Elsevier Adaptive Quizzing for Pediatrics

Which description provided by the parent of a preschool-age client would suggest to the nurse that the child is experiencing sleep terrors? a. sweating profusely b. calling out after a dream c. awakening during the second half of the night d. being aware that others are in the room after awakening

a. sweating profusely Profuse sweating is a characteristic that would cause the nurse to believe that the child is experiencing a sleep terror versus a bad dream. Calling out after the dream is over, awakening during the second half of the night, and being aware that others are with them after the dream is over are characteristics associated with a bad dream, not a sleep terror.

A nurse is caring for a 9-month-old infant with severe dehydration. What does the nurse expect to note while completing a physical assessment of this infant? a. frothy stools b. weak, rapid pulse c. pale, copious urine d. bulging anterior fontanel

b. weak, rapid pulse A weak, rapid pulse is an expected adaptation with a state of severe dehydration because of hypovolemia. Children with untreated cystic fibrosis and celiac disease have frothy stools. There is no indication that this infant has either of these disorders. Severe dehydration results in decreased urine output and concentrated urine. One of the signs of dehydration in an infant is a sunken, not bulging, anterior fontanel.

To which client should the nurse provide education regarding the pubertal growth spurt? a. an 8-year-old school-age male client b. a 16-year-old adolescent male client c. a 12-year-old school age female client d. an 18-year-old adolescent female client

c. a 12-year-old school age female client The pubertal growth spurt reaches a peak for female clients at 12 years of age; therefore, the nurse should provide education to this client regarding expected growth during this time period. The 8-year-old male client would not be expected to experience the pubertal growth spurt until the age of 14 years. The 16-year-old and the 18-year-old adolescent clients would have already experienced the pubertal growth spurt.

A 3-year-old child is admitted to the pediatric unit with a tentative diagnosis of Wilms tumor. The nurse obtains the child's health history from the parents. What does the child's history reveal that will help establish the diagnosis? a. periorbital edema b. projectile vomiting c. abdominal swelling d. low-grade temperature

c. abdominal swelling Wilms tumor is a nephroblastoma that is first observed as a firm, painless intraabdominal mass located on one side of the abdomen. Periorbital edema is a sign of glomerulonephritis, not Wilms tumor. Projectile vomiting is indicative of central nervous system problems or a gastrointestinal obstruction, not Wilms tumor. A low-grade fever is a nonspecific sign of many illnesses, not necessarily Wilms tumor.

An adolescent who has had a leg amputated because of bone cancer begins to experience phantom limb sensations. How should the nurse respond when the client complains of pain and requests medication? a. by withholding the medication to prevent addiction b. by stating that the limb has been removed and that the pain is psychological c. by acknowledging that the pain is real and administering medication to relieve it d. by explaining that the phantom limb sensation will subside within a few more days

c. by acknowledging that the pain is real and administering medication to relieve it Pain medication is required, along with intensive supportive nursing care. To the client the pain is real, requiring pain medication; addiction is not a concern at this time. Explaining that the pain is psychological in origin does not help relieve the pain; medication and emotional support are required. The pain may not recede within a few days; pain medication should be administered.

What is the average optimal blood pressure of an adolescent? a. 85/54 mm Hg b. 95/65 mm Hg c. 105/65 mm Hg d. 110/65 mm Hg

d. 110/65 mm Hg The optimal blood pressure of an adolescent is 110/65 mm Hg. The average optimal blood pressure in an infant is 85/54 mm Hg. The average optimal pressure in a toddler is 95/65 mm Hg. The average optimal blood pressure seen in children between the ages of 6 and 13 is 105/65 mm Hg.

A preschool-aged child with leukemia who is undergoing chemotherapy is susceptible to rectal ulcerations. What should the nurse recommend to the parents that will lessen the severity of this problem? a. encourage lying on the abdomen when in bed b. have the child wear cotton underpants at night c. apply rectal ointment liberally 4 times a day d. clean the child's perianal area after each bowel movement

d. clean the child's perianal area after each bowel movement Meticulous toilet hygiene is essential to prevent infection and promote comfort. Changing positions in bed is preferable. Underpants keep the area moist and promote bacterial growth; it is preferable to leave the area exposed to air, even if it remains under bed linens. Ointments tend to occlude and trap organisms, thus promoting infection.

A parent asks the nurse what to do when the toddler has temper tantrums. What play materials should the nurse suggest that the child be offered as another means of expressing anger? a. ball and bat b. wad of clay c. punching bag d. pegs and a pounding board

d. pegs and a pounding board A pounding board with pegs to hammer into holes is a safe toy for toddlers because it is fairly large, easy to manipulate, and sturdy. It also provides an acceptable way for anger to be expressed. The child's motor and hand-eye coordination are too immature for the child to use a ball and bat. A wad of clay is not as effective for releasing anger as a pounding board. A punching bag is appropriate for an older child with more mature motor coordination to compensate for a moving object.

A nurse is evaluating a 3-year-old child's developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay? a. copying a square b. hopping on one foot c. catching a ball reliably d. using a spoon effectively

d. using a spoon effectively Using a spoon effectively is a task expected of 3-year-old children. Copying a square is a task expected of 4- or 5-year-old children. Hopping on one foot and catching a ball reliably are tasks expected of 4-year-old children.