Chapter 27 Principles of Pediatric Nursing 6th Ed By Ball

Chapter 27 Principles of Pediatric Nursing 6th Ed By Ball

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A child is diagnosed with epilepsy and is prescribed daily phenytoin (Dilantin). Which topic is most appropriate for the nurse to include in the discharge teaching?

1. Increasing fluid intake
2. Performing good dental hygiene
3. Decreasing intake of vitamin D
4. Taking the medication with milk

Correct Answer: 2

Rationale 1: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drug’s effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

Rationale 2: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drug’s effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

Rationale 3: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drug’s effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

Rationale 4: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drug’s effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

Global Rationale: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drug’s effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 27.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

 

Question 2

Type: MCSA

A toddler-age client has a tonic-clonic seizure while in a crib in the hospital. The client’s jaw is clamped. Which nursing action is the priority?

1. Place a padded tongue blade between the child’s jaws.
2. Stay with the child and observe the respiratory status.
3. Prepare the suction equipment.
4. Restrain the child to prevent injury.

Correct Answer: 2

Rationale 1: During a seizure, the nurse remains with the child, watching for complications. The child’s respiratory rate should be monitored. Be sure nothing is placed in the child’s mouth during a seizure. Suction equipment should already be set up at the bedside before a seizure begins. The child should not be restrained during a seizure.

Rationale 2: During a seizure, the nurse remains with the child, watching for complications. The child’s respiratory rate should be monitored. Be sure nothing is placed in the child’s mouth during a seizure. Suction equipment should already be set up at the bedside before a seizure begins. The child should not be restrained during a seizure.

Rationale 3: During a seizure, the nurse remains with the child, watching for complications. The child’s respiratory rate should be monitored. Be sure nothing is placed in the child’s mouth during a seizure. Suction equipment should already be set up at the bedside before a seizure begins. The child should not be restrained during a seizure.

Rationale 4: During a seizure, the nurse remains with the child, watching for complications. The child’s respiratory rate should be monitored. Be sure nothing is placed in the child’s mouth during a seizure. Suction equipment should already be set up at the bedside before a seizure begins. The child should not be restrained during a seizure.

Global Rationale: During a seizure, the nurse remains with the child, watching for complications. The child’s respiratory rate should be monitored. Be sure nothing is placed in the child’s mouth during a seizure. Suction equipment should already be set up at the bedside before a seizure begins. The child should not be restrained during a seizure.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 27.3 Differentiate between the signs of a seizure and status epilepticus in infants and children, and describe appropriate nursing management for each condition.

 

Question 3

Type: MCSA

A lumbar puncture is performed on an infant suspected of having meningitis. Which finding does the nurse expect in the cerebral spinal fluid if the infant has meningitis?

1. Elevated white blood cell count
2. Elevated red blood cell count
3. Normal glucose
4. Decreased white blood cell count

Correct Answer: 1

Rationale 1: The lumbar puncture is done to obtain cerebral spinal fluid (CSF). Elevated white blood cell count is seen with bacterial meningitis. The red blood cell count is not elevated, and the glucose is decreased in meningitis.

Rationale 2: The lumbar puncture is done to obtain cerebral spinal fluid (CSF). Elevated white blood cell count is seen with bacterial meningitis. The red blood cell count is not elevated, and the glucose is decreased in meningitis.

Rationale 3: The lumbar puncture is done to obtain cerebral spinal fluid (CSF). Elevated white blood cell count is seen with bacterial meningitis. The red blood cell count is not elevated, and the glucose is decreased in meningitis.

Rationale 4: The lumbar puncture is done to obtain cerebral spinal fluid (CSF). Elevated white blood cell count is seen with bacterial meningitis. The red blood cell count is not elevated, and the glucose is decreased in meningitis.

Global Rationale: The lumbar puncture is done to obtain cerebral spinal fluid (CSF). Elevated white blood cell count is seen with bacterial meningitis. The red blood cell count is not elevated, and the glucose is decreased in meningitis.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 27.4 Differentiate between signs of bacterial meningitis, viral meningitis, encephalitis, Reye syndrome, and Guillain-Barré syndrome in infants and children.

 

Question 4

Type: MCSA

The nurse is planning care for a school-age child diagnosed with bacterial meningitis. Which intervention is most appropriate?

1. Keeping environmental stimuli at a minimum
2. Avoiding giving pain medications that could dull sensorium
3. Measuring head circumference to assess developing complications
4. Having the child move the head from side to side at least every two hours

Correct Answer: 1

Rationale 1: A quiet environment should be maintained because noise can disturb a child with meningitis. Pain medications are appropriate to give and should be used when needed. Measuring head circumference would only be appropriate for a child less than 2 years. Excessive head movement should be avoided because it can increase irritation of the meninges.

Rationale 2: A quiet environment should be maintained because noise can disturb a child with meningitis. Pain medications are appropriate to give and should be used when needed. Measuring head circumference would only be appropriate for a child less than 2 years. Excessive head movement should be avoided because it can increase irritation of the meninges.

Rationale 3: A quiet environment should be maintained because noise can disturb a child with meningitis. Pain medications are appropriate to give and should be used when needed. Measuring head circumference would only be appropriate for a child less than 2 years. Excessive head movement should be avoided because it can increase irritation of the meninges.

Rationale 4: A quiet environment should be maintained because noise can disturb a child with meningitis. Pain medications are appropriate to give and should be used when needed. Measuring head circumference would only be appropriate for a child less than 2 years. Excessive head movement should be avoided because it can increase irritation of the meninges.

Global Rationale: A quiet environment should be maintained because noise can disturb a child with meningitis. Pain medications are appropriate to give and should be used when needed. Measuring head circumference would only be appropriate for a child less than 2 years. Excessive head movement should be avoided because it can increase irritation of the meninges.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 27.4 Differentiate between signs of bacterial meningitis, viral meningitis, encephalitis, Reye syndrome, and Guillain-Barré syndrome in infants and children.

 

Question 5

Type: MCSA

A nurse is conducting a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would indicate a malfunction in the shunt?

1. Incisional pain
2. Movement of all extremities
3. Negative Brudzinski sign
4. Bulging fontanel

Correct Answer: 4

Rationale 1: A bulging fontanel would be an abnormal finding and could indicate that the shunt is malfunctioning. Incisional pain, movement of all extremities, and negative Brudzinski sign are all normal findings after a ventriculoperitoneal shunt has been placed.

Rationale 2: A bulging fontanel would be an abnormal finding and could indicate that the shunt is malfunctioning. Incisional pain, movement of all extremities, and negative Brudzinski sign are all normal findings after a ventriculoperitoneal shunt has been placed.

Rationale 3: A bulging fontanel would be an abnormal finding and could indicate that the shunt is malfunctioning. Incisional pain, movement of all extremities, and negative Brudzinski sign are all normal findings after a ventriculoperitoneal shunt has been placed.

Rationale 4: A bulging fontanel would be an abnormal finding and could indicate that the shunt is malfunctioning. Incisional pain, movement of all extremities, and negative Brudzinski sign are all normal findings after a ventriculoperitoneal shunt has been placed.

Global Rationale: A bulging fontanel would be an abnormal finding and could indicate that the shunt is malfunctioning. Incisional pain, movement of all extremities, and negative Brudzinski sign are all normal findings after a ventriculoperitoneal shunt has been placed.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 27.5 Develop a nursing care plan for the infant with hydrocephalus and spina bifida.