A nurse is educating the parents of a pediatric patient who recently had a ventriculoperitoneal (VP) shunt placed to treat hydrocephalus. Which statement by the parents indicates the most critical understanding about care and potential complications?
We should limit physical activity and keep the child in bed to prevent dislodging the shunt.
If the child develops a fever, we can give over-the-counter fever reducers and only call the doctor if it persists more than 3 days.
We will need to flush the shunt regularly at home to keep it from clogging.
We will watch closely for sudden vomiting headache, or changes in behavior and notify the provider immediately if these occur.
The Correct Answer is D
A. Limiting physical activity and keeping the child in bed is incorrect because children with VP shunts do not need prolonged bed rest. Normal activity is encouraged as long as it is safe; the shunt is designed to withstand routine movement.
B. Managing fever with over-the-counter medications and waiting 3 days to call the provider is incorrect because fever may indicate a shunt infection, which is a medical emergency. Prompt assessment is essential for early intervention.
C. Flushing the shunt at home is incorrect because VP shunts should never be flushed by caregivers; doing so could cause serious injury or infection. Shunt function is monitored by observing for signs of malfunction, not by manual flushing.
D. Watching for sudden vomiting, headache, or changes in behavior and notifying the provider immediately is correct because these are key signs of shunt malfunction or increased intracranial pressure, which can be life-threatening. Early recognition and prompt medical evaluation are critical for preventing complications such as brain damage or infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"}}
Explanation
- Irregular, sporadic contractions: Characteristic of false labor; these contractions are inconsistent and do not lead to cervical changes.
- Contractions felt primarily in the lower back: True labor often presents with back pain that radiates to the abdomen.
- Contractions that subside with walking or hydration: False labor contractions often diminish with movement or hydration.
- Contractions that increase in intensity and frequency: True labor contractions become stronger, longer, and closer together over time.
- Cervical dilation and effacement occurring: True labor leads to progressive cervical changes.
- No cervical change after hours of contractions: Indicates false labor, as the cervix does not change despite contractions.
Correct Answer is A
Explanation
A. Sweat chloride test is correct because it is the gold standard diagnostic test for cystic fibrosis. In CF, mutations in the CFTR gene lead to abnormal chloride transport in epithelial cells. This results in elevated chloride levels in sweat, typically ≥60 mmol/L in children, which confirms the diagnosis.
B. Genetic testing for CFTR mutations is incorrect as the sole diagnostic tool because not all CF mutations are detectable, and testing may identify carriers or atypical variants. While genetic testing is useful for confirmation or family counseling, it is not the first-line diagnostic test.
C. Chest x-ray is incorrect because, although it may reveal hyperinflation, bronchiectasis, or infiltrates indicative of chronic lung disease in CF, it cannot confirm the diagnosis. Imaging is supportive but not diagnostic.
D. Pulmonary function tests (PFTs) are incorrect because these tests assess lung function and airflow limitation, but they are not diagnostic for CF, especially in young children who may not be able to perform the tests reliably.
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