ATI Peds 1

Which breakfast selection indicates that parents understand the nurse's instructions about the dietary management for a child diagnosed with Phenylketonuria (PKA)?

White bread toast and orange juice

A child is admitted after being diagnosed with Wilms tumor. The admitting nurse knows to place a sign that says:

"Do not palpate abdomen"

A patient who is withdrawn says, "When I have the opportunity, I am going to commit suicide." What response by the nurse is of the highest priority?

"Do you have a plan in place?"

The mother of a child with hemophilia asks the nurse how long her child will need to be treated for hemophilia. What is the best response to this question?

"Hemophilia is a life-long blood disorder"

Which of the following statements made by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections?

"I really like taking bubble baths every night"

What is the best response to a parent who asks the nurse whether her 5-month-old infant can have cow's milk?

"Infants younger than 12 months need iron-rich formula to get the iron they need"

What is the nurse's best response to a mother whose child has a diagnosis of acute lymphoblastic leukemia and is expressing guilt about not having responded sooner to her child's symptoms?

"It is not uncommon for parents not to notice the subtle changes in their children's health"

The nurse is caring for a child with Wilms tumor. The child is scheduled for a MRI of the lungs. The parents ask the reason because Wilms involves the kidneys. What is the best response?

"The test is dont to check to see if the disease has spread to the lungs"

The parents of a child with Duchenne muscular dystrophy have just learned that children with this disease have a limited life expectancy. They ask what this means for how they will raise their son. What is the nurse's best response?

"Throughout his disease, we will focus on maximizing his abilities and keeping him comfortable"

Which of the following statements made by parents of a child with leukemia, indicates an understanding of teaching related to home care associated with the disease?

"We will take our son's temperature daily and report any fevers"

The nurse is teaching the parents of a child recently diagnosed with ADHD who has been prescribed methyphenidate (Ritalin). Which of the following should the nurse include in teaching about the side effects of methylphenidate?

"Your child may experience a sense of nervousness"

A two year old child comes to the hospital with anorexia, abdominal distention, chronic constipation, foul-smelling and ribbonlike stools. Which orders might the nurse anticipate for this child? (Select all that apply)

1. Administer enemas to clean bowel 2. Preoperative care for a surgical removal of affected portion of bowel 3. IV antibiotics

Which of the following should the nurse include when teaching the mother of a 9-month-old about administering liquid iron preparations?

Adequate dosage will turn the stools a tarry green color

What will be included in the discharge plan for a three-year old with sickle cell disease?

Administration of penicillin daily as ordered

Which of the following symptoms would the nurse expect to observe dring the physical assessment of an adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa?

Lowered body temperature and brittle nails

Which of the following suggestions are important to include when teaching parents of an 18-month-old with iron-deficiency anemia? (select all that apply)

1. Decrease the toddler's daily milk intake to 24 ounces or less 2. Give oral iron supplement between meals with orange juice 3. Include apricots, dark-green leafy veggies and Cream of Wheat in diet

A mom comes to the clinic that her 2-year-old child has begun to repetitively flap his arms when agitated and echo's words or phrases said to him. What additional findings might the nurse discover when completing the history and assessment? (Select all that apply)

1. Eye contact avoidance 2. Insists on a routine 3. Difficulty with understanding other people's feelings

A 5-year-old is being evaluated for a lower UTI. Which symptoms is she likely to be displaying to warrant evaluation? (Select all that apply)

1. Frequency or urgency 2. Strong smelling urine 3. Incontinence in a toilet-trained child

A 7 year old child experiences intracranial pressure secondary to malignancy. Which assessment findings will the nurse anticipate? (select all that apply)

1. Headache 2. Blurred vision 3. Vomiting especially in the morning

The parents of a child who is disruptive in the classroom consults with the school nurse for ideas concerning behavior modification. Which findings lead the nurse to refer the parent to take the child for an assessment for ADHD? (Select all that apply)

1. Inability to stay on task 2. Frequent shifts from one uncompleted activity to another 3. Fidgeting, squirming when seated

Nursing care of all infants who have had a myelomeningocele repair includes which of the following interventions? (select all that apply)

1. Monitor for skin breakdown 2. Frequent neurological checks 3. Monitor intake and output

A parent brings his 4-month-old to the ED. Upon assessing the infant, the nurse knows which of the following signs indicate the need for prompt treatment? (Select all that apply)

1. Nasal flaring 2. Respiratory rate of 10 breaths/minute 3. Grunting 4. Oxygen saturation of 90%

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which of the following interventions should be included in the child's postoperative care? (select all that apply)

1. Observe closely for signs of infection 2. Maintain an accurate record of intake and output 3. Monitor for abdominal distention

Which of the following factors indicates a potentially, undetected cardiac defect when assessing a 1 month old infant? (Select all that apply)

1. Tachypnea 2. Tachycardia 3. Poor nutritional intake

An active 13 year old boy is complaining of swelling and pain at the tibial tubercle. He is prohibited from playing outside with his friends. Which nursing problems would be most appropriate?

Social isolation

The nurse is caring for a child with a diagnosis of ALL who is receiving chemotherapy. The patient's platelet count is 20,000. Based on this laboratory finding, what information should the nurse provide to the child and parents?

A soft toothbrush should be used for mouth care

Which of the following is the best nursing diagnosis for a child with anemia?

Activity intolerence r/t generalized weakness

A child with sickle cell disease is seen in the ED with paleness, fatigue, decreased BP and increased pulse. What is this child potentially experiencing?

Acute sequestration crisis

A 10-year-old with severe hemophilia falls, injures his elbow and is brought to the ER. The nurse should prepare which of the following?

An intravenous infusion of factor VIII

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include which of the following?

Answer questions with straightforward honesty

The nurse assesses a 15 year old boy who has just returned to the recovery area after undergoing a cardiac catheterization. Which of the following is of most concern?

Apical pulse is 150 beats/min and regular

A young girl has just injured her ankle at school. In addition to assessing the ankle and calling the child's parents, what intervention has the highest priority?

Apply ice and elevate extremity

The nurse notes skin breakdown on a neutopenic child with leukemia. What is the nurse's priority action?

Assess the child's vital signs for symptoms of infection

A pre-school aged child is hospitalized for leukemia. The nurse should anticipate which fears when planning nursing care for this patient?

Body mutilations and being left alone, and the dark

A 10 year old girl sustained a fracture in the epiphyseal plate of her right fibula when she fell out a tree. When discussing this injury with her parents, the nurse considers which of the following?

Bone growth can be affected by this type of fracture

The nurse understands that the most important precautions needed for children receiving chemotherapy is based on which of the following actions of chemotherapeutic agent?

Bone marrow suppression

Which of the following is true about the genetic transmission of sickle cell disease?

Both parents must carry the sickle cell trait

A child with a history of fever of unknown origin, excessive bruising, lymphadenopathy, and fatigue is exhibiting symptoms most suggestive of which condition?

Leukemia

Which of the following is a characteristic of children with depression?

Change in appetite, resulting in weight loss or gain

It is important to surgically correct hypospadias prior to which procedure?

Circumcision

Which of the following would cause to suspect that a child's cast is too tight?

Complaint of numbness and tingling

Young people with anorexia nervosa are often described as being which of the following?

Conforming

An adolescent patient tells the nurse that he is experiencing a change in sleeping patterns, irritability, fatigue, and anxiety. His mother reports all his grades dropped 2 letter grades. Given the symptoms, what diagnosis might the nurse suspect?

Depression

When does idiopathic scoliosis become most noticable?

During preadolescent growth spurt

What is the priority outcome of mandatory newborn screening for hypothyroidism?

Early identification of the disorder

Adolescents with bulimia may experience which of the following complications as a result of the frequent vomiting?

Erosion of tooth enamel

A 6 year old comes to the clinic and is diagnosed with precocious puberty. Which intervention is important when considering risks associated with this disorder?

Explain the importance of having the child foster relationships with same-age peers

Children with spina bifida are at low risk for development of a latex allergy

False

Congenital hypothyroidism is treated only during childhood with thyroid replacement therapy?

False

Johnny is a 5 year old in the ED after a traumatic motor vehicle accident. The physician calls out Glasgow scare of 15. The nurse knows this means she has an altered LOC

False

Which of the following is the most commonly used method in completed suicides?

Firearms

A neonate is born with mild clubfeet. When the parents as the nurse how this will be corrected, what will the nurse explain to the parents?

Frequent, serial casting is tried first

A neonate is displaying tremors, twitching, weak-high pitched cry and diaphoresis. The nurse knows which of the following labs levels, if low, will indicate the cause?

Glucose

A clinical manifestation of growth hormone deficiency is:

Height less than 5th percentile for age and sex

What are the nursing priorities for a child with sickle cell disease in vaso-occulusive crisis?

Hydration and pain management

When a 2 week-old infant is seen for irritability, poor appetite, and rapid head growth with an observable distended scalp vein, the nurse recognizes these signs as indicative of which condition?

Hydrocephalus

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia?

Immobilization and elevation of the affected joint

Which of the following is a symptom of a brain tumor in an infant?

Increased head circumference

An infant arrives in the ED with a fever, bulging fontanel, and lethargy. The lumbar puncture reveals cloudy CSF. What intervention has the highest priority?

Institute droplet isolation

Which of the following is the primary method of treating osteomyelitis?

Intravenous antibiotic therapy

Which assessment is most indicative of neurological dysfunction and should be reported immediately?

Lack of response to painful stimuli

Which finding in an analysis of cerebrospinal fluid (CSF) is consistent with diagnosis of bacterial meningitis?

Large amount of leukocytes present

An assessment of a 7-month-old with hemoglobin level of 6.5 is likely to reveal which of the following symptoms?

Lethargic, pale and irritable

Which of the following is descriptive of attention deficit hyperactivity disorder (ADHD)?

Manifestations affect every aspect of the child's life but are most obvious in the classroom

Which of the following explains why iron deficiency anemia is common during toddlerhood?

Milk is a poor source of iron

Which of the following analgesics is most effective for a child with sickle cell pain crisis?

Morphine

Which of the following clinical manifestations should the nurse expect when a child with sickle cell anemia experience an acute vaso-occlusive crisis?

Painful swelling of hands and feet; painful joints

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which of the following should be included?

Place diaper under harness, preferably using a superabsorbent disposable diaper that is relatively thin

Considering both safety and development, which of the following is the best play activity for a 3 year old child with a spica cast?

Playing with a toy telephone

Which of the following clinical manifestations of developmental dysplasia of the hip are seen in the newborn?

Positive Ortolani click

A 15 year old with spina bifida is seen in the clinic for a well-child checkup. The teen uses leg braces and crutches to ambulate. Which of the following nursing diagnoses takes priority?

Potential body image disturbance

The nurse will preoperatively position a neonate born with myelomeningocele in which of the following positions?

Prone

Anorexia nervosa may best be described as which of the following?

Results in severe weight loss in the absence of obvious physical cause

Which of the following factors predisposes a child to urinary tract infections?

Short urethra in young girls

An 8-month-old being evaluated for a UTI. A urinalysis and urine culture are ordered. Which of the following is the best way to obtain the urine samples?

Suprapubic aspiration with bladder catheterization after excluding first few milliliter from collection

An important nursing consideration when caring for a child with juvenile rheumatoid arthritis would be which of the following?

Teach the child and family about correct administration of medications

What is the most important factor for a nurse to consider when teaching a child with cerebral palsy?

The child's developmental level

The nurse is teaching the parents of a child with vesicoureteral reflux. What is the most important instruction to include?

The importance of taking prophylactic antibiotics

The nurse is caring for a 4-year-old who weighs 15 kg. At the end of a 10 hour period, the nurse notes the urine output is 150 ml. What action should the nurse take?

The nurse records the patient's urine output in the chart

Which is true concerning the girls/women who have bulimia?

They are mostly within to slightly higher than above average weight

A newborn develops tetany and a seizure just prior to discharge for the nursery. The newborn is diagnosed with hypocalcemia secondary to hypoparathyroidism and is started on calcium and vitamin D. What would be important to teach the parents?

They should observe for signs of vitamin D toxicity: weakness, nausea, vomiting, and diarrhea

Before surgery the neonate with a myelomeningocele is at greatest risk for infection

True

Folic acid deficiency in the mother has been linked to neural tube defects

True

Prenatal screening involves measurement of maternal serum alpha-fetoprotein

True

The degree of impairment is related to the level of the defect on the spinal cord

True

The pupils dilate as intracranial pressure increases

True