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Mother bring 2 wk-old infant to clinic for treatment after Dx of clubfoot. Which statement indicates need for further teaching?

"I need to bring my infant back to the clinic 1 month for a new cast

Nurse taking care of 10 y/o child that weight 30 kg. The doctor ahs ordered azithromycin PO 300mg x 1 dose. Azithromycin comes in an oral suspension 100mg/5 ml in a 15 mL bottle. According to the drug handbook for children 2 - 15 y/o, 10mg/kg/day but not to exceed 500mg/day. How many millimeters should be given?

15

A woman's obstetric Hx indicates that she is pregnant for the fourth time, all her children from previous pregnancies are living. One was born at 39 weeks, twins were born at 34 weeks, and another child was born at 35 weeks. What is her gravidity, and partiy using GTPAL?

4-1-2-0-4

Which statement about pregnancy is accurate?

A normal pregnancy lasts about 10 lunar months

Nursing intervention for the child after cardiac catheterization should include? SATA

Assess the affected extremity for temp and color Maintain a patent peripheral intravenous catheter until discharge

Nurse is counseling the parents of 12 y/o child with Duchenne muscular dystrophy about problems that may develop during adolescents. What body system does the nurse expect might be affected?

Cardiopulmonary

Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand. Nurses should know that:

During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus

A 12 y/o comes into the clinical with left thigh pain and a lump over the distal femure. The nurse is aware that these symptoms can be linked to which of the following problems? SATA

Ewing sarcoma Osteosarcoma

As a perinatal nurse, you realize that a FHR that is tachycardic, bradycardic, has late decelerations, or loss of variability is non-reassuring and is associated with:

Hypoxemia

Nurse must assess a four month-old infant. The infant is sitting in the father's lap and appears to be afraid of the nurse and what happens next. Which initial action by the nurse would be most appropriate?

Initiate a game of peek-a-boo

A client comes to the ED after being bitten by a bat. The nurse observes 2 small non-draining puncture wounds resembling pinpricks on the fingertip. Which action should the nurse implement first?

Inject human rabies immunoglobulin into the proximal would area and IM

Emergency conditions during labor that require immediate nursing intervention can arise with startling speed. Examples of such emergencies include: SATA

Non-reasurring or abnormal FHR pattern Inadequate uterine relaxation Vaginal bleeding Prolapsed cord

Probable pregnancy sign are:

Observed by HCP

What is most important for a nurse to teach the parents of a child with Duchenne muscular dystrophy to do for their child?

Perform ROM exercises

The fetal tracing shows the presence of late decelerations and the mother's BP is 82/50 following her epidural. What interventions should the nurse initiate? SATA

Place the woman in a lateral position Increase IV fluids Administer O2

A woman is preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this is:

Stimulate fetal surfactant production

The most effective and least expensive treatment of puerperal (postpartum) infection is prevention. What is the most important strategy?

Strict technique, including hand washing, by all health care personnel

A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by:

Subinvolution of the uterus

One of the first symptoms of puerperal infection to assess for in the postpartum woman is:

Temp of 38C (100.4F) or higher on 2 successive days darting 24 hours after birth

Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance:

Traditionally, PPH has been classified as early or late with respect to birth

A perinatal nurse is caring for a woman in the immediate post-birth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:

Uterine atony

Which statement most accurately describes the HELLP syndrome?

Characterized by hemolysis, elevated liver enzymes, and low platelets

Nurse is educating parents in age appropriate activities. Which of the following would be included on the list for a 18 moth old?

Push-pull toys

5 essential components of any FHR tracing must be evaluated regularly. These include: SATA

Baseline rate Baseline variability Accelerations Decelerations Changes or trends over time

Obese women are at risk for several complications during pregnancy and birth. They include what:

Breech presentation

Nurses should be aware that chronic hypertension

Can occur independently of or simultaneously with preeclampsia

Nurse enters a PTs room and notices the PT has very deep and laborious (rapid) respirations. What is the priority nursing action?

Check the blood sugar stat

An important nursing intervention when caring for a child who is experiencing a seizure would be to:

Describe and record the seizure activity observed

Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? SATA

Maintain the child in private room Reduce exposure to environmental organisms Use strict aseptic technique for all procedures Ensure that anyone entering the child's room wears a mask

The nurse is caring for a 5 y/o child who is schedules for a tonsillectomy in 2 hours. Which action should the nurse include in post-op care?

Notify surgeon if the child swallows frequently Place the child on the abdomen until fully awake Allow the child to have ice chips and popsicles after the procedure

Four-year-old David is placed in buck's traction for Legg-Calve Perthes disease. He is crying with pain as the nurse assess that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first?

Notify the practitioner of the changes noted

A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is:

Perform fundal massage

While taking a diet Hx the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. What is this called?

Pica

Medications used to manage postpartum hemorrhage (PPH) include: SATA

Pitocin Methergine Cytotec

Nurse caring for a school-age PT who possibly has Reye Syndrome. What are risk factors for developing Reye Syndrome? SATA

Use of aspirin A recent infection with Influenza A A recent infection with chicken pox

School nurse is examining a third-grade student complaining of a small lump on her head. After parting the hair, it is evident that t tick has embedded into the scalp. Which intervention should nurse take?

Use tweezers of forceps to remove the tick, pulling up with steady pressure

School nurse is conducting pediculosis capitis assessments. A child with a "positive" head check would have which of the following noted upon examination?

White sacs attached to the hair shafts in the occipital region

During a prenatal visit a nurse is explaining dietary management to a woman with pregestational diabetes. The nurse evaluates that teaching has been effective when the woman sates:

"Diet and insulin needs change during pregnancy."

Nurse providing instructions to parents of a child with scoliosis regarding the use of a brace. Which statement by parents indicates need for FURTHER TEACHING?

"I should apply lotion under the brace to prevent skin break down."

Nurse is teaching an adolescent how to use a peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made

"I will record the readings at the same time every day."

Nurse recognizes that t woman is in true labor when she sates:

"The contractions in my uterus are getting stronger and closer together."

Your client is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of Pitocin administration. She asks the nurse, "Why is it taking so long?" The best answer is:

"The magnesium is relaxing your uterus and competing with the Pitocin. It may increase the duration of your labor

Nurse caring for a child who is on clear liquid diet. At lunch, the child consumed ½ cup of juice, 3 oz gelatin, 1 oz of an ice pop, and 20 mL ginger ale. How many mL should be recorded as fluid intake?

260

Lacerations of the cervix, vagina, or perineum are also causes of PPH. Factors that influence the causes and incidences of obstetric lacerations of the lower genital tract include all except:

Adherent retained placenta

A nurse caring for a laboring woman is cognizant that early decelerations are caused by:

Altered fetal cerebral blood flow (head compressions

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive S/S of pregnancy likely has?

Amenorrhea

Preeclampsia is a unique disease process related only to human pregnancy. The exact cause of this condition continues to elude researchers. The American college of Obstetricians and Gynecologists has developed a comprehensive list of risk factors. Whick clients exhibits the greatest number of risk factors?

An African-American client who is 18 y/o and pregnant with twins

The child has been complaining of joint pain in the knees and jaw for the last 6 weeks, both joints are swollen and warm to touch, but not red. The HCP is ordering blood to rule out Junior Idiopathic Arthritis. Which lab tests would the nurse expect to be ordered?

Anti-nuclear antibody titer CBC with differential C-Reactive Protein

The nurse is assessing a 7 y/o child at a pediatric clinic. The nurse notices that several developmental milestones have been missed or are late during previous visits. The parent states "I know she is a little slow, but she will catch up quickly." Which action by the nurse is warranted?

Ask the parent detailed questions about the pregnancy, birth, and early childhood health

A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She is groaning and perspiring excessively; she states that she did not attend childbirth classes. The most important nursing action is to:

Assist her with simple breathing and relaxation techniques

Mother brings her child with cerebral palsy in to the clinic and is afraid the child is having seizures as the child has the slow "worm like" or "writhing quality" movements in her arms and she drools when this occurs. The nurse explains to the mother that this is not a seizure but what type of activity?

Athetoid

Nurse caring for a school-age child who has a concussion. Which of the following actions would nurse implement to decrease intracranial pressure (ICP)? SATA

Avoid extreme flexion, extension, or rotation of the head Nasal suctioning is contraindicated

8 y/o girl receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis and a dry cough. These manifestations are most suggestive of:

Circulatory overload

Ryan is an 11-month-old with Down's Syndrome and atrial septal defect. His parents report that Ryan has been lethargic and has had diarrhea for the past 24 hours. The nurse questions digoxin toxicity. What results support this? SATA Weight: 7 kg (15.4lbs) VS: · Temp - 36.5 C (97.7F) rectal · Pulse - 80 · Resp - 35 bpm · Pulse Ox - 95% RA · Potassium - 2.9 · Digoxin - 2.5

Dig level K+ level

When assessing a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that the uterine contractions are effective is

Dilation of the cervix

Nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to left forearm. Which instructions wold be included? SATA

Do not put small toys in the cast Contact the HCP if child complains of numbness or tingling in the extremity Elevate the extremity on pillows for first 24 to 48 hours after casting to prevent swelling

Nurse planning to use an interpreter during the health Hx interview. Which guidelines should nurses follow? SATA

Elicit one answer at a time Arrange for the family to speak with the same interpreter if possible Introduce the interpreter to the family

A nurse special education program is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?

Establish a reward system for positive behaviors

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in the vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Prior to initiation of the epidural the woman should be informed regarding the disadvantages of an epidural block. They include:

Gastric emptying is not delayed

Nurse planning care for a 6 y/o child who has bacterial meningitis. Which of the following nursing interventions should the nurse include in the plan of care?

Implement seizure precaution

When planning care for a laboring mom whose membrane have ruptured, the nurse recognizes that the woman's risk for __ has increased.

Intrauterine infection

Nurse caring for a 13 y/o PT Dx with adolescent idiopathic scoliosis. The curve in her back was treated by spinal fusion with rod insertion. Which is the priority nursing intervention in the postoperative period?

Keep oxygen saturation within normal limits

The most critical nursing action in caring for the newborn immediately after birth is:

Keeping the airway clear

Which fetal heart rate (FHR) findings concerns the nurse during labor?

Late Decelerations

Which assessment finding should the nurse note in a school-age child with Duchenne Muscular Dystrophy? SATA

Lordosis Gower sign Waddling gait

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:

Macrosomia

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. What advice should she expect?

Make sure you include adequate folic acid in your diet

When caring for the child with Reye Syndrome, the priority nursing intervention should be to:

Monitor intake and output

A laboring woman received meperidine (Demerol) IV 90 minutes before she gave birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate?

Naloxone (Narcan)

Child with right femur fracture caused by MVA and placed in skin traction. During assessment, nurse notes that the dorsalis pedal pulse is absent on the right foot. What action should nurse take?

Notify HCP

A woman arrives at the clinic for a pregnancy test. Her last menstrual period was Feb 14, 2011. What is her expected due date?

November 21, 2011

Nisha a 14 y/o girl with sickle cell anemia. She comes into the clinic with complaints for severe generalized pain following a softball game. She is admitted to the PEDs unit. The HCP has written the flowing orders. Which if any of these orders should the nurse question? VS: · Temp - 37.7C (99.7F) oraly · Pulse - 110 bpm · Resp - 30 bpm · BP 96/70 · O2 Sat 89% · Pain 8/10, sharp, stabbing · Weight 110 lbs Labs · Hemoglobin - 9g/L · Hct - 24% · WBC - 12,000 cells/mm2 · Platelet count - 140,000 cels/mm2

PCA Meperidine 20 mg continuous with 3 mg saline to infuse at 175/ml/hr

Pancreatic enzymes are administered to the child with cystic fibrosis (CF). Nursing consideration should include to:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of the meal

Phenylketonuria (PKU) is a genetic disease that results in the body's inability to correctly metabolize

Phenylalanine

HELLP syndrome is associated with an increased risk for adverse perinatal outcomes, including: SATA

Placental abruption Renal failure Maternal and fetal death

An 11 y/o child has a recurrence of Ewing sarcoma and is verbalizing wanting to stop all treatment. The nurse is aware that the best ethical practice is what?

Plan a meeting with parents, child, and the medical team to provide an opportunity to discuss the child's concerns

Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate?

Preparation and training of family

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance:

Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 27 weeks of pregnancy

Magnesium sulfate is given to woman with preeclampsia and eclampsia to:

Prevent and treat convulsion

School nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care?

Protect the student from injury related to seizure movements

What three measures should the nurse implement to provide intrauterine resuscitation? Select the best response that indicates the priority of actions that should be taken, starting with the most important.

Provide O2 via face mask, reposition the mother, and increase IV fluids

16 y/o boy comes into the office of the school nurse complaining of left hip pain that began when playing Bball in gym class. They boy is in the 85th percentile for height and weight. He complains of increased pain with weight bearing. The nurse observes out-toeing of the left leg with ambulation. Which action is priority?

Refer the boy to the emergency department

PT recently came into ED with a Dx of Gullain-Barre Syndrom (GBS). What is the priority system to initially monitor for the PT?

Respiratory

Misoprostol (Cytotec) has been ordered for a pregnant woman at 43 weeks of gestation. The nurse recognizes this med is administered to:

Ripen the cervix in preparation for labor induction

S/S that woman should report immediately to the HCP are:

Rupture of membranes Heartburn accompanied by severe headache Vaginal bleeding

12 y/o girl is noted to walk with uneven gait, and her shoulders appear uneven. Left shoulder sits lower than the right, and her waist appears to be tilted from side to side. Which conditions is likely?

Scoliosis

Child steps on a nail and sustains a puncture would of the foot. Which is the most appropriate method for cleansing the wound?

Soak foot in warm water and soap

The nurse is conducting a staff in-service on childhood blood disorders. Which statement by the student nurse would indicate a need for further instruction?

Teach about the side effects of steroid therapy including possible fluid and weight loss

A woman gave birth to a 7lb, 6 oz infant girl 1 hour ago. The birth was vaginal and the estimated blood loss was 1500 mls. When assessing the woman's vital signs, the nurse is concerned to see:

Temp, 37.9C, HR 120, respirations 20, BP 90/50

With regard to the care management of preterm labor, nurses should be aware that:

The Dx is preterm labor is based on gestational age, uterine activity, and progressive cervical changes

Nurse has received a report about a woman in labor. The woman's last vaginal examination was recorded as a 3 cm, 30%, and -2. The nurse interpretation of the assessment is:

The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines

An ED nurse is caring for a child Dx with epiglottitis. Assessing the child, the nurse monitors for which indication that the child may be experiencing airway obstruction?

The child is leaning forward, with the chin thrust out

1Nurse provide care to 7 y/o child Dx with avascular necrosis. PTs guardians ask what to expect with Dx. Which would be appropriate info to give?

The child will be hospitalized and placed in traction

A Hispanic toddler had pneumonia. Nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, popsicles, and juices are left. Which statement would best explain?

The parent is trying to restore normal balance through appropriate "hot" remedies

The nurse providing care for the laboring woman understands that variable fetal heart rate (FHR) Decelerations are caused by:

Umbilical cord compressions

Which is the preferred site for intramuscular injections in infants?

Vastus lateralis

The exact cause of preterm labor is unknown and believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Select the type of infection that has bot been linked to preterm birth:

Viral

A PT states to the nurse that she eats a healthy vegetarian diet. The nurse recommends she eats which supplement?

Vitamin B12

Complications and risks associated with cesarean borths to mom and baby include: SATA

Wound dehiscence Hemorrhage Urinary tract infections Fetal injuries

Nurse providing teaching to a parent of a child who has a fracture of an epiphyseal (physeal) plate. Which of the following statement should the nurse make?

"Normal bone growth can be affected."