An infant who is developmentally delayed has a ventricular peritoneal (VP) shunt for hydrocephalus. The nurse makes a postoperative home visit to assess the child's progress. During the visit, the mother tells the nurse, "When the shunt is removed, the pressure in my baby's head will be gone." Which response should the nurse provide?

"Many infants outgrow the need for a shunt after the neonatal period."

"The shunt will be replaced as your child grows to reduce pressure in the brain."

"Other pathways in the brain will drain fluid after the shunt is removed."

"The shunt will have to be reinserted only if an infection or blockage develops."

Answer and Explanation

The Correct Answer is B

Choice A reason: "Many infants outgrow the need for a shunt after the neonatal period." is not a correct response that the nurse should provide. This statement is false, as most infants with hydrocephalus will need a shunt for life. Only a small percentage of infants with post-hemorrhagic hydrocephalus may outgrow the need for a shunt .

Choice B reason: "The shunt will be replaced as your child grows to reduce pressure in the brain." is the correct response that the nurse should provide. This statement is true, as the shunt will need to be adjusted or replaced as the child grows to accommodate the changes in the size and shape of the head and the amount of fluid drainage. The nurse should educate the mother about the signs and symptoms of shunt malfunction and the need for regular follow-up visits.

Choice C reason: "Other pathways in the brain will drain fluid after the shunt is removed." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that bypasses the blocked or impaired pathways in the brain and allows the fluid to drain into the abdomen. Without the shunt, the fluid will accumulate in the brain and cause increased pressure and damage.

Choice D reason: "The shunt will have to be reinserted only if an infection or blockage develops." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed and reinserted unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that stays in place unless it malfunctions or becomes infected. The nurse should educate the mother about the signs and symptoms of shunt infection and the need for prompt treatment.

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Correct Answer is B

Explanation

Choice A reason: Enabling limited time for cell phone use is not the best intervention that the nurse can implement to support the client's psychosocial needs. While cell phone use can help the client stay connected with their peers and social media, it can also be a source of distraction and stress. The nurse should encourage the client to balance their cell phone use with other activities that promote their well-being.

Choice B reason: Providing an activity room to spend time with other adolescents is the best intervention that the nurse can implement to support the client's psychosocial needs. This intervention can help the client cope with the anxiety and isolation that may result from their condition and hospitalization. It can also provide an opportunity for the client to interact with other adolescents who have similar experiences and challenges, and to engage in fun and meaningful activities that enhance their self-esteem and mood.

Choice C reason: Delivering 3 meals and snacks each day upon request is not the best intervention that the nurse can implement to support the client's psychosocial needs. While it is important to maintain the client's nutrition and hydration, it is not enough to address their emotional and social needs. The nurse should also encourage the client to eat with other adolescents or family members when possible, and to express their preferences and concerns about their food.

Choice D reason: Allowing family and friends to be present during assessments is not the best intervention that the nurse can implement to support the client's psychosocial needs. While it is important to involve the client's family and friends in their care, it is not necessary to have them present during every assessment. The nurse should respect the client's privacy and autonomy, and ask for their consent before allowing others to observe or participate in their assessments. The nurse should also provide the client with opportunities to talk to their family and friends in a comfortable and confidential setting.

A. Arrested growth. B. Weight gain. C. Low blood pressure. D. Hypervitaminosis D.

Correct Answer is A

Explanation

Choice A reason: Arrested growth is a common outcome of renal osteodystrophy in children. It is caused by the impaired bone formation and mineralization that result from the abnormal calcium, phosphorus, vitamin D, and parathyroid hormone levels in chronic kidney disease. Arrested growth can lead to short stature, delayed puberty, and poor quality of life.

Choice B reason: Weight gain is not a specific outcome of renal osteodystrophy in children. It may be related to other factors, such as fluid retention, decreased physical activity, or increased appetite due to medications or hormonal imbalances. Weight gain can worsen the kidney function and increase the risk of cardiovascular complications.

Choice C reason: Low blood pressure is not a specific outcome of renal osteodystrophy in children. It may be caused by other factors, such as dehydration, blood loss, infection, or medications. Low blood pressure can affect the perfusion of vital organs and cause dizziness, fainting, or shock.

Choice D reason: Hypervitaminosis D is not a specific outcome of renal osteodystrophy in children. It may occur as a side effect of vitamin D supplementation, which is often prescribed to treat or prevent renal osteodystrophy. Hypervitaminosis D can cause hypercalcemia, which can lead to nausea, vomiting, constipation, confusion, or kidney stones.

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Naxlex Comprehensive Predictor Exams

An adolescent with a congenital heart defect is admitted for diagnostic testing with surgery scheduled in 3 days. Which intervention should the nurse implement to best support the client's psychosocial needs?

Correct Answer is B

Explanation

The nurse is caring for a child with chronic kidney disease who is experiencing renal osteodystrophy. Which outcome should the nurse explain to the parents about the sequela for their child with renal osteodystrophy?

Correct Answer is A

Explanation

The nurse is caring for an infant admitted with dehydration, irritability, signs of extreme hunger, and a palpable olive-like mass in the upper right abdominal quadrant. When feeding the infant, the nurse should monitor for which development?

A 9-month-old with Tay-Sachs disease is admitted due to seizures. Which assessment is most important for the nurse to obtain?

The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?

A school-age child with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response?

A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

When providing care for a child who is in balanced suspension skeletal traction using a Thomas splint and Pearson attachment to the right femur, which intervention is most important for the nurse to implement?

A 9-year-old admitted to the unit with severe abdominal pain and fever is diagnosed with appendicitis and is placed on the surgery schedule for an appendectomy. The child reports to the nurse of experiencing sudden relief in abdominal pain. Which action should the nurse take first?