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Question
A child who is medically fragile is being discharged home after a long hospital stay. The child will require someone to provide medical treatments several times a day. In planning discharge, the nurse will:
1. Train all members of the family to take part in the child's care.
2. Plan for a home health nurse to visit the child four times a day to provide the medical treatment.
3. Determine with the family which family members may be trained to provide care for the child.
4. Evaluate the size of the child's room for therapy.
Answer
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Following diagnosis of osteosarcoma, a 14-year-old girl has a below-the-knee amputation. The girl has had trouble accepting the reality of her amputation. Which behavior, when observed by the nurse, indicates she is beginning to accept the amputation?
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A child has been diagnosed with Ewing sarcoma and is being started on a chemotherapy protocol. The mother questions the nurse on why more than one drug is being used as it would seem that using fewer drugs would decrease the side effects. The best response by the nurse would include the information that:
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2. A protocol is a proven means of treatment.
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During rounds, the interdisciplinary team is discussing the care of a child with a newly diagnosed Wilms' tumor. The nurse describes the mother as being angry and upset that they are not caring properly for her child. What behavior probably is the cause of the mother's anger?
1. The mother is beginning the stages of grief over loss of her previously well child.
2. The mother is feeling guilty for not recognizing that the child was ill.
3. The nurses are negligent in providing safe care for the child.
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After years of treatment with chemotherapy and radiation, a child with a brain tumor is shown to be refractory to treatment, and a DNR (Do Not Resuscitate) has been obtained. The mother has reached the stage of acceptance; the father is angry that the medical and nursing team has not been able to "save" his child. How would the multidisciplinary team best support this family?
1. Tell the father that he should have brought his child in earlier for treatment.
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3. Initiate a Social Services referral.
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The nurse is doing an assessment on a four-month-old infant. Which assessment finding would the nurse consider abnormal?
1. The posterior fontanel is open.
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4. The anterior fontanel is open and soft.
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Q:
The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions to minimize pain will the nurse include in the teaching?
Standard Text: Select all that apply.
1. Do not reuse needles.
2. Remove all bubbles from the syringe before injecting.
3. Have the child flex the muscle during injection.
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5. Do not change the direction of the needle during insertion or withdrawal.
Q:
A teenager has arrived in the emergency department (ED) with confusion. The physician suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 76l5 mg/dL. The nurse expects that this teen has which symptoms?
1. Tachycardia, dehydration, and abdominal pain
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Q:
The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which of the physician's orders should the nurse question?
1. Neurological checks hourly
2. Insert urinary catheter and measure output hourly.
3. NPH insulin IV at 0.1 units/kg per hour
4. Stat serum electrolytes
Q:
A five-year-old with a history of being treated for hypopituitarism comes to the physician with complaints of right hip and leg pain. The nurse understands that this symptom might be related to which medication that is used to treat hypopituitarism?
1. Daily growth hormone
2. Insulin before meals and bedtime
3. DDAVP (desmopressin acetate) at HS
4. Cortisone injections