PEDS FINAL EXAM QUESTIONS WITH ANSWERS PERFECTLY VERIFIED UPDATES, Exams of Nursing

Download PEDS FINAL EXAM QUESTIONS WITH ANSWERS PERFECTLY VERIFIED UPDATES and more Exams Nursing in PDF only on Docsity! 1 PEDS FINAL EXAM QUESTIONS WITH ANSWERS PERFECTLY VERIFIED UPDATES MORBIDITY/MORTALITY STATISTICS: The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? -The United States is ranked last among 27 countries. Which is the leading cause of death in infants younger than 1 year in the United States? -congenital anomalies What is the major cause of death for children older than 1 year in the United States? -Unintentional injuries In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? -Suicide and homicide The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries? -more deaths occur in males What do mortality statistics describe? -the number of individuals who have died over a specific period The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? -late school age and adolescents Parents of a hospitalized toddler ask the nurse, what is meant by family-centered care? The nurse should respond with which statement? -Family-centered care recognizes that the family is the constant in a child’s life The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which? -95th percentile The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) -hypertension, dyslipidemia, and altered glucose metabolism COMPLICATIONS OF JAUNDICE What is an infant with severe jaundice at risk for developing? -encephalopathy 2 When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant? -2-4 days Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant? -institute early and frequent feedings What is an important nursing intervention for a full-term infant receiving phototherapy? -observing for signs of dehydration When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease? -within 24 hours after birth The nurse is caring for an infant who will be discharged on home phototherapy. What instructions should the nurse include in the discharge teaching to the parents? -Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy IMMUNIZATIONS Pertussis vaccination should begin at which age? -2 months A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain? -A topical anesthetic can be applied before injections are given. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which? -DTaP and IPV can be safely given Which serious reaction should the nurse be alert for when administering vaccines? -allergic reaction Which muscle is contraindicated for the administration of immunizations in infants and young children? -dorsogluteal The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination? -after 6 months The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? -the child has a disorder that causes a deficient immune system 5 A preterm infant has just been admitted to the neonatal intensive care unit. The infant’s parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse’s explanation be? -pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching? -we will respond matter-of-factly to requests for special attention NEPHROTIC SYNDROME What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome? -reduced serum albumin What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)? -minimize excretion of urinary protein A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child? -minimize risk of infection The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need? -restricting fluids A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child’s prognosis is related to what factor? -response to steroid therapy The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching? -I should not add additional salt to any of my child’s meals What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema? -elevate the scrotum with a rolled washcloth What do the clinical manifestations of minimal change nephrotic syndrome include? -massive proteinuria, hypoalbuminemia, and edema For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs? -diuresis occurs as urinary protein excretion diminishes 6 A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what? -we understand our child will not be able to attend school, so we will arrange for home schooling The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what? -2 to 3 years What dietary instructions should the nurse give to parents of a child with minimal change nephrotic syndrome with massive edema? (Select all that apply.) -no salt added at the table -restriction of foods high in sodium NURSING INTERVENTIONS FOR IV THERAPY The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first? -administer naloxone (Narcan) The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? -provides most rapid onset of effect, usually in about 5 minutes When caring for a child with an intravenous (IV) infusion, what is an appropriate nursing action? -check the insertion site frequently for signs of infiltration The nurse determines that a child’s intravenous infusion has infiltrated. The infused solution is a vesicant. What is the most appropriate nursing action? -end the infusion and notify the practitioner CYSTIC FIBROSIS Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? -mechanical obstruction caused by increased viscosity of mucous gland secretions What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? -Meconium ileus What tests aid in the diagnosis of cystic fibrosis (CF)? -sweat test, stool for fat, chest radiography 7 A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? -before chest physiotherapy (CPT) A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true? -may cause voice alterations The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition? -pneumothorax Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care? -pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal A child is in the hospital for cystic fibrosis. What health care providers prescription should the nurse clarify before implementing? -pancreatic enzymes every 6 hours In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? -diet should be high in calories, proteins, and unrestricted fats A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)? -greater than 60 mEq/L A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurse’s action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what? -needs to be increased to decrease the number of bowel movements per day RESPIRATORY INFECTIONS Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? -they are safer Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information? -do not use for more than 3 days 10 -everyone who has been in close contact with my child will need to be treated An 18-month-old child has been diagnosed with pediculosis capitis (head lice). Which prescription should the nurse question if ordered for the child? -Malathion (Ovide) Which of the following is an important nursing consideration when caring for a child with impetigo contagiosa? -carefully wash hands and maintain cleanliness when caring for an infected child Impetigo ordinarily results in which of the following? -no scarring Which of the following is the primary clinical manifestation of scabies? -pruritus BURNS Which of the following best describes a full-thickness (third-degree) burn? -destruction of all layers of skin evident with extension into subcutaneous tissue A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has: -an inhalation injury Which of the following explains physiologically the edema formation that occurs with burns? -increased capillary permeability The most immediate threat to life in children with thermal injuries is: -shock After the acute stage and during the healing process, the primary complication from burn injury is which of the following? -infection An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which of the following is important in her immediate care? -remove her burned clothing and jewelry A young child has sustained a minor burn to the foot. Which of the following is the best method to stop the burning process? -run under cool water A toddler sustains a minor burn on the hand from hot coffee. The first action in treating this burn is to: -hold burned area under cool running water 11 A high-protein diet for the child with major burns is ordered to: -avoid protein breakdown Fentanyl and midazolam (Versed) are given before debridement of a child's burn wounds. These drugs are important to: -provide pain relief Nitrous oxide is being administered to a child with extensive burn injuries. The purpose of this drug is to: -provide anesthesia Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds. What is the primary purpose of hydrotherapy? -debride the wounds What is a systemic response to severe burns in a child? -abrupt drop in CO What sign is one of the first to indicate overwhelming sepsis in a child with burn injuries? -disorientation What finding is the most reliable guide to the adequacy of fluid replacement for a small child with burns? -urinary output of 1-2 ml/kg of body weight/hour What is the nursing action related to the applying of biologic or synthetic skin coverings for a child with partial-thickness burns of both legs? -observe wounds for signs of infection What is an effective strategy to reduce the stress of burn dressing procedures? -involve the child and give choices What consideration is important for the nurse when changing dressings and applying topical medication to a child’s abdomen and leg burns? -wash hands and forearms before and after dressing change What is a strategy used to minimize scarring with burn injury in a child? -limitation of period without pressure to areas of scarring Prevention of burn injury is important anticipatory guidance. In the infant and toddler period, which mode is the most common cause of burn? -hot liquids in the kitchen 12 CHF What statement best identifies the cause of heart failure (HF)? -consequence of an underlying cardiac defect The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse’s response should be based on which knowledge? -parents need to learn specific, important guidelines for administration of digoxin What nutritional component should be altered in the infant with heart failure (HF)? -increase in calories Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant’s status, which finding is indicative of achieving this goal? -appropriate weight gain for age Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? -wheezing What medication used to treat heart failure (HF) is a diuretic? -Hydrochlorothiazide (Diuril) KAWASAKI DISEASE When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? -therapeutic management includes administration of gamma globulin and salicylates Nursing care of the child with Kawasaki disease is challenging because of which occurrence? -the child’s irritability A child is recovering from Kawasaki disease (KD). The child should be monitored for which? -ECG changes The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.) -cervical lymphadenopathy -strawberry tongue -erythematous palms PDA The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? -pulmonary vascular congestion 15 An infant with an isolated cleft lip is being bottle fed. Which actions should the nurse plan to implement to assist with the feeding? (Select all that apply.) -use an NUK nipple -use cheek support -position the infant upright HIRSCHSPRUNG DISEASE/INTUSSUSCEPTION/GER/PYLORIC STENOSIS What statement best describes Hirschsprung disease? -the colon has an aganglionic segment A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child? -it is essential because it will be an adjustment A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube? -prevent abdominal distention A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? -thicken feedings and enlarge the nipple hole After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time? -notify practitioner A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication? -metabolic alkalosis A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? -Hirschsprung disease A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include? -assessing bowel function The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time? -30 min before breakfast 16 The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include? (Select all that apply.) -hold the infant in prone position after feeding -prescribed Cimetidine should be given 30 min before feedings The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.) -passage of red, currant jellylike stools -tender, distended abdomen -sudden acute abdominal pain The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply.) -citrus -spicy foods -peppermint The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) -weight loss -projectile vomiting -the infant is hungry after vomiting The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.) -spitting up -failure to thrive -excessive crying -respiratory problems ACUTE APPENDICITIS What clinical manifestation should be the most suggestive of acute appendicitis? -colicky, cramping, abdominal pain around the umbilicus When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation? -sudden relief from pain The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation? -allow the child to assume a position of comfort The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) -fever 17 -vomiting -tachycardia What intervention is contraindicated in a suspected case of appendicitis? -enemas DIALYSIS The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause? -resentment of the control and enforcement imposed by dialysis What statement is an advantage of peritoneal dialysis compared with hemodialysis? -it is easy to learn and safe to perform What dietary instructions should the nurse give to parents of a child undergoing chronic hemodialysis? (Select all that apply.) -fluid restriction -sodium restriction -potassium restriction Parents of a child who will need hemodialysis ask the nurse, what are the advantages of a fistula over a graft or external access device for hemodialysis? What response should the nurse give? (Select all that apply.) -there are fewer complication w/ a fistula -there is less restriction of activity w/ a fistula -it produces dilation and thickening of the superficial vessels STI’S What statement is true about gonorrhea? -treatment of all sexual partners is essential What statement regarding chlamydial infections is correct? -both men and women may be asymptomatic It is important that women with anogenital warts caused by the human papillomavirus (HPV) receive adequate treatment because this sexually transmitted infection increases the risk of what? -cervical cancer HYDROCEPHALUS/PLAGIOCEPHALY What clinical manifestations suggest hydrocephalus in an infant? -bulging fontanel and dilated scalp veins 20 A child, age 10 years, has a neuroblastoma and is in the hospital for additional chemotherapy treatments. What laboratory values are most likely this child’s? -WBC 3,000/mm^3. Hemoglobin 11.5 g/dl The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma? -infant or toddler The nurse is collecting a 24-hour urine sample on a child with suspected diagnosis of neuroblastoma. What finding in the urine is expected with neuroblastomas? -Catecholamines The nurse is caring for a child with retinoblastoma that was treated with an enucleation. What interventions should the nurse plan for care of an eye socket after enucleation? (Select all that apply.) -change the eye pad daily -irrigate the socket daily w/ a prescribed solution -apply a prescribed antibiotic ointment after irrigation LEUKEMIA The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate? -stop the drug infusion After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention? -hydration Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention? -use good hand-washing A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments? -give an antiemetic before chemo A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try? -relax any eating pressures The nurse is caring for a child receiving chemotherapy for leukemia. The child’s granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child? -daily toothbrushing and flossing 21 What description identifies the pathophysiology of leukemia? -unrestricted proliferation of immature WBC’s A child with leukemia is receiving intrathecal chemotherapy to prevent which condition? -CNS damage A parent tells the nurse that 80% of children with the same type of leukemia as his sons have a 5- year survival. He believes that because another child on the same protocol as his son has just died, his son now has a better chance of success. What is the best response by the nurse? -each child has an 80% likelihood of 5-year survival The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, my child has a low platelet count, and we are being discharged this afternoon. What do I need to do at home? What statement is most appropriate for the nurse to make? -your child should avoid contact sports or activities that could cause bleeding What are favorable prognostic criteria for acute lymphoblastic leukemia? (Select all that apply.) -CALLA positive -early preB cell -2 to 10 years of age ANEMIA What physiologic defect is responsible for causing anemia? -decreased oxygen-carrying capacity of blood A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason? -increase her energy so she will not be so tired What explanation provides the rationale for why iron-deficiency anemia is common during infancy? -cow’s milk is a poor source of iron What statement best describes iron deficiency anemia in infants? -clinical manifestations are related to a reduction in the amount of oxygen available to tissues A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The child’s care should include which therapeutic interventions? -hydration and pain management In which condition are all the formed elements of the blood simultaneously depressed? -aplastic anemia For children who do not have a matched sibling bone marrow donor, the therapeutic management of aplastic anemia includes what intervention? -immunosuppressive therapy 22 The nurse is preparing a community outreach program about the prevention of iron-deficiency anemia in infants. What statement should the nurse include in the program? -breast milk or iron-fortified formula should be used for the first 12 months The nurse is caring for a school-age child with severe anemia and activity intolerance. What diversional activity should the nurse plan for this child? -playing board or card games What rationale explains why prolonged use of oxygen should be discouraged in a child with anemia? -prolonged use of oxygen can decrease erythropoiesis What are signs and symptoms of anemia? (Select all that apply.) -pallor -fatigue -muscle weakness The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron. What should the nurse recognize as causes for iron deficiency caused by an inadequate iron supply? (Select all that apply.) -prematurity -excessive milk intake -severe iron deficiency in the mother The clinic nurse is evaluating causes for iron deficiency due to impaired iron absorption. What should the nurse recognize as causes for iron deficiency due to impaired iron absorption? (Select all that apply.) -chronic diarrhea -lactose intolerance -inflammatory bowel disease SICKLE CELL ANEMIA The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA? -each sibling has a 25% chance of having SCA The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration? -increased RBC destruction A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse? -notify the practitioner because chest syndrome is suspected 25 What statement applies to the current focus of the dietary management of children with diabetes? -the intake ensures day-to-day consistency in total calories, protein, carbs and moderate fat while allowing for a wide variety of foods During the summer many children are more physically active. What changes in the management of the child with diabetes should be expected as a result of more exercise? -food intake The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include? (Select all that apply.) -type 1 has an abrupt onset -type 1 occurs primarily in whites -type 2 frequently has a familial history -type 2 occurs in people who are overweight The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session? (Select all that apply.) -diabetic supplies should not be left in a hot environment -after is has been opened, insulin is good for up to 28-30 days -Insulin bottles that have been opened should be stored at room temp or in the fridge What are characteristics of diabetic ketoacidosis? (Select all that apply.) -acidosis -dehydration -electrolyte imbalance The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.) -oral agents are effective -ketoacidosis is infrequent -diet only is often effective HIP DYSPLASIA/CLUB FEET A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain? -frequent, serial casting is tried first The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what? -we’re happy this is the only cast our baby will need The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching? 26 -I should gently massage the skin under the straps once a day to stimulate circulation BONE FRACTURE What finding is characteristic of fractures in children? -rapidity of healing is inversely related to the child’s age A 14-year-old is admitted to the emergency department with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture? -this type of fracture requires different management to prevent bone growth complications Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time? -calmly ask the child to point to where the pain is the worst and to wiggle fingers A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions? -elevate casted arm when both upright and resting The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign? -paresthesia A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material? -soak in a bathtub The nurse is caring for a hospitalized adolescent whose femur was fractured 18 hours ago. The adolescent suddenly develops chest pain and dyspnea. The nurse should suspect what complication? -PE A child has just returned from surgery for repair of a fractured femur. The child has a long-leg cast on. The toes on the leg with the cast are edematous, but they have color, sensitivity, and movement. What action should the nurse take? -elevate the foot and leg on pillows A 3-year-old child has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this child is how long? -4 weeks SCOLIOSIS When does idiopathic scoliosis become most noticeable? 27 -during the preadolescent growth spurt A preadolescent has been diagnosed with scoliosis. The planned therapy is the use of a thoracolumbosacral orthotic. The preadolescent asks how long she will have to wear the brace. What is the appropriate response by the nurse? -until your vertebral column has reached skeletal maturity A 17-year-old patient is returning to the surgical unit after Luque instrumentation for scoliosis repair. In addition to the usual postoperative care, what additional intervention will be needed? -position changes are made by log rolling