NSG334 PEDS ATI ADAPTIVE QUIZ (MODERATE - 76/146)

A nurse is caring for an 8-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse expect? A. Hypotension B. Stomatitis C. Bloody diarrhea D. Periorbital edema

Correct Answer: D. Periorbital edema Periorbital edema is an expected finding in a child who has glomerulonephritis.

A nurse is providing dietary teaching to the parent of a toddler who has phenylketonuria. Which of the following foods should the nurse recommend? A. Whole milk B. Ground beef C. Cooked carrots D. Eggs

Correct Answer: C. Cooked carrots The nurse should instruct the parent to offer the toddler foods that are low in protein such as cooked carrots and fruits.

A nurse is caring for a 16-year-old client who reports dysmenorrhea and asks about alternative therapies for treatment. Which of the following statements should the nurse make? A. "Herbal medication can be effective but should be monitored by your provider." B. "You should place a cold compress on your lower abdomen to decrease inflammation." C. "You should limit exercise, which can increase the pain." D. "Avoid touching the painful areas because this can increase your discomfort."

Correct Answer: A. "Herbal medication can be effective but should be monitored by your provider." Herbal medicine may be helpful in relieving menstrual pain. However, there is a risk of toxicity and drug interactions if herbal medicine is taken in the wrong doses or with other medications. The nurse should ask the client if she is using herbal medication and document the dose and effects.

A nurse is providing teaching to the parents of a school-aged child who has type 1 diabetes mellitus about managing hypoglycemia. Which of the following responses by a parent indicates an understanding of the teaching? A. "I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible." B. "I will give my child 2 units of regular insulin." C. "I will insist that my child lie down to rest for 30 min." D. "I will check my child's urine for glucose twice daily."

Correct Answer: A. "I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible." Giving the child 10 to 15 g of simple carbohydrates such as 240 mL (8 oz) of milk will elevate the blood glucose level and alleviate hypoglycemia.

A nurse is performing a developmental assessment on a 3-year-old child. Which of the following commands should the nurse expect the child to complete successfully? A. "Put your shoes on." B. "Name the days of the week." C. "Cut out this picture with a pair of scissors." D. "Balance on 1 foot with your eyes closed."

Correct Answer: A. "Put your shoes on." Children should be able to pull on their shoes when they are 3 years old. They typically cannot tie their shoes until they are 5 years of age.

A nurse is assessing an infant who has untreated congenital hypothyroidism. Which of the following manifestations should the nurse expect? A. Constipation B. Hyperreflexia C. Oily skin D. Hyperthermia

Correct Answer: A. Constipation The nurse should expect an infant who has untreated congenital hypothyroidism to exhibit constipation and an enlarged abdomen.

A nurse is teaching the parent of a school-age child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching? A. Corn tortilla with black beans B. Pizza C. Canned soup D. Hot dogs

Correct Answer: A. Corn tortilla with black beans Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching, as corn and beans are gluten-free foods.

A nurse is providing teaching about disease management to the parent of a preschooler who has a new diagnosis of asthma. Which of the following parent statements indicates an understanding of the teaching? A. "My child should not receive live virus vaccines." B. "I will encourage my child to participate in sports." C. "I will give my child aspirin when she has a fever." D. "My child will outgrow asthma by adulthood."

Correct Answer: B. "I will encourage my child to participate in sports." The parent should encourage the child to remain physically active because this promotes lung expansion and air exchange.

A nurse is providing teaching about immunizations to the parents of a severely immunocompromised child who has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching? A. "Your child's immunizations today will be half-doses." B. "The pneumococcal and influenza vaccines are recommended for your child." C. "Immunizations will be delayed until your child tests HIV-negative." D. "Your child will need to restart the immunization schedule once your child's laboratory values are within the reference range."

Correct Answer: B. "The pneumococcal and influenza vaccines are recommended for your child." Immunization against common childhood illnesses, including influenza and pneumococcal disease, is recommended for all children exposed to and infected with HIV.

A nurse is providing teaching to the guardian of a child about bicycle safety. Which of the following pieces of information should the nurse include? A. Instruct the child to ride against the flow of traffic B. Instruct the child to walk the bike through intersections C. Provide a larger bike that the child will be able to grow into D. Ensure the child's helmet covers the ears

Correct Answer: B. Instruct the child to walk the bike through intersections The child should walk the bike through intersections and crosswalks to decrease the risk of injury.

A nurse is caring for a toddler who has asthma. The parents are concerned about the toddler's reaction to the hospitalization. Which of the following actions should the nurse take to decrease the child's anxiety? A. Provide privacy B. Give the child a thorough explanation before providing care C. Encourage rooming-in D. Tell the child you will help fix her

Correct Answer: C. Encourage rooming-in Rooming-in is the most effective means of providing emotional support for a toddler. The family's presence provides a sense of security that increases the child's ability to cope with an unfamiliar environment.

A nurse in the emergency department is caring for a child who has bruises that support a suspicion of child abuse. Which of the following actions should the nurse take? A. Ask the child if his parents are responsible for the abuse B. Notify the facility's risk manager C. Interview the child with his parents present D. Report the suspected abuse to local authorities

Correct Answer: D. Report the suspected abuse to local authorities The nurse should initiate the process of removing the child from the abusive environment by following the facility's protocol for reporting the situation to child protective services or local law enforcement.

A nurse is assessing a 3-year-old preschooler. Which of the following developmental milestones should the nurse expect the preschooler to demonstrate? A. Stacking 10 blocks B. Printing 1 letter C. Tying shoelaces D. Using 7-word sentences

Correct Answer: A. Stacking 10 blocks The nurse should expect a 3-year-old preschooler to have the fine motor ability to stack 10 blocks.

A nurse is assessing an adolescent who is receiving fentanyl via epidural. Which of the following assessments should the nurse identify as the priority? A. Skin around the catheter site B. Blood pressure C. Pain level D. Oxygen saturation

Correct Answer: D. Oxygen saturation When using the airway, breathing, and circulation (ABC) lapproach to client care, the nurse should identify that checking the adolescent's oxygen saturation level is the priority. By monitoring the adolescent's oxygen saturation level and respiratory status, the nurse can identify if the client has developed opioid-induced respiratory depression.

A nurse is assessing a 6-month-old infant who had a cardiac catheterization with right femoral entry to diagnose a possible congenital heart defect. Which of the following findings should the nurse report to the provider? A. Cool toes on the right foot B. Weak pedal pulses on both feet C. Positive Babinski reflex on both feet D. Erythema on the right foot

Correct Answer: A. Cool toes on the right foot The nurse should monitor the temperature of the infant's right extremity and should report any indication of coolness distal to the entry site to the provider because this can indicate an obstruction of an artery.

A nurse is caring for a child who has electrical burns on the lower arms and hands. Which of the following findings indicate the child is experiencing a complication of the injury? A. Dark urine B. 2+ radial pulses C. Respiratory rate of 20/min D. Minimal pain

Correct Answer: A. Dark urine Dark urine can be an indication of myoglobinuria. It results from the elimination of waste products from muscle damage and can cause renal failure.

A nurse is assessing the gross motor skills of a 4-year-old preschooler. The nurse should expect the preschooler to perform which of the following activities? A. Hopping on 1 foot B. Skipping on alternate feet C. Jumping rope D. Roller skating

Correct Answer: A. Hopping on 1 foot The nurse should expect a 4-year-old preschooler to hop on 1 foot.

A nurse is caring for an infant who is breastfed and is receiving amoxicillin for an upper respiratory infection. An assessment of the mouth reveals whitish patches on the tongue that will not scrape off. Which of the following actions should the nurse take? A. Offer the infant water before feedings B. Discontinue amoxicillin C. Administer an antifungal medication after feedings D. Give the infant formula instead of breast milk

Correct Answer: C. Administer an antifungal medication after feedings The nurse should administer an antifungal medication to the infant after feedings to ensure adequate contact time with the oral mucosa and tongue to enhance treatment of the oral candidiasis.

A nurse is assessing a school-aged child who has acute glomerulonephritis. Which of the following manifestations should the nurse expect? A. Hypokalemia B. Decreased blood pressure C. Increased urine volume D. Periorbital edema

Correct Answer: D. Periorbital edema Periorbital edema is a manifestation of acute glomerulonephritis. Swelling is usually worse in the mornings and spreads throughout the day to the genitalia, abdomen, and extremities.

A nurse is caring for a school-aged child who has sickle cell anemia and was admitted for a vaso-occlusive crisis. Which of the following findings should the nurse report to the provider immediately? A. Slurred speech B. Hemoglobin level of 9 g/dL C. Hematuria D. Pain level of 7 on FACES scale

Correct Answer: A. Slurred speech The nurse should identify that slurred speech in a child who has sickle cell anemia is an indication of a stroke. The nurse should report this finding to the provider immediately.

A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following examples should the nurse use to illustrate a suggestive finding? A. Bruising of both knees with sutures on 1 B. Arm cast for a spiral fracture of the forearm C. Consistent bedwetting at nap time D. Frequent, vague reports of a stomachache or a headache

Correct Answer: B. Arm cast for a spiral fracture of the forearm Spiral fractures occur from the twisting of an extremity. In most instances, spiral fractures of the arm result from an abusive injury.

A nurse is caring for a 3-year-old child on a pediatric unit. The nurse should identify which of the following as an appropriate toy for the child? A. Jump rope B. Coloring book and crayons C. Checkers game D. Jack-in-the-box

Correct Answer: B. Coloring book and crayons Preschoolers have increasing fine motor control and imagination. They enjoy toys that allow creativity and self-expression.

A nurse is caring for a 4-month-old child who has acute otitis media and a fever of 38.3°C (101°F). Which of the following medications should the nurse administer? A. Diphenhydramine B. Furosemide C. Amoxicillin D. Ibuprofen

Correct Answer: C. Amoxicillin A child who has acute otitis media should take an antibiotic to help alleviate the infection.

A nurse is caring for a school-aged child who has sickle cell anemia. Which of the following actions should the nurse plan to take to help decrease the risk of a vaso-occlusive crisis? A. Provide adequate fluid intake throughout the day B. Provide oxygen at 2 L/min via nasal cannula C. Administer a blood transfusion D. Give ibuprofen to manage pain

Correct Answer: A. Provide adequate fluid intake throughout the day Adequate hydration is an effective strategy to help prevent sickle cell crises. Maintaining adequate hydration can reduce the risk of sickle cell formation.

A nurse is caring for a toddler who is postoperative following a cleft palate repair. Which of the following actions should the nurse take? A. Restrain the toddler's arms at the elbows B. Feed the toddler with a spoon C. Monitor the toddler's oral temperature D. Weigh the toddler every 48 hours

Correct Answer: A. Restrain the toddler's arms at the elbows When caring for a toddler who is postoperative following a cleft palate repair, the nurse should apply elbow restraints (unless prescribed otherwise) to prevent the toddler from rubbing or disrupting the sutured area.

A nurse is providing discharge teaching to parents whose infant had a ventriculoperitoneal shunt placement for the treatment of hydrocephalus. Which of the following statements by the parents indicates an understanding of the teaching? A. "We will check his abdomen daily for signs of fluid accumulation." B. "We will notify the doctor right away if he has a fever." C. "We should keep a helmet on him when he's awake." D. "We can expect him to have occasional seizure episodes."

Correct Answer: B. "We will notify the doctor right away if he has a fever." Infection is a risk after ventriculoperitoneal shunt insertion, especially 1 to 2 months after placement. The parents should report fevers, vomiting, seizure activity, and decreased responsiveness, as these findings can indicate infection.

A nurse at a clinic is preparing to administer immunizations to a 5-year-old child. Which of the following immunizations should the nurse plan to give? A. Diphtheria, tetanus, and pertussis (DTaP) B. Pneumococcal (PCV) C. Haemophilus influenzae type B (Hib) D. Hepatitis B (Hep B)

Correct Answer: A. Diphtheria, tetanus, and pertussis (DTaP) Children should receive booster doses of the DTaP immunization between the ages of 4 and 6. Around this age, blood titers drop due to decreasing antibodies.

A nurse is caring for a female adolescent who is being treated for frequent urinary tract infections (UTIs). Which of the following statements by the adolescent indicates a possible cause of the UTIs? A. "I have bowel movements every 4 to 5 days." B. "My mom taught me to wipe from front to back after going to the bathroom." C. "I urinate every 2 to 3 hr during the day." D. "I don't wear nylon underwear."

Correct Answer: A. "I have bowel movements every 4 to 5 days." The nurse should identify that this frequency of UTIs indicates the adolescent is constipated. Therefore, large stool masses might prevent complete emptying of the bladder and lead to urinary stasis and infection.

A nurse is teaching the parents of a 4-month-old infant who has gastroesophageal reflux. Which of the following statements by a parent indicates an understanding of the teaching? A. "I will add 1 teaspoon of rice cereal per ounce to my baby's formula." B. "I will place my baby on her side when sleeping." C. "I will decrease the number of feedings my baby receives per day." D. "I will give my baby loperamide with each feeding."

Correct Answer: A. "I will add 1 teaspoon of rice cereal per ounce to my baby's formula." The parents can give the infant thickened feedings with rice cereal to help decrease reflux. The added calories also can help infants who are underweight due to gastroesophageal reflux.

A nurse is providing teaching to the guardians of an infant who has failure to thrive (FTT). Which of the following pieces of information should the nurse include in the teaching? A. Add fortified rice cereal to the infant's formula B. Alternate feedings between several family members C. Offer the infant juice between feedings D. Provide feedings on demand rather than on a schedule

Correct Answer: A. Add fortified rice cereal to the infant's formula The nurse should inform the guardians that adding fortified rice cereal or vegetable oil to the infant's formula helps promote weight gain.

A nurse is assessing an infant who is at risk for increased intracranial pressure (ICP). Which of the following findings should indicate to the nurse that this complication is developing? A. High-pitched cry B. Sunken fontanel C. Tachycardia D. Increased awake time

Correct Answer: A. High-pitched cry The nurse should identify that an infant's high-pitched cry is an indication of increased ICP. Other indications include a bulging fontanel, a high-pitched cry, and increased sleeping.

A nurse is teaching a newly hired nurse about caring for an infant who is postoperative following myelomeningocele repair. The nurse should teach the newly hired nurse to monitor the infant for which of the following complications? A. Hydrocephalus B. Congenital hypotonia C. Otitis media D. Osteomyelitis

Correct Answer: A. Hydrocephalus In the surgical repair of the myelomeningocele, the pathway for the cerebral spinal fluid is altered. Therefore, the infant is at risk of hydrocephalus, and the nurse should monitor the infant for this condition.

A nurse is assessing a toddler who has measles (rubeola). Which of the following findings should the nurse expect? A. Koplik spots B. Parotitis C. Strawberry tongue D. Paroxysmal coughing

Correct Answer: A. Koplik spots Koplik spots are small, irregular oral lesions with a bluish-white center. They are characteristic of measles (rubeola). Koplik spots appear about 2 days before the maculopapular rash and are accompanied by fevers, malaise, conjunctivitis, and other cold manifestations.

A nurse is planning care for a toddler who has acute gastroenteritis and was recently admitted. Which of the following should the nurse plan to provide for the child? A. Oral rehydration solution B. Bananas or applesauce C. Chicken or beef broth D. Hypertonic IV solution

Correct Answer: A. Oral rehydration solution The nurse should plan to provide an oral rehydration solution (ORS) to this child who has acute gastroenteritis. ORS promotes the body's reabsorption of water and sodium and is more effective and less traumatic than the administration of IV fluids for the treatment of dehydration due to diarrhea and emesis

A nurse is providing teaching to the parents of a child who has strabismus. Which of the following instructions should the nurse include to prevent the development of amblyopia? A. Patch the unaffected eye B. Administer mydriatic eye drops daily C. Obtain prescription eyeglasses D. Administer antihistamines

Correct Answer: A. Patch the unaffected eye Amblyopia is a disorder of the eye in which unilateral central blindness occurs as a result of another problem such as strabismus. With strabismus, muscle weakness allows an eye to wander so that the child cannot focus on an object with both eyes at the same time. This confusion causes the brain to ignore the signals from the weak eye in favor of the strong eye. This will result in central blindness if the child does not receive treatment by 6 years of age. To strengthen the weak eye muscles, the parents should patch the unaffected eye.

A nurse is reviewing the laboratory results of a child who has experienced diarrhea for the past 24 hr. Which of the following values for urine specific gravity should the nurse expect? A. 1.010 B. 1.035 C. 1.020 D. 1.005

Correct Answer: B. 1.035 1.035 is a concentrated specific gravity, which is an expected value for a child who is dehydrated; therefore, this is an expected urine specific gravity for a child who has experienced diarrhea for 24 hours.

A nurse is reviewing the risk factors for the development of congenital heart disease with a client who is planning to conceive. Which of the following conditions should the nurse include as a maternal risk factor? A. Preeclampsia B. Alcohol consumption C. Placenta previa D. Late prenatal care

Correct Answer: B. Alcohol consumption Alcohol consumption is a maternal risk factor for the development of congenital heart disease.

A nurse is caring for a school-aged child who begins to have a tonic-clonic seizure when leaving the bathroom. Which of the following actions should the nurse take first? A. Obtain a portable suction machine and suction tubing B. Ease the child to the floor in Sims' position C. Time the length of the seizure D. Notify the child's parents

Correct Answer: B. Ease the child to the floor in Sims' position The greatest risk to the child is an injury resulting from a fall; therefore, the nurse should first gently ease the child to the floor to decrease the chance of injury and turn the child on the left side to prevent aspiration.

A nurse is providing teaching about disease-management strategies to a 9-year-old client who has cystic fibrosis. Which of the following statements should the nurse include? A. "Thorough and effective pulmonary clearance can help prevent the need for a lung transplant when you get older." B. "You should eat these kinds of foods because they will help you grow big and strong." C. "Your mucus is thick because cystic fibrosis interferes with how your glands work." D. "Your medication follows a certain schedule to help you sleep better."

Correct Answer: C. "Your mucus is thick because cystic fibrosis interferes with how your glands work." A 9-year-old child should understand that the production of thick mucus is a part of the disease process.

A nurse is reviewing the laboratory report of a toddler who is receiving chemotherapy for leukemia. Which of the following laboratory values should the nurse report to the provider? A. Platelets 150,000/mm^3 B. Hgb 6 g/dL C. WBC 6,000/mm^3 D. Potassium 4.5 mEq/L

Correct Answer: B. Hgb 6 g/dL This hemoglobin level is below the expected reference range and is indicative of anemia; therefore, the nurse should report this finding to the provider.

A nurse is creating a plan of care for a child who has leukopenia secondary to chemotherapy. Which of the following interventions should the nurse include in the plan? A. Maintain the child on bed rest B. Monitor the child for increased temperature C. Administer oxygen to the child D. Monitor the child for bleeding

Correct Answer: B. Monitor the child for increased temperature Leukopenia places the child at risk of infection; therefore, the nurse should monitor the child for a fever.

A nurse on a pediatric unit is admitting a 4-year-old child. Which of the following toys should the nurse plan to provide for the child to engage in independent play? A. Brightly colored mobile B. Plastic stethoscope C. Small-piece jigsaw puzzle D. Book of short stories

Correct Answer: B. Plastic stethoscope Preschool play centers on imitative activities. Providing a stethoscope allows the child to engage in therapeutic play. Imitating health care personnel may ease the child's fear of unfamiliar equipment.

A nurse is caring for a child who has a tracheostomy. Which of the following techniques should the nurse use to suction the child's tracheostomy? A. Insert the catheter to 2 cm (0.79 in) beyond the end of the tracheostomy tube B. Remove the catheter while applying intermittent suction C. Instill 0.9% sodium chloride irrigation to loosen secretions while suctioning D. Continue suctioning until the secretions are removed

Correct Answer: B. Remove the catheter while applying intermittent suction The nurse should insert the catheter without suction and then withdraw the catheter while applying intermittent suction.

A nurse is caring for a 4-week-old infant who is 2 weeks postoperative following surgical correction of biliary atresia. Which of the following findings is an indication that the surgery was successful? A. The infant has lost 2.2 kg (1 lb) since the surgery. B. The infant has a total bilirubin level of 0.3 mg/dL. C. The infant has an aspartate aminotransferase (AST) level of 120 units/L. D. The infant's stools are gray in color.

Correct Answer: B. The infant has a total bilirubin level of 0.3 mg/dL. A bilirubin level of 0.3 mg/dL is within the expected reference range and indicates the surgery was successful.

A nurse in a provider's office is observing children playing in the waiting room. The nurse should expect to identify parallel behavior in which of the following age groups? A. Infants B. Toddlers C. Preschoolers D. School-age children

Correct Answer: B. Toddlers Toddlers demonstrate parallel play. Infants demonstrate solitary play. Preschoolers demonstrate associative play. School-age children demonstrate cooperative play.

A nurse on a pediatric unit is caring for a child who is not eating well. Which of the following suggestions should the nurse offer to the parents to promote the child's food intake? A. "Make dietary selections for your child." B. "Offer foods that have strong flavors or smells." C. "Let your child eat with others when possible." D. "Make sure your child eats most of the food on his plate."

Correct Answer: C. "Let your child eat with others when possible." Socialization with others promotes nutrition by making the child feel more comfortable in his surroundings and enhancing the enjoyment of meal times.

A nurse is providing teaching to the parent of a toddler who is undergoing insertion of tympanostomy tubes. Which of the following statements should the nurse include? A. "The doctor will replace the tubes routinely about every 2 years." B. "If your child gets water in her ears will not cause any further problems." C. "The tubes should stay in place until they fall out on their own." D. "Now that the tubes are in place, she should not have any further problems with hearing."

Correct Answer: C. "The tubes should stay in place until they fall out on their own." Tympanostomy tubes allow drainage from and ventilation to the middle ear. They usually fall out on their own within 6 to 12 months after insertion. Incorrect Answers:

A nurse is teaching the parents of a child who has cerebral palsy. Which of the following statements should the nurse make? A. "Your child will be unable to eat by mouth." B. "Your child will be unable to participate in recreational activities." C. "Your child will need a botulinum toxin A injection to reduce muscle spasticity." D. "Your child will need throw rugs placed over non-carpeted areas."

Correct Answer: C. "Your child will need a botulinum toxin A injection to reduce muscle spasticity." Children who have cerebral palsy have spasticity in their muscles. The child can receive botulinum toxin type A injections into affected muscles, which reduce spasticity.

A nurse in the emergency department is admitting a child who has full-thickness burns over 45% of his body. Which of the following actions should the nurse take first? A. Administer IV morphine B. Administer topical antimicrobials C. Administer IV fluid replacement D. Administer tetanus prophylaxis

Correct Answer: C. Administer IV fluid replacement The greatest risk to this child is an injury from hypovolemic shock; therefore, the first action the nurse should take after ensuring the child has a patent airway is to administer IV fluid replacement therapy.

A nurse is preparing to administer recommended immunizations to a 2-month-old infant. Which of the following immunizations should the nurse plan to administer? A. Human papillomavirus (HPV) and hepatitis A B. Measles, mumps, and rubella (MMR) and tetanus, diphtheria, and acellular pertussis (TDaP) C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)

Correct Answer: C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) The recommended immunizations for a 2-month-old infant include Hib and IPV. The Hib immunization series consists of 3 to 4 doses, depending on the immunization used. At minimum, it is administered at 2 months, 4 months, and 12 to 15 months of age. The IPV immunization series consists of 4 doses and is administered at 2 months, 4 months, 6 to 18 months, and 4 to 6 years of age.

A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions should the nurse include in the plan? A. Apply cold compresses to the child's extremities B. Administer meperidine every 4 hr until the crisis has resolved C. Maintain the child on bed rest D. Decrease the child's fluid intake for 8 hr

Correct Answer: C. Maintain the child on bed rest The nurse should maintain bed rest for this child who is experiencing a vaso-occlusive crisis to minimize energy expenditure and avoid additional oxygen needs.

A nurse in an emergency department is assessing an infant who has laryngotracheobronchitis. Which of the following findings should the nurse report as an indication of impending airway obstruction? A. Bradycardia B. Respiratory depression C. Nasal flaring D. Barking cough

Correct Answer: C. Nasal flaring Acute laryngotracheobronchitis (croup) causes dyspnea and swelling of the upper airway. Indications of impending airway instruction include tachycardia, tachypnea, increasing restlessness, flaring nares, and intercostal retractions.

A nurse in the emergency department is assessing an infant who recently started taking digoxin to treat a supraventricular arrhythmia. Which of the following findings should the nurse identify as an indication of digoxin toxicity? A. Irritability B. Diaphoresis C. Vomiting D. Tachycardia

Correct Answer: C. Vomiting The nurse should identify that vomiting, especially when unrelated to feedings, is a manifestation of digoxin toxicity. The nurse should report this finding to the provider immediately.

A nurse is providing teaching to the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should expect my child to gain weight while taking this medication." B. "I should expect this medication to decrease my child's heart rate." C. "I should crush the medication and put it in my child's food." D. "I should give this medication to my child half an hour before breakfast."

Correct Answer: D. "I should give this medication to my child half an hour before breakfast." The parent should administer the medication to the child on an empty stomach.

A clinic nurse is providing teaching to the parent of a 1-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will give lansoprazole 30 min after my baby's feedings." B. "I will lay my baby on her right side after feedings." C. "I will give my baby a bottle just before bedtime." D. "I will add rice cereal to my baby's feedings."

Correct Answer: D. "I will add rice cereal to my baby's feedings." The parent should add 1 tsp to 1 tbsp of rice cereal per ounce of formula or expressed breast milk to thicken the feedings and decrease the number of vomiting episodes.

A nurse is teaching an adolescent who has asthma about how to use a peak expiratory flow meter (PEFM). Which of the following responses by the adolescent indicates an understanding of the teaching? A. "I will breathe in through the mouthpiece, hold my breath for 5 sec, and then exhale." B. "If I get a reading in the green zone, I will tell my parents immediately so they can call the doctor." C."I will slowly exhale through the mouthpiece over a 10 sec interval." D. "I will record the highest reading of three attempts."

Correct Answer: D. "I will record the highest reading of three attempts." After establishing a personal best, the client should routinely check the PEFM by performing 3 attempts and recording the highest reading of the 3.

A nurse is teaching a parent of a 12-month-old infant about development during the toddler years. Which of the following statements should the nurse include? A. "Your child should be referring to himself using the appropriate pronoun by 18 months of age." B. "A toddler first shows interest in looking at pictures at 20 months of age." C. "A toddler should have daytime control of his bowel and bladder by 24 months of age." D. "Your child should be able to scribble spontaneously using a crayon at 15 months of age."

Correct Answer: D. "Your child should be able to scribble spontaneously using a crayon at 15 months of age." At the age of 15 months, the toddler should be able to scribble spontaneously. At the age of 18 months, the toddler should be able to make strokes imitatively.

A nurse is providing anticipatory nutritional guidance for the caregivers of a 5-month-old infant. Which of the following points should the nurse include in the teaching? A. Switch the infant from formula to low-fat cow's milk at 6 months of age. B. Heat fruit juice before offering it to the infant. C. Introduce a new food every other day. D. Allow the infant to try finger foods, such as crackers, after 6 months of age.

Correct Answer: D. Allow the infant to try finger foods, such as crackers, after 6 months of age. The nurse should instruct the caregivers that infants will acquire the coordination to begin self-feeding finger foods at around 6 months of age.

A nurse is caring for an infant who has a cleft palate. The parents ask the nurse how long they should wait before the child can have corrective surgery. The nurse should explain that the parents should wait no longer than 6 to 12 months for surgery to prevent which of the following outcomes? A. Repeated ear infections B. Nutritional deficits C. Immune system deficits D. Difficulty with language acquisition

Correct Answer: D. Difficulty with language acquisition Clients who have a cleft palate can have difficulty acquiring language because they need to use the palate for vocalizing sounds. Because of the cleft in the palate, these infants could develop poor speech habits.

A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead level of 3 mcg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following pieces of information is appropriate for the nurse to include? A. Decrease the child's vitamin C intake until the blood lead level decreases to zero B. Administer a folic acid supplement to the child each day C. Give pancreatic enzymes to the child with meals and snacks D. Ensure the child's dietary intake of calcium and iron is adequate

Correct Answer: D. Ensure the child's dietary intake of calcium and iron is adequate A child who has an elevated blood lead level should have an adequate intake of calcium and iron to reduce the absorption of and effects from the lead. Dietary recommendations should include milk as a good source of calcium.

A nurse is admitting a child who has a history of tonic-clonic seizures. Which of the following items is the priority to have in the child's room? A. Pulse oximeter B. Oxygen therapy C. Bag valve mask D. Suction equipment

Correct Answer: D. Suction equipment When using the airway, breathing, and circulation (ABC) approach to client care, the nurse should determine that the priority item to have in the child's room is suction equipment. If the child experiences a tonic-clonic seizure, the child is at risk for aspiration and airway occlusion due to secretions, food, or fluids. The nurse should have suction equipment available to maintain a patent airway for effective respiration, administration of oxygen, and use of a bag valve mask if needed.

A nurse is assessing a 10-month-old infant at a well-infant checkup. Which of the following assessment findings should the nurse report to the provider? A. The infant is unable to walk independently B. The infant's Moro reflex is absent C. The infant's anterior fontanel is open D. The infant needs assistance to sit up

Correct Answer: D. The infant needs assistance to sit up An infant is expected to have the ability to sit up unsupported around 8 months of age. Therefore, the nurse should report this finding to the provider.

A nurse is performing a well-child assessment on a 4-year-old child. Which of the following findings should the nurse expect? A. The child is able to hop on 1 foot. B. The child is able to build a tower of up to 6 blocks. C. The child is able to name the days of the week. D. The child is able to identify left and right.

Correct Answer: A. The child is able to hop on 1 foot. The nurse should expect a 4-year-old child to have the gross motor ability to hop on 1 foot.

A nurse is caring for a 6-month-old infant who has intussusception. Which of the following actions should the nurse take? A. Prepare to administer high-dose steroids B. Give the child magnesium hydroxide PO C. Prepare the child for a barium enema D. Inform the parents that the child will need a colostomy

Correct Answer: C. Prepare the child for a barium enema The pressure created by a barium enema might force the bowel to resume a normal configuration. Some children with intussusception are treated with the barium enema and do not require surgical intervention.

A nurse is assessing a 6-month-old infant who was recently admitted with acute vomiting and diarrhea. Which of the following findings indicates the infant has moderate dehydration? A. Bulging anterior fontanel B. Bradycardia C. Tachypnea D. Polyuria

Correct Answer: C. Tachypnea An infant who has moderate dehydration will have slight tachypnea.

A nurse is assessing a preschooler who has influenza and reports the new onset of a sore throat and difficulty swallowing. Which of the following findings is the priority for the nurse to report to the provider? A. The child's temperature is 39°C (102°F) B. The child's skin is sallow C. The child is drooling D. The child's voice is hoarse

Correct Answer: C. The child is drooling When using the urgent versus nonurgent approach to client care, the nurse should determine that the presence of drooling is the priority finding because it can indicate the child might have developed epiglottitis, a medical emergency. Left untreated, the child can develop a complete respiratory obstruction.

A nurse is teaching the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which of the following pieces of information should the nurse include in the teaching? A. "Crush the medication and mix it in your child's food." B. "Administer the medication 1 hour before bedtime." C. "Expect your child to have cloudy urine while he is taking this medication." D. "Weigh your child twice per week while he is taking this medication."

Correct Answer: D. "Weigh your child twice per week while he is taking this medication." The nurse should instruct the parent to weigh the child 2 to 3 times per week to monitor for weight loss, which is an adverse effect of methylphenidate. The parent should report weight loss to the provider.

A nurse is teaching a group of parents and guardians about otitis media. Which of the following should the nurse identify as a risk factor for this illness? A. Summer months B. Breastfeeding C. Ages 7 to 10 years D. Passive smoking

Correct Answer: D. Passive smoking The nurse should identify passive smoking as a risk factor for otitis media. Exposure to secondhand smoke promotes the attachment of pathogens to the middle ear, extends the inflammatory response, and impairs drainage through the Eustachian tube. Each of these effects increases the risk for development of otitis media.

A nurse in an emergency department is assessing a school-aged child who is experiencing an acute asthma exacerbation. Which of the following findings is the priority for the nurse to report to the provider? A. Excessively prolonged expiration B. Increased diaphoresis C. Increased production of frothy sputum D. Sudden decrease in wheezing

Correct Answer: D. Sudden decrease in wheezing When applying the urgent versus nonurgent priority-setting framework, the nurse should consider urgent needs to be the priority because they pose a larger risk to the client. A sudden decrease in wheezing can indicate that the child is experiencing decreased air movement and should be reported to the provider. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which finding is the most urgent. A sudden decrease in wheezing (silent chest) indicates ventilatory failure and imminent respiratory arrest.

A nurse is caring for a child with a vesicular rash that has been present for 6 days. The nurse should expect that the child has which of the following conditions? A. Measles B. Fifth disease C. Tetanus D. Varicella

Correct Answer: D. Varicella Children who have varicella may present first with a maculopapular rash that progresses to vesicles on erythematous bases, which eventually rupture and crust over.