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Question
The mother of a 16-year-old child with multiple medical and developmental issues says to the nurse: "There are times that I think about just walking out of the house and not coming back." Which would be an appropriate nursing diagnosis for this mother?
1. Caregiver role strain related to providing 24-hour care for a child with medical and developmental issues
2. Risk for injury (maternal) related to overwhelming demands of the medically fragile child
3. Knowledge deficit (maternal) nursing care of the child
4. Health seeking behaviors (maternal) related to interest in learning to care for her child
Answer
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Related questions
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A three-year-old child is suspected of having Hirschsprung's disease. Which assessment factors would support such a medical diagnosis?
1. Clay-colored stools and dark urine
2. History of early passage of meconium in the newborn period
3. History of chronic, progressive constipation and failure to gain weight
4. Continual bouts of foul-smelling diarrhea
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The 10-year-old boy is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. The nurse will assess the child with which symptoms related to this brain tumor?
Standard Text: Select all that apply.
1. Evening nausea
2. Excessive urination leading to dehydration
3. Nystagmus
4. Headaches
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The ten-year-old child was diagnosed with a medulloblastoma; following surgery the child is started on chemotherapy by intrathecal injection. While preparing the family for the start of chemotherapy, the nurse will explain that intrathecal administration was chosen because:
1. It reduces side effects.
2. It does not require the child being "stuck."
3. Many chemotherapy drugs do not cross the blood-brain barrier.
4. Intrathecal administration is less expensive than intravenous administration.
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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?
1. The girl complains of pain in the missing leg.
2. When physical therapy comes, she is willing to have her temporary prosthetic applied and attempts crutch training.
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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.
3. A protocol is used in children but not adults due to the chemotherapy's effect on growth.
4. A protocol involves a group of drugs that work in different modes and have different side effects.
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The nurse is explaining to the mother that her child with cancer will receive chemotherapy daily for one month and then no treatments for six weeks. Following the period of rest, chemotherapy will be administered again for another month. The mother asks why the child can"t receive the medication for two months straight. The nurse would explain that the rest period:
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3. Is necessary because receiving the medication for more than one month can cause heart failure.
4. Allows normal cells to repair themselves while the cancer cells die.
Q:
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.
2. Continue to include the family in planning care and assure them that the child will be kept comfortable in the days to come.
3. Initiate a Social Services referral.
4. Contact the on-call chaplain for consultation with the entire family and ask him to take the father aside for additional assistance.
Q:
The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It should be administered:
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2. Before chemotherapy administration, as a prophylactic measure.
3. After the chemotherapy has been administered.
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2. The child's vitamin C consumption is limited after one year of age.
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A seven-year-old girl has been diagnosed with rheumatic fever. The physician has talked with the parents and child and explained the disease and the planned medical treatment. Which statement by the parents needs further clarification?
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The nurse knows that the mother of a six-year-old needs more teaching about her son's diagnosis of ADHD when she states:
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Q:
When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks for injury to the child. Which observation will the nurse discuss with the mother?
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Standard Text: Select all that apply.
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A young child admitted to the pediatric unit has fever, irritability, and vomiting. The physician suspects bacterial meningitis. The nurse would expect the cerebrospinal fluid (CSF) to show:
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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.
2. The infant has good head control when held upright.
3. The infant is able to roll only from abdomen to back.
4. The anterior fontanel is open and soft.
Q:
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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.
4. Inject insulin when it is cold.
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
2. Sweating, photophobia, and tremors
3. Dry mucous membranes, blurred vision, and weakness
4. Dry skin, shallow rapid breathing, and dehydration
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