Integrated exam 5

The nurse is providing instructions to a parent of a child with patent ductus arteriosus (PDA). Which statement by the parent would indicate a need for further teaching?

"I know that my child will outgrow this problem; just give him time."

The nurse provides instructions to the parents of an infant with gastroesophageal reflux (GER) regarding proper positioning to manage reflux. The nurse would tell the parents that the infant would be maintained in which position?

A 60-degree angle when supine

The nurse reviews the record of an infant who is seen in the clinic. The nurse notes that a diagnosis of esophageal atresia with tracheoesophageal fistula (TEF) is suspected. The nurse expects to note which most likely manifestation of this condition in the medical record?

Choking with feedings

The nurse has reviewed the primary health care provider's prescriptions for a child suspected of a diagnosis of neuroblastoma and is preparing to implement diagnostic procedures that will confirm the diagnosis. The nurse prepares to do which?

Collect a 24-hour urine sample.

A diagnostic workup is performed on a 1-year-old child suspected of a diagnosis of neuroblastoma. Which finding specifically associated with this type of tumor would the nurse expect to find documented in the child's record?

Elevated vanillylmandelic acid (VMA) levels in the urine

The nurse is teaching the mother of a child how to control and treat a problem with pediculosis capitis (head lice). What is the most important information the nurse should give to the mother?

The 1% permethrin rinse should not be used again for 7 to 10 days.

A child is scheduled for a tonsillectomy. Which would present the highest risk of aspiration during surgery?

The presence of loose teeth

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most specifically elicit information regarding this disorder?

"Does your infant have foul-smelling, ribbon-like stools?"

The nurse is providing discharge instructions to the parents of a 14-year-old child who is undergoing radiation for Hodgkin's disease. Which statement by a parent indicates the need for further teaching?

"I will need to keep my child's skin from flaking, so we will be allowing showers every 2 or 3 days."

In which situation would it be appropriate for the nurse to administer a skin test?

A child who is to receive ampicillin for the first time

A mother of a child with a diagnosis of intussusception calls the nurse into the hospital room because the child is screaming in pain. Which manifestations of perforation would the nurse report immediately? Select all that apply.

Increased heart rate Change in the level of consciousness

The nurse assists in creating a nursing care plan for the child with an arm cast and would include which interventions in the plan? Select all that apply.

Notify the registered nurse (RN) immediately if circulatory impairment occurs. Instruct parents to keep the cast clean and dry. Monitor the extremity for circulatory impairment. Instruct the child not to stick objects down the cast.

The nursing instructor asks the nursing student to plan and conduct a clinical conference on phenylketonuria (PKU). The student researches the topic and plans to include which information in the conference?

PKU results in central nervous system (CNS) damage.

The nurse reinforces home-care instructions to the parents of a child with celiac disease. Which food item would the nurse advise the parents to include in the child's diet?

Rice

A camp nurse is reinforcing instructions to the parents of the children who are attending a daytime camp for the summer. The nurse instructs the parents to check their child daily for the presence of tick bites and tells the parents that if a tick is found to do which action first?

Suffocate the tick with a substance such as nail polish.

The nurse is employed in a newborn nursery. The nurse is reviewing all medications prescribed for newborns to prevent toxicity due to which causes? Select all that apply.

The liver is immature. The kidneys are less able to excrete medications.

A primary health care provider has prescribed oxygen as needed for a 10-month-old infant with heart failure (HF). In which situation would the nurse administer the oxygen to the child?

When drawing blood for electrolyte levels

A 12-year-old child is seen in the clinic, and a diagnosis of Hodgkin's disease is suspected. Several diagnostic studies are performed to determine the presence of this disease. When evaluating the diagnostic results, the nurse would expect to note which evidence if this child has Hodgkin's disease?

The presence of Reed-Sternberg cells

A child is diagnosed with an infestation of scabies. What will be important for the nurse to teach the parents regarding treatment of this problem?

Permethrin 5% cream should be massaged into the skin from the scalp to the soles of the feet.

The nurse was caring for an infant who had come to the nursing unit for observation and treatment of tetralogy of Fallot. The child suddenly becomes cyanotic, and the oxygen saturation reading drops to 60%. The nurse would perform which action first?

Place the child in a knee-chest position.

The nurse is reviewing the laboratory results of an infant suspected of having hypertrophic pyloric stenosis. Which acid-base disorder would the nurse expect to note in the infant?

Metabolic alkalosis

Isoniazid is prescribed for a 2-year-old child with a positive tuberculin skin test. The mother of the child asks the nurse how long the child will need to take the medication. Which time frame is the appropriate response to the mother?

9M

The nurse is asked to prepare for the admission of a child to the pediatric unit with a diagnosis of Wilms' tumor. The nurse assists in developing a plan of care for the child and suggests including which intervention in the plan of care?

Inspect the urine for the presence of hematuria at each voiding.

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?

Normal saline infusion

The child with cryptorchidism is being discharged after orchiopexy, which was performed on an outpatient basis. The nurse would reinforce instructions to the parents about which priority care measure?

Preventing infection at the surgical site

The nurse is planning care for a child with hemolytic-uremic syndrome (HUS). The child has been anuric and will be receiving peritoneal dialysis treatment. The nurse would plan to include which interventions in the care of the child? Select all that apply..

Provide adequate nutrition. Restrict fluids, as prescribed. Institute measures to prevent infection. Administer blood products to treat severe anemia. Anticipate the child will have central nervous system involvement.

The nurse is assisting a primary health care provider (PHCP) during an examination of an infant with hip dysplasia. The PHCP performs the Ortolani maneuver. Which data would the nurse expect to note during the examination?

The dislocated femoral head pops back into the acetabulum

The nurse is reviewing the record of a child with a diagnosis of pyloric stenosis. Which data would the nurse expect to note as having been documented in the child's record?

Projectile vomiting

The nurse is reviewing the postoperative primary health care provider's (PHCP'S) prescriptions for a 3-week-old infant with Hirschsprung's disease admitted to the hospital for surgery. Which prescriptions documented in the child's record would the nurse question? Select all that apply.

Take temperature measurements rectally. Start clear liquid diet after 8 hours postoperative.

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. Which assessment finding is unassociated with this diagnosis?

The passage of currant jelly-like stool

The nurse is told that a child with rheumatic fever (RF) will be arriving to the nursing unit for admission. Which question would the nurse ask the family to elicit information specific to the development of RF?

"Has the child had a sore throat or a fever within the past 2 months?"

An infant returns to the nursing unit following surgery for an esophageal atresia with tracheoesophageal fistula (TEF). The infant is receiving intravenous (IV) fluids, and a gastrostomy tube is in place. The nurse assisting in caring for the infant would ensure that which action is done to the gastrostomy tube?

Elevated

The nurse is working in the emergency department and is caring for a child who has been diagnosed with epiglottitis. Which is an indication that the child may be experiencing airway obstruction?

Tripod positioning and dyspnea

The nurse is reinforcing dietary instructions to the mother of a child with celiac disease. Which statement by the mother indicates a need for further teaching?

"I am so pleased that I won't have to eliminate oatmeal from my child's diet."

The nurse is assisting with preparing a plan of care for a 4-year-old child hospitalized with nephrotic syndrome. Which intervention is most appropriate for this child?

Encourage the child to eat in the playroom.

The nurse is reviewing the postoperative prescriptions for an infant with hydrocephalus, who came back from surgery with a ventriculoperitoneal shunt. Which of the primary health care provider's prescriptions does the nurse question?

Keep the head of the bed elevated 45 degrees.

A child with a diagnosis of a hernia has been scheduled for a surgical repair in 2 weeks. The nurse reinforces instructions to the parents about the signs of possible incarcerated hernia. The nurse tells the parents that which manifestation requires primary health care provider (PHCP) notification by the parents?

Pain

The nurse has provided instructions to the mother of an infant with viral pneumonia. Which statement by the mother would indicate the need for further teaching?

"I understand I will need to have my baby on antibiotics for this pneumonia."

The nurse is reinforcing home-care instructions to the parents of a 3-year-old child with scabies. Which statement by a parent indicates the need for further teaching?

"I understand that I need to leave the scabicide on for 4 hours before washing it off."

The nursing instructor asks a student nurse to describe osteogenic sarcoma. Which statement by the student indicates the need for further teaching?

"The child does not experience pain at the primary tumor site."

A child is diagnosed with several lesions of impetigo on the face. How would the nurse instruct the parent to take care of the child?

Administer the oral antibiotic until it is all gone.

The nurse is providing information to assistive personnel (AP) regarding caring for an older adult. The nurse determines the AP understands the information provided if the AP identifies which situation portrays ageism?

Advising older adults to forgo aggressive treatment

The nurse is providing instructions to a new parent regarding the psychosocial development of the infant. Using Erikson's psychosocial development theory, which instruction would the nurse reinforce to the parents?

Allow the infant to signal a need.

A child is admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which findings would the nurse expect to observe? Select all that apply.

Ascites Anorexia Proteinuria Periorbital and facial edema

The nurse is planning care for a pediatric client experiencing thyrotoxicosis (thyroid storm). Which prescribed medications would the nurse plan to administer? Select all that apply.

Atenolol Propranolol Methimazole

The nurse employed in a well-baby clinic is collecting data on the language and communication developmental milestones of a 4-month-old infant. Based on the age of the infant, the nurse expects to note which highest level of developmental milestones?

Babbling sounds

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. The nurse reviews the child's record for the laboratory results of the urine test and would most likely expect to note which finding?

Bacteriuria

A child has fluid volume deficit. The nurse collects data and determines that the child is improving and the deficit is resolving if which finding is noted?

Capillary refill is less than 2 seconds.

The nurse is assessing a pediatric client with a diagnosis of retinoblastoma. The nurse assesses for which most common clinical finding for a child with this diagnosis?

Cat's-eye reflex

When the nurse is collecting data from the older adult, which findings would be considered normal physiological changes? Select all that apply.

Decline in visual acuity. Increased susceptibility to urinary tract infections Increased incidence of awakening after sleep onset

A child has been diagnosed with pediculosis capitis. The parent of the child asks the nurse how the child contracted the condition. The nurse's best response would be:

It spreads easily because children share their hats and combs.

A 1-year-old child with hypospadias is scheduled for surgery to correct this condition. The nurse is asked to assist in preparing a plan of care for this child. During this developmental time period, which factor would the nurse take into account?

Fears of separation and mutilation are present.

The nurse reinforces instructions to the parents of a child with sickle cell anemia regarding the precipitating factors related to pain crisis. Which, if identified by a parent as a precipitating factor, indicates the need for further teaching?

Fluid overload

The nurse is admitting a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to note?

Frothy stools

The nurse assists in preparing a teaching plan regarding the administration of eardrops for the parents of a 4-year-old child with otitis media. Which would be included in the plan?

Pull the ear up and back before instilling the eardrops.

The nurse assists in preparing a teaching plan regarding the administration of eardrops for the parents of a 2-year-old child with otitis media. Which would be included in the plan?

Pull the earlobe down and back before instilling the eardrops.

The nurse notes that a 6-year-old child does not recognize that objects exist when the objects are outside of the visual field. Based on this observation, which action would the nurse take?

Report the observation to the primary health care provider.

The nurse is monitoring a child following a tonsillectomy. Which finding would indicate that the child is bleeding?

Restlessness

The nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement by the mother indicates a need for further teaching?

"I need to use a nipple with a small hole to prevent choking."

The nurse determines an adolescent is showing progress toward completing Erikson's psychosocial developmental stages if the adolescent makes which statement?

"I've met people who like that kind of music and we're going to a concert next week."

A hospitalized 2-year-old child with croup is receiving corticosteroid therapy. The mother asks the nurse why the primary health care provider did not prescribe antibiotics. The nurse makes which response to the mother?

"Antibiotics are not indicated unless a bacterial infection is present."

The nurse is reinforcing instructions to the mother of an 8-year-old child who had a tonsillectomy. The mother tells the nurse that the child loves tacos and asks when the child can safely eat one. The nurse would make which response to the mother?

"In 3 weeks"

The parents of a newborn have been told that their child was born with bladder exstrophy and the parents ask the nurse about this condition. Which response would the nurse give to the parents about bladder exstrophy?

"It is an extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall."

The nurse is instructing a mother of a 1-year-old child with strabismus about the treatment options. Which statement by the mother would indicate the need for further teaching?

"My child will outgrow this by the time he is 2 years old and be able to see just fine."

A primary health care provider prescribes intravenous potassium for a child with hypertonic dehydration. The nurse assigned to assist in caring for the child would check which highest priority item before administration of the potassium?

Urine output

The nurse is caring for a 8-month-old infant. The nurse determines the child is at the expected developmental level if the child displays which behavior?

Waves bye-bye

The nurse is monitoring several older adults for adverse drug effects. Which client requires closest monitoring for drug toxicity?

A client who consumes a high-carbohydrate, low-protein diet

A 6-year-old is hospitalized with a fracture of the femur and is placed in traction. In meeting the psychosocial needs of the child, the nurse most appropriately selects which play activity for the child?

A board game

The nurse is assisting in preparing to care for a child with a brain tumor who will be returning from the recovery room following debulking of the tumor. Which item would the nurse place at the bedside in preparation for the child's return from surgery?

A cooling blanket

The nurse is assigned to care for a child with a diagnosis of Wilms' tumor. The child's mother asks the nurse what kind of tumor this is. What is the best response by the nurse?

A nephroblastoma

A 39-year-old man learned today that his 36-year-old wife has an incurable cancer and is expected to live not more than a few weeks. The nurse identifies which responses by the husband as indicative of effective individual coping? Select all that apply.

He expresses his anger at God and the primary health care providers for allowing this to happen. He tells the nurse he has prayed that God will allow his wife to live long enough to watch their children's high school graduation. He has asked his wife and children to assist him in making funeral arrangements, such as casket selection and cemetery burial sites.

The nurse caring for an infant with congenital heart disease is monitoring the infant closely for signs of heart failure (HF). The nurse would observe for which early signs of HF? Select all that apply.

Irritability Scalp diaphoresis Tachypnea, tachycardia

The nurse is assisting a primary health care provider with an assessment of a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the primary health care provider palpates the child at McBurney's point. What response does the nurse expect the child to have during the examination?

Pain in the lower right side between the umbilicus and the iliac crest

A 4-year-old child is hospitalized with a suspected diagnosis of Wilms' tumor. The nurse reviews the plan of care and would question which intervention that is written in the plan?

Palpate the abdomen for a mass.

A parent tells the nurse that her child is scratching his head and complaining of intense itching of the scalp. The nurse notices tiny white material at the base of the child's hair shaft. What condition does this assessment reflect?

Pediculosis capitis

After a tonsillectomy, a child is brought to the pediatric unit. The nurse places the child in which appropriate position?

Prone

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. During data collection about the child, the nurse expects to note which characteristic of this type of posturing?

Rigid extension and pronation of the arms and legs

A child has scabies. What should the nurse explain to the parent?

Spread the prescribed cream all over the body, leave it on for 8 to 12 hours, and then wash it off.

The nurse is assisting in performing pediculosis capitis (head lice) checks. Which finding indicates that a child has a "positive" head check?

White sacs attached to the hair shafts in the occipital area

The nurse reinforces instructions to the mother of a child with croup about the measures to take if an acute spasmodic episode occurs. Which statement by the mother indicates the need for further teaching?

"I will place a steam vaporizer in my child's bedroom."

The nursing instructor asks a nursing student about phenylketonuria (PKU). Which statement made by the student indicates a need for further teaching?

"PKU primarily affects the gastrointestinal system."

A 6-year-old child has just been diagnosed with localized Hodgkin's disease, and chemotherapy is planned to begin immediately. The mother of the child asks the nurse about radiation therapy because it was not prescribed as a part of treatment. Which is the most appropriate response to the mother?

"The child is too young to have radiation therapy."

The nurse is assisting with gathering admission assessment data on a 2-year-old child who has been diagnosed with nephrotic syndrome. The nurse collects data knowing that which is a common characteristic associated with nephrotic syndrome?

Generalized edema

The nurse is monitoring for bleeding in a child after surgery to remove a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which nursing action is appropriate?

Notify the registered nurse (RN).

The nurse reinforces instructions to the mother of a child who has been hospitalized with croup. Which statement made by the mother would indicate the need for further teaching?

"I will give my child cough syrup if a cough develops."

A mother arrives at the emergency department with her child and a diagnosis of epiglottitis is documented. Which of the primary health care provider's prescription would the nurse question?

Obtain a throat culture.

The nurse assists with preparing a nursing care plan for a child who has Reye's syndrome. Which is the priority nursing intervention?

Providing a quiet atmosphere with dimmed lights

A male child who had surgery to correct hypospadias is seen in a primary health care provider's office for a well-baby checkup. The nurse provides instructions to the mother, knowing that which long-term complication is associated with hypospadias?

Renal anomalies

The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease?

Respiratory disease caused by a virus involving the parotid gland

The nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is appropriate?

Forty-eight hours after using the antibiotic ointment

Which home care instructions would the nurse plan to reinforce to the mother of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

Frequent hand washing is important. The child should avoid exposure to other illnesses. Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).

The nurse is reinforcing instructions to the parents of an infant with clubfoot about the care of a plaster cast. Which statement would the nurse include in the instructions? Select all that apply.

"The foot should be kept elevated for the first 24 to 48 hours." "Reposition the infant every 2 to 4 hours until cast is thoroughly dried." "The edges of the cast can be 'petaled' with small pieces of moleskin or adhesive tape."

The nurse reinforces instructions regarding the use of permethrin 1% to the parents of a child who has been diagnosed with pediculosis capitis. Which statements by the parents indicate they understand the instructions? Select all that apply.

"The hair should not be shampooed for 24 hours after treatment." "The medication can be obtained over the counter in a local pharmacy." "The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out."

A 13-year-old child is diagnosed with osteogenic sarcoma of the femur. Following a course of chemotherapy, it is decided that leg amputation is necessary. Following the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. Which statement made by the nurse will best assist in alleviating the child's fear?

"This aching and cramping are normal and temporary and will subside."

A nursing student is asked to discuss juvenile idiopathic arthritis (JIA) at a clinical conference scheduled for the end of the clinical day. Which statement by the nursing student indicates the need for further research of this disorder?

"This disease is twice as likely to occur in boys as in girls."

Which statement would the nurse include when providing safety instructions to the parents of an infant with a diagnosis of hydrocephalus?

"When picking up your infant, support the infant's neck and head with the open palm of your hand."

A non-stress test is performed on a pregnant client, and the client is told by the obstetrician that the results are nonreactive. Based on this test result, what determination is made?

A contraction stress test will be scheduled.

A 4-year-old child is diagnosed with otitis media, and the mother asks the nurse about the causes of this illness. The nurse responds, knowing that which is an unassociated risk factor related to otitis media?

A history of urinary tract infections

Oral contraceptive therapy has been prescribed for a client with a history of seizures who is taking phenytoin. Which information should the nurse provide to the client after reviewing the new prescription?

An increased dosage of the oral contraceptive must be prescribed because phenytoin reduces the effectiveness of oral contraceptives.

The nurse is caring for a child with a suspected diagnosis of rheumatic fever (RF). The nurse reviews the laboratory results. Which laboratory study would assist in confirming the diagnosis of RF?

Antistreptolysin O titer

A nurse preparing a client in the third trimester of pregnancy for a physical examination assists the client into the supine position on the examining table. While waiting for the obstetrician to arrive, the client suddenly complains of feeling lightheaded and dizzy. Which immediate action would the nurse take?

Assist the client into a lateral recumbent position.

That evening, during an assessment, the nurse finds that the client's uterine fundus is above the umbilicus and to the left of the midline of the abdomen. Which action by the nurse is a priority?

Assisting the client to the bathroom to help the client void .

An infant is seen in a clinic and is diagnosed with unilateral hip dysplasia. Which finding is associated with this condition?

Asymmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table

Which finding would indicate that a child had a tonic-clonic seizure during the night?

Blood on the pillow

The nurse caring for an infant with bronchiolitis is monitoring for signs of dehydration. The nurse monitors which method as reliable for determining fluid loss?

Body weight

A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox?

Macular rash on the trunk and scalp

A nursing instructor asks a nursing student about the use of bacillus Calmette-Guerin vaccine (BCG). Which response made by the nursing student is correct?

"BCG is administered to asymptomatic human immunodeficiency virus (HIV)-infected children who are at increased risk for developing TB."

A nurse discussing options with a mother of a child with cystic fibrosis (CF) asks if she understands the education. Which statement by the mother indicates a need for further teaching?

"I can give my child whatever foods he likes to eat, since he gets enzymes anyway."

The nurse reinforces discharge instructions to the mother of a child following a myringotomy with insertion of tympanostomy tubes. Which statement by the mother indicates a need for further teaching?

"I need to be sure my child uses soft tissues to blow his nose."

The nurse reinforces home care instructions to the mother of a child recovering from Reye's syndrome. Which statement by the mother indicates a need for further teaching?

"I need to give frequent, small, nutritious meals if my child starts to vomit."

The nurse reviews the home care instructions with a parent of a 3-year-old with pertussis. Which statement by the parent indicates a need for further teaching?

"I understand this whooping cough is viral and I have to let it run its course."

The nurse reviews measures to prevent tick bites with a parent of a child with Rocky Mountain spotted fever. Which statement by the parent indicates a need for further teaching?

"I will have my child wear dark colored clothing so the tick will not be attracted to the colors."

The nurse is assigned to care for an infant with cryptorchidism. One testis cannot be palpated. The nurse anticipates that which diagnostic study will be prescribed to determine where the undescended testis is located in the body?

Computed tomography scan

A mother of a child with cystic fibrosis asks the clinic nurse about the disease. How would the nurse respond to the mother about the disease?

Cystic fibrosis is a chronic multisystem disorder affecting the exocrine glands.

The nurse is assisting in developing a plan of care for a child diagnosed with acute glomerulonephritis. The nurse would include which intervention in the plan of care?

Encourage limited activity and provide safety measures.

A mother of a child who underwent a myringotomy with insertion of tympanostomy tubes calls the nurse and reports that the child is complaining of discomfort. Which would the nurse instruct the mother to do?

Give the child acetaminophen for the discomfort as per discharge instructions.

A mother arrives at the clinic with her child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days, and this morning the child began to wheeze. Viral pneumonia is diagnosed. Which component of the treatment plan would the nurse anticipate?

Hospitalization and antibiotics

A child with a fractured femur is placed in Buck's skin traction, and the nurse is planning care for the client. Which information about this type of traction is correct?

Is a type of skin traction that pulls the hip and leg into extension

Which criteria would the nurse determine are characteristics of scabies? Select all that apply.

It appears as burrows or fine, grayish-red lines.3 It is transmitted by close personal contact with an infected person. It is endemic among school children and institutionalized populations.

The nurse is caring for a child with a diagnosis of Kawasaki disease. The mother of the child asks the nurse about the disorder. Which statement by the nurse most accurately describes Kawasaki disease?

It is also called mucocutaneous lymph node syndrome and is a febrile generalized vasculitis of unknown cause.

A child seen in the clinic is found to have rubeola (measles), and the mother asks the nurse how to care for the child. Which instruction would the nurse provide to the mother?

Keep the child in a room with dim lights.

The nurse is monitoring a 7-year-old child who sustained a head injury in a motor vehicle crash for signs of increased intracranial pressure (ICP). The nurse assesses the child frequently for which early sign of increased ICP?

Nausea

The nurse assists in preparing a plan of care for the infant with bladder exstrophy. The nurse identifies which immediate problem as the priority for the infant?

Skin disruption

A licensed practical nurse is providing care for a child with hydrocephalus who has had a ventriculoperitoneal shunt revision. Which data collection finding would be reported to the registered nurse immediately?

Temperature 100.9°F

A child is brought to a clinic after developing a rash on the trunk and on the scalp. The parents report that the child has had a low-grade fever, has not felt like eating, and has been generally tired. The child is diagnosed with chickenpox. Which statement by the nurse is accurate regarding chickenpox?

The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions.

The nurse is caring for a newborn diagnosed with Down syndrome. The parents are asking questions about the disorder. The nurse would provide which information when discussing Down syndrome?

The condition is congenital and results in moderate to severe retardation and has been linked to an extra chromosome 21 (group G).

The nurse is preparing a 2-year-old child with suspected nephrotic syndrome for a renal biopsy to confirm the diagnosis. The mother asks the nurse, "Will my child ever look thin again?" The nurse would respond by giving which statement?

"In most cases, medication and diet will control fluid retention."

The nurse is assisting with collecting data on a child with seizures. The nurse is interviewing the child's parents to establish their adjustment to caring for their child with a chronic illness. Which statement by the parents indicates a need for further teaching?

"Our child sleeps in our bedroom at night."

Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the school children. Which statement, if made by a parent, indicates a need for further teaching regarding this communicable disease?

"The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."

A nurse is providing information about the fetal circulation to a client who is pregnant for the first time. What would the nurse tell the client?

The umbilical vein carries freshly oxygenated, nutrient-laden blood from the placenta to the fetus.

The nurse would implement which actions in the care of a child who is having a seizure? Select all that apply.

Time the seizure. Stay with the child. Loosen clothing around the child's neck.

The nurse is assigned to care for a child with a spica cast. Which action would be avoided when caring for the child?

Using pillows to elevate the head and shoulders

The nurse is assigned to care for a child who is suspected of having glomerulonephritis. The nurse reviews the child's record and notes that which findings are associated with the diagnosis of glomerulonephritis? Select all that apply.

Headache Red-brown urine Periorbital edema

A child has impetigo. What is a characteristic of this condition?

It is most often a streptococcal infection.

An 18-month-old has been diagnosed with scabies. Which assessment findings would the nurse note?

Severe pruritus, especially at night

A mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. The nurse plans to base the response on which information?

It is a congenital aganglionosis or megacolon.

The nurse is reviewing the health record of a child with a diagnosis of celiac disease. Which clinical manifestation would the nurse expect to note documented in the health record?

Profuse watery diarrhea and vomiting

A client's spouse becomes distraught when thinking about his wife's terminal prognosis. Which action would the nurse implement to best assist the spouse?

Encourage development of realistic goals.

The nurse reviews the record of a child who was just seen by the primary health care provider (PHCP). The PHCP has documented a diagnosis of suspected aortic stenosis. Which specific sign/symptom of aortic stenosis would the nurse anticipate?

Exercise intolerance

A nursing student is asked to discuss the pathophysiology related to childhood leukemia during a clinical conference and reviews the planned presentation with the nursing instructor. The nursing instructor advises the student to review the disorder before the clinical conference if the student states that which is associated with this type of cancer?

Reed-Sternberg cells are found on biopsy.

After a tonsillectomy, the child begins to vomit bright red blood. Which is the initial nursing action?

Turn the child to the side.

The nurse is collecting data from a child with a diagnosis of diabetes insipidus. Which clinical finding is consistent with this diagnosis?

Urinary output is increased.

The nurse is preparing to administer beractant to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route?

Intratracheal

The nurse is caring for a child with osteosarcoma following amputation of the left lower limb. The child is continually complaining of aching and cramping in the missing limb. Which action would the nurse take?

Reassure the child that this is a temporary condition.

The nurse assists with admitting a child with a diagnosis of acute stage Kawasaki disease. When obtaining the child's medical history, which manifestation is likely to be noted?

Conjunctival hyperemia

The nurse reinforces home-care instructions to the parents of a child with hepatitis regarding the care of the child and the prevention of the transmission of the virus. Which statement by a parent indicates a need for further teaching?

"I need to provide a well-balanced, high-fat diet to my child."