Combined-Peds PrepU: Chapter 20

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education?

"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

The nurse is talking with a woman who is in her 2nd trimester of pregnancy who has been diagnosed with polyhdyramnios. The physician has ordered an ultrasound be performed to check for the presence of esophageal atresia. Which statement by the woman indicates an understanding of the relationship between these conditions?

"Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup." Review the maternal history for polyhydramnios. Often this is the first sign of esophageal atresia because the fetus cannot swallow and absorb amniotic fluid in utero, leading to accumulation. Esophageal atresia is an underlying cause of polyhydramnios.

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate?

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? a) "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." b) "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." c) "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing." d) "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding."

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." Infants are comprised of a high percentage of fluid that can be lost very quickly when vomiting, fever, and diarrhea are all present. This infant needs to be seen by the physician based on her age and symptoms; hospitalization may be necessary for intravenous rehydration depending upon her status when assessed.

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? a) "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." b) "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing." c) "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." d) "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding."

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." Infants are comprised of a high percentage of fluid that can be lost very quickly when vomiting, fever, and diarrhea are all present. This infant needs to be seen by the physician based on her age and symptoms; hospitalization may be necessary for intravenous rehydration depending upon her status when assessed.

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? a) "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." b) "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." c) "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding." d) "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing."

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." Infants are comprised of a high percentage of fluid that can be lost very quickly when vomiting, fever, and diarrhea are all present. This infant needs to be seen by the physician based on her age and symptoms; hospitalization may be necessary for intravenous rehydration depending upon her status when assessed.

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? a) "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." b) "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." c) "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding." d) "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing."

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." Infants are comprised of a high percentage of fluid that can be lost very quickly when vomiting, fever, and diarrhea are all present. This infant needs to be seen by the physician based on her age and symptoms; hospitalization may be necessary for intravenous rehydration depending upon her status when assessed.

A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse?

"Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses."

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. What is the most important instruction to emphasize to the mother to avoid an emergency situation?

"Call the doctor immediately if the stoma is not pink/red and moist."

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. Which of the following is the most important instruction to emphasize to the mother to avoid an emergency situation? a) "Gather all of your supplies before you begin." b) "Call the doctor immediately if the stoma is not pink/red and moist." c) "You may need adhesive remover to ease pouch removal." d) "You must be meticulous in caring for the surrounding skin."

"Call the doctor immediately if the stoma is not pink/red and moist." Explanation: A healthy stoma is pink and moist. If the stoma is dry or pale, the mother must notify the doctor immediately because it could indicate compromised circulation. Gathering supplies is important but would not be involved in avoiding an emergency situation. All of the other instructions are valid, but emphasizing the color of the healthy stoma is most important to avoid an emergency situation. Adhesive remover may be needed to ease pouch removal, but this action would not necessarily avoid an emergency situation. Meticulous skin care is important, but this action would not necessarily avoid an emergency situation.

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. Which of the following is the most important instruction to emphasize to the mother to avoid an emergency situation? a) "You may need adhesive remover to ease pouch removal." b) "Call the doctor immediately if the stoma is not pink/red and moist." c) "You must be meticulous in caring for the surrounding skin." d) "Gather all of your supplies before you begin."

"Call the doctor immediately if the stoma is not pink/red and moist." Explanation: A healthy stoma is pink and moist. If the stoma is dry or pale, the mother must notify the doctor immediately because it could indicate compromised circulation. Gathering supplies is important but would not be involved in avoiding an emergency situation. All of the other instructions are valid, but emphasizing the color of the healthy stoma is most important to avoid an emergency situation. Adhesive remover may be needed to ease pouch removal, but this action would not necessarily avoid an emergency situation. Meticulous skin care is important, but this action would not necessarily avoid an emergency situation.

The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their child. What is the best response by the nurse?

"Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs."

The nurse is caring for a child recently fitted with braces on both legs due to cerebral palsy (CP). What would the nurse emphasize in the discharge teaching?

"Check the skin that is covered by the braces for redness and breakdown."

In discussing the treatment for children with scoliosis, a group of pediatric nurses makes the following statements. Which statement is most accurate related to the treatment of scoliosis?

"Children treated for scoliosis by using braces have to wear the brace almost all the time."

The nurse is providing postoperative care for a boy who has undergone surgical correction for pectus excavatum. The nurse should emphasize which instruction to the child's parents?

"Do not allow him to lie on either side."

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea, the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea?

"Emotional stress can be a cause of this disorder."

The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching?

"Encourage a bland diet."

The nurse is preparing an 18-month-old for discharge after treatment for dehydration following diarrhea. What instruction would the nurse most likely include in the discharge teaching? a) "Offer her flavored gelatin if she is hungry." b) "Encourage bananas, applesauce, and crackers." c) "Give her plenty of fruit juice or soda." d) "Make sure she gets lots of clear liquids."

"Encourage bananas, applesauce, and crackers." After rehydration is achieved, it is important to encourage the child to consume a regular diet in order to maintain energy and growth. The solid foods presented are easily digested and age appropriate. The parents should avoid prolonged used of clear liquids in the child with diarrhea because "starvation stools" might result. Fluids high in glucose such as fruit juice, gelatin, and soda may worsen diarrhea. Gelatin is high in glucose and may worsen diarrhea.

The nurse is preparing an 18-month-old for discharge after treatment for dehydration following diarrhea. Which of the following would the nurse most likely include in the discharge teaching? a) "Give her plenty of fruit juice or soda." b) "Make sure she gets lots of clear liquids." c) "Offer her flavored gelatin if she is hungry." d) "Encourage bananas, applesauce, and crackers."

"Encourage bananas, applesauce, and crackers." Correct Explanation: After rehydration is achieved it is important to encourage the child to consume a regular diet in order to maintain energy and growth. The solid foods presented are easily digested and age appropriate. The parents should avoid prolonged used of clear liquids in the child with diarrhea because "starvation stools" might result. Fluids high in glucose such as fruit juice, gelatin, and soda may worsen diarrhea. Gelatin is high in glucose and may worsen diarrhea.

The parents of a child diagnoses with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse?

"Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis."

The nurse is evaluating parents' understanding of atopic dermatitis. Which statement shows their understanding?

"Flare-ups of lesions are not uncommon following therapy."

A child with asthma has been monitoring his peak expiratory flow rate (PEFR) and has been maintaining it within 90% of his personal best. Today, the child is experiencing symptoms and his PEFR is at 40% of his personal best. The child's mother calls the office and asks the nurse what she should do. What would the nurse instruct the mother to do first?

"Have him use his short-acting bronchodilator right away."

The nurse is doing teaching with the caregivers of toddler and preschool aged-children. One of the caregivers tells the group that her child had diarrhea and she was told that it was caused by giardiasis. Which statement made by the caregiver indicates the most likely situation in which the child contacted the disorder?

"He attends a day care center four days a week while I am at work." Giardiasis is caused by the protozoan parasite Giardia lamblia. It is a common cause of diarrhea and is prevalent in children who attend day care centers and other types of residential facilities; it may be found in contaminated mountain streams or pools frequented by diapered infants. Bubble baths can lead to urinary tract infections, but are not the cause of Giardiasis infestations. It is not related to either C. Diff or pinworms.

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching?

"I can tape a quarter over the hernia to reduce it."

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching?

"I can tape a quarter over the hernia to reduce it." The use of home remedies to reduce an umbilical hernia should be discouraged because of the risk of bowel strangulation. The mother needs to be aware that strangulation can occur, but it is rare with an umbilical hernia. Pain, tenderness, or redness indicates incarceration, which although rare with umbilical hernias, can occur. She needs to understand the signs of strangulation and understand that some children have self-esteem issues related to the large protrusion of the unrepaired umbilical hernia. Physical needs of the child have priority over any types of potential psychosocial issues. Self-esteem issues may arise due to a large protrusion of an unrepaired umbilical hernia.

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching? a) "I can tape a quarter over the hernia to reduce it." b) "My son could have some appearance-related self-esteem issues." c) "I need to watch for pain, tenderness, or redness." d) "Incarceration is rare, but it can occur."

"I can tape a quarter over the hernia to reduce it." The use of home remedies to reduce an umbilical hernia should be discouraged because of the risk of bowel strangulation. The mother needs to be aware that strangulation can occur, but it is rare with an umbilical hernia. Pain, tenderness, or redness indicates incarceration, which although rare with umbilical hernias, can occur. She needs to understand the signs of strangulation and understand that some children have self-esteem issues related to the large protrusion of the unrepaired umbilical hernia. Physical needs of the child have priority over any types of potential psychosocial issues. Self-esteem issues may arise due to a large protrusion of an unrepaired umbilical hernia.

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which of the following responses from the mother indicates a need for further teaching? a) "My son could have some appearance-related self-esteem issues." b) "Incarceration is rare, but it can occur." c) "I need to watch for pain, tenderness, or redness." d) "I can tape a quarter over the hernia to reduce it."

"I can tape a quarter over the hernia to reduce it." Correct Explanation: The use of home remedies to reduce an umbilical hernia should be discouraged because of the risk of bowel strangulation. The mother needs to be aware that strangulation can occur, but it is rare with an umbilical hernia. Pain, tenderness, or redness indicates incarceration, which although rare with umbilical hernias, can occur. She needs to understand the signs of strangulation and understand that some children have self-esteem issues related to the large protrusion of the unrepaired umbilical hernia. Physical needs of the child have priority over any types of potential psychosocial issues. Self-esteem issues may arise due to a large protrusion of an unrepaired umbilical hernia.

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which of the following responses from the mother indicates a need for further teaching? a) "I can tape a quarter over the hernia to reduce it." b) "I need to watch for pain, tenderness, or redness." c) "My son could have some appearance-related self-esteem issues." d) "Incarceration is rare, but it can occur."

"I can tape a quarter over the hernia to reduce it." Explanation: The use of home remedies to reduce an umbilical hernia should be discouraged because of the risk of bowel strangulation. The mother needs to be aware that strangulation can occur, but it is rare with an umbilical hernia. Pain, tenderness, or redness indicates incarceration, which although rare with umbilical hernias, can occur. She needs to understand the signs of strangulation and understand that some children have self-esteem issues related to the large protrusion of the unrepaired umbilical hernia. Physical needs of the child have priority over any types of potential psychosocial issues. Self-esteem issues may arise due to a large protrusion of an unrepaired umbilical hernia.

The parents of an 8-year-old boy diagnosed with frostbite are distraught and state to the nurse, "We can't believe we didn't make our child come inside when he complained about his fingers being numb and hurting." How should the nurse respond?

"I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son."

The nurse is caring for a child who was involved in an automobile accident in which extensive damage to the small intestine occurred. A surgical resection of the small intestine resulted in massive small intestine loss, causing short bowel syndrome. The parents voice concern to the nurse that their child will "never be the same." What is the best response by the nurse?

"I can't imagine what you're going through. We will be here to support and educate you on your child's condition and treatments throughout their care." Being empathetic and reassuring the parents that the staff will be there to support them and educate them will provide some relief of anxiety since this is a chronic condition. Telling them their is nothing they could have done to prevent this from happening does not help the current situation. Giving hope is good, but giving possible false hope sets the family up for disappointment. Telling the family to be strong does not provide support.

The nurse is caring for a child who was involved in an automobile accident in which extensive damage to the small intestine occurred. A surgical resection of the small intestine resulted in massive small intestine loss, causing short bowel syndrome. The parents voice concern to the nurse that their child will "never be the same." What is the best response by the nurse? a) "Having a chronic condition is difficult but you have to be strong for your child. You are their main support person." b) "There are so many new treatments available every day. There may be something to correct this in the near future." c) "I can't imagine what you're going through. We will be here to support and educate you on your child's condition and treatments throughout their care." d) "I know it must be difficult but there was nothing you could have done to prevent this."

"I can't imagine what you're going through. We will be here to support and educate you on your child's condition and treatments throughout their care." Being empathetic and reassuring the parents that the staff will be there to support them and educate them will provide some relief of anxiety since this is a chronic condition. Telling them their is nothing they could have done to prevent this from happening does not help the current situation. Giving hope is good, but giving possible false hope sets the family up for disappointment. Telling the family to be strong does not provide support.

The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents, regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred?

"I have to be careful because I am prone to not absorbing nutrients."

The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred? a) "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." b) "It's unusual for someone my age to get Crohn disease." c) "I have a lot of diarrhea every day because of how my small intestine is damaged." d) "I have to be careful because I am prone to not absorbing nutrients."

"I have to be careful because I am prone to not absorbing nutrients." Crohn disease typically effects the small intestine more than the large intestine and it's onset is between the ages of 10 to 20 years. The cobblestone lesions in the small intestine prevents absorption of nutrients that normally occurs. The diarrhea is not directly related to the cobblestone lesions, and ulcerative colitis is characterized by the disease effecting the intestine(s) in a continuous pattern.

The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred? a) "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." b) "It's unusual for someone my age to get Crohn disease." c) "I have a lot of diarrhea every day because of how my small intestine is damaged." d) "I have to be careful because I am prone to not absorbing nutrients."

"I have to be careful because I am prone to not absorbing nutrients." Crohn disease typically effects the small intestine more than the large intestine and it's onset is between the ages of 10 to 20 years. The cobblestone lesions in the small intestine prevents absorption of nutrients that normally occurs. The diarrhea is not directly related to the cobblestone lesions, and ulcerative colitis is characterized by the disease effecting the intestine(s) in a continuous pattern.

The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents, regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred?

"I have to be careful because I am prone to not absorbing nutrients." Crohn disease typically effects the small intestine more than the large intestine and it's onset is between the ages of 10 to 20 years. The cobblestone lesions in the small intestine prevents absorption of nutrients that normally occurs. The diarrhea is not directly related to the cobblestone lesions, and ulcerative colitis is characterized by the disease effecting the intestine(s) in a continuous pattern.

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. What would be the best response from the nurse?

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?"

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. Which of the following would be the best response from the nurse? a) "Your son needs you right now. You should put your negative feelings about his condition aside for his sake." b) "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" c) "Keep in mind that your son's condition is not life-threatening and can be corrected eventually." d) "Many infants are born with this condition. Your son's palate is not nearly as bad as some cases."

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" Explanation: The nurse should support the family's adjustment to a child's condition by demonstrating an accepting, caring attitude toward the child and family and providing the parents with opportunities and support for normal infant-parent interactions.

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. What would be the best response from the nurse?

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" The nurse should support the family's adjustment to a child's condition by demonstrating an accepting, caring attitude toward the child and family and providing the parents with opportunities and support for normal infant-parent interactions.

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. What would be the best response from the nurse? a) "Keep in mind that your son's condition is not life-threatening and can be corrected eventually." b) "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" c) "Your son needs you right now. You should put your negative feelings about his condition aside for his sake." d) "Many infants are born with this condition. Your son's palate is not nearly as bad as some cases."

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" The nurse should support the family's adjustment to a child's condition by demonstrating an accepting, caring attitude toward the child and family and providing the parents with opportunities and support for normal infant-parent interactions.

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. Which of the following would be the best response from the nurse? a) "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" b) "Keep in mind that your son's condition is not life-threatening and can be corrected eventually." c) "Many infants are born with this condition. Your son's palate is not nearly as bad as some cases." d) "Your son needs you right now. You should put your negative feelings about his condition aside for his sake."

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" Correct Explanation: The nurse should support the family's adjustment to a child's condition by demonstrating an accepting, caring attitude toward the child and family and providing the parents with opportunities and support for normal infant-parent interactions.

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful?

"I should not cover the area with plastic wrap after applying the cream."

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred?

"I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." "Oral rehydration solutions (ORS) are good sources of fluids for rehydration." "I should be sure my child receives 50 to 100 mL/kg of oral rehydration solution (ORS) over 4 In the child with mild to moderate dehydration resulting from vomiting, withhold oral feeding for 1 to 2 hours after emesis, after which time oral rehydration can begin. Tap water, milk, undiluted fruit juice, soup, and broth are NOT appropriate for oral rehydration. Oral rehydration solutions include standard ORS solutions include Pedialyte, Infalyte, and Ricelyte. The recommendation for children with mild to moderate dehydration is 50 to 100 mL/kg of ORS over 4 hours.

The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective?

"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration." Mild diarrhea is not considered serious and at the end of approximately 1 hour, parents can begin to offer an oral rehydration solution such as Pedialyte in small amounts. Infants may develop a temporary lactase deficiency after diarrhea that leads to lactose intolerance. With this, a child cannot take formula or breast milk without new diarrhea beginning. Parents should alert their health care provider if they feel this is happening as the infant will need to be introduced to a lactose-free formula initially before being returned to the usual formula or to breast milk. An elevated temperature is seen in severe diarrhea. The parents should be cautioned to contact their health care provider prior to initiating over-the-counter drugs such as kaolin and pectin (Kaopectate) to halt diarrhea because toxic levels of these can occur quickly.

The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond?

"I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately."

The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond?

"I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately." The mother is describing common symptoms of an inguinal hernia. It may be possible to visualize the mass, but often the mass is seen only during crying or straining, making it difficult to actually identify in the clinic setting. It is important to notify the physician so treatment can be initiated.

The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond? a) "I didn't notice any masses while I was assessing your infant. It may just appear they have a mass due to pressure in the abdomen when crying." b) "I will be sure to note this in your child's chart so it is something we will continue to monitor in future visits." c) "The muscle wall of infants are not yet strong so it isn't unusual to see this happening when the baby is crying or straining." d) "I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately."

"I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately." The mother is describing common symptoms of an inguinal hernia. It may be possible to visualize the mass, but often the mass is seen only during crying or straining, making it difficult to actually identify in the clinic setting. It is important to notify the physician so treatment can be initiated. (less)

The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond? a) "I didn't notice any masses while I was assessing your infant. It may just appear they have a mass due to pressure in the abdomen when crying." b) "I will be sure to note this in your child's chart so it is something we will continue to monitor in future visits." c) "The muscle wall of infants are not yet strong so it isn't unusual to see this happening when the baby is crying or straining." d) "I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately."

"I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately." The mother is describing common symptoms of an inguinal hernia. It may be possible to visualize the mass, but often the mass is seen only during crying or straining, making it difficult to actually identify in the clinic setting. It is important to notify the physician so treatment can be initiated. (less)

The nurse is caring for an infant recently diagnosed with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education?

"I will add the nystatin to her bottle four times per day."

The nurse is caring for an infant recently diagnoses with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education?

"I will add the nystatin to her bottle four times per day." Administer nystatin suspension four times per day following feeding, not mixed in the bottle, to allow the medication to remain in contact with the lesions. In the younger infant, apply nystatin to the lesions with a cotton-tipped applicator. Infants and young children often mouth their toys, so it is important to clean them appropriately. Explain to parents of infants with thrush the importance of reporting diaper rash because fungal infections in the diaper area often occur concomitantly with thrush and also need to be treated.

The nurse is caring for an infant recently diagnoses with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education? a) "I will add the nystatin to her bottle four times per day." b) "I will use a cotton tipped applicator to apply the medication to her mouth." c) "I will make sure to clean all of her toys before I give them to her." d) "I will watch for diaper rash."

"I will add the nystatin to her bottle four times per day." Administer nystatin suspension four times per day following feeding, not mixed in the bottle, to allow the medication to remain in contact with the lesions. In the younger infant, apply nystatin to the lesions with a cotton-tipped applicator. Infants and young children often mouth their toys, so it is important to clean them appropriately. Explain to parents of infants with thrush the importance of reporting diaper rash because fungal infections in the diaper area often occur concomitantly with thrush and also need to be treated.

The nurse is caring for an infant recently diagnoses with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education? a) "I will make sure to clean all of her toys before I give them to her." b) "I will use a cotton tipped applicator to apply the medication to her mouth." c) "I will watch for diaper rash." d) "I will add the nystatin to her bottle four times per day."

"I will add the nystatin to her bottle four times per day." Administer nystatin suspension four times per day following feeding, not mixed in the bottle, to allow the medication to remain in contact with the lesions. In the younger infant, apply nystatin to the lesions with a cotton-tipped applicator. Infants and young children often mouth their toys, so it is important to clean them appropriately. Explain to parents of infants with thrush the importance of reporting diaper rash because fungal infections in the diaper area often occur concomitantly with thrush and also need to be treated.

The nurse is caring for an infant recently diagnoses with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education? a) "I will make sure to clean all of her toys before I give them to her." b) "I will use a cotton tipped applicator to apply the medication to her mouth." c) "I will watch for diaper rash." d) "I will add the nystatin to her bottle four times per day."

"I will add the nystatin to her bottle four times per day." Administer nystatin suspension four times per day following feeding, not mixed in the bottle, to allow the medication to remain in contact with the lesions. In the younger infant, apply nystatin to the lesions with a cotton-tipped applicator. Infants and young children often mouth their toys, so it is important to clean them appropriately. Explain to parents of infants with thrush the importance of reporting diaper rash because fungal infections in the diaper area often occur concomitantly with thrush and also need to be treated.

The nurse is caring for a child with an order for PO prednisone. Which statement by the child's mother would indicate a need for further education?

"I will give it to her at least 1 hour before all of her meals."

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake". Which statement by the student would indicate a need for further education by the nursing instructor?

"I will make sure there is plenty of orange juice available. It's her favorite juice." Proper interventions for children at risk for fluid volume deficit include maintaining IV line and administer IV fluid as ordered to maintain fluid volume. Offer small amounts of oral rehydration solution frequently to maintain fluid volume. Small amounts are usually well tolerated by children with diarrhea and vomiting. Avoid high-carbohydrate fluids such as Kool-Aid and fruit juice, as they are low in electrolytes, and increased simple carbohydrate consumption can decrease stool transit time. Daily weights are one of the best indicators of fluid volume status in children.

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake". Which statement by the student would indicate a need for further education by the nursing instructor? a) "I will teach her mother to give her small drinks frequently." b) "I will weigh her every morning at the same time." c) "I will monitor her IV line to help maintain her fluid volume." d) "I will make sure there is plenty of orange juice available. It's her favorite juice."

"I will make sure there is plenty of orange juice available. It's her favorite juice." Proper interventions for children at risk for fluid volume deficit include maintaining IV line and administer IV fluid as ordered to maintain fluid volume. Offer small amounts of oral rehydration solution frequently to maintain fluid volume. Small amounts are usually well tolerated by children with diarrhea and vomiting. Avoid high-carbohydrate fluids such as Kool-Aid and fruit juice, as they are low in electrolytes, and increased simple carbohydrate consumption can decrease stool transit time. Daily weights are one of the best indicators of fluid volume status in children.

The nurse is performing discharge teaching for a 16-year-old diagnosed with peptic ulcer disease. Which statements by the parents and client demonstrate learning has occurred? "The prednisone that I take for my rheumatoid arthritis may be a cause of my peptic ulcer disease." "My proton pump inhibitor should be taken when I feel discomfort." "My mom having peptic ulcer disease has nothing to do with my having it." "I will need to make sure to take all of the antibiotic prescribed." "It's important to take my histamine agonist medication at the appropriate time."

"I will need to make sure to take all of the antibiotic prescribed." "It's important to take my histamine agonist medication at the appropriate time." "The prednisone that I take for my rheumatoid arthritis may be a cause of my peptic ulcer disease." If Helicobacter pylori (H. pylori was detected as a cause of the peptic ulcer disease (PUD), the client will be prescribed an antibiotic and should take all of the medication. Histamine agonists and/or proton pump inhibitors should be taken routinely as prescribed. Risk factors include a family history of PUD or other GI diseases, or chronic salicylate or prednisone use.

The nurse is performing discharge teaching for a 16-year-old diagnosed with peptic ulcer disease. Which statements by the parents and client demonstrate learning has occurred?

"I will need to make sure to take all of the antibiotic prescribed." "It's important to take my histamine agonist medication at the appropriate time." "The prednisone that I take for my rheumatoid arthritis may be a cause of my peptic ulcer disease." If Helicobacter pylori (H. pylori was detected as a cause of the peptic ulcer disease (PUD), the client will be prescribed an antibiotic and should take all of the medication. Histamine agonists and/or proton pump inhibitors should be taken routinely as prescribed. Risk factors include a family history of PUD or other GI diseases, or chronic salicylate or prednisone use.

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education?

"I will use rubber pants over the cloth diapers in the future."

The nurse has completed client teaching with a 16-year-old female who has been prescribed Accutane (isotretinoin) for cystic acne. Which statements indicate learning has occurred? Select all that apply.

"If I am sexually active I need to let my doctor know." "It's important I get my CBC blood test when my doctor orders it." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her."

The nurse is caring for a newborn with facial nerve palsy from birth trauma. The mother is very upset and concerned about the child's prognosis. Which response by the nurse would be most appropriate?

"In most cases treatment is not necessary, only observation."

A 9-year-old child has undergone a temporary colostomy in the ascending colon several days ago. The nurse has just completed discharge teaching to the child and the parents. Which statements by the child or parents warrants additional instruction from the nurse?

"It is important to change the pouch and skin appliance every other day to decrease the risk of problems with the skin." "We will need to use an antimicrobial soap to cleanse the area around the stoma in order to prevent any skin infection." Appliances and pouches can be left in place for 4 days as long as the appliance is intact; changing more frequently can lead to skin impairment. Regular soap, not antimicrobial soap, and water is all that is needed to clean around the stoma site. Antimicrobial and perfumed soaps may be irritating to the skin. An ascending colostomy will produce unformed, thick liquid stool so emptying the pouch more frequently will be necessary; this will likely be a challenge for the child at school initially. A pale stoma indicates poor perfusion; this should be reported to the physician immediately.

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?

"It is important to increase the intake of protein for these children."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?

"It is important to increase the intake of protein for these children." Kwashiorkor results from severe deficiency of protein with an adequate caloric intake. It accounts for most of the malnutrition in the world's children today. The highest incidence is in children 4 months to 5 years of age. Although strenuous efforts are being made around the world to prevent this condition, its causes are complex.

The nurse is providing instructions to the parents of a 10-year-old boy who has undergone a barium swallow/upper and lower GI for suspected inflammatory bowel disease. Which of the following instructions is most important? a) "Your child might have lighter stools for the next few days." b) "Your child could have diarrhea for several days afterward." c) "It is very important to drink lots of water and fluids after the test is finished." d) "Please be aware of any signs of infection."

"It is very important to drink lots of water and fluids after the test is finished." It is very important to encourage large amounts of water/fluids after this test to avoid barium-induced constipation. It is also important to tell the parents about a possible change in stool color, but the fluids are most important. This procedure is unlikely to cause an infection. Diarrhea is usually not a problem after this examination.

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond?

"It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain."

The mother of a young child, who has been treated for a bacterial urinary tract infection, tells the nurse her daughter has a white thick covering over her tongue. The mother states that she "has tried everything to get it off my child's tongue." How should the nurse respond?

"It's not unusual for a fungal infection to occur while taking an antibiotic for an infection. I will let your primary care provider know so we can get it treated."

The mother of a young child, who has been treated for a bacterial urinary tract infection, tells the nurse her daughter has a white thick covering over her tongue. The mother states that she "has tried everything to get it off my child's tongue." How should the nurse respond? a) "That is a common side effect after taking an antibiotic. It will go away after the antibiotic is out of the system." b) "Have you tried using a toothbrush to get it off?" c) "It is likely an infection was caused by the antibiotic for the urinary tract infection. I am sure a different antibiotic will help it." d) "It's not unusual for a fungal infection to occur while taking an antibiotic for an infection. I will let your primary care provider know so we can get it treated."

"It's not unusual for a fungal infection to occur while taking an antibiotic for an infection. I will let your primary care provider know so we can get it treated." Thrush is a fungal infection that can occur on the tongue while on an antibiotic for an unrelated bacterial infection. The antibiotic destroys normal flora, which allows the fungal infection to occur. Thrush requires an antifungal agent, such as nystatin liquid, to destroy the infection. Additional antibiotics will not help since it is a fungal infection.

The nurse is caring for an 8-year-old girl in traction. She has been in an acute care setting for two weeks and will require an additional 10 days in the hospital. She is showing signs of regression with thumb sucking and pleas for her tattered baby blanket. What would be the most helpful intervention?

"Let's ask your mom to bring your friends for a visit."

A child will be undergoing a Holter monitor test. Which statement by the mother indicates the need for further instruction?

"My child cannot have any thing to eat or drink after midnight the day of the test."

A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?

"My daughter can eat any kind of fruit." While most fruits and fruit juices are allowed, the nurse needs to make sure the mother knows that some fruit pie fillings and dried fruit may contain gluten.

The nurse is working with a group of caregivers of children diagnosed with asthma. Which statement made by the caregivers is most accurate regarding the triggers that may cause an asthmatic attack?

"My sister and her family love animals, and when we go to their house my daughter always has an asthma attack."

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate?

"Offer 'magic mouthwash' followed by a popsicle."

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate?

"Offer 'magic mouthwash' followed by a popsicle." Children are more likely to cooperate with interventions if play is involved. "Magic" analgesic mouthwash followed by a popsicle is most likely to alleviate some pain and then provide hydration. Soda should be avoided because it can cause stinging and burning. Orange juice should be avoided because it can cause stinging and burning. Anbesol might be helpful but it will likely be difficult to apply. Additionally, oral analgesics are often necessary.

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? a) "Offer 'magic mouthwash' followed by a popsicle." b) "Encourage him to have some soda." c) "Try some Anbesol or Kank-A." d) "Offer him some orange juice."

"Offer 'magic mouthwash' followed by a popsicle." Children are more likely to cooperate with interventions if play is involved. "Magic" analgesic mouthwash followed by a popsicle is most likely to alleviate some pain and then provide hydration. Soda should be avoided because it can cause stinging and burning. Orange juice should be avoided because it can cause stinging and burning. Anbesol might be helpful but it will likely be difficult to apply. Additionally, oral analgesics are often necessary.

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? a) "Try some Anbesol or Kank-A." b) "Encourage him to have some soda." c) "Offer 'magic mouthwash' followed by a popsicle." d) "Offer him some orange juice."

"Offer 'magic mouthwash' followed by a popsicle." Children are more likely to cooperate with interventions if play is involved. "Magic" analgesic mouthwash followed by a popsicle is most likely to alleviate some pain and then provide hydration. Soda should be avoided because it can cause stinging and burning. Orange juice should be avoided because it can cause stinging and burning. Anbesol might be helpful but it will likely be difficult to apply. Additionally, oral analgesics are often necessary.

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? a) "Offer 'magic mouthwash' followed by a popsicle." b) "Encourage him to have some soda." c) "Try some Anbesol or Kank-A." d) "Offer him some orange juice."

"Offer 'magic mouthwash' followed by a popsicle." Correct Explanation: Children are more likely to cooperate with interventions if play is involved. "Magic" analgesic mouthwash followed by a popsicle is most likely to alleviate some pain and then provide hydration. Soda should be avoided because it can cause stinging and burning. Orange juice should be avoided because it can cause stinging and burning. Anbesol might be helpful but it will likely be difficult to apply. Additionally, oral analgesics are often necessary.

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? a) "Try some Anbesol or Kank-A." b) "Offer him some orange juice." c) "Offer 'magic mouthwash' followed by a popsicle." d) "Encourage him to have some soda."

"Offer 'magic mouthwash' followed by a popsicle." Explanation: Children are more likely to cooperate with interventions if play is involved. "Magic" analgesic mouthwash followed by a popsicle is most likely to alleviate some pain and then provide hydration. Soda should be avoided because it can cause stinging and burning. Orange juice should be avoided because it can cause stinging and burning. Anbesol might be helpful but it will likely be difficult to apply. Additionally, oral analgesics are often necessary.

The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?

"Our son's condition may resolve on its own."

A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching?

"Pale, cool, or blue skin coloration is to be expected."

The nurse is caring for an infant. The infant's mother asks the mother, "what did the doctor mean when he said she may have regurgitation?" What response by the nurse is appropriate?

"Regurgitation is the backflow of stomach contents up into the esophagus or mouth." Regurgitation is the backflow of stomach contents up into the esophagus and/or oral cavity. The muscle tone of the lower esophageal sphincter is not fully developed until age 1 month, so infants younger than 1 month of age frequently regurgitate after feedings. Many children younger than 1 year of age continue to regurgitate for several months, but this usually disappears with age

The nurse is caring for an infant. The infant's mother asks the mother, "what did the doctor mean when he said she may have regurgitation?" What response by the nurse is appropriate? a) "Regurgitation is the backflow of stomach contents up into the esophagus or mouth." b) "Regurgitation is not normal in infants. She will need more testing to see what is causing this." c) "Regurgitation is just another term for vomiting. All infants vomit some." d) "Regurgitation is when an infant can't tolerate their formula. You will need to switch."

"Regurgitation is the backflow of stomach contents up into the esophagus or mouth." Regurgitation is the backflow of stomach contents up into the esophagus and/or oral cavity. The muscle tone of the lower esophageal sphincter is not fully developed until age 1 month, so infants younger than 1 month of age frequently regurgitate after feedings. Many children younger than 1 year of age continue to regurgitate for several months, but this usually disappears with age. (

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome?

"She loves hot dogs, and we always cut hers up into small pieces." Commercially canned creamed soups, cold cuts, frankfurters, and pudding mixes generally contain wheat products and should not be included in the diet of the child with celiac syndrome. This caregiver needs further teaching regarding giving her child hot dogs, even if they are cut into small pieces. The other choices show an understanding of the dietary restrictions.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome?

"She loves hot dogs, and we always cut hers up into small pieces." Commercially canned creamed soups, cold cuts, frankfurters, and pudding mixes generally contain wheat products and should not be included in the diet of the child with celiac syndrome. This caregiver needs further teaching regarding giving her child hotdogs, even if they are cut into small pieces. The other choices show an understanding of the dietary restrictions.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome? a) "Even though milk and pudding are good for her, we don't give her those foods." b) "The soup we eat at our house is all made from scratch." c) "She loves hotdogs, and we always cut hers up into small pieces." d) "I have learned to make my own bread with no gluten."

"She loves hotdogs, and we always cut hers up into small pieces." Correct Explanation: Commercially canned creamed soups, cold cuts, frankfurters, and pudding mixes generally contain wheat products and should not be included in the diet of the child with celiac syndrome. This caregiver needs further teaching regarding giving her child hotdogs, even if they are cut into small pieces. The other choices show an understanding of the dietary restrictions.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome? a) "Even though milk and pudding are good for her, we don't give her those foods." b) "The soup we eat at our house is all made from scratch." c) "She loves hotdogs, and we always cut hers up into small pieces." d) "I have learned to make my own bread with no gluten."

"She loves hotdogs, and we always cut hers up into small pieces." Correct Explanation: Commercially canned creamed soups, cold cuts, frankfurters, and pudding mixes generally contain wheat products and should not be included in the diet of the child with celiac syndrome. This caregiver needs further teaching regarding giving her child hotdogs, even if they are cut into small pieces. The other choices show an understanding of the dietary restrictions.

The nurse is caring for a child brought to the emergency department by the parents. Upon assessment the physician suspects the child has been bitten by a spider. While obtaining the nursing history of the present condition, which statement by the parent will require clarification from the nurse?

"Since my child just has a rash around the area of the bite there is nothing to worry about."

The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris?

"Sometimes I get acne when I use my sister's makeup."

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.

"Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." "The only treatment for celiac disease is a strict gluten-free diet." "Gluten is found in most wheat products, rye, barley and possibly oats." Celiac disease is an immunologic disorder in which gluten causes damage to the small intestine. The only treatment currently is a gluten-free diet. While the child needs to have a gluten-free diet, the rest of the family does not. Most children present by the age of 2 for evaluation. Symptoms of celiac disease include diarrhea, constipation, steatorrhea, weight loss, poor muscle tone, anemia and dental disorders. Gluten is found in most grains, like wheat, rye, barley and possibly oats.

The nurse is collecting data on a 2 ½-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

"Tell me about the types of stools you child has been having."

The nurse is collecting data on a 2 ½-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

"Tell me about the types of stools you child has been having." For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

The nurse is collecting data on a 2 ½-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? a) "What foods has your child eaten during the last few days." b) "How many times a day does your child urinate?" c) "Tell me about the types of stools you child has been having." d) "How long has your child been toilet trained?"

"Tell me about the types of stools you child has been having." For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

The nurse is collecting data on a 2 ½-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? a) "What foods has your child eaten during the last few days." b) "Tell me about the types of stools you child has been having." c) "How long has your child been toilet trained?" d) "How many times a day does your child urinate?"

"Tell me about the types of stools you child has been having." For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

The nurse is collecting data on a 2 ½ year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask? a) "How many times a day does your child urinate?" b) "What foods has your child eaten during the last few days." c) "Tell me about the types of stools you child has been having." d) "How long has your child been toilet trained?"

"Tell me about the types of stools you child has been having." Correct Explanation: For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern. (less)

The nurse is collecting data on a 2 ½ year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask? a) "Tell me about the types of stools you child has been having." b) "What foods has your child eaten during the last few days." c) "How many times a day does your child urinate?" d) "How long has your child been toilet trained?"

"Tell me about the types of stools you child has been having." Explanation: For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

"Tell me about the types of stools you child has been having." Explanation: For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on number and type of stools per day. Recent eating patterns, if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver?

"That's not an uncommon reaction, although it's hard on you and on your child."

The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment?

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching?

"The feeling of the heart skipping a beat is common."

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.

"The only treatment for celiac disease is a strict gluten-free diet." "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." "Gluten is found in most wheat products, rye, barley and possibly oats." Celiac disease is an immunologic disorder in which gluten causes damage to the small intestine. The only treatment currently is a gluten-free diet. While the child needs to have a gluten-free diet, the rest of the family does not. Most children present by the age of 2 for evaluation. Symptoms of celiac disease include diarrhea, constipation, steatorrhea, weight loss, poor muscle tone, anemia and dental disorders. Gluten is found in most grains, like wheat, rye, barley and possibly oats.

A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response?

"The surgery creates an opening between the stomach and abdominal wall."

A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response?

"The surgery creates an opening between the stomach and abdominal wall." Ostomies can be created at various sites in the GI tract, depending on the child's clinical condition. A gastrostomy provides an opening between the stomach and the abdominal wall, and an esophagostomy communicates between the esophagus and an external site on the neck. Ostomies may be created at various sites in the small intestine (e.g., jejunostomy, ileostomy) or in the large intestine (e.g., colostomy).

A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response? a) "The surgery will create an opening to the large intestine." b) "The surgery will create an opening to the small intestine." c) "The surgery is performed to create an opening between the esophagus and the neck." d) "The surgery creates an opening between the stomach and abdominal wall."

"The surgery creates an opening between the stomach and abdominal wall." Ostomies can be created at various sites in the GI tract, depending on the child's clinical condition. A gastrostomy provides an opening between the stomach and the abdominal wall, and an esophagostomy communicates between the esophagus and an external site on the neck. Ostomies may be created at various sites in the small intestine (e.g., jejunostomy, ileostomy) or in the large intestine (e.g., colostomy).

A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response? a) "The surgery will create an opening to the small intestine." b) "The surgery creates an opening between the stomach and abdominal wall." c) "The surgery will create an opening to the large intestine." d) "The surgery is performed to create an opening between the esophagus and the neck."

"The surgery creates an opening between the stomach and abdominal wall." Ostomies can be created at various sites in the GI tract, depending on the child's clinical condition. A gastrostomy provides an opening between the stomach and the abdominal wall, and an esophagostomy communicates between the esophagus and an external site on the neck. Ostomies may be created at various sites in the small intestine (e.g., jejunostomy, ileostomy) or in the large intestine (e.g., colostomy).

A physician recommends a gastrostomy for a 4-year-old patient with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response? a) "The surgery is performed to create an opening between the esophagus and the neck." b) "The surgery creates an opening between the stomach and abdominal wall." c) "The surgery will create an opening to the large intestine." d) "The surgery will create an opening to the small intestine."

"The surgery creates an opening between the stomach and abdominal wall." Correct Explanation: Ostomies can be created at various sites in the GI tract, depending on the child's clinical condition. A gastrostomy provides an opening between the stomach and the abdominal wall and an esophagostomy communicates between the esophagus and an external site on the neck. Ostomies may be created at various sites in the small intestine (e.g., jejunostomy, ileostomy) or in the large intestine (e.g., colostomy).

A physician recommends a gastrostomy for a 4-year-old patient with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response? a) "The surgery will create an opening to the large intestine." b) "The surgery will create an opening to the small intestine." c) "The surgery creates an opening between the stomach and abdominal wall." d) "The surgery is performed to create an opening between the esophagus and the neck."

"The surgery creates an opening between the stomach and abdominal wall." Explanation: Ostomies can be created at various sites in the GI tract, depending on the child's clinical condition. A gastrostomy provides an opening between the stomach and the abdominal wall and an esophagostomy communicates between the esophagus and an external site on the neck. Ostomies may be created at various sites in the small intestine (e.g., jejunostomy, ileostomy) or in the large intestine (e.g., colostomy)

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?

"The treatment for the disorder will be a surgical procedure."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?

"The treatment for the disorder will be a surgical procedure." Treatment of congenital aganglionic megacolon involves surgery with the ultimate resection of the aganglionic portion of the bowel. Chronic anemia may be present, but iron will not correct the disorder. Enemas may be given to initially achieve bowel elimination, but they will not treat the disorder. Differentiation must be made between this condition and psychogenic megacolon because of coercive toileting or other emotional problems. The child with aganglionic megacolon does not withhold stools or defecate in inappropriate places, and no soiling occurs.

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? a) "The treatment for the disorder will be a surgical procedure." b) "Your child will receive counseling so the underlying concerns will be addressed." c) "Your child will be treated with oral iron preparations to correct the anemia." d) "We will give enemas until clear and then teach you how to do these at home."

"The treatment for the disorder will be a surgical procedure." Treatment of congenital aganglionic megacolon involves surgery with the ultimate resection of the aganglionic portion of the bowel. Chronic anemia may be present, but iron will not correct the disorder. Enemas may be given to initially achieve bowel elimination, but they will not treat the disorder. Differentiation must be made between this condition and psychogenic megacolon because of coercive toileting or other emotional problems. The child with aganglionic megacolon does not withhold stools or defecate in inappropriate places, and no soiling occurs.

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? a) "Your child will be treated with oral iron preparations to correct the anemia." b) "We will give enemas until clear and then teach you how to do these at home." c) "Your child will receive counseling so the underlying concerns will be addressed." d) "The treatment for the disorder will be a surgical procedure."

"The treatment for the disorder will be a surgical procedure." Treatment of congenital aganglionic megacolon involves surgery with the ultimate resection of the aganglionic portion of the bowel. Chronic anemia may be present, but iron will not correct the disorder. Enemas may be given to initially achieve bowel elimination, but they will not treat the disorder. Differentiation must be made between this condition and psychogenic megacolon because of coercive toileting or other emotional problems. The child with aganglionic megacolon does not withhold stools or defecate in inappropriate places, and no soiling occurs.

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which of the following statements is the best explanation of the treatment for this diagnosis? a) "Your child will be treated with oral iron preparations to correct the anemia." b) "The treatment for the disorder will be a surgical procedure." c) "We will give enemas until clear and then teach you how to do these at home." d) "Your child will receive counseling so the underlying concerns will be addressed."

"The treatment for the disorder will be a surgical procedure." Correct Explanation: Treatment of congenital aganglionic megacolon involves surgery with the ultimate resection of the aganglionic portion of the bowel. Chronic anemia may be present, but iron will not correct the disorder. Enemas may be given to initially achieve bowel elimination, but they will not treat the disorder. Differentiation must be made between this condition and psychogenic megacolon because of coercive toileting or other emotional problems. The child with aganglionic megacolon does not withhold stools or defecate in inappropriate places, and no soiling occurs.

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which of the following statements is the best explanation of the treatment for this diagnosis? a) "The treatment for the disorder will be a surgical procedure." b) "Your child will be treated with oral iron preparations to correct the anemia." c) "We will give enemas until clear and then teach you how to do these at home." d) "Your child will receive counseling so the underlying concerns will be addressed."

"The treatment for the disorder will be a surgical procedure." Explanation: Treatment of congenital aganglionic megacolon involves surgery with the ultimate resection of the aganglionic portion of the bowel. Chronic anemia may be present, but iron will not correct the disorder. Enemas may be given to initially achieve bowel elimination, but they will not treat the disorder. Differentiation must be made between this condition and psychogenic megacolon because of coercive toileting or other emotional problems. The child with aganglionic megacolon does not withhold stools or defecate in inappropriate places, and no soiling occurs.

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse?

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."

A child has an order for an erythrocyte sedimentation rate (ESR). The child's mother asks what the purpose of the test is. What is the best response by the nurse?

"This test will tell if your child has an infection or inflammation somewhere in their body."

A young female has been prescribed corticosteroids for dermatomyositis. Which statements by her mother indicates the need for further education? Select all that apply.

"We are taking her to Disney in the summer." "I give it to her first thing in the morning before breakfast."

The nurse is caring for a newborn diagnosed with imperforate anus following delivery. The physician has discussed the treatment options and prognosis with the parents. The nurse is talking with the parents and determines that learning has occurred when the parents make which statement? a) "Since our baby has a defect high in the anorectal opening there is a good chance that stool continence won't be a problem." b) "We are worried that our child may have other congenital problems that we aren't aware of." c) "We aren't sure if our baby will need surgery at some point for this problem." d) "We know we will need to use baby wipes around the anal area after surgery to prevent infection."

"We are worried that our child may have other congenital problems that we aren't aware of." Imperforate anus is a congenital malformation of the anorectal opening. Other congenital anomalies may be associated with imperforate anus in 50% of cases. Surgical intervention is needed for both high and low types of imperforate anus. After repair, only about 30% with a high defect will achieve continence. To decrease the drying associated with frequent cleaning, avoid baby wipes and frequent use of soap and water.

The nurse is caring for a newborn diagnosed with imperforate anus following delivery. The physician has discussed the treatment options and prognosis with the parents. The nurse is talking with the parents and determines that learning has occurred when the parents make which statement? a) "Since our baby has a defect high in the anorectal opening there is a good chance that stool continence won't be a problem." b) "We are worried that our child may have other congenital problems that we aren't aware of." c) "We aren't sure if our baby will need surgery at some point for this problem." d) "We know we will need to use baby wipes around the anal area after surgery to prevent infection."

"We are worried that our child may have other congenital problems that we aren't aware of." Imperforate anus is a congenital malformation of the anorectal opening. Other congenital anomalies may be associated with imperforate anus in 50% of cases. Surgical intervention is needed for both high and low types of imperforate anus. After repair, only about 30% with a high defect will achieve continence. To decrease the drying associated with frequent cleaning, avoid baby wipes and frequent use of soap and water.

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed?

"We can stop the penicillin when her symptoms disappear."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis?

"We have taken the carpet out of our house and let my mom take our dog."

A pediatric client was brought to the emergency department by the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. Which statement by the parents indicate learning occurred?

"We need to get our child a medical alert bracelet as soon as possible in case this happens again."

The nurse is teaching the parents of a 6-year-old who has sustained a large laceration about providing care to the wound at home. The nurse determines that the parents need additional teaching when they state:

"We need to keep the wound tightly bandaged for at least 3 days."

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching?

"We should avoid using petroleum jelly."

A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching?

"We should bathe our child in hot water, twice a day."

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?

"We should not stop this medication abruptly."

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?

"We should not stop this medication abruptly." Prednisone is a corticosteroid. Stopping the medication abruptly could lead to adrenal insufficiency. Weight gain would be associated with corticosteroid use. Weight loss is associated with the disease. Corticosteroids help to reduce inflammation and suppress the normal immune response. Typically, anti-inflammatory agents such as mesalamine may appear in the stool. This indicates poor absorption.

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? a) "We should not stop this medication abruptly." b) "She might lose some weight initially." c) "We might notice some of the medication in her stool" d) "This drug helps to control the abdominal cramping."

"We should not stop this medication abruptly." Correct Explanation: Prednisone is a corticosteroid. Stopping the medication abruptly could lead to adrenal insufficiency. Weight gain would be associated with corticosteroid use. Weight loss is associated with the disease. Corticosteroids help to reduce inflammation and suppress the normal immune response. Typically, anti-inflammatory agents such as mesalamine may appear in the stool. This indicates poor absorption.

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? a) "We should not stop this medication abruptly." b) "This drug helps to control the abdominal cramping." c) "She might lose some weight initially." d) "We might notice some of the medication in her stool"

"We should not stop this medication abruptly." Explanation: Prednisone is a corticosteroid. Stopping the medication abruptly could lead to adrenal insufficiency. Weight gain would be associated with corticosteroid use. Weight loss is associated with the disease. Corticosteroids help to reduce inflammation and suppress the normal immune response. Typically, anti-inflammatory agents such as mesalamine may appear in the stool. This indicates poor absorption

The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most important to emphasize to the boy and his parents?

"You and your coaches need to understand that you cannot play soccer for at least six weeks."

The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond?

"You will most likely have a blood test to check for certain antibodies."

The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond?

"You will most likely have a blood test to check for certain antibodies." Anti-nuclear antibodies are one of the diagnostic tests performed to diagnose autoimmune hepatitis. Ultrasound is to assess for liver or spleen abnormalities. Viral studies are performed to screen for viral causes of hepatitis. Ammonia levels may be ordered if hepatic encephalopathy is suspected.

The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond? a) "You will most likely have viral studies." b) "You will most likely be tested for ammonia levels." c) "You will most likely have an ultrasound evaluation." d) "You will most likely have a blood test to check for certain antibodies."

"You will most likely have a blood test to check for certain antibodies." Anti-nuclear antibodies are one of the diagnostic tests performed to diagnose autoimmune hepatitis. Ultrasound is to assess for liver or spleen abnormalities. Viral studies are performed to screen for viral causes of hepatitis. Ammonia levels may be ordered if hepatic encephalopathy is suspected.

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply. A. "Most children with celiac disease" B. "The entire family will need to eat gluten-free." C. "The only treatment for celiac disease is a strict gluten-free diet." D. "Gluten is found in most wheat products, rye, barley and possibly oats." E. "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders."

- "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." - "The only treatment for celiac disease is a strict gluten-free diet." - "Gluten is found in most wheat products, rye, barley and possibly oats." Celiac disease is an immunologic disorder in which gluten causes damage to the small intestine. The only treatment currently is a gluten-free diet. While the child needs to have a gluten-free diet, the rest of the family does not. Most children present by the age of 2 for evaluation. Symptoms of celiac disease include diarrhea, constipation, steatorrhea, weight loss, poor muscle tone, anemia and dental disorders. Gluten is found in most grains, like wheat, rye, barley and possibly oats.

The nurse is working with the mother of a toddler experiencing constipation. What information regarding childhood constipation should the nurse share with the mother? Select all that apply.

-"Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes." -"If your child has a fecal impaction, you can give him an enema." -"Reward your child for sitting on the toilet as asked, not just when they have a bowel

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred

-"I should be sure my child receives 50 to 100 mL/kg of oral rehydration solution (ORS) over 4 hours." -"Oral rehydration solutions (ORS) are good sources of fluids for rehydration." -"I should not give my child any fluids for 1 to 2 hours after an episode of vomiting."

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.

-"Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." -"The only treatment for celiac disease is a strict gluten-free diet." -"Gluten is found in most wheat products, rye, barley and possibly oats."

The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore® Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply.

-"We will be sure to not allow our child to ride a bicycle for at least 2 weeks." -"We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed." -"We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any."

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

-Color. -Sensation. -Pulse. -Capillary refill.

The school nurse cares for children with overuse injuries and refers them for treatment. Which statements accurately describe conservative interventions to prevent or care for these types of injuries? Select all that apply.

-Encourage 1 to 2 days off per week of competitive athletics. -Perform appropriate stretching during a 20-to 30-minute warmup. -Apply ice to the injured area to reduce inflammation.

A 10-year-old has been bitten on the lower posterior arm by a dog, requiring several stitches. The child was just admitted to the hospital for 3 days of antibiotic therapy. When developing the care plan, the nurse identifies which nursing diagnoses as being the top 2 priorities?

-Impaired skin integrity. -Risk for infection.

A nurse is preparing a plan of care for an infant who has undergone surgery to repair a myelomeningocele. The nurse would include placing the infant in which positions postoperatively? Select all that apply.

-Prone. -Right side lying. -Left side lying.

A nurse manages the interdisciplinary care for a client with pancreatitis. What are recommended interventions for this condition? Select all that apply.

-Providing glycemia control -Keeping the child NPO to rest the pancreas -Administering analgesics for pain -Positioning the client in a fetal position

A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply.

-Reduced hemoglobin levels -Elevated erythrocyte sedimentation rate (ESR)

A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which findings would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply.

-Sunken fontanels. -Cool mottled extremities. -Bradycardia.

The child has been admitted to the hospital with a possible diagnosis of pneumonia. Which findings are consistent with this diagnosis? Select all that apply.

-The child's chest x-ray indicates the presence of perihilar infiltrates. -The child's respiratory rate is rapid. -The child's white blood cell count is elevated. -The child is producing yellow purulent sputum.

The nurse is caring for a newborn following delivery who has been diagnosed with gastroschisis. Which actions by the nurse indicated knowledge of appropriate care for this disorder?

-The nurse assesses the color of the newborns abdominal organs -The nurse places the newborn in a radiant warmer to maintain the newborn's temperature -The nurse closely monitors the hydration status of the newborn for signs of dehydration

The infant has been hospitalized and develops hypercyanosis. The physician has ordered the nurse to administer 0.1 mg of morphine sulfate per every kilogram of the infant's body weight. The infant weighs 15.2 lb (6.81 kg). Calculate the infant's morphine sulfate dose. Record your answer using one decimal place.

0.7

A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame?

1 week

The young child has been diagnosed with group A streptococcal pharyngitis. The physician orders amoxicillin 45 mg/kg in three equally divided doses. The child weighs 23 lb (10.45 kg). Calculate how many milligrams the child will receive with each dose of amoxicillin. Record your answer using a whole number.

157

Which client most likely has ulcerative colitis rather than Crohn disease?

16-year-old female with continuous distribution of disease in the colon, distal to proximal Ulcerative colitis is usually continuous through the colon while the distribution of Crohn disease is segmental. Crohn disease affects the full thickness of the intestine while ulcerative colitis is more superficial. Both conditions share age at onset of 10 to 20 years, with abdominal pain and fever in 40% to 50% of cases.

The nurse working at the child community clinic must administer the influenza vaccine to the high-risk kids first. Which child would she choose?

23-month-old Ava who had heart surgery as an infant for a defect

The child has been diagnosed with severe dehydration. The physician has ordered the nurse to administer a bolus of 20 mL/kg of normal saline over a 2-hour period. The child weighs 63.5 lb (28.8 kg). At which mL/hour should the nurse set the child's intravenous administration pump? Record your answer using a whole number.

289 The child weighs 63.5 pounds. 63.5 pounds x 1 kg/2.2 pounds = 577.2727 mL 577.2727 mL of normal saline/2 hours = 288.6364 mL Rounded to the nearest whole number = 289 mL/hour

The child has been diagnosed with severe dehydration. The physician has ordered the nurse to administer a bolus of 20 mL/kg of normal saline over a 2-hour period. The child weighs 63.5 pounds. How should the nurse set the child's intravenous administration pump? (mL/hour) Round to the nearest whole number. _____ mL/hour

289 Correct Explanation: The child weighs 63.5 pounds. 63.5 pounds x 1 kg/2.2 pounds = 577.2727 mL 577.2727 mL of normal saline/2 hours = 288.6364 mL Rounded to the nearest whole number = 289 mL/hour

The child has been diagnosed with severe dehydration. The physician has ordered the nurse to administer a bolus of 20 mL/kg of normal saline over a 2-hour period. The child weighs 63.5 pounds. How should the nurse set the child's intravenous administration pump? (mL/hour) Round to the nearest whole number. ___ mL/hour

289 Explanation: The child weighs 63.5 pounds. 63.5 pounds x 1 kg/2.2 pounds = 577.2727 mL 577.2727 mL of normal saline/2 hours = 288.6364 mL Rounded to the nearest whole number = 289 mL/hour

The nurse is monitoring the intake and output of a client with deep partial-thickness burns. The child weighs 75 pounds. The nurse will contact the physician if the child's urine output drops below how many milliliters per hour? (Round you answer to the nearest whole number.)

34

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? Record your answer using a whole number

48 Urine output should be calculated using weight in kilograms. 6 kg x 1 mL/kg = 6 mL/hour 6 mL x 8 hours = 48 mL/8-hour shift

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? Record your answer using a whole number.

48 Urine output should be calculated using weight in kilograms. 6 kg x 1 mL/kg = 6 mL/hour 6 mL x 8 hours = 48 mL/8-hour shift

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 pounds. At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? _____ mL

48 Correct Explanation: 13.2 pounds x 1 kg/2.2 pounds = 6 kg 6 kg x 1 mL/kg = 6 mL/hour 6 mL x 8 hours = 48 mL/8-hour shift

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 pounds. At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? ___ ml

48 Explanation: 13.2 pounds x 1 kg/2.2 pounds = 6 kg 6 kg x 1 mL/kg = 6 mL/hour 6 mL x 8 hours = 48 mL/8-hour shift

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for which time frame? a) 7 to 14 days b) 1 to 3 days c) 3 to 5 days d) 5 to 7 days

7 to 14 days Explanation: The child with a perforated appendix requires 7 to 14 days of intravenous antibiotic therapy. If the child has a suppurative or gangrenous appendix that was not perforated, 2 to 3 days of antibiotics would be most likely ordered.

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for how long?

7 to 14 days The child with a perforated appendix requires 7 to 14 days of intravenous antibiotic therapy. If the child has a suppurative or gangrenous appendix that was not perforated, 2 to 3 days of antibiotics would be most likely ordered.

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for which time frame? a) 1 to 3 days b) 3 to 5 days c) 5 to 7 days d) 7 to 14 days

7 to 14 days Explanation: The child with a perforated appendix requires 7 to 14 days of intravenous antibiotic therapy. If the child has a suppurative or gangrenous appendix that was not perforated, 2 to 3 days of antibiotics would be most likely ordered.

The nurse is caring for a child that was dehydrated following gastric surgery but has since been re-hydrated. The physician orders intravenous maintenance fluid rate for the child. How will the nurse determine the intravenous maintenance fluid rate per hour for this child who weighs 40 kg?

79 The formula to determine maintenance fluid rate is: *100 mL/kg for first 10 kg *50 mL/kg for next 10 kg *20 mL/kg for remaining kg *Add together for total mL needed per 24-hour period. *Divide by 24 for mL/hour fluid requirement. Therefore, for a child weighing 40kg the equation is: *100 X 10= 1000 *50 X 10= 500 *20 X 20= 400 *1000 + 500 + 400= 1900 *1900/24= 79.17= 79 mL/hr

The nurse is assessing the heart rate of a healthy 6-month-old. In which range should the nurse expect the infant's heart rate?

90 to 160 bpm

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

The nurse is caring for a 2-year-old boy with a burn. What finding would warrant referral to a burn unit?

A chemical burn

The nurse is conducting a presentation for a group of nurses who work with adolescents. The group of nurses discusses dysmenorrhea. Which statement is most accurate related to dysmenorrhea?

A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.

A 4-year-old girl has acute nasopharyngitis (a common cold). What measure would the nurse want to teach her parents?

A cough that accompanies a cold should rarely be suppressed.

A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is:

A dull, aching abdominal pain at ovulation

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon?

A partial or complete intestinal obstruction occurs. Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, which leads to an obstruction at the distal end of the stomach. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon? a) In this disorder the sphincter that leads into the stomach is relaxed. b) There are recurrent paroxysmal bouts of abdominal pain. c) A partial or complete intestinal obstruction occurs. d) A thickened, elongated muscle causes an obstruction at the end of the stomach.

A partial or complete intestinal obstruction occurs. Correct Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon? a) In this disorder the sphincter that leads into the stomach is relaxed. b) A partial or complete intestinal obstruction occurs. c) There are recurrent paroxysmal bouts of abdominal pain. d) A thickened, elongated muscle causes an obstruction at the end of the stomach.

A partial or complete intestinal obstruction occurs. Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition?

A sausage-shaped mass in the upper midabdomen A sausage-shaped mass in the upper midabdomen is the hallmark of intussusception. Perianal skin tags are highly suspicious of Crohn disease. Abdominal pain and guarding are also common with intussusception but are seen with many other conditions. Tenting would indicate dehydration.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition? a) Perianal skin tags b) A sausage-shaped mass in the upper midabdomen c) Abdominal pain and guarding d) Skin tenting

A sausage-shaped mass in the upper midabdomen A sausage-shaped mass in the upper midabdomen is the hallmark of intussusception. Perianal skin tags are highly suspicious of Crohn disease. Abdominal pain and guarding are also common with intussusception but are seen with many other conditions. Tenting would indicate dehydration.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition? a) Skin tenting b) A sausage-shaped mass in the upper midabdomen c) Abdominal pain and guarding d) Perianal skin tags

A sausage-shaped mass in the upper midabdomen A sausage-shaped mass in the upper midabdomen is the hallmark of intussusception. Perianal skin tags are highly suspicious of Crohn disease. Abdominal pain and guarding are also common with intussusception but are seen with many other conditions. Tenting would indicate dehydration.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which of the following findings would the nurse identify as the hallmark of this condition? a) A sausage-shaped mass in the upper midabdomen b) Skin tenting c) Perianal skin tags d) Abdominal pain and guarding

A sausage-shaped mass in the upper midabdomen Correct Explanation: A sausage-shaped mass in the upper midabdomen is the hallmark of intussusception. Perianal skin tags are highly suspicious of Crohn disease. Abdominal pain and guarding are also common with intussusception but are seen with many other conditions. Tenting would indicate dehydration.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which of the following findings would the nurse identify as the hallmark of this condition? a) A sausage-shaped mass in the upper midabdomen b) Abdominal pain and guarding c) Perianal skin tags d) Skin tenting

A sausage-shaped mass in the upper midabdomen Explanation: A sausage-shaped mass in the upper midabdomen is the hallmark of intussusception. Perianal skin tags are highly suspicious of Crohn disease. Abdominal pain and guarding are also common with intussusception but are seen with many other conditions. Tenting would indicate dehydration

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of pyloric stenosis?

A thickened, elongated muscle causes an obstruction at the end of the stomach. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, with a severe narrowing of its lumen. The pylorus is thickened to as much as twice its size, is elongated, and has a consistency resembling cartilage. As a result of this obstruction at the distal end of the stomach, the stomach becomes dilated. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of pyloric stenosis? a) A partial or complete intestinal obstruction occurs. b) In this disorder the sphincter that leads into the stomach is relaxed. c) There are recurrent paroxysmal bouts of abdominal pain. d) A thickened, elongated muscle causes an obstruction at the end of the stomach.

A thickened, elongated muscle causes an obstruction at the end of the stomach. Correct Explanation: Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, with a severe narrowing of its lumen. The pylorus is thickened to as much as twice its size, is elongated, and has a consistency resembling cartilage. As a result of this obstruction at the distal end of the stomach, the stomach becomes dilated. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of pyloric stenosis? a) There are recurrent paroxysmal bouts of abdominal pain. b) In this disorder the sphincter that leads into the stomach is relaxed. c) A thickened, elongated muscle causes an obstruction at the end of the stomach. d) A partial or complete intestinal obstruction occurs.

A thickened, elongated muscle causes an obstruction at the end of the stomach. Correct Explanation: Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, with a severe narrowing of its lumen. The pylorus is thickened to as much as twice its size, is elongated, and has a consistency resembling cartilage. As a result of this obstruction at the distal end of the stomach, the stomach becomes dilated. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is caring for a child with celiac disease. The parents and the child have attended a class with a group of other clients with the disorder. Which statements by the child or the parents indicates the need for further teaching? Select all that apply. A. "I love pasta, so as long as I only eat it occasionally I should be fine." B. "I hope they find a cure for celiac disease some day." C. "Celiac disease is the same as gluten intolerance that everyone is talking about these days." D. "I must be careful to eat only 100% whole grain foods." E. "My brother and sister are more likely to develop celiac disease since I have it."

A. "I love pasta, so as long as I only eat it occasionally I should be fine." C. "Celiac disease is the same as gluten intolerance that everyone is talking about these days." D. "I must be careful to eat only 100% whole grain foods."

A doctor orders an abdominal radiograph for a newborn to check for Hirschsprung disease. The nurse examines the infant and finds which symptoms that are indicative of this disease? Select all that apply.

Abdominal distention Absence of stool in the rectum Enterocolitis Bilious vomiting The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth and has bilious vomiting or has abdominal distention, feeding intolerance, with bilious aspirates and vomiting. In anorectal malformations the anus is absent or displaced and the presence of a fistula may be noted when gas or stool is expelled from the urethra or vagina.

The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?

Absence of a thrill

Which nursing diagnosis would best apply to a child with rheumatic fever?

Activity intolerance related to inability of heart to sustain extra workload

Which nursing diagnosis would be most appropriate for a child with pneumonia during the acute phase of illness?

Activity intolerance related to poor oxygen-carbon dioxide exchange

The nurse is caring for a child with burns in a pediatric hospital. What would be an appropriate nursing diagnosis for this client?

Acute pain related to thermal injuries and procedures

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect?

Acute upper GI bleeding

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect?

Acute upper GI bleeding Vomiting bright red blood indicates acute upper GI bleeding. Emesis containing brown, foul-smelling stool indicates GI obstruction. Stool with red blood and mucus is associated with intussusception. Bleeding is not generally indicative of gastroesophageal reflux.

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a) Acute upper GI bleeding b) Gastroesophageal reflux c) GI tract obstruction d) Intussusception

Acute upper GI bleeding Vomiting bright red blood indicates acute upper GI bleeding. Emesis containing brown, foul-smelling stool indicates GI obstruction. Stool with red blood and mucus is associated with intussusception. Bleeding is not generally indicative of gastroesophageal reflux.

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a) Intussusception b) Acute upper GI bleeding c) GI tract obstruction d) Gastroesophageal reflux

Acute upper GI bleeding Vomiting bright red blood indicates acute upper GI bleeding. Emesis containing brown, foul-smelling stool indicates GI obstruction. Stool with red blood and mucus is associated with intussusception. Bleeding is not generally indicative of gastroesophageal reflux.

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a) GI tract obstruction b) Acute upper GI bleeding c) Intussusception d) Gastroesophageal reflux

Acute upper GI bleeding Correct Explanation: Vomiting bright red blood indicates acute upper GI bleeding. Emesis containing brown, foul-smelling stool indicates GI obstruction. Stool with red blood and mucus is associated with intussusception. Bleeding is not generally indicative of gastroesophageal reflux.

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a) GI tract obstruction b) Intussusception c) Gastroesophageal reflux d) Acute upper GI bleeding

Acute upper GI bleeding Correct Explanation: Vomiting bright red blood indicates acute upper GI bleeding. Emesis containing brown, foul-smelling stool indicates GI obstruction. Stool with red blood and mucus is associated with intussusception. Bleeding is not generally indicative of gastroesophageal reflux.

A nurse is caring for an infant who is experiencing heart failure. What would be the most appropriate care for this infant?

Administer oxygen.

Urinary tract infections are usually successfully treated by what means?

Administering antibiotics

The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention?

Administration of adequate vitamin D Rickets results from inadequate vitamin D; supplements are necessary. There is no direct need to increase calorie, thiamine or protein intake.

A 4-year-old girl has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. Her parents are extremely distraught over her condition and the fact she has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of these parents?

Allow the parents to remain with the child as much as possible.

A child is diagnosed with short bowel syndrome. What would the nurse expect to be included in the child's plan of care? Select all that apply.

Antibiotics Vitamin supplements Total parenteral nutrition For the child with short bowel syndrome, typically, antibiotics, vitamin and mineral supplements, antidiarrheal agents, and total parenteral nutrition are prescribed. Laxatives and immunosuppressants are not used.

A child is diagnosed with short bowel syndrome. What would the nurse expect to be included in the child's plan of care? Select all that apply.

Antibiotics • Vitamin supplements • Total parenteral nutrition Explanation: For the child with short bowel syndrome, typically, antibiotics, vitamin and mineral supplements, antidiarrheal agents, and total parenteral nutrition are prescribed. Laxatives and immunosuppressants are not used.

A child is diagnosed with short bowel syndrome. Which of the following would the nurse expect to be included in the child's plan of care? Select all that apply. a) Immunosuppressants b) Laxatives c) Antibiotics d) Vitamin supplements e) Total parenteral nutrition

Antibiotics • Vitamin supplements • Total parenteral nutrition Explanation: For the child with short bowel syndrome, typically, antibiotics, vitamin and mineral supplements, antidiarrheal agents, and total parenteral nutrition are prescribed. Laxatives and immunosuppressants are not used.

An 8-year-old girl presents with drooling and a complaint of painful swallowing. She has a high fever and is lethargic. On examination the nurse sees that her palatine tonsils are bright red and swollen. The girl's mother says that she has never had these symptoms before. A throat culture indicates a streptococcus infection. What is the course of treatment that the nurse would expect in this situation?

Antipyretic, analgesic, and antibiotic

The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use?

Apply a urine bag to the anal area.

The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use? a) Apply a urine bag to the anal area. b) Have the child defecate into a container in the toilet. c) Use a clean bedpan to collect the specimen. d) Use a tongue blade to scrape a specimen from a diaper.

Apply a urine bag to the anal area. With very liquid stool, applying a urine bag to the anal area is most effective in collecting the specimen. Using a tongue blade to scrape a specimen from a diaper would be appropriate if the stool is formed. However, putting a diaper on a 4-year-old would be demeaning. Defecating into a collection container that sits at the back of the toilet would be more appropriate for an older child who is ambulatory. A bedpan would be appropriate if the child was bedridden.

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? a) Explain to the parents that surgical intervention will fix the defect in the baby's lip. b) Refer the family to a social worker or mental health practitioner. c) Teach the mother the appropriate technique for breast-feeding an infant with cleft lip. d) Ask the parents if they have any questions regarding the care of their child.

Ask the parents if they have any questions regarding the care of their child. The family's emotional response to the birth of a child with cleft lip, palate, or both may range from grief to anger to denial. The nurse should encourage the parents to express their feelings and provide the parents with opportunities and support for normal infant-parent interactions.

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? a) Explain to the parents that surgical intervention will fix the defect in the baby's lip. b) Teach the mother the appropriate technique for breast-feeding an infant with cleft lip. c) Refer the family to a social worker or mental health practitioner. d) Ask the parents if they have any questions regarding the care of their child.

Ask the parents if they have any questions regarding the care of their child. The family's emotional response to the birth of a child with cleft lip, palate, or both may range from grief to anger to denial. The nurse should encourage the parents to express their feelings and provide the parents with opportunities and support for normal infant-parent interactions

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? a) Teach the mother the appropriate technique for breast-feeding an infant with cleft lip. b) Ask the parents if they have any questions regarding the care of their child. c) Explain to the parents that surgical intervention will fix the defect in the baby's lip. d) Refer the family to a social worker or mental health practitioner.

Ask the parents if they have any questions regarding the care of their child. Explanation: The family's emotional response to the birth of a child with cleft lip, palate, or both may range from grief to anger to denial. The nurse should encourage the parents to express their feelings and provide the parents with opportunities and support for normal infant-parent interactions.

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? a) Teach the mother the appropriate technique for breast-feeding an infant with cleft lip. b) Refer the family to a social worker or mental health practitioner. c) Ask the parents if they have any questions regarding the care of their child. d) Explain to the parents that surgical intervention will fix the defect in the baby's lip.

Ask the parents if they have any questions regarding the care of their child. Explanation: The family's emotional response to the birth of a child with cleft lip, palate, or both may range from grief to anger to denial. The nurse should encourage the parents to express their feelings and provide the parents with opportunities and support for normal infant-parent interactions.

The nurse completes a 1-month-old's feeding and sits the infant up to burp. The infant vomits back the feeding. Which is the nurse's primary concern?

Aspiration The primary concern for the nurse is that the infant aspirates vomit into the lungs. Aspiration after vomiting may lead to respiratory concerns such as apnea and pneumonia. Nutritional deficiencies may occur if the vomiting continues. This is a concern but not the primary concern. Stomach irritation and stunted growth is not a typical concern at this time.

A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast?

Assess the fingers for warmth, pain, and function

Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition?

Assessing for the presence of femoral pulses

The nurse is caring for a child with urticaria. What is the priority action?

Assessing the child's airway and breathing and noting any wheezing or stridor

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder?

Asthma

A nurse is performing a physical examination of a child with a suspected musculoskeletal dysfunction. Which assessment technique would the nurse assume would not be used?

Auscultation

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant?

Baclofen

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet?

Bananas

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet?

Bananas The young child should be started on a starch-free, low-fat diet. Bananas contain invert sugar and are usually well tolerated. Products that contain wheat, rye, or oats should be excluded.

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? a) Bananas b) Potatoes c) Oatmeal d) Toast

Bananas The young child should be started on a starch-free, low-fat diet. Bananas contain invert sugar and are usually well tolerated. Products that contain wheat, rye, or oats should be excluded.

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? a) Oatmeal b) Toast c) Bananas d) Potatoes

Bananas The young child should be started on a starch-free, low-fat diet. Bananas contain invert sugar and are usually well tolerated. Products that contain wheat, rye, or oats should be excluded.

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? a) Oatmeal b) Potatoes c) Toast d) Bananas

Bananas Correct Explanation: The young child should be started on a starch-free, low-fat diet. Bananas contain invert sugar and are usually well tolerated. Products that contain wheat, rye, or oats should be excluded

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? a) Bananas b) Oatmeal c) Toast d) Potatoes

Bananas Correct Explanation: The young child should be started on a starch-free, low-fat diet. Bananas contain invert sugar and are usually well tolerated. Products that contain wheat, rye, or oats should be excluded.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply.

Bananas Skim milk Applesauce The child is usually started on a gluten-free, low-fat diet. Skim milk and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour, and cornmeal are not included in the diet.

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema A barium enema is successful in reducing a large percentage of intussusception cases. Other cases are reduced surgically. Upper endoscopy is used to visualize the upper gastrointestinal tract from the mouth to the upper jejunum. Endoscopic retrograde cholangiopancreatography is used to view the hepatobiliary system.

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? a) Surgery b) Barium enema c) Endoscopic retrograde cholangiopancreatography d) Upper endoscopy

Barium enema A barium enema is successful in reducing a large percentage of intussusception cases. Other cases are reduced surgically. Upper endoscopy is used to visualize the upper gastrointestinal tract from the mouth to the upper jejunum. Endoscopic retrograde cholangiopancreatography is used to view the hepatobiliary system.

A child is diagnosed with intussusception. The nurse anticipates that which of the following would be attempted first to reduce this condition? a) Upper endoscopy b) Endoscopic retrograde cholangiopancreatography c) Surgery d) Barium enema

Barium enema Correct Explanation: A barium enema is successful in reducing a large percentage of intussusception cases. Other cases are reduced surgically. Upper endoscopy is used to visualize the upper gastrointestinal tract from the mouth to the upper jejunum. Endoscopic retrograde cholangiopancreatography is used to view the hepatobiliary system.

A child is diagnosed with intussusception. The nurse anticipates that which of the following would be attempted first to reduce this condition? a) Endoscopic retrograde cholangiopancreatography b) Surgery c) Upper endoscopy d) Barium enema

Barium enema Explanation: A barium enema is successful in reducing a large percentage of intussusception cases. Other cases are reduced surgically. Upper endoscopy is used to visualize the upper gastrointestinal tract from the mouth to the upper jejunum. Endoscopic retrograde cholangiopancreatography is used to view the hepatobiliary system.

Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes?

Before meals and snacks with milk

The nurse is taking a health history of a 2-year-old girl presenting with a sudden onset of severe vomiting. Which description would suggest an obstruction?

Bilious vomiting Correct Explanation: The contents and character of the vomitus may give clues to the cause of vomiting. Bilious vomiting is never considered normal and suggests an obstruction distal to the ampulla of Vater. Projectile vomiting is associated with pyloric stenosis. The gender and the age of the child are not consistent with pyloric stenosis. Effortless vomiting is often seen in gastroesophageal reflux. Bloody emesis can signify esophageal or gastrointestinal bleeding.

The nurse is taking a health history of a 2-year-old girl presenting with a sudden onset of severe vomiting. Which of the following descriptions would suggest an obstruction distal to the ampulla of Vater? a) Bloody vomiting b) Effortless vomiting c) Bilious vomiting d) Projectile vomiting

Bilious vomiting Correct Explanation: The contents and character of the vomitus may give clues to the cause of vomiting. Bilious vomiting is never considered normal and suggests an obstruction distal to the ampulla of Vater. Projectile vomiting is associated with pyloric stenosis. The gender and the age of the child are not consistent with pyloric stenosis. Effortless vomiting is often seen in gastroesophageal reflux. Bloody emesis can signify esophageal or gastrointestinal bleeding.

The nurse is taking a health history of a 2-year-old girl presenting with a sudden onset of severe vomiting. Which of the following descriptions would suggest an obstruction distal to the ampulla of Vater? a) Bilious vomiting b) Bloody vomiting c) Effortless vomiting d) Projectile vomiting

Bilious vomiting Explanation: The contents and character of the vomitus may give clues to the cause of vomiting. Bilious vomiting is never considered normal and suggests an obstruction distal to the ampulla of Vater. Projectile vomiting is associated with pyloric stenosis. The gender and the age of the child are not consistent with pyloric stenosis. Effortless vomiting is often seen in gastroesophageal reflux. Bloody emesis can signify esophageal or gastrointestinal bleeding.

A 7-year-old child has been scheduled for a tonsillectomy. What would be most important to assess prior to surgery?

Bleeding and clotting time

The nurse is caring for a child admitted with partial thickness burns. What is most characteristic of this type of burn?

Blisters appear

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?

Blood pressure 136/84

In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?

Cartilage

A nurse is administering an enteral feeding to a child with a G-tube. What is a recommended step in this procedure? a) After feeding, flush the tube with a small amount of saline and leave the gastrostomy tube open for 2 to 5 minutes. b) Position with the head of the bed lowered at a 20° angle. c) Check for gastric residual before starting feeding by gently aspirating from the tube with a syringe. d) Administer feeding by connecting the syringe barrel to the tube and pouring formula into the syringe with a syringe plunger.

Check for gastric residual before starting feeding by gently aspirating from the tube with a syringe. The nurse should check for gastric residual before starting feeding by gently aspirating from the tube with a syringe or positioning the tube below the level of the stomach with only the barrel of the syringe attached. The client should be positioned with his or her head elevated 30° to 45° and formula should be allowed to flow with gravity, not plunged unless it is clogged. After feeding, the nurse should flush the tube with a small amount of water, unless contraindicated, and leave the gastrostomy tube open for 5 to 10 minutes after feeding to allow for escape of air.

A nurse is administering an enteral feeding to a patient with a G-tube. Which of the following is a recommended step in this procedure? a) Check for gastric residual before starting feeding by gently aspirating from the tube with a syringe. b) After feeding, flush the tube with a small amount of saline and leave the gastrostomy tube open for 2 to 5 minutes. c) Position with the head of the bed lowered at a 20° angle. d) Administer feeding by connecting the syringe barrel to the tube and pouring formula into the syringe with a syringe plunger.

Check for gastric residual before starting feeding by gently aspirating from the tube with a syringe. Explanation: The nurse should check for gastric residual before starting feeding by gently aspirating from the tube with a syringe or positioning the tube below the level of the stomach with only the barrel of the syringe attached. The patient should be positioned with his or her head elevated 30° to 45° and formula should be allowed to flow with gravity, not plunged unless it is clogged. After feeding, the nurse should flush the tube with a small amount of water, unless contraindicated, and leave the gastrostomy tube open for 5 to 10 minutes after feeding to allow for escape of air.

In caring for the child with lead poisoning, which method of treatment is used to remove the lead from the child's system?

Chelating agents The use of a chelating agent (an agent that binds with metal) increases the urinary excretion of lead. Diuretics, laxatives, and emetics are not used in the treatment of lead poisoning.

The nurse is reviewing the laboratory test results of several children who have come to the clinic for evaluation. Which child would the nurse identify as having the least risk for hyperlipidemia?

Child A with a total cholesterol of 150 mg/dL and low-density lipoprotein (LDL) of 80 mg/dL.

The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be:

Chronic lack of oxygen

The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect?

Community acquired MRSA

The nurse is working with a group of caregivers of school-age children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:

Complete

The nurse is caring for a 14-month-old boy with cystic fibrosis. Which sign of ineffective family coping requires urgent intervention?

Compliance with therapy is diminished.

The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal?

Creatine kinase

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?

Creatinine clearance rate

What is the most common debilitating disease of childhood among those of European descent?

Cystic fibrosis

In understanding the disease of marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following?

Deficiency of protein and calories Marasmus is a deficiency in calories as well as protein. Scurvy is caused by inadequate intake of vitamin C, and anemia is caused by lack of iron. Excess calories add to the concern of obesity in children. Excess vitamin C is excreted, and it is unusual to have an excess of iron or protein in the diet of children; those nutrients are more often inadequate in children's diets.

A parent is asking how she can help her son deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?

Demonstrate love and acceptance at home.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason?

Detect Helicobacter pylori

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason?

Detect Helicobacter pylori Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Confirm pancreatitis b) Determine esophageal contractility c) Evaluate gastric pH d) Detect Helicobacter pylori

Detect Helicobacter pylori Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Detect Helicobacter pylori b) Evaluate gastric pH c) Confirm pancreatitis d) Determine esophageal contractility

Detect Helicobacter pylori Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness. (less)

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Determine esophageal contractility b) Detect Helicobacter pylori c) Confirm pancreatitis d) Evaluate gastric pH

Detect Helicobacter pylori Correct Explanation: Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Confirm pancreatitis b) Evaluate gastric pH c) Determine esophageal contractility d) Detect Helicobacter pylori

Detect Helicobacter pylori Explanation: Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Evaluate gastric pH b) Confirm pancreatitis c) Detect Helicobacter pylori d) Determine esophageal contractility

Detect Helicobacter pylori Explanation: Urea breath test is used to detect the presence of H. pylori in the exhaled breath. This test does not evaluate gastric pH. Serum amylase and lipase levels are used to confirm pancreatitis. Esophageal manometry is used to evaluate esophageal contractile activity and effectiveness.

When providing diaper care to an infant after pyloric stenosis surgery, which approach is indicated?

Diapers should be folded so that the incision line does not become contaminated. Folding diapers low so they do not contact the incision line can help prevent infection following surgery.

The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. What would the nurse expect to administer if ordered?

Diazepam

The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed?

Digoxin

The nurse is administering medications to the child with congestive heart failure. Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level?

Digoxin (Lanoxin)

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client?

Disturbed body image

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client?

Duchenne muscular dystrophy

The nurse receives a report on a child admitted with severe muscular dystrophy. The nurse suspects the child has been diagnosed with the most severe form of the disease, known as:

Duchenne.

The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe?

Edema with wet blistering skin

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child?

Effortless vomiting just after the child has eaten Almost immediately after feeding, the child with gastroesophageal reflux vomits the contents of the stomach. The vomiting is effortless, not projectile in nature.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a) Severe constipation with occasional ribbon-like stools b) Effortless vomiting just after the child has eaten c) Bouts of diarrhea with failure to gain weight d) Forceful vomiting followed by the child being eager to eat again

Effortless vomiting just after the child has eaten Almost immediately after feeding, the child with gastroesophageal reflux vomits the contents of the stomach. The vomiting is effortless, not projectile in nature.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which of the following clinical manifestations would likely be seen in this child? a) Bouts of diarrhea with failure to gain weight b) Severe constipation with occasional ribbon-like stools c) Forceful vomiting followed by the child being eager to eat again. d) Effortless vomiting just after the child has eaten.

Effortless vomiting just after the child has eaten. Correct Explanation: Almost immediately after feeding, the child with gastroesophageal reflux vomits the contents of the stomach. The vomiting is effortless, not projectile in nature.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which of the following clinical manifestations would likely be seen in this child? a) Forceful vomiting followed by the child being eager to eat again. b) Effortless vomiting just after the child has eaten. c) Severe constipation with occasional ribbon-like stools d) Bouts of diarrhea with failure to gain weight

Effortless vomiting just after the child has eaten. Explanation: Almost immediately after feeding, the child with gastroesophageal reflux vomits the contents of the stomach. The vomiting is effortless, not projectile in nature.

A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet?

Eggs and orange juice

A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet? a) Eggs and orange juice b) Rye toast and peanut butter c) Wheat toast and grape jelly d) Cheerios (oat cereal) and skim milk

Eggs and orange juice Correct Explanation: Children with celiac disease cannot digest the protein in common grains, such as wheat, rye, and oats

A preschooler has celiac disease. Her mother is preparing a gluten-free diet. The nurse knows that the mother understands the diet when she prepares which breakfast foods?

Eggs and orange juice Correct Explanation: Children with celiac disease cannot digest the protein in common grains, such as wheat, rye, and oats

A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet? a) Cheerios (oat cereal) and skim milk b) Wheat toast and grape jelly c) Eggs and orange juice d) Rye toast and peanut butter

Eggs and orange juice Correct Explanation: Children with celiac disease cannot digest the protein in common grains, such as wheat, rye, and oats.

The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions?

Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?

Encourage high fluid intake.

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse?

Encourage the mother to provide care for her infant. Providing care to the infant is the best means for the mother to begin bonding with her baby. Activities such as feeding, diapering and bathing will be helpful. Encouraging the mother to avoid looking at the cleft lip will not assist her in the process of accepting it. While surgery will be performed it will not take place for a few months making it vital that she begin bonding with her infant. Telling the parent she will get used to it minimizes her concerns and is not the most therapeutic response by the nurse.

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse?

Encourage the mother to provide care for her infant. Providing care to the infant is the best means for the mother to begin bonding with her baby. Activities such as feeding, diapering and bathing will be helpful. Encouraging the mother to avoid looking at the cleft lip will not assist her in the process of accepting it. While surgery will be performed it will not take place for a few months making it vital that she begin bonding with her infant. Telling the parent she will get used to it minimizes her concerns and is not the most therapeutic response by the nurse.

A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure?

Encouraging fluid intake after dinner

A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the child gets panicky, immediately sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which condition?

Epiglottitis

The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and the tongue out. The nurse recognizes these symptoms as those seen with which disorder?

Epiglottitis

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder?

Esophageal atresia

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder?

Esophageal atresia Esophageal atresia refers to a congenitally interrupted esophagus where the proximal and distal ends do not communicate; the upper esophageal segment ends in a blind pouch and the lower segment ends a variable distance above the diaphragm. Polyhydramnios is often the first sign of esophageal atresia because the fetus cannot swallow and absorb amniotic fluid in utero, leading to accumulation. Omphalocele and gastroschisis are congenital anomalies of the anterior abdominal wall. Hiatal hernia involves a weakened diaphragm.

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder? a) Hiatal hernia b) Gastroschisis c) Esophageal atresia d) Omphalocele

Esophageal atresia Esophageal atresia refers to a congenitally interrupted esophagus where the proximal and distal ends do not communicate; the upper esophageal segment ends in a blind pouch and the lower segment ends a variable distance above the diaphragm. Polyhydramnios is often the first sign of esophageal atresia because the fetus cannot swallow and absorb amniotic fluid in utero, leading to accumulation. Omphalocele and gastroschisis are congenital anomalies of the anterior abdominal wall. Hiatal hernia involves a weakened diaphragm.

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate?

Esophageal atresia (EA)

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate?

Esophageal atresia (EA) A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Pyloric stenosis b) Cleft palate c) Esophageal atresia (EA) d) Hernia

Esophageal atresia (EA) A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Pyloric stenosis b) Cleft palate c) Esophageal atresia (EA) d) Hernia

Esophageal atresia (EA) A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Cleft palate b) Pyloric stenosis c) Hernia d) Esophageal atresia (EA)

Esophageal atresia (EA) Correct Explanation: A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Hernia b) Pyloric stenosis c) Cleft palate d) Esophageal atresia (EA)

Esophageal atresia (EA) Correct Explanation: A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Cleft palate b) Hernia c) Pyloric stenosis d) Esophageal atresia (EA)

Esophageal atresia (EA) Explanation: A maternal history of polyhydramnios is usually present in one-third of cases of EA and in some cases of tracheoesophageal fistula (TEF).

A nurse examining a neonate is unable to identify the fetal stomach. The nurse knows that this sign strongly indicates which of the following conditions? a) Pyloric stenosis b) Duodenal atresia c) Esophageal atresia (EA) d) Hernia

Esophageal atresia (EA) Explanation: Inability to identify the fetal stomach strongly suggests EA. The upper abdomen is typically distended in pyloric stenosis and duodenal atresia. Hernias typically present as a bulge in the groin area.

The nurse admits an infant who is nutritionally deprived. The infant is weak and seems somewhat uninterested in food. In developing the infant's plan of care, how often will the nurse most likely plan to feed this infant?

Every 2 or 3 hours For the child who is nutritionally deprived, scheduling feedings every 2 or 3 hours is best because most weak babies can handle frequent, small feedings better than feedings every 4 hours. Feeding every hour would not give the weak child an adequate amount of time to rest and sleep between feedings.

A 16-year-old girl visits her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she was prescribed an oral contraceptive at her last visit. Which intervention should the nurse implement in this situation?

Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that.

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?

Eyes

Inguinal hernia usually occurs in girls.

False

Inguinal hernia usually occurs in girls.

False Inguinal hernia is a protrusion of a section of the bowel into the inguinal ring. It occurs usually in boys (9:1) because, as the testes descend from the abdominal cavity into the scrotum late in fetal life, a fold of parietal peritoneum also descends, forming a tube from the abdomen to the scrotum.

Inguinal hernia usually occurs in girls. a) True b) False

False Inguinal hernia is a protrusion of a section of the bowel into the inguinal ring. It occurs usually in boys (9:1) because, as the testes descend from the abdominal cavity into the scrotum late in fetal life, a fold of parietal peritoneum also descends, forming a tube from the abdomen to the scrotum.

The pH of blood is normally slightly acidic, ranging from 6.85 to 6.95. a) True b) False

False The pH of blood is normally slightly alkaline, ranging from 7.35 to 7.45.

The pH of blood is normally slightly acidic, ranging from 6.85 to 6.95. a) False b) True

False Correct Explanation: The pH of blood is normally slightly alkaline, ranging from 7.35 to 7.45.

The pH of blood is normally slightly acidic, ranging from 6.85 to 6.95. a) True b) False

False Correct Explanation: The pH of blood is normally slightly alkaline, ranging from 7.35 to 7.45.

A mother brings her 2-week-old newborn to the doctor's office because the child has been experiencing gastroesophageal reflux over the past week. Which interventions should the nurse recommend to the mother at this point? Select all that apply.

Feed the infant a formula thickened with rice cereal. Feed the infant while holding her in an upright position. Keep the infant upright in an infant chair for 30 minutes after feeding. The traditional treatment of GI reflux is to feed infants a formula thickened with rice cereal (1 tbsp of cereal per 1 oz of formula or breast milk) while holding them in an upright position and then keeping them upright in an infant chair for 30 minutes after feeding so gravity can help prevent reflux. There is no need for the mother to switch from breastfeeding to formula. Injection of botulinum toxin into the lower esophageal sphincter and a myotomy procedure are interventions that would be considered only if the problem does not disappear with feeding solid food and maintaining the child in a more upright position during and following feeding; they would not be appropriate at this point.

What is a symptom of bacterial pharyngitis?

Fever

The mother of a 3-year-old with a myelomeningocele is thinking about having another baby. The nurse should inform the woman that she should increase her intake of which acid?

Folic acid above 0.4 mg/day

The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other patients, the nurse should a) Discourage anyone from visiting b) Follow standard precautions c) Wear a mask when handling articles contaminated with feces d) Sterilize thermometers between patients

Follow standard precautions Explanation: To prevent the spread of possibly infectious organisms to other pediatric patients, follow standard precautions issued by the Centers for Disease Control. Gloves should be worn when handling items contaminated with feces, but masks are not necessary. Visitor should be limited to family only. Take the temperature with a thermometer that is used only for that child.

The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other patients, the nurse should a) Follow standard precautions b) Sterilize thermometers between patients c) Discourage anyone from visiting d) Wear a mask when handling articles contaminated with feces

Follow standard precautions Explanation: To prevent the spread of possibly infectious organisms to other pediatric patients, follow standard precautions issued by the Centers for Disease Control. Gloves should be worn when handling items contaminated with feces, but masks are not necessary. Visitor should be limited to family only. Take the temperature with a thermometer that is used only for that child.

The nurse is collecting data on a child who has been brought to the clinic. The child has urticaria, pruritus, stomach pains, and respiratory symptoms. The nurse recognizes that the clinical manifestations noted in this child are commonly seen in which of the following disorders? a) Vitamin deficiency b) Protein malnutrition c) Calcium insufficiency d) Food allergies

Food allergies Correct Explanation: Common symptoms of food allergies are urticaria (hives), pruritus (itching), stomach pains, and respiratory symptoms.

The nurse is preparing a presentation for a local community parent group about measures to prevent the common cold. What would the nurse stress as a vital prevention measure?

Frequent hand washing

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis Outbreaks of gastroenteritis routinely occur in day care centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect? a) Appendicitis b) Pancreatitis c) Gastroenteritis d) Hirschsprung disease

Gastroenteritis Outbreaks of gastroenteritis routinely occur in day care centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect? a) Gastroenteritis b) Appendicitis c) Hirschsprung disease d) Pancreatitis

Gastroenteritis Outbreaks of gastroenteritis routinely occur in day care centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect? a) Appendicitis b) Pancreatitis c) Gastroenteritis d) Hirschsprung disease

Gastroenteritis Correct Explanation: Outbreaks of gastroenteritis routinely occur in daycare centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis Explanation: Outbreaks of gastroenteritis routinely occur in daycare centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect? a) Pancreatitis b) Appendicitis c) Gastroenteritis d) Hirschsprung disease

Gastroenteritis Explanation: Outbreaks of gastroenteritis routinely occur in daycare centers, schools, institutions for the handicapped, and other places where overcrowding is prevalent and hygiene is inadequate. Typical signs and symptoms include diarrhea, nausea, vomiting, and abdominal pain.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) Hirschsprung disease b) Cystic fibrosis c) Inflammatory bowel disease d) Gastroesophageal reflux disease

Gastroesophageal reflux disease Correct Explanation: The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) Inflammatory bowel disease b) Cystic fibrosis c) Gastroesophageal reflux disease d) Hirschsprung disease

Gastroesophageal reflux disease Correct Explanation: The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to:

Gastroesophageal reflux disease. The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy?

Gowers sign

The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?

Grilled chicken, half of a banana, and flavored water

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?

Handling the cast with open palms when moving the arm.

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?

Hard, moveable "olive-like mass" in the upper right quadrant

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? Hard, moveable "olive-like mass" in the upper right quadrant Abdominal pain and irritability Sausage-shaped mass in the upper mid abdomen Perianal fissures and skin tags

Hard, moveable "olive-like mass" in the upper right quadrant A hard, moveable "olive-like mass" in the right upper quadrant is the hypertrophied pylorus. A sausage-shaped mass in the upper mid abdomen is the hallmark of intussusception. Perianal fissures and skin tags are typical with Crohn disease. Abdominal pain and irritability is common with pyloric stenosis but are seen with many other conditions

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?

Hard, moveable "olive-like mass" in the upper right quadrant A hard, moveable "olive-like mass" in the right upper quadrant is the hypertrophied pylorus. A sausage-shaped mass in the upper mid abdomen is the hallmark of intussusception. Perianal fissures and skin tags are typical with Crohn disease. Abdominal pain and irritability is common with pyloric stenosis but are seen with many other conditions.

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a) Perianal fissures and skin tags b) Hard, moveable "olive-like mass" in the upper right quadrant c) Sausage-shaped mass in the upper mid abdomen d) Abdominal pain and irritability

Hard, moveable "olive-like mass" in the upper right quadrant A hard, moveable "olive-like mass" in the right upper quadrant is the hypertrophied pylorus. A sausage-shaped mass in the upper mid abdomen is the hallmark of intussusception. Perianal fissures and skin tags are typical with Crohn disease. Abdominal pain and irritability is common with pyloric stenosis but are seen with many other conditions.

A 2-month-old boy is admitted to the emergency room with severe diarrhea. Intravenous fluid is prescribed for him. Before adding potassium to this solution, which assessment would you record? a) He has voided. b) He cries with tears. c) He "attunes" to a music box. d) His hands are restrained.

He has voided. With severe diarrhea, kidney function may fail. It is important to document that kidney function is intact before adding potassium to prevent hyperkalemia.

A 2-month-old boy is admitted to the emergency room with severe diarrhea. Intravenous fluid is prescribed for him. Before adding potassium to this solution, which assessment would you record? a) He "attunes" to a music box. b) His hands are restrained. c) He has voided. d) He cries with tears.

He has voided. Explanation: With severe diarrhea, kidney function may fail. It is important to document that kidney function is intact before adding potassium to prevent hyperkalemia.

A 2-month-old boy is admitted to the emergency room with severe diarrhea. Intravenous fluid is prescribed for him. Before adding potassium to this solution, which assessment would you record? a) He cries with tears. b) He has voided. c) His hands are restrained. d) He "attunes" to a music box.

He has voided. Explanation: With severe diarrhea, kidney function may fail. It is important to document that kidney function is intact before adding potassium to prevent hyperkalemia.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care?

He will become fatigued easily.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care?

He will become fatigued easily. Most children with hepatitis are exhausted. Urine is not infectious.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? a) He will be very irritable and perhaps require sedation. b) Hypothermia is common. c) He will become fatigued easily. d) His urine will be dark and infectious.

He will become fatigued easily. Most children with hepatitis are exhausted. Urine is not infectious.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? a) Hypothermia is common. b) He will be very irritable and perhaps require sedation. c) He will become fatigued easily. d) His urine will be dark and infectious.

He will become fatigued easily. Most children with hepatitis are exhausted. Urine is not infectious.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? a) His urine will be dark and infectious. b) He will be very irritable and perhaps require sedation. c) Hypothermia is common. d) He will become fatigued easily.

He will become fatigued easily. Correct Explanation: Most children with hepatitis are exhausted. Urine is not infectious.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? a) He will become fatigued easily. b) He will be very irritable and perhaps require sedation. c) Hypothermia is common. d) His urine will be dark and infectious.

He will become fatigued easily. Explanation: Most children with hepatitis are exhausted. Urine is not infectious.

What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn?

Hematocrit and WBC counts elevate

Testing is being performed to confirm the presence of Meckel diverticulum. Which findings are consistent with this condition? Select all that apply.

Hemoglobin 9.4 g/dL Stool test reveals occult blood. Meckel diverticulum is a disorder where there are weaknesses on the intestine resulting in pouchlike areas. Test findings that are consistent with this disorder are anemia and the presence of occult blood. The values listed for white blood cell count, platelet levels, and hematocrit levels are within normal limits.

Through which mechanism is Duchenne muscular dystrophy acquired?

Heredity

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease

High calorie, high protein Correct Explanation: The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Dietary management focuses on enhancing protein and calorie intake. Generally, a high-protein, high-calorie diet is recommended.

A nurse prepares a menu for a patient with Crohn Disease. What is the focus of dietary management for this disease? a) Low fiber, low calorie b) Low calorie, high carbohydrate c) High calorie, high protein d) High calorie, high fiber

High calorie, high protein Correct Explanation: The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Dietary management focuses on enhancing protein and calorie intake. Generally, a high-protein, high-calorie diet is recommended.

A nurse prepares a menu for a patient with Crohn Disease. What is the focus of dietary management for this disease? a) High calorie, high protein b) High calorie, high fiber c) Low calorie, high carbohydrate d) Low fiber, low calorie

High calorie, high protein Explanation: The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Dietary management focuses on enhancing protein and calorie intake. Generally, a high-protein, high-calorie diet is recommended.

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease? a) High calorie, high fiber b) Low calorie, high carbohydrate c) High carbohydrate, high protein d) Low fiber, low calorie

High carbohydrate, high protein The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Adequate nutrition with a high-protein and high-carbohydrate diet may be recommended

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease?

High carbohydrate, high protein The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Adequate nutrition with a high-protein and high-carbohydrate diet may be recommended.

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease? a) High calorie, high fiber b) Low calorie, high carbohydrate c) High carbohydrate, high protein d) Low fiber, low calorie

High carbohydrate, high protein The goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Adequate nutrition with a high-protein and high-carbohydrate diet may be recommended

The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works?

High-frequency sound waves are directed toward the heart

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?

Hirschsprung disease

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?

Hirschsprung disease The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth, and has bilious vomiting or abdominal distention and feeding intolerance with bilious aspirates and vomiting. Typical signs and symptoms of gastroenteritis include diarrhea, nausea, vomiting, and abdominal pain. The characteristic GI manifestation of UC is bloody diarrhea accompanied by crampy, typically left-sided lower abdominal pain. Clinical manifestations of untreated SBS include profuse watery diarrhea, malabsorption, and failure to thrive.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a) Hirschsprung disease b) Short bowel syndrome (SBS) c) Ulcerative colitis (UC) d) Gastroenteritis

Hirschsprung disease The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth, and has bilious vomiting or abdominal distention and feeding intolerance with bilious aspirates and vomiting. Typical signs and symptoms of gastroenteritis include diarrhea, nausea, vomiting, and abdominal pain. The characteristic GI manifestation of UC is bloody diarrhea accompanied by crampy, typically left-sided lower abdominal pain. Clinical manifestations of untreated SBS include profuse watery diarrhea, malabsorption, and failure to thrive.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a) Ulcerative colitis (UC) b) Gastroenteritis c) Short bowel syndrome (SBS) d) Hirschsprung disease

Hirschsprung disease Correct Explanation: The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth, and has bilious vomiting or abdominal distention and feeding intolerance with bilious aspirates and vomiting. Typical signs and symptoms of gastroenteritis include diarrhea, nausea, vomiting, and abdominal pain. The characteristic GI manifestation of UC is bloody diarrhea accompanied by crampy, typically left-sided lower abdominal pain. Clinical manifestations of untreated SBS include profuse watery diarrhea, malabsorption, and failure to thrive.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a) Short bowel syndrome (SBS) b) Gastroenteritis c) Hirschsprung disease d) Ulcerative colitis (UC)

Hirschsprung disease Explanation: The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth, and has bilious vomiting or abdominal distention and feeding intolerance with bilious aspirates and vomiting. Typical signs and symptoms of gastroenteritis include diarrhea, nausea, vomiting, and abdominal pain. The characteristic GI manifestation of UC is bloody diarrhea accompanied by crampy, typically left-sided lower abdominal pain. Clinical manifestations of untreated SBS include profuse watery diarrhea, malabsorption, and failure to thrive.

The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?

Hypertension

The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as:

Hypospadias

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply.

IV fluid administration Monitor of intake and output Daily weight assessment Rotavirus is viral in nature. Antibiotic therapy is not used in the care and treatment of a viral infection. Antidiarrhea medications are not utilized as they are not effective. Intake and output will be observed. Daily weight will aid in the determination of hydration status. IV fluids may be indicated in the rehydration process.

The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?

Impetigo

The nurse is working in a community setting and receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo, and the director of the day care center wants to know whether she should be concerned. The nurse's response should reflect what information related to impetigo?

Impetigo is highly contagious and can spread quickly.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration Preoperatively the highest priority for the child with pyloric stenosis is to improve nutrition and hydration. Maintaining mouth and skin integrity, and relieving family anxiety are important, but these are not the priority. The child will not likely have intense pain. Preparing the family for home care would be a postoperative goal.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? a) Improving hydration b) Promoting comfort c) Maintaining skin integrity d) Preparing family for home care

Improving hydration Preoperatively the highest priority for the child with pyloric stenosis is to improve nutrition and hydration. Maintaining mouth and skin integrity, and relieving family anxiety are important, but these are not the priority. The child will not likely have intense pain. Preparing the family for home care would be a postoperative goal.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration Preoperatively, the highest priority for the child with pyloric stenosis is to improve nutrition and hydration. Maintaining mouth and skin integrity, and relieving family anxiety are important, but these are not the priority. The child will not likely have intense pain. Preparing the family for home care would be a postoperative goal.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. Which of the following goal has the highest priority at this time? a) Preparing family for home care b) Promoting comfort c) Improving hydration d) Maintaining skin integrity

Improving hydration Explanation: Preoperatively the highest priority for the child with pyloric stenosis is to improve nutrition and hydration. Maintaining mouth and skin integrity, and relieving family anxiety are important, but these are not the priority. The child will not likely have intense pain. Preparing the family for home care would be a postoperative goal.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. Which of the following goal has the highest priority at this time? a) Maintaining skin integrity b) Improving hydration c) Promoting comfort d) Preparing family for home care

Improving hydration Explanation: Preoperatively the highest priority for the child with pyloric stenosis is to improve nutrition and hydration. Maintaining mouth and skin integrity, and relieving family anxiety are important, but these are not the priority. The child will not likely have intense pain. Preparing the family for home care would be a postoperative goal.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?

In this disorder the sphincter that leads into the stomach is relaxed.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a) In this disorder the sphincter that leads into the stomach is relaxed. b) A partial or complete intestinal obstruction occurs. c) A thickened, elongated muscle causes an obstruction at the end of the stomach. d) There are recurrent paroxysmal bouts of abdominal pain.

In this disorder the sphincter that leads into the stomach is relaxed. Explanation: Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, which leads to an obstruction at the distal end of the stomach.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?

In this disorder the sphincter that leads into the stomach is relaxed. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a) There are recurrent paroxysmal bouts of abdominal pain. b) A thickened, elongated muscle causes an obstruction at the end of the stomach. c) In this disorder the sphincter that leads into the stomach is relaxed. d) A partial or complete intestinal obstruction occurs.

In this disorder the sphincter that leads into the stomach is relaxed. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?

In this disorder the sphincter that leads into the stomach is relaxed. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, which leads to an obstruction at the distal end of the stomach.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a) A thickened, elongated muscle causes an obstruction at the end of the stomach. b) In this disorder the sphincter that leads into the stomach is relaxed. c) There are recurrent paroxysmal bouts of abdominal pain. d) A partial or complete intestinal obstruction occurs.

In this disorder the sphincter that leads into the stomach is relaxed. Correct Explanation: Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a) A partial or complete intestinal obstruction occurs. b) In this disorder the sphincter that leads into the stomach is relaxed. c) A thickened, elongated muscle causes an obstruction at the end of the stomach. d) There are recurrent paroxysmal bouts of abdominal pain.

In this disorder the sphincter that leads into the stomach is relaxed. Explanation: Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Colic consists of recurrent paroxysmal bouts of abdominal pain. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach.

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia?

Increased RBC

What measure at home could help a child with an upper respiratory infection breathe more easily?

Increasing room humidity

An 8-month-old has a ventricular septal defect. Which nursing diagnosis would best apply?

Ineffective tissue perfusion related to inefficiency of the heart as a pump

The nurse examining an infant forms the following diagnosis: "Risk for impaired skin integrity related to effects of diarrhea." This diagnosis would be most appropriate for which disease states? Select all that apply.

Inflammatory bowel disease Crohn disease Ulcerative colitis Inflammatory bowel disease (IBD) is a group of diseases characterized by inflammation of the GI tract and diarrhea. Crohn disease (CD) and ulcerative colitis (UC) are the most common forms of IBD and account for more than 80% of all cases.

A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother?

Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions

The nurse is providing discharge teaching to an adolescent who has been treated for pelvic inflammatory disease (PID). What would the nurse include as a preventive measure?

Insisting that sexual partners use condoms

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?

Intussusception Intussusception, the invagination of one portion of the intestine into another, usually occurs in the second half of the first year of life. Children with this disorder suddenly draw up their legs and cry as if they are in severe pain; they may vomit. After the peristaltic wave that caused the discomfort passes, they are symptom-free and play happily. In approximately 15 minutes, however, the same phenomenon of intense abdominal pain strikes again. After approximately 12 hours, blood appears in the stool and possibly in vomitus, described as a "currant jelly" appearance. Volvulus with malrotation and necrotizing entercolitis typically occur in the first 6 months of life and do not match the symptoms described above. Short-bowel/short-gut syndrome typically occurs when a large portion of the intestine has been removed due to a previous disease or trauma.

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? a) Volvulus with malrotation b) Intussusception c) Short-bowel/short-gut syndrome d) Necrotizing enterocolitis

Intussusception Intussusception, the invagination of one portion of the intestine into another, usually occurs in the second half of the first year of life. Children with this disorder suddenly draw up their legs and cry as if they are in severe pain; they may vomit. After the peristaltic wave that caused the discomfort passes, they are symptom-free and play happily. In approximately 15 minutes, however, the same phenomenon of intense abdominal pain strikes again. After approximately 12 hours, blood appears in the stool and possibly in vomitus, described as a "currant jelly" appearance. Volvulus with malrotation and necrotizing entercolitis typically occur in the first 6 months of life and do not match the symptoms described above. Short-bowel/short-gut syndrome typically occurs when a large portion of the intestine has been removed due to a previous disease or trauma.

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. Which of the following conditions should the nurse suspect in this case? a) Volvulus with malrotation b) Short-bowel/short-gut syndrome c) Intussusception d) Necrotizing enterocolitis

Intussusception Explanation: Intussusception, the invagination of one portion of the intestine into another, usually occurs in the second half of the first year of life. Children with this disorder suddenly draw up their legs and cry as if they are in severe pain; they may vomit. After the peristaltic wave that caused the discomfort passes, they are symptom-free and play happily. In approximately 15 minutes, however, the same phenomenon of intense abdominal pain strikes again. After approximately 12 hours, blood appears in the stool and possibly in vomitus, described as a "currant jelly" appearance. Volvulus with malrotation and necrotizing entercolitis typically occur in the first 6 months of life and do not match the symptoms described above. Short-bowel/short-gut syndrome typically occurs when a large portion of the intestine has been removed due to a previous disease or trauma

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. Which of the following conditions should the nurse suspect in this case? a) Necrotizing enterocolitis b) Short-bowel/short-gut syndrome c) Intussusception d) Volvulus with malrotation

Intussusception Explanation: Intussusception, the invagination of one portion of the intestine into another, usually occurs in the second half of the first year of life. Children with this disorder suddenly draw up their legs and cry as if they are in severe pain; they may vomit. After the peristaltic wave that caused the discomfort passes, they are symptom-free and play happily. In approximately 15 minutes, however, the same phenomenon of intense abdominal pain strikes again. After approximately 12 hours, blood appears in the stool and possibly in vomitus, described as a "currant jelly" appearance. Volvulus with malrotation and necrotizing entercolitis typically occur in the first 6 months of life and do not match the symptoms described above. Short-bowel/short-gut syndrome typically occurs when a large portion of the intestine has been removed due to a previous disease or trauma.

A 10-year-old girl with an intestinal virus has been vomiting and has become dehydrated. She says she is mildly thirsty, her skin turgor is poor, and her skin is dry and cool. Her serum sodium level is normal. The nurse recognizes that she has which type of dehydration? a) Acidotic b) Hypertonic c) Isotonic d) Hypotonic

Isotonic Signs and symptoms of isotonic dehydration include the following: mild thirst; poor skin turgor; dry, cool skin; decreased urine output; irritability; and a normal sodium level. Signs and symptoms of hypotonic dehydration include the following: moderate thirst; very poor skin turgor; clammy, cool skin; decreased urine output; lethargy; and a reduced sodium level. Signs and symptoms of hypertonic dehydration include the following: extreme thirst; moderate skin turgor; warm skin; decreased urine output; extreme lethargy; and an increased sodium level. Acidotic is not a type of dehydration.

A 10-year-old girl with an intestinal virus has been vomiting and has become dehydrated. She says she is mildly thirsty, her skin turgor is poor, and her skin is dry and cool. Her serum sodium level is normal. The nurse recognizes that she has which type of dehydration? a) Hypotonic b) Isotonic c) Hypertonic d) Acidotic

Isotonic Correct Explanation: Signs and symptoms of isotonic dehydration include the following: mild thirst; poor skin turgor; dry, cool skin; decreased urine output; irritability; and a normal sodium level. Signs and symptoms of hypotonic dehydration include the following: moderate thirst; very poor skin turgor; clammy, cool skin; decreased urine output; lethargy; and a reduced sodium level. Signs and symptoms of hypertonic dehydration include the following: extreme thirst; moderate skin turgor; warm skin; decreased urine output; extreme lethargy; and an increased sodium level. Acidotic is not a type of dehydration.

A 10-year-old girl with an intestinal virus has been vomiting and has become dehydrated. She says she is mildly thirsty, her skin turgor is poor, and her skin is dry and cool. Her serum sodium level is normal. The nurse recognizes that she has which type of dehydration? a) Isotonic b) Hypertonic c) Acidotic d) Hypotonic

Isotonic Explanation: Signs and symptoms of isotonic dehydration include the following: mild thirst; poor skin turgor; dry, cool skin; decreased urine output; irritability; and a normal sodium level. Signs and symptoms of hypotonic dehydration include the following: moderate thirst; very poor skin turgor; clammy, cool skin; decreased urine output; lethargy; and a reduced sodium level. Signs and symptoms of hypertonic dehydration include the following: extreme thirst; moderate skin turgor; warm skin; decreased urine output; extreme lethargy; and an increased sodium level. Acidotic is not a type of dehydration

An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse?

It will determine if the heart is enlarged.

A nurse reads the medical history of a client who is scheduled for a hernia repair that is termed "reducible." What best describes this type of hernia? a) Its contents can be easily manipulated back into the peritoneal cavity. b) The herniated intestines are twisted and edematous. c) Intestinal obstruction and ischemia may occur. d) The abdominal contents have become trapped.

Its contents can be easily manipulated back into the peritoneal cavity. A hernia in the abdominal region is considered reducible when its contents are easily manipulated back into the peritoneal cavity. An incarcerated hernia occurs when the abdominal contents become trapped and difficult to reduce. A strangulated hernia occurs when the herniated intestines become twisted and edematous compromising blood flow. Intestinal obstruction and ischemia may occur.

A nurse reads the medical history of a client who is scheduled for a hernia repair that is termed "reducible." What best describes this type of hernia? a) The herniated intestines are twisted and edematous. b) Its contents can be easily manipulated back into the peritoneal cavity. c) Intestinal obstruction and ischemia may occur. d) The abdominal contents have become trapped.

Its contents can be easily manipulated back into the peritoneal cavity. A hernia in the abdominal region is considered reducible when its contents are easily manipulated back into the peritoneal cavity. An incarcerated hernia occurs when the abdominal contents become trapped and difficult to reduce. A strangulated hernia occurs when the herniated intestines become twisted and edematous compromising blood flow. Intestinal obstruction and ischemia may occur.

A nurse reads the medical history of a patient who is scheduled for a hernia repair that is termed "reducible." Which of the following best describes this type of hernia? a) The herniated intestines are twisted and edematous. b) The abdominal contents have become trapped. c) Intestinal obstruction and ischemia may occur. d) Its contents can be easily manipulated back into the peritoneal cavity.

Its contents can be easily manipulated back into the peritoneal cavity. Correct Explanation: A hernia in the abdominal region is considered reducible when its contents are easily manipulated back into the peritoneal cavity. An incarcerated hernia occurs when the abdominal contents become trapped and difficult to reduce. A strangulated hernia occurs when the herniated intestines become twisted and edematous compromising blood flow: Intestinal obstruction and ischemia may occur.

A mother brings her 2-week-old newborn to the doctor's office because the child has been experiencing gastroesophageal reflux over the past week. Which interventions should the nurse recommend to the mother at this point? Select all that apply. a) Keep the infant upright in an infant chair for 30 minutes after feeding. b) Feed the infant a formula thickened with rice cereal. c) If breastfeeding, switch to formula. d) Feed the infant while holding her in an upright position. e) Consult a pediatric surgeon regarding having a myotomy procedure performed. f) Consult the physician regarding having botulinum toxin injected into the lower esophageal sphincter.

Keep the infant upright in an infant chair for 30 minutes after feeding. • Feed the infant a formula thickened with rice cereal. • Feed the infant while holding her in an upright position. The traditional treatment of GI reflux is to feed infants a formula thickened with rice cereal (1 tbsp of cereal per 1 oz of formula or breast milk) while holding them in an upright position and then keeping them upright in an infant chair for 30 minutes after feeding so gravity can help prevent reflux. There is no need for the mother to switch from breastfeeding to formula. Injection of botulinum toxin into the lower esophageal sphincter and a myotomy procedure are interventions that would be considered only if the problem does not disappear with feeding solid food and maintaining the child in a more upright position during and following feeding; they would not be appropriate at this point.

An infant with a femur fracture is placed in Bryant traction. What would the nurse include in the infant's plan of care?

Keeping the buttocks slightly elevated

The nurse is conducting a presentation on children with nutritional problems for a group of nurses. Which of the following statements made by the group members is accurate? Select all that apply.

Kwashiorkor results from severe deficiency of protein with an adequate caloric intake. Rickets is caused by a lack of vitamin D. Thiamine is one of the major components of the vitamin B complex. Niacin insufficiency in the diet causes a disease known as pellagra. Kwashiorkor results from severe deficiency of protein with an adequate caloric intake. Rickets is caused by a lack of vitamin D. Thiamine is one of the major components of the vitamin B complex. Niacin insufficiency in the diet causes a disease known as pellagra. Marasmus involves calorie and protein deficiency.

The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect?

Lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk

The nurse is caring for a neonate who has undergone an intestinal pull-through procedure for an imperforate anus. Which of the following would be most important for the nurse to do postoperatively? a) Observing the abdominal skin b) Determining the infant's ability to suck on a pacifier c) Turning the infant every 4 hours d) Listening for bowel sounds

Listening for bowel sounds Correct Explanation: Bowel sounds will allow the nurse to know how peristalsis is progressing after surgery. This will determine when the infant is able to receive nourishment other than through the intravenous route. Observing the perianal skin would be important because the perianal skin is at significant risk for breakdown because this will be the first time that stool has passed through the anal sphincter. The infant's ability to suck on the pacifier is important but is unrelated to the surgery. The infant should be turned at least every 2 hours.

he nurse is caring for a neonate who has undergone an intestinal pull-through procedure for an imperforate anus. Which action would be most important for the nurse to do postoperati

Listening for bowel sounds Correct Explanation: Bowel sounds will allow the nurse to know how peristalsis is progressing after surgery. This will determine when the infant is able to receive nourishment other than through the intravenous route. Observing the perianal skin would be important because the perianal skin is at significant risk for breakdown because this will be the first time that stool has passed through the anal sphincter. The infant's ability to suck on the pacifier is important but is unrelated to the surgery. The infant should be turned at least every 2 hours.

A father brings his 10-year-old daughter in to the physician's office with jaundice, headache, fever, and anorexia, symptoms she has had for the past few days. The nurse should suspect infection of which organ in this client? a) Stomach b) Esophagus c) Small intestines d) Liver

Liver Correct Explanation: No matter which virus is involved, hepatitis is a generalized body infection with specific intense liver effects. Type A occurs in children of all ages and accounts for approximately 30% of instances. With hepatitis A, children notice headache, fever, and anorexia. Jaundice occurs as liver function slows.

The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record?

Low serum calcium levels

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child?

Lower extremities

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?

Lower right

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?

Lower right With appendicitis, percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness present with palpation in the right lower quadrant, is referred to as the McBurney point, an area of tenderness 1.5 to 2 in. (3.8 to 5 cm) in from the right anterior superior iliac spine along a line extending to the umbilicus.

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant? a) Lower right b) Upper left c) Upper right d) Lower left

Lower right With appendicitis, percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness present with palpation in the right lower quadrant, is referred to as the McBurney point, an area of tenderness 1.5 to 2 in. (3.8 to 5 cm) in from the right anterior superior iliac spine along a line extending to the umbilicus.

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant? a) Upper left b) Upper right c) Lower left d) Lower right

Lower right Correct Explanation: With appendicitis, percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness present with palpation in the right lower quadrant, is referred to as the McBurney point, an area of tenderness 1.5 to 2 in. (3.8 to 5 cm) in from the right anterior superior iliac spine along a line extending to the umbilicus.

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant? a) Upper right b) Lower right c) Upper left d) Lower left

Lower right Correct Explanation: With appendicitis, percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness present with palpation in the right lower quadrant, is referred to as the McBurney point, an area of tenderness 1.5 to 2 in. (3.8 to 5 cm) in from the right anterior superior iliac spine along a line extending to the umbilicus.

The nurse is assessing a child who was admitted with a fever, chills, nausea and vomiting, and reports of abdominal pain. The physician suspects appendicitis. During the nursing assessment the nurse notes maximal tenderness upon palpation over the McBurney point. Place an X on McBurney's point.

McBurney's point is the area in the right lower quadrant of the abdomen where the most pressure tends to be felt upon palpation when the client has appendicitis. It lies between the naval and the right anterior superior iliac spine.

where is Mcburney's Point

McBurney's point is the area in the right lower quadrant of the abdomen where the most pressure tends to be felt upon palpation when the client has appendicitis. It lies between the naval and the right anterior superior iliac spine.

The nurse is assessing a child who was admitted with a fever, chills, nausea and vomiting, and reports of abdominal pain. The physician suspects appendicitis. During the nursing assessment the nurse notes maximal tenderness upon palpation over the McBurney point. Place an X on McBurney's point.

McBurney's point is the area in the right lower quadrant of the abdomen where the most pressure tends to be felt upon palpation when the client has appendicitis. It lies between the naval and the right anterior superior iliac spine. p730

The nurse is caring for a 3 year old with repeated diarrhea. The client is listless ad clings to the parent. The nurse reviews the labwork which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented?

Metabolic acidosis. Diarrhea leads to a metabolic acidosis through the extreme loss of base substances in stools. This is noted in the ABG levels with blood pH indicating acidosis and the bicarb being abnormal.

During a class for caregivers of children with asthma, a caregiver asks the nurse the following question when medications are being discussed. "They told me about a plastic device my child can hold in his a hand which will give him a premeasured and exact amount of his corticosteroid." The nurse recognizes that the caregiver is most likely referring to which device?

Metered-dose inhaler

The parents of a 6-month-old have brought their child to the emergency department with vomiting and diarrhea for the past 3 days. The report the child as being very lethargic today. During the assessment the nurse notes decreased skin turgor, delayed capillary refill, and pale, slightly dry skin. Based on the objective and subjective data, what does the nurse determine the child to be? a) Moderately dehydrated b) Severely dehydrated c) Mildly dehydrated d) Well hydrated

Moderately dehydrated In addition to these signs and symptoms, signs and symptoms of moderate dehydration also include sunken fontanels, mildly sunken orbits, and urine output

The parents of a 6-month-old have brought their child to the emergency department with vomiting and diarrhea for the past 3 days. The report the child as being very lethargic today. During the assessment the nurse notes decreased skin turgor, delayed capillary refill, and pale, slightly dry skin. Based on the objective and subjective data, what does the nurse determine the child to be?

Moderately dehydrated In addition to these signs and symptoms, signs and symptoms of moderate dehydration also include sunken fontanels, mildly sunken orbits, and urine output <1 mL/kg/hour.

The parents of a 6-month-old have brought their child to the emergency department with vomiting and diarrhea for the past 3 days. The report the child as being very lethargic today. During the assessment the nurse notes decreased skin turgor, delayed capillary refill, and pale, slightly dry skin. Based on the objective and subjective data, what does the nurse determine the child to be? a) Mildly dehydrated b) Moderately dehydrated c) Severely dehydrated d) Well hydrated

Moderately dehydrated In addition to these signs and symptoms, signs and symptoms of moderate dehydration also include sunken fontanels, mildly sunken orbits, and urine output

What statement is the most accurate regarding the structure and function of the newborn's respiratory system?

Most infants are nasal breathers rather than mouth breathers.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?

Mother age 42 with pregnancy

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?

Mother age 42 with pregnancy Advanced maternal age is a risk factor for cleft lip and palate. Drugs such as anticonvulsants, steroids, and other medications during early pregnancy are considered risk factors. Acetaminophen is not associated with an increased risk for cleft lip and palate. Preterm birth is not a risk factor for the development of cleft lip and palate. Hypoxia or anoxia is a risk factor for the development of necrotizing enterocolitis.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition? a) Maternal use of acetaminophen in third trimester b) Mother age 42 with pregnancy c) Preterm birth d) History of hypoxia at birth

Mother age 42 with pregnancy Advanced maternal age is a risk factor for cleft lip and palate. Drugs such as anticonvulsants, steroids, and other medications during early pregnancy are considered risk factors. Acetaminophen is not associated with an increased risk for cleft lip and palate. Preterm birth is not a risk factor for the development of cleft lip and palate. Hypoxia or anoxia is a risk factor for the development of necrotizing enterocolitis.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, which of the following would the nurse identify as a risk factor for this condition? a) Maternal use of acetaminophen in third trimester b) Mother age 42 with pregnancy c) Preterm birth d) History of hypoxia at birth

Mother age 42 with pregnancy Explanation: Advanced maternal age is a risk factor for cleft lip and palate. Drugs such as anticonvulsants, steroids, and other medications during early pregnancy are considered risk factors. Acetaminophen is not associated with an increased risk for cleft lip and palate. Preterm birth is not a risk factor for the development of cleft lip and palate. Hypoxia or anoxia is a risk factor for the development of necrotizing enterocolitis.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, which of the following would the nurse identify as a risk factor for this condition? a) Mother age 42 with pregnancy b) Maternal use of acetaminophen in third trimester c) Preterm birth d) History of hypoxia at birth

Mother age 42 with pregnancy Explanation: Advanced maternal age is a risk factor for cleft lip and palate. Drugs such as anticonvulsants, steroids, and other medications during early pregnancy are considered risk factors. Acetaminophen is not associated with an increased risk for cleft lip and palate. Preterm birth is not a risk factor for the development of cleft lip and palate. Hypoxia or anoxia is a risk factor for the development of necrotizing enterocolitis.

The digestive process begins in which organ of the gastrointestinal system?

Mouth Food enters the mouth, and the digestive process begins. Digestion takes place by mechanical and chemical mechanisms. As the food continues through the stomach and intestines, digestion continues.

The digestive process begins in which organ of the gastrointestinal system?

Mouth Food enters the mouth, and the digestive process begins. Digestion takes place by mechanical and chemical mechanisms. As the food continues through the stomach and intestines, digestion continues.

The digestive process begins in which of the following organs of the gastrointestinal system? a) Small intestine b) Large intestine c) Mouth d) Stomach

Mouth Explanation: Food enters the mouth, and the digestive process begins. Digestion takes place by mechanical and chemical mechanisms. As the food continues through the stomach and intestines, digestion continues.

The nurse caring for a client with suspected muscular dystrophy would prepare her client for which diagnostic test?

Muscle biopsy

When a child is suspected of having muscular dystrophy, a nurse should expect which muscles to be affected first?

Muscles of the hip

Which age of children have a trachea 4 mm long?

Newborn

The nurse is discussing the disease known as pellagra. This disease is due to a deficiency in which of the following?

Niacin Niacin insufficiency in the diet causes a disease known as pellagra, which presents with GI and neurologic symptoms. A diet deficient in thiamine causes beriberi. Lack of vitamin C causes scurvy, and lack of iron causes anemia.

A 3-month-old girl is found to have an umbilical hernia at a well visit. On examination, the nurse discovers that the fascial ring through which the intestine protrudes is about 1 cm in diameter. Which of the following should she mention to the girl's father as the likely intervention required to correct this condition? a) No intervention is needed, as the opening will most likely close spontaneously b) Taping a silver dollar over the area will help reduce the hernia c) Surgery at age 1 to 2 years will likely be needed to repair the condition d) Wrapping an elastic band around the child's waist should correct the problem

No intervention is needed, as the opening will most likely close spontaneously An umbilical hernia is a protrusion of a portion of the intestine through the umbilical ring, muscle, and fascia surrounding the umbilical cord. If the fascial ring through which the intestine protrudes is less than 2 cm, closure will usually occur spontaneously after the child begins to walk so no repair of the disorder will be necessary. If the fascial ring is larger than 2 cm, ambulatory surgery for repair is generally indicated to prevent herniation and intestinal obstruction or bowel strangulation. This is usually done at 1 to 2 years of age. Some parents believe holding an umbilical hernia in place by using "belly bands" or taping a silver dollar over the area will help reduce the hernia. These actions can actually lead to bowel strangulation so should be avoided.

A nurse is providing supplemental oxygen therapy to a young child. Based on the nurse's understanding of oxygen delivery methods, what would the nurse expect to be used to deliver the highest concentration of oxygen to the child?

Nonrebreathing mask

A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention?

Notify the doctor immediately.

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

Obtaining a clean catch voided urine

The nurse is preparing to administer an enema to a toddler. How should she position the child?

On their abdomen with knees bent The best position for administering an enema to an infant or child is on their abdomen with knees bent. For a child or adolescent, place the child on the left side with right leg flexed toward the chest.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting?

Only occurs with feeding

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting? a) Is projected 1 ft away from infant b) Only occurs with feeding c) Continues until stomach is empty d) Is curdled and extremely sour smelling

Only occurs with feeding Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting?

Only occurs with feeding Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting? a) Is curdled and extremely sour smelling b) Continues until stomach is empty c) Is projected 1 ft away from infant d) Only occurs with feeding

Only occurs with feeding Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. Which of the following would indicate that the child is regurgitating as opposed to vomiting? a) Is curdled and extremely sour smelling b) Continues until stomach is empty c) Is projected 1 ft away from infant d) Only occurs with feeding

Only occurs with feeding Correct Explanation: Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting

Only occurs with feeding Explanation: Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. Which of the following would indicate that the child is regurgitating as opposed to vomiting? a) Is curdled and extremely sour smelling b) Only occurs with feeding c) Continues until stomach is empty d) Is projected 1 ft away from infant

Only occurs with feeding Explanation: Regurgitation typically occurs only with feeding, runs out of the mouth with little force, smells barely sour and is only slightly curdled, appears to cause no pain or distress, occurs only once per feeding, and amounts to only about 1 to 2 tsp. Vomiting may occur at times other than feeding, is forceful and is typically projected 1 ft or more away from infant, is extremely sour smelling and curdled, is typically accompanied by crying, continues until the stomach is empty, and amounts to the full stomach contents.

The nurse is administering medications to a child with cystic fibrosis. Which method would the nurse most likely use to give medications to treat the pancreatic involvement seen in this disease?

Open capsule and sprinkle on food

The nurse caring for patients with GI disorders knows that various enteral feedings tubes are used to deliver enteral nutrition. What type of tube is most commonly used for premature infants? a) Jejunostomy tube b) Orogastric feeding tube c) Gastronomy tube d) Nasoenteric feeding tube

Orogastric feeding tube Explanation: The orogastric feeding tube is most commonly used for premature infants or infants younger than 4 weeks old, who are obligatory nose breathers and might experience respiratory distress, airway obstruction, or both if a feeding tube is passed transnasally.

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question? a) Nasogastric tube placed to suction b) Serum amylase levels c) NPO d) PO pain management

PO pain management Maintain NPO status and nasogastric tube suction and patency. Administer intravenous fluids to keep the child hydrated and correct any alterations in fluid and electrolyte balance. Pain management is crucial in children with pancreatitis, due to NPO status, medications are typically prescribed intravenously. Serial monitoring of serum amylase levels will determine when oral feeding may be restarted.

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question? a) Nasogastric tube placed to suction b) Serum amylase levels c) NPO d) PO pain management

PO pain management Maintain NPO status and nasogastric tube suction and patency. Administer intravenous fluids to keep the child hydrated and correct any alterations in fluid and electrolyte balance. Pain management is crucial in children with pancreatitis, due to NPO status, medications are typically prescribed intravenously. Serial monitoring of serum amylase levels will determine when oral feeding may be restarted.

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:

Painless rectal bleeding

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:

Painless rectal bleeding With Meckel diverticulum, most symptomatic children present younger than age 2 years. Intermittent, painless rectal bleeding is the most common clinical manifestation of Meckel diverticulum. The blood is most often bright red or maroon and may be passed independent of stool due to ulceration at the junction of the ectopic tissue and the normal ileal mucosa.

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: a) Painless rectal bleeding b) Dehydration c) Ischemia d) Respiratory distress

Painless rectal bleeding With Meckel diverticulum, most symptomatic children present younger than age 2 years. Intermittent, painless rectal bleeding is the most common clinical manifestation of Meckel diverticulum. The blood is most often bright red or maroon and may be passed independent of stool due to ulceration at the junction of the ectopic tissue and the normal ileal mucosa.

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: a) Dehydration b) Respiratory distress c) Ischemia d) Painless rectal bleeding

Painless rectal bleeding Correct Explanation: With Meckel diverticulum, most symptomatic children present younger than age 2 years. Intermittent, painless rectal bleeding is the most common clinical manifestation of Meckel diverticulum. The blood is most often bright red or maroon and may be passed independent of stool due to ulceration at the junction of the ectopic tissue and the normal ileal mucosa.

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: a) Painless rectal bleeding b) Dehydration c) Respiratory distress d) Ischemia

Painless rectal bleeding Explanation: With Meckel diverticulum, most symptomatic children present younger than age 2 years. Intermittent, painless rectal bleeding is the most common clinical manifestation of Meckel diverticulum. The blood is most often bright red or maroon and may be passed independent of stool due to ulceration at the junction of the ectopic tissue and the normal ileal mucosa.

The most common source of lead poisoning in children comes from which of the following sources?

Paint used in older homes

A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, in addition to the lungs which parts of the body are most affected by this disease?

Pancreas and liver

The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse will teach the caregiver that the amount of substance in the child's diet likely needs adjustment ?

Pancreatic enzymes

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse consider as a diagnosis?

Pancreatitis The child admitted with the suspicion of pancreatitis typically has a complaint of abdominal pain, either epigastric, upper left, or upper right quadrant pain that may radiate to the back. Nausea and vomiting, fever, tachycardia, hypotension, and jaundice may be present. Abdominal signs such as abdominal distention, decreased bowel sounds, rebound tenderness, and guarding also may be noted.

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse consider as a diagnosis? a) Crohn disease b) Ulcerative colitis c) Appendicitis d) Pancreatitis

Pancreatitis The child admitted with the suspicion of pancreatitis typically has a complaint of abdominal pain, either epigastric, upper left, or upper right quadrant pain that may radiate to the back. Nausea and vomiting, fever, tachycardia, hypotension, and jaundice may be present. Abdominal signs such as abdominal distention, decreased bowel sounds, rebound tenderness, and guarding also may be noted.

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse consider as a diagnosis? a) Ulcerative colitis b) Appendicitis c) Pancreatitis d) Crohn disease

Pancreatitis The child admitted with the suspicion of pancreatitis typically has a complaint of abdominal pain, either epigastric, upper left, or upper right quadrant pain that may radiate to the back. Nausea and vomiting, fever, tachycardia, hypotension, and jaundice may be present. Abdominal signs such as abdominal distention, decreased bowel sounds, rebound tenderness, and guarding also may be noted.

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which of the following diseases would the nurse consider as a diagnosis? a) Crohn disease b) Appendicitis c) Pancreatitis d) Ulcerative colitis

Pancreatitis Explanation: The child admitted with the suspicion of pancreatitis typically has a complaint of abdominal pain, either epigastric, upper left, or upper right quadrant pain that may radiate to the back. Nausea and vomiting, fever, tachycardia, hypotension, and jaundice may be present. Abdominal signs such as abdominal distention, decreased bowel sounds, rebound tenderness, and guarding also may be noted.

The nurse is obtaining the history of an infant with a suspected intestinal obstruction. Which response regarding newborn stool patterns would indicate a need for further evaluation for Hirschsprung disease? a) Has had diarrhea for 3 days b) Passed a meconium stool in the first 24 to 48 hours of life c) Passed a meconium plug d) Constipated and passing gas for 2 days

Passed a meconium plug If the parent reports that the child passed a meconium plug, the infant should be evaluated for Hirschsprung disease. Constipation, not diarrhea, is associated with this condition; however, constipation alone would not necessarily warrant further evaluation for Hirschsprung disease. Passing a meconium stool in the first 24 to 48 hours of life is normal.

The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction?

Peanut butter and jelly sandwich

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see?

Peeling hands and feet and fever

The nurse is caring for a child admitted with congenital aganglionic megacolon. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Persistent constipation Correct Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Prolonged bleeding is a manifestation of hemophilia. A chronic cough is noted in the child with cystic fibrosis. Irregular breathing occurs in children with seizures.

The nurse is caring for a child admitted with congenital aganglionic megacolon. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? a) Chronic cough b) Irregular breathing c) Persistent constipation d) Prolonged bleeding

Persistent constipation Correct Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Prolonged bleeding is a manifestation of hemophilia. A chronic cough is noted in the child with cystic fibrosis. Irregular breathing occurs in children with seizures.

The nurse is caring for a child admitted with congenital aganglionic megacolon. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? a) Chronic cough b) Prolonged bleeding c) Irregular breathing d) Persistent constipation

Persistent constipation Correct Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Prolonged bleeding is a manifestation of hemophilia. A chronic cough is noted in the child with cystic fibrosis. Irregular breathing occurs in children with seizures.

The nurse is examining a 7-year-old with suspected appendicitis. Which of the following physical findings would indicate the possibility of appendicitis? a) Persistent, right lower quadrant pain with rebound tenderness b) Tenderness that comes and goes in the lower abdomen c) Intermittent, left lower quadrant pain with rebound tenderness d) Diffuse, intermittent abdominal pain

Persistent, right lower quadrant pain with rebound tenderness Explanation: With appendicitis, symptoms typically do not come and go. They are usually persistent and intensify with time. With appendicitis, maximal tenderness occurs in the area of the McBurney point in the right lower quadrant, not the left. There is pain upon palpation with rebound tenderness. Pain is usually in the right lower quadrant, not the left, and is persistent. There is pain on palpation with rebound tenderness. Pain typically occurs in the right lower quadrant and is persistent and intensifies with time.

The nurse is caring for a 6-month-old infant who has chronic apneic episodes. Which intervention should the nurse institute?

Place on a cardiopulmonary monitor and do frequent assessments.

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority?

Place the child in a knee-to-chest position.

An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority?

Place the infant in the knee-chest position.

What is a complication of cystic fibrosis?

Pneumothorax

When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover?

Polycythemia

An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do?

Premedicate the child before changing the dressing.

The emergency department nurse is assessing a child who has presented with a 2-day history of nausea and vomiting with pain that is isolated to the right upper quadrant of the abdomen. Which action is most appropriate?

Prepare the child for admission to the hospital The child's presentation is consistent with cholecystitis, which necessitates surgery in most cases. The child should be kept NPO and antacids are of no benefit. Genitourinary involvement is atypical.

The emergency department nurse is assessing a child who has presented with a 2-day history of nausea and vomiting with pain that is isolated to the right upper quadrant of the abdomen. Which action is most appropriate? a) Assess the child's usual urinary voiding pattern b) Administer antacids as ordered c) Prepare the child for admission to the hospital d) Encourage fluid intake

Prepare the child for admission to the hospital The child's presentation is consistent with cholecystitis, which necessitates surgery in most cases. The child should be kept NPO and antacids are of no benefit. Genitourinary involvement is atypical.

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate doing which of the following? a) Changing the infant's diet to lactose-free b) Medicating the infant with analgesics c) Preparing the infant for surgery d) Assisting in doing a barium enema procedure on the infant

Preparing the infant for surgery Correct Explanation: A surgical procedure called a pyloromyotomy (also known as a Fredet-Ramstedt operation) is the treatment of choice for pyloric stenosis.

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate doing which of the following? a) Medicating the infant with analgesics b) Assisting in doing a barium enema procedure on the infant c) Changing the infant's diet to lactose-free d) Preparing the infant for surgery

Preparing the infant for surgery Correct Explanation: A surgical procedure called a pyloromyotomy (also known as a Fredet-Ramstedt operation) is the treatment of choice for pyloric stenosis.

The nurse is conducting a physical examination of a 9-month-old infant with a suspected neuromuscular disorder. Which finding would warrant further evaluation?

Presence of Moro reflex

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention?

Prevention of hypoglycemia

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention?

Prevention of hypoglycemia Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention?

Prevention of hypoglycemia Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension.

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention? a) Prevention of T-cell rejection of the transplanted liver b) Prevention of hypoglycemia c) Reduction of hypertension d) Maintenance of electrolyte balance

Prevention of hypoglycemia Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension.

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention? a) Maintenance of electrolyte balance b) Prevention of T-cell rejection of the transplanted liver c) Reduction of hypertension d) Prevention of hypoglycemia

Prevention of hypoglycemia Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension.

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. Which of the following is the correct rationale for this intervention? a) Maintenance of electrolyte balance b) Prevention of T-cell rejection of the transplanted liver c) Reduction of hypertension d) Prevention of hypoglycemia

Prevention of hypoglycemia Correct Explanation: Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension.

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. Which of the following is the correct rationale for this intervention? a) Prevention of hypoglycemia b) Reduction of hypertension c) Prevention of T-cell rejection of the transplanted liver d) Maintenance of electrolyte balance

Prevention of hypoglycemia Correct Explanation: Hypoglycemia is a major danger following liver transplantation because glucose levels are regulated by the liver, and the transplanted organ may not function efficiently at first. Assess serum glucose levels hourly by finger stick puncture. A 10% solution of dextrose IV may be necessary to prevent hypoglycemia. Careful tissue matching before the transplantation is needed to reduce the possibility of stimulating T-cell rejection. Sodium, potassium, chloride, and calcium levels are evaluated approximately every 6 to 8 hours to be certain electrolyte balance is maintained, but potassium is rarely added to IV solutions because of the risk that renal failure has occurred. IV therapy with hypotensive agents such as hydralazine (Apresoline) and nitroprusside may be needed to reduce hypertension.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Projectile vomiting

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Projectile vomiting During the first weeks of life, the infant with pyloric stenosis often eats well and gains weight and then starts vomiting occasionally after meals. Within a few days the vomiting increases in frequency and force, becoming projectile. The child may have constipation, and peristaltic waves may be seen in the abdomen, but the child does not appear in severe pain. Urine output is decrease and urination is infrequent.

The nurse is caring for a child admitted with pyloric stenosis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? a) Severe abdominal pain b) Explosive diarrhea c) Frequent urination d) Projectile vomiting

Projectile vomiting Correct Explanation: During the first weeks of life, the infant with pyloric stenosis often eats well and gains weight and then starts vomiting occasionally after meals. Within a few days the vomiting increases in frequency and force, becoming projectile. The child may have constipation, and peristaltic waves may be seen in the abdomen, but the child does not appear in severe pain. Urine output is decrease and urination is infrequent.

The nurse is caring for a child admitted with pyloric stenosis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? a) Explosive diarrhea b) Frequent urination c) Severe abdominal pain d) Projectile vomiting

Projectile vomiting Explanation: During the first weeks of life, the infant with pyloric stenosis often eats well and gains weight and then starts vomiting occasionally after meals. Within a few days the vomiting increases in frequency and force, becoming projectile. The child may have constipation, and peristaltic waves may be seen in the abdomen, but the child does not appear in severe pain. Urine output is decrease and urination is infrequent

Which intervention is the most beneficial for a burn client undergoing a skin graft?

Provide around-the-clock pain medication as soon as pain is reported.

What would the appropriate nursing intervention be for a child with an ineffective breathing pattern?

Provide oxygen as needed to maintain oxygen saturation above 93%.

A nurse manages the interdisciplinary care for a client with pancreatitis. What are recommended interventions for this condition? Select all that apply.

Providing glycemia control Positioning the client in a fetal position Administering analgesics for pain Keeping the child NPO to rest the pancreas The main interventions for pancreatitis are supportive, including administration of antibiotics; stress ulcer prophylaxis; pain relief by analgesic administration; managing fluids; glycemia control; using a low-fat diet when lipase occurs; positioning the child in the fetal position to minimize tension of the peritoneum; and keeping the child NPO to rest the pancreas.

A parent brings an infant in for poor feeding. Which assessment data would most likely indicate a coarctation of the aorta?

Pulses weaker in lower extremities compared to upper extremities

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?

Pyloric stenosis

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?

Pyloric stenosis With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost immediately after each feeding. The vomiting grows increasingly forceful until it is projectile, possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after vomiting because they are not nauseated. A definitive diagnosis can be made by watching the infant drink. If a pyloric stenosis is present, the sphincter feels round and firm, approximately the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and vomiting may then occur, followed by diffuse abdominal pain.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? a) Appendicitis b) Pyloric stenosis c) Peptic ulcer disease d) Gastroesophageal reflux

Pyloric stenosis With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost immediately after each feeding. The vomiting grows increasingly forceful until it is projectile, possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after vomiting because they are not nauseated. A definitive diagnosis can be made by watching the infant drink. If a pyloric stenosis is present, the sphincter feels round and firm, approximately the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and vomiting may then occur, followed by diffuse abdominal pain.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? a) Pyloric stenosis b) Peptic ulcer disease c) Gastroesophageal reflux d) Appendicitis

Pyloric stenosis With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost immediately after each feeding. The vomiting grows increasingly forceful until it is projectile, possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after vomiting because they are not nauseated. A definitive diagnosis can be made by watching the infant drink. If a pyloric stenosis is present, the sphincter feels round and firm, approximately the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and vomiting may then occur, followed by diffuse abdominal pain.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which of the following conditions should the nurse suspect in this child? a) Appendicitis b) Gastroesophageal reflux c) Peptic ulcer disease d) Pyloric stenosis

Pyloric stenosis Correct Explanation: With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost immediately after each feeding. The vomiting grows increasingly forceful until it is projectile, possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after vomiting because they are not nauseated. A definitive diagnosis can be made by watching the infant drink. If a pyloric stenosis is present, the sphincter feels round and firm, approximately the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and vomiting may then occur, followed by diffuse abdominal pain.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which of the following conditions should the nurse suspect in this child? a) Pyloric stenosis b) Gastroesophageal reflux c) Peptic ulcer disease d) Appendicitis

Pyloric stenosis Correct Explanation: With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost immediately after each feeding. The vomiting grows increasingly forceful until it is projectile, possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after vomiting because they are not nauseated. A definitive diagnosis can be made by watching the infant drink. If a pyloric stenosis is present, the sphincter feels round and firm, approximately the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and vomiting may then occur, followed by diffuse abdominal pain.

The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at:

Reducing swelling and relieving itching

The nurse is working with a school district to ensure students do not develop food-borne illnesses. Which intervention should the nurse emphasize that supports the 2020 National Health Goals regarding food preparation?

Refrigerate foods promptly. Unsafe food preparation is an area that could be reduced in incidence if people knew more about it and took active interventions to reduce its occurrence or spread. The 2020 National Health Goals addressing these include reducing infections caused by key pathogens transmitted commonly through food and increasing the proportion of consumers who follow key food safety practices of "Chill: refrigerate promptly." Nurses can help the nation achieve the goal by counseling parents about safe food preparation and serving as consultants to those responsible for food preparation.

In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason?

Relief of acute symptoms

The nurse is caring for a 10-year-old child in traction. After performing a skin assessment, she notices that the skin over the calcaneus appears slightly red and irritated. What should be the first intervention?

Reposition the child's foot on a pressure-reducing device.

The nurse is positioning an infant who has just had his left-sided cleft lip repaired. What positions are acceptable for this infant? Select all that apply.

Right side lying Supine It is critical to prevent injury to the facial suture line or to the palatal operative sites. Do not allow the infant to rub the facial suture line. To prevent this, position the infant in a supine or side-lying position.

Which nursing diagnosis will the nurse prepare for the infant who is placed prone to protect the myelomeningocele repair site?

Risk for impaired skin integrity

The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period?

Risk for infection of incision line, related to disruption of skin barrier during surgery Because the incision line for a pyloric stenosis repair is near the diaper area, the child is at risk for developing a surgical infection. The diagnosis risk for infection of incision line is the most appropriate during the immediate postoperative period. Anxiety might be appropriate after the immediate postoperative period has passed. There is no enough information to determine if the infant is being given excessive fluid or if the infant is experiencing ineffective tissue perfusion.

An infant has surgery to relieve pyloric stenosis. Which of the following nursing diagnoses would apply in the immediate postoperative period?

Risk for infection of incision line, related to disruption of skin barrier during surgery Because the incision line for pyloric stenosis surgery is near the diaper area, infection of the incision line is a possible complication following surgery.

Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant?

Risk for infection related to immunocompromised state

The school nurse is caring for a 12-year-old boy with a bloody nose. Which action would be most appropriate for the nurse to do?

Seat the child leaning forward and pinch the anterior portion of the nose closed.

The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?

Second degree frostbite

A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor?

Serum potassium level

After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma?

Shellfish

Which diagnostic measure is most accurate in detecting neural tube defects?

Significant level of alpha-fetoprotein present in amniotic fluid

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is:

Skeletal traction

The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test?

Skin scrapings

The nurse is caring for a 10-year-old boy with end-stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to administer if ordered?

Sodium bicarbonate tablets

The nurse is caring for an 8-month-old infant with a suspected congenital heart defect. The nurse examines the child and documents which expected finding?

Softening of the nail beds

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

Spica cast

The nurse is reinforcing teaching with the parents of a 2-year-old who has cystic fibrosis regarding medications. The nurse suggests that pancreatic enzymes may be given by which method?

Sprinkled onto the food

Based on knowledge of the progression of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first?

Standing

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply.

Steatorrhea Constipation Diarrhea Failure to thrive Classic symptoms of celiac disease include steatorrhea, constipation, diarrhea, failure to thrive, weight loss, abdominal distention or bloating (not a sunken abdomen), and anemia (not polycythemia).

The nurse is collecting data for a child with idiopathic celiac disease. The caregiver tells the nurse that her child has bulky and greasy stools. The nurse recognizes that the child has which of the following? a) Invagination b) Steatorrhea c) Polyuria d) Pica

Steatorrhea Correct Explanation: Intestinal malabsorption with steatorrhea (fatty stools) is a condition brought about by various causes, one being idiopathic celiac disease. Pica is the ingestion of nonfood substances, invagination is the telescoping of a portion of the bowel, and polyuria is a dramatic increase in the urinary output.

The caregiver of a child diagnosed with celiac syndrome tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is which of the following? a) Projectile stools b) Severe diarrhea c) Current jelly stools d) Steatorrhea

Steatorrhea Correct Explanation: The term celiac syndrome is used to designate the complex of malabsorptive disorders. Intestinal malabsorption with steatorrhea (fatty stools) is a condition brought about by various causes

The nurse is collecting data for a child with idiopathic celiac disease. The caregiver tells the nurse that her child has bulky and greasy stools. The nurse recognizes that the child has

Steatorrhea Correct Explanation: The term celiac syndrome is used to designate the complex of malabsorptive disorders. Intestinal malabsorption with steatorrhea (fatty stools) is a condition brought about by various causes

The caregiver of a child diagnosed with celiac syndrome tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is which of the following? a) Severe diarrhea b) Current jelly stools c) Steatorrhea d) Projectile stools

Steatorrhea Correct Explanation: The term celiac syndrome is used to designate the complex of malabsorptive disorders. Intestinal malabsorption with steatorrhea (fatty stools) is a condition brought about by various causes.

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a child abuse-induced burn?

Stocking-glove pattern on hands or feet

If an adolescent has hepatitis B, what would be an important nursing action? a) Strict enforcement of standard precautions b) Strict calculation of caloric and vitamin B intake c) Close observation to detect cerebral hallucinations d) Conscientious collection of stool for ova and parasites

Strict enforcement of standard precautions Explanation: Hepatitis B is spread through contaminated blood. Standard precautions help prevent contact with this

If an adolescent has hepatitis B, what would be an important nursing action?

Strict enforcement of standard precautions Hepatitis B is spread through contaminated blood. Standard precautions help prevent contact with this.

If an adolescent has hepatitis B, what would be an important nursing action? a) Conscientious collection of stool for ova and parasites b) Strict enforcement of standard precautions c) Strict calculation of caloric and vitamin B intake d) Close observation to detect cerebral hallucinations

Strict enforcement of standard precautions Correct Explanation: Hepatitis B is spread through contaminated blood. Standard precautions help prevent contact with this.

The nurse identifies a nursing diagnosis of Ineffective airway clearance related to inflammation and copious thick secretions. What action is the priority?

Suctioning secretions from the airway

The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?

Sudden onset of severe scrotal pain with significant hemorrhagic swelling

A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which of the following would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply. a) Cool mottled extremities b) Slightly decreased urine output c) Pink moist oral mucosa d) Sunken fontanels e) Bradycardia

Sunken fontanels • Bradycardia • Cool mottled extremities Explanation: Severe dehydration would be indicated by sunken fontanels, increased heart rate progressing to bradycardia, cool mottled or dusky extremities, dry oral mucosa, and significantly decreased urine output of less than 1 mL/kg/hour. Pink moist oral mucosa and slightly decreased urine output would suggest mild dehydration.

The nurse is caring for an infant immediately after a pyloromyotomy surgery has been performed to treat pyloric stenosis. The infant's parents are understandably anxious about their child. Given the situation, what is the most appropriate way for the nurse to position the infant during the anesthesia recovery period?

Support him and place him on his side. Postoperatively the child should be placed on his side to prevent aspiration of mucus or vomitus, especially during the anesthesia recovery period. After fully waking from the surgery, he can be held by a family caregiver in a position that does not interfere with IV infusions and is comforting to both caregiver and child.

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child?

Sweat sodium choloride test

Constipation may be initially caused by psychological problems T or F

T

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F (40° C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention?

Take a stool culture Treatment of severe diarrhea focuses on regulating electrolyte and fluid balance by initiating a temporary rest for the GI tract, oral or IV rehydration therapy, and discovering the organism responsible for the diarrhea. All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a stool culture taken to determine if bacteria are causing the diarrhea, and if so, a definite antibiotic therapy can be prescribed. Because a side effect of many antibiotics is diarrhea, antibiotics should not routinely be used to treat diarrhea without an identifiable bacterial cause. Before the initial IV fluid is changed to a potassium solution, be certain the infant or child has voided—proof that the kidneys are functioning; in this case, the child is not voiding yet. The child should not be fed a cracker, as the GI tract should be rested until the diarrhea stops.

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F, with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which of the following is the priority nursing intervention? a) Administer IV potassium b) Feed the child a cracker c) Take a stool culture d) Administer antibiotic therapy

Take a stool culture Correct Explanation: Treatment of severe diarrhea focuses on regulating electrolyte and fluid balance by initiating a temporary rest for the GI tract, oral or IV rehydration therapy, and discovering the organism responsible for the diarrhea. All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a stool culture taken to determine if bacteria are causing the diarrhea, and if so, a definite antibiotic therapy can be prescribed. Because a side effect of many antibiotics is diarrhea, antibiotics should not routinely be used to treat diarrhea without an identifiable bacterial cause. Before the initial IV fluid is changed to a potassium solution, be certain the infant or child has voided—proof that the kidneys are functioning; in this case, the child is not voiding yet. The child should not be fed a cracker, as the GI tract should be rested until the diarrhea stops.

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F, with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which of the following is the priority nursing intervention? a) Feed the child a cracker b) Administer antibiotic therapy c) Administer IV potassium d) Take a stool culture

Take a stool culture Correct Explanation: Treatment of severe diarrhea focuses on regulating electrolyte and fluid balance by initiating a temporary rest for the GI tract, oral or IV rehydration therapy, and discovering the organism responsible for the diarrhea. All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a stool culture taken to determine if bacteria are causing the diarrhea, and if so, a definite antibiotic therapy can be prescribed. Because a side effect of many antibiotics is diarrhea, antibiotics should not routinely be used to treat diarrhea without an identifiable bacterial cause. Before the initial IV fluid is changed to a potassium solution, be certain the infant or child has voided—proof that the kidneys are functioning; in this case, the child is not voiding yet. The child should not be fed a cracker, as the GI tract should be rested until the diarrhea stops.

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F, with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which of the following is the priority nursing intervention? a) Take a stool culture b) Feed the child a cracker c) Administer antibiotic therapy d) Administer IV potassium

Take a stool culture Explanation: Treatment of severe diarrhea focuses on regulating electrolyte and fluid balance by initiating a temporary rest for the GI tract, oral or IV rehydration therapy, and discovering the organism responsible for the diarrhea. All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a stool culture taken to determine if bacteria are causing the diarrhea, and if so, a definite antibiotic therapy can be prescribed. Because a side effect of many antibiotics is diarrhea, antibiotics should not routinely be used to treat diarrhea without an identifiable bacterial cause. Before the initial IV fluid is changed to a potassium solution, be certain the infant or child has voided—proof that the kidneys are functioning; in this case, the child is not voiding yet. The child should not be fed a cracker, as the GI tract should be rested until the diarrhea stops.

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention?

Take a stool culture Explanation: Treatment of severe diarrhea focuses on regulating electrolyte and fluid balance by initiating a temporary rest for the GI tract, oral or IV rehydration therapy, and discovering the organism responsible for the diarrhea. All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a stool culture taken to determine if bacteria are causing the diarrhea, and if so, a definite antibiotic therapy can be prescribed. Because a side effect of many antibiotics is diarrhea, antibiotics should not routinely be used to treat diarrhea without an identifiable bacterial cause. Before the initial IV fluid is changed to a potassium solution, be certain the infant or child has voided—proof that the kidneys are functioning; in this case, the child is not voiding yet. The child should not be fed a cracker, as the GI tract should be rested until the diarrhea stops.

A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this?

Take over-the-counter ibuprofen for its prostaglandin action.

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to do which action?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important?

Taking pedal pulses for the first 4 hours

The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Tea-colored urine

A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client?

Teach the client not to rest with the crutch pad pressing on the axilla.

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?

Tenting of skin

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?

Tenting of skin Tenting of skin is an indicator of severe dehydration. Soft and flat fontanels indicate mild dehydration. Pale and slightly dry mucosa indicates mild or moderate dehydration. Blood pressure of 80/42 mm Hg is a normal finding for an infant.

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? a) Pale and slightly dry mucosa b) Soft and flat fontanels c) Tenting of skin d) Blood pressure of 80/42 mm Hg

Tenting of skin Tenting of skin is an indicator of severe dehydration. Soft and flat fontanels indicate mild dehydration. Pale and slightly dry mucosa indicates mild or moderate dehydration. Blood pressure of 80/42 mm Hg is a normal finding for an infant.

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? a) Pale and slightly dry mucosa b) Soft and flat fontanels c) Tenting of skin d) Blood pressure of 80/42 mm Hg

Tenting of skin Tenting of skin is an indicator of severe dehydration. Soft and flat fontanels indicate mild dehydration. Pale and slightly dry mucosa indicates mild or moderate dehydration. Blood pressure of 80/42 mm Hg is a normal finding for an infant.

The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?

Testis cannot be "milked" down inguinal canal

A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis?

Tetralogy of Fallot

The nurse is caring for a child with an order for silver sulfadiazine 1% for a burn. What would make the nurse question this order?

The burn is on the child's face.

The nurse knows this is a description of peritoneal dialysis when compared to hemodialysis:

The child can live a more normal lifestyle.

Which of the following is most correct regarding the gastrointestinal system of the child?

The child cannot break down and use complex carbohydrates in the same way the adult can. In the GI tract of the newborn, the enzymes secreted by the liver and pancreas are reduced. Thus, the infant cannot break down and use complex carbohydrates. In the infant, food moves through the GI tract with increased speed. The GI tract matures and the capacity of the GI tract increases as the child gets older.

Which of the following is most correct regarding the gastrointestinal system of the child? a) The child's gastrointestinal system is fully matured when the child is born. b) The child cannot break down and use complex carbohydrates in the same way the adult can. c) The enzymes secreted by the child's liver and pancreas are much greater in amount than in the adult. d) The speed with which food passes through the gastrointestinal tract in the child is much slower than in the adult.

The child cannot break down and use complex carbohydrates in the same way the adult can. Correct Explanation: In the GI tract of the newborn the enzymes secreted by the liver and pancreas are reduced. Thus, the infant cannot break down and use complex carbohydrates. In the infant, food moves through the GI tract with increased speed. The GI tract matures and the capacity of the GI tract increases as the child gets older. (less)

Which of the following is most correct regarding the gastrointestinal system of the child? a) The child cannot break down and use complex carbohydrates in the same way the adult can. b) The child's gastrointestinal system is fully matured when the child is born. c) The enzymes secreted by the child's liver and pancreas are much greater in amount than in the adult. d) The speed with which food passes through the gastrointestinal tract in the child is much slower than in the adult.

The child cannot break down and use complex carbohydrates in the same way the adult can. Explanation: In the GI tract of the newborn the enzymes secreted by the liver and pancreas are reduced. Thus, the infant cannot break down and use complex carbohydrates. In the infant, food moves through the GI tract with increased speed. The GI tract matures and the capacity of the GI tract increases as the child gets older.

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a one-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting?

The child has been sexually abused, maybe on the fishing trip

You see a 3-year-old boy in an ambulatory setting for localized wheezing on auscultation. Which statement by his mother would be most important to report?

The child was eating peanuts yesterday.

A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect?

The child will need the blood pressure checked two more times.

A nurse explains to the family of an infant with an inguinal hernia that the surgeon will attempt manual reduction prior to surgical repair. Which statement describes this technique?

The client is sedated and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity.

A nurse explains to the family of an infant with an inguinal hernia that the surgeon will attempt manual reduction prior to surgical repair. Which statement describes this technique? The client is sedated, the lower torso is elevated, and the contents are gently manipulated back into the stomach. The client is sedated and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity. The client is sedated, the lower torso is lowered, and the contents of the hernia are manipulated back into the peritoneal cavity. The client is sedated, an incision is made in the peritoneal cavity, and the contents are gently manipulated back into the stomach.

The client is sedated and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity. Manual reduction of an incarcerated hernia of any type is attempted before surgical repair. The child is sedated, the lower torso is elevated, and the incarcerated contents of the hernia are gently manipulated back into the peritoneal cavity. If the reduction is successful, elective surgical repair is scheduled 24 to 48 hours later.

The nurse is working with the mother of a newborn. The mother asks why a baby needs small feedings at frequent intervals. The nurse explains to the mother that this is necessary because in the infant a) Peristaltic action is absent in the lower portion of the bowel b) The pylorus has not been fully formed c) Food moves more slowly through the GI tract d) The enzymes secreted by the liver and pancreas are reduced

The enzymes secreted by the liver and pancreas are reduced Correct Explanation: In the newborn the enzymes secreted by the liver and pancreas are reduced. Thus, the infant cannot break down and use complex carbohydrates. As a result, the newborn diet must be adjusted to allow for this immaturity. By the age of 4 to 6 months, the needed enzymes are usually sufficient in amount. The smaller capacity of the infant's stomach and the increased speed at which food moves through the GI tract require feeding smaller amounts at more frequent intervals. In addition, the small capacity of the colon leads to a bowel movement after each feeding. The pyloric spincter is formed, but is lax and does not have bearing on the frequency of feeding.

The nurse is working with the mother of a newborn. The mother asks why a baby needs small feedings at frequent intervals. The nurse explains to the mother that this is necessary because in the infant a) The enzymes secreted by the liver and pancreas are reduced b) The pylorus has not been fully formed c) Peristaltic action is absent in the lower portion of the bowel d) Food moves more slowly through the GI tract

The enzymes secreted by the liver and pancreas are reduced Explanation: In the newborn the enzymes secreted by the liver and pancreas are reduced. Thus, the infant cannot break down and use complex carbohydrates. As a result, the newborn diet must be adjusted to allow for this immaturity. By the age of 4 to 6 months, the needed enzymes are usually sufficient in amount. The smaller capacity of the infant's stomach and the increased speed at which food moves through the GI tract require feeding smaller amounts at more frequent intervals. In addition, the small capacity of the colon leads to a bowel movement after each feeding. The pyloric spincter is formed, but is lax and does not have bearing on the frequency of feeding.

A newborn is diagnosed with hypospadias and the parents want him to be circumcised. What would be the best response by the nurse?

The foreskin is needed for repair.

The nurse is caring for a child that was dehydrated following gastric surgery but has since been re-hydrated. The physician orders intravenous maintenance fluid rate for the child. How will the nurse determine the intravenous maintenance fluid rate per hour for this child who weighs 40 kg?

The formula to determine maintenance fluid rate is: *100 mL/kg for first 10 kg *50 mL/kg for next 10 kg *20 mL/kg for remaining kg *Add together for total mL needed per 24-hour period. *Divide by 24 for mL/hour fluid requirement. Therefore, for a child weighing 40kg the equation is: *100 X 10= 1000 *50 X 10= 500 *20 X 20= 400 *1000 + 500 + 400= 1900 *1900/24= 79.17= 79 mL/hr

When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?

The liver size increases in right-sided heart failure.

A nurse is interviewing a mother who is about to deliver her baby. Which response would alert the nurse for a higher potential for a heart defect in the infant?

The mother states she has lupus.

The nurse is caring for a newborn following delivery who has been diagnosed with gastroschisis. Which actions by the nurse indicated knowledge of appropriate care for this disorder?

The nurse assesses the color of the newborns abdominal organs The nurse places the newborn in a radiant warmer to maintain the newborn's temperature The nurse closely monitors the hydration status of the newborn for signs of dehydration Gastroschisis is a herniation of the abdominal contents through an abdominal wall defect, usually to the left or right of the umbilicus.Gastroschisis differs from omphalocele in that there is no peritoneal sac protecting the herniated organs. The color of the protruding organs should be assessed to determine if perfusion is sufficient. The contents should be covered with a sterile, rather than a clean, dressing. Temperature regulation is compromised with the open abdominal wall so a radiant warmer is imperative. The parents should be encouraged to touch and spend time with the newborn to facilitate bonding. IV fluid will be ordered to prevent dehydration so close monitoring of the hydration status is imperative.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. Of the following nursing interventions, which would be most important for the nurse to include in working with this child and the child's caregivers?

The nurse should help the caregivers to understand and the child to effectively use the corrective devices.

In caring for a child in traction, of the following interventions, which is the highest priority for the nurse?

The nurse should monitor for decreased circulation every four hours.

The nurse is caring for a 6-month-old girl with diarrhea and dehydration. The mother is concerned because the girl has some patches on her tongue. Which feature indicates a geographic tongue rather than thrush?

The patches are light in color on the tongue. A geographic tongue is a benign, noncontagious condition characterized by a reduction in the filiform papillae. Thrush is characterized by thick white plaques that form on the tongue. With thrush, plaques also appear on the buccal mucosa and often occur concomitantly in the diaper area. There would not be any patches on the few teeth the child might have by that age.

The nurse is caring for a 6-month-old girl with diarrhea and dehydration. The mother is concerned because the girl has some patches on her tongue. Which of the following features indicates a geographic tongue rather than thrush? a) The patches are thick and white plaques on the tongue. b) There are plaques on the buccal mucosa. c) The patches are light in color on the tongue. d) There are white patches on the erupted teeth.

The patches are light in color on the tongue. Correct Explanation: A geographic tongue is a benign, noncontagious condition characterized by a reduction in the filiform papillae. Thrush is characterized by thick white plaques that form on the tongue. With thrush, plaques also appear on the buccal mucosa and often occur concomitantly in the diaper area. There would not be any patches on the few teeth the child might have by that age.

The nurse is caring for a 6-month-old girl with diarrhea and dehydration. The mother is concerned because the girl has some patches on her tongue. Which of the following features indicates a geographic tongue rather than thrush? a) The patches are thick and white plaques on the tongue. b) There are white patches on the erupted teeth. c) There are plaques on the buccal mucosa. d) The patches are light in color on the tongue.

The patches are light in color on the tongue. Explanation: A geographic tongue is a benign, noncontagious condition characterized by a reduction in the filiform papillae. Thrush is characterized by thick white plaques that form on the tongue. With thrush, plaques also appear on the buccal mucosa and often occur concomitantly in the diaper area. There would not be any patches on the few teeth the child might have by that age

An adolescent patient is diagnosed with hepatitis A. Which problem should the nurse consider when planning the care for this patient?

The patient will become easily fatigued.

An adolescent patient is diagnosed with hepatitis A. Which problem should the nurse consider when planning the care for this patient?

The patient will become easily fatigued. The treatment for hepatitis A is increased rest because of fatigue. Hypothermia is not associated with hepatitis A. Dark infectious urine is not associated with this disease process. The patient will not be irritable and will not need sedation.

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as: a) The brain and spinal cord b) The pharynx and esopagus c) Nerves throughout the abdomen d) A protective cushion lining the organs

The pharynx and esopagus The main organs of the gastrointestinal (GI) or digestive system are the mouth, pharynx (throat), esophagus, stomach, small intestine, large intestine, rectum, and anal canal. The brain, spinal column, and nerves are part of the nervous system, and there is a protective coating surrounding the nerves.

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as which of the following? a) Nerves throughout the abdomen b) The pharynx and esopagus c) A protective cushion lining the organs d) The brain and spinal cord

The pharynx and esopagus Correct Explanation: The main organs of the gastrointestinal (GI) or digestive system are the mouth, pharynx (throat), esophagus, stomach, small intestine, large intestine, rectum, and anal canal. The brain, spinal column and nerves are part of the nervous system and there is a protective coating surrounding the nerves.

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as which of the following? a) A protective cushion lining the organs b) The brain and spinal cord c) The pharynx and esopagus d) Nerves throughout the abdomen

The pharynx and esopagus Explanation: The main organs of the gastrointestinal (GI) or digestive system are the mouth, pharynx (throat), esophagus, stomach, small intestine, large intestine, rectum, and anal canal. The brain, spinal column and nerves are part of the nervous system and there is a protective coating surrounding the nerves.

The nurse is discussing the diagnosis of intussuseption with a group of peers. Which of the following is an accurate statement regarding this disorder? a) The infant is pale, cries weakly, and has spasms of pain continuously. b) The disorder is seen most often in female infants under the age of 3 months. c) The stools of the infant are called currant jelly stools and consist of blood and mucuous. d) There is a telescoping of the lower part of the bowel up over the upper part of the bowel.

The stools of the infant are called currant jelly stools and consist of blood and mucuous. Correct Explanation: In the child with intussusception, the stools consist of blood and mucus, thereby earning the name currant jelly stools. There is a telescoping of the upper portion of the bowel slipping over the lower portion.The condition occurs more often in boys than in girls and the highest incidence occurs in infants between the ages of 4 and 10 months. The infant who previously appeared healthy and happy suddenly becomes pale, cries out sharply, and draws up the legs in a severe colicky spasm of pain. This spasm may last for several minutes, after which the infant relaxes and appears well until the next episode, which may occur 5, 10, or 20 minutes later.

The novice nurse is discussing the diagnosis of intussusception with a group of peers. What statement demonstrates the nurse's appropriate understanding regarding this disorder?

The stools of the infant are called currant jelly stools and consist of blood and mucuous. Explanation: In the child with intussusception, the stools consist of blood and mucus, thereby earning the name currant jelly stools. There is a telescoping of the upper portion of the bowel slipping over the lower portion.The condition occurs more often in boys than in girls and the highest incidence occurs in infants between the ages of 4 and 10 months. The infant who previously appeared healthy and happy suddenly becomes pale, cries out sharply, and draws up the legs in a severe colicky spasm of pain. This spasm may last for several minutes, after which the infant relaxes and appears well until the next episode, which may occur 5, 10, or 20 minutes later

The nurse is discussing the diagnosis of intussuseption with a group of peers. Which of the following is an accurate statement regarding this disorder? a) The stools of the infant are called currant jelly stools and consist of blood and mucuous. b) The infant is pale, cries weakly, and has spasms of pain continuously. c) The disorder is seen most often in female infants under the age of 3 months. d) There is a telescoping of the lower part of the bowel up over the upper part of the bowel.

The stools of the infant are called currant jelly stools and consist of blood and mucuous. Explanation: In the child with intussusception, the stools consist of blood and mucus, thereby earning the name currant jelly stools. There is a telescoping of the upper portion of the bowel slipping over the lower portion.The condition occurs more often in boys than in girls and the highest incidence occurs in infants between the ages of 4 and 10 months. The infant who previously appeared healthy and happy suddenly becomes pale, cries out sharply, and draws up the legs in a severe colicky spasm of pain. This spasm may last for several minutes, after which the infant relaxes and appears well until the next episode, which may occur 5, 10, or 20 minutes later

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of colic?

There are recurrent paroxysmal bouts of abdominal pain. Colic consists of recurrent paroxysmal bouts of abdominal pain and is fairly common in young infants. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus, which leads to an obstruction at the distal end of the stomach. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of colic? a) A partial or complete intestinal obstruction occurs. b) There are recurrent paroxysmal bouts of abdominal pain. c) In this disorder the sphincter that leads into the stomach is relaxed. d) A thickened, elongated muscle causes an obstruction at the end of the stomach.

There are recurrent paroxysmal bouts of abdominal pain. Explanation: Colic consists of recurrent paroxysmal bouts of abdominal pain and is fairly common in young infants. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of colic? a) In this disorder the sphincter that leads into the stomach is relaxed. b) A partial or complete intestinal obstruction occurs. c) A thickened, elongated muscle causes an obstruction at the end of the stomach. d) There are recurrent paroxysmal bouts of abdominal pain.

There are recurrent paroxysmal bouts of abdominal pain. Explanation: Colic consists of recurrent paroxysmal bouts of abdominal pain and is fairly common in young infants. Congenital aganglionic megacolon is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Pyloric stenosis is characterized by hypertrophy of the circular muscle fibers of the pylorus which leads to an obstruction at the distal end of the stomach. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus is relaxed and allows gastric contents to be regurgitated back into the esophagus.

A parent asks if the reason her infant has a congenital heart defect is because of something she did while she was pregnant. What is the best response by the nurse?

There are several reasons a baby can have a heart defect, let's talk about those causes.

What occurs in the gastrointestinal system of the child with Hirschsprung disease?

There is a partial or complete mechanical obstruction in the intestine. Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin.

Which of the following occurs in the gastrointestinal system of the child with Hirschsprung disease? a) There is an invagination or telescoping of one portion of the bowel into a distal portion. b) There is a relaxed sphincter in the lower portion of the esophagus. c) There is a partial or complete mechanical obstruction in the intestine. d) There is a severe narrowing of the lumen of the pylorus.

There is a partial or complete mechanical obstruction in the intestine. Correct Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin.

Which of the following occurs in the gastrointestinal system of the child with Hirschsprung disease? a) There is a severe narrowing of the lumen of the pylorus. b) There is a partial or complete mechanical obstruction in the intestine. c) There is a relaxed sphincter in the lower portion of the esophagus. d) There is an invagination or telescoping of one portion of the bowel into a distal portion.

There is a partial or complete mechanical obstruction in the intestine. Explanation: Congenital aganglionic megacolon, also called Hirschsprung disease, is characterized by persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin

A nurse is caring for a child that just had open-heart surgery and the parents are asking why there are wires coming out of the chest of the infant. What is the best response by the nurse?

These wires are connected to the heart and will detect if your child's heart gets out of rhythm.

A parent is asking for more information about their infant's patent ductus arteriosus (PDA). What would be included in the education?

This is caused by an opening that usually closes by 1 week of age.

Which intervention is the most effective in treating burn wound infections?

Topical antibiotics applied to the wound site

A Mantoux skin test is used to screen for tuberculosis.

True

A neonatal nurse examines an infant and notes decreased hip motion that causes pain upon movement. This nurse suspects Legg-Calvé-Perthes disease, a common pediatric hip disorder that causes pain and decreased hip motion, possibly leading to a femoral head deformity.

True

Idiopathic scoliosis is the most common form that occurs.

True

Constipation may be initially caused by psychological problems. a) True b) False

True Some children begin holding stool for psychological reasons. Once the process begins, however, the hardened stool, the anal fissures, and the pain on defecation soon occur, and what began for an emotional reason becomes a physical ailment. This is important to understand, because with these children, therapy involves both counseling to correct the initial problem and treatment of the physical symptoms.

Constipation may be initially caused by psychological problems. a) True b) False

True Explanation: Some children begin holding stool for psychological reasons. Once the process begins, however, the hardened stool, the anal fissures, and the pain on defecation soon occur, and what began for an emotional reason becomes a physical ailment. This is important to understand, because with these children, therapy involves both counseling to correct the initial problem and treatment of the physical symptoms

Constipation may be initially caused by psychological problems. a) True b) False

True Explanation: Some children begin holding stool for psychological reasons. Once the process begins, however, the hardened stool, the anal fissures, and the pain on defecation soon occur, and what began for an emotional reason becomes a physical ailment. This is important to understand, because with these children, therapy involves both counseling to correct the initial problem and treatment of the physical symptoms.

In caring for the child with rheumatic fever, which medication would the nurse likely administer?

Tylenol

The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification?

Type II

The parents of a 4-week-old report that their infant has forceful vomiting but seems very hungry immediately after vomiting. Upon further questioning, the nurse notifies the physician of the findings and pyloric stenosis is suspected. The nurse prepares the parents for the possibility of which diagnostic procedures and treatment?

Upper GI series Pyloric ultrasound Physical examination of the abdomen Surgical repair Frequently a diagnosis is made with the client history and palpation of a hard, moveable "olive" mass in the right upper quadrant. If no mass is palpated the most common diagnostic procedure is a pyloric ultrasound. An upper GI series is sometimes performed, but this test is much more invasive than an ultrasound. Surgical repair is necessary. A CT scan is not warranted.

A 12-year-old girl reports pain and a burning sensation on urination. The nurse suspects a urinary tract infection. Which diagnostic test would be most appropriate for confirming this condition?

Urine culture

The nurse is caring for a child, weighing 100 pounds, on the burn unit who has partial-thickness burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse?

Urine output of 15 mL per hour over the last 4 hours

The nurse is caring for a pediatric client with multiple wounds from a bike accident. What is the best method for cleansing or washing out the wound?

Use normal saline solution to wash the wound.

The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child's caregiver that the child may:

Vomit dark, old blood, but the caregiver should call the clinic if the child has bleeding between the fifth and seventh days postoperatively

Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed?

Vomiting Vomiting after a feeding suggests the pyloric valve is not yet able to accommodate feedings well, possibly from edema.

Which of the following assessments would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed? a) Flatulence b) Vomiting c) Semiformed bowel movements d) Falling asleep at each feeding

Vomiting Explanation: Vomiting after a feeding suggests the pyloric valve is not yet able to accommodate feedings well, possibly from edema.

A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe?

Vomiting immediately after feeding A narrowing of the pyloric valve leads to projectile vomiting soon after eating.

A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe? a) Refusal to eat b) Chronic diarrhea c) Vomiting immediately after feeding d) Vomiting about 2 hours after feeding

Vomiting immediately after feeding A narrowing of the pyloric valve leads to projectile vomiting soon after eating.

A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe? a) Chronic diarrhea b) Vomiting about 2 hours after feeding c) Refusal to eat d) Vomiting immediately after feeding

Vomiting immediately after feeding Correct Explanation: A narrowing of the pyloric valve leads to projectile vomiting soon after eating.

A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe? a) Chronic diarrhea b) Vomiting about 2 hours after feeding c) Vomiting immediately after feeding d) Refusal to eat

Vomiting immediately after feeding Explanation: A narrowing of the pyloric valve leads to projectile vomiting soon after eating.

A 6-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?

Wait a year or two to see whether the testes will descend on their own

The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?

Weigh the old dialysate

In caring for a child with nephrotic syndrome, which interventions will be included in the child's plan of care?

Weighing on the same scale each day

A client with muscular dystrophy has lost complete control of his lower extremities. He has some strength bilaterally in the upper extremities, but poor trunk control. Which mechanism would be the most important to have on the wheelchair?

Wheelchair belt

The nurse is admitting a child who is experiencing an asthma attack. Which clinical manifestation would likely be noted in this child?

Wheezing

The nurse is caring for a child admitted with asthma. Which clinical manifestations would likely have been noted in the child with this diagnosis?

Wheezing

If there is a foreign body in the larynx, how will the client present?

With stridor

A nurse is caring for a 13-year-old boy with end-stage renal disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?

Withhold his routine medication until after dialysis is completed

The caregivers of an 8-year-old bring their child to the pediatrician and report that the child has not had breathing problems before, but since taking up lacrosse the child has been coughing and wheezing at the end of every practice and game. Their friend's child has often been hospitalized for asthma; they are concerned that their child has a similar illness. The nurse knows that because the problems seem to be directly related to exercise, it is likely that the child will be able to be treated with:

a bronchodilator and mast cell stabilizers.

Inguinal hernia usually occurs in girls. a) False b) True

a) False Explanation: Inguinal hernia is a protrusion of a section of the bowel into the inguinal ring. It occurs usually in boys (9:1) because, as the testes descend from the abdominal cavity into the scrotum late in fetal life, a fold of parietal peritoneum also descends, forming a tube from the abdomen to the scrotum.

12-year-old Hilary is brought to the emergency room by her parents with severe abdominal pain. The nurse performs a physical assessment to check for appendicitis. Which of the following assessment parameters indicate appendicitis? Select all that apply. a) Hypoactive bowel sounds with perforation b) Distended abdomen with unperforated appendicitis c) Low-grade fever, nausea, anorexia, and vomiting d) Rebound tenderness present with palpation in the left upper quadrant e) Irritation and pain in the right lower quadrant f) Normal to hyperactive bowel sounds early

a) Hypoactive bowel sounds with perforation c) Low-grade fever, nausea, anorexia, and vomiting e) Irritation and pain in the right lower quadrant f) Normal to hyperactive bowel sounds early Explanation: On auscultation, bowel sounds are normal to hyperactive early in the course of appendicitis but become hypoactive with perforation. Percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness is present with palpation in the right lower quadrant. Low-grade fever, nausea, anorexia, and vomiting typically occur after the onset of abdominal pain. The abdomen appears flat with unperforated appendicitis, but abdominal distention may be present once perforation occurs.

A school aged child is brought to the emergency room by her parents with severe abdominal pain. The nurse performs a physical assessment to check for appendicitis. Which assessment parameters indicate appendicitis? Select all that apply

a) Hypoactive bowel sounds with perforation c) Low-grade fever, nausea, anorexia, and vomiting e) Irritation and pain in the right lower quadrant f) Normal to hyperactive bowel sounds early Explanation: On auscultation, bowel sounds are normal to hyperactive early in the course of appendicitis but become hypoactive with perforation. Percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness is present with palpation in the right lower quadrant. Low-grade fever, nausea, anorexia, and vomiting typically occur after the onset of abdominal pain. The abdomen appears flat with unperforated appendicitis, but abdominal distention may be present once perforation occurs.

A mother brings her 2-week-old newborn to the doctor's office because the child has been experiencing gastroesophageal reflux over the past week. Which of the following interventions should the nurse recommend to the mother at this point? (Select all that apply.) a) Keep the infant upright in an infant chair for 1 hour after feeding b) Feed the infant while holding her in an upright position c) Consult a pediatric surgeon regarding having a myotomy procedure performed d) Consult the physician regarding having botulinum toxin injected into the lower esophageal sphincter e) If breastfeeding, switch to formula f) Feed the infant a formula thickened with rice cereal

a) Keep the infant upright in an infant chair for 1 hour after feeding b) Feed the infant while holding her in an upright position f) Feed the infant a formula thickened with rice cereal Explanation: The traditional treatment of GI reflux is to feed infants a formula thickened with rice cereal (1 tbsp of cereal per 1 oz of formula or breast milk) while holding them in an upright position and then keeping them upright in an infant chair for 1 hour after feeding so gravity can help prevent reflux. There is no need for the mother to switch from breastfeeding to formula. Injection of botulinum toxin into the lower esophageal sphincter and a myotomy procedure are interventions that would be considered only if the problem does not disappear with feeding solid food and maintaining the child in a more upright position during and following feeding; they would not be appropriate at this point.

After tonsillectomy surgery, the preferred position of a child until fully awake is on the:

abdomen with a pillow under the chest.

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

acute glomerulonephritis.

A 3-year-old child has been brought to the clinic for assessment because of frequent episodes of constipation. After ruling an out an organic cause, the child's plan of care should prioritize:

administering over the counter stool softeners on a temporary basis. Once any organic process is ruled out as a cause, constipation may initially be managed with dietary manipulation such as increasing fiber and fluids. However, behavior modification is necessary for most children. Children need to relearn to allow bowel evacuation when stool is present. Medications are used when other measures have failed. Frequent toileting may or may not be beneficial.

The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use? a) Use a clean bedpan to collect the specimen. b) Apply a urine bag to the anal area. c) Have the child defecate into a container in the toilet. d) Use a tongue blade to scrape a specimen from a diaper.

b) Apply a urine bag to the anal area. Explanation: With very liquid stool, applying a urine bag to the anal area is most effective in collecting the specimen. Using a tongue blade to scrape a specimen from a diaper would be appropriate if the stool is formed. However, putting a diaper on a 4-year-old would be demeaning. Defecating into a collection container that sits at the back of the toilet would be more appropriate for an older child who is ambulatory. A bedpan would be appropriate if the child was bedridden.

The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use? a) Use a clean bedpan to collect the specimen. b) Apply a urine bag to the anal area. c) Have the child defecate into a container in the toilet. d) Use a tongue blade to scrape a specimen from a diaper.

b) Apply a urine bag to the anal area. Explanation: With very liquid stool, applying a urine bag to the anal area is most effective in collecting the specimen. Using a tongue blade to scrape a specimen from a diaper would be appropriate if the stool is formed. However, putting a diaper on a 4-year-old would be demeaning. Defecating into a collection container that sits at the back of the toilet would be more appropriate for an older child who is ambulatory. A bedpan would be appropriate if the child was bedridden.

The nurse examining an infant forms the following diagnosis: "Risk for impaired skin integrity related to effects of diarrhea." This diagnosis would be most appropriate for which of the following disease states (select all that apply): a) Pyloric stenosis b) Crohn disease c) Ulcerative colitis d) Inflammatory bowel disease e) Congenital diaphragmatic hernia f) Meckel diverticulum

b) Crohn disease c) Ulcerative colitis d) Inflammatory bowel disease Explanation: Inflammatory bowel disease (IBD) is a group of diseases characterized by inflammation of the GI tract and diarrhea. Crohn disease (CD) and ulcerative colitis (UC) are the most common forms of IBD and account for more than 80% of all cases.

A nurse examining a neonate is unable to identify the fetal stomach. The nurse knows that this sign strongly indicates which of the following conditions? a) Hernia b) Esophageal atresia (EA) c) Duodenal atresia d) Pyloric stenosis

b) Esophageal atresia (EA) Explanation: Inability to identify the fetal stomach strongly suggests EA. The upper abdomen is typically distended in pyloric stenosis and duodenal atresia. Hernias typically present as a bulge in the groin area.

A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care for an omphalocele?

b) Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. Explanation: For an omphalocele, protect the bowel by wrapping the exposed viscera with warm saline-soaked gauze and cover and seal with a plastic wrap or place in a "bowel bag" which will contain the defect, torso, and legs, to prevent heat and fluid loss from the exposed viscera. Obtain IV access. Give fluid resuscitation and correct any electrolyte abnormalities. Oral prednisone or prednisolone, or IV methylprednisolone, are administered for irritable bowel syndrome. An NG tube may be placed to decompress the stomach to prevent gastric distention when severe emesis is present with pancreatitis.

A nurse manages the interdisciplinary care for an infant born with an omphalocele. Which of the following is an accurate description of the care for an omphalocele? a) Administer corticosteroids as prescribed—either oral prednisone or prednisolone or as IV methylprednisolone. b) Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. c) Insert an NG tube to decompress the stomach and to prevent gastric distention. d) At birth protect the exposed bowel by gently manipulating it back into the abdominal cavity.

b) Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. Explanation: For an omphalocele, protect the bowel by wrapping the exposed viscera with warm saline-soaked gauze and cover and seal with a plastic wrap or place in a "bowel bag" which will contain the defect, torso, and legs, to prevent heat and fluid loss from the exposed viscera. Obtain IV access. Give fluid resuscitation and correct any electrolyte abnormalities. Oral prednisone or prednisolone, or IV methylprednisolone, are administered for irritable bowel syndrome. An NG tube may be placed to decompress the stomach to prevent gastric distention when severe emesis is present with pancreatitis.

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which of the following as classic symptoms? Select all that apply. a) Sunken abdomen b) Steatorrhea c) Polycythemia d) Constipation e) Failure to thrive f) Diarrhea

b) Steatorrhea d) Constipation e) Failure to thrive f) Diarrhea Explanation: Classic symptoms of celiac disease include steatorrhea, constipation, diarrhea, failure to thrive, weight loss, abdominal distention or bloating (not a sunken abdomen), and anemia (not polycythemia).

The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to:

be at risk for respiratory distress.

The nurse caring for a patient with Crohn disease knows that long-term complications for this patient might include (select all that apply): a) Pancreatitis b) Gallstones c) Stricture d) Short-bowel syndrome e) Intra-abdominal abscess formation f) Fistula

c) Stricture d) Short-bowel syndrome e) Intra-abdominal abscess formation f) Fistula Explanation: Crohn disease is a recurrent disease. Long-term complications may include stricture, fistula, and intra-abdominal abscess formation. Individuals with severe disease who require extensive resection of diseased bowel may be left with short bowel syndrome and long-term dependence on PN.

Infants with congenital heart disease should not be allowed to become dehydrated because this makes them prone to:

cerebrovascular accident.

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breath. The signs the nurse noted indicate the child likely has:

epiglottitis.

The nurse is caring for an 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and reports shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on these reported symptoms, the nurse is aware that the disorder is most likely to be:

epiphysiolysis of the proximal humerus.

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:

femoral pulse weaker than brachial pulse.

A group of nursing students are reviewing information about variations in the anatomy of a child's respiratory tract structures in comparison to adults. The students demonstrate an understanding of the information when they describe the shape of the larynx in infants as:

funnel.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to:

gastroesophageal reflux disease.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to:

gastroesophageal reflux disease. The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) Hirschsprung disease. b) cystic fibrosis. c) gastroesophageal reflux disease. d) inflammatory bowel disease.

gastroesophageal reflux disease. The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) gastroesophageal reflux disease. b) inflammatory bowel disease. c) cystic fibrosis. d) Hirschsprung disease.

gastroesophageal reflux disease. The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) gastroesophageal reflux disease. b) inflammatory bowel disease. c) cystic fibrosis. d) Hirschsprung disease.

gastroesophageal reflux disease. The child with gastroesophageal reflux disease may present with the physical findings of pneumonia secondary to aspiration of refluxed stomach contents.

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children. The nurse most likely is referring to:

impetigo.

The nurse teaches a parent to differentiate between regurgitation and vomiting in the infant. The parent correctly states which characteristic of regurgitation? Select all that apply.

no appearance of distress occurs with feeding Regurgitation occurs with feeding; the infant does not exhibit signs of distress. Forceful expulsion of stomach contents that is followed by dry retching unrelated to feeding are characteristics of vomiting.

A 7-year-old boy has experienced severe diarrhea resulting from an intestinal virus. The nurse is concerned that the child will develop an acid-base imbalance. Which of the following blood test results would indicate that the boy is experiencing metabolic acidosis? a) pH of 7.35, HCO3 of 24 mEq/L b) pH of 7.4, HCO3 of 26 mEq/L c) pH of 7.5, HCO3 of 29 mEq/L d) pH of 7.25, HCO3 of 20 mEq/L

pH of 7.25, HCO3 of 20 mEq/L Correct Explanation: The pH of blood is normally slightly alkaline, ranging from 7.35 to 7.45. The level of bicarbonate (HCO3) in arterial blood is normally 22 to 26 mEq/L. Metabolic acidosis results from diarrhea as a great deal of sodium is lost with stool. With metabolic acidosis, arterial blood gas analysis will reveal a decreased pH (under 7.35) and a low HCO3 value (near or below 22 mEq/L). With metabolic alkalosis, pH will be elevated (near or above 7.45), and HCO3 level will be near or above 28 mEq/L

A 7-year-old boy has experienced severe diarrhea resulting from an intestinal virus. The nurse is concerned that the child will develop an acid-base imbalance. Which of the following blood test results would indicate that the boy is experiencing metabolic acidosis? a) pH of 7.25, HCO3 of 20 mEq/L b) pH of 7.35, HCO3 of 24 mEq/L c) pH of 7.4, HCO3 of 26 mEq/L d) pH of 7.5, HCO3 of 29 mEq/L

pH of 7.25, HCO3 of 20 mEq/L Correct Explanation: The pH of blood is normally slightly alkaline, ranging from 7.35 to 7.45. The level of bicarbonate (HCO3) in arterial blood is normally 22 to 26 mEq/L. Metabolic acidosis results from diarrhea as a great deal of sodium is lost with stool. With metabolic acidosis, arterial blood gas analysis will reveal a decreased pH (under 7.35) and a low HCO3 value (near or below 22 mEq/L). With metabolic alkalosis, pH will be elevated (near or above 7.45), and HCO3 level will be near or above 28 mEq/L.

The nursing diagnosis you anticipate that would best apply to a child with allergic rhinitis is:

pain related to sinus edema and headache.

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate that she would:

prepare the infant for surgery.

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate that she would:

prepare the infant for surgery. A surgical procedure called a pyloromyotomy (also known as a Fredet-Ramstedt operation) is the treatment of choice for pyloric stenosis.

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate that she would: a) prepare the infant for surgery. b) medicate the infant with analgesics. c) change the infant's diet to lactose-free. d) assist in doing a barium enema procedure on the infant.

prepare the infant for surgery. A surgical procedure called a pyloromyotomy (also known as a Fredet-Ramstedt operation) is the treatment of choice for pyloric stenosis.

A nurse notices a child chewing several pieces of something white. The child is also drooling and crying. A container that looks like an empty pill bottle is on the floor. The first action by the nurse would be to:

remove the substance from the child's mouth. Treatment steps in order of importance for poisoning: Remove the obvious remnants of the poison. Call 911 for emergency help if the child has collapsed or stopped breathing. If the child is conscious and alert, call the poison control center and follow their instructions. Administer the appropriate antidote if recommended. Administer general supportive and symptomatic care. The American Academy of Pediatrics no longer recommends administering syrup of ipecac because it hasn't been proven that inducing vomiting prevents poisoning. Because of the potential for misuse, the AAP also recommends safely disposing of any syrup of ipecac already in the home. In an emergency care setting, gastric lavage may be used to empty the stomach of toxic substances.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if:

she has a temperature.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if:

she has a temperature. Because Crohn disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if: a) lung sounds are clear. b) her joints are not swollen. c) she has a headache. d) she has a temperature.

she has a temperature. Because Crohn disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if: a) lung sounds are clear. b) she has a temperature. c) her joints are not swollen. d) she has a headache.

she has a temperature. Because Crohn disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if: a) lung sounds are clear. b) she has a temperature. c) her joints are not swollen. d) she has a headache.

she has a temperature. Because Crohn disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if: a) she has a temperature. b) she has a headache. c) lung sounds are clear. d) her joints are not swollen.

she has a temperature. Because Crohn disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn's disease. A primary assessment you would want to make when caring for her would be to note if a) her joints are not swollen. b) she has a temperature. c) she has a headache. d) lung sounds are clear.

she has a temperature. Correct Explanation: Because Crohn's disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

The nurse is caring for a 12-year-old girl with Crohn disease. A primary assessment the nurse would want to make when caring for her would be to note if:

she has a temperature. Explanation: Because Crohn's disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

You care for a 12-year-old girl with Crohn's disease. A primary assessment you would want to make when caring for her would be to note if a) she has a headache. b) she has a temperature. c) lung sounds are clear. d) her joints are not swollen.

she has a temperature. Explanation: Because Crohn's disease leads to patches of inflammation in the bowel, the temperature increases if more patches become involved.

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as:

significant bending without actual breaking.

A 3-year-old is scheduled for a surgery to correct undescended testes. An important postoperative consideration the nurse would want to prepare the parents for is:

some discomfort at the surgery site.

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is:

steatorrhea Steatorrhea (fatty stools) is a classic symptom of celiac disease. Currant jelly stools are a sign of intussusception. Projectile vomiting is a sign of pyloric stenosis.

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is:

steatorrhea.

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is:

steatorrhea. Steatorrhea (fatty stools) is a classic symptom of celiac disease. Currant jelly stools are a sign of intussusception. Projectile vomiting is a sign of pyloric stenosis.

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is: a) steatorrhea. b) severe diarrhea. c) projectile stools. d)

steatorrhea. Steatorrhea (fatty stools) is a classic symptom of celiac disease. Currant jelly stools are a sign of intussusception. Projectile vomiting is a sign of pyloric stenosis.

What is the only treatment for celiacs disease

strict gluten free diet

During an assessment, a child exhibits an audible high-pitched inspiratory noise. The nurse documents this as:

stridor.

While an adolescent wears a body brace for scoliosis, you would teach her:

to continue with age-appropriate activities.

Constipation may be initially caused by psychological problems.

true

A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, the nurse would want to prepare her to:

void during the procedure.

An adolescent asks you how to best prevent vulvovaginitis. Your best answer would be to:

wipe from front to back after urinating or defecating.

The nurse is working with the mother of a toddler experiencing constipation. What information regarding childhood constipation should the nurse share with the mother? Select all that apply. a) "Reward your child for sitting on the toilet as asked, not just when they have a bowel movement." b) "Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes." c) "If your child has a fecal impaction, you can give him an enema." d) "Reward your child only when they have a bowel movement with a sticker." e) "You should not give your son laxatives."

• "Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes." • "If your child has a fecal impaction, you can give him an enema." • "Reward your child for sitting on the toilet as asked, not just when they have a bowel movement." Proper education for constipation in children includes educating the families about the importance of compliance with medication use. Many children present to their physician or nurse practitioner with fecal impaction or partial impaction. Teach parents how to disimpact their children at home; this often requires an enema or stimulation therapy. To facilitate daily bowel evacuation, the child should sit on the toilet twice a day (after breakfast and dinner) for 5 to 15 minutes. Instruct the family to keep a "star" or reward chart to encourage compliance. Parents should award the star for compliance with time sitting on the toilet and should not reserve rewards for successful bowel movements only.

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred? a) "My child can drink milk if they feel like it to help in rehydration." b) "I should be sure my child receives 50 to 100 mL/kg of oral rehydration solution (ORS) over 4 hours." c) "Solutions like Pedialyte are not necessary for mild dehydration." d) "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." e) "Oral rehydration solutions (ORS) are good sources of fluids for rehydration."

• "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." • "Oral rehydration solutions (ORS) are good sources of fluids for rehydration." • "I should be sure my child receives 50 to 100 mL/kg of oral rehydration solution (ORS) over 4 hours." In the child with mild to moderate dehydration resulting from vomiting, withhold oral feeding for 1 to 2 hours after emesis, after which time oral rehydration can begin. Tap water, milk, undiluted fruit juice, soup, and broth are NOT appropriate for oral rehydration. Oral rehydration solutions include standard ORS solutions include Pedialyte, Infalyte, and Ricelyte. The recommendation for children with mild to moderate dehydration is 50 to 100 mL/kg of ORS over 4 hours.

The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statements by the teen indicates that adequate learning has occurred? Select all that apply. a) "It sounds like the physician is reluctant to give me a prokinetic because of the side effects." b) "This famotidine may make me tired." c) "I should try to lie down right after I eat." d) "I will probably need a laxative because of the omeprazole." e) "The omeprazole could give me a headache."

• "It sounds like the physician is reluctant to give me a prokinetic because of the side effects." • "This famotidine may make me tired." • "The omeprazole could give me a headache." Famotidine may cause fatigue. Omeprazole can cause headaches. Prokinetics use may result in side effects involving the central nervous system. Omeprazole use more likely will result in diarrhea, not constipation. Children with GERD should not lie down after meals

The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statements by the teen indicates that adequate learning has occurred? Select all that apply. a) "The omeprazole could give me a headache." b) "I should try to lie down right after I eat." c) "I will probably need a laxative because of the omeprazole." d) "This famotidine may make me tired." e) "It sounds like the physician is reluctant to give me a prokinetic because of the side effects."

• "This famotidine may make me tired." • "The omeprazole could give me a headache." • "It sounds like the physician is reluctant to give me a prokinetic because of the side effects." Famotidine may cause fatigue. Omeprazole can cause headaches. Prokinetics use may result in side effects involving the central nervous system. Omeprazole use more likely will result in diarrhea, not constipation. Children with GERD should not lie down after meals.

A doctor orders an abdominal radiograph for a newborn to check for Hirschsprung disease. The nurse examines the infant and finds which symptoms that are indicative of this disease? Select all that apply. a) Absence of stool in the rectum b) Presence of a fistula c) Abdominal distention d) Bilious vomiting e) Enterocolitis f) Displaced anus

• Abdominal distention • Absence of stool in the rectum • Bilious vomiting • Enterocolitis The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth and has bilious vomiting or has abdominal distention, feeding intolerance, with bilious aspirates and vomiting. In anorectal malformations the anus is absent or displaced and the presence of a fistula may be noted when gas or stool is expelled from the urethra or vagina

A doctor orders an abdominal radiograph for a newborn to check for Hirschsprung disease. The nurse examines the infant and finds which symptoms that are indicative of this disease? Select all that apply. a) Abdominal distention b) Presence of a fistula c) Bilious vomiting d) Enterocolitis e) Absence of stool in the rectum f) Displaced anus

• Abdominal distention • Absence of stool in the rectum • Enterocolitis • Bilious vomiting The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth and has bilious vomiting or has abdominal distention, feeding intolerance, with bilious aspirates and vomiting. In anorectal malformations the anus is absent or displaced and the presence of a fistula may be noted when gas or stool is expelled from the urethra or vagina.

A doctor orders an abdominal radiograph for a newborn to check for Hirschsprung disease. The nurse examines the infant and finds the following symptoms indicative of this disease (select all that apply): a) Absence of stool in the rectum b) Displaced anus c) Presence of a fistula d) Enterocolitis e) Abdominal distention f) Bilious vomiting

• Abdominal distention • Absence of stool in the rectum • Enterocolitis • Bilious vomiting Explanation: The nurse should suspect Hirschsprung disease when the newborn does not pass meconium in the first 24 hours after birth and has bilious vomiting or has abdominal distention, feeding intolerance, with bilious aspirates and vomiting. In anorectal malformations the anus is absent or displaced and the presence of a fistula may be noted when gas or stool is expelled from the urethra or vagina

The nurse is assessing a child with suspected necrotizing enterocolitis. Which of the following would the nurse expect to find? Select all that apply. a) Bilious vomiting b) Hyperirritability c) Tachypnea d) Clay-colored stools e) Abdominal distention

• Abdominal distention • Bilious vomiting Assessment findings associated with necrotizing enterocolitis include abdominal distention and tenderness, bloody stools, feeding intolerance characterized by bilious vomiting, sepsis, lethargy, apnea, and shock.

The nurse is assessing a child with suspected necrotizing enterocolitis. Which of the following would the nurse expect to find? Select all that apply. a) Abdominal distention b) Bilious vomiting c) Tachypnea d) Clay-colored stools e) Hyperirritability

• Abdominal distention • Bilious vomiting Explanation: Assessment findings associated with necrotizing enterocolitis include abdominal distention and tenderness, bloody stools, feeding intolerance characterized by bilious vomiting, sepsis, lethargy, apnea, and shock.

The nurse is assessing a child with suspected necrotizing enterocolitis. Which of the following would the nurse expect to find? Select all that apply. a) Tachypnea b) Bilious vomiting c) Clay-colored stools d) Hyperirritability e) Abdominal distention

• Abdominal distention • Bilious vomiting Explanation: Assessment findings associated with necrotizing enterocolitis include abdominal distention and tenderness, bloody stools, feeding intolerance characterized by bilious vomiting, sepsis, lethargy, apnea, and shock.

A child is diagnosed with short bowel syndrome. Which of the following would the nurse expect to be included in the child's plan of care? Select all that apply. a) Immunosuppressants b) Laxatives c) Antibiotics d) Vitamin supplements e) Total parenteral nutrition

• Antibiotics • Vitamin supplements • Total parenteral nutrition Explanation: For the child with short bowel syndrome, typically, antibiotics, vitamin and mineral supplements, antidiarrheal agents, and total parenteral nutrition are prescribed. Laxatives and immunosuppressants are not used

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which of the following foods would be permitted in the diet of the child with celiac syndrome? (Select all that apply) a) Wheat bread b) oatmeal c) Applesauce d) Bananas e) Corn bread f) Skim milk

• Applesauce • Bananas • Skim milk Correct Explanation: The child is usually started on a gluten-free, low-fat diet. Skim milk, banana flakes and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour and cornmeal are not included in the diet.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply.

• Bananas • Skim milk • Applesauce Explanation: The child is usually started on a gluten-free, low-fat diet. Skim milk, banana flakes and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour and cornmeal are not included in the diet.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which of the following foods would be permitted in the diet of the child with celiac syndrome? (Select all that apply) a) Corn flakes b) Rye bread c) Applesauce d) Oatmeal e) Bananas f) Skim milk

• Bananas • Skim milk • Applesauce Explanation: The child is usually started on a gluten-free, low-fat diet. Skim milk, banana flakes and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour and cornmeal are not included in the diet.

What are the classic symptoms of celiacs disease

• Constipation • Diarrhea • Steatorrhea • Failure to thrive Classic symptoms of celiac disease include steatorrhea, constipation, diarrhea, failure to thrive, weight loss, abdominal distention or bloating (not a sunken abdomen), and anemia (not polycythemia).

A mother brings her 2-week-old newborn to the doctor's office because the child has been experiencing gastroesophageal reflux over the past week. Which of the following interventions should the nurse recommend to the mother at this point? (Select all that apply.) a) Consult a pediatric surgeon regarding having a myotomy procedure performed b) Consult the physician regarding having botulinum toxin injected into the lower esophageal sphincter c) Feed the infant a formula thickened with rice cereal d) If breastfeeding, switch to formula e) Keep the infant upright in an infant chair for 1 hour after feeding f) Feed the infant while holding her in an upright position

• Feed the infant a formula thickened with rice cereal • Feed the infant while holding her in an upright position • Keep the infant upright in an infant chair for 1 hour after feeding Explanation: The traditional treatment of GI reflux is to feed infants a formula thickened with rice cereal (1 tbsp of cereal per 1 oz of formula or breast milk) while holding them in an upright position and then keeping them upright in an infant chair for 1 hour after feeding so gravity can help prevent reflux. There is no need for the mother to switch from breastfeeding to formula. Injection of botulinum toxin into the lower esophageal sphincter and a myotomy procedure are interventions that would be considered only if the problem does not disappear with feeding solid food and maintaining the child in a more upright position during and following feeding; they would not be appropriate at this point.

Testing is being performed to confirm the presence of Meckel diverticulum. Which findings are consistent with this condition? Select all that apply. a) Platelet count 200,000 b) Hematocrit 37% c) Stool test reveals occult blood. d) White blood cell count 8 g/dL. e) Hemoglobin 9.4 g/dL

• Hemoglobin 9.4 g/dL • Stool test reveals occult blood. Meckel diverticulum is a disorder where there are weaknesses on the intestine resulting in pouchlike areas. Test findings that are consistent with this disorder are anemia and the presence of occult blood. The values listed for white blood cell count, platelet levels, and hematocrit levels are within normal limits.

The nurse examining an infant forms the following diagnosis: "Risk for impaired skin integrity related to effects of diarrhea." This diagnosis would be most appropriate for which of the following disease states (select all that apply): a) Congenital diaphragmatic hernia b) Meckel diverticulum c) Ulcerative colitis d) Inflammatory bowel disease e) Crohn disease f) Pyloric stenosis

• Inflammatory bowel disease • Crohn disease • Ulcerative colitis Explanation: Inflammatory bowel disease (IBD) is a group of diseases characterized by inflammation of the GI tract and diarrhea. Crohn disease (CD) and ulcerative colitis (UC) are the most common forms of IBD and account for more than 80% of all cases.

A child with cirrhosis of the liver is admitted to the acute care facility in preparation for a liver transplant. When completing the physical examination, what would the nurse expect to assess? Select all that apply. a) Jaundice b) Facial erythema c) Fatty stools d) Ascites e) Spider angiomas

• Jaundice • Ascites • Spider angiomas Assessment findings associated with cirrhosis include jaundice, ascites, spider angiomas, and palmar erythema. Fatty stools are associated with celiac disease.

A child with cirrhosis of the liver is admitted to the acute care facility in preparation for a liver transplant. When completing the physical examination, what nursing assessment findings related to the liver would be documented? Select all that apply.

• Jaundice • Ascites • Spider angiomas Explanation: Assessment findings associated with cirrhosis include jaundice, ascites, spider angiomas, and palmar erythema. Fatty stools are associated with celiac disease.

A child with cirrhosis of the liver is admitted to the acute care facility in preparation for a liver transplant. When completing the physical examination, which of the following would the nurse expect to assess? Select all that apply. a) Ascites b) Facial erythema c) Fatty stools d) Spider angiomas e) Jaundice

• Jaundice • Ascites • Spider angiomas Explanation: Assessment findings associated with cirrhosis include jaundice, ascites, spider angiomas, and palmar erythema. Fatty stools are associated with celiac disease.

A child with cirrhosis of the liver is admitted to the acute care facility in preparation for a liver transplant. When completing the physical examination, what would the nurse expect to assess? Select all that apply. a) Facial erythema b) Ascites c) Spider angiomas d) Fatty stools e) Jaundice

• Jaundice • Spider angiomas • Ascites Assessment findings associated with cirrhosis include jaundice, ascites, spider angiomas, and palmar erythema. Fatty stools are associated with celiac disease

The nurse is caring for a newborn with a cleft palate. Which findings in the maternal medical record are considered to be contributing factors? Select all that apply. a) Moderate maternal alcohol use prior to pregnancy. b) Anticonvulsant therapy used to manage a seizure disorder. c) Reports of marijuana use in early pregnancy. d) Maternal tobacco use. e) Maternal age less than 18 years.

• Maternal tobacco use. • Anticonvulsant therapy used to manage a seizure disorder. Infants born with a cleft palate may have mother's with risk factors. These include maternal smoking, prenatal infection, advanced maternal age, use of anticonvulsants or steroids

The nurse is caring for a newborn with a cleft palate. Which findings in the maternal medical record are considered to be contributing factors? Select all that apply. a) Moderate maternal alcohol use prior to pregnancy. b) Anticonvulsant therapy used to manage a seizure disorder. c) Reports of marijuana use in early pregnancy. d) Maternal tobacco use. e) Maternal age less than 18 years.

• Maternal tobacco use. • Anticonvulsant therapy used to manage a seizure disorder. Infants born with a cleft palate may have mother's with risk factors. These include maternal smoking, prenatal infection, advanced maternal age, use of anticonvulsants or steroids

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply. a) Antidiarrheal agents b) Monitor of intake and output c) Antibiotic therapy d) IV fluid administration e) Daily weight assessment

• Monitor of intake and output • IV fluid administration • Daily weight assessment Rotavirus is viral in nature. Antibiotic therapy is not used in the care and treatment of a viral infection. Antidiarrhea medications are not utilized as they are not effective. Intake and output will be observed. Daily weight will aid in the determination of hydration status. IV fluids may be indicated in the rehydration process.

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply. a) Antidiarrheal agents b) Monitor of intake and output c) Antibiotic therapy d) IV fluid administration e) Daily weight assessment

• Monitor of intake and output • IV fluid administration • Daily weight assessment Rotavirus is viral in nature. Antibiotic therapy is not used in the care and treatment of a viral infection. Antidiarrhea medications are not utilized as they are not effective. Intake and output will be observed. Daily weight will aid in the determination of hydration status. IV fluids may be indicated in the rehydration process.

The nurse is talking with a pregnant client about cleft lips and palates. The client has asked if these can be tested for. What information should be included in the nurse's response? Select all that apply. a) The nuchal translucency test can be used to screen for cleft lips and palates. b) The quadruple marker test can be used to detect these conditions. c) Most cleft lips and palates are found at delivery. d) Ultrasounds can be used to assess for these conditions. e) There are no ways to determine the presence of cleft lips or palates prior to delivery.

• Most cleft lips and palates are found at delivery. • Ultrasounds can be used to assess for these conditions. Ultrasounds can be used to identify the presence of cleft lips or palates. Most, however, are found after birth. The quadruple screening test assesses for potential down syndrome and neuro tube defects. Nuchal translucency testing is used to assess for down syndrome.

12-year-old Hilary is brought to the emergency room by her parents with severe abdominal pain. The nurse performs a physical assessment to check for appendicitis. Which assessment parameters indicate appendicitis? Select all that apply. a) Rebound tenderness present with palpation in the left upper quadrant b) Normal to hyperactive bowel sounds early c) Distended abdomen with unperforated appendicitis d) Hypoactive bowel sounds with perforation e) Irritation and pain in the right lower quadrant f) Low-grade fever, nausea, anorexia, and vomiting

• Normal to hyperactive bowel sounds early • Hypoactive bowel sounds with perforation • Irritation and pain in the right lower quadrant • Low-grade fever, nausea, anorexia, and vomiting On auscultation, bowel sounds are normal to hyperactive early in the course of appendicitis but become hypoactive with perforation. Percussion reveals irritation and pain in the right lower quadrant. Rebound tenderness is present with palpation in the right lower quadrant. Low-grade fever, nausea, anorexia, and vomiting typically occur after the onset of abdominal pain. The abdomen appears flat with unperforated appendicitis, but abdominal distention may be present once perforation occurs.

A nurse manages the interdisciplinary care for a client with pancreatitis. What are recommended interventions for this condition? Select all that apply. a) Administering analgesics for pain b) Administering corticosteroids c) Providing glycemia control d) Positioning the client in a fetal position e) Keeping the child NPO to rest the pancreas f) Using a high-fat diet when lipase occurs

• Providing glycemia control • Positioning the client in a fetal position • Administering analgesics for pain • Keeping the child NPO to rest the pancreas The main interventions for pancreatitis are supportive, including administration of antibiotics; stress ulcer prophylaxis; pain relief by analgesic administration; managing fluids; glycemia control; using a low-fat diet when lipase occurs; positioning the child in the fetal position to minimize tension of the peritoneum; and keeping the child NPO to rest the pancreas.

A nurse manages the interdisciplinary care for a client with pancreatitis. What are recommended interventions for this condition? Select all that apply. a) Administering analgesics for pain b) Administering corticosteroids c) Providing glycemia control d) Positioning the client in a fetal position e) Keeping the child NPO to rest the pancreas f) Using a high-fat diet when lipase occurs

• Providing glycemia control • Positioning the client in a fetal position • Administering analgesics for pain • Keeping the child NPO to rest the pancreas The main interventions for pancreatitis are supportive, including administration of antibiotics; stress ulcer prophylaxis; pain relief by analgesic administration; managing fluids; glycemia control; using a low-fat diet when lipase occurs; positioning the child in the fetal position to minimize tension of the peritoneum; and keeping the child NPO to rest the pancreas.

The nurse is positioning an infant who has just had his left-sided cleft lip repaired. What positions are acceptable for this infant? Select all that apply. a) High fowlers b) Supine c) Prone d) Right side lying e) Left side lying

• Right side lying • Supine It is critical to prevent injury to the facial suture line or to the palatal operative sites. Do not allow the infant to rub the facial suture line. To prevent this, position the infant in a supine or side-lying position

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply. a) Skim milk b) Rye bread c) Oatmeal d) Applesauce e) Corn flakes f) Bananas

• Skim milk • Applesauce • Bananas The child is usually started on a gluten-free, low-fat diet. Skim milk and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour, and cornmeal are not included in the diet.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply. a) Corn flakes b) Bananas c) Oatmeal d) Applesauce e) Rye bread f) Skim milk

• Skim milk • Bananas • Applesauce The child is usually started on a gluten-free, low-fat diet. Skim milk, banana flakes, and bananas are usually well tolerated. Lean meats, puréed vegetables, and fruits are gradually added to the diet. Wheat, rye, oat products, corn flour, and cornmeal are not included in the diet.

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which of the following as classic symptoms? Select all that apply. a) Diarrhea b) Failure to thrive c) Steatorrhea d) Constipation e) Polycythemia f) Sunken abdomen

• Steatorrhea • Constipation • Diarrhea • Failure to thrive Explanation: Classic symptoms of celiac disease include steatorrhea, constipation, diarrhea, failure to thrive, weight loss, abdominal distention or bloating (not a sunken abdomen), and anemia (not polycythemia).

The nurse caring for a patient with Crohn disease knows that long-term complications for this patient might include (select all that apply): a) Fistula b) Gallstones c) Stricture d) Short-bowel syndrome e) Intra-abdominal abscess formation f) Pancreatitis

• Stricture • Fistula • Intra-abdominal abscess formation • Short-bowel syndrome Crohn disease is a recurrent disease. Long-term complications may include stricture, fistula, and intra-abdominal abscess formation. Individuals with severe disease who require extensive resection of diseased bowel may be left with short bowel syndrome and long-term dependence on PN.

The nurse caring for a patient with Crohn disease knows that long-term complications for this patient might include (select all that apply): a) Short-bowel syndrome b) Gallstones c) Pancreatitis d) Stricture e) Intra-abdominal abscess formation f) Fistula

• Stricture • Fistula • Intra-abdominal abscess formation • Short-bowel syndrome Explanation: Crohn disease is a recurrent disease. Long-term complications may include stricture, fistula, and intra-abdominal abscess formation. Individuals with severe disease who require extensive resection of diseased bowel may be left with short bowel syndrome and long-term dependence on PN.

A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which of the following would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply. a) Pink moist oral mucosa b) Sunken fontanels c) Slightly decreased urine output d) Cool mottled extremities e) Bradycardia

• Sunken fontanels • Bradycardia • Cool mottled extremities Explanation: Severe dehydration would be indicated by sunken fontanels, increased heart rate progressing to bradycardia, cool mottled or dusky extremities, dry oral mucosa, and significantly decreased urine output of less than 1 mL/kg/hour. Pink moist oral mucosa and slightly decreased urine output would suggest mild dehydration.

The newborn was diagnosed with esophageal atresia and a nasogastric tube was inserted. Which finding is most consistent with this condition? a) X-ray revealed that the nasogastric tube was coiled in the upper esophagus. b) The newborn's skin was very jaundiced. c) The newborn coughed excessively during attempts to feed. d) Coarse crackles were auscultated throughout all lung fields. e) The newborn's mouth was very dry.

• The newborn coughed excessively during attempts to feed. • Coarse crackles were auscultated throughout all lung fields. • X-ray revealed that the nasogastric tube was coiled in the upper esophagus. Newborns with esophageal atresia cough during attempts to feed, may have fluid in their lungs, and x-rays will show that nasogastric tubes just coil in the upper part of the esophagus because the esophagus does not extend to the stomach. They have increased salivation in their mouths and their skin may be dusky or cyanotic.

The newborn was diagnosed with esophageal atresia and a nasogastric tube was inserted. Which finding is most consistent with this condition? a) X-ray revealed that the nasogastric tube was coiled in the upper esophagus. b) The newborn's skin was very jaundiced. c) The newborn coughed excessively during attempts to feed. d) Coarse crackles were auscultated throughout all lung fields. e) The newborn's mouth was very dry.

• The newborn coughed excessively during attempts to feed. • Coarse crackles were auscultated throughout all lung fields. • X-ray revealed that the nasogastric tube was coiled in the upper esophagus. Newborns with esophageal atresia cough during attempts to feed, may have fluid in their lungs, and x-rays will show that nasogastric tubes just coil in the upper part of the esophagus because the esophagus does not extend to the stomach. They have increased salivation in their mouths and their skin may be dusky or cyanotic.