2025 WITH LATEST VERIFIED
QUESTIONS AND 100% CORRECT
ANSWERS ALREADY GRADED A+
Priority finding to report for a brain tumor= - ANS-Increased intracranial pressure (ICP)
A nurse is caring for an adolescent who has sustained a closed head injury. Which of the following are
clinical manifestations of increased intracranial pressure (ICP)? Select all.
A. Report of headache
B. Alteration in pupillary response
C. Increased motor response
D. Increased sleeping
E. Increased sensory response - ANS-A, B, D
Not C-decreased motor response is a sign of ICP, Not E-decreased sensory response is a sign of ICP
indications of protein deficiency include... - ANS--skin breakdown
-delayed wound healing
,-infections
-organ failure
-ulcers
-impaired med tolerance
Age appropriate response to death: birth to 3 yrs= - ANS-regression
They have little to no concept of death, egocentric, and will mirror the parents emotion
Age appropriate response to death: Preschool age 3-6yrs= - ANS-death is similar to sleep-death is
temporary
What are the clinical manifestations of ICP in infants? - ANS-Bulging fontanel, separation of cranial
sutures, irritability, increased sleeping, high-pitched cry, poor feeding & setting-sun sign
What are the clinical manifestations of ICP in children? - ANS-nausea, vomiting, headache, blurred
vision, increased sleeping, inability to follow simple commands, & seizures
Home safety for infants: hot water thermostats should be set at or below= - ANS-49 C (120 F)
Home safety for infants: crib slats should be no farther apart than= - ANS-6 cm (2.375 in)
Home safety for infants: Crib mobiles or crib gyms should be removed by= - ANS-4 to 5 months of age
What is Pediculosis capitis? - ANS-head lice
What are the clinical manifestations of pediculosis capitis? - ANS--small red bumps on the scalp
-intense itching
-nits (white specks) on the hair shaft
A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following should the
nurse include in the teaching?
, A. Apply mayonnaise to the affected area at night
B. Treat all household pets
C. Use an over-the-counter medication containing 1% permethrin
D. Discard the child's stuffed animals - ANS-C. Pediculosis capitis is treated w/1% permethrin, which can
be purchased over the counter
It does not affect pets, it is transmitted person to person. Home remedies like mayo increase the risk of
infection & should be avoided. Items such as stuffed animals that cannot be placed in the laundry can be
sealed in a bag for 14 days to kill the lice.
Restraining methods for an infant include... - ANS--non-nutritive sucking (sugar pacifier) prior, during, &
after procedure
-allow the parents to stay
-swaddle
-therapeutic holding
-use a 24-29 gauge catheter
-apply EMLA topical to multiple sites prior to injection
A nurse is providing anticipatory guidance to the parents of a toddler. Which of the following should the
nurse include? Select all.
A. Develop food habits that will prevent dental caries
B. Meeting caloric needs results in an increased appetite
C. Expression of bedtime fears is common
D. Expect behaviors associated w/negativism & ritualism
E. Annual screenings for phenylketouria are important - ANS-A, C, D
Not B because toddlers often experience physiologic anorexia & become fussy eaters because of a
decreased appetite
Not E because screening for this is for the newborn.