | | |
1. deletion.
|
2. nondisjunction.
|
3. duplication.
|
4. translocation. - CORRECT ANSWER✔✔-2
| | | |
Rationale: Trisomy 21 (Down syndrome) is a disorder caused by nondisjunction or
| | | | | | | | | | |
|error in cell division. It is not due to the loss of a portion of the chromosome
| | | | | | | | | | | | | | | | |
(deletion), an extra segment being present (duplication), or transfer of one part
| | | | | | | | | | | |
of the chromosome to another (translocation).
| | | | |
The nurse is describing some of the developmental milestones the parent of a 3-
| | | | | | | | | | | | |
month-old infant with trisomy 21 (Down syndrome) can expect to see in the child.
| | | | | | | | | | | | |
Which statement describes the milestones that are expected in a child with this
| | | | | | | | | | | | | |
genetic disorder? |
1. "Your child will be speaking in sentences at 21 months of age."
| | | | | | | | | | | |
2. "Bladder training can be expected by 2.5 to 3 years of age."
| | | | | | | | | | | |
3. "Your child will be crawling all over the house by 9 months of age."
| | | | | | | | | | | | | |
,4. "You can expect your child to eat with the hands by age 12 months." -
| | | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-4 |
Rationale: Children with trisomy 21 (Down syndrome) will accomplish eating with
| | | | | | | | | | |
their hands by about 12 months of age. They will develop the skills of typical
| | | | | | | | | | | | | | |
children, but at an older age. The child with Down syndrome will speak in
| | | | | | | | | | | | | |
sentences at 24 months rather than 21 months. Bladder training would occur by
| | | | | | | | | | | | |
48 months rather than 32 months. A child with Down syndrome will crawl at 11
| | | | | | | | | | | | | | |
months rather than 9 months. | | | |
The nurse is caring for a 1-year-old infant with trisomy 21 (Down syndrome).
| | | | | | | | | | | | |
Which would the nurse be least likely to include in the child's plan of care?
| | | | | | | | | | | | | |
1. Educating parents about how to deal with seizures
| | | | | | | |
2. Promoting annual vision and hearing tests
| | | | | |
3. Describing the importance of a high-fiber diet
| | | | | | |
4. Explaining developmental milestones to parents - CORRECT ANSWER✔✔-1
| | | | | | | |
Rationale: It is unlikely that the parents will need to know how to deal with
| | | | | | | | | | | | | | |
seizures. It will be helpful to provide parents with growth and developmental
| | | | | | | | | | | |
milestones that are unique to children with trisomy 21 (Down syndrome). More
| | | | | | | | | | | |
than 60% of children with Down syndrome have hearing loss, so promoting
| | | | | | | | | | | |
annual vision and hearing tests is the priority intervention. Special diets are
| | | | | | | | | | | |
usually not necessary; however, a balanced, high-fiber diet and exercise are
| | | | | | | | | | |
important because constipation is frequently a problem.
| | | | | |
The nurse is assessing a newly admitted 14-year-old adolescent and notes that
| | | | | | | | | | | |
the adolescent makes very little eye contact, becomes very frustrated with
| | | | | | | | | | |
questions and conversation, and does not smile or laugh. What nursing diagnoses
| | | | | | | | | | |
will the nurse add to the care plan based on these assessment findings? (Select
| | | | | | | | | | | | | | |
all that apply.)
| |
, 1. Ineffective individual coping
| | |
2. Disturbed thought process
| | |
3. Delayed growth and development
| | | |
4. Imbalanced nutrition, less than body requirements
| | | | | |
5. Impaired social interaction - CORRECT ANSWER✔✔-1
| | | | | |
5
Rationale: Limited eye contact, lack of smiling support the nursing diagnosis of
| | | | | | | | | | | |
impaired social interaction. Becoming frustrated easily with conversation supports
| | | | | | | |
|both impaired social interaction and ineffective individual coping.
| | | | | | |
The nurse is performing the physical examination of a child with bulimia. What
| | | | | | | | | | | | |
findings would the nurse identify as supporting this disorder? (Select all that
| | | | | | | | | | | |
apply.)
1. Pink moist gums
| | |
2. Split fingernails
| |
3. Bradycardia
|
4. Eroded dental enamel
| | |
5. Dry sallow skin - CORRECT ANSWER✔✔-2
| | | | | |
4
Rationale: The adolescent with bulimia will be of normal weight or slightly
| | | | | | | | | | | |
overweight. The hands will show calluses on the backs of the knuckles and split
| | | | | | | | | | | | | |
fingernails. The mouth and oropharynx will exhibit eroded dental enamel, red
| | | | | | | | | | |
gums, and an inflamed throat from self-induced vomiting. Bradycardia and dry
| | | | | | | | | | |
sallow skin suggest anorexia.
| | |
WITH CORRECT ANSWERS
The nurse is assessing a 7-year-old child with trisomy 21 (Down syndrome). Which
| | | | | | | | | | | |
would the nurse be least likely to assess?
| | | | | | | |
1. Inspection finds the nasal passages clear and open.
| | | | | | | |
2. Auscultation reveals a definite heart murmur.
| | | | | |
3. Palpation indicates that the child may be constipated.
| | | | | | | |
4. The child is significantly underweight. - CORRECT ANSWER✔✔-1
| | | | | | | |
|Rationale: It is LEAST LIKELY that the nurse would find the child's nasal passages
| | | | | | | | | | | | | |
clear and open. Children with trisomy 21 (Down syndrome) have chronically
| | | | | | | | | | |
stuffy noses due to underdeveloped nasal bones. Typically, children with Down
| | | | | | | | | | |
syndrome are overweight. Children with Down syndrome often experience
| | | | | | | | |
digestive problems such as constipation. Children with Down syndrome often
| | | | | | | | | |
experience cardiac problems, such as a heart murmur.
| | | | | | |
Parents have just given birth to a child diagnosed with trisomy 21 (Down
| | | | | | | | | | | | |
syndrome). The couple are parents of three other children under the age of 8
| | | | | | | | | | | | | |
years old with no genetic disorders. What would be a priority nursing diagnosis at
| | | | | | | | | | | | |
this time?
| |
1. Decisional conflict
| |
2. Interrupted family processes
| | |
,3. Deficient knowledge regarding trisomy 21
| | | | |
4. Risk for delayed growth and development - CORRECT ANSWER✔✔-3
| | | | | | | | |
Rationale: Based on the child just being born and the parents dealing with three
| | | | | | | | | | | | | |
other children, the highest priority is Deficient knowledge regarding trisomy 21,
| | | | | | | | | | |
followed by interrupted family processes.
| | | |
A nurse is describing the underlying cause of trisomy 21 (Down syndrome) to a
| | | | | | | | | | | | | |
group of parents, integrating knowledge that the disorder is due to:
| | | | | | | | | |
1. deletion.
|
2. nondisjunction.
|
3. duplication.
|
4. translocation. - CORRECT ANSWER✔✔-2
| | | |
Rationale: Trisomy 21 (Down syndrome) is a disorder caused by nondisjunction or
| | | | | | | | | | |
|error in cell division. It is not due to the loss of a portion of the chromosome
| | | | | | | | | | | | | | | | |
(deletion), an extra segment being present (duplication), or transfer of one part
| | | | | | | | | | | |
of the chromosome to another (translocation).
| | | | |
The nurse is describing some of the developmental milestones the parent of a 3-
| | | | | | | | | | | | |
month-old infant with trisomy 21 (Down syndrome) can expect to see in the child.
| | | | | | | | | | | | |
Which statement describes the milestones that are expected in a child with this
| | | | | | | | | | | | | |
genetic disorder? |
1. "Your child will be speaking in sentences at 21 months of age."
| | | | | | | | | | | |
2. "Bladder training can be expected by 2.5 to 3 years of age."
| | | | | | | | | | | |
3. "Your child will be crawling all over the house by 9 months of age."
| | | | | | | | | | | | | |
,4. "You can expect your child to eat with the hands by age 12 months." -
| | | | | | | | | | | | | | | |
CORRECT ANSWER✔✔-4 |
Rationale: Children with trisomy 21 (Down syndrome) will accomplish eating with
| | | | | | | | | | |
their hands by about 12 months of age. They will develop the skills of typical
| | | | | | | | | | | | | | |
children, but at an older age. The child with Down syndrome will speak in
| | | | | | | | | | | | | |
sentences at 24 months rather than 21 months. Bladder training would occur by
| | | | | | | | | | | | |
48 months rather than 32 months. A child with Down syndrome will crawl at 11
| | | | | | | | | | | | | | |
months rather than 9 months. | | | |
The nurse is caring for a 1-year-old infant with trisomy 21 (Down syndrome).
| | | | | | | | | | | | |
Which would the nurse be least likely to include in the child's plan of care?
| | | | | | | | | | | | | |
1. Educating parents about how to deal with seizures
| | | | | | | |
2. Promoting annual vision and hearing tests
| | | | | |
3. Describing the importance of a high-fiber diet
| | | | | | |
4. Explaining developmental milestones to parents - CORRECT ANSWER✔✔-1
| | | | | | | |
Rationale: It is unlikely that the parents will need to know how to deal with
| | | | | | | | | | | | | | |
seizures. It will be helpful to provide parents with growth and developmental
| | | | | | | | | | | |
milestones that are unique to children with trisomy 21 (Down syndrome). More
| | | | | | | | | | | |
than 60% of children with Down syndrome have hearing loss, so promoting
| | | | | | | | | | | |
annual vision and hearing tests is the priority intervention. Special diets are
| | | | | | | | | | | |
usually not necessary; however, a balanced, high-fiber diet and exercise are
| | | | | | | | | | |
important because constipation is frequently a problem.
| | | | | |
The nurse is assessing a newly admitted 14-year-old adolescent and notes that
| | | | | | | | | | | |
the adolescent makes very little eye contact, becomes very frustrated with
| | | | | | | | | | |
questions and conversation, and does not smile or laugh. What nursing diagnoses
| | | | | | | | | | |
will the nurse add to the care plan based on these assessment findings? (Select
| | | | | | | | | | | | | | |
all that apply.)
| |
, 1. Ineffective individual coping
| | |
2. Disturbed thought process
| | |
3. Delayed growth and development
| | | |
4. Imbalanced nutrition, less than body requirements
| | | | | |
5. Impaired social interaction - CORRECT ANSWER✔✔-1
| | | | | |
5
Rationale: Limited eye contact, lack of smiling support the nursing diagnosis of
| | | | | | | | | | | |
impaired social interaction. Becoming frustrated easily with conversation supports
| | | | | | | |
|both impaired social interaction and ineffective individual coping.
| | | | | | |
The nurse is performing the physical examination of a child with bulimia. What
| | | | | | | | | | | | |
findings would the nurse identify as supporting this disorder? (Select all that
| | | | | | | | | | | |
apply.)
1. Pink moist gums
| | |
2. Split fingernails
| |
3. Bradycardia
|
4. Eroded dental enamel
| | |
5. Dry sallow skin - CORRECT ANSWER✔✔-2
| | | | | |
4
Rationale: The adolescent with bulimia will be of normal weight or slightly
| | | | | | | | | | | |
overweight. The hands will show calluses on the backs of the knuckles and split
| | | | | | | | | | | | | |
fingernails. The mouth and oropharynx will exhibit eroded dental enamel, red
| | | | | | | | | | |
gums, and an inflamed throat from self-induced vomiting. Bradycardia and dry
| | | | | | | | | | |
sallow skin suggest anorexia.
| | |
