Question

The nurse is planning care for a 4-year-old client who is diagnosed as having a developmental disability. Which action should be the primary focus of treatment for this child?

Answer 1

Correct Answers:

Help the client in achieving their maximum potential.

Rationale :

💎 The primary nursing goal for a child with a developmental disability is to assist in achieving their maximum level of functioning rather than focusing on what they cannot do.

💎 This involves creating an individualized care plan that promotes independence, self-confidence, and adaptive skills suitable for the child’s developmental level.

💎 By emphasizing strengths and capabilities, the nurse encourages growth and participation in self-care and social interactions.

💎 This holistic approach supports the child’s physical, emotional, and intellectual development, helping them reach their full potential within their limitations.

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Answer 2

Correct Answers:

Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.

Rationale :

🟢 Wilm’s tumor is an encapsulated renal malignancy, and performing a biopsy before surgery can rupture the capsule.

🟢 Rupture can lead to spillage of malignant cells into the peritoneal cavity, increasing the risk of tumor seeding and metastasis.

🟢 For this reason, surgical removal of the kidney (nephrectomy) is performed first to maintain the integrity of the tumor.

🟢 This surgical approach allows for accurate staging and diagnosis while minimizing the risk of spreading cancer cells during handling.

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Answer 3

Correct Answers:

Pancreatic enzymes.

Rationale :

🔷 Children with cystic fibrosis have thickened secretions that obstruct the pancreatic ducts, preventing the release of digestive enzymes into the small intestine.

🔷 This results in malabsorption of fats, proteins, and carbohydrates, leading to steatorrhea and poor growth.

🔷 Administering pancreatic enzyme supplements (e.g., pancrelipase) with every meal and snack helps facilitate proper digestion and nutrient absorption.

🔷 These enzymes should be given before or with meals to mimic the normal release of pancreatic secretions and improve nutritional status.

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Answer 4

Correct Answers:

"Sexual maturity differences between my daughter and her peers will disappear within a few years."

Rationale :

💠 Luteinizing hormone-releasing hormone (LHRH) analogs act by suppressing premature secretion of gonadotropins from the pituitary gland, which halts early sexual development.

💠 As treatment progresses, the child’s growth and sexual maturation slow down, allowing peers to catch up developmentally.

💠 Over time, this leads to a more age-appropriate appearance and puberty progression once treatment is stopped.

💠 The therapy is temporary and helps synchronize the child’s physical maturity with their chronological age, reducing psychosocial stress.

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Answer 5

Correct Answers:

0.25

Rationale :

🟢 The formula for dose calculation is:

Dose (mL) = Ordered dose ÷ Concentration

🟢 Ordered dose = 1.25 mg, Concentration = 5 mg/mL

🟢 1.25÷5=0.25 mL1.25 ÷ 5 = 0.25 \, mL1.25÷5=0.25mL

🟢 The nurse should therefore administer 0.25 mL subcutaneously to deliver the prescribed dose accurately.

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Answer 6

Correct Answers:

Signs of perforation.

Rationale :

🟣 A child presenting with fever, vomiting, and periumbilical pain that suddenly resolves followed by abdominal distention suggests appendiceal rupture and peritonitis.

🟣 The sudden relief of pain occurs when the inflamed appendix perforates, releasing pressure and temporarily easing discomfort.

🟣 However, this is quickly followed by worsening abdominal distention, fever, and rigidity as infection spreads through the peritoneum.

🟣 This is a surgical emergency, requiring immediate medical intervention to prevent sepsis and further complications.

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Answer 7

Correct Answers:

Regulation of diet based on type of insulin.
Self administration of subcutaneous insulin.
Rotation of insulin injection sites.
Sick-day management procedures.
Finger stick blood glucose testing.

Rationale :

Regulation of diet based on type of insulin

🔶 Proper diet regulation is essential in managing Type 1 Diabetes Mellitus, as insulin therapy must be balanced with carbohydrate intake.

🔶 Teaching the client to coordinate meals with insulin type (rapid, short, intermediate, or long-acting) helps prevent hypoglycemia or hyperglycemia.

🔶 The nurse should emphasize consistent carbohydrate counting and spacing meals evenly throughout the day.

🔶 Understanding how insulin interacts with food intake allows the teenager to maintain stable blood glucose levels and participate safely in daily activities.

Self-administration of subcutaneous insulin

💎 Independence in insulin administration is a critical skill for adolescents with Type 1 Diabetes, promoting self-care and responsibility.

💎 Teaching includes selecting appropriate sites (abdomen, thigh, upper arm, buttocks), correct syringe use, and proper needle angles for subcutaneous injection.

💎 This empowers the teenager to manage their condition confidently and enhances treatment adherence.

💎 The nurse should also review storage guidelines and recognition of insulin types to ensure safe and effective use.

Rotation of insulin injection sites

🟢 Rotating injection sites helps prevent lipohypertrophy and ensures consistent insulin absorption.

🟢 The nurse should teach the teen to rotate injections within the same anatomical region (e.g., different areas of the abdomen) to maintain predictable insulin action.

🟢 Poor rotation practices can lead to fatty tissue buildup or scarring, altering insulin absorption rates and blood glucose control.

🟢 Maintaining a regular rotation schedule enhances comfort and insulin efficacy.

Sick-day management procedures

🔷 During illness, stress hormones increase glucose levels, even if the client is eating less.

🔷 The nurse should teach the teenager to continue taking insulin, monitor glucose and ketones frequently, and stay hydrated with sugar-free fluids.

🔷 Knowing when to seek medical attention for persistent hyperglycemia or ketones is vital to prevent diabetic ketoacidosis (DKA).

🔷 Proper sick-day management helps maintain stability and prevents hospitalization during minor illnesses.

Finger stick blood glucose testing

🟣 Regular blood glucose monitoring helps the teenager make informed decisions about insulin dosing, diet, and physical activity.

🟣 The nurse should teach correct hand hygiene, lancing technique, and interpretation of results using a glucometer.

🟣 Consistent testing provides data for recognizing patterns and adjusting therapy to prevent hypo- or hyperglycemia.

🟣 This practice empowers the adolescent to maintain tight glycemic control, reducing long-term complications of diabetes.

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Answer 8

Correct Answers:

Chest pain.

Rationale :

💎 Chest pain in a child with sickle cell disease may indicate acute chest syndrome, one of the most serious and life-threatening complications of the disorder.

💎 This condition occurs when sickled red blood cells block pulmonary vessels, leading to decreased oxygen exchange, hypoxia, and possible respiratory failure.

💎 It often presents with symptoms such as fever, cough, tachypnea, dyspnea, and chest pain, requiring immediate medical attention.

💎 Early recognition and treatment with oxygen therapy, antibiotics, and blood transfusion are critical to prevent severe complications and mortality.

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Answer 9

Correct Answers:

Determine if the child can administer the insulin.

Rationale :

🔹 By age 10, many children with Type 1 Diabetes Mellitus have the fine motor skills, maturity, and understanding needed to participate in their own care under supervision.

🔹 Encouraging the child to self-administer insulin promotes independence, self-confidence, and adherence to the treatment plan.

🔹 The nurse should assess the child’s readiness, coordination, and comprehension before teaching safe injection techniques.

🔹 This approach supports the child’s long-term diabetes self-management and reduces the stress for both the child and the parent who fears needles.

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Answer 10

Correct Answers:

Hirschsprung's disease.

Rationale :

🔷 Hirschsprung’s disease (congenital aganglionic megacolon) occurs when ganglion cells are absent in portions of the distal colon, leading to a failure of the internal rectal sphincter to relax.

🔷 This defect prevents normal peristalsis, causing chronic constipation, abdominal distention, and poor weight gain in infants.

🔷 Because stool cannot pass through the aganglionic segment, the infant often exhibits delayed meconium passage, vomiting, and ribbon-like stools.

🔷 Early diagnosis and surgical removal of the affected segment (pull-through procedure) are essential to restore normal bowel function and promote healthy growth.

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RN Pediatrics with NGN-HESI 2025 October —Fall

No.

1 :
The nurse is planning care for a 4-year-old client who is diagnosed as having a developmental disability. Which action should be the primary focus of treatment for this child?

2 :
The parents of a child who is diagnosed with Wilm's tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?

3 :
The nurse is caring for a school-age child with cystic fibrosis and reviews the admission medication prescriptions. Which medication should the nurse obtain a prescription for to be administered with every meal?

4 :
An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

7 :
The nurse is preparing a teaching plan for a teenager who was recently diagnosed with type 1 diabetes mellitus. Which topic(s) should the nurse include in the self care teaching plan? Select all that apply.

8 :
The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider (HCP) immediately?

10 :
The nurse is admitting a 3-month-old infant with chronic constipation and poor weight gain. Which condition is characterized by difficulty passing stool due to the failure of the internal rectal sphincter to relax?

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RN Pediatrics with NGN-HESI 2025 October —Fall

No.

1 : The nurse is planning care for a 4-year-old client who is diagnosed as having a developmental disability. Which action should be the primary focus of treatment for this child?

2 : The parents of a child who is diagnosed with Wilm's tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?

3 : The nurse is caring for a school-age child with cystic fibrosis and reviews the admission medication prescriptions. Which medication should the nurse obtain a prescription for to be administered with every meal?

4 : An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

7 : The nurse is preparing a teaching plan for a teenager who was recently diagnosed with type 1 diabetes mellitus. Which topic(s) should the nurse include in the self care teaching plan? Select all that apply.

8 : The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider (HCP) immediately?

10 : The nurse is admitting a 3-month-old infant with chronic constipation and poor weight gain. Which condition is characterized by difficulty passing stool due to the failure of the internal rectal sphincter to relax?

1 :
The nurse is planning care for a 4-year-old client who is diagnosed as having a developmental disability. Which action should be the primary focus of treatment for this child?

2 :
The parents of a child who is diagnosed with Wilm's tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?

3 :
The nurse is caring for a school-age child with cystic fibrosis and reviews the admission medication prescriptions. Which medication should the nurse obtain a prescription for to be administered with every meal?

4 :
An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

7 :
The nurse is preparing a teaching plan for a teenager who was recently diagnosed with type 1 diabetes mellitus. Which topic(s) should the nurse include in the self care teaching plan? Select all that apply.

8 :
The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider (HCP) immediately?

10 :
The nurse is admitting a 3-month-old infant with chronic constipation and poor weight gain. Which condition is characterized by difficulty passing stool due to the failure of the internal rectal sphincter to relax?