RN growth and development EAQ
A 12-year-old child with Down syndrome is admitted to the hospital for intravenous
antibiotics for pneumonia. Which clinical findings associated with Down syndrome
should the nurse expect when performing a physical assessment? Select all that
apply.
1. Saddle nose
2. Thin fingers
3. Inner epicanthic folds
4. Hypertonic musculature
5. Transverse palmar crease - ANSWER: 1.Saddle Nose
2.Inner epicanthic folds
3.Transverse palmar crease
Children with Down syndrome have a broad nose with a depressed bridge (saddle
nose), as well as inner epicanthic folds, and oblique palpebral fissures; they also have
speckling of the iris (Brushfield spots). Children with Down syndrome have a
transverse palmar crease (simian crease) formed by fusion of the proximal and distal
palmar creases. These children also have broad, short, stubby hands and feet.
Children with Down syndrome have hypotonic, not hypertonic, musculature.
A nurse plans to discuss childhood nutrition with a group of parents whose children
have Down syndrome in an attempt to minimize a common nutritional problem.
What problem should be addressed?
1.Rickets
2.Obesity
3.Anemia
4.Rumination - ANSWER: 2. Obesity
Obesity is a common nutritional problem of children with Down syndrome. It is
thought to be related to excessive caloric intake and impaired growth. Rickets is a
nutritional disorder related to vitamin D deficiency; it is usually not encountered in
these children. Anemia is the most common nutritional problem in children with iron
deficiency. Rumination is an eating disorder of infancy characterized by repeated
regurgitation without a gastrointestinal illness.
The mother of a 2-year-old child tells the nurse that she is concerned about her
child's vision. What behavior when the child is tired leads the nurse to suspect
strabismus?
1 One eyelid droops.
2Both eyes look cloudy.
3One eye moves inward.
4Both eyes blink excessively - ANSWER: 3. One eye moves inward
,An inward moving eye (tropia) is one form of strabismus. A drooping eyelid is called
ptosis; it may be congenital or caused by trauma. Cloudy eyes are associated with
congenital cataracts. Blinking may be a tic.
A child is being treated with oral ampicillin (Omnipen) for otitis media. What should
be included in the discharge instructions that the nurse provides to the parents of
the client?
1. Complete the entire course of antibiotic therapy.
2. Herbal fever remedies are highly discouraged.
3.Administer the medication with meals.
4.Stop the antibiotic therapy when the child no longer has a fever. - ANSWER: 1.
Complete the entire course of antibiotic therapy
Once antibiotics therapy is initiated, the antibiotics start to destroy specific bacterial
infections that the health care provider is trying to treat. Antibiotic therapy takes a
specific dose and number of days to completely eliminate the bacteria. If the
caregivers start a dose and stop it before the course is complete, the remaining
bacteria has a chance to grow again, become resistant to antibiotic treatment, and
multiply. The nurse should not discourage use of herbal fever remedies; however the
herbal treatment should be reviewed to see if it is contraindicated. Ampicillin should
be taken 1 to 2 hours after meals. Antibiotic therapy should be completed as
prescribed.
View Topics
The parents of an 18-month-old toddler are anxious to know why their child has
experienced several episodes of acute otitis media. What should the nurse explain to
the parents about why toddlers are prone to middle ear infections?
1.Immunological differences between adults and young children
2.Structural differences between eustachian tubes of younger and older children
3.Functional differences between eustachian tubes of younger and older children
4.Circumference differences between middle ear cavity size of adults and young
children - ANSWER: 2. Structural differences b/w Eustachian tubes of younger and
older children.
The eustachian tube in young children is shorter and wider, allowing a reflux of
nasopharyngeal secretions. Immunological differences are not a factor in the
development of otitis media. There is no difference in the function of the eustachian
tube among age groups. The size of the middle ear does not play a role in the
occurrence of otitis media in young children.
,A 9-year-old child has a fractured tibia, and a full leg cast is applied. Which
assessment findings should the nurse immediately report to the health care
provider? Select all that apply.
1. Inability to move the toes
2.Increased urine output
3.Pedal pulse of 90 beats/min
4.Tingling sensation in the foot
5.Fiberglass cast that is damp after 4 hours - ANSWER: 1, 4 & 5
A cast is not flexible and can inhibit circulation. Cold toes, loss of sensation in toes,
pain, and inability to move the toes should be reported immediately. A tingling
sensation in the foot may indicate excessive pressure on the nerves and circulatory
system in the casted extremity. A fiberglass cast dries within minutes; if it remains
damp, it should be reported before 4 hours have elapsed. Increased urine output is
not significant; it may be related to increased fluid intake. The expected pulse rate
for a 9-year-old child ranges from 70 to 110 beats/min.
A nurse is helping a 7-year-old child with juvenile idiopathic arthritis (JIA) perform
range-of-motion exercises. What outcome indicates that the exercises have been
effective?
1.The knees are more mobile.
2.The pedal pulses become stronger.
3.Subcutaneous nodules at the joints recede.
4.The child states that the pain is diminished. - ANSWER: 1. The knees are more
mobile.
The exercises are done to preserve function by mobilizing restricted joints.
Circulation is not affected by the arthritic process. Exercises are done to restore joint
function; they do not necessarily relieve pain. Exercise does not affect the
subcutaneous nodules in the joints.
A 9-year-old child who has had type 1 diabetes for several years is brought to the
emergency department of a community hospital. The child is exhibiting deep, rapid
respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst.
What blood pH and glucose level does the nurse expect the laboratory tests to
reveal?
1.7.20 and 60 mg/dL
2.7.50 and 60 mg/dL
3.7.50 and 460 mg/dL
4.7.20 and 460 mg/dL - ANSWER: 4. 7.20 and 460 mg/dL
A pH of 7.20 and blood glucose level of 460 mg/dL are expected values in
ketoacidosis; the pH of 7.20 indicates acidosis (metabolic) and the blood glucose
level of 460 mg/dL is higher than the expected range of 90 to 110 mg/dL. Although
, the blood pH of 7.20 indicates acidosis, the blood glucose of 60 mg/dL is less than
the expected range of 90 to 110 mg/dL, indicating hypoglycemia rather than
hyperglycemia. Neither the pH of 7.50 nor the blood glucose value of 60 mg/dL is
expected with ketoacidosis; with ketoacidosis, the pH is decreased and the blood
glucose level is increased. Although the blood glucose is increased with ketoacidosis,
the pH is decreased, not increased; a pH of 7.50 indicates alkalosis.
What clinical indicators should a nurse expect when assessing a client with
hyperthyroidism? Select all that apply.
1. Dry Skin
2. Weight loss
3.Tachycardia
4.Restlessness
5.Constipation
6.Exophthalmos - ANSWER: 2, 3, 4 & 6
Weight loss is associated with hyperthyroidism because of the increase in the
metabolic rate. Muscle weakness and wasting also occur. Tachycardia, palpitations,
increased systolic blood pressure, and dysrhythmias occur with hyperthyroidism
because of the increased metabolic rate. Restlessness and insomnia are also
associated with hyperthyroidism because of the increased metabolic rate. Protrusion
of the eyeballs occurs with hyperthyroidism because of peribulbar edema. Dry,
coarse, scaly skin occurs with hypothyroidism, not hyperthyroidism, because of
decreased glandular function. Smooth, warm, moist skin occurs with
hyperthyroidism. Constipation is associated with hypothyroidism. Increased stools
and diarrhea are associated with hyperthyroidism.
What should the nurse teach parents about their newborn's diagnosis of
phenylketonuria (PKU)?
1.A low-phenylalanine diet is required.
2.Phenylalanine is not necessary for growth.
3.Phenylalanine can be administered to correct the deficiency.
4.A substitute for phenylalanine is an increased amount of other amino acids. -
ANSWER: 1.A low-phenylalanine diet is required
Reducing dietary phenylalanine helps prevent brain damage. The PKU diet is planned
to maintain the serum phenylalanine level at 2 to 8 mg/100 mL. Phenylalanine is
essential for growth and development of the brain. Administering phenylalanine is
contraindicated. There are no substitute for phenylalanine, which is one of the
essential amino acids.
A child with recently diagnosed idiopathic scoliosis has a mild structural curve. The
child's mother asks whether the problem can be corrected with exercise. What
should the nurse tell the mother concerning an exercise program?
A 12-year-old child with Down syndrome is admitted to the hospital for intravenous
antibiotics for pneumonia. Which clinical findings associated with Down syndrome
should the nurse expect when performing a physical assessment? Select all that
apply.
1. Saddle nose
2. Thin fingers
3. Inner epicanthic folds
4. Hypertonic musculature
5. Transverse palmar crease - ANSWER: 1.Saddle Nose
2.Inner epicanthic folds
3.Transverse palmar crease
Children with Down syndrome have a broad nose with a depressed bridge (saddle
nose), as well as inner epicanthic folds, and oblique palpebral fissures; they also have
speckling of the iris (Brushfield spots). Children with Down syndrome have a
transverse palmar crease (simian crease) formed by fusion of the proximal and distal
palmar creases. These children also have broad, short, stubby hands and feet.
Children with Down syndrome have hypotonic, not hypertonic, musculature.
A nurse plans to discuss childhood nutrition with a group of parents whose children
have Down syndrome in an attempt to minimize a common nutritional problem.
What problem should be addressed?
1.Rickets
2.Obesity
3.Anemia
4.Rumination - ANSWER: 2. Obesity
Obesity is a common nutritional problem of children with Down syndrome. It is
thought to be related to excessive caloric intake and impaired growth. Rickets is a
nutritional disorder related to vitamin D deficiency; it is usually not encountered in
these children. Anemia is the most common nutritional problem in children with iron
deficiency. Rumination is an eating disorder of infancy characterized by repeated
regurgitation without a gastrointestinal illness.
The mother of a 2-year-old child tells the nurse that she is concerned about her
child's vision. What behavior when the child is tired leads the nurse to suspect
strabismus?
1 One eyelid droops.
2Both eyes look cloudy.
3One eye moves inward.
4Both eyes blink excessively - ANSWER: 3. One eye moves inward
,An inward moving eye (tropia) is one form of strabismus. A drooping eyelid is called
ptosis; it may be congenital or caused by trauma. Cloudy eyes are associated with
congenital cataracts. Blinking may be a tic.
A child is being treated with oral ampicillin (Omnipen) for otitis media. What should
be included in the discharge instructions that the nurse provides to the parents of
the client?
1. Complete the entire course of antibiotic therapy.
2. Herbal fever remedies are highly discouraged.
3.Administer the medication with meals.
4.Stop the antibiotic therapy when the child no longer has a fever. - ANSWER: 1.
Complete the entire course of antibiotic therapy
Once antibiotics therapy is initiated, the antibiotics start to destroy specific bacterial
infections that the health care provider is trying to treat. Antibiotic therapy takes a
specific dose and number of days to completely eliminate the bacteria. If the
caregivers start a dose and stop it before the course is complete, the remaining
bacteria has a chance to grow again, become resistant to antibiotic treatment, and
multiply. The nurse should not discourage use of herbal fever remedies; however the
herbal treatment should be reviewed to see if it is contraindicated. Ampicillin should
be taken 1 to 2 hours after meals. Antibiotic therapy should be completed as
prescribed.
View Topics
The parents of an 18-month-old toddler are anxious to know why their child has
experienced several episodes of acute otitis media. What should the nurse explain to
the parents about why toddlers are prone to middle ear infections?
1.Immunological differences between adults and young children
2.Structural differences between eustachian tubes of younger and older children
3.Functional differences between eustachian tubes of younger and older children
4.Circumference differences between middle ear cavity size of adults and young
children - ANSWER: 2. Structural differences b/w Eustachian tubes of younger and
older children.
The eustachian tube in young children is shorter and wider, allowing a reflux of
nasopharyngeal secretions. Immunological differences are not a factor in the
development of otitis media. There is no difference in the function of the eustachian
tube among age groups. The size of the middle ear does not play a role in the
occurrence of otitis media in young children.
,A 9-year-old child has a fractured tibia, and a full leg cast is applied. Which
assessment findings should the nurse immediately report to the health care
provider? Select all that apply.
1. Inability to move the toes
2.Increased urine output
3.Pedal pulse of 90 beats/min
4.Tingling sensation in the foot
5.Fiberglass cast that is damp after 4 hours - ANSWER: 1, 4 & 5
A cast is not flexible and can inhibit circulation. Cold toes, loss of sensation in toes,
pain, and inability to move the toes should be reported immediately. A tingling
sensation in the foot may indicate excessive pressure on the nerves and circulatory
system in the casted extremity. A fiberglass cast dries within minutes; if it remains
damp, it should be reported before 4 hours have elapsed. Increased urine output is
not significant; it may be related to increased fluid intake. The expected pulse rate
for a 9-year-old child ranges from 70 to 110 beats/min.
A nurse is helping a 7-year-old child with juvenile idiopathic arthritis (JIA) perform
range-of-motion exercises. What outcome indicates that the exercises have been
effective?
1.The knees are more mobile.
2.The pedal pulses become stronger.
3.Subcutaneous nodules at the joints recede.
4.The child states that the pain is diminished. - ANSWER: 1. The knees are more
mobile.
The exercises are done to preserve function by mobilizing restricted joints.
Circulation is not affected by the arthritic process. Exercises are done to restore joint
function; they do not necessarily relieve pain. Exercise does not affect the
subcutaneous nodules in the joints.
A 9-year-old child who has had type 1 diabetes for several years is brought to the
emergency department of a community hospital. The child is exhibiting deep, rapid
respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst.
What blood pH and glucose level does the nurse expect the laboratory tests to
reveal?
1.7.20 and 60 mg/dL
2.7.50 and 60 mg/dL
3.7.50 and 460 mg/dL
4.7.20 and 460 mg/dL - ANSWER: 4. 7.20 and 460 mg/dL
A pH of 7.20 and blood glucose level of 460 mg/dL are expected values in
ketoacidosis; the pH of 7.20 indicates acidosis (metabolic) and the blood glucose
level of 460 mg/dL is higher than the expected range of 90 to 110 mg/dL. Although
, the blood pH of 7.20 indicates acidosis, the blood glucose of 60 mg/dL is less than
the expected range of 90 to 110 mg/dL, indicating hypoglycemia rather than
hyperglycemia. Neither the pH of 7.50 nor the blood glucose value of 60 mg/dL is
expected with ketoacidosis; with ketoacidosis, the pH is decreased and the blood
glucose level is increased. Although the blood glucose is increased with ketoacidosis,
the pH is decreased, not increased; a pH of 7.50 indicates alkalosis.
What clinical indicators should a nurse expect when assessing a client with
hyperthyroidism? Select all that apply.
1. Dry Skin
2. Weight loss
3.Tachycardia
4.Restlessness
5.Constipation
6.Exophthalmos - ANSWER: 2, 3, 4 & 6
Weight loss is associated with hyperthyroidism because of the increase in the
metabolic rate. Muscle weakness and wasting also occur. Tachycardia, palpitations,
increased systolic blood pressure, and dysrhythmias occur with hyperthyroidism
because of the increased metabolic rate. Restlessness and insomnia are also
associated with hyperthyroidism because of the increased metabolic rate. Protrusion
of the eyeballs occurs with hyperthyroidism because of peribulbar edema. Dry,
coarse, scaly skin occurs with hypothyroidism, not hyperthyroidism, because of
decreased glandular function. Smooth, warm, moist skin occurs with
hyperthyroidism. Constipation is associated with hypothyroidism. Increased stools
and diarrhea are associated with hyperthyroidism.
What should the nurse teach parents about their newborn's diagnosis of
phenylketonuria (PKU)?
1.A low-phenylalanine diet is required.
2.Phenylalanine is not necessary for growth.
3.Phenylalanine can be administered to correct the deficiency.
4.A substitute for phenylalanine is an increased amount of other amino acids. -
ANSWER: 1.A low-phenylalanine diet is required
Reducing dietary phenylalanine helps prevent brain damage. The PKU diet is planned
to maintain the serum phenylalanine level at 2 to 8 mg/100 mL. Phenylalanine is
essential for growth and development of the brain. Administering phenylalanine is
contraindicated. There are no substitute for phenylalanine, which is one of the
essential amino acids.
A child with recently diagnosed idiopathic scoliosis has a mild structural curve. The
child's mother asks whether the problem can be corrected with exercise. What
should the nurse tell the mother concerning an exercise program?
