Pediatrics Growth and Development Exam - Questions, Answers and Rationales

Pediatrics Growth and Development Exam - Questions, Answers and Rationales An adolescent with type 1 diabetes is brought to the emergency department in ketoacidosis. The adolescent admits to not adhering to the diabetic regimen. What can the nurse do to help the adolescent become more accepting of the diabetic regimen? Encourage the adolescent to express feelings about having diabetes. Rationale: Psychosociocultural factors related to chronic illness often affect individual adherence to a medical regimen, particularly in an adolescent. These feelings must be explored and addressed before there can be acceptance of the treatment plan. The adolescent's feelings should be explored before it is determined what the adolescent knows about diabetes. Although it is important for the parents to demonstrate acceptance, adolescents need control and therefore the teaching must begin with the adolescent. Printed materials may be helpful later, but scare tactics rarely prompt changes with any lasting benefit. An adolescent is hospitalized with multiple internal injuries after an automobile collision. The adolescent is being kept NPO and is receiving an IV infusion at 125 mL/hr and an antibiotic reconstituted in 10 mL of normal saline every 6 hours (6 am, 12 pm, 6 pm, 12 am). What is the intake from 7 am to 3 pm? Record your answer as a whole number with no punctuation. ___ mL 1010 A nurse is discussing the need for genetic counseling with a male teenager who has a sibling with cystic fibrosis (CF). The identification of which test by the teenager indicates that he understands the genetic counseling? Carrier testing Rationale: More than one gene can cause cystic fibrosis (CF); carrier testing is done to detect known alleles. The results of a chest x-ray will not determine whether the individual is a carrier of CF; this may be one of the tests that are conducted when CF is suspected. A sweat chloride test is performed to diagnose CF, not to determine whether the adolescent is a carrier. CF does not result from a chromosomal anomaly. What play activity should the nurse provide for a 4-year-old child on bedrest? Finger painting on blank sheets of paper Rationale: Finger painting is appropriate for this age child; it provides the child an opportunity for free expression, and its freeform nature can give the child a sense of mobility. Coloring within the lines of pictures in a coloring book requires more skill than most 4-year-olds possess; also, it does not allow freedom of expression or movement. Checkers is a game with too many rules for a 4-year-old to comprehend. Playing dominoes requires the ability to count and conserve numbers, which most 4-year-olds do not possess. During follow-up visits, the nurse informs the mother of a 3-month-old infant how to feed the infant expressed milk. Which statements by the mother indicate effective learning? Select all that apply. "I can express milk by hand or with a breast pump.", "I can store expressed milk in the refrigerator for 5 days." Rationale: Expressing milk by hand or with a breast pump does not result in contamination. Expressed milk can be stored in the refrigerator at a temperature of 4° C or 39° F for 5 days without bacterial contamination. Giving excess water to infants of less than 4 months of age can result in hyponatremia and water intoxication. High temperatures can spoil expressed milk; therefore, the expressed milk should not be stored at room temperature. Honey can cause botulism in infants. A nurse is assessing an adolescent after the administration of epinephrine. What side effect is most important for the nurse to identify? Tachycardia Rationale: Epinephrine is a sympathetic nervous system stimulant that causes tachycardia. Hyperglycemia, not hypoglycemia, may result. The pupils will be dilated, not constricted. Epinephrine is more likely to cause hypertension than hypotension. The mother of a 17-year-old adolescent who is going to be a foreign exchange student asks the nurse why her child must have a tetanus toxoid immunization instead of tetanus immunoglobulin. The nurse responds that the tetanus toxoid immunization provides: Longer-lasting active immunity Rationale: Toxoids are modified toxins that stimulate the body to form antibodies that can last up to 10 years against the specific disease. Because the adolescent will be in a foreign country, the tetanus toxoid is given prophylactically. The tetanus toxoid provides active, not passive, immunity; all passive immunity is short acting. Only by having the disease can a person gain natural immunity. A preschooler with partial-thickness burns on 21% of the total body surface area progresses from the emergency phase to the acute phase of burn care. What is the most important nursing intervention at this time? Instituting a pain management plan Rationale: Implementing a pain-management plan is the priority action of the medical and nursing staff. There is less physiological stress when the child's pain is managed, which allows healing to occur. Although monitoring of intake and output, monitoring for infection, and maintaining nutrition are all important and will be done, none of these is the priority. What does the nurse expect the primary health care provider (PCP) to advise the parents after their child is diagnosed with a mitochondrial disorder?