Care of Children 2019 B

52. A nurse is teaching the parents of a toddler who has cognitive impairment about toilet training. Which of the following instructions should the nurse include in the teaching?

"Award your child with a sticker when they sit on the potty chair."

A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse assess first?

A toddler who has a concussion and an episode of forceful vomiting.; indication of increased intracranial pressure in a toddler who has a concussion.

A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS complexes and peaked T waves on the cardiac monitor. Which of the following prescriptions should the nurse clarify with the provider?

Potassium Chloride

A school nurse is caring for a child following tonic-clonic seizure. Which of the following actions should the nurse take first?

Check the childs respiratory rate.

A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking prednisone. Following 1 week of treatment, which of the following manifestations indicates to the nurse that the medication is effective?

Decreased edema; experience edema due to the increased glomerular permeability, which increases protein loss. Prednisone decreases glomerular permeability, which causes fluid to shift from the extracellular spaces, resulting in decreased edema.

A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include?

Expressed likes and dislikes

A nurse is assessing the pain level of a 3-year-old toddler. Which of the following pain assessment scales should the nurse use?

FACES

A nurse is creating a plan of care for a newly admitted adolescent who has bacterial meningitis. How long should the nurse plan to maintain the adolescent in droplet precautions?

For 24 hr following initiation of antimicrobial therapy

A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?

Great Toe

A nurse is planning n educational program to teach parents about protecting their children from sunburns. Which of the following instructions should the nurse plan to include?

"Choose a waterproof sunscreen with a minimum SPF of 15."

A nurse is teaching the guardian of a 6-month-old infant about teething. Which of the following statements should the nurse make?

"Your baby might pull at their ears when they are teething."

A nurse is caring for a school-age child who has diabetes mellitus and was admitted with a diagnosis of diabetic ketoacidosis. When performing the respiratory assessment, which of the following findings should the nurse expect?

Deep respirations of 32/min; Kussmaul respirations; deep and rapid respirations are the body's attempt to eliminate excess carbon dioxide and achieve a state of homeostasis.

A nurse is planning care for a newly admitted schole-age child who has generalized seizure disorder. Which of the following interventions should the nurse plan to include?

Ensure the oxygen source is functioning in the childs room

A nurse is providing discharge teaching to the parents of a 6-month-old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instructions should the nurse include in the teaching?

"Allow the stent to drain into your infants diaper."

A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation?

An 8-month-old who is not yet making babbling sounds.

A charge nurse is preparing to make a room assignment for a newly admitted school-age child. Which of the following considerations is the nurses priority?

Disease process

A community health nurse is assessing an 18-month-old toddler in a community day care. Which of the following findings should the nurse identify as a potential indication of physical neglect?

Poor personal hygiene

A nurse is reviewing the dietary choices of an adolescent who has iron deficiency anemia. The nurse should identify that which of the following menu items has the highest amount of nonheme iron?

½ cup raisins

A nurse is providing teaching to an adolescent about how to manage tinea pedis. Which of the following statements by the adolescent indicates an understanding of the teaching?

"I should wear sandals as much as possible."

A nurse is discussion organ donation with the parents of a school-age child who has sustained brain death due to a bicycle crash. Which of the following actions should the nurse take first?

Explore the parents feelings and wishes regarding organ donation.

A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider?

Presence of strabismus; crossing of the eyes, typically disappears at 3 to 4 months of age. If not corrected early, this can lead to blindness. Therefore, the nurse should report this finding to the provider.

A nurse in an emergency department is caring for a school-age child who has sustained a minor superficial burn from fireworks on their forearm. Which of the following actions should the nurse take?

Apply an antimicrobial ointment to the affected area.

A nurse is providing teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin twice daily. Which of the following instructions should the nurse include in the teaching?

"Brush the childs teeth after giving the medication."

A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistant asthma. Which of the following instructions should the nurse include?

"Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy."

A nurse is assessing a school-age child who has an acute spinal cord injury following a sports injury 1 week ago. Identify the area the nurse should tap to elicit the bicep reflect.

Correct answer is A

A nurse is admitting an infant who has intussusception. Which of the following findings should the nurse expect? (Select all that apply.)

Vomiting; due to the obstruction that occurs when a segment of the bowel telescopes within another segment of the bowel. Lethargy; due to episodes of severe pain during which the infant cries inconsolably, leading to exhaustion and decreased nutritional intake.

A nurse in a providers office is caring for a school-age child who has varicella. The parents asks the nurse when their child will no longer be contagious. Which of the following responses should the nurse make?

"When your childs lesions are crusted, usually 6 days after they appear."; the child is contagious 1 day prior to lesion eruption and until the vesicles have crusted over, which usually takes about 6 days.

A nurse is providing dietary teaching to the guardian of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make?

"You should offer your child high-protein meals and snacks throughout the day."; well-balanced and high in protein and calories. Children who have cystic fibrosis require a higher percentage of the recommended dietary allowances of all nutrients to meet their energy requirements.

A nurse is reviewing the laboratory results of a school-age child who is 1 week postoperative following an open fracture repair. Which of the following findings should the nurse identify as an indication of a potential complication?

Erythrocyte sedimentation rate 18 mm/hr; bove the expected reference range of up to 10 mm/hr and is an indication of osteomyelitis. WBC Count Normal: 5,000 to 10,000/mm3 C-Reactive Protein Normal: Less than 10.0 mg/L RBC Count Normal: 4.0 to 5.5 million/mm3

A nurse is providing discharge teaching to the parent of an 18-month-old toddler who has dehydration due to acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching?

"I will monitor my childs number of wet diapers."

A nurse is planning developmental activities for a newly admitted 10-year-old child who has neutropenia. Which of the following actions should the nurse plan to take?

Provide the child with a book about adventure.

A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by parent indicates an understanding the teaching?

"Mononucleosis is caused by an infection with the Epstein-Barr virus."; a mildly contagious illness that occurs sporadically or in groups, and is primarily caused by the Epstein-Barr virus.

A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hr PRN for a temperatures above 38.0 C (100.5 F) to an infant who weighs 17.6 lb. Available is ibuprofen oral suspension 100mg/5mL. How many mL should the nurse administer to the infant per dose?

2 mL

A nurse is caring for a 1-month-old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize the infants pain?

Allow the mother to breastfeed while the sample is being obtained.

A nurse is assessing an 8-year-old child who has early indications of shock. After establishing an airway and stabilizing the childs respirations, which of the following actions should the nurse take next?

Initiate IV access.

A nurse is caring for a school-age child who has peripheral edema. The nurse should identify that which of the following assessments should be performed to confirm peripheral edema?

Palpate the dorsum of the childs feet

A nurse in an emergency department is assessing a 3-month-old infant who has rotavirus and is experiencing acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that the infant has moderate to severe dehydration?

Sunken anterior fontanel

A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following?

Wheezes

A nurse is creating a plan of care for a child who has varicella. Which of the following interventions should the nurse include?

Initiate airborne precautions for the child.

A nurse is an emergency department is caring for a school-age child who has epiglottitis. Which of the following actions should the nurse take?

Monitor the childs oxygen saturation

A nurse is planning an educational program for school-age children and their parents about bicycle safety. Which of the following information should the nurse plan to include?

The child should be able to stand on the balls of their feet when sitting on the bike.; To decrease the risk for injury, parents should ensure that the bike is the correct size for the child

A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication?

Serum potassium level 4.1 mEq/L; The nurse should monitor the adolescent's serum potassium level following the administration of sodium polystyrene sulfonate. This medication is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestine. Therefore, a potassium level within the expected reference range of 3.4 to 4.7 mEq/L indicates the effectiveness of the medication.

A nurse is providing discharge teaching to the guardians of a toddler who had lower leg cast applied 24 hr ago. The nurse should instruct the guardians to report which of the following finding to the provider?

Restricted ability to move the toes.; restricted ability of the toddler to move their toes is an indication of neurovascular compromise and requires immediate notification of the provider. Permanent muscle and tissue damage can occur in just a few hours.

A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthritis. Which if the following instructions should the nurse include in the teaching?

"Encourage the child to perform independent self-care."

A nurse is creating a plan of care for a preschooler who has Wilms' tumor and is scheduled for surgery. Which of the following interventions should the nurse include?

Avoid palpating the abdomen when bathing the child before surgery.

A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?

Increase fat content in the childs diet to 40% of total calories.; A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of pancreatic enzymes. The nurse should increase the child's fat intake to 35% to 40% of total caloric intake.

A nurse is planning care for a school-age child who has tunneled central venous access device. Which of the following interventions should the nurse include in the plan?

Use a semipermeable transparent dressing to cover the site.; reduce the risk of infection.

A nurse in an emergency department is assessing a toddler who has Kawasaki disease. Which of the following findings should the nurse expect? (Select all that apply.)

Increased temperature; an acute illness associated with a fever that is unresponsive to antipyretics or antibiotics. Xerophthalmia; Ophthalmic manifestations of Kawasaki disease include reddening of the conjunctiva and dryness of the eyes, or xerophthalmia. Cervical lymphadenopathy; A child who has Kawasaki disease can develop enlarged cervical nodes on one side of the neck that are nontender and greater than 1.5 cm in size.

A nurse is caring for a newly admitted school-age child who has hypopituitarism. Which of the following medications should the nurse expect the provider to prescribe?

Recombinant growth hormone; which inhibits cell growth and results in growth failure. The nurse should expect the provider to prescribe this treatment.

A nurse assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?

Difficulty concentrating; irritability, inability to follow commands, and difficulty concentrating are manifestations of increased intracranial pressure due to decreased blood flow within the brain and pressure on the brainstem.

A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider?

Nasal flaring

A nurse is providing discharge teaching to the parents of a 3-month old infant following a cheiloplasty. Which of the following instructions should the nurse include?

"Apply a thin layer of antibiotic ointment on the your babys suture line daily for the next 3 days."

A nurse is providing discharge teaching to the guardian of a school-age child who has undergone a tonsillectomy. Which of the following statements by the guardian indicates an understanding the teaching?

"I will notify the doctor if I notice that my child is swallowing frequently."; indication of bleeding and, if it is observed.

A school nurse is providing an in-service for faculty about improving education for students who have ADHD. Which of the following statements by a faculty member indicates an understanding of the teaching?

"I will teach challenging academic subjects to students who have ADHD in the morning."

A nurse is teaching a school-age child and their parent about postoperative care following cardiac catheterization. Which of the following instructions should the nurse include?

"Wait 3 days before taking a tub bath."

A nurse is caring for a toddler who has acute otitis media and a temperature of 40 C (104 F). After administering acetaminophen, which of the following actions should the nurse plan to take to reduce the toddler's temperature?

Dress the toddler in minimal clothing.

A nurse is admitting a 4-month-old infant who has heart failure. Which of the following findings is the nurses priority?

Episodes of vomiting; This can indicate digoxin toxicity, which requires immediate intervention. Therefore, this is the nurse's priority finding.

A nurse in a health department is caring for an emancipated adolescent who has an STI and is unaccompanied by a guardian. Which of the following actions should the nurse take?

Have the adolescent sign a consent form for treatment.

A nurse is caring for an infant who is receiving IV fluids for the treatment of Tetralogy of Fallot and begins to have hypercryanotic spell. Which of the following actions should the nurse take?

Place the infant in a knee-chest position; decrease the return of desaturated venous blood from the legs and to direct more blood into the pulmonary artery by increasing systemic vascular resistance.

A nurse is caring for a 10-year-old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus?

Sodium 155 mEq/L; as a result of pituitary hypofunction leading to a deficiency of antidiuretic hormone. Underexcretion of antidiuretic hormone leads to polyuria and polydipsia, and possibly dehydration. With the excessive loss of free water, sodium levels rise above the expected reference range of 136 to 145 mEq/L. Urine specific gravity of 1.045 is above the expected reference range of 1.005 to 1.030. A child who has diabetes insipidus is more likely to have diluted urine and a urine specific gravity below the expected reference range. Urinary output of 35 mL/hr is within the expected reference range of 33 to 58 mL/hr for a 10-year-old child. A child who has diabetes insipidus is expected to have polyuria. Blood glucose of 45 mg/dL is below the expected reference range of 70 to 110 mg/dL. A child who has diabetes insipidus is expected to have a blood glucose level within the expected reference range.