Child Health Nursing (NURS 4140) Final Exam Questions & Answers (Explained Solutions)

Child Health Nursing (NURS 4140) Final Exam Questions & Answers (Explained Solutions)
The nurse is caring for a special needs infant. Which intervention will be most important
in helping the child reach her maximum developmental potential?
A. Monitoring her progress in elementary school
B. Directing her parents to an early intervention program
C. Serving on an individualized education program committee
D. Preparing a plan for her to transition to college - B.
Early intervention is critical to maximizing the child's developmental potential by laying
the foundation for health and development. While important, intervention in elementary
or secondary school does not have the impact of early intervention. When the time
arrives, it is important to have a written plan for transition to college, if this is a
possibility for the grown child.
A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's
laboratory test results would reveal which of the following?
A. Respiratory acidosis and proteinuria
B. Decreased blood urea nitrogen (BUN) and creatinine
C. Hypernatremia and hypokalemia
D. Decreased platelets and leukocytosis - D.
The child with HUS typically exhibits severe thrombocytopenia (decreased platelets) and
leukocytosis. BUN and creatinine are elevated. Hyponatremia, hyperkalemia, metabolic
acidosis, and proteinuria also may be noted.
A 2-month-old infant is admitted with suspected Spinal Muscular Atrophy. Which of the
following findings is the nurse likely to assess?
Select one or more
a. Scoliosis
b. Generalized weakness
c. Low weight-to-length ratio
d. Weak cry - B. C. D.
A 2-year-old has a tonic-clonic seizure while in the hospital crib. The child's jaws are
clamped. Which is the most important nursing action at this time?
a. Place a padded tongue blade between the child's jaws.
b. Restrain the child to prevent injury.
c. Prepare the suction equipment.
d. Stay with the child and observe his respiratory status. - D.
It is important for the nurse to stay with the child to assess for any changes in the child's
respiratory status. Place the child in side-lying position, if possible, to allow secretions to
drain. Monitor for adequate oxygenation. The child is at risk for hypoxic injury if the
respiratory status is compromised.
A 15-year-old boy comes to the emergency department accompanied by his parents. The
boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked
to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states, "It's a
12." Further assessment reveals a blue-black swelling on the affected side. The nurse
suspects testicular torsion and immediately notifies the physician based on the
understanding of which of the following?
A. The condition is a surgical emergency.
B. Renal failure is imminent.
C. Intravenous antibiotics need to be initiated
D. The boy is at risk for sepsis. - A.
Testicular torsion is a surgical emergency that necessitates immediate surgical correction
to prevent testicular necrosis and possible gangrene. There is no infection with testicular
torsion, intravenous antibiotics are not used to treat this condition, and renal failure is not
imminent.
Ordered: IV + PO to equal maintenance
Child's weight: 6.3 kg
IVF ran at full maintenance all night while the child slept. At 0800, child drinks 46 mL
formula. Adjust the rate for the next four hours. - 6.3 kg * 100ml/day = 630 ml/day =
maintenance = 26.3 ml/hour
4 hours worth = 105.2
Minus the 46 the child took po = 59.2 to be made up with IVF/4 hours = 14.8 ml/hr
The nurse assesses a child's level of consciousness, noting that the child falls asleep
unless he is stimulated. The nurse documents this finding as:
A. Confusion
B. Obtunded
C. Stupor
D. Coma - B.
Obtunded is a state in which the child has limited responses to the environment and falls
asleep unless stimulation is provided. Confusion involves disorientation; the child may be
alert but responds inappropriately to questions. Stupor exists when the child responds
only to vigorous stimulation. Coma is a state in which the child cannot be aroused even
with painful stimuli.
Ordered: D5 1/2 NS with 20 mEq KCl/L at maintenance.

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