Nursing Care of Children-B ati
Q: A nurse is caring for a newly admitted school age child who has hypopituitarism. Which of the following medications should the nurse expect the provider to recommend to the parents for treating the child's condition?
A: Recombinant growth hormone. r: Recombinant growth hormone injections are used to treat hypopituitarism, which inhibits cell growth and results in growth failure. The nurse should expect the provider to recommend this treatment to the child's parents. The nurse's role is to provide emotional support for the parents as they make a decision about the treatment they feel is best for their child.
Q: A nurse in an ED is caring for a school-age child who has sustained a superficial minor burn from fireworks on his forearm. Which of the following actions should the nurse take?
A: Use an antimicrobial ointment on the affected area.
Q: A nurse in an ED is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following?
A: Wheezes.
*** A nurse is caring for a toddler who has acute otitis media and a temp of 40 C (104 F). After administering acetaminophen, which of the following actions should the nurse plan to take to reduce the toddler/s temp?
A: Dress the toddler in minimal clothing. R: The nurse should recognize that dressing the toddler in minimal clothing will expose the skin to air and maximize heat evaporation from the skin, thus reducing the toddler's temperature.
Q: A nurse is discussing organ donation with the parents of a school age child who has sustained brain death due to a bicycling accident. Which of the following actions should the nurse take first?
A: Explore the parents' feelings and wishes regarding organ donation.
** A school nurse is assessing a school age child who has erythema infectiosum (fifth disease). Which of the following findings should the nurse expect?
A: Facial rash.
**** A nurse is caring for a school age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction?
A: Flank pain. R: The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic reaction to the blood transfusion.
*** A nurse is reviewing lab results of a school age child who is 1 week postoperative following an open fracture repair. Which of the following values should the nurse identify as an indication of a potential complication?
A: Erythrocyte sedimentation rate 18 mm/hr.
****A nurse is planning care for a school age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan?
A: Initiate seizure precautions for the child. R: A sodium level of 129 mEq/L indicates hyponatremia and places the child at increased risk for neurological deficits and seizure activity. The nurse should complete a neurologic assessment and implement seizure precautions in order to maintain the child's safety.
**** A nurse is planning an educational program for school age children and their parents about bicycle safety. Which of the following information should the nurse plan to include?
A: The child should be able to stand on the balls of her feet when sitting on the bike. r: To decrease the risk for injury, parents should ensure that the bike is the correct size for the child. When seated on the bike, the child should be able to stand with the ball of each foot touching the ground and should be able to stand with each foot flat on the ground when straddling the bike's center bar.
*****A nurse is caring for an infant who is receiving IV fluids for the treatment of Tertralogy of Fallot and begins to have cyanotic spell. Which of the following actions should the nurse take?
Place the infant in knee-chest position R: The nurse should place the infant in a knee-chest position during a hypercyanotic spell to decrease the return of desaturated venous blood from the legs and to direct more blood into the pulmonary artery by increasing systemic vascular resistance.
Q: A nurse is admitting a school-age child who has pertussis. Which of the following actions should the nurse take?
A: Initiate droplet precautions for the child.
Q: A nurse is caring for a school age child who is receiving chem and is severely immunocompromised. Which of the following actions should the nurse take?
A: Screen the child's visitors for indication of infection.
Q: A nurse is providing anticipatory guidance to the parents of an 8 month old infant during a well-child visit. Which of the following statements should the nurse make?
A: Your baby should be able to sit unsupported.
Q: A nurse is admitting a 4 month old infant who has heart failure. Which of the following findings is the nurse's priority?
A: Episodes of vomiting. r: When using the urgent vs. nonurgent approach to client care, the nurse determines that the priority finding is three episodes of vomiting. This can indicate digoxin toxicity, which requires immediate intervention; therefore, this is the priority finding.
**** A nurse is reviewing the lumbar puncture results of a school age child suspected of having bacterial meningitis. which of the following results should the nurse identify as a finding associated with bacterial meningitis?
A: Increased protein concentration. r: The nurse should recognize that an increased protein concentration in the spinal fluid is a finding associated with bacterial meningitis.
Q: A hospice nurse is caring for a preschooler who has a terminal illness. The father tells the nurse that he cannot cope anymore and has decided to move out of the house. Which of the following statements should the nurse make?
A: Let's talk about some of the ways you have handled previous stressors in your life.
Q: A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler?
A: Oral re-hydration solution. R: oral rehydration solution to replace electrolytes and water and promote recovery from dehydration.
*** A community health nurse is assessing an 18 month old toddler in a community day care. Which of the following findings should the nurse identify as a potential indication of physical neglect?
A: Poor personal hygiene. R: Poor personal hygiene in a toddler is a potential indication of physical neglect. Because toddlers are still dependent on their parents for help with hygiene needs, poor personal hygiene indicates a lack of supervision.
*** A nurse in an ED suspects that a toddler has epiglottis. Which of the following actions should the nurse take?
A: Prepare the toddler for nasotracheal intubation. r: When epiglottitis is suspected the nurse should prepare for nasotracheal intubation or a tracheostomy, which might be required if the toddler begins to experience severe respiratory distress.
Q: A nurse is preparing to suction an infant who has a tracheostomy. Which of the following actions should the nurse take?
A: Suction for 5 seconds or less. r: to prevent hypoxia.
*** A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?
A: Epinephrine. r: This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence-based practice the nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the heart, causes vasoconstriction of blood vessels in the skin and mucous membranes, and triggers bronchodilation in the lungs.
***A nurse is reviewing the lab report of a 6 year old child who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider?
A: Hgb 8.5g/dL. R: The child receiving chemotherapy is at risk for anemia due to the chemotherapy effects on the blood forming cells of the bone marrow. The development of anemia is diagnosed through laboratory testing of hemoglobin and hematocrit levels. The nurse should recognize that a hemoglobin level of 8.5 g/dL is below the expected reference range for a 6-year-old child and should be reported to the provider.
Q: A nurse is providing teaching to the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statement by the parent should the nurse identify as understanding the teaching?
A: I should keep my child indoors when I mow the yard.
****A nurse is teaching a school age child who has anew diagnosis of type 1 diabetes mellitus. The nurse should identify which of the following statements by the child as understanding the teaching?
A: I will give myself a shot of regular insulin 30 minutes before I eat breakfast. r: The child should administer regular insulin 30 min before meals so that the onset coincides with food intake.
Q: A nurse is teaching the parent of an infant who has a Pavlik harness to treat developmental dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates an understanding of the teaching?
A: I will place my infant's diapers under the harness straps. r: To prevent soiling of the harness the parent should apply the infant's diaper under the straps.
**A nurse is planning care for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?
A: Increase fat content in the child's diet to 40% of total calories. R: A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of pancreatic enzymes. The nurse should increase the child's fat intake to equal 40% of total caloric intake.
*****A nurse in the ED is assessing a toddler who has Kawasaki disease. Which of the following findings should the nurse expect? (Select All)
A: Increased temp Xerophthalmia Cervical lymphadenopathy. R: Kawasaki disease is an acute illness associated with a fever lasting more than 4 days that is unresponsive to antipyretics or antibiotics. Ophthalmic manifestations of Kawasaki disease include reddening of the conjunctiva and dryness of the eyes, or xerophthalmia. The child who has Kawasaki disease may develop enlarged cervical nodes on one side of the neck that are nontender and greater than 1.5 cm in size.
Q: A nurse is assessing an 8 year old child who has early indications of shock. After establishing an airway and stabilizing the child's respirations, which of the following actions should the nurse take next?
A: Initiate IV access. R: Since the child's airway is established and respirations are stabilized, the next action the nurse should take using the airway, breathing, circulation approach to client care is to establish IV access to maintain the child's circulatory volume.
Q: A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should the nurse expect?
A: Loud, harsh murmur. r: The nurse should expect to hear a loud, harsh murmur with a ventricular septal defect due to the left-to-right shunting of blood, which contributes to hypertrophy of the infant's heart muscle.
****A nurse is caring for a school age child who has acute rheumatic fever. Which of the following actions should the nurse take?
A: Maintain the child on bed rest. R: The nurse should maintain the child on bed rest as well as limit the child's activity during the acute phase of rheumatic fever to assist with the prevention of cardiac damage.
***A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent should the nurse identify as understanding the teaching?
A: Mono is caused by an infection with the Epstein-Barr virus. r: Mononucleosis is a mildly contagious illness that occurs sporadically or in groups and is primarily caused by the Epstein-Barr virus.
Q: A nurse is assessing a 6 month old infant at a well infant visit. Which of the following findings should the nurse report to the provider?
A: Presence of strabismus. r: Strabismus, or crossing of the eyes, disappears at 3 to 4 months of age. Therefore, the nurse should report this finding to the provider.
Q: A nurse is creating a plan of care for a school age child who has heart disease and has developed heart failure. Which of they following interventions should the nurse include in the plan?
A: Provide small, frequent meals to the child.
Q: A nurse is assessing a toddler who has leukemia and is receiving his first round of chemo. Which of the following findings is the priority for the nurse to report to the provider?
A: Urticaria. r: The greatest risk to a toddler who is receiving his first round of chemotherapy is an anaphylactic reaction; therefore, urticaria is the priority finding for the nurse to report to the provider. The nurse should monitor the child for anaphylaxis during and up to 1 hr after the infusion is complete, and immediately report associated findings, such as urticaria, rash, angioedema, and wheezing to the provider.
Q: A nurse is planning care for a school age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the plan?
A: Use a semipermeable transparent dressing to cover the site.
*** A nurse is admitting an infant who has intussusception. Which of the following finding should the nurse expect? Select all that apply.
A: Vomiting, Lethargy. R: have bloody stools that are currant jelly-like in appearance he nurse should expect the infant with intussusception to exhibit lethargy due to episodes of severe pain during which the infant cries inconsolably leading to exhaustion and decreased nutritional intake. vomiting due to the obstruction that occurs when a segment of the bowel telescopes within another segment of the bowel.
Q: A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of dehydration. Which of the following findings should the nurse address first?
A: Tachypnea.
****A school nurse is assessing an adolescent who has scoliosis. Which of the following findings should the nurse expect?
A: A unilateral rib hump. r: When assessing an adolescent for scoliosis, the school nurse should expect to see a unilateral rib hump with hip flexion. This results from a lateral S- or C-shaped curvature to the thoracic spine resulting in asymmetry of the ribs, shoulders, hips, or pelvis. Scoliosis can be the result of a neuromuscular or connective tissue disorder, or it can be congenital in nature.
Q: A nurse is interviewing the parent of an 18 month old toddler during a well child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss?
A: The toddler received tobramycin during a hospitalization 2 weeks ago. r: The nurse should identify tobramycin as an aminoglycoside, which is an ototoxic medication that can cause mild to moderate hearing loss, and should assess the toddler for a hearing impairment.
**** A nurse is teaching a school age child who has a severe allergy to bee venom and his parent about epinephrine. Which of the following
A: Use a second dose if the first does of epi does not completely reverse the symptoms. r: A biphasic response, in which the child will appear to recover and then experience a recurrence of symptoms, is possible with some allergic reactions. The nurse should instruct the parent and child to use a second dose if the first dose does not resolve all the symptoms.
Q: A nurse is providing discharge teaching to the parents of a 6 month old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instruction should the nurse include in the teaching?
A: Allow the stent to drain directly into your infants diaper. r: The nurse should instruct the parents to ensure that the stent drains directly into the infant's diaper to prevent kinking or twisting that can interfere with urine flow.
Q: A nurse is preparing to administer a hep B vaccine to a 1 month of infant. The nurse should plan to inject the medication at which of the following locations?
A: C vastus lateralis.
Q: A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should teach the parent to apply which of the following to the affected area?
A: Zinc Oxide. r: Diaper dermatitis is a common inflammatory skin disorder caused by contact with an irritant such as urine, feces, soap, or friction, and takes the form of scaling, blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide, against the irritants allows the skin to heal.
***A nurse is assessing a 4 year old child at a well child visit. Which of the following developmental milestones should the nurse expect to observe?
A: Cuts a shape using scissors.
Q: A nurse is assessing a school age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?
A: Decreased attention span.
**** A nurse is caring for a school-age child who has diabetes mellitus and was admitted with a diagnosis of diabetic ketoacidosis. When performing the respiratory assessment, which of the following findings should the nurse expect?
A: Deep respirations of 32/min. r: The nurse should expect deep and rapid respirations in a child who has diabetic ketoacidosis. This respiratory rhythm is the body's attempt to blow off excess carbon dioxide and achieve a state of homeostasis.
Nursing Care of Children-B
Nursing Care of Children-B
Q: A nurse in an ED is caring for a school age child who has appendicitis and rates his abdominal pain at 7/10. Which of the following actions should the nurse take?
A: Give morphine 0.05 mg/kg IV. *A pain level of 7 on a 0 to 10 scale is considered severe and the nurse should administer an analgesic medication for pain relief.
Q: A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school aged child who weights 75 lbs. Available is atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day?
A: 1 capsule.
Q: A nurse is assessing a school age child who has appendicitis with possible perforation. The nurse should identify which of the following as a manifestation of peritonitis?
A: Abdominal distention.
Q: A nurse is caring for a 2 week old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize the infant's pain?
A: Administer sucrose to the infant prior to the procedure.
****A charge nurse is preparing to make a room assignment for a newly admitted school age child. Which of the following considerations is the nurse's priority when making a room assignment?
A: Disease process. R: The transmission of infectious diseases is the greatest risk to this child and other children on the unit; therefore, the child's disease process is the nurse's priority consideration. Self-care ability
Q: A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should the nurse identify as an indication the adolescent is rejecting the kidney?
A: Serum creatinine 3.0 mg/dl. r: Creatinine is a byproduct of protein metabolism and is excreted from the body through the kidneys. An elevated serum creatinine level, therefore, can be an indication that the kidneys are not functioning. The nurse should identify that the adolescent's serum creatinine level is higher than the normal reference range and may indicate rejection of the kidney.
Q: A nurse is providing anticipatory guidance to the parents of a 2 week old infant about risk factors for sudden infant death syndrome (SIDS). Which of the following risk factors should the nurse include in the teaching?
A: Covering the sleeping infant with a blanket. R: The use of quilts or blankets to cover the sleeping infant increases the risk of SIDS due to the potential for suffocation. The nurse should recommend the parents dress the infant warmly and increase the temperature in the home.
Q: A nurse is providing discharge teaching to the parent of a school age child who has undergone a tonsillectomy. Which of the following statements by the parent should the nurse identify as understanding the teaching?
A: I will notify the Dr if I notice that my child is swallowing frequently. r: The nurse should instruct the parent that frequent swallowing is a sign of bleeding and, if it is observed, to notify the primary care provider immediately.
Q: A nurse is caring for a school age child who has experience a tonic clonic seizure. Which of the following actions should the nurse take during the immediate postictal period?
A: Place the child in a lateral position. r: to prevent aspiration.
**** A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?
A: Great toe. r: The nurse should secure the sensor to the great toe of the infant and then place a snug-fitting sock on the foot to hold the sensor in place. The nurse should also check the skin under the sensor site frequently for pulses, temperature, and color.
Q: A nurse is caring for an infant who is receiving IV fluids for the treatment of tetralogy of allot and begins to have a hypercyanotic spell. Which of the following actions should the nurse take?
A: Place the infant in a knee-chest position.
Q: A nurse is providing discharge teaching to the parents of a Caucasian toddler who had a lower leg cast applied 24 hr ago. The nurse should instruct the parents to report which of the following findings to the provider?
A: Restricted ability to move the toes.
****A nurse is teaching a school age child and his parent about postoperative care following cardiac catheterization. Which of the following instructions should the nurse include?
A: Wait 3 days before taking a tub bath. R: The child should keep the site clean and dry for at least 3 days to reduce the risk of infection. He should not take a tub bath for 3 days to avoid immersion of the incision in water.
*****A nurse is teaching the mother of a 6 month old infant about teething. Which of the following statements should the nurse make?
A: Your baby may pull at her ears when she is teething. R: The nurse should inform the mother that teething can result in discomfort for the infant. Therefore, the mother should look for indications such as pulling on the ears, difficulty sleeping, increased drooling, or increased fussiness.