Family Final

3. An adolescent with juvenile idiopathic arthritis (JIA) is prescribed abatacept (Orencia). Which should the nurse teach the adolescent regarding this medication? (Select all that apply.) a. Avoid receiving live immunizations while taking the medication. b. Before beginning this medication, a tuberculin screening test will be done. c. You will be getting a twice-a-day dose of this medication. d. This medication is taken orally.

ANS: A, B Abatacept reduces inflammation by inhibiting T cells and is given intravenously every 4 weeks. Possible side effects of biologics include an increased infection risk. Because of the infection risk, children should be evaluated for tuberculosis exposure before starting these medications. Live vaccines should be avoided while taking these agents.

11. Which should cause a nurse to suspect that an infection has developed under a cast? a. Complaint of paresthesia b. Cold toes c. Increased respirations d. "Hot spots" felt on cast surface

ANS: D If hot spots are felt on the cast surface, they usually indicate infection beneath the area. This should be reported so that a window can be made in the cast to observe the site. The five Ps of ischemia from a vascular injury are pain, pallor, pulselessness, paresthesia, and paralysis. Paresthesia is an indication of vascular injury, not infection. Cold toes may be indicative of too tight a cast and need further evaluation. Increased respirations may be indicative of a respiratory tract infection or pulmonary emboli. This should be reported, and child should be evaluated.

Which statement made by a parent of an adolescent with anorexia nervosa indicates an understanding of this condition? a. "There really isn't anything to worry about. Don't they say you can never be too thin?" b. "My daughter just doesn't have much of an appetite." c. "She is just trying to punish me for divorcing her father." d. "She seems to see herself as fat, even though her weight is below normal."

ANS: D Individuals with anorexia nervosa have a disturbed body image, which this parent correctly recognizes.

A nurse is assessing a child with a tick-borne disease. Which of the following would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain Spotted Fever? a) Malaise b) Fever c) Absence of rash d) Headache

Absence of rash Both Rocky Mountain Spotted Fever and ehrlichiosis are manifested by fever, headache, and malaise. However, there is rarely a rash with ehrlichiosis, which helps to differentiate it from Rocky Mountain Spotted Fever.

Which type of urine specimen is collected when the nurse places a cotton ball in the diaper of a newborn or infant?

Clean catch

Which is the priority nursing intervention when caring for a neonate who is born with bladder exstrophy?

Covering the defect with sterile plastic wrap

A beneficial effect of administering digoxin (Lanoxin) is that it a. Decreases edema b. Decreases cardiac output c. Increases heart size d. Increases venous pressure

Decreases edema Digoxin has a rapid onset and is useful increasing cardiac output, decreasing venous pressure, and as a result, decreasing edema.

A toddler who seems to be withdrawn and no longer cries when his or her mother leaves the room is displaying behavior that is characteristic of which stage of separation?

Despair

A child presents to the emergency department with a fractured arm. During the assessment the child tells the nurse "daddy twisted my arm." Which is the nurse's best action?

Document the child's report in the record.

A 4-year-old child is admitted to the emergency department (ED) with burns to the back of both hands, and the nurse suspects that the child has been abused. Which action should the nurse perform first?

Examine the child while sitting on a chair

When a child is placed in isolation, what is the best approach the nurse can take in preparing the young child to feel in control?

Give simple explanations that the child can understand.

Which data collected by the nurse support the diagnosis of isotonic dehydration for a pediatric patient?

Hemorrhage

a nurse is preparing to administer recommend immunizations to a two month old infant. which of the following immunizations should the nurse plan to administer?

Hib and IPV

Which congenital anomaly should the nurse document when providing care to a newborn with abnormal positioning of the urinary meatus?

Hypospadias

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. The nurse documents this as which of the following? a) Slapped cheek appearance b) Nits c) Lymphadenopathy d) Koplik spots

Koplik spots Koplik spots are bright red spots with blue-white centers appearing primarily on the buccal mucosa and indicate rubeola (measles). They are often described as tiny grains of white sand surrounded by red rings. Lymphadenopathy is used to document enlargement of the lymph nodes. Slapped cheek appearance refers to the erythematous flushing associated with fifth disease. Nits refer to the adult eggs of pediculosis.

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). Which of the following goal has the highest priority for this child? a) Improving nutrition b) Preventing spread of infection c) Maintaining skin integrity d) Promoting comfort

Preventing spread of infection Major goals for the child include maintaining the highest level of wellness possible by preventing infection and the spread of the infection. Because the adolescent has the belief that nothing can hurt him or her, and also because of the increasing rate of sexual activity in this age group which often involves multiple partners, the highest priority is teaching and preventing the spread of the infection. Othe goals include maintaining skin integrity, minimizing pain, improving nutrition, alleviating social isolation, and diminishing a feeling of hopelessness. The primary goal for the family is improving coping skills and helping the teen cope with the illness.

A nurse is teaching an adolescent about primary hypertension. Which statement made by the adolescent indicates an understanding of primary hypertension? a. Primary hypertension should be treated with diuretics as soon as it is detected. b. Congenital heart defects are the most common cause of primary hypertension. c. Primary hypertension may be treated with weight reduction. d. Primary hypertension is not affected by exercise.

Primary hypertension may be treated with weight reduction. Primary hypertension in children may be treated with weight reduction and exercise programs.

A 1 year old who screams and cries when his mother leaves the room and screams even louder when the nurse approaches is displaying behavior that is characteristic of which stage of separation?

Protest

A nurse practitioner suspects that a child has scarlet fever based on which of the following assessment findings? a) Red, strawberry tongue b) White exudate on the tonsils c) An enanthematous rash d) Severity of the sore throat

Red, strawberry tongue The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis.

Which is the appropriate nursing intervention when providing care to a child diagnosed with nephrotic syndrome who is edematous and on bedrest?

Repositioning every 2 hours

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what condition occurs? Select all that apply. a. Respiratory rate of 36 at rest b. Appetite slowly increasing c. Temperature above 37.7° C (100° F) d. New, frequent coughing e. Turning blue or bluer than normal

Temperature above 37.7° C (100° F) New, frequent coughing Turning blue or bluer than normal The parents should be instructed to notify the physician after their infant's cardiac surgery for a temperature above 37.7° C; new, frequent coughing; and any episodes of the infant turning blue or bluer than normal. Incorrect: A respiratory rate of 36 at rest for an infant is within normal expectations, and it is expected that the appetite will increase slowly.

As a nurse working in the newborn nursery, you notice an infant who is having circumoral cyanosis. Which CHD do you suspect the child may have? Select all that apply. a. Patent ductus arteriosus (PDA) b. Tetralogy of Fallot c. Pulmonary atresia d. Transposition of the great arteries e. Ventricular septal defect

Tetralogy of Fallot Pulmonary atresia Transposition of the great arteries

The nurse is caring for a child with suspected physical abuse. Which statement regarding family history supports the likelihood of physical abuse having occurred?

The mother reports a serious personal financial crisis.

The nurse is caring for a child diagnosed with Haemophilus Influenzae type B. Which of the following nursing interventions would be the highest priority in the prevention of complications seen with this disorder? a) The nurse will monitor for seizure activity. b) The nurse will monitor fluid intake. c) The nurse will administer antibiotics. d) The nurse will elevate the head of the bed.

The nurse will administer antibiotics. A serious complication of Haemophilus Influenzae type B is meningitis. Antibiotics are administered to treat the bacterium infection caused by Haemophilus Influenzae type B.

The nurse is caring for a child hospitalized with pertussis. Which of the following nursing interventions would be the highest priority for this child? a) The nurse will administer oxygen. b) The nurse will monitor caloric intake. c) The nurse will administer antibiotics. d) The nurse will encourage bed rest.

The nurse will administer oxygen. The major complication of pertussis (whooping cough) is pneumonia and respiratory complications. Oxygen, bed rest, and monitor for airway obstruction are nursing interventions. The highest priority is administering oxygen to maintain adequate oxygenation of cells.

Which laboratory result indicates good metabolic control for a child with type 1 diabetes mellitus? a. Glycosylated hemoglobin value of 8% b. Fasting blood glucose level less than 140 mg/dL c. Glucose tolerance test result of 190 mg/dL d. No glucose or ketones present in the urine

a. Glycosylated hemoglobin value of 8%

The home health nurse is monitoring an 8-month-old child with hypothyroidism taking levothyroxine (Synthroid). Which symptoms does the nurse recognize as signs of overdose? (Select all that apply.) a. Tachycardia b. Irritability c. Vomiting d. Weight gain e. Diaphoresis

a. Tachycardia b. Irritability e. Diaphoresis

On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus? a. There is an absolute deficiency of insulin. b. Insufficient quantities of insulin are produced by the pancreas. c. Oral hypoglycemic agents can control it. d. Insulin deficiency is caused by another disease affecting the pancreas.

a. There is an absolute deficiency of insulin.

a nurse in an emergency department is caring for an eight year old who is up to date with current immunizations recommendation and has a deep puncture injury. which of the following should the nurse anticipate administering?

adult tetanus booster

A nurse on a pediatric unit is caring for a toddler. Which of the following behaviors is an effect of hospitalization? ( Select all that apply.) a. Believes the experience is a punishment b. Experiences separation anxiety c. Displays intense emotions d. Exhibits regressive behaviors e. Manifest disturbance in body image

b. Experiences separation anxiety c. Displays intense emotions d. Exhibits regressive behaviors

What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning? a. Dawn phenomenon b. Somogyi phenomenon c. Honeymoon effect d. Ketoacidosis

b. Somogyi phenomenon

a nurse is assessing a 30 month old infant during a well child visit. which of the following findings requires further assessment by the nurse?

birth weight is tripled

a nurse is caring for a two year old child who has cystic fibrosis. the nurse is planning to take the child to the playroom. which of the following activities would be appropriate for the child?

building towers of blocks

What is an important consideration for the school-age child taking DDAVP for diabetes insipidus? a. Observe for signs of water deprivation. b. Restrict his physical education program. c. Arrange for the child to use the bathroom when needed. d. Limit fluid intake other than during the lunch period.

c. Arrange for the child to use the bathroom when needed.

The nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting? a. Lispro b. Aspart c. Glargine d. Regular

c. Glargine

What does the nurse instruct a 12-year-old to do when teaching how to administer insulin? a. Make sure injection sites are 6 inches apart. b. Select an injection site that was recently exercised. c. Inject the needle at a 90-degree angle. d. Give the injection deep into the muscle.

c. Inject the needle at a 90-degree angle.

A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing? a. Somogyi phenomenon b. Dawn syndrome c. Ketoacidosis d. Water intoxication

c. Ketoacidosis

Preschoolers have a lack of understanding of ________________, and therefore may perceive that all nurses inflict pain or that everyone in scrubs inflicts pain.

cause-and-effect relationships

a nurse in the emergency department is caring for a two year old child who was found by his parents crying and holding a container of toilet bowl cleaner. the child's lips a edematous and inflamed, and he is drooling. which of the following is the priority action by the nurse?

check the child's respiratory status.

The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The nurse would tell the parents to be alert for what symptom? a. Polyuria b. Cough c. Weight loss d. Lethargy

d. Lethargy

a nurse in a pediatric clinical is caring for a three year old child who has a blood lead level of 3mcg/dL. what should nutrition look like?

ensure the child's dietary intake of calcium and iron is adequate.

a nurse is developing plan of care for a school age child who underwent a surgical procedure that resulted in a temporary loss of vision. which of the following interventions should the nurse include in the plan of care?

explain sounds the child is hearing

a nurse is preparing to administer a liquids medication to an infant. which of the following actions should the nurse take?

give the medication at the side of the infant's mouth.

a nurse at a pediatric clinic is assessing a five month old infant during a well child visit. which of the following findings should the nurse report to the provider?

head lags when pulled from a lying to a sitting position

a nurse is assessing a 12 month old male infant's vital signs during a well child visit. the infant is in the 90th percentile of height. which of the following findings should the nurse report to the provider?

heart rate 175/min

Long-acting types of insulin are seldom given to children because of the danger of ___________________ during sleep.

hypoglycemia

a nurse is assessing a nine month old infant during a well child visit. which of the following findings indicates that the infant has a developmental delay?

inability to vocalize vowel sounds

a nurse on a pediatric unit is reviewing the health record of a client who is demonstrating increasing levels of stress after admission. the nurse should identify which of the following findings as a risk factor for a stress related reaction to hospitalization

male gender

a nurse in a pediatric clinic is assessing a toddler at a well child visit. Which of the following actions should the nurse take?

minimize physical contact with the child initially

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which of the following infectious diseases? a) scabies b) mumps c) whooping cough d) measles

mumps Mumps is an infectious disease with a primary symptom of a swollen parotid gland.

a nurse is planning care for a 10 month old infant who has suspected failure to thrive. which of the following interventions should the nurse include in the plan of care

observe the parents' actions when feeding the child, maintain a detailed record of food and fluid intake.

a nurse is planning to implement relaxation strategies with a young child prior to a painful procedure. which of the following actions should the nurse take?

rock the child in long rhythmic moments

A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate on the basis of the current data? 1) Placing the newborn on a radiant warmer 2) Placing the newborn in an open crib 3) Preparing the newborn for phototherapy 4) Preparing the newborn for a bottle feeding

1) Placing the newborn on a radiant warmer

The emergency department nurse admits an infant who experienced an apparent life-threatening event. When reviewing the patient's history, the nurse recognizes which factors as potential risks? (Select all that apply.) 1) Premature birth 2) Male gender 3) History of reflux 4) Lower socioeconomic class 5) History of seizure disorder

1) Premature birth 2) Male gender 3) History of reflux 5) History of seizure disorder

The school nurse is developing an action plan for a child with asthma. Which are goals for the action plan? (Select all that apply.) 1) Promote adequate oxygenation 2) Increase the size of the airway 3) Facilitate secretion removal 4) Rapid administration of steroids 5) Reduce anxiety

1) Promote adequate oxygenation 2) Increase the size of the airway 3) Facilitate secretion removal 5) Reduce anxiety

Which type of play should the nurse encourage when providing age-appropriate care to a preschool-aged child? 1) Team 2) Parallel 3) Solitary 4) Associative

4 1 Team play is expected for the school-aged, not preschool-aged, child. 2 Parallel play is expected for the toddler, not the preschool-aged child. 3 Solitary play is expected for the infant, not the preschool-aged child. 4 Associative play should be encouraged when providing care to a preschool-aged child.

The nurse is caring for a 3-month-old who requires oxygen. The baby repeatedly removes the nasal cannula. Which is the nurse's best action? 1) Restraining the child's hands 2) Asking the mother to hold the oxygen 3) Applying a face mask 4) Applying an oxygen tent

4) Applying an oxygen tent4

Which is the correct hourly rate of IV fluid replacement for a child who weighs 25 kg?

67 mL/hr

The nurse is providing care to a toddler-aged patient who weighs 10 kg. What is the maximum number of kilocalories this child should receive each day? Record your answer as a whole number. ____________________

900 Feedback: The maximum number of kilocalories per day for a toddler-aged patient is 90 kcal/kg/day. For a toddler who is 10 kg, this means a maximum of 900 kcal per day.

A nurse is reviewing the night-shift patient assignments on the pediatric unit. Which assessment finding is concerning for possible child abuse?

A 10-month-old infant with scalp bruises.

The school nurse is reviewing the personal and family history of several students. The nurse correctly identifies which student as having the greatest risk for child abuse?

A child with Down syndrome who lives at home with other siblings.

a nurse is assessing a sven year old child's psycosocial development. which of the following findings should the nurse recognize as requiring further evaluation?

the child complains daily about going to school

a nurse is caring for a preschool age child who is dying. which of the following findings is an age appropriate reaction to death by the child

the child views death as similar to sleeping, the child bellies his thought can cause death, the child thinks death is a punishment

a nurse is caring for a 15 month old toddler who requires droplet precautions. which of the following actions should the nurse take?

wear a mask when assisting the toddler with meals

Which statement made by a parent indicates understanding of restrictions for a child after cardiac surgery? a. "My child needs to get extra rest for a few weeks." b. "My son is really looking forward to riding his bike next week." c. "I'm so glad we can attend religious services as a family this coming Sunday." d. "I am going to keep my child out of daycare for 6 weeks."

"I am going to keep my child out of daycare for 6 weeks." Settings where large groups of people are present should be avoided for 4 to 6 weeks after discharge, including day care.

According to Erikson, which person has the most influence over the adolescent? 1) Peers 2) Siblings 3) Parents 4) Teachers

1 1 Peers are highly influential during adolescence. 2 Peers, not siblings, are highly influential during adolescence. 3 Peers, not parents, are highly influential during adolescence. 4 Peers, not teachers, are highly influential during adolescence.

. The nurse measures respirations in a 4-year-old child and counts 16 respirations per minute. How will the nurse describe this rate? 1) Normal for age 2) Tachypnea 3) Bradypnea 4) Apnea

3) Bradypnea

32. The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy. The adolescent had a right above-the-knee amputation 2 months ago and has been experiencing "phantom limb pain." Which prescribed medication is appropriate to administer to relieve phantom limb pain? a. Amitriptyline (Elavil) b. Hydrocodone (Vicodin) c. Oxycodone (OxyContin) d. Alprazolam (Xanax)

ANS: A Amitriptyline (Elavil) has been used successfully to decrease phantom limb pain. Opioids such as Vicodin or OxyContin would not be prescribed for this pain. A benzodiazepine, Xanax, would not be prescribed for this type of pain.

An adolescent is brought to the emergency department after an automobile accident. When the nurse approaches the adolescent, he becomes combative. The nurse notes his speech is slurred and his gait is ataxic. What does the nurse suspect the adolescent has used? a. Alcohol b. Cocaine c. Amphetamines d. PCP

ANS: A Behavioral signs of alcohol ingestion include slurred speech, short attention span, drowsiness, combativeness, and violence.

4. Which can result from the bone demineralization associated with immobility? a. Osteoporosis b. Urinary retention c. Pooling of blood d. Susceptibility to infection

ANS: A Bone demineralization leads to a negative calcium balance, osteoporosis, pathologic fractures, extraosseous bone formation, and renal calculi. Urinary retention is secondary to the effect of immobilization on the urinary tract. Pooling of blood is a result of the cardiovascular effects of immobilization. Susceptibility to infection can result from the effects of immobilization on the respiratory and renal systems.

How would the nurse identify a member of the child guidance team who is a medical doctor with special training in psychoanalytic theory? a. Psychiatrist b. Psychoanalyst c. Psychologist d. Counselor

ANS: A The psychiatrist is a medical doctor; the psychoanalyst may be a medical doctor or a psychologist. The psychologist is not a medical doctor, and neither is the counselor.

When the nurse is collecting a nursing history, an adolescent states that she has tried speed. For what does the nurse recognize this as the street name? a. Barbiturates b. Cocaine c. Methamphetamine d. Marijuana

ANS: C "Speed" is the street name for methamphetamine.

What is an appropriate nursing intervention for a hospitalized child who is autistic? a. Place the child in a location where she can watch all of the activity on the unit. b. Use the child's chronological age as a guide for communication. c. Keep the child's room free of toys or objects that she might want to take home with her. d. Organize care to provide as few disruptions to the routine as possible.

ANS: D During hospitalization, the nurse should provide a highly structured environment with few distractions for a child who is autistic.

The nurse is caring for a child who presents with multiple bruises in various stages of healing. Which action by the nurse is most appropriate?

Allow the child to describe how the bruises occurred.

Which defect results in increased pulmonary blood flow? a. Pulmonic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries

Atrial septal defect . The atrial septal defect results in increased pulmonary blood flow. Blood flows from the left atrium (higher pressure) into the right atrium (lower pressure) and then to the lungs via the pulmonary artery.

Which laboratory test should the nurse prepare to draw when admitting a pediatric patient with possible obstructive uropathy?

Blood urea nitrogen (BUN)

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders? a) Eosinophils b) Monocytes c) Neutrophils d) Lymphocytes

Eosinophils Eosinophils function to combat allergic disorders and parasitic infestations. Neutrophils function to combat bacterial infections. Lymphocytes function to combat viral infections. Monocytes function to combat severe infections.

Greg, age 2.5 years, was admitted to the pediatric unit yesterday. His parents are making plans to visit as often as possible during his hospitalization. Greg's parents complain to the nurse that the child " cries, screams, and throws himself" whenever they leave the hospital to eat. The nurse should do which of the following? a. Explain that his behavior is a normal response to hospitalization b. Explain that his behavior will diminish in a few days c. Encourage the parents not to leave the child's room d. Encourage the parents to leave when the child is asleep

Explain that his behavior is a normal response to hospitalization

Nursing care for the child in congestive heart failure includes a. Counting the number of saturated diapers b. Putting the infant in the Trendelenburg position c. Removing oxygen while the infant is crying d. Organizing care to provide rest periods

Organizing care to provide rest periods Nursing care should be planned to allow for periods of undisturbed rest.

Which of the following begins as an upper respiratory illness and progresses to a persistent cough characterized by an inspiratory whoop? a) TB b) Sepsis c) HIV d) Pertussis

Pertussis Pertussis, also known as whooping cough, begins as an upper respiratory illness and progresses to a persistent cough characterized by an inspiratory whoop. TB is not characterized by an inspiratory whoop. Sepsis and HIV are not associated with an inspiratory whoop.

The nurse is caring for an infant who is diagnosed with a UTI. Which symptom does the nurse anticipate when assessing this infant?

Poor feeding

Which CHD results in increased pulmonary blood flow? a. Ventricular septal defect b. Coarctation of the aorta c. Tetralogy of Fallot d. Pulmonary stenosis

Ventricular septal defect Ventricular septal defect causes a left-to-right shunting of blood, thus increasing pulmonary blood flow. .

A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about the pattern of inheritance for inborn errors of metabolism? a. They are usually autosomal recessive. b. They are usually autosomal dominant. c. They are usually X-linked recessive. d. They are usually multifactorial

a. They are usually autosomal recessive.

Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus? a. Control intake of carbohydrates and consume fewer calories. b. Focus on complex carbohydrates and eat foods high in fiber. c. Obtain most calories from proteins and fats. d. Eat a diet low in fat and low in complex carbohydrates.

b. Focus on complex carbohydrates and eat foods high in fiber.

A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse? a. Notify the charge nurse. b. Give the patient a snack of graham crackers and milk. c. Ambulate the patient in the hall for a short time. d. Give the patient more insulin according to the sliding scale.

b. Give the patient a snack of graham crackers and milk.

What occurs as a result of an inadequate secretion of insulin? a. Protein synthesis is increased. b. Increased fat breakdown leads to ketonemia. c. Serum glucose levels are markedly decreased. d. More rapid conversion and storage of carbohydrates to glucose occurs.

b. Increased fat breakdown leads to ketonemia.

What is the function of an insulin pump? a. Releases insulin as blood glucose rises b. Provides continuous infusion of insulin c. Decreases need for painful glucose monitoring d. Delivers a prescribed amount of insulin twice a day

b. Provides continuous infusion of insulin

The parents of a child newly diagnosed with diabetes mellitus tell the nurse, "Our son's body is resistant to insulin." With what does the nurse recognize this description is consistent? a. Type 1, insulin-dependent diabetes mellitus b. Type 2, non-insulin-dependent diabetes mellitus c. Maturity-onset diabetes of youth d. Drug-induced diabetes

b. Type 2, non-insulin-dependent diabetes mellitus

Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the child is complaining of hunger and thirst and is drowsy at 10:30 AM. What should the nurse do first? a. Walk the patient in the hall for 10 minutes. b. Allow the patient a short nap. c. Give her a cup of orange juice. d. Test her blood with a glucometer and give insulin according to the sliding scale

c. Give her a cup of orange juice.

What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid) correctly? a. "I stopped giving the medication because my daughter was losing her hair." b. "I am using a different brand now because it costs less money." c. "I don't give the medication on the weekends." d. "I give the medication at 8:00 AM every day."

d. "I give the medication at 8:00 AM every day."

a nurse in the emergency department is caring for a 12 year old child who has ingested bleach. which of the following statements by the nurse indicates an understanding of this ingestion?

immediate administration of activated charcoal is warranted

a nurse is assessing a three year old child who is 1 day postoperative following a tonsillectomy. which of the following methods should the nurse use to determine if the child is experiencing pain?

use the FACES scale

a nurse is planning to collect a specimen form the male infant using a urine collection bag. which of the following actions should the nurse take?

wash and dry the infant's genitalia and perineum thoroughly.

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is which of the following? a) Acyclovir b) Penicillin c) Griseofluvin d) Rocephin

Acyclovir The drug acyclovir (zovirax) is useful in relieving or suppressing the symptoms of genital herpes

Which postoperative intervention should be questioned for a child after a cardiac catheterization? a. Continue intravenous (IV) fluids until the infant is tolerating oral fluids. b. Check the dressing for bleeding. c. Assess peripheral circulation on the affected extremity. d. Keep the affected leg flexed and elevated.

. Keep the affected leg flexed and elevated. The child should be positioned with the affected leg straight for 4 to 6 hours after the procedure.

Which finding may be associated with child neglect?

A child attends school dressed in dirty clothes.

What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well? a. Recheck the infant's blood pressure. b. Alert the physician. c. Withhold oral feeding. d. Increase the oxygen rate.

Alert the physician. These are signs of early congestive heart failure, and the physician should be notified.

An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension. On further testing, it is discovered the child has a cardiac abnormality. The initial treatment of secondary hypertension initially involves a. Weight control and diet b. Treating the underlying disease c. Administration of digoxin d. Administration of beta-adrenergic receptor blockers

Treating the underlying disease Identification of the underlying disease should be the first step in treating secondary hypertension. .

In which situation is there a risk that a newborn infant will have a congenital heart defect (CHD)? a. Trisomy 21 detected on amniocentesis b. Family history of myocardial infarction c. Father has type 1 diabetes mellitus d. Older sibling born with Turner syndrome

Trisomy 21 detected on amniocentesis A The incidence of congenital heart disease is approximately 50% in children with trisomy 21 (Down syndrome).

A child with diabetes mellitus is observed to have cold symptoms. What signs and symptoms will alert parents of the possibility of ketoacidosis? (Select all that apply.) a. Chest congestion b. Ear pain c. Fruity breath d. Hyperactivity e. Nausea

c. Fruity breath e. Nausea

The nurse is evaluating the understanding a hospitalized child with a history of abuse who is awaiting placement into a foster home. Which statement by the child would be a concern for the nurse and requires further follow-up?

"If I am good, I can go back home."

How can the experienced nurse best explain factitious disorder by proxy to a student nurse?

"It occurs when parents falsify illness in their child, yet there are no significant findings upon work-up."

A neonate is brought to the emergency department by her mother because she "just doesn't look right." The neonate is suspected of having sepsis. Which statement by the mother would help to confirm this suspicion? a) "She seems to be breathing a little fast." b) "Her cry seems to be pretty strong." c) "She hasn't had a fever." d) "My water broke quite a while before I actually delivered her."

"My water broke quite a while before I actually delivered her." Prolonged or premature rupture of membranes increases a neonate's risk for sepsis. A weak cry or lack of smile or facial expression may be present with sepsis. A significant increase in breathing rate (tachypnea) or increased work of breathing evidenced by nasal flaring, grunting, and a retraction is noted with sepsis. Neonates with sepsis do not have a fever. In fact, they may have below-normal temperature.

The nurse is providing information to new parents about infant abusive head trauma. Based on known causes of abusive head trauma, which information should the nurse provide to the parents to help prevent abusive head trauma in the infant?

"Place the infant in a safe place if you become frustrated by crying."

The nurse is caring for a 6-year-old boy with mumps. Which of the following statements by the child would cause the nurse to suspect the boy is experiencing a complication of mumps? a) "My knees are sore and stiff." b) "I keep coughing up mucus." c) "Please talk a little louder." d) "I feel wobbly when I walk."

"Please talk a little louder." Complications of mumps include meningoencephalitis with seizures and auditory neuritis, which can result in deafness. Joint complaints, which might suggest arthritis, are a complication of erythema infectiosum. Difficulty walking, which might suggest cerebellar ataxia, is a complication of chickenpox. Coughing, which might suggest bronchopneumonia, is a complication of rubeola.

The nurse educator teaches a group of nursing students about the anatomy and physiology of the kidneys. Which statement made by a student indicates an appropriate understanding of the information presented?

"The blood supply of the kidney is through a single renal artery that comes from each side of the aorta, one to each kidney."

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which of the following statements would be the most appropriate statement for the nurse to make to this mother? a) "Infants are unable to develop antibodies to protect them from diseases so they must be immunized." b) "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." c) "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." d) "The immunities that the infant is born with are not for the same diseases they will be immunized against."

"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." During fetal life, the mother's antibodies cross the placenta, giving the fetus a temporary immunity against certain diseases. This immunity is present at birth and decreases during the first year of life. In the meantime, the infant begins developing antibodies to fight against pathogens and disease. In addition, during the first year of life immunizations are started to help the infant develop protection against certain diseases. (less)

The nurse is providing care to a 4-year-old patient who is experiencing nocturnal incontinence. Which parental statement indicates the need for further education?

"We should limit fluids after lunchtime"

A group of grade-school children is going camping. As a school nurse, you would offer them which advice to prevent Lyme disease? a) "Don't approach strange animals outside the campsite." b) "Don't drink water from mountain streams while hiking." c) "Don't touch any bush without knowing what kind it is." d) "Wear jeans tucked inside your socks when in the woods."

"Wear jeans tucked inside your socks when in the woods." Lyme disease is prevented by measures to reduce the possibility of tick bites.

What are some nursing interventions to help a child in isolation better understand isolation?

* "dress up" with the gowns, gloves and mask * explain that only " special" people can come inside * explain that they are in a special room that will help them feel better

Protest, Despair or Detachment: _________= Crying stops; evidence of depression; withdrawn _________ = Resignation but not contentment; superficial adjustment _________ = Crying and screaming; clinging to the parent

* Despair-Crying stops; evidence of depression; withdrawn * Detachment-Resignation but not contentment; superficial adjustment * Protest-Crying and screaming; clinging to the parent

What are 2 ways that a nurse can alter the perception of a child who is upset about his or her illness?

* Provide a somewhat different and less negative account of the disease * Offer an explanation that is characteristic of the next stage of cognitive development ** Explain that although germs can make your throat sore again, they can never make your tonsils sick again ; following a tonsillectomy.

What are 3 nursing interventions to accomplish the nursing goal, " Child will experience positive relationships."

* Select a compatible roommate * Allow playtime with similar children ( age, disability, etc. ) * Promote therapeutic relationships between the child and the health care team

What are 3 nursing interventions that can be used to help children resume school activities while hospitalized?

* encourage them to resume school work as soon as possible * help them schedule study time * help the family coordinate hospital educational services with their child's school

The nurse is caring for a 4-year-old child admitted to the pediatric unit. During the assessment, the nurse notes extensive bruising to the torso, but the assessment is otherwise normal. The parents report the child does not listen well and fell while riding a bicycle. Which nursing actions are most appropriate?

-Ask the child about the injury when they are not in the parent's presence. -Ask the parents which safety equipment the child wears while riding a bicycle.

The nurse is caring for a 4-month-old infant who is admitted to the hospital for failure to thrive. Which other findings are consistent with child neglect?

-Immunizations are not up to date. -Mother does not respond to infant's cries. -Weight gain is below that expected for age.

The nurse is caring for a 3-year-old child admitted for a fractured arm. Which findings would cause the nurse to suspect the child is being abused?

-The child appears small for age. -Radiograph that reveals a healing femur fracture. -An assessment that reveals bruising on the forearm.

Which activity is easier for a school-aged child because of changes in proportions from the preschool stage of development? 1) Climbing 2) Handwriting 3) Problem-solving 4) Cooperative play

1 1 Activities such as bike riding, skateboarding, in-line skating, skiing, and climbing become more comfortable and much easier during the school-aged stage of development. 2 Handwriting is an activity that is still developing during this stage of development. 3 Problem-solving is an activity that is still developing during this stage of development. 4 Although cooperative play is an expectation during this stage of development, this is not due to changes in proportions that occur during the school-aged years.

The nurse is preparing to assess a preschool-aged child who states, "This is Bella, my bear. People tell me that they can't hear Bella talking, but that hurts her feelings and makes her cry." When documenting this interaction in the child's medical record, which term should the nurse use? 1) Animism 2) Seriation 3) Conservation 4) Object permanence

1 1 Animism, a characteristic of preconceptual thinking, is documented for the preschool-aged patient who believes that inanimate objects are alive. 2 The nurse should not document seriation given this scenario. 3 The nurse should not document conservation given this scenario. 4 The nurse should not document object permanence given this scenario.

The parent of a toddler states, "My child wants to do everything by herself." Which term should the nurse use to describe this behavior in the medical record? 1) Autonomy 2) Egocentric 3) Negativism 4) Temperament

1 1 Autonomy is defined as being self-governing. A toddler-aged child is exhibiting autonomy by wanting to do everything by herself. 2 Egocentric, or not being able to process the views of others, is a common trait during the toddler stage of development. However, this is not the best term to use to describe this situation in the medical record. 3 Negativism, or the tendency to be negative with attitude, is a common trait for the toddler that is manifested by the word no. 4 Temperament is the mental, physical, and emotional traits of the child. This is not the best term to use to describe this situation in the medical record.

On the basis of a child's complaint of abdominal pain, the nurse suspects a Wilms' tumor. An abdominal mass associated with a Wilms' tumor will be detected in which location? 1) On one side 2) On the front side 3) On both the left and right sides 4) On all sides of the abdomen

1 1 Children with a Wilms' tumor present with an abdominal mass that is usually painless. The mass frequently presents on one side and seldom crosses the midline as does a neuroblastoma. 2 This is not an accurate presentation of a Wilms' tumor. 3 This is not an accurate presentation of a Wilms' tumor. 4 This is not an accurate presentation of a Wilms' tumor.

Which action should the nurse include when providing education regarding methods to enhance health promotion during a scheduled health maintenance visit for a 4-year-old child? 1) Recognizing that food jags are common 2) Mentioning the importance of foods high in sodium 3) Encouraging the use of a high chair with a safety strap 4) Recommending that the child consume high-fat foods

1 1 Food jags may still occur during the preschool-age stage of development, which can affect the child's nutritional intake; therefore, the nurse should include this information in the educational session. 2 Salt should be limited and not encouraged for the preschool-aged child. 3 A high chair with a safety strap is appropriate to include in the teaching session for an infant or toddler, not a preschool-aged child. 4 High-fat foods should be consumed in moderation.

Which nursing action is appropriate when treating a school-aged child diagnosed with hemophilia for a superficial wound above the knee? 1) Applying pressure to the area 2) Applying a warm, moist pack to the area 3) Performing some passive range of motion to the affected leg 4) Keeping the affected extremity in a dependent position

1 1 If a child with hemophilia experiences a bleeding episode, superficial bleeding should be controlled by applying pressure to the wound. 2 Heat increases the bleeding by dilating the superficial blood vessels. A cool compress should be applied. 3 The extremity should be immobilized to prevent further bleeding; passive range of motion could cause further bleeding at the site. 4 The extremity should be elevated if possible to prevent swelling at the site.

Which should the nurse keep in mind when providing care to an adolescent patient during the initial health maintenance visit at the provider's office? 1) The importance of explaining procedures and introducing personnel to adolescents 2) Many adolescents are quiet and will offer no opinions. 3) The importance of attending to and discharging the adolescent quickly 4) Many adolescents are comfortable with their surroundings.

1 1 In order to gain the trust of an adolescent, it is important for the nurse to explain each procedure and to introduce the personnel who will be working with the adolescent prior to the actual examination process. 2 Adolescent patients have strong opinions. 3 It is important for the nurse to spend time with the adolescent in order to gain his or her trust. 4 Adolescence is a time of tumultuous feelings; therefore, many are not comfortable with their surroundings.

A hematologist diagnoses a school-aged child with thrombocytopenia. When educating the parents of the child about this condition, which description of the disease does the nurse include? 1) A decrease in platelets 2) An increase in red blood cells 3) A decrease in white blood cells 4) An increase in platelets

1 1 Thrombocytopenia is a decrease in platelets. 2 Polycythemia is an increase in RBCs. 3 Leukopenia is a decrease in WBCs. 4 Thrombocytosis is an increase in platelets.

Which nursing action is appropriate when assisting with the assessment of a toddler-aged patient who is diagnosed with a communicable disease? 1) Asking the parents if the child has been exposed to anyone who has been sick 2) Determining if the child has received the human papillomavirus (HPV) vaccine 3) Establishing if the mother was exposed to any sexually transmitted infections (STIs) during pregnancy 4) Monitoring for any musculoskeletal abnormalities

1 1 It is important to determine if the toddler-aged patient who presents with symptoms of an infectious disease process has been exposed to anyone who has recently been ill. 2 The Centers for Disease Control and Prevention (CDC) does not recommend that the toddler-aged patient be immunized with HPV; therefore, this is not an appropriate action by the nurse. 3 Although exposure to STIs during pregnancy can expose the newborn to infectious diseases, this topic is not applicable when assessing the toddler-aged patient with an infectious disease. 4 The nurse should closely assess the child's skin and respiratory systems, but not the musculoskeletal system.

Which is a priority teaching point regarding nutrition for the toddler-aged child? 1) Limiting milk consumption 2) Offering water with each meal 3) Offering the child finger foods only 4) Emphasizing the need for two snacks per day

1 1 Milk consumption should be limited to no more than 24 to 32 ounces per day. Milk consumption greatly reduces the toddler's consumption of other sources of vitamins and proteins. 2 Although offering water with meals is appropriate, this is not the priority teaching point. 3 Although offering finger foods enhances autonomy, the toddler-aged child should be offered the same foods that other members of the family are eating during mealtimes. 4 The toddler should consume three meals per day with three snacks per day in order to take in adequate calories without drops in blood glucose.

Which physical change noted by the nurse during a growth and developmental assessment for a 7-year-old patient necessitates further action? 1) Pubescent changes 2) Weight gain of 4 lb (2 kg) per year 3) Eruption of central incisors 4) Height increase of 1 to 2 feet (30 to 60 cm) during the entire period

1 1 Pubescent changes are not anticipated until the age of 8 years. 2 This weight gain is within normal limits for the school-aged patient. 3 Eruption of central incisors is anticipated during the school-aged years. 4 This is an expected finding for the school-aged patient during this stage of development.

Which type of relationship is most important to the school-aged child? 1) Same-sex peer relationship 2) Opposite-sex peer relationship 3) Same-sex parental relationship 4) Opposite-sex parental relationship

1 1 Same-sex peer relationships are most important for the school-aged child. 2 Same-sex, not opposite-sex, peer relationships are most important for the school-aged child. 3 Although the same-sex parental relationship is still important, the peer relationship is most important to the school-aged child. 4 Although the opposite-sex parental relationship is still important, the peer relationship is most important to the school-aged child.

The pediatric nurse explains to a parent that his child's sarcoma arises from which type of tissue? 1) Connective 2) Epithelial 3) Lymphatic 4) Glandular

1 1 Sarcomas arrive from connective or supporting tissue such as bone or muscle. 2 Carcinomas are cancers that arise from the body's glandular cells and epithelial cells. 3 Lymphomas are cancers of the lymphoid organs such as the lymph nodes, spleen, and thymus, which produce and store infection-fighting cells. 4 Carcinomas are cancers that arise from the body's glandular cells and epithelial cells.

Which should the nurse recommend to the parents of a toddler who is exhibiting tantrums? 1) Ignoring the child's behavior 2) Locking the child in the bedroom 3) Swatting the child on the backside 4) Giving in to the demands of the child

1 1 The nurse should recommend that the parents ignore the toddler's behavior during a tantrum; however, safety should also be ensured. 2 Locking the child in the bedroom without supervision is a safety risk. 3 Swatting the child on the backside is not a recommended response to a child who is exhibiting a tantrum. 4 Giving in to the demands of the child will encourage the behavior to continue.

The school nurse is performing annual height and weight screenings. The nurse notes that three adolescent girls who are close friends have each lost 15 pounds over the past year. Which is the priority nursing action? 1) Obtaining a nutritional history for each of these adolescents 2) Referring these adolescents to the school psychologist 3) Calling the respective parents to discuss the eating pattern of each adolescent 4) Speaking with the adolescents in a group to discuss the problems associated with anorexia nervosa

1 1 The priority action by the nurse is to obtain a nutritional history for each adolescent in order to assess the weight loss. 2 Although the adolescents may require a referral to the school psychologist, this is not the priority action by the nurse. 3 Although the nurse many need to discuss the adolescents' eating patterns with the respective parents, this is not the priority. 4 If anorexia nervosa is suspected, the nurse should speak to each adolescent privately.

Which growth and developmental change indicates increased maturity during the school-aged stage of development? 1) An increase in leg length in relation to height 2) A decreased head circumference in relation to standing height 3) The face growing faster in relation to the remainder of the cranium 4) Little increase in the size of the skull and the brain, which grow very slowly

1 1 The school-aged child experiences an increase in leg length in relation to height. 2 The school-aged child does not experience a decrease in head circumference in relation to standing height. 3 The school-aged child's face does not grow faster in relation to the remainder of the cranium. 4 The skull and the brain have significant growth during the school-aged stage of development.

A mother reports that her adolescent daughter is always late. The mother states, "She was born late and has been late every day of her life." Which response by the nurse is appropriate? 1) "Setting specific alarms and then reinforcing the value of being 'on time' may be helpful strategies." 2) "Just let it go for now. Teachers and employers are the best people to help her be on time." 3) "You need to establish specific time frames for your adolescent and be certain she adheres to them." 4) "You have a major problem. There must be a lot of screaming in your home."

1 1 This suggestion assists both the parent and the adolescent; therefore, it is an appropriate response by the nurse. 2 Telling the parent to let it go does not address the mother's concern. 3 This response places responsibility on the mother rather than the adolescent. 4 This response is not therapeutic and does not address the mother's concern.

The nurse reinforces teaching for a parent whose child has been diagnosed with croup. Which statement by the parent indicates the need for further teaching? 1) "I will keep his bedroom nice and warm to prevent coughing." 2) "I will put a cool mist humidifier next to his bed." 3) "If his croupy cough gets worse, I will take him outside." 4) "I'll make some Popsicles to encourage him to take in more fluids."

1) "I will keep his bedroom nice and warm to prevent coughing."

A pediatric nurse discusses with the parents medications prescribed for a school-aged child who is diagnosed with Crohn's disease. Which are usual pharmacological options for treatment? 1) Antidiarrheal drugs 2) Antianxiety drugs 3) Diuretic drugs 4) Cardiac drugs

1) Antidiarrheal drugs

A neonate is born with a bilateral cleft lip that was not detected during the pregnancy. The parents are distressed about the appearance of their infant. Which nursing actions are appropriate to assist the parents in bonding with their newborn? (Select all that apply.) 1) Calling the newborn by the chosen name 2) Keeping the newborn's lower face covered with a blanket 3) Smiling and talking to the newborn in the parents' presence 4) Showing the parents before and after pictures of other children with cleft lips 5) Discussing positive features of the baby

1) Calling the newborn by the chosen name 3) Smiling and talking to the newborn in the parents' presence 4) Showing the parents before and after pictures of other children with cleft lips 5) Discussing positive features of the baby

A pediatric nurse examines the abdomen of a preschool-aged child brought to the doctor's office by the grandmother because of vomiting over the last several days. Upon inspection, the nurse observes that the child's stomach is distended. On the basis of these data, which condition does the nurse suspect? 1) Intestinal obstruction 2) Kidney failure 3) Displaced abdominal organs 4) Omphalitis

1) Intestinal obstruction

The pediatric nurse is interpreting laboratory values for a patient suspected of having ulcerative colitis. Which finding does the nurse anticipate on the basis of the diagnosis? 1) Microcytic anemia 2) Decreased sedimentation rate 3) Decreased white blood cell count 4) Protein in the urine

1) Microcytic anemia

Which order will the nurse anticipate for a child suspected of having bronchiolitis in order to confirm the diagnosis? 1) Nasal swab 2) Pulse oximeter 3) Cardiorespiratory monitor 4) Oxygen at 2 L per minute via nasal cannula

1) Nasal swab

The pediatric nurse understands how each developmental stage contributes to the promotion of the health of the child. Which is a normal developmental attribute of the digestive system of the infant? 1) The infant has a built-in safeguard to prevent choking while swallowing and sucking. 2) The passage from mouth to pharynx is larger to allow more liquid to be swallowed. 3) The infant's stomach usually empties in 5 to 6 hours, necessitating frequent feedings. 4) The liver and pancreas are not mature until 12 months, which limits solid food intake.

1) The infant has a built-in safeguard to prevent choking while swallowing and sucking.

Which push-pull toys should the nurse recommend for play when providing education to the parents of a toddler-aged patient? (Select all that apply.) 1) Child grocery carts 2) Large trucks or cars 3) Soft foam balls 4) Soft mats 5) Safety noodles

1,2 1. This is correct. A child grocery cart is an appropriate push-pull toy for the nurse to recommend to the parents of a toddler-aged patient. 2. This is correct. A large truck or car is an appropriate push-pull toy for the nurse to recommend to the parents of a toddler-aged patient. 3. This is incorrect. Although a soft foam ball is an appropriate toy for a toddler, it is used for throwing and catching and not for pushing and pulling. 4. This is incorrect. Although a soft mat is an appropriate toy for a toddler, it is used for rocking and rolling and not for pushing and pulling. 5. This is incorrect. Although safety noodles are appropriate for swimming, this is not an example of a pushing-and-pulling toy.

Which screenings are appropriate for an adolescent who admits to being sexually active during a scheduled health maintenance visit? (Select all that apply.) 1) Herpes simplex virus 2) Gonorrhea 3) Chlamydia 4) Impetigo 5) Mononucleosis

1,2,3 1. This is correct. Herpes simplex virus is a sexually transmitted infection (STI) that is appropriate to include in the screening for an adolescent who is sexually active. 2. This is correct. Gonorrhea is an STI that is appropriate to include in the screening for an adolescent who is sexually active. 3. This is correct. Chlamydia is an STI that is appropriate to include in the screening for an adolescent who is sexually active. 4. This is incorrect. Impetigo is not sexually transmitted. 5. This is incorrect. Mononucleosis is not sexually transmitted.

Which health screenings should the nurse include during a scheduled health maintenance visit for a preschool-aged patient? (Select all that apply.) 1) Vision 2) Obesity 3) Lead 4) Asthma 5) Platelets

1,2,3 1. This is correct. Vision is a screening that should be included during a scheduled health maintenance visit. 2. This is correct. Obesity is a screening that should be included during a scheduled health maintenance visit. 3. This is correct. Lead is a screening that should be included during a scheduled health maintenance visit. 4. This is incorrect. Asthma is not a screening that should be included during a scheduled health maintenance visit. 5. This is incorrect. Hemoglobin and hematocrit, not platelets, are screenings that should be included during a scheduled health maintenance visit.

According to Piaget, which data does the nurse expect for a school-aged child during the nursing assessment process? (Select all that apply.) 1) Classifying objects 2) Understanding reversibility 3) Having theoretical thoughts 4) Describing a process without actually doing it 5) Believing personal actions are constantly being scrutinized

1,2,4 1. This is correct. According to Piaget, classifying objects is expected for the school-aged child. 2. This is correct. According to Piaget, understanding reversibility is expected for the school-aged child. 3. This is incorrect. Having theoretical thoughts is not anticipated for the school-aged child. 4. This is correct. According to Piaget, describing a process without actually doing it is expected for the school-aged child. 5. This is incorrect. Believing that personal actions are constantly being scrutinized is not anticipated for the school-aged child.

Which recommendations does the nurse make to the parents of a preschool-aged child who is experiencing frequent nightmares? (Select all that apply.) 1) Reassure the child by back rubbing 2) Repeat a nighttime routine, such as reading a story 3) Bring the child to the parental bed 4) Allow the child time to settle back into sleep 5) Place a television in the child's room for distraction

1,2,4 1. This is correct. Reassuring the child by rubbing his or her back is an appropriate recommendation from the nurse. 2. This is correct. Repeating a nighttime ritual, such as reading a story, is an appropriate recommendation from the nurse. 3. This is incorrect. Bringing the child to the parental bed is not an appropriate recommendation because the child may continue this behavior. 4. This is correct. Allowing the child time to settle back into sleep is an appropriate recommendation from the nurse. 5. This is incorrect. Placing a television in the child's room for distraction may cause overstimulation and increase the occurrence of nightmares.

Which difficulties faced by an adolescent are attributed to normal development? (Select all that apply.) 1) Risk-taking 2) Rebelliousness 3) Peer socialization 4) Lack of cooperation 5) Hostility toward authority

1,2,4,5 1. This is correct. Risk-taking is an adolescent difficulty attributed to normal development. 2. This is correct. Rebelliousness is an adolescent difficulty attributed to normal development. 3. This is incorrect. Peer relationships, while important, are not an adolescent difficulty. 4. This is correct. Lack of cooperation is an adolescent difficulty attributed to normal development. 5. This is correct. Hostility toward authority is an adolescent difficulty attributed to normal development.

Which information related to school-aged play should the nurse include in a teaching session for the parents of children in this stage of development? (Select all that apply.) 1) Team play 2) Card games 3) Parallel play 4) Board games 5) Club membership

1,2,4,5 1. This is correct. Team play is an appropriate topic to include in a teaching session regarding school-aged play. 2. This is correct. Card games are an appropriate topic to include in a teaching session regarding school-aged play. 3. This is incorrect. Parallel play is more appropriate for the toddler and young preschool-aged child, not the school-aged child. 4. This is correct. Board games are an appropriate topic to include in a teaching session regarding school-aged play. 5. This is correct. Club membership is an appropriate topic to include in a teaching session regarding school-aged play.

Which should be included in the anticipatory guidance for high-risk behaviors provided to adolescents and their parents during a health maintenance visit? (Select all that apply.) 1) Alcohol use 2) Tobacco use 3) Sexual preference 4) College application process 5) Motor vehicle accidents

1,2,5 1. This is correct. Alcohol use is a high-risk behavior that is included in anticipatory guidance. 2. This is correct. Tobacco use is a high-risk behavior that is included in anticipatory guidance. 3. This is incorrect. Although unsafe sexual practices are considered high-risk behaviors, sexual preference is not. 4. This is incorrect. The college application process is not a high-risk behavior requiring anticipatory guidance. 5. This is correct. Motor vehicle accidents are high-risk behaviors that are included in anticipatory guidance.

Which questions related to socialization should the nurse include when assisting with the assessment of a school-aged child who is new to the pediatric practice? (Select all that apply.) 1) "What grade are you currently attending?" 2) "At what age did your child cut the first tooth?" 3) "Do you have a best friend at your new school?" 4) "What was your child's approximate length at 1 year of age?" 5) "What was your child's approximate weight at 6 months and at 1, 2, and 5 years of age?"

1,3 1. This is correct. When assessing the school-aged patient's socialization, the nurse should ask which grade he or she is currently attending. 2. This is incorrect. Asking when a school-aged child cut the first tooth is not appropriate when assessing socialization. 3. This is correct. When assessing the school-aged patient's socialization, the nurse should ask if he or she has a best friend. 4. This is incorrect. Asking about the child's approximate length at 1 year of age is not appropriate when assessing socialization. 5. This is incorrect. Asking about the child's approximate weight throughout the stages of development is not appropriate when assessing socialization.

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? (Select all that apply.) 1) Infection 2) Polycythemia 3) Petechiae 4) Pain 5) Cachexia

1,3,4,5 1. This is correct. Infection is often a general manifestation associated with cancer caused by altered immune function. 2. This is incorrect. Anemia, not polycythemia, is a general manifestation associated with cancer. 3. This is correct. Hemorrhagic spots, or petechiae, are general manifestations associated with cancer. 4. This is correct. Pain is often a general manifestation of cancer resulting from neoplasms directly or indirectly affecting nerve receptors. 5. This is correct. Cachexia is a state that is often associated with cancer. Specific symptoms include anorexia, nausea, and vomiting.

According to Erikson, which should the nurse anticipate when assessing a school-aged child? (Select all that apply.) 1) Being engaged in tasks 2) Questioning sexual identity 3) Having highly imaginative thoughts 4) Wanting to participate in organized activities 5) Struggling with self-control and independence

1,4 1. This is correct. According to Erikson, the school-aged child should be engaged in tasks. 2. This is incorrect. According to Erikson, the school-aged child should not question sexual identity. 3. This is incorrect. According to Erikson, the school-aged child should not have highly imaginative thoughts. 4. This is correct. According to Erikson, the school-aged child should want to participate in organized activities. 5. This is incorrect. According to Erikson, the school-aged child should not struggle with self-control and independence.

Which statements should the nurse include in an educational session for a preschool-aged patient diagnosed with enuresis? (Select all that apply.) 1) "Bed-wetting might occur because of anxiety." 2) "A diagnosis of enuresis occurs when bed-wetting occurs nightly." 3) "Girls are more likely to experience bed-wetting than boys." 4) "Bed-wetting can alter a child's social experiences." 5) "Nightmares are often associated with bed-wetting."

1,4,5 1. This is correct. Bed-wetting might occur because of anxiety; therefore, this statement is appropriate to include in an educational setting. 2. This is incorrect. Enuresis is diagnosed with two bed-wetting episodes in a 3-month period. 3. This is incorrect. Boys, not girls, are more prone to bed-wetting. 4. This is correct. Bed-wetting can alter a child's social experiences. 5. This in correct. Nightmares, especially with the preschool-aged patient, are often associated with bed-wetting.

The nurse explains that the diagnosis of diabetes is made when the fasting blood glucose level is _______ mg/dL on two separate occasions, and the history is positive for indication of the disease.

126

A child is diagnosed with early disseminated Lyme disease. The nurse informs the parents the child will most likely receive antibiotic therapy for which length of time? a) 10 to 14 days b) 14 to 18 days c) 7 to 10 days d) 14 to 28 days

14 to 28 days For early disseminated or late Lyme disease, intravenous penicillin or ceftriaxone is used for 14 to 28 days. Early Lyme disease is treated for 14 to 21 days; treatment for Rocky Mountain Spotted Fever is usually 7 to 10 days.

The nurse is preparing to administer a blood transfusion to a child with severe anemia. Which type of transfusion reaction can be avoided by the nurse's assessment? 1) Allergic 2) Hemolytic 3) Febrile 4) Septic

2 1 Allergic reactions are due to a protein in the donated blood to which the child reacts. The nurse cannot prevent this type of reaction. 2 A hemolytic reaction results from mismatched blood, a preventable error. This error is most likely to occur at the bedside if the nurse does not carefully identify the unit of blood and the patient. 3 A febrile reaction is related to contamination of blood. The nurse has no control over this type of reaction. 4 Septic is another name for a febrile reaction and is not preventable by the nurse.

During a health maintenance visit, an adolescent says, "I have no friends in my new school, and I no longer want to go to college. I know I will be lonely there, too." Which priority screening should the nurse implement? 1) Substance abuse 2) Depression 3) Anorexia nervosa 4) Pregnancy

2 1 Although substance abuse is often a required screening during adolescence, this is not the priority in this situation. 2 On the basis of the current situation, the nurse should address the adolescent's mental health by implementing a screening for depression. 3 Although anorexia nervosa is often a required screening during adolescence, this is not the priority in this situation. 4 Although pregnancy is often a required screening during adolescence, this is not the priority in this situation.

Which question allows the nurse to assess a preschool-aged child for delayed peer relationships? 1) "Can your child independently dress each day?" 2) "Does your child play with the other children in the playroom?" 3) "Has your child ever thought that asthma is a punishment?" 4) "Does your child become anxious before respiratory treatments?"

2 1 Asking if the child is able to independently dress does not assess for delayed peer relationships. 2 Associative play is anticipated for the preschool-aged patient; therefore, this question is appropriate to monitor for delayed peer relationships. 3 Asking if the child views asthma as a punishment does not assess for delayed peer relationships. 4 Asking if the child becomes anxious before respiratory treatments does not assess for delayed peer relationships.

Which is a psychological and developmental task of adolescence? 1) Being engaged in tasks 2) Forming a self-identity 3) Having highly imaginative thoughts 4) Wanting to participate in organized activities

2 1 Being engaged in tasks is not a psychological and developmental task of adolescence. 2 Forming a self-identity is a psychological and developmental task of adolescence. 3 Having highly imaginative thoughts is not a psychological and developmental task of adolescence. 4 Wanting to participate in organized activities is not a psychological and developmental task of adolescence.

Which psychosocial concern should the nurse monitor for when providing care to a school-aged child who is diagnosed with pediculosis? 1) Itching of the scalp 2) Feeling dirty 3) Applying medication appropriately 4) Educating the family on prevention

2 1 Itching of the scalp is a physiological, not a psychosocial, concern associated with pediculosis. 2 A school-aged child who is diagnosed with pediculosis may have several psychosocial concerns including feeling very bad, dirty, and sad. These are often due to teasing by other children with whom the patient is in contact. 3 Application of the medication is a physiological, not a psychosocial, concern associated with pediculosis. 4 Education related to prevention is a physiological, not a psychosocial, concern associated with pediculosis.

A pediatric nurse assesses the language skills of a preschool child. This nurse is assessing an aspect of which developmental domain? 1) Physical 2) Cognitive 3) Psychosocial 4) Moral/spiritual

2 1 Language skills are not included in a physical assessment. 2 Language skills are included during the cognitive assessment. 3 Language skills are not included in a psychosocial assessment. 4 Language skills are not included in a moral/spiritual assessment.

When talking to the parents of a school-aged cancer patient, the pediatric nurse identifies which as the most common cancer found in children? 1) Nasopharyngeal cancer 2) Acute lymphocytic leukemia 3) Chronic lymphocytic leukemia 4) Ewing sarcoma

2 1 Nasopharyngeal cancer is not the most common cancer found in children. 2 Acute lymphocytic leukemia (ALL) is the most common type of cancer in children. ALL accounts for 75% to 80% of all childhood leukemias and for approximately one-third of all childhood cancers. Approximately 2800 children are diagnosed with ALL in the United States annually. 3 Chronic lymphocytic leukemia is not the most common cancer found in children. 4 Ewing sarcoma is not the most common cancer found in children.

The nurse is planning to teach a group of adolescents about what can happen during unprotected sex. Which nursing action allows effective communication with the group? 1) Offering personal opinions on the topic 2) Allowing for discussion among the participants 3) Lecturing on the topic for the allotted time without any discussion 4) Discussing sex education related to religious belief

2 1 Offering personal opinions on any topic is not an appropriate nursing action when communicating with adolescent patients. 2 Adolescents should be allowed to engage in discussion with other participants, their peers, when teaching them about the consequences of unprotected sex. 3 Lecturing on a topic without discussion is not an appropriate nursing action when teaching the adolescent population about the consequences of unprotected sex. 4 Although religious beliefs can impact safer sex practices, the nurse should communicate with adolescents using facts when discussing the consequences of unprotected sex.

Which should the nurse identify as most important to social development during the toddler stage of development? 1) Peers 2) Siblings 3) Religious figures 4) Day-care providers

2 1 Peers become important for socialization during school age and adolescence. 2 Family members, including siblings, are most important to socialization during the toddler stage of development. 3 Religious figures may be important to moral development, not social development. 4 Day-care providers or teachers become important to socialization during the preschool and school-age years.

The parents of a toddler have not sought the recommended dental care for their child. Which type of abuse should the nurse identify in this situation? 1) Physical abuse 2) Physical neglect 3) Emotional abuse 4) Emotional neglect

2 1 Physical abuse is the act of hitting a child to produce harm. 2 Physical neglect occurs when a child's medical needs, such as dental visits, are not provided. 3 Emotional abuse includes constant belittling. 4 Emotional neglect occurs when a child's emotional needs are not attended to appropriately.

The pediatric nurse plans care for a child experiencing a sickle cell crisis. Which nursing intervention is appropriate for this patient? 1) Encouraging an increased amount of activity 2) Monitoring respiratory status and oxygenation 3) Using only nonpharmacological pain interventions to avoid an acute pulmonary event 4) Implementing fluid restrictions

2 1 Rest, not activity, should be encouraged for this patient. 2 Nursing care should focus on rest, hydration, pain control, and adequate oxygenation. Another critical assessment factor is the monitoring of respiratory status and oxygenation of sickle cell patients. The child with sickle cell crisis may be at risk for an acute pulmonary event, which may be a result of the disease and/or the use of opiates. 3 Pain control can be pharmacological and/or nonpharmacological; ideally, a combination of both is preferred. 4 The fluid requirement recommendations are one and one-half times above the child's normal calculated requirements.

Which deciduous teeth should the nurse anticipate the school-aged child will lose first? 1) Lateral incisors 2) Central incisors 3) Third molars 4) Second molars

2 1 The nurse should not anticipate that the school-aged child will lose the lateral incisors first. 2 The nurse should anticipate that the school-aged child will lose the central incisors first. 3 The nurse should not anticipate that the school-aged child will lose the third molars at all because these are adult teeth. 4 The nurse should not anticipate that the school-aged child will lose the second molars at all because these are adult teeth.

The nurse is assessing an adolescent patient to determine her relationships with others. Which nursing action is appropriate? 1) Telling the parents that information will be shared with them after the examination 2) Providing separate times to communicate with the adolescent and the parents 3) Avoiding asking the parents their opinions of the adolescent's friends 4) Telling the parents they are not allowed to come into the examination room

2 1 The nurse should share with the adolescent's parents only information that is not protected by HIPAA. 2 In order for the adolescent to open up and communicate with the nurse, it is important to speak with the parents and the adolescent separately. There are certain topics that the adolescent may not feel comfortable sharing in front of his or her parents. 3 The nurse may need to determine the parents' opinion regarding the adolescent's friends if there is an issue. 4 It is not appropriate to tell the parents that they are not allowed in the examination room. The adolescent, however, does have the right to privacy, and this should be shared with the parents in a meaningful way.

The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for a. Sore throat b. Elevated blood pressure c. Desquamation of the fingers and toes d. Tender, warm, inflamed joints

Tender, warm, inflamed joints Arthritis, characterized by tender, warm, erythematous joints, is one of the major manifestations of acute rheumatic fever in the first 1 to 2 weeks of the illness.

Which primary function of red blood cells (RBCs) should the nurse consider when providing care to a pediatric patient who has been diagnosed with anemia? 1) Mediating the immune system to decrease areas of serious inflammation 2) Transporting hemoglobin that carries oxygen from the lungs to the tissues 3) Migrating and providing a rapid defense against any foreign agent 4) Providing hemostasis and vascular repair following injury to a vessel wall

2 1 White blood cells (WBCs) are important for immune system mediation. 2 The RBCs, also known as erythrocytes, have the primary function of transporting hemoglobin, which carries oxygen from the lungs to the tissues. 3 Most leukocytes migrate to areas of serious inflammation and provide a rapid defense against any foreign agent. 4 The primary function of platelets is hemostasis and vascular repair following injury to a vessel wall; platelets aggregate to form a plug.

Which statements made by the adolescent following dietary teaching for Crohn's disease indicate correct understanding of the content presented by the nurse? (Select all that apply.) 1) "I can promote solid stools by increasing fiber in my diet." 2) "Small, frequent meals are preferred over three meals a day." 3) "I should identify foods that cause distress and eliminate them from my diet." 4) "High-calorie dietary supplement shakes can help me meet my nutritional requirements." 5) "Socialization during mealtime is important even if my parents do not agree with my food choices."

2) "Small, frequent meals are preferred over three meals a day." 3) "I should identify foods that cause distress and eliminate them from my diet." 4) "High-calorie dietary supplement shakes can help me meet my nutritional requirements."

The nurse is providing care to a newborn client who presents in the pediatric clinic for a 2-week health maintenance visit. The parents of the newborn are concerned because their baby has "gas all the time." Which responses from the nurse are appropriate? (Select all that apply.) 1) "Your baby has a relaxed lower esophageal sphincter, which is causing the gas." 2) "Your baby lacks the enzyme amylase, which is causing the gas." 3) "Your baby lacks the enzyme insulin, which is causing the gas." 4) "Your baby has an immature liver, which is causing the gas." 5) "Your baby lacks an enzyme that helps to digest fats, which is causing the gas."

2) "Your baby lacks the enzyme amylase, which is causing the gas." 5) "Your baby lacks an enzyme that helps to digest fats, which is causing the gas."

Which gastrointestinal defects often diagnosed shortly after birth should the nurse include in the assessment process of all newborns? (Select all that apply.) 1) Pyloric stenosis 2) Biliary atresia 3) Hirschsprung's disease 4) Crohn's disease 5) Cleft palate

2) Biliary atresia 5) Cleft palate

The pediatric nurse examines a 5-week-old infant who has been observed having projectile, nonbilious vomiting. Upon palpation, the nurse feels an olive-shaped mass in the midepigastrium. On the basis of these data, which condition does the nurse suspect? 1) Rectal atresia 2) Hypertrophic pyloric stenosis 3) Intussusception 4) Malrotation of the intestine

2) Hypertrophic pyloric stenosis

A nurse educator teaches her students about the anatomy of the gastrointestinal system. Which description about the functions of these organs might be discussed? 1) Digestion begins in the lower portion of the gastrointestinal (ascending and descending colon) system. 2) The upper portion of the gastrointestinal system (mouth and esophagus) is responsible for nutrient intake or ingestion. 3) The small intestine transports food to the stomach by the process of peristalsis. 4) The large intestine does the main work of absorption through a system of villi and folds.

2) The upper portion of the gastrointestinal system (mouth and esophagus) is responsible for nutrient intake or ingestion.

An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect on the basis of these data? 1) Necrotizing enterocolitis (NEC) 2) Ulcerative colitis (UC) 3) Crohn's disease 4) Appendicitis

2) Ulcerative colitis (UC)

Which topics are appropriate for the nurse to include in a teaching session for an adolescent patient who is experiencing acne? (Select all that apply.) 1) Discouraging the consumption of greasy foods 2) Washing the face twice per day 3) Using a mild soap on the face 4) Scrubbing the face with a washcloth 5) Recommending products that contain oil

2,3 1. This is incorrect. Foods such as chocolate and those that contain grease do not contribute to acne. 2. This is correct. It is appropriate to wash the face twice per day. 3. This is correct. It is appropriate to use a mild soap on the face. 4. This is incorrect. Scrubbing the face should be discouraged. Instead, the nurse should recommend gentle cleansing when washing the face. 5. This is incorrect. Products containing oil should be discouraged, not recommended.

The clinic nurse conducts an interview with an adolescent diagnosed with beta-thalassemia and his parents. Prior to planning the adolescent's care, which should the nurse take into consideration? (Select all that apply.) 1) There is no cure for beta-thalassemia, but early remission is possible. 2) Hemosiderosis may occur as a result of chronic blood transfusion therapy. 3) Hand washing is essential because patients are often asplenic. 4) If the patient has a fever, antibiotic prophylaxis may be indicated. 5) To provide pain medication per order around the clock

2,3,4 1. This is incorrect. Children with beta-thalassemia may be cured of their disorder with a bone marrow transplant. 2. This is correct. As a result of the chronic blood transfusion therapy, in which each unit contains approximately 200 mg of iron, iron may accumulate in the body (hemosiderosis). 3. This is correct. Nursing interventions include good hand washing because these children are often asplenic, which increases their susceptibility to infection. 4. This is correct. If the patient develops a temperature of 101.5°F (38.6°C), antibiotic prophylaxis may be indicated. 5. This is incorrect. Pain is not associated with beta-thalassemia; therefore, the nurse does not anticipate the need to medicate the child for pain around the clock.

A school-aged African American male is brought to an emergency department (ED) by his parents with a vaso-occlusive crisis. When caring for this child, the nurse monitors for which conditions during the assessment? (Select all that apply.) 1) Uncontrolled bleeding 2) Acute chest syndrome 3) Splenic sequestration 4) Leg ulcerations 5) Diuresis

2,3,4 1. This is incorrect. This is not a clinical manifestation the nurse monitors this patient for on the basis of the current data. 2. This is correct. Acute chest syndrome is a complication of a vaso-occlusive crisis. 3. This is correct. Splenic sequestration is a complication of vaso-occlusive crisis. 4. This is correct. Leg ulcerations are a complication of vaso-occlusive crisis. 5. This is incorrect. This is not a clinical manifestation the nurse monitors this patient for on the basis of the current data.

The nurse is providing care to a child diagnosed with cancer. Laboratory results indicate anemia. On the basis of the laboratory results, which clinical manifestations do(es) the nurse anticipate? (Select all that apply.) 1) Fever 2) Fatigue 3) Bleeding 4) Headache 5) Tachycardia

2,4,5 1. This is incorrect. Fever is often a clinical manifestation associated with neutropenia. 2. This is correct. Fatigue, headache, and tachycardia are all clinical manifestations the nurse expects to find when assessing a child diagnosed with anemia. 3. This is incorrect. Bleeding is often a clinical manifestation of thrombocytopenia. 4. This is correct. Fatigue, headache, and tachycardia are all clinical manifestations the nurse expects to find when assessing a child diagnosed with anemia. 5. This is correct. Fatigue, headache, and tachycardia are all clinical manifestations the nurse expects to find when assessing a child diagnosed with anemia.

Which statements should the nurse include when discussing the use of child safety seats for the parents of a toddler-aged patient? (Select all that apply.) 1) "Your child should be placed in a safety seat that is rear facing." 2) "If your child must be placed in the front seat, it is important to adjust the seat so it is as far from the dashboard as possible and to disengage the airbag system." 3) "Your child can be secured using the seat belt provided within the vehicle without an additional car seat." 4) "It is appropriate to hold your child in your lap for short distances if there isn't room for a safety seat within the vehicle." 5) "It is appropriate to place your child in the back seat with the use of an appropriate child safety seat."

2,5 1. This is incorrect. The toddler-aged child does not need to be rear facing when placed in a child safety seat. 2. This is correct. If the child must be placed in the front seat, it is important to ensure the seat is as far as possible from the dashboard and that the airbag system is disengaged. 3. This is incorrect. The toddler-aged child should be placed in a child safety seat, and the seat should be secured using the seat belt provided. It is not appropriate for the child to be secured with a seat belt alone. 4. This is incorrect. The child should never be held on the lap, even for short distances. 5. This is correct. The best place for the child in the car is in the back seat with the use of an appropriate child safety seat.

A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate? 1) "Aplastic anemia causes a proliferation of white blood cells." 2) "Aplastic anemia is characterized by abnormally shaped red blood cells 3) "Aplastic anemia is caused by the bone marrow producing inadequate cells." 4) "Aplastic anemia is a disorder that occurs after a viral illness."

3 1 All blood cells, not just WBCs, are affected by aplastic anemia. 2 Aplastic anemia does not cause abnormally shaped RBCs; this is a description of SCD. 3 In aplastic anemia, the bone marrow does not produce sufficient numbers of circulating blood cells. 4 There is no known association between aplastic anemia and viral illness.

The nurse assessing a glycosylated hemoglobin (HbA1c) test is aware that this test can evaluate average glucose levels over a period of _____ to _____ months.

3;4

The nurse is conducting a growth and development assessment and must calculate the body mass index (BMI) of a pediatric client. The child's weight is 33 lb and 4 oz. The child's height is 37 and 5/8 in. tall. What is the child's BMI? 1) 14.5 2) 15.5 3) 16.5 4) 17.5

3 1 14.5 is not the BMI obtained when using the equation for this patient's height and weight. 2 15.5 is not the BMI obtained when using the equation for this patient's height and weight. 3 This child's BMI is 16.5 using the following equation: [(33.25 lb ÷ 37.625 in.) ÷ 37.625 in.] 703 = 16.5. 4 17.5 is not the BMI obtained when using the equation for this patient's height and weight.

For which immunization booster does the nurse provide parental education during the health maintenance visit for a 4-year-old patient? 1) Hepatitis B 2) Haemophilus influenzae type B 3) Inactivated poliovirus (IPV) 4) Human papillomavirus (HPV)

3 1 A hepatitis B booster is not required during the preschool stage of development. 2 An H influenzae type B booster is not required during the preschool stage of development. 3 An IPV booster is required during the preschool stage of development; therefore, the nurse should provide education to the parents during the health maintenance visit. 4 An HPV booster is not required during the preschool stage of development.

The nurse is conducting a health history for a preschool-aged patient. Which should the nurse anticipate regarding language development at the age of 4 years? 1) Using 50 words 2) Knowing 900 words 3) Answering simple questions with simple answers 4) Articulating complex and compound sentences

3 1 A toddler, not a preschool-aged child, is expected to know 50 words. 2 A preschool-aged child at the age of 3 years should know approximately 900 words. 3 A preschool-aged child at the age of 4 years is expected to answer simple questions with simple answers. 4 The preschool-aged child at the age of 5 years should articulate complex and compound sentences.

According to Erikson, which should the nurse anticipate when assessing a preschool-aged child? 1) Being engaged in tasks 2) Questioning sexual identity 3) Having highly imaginative thoughts 4) Wanting to participate in organized activities

3 1 According to Erikson, being engaged in tasks is not anticipated when assessing a preschool-aged child. 2 According to Erikson, questioning sexual identity is not anticipated when assessing a preschool-aged child. 3 According to Erikson, having highly imaginative thoughts, such as magical thinking, is anticipated when assessing a preschool-aged child. 4 According to Erikson, wanting to participate in organized activities is not anticipated when assessing a preschool-aged child.

Which is often the reason why an adolescent engages in self-harm activities such as cutting? 1) For peer approval 2) For attention 3) To release anger 4) To seek medical attention

3 1 Adolescents do not engage in self-harm activities for peer approval. 2 Adolescents do not engage in self-harm activities for attention. 3 Self-harm activities such as cutting are often engaged in by the adolescent in order to release anger. 4 Adolescents do not engage in self-harm activities to seek medical attention.

The nurse performs an assessment of a child's breathing. Which finding is not the result of respiratory distress? 1) Sniff position 2) Intercostal retractions 3) Nasal flaring 4) Irritability

4) Irritability

Which point should the nurse include in a teaching session for the parents of a toddler-aged patient who live in a home with stairs? 1) Allowing the child to walk up and down the steps to enhance autonomy 2) Ensuring that the child is instructed not to use the steps without assistance 3) Placing a gate so the child is unable to access the steps without supervision 4) Suggesting that the family consider moving to a home that does not have steps

3 1 Allowing the toddler-aged patient who is still learning to walk independently to walk up and down the steps is not safe. 2 Teaching the child not to use the steps without assistance is not an age-appropriate teaching point because the child may not understand and follow verbal rules. 3 Placing a gate so the child is unable to access the steps without assistance is an appropriate teaching point for the parents of a toddler-aged child in a home with stairs. 4 Suggesting that the family move because of this safety issue is not an appropriate suggestion.

Which teaching point regarding safety should the nurse include in instructions for the parents of a school-aged patient? 1) "Consider getting a pet for your child." 2) "Plan play dates for your child to attend on afternoons you are not home." 3) "Teach your children not to let others know that they are home alone after school." 4) "Encourage your child to use a helmet when riding a bike. Other equipment is not necessary."

3 1 Although a pet may help a school-aged child learn responsibility, this is not a teaching point to enhance safety. 2 Play dates should be planned when a parent is present because the school-aged child requires adult supervision. 3 Children who are latchkey kids should not let others know that they are home alone after school. 4 A helmet, along with knee and elbow pads, should be encouraged for a school-aged child who rides a bike.

The nurse is providing care to a toddler-aged client whose laboratory data indicate anemia. Which question should the nurse include in the health history of this patient? 1) "Does your child eat green leafy vegetables?" 2) "Does your child have a history of bleeding?" 3) "How much milk does your child drink each day?" 4) "Does your child eat the same types of foods as the rest of the family?"

3 1 Although green leafy vegetables are a source of iron, this is not the question the nurse should include in the health history for a toddler-aged child. 2 This question is more appropriate if the toddler-aged child is suspected of having a clotting disorder versus anemia. 3 Many toddler-aged children develop iron-deficiency anemia because of overconsumption of milk; therefore, this question is most appropriate to include in the health history for this child. 4 Although it is important to determine if the toddler-aged child eats the same types of foods as the rest of the family to determine developmental milestones, this question is not appropriate to determine the source of anemia.

The nurse is conducting a physical assessment for a preschool-aged child. When plotting the child's body mass index (BMI), the nurse notes that the child is in the 90th percentile. Which action by the nurse is most appropriate? 1) Referring the child to a nutritionist 2) Conducting a developmental assessment 3) Assessing the child's level of activity 4) Checking the child's blood glucose level

3 1 Although referring the child to a nutritionist may be necessary, this is not the most appropriate action based on the information provided. 2 The information provided does not support the implementation of a developmental assessment. 3 The most appropriate action is to assess the child's level of activity and then suggest activities that will enhance the child's level of activity. 4 Checking the blood glucose level may be necessary if the child is also exhibiting symptoms associated with type 2 diabetes mellitus.

An obese adolescent who adamantly denies sexual activity has a positive pregnancy test. Which response by the nurse is most appropriate? 1) "When was your last menstrual period (LMP)?" 2) "Tell me how you feel about your body image." 3) "Let's discuss some activities that you have done within the past few months that could possibly lead to pregnancy." 4) "Why are you denying sexual intercourse?"

3 1 Although this question is necessary, it is not a therapeutic response based on the current situation. 2 Although the adolescent is obese, this is not the time to discuss body image. 3 Offering straightforward information on sexuality, sexual activity, risks, and protection is an important nursing role. 4 This is accusatory and does not facilitate a therapeutic relationship with the adolescent.

The parent of a toddler states, "My child is constantly saying 'no.'" When documenting this in the medical record, which term should the nurse use? 1) Autonomy 2) Egocentric 3) Negativism 4) Temperament

3 1 Autonomy is defined as being self-governing. This is not the best term to use to describe this situation in the medical record. 2 Egocentric, or not being able to process the views of others, is a common trait during the toddler stage of development. However, this is not the best term to use to describe this situation in the medical record. 3 Negativism, or the tendency to be negative with attitude, is a common trait for the toddler that is manifested by the word no. 4 Temperament is the mental, physical, and emotional traits of the child. This is not the best term to use to describe this situation in the medical record.

The home-care nurse is conducting a home visit for the family of a toddler-aged patient. Which finding necessitates education related to safety? 1) Drugs kept in a medicine cabinet in the bathroom 2) Knives stored on the counter out of reach 3) A bucket of water used for mopping in the hallway 4) Cleaning supplies stored in a locked cabinet under the sink

3 1 Drugs kept in a medicine cabinet that is out of reach of the toddler-aged child are not a safety concern necessitating education. 2 Knives kept on the counter that are out of reach of the toddler-aged child are not a safety concern necessitating education. 3 A bucket of water used for mopping, kept out in the open, is a drowning risk for the toddler-aged child. The nurse should educate the family regarding this issue. 4 Cleaning supplies that are stored in a locked cabinet under the sink are not a safety concern necessitating education.

Which parental statement during a scheduled health maintenance assessment for a preschool-aged child causes the nurse concern? 1) "We have dinner together as a family each evening." 2) "We are so proud that our child is able to recognize letters of the alphabet." 3) "Our child wakes up each night screaming because of nightmares." 4) "Our child attends a day-care program 3 days per week."

3 1 Eating dinner together as a family is encouraged; therefore, this should not cause the nurse concern. 2 Recognition of letters in the alphabet is expected during the preschool stage of development; therefore, this should not cause the nurse concern. 3 Night terrors should be expanded upon because they can be a source of concern. 4 Day-care attendance is often needed when both parents work full-time; therefore, this should not cause the nurse concern.

Which result does the nurse anticipate when providing care to a preschool-aged child who successfully completes tasks associated with this stage of Erikson's theory of psychosocial development? 1) Faith and optimism 2) Devotion and fidelity 3) Direction and purpose 4) Self-control and willpower

3 1 Faith and optimism are not anticipated for the preschool-aged child when completing tasks associated with Erikson's theory of psychosocial development. 2 Devotion and fidelity are not anticipated for the preschool-aged child when completing tasks associated with Erikson's theory of psychosocial development. 3 Direction and purpose are anticipated for the preschool-aged child when completing tasks associated with Erikson's theory of psychosocial development. 4 Self-control and willpower are not anticipated for the preschool-aged child when completing tasks associated with Erikson's theory of psychosocial development.

When planning community health promotion activities, which should the nurse consider when catering an educational session to the adolescent? 1) More females smoke cigarettes than males. 2) Marijuana is not an issue until college. 3) Alcohol and drug use often goes hand-in-hand with sexual intercourse. 4) There is no risk of texting and driving during adolescence.

3 1 More males than females smoke cigarettes. 2 Approximately 47% of high school students admit to trying marijuana. 3 Teenagers face many social pressures concerning experimentation with drugs, alcohol, and sexuality, and their decisions about these pressures influence their health. Pediatric nurses provide straightforward information to teens about health promotion and injury, disease, and infection prevention, as well as specific information about pregnancy and sexually transmitted infection prevention. 4 Adolescents often engage in risky behavior such as texting and driving.

Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted in a sickle cell crisis? 1) Rapid weaning of pain medications 2) A diet high in protein 3) Adequate hydration 4) Restriction of activitie

3 1 Rapid weaning is not necessary; reduction of pain medication should proceed at a rate dictated by the child's pain. 2 A high-protein diet is not necessary; a well-balanced diet should be promoted. 3 Adequate hydration will help prevent further sequestration and crisis. 4 Normal activities are not restricted.

Which risk is increased for a child during the toddler stage of development because of exploration and curiosity? 1) SIDS 2) Suffocation injuries 3) Accidental poisoning 4) Motor vehicle accidents

3 1 SIDS, or sudden infant death syndrome, occurs during infancy and not the toddler stage of development. 2 Suffocation injuries are more likely to occur in infancy than during the toddler stage of development. 3 Accidental poisoning is a risk for injury during the toddler stage of development because of exploration. 4 Motor vehicle accidents are the leading cause of death among adolescents, not toddlers.

Which form of discipline should the nurse encourage when providing care to the family of a toddler-aged child? 1) Saying "no" 2) Ignoring the behavior 3) Implementing "time-outs" 4) Implementing corporal punishment

3 1 Saying "no" is an appropriate form of discipline for the infant. 2 Ignoring the behavior is encouraged during tantrums; however, this is not a form of discipline. 3 Implementing time-outs is an effective form of discipline during the toddler stage of development. 4 Corporal punishment should never be encouraged as a form of discipline.

How many hours of sleep should the nurse recommend for an 11-year-old patient? 1) 6 to 8 2) 8 to 10 3) 10 to 12 4) 14 to 16

3 1 Six to 8 hours of sleep is not appropriate for a school-aged patient. 2 Eight to 10 hours of sleep is not appropriate for a school-aged patient. 3 Ten to 12 hours of sleep is appropriate for a school-aged patient. 4 Fourteen to 16 hours of sleep is not appropriate for a school-aged patient.

Which nursing action is appropriate when providing care to an adolescent patient who is accompanied to an appointment by a parent? 1) Instructing the parent to stay in the waiting room, with the explanation that the adolescent will provide a report after the examination 2) Telling the parent it is against policy for a parent to accompany the adolescent to the examination room 3) Reassuring the parent that the nurse will discuss any parental concerns or questions after the examination 4) Allowing the parent to come into the examination room with the adolescent

3 1 The adolescent does not have to share information with the parent after the examination process. 2 It is not against policy for the parent to accompany the adolescent to the examination room; however, the adolescent does have the right to privacy during the examination process. 3 It is important for the nurse to communicate with the parents that he or she is available to discuss their concerns after the physical examination of the adolescent. 4 The nurse should allow the parent to come into the examination room only if the adolescent gives permission for this to occur.

Which action is appropriate when assisting a preschool-aged child with hand washing? 1) Offering a hand towel to dry the hands 2) Using hot water to wash the hands 3) Singing the Happy Birthday song while washing the hands for timing purposes 4) Rinsing the hands, ensuring that the hands are upright

3 1 The child should be offered a paper towel and not a hand towel for drying the hands. 2 The child should be told to use warm, not hot, water when washing the hands. 3 Singing the Happy Birthday song for timekeeping purposes is an appropriate action when teaching a preschool-aged patient to perform hand hygiene. 4 The child should be told to ensure that the hands are down, not upright, during hand washing.

Which parental statement indicates correct understanding of information presented regarding the treatment for infant anemia? 1) "We will add green leafy vegetables to our child's low-iron formula." 2) "We will discontinue the use of vitamin C supplements by 6 months of age." 3) "We will begin an iron-fortified infant cereal at 4 to 6 months of age." 4) "We will introduce cow's milk by 6 months of age."

3 1 The infant's maternal iron stores are depleted by 6 months. Infants who are not breastfed should get iron-fortified formula. Green leafy vegetables, though iron-fortified, are not appropriate for an infant. 2 Vitamin C should be started at 6 to 9 months of age and continued because foods rich in vitamin C improve iron absorption. 3 Starting iron-fortified infant cereal at 4 to 6 months of age is recommended for prevention of iron deficiency in children. 4 Cow's milk should not be introduced until 12 months of age.

The nurse is assessing abdominal girth for a pediatric client who presents with vomiting. Which nursing action is appropriate? 1) Measuring the girth just below the umbilicus 2) Measuring the girth just below the sternum 3) Measuring the girth just above the pubic bone 4) Measuring the girth around the portion of the stomach

4) Measuring the girth around the portion of the stomach

The mother of a 4-year-old male tells the clinic nurse that her son asked her about the differences in his anatomy and that of his baby sister. The nurse reassures the mother that this is normal behavior for her son because the child is in which of Freud's developmental stages? 1) Oral stage 2) Anal stage 3) Phallic stage 4) Latency stage

3 1 The infant, not the preschool-aged child, is classified as experiencing the oral stage of Freud's developmental stages. 2 The toddler, not the preschool-aged child, is classified as experiencing the anal stage of Freud's developmental stages. 3 The preschool-aged child is expected to experience the phallic stage of sexual development as exhibited by this scenario. 4 This behavior is not characteristic of the latency stage of sexual development.

At which stage of development should the nurse anticipate that pediatric patients will begin to show differences in play activities that are related to gender? 1) Preschool 2) Adolescence 3) Late school age 4) Early school age

3 1 The preschool-aged patient does not begin to show differences in play activities related to gender. 2 The adolescent patient has already shown differences (i.e., is not beginning to show differences) in play activities related to gender. 3 During the late school-aged years, the child begins to show differences in play activities related to gender. 4 The early school-aged child does not begin to show differences in play activities related to gender.

Which stage of development is characterized by a slower, steadier pattern of growth and development? 1) Toddler 2) Preschool 3) School-age 4) Adolescence

3 1 The toddler stage of development is not characterized by a slower, steadier pattern of growth and development. 2 The preschool stage of development is not characterized by a slower, steadier pattern of growth and development. 3 The school-aged stage of development is characterized by a slower, steadier pattern of growth and development. 4 The adolescent stage of development is not characterized by a slower, steadier pattern of growth and development.

Which activity should the nurse recommend to the parents of a toddler-aged child to challenge object permanence? 1) Jumping rope 2) Stacking blocks 3) Playing hide-and-go-seek 4) Reading books about colors

3 1 The toddler-aged child does not have the coordination for jumping rope. Also, this activity does not challenge object permanence. 2 Stacking blocks is an age-appropriate activity for the toddler for mastery of fine motor skills but does not challenge object permanence. 3 Playing hide-and-go-seek is an activity that challenges the toddler's object permanence. 4 Reading books about colors is not an activity that challenges object permanence for the toddler-aged child.

The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD). When should the nurse monitor the child closely because of the risk of reaction? 1) 6 hours after the transfusion is given 2) At the end of the administration of the transfusion 3) The first 20 mL of blood administered 4) Never; children with SCD do not have reactions

3 1 Transfusion reaction does not occur this long after the transfusion. 2 Reactions generally occur at the onset or during the first 20 minutes of transfusion. 3 Blood reactions can occur as soon as the blood transfusion begins. The nurse should administer the first 20 mL of blood slowly and monitor for a reaction during this time frame. 4 Anyone can have a transfusion reaction during any transfusion.

Which goal should the nurse include in the plan of care for a toddler-aged client who is diagnosed with seasonal flu? 1) "The child will verbalize the need to have a bowel movement." 2) "The child will ask for fever reducers when hyperthermia occurs." 3) "The child will sneeze and cough into a tissue provided by the caregiver." 4) "The child will use hand sanitizer prior to touching other children in the day-care environment."

3 1 Verbalization of bowel movements is not an age-appropriate intervention because many toddlers are not toilet-trained. 2 It is unrealistic to expect a toddler-aged patient to ask for a fever reducer with hyperthermia. 3 It is appropriate to ask the toddler-aged patient to sneeze or cough into a tissue provided by the caregiver. 4 Although the toddler-aged child can be provided hand sanitizer for use, it is unrealistic to expect a child in this stage of development to implement hand hygiene practices independently.

The nurse is teaching the parents of a 6-year-old child what to expect in terms of normal growth and development. Which parental statement indicates the need for further education? 1) "My child's vision has reached maturity." 2) "I should expect my child to be constantly active." 3) "Finger feeding is abnormal and indicates the need for intervention." 4) "A coloring book is a developmentally appropriate activity for my child."

3 1 Vision has reached maturity by 6 years of age. 2 A 6-year-old, school-aged child is expected to be constantly active. 3 A 6-year-old child is closer to preschool than adolescence; therefore, some preschool behaviors are still expected. This statement indicates the need for further education. 4 A coloring book is developmentally appropriate for a 6-year-old child.

Which should the nurse encourage for a school-aged patient to enhance a sense of accomplishment? 1) Wearing makeup 2) Going on a date 3) Participating in sports activities 4) Gaining weight during the school year

3 1 Wearing makeup is more appropriate for the adolescent than for the school-aged patient. 2 Going on a date is more appropriate for the adolescent than for the school-aged patient. 3 Participation in sports activities enhances a sense of accomplishment for the school-aged patient. 4 Weight gain is anticipated for the school-aged patient each year; however, this does not enhance a sense of accomplishment.

The pediatric nurse listens to a 9-year-old child read to his 6-year-old roommate. What action by 9-year-old child leads the nurse to question possible dyslexia? a. Becomes hyperactive and ceases to read. b. Reads the word dog as God. c. Makes up a story rather than reading the text. d. Stutters as he reads.

ANS: B Dyslexics often transpose a word as they read; for example, the word is dog, but it appears to the dyslexic child as the word God.

For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E1? a. To decrease inflammation b. To control pain c. To decrease respirations d. To improve oxygenation

To improve oxygenation Prostaglandin E1 is given to infants with a right-to-left shunt to keep the ductus arteriosus patent. This will improve oxygenation.

Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client? 1) "We will change the colostomy bag with each wet diaper." 2) "We will expect a moderate amount of bleeding after cleansing the area around the stoma." 3) "We will watch for skin irritation around the stoma." 4) "We will use adhesive enhancers when we change the bag."

3) "We will watch for skin irritation around the stoma."

Which parental action observed during a home-care visit for an infant diagnosed with gastroesophageal reflux requires intervention by the nurse? 1) The infant's formula has rice cereal added. 2) The mother holds the infant in a high Fowler position while feeding. 3) After feeding, the infant is placed in a car seat. 4) The mother draws up the ranitidine (Zantac) in a syringe for oral administration.

3) After feeding, the infant is placed in a car seat.

An adolescent who is brought to the emergency department (ED) by his parents has the following symptoms: periumbilical pain that peaks at 4-hour intervals followed by right lower quadrant pain, which is followed by vomiting. On the basis of these data, which condition does the nurse suspect? 1) Meckel's diverticulum 2) Omphalitis 3) Appendicitis 4) Ulcerative colitis

3) Appendicitis

The nurse working on a pediatric unit receives a call from the emergency department to prepare for admission of a 4-year-old diagnosed with epiglottitis. Which emergency item will the nurse place in the child's room? 1) Oral airway 2) Nasal airway 3) Emergency tracheotomy kit 4) Code cart

3) Emergency tracheotomy kit

Which assessment data cause the nurse to suspect that a 3-year-old child has Hirschsprung's disease? 1) Clay-colored stools and dark urine 2) History of early passage of meconium in the newborn period 3) History of chronic, progressive constipation and failure to gain weight 4) Continual bouts of foul-smelling diarrhea

3) History of chronic, progressive

The nurse auscultates the lungs of a child and hears a high-pitched sound on inspiration. How does the nurse document this sound? 1) Wheezing 2) Rales 3) Stridor 4) Grunting

3) Stridor

The nurse is preparing to discharge a child diagnosed with Hirschsprung's disease from the hospital. Which topic is appropriate for the nurse to include in the discharge teaching with the child's parents? 1) The foods to avoid because of increased risk for allergic reactions 2) The importance of eliminating dairy products 3) The care required for a temporary colostomy 4) Home administration of total parental nutrition (TPN) and lipids

3) The care required for a temporary colostomy

Which growth characteristic should the nurse anticipate when assisting with the physical examination process? 1) An increase in physical growth 2) The need for snacks due to blood glucose instability 3) The eruption of 15 of the 20 deciduous teeth 4) A weight gain of 5 lb per year

4 1 A decrease, not an increase, in physical growth is expected during the preschool stage of development. 2 The need to snack decreases, not increases, during the preschool stage of development. Blood glucose levels stabilize during this stage of development. 3 The nurse should anticipate that all 20 deciduous teeth are present during this stage of development. 4 Weight gain during the preschool stage of development is typically 5 lb per year.

Which parental statement regarding the sleep needs of a toddler indicates the need for additional education from the nurse? 1) "My child should sleep a total of 14 hours per day." 2) "My child will need only one afternoon nap versus two naps per day." 3) "I should not put my child down for a nap too late in the afternoon." 4) "I should expect my child to sleep 14 hours each night in addition to an afternoon nap."

4 1 A toddler-aged child should sleep a total of 14 hours in a 24-hour period. 2 A toddler-aged child needs only one afternoon nap versus two naps per day. 3 Late afternoon naps should be avoided because they interfere with the toddler's ability to sleep at night. 4 The total amount of sleep the toddler should get in a 24-hour period is 14 hours; this includes the afternoon nap, which is expected.

Which is a theoretical reason for why adolescents engage in risky behavior? 1) As a coping mechanism 2) To impress a teacher 3) As a cry for help 4) To receive peer approval

4 1 Adolescents theoretically do not engage in risky behavior as a coping mechanism. 2 Adolescents theoretically do not engage in risky behavior to impress a teacher. 3 Adolescents theoretically do not engage in risky behavior as a cry for help. 4 Theoretically, adolescents engage in risky behavior to receive peer approval.

Which behavior noted by the school-aged patient indicates the development of conservation? 1) Learning to spell 2) Becoming interested in collections 3) Developing a sense of cause and effect 4) Being able to classify objects according to mass

4 1 Although learning to spell is an expected behavior during this stage of development, this is not an example of conservation. 2 Although becoming interested in collections is an expected behavior during this stage of development, this is not an example of conservation. 3 Although developing a sense of cause and effect is an expected behavior during this stage of development, this is not an example of conservation. 4 Classification of objects according to mass is an example of conservation.

The pediatric nurse teaches the parents of a preschool-aged child diagnosed with anemia that it is important to identify the cause of anemia so treatment can be tailored to their child's specific needs. The nurse tells the parents that their child's anemia is caused by an increased destruction of red blood cells that occurs with which condition noted in the medical history? 1) Bone marrow failure 2) Acute blood loss 3) Myelodysplastic syndrome 4) Sickle cell anemia

4 1 Bone marrow failure causes a decreased production of RBCs. 2 Acute or chronic blood loss does not cause the destruction of RBCs but an inability to reproduce RBCs to replace those lost. 3 Myelodysplastic syndrome causes decreased production of RBCs. 4 An increased destruction of RBCs occurs with conditions such as sickle cell anemia or hereditary spherocytosis.

Which developmental theorist stated that the adolescent is able to logically manipulate abstract, observable, and nonobservable concepts with greater depth? 1) Erikson 2) Freud 3) Kohlberg 4) Piaget

4 1 Erikson is not the developmental theorist who stated that adolescents engage in abstraction thinking. 2 Freud is not the developmental theorist who stated that adolescents engage in abstraction thinking 3 Kohlberg is not the developmental theorist who stated that adolescents engage in abstraction thinking 4 Piaget is the developmental theorist who stated that the adolescent is able to logically manipulate abstract, observable, and nonobservable concepts with greater depth.

Which is the priority nursing intervention for a pediatric client diagnosed with leukemia who has a granulocyte count of 250/mm3 and a platelet count of 150,000/mm3? 1) Fluid restriction 2) Mouth care 3) Neutropenic precautions 4) Hand hygiene

4 1 Fluid restriction is not a priority nursing intervention on the basis of the current data. Fluids should continue to be encouraged. 2 Platelet count is normal; mouth care should include brushing with a soft toothbrush and frequent rinsing. 3 The child should be isolated from anyone infectious, but neutropenic isolation is not necessary. 4 Hand hygiene is vital for preventing the spread of infection.

The nurse is providing care to a school-aged patient who is overweight. Which nursing action is appropriate to enhance the child's intake of a healthy diet? 1) Offering food as a reward for good grades 2) Encouraging the consumption of high-fat foods 3) Educating on the importance of soda consumption 4) Making fruits and vegetables available for daily snacks

4 1 Food should not be offered as a reward for good grades because this can encourage overeating. 2 Low-fat, not high-fat, foods should be encouraged. 3 Soda should be consumed in moderation or not at all because this is a source of sugar. 4 Fruits and vegetables should be encouraged as snacks for the school-aged patient.

The nurse is providing education to the parents of a preschool-aged child. Which statement regarding infectious disease should the nurse include in the teaching session? 1) "Immunizations are voluntary prior to entering the public school system." 2) "Immunizations can increase the risk of your child developing ovarian cancer." 3) "Immunizations decrease your child's risk for developing autism spectrum disorder." 4) "Immunizations can decrease the risk for serious complications associated with communicable diseases."

4 1 Immunizations are mandatory, not voluntary, prior to admission to a public school. 2 Immunizations do not impact the risk for the development of ovarian cancer. 3 Immunizations do not impact the development of autism spectrum disorder. 4 Immunizations can decrease the risk for serious complications associated with communicable diseases.

Which activity should the nurse identify as a safety risk for a preschool-aged patient? 1) The parents are participating in a methadone program. 2) The parents consume alcohol on a daily basis. 3) The child watches television for 2 hours each day. 4) The child is permitted to swim in the family pool unsupervised.

4 1 Parents who are participating in a methadone program receive their medication at a clinic, not in the home. 2 Consumption of alcohol by the parents on a daily basis is not a safety risk for the child. 3 Although watching 2 hours of television each day can impact physical activity, this is not a safety risk for the child. 4 The preschooler who is swimming alone is at risk for drowning; therefore, this should be identified as a safety risk.

Which data collected during the health history process cause the nurse to assess for autism? 1) Using pronouns incorrectly 2) Sleeping less than 14 hours per day 3) Using two-word sentences at 20 months of age 4) Lacking interest in games such as hide-and-go-seek

4 1 Pronoun use begins during the toddler stage of development; however, it is not uncommon for a toddler to use pronouns incorrectly, and this does not necessitate further assessment for autism. 2 A toddler who sleeps less than 14 hours per day is not manifesting a behavior indicative of autism. 3 The toddler is expected to use two-word sentences by 20 months of age. 4 Poor social and play skills may indicate autism. These data necessitate further examination for autism.

The parent of an adolescent states, "My daughter slouches all the time. She is so lazy." Which should the nurse assess in order to provide the parent with the most appropriate anticipatory guidance? 1) Asthma 2) Depression 3) Alcohol use 4) Scoliosis

4 1 Slouching is not a clinical manifestation associated with asthma. 2 Slouching is not a clinical manifestation associated with depression. 3 Slouching is not a clinical manifestation associated with alcohol use. 4 Slouching is a clinical manifestation associated with scoliosis and the nurse should assess for this in the adolescent patient to provide the most appropriate anticipatory guidance.

The nurse is planning care for an overweight adolescent. Which topic is appropriate to include in the plan of care? 1) Preventing substance abuse 2) Assessing for school phobia 3) Monitoring for spiritual distress 4) Determining self-esteem

4 1 There is no documented association between being overweight and substance abuse. 2 School phobia is more apt to occur for the school-aged, not the adolescent, patient who is overweight. 3 There is no documented association between being overweight and spiritual distress. 4 Being overweight can significantly impact the adolescent's self-esteem; therefore, the nurse should include this in the plan of care.

The mother of a school-aged patient says, "My daughter appears much thinner than she did a few years ago. Should I be worried?" Which response by the nurse is most appropriate? 1) "Does your child vomit after meals?" 2) "How many meals does your child eat each day?" 3) "It is important that we monitor your concern closely with frequent visits." 4) "Body fat diminishes and distribution changes during this stage of development."

4 1 There is no indication that the patient is experiencing bulimia nervosa, which would necessitate this question. 2 Although the nurse should determine how many meals the patient eats per day, this is not the most appropriate response by the nurse given the situation. 3 A school-aged patient who appears thinner than a few years prior is not an abnormal finding necessitating close monitoring. 4 Body fat diminishes and distribution changes during the school-aged stage of development; therefore, this is the most appropriate response by the nurse.

The parents of an infant diagnosed with sickle cell disease ask, "How did our child get this disease? Neither one of us has it." Which should the nurse consider when responding to the parents? 1) The child is adopted. 2) The mother of the child has the trait, but the father does not. 3) The father of the child has the trait, but the mother does not. 4) The mother and the father of the child have the sickle cell trait.

4 1 There is no indication the child is adopted. 2 Both parents must have the trait for the child to have a 25% chance of having this disease. 3 Both parents must have the trait for the child to have a 25% chance of having this disease. 4 Sickle-cell disease (SCD) is an autosomal recessive disorder; both parents must have the trait in order for a child to have a 25% chance of having this disease.

A school-aged child is tentatively diagnosed with acute lymphocytic leukemia. The clinic nurse reviews the child's laboratory results and recognizes that which finding reflects the best prognosis? 1) WBC count greater than 30,000/mm3 2) WBC count greater than 20,000/mm3 3) WBC count less than 10,000/mm3 4) WBC count less than 5000/mm3

4 1 This WBC count does not reflect the best prognosis. 2 This WBC count does not reflect the best prognosis. 3 This WBC count does not reflect the best prognosis. 4 The child's WBC count and age at diagnosis are the most important prognostic signs in ALL. The best prognosis is a WBC count less than 5000/mm3 with an age of 2 to 9 years.

Which teaching points regarding pertussis should the nurse include in an educational session in the community? (Select all that apply.) 1) "This infection manifests on the scalp." 2) "This infection will cause a scalelike rash." 3) "This infection may cause the formation of scars." 4) "This infection will cause violent coughing to occur." 5) "This infection can be prevented through immunization."

4,5 1. This is incorrect. Ringworm, not pertussis, manifests on the scalp. 2. This is incorrect. Ringworm, not pertussis, manifests as a scalelike rash. 3. This is incorrect. Impetigo, not pertussis, can cause the formation of scars. 4. This is correct. Pertussis causes violent coughing to occur. This statement is appropriate to include in the teaching session. 5. This is correct. Pertussis can be prevented through immunization. This statement is appropriate for the nurse to include in a community education session.

The mother of a 2-year-old child asks, "Why does he keep getting ear infections? Which is the nurse's best response? 1) "Some children are just more susceptible to infection." 2) "Proper nutrition is essential to preventing ear infections." 3) "Ear infections tend to be more frequent in some families." 4) "His eustachian tube is shorter and wider, so bacteria from the throat can enter the ear."

4) "His eustachian tube is shorter and wider, so bacteria from the throat can enter the ear."

The nurse is providing care to a pediatric client diagnosed with inflammatory bowel disease who is prescribed daily prednisone. Which parental statement regarding administration of this drug indicates correct understanding of the teaching provided by the nurse? 1) "I will administer this medication between meals." 2) "I will administer this medication at bedtime." 3) "I will administer this medication 1 hour before meals." 4) "I will administer this medication with meals."

4) "I will administer this medication with meals."

The pediatric nurse examines a 14-month-old patient for bowel sounds. Which assessment finding is typical for this stage of development? 1) Bowel sounds occur normally every 20 to 25 seconds. 2) Bruits are normally heard upon auscultation. 3) Hypoactive bowel sounds may indicate excessive activity is present. 4) Hyperactive bowel sounds mean rapid movement through the intestines.

4) Hyperactive bowel sounds mean rapid movement through the intestines.

The nurse reminds the parents of a diabetic with an insulin pump that the tubing of the pump should be changed aseptically every ______ hours. ANS:

48

The nurse is providing care to a toddler-aged patient who weighs 10 kg. What is the minimum number of kilocalories this child should receive each day? Record your answer as a whole number. ____________________

700 Feedback: The minimum number of kilocalories per day for a toddler-aged patient is 70 kcal/kg/day. For a toddler who is 10 kg, this means a minimum of 700 kcal per day.

A nurse is planning to speak with a parent support group about childhood autism. What will the nurse include? a. Significant signs of the disorder manifest by 1 year of age. b. The earliest signs of autism are impulsivity and overactivity. c. Autism is usually diagnosed when the child goes to elementary school. d. Medications can cure childhood autism.

ANS: A Failure to use eye contact and look at others, poor attention span, and poor orienting to one's name are significant signs of dysfunction by 1 year of age.

27. An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurse's approach should include which action? a. Answering questions with straightforward honesty b. Avoiding discussing the seriousness of the condition c. Explaining that, although the amputation is difficult, it will cure the cancer d. Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy

ANS: A Honesty is essential to gain the child's cooperation and trust. The diagnosis of cancer should not be disguised with falsehoods. The adolescent should be prepared for the surgery so he or she has time to reflect on the diagnosis and subsequent treatment. This allows questions to be answered. To accept the need for radical surgery, the child must be aware of the lack of alternatives for treatment. Amputation is necessary, but it will not guarantee a cure. Chemotherapy is an integral part of the therapy with surgery. The child should be informed of the need for chemotherapy and its side effects before surgery.

6. Which term is used to describe a type of fracture that does not produce a break in the skin? a. Simple b. Compound c. Complicated d. Comminuted

ANS: A If a fracture does not produce a break in the skin, it is called a simple, or closed, fracture. A compound, or open, fracture is one with an open wound through which the bone protrudes. A complicated fracture is one in which the bone fragments damage other organs or tissues. A comminuted fracture occurs when small fragments of bone are broken from the fractured shaft and lie in the surrounding tissue. These are rare in children.

A 9-year-old child has been admitted to the hospital after "huffing" lighter fluid and is in a high euphoric state. For what should the nurse assess? a. Depressed respirations b. Severe vomiting c. Frightening hallucinations d. Elevation of temperature

ANS: A Inhaling hydrocarbons depresses the central nervous system, including respiratory rate and general sensorium.

A parent asks the nurse to describe what is meant by a "learning disability." Which is the nurse's most helpful response? a. "A child may have difficulty with perception, language, comprehension, or memory." b. "It is characterized by inattention, impulsiveness, and hyperactivity." c. "The child's intellectual ability limits his learning." d. "The child has difficulty learning because of brain damage."

ANS: A Learning disability is an educational term. Children with learning disabilities may have average to above-average intelligence, but they may experience difficulties in perception, language, comprehension, and conceptualization.

23. The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include? a. Nasogastric intubation and urinary catheter may be required. b. Ambulation will not be allowed for up to 3 months. c. Surgery eliminates the need for casting and bracing. d. Discomfort can be controlled with nonpharmacologic methods.

ANS: A Luque-rod segmental spinal instrumentation is a surgical procedure. Nasogastric intubation and urinary catheterization may be required. Ambulation is allowed as soon as possible. Depending on the instrumentation used, most patients walk by the second or third postoperative day. Casting and bracing are required postoperatively. The child usually has considerable pain for the first few days after surgery. Intravenous opioids should be administered on a regular basis.

25. A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma? a. Femur b. Humerus c. Pelvis d. Tibia

ANS: A Osteosarcoma is the most frequently encountered malignant bone cancer in children. The peak incidence is between ages 10 and 25 years. More than half occur in the femur. After the femur, most of the remaining sites are the humerus, tibia, pelvis, jaw, and phalanges.

12. A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. Which should the nurse suggest to remove this material? a. Soak in a bathtub. b. Vigorously scrub leg. c. Apply powder to absorb material. d. Carefully pick material off leg.

ANS: A Simple soaking in the bathtub is usually sufficient for the removal of the desquamated skin and sebaceous secretions. It may take several days to eliminate the accumulation completely. The parents and child should be advised not to scrub the leg vigorously or forcibly remove this material because it may cause excoriation and bleeding. Oil or lotion, but not powder, may provide comfort for the child.

5. A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is to: a. apply ice. b. observe for edema and discoloration. c. encourage child to assume a position of comfort. d. obtain parental permission for administration of acetaminophen or aspirin.

ANS: A Soft-tissue injuries should be iced immediately. In addition to ice, the extremity should be rested, be elevated, and have compression applied. Observing for edema and discoloration, encouraging the child to assume a position of comfort, and obtaining parental permission for administration of acetaminophen or aspirin are not immediate priorities. The application of ice can reduce the severity of the injury.

16. Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first? a. Notify the practitioner of the changes noted. b. Give the child medication to relieve the pain. c. Reposition the child and notify physician. d. Chart the observations and check the extremity again in 15 minutes.

ANS: A The absence of a pulse and change in color of the foot must be reported immediately for evaluation by the practitioner. Pain medication should be given after the practitioner is notified. Legg-Calvé-Perthes disease is an emergency condition; immediate reporting is indicated. The findings should be documented with ongoing assessment.

26. The nurse is taking care of an adolescent with osteosarcoma. The parents ask the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma? a. Treatment usually consists of surgery and chemotherapy. b. Amputation of affected extremity is rarely necessary. c. Intensive irradiation is the primary treatment. d. Bone marrow transplantation offers the best chance of long-term survival.

ANS: A The optimal therapy for osteosarcoma is a combination of surgery and chemotherapy. Intensive irradiation and bone marrow transplantation are usually not part of the therapeutic management.

3. The nurse should monitor for which effect on the cardiovascular system when a child is immobilized? a. Venous stasis b. Increased vasopressor mechanism c. Normal distribution of blood volume d. Increased efficiency of orthostatic neurovascular reflexes

ANS: A The physiologic effects of immobilization, as a result of decreased muscle contraction, include venous stasis. This can lead to pulmonary emboli or thrombi. A decreased vasopressor mechanism results in orthostatic hypotension, syncope, hypotension, decreased cerebral blood flow, and tachycardia. An altered distribution of blood volume is found with decreased cardiac workload and exercise tolerance. Immobilization causes a decreased efficiency of orthostatic neurovascular reflexes with an inability to adapt readily to the upright position and with pooling of blood in the extremities in the upright position.

1. The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Positive Ortolani click b. Unequal gluteal folds c. Negative Babinski sign d. Trendelenburg sign e. Telescoping of the affected limb f. Lordosis

ANS: A, B A positive Ortolani test and unequal gluteal folds are clinical manifestations of developmental dysplasia of the hip seen from birth to 2 to 3 months. Unequal gluteal folds, negative Babinski sign, and Trendelenburg sign are signs that appear in older infants and children. Telescoping of the affected limb and lordosis are not clinical manifestations of developmental dysplasia of the hip.

4. A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child? (Select all that apply.) a. Instructions to avoid exposure to sunlight b. Teaching about body changes associated with SLE c. Preparation for home schooling d. Restricted activity

ANS: A, B Key issues for a child with SLE include therapy compliance; body-image problems associated with rash, hair loss, and steroid therapy; school attendance; vocational activities; social relationships; sexual activity; and pregnancy. Specific instructions for avoiding exposure to the sun and UVB light, such as using sunscreens, wearing sun-resistant clothing, and altering outdoor activities, must be provided with great sensitivity to ensure compliance while minimizing the associated feeling of being different from peers. The child should continue school attendance in order to gain interaction with peers and activity should not be restricted, but promoted.

A nurse is hired to work in a psychiatric facility on a unit specializing in obsessive-compulsive disorders (OCD). Which diagnoses might the nurse expect to encounter? (Select all that apply.) a. Trichotillomania b. Hoarding disorder c. Excoriation disorder d. Body dysmorphic disorder e. Oppositional defiant disorder

ANS: A, B, C, D Oppositional defiant disorder is described as an ongoing pattern of anger-guided disobedience, a hostile or defiant response to authority and is not considered a form of OCD.

The nurse states that the members of a mental health team for child guidance include which member(s)? (Select all that apply.) a. Psychiatrist b. Pediatrician c. Psychologist d. Dietitian e. Social worker

ANS: A, B, C, E The traditional members of the child guidance team are the psychiatrist, pediatrician, psychologist, and social worker. The dietitian is not usually on the treatment team.

The nurse is planning the care of an adolescent with anorexia nervosa. What characteristic(s) cause this disorder? (Select all that apply.) a. Discomfort relative to emerging sexuality b. Fear of intimacy c. Pervasive high self-esteem d. Egocentricity e. Inability to meet developmental needs

ANS: A, B, D, E All options except pervasive high self-esteem are considered to be a cause of anorexia nervosa. Pervasive low self-esteem also is considered a cause of anorexia nervosa.

The nurse working with children from dysfunctional families must be prepared to address what associated problem(s)? (Select all that apply.) a. Lack of trust b. Acting out c. Exaggerated self-confidence d. Blaming others for problems e. Depression

ANS: A, B, E Children from dysfunctional families exhibit lack of trust, act out, and show signs of depression.

The nurse is assessing a 16-year-old female for characteristics of anorexia nervosa. Which assessment finding(s) would lead the nurse to suspect the possibility of this diagnosis? (Select all that apply.) a. Amenorrhea b. Severe weight loss c. Oily skin d. Hypertension e. Lanugo on back

ANS: A, B, E The primary symptom of anorexia nervosa is severe weight loss. Adolescents who wish to be fashion models or actresses or who participate in sports, dance, or gymnastics activities may be at risk for developing an eating disorder. On physical examination, some of the following conditions may be evident: dry skin, amenorrhea, lanugo hair over the back and extremities, cold intolerance, low blood pressure, abdominal pain, and constipation.

The school nurse cautions a group of parents about the prevalence of children who get high by inhaling hydrocarbons and fluorocarbons. Which products contain these substances? (Select all that apply.) a. Glue b. Chlorine c. Cleaning fluid d. Copy machine toner e. Aerosol sprays

ANS: A, C, E Although there are many products that could be inhaled, the most frequently used products are glue, cleaning fluid, aerosol sprays, Freon, shoe polish, and gasoline products.

8. The nurse is conducting a staff in-service on casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast? a. Cheaper b. Dries rapidly c. Molds closely to body parts d. Smooth exterior

ANS: B A synthetic casting material dries in 5 to 30 minutes as compared with a plaster cast, which takes 10 to 72 hours to dry. Synthetic casts are more expensive and have a rough exterior, which may scratch surfaces. Plaster casts mold closer to body parts.

How does the nurse describe a person who is bulimic? a. Severely underweight b. Alternates binge eating with purging c. Introverted perfectionist d. Has extremely close family relationships

ANS: B Bulimia is characterized by alternating binge eating and purge behavior.

7. Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement? a. Healing is usually delayed in this type of fracture. b. Growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. This type of fracture is inconsistent with a fall.

ANS: B Detection of epiphyseal injuries is sometimes difficult, but fractures involving the epiphysis or epiphyseal plate present special problems in determining whether bone growth will be affected. Healing of epiphyseal injuries is usually prompt. The epiphysis is the weakest point of the long bones. This is a frequent site of damage during trauma.

2. The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status? a. Hypocalcemia b. Decreased metabolic rate c. Positive nitrogen balance d. Increased production of stress hormones

ANS: B Immobilization causes a decreased metabolic rate with slowing of all systems and a decreased food intake. Immobilization leads to hypercalcemia and causes a negative nitrogen balance secondary to muscle atrophy. A decreased production of stress hormones occurs with decreased physical and emotional coping capacity.

A 14-year-old girl with obsessive-compulsive disorder (OCD) tells the nurse other adolescents tease her because she washes her hands many times during the school day. For what does this disorder put the adolescent at greater risk? a. Anorexia nervosa b. Depression c. ADHD d. A learning disability

ANS: B OCD is related to depression and other psychiatric disorders. Suicidal behavior is a high risk for adolescents with OCD.

What role has the child of an alcoholic assumed if he tries to do everything perfectly? a. Perfect child b. Super coper c. Flight d. Helper

ANS: B Of the four roles for the child of the alcoholic, the super coper is one who tries to do everything perfectly and feels overly responsible. The perfect child is the child who tries to earn love by never causing any trouble.

A young child on the pediatric unit cannot express himself well. What therapeutic intervention might the nurse implement that allows children to act out their feelings? a. Art therapy b. Play therapy c. Music therapy d. Bibliotherapy

ANS: B Play therapy allows a young child to act out with dolls or figures concerns that the child may be unable to adequately express verbally.

The nurse explains that use of stimulants will decrease hyperactivity in the autistic child. What is a negative aspect of stimulants? a. Sedating the child b. Impairing cognition c. Causing hypotension d. Creating fluid retention

ANS: B Stimulants that decrease the hyperactivity in the autistic child also impair cognition and may increase the potential of self-injuring behavior.

The nurse is answering phone calls at a local suicide prevention hotline. Which statement would be recognized as the greatest risk of suicide? a. "I just needed to talk to someone to keep myself from thinking silly thoughts about killing myself." b. "My parents aren't home and won't be back for 4 hours. That should be enough time for the pills to work. I've got a hundred of them." c. "My dad will be home first, so he'll find me. So I think I'll use his gun. I hope he didn't lock the cabinet." d. "My girlfriend is here with me. She told me to call because I was talking crazy about killing myself."

ANS: B The risk of death increases when there is a definite plan of action, the means are readily available, and the person has few resources for help and support.

Which substance puts a person at the greatest risk for HIV and hepatitis B? a. Alcohol b. Opiates c. Cocaine d. Marijuana

ANS: B The use of opiates coupled with sharing needles put the user at risk for HIV and hepatitis B.

17. Which is an appropriate nursing intervention when caring for a child in traction? a. Remove adhesive traction straps daily to prevent skin breakdown. b. Assess for tightness, weakness, or contractures in uninvolved joints and muscles. c. Provide active range-of-motion exercises to affected extremity three times a day. d. Keep the child in one position to maintain good alignment.

ANS: B Traction places stress on the affected bone, joint, and muscles. The nurse must assess for tightness, weakness, or contractures developing in the uninvolved joints and muscles. The adhesive straps should be released or replaced only when absolutely necessary. Active, passive, or active with resistance exercises should be carried out for the unaffected extremity only. Movement is expected with children. Each time the child moves, the nurse should check to ensure that proper alignment is maintained.

13. An adolescent with a fractured femur is in Russell's traction. Surgical intervention to correct the fracture is scheduled for the morning. Nursing actions should include which action? a. Maintaining continuous traction until 1 hour before the scheduled surgery b. Maintaining continuous traction and checking position of traction frequently c. Releasing traction every hour to perform skin care d. Releasing traction once every 8 hours to check circulation

ANS: B When the muscles are stretched, muscle spasm ceases and permits realignment of the bone ends. The continued maintenance of traction is important during this phase because releasing the traction allows the muscle's normal contracting ability to again cause malpositioning of the bone ends. Continuous traction must be maintained to keep the bone ends in satisfactory realignment. Releasing at any time, either 1 hour before surgery, once every hour for skin care, or once every 8 hours would not keep the fracture in satisfactory alignment.

A child is diagnosed with attention-deficit hyperactivity disorder (ADHD). Which characteristics would the nurse assess in this child? (Select all that apply.) a. Social anxiety b. Impulsivity c. Hyperactivity d. Distractibility e. Inattention

ANS: B, C, D, E ADHD is characterized by inattention, hyperactivity, impulsivity, and distractibility.

2. A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session? (Select all that apply.) a. Bone fractures b. Abdominal mass c. Sore throat and ear pain d. Headache e. Ecchymosis of conjunctiva

ANS: B, C, E The initial signs and symptoms of rhabdomyosarcoma tumors are related to the site of the tumor and compression of adjacent organs. Some tumor locations, such as the orbit, manifest early in the course of the illness. Other tumors, such as those of the retroperitoneal area, only produce symptoms when they are relatively large and compress adjacent organs. Unfortunately, many of the signs and symptoms attributable to rhabdomyosarcoma are vague and frequently suggest a common childhood illness, such as "earache" or "runny nose." An abdominal mass, sore throat and ear pain, and ecchymosis of conjunctiva are signs of a rhabdomyosarcoma tumor. Bone fractures would be seen in osteosarcoma and a headache is a sign of a brain tumor.

What is an expected assessment finding in a child with coarctation of the aorta? a. Orthostatic hypotension b. Systolic hypertension in the lower extremities c. Blood pressure higher on the left side of the body d. Disparity in blood pressure between the upper and lower extremities

Disparity in blood pressure between the upper and lower extremities The classic finding in children with coarctation of the aorta is a disparity in pulses and blood pressures between the upper and lower extremities.

A 15-year-old boy was previously active in a band and saved money to buy a special guitar. What would a nurse assess as an early sign of depression in this boy? a. He gives up the band to spend time with his girlfriend. b. He spends all of his time at the library studying to qualify for the honor society. c. He gives his guitar away and spends his time listening to music in his room. d. He withdraws all of his money out of the bank to buy an expensive leather jacket.

ANS: C A major depression is characterized by a prolonged behavioral change from baseline that interferes with school, family life, and age-specific activities, frequently signaled by giving prized possessions away.

22. A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable? a. Newborn period b. When child starts to walk c. Preadolescent growth spurt d. Adolescence

ANS: C Idiopathic scoliosis is most noticeable during the preadolescent growth spurt. Idiopathic scoliosis is seldom apparent before age 10 years. Diagnosis usually occurs during the preadolescent growth spurt.

18. The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included? a. Apply lotion or powder to minimize skin irritation. b. Remove harness several times a day to prevent contractures. c. Return to clinic every 1 to 2 weeks. d. Place diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin.

ANS: C Infants have a rapid growth pattern. The child needs to be assessed by the practitioner every 1 to 2 weeks for possible adjustments. Lotions and powders should not be used with the harness. The harness should not be removed, except as directed by the practitioner. A thin disposable diaper can be placed under the harness.

24. The nurse is taking care of a 10-year-old child who has osteomyelitis. Which treatment plan is considered the primary method of treating osteomyelitis? a. Joint replacement b. Bracing and casting c. Intravenous antibiotic therapy d. Long-term corticosteroid therapy

ANS: C Osteomyelitis is an infection of the bone, most commonly caused by Staphylococcus aureus. The treatment of choice is antibiotics. Joint replacement, bracing and casting, and long-term corticosteroid therapy are not indicated for infectious processes.

15. Which type of traction uses skin traction on the lower leg and a padded sling under the knee? a. Dunlop b. Bryant c. Russell d. Buck extension

ANS: C Russell traction uses skin traction on the lower leg and a padded sling under the knee. The combination of longitudinal and perpendicular traction allows realignment of the lower extremity and immobilizes the hips and knees in a flexed position. Dunlop traction is an upper-extremity traction used for fractures of the humerus. Bryant traction is skin traction with the legs flexed at a 90-degree angle at the hip. Buck extension traction is a type of skin traction with the legs in an extended position. It is used primarily for short-term immobilization, preoperatively with dislocated hips, for correcting contractures, or for bone deformities such as Legg-Calvé-Perthes disease.

19. A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation? a. Traction is tried first. b. Surgical intervention is needed. c. Frequent, serial casting is tried first. d. Children outgrow this condition when they learn to walk.

ANS: C Serial casting is begun shortly after birth before discharge from nursery. Successive casts allow for gradual stretching of skin and tight structures on the medial side of the foot. Manipulation and casting of the leg are repeated frequently (every week) to accommodate the rapid growth of early infancy. Serial casting is the preferred treatment. Surgical intervention is done only if serial casting is not successful. Children do not improve without intervention.

What is the most appropriate classroom intervention for a child with attention-deficit hyperactivity disorder (ADHD) for the school nurse to suggest? a. Seat the child in the back of the room to prevent distractions for other children. b. Pair the child with a student buddy to offer reminders to pay attention. c. Divide work assignments into shorter periods with breaks in between. d. Separate the child from others to increase his focus on schoolwork.

ANS: C The child with ADHD needs breaks between periods of work and study.

29. The nurse is caring for a school-age child diagnosed with juvenile idiopathic arthritis (JIA). Which intervention should be a priority? a. Apply ice packs to relieve stiffness and pain. b. Administer acetaminophen to reduce inflammation. c. Teach the child and family correct administration of medications. d. Encourage range-of-motion exercises during periods of inflammation.

ANS: C The management of JIA is primarily pharmacologic. The family should be instructed regarding administration of medications and the value of regular schedule of administration to maintain a satisfactory blood level in the body. They need to know that NSAIDs should not be given on an empty stomach and to be alert for signs of toxicity. Warm moist heat is best for relieving stiffness and pain. Acetaminophen does not have antiinflammatory effects. Range-of-motion exercises should not be done during periods of inflammation.

31. A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement? a. "We will be very careful handling the baby." b. "We will lift the baby by the buttocks when diapering." c. "We're glad there is a cure for this disorder." d. "We will schedule follow-up appointments as instructed."

ANS: C The treatment for OI is primarily supportive. Although patients and families are optimistic about new research advances, there is no cure. The use of bisphosphonate therapy with IV pamidronate to promote increased bone density and prevent fractures has become standard therapy for many children with OI; however, long bones are weakened by prolonged treatment. Infants and children with this disorder require careful handling to prevent fractures. They must be supported when they are being turned, positioned, moved, and held. Even changing a diaper may cause a fracture in severely affected infants. These children should never be held by the ankles when being diapered but should be gently lifted by the buttocks or supported with pillows. Follow-up appointments for treatment with bisphosphonate can be expected.

30. The nurse is caring for a 12-year-old child with a left leg below the knee amputation (BKA). The child had the surgery 1 week ago. Which intervention should the nurse plan to implement for this child? a. Elevate the left stump on a pillow. b. Place ice pack on the stump. c. Encourage the child to use an overhead bed trapeze when repositioning. d. Replace the ace wrap covering the stump with a gauze dressing.

ANS: C Use of the overhead bed trapeze should be encouraged to begin to build up the arm muscles necessary for walking with crutches. Stump elevation may be used during the first 24 hours, but after this time, the extremity should not be left in this position because contractures in the proximal joint will develop and seriously hamper ambulation. Ice would not be an appropriate intervention and would decrease circulation to the stump. Stump shaping is done postoperatively with special elastic bandaging using a figure-eight bandage, which applies pressure in a cone-shaped fashion. This technique decreases stump edema, controls hemorrhage, and aids in developing desired contours so the child will bear weight on the posterior aspect of the skin flap rather than on the end of the stump. This wrap should not be replaced with a gauze dressing.

5. The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.) a. Palpable distal pulse b. Capillary refill to extremity less than 3 seconds c. Severe pain not relieved by analgesics d. Tingling of extremity e. Inability to move extremity

ANS: C, D, E Indications of compartment syndrome are severe pain not relieved by analgesics, tingling of extremity, and inability to move extremity. A palpable distal pulse and capillary refill to the extremity less than 3 seconds are expected findings.

The nurse counsels parents that the early school years create nervous tension in the child manifested by which abnormal behavior(s)? (Select all that apply.) a. Masturbation b. Food fads c. Stuttering d. Aggressive behavior e. Nonnutritive sucking

ANS: C, D, E Stuttering, aggressive behavior, and finger or thumb sucking that appear suddenly with no previous history are a clue to increased nervous tension in the young school-age child. Masturbation and food fads are normal behavioral phenomena for the early school-age child.

How is a gateway substance defined? a. Recreational drug used occasionally b. Nonaddictive drug used daily c. Drug used to wean from stronger drugs d. Substance that can lead to use of stronger drugs

ANS: D A gateway drug is a substance that creates a high that can lead to the use of stronger drugs.

14. Which is a type of skin traction with legs in an extended position? a. Dunlop b. Bryant c. Russell d. Buck extension

ANS: D Buck extension traction is a type of skin traction with the legs in an extended position. It is used primarily for short-term immobilization, preoperatively with dislocated hips, for correcting contractures, or for bone deformities such as Legg-Calvé-Perthes disease. Dunlop traction is an upper-extremity traction used for fractures of the humerus. Bryant traction is skin traction with the legs flexed at a 90-degree angle at the hip. Russell traction uses skin traction on the lower leg and a padded sling under the knee. The combination of longitudinal and perpendicular traction allows realignment of the lower extremity and immobilizes the hips and knees in a flexed position.

The nurse asks, "Do your parents drink every day?" The adolescent suddenly shouts, "I'm not going to talk about that! It's none of your business, anyway! Leave me alone!" How does the nurse interpret the adolescent's behavior? a. The adolescent is acting out and needs to be brought under control so the conference can continue. b. The adolescent is trying to shift the focus of the conference away from himself, and the nurse needs to refocus. c. The adolescent is demonstrating that this problem requires the assistance of a psychiatrist. d. The adolescent is responding to the discrediting of his parents, which causes anxiety.

ANS: D Discrediting parents threatens the child's security and creates anxiety.

A mother is concerned because her adolescent son is always in trouble for fighting at school and always seems to be angry. She mentions that her husband drinks a bit. Which understanding will guide the nurse's response? a. The boy is displaying antisocial behavior and should be evaluated for mental illness. b. The boy is displaying one of the typical defense patterns of children of alcoholics and should receive immediate treatment. c. The mother is displaying her own anger with her husband's drinking, and she needs immediate intervention. d. The boy is only one member of the family affected by alcoholism, and all members should receive immediate intervention.

ANS: D Early recognition of and intervention for children of alcoholics are paramount. This adolescent is using the coping pattern of acting-out behaviors to deal with the family situation.

21. The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition? a. Lateral curvature of the spine b. Immobility of the shoulder joint c. Exaggerated concave lumbar curvature of the spine d. Increased convex angulation in the curve of the thoracic spine

ANS: D Kyphosis is an abnormally increased convex angulation in the curve of the thoracic spine. Scoliosis is a complex spinal deformity usually involving lateral curvature, spinal rotation causing rib asymmetry, and thoracic hypokyphosis. Ankylosis is the immobility of a joint. Lordosis is an exaggerated concave lumbar curvature of the spine.

28. Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? a. Aspirin b. Corticosteroids c. Cytotoxic drugs such as methotrexate d. Nonsteroidal anti-inflammatory drugs (NSAIDs)

ANS: D NSAIDs are the first drugs used in JIA. Naproxen, ibuprofen, and tolmetin are approved for use in children. Aspirin, once the drug of choice, has been replaced by the NSAIDs because they have fewer side effects and easier administration schedules. Corticosteroids are used for life-threatening complications, incapacitating arthritis, and uveitis. Methotrexate is a second-line therapy for JIA.

20. A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action? a. Encouraging normal activity for as long as is possible b. Explaining the cause of the disease to the child and family c. Preparing the child and family for long-term, permanent disabilities d. Teaching the family the care and management of the corrective appliance

ANS: D The family needs to learn the purpose, function, application, and care of the corrective device and the importance of compliance to achieve the desired outcome. The initial therapy is rest and non-weight bearing, which helps reduce inflammation and restore motion. Legg-Calvé-Perthes is a disease with an unknown etiology. A disturbance of circulation to the femoral capital epiphysis produces an ischemic aseptic necrosis of the femoral head. The disease is self-limiting, but the ultimate outcome of therapy depends on early and efficient therapy and the child's age at onset.

9. The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching? a. Swelling of the fingers is to be expected for the next 48 hours. b. Immobilize the shoulder to decrease pain in the arm. c. Allow the affected limb to hang down for 1 hour each day. d. Elevate casted arm when resting and when sitting up.

ANS: D The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return. Swelling of the fingers may indicate neurovascular damage and should be reported immediately. Permanent damage can occur within 6 to 8 hours. Joints above and below the cast on the affected extremity should be moved. The affected limb should not hang down for any length of time.

What would be the appropriate response to an adolescent who states, "This has been the worst day of my life?" a. "You should focus your mind on positive thoughts." b. "Everybody has a bad day now and then." c. "You're young. What could be so terrible?" d. "Tell me about the worst day of your life."

ANS: D The nurse establishes a rapport with the adolescent by acknowledging his or her feelings and giving the adolescent full attention.

1. The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status? a. Metabolic rate increases b. Increased joint mobility leading to contractures c. Bone calcium increases, releasing excess calcium into the body (hypercalcemia) d. Venous stasis leading to thrombi or emboli formation

ANS: D The physiologic effects of immobilization, as a result of decreased muscle contraction, include venous stasis. This can lead to pulmonary emboli or thrombi. The metabolic rate decreases with immobilization. Loss of joint mobility leads to contractures. Bone demineralization with osteoporosis and hypercalcemia occur with immobilization.

10. The nurse uses the palms of the hands when handling a wet cast for which reason? a. To assess dryness of the cast b. To facilitate easy turning c. To keep the patient's limb balanced d. To avoid indenting the cast

ANS: D Wet casts should be handled by the palms of the hands, not the fingers, to avoid creating pressure points. Assessing dryness, facilitating easy turning, and keeping the patient's limb balanced are not reasons for using the palms of the hand rather than the fingers when handling a wet cast.

A nurse is assessing a child with a tick-borne disease. Which of the following would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain Spotted Fever? a) Headache b) Fever c) Absence of rash d) Malaise

Absence of rash Both Rocky Mountain Spotted Fever and ehrlichiosis are manifested by fever, headache, and malaise. However, there is rarely a rash with ehrlichiosis, which helps to differentiate it from Rocky Mountain Spotted Fever.

Before giving a dose of digoxin (Lanoxin), the nurse checked an infant's apical heart rate and it was 114 bpm. What should the nurse do next? a. Administer the dose as ordered. b. Hold the medication until the next dose. c. Wait and recheck the apical heart rate in 30 minutes. d. Notify the physician about the infant's heart rate.

Administer the dose as ordered. The infant's heart rate is above the lower limit for which the medication is held. The dose can be given.

The parent of a child with mumps calls the clinic to find out how long the child needs to stay home from school. The nurse would instruct the parent to allow the child to return to school at which time? a) After 9 days from the onset of swelling b) Within 3 days of starting antiviral therapy c) Usually 7 days after the last lesion appears d) In about 5 days, once the lesions crust

After 9 days from the onset of swelling In the home, educate the family to keep the child with mumps from attending school or daycare until 9 days after the onset of swelling. Mumps involves swelling of the salivary glands; no lesions are present. Therapy for mumps is primarily supportive; antiviral agents are not used.

When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure? a. The right arm b. The left arm c. All four extremities d. Both arms while the child is crying

All four extremities When a CHD is suspected, the blood pressure should be measured in all four extremities while the child is quiet. Discrepancies between upper and lower extremities may indicate cardiac disease.

A child had an aortic stenosis defect surgically repaired 6 months ago. Which antibiotic prophylaxis is indicated for an upcoming tonsillectomy? a. No antibiotic prophylaxis is necessary. b. Amoxicillin is taken orally 1 hour before the procedure. c. Oral penicillin is given for 7 to 10 days before the procedure. d. Parenteral antibiotics are administered for 5 to 7 days after the procedure.

Amoxicillin is taken orally 1 hour before the procedure. The standard prophylactic agent is amoxicillin given orally 1 hour before the procedure.

The rash in roseola is pruritic. Which of the following measures would you teach the father to provide comfort? a) Discuss with the child the importance of not scratching lesions. b) Dress the child warmly to bring out the rash so that it fades quickly. c) Apply cool compresses to the skin to stop local itching. d) Administer infant aspirin every 4 hours as necessary for comfort.

Apply cool compresses to the skin to stop local itching. Cool compresses can minimize pruritus. Aspirin should not be given with increased temperature (flu-like symptoms).

What is the nurse's first action when planning to teach the parents of an infant with a CHD? a. Assess the parents' anxiety level and readiness to learn. b. Gather literature for the parents. c. Secure a quiet place for teaching. d. Discuss the plan with the nursing team.

Assess the parents' anxiety level and readiness to learn. Any effort to organize the right environment, plan, or literature is of no use if the parents are not ready to learn or have high anxiety. Decreasing level of anxiety is often needed before new information can be processed.

A 3-week-old infant is diagnosed with pertussis. Which antimicrobial agent would the nurse expect the physician to prescribe? a) Trimethoprim-sulfamethoxazole b) Erythromycin c) Clarithromycin d) Azithromycin

Azithromycin The macrolides (erythromycin, azithromycin, and clarithromycin) are the drugs of choice for pertussis in children over 6 months of age. Azithromycin and clarithromycin are not FDA approved for use in infants younger than 6 months; however, infants younger than 1 month old should be treated with azithromycin because erythromycin is associated with increased risk of infantile hypertrophic pyloric stenosis. Trimethoprim-sulfamethoxazole is an alternative antibiotic for children who cannot tolerate erythromycin.

A 13-year-old boy who recently immigrated to the United States from India is found to be infected by a strain of the poliovirus. After initial symptoms of fever, headache, nausea, vomiting and abdominal pain subside, the virus proceeds to his central nervous system. Which of the following would be the best intervention for this client at this point? a) Salicylic acid solution b) Bed rest, analgesia, and application of moist hot packs c) Vaccination d) Antibiotics

Bed rest, analgesia, and application of moist hot packs Treatment for poliomyelitis is bed rest with analgesia and moist hot packs to relieve pain. Vaccination would be too late, at this point, as the infection has already occurred. Antibiotics would be ineffective as this is a viral, not a bacterial, infection. Salicylic acid solution is used to treat warts.

When developing the plan of care for a 5-year-old boy with Rocky Mountain spotted fever, the nurse integrates knowledge of this infection as being caused by which of the following? a) Animal bite b) Infection with group A streptococcus c) Contact with contaminated sports equipment d) Bite of a tick

Bite of a tick Rocky Mountain spotted fever is a tick-borne infection. Rabies is due to the bite of an animal. Community-acquired methicillin-resistant Staphylococcus aureus is transmitted through direct person-to-person contact, respiratory droplets, blood, or sharing of personal items and touching surfaces or items contaminated with methicillin-resistant S. aureus. Scarlet fever is an infection resulting from group A streptococcus.

Which of the following is a symptom of neonatal sepsis? a) Hyperglycemia b) Hypertension c) Bradycardia d) Increased urine output

Bradycardia Symptoms of neonatal sepsis are bradycardia or tachycardia, hypotension, decreased urine output, and hypoglycemia.

An adolescent is brought to the emergency department. The patient reports decreased urine output headaches, and abdominal swelling. On the basis of these data, which condition does the nurse suspect?

Chronic glomerulonephritis

What should the nurse include in discharge teaching as the highest priority for the child with a cardiac dysrhythmia? a. CPR instructions b. Repeating digoxin if the child vomits c. Resting if dizziness occurs d. Checking the child's pulse after digoxin administration

CPR instructions This could potentially be life-saving for the child. The parents and significant others in the child's life should have CPR training.

A nurse is assigned to care for an infant with an unrepaired tetralogy of Fallot. What should the nurse do first when the baby is crying and becomes severely cyanotic? a. Place the infant in a knee-chest position. b. Administer oxygen. c. Administer morphine sulfate. d. Calm the infant.

Calm the infant. Calming the crying infant is the first response. An infant with unrepaired tetralogy of Fallot who is crying and agitated may eventually lose consciousness.

Which drug is an angiotensin-converting enzyme (ACE) inhibitor? a. Captopril (Capoten) b. Furosemide (Lasix) c. Spironolactone (Aldactone) d. Chlorothiazide (Diuril)

Captopril (Capoten) Capoten is a drug in an ACE inhibitor.

A common, serious complication of rheumatic fever is a. Seizures b. Cardiac dysrhythmias c. Pulmonary hypertension d. Cardiac valve damage

Cardiac valve damage Cardiac valve damage is the most significant complication of rheumatic fever.

Which menu choices for a child diagnosed with urinary disorder leading to hyperkalemia indicate the need for further instruction by the nurse?

Carrots and green, leafy vegetables

A child is diagnosed with an enterovirus infection. Which type of infection control precaution would be most important for the nurse to use? a) Droplet b) Standard c) Contact d) Airborne

Contact For the child with an enterovirus infection, contact precautions are used during the illness. Standard precautions are followed at all times and are appropriate for any child. Droplet precautions would be used for a child infected with pertussis. Airborne precautions would be indicated for the child with varicella.

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions requires placing a patient in an isolated room with limited access, wearing gloves during contact with the patient and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between patients? a) Droplet precautions b) Standard precautions c) Airborne precautions d) Contact precautions

Contact precautions Contact precautions means placing the patient in an isolation room with limited access, wearing gloves during contact with the patient and all body fluids, wearing two layers of protective clothing, limiting movement of the patient from the room, and avoiding sharing equipment between patients

The nurse is admitting a child who has been diagnosed with Kawasaki disease. What is the most serious complication for which the nurse should assess in Kawasaki disease? a. Cardiac valvular disease b. Cardiomyopathy c. Coronary aneurysm d. Rheumatic fever

Coronary aneurysm Coronary artery aneurysms are seen in 20% to 25% of children with untreated Kawasaki disease.

The primary nursing intervention to prevent bacterial endocarditis is a. Institute measures to prevent dental procedures. b. Counsel parents of high-risk children about prophylactic antibiotics. c. Observe children for complications, such as embolism and heart failure. d. Encourage restricted mobility in susceptible children.

Counsel parents of high-risk children about prophylactic antibiotics. The objective of nursing care is to counsel the parents of high risk children about both the need for prophylactic antibiotics for dental procedures and the necessity of maintaining excellent oral health. The child's dentist should be aware of the child's cardiac condition.

A young patient arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as which of the following? a) Pityriasis rosea b) Fifth disease c) Enterovirus d) Rosacea

Fifth disease Erythema infectiosum is also known as "fifth disease." It starts with a fever, headache, and malaise. One week later, a rash appears on the face. A day later, the rash appears on the extensor surfaces of the extremities. One more day later, the rash appears on the trunk and flexor surfaces of the extremities.

The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection. Which of the following would the nurse expect to assess if the adolescent has trichomoniasis? a) Urinary incontinence b) Green vaginal discharge c) Lesions on the vulva d) Flu-like symptoms

Green vaginal discharge Symptoms of trichomoniasis include a yellow, green, or gray vaginal discharge with a foul odor. Urinary incontinence is not indicative of trichomoniasis, but dysuria is. Syphilis is associated with flu-like symptoms Lesions on the vulva are a sign of venereal warts.

What nursing intervention can be used as a diversion for a child who is hospitalized for a length of time and whose parents are unable to visit frequently?

Have the parents bring a box with smaller packages in it marked with different days. The child can open one each day until the parents return.

The nurse is performing a physical assessment of a school-aged child with a history of urinary tract infection (UTI). The child's urine has been brownish lately. On the basis of these data, the nurse explains that a diagnostic test may be ordered to assess for which item in the urine?

Hematuria

Which urinalysis result should the nurse anticipate for a child who is admitted with acute glomerulonephritis?

Hematuria and proteinuria

The nurse is admitting a child to the hospital for a cardiac workup. What is the first step in a cardiac assessment? a. Percussion b. Palpation c. Auscultation d. History and inspection

History and inspection The assessment should begin with the least threatening interventions—the history and inspection. Assessment progression includes inspection, auscultation, and palpation because each step includes more touching.

Which statement suggests that a parent understands how to correctly administer digoxin? a. "I measure the amount I am supposed to give with a teaspoon." b. "I put the medicine in the baby's bottle." c. "When she spits up right after I give the medicine, I give her another dose." d. "I give the medicine at 8 in the morning and 8 in the evening every day."

I give the medicine at 8 in the morning and 8 in the evening every day For maximum effectiveness, the medication should be given at the same time every day.

a nurse is teaching the parent of a toddler about home safety. which of the following statements by the parent indicates an understanding of the teaching?

I lock my medications in the medicine cabinet

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which of the following? a) Prodromal period b) Illness period c) Incubation period d) Convalescent period

Incubation period The incubation period is the first stage of the infectious disease. It is the time between the invasion of an organism and the onset of symptoms of infection.

Which of the following would you expect to observe about the rash associated with chickenpox (varicella)? a) Noticeable crusts but no pruritus b) Dark red color (red hen marks) c) Various stages of lesions present at the same time d) Dark red, macular, very pruritic lesions

Various stages of lesions present at the same time Chickenpox lesions appear "in waves," so many stages of lesions are present at the same time.

A nurse is teaching a group of parents about separation anxiety. Which of the following information should the nurse include in the teaching? a. It is often observed in the school-age child b. Detachment is the stage exhibited in the hospital c. It results in prolonged issues of adaptability d. Kicking a stranger is an example

Kicking a stranger is an example

The appearance of which hallmark clinical manifestation occurs in measles? a) Koplik spots b) Fever c) Cough d) Conjunctivitis

Koplik spots The hallmark of measles is the appearance of Koplik spots. Other typical symptoms include fever, conjunctivitis, and a cough.

Which strategy is appropriate when feeding the infant with congestive heart failure? a. Continue the feeding until a sufficient amount of formula is taken. b. Limit feeding time to no more than 30 minutes. c. Always bottle feed every 4 hours. d. Feed larger volumes of concentrated formula less frequently.

Limit feeding time to no more than 30 minutes. The infant with congestive heart failure may tire easily, so the feeding should not continue beyond 30 minutes. If inadequate amounts of formula are taken, gavage feedings should be considered.

The nurse discovers a heart murmur in an infant 1 hour after birth. She is aware that fetal shunts are closed in the neonate at what point? a. When the umbilical cord is cut b. Within several days of birth c. Within a month after birth d. By the end of the first year of life

Within several days of birth In the normal neonate, fetal shunts functionally close in response to pressure changes in the systemic and pulmonary circulations and to increased oxygen content. This process may take several days to complete.

A group of camp nurses is discussing various types of tick bites. One of the nurses states that deer ticks are carried by white-footed mice and white-tailed deer, and can carry the organism that causes which of the following diseases? a) Gonorrhea b) Lyme disease c) Rheumatic fever d) Acquired immunodeficiency syndrome

Lyme disease Deer ticks, carried by white-footed mice and white-tailed deer, can carry the organism that causes lyme disease.

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which of the following conditions? a) Herpes zoster b) Poliomyelitis c) Infectious mononucleosis d) Mumps

Mumps Initial symptoms of mumps include fever, headache, anorexia, and malaise. Within 24 hours, pain on chewing and an "earache" occurs. When the child points to the site of the earache, however, the child points, not to the ear, but to the jawline just in front of the ear lobe, the site of the parotid gland. By the next day, the gland appears swollen and feels tender; the ear becomes displaced upward and backward. Boys may also develop testicular pain and swelling (orchitis). None of the other conditions listed matches the symptoms indicated.

A 7-year-old patient with an earache comes to the clinic. The child's mother reports that 1 day ago the patient had a fever and headache and did not want to play. When the nurse asks where it hurts, the patient points to the jawline in front of the earlobe. What does the nurse expect the diagnosis to be for this patient? a) Fifth disease b) Mumps c) Measles d) Mononucleosis

Mumps Mumps begin with a fever, headache, anorexia, and malaise. Within 24 hours an earache occurs. When pointing to the site of pain, however, the child points to the jawline just in front of the earlobe.

After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does the nurse suspect has developed? a. Diabetes insipidus b. Diabetes mellitus c. Hypothyroidism d. Hyperthyroidism

a. Diabetes insipidus

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? a) Legs b) Stomach c) Neck d) Arms

Neck Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach.

The nurse is speaking to a health care provider who states, "Yes, this type of child abuse is the most common that we see." The nurse interprets that the health care provider is describing which type of child abuse?

Neglect.

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect? a. Pulmonary stenosis b. Patent ductus arteriosus c. Ventricular septal defect d. Coarctation of the aorta

Patent ductus arteriosus A systolic ejection murmur that may be accompanied by a palpable thrill is a manifestation of pulmonary stenosis.

Before preparing a teaching plan for the parents of an infant with ductus arteriosus, it is important that the nurse understands this condition. Which statement best describes patent ductus arteriosus? a. Patent ductus arteriosus involves a defect that results in a right-to-left shunting of blood in the heart. b. Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. c. Patent ductus arteriosus is a stenotic lesion that must be surgically corrected at birth. d. Patent ductus arteriosus causes an abnormal opening between the four chambers of the heart.

Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. Patent ductus arteriosus is failure of the fetal shunt between the aorta and the pulmonary artery to close.

When the physician looks in a child's mouth during a sick-visit exam, the mother exclaims: "Her tongue is bright red! It was not like that yesterday." The physician would most likely order which medication based on the probable diagnosis of scarlet fever? a) Penicillin to prevent acute glomerulonephritis b) Acetaminophen to decrease the throat pain c) Erythromycin to prevent the spread to siblings d) Steroids to decrease the inflammation

Penicillin to prevent acute glomerulonephritis A "strawberry tongue" is a classic sign of scarlet fever. Penicillin is prescribed to prevent the complications of acute glomerulonephritis and rheumatic fever associated with beta-hemolytic group A streptococcal infections.

A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this child's laboratory values, the nurse is not surprised to notice which abnormality? a. Polycythemia b. Infection c. Dehydration d. Anemia

Polycythemia Polycythemia is a compensatory response to chronic hypoxia. The body attempts to improve tissue oxygenation by producing additional red blood cells and thereby increases the oxygen-carrying capacity of the blood.

A nurse is conducting a class for nursing students about fetal circulation. Which statement is accurate about fetal circulation and should be included in the teaching session? a. Oxygen is carried to the fetus by the umbilical arteries. b. Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen ovale. c. Pulmonary vascular resistance is high because the lungs are filled with fluid. d. Blood flows from the ductus arteriosus to the pulmonary artery.

Pulmonary vascular resistance is high because the lungs are filled with fluid. Resistance in the pulmonary circulation is very high because the lungs are collapsed and filled with fluid.

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes erythema? a) Small elevation of epidermis filled with a viscous fluid b) Small, circumscribed, solid elevation of the skin c) Discolored skin spot not elevated at the surface d) Redness of the skin produced by congestion of the capillaries

Redness of the skin produced by congestion of the capillaries Erythema is redness of the skin produced by congestion of the capillaries.

A toddler who refuses to eat, demands a bottle and asks his mother to feed him is demonstrating _______ through his behaviors.

Regression

A nurse is caring for a preschooler. Which of the following is an expected behavior of a preschool-age child? a. Describing manifestations of illness b. Relating fears to magical thinking c. Understanding cause of illness d. Awareness of body functioning

Relating fears to magical thinking

A school-aged child is diagnosed with pyelonephritis. When planning to teach the child's parents about this diagnosis, the nurse tells them that the infection is located in which structure?

Renal parenchyma

A child has a total cholesterol level of 180 mg/dL. What dietary recommendations should the nurse make to the child and the child's parents? Select all that apply. a. Replace whole milk for 2% or 1% milk. b. Increase servings of red meat. c. Increase servings of fish. d. Avoid excessive intake of fruit juices. e. Limit servings of whole grain.

Replace whole milk for 2% or 1% milk. Increase servings of fish. Avoid excessive intake of fruit juices. A low-fat diet includes using nonfat or low-fat dairy products, limiting red meat intake, and increasing intake of fish, vegetables, whole grains, and legumes. Incorrect Children should avoid excessive intake of fruit juices and other sweetened drinks, sugars, and saturated fats.

A 6-month-old baby boy is brought to the doctor's office with a high fever. The physician diagnoses the child as having a viral infection of some kind and recommends acetaminophen to reduce the fever. After 3 days, the mother returns with the child. The fever is gone, but a rash of discrete, rose-pink macules approximately 2 to 3 mm and flat with the skin surface appears. Which condition should the nurse suspect? a) Roseola b) Rubella (German measles) c) Measles (Rubeola) d) Chickenpox (Varicella)

Roseola Roseola begins with a high fever; after 3 or 4 days, the fever falls abruptly and a distinctive rash of discrete, rose-pink macules approximately 2 to 3 mm in size and flat with the skin surface appears. With rubella, after the 1 to 5 days of prodromal signs, a discrete pink-red maculopapular rash begins on the face, then spreads downward to the trunk and extremities. On the third day, the rash disappears. Measles feature Koplik's spots (small, irregular, bright-red spots with a blue-white center point), which appear on the buccal membrane. Chickenpox is marked by a low-grade fever, malaise, and, in 24 hours, the appearance of a distinctive rash. Varicella lesions first begin as a macula, then progress rapidly within 6 to 8 hours to a papule, then a vesicle that becomes umbilicated and then forms a crust.

A nurse is assessing a child who was recently adopted from a foreign country and has not yet received any immunizations. The child has a high fever, rhinitis, and sore throat. The nurse also notes small, irregular, bright red spots on the buccal membrane. Which of the following would the nurse suspect? a) Rubella b) Variola c) Rubeola d) Varicella

Rubeola Small, irregular, bright red spots on the buccal membrane suggest Koplik's spots and, together with the child's other assessment findings, suggest rubeola. Koplik spots distinguish the disease because none of the other exanthems has this finding. Rubella is characterized by a low-grade fever, mild cough, sore throat, and red maculopapular rash. Varicella is characterized by a low-grade fever, malaise, and rash that begins as a macule and progresses to a papule and then a vesicle. Variola is characterized by chills, fever, headache, vomiting, and the appearance of a rash and high fever after 3 to 4 days.

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of which of the following? a) Scarlet fever b) Osteomyelitis c) Impetigo d) Pneumonia

Scarlet fever Group A streptococcal pharyngitis can progress to scarlet fever with the rash appearing in about 12 hours after the onset of the disease. Group A streptococcal pharyngitis is not associated with pneumonia. Impetigo is a group A strep infection involving the skin. Osteomyelitis can occur with an infection by group B streptococcus.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature has been over 102°F. He has this rash on his face and chest that looks like sunburn but feels really rough." Which of the following would the nurse suspect? a) Diphtheria b) Scarlet fever c) Pertussis d) Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA)

Scarlet fever Scarlet fever typically is associated with a sore throat, fever greater than 101°F, and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper. CAMRSA is typically manifested by skin and tissue infections. Diphtheria is characterized by a sore throat and difficulty swallowing but fever is usually below 102°F. Airway obstruction is apparent. Pertussis is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions.

A nurse is providing care to an infant who develops roseola during hospitalization. The nurse would institute which of the following infection control precautions. a) Contact b) Airborne c) Droplet d) Standard

Standard If an infant develops roseola infantum in the hospital, the nurse would follow standard precautions. There is no need for airborne, droplet, or contact precautions.

What is the most common causative agent of bacterial endocarditis? a. Staphylococcus albus b. Streptococcus hemolyticus c. Staphylococcus albicans d. Streptococcus viridans

Streptococcus viridans Streptococcus . viridans and S. aureus are the most common causative agents in bacterial (infective) endocarditis

What intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure? a. Weigh the infant every day on the same scale at the same time. b. Notify the physician when weight gain exceeds more than 20 g/day. c. Put the infant in a car seat to minimize movement. d. Administer digoxin (Lanoxin) as ordered by the physician.

Weigh the infant every day on the same scale at the same time. Excess fluid volume may not be overtly visible. Weight changes may indicate fluid retention. Weighing the infant on the same scale at the same time each day ensures consistency.

Which information should be included in the nurse's discharge instructions for a child who underwent a cardiac catheterization earlier in the day? a. Pressure dressing is changed daily for the first week. b. The child may soak in the tub beginning tomorrow. c. Contact sports can be resumed in 2 days. d. The child can return to school on the third day after the procedure.

The child can return to school on the third day after the procedure. . The child can return to school on the third day after the procedure. It is important to emphasize follow-up with the cardiologist.

The nurse is assessing a 6-year-old boy admitted to the hospital for a spiral fracture of the left arm. The mother reports he fell off the swing while outside. Which additional finding is suspicious for physical abuse?

The child clings to the nurse when his father enters the room.

One method of preventing communicable diseases in children is to administer vaccines to stimulate the development of antibodies. Which of the following best describes what occurs in the child when vaccines are given? a) The child develops a passive immunity. b) The child develops an active immunity. c) The child becomes a carrier of the disease. d) The child becomes a host for the disease.

The child develops an active immunity. When a vaccine is given, active immunity occurs which then stimulates the development of antibodies to destroy infective agents without causing the disease.

The nurse is assessing a 2-year-old child for signs of abuse. Which finding warrants further investigation by the nurse for possible abuse?

The child only says "baba" when speaking.

A nurse is teaching a parent about parallel play in children. Which of the following statements should the nurse include in the teaching? a. Children sit and observe others playing. b. Children exhibit organized play when in a group c. The child plays alone d. The child plays independently when in a group

The child plays independently when in a group

A 6-month-old boy develops roseola. When obtaining information from his father, which of the following information would you expect him to report? a) The infant is lethargic and not interested in playing. b) The infant's temperature fell when the rash appeared. c) The infant's temperature rose at the same time as the rash appeared. d) The rash is a mixture of papules and pustules.

The infant's temperature fell when the rash appeared. The mark of roseola is that the rash appears as the initial temperature decreases.

An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this patient that clearly indicates scarlet fever? a) There is pain along the jawline just in front of the ear lobe b) Fever blisters on the lips c) The tongue has a white or red "strawberry" appearance d) Vesicles that become purulent, ooze, and form honey-colored crusts

The tongue has a white or red "strawberry" appearance A "strawberry tongue" is a hallmark symptom of scarlet fever and helps to differentiate the disease from other rashes or pharyngeal infections. Pain along the jawline in front of the ear lobe indicates mumps. Vesicles that become purulent, ooze, and form honey-colored crusts are associated with impetigo. Fever blisters on the lips are caused by a herpes simplex infection.

What is important to explain to the family of a child who is moving from an intensive care unit to a step-down unit or to a regular floor?

They have a perception of security resulting from constant monitoring and individualized care. Explain that they will not receive the same type of care on the step-down units because it is not necessary.

A 5-year-old girl catches the flu from a friend at daycare after the friend sneezed and wiped mucus on a toy that the girl played then with. In this case, which of the following is the portal of exit in the chain of infection? a) Upper respiratory excretion b) The friend c) The 5-year-old girl d) Toy

Upper respiratory excretion The portal of exit is the route by which an organism leaves an infected child's body to be spread to others. Organism can be carried out of the body by upper respiratory excretions, feces, vomitus, saliva, urine, vaginal secretions, blood, or lesion secretions. The friend would be the reservoir, which is the container or place in which an organism grows and reproduces. The toy would be the means of transmission. The 5-year-old girl would be the susceptible host.

Which clinical manifestations should the nurse anticipate upon assessment of a preschool-aged child with a UTI?

Urgency, dysuria, and fever

The nurse is caring for a 10-year-old boy with diphtheria. Which of the following would the nurse institute as a tier 2 precaution? a) Use of a protective mask b) Use of a protective face shield c) Negative air pressure ventilation d) Use of a protective gown

Use of a protective mask : Use of a protective mask if within 3 feet of the child is a tier 2 precaution with diphtheria, which is transmitted through contact with droplets. Use of a protective gown is a tier 2 precaution for contact transmission. Negative air pressure ventilation is a tier 2 precaution for airborne transmission. Face shields are part of tier 1 precautions against contaminated splashes.

After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify which of the following as the primary cause? a) Bacteria b) Viruses c) Parasites d) Fungi

Viruses Most childhood exanthems are caused by viruses.

Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more teaching? a. "My pancreas is sick and needs insulin until it is well." b. "I will need to take my insulin every day." c. "I need to keep a piece of candy in my pocket in case I start to feel shaky." d. "My mom has to give me insulin shots twice a day.

a. "My pancreas is sick and needs insulin until it is well."

The nurse is discussing insulin shock with parents of a child recently diagnosed with diabetes mellitus. What will the nurse respond when the parents ask why children are more prone to insulin reactions? (Select all that apply.) a. "The condition is more unstable in children." b. "Parents are often noncompliant." c. "The activities are irregular." d. "They are still growing." e. "Sleep patterns are not established."

a. "The condition is more unstable in children." c. "The activities are irregular." d. "They are still growing."

The nurse discussed treatment of hypoglycemia with an adolescent. Which statement by the adolescent leads the nurse to determine the patient understood the instructions? a. "When my blood glucose is low or if I begin to feel hungry and weak, I will eat six LifeSavers." b. "When my blood glucose is low or if I begin to feel hungry and weak, I will give myself Lispro insulin." c. "When my blood glucose is low or if I begin to feel hungry and weak, I will have a slice of cheese." d. "When my blood glucose is low or if I begin to feel hungry and weak, I will drink a diet soda."

a. "When my blood glucose is low or if I begin to feel hungry and weak, I will eat six LifeSavers."

Match the Following: a. Play Therapy b. Therapeutic Play c. Dramatic Play d. Expressive Activities 1. Offers the best opportunity for emotional expression, including the release of anger 2. A psychological technique reserved for use by trained therapists as an interpretive method 3. A non-directive method for helping children deal with their concerns and fears 4. Allows children to reenact frightening of puzzling hospital experiences

a. 2. A psychological technique reserved for use by trained therapists as b. 3.A non-directive method for helping children deal with their concerns and fears c. 4.Allows children to reenact frightening of puzzling hospital experiences d. 1.Offers the best opportunity for emotional expression, including the release of anger

When discussing possible causes of diabetes in children, the nurse mentions chromosomal defects. Which chromosomes are associated with diabetes? (Select all that apply.) a. 6 b. 7 c. 12 d. 20 e. 21

a. 6 b. 7 c. 12 d. 20

What does the nurse remind the adolescent with diabetes that soluble fiber in the diet can reduce? (Select all that apply.) a. Blood glucose b. Serum cholesterol c. Incidence of infections d. Absorption of sugar e. Insulin requirements

a. Blood glucose b. Serum cholesterol d. Absorption of sugar e. Insulin requirements

What makes keeping diabetes in control in an adolescent difficult? (Select all that apply.) a. Hormonal changes b. Developmental conflicts c. Preference for fast food d. Growth spurts e. Knowledge of disease

a. Hormonal changes b. Developmental conflicts c. Preference for fast food d. Growth spurts

A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes these signs are characteristic of what? a. Hypothyroidism b. Hyperthyroidism c. Type 1 diabetes mellitus d. Tay-Sachs disease

a. Hypothyroidism

hich process(es) does the nurse explain the endocrine system is primarily responsible for controlling? (Select all that apply.) a. Maturation b. Reproduction c. Stress response d. Sexual identity e. Growth

a. Maturation b. Reproduction c. Stress response e. Growth

Which food sources are high in soluble fiber? (Select all that apply.) a. Raw fruits b. Cooked vegetables c. Beans d. Lean meat e. Bran cereal

a. Raw fruits c. Beans e. Bran cereal

A chief danger of scarlet fever is that children may develop a) local areas of skin necrosis. b) acute glomerulonephritis. c) liver destruction. d) respiratory obstruction.

acute glomerulonephritis. Because this is a streptococci-based infection, there is a chance the child will develop rheumatic fever or glomerulonephritis following the illness.

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be a) as soon as all lesions are crusted. b) as soon as the temperature is normal. c) 10 days after the initial lesions appear. d) not until all lesions have completely faded.

as soon as all lesions are crusted. Chickenpox lesions are infectious until they crust.

hat would be the most appropriate nursing response to a woman who says, "My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition"? a. "The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease." b. "A screening test can be done to determine if you are a carrier of the gene." c. "The gene for Tay-Sachs disease is transmitted by the father." d. "The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus."

b. "A screening test can be done to determine if you are a carrier of the gene."

Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise? a. "I carry a piece of hard candy with me in case I start to feel shaky." b. "I make sure I have emergency money when I have soccer practice or a game." c. "Sometimes I skip my breakfast when I have a game in the morning." d. "I play in soccer games that are scheduled after dinner."

c. "Sometimes I skip my breakfast when I have a game in the morning."

Why does the nurse instruct an 11-year-old diabetic child to use the side of the finger for blood testing? a. It has fewer capillaries. b. It is easier to puncture. c. It is less likely to become infected. d. It has fewer nerve endings.

d. It has fewer nerve endings.

a nurse is assessing a provider during a femoral venipuncture on a toddler. the nurse should place the child in which of the following positions?

supine

a nurse is teaching a parent of a 12 month old child about development during the toddler years. which of the following statements should the nurse include?

your child should be able to scribble spontaneously using a crayon at the age of 15 months.

A nurse is preparing a presentation for parents about common childhood infectious diseases. Which of the following would the nurse include as being caused by a tick bite? Select all that apply. a) Lyme disease b) Scabies c) Rocky Mountain Spotted Fever d) Ascariasis e) Psittacosis

• Lyme disease • Rocky Mountain Spotted Fever Infectious diseases caused by tick bites include Lyme disease and Rocky Mountain Spotted Fever. Psittacosis is transmitted to children by birds. Ascariasis is a roundworm infection. Scabies is a parasitic infection caused by a female mite.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and asks for suggestions on what to do to reduce their child's risk. Which of the following would be appropriate for the nurse to suggest? Select all that apply. a) Contacting the health care provider if there is any area of inflammation that might be a bite. b) Dressing the child in dark clothing when going outdoors. c) Removing ticks by rubbing them away from the skin with a credit card. d) Inspecting the skin closely for ticks after the child plays in wooded areas. e) Wearing protective clothing when playing in wooded areas.

• Wearing protective clothing when playing in wooded areas. • Inspecting the skin closely for ticks after the child plays in wooded areas. • Contacting the health care provider if there is any area of inflammation that might be a bite. The nurse should teach the parents to have the child wear protective clothing and dress the child in light clothing when playing in wooded areas or going outdoors. The parents should inspect the child's skin closely for ticks after being outside in wooded areas and if any ticks are found, remove them with a tweezer, not rub them with a credit card. The parents also should be instructed to contact their health care provider if they notice any area of inflammation that might be a tick bite.