abuse by pediatrics

The nurse suspects that a client who comes to the maternity clinic for a pregnancy test is in an abusive relationship. The nurse includes the abuse assessment screen as part of the assessment. Although the woman was very emotional and hesitant in responding to the questions, verbally she denied abuse as being a problem. While waiting for the results of the pregnancy test, the nurse decides to teach the client about partner abuse anyway. The rationale for the nurse's decision is that all women should be informed about:

The cycle of violence, which continues and escalates over time once it begins

Which factor should the nurse include when teaching a parent about the care of a child in a Pavlik harness for hip dysplasia?

The harness is used to maintain the infant's hips in flexion and abduction and external rotation.

Which is an important focus of nursing care for the dying child and his or her family?

Families should be made aware that hearing is the last sense to stop functioning before death.

What should the nurse include in a teaching plan for a mother of a toddler who will be taking prednisone for several months?

The medication should not be stopped abruptly.

What discharge information should the nurse give to the parents of an adolescent who has been diagnosed with the Epstein-Barr virus?

Fatigue may persist, and the adolescent may need to increase school activities gradually

Ringworm, frequently found in schoolchildren, is caused by which of the following?

Fungus

Which of the following may be suggested as an appropriate intervention to provide comfort for the child with itching associated with chickenpox?

Give an antipruritic medication such as diphenhydramine (Benadryl).

A nurse assesses a child on long-term systemic corticosteroid therapy for which condition?

Growth delays

Which symptom should be reported to the primary care provider if it occurs when a child with an infectious disease is febrile?

Headache

A young refugee has come to your clinic for medical care. On examination, you discover she underwent female genital cutting as a young girl. You recognize this practice is primarily based on:

Her culture

A young child has sustained a minor burn to the foot. Which of the following is the best method to stop the burning process?

Hold foot under cool running water

The teaching plan for the child with structural disorders of the bones and joints, such as developmental dysplasia of the hip, should include which instruction?

Importance of follow-up until the child reaches skeletal maturity

Which of the following explains physiologically the edema formation that occurs with burns?

Increased capillary permeability

Which of the following is described as the time interval between infection or exposure to disease and appearance of initial symptoms?

Incubation period

Systemic lupus erythematosus (SLE)

Ineffective breathing pattern

Intervention for the sexual abuse survivor often is not attempted by maternity and women's health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman's care?

Listening and encouraging therapeutic communication skills

After conducting a class for college students about cervical cancer prevention, the nurse determines that the class understands that steps can be taken to help prevent cervical cancer based on which statement?

More than 90% of squamous cervical cancers contain HPV DNA

Parents of the child with lice infestation should be instructed carefully in the use of anti-lice products because of which potential side effect?

Neurotoxicity

Biologic dressings are applied to a child with partial-thickness burns of both legs. Nursing actions related to this include which of the following?

Observe wounds for signs of infection.

The nurse is educating a female client about lifetime risk for developing cancer. The nurse determines that the teaching was successful when the woman states that regardless of her risk factors, her chances for developing cancer are:

One-in-three

Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles?

Place the child in strict isolation and on airborne precautions

Nursing care of the infant with atopic dermatitis focuses on which of the following?

Preventing infection

Which of the following is the primary clinical manifestation of scabies?

Pruritus

According to the article by D. Sabella, "Sex trafficking is defined by law as the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act."

True

A child falls on the playground and has a small laceration on the forearm. The school nurse should do which of the following to cleanse the wound?

Wash wound gently with mild soap and water for several minutes

When is a child with chickenpox considered to be no longer contagious?

When lesions are crusted

A woman who has given birth to a post-term newborn asks the nurse why her baby looks so thin, with so little muscle. The nurse integrates understanding about which concept when responding to the mother

With post-term birth, the fetus uses stored nutrients to stay alive, and wasting occurs.

A nurse has just completed a teaching session for parents about children's understanding of death. Parents of a 5-year-old child understood the teaching if they indicate which corresponds to their child's understanding of death?

Reversible and temporary

During a routine physical examination, the client is noted to have a Bartholin's cyst abscess. The nurse recognizes the need to obtain testing to rule out:

STI

Cellulitis is often caused by:

Streptococcus or Staphylococcus organisms.

The nurse observes a red rash that spreads across the child's cheeks and nose. This assessment finding is characteristic of which of the following conditions?

Systemic lupus erythematosus (SLE)

A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. The nurse should explain that:

a topical anesthetic, EMLA, can be applied before injections are given.

A nurse is assessing a preterm newborn's status based on the understanding that the newborn is at greatest risk for which complication?

atelectasis

A high-protein diet for the child with major burns is primarily ordered to

avoid protein breakdown.

A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. The nurse's most appropriate action would be to:

go to the parents, introduce himself or herself, and gently encourage the parents to come meet their infant; explain the equipment first, and then focus on the newborn

A 34-year-old Caucasian arrives at the emergency department with a black right eye; she also is bleeding from the left side of her head. She reports that her boyfriend has been abusing her physically. The nurse performs a history and physical examination and documents her findings.

"Client is a 34-year-old Caucasian female. Presents with periorbital ecchymosis on right side. Laceration of left parietal area, 3 cm long with tissue bridging. Approximately 1 cm deep. Client states that her boyfriend 'threw a brick from 10 feet away, aiming at my head. The corner of the brick hit the left side of my head.' She reports that he also 'hit me in the eye.' Client indicates that the hit was with her boyfriend's closed left fist."

Necrotizing enterocolitis (NEC) is an acute inflammatory disease of the gastrointestinal mucosa that can progress to perforation of the bowel. Approximately 2% to 5% of premature infants succumb to this fatal disease. Care is supportive; however, known interventions may decrease the risk of NEC. To develop an optimal plan of care for this infant, the nurse must understand which intervention has the greatest effect on lowering the risk of NEC:

human milk or breastfeeding

An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of:

hypoglycemia

In the assessment of a preterm infant, the nurse notices continued respiratory distress even though oxygen and ventilation have been provided. The nurse should suspect:

hypovolemia and/or shock

From a worldwide perspective, infant mortality in the United States

is the highest of the other developed nations

The nurse has educated a client about confidentiality. explaining that which mandate against confidentiality requires that some injuries, complaints, and/or situations must be reported?

laws

A nurse is caring for an infant born with polycythemia. Which intervention is most appropriate when caring for this infant?

focus on decreasing blood viscosity by increasing fluid volume

A nurse is conducting an in-service presentation for a group of neonatal nurses. After teaching the group about the effects of prematurity on various body systems, the nurse determines that the class was successful when the group identifies which condition as an effect of prematurity?

fragile cerebral blood vessels

A 6-month-old infant is due for routine immunizations. The parent reports the infant was exposed to pertussis 2 days ago. The nurse should:

give the 6 month immunizations as scheduled.

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates. A nonstress test (NST) in the obstetrician's office revealed a nonreactive tracing. On artificial rupture of membranes, thick, meconium-stained fluid was noted. The nurse caring for the infant after birth should anticipate

meconium aspiration, hypoglycemia, and dry, cracked skin

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lbs, 6 ounces). The nurse's most appropriate action is to:

monitor blood glucose levels frequently and observe closely for signs of hypoglycemia.

A 4-year-old child with a long leg cast complains of "fire" in his cast. The nurse should

notify the physician immediately.

When instructing parents about the care of an infant in a cast for a clubfoot, the nurse should include:

notifying the physician of any vascular problems, such as toe swelling.

A nurse is reading a journal article about female reproductive cancers. Which malignancy would the nurse expect to be described as a "silent killer"?

ovarian cancer

A young couple presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect

polycystic ovary syndrome

The nurse begins intermittent oral feedings for a small-for-gestational-age newborn to prevent which occurrence?

polycythemia

Infants of mothers with diabetes (IDMs) are at higher risk for developing:

respiratory distress syndrome

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate (FHR) before birth is 180 beats/min with limited variability. At birth, the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. On the basis of the maternal history, the cause of this newborn's distress is most likely to be:

sepsis

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

swaddling the infant snugly and holding the baby tightly

A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should explain that:

terminally ill children know when they are seriously ill.

A nurse plans to include family in the aspects of care their dying 12-month-old child. The infant or toddler would understand death to be:

the loss of his or her caretaker

A client has been diagnosed with cervical cancer during her second trimester of pregnancy. She decides to delay treatment until after the baby is born. The nurse prepares her for birth by explaining the birth will most likely be

via cesarean section

Which is the most appropriate response to a parent who tells the nurse, "I don't want my child to know she is dying?"

"I'll answer any questions she asks me as honestly as I can."

Which statement made by a parent indicates incorrect information about an intervention for a child's fever?

"I'll look for over-the-counter preparations that contain salicylates (Aspirin)."

Which statement made by a parent of a child with osteogenesis imperfecta (OI) needs clarification by the nurse?

"My child will never be able to attend school to protect him from injury"

A young woman arrives at the emergency department and states that she thinks she has been raped. She is sobbing and expresses disbelief that this could happen because the man was her best friend. In an effort to calm the client in order to perform a thorough assessment and physical examination, the nurse acknowledges the client's fear and anxiety and tells her:

"Rape is not limited to strangers and frequently occurs by someone who is known to the victim."

A premature infant with respiratory distress syndrome receives artificial surfactant. How would the nurse explain surfactant therapy to the parents?

"Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide."

What is the drug of choice the nurse would administer in the acute treatment of anaphylaxis?

Epinephrine (Adrenaline)

A nurse is reading a journal article about neural tube defects and preventive measures. Which defect would the nurse most likely find identified as the most severe?

anencephaly

According to the article, Human trafficking: The role of the healthcare provider, Human trafficking is the SATA 2

-3rd largest source of income for organized crime -there are double the amount of people enslaved today as during the African slave trade.

Which interventions should the nurse include in the home care instructions for the parents of a child who has a cast applied to the left forearm? Select all that apply. 3

-Keep small toys away from the cast. -Daily assess the cast for unusual odors. -Elevate the extremity on pillows for the first 24 to 48 hours.

Tissue ischemia and nerve damage are serious complications that may result from immobilization in a cast or from traction. The five P's of vascular impairment can be used as a guide when assessing for neurovascular problems. Select all that apply that are part of the 5 P's.

-Pain, unrelieved by medication -Pulselessness -Pallor -Paralysis -Parathesia

The nurse who is evaluating the client for potential abuse should be aware that intimate partner violence includes (choose all that apply): 5

-Psychologic abuse -Sexual abuse -Economic abuse -Physical abuse -Emotional abuse

Which indicators of imminent death in a child should the nurse expect to assess? Select all that apply 2

-Respirations become rapid and shallow. -Heart rate increases.

The nurse should provide which information to parents about the prevention of parasitic infections? Select all that apply. 3

-Shoes should be worn outside. -Fruits and vegetables should be washed before eating. -Perform good handwashing.

Which nursing diagnosis would be most applicable for battered women? Choose all that apply. 4

-Situational low self-esteem -Loss of trust -Risk for self-directed violence -Ineffective family coping

Common characteristics of a potential batterer include (choose all that apply): 3

-Substance abuse problems -Personality disorders -High level of self-esteem

A nurse is teaching parents about prevention of diaper dermatitis. Which should the nurse include in the teaching plan? Select all that apply 3

-Wash cloth diapers in hot water with a mild soap and double rinse. -Clean the diaper area gently after every diaper change with a mild soap. -Use a protective ointment to clean dry intact skin.

The nurse needs to conduct a procedure on a preterm newborn. Which measures would be most effective in reducing pain? Select all that apply. 3

-encouraging kangaroo care during procedures -swaddling the newborn closely -offering a pacifier prior to a procedure

Asymmetric fetal growth restriction includes select all that apply 3

-head, abdomen and long bones are spared -cognitive deficiencies -insult occured at less than 28 weeks gestation

Which findings would the nurse expect in a newborn who is considered small for gestational age? Select all that apply. 3

-poor muscle tone over buttocks -sunken abdomen -dry or thin umbilical cord

A nurse is preparing to administer epinephrine intravenously to a preterm newborn. The newborn weighs 1,500 g, and the primary care provider prescribes 0.1 mL/kg. How much would the nurse administer?

0.15 mL

A client is trying to understand how she could have cervical cancer if all her previous Pap smears were negative. When responding to the client, the nurse integrates understanding that false negative rates of the conventional Pap smear occur at what rate?

20%

The nurse recognizes that the group of infants born during which time frame are at a higher risk for morbidity and mortality?

34 to 37 weeks

The nurse is concerned that a newborn is hypoglycemic. Which blood glucose level would support the nurse's suspicion?

35 mg/dL

The nurse works at a cancer treatment center working with clients with a diagnosis of vaginal cancer. The nurse understands that these clients have what percent chance of being diagnosed with another form of cancer?

80%

An 18-year-old client presents to the office reporting severe lower abdominal pain. Ultrasound reveals an ovarian cyst. The client asks, "Is the cyst benign" The nurse responds, explaining that ovarian cysts are benign approximately how often?

90% of the time

Which of the following is one of the first signs of overwhelming sepsis in a child with burn injuries?

Disorientation

The primary responsibility of the nurse who suspects or confirms any type of violence against a woman is

Document the incident (or findings) accurately and concisely in the client's record

Which of the following is the most important nursing consideration in the management of cellulitis?

Administration of oral or parenteral antibiotics

A pregnant woman presents in labor at term, having had no prenatal care. After birth, her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. On the basis of her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy?

Alcohol

The abuse of which of the following substances during pregnancy is the leading cause of cognitive impairment in the United States?

Alcohol

When infants are seen for fractures, which nursing intervention is a priority?

Assess for child abuse. Fractures in infants are often non-accidental

When teaching care for a child immobilized in a hip-spica cast, which is the most appropriate intervention?

Assessment for a sluggish capillary refill

Atopic dermatitis (eczema) in the infant is which of the following?

Associated with allergy with a hereditary tendency

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following

Bone growth can be affected by this type of fracture.

When does idiopathic scoliosis become most noticeable

During preadolescent growth spurt

The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by which of the following?

Candida albicans

The nurse should know that Lyme disease is which of the following?

Caused by a spirochete that enters the skin through a tick bite

With regard to violence against women, intimate partner violence (IPV) nurses should be aware that:

Economic coercion is considered part of IPV

Which of the following best describes a full-thickness (third-degree) burn?

Destruction of all layers of skin evident with extension into subcutaneous tissue

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. Some generalized signs include:

abdominal distention, temperature instability, and grossly bloody stools

Assessment reveals that a young mother has several risk factors for delivering an infant with a neural tube defect. Which laboratory test would the nurse expect to be used to monitor the fetus for this birth defect?

alpha-fetoprotein levels

A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has:

an inhalation injury.

A nurse is trying to assist her client in dealing with her newly diagnosed cervical cancer, but the client is not wanting to discuss it. The nurse needs to understand that this may be due to:

cultural background