module 3 and 4 prepu
The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care?
Abdominal palpation
The nursing student correctly identifies the major cause of death in the 1- to 4-year-old age group to be which of the following?
Accidents
The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?
Improving hydration
The nurse is caring for a 13-year-old boy with acute myeloid leukemia (AML) who is experiencing feelings of powerlessness due to the effects of chemotherapy. What intervention will best help the teen's sense of control?
Involving the boy in decisions whenever possible
The pediatric nurse is explaining to a new graduate nurse the differences in planning well-child maintenance for a child with cancer. Which statement by the new nurse demonstrates understanding of the teaching?
No routine live vaccines are administered while on chemotherapy.
A nurse is providing care to a pediatric client hospitalized with a diagnosis of Duchenne muscular dystrophy (DMD). The nurse is reviewing the above laboratory results. Which laboratory result will have the greatest impact on the client's condition?
Potassium
The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching?
We should avoid using petroleum jelly."
In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care?
Weighing on the same scale each day
The nurse receives a call from a parent whose toddler received a prescription for amoxicillin one teaspoon every 8 hours. The child has received 2 doses and the parent is noticing unusual symptoms. Which symptoms may indicate a severe penicillin allergy? Select all that apply. - Wheezing - Urticaria - Serum sickness - Seizures - Incontinence
Wheezing Urticaria Serum sickness
The parents of an 8-year-old child with nocturnal enuresis bring the child to the clinic for a follow-up. History reveals that the parents have tried numerous behavioral and motivational therapies without success. The nurse anticipates medication therapy. Which agents would the nurse identify as being used? Select all that apply. - oxybutynin - imipramine - desmopressin - prednisone - Albumin
oxybutynin imipramine desmopressin
A nurse is providing care to an 11-month-old infant diagnosed with intussusception. When assessing the appearance of the child's stool, the nurse expects to note which finding?
red, currant jelly-like stool
A child is brought to the emergency department for evaluation. The caregiver states, "The child was running and tripped over the scooter on the sidewalk and landed on the left arm." The nurse assesses and records the findings (above). The nurse suspects child abuse (child mistreatment) and notifies the proper authorities. Which finding(s) will the nurse use to support this suspicion? Select all that apply. - spiral fracture - bruises on the knees - bruises on the thighs - abrasion on the left palm - bruise on the upper back
spiral fracture bruises on the thighs bruise on the upper back
The mother of a child with pediculosis capitis infestation tells the nurse that she does not understand why her child still has the infestation. The mother states, "I used the prescribed treatment just like I was instructed." How should the nurse respond?
"After finding the infestation did you wash items that your child's head came into contact with, like bed linen?"
The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of the treatment?
"At least when I take a shower I have a few minutes out of this brace."
The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate?
"I will help you become comfortable in caring for your daughter."
A nurse is assisting the parents of a child who requires a Pavlik harness. The parents are apprehensive about how to care for their baby. The nurse should stress which teaching point?
"It is important that the harness be worn continuously."
A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast?
Assess the fingers for warmth, pain, and function
The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority?
Calling the doctor if the child gets a sore throat
A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?
Encourage the child to take all the antibiotics if diagnosed with strep throat.
The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching?
Ensure a consistent and daily intake of adequate fluids to prevent dehydration.
An infant brought to the emergency department has been vomiting for 2 days. The nurse assesses the infant and finds sunken fontanels (fontanelles), tenting skin, dry mucus membranes and no urine output for 12 hours. Which intervention(s) will the nurse complete as first-line care for this infant? Select all that apply. - Insert a peripheral IV. - Begin maintenance IV fluids. - Start oral rehydration. - Administer a prescribed IV fluid bolus. - Administer an antiemetic.
Insert a peripheral IV. Administer a prescribed IV fluid bolus. Administer an antiemetic.
A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression?
Methotrexate
A 6-month-old 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?
Roseola
Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?
Swimming
The nurse is collecting data on an 18-month-old child with a diagnosis of autism spectrum disorder (ASD). What clinical manifestation would likely have been noted in the child with this diagnosis?
The child does not make eye contact.
A child has been diagnosed with pinworms. What home care instruction(s) will the nurse give the parent? Select all that apply. - Trim all nails short. - Wash the hands after toileting and before meals. - Restrict the child and siblings from sleeping in the same room. - Change the bedding and wash in hot water. - Encourage all family members to get treated with an anthelminthic. - Only one dosage of anthelmintic is needed.
Trim all nails short. Wash the hands after toileting and before meals. Change the bedding and wash in hot water. Encourage all family members to get treated with an anthelminthic.
The nurse is caring for a child on the burn unit weighing 100 lb (45.5 kg) who has second-degree (partial-thickness) burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse?
Urine output of 15 ml per hour over the last 4 hours
The nurse is working with a child with altered genitourinary status. Which intervention should be included in the plan of care for the client with excess fluid volume?
Weigh the child daily on the same scale.
The nurse is caring for a 6-year-old child brought into the emergency department for burns from a house fire. The nurse notes burn areas surrounding the client's nose and mouth upon initial assessment. For which priority complication should the nurse be alert?
airway obstruction related to swelling
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. Which adverse effect of this medication should the nurse discuss with the parents?
appetite suppression
The nurse is assessing a 1-month-old infant in the emergency department who is experiencing difficulty breathing. Which assessment finding(s) warrants further action? Select all that apply. - circumoral pallor - respiratory rate 42 breaths/min - hypoventilation - absence of retractions - periodic breathing
circumoral pallor hypoventilation
The nurse is caring for a child admitted with suspected leukemia. The nurse has taken the child's history and performed an assessment. The nurse will plan to prepare the child for which additional diagnostic test first?
complete blood cell count (CBC)
The nurse is preparing a teaching plan for the family and their 6-year-old child who has just been diagnosed with diabetes. What would the nurse identify as the initial goal for the teaching plan?
developing management and decision-making skills
A nurse is conducting a physical examination of an infant with suspected metatarsus adductus. Type II metatarsus adductus is indicated when the forefoot is:
flexible passively past neutral, but only to midline actively.
An infant has been born and diagnosed with a meningocele. Which action will the nurse incorporate into each contact with this infant?
inspection of the cystic sac on the child's back for leakage
A 9-month-old infant presents to the emergency department with vomiting and abdominal pain. While assessing the client, the nurse notes the client screaming intermittently and drawing up legs toward chest a palpable mass in upper right quadrant (above). What does the nurse anticipate in this child's stools?
jellylike, bloody stools
In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia?
"Milk is a perfect food, and babies should be able to have all the milk they want."
A group of grade-school children is going camping. As a school nurse, you would offer them which advice to prevent Lyme disease?
"Wear jeans tucked inside your socks when in the woods."
The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find?
Hard, moveable, olive-shaped mass in the right upper quadrant
The nurse is providing education to the parents of a child diagnosed with pinworms. Which statement is most important for the nurse to include in the teaching?
"Make sure your child washes hands before eating."
The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?
Impetigo
A nurse is giving instructions to the father of a boy who is receiving chemotherapy (including methotrexate) regarding how best to care for the boy during this period of treatment. What should the nurse mention to him?
Keep him away from people with known infections
The nurse is caring for a 14-year-old client in traction prior to surgery. The client has been in the hospital for 2 weeks and will require an additional 10 days in the hospital following surgery. The client states, "I feel isolated and I am refusing any more treatment." Which response by the nurse is most appropriate?
"Let's come up with things for you to do and see if your friends can come visit."
A nurse is providing teaching to the parents of a child diagnosed with sickle cell anemia. The discussion is focused on precipitating factors for sickle cell crisis. Which statement by the parents requires the nurse to reinforce the teaching?
"Our family is taking a fun hiking trip up in the mountains next week."
The nurse is providing a routine wellness examination for a 5-year-old child diagnosed with autism spectrum disorder (ASD). Which response by the client's parent will cause the nurse to intervene?
"We try to be flexible and change our child's routine from day to day."
The nurse is providing education to a community group on child play safety. Which statement by a parent indicates teaching was effective?
"When my child rides a bicycle, a helmet will be worn at all times."
A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse?
"You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep."
A 10-year-old client is upset and tells the school nurse. "I am the shortest one in my class. I am done with school and just want to stay home." Which response by the nurse is most appropriate?
"You seem very upset. Sit down and let's talk about what is going on."
A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform?
Administer diphenhydramine.
The nurse assesses that the client is at risk for an infection related to chemotherapy-induced immunosuppression. What will the nurse include in the teaching plan for the child and parents to help reduce this risk? Select all that apply. - Have the child sleep in a single bed and room. - Encourage frequent, thorough handwashing. - Provide a low-carbohydrate, low-protein diet. - Encourage frequent contact with multiple visitors. - Cheer up the environment with fresh flowers and plants.
Have the child sleep in a single bed and room. Encourage frequent, thorough handwashing.
