4-year-old presented to the ER with the parents with complaints of bowel incontinence, extremity weakness and neck pain. Child has a history of Trisomy 21 with atlantoaxial stability. began having neck pain 24 hours ago after falling off the steps. No injuries reported

The nurse is caring for a client diagnosed with Down Syndrome and a history

of hypotonia and atlantoaxial instability. Which of the following symptoms require priority interventions? (Select All that Apply.)

Pain of the facial bones

Continuous neck pain

Lower extremity pain

Loss of established bladder control

Loss of established motor skills

Answer and Explanation

Correct Answer : C,D,E

A.   Although facial pain could be concerning, it is not the immediate priority when the child has a history of atlantoaxial instability and is presenting with signs that could indicate spinal cord compression. Facial pain does not suggest a direct threat to the spinal cord, which is a more critical concern in this case.
B.   Continuous neck pain in a child with atlantoaxial instability is a significant priority and requires immediate intervention. This could be a sign of spinal cord compression or injury to the cervical spine, which can occur after trauma such as a fall. Since this child has a predisposition for atlantoaxial instability, there is a high risk for neck instability and spinal cord injury, making this a top priority.
C.   While lower extremity pain may be concerning, it is not as high a priority as neck pain in this context. The primary concern here is potential spinal cord compression or neurological injury. If the child is able to move their extremities or does not have severe pain or weakness, this may not require as urgent intervention. However, it should still be monitored closely.
D.   Loss of bladder control is a red flag in children with suspected spinal cord injury. It can indicate nerve involvement in the spinal cord or cauda equina, which can be caused by injury or compression, particularly in a child with atlantoaxial instability. This requires priority intervention to prevent further damage and to initiate appropriate care (e.g., neurological assessment, imaging, and potentially surgical intervention).
E.   The loss of established motor skills is another concerning sign. In this child, it may indicate neurological impairment or spinal cord injury. Since the child has atlantoaxial instability, this is a critical symptom that suggests the possibility of spinal cord compression or injury, requiring immediate evaluation and intervention to prevent permanent neurological damage.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Budesonide is an inhaled corticosteroid used for long-term asthma control and is not appropriate for immediate relief during an acute asthma attack.
B. Albuterol is a short-acting beta-agonist (SABA) and is the first-line medication for quickly relieving bronchospasm during an acute asthma attack.
C. Fluticasone is an inhaled corticosteroid, which is used for long-term asthma control but not for rapid relief during an acute episode.
D. Montelukast is a leukotriene receptor antagonist, used for long-term asthma control, and would not be effective for immediate relief during an acute attack.

A. "This is a concern, but strabismus is easily treated with patching." B. "I will take your baby to the nursery for further examination." C. "This occurs because newborns lack muscle control to regulate eye movement." D. "I will call your primary care provider to report your concerns."

Correct Answer is C

Explanation

A. While strabismus may be treated with interventions such as patching, it is not always immediately concerning in newborns. The nurse should first provide accurate information about normal development.
B. Taking the baby to the nursery may not be necessary unless the child’s condition worsens or there is a
clear concern. A thorough assessment and explanation by the nurse are more appropriate.
C. Strabismus is common in newborns due to the immaturity of eye muscle control and usually resolves as the child develops. This is the most therapeutic response as it provides reassurance based on developmental norms.
D. Calling the primary care provider might be premature unless the nurse identifies a significant concern beyond normal development.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an 11-year-old client who is experiencing an acute asthma attack. Which of the following medications should the nurse expect to administer first?

Correct Answer is B

Explanation

A nurse is caring for a new mother who is concerned that her newborn has strabismus. Which of the following statements is a therapeutic response by the nurse?

Correct Answer is C

Explanation

A nurse is educating new parents about choking hazards in the home. Which food item should the parents understand is the highest risk in younger children?

The nurse is caring for a newborn with a diagnosis of tracheoesophageal fistula (TEF). Which of the following assessment findings may be present in a newborn with TEF? (Select All that Apply.)

A nurse is caring for a 4-year-old client diagnosed with Fragile X Syndrome. Which information should be included in the teaching plan for the parents?

A nurse is caring for a 7-year-old child in the urgent care with complaints of blurred vision. The nurse should complete which of the following as the priority action?

A nurse is planning care for a 4-year-old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?

A nurse is providing education to the parents of a 4-year-old child with acute epiglottitis. The nurse recognizes that the parents need further teaching when they make which of the following statements?

A nurse at the well-baby clinic is preparing to give an immunization vaccine to an 18-month-old child. Which vaccine should the nurse prioritize for administration?

A nurse is providing teaching to a parent of a 5-year-old client diagnosed with celiac disease. The nurse should include which of the following food choices in the teaching plan?