Review NACE Care of the Child

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NACE Care of the Child

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Total Questions : 101

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Question 1:

A patient taking a combination of antineoplastic agents develops stomatitis. Nursing care should include actions to prevent which problem?

A. Inadequate nutritional intake. B. Dental caries. C. Diarrhea. D. Gingival hyperplasia.

Answer and Explanation

Choice A:

Stomatitis, inflammation of the oral mucosa, can make eating painful, leading to inadequate nutritional intake. The discomfort caused by stomatitis can discourage the patient from eating, potentially resulting in malnutrition. Ensuring adequate nutritional intake is crucial to support the patient's immune system and healing during antineoplastic therapy.

Choice B:

Dental caries are not directly related to stomatitis. Stomatitis is inflammation of the oral mucosa, whereas dental caries involve decay of tooth structure due to bacterial action on food debris and sugars.

Choice C:

Diarrhea is unrelated to stomatitis. Diarrhea involves frequent, loose, or watery stools, often caused by gastrointestinal infections, certain medications, or dietary intolerances.

Choice D:

Gingival hyperplasia is an overgrowth of gum tissue and is not a likely result of stomatitis. It can be associated with some medications like anticonvulsants.

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Question 2:

In consideration of the patient's body image, the nurse should take which action when performing venipuncture in a preschool-aged child?

A. Show the patient the needle and the syringe to be used for the venipuncture. B. Have the patient help to cleanse the site chosen for the venipuncture. C. After the venipuncture, encourage the patient to show the site to adults in the area. D. After the venipuncture, help the patient apply a small dressing to the venipuncture site.

Answer and Explanation

Choice A:

Showing the needle and syringe might intensify anxiety in the child, making venipuncture more distressing. It's important to minimize any distress during the procedure.

Choice B:

Allowing the child to help cleanse the site could lead to more anxiety as the child might interpret it as their own responsibility for the procedure.

Choice C:

Encouraging the child to show the site to adults may not be reassuring for the child and could potentially exacerbate their apprehension.

Choice D:

Preschool-aged children may fear pain and bleeding, and applying a small dressing after venipuncture helps alleviate anxiety. It provides a sense of control and comfort, as the child perceives their active participation in caring for the site.

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Question 3:

What information should a nurse plan to give the parents of a 9-month-old infant who is to be discharged after a cleft palate repair?

A. Allow the child to self-feed with a spoon. B. Feed the child pureed or soft foods. C. Use a cup with a straw instead of a bottle. D. Restrict breastfeeding for the first month.

Answer and Explanation

Choice A:

Allowing the child to self-feed with a spoon can introduce solid textures prematurely and pose a risk of disrupting the surgical repair.

Choice B:

After cleft palate repair, infants should be fed pureed or soft foods to prevent trauma to the surgical site and facilitate healing. These textures minimize the risk of injury and avoid strain on the repaired area.

Choice C:

Using a cup with a straw might cause suction that could negatively impact the healing surgical site, increasing the risk of complications.

Choice D:

Restricting breastfeeding is not necessary for cleft palate repair. However, positioning adjustments may be needed to facilitate effective breastfeeding while minimizing stress on the surgical area.

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Question 4:

What information should a nurse plan to give the parents of a child newly diagnosed with cognitive impairment (mental retardation)?

A. Avoid setting limits or establishing disciplinary guidelines. B. Encourage the child to socialize with same-aged children. C. Avoid discussing sexuality until the child is an adult. D. Encourage delaying the child's entry into educational programs.

Answer and Explanation

Choice A:

Avoid setting limits or establishing disciplinary guidelines is not appropriate. Children with cognitive impairment require structure and consistent boundaries to ensure their safety and development.

Choice B:

Encouraging the child to socialize with same-aged children is important for their social and emotional development. Interaction with peers fosters communication skills and helps them integrate into society.

Choice C:

Avoid discussing sexuality until the child is an adult may lead to misinformation and confusion. Addressing sexuality in an age-appropriate manner is vital to help the child develop a healthy understanding of their body and relationships.

Choice D:

Encouraging delaying the child's entry into educational programs hinders their cognitive and intellectual growth. Early intervention and tailored educational programs are crucial for children with cognitive impairment to reach their full potential.

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Question 5:

What information should a nurse plan to give the parents of a child recently diagnosed with autism spectrum disorder?

A. High levels of structure will cause behavioral problems. B. Negative reinforcement works better than positive reinforcement. C. Strict dietary modifications can sometimes cure autism. D. Level of functioning varies significantly among children with autism.

Answer and Explanation

Choice A:

High levels of structure will cause behavioral problems is incorrect. Structure and routine often provide a sense of security for children with autism and can help minimize behavioral challenges.

Choice B:

Negative reinforcement works better than positive reinforcement is not accurate. Positive reinforcement is generally more effective in promoting desired behaviors in children with autism.

Choice C:

Strict dietary modifications can sometimes cure autism is a misconception. While a balanced diet can positively impact overall health, there is no dietary cure for autism spectrum disorder.

Choice D:

Level of functioning varies significantly among children with autism is crucial information for parents. Autism is a spectrum disorder, leading to a wide range of abilities and challenges. Tailoring interventions to the child's specific needs is important.

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Question 6:

A patient has a neurogenic bladder with incomplete emptying. Which discharge instruction for the patient's mother should be included in the teaching plan?

A. Instruct the mother in palpation of bladder distention. B. Inform her mother that life-long antibiotic administration will be necessary. C. Prepare the mother for the need for urinary diversion surgery. D. Instruct the mother in the technique of clean intermittent catheterization.

Answer and Explanation

Choice A:

Instructing the mother in palpation of bladder distention might not effectively address the issue of incomplete bladder emptying. Clean intermittent catheterization is a more appropriate technique to ensure complete emptying.

Choice B:

Informing the mother that life-long antibiotic administration will be necessary is not the primary approach. Antibiotics may be required in specific situations, but addressing incomplete emptying is the key focus.

Choice C:

Preparing the mother for the need for urinary diversion surgery is premature. Clean intermittent catheterization is a conservative measure that should be attempted before considering surgical options.

Choice D:

Instructing the mother in the technique of clean intermittent catheterization helps manage the neurogenic bladder's incomplete emptying. This technique reduces the risk of urinary tract infections and promotes bladder health.

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Question 7:

The nurse plans to begin teaching a 7-year-old patient and the child's mother about diabetes management. Which action should the nurse take initially?

A. Limit their first session to 40 minutes. B. Have them handle the necessary equipment. C. Give them an illustrated book to read. D. Evaluate their readiness to learn.

Answer and Explanation

Choice A:

Limiting the session to 40 minutes might not be the initial step, as it doesn't assess the patient and mother's readiness to learn. Teaching sessions should be tailored to their learning capacity, and time restrictions should come after assessing their readiness.

Choice B:

Having them handle equipment is a valuable step in teaching, but it doesn't address the foundational aspect of assessing their readiness to learn. Jumping straight into equipment handling might not be effective if they are not prepared to absorb the information.

Choice C:

Giving an illustrated book might engage visual learners, but without evaluating their readiness, this approach might not be the most effective starting point. Readiness assessment helps tailor teaching methods to their learning styles and capacities.

Choice D:

Evaluating their readiness to learn is the best initial action. Assessing their understanding, motivation, and any barriers to learning allows the nurse to create a customized teaching plan. This approach enhances the effectiveness of subsequent teaching strategies.

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Question 8:

A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?

A. An hour before meals and at bedtime. B. Every six hours around the clock. C. Upon awakening and within an hour after meals. D. Evenly spaced when the patient is awake.

Answer and Explanation

Choice A:

Scheduling chest physiotherapy an hour before meals and at bedtime is optimal. This timing helps prevent aspiration during meals and aids in clearing secretions before sleep. It complements the patient's meal schedule and sleep routine.

Choice B:

Every six hours around the clock could disrupt the patient's sleep and meal times. Chest physiotherapy might not align well with the patient's daily activities, potentially affecting treatment compliance and effectiveness.

Choice C:

Performing chest physiotherapy upon awakening and after meals might increase the risk of aspiration during meals. Clearing airways before meals is safer, and performing it right after meals could cause discomfort.

Choice D:

Evenly spaced physiotherapy when awake lacks synchronization with meal and sleep times. This approach might not optimize treatment effects and patient convenience.

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Question 9:

The nurse is exploring strategies to help a patient with multiple allergies to have less frequent and less severe exacerbations of his asthma. Which strategy is most appropriate for the nurse to teach the family?

A. Dust the child's room with a damp cloth every week. B. Provide down pillows for the child. C. Use a warm mist humidifier in the child's room. D. Encourage the child to go outside into the cold air at the start of an asthma attack.

Answer and Explanation

Choice A:

Dusting the child's room with a damp cloth weekly is the most appropriate strategy. This minimizes allergen exposure by capturing and removing dust particles instead of dispersing them, as dry dusting might. Consistent, thorough cleaning can help prevent exacerbations.

Choice B:

Providing down pillows might aggravate allergies due to their potential to harbor dust mites and allergens, worsening the child's asthma symptoms.

Choice C:

Using a warm mist humidifier could promote mold growth and allergen accumulation in the room, potentially worsening asthma symptoms rather than alleviating them.

Choice D:

Encouraging the child to go outside in cold air during an asthma attack is not recommended. Cold air can trigger bronchospasms and worsen asthma symptoms, making this strategy potentially harmful.

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Question 10:

A 5-year-old child is being admitted to the hospital for surgery. Which intervention would be appropriate to help prepare this child for hospitalization?

A. Wait to discuss the surgery with until the child asks specific questions. B. Set aside an hour a day to talk about the child's feelings concerning the surgery. C. Read the child a story about children of similar age who go to the hospital for surgery. D. Have the child visit a family whose preschool child has just been discharged from the hospital.

Answer and Explanation

Choice A:

Waiting to discuss the surgery until the child asks specific questions might lead to increased anxiety as the child may be apprehensive about the surgery but unable to express their concerns.

Choice B:

Setting aside an hour a day to talk about the child's feelings concerning the surgery can be overwhelming for a 5-year-old, potentially increasing anxiety and making the procedure seem more daunting.

Choice C:

Reading the child a story about children of similar age who go to the hospital for surgery provides a developmentally appropriate approach. It helps the child understand the process through relatable characters, reducing fear and uncertainty about the upcoming experience.

Choice D:

Having the child visit a family whose preschool child has just been discharged from the hospital might expose the child to unfamiliar situations, possibly leading to more confusion and anxiety.

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Total Questions : 101

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NACE Care of the Child

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