Passpoint - Preschooler

A boy, age 4, begins to use foul language. Concerned about this behavior, his parents ask the nurse how to stop it. Which advice should the nurse offer?

"Tell him it isn't acceptable and he'll be disciplined if he continues to do it."

The nurse is preparing a child, age 4, for cardiac catheterization. Which explanation of the procedure is most appropriate?

"The special medicine will feel warm when it's put in the tubing."

How should the nurse prepare a suspension before administration?

By shaking it so that all the drug particles are dispersed uniformly

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?

Decrease environmental stimulation.

In a pediatric client, what is an early sign of acute renal failure (ARF)?

Decreased urine output

The nurse is obtaining the history of a pediatric client, age 4. Which area usually takes longer to evaluate in a child than in an adult?

Developmental status

The nurse is teaching the mother of an ill child about childhood immunizations. The nurse should tell the mother that live virus vaccines shouldn't be administered to children with:

leukemia.

A child has arrived in the emergency department. The nurse documents the following findings in the chart understanding that they are consistent with which disease process?

pneumonia

A mother asks the nurse how to handle her 4-year-old child, who recently started wetting his pants after being completely toilet trained. The child just started attending nursery school 2 days a week. Which principle should guide the nurse's response?

The child returns to a level of behavior that increases his sense of security.

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?

Avoid making noise when in the child's room.

A 4-year-old child has a tick embedded in the scalp. Which method should the nurse use to remove the tick?

Grasp the tick with tweezers and apply slow, outward pressure.

The nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement?

Increased urine output

A preschooler goes into cardiac arrest. When performing cardiopulmonary resuscitation (CPR) on a child, how should the nurse deliver chest compressions?

With the heel of one hand

A 4-year-old girl is admitted to the hospital to rule out a diagnosis of leukemia. Which would be the best room assignment for the nurse to select for this child?

alone in a private room

For a child who's admitted to the emergency department with an acute asthma attack, nursing data collection is most likely to reveal:

expiratory wheezing.

A 4-year-old has a petechial rash. The platelet count is 20,000/L, and the hemoglobin level and white blood cell (WBC) count are normal. Which diagnosis would the nurse most likely suspect?

idiopathic thrombocytopenic purpura (ITP)

The nurse is caring for a preschooler with human immunodeficiency virus (HIV). The preschooler is being prepared to be discharged. What is the most important thing for the nurse to reinforce?

infection control

A preschooler has vomiting, diarrhea, and a potassium level of 3.0 mEq/L. The physician prescribes an I.V. infusion of dextrose 5% in water and half-normal saline solution with 10 mEq of potassium chloride. The nurse knows that a child with vomiting and diarrhea needs fluids and potassium chloride to:

meet physiologic needs.

A 4-year-old child is admitted to the burn unit with a circumferential burn to the left forearm. Which finding would alert the nurse to a potential complication that should be reported to the health care provider?

numbness of fingers

The mother of a child with sickle cell anemia confides in the nurse that she feels guilty about letting the child run and play with the neighborhood children and that if she had been a better mother, the child wouldn't have suffered a sickle cell crisis. Which response would be most appropriate?

"Tell me more about how you feel."

A 4-year-old is receiving peritoneal dialysis to treat renal failure. The nurse is most correct to complete a focused assessment on which early finding of peritonitis?

Abdominal tenderness on palpation

Which method is most reliable for confirming a preschooler's identity before administering a medication?

Check the hospital identification bracelet.

A 5-year-old newly diagnosed asthma client is being discharged from the hospital following asthma exacerbation. While providing discharge instructions to an overwhelmed parent, which instruction is essential for home medication use?

Provide the family with the drug's name, dosage, route, and frequency of administration.

The nurse is caring for a preschool child who is newly diagnosed with cystic fibrosis. In preparing the parents for the child's discharge home, which instructions will need to be reinforced? Select all that apply.

postural drainage techniques respiratory therapy instruction digestive enzyme replacement

A 3-year-old child with Down syndrome, admitted to the pediatric unit with asthma, does not enunciate words well and holds on to furniture when walking. What question would be appropriate for the nurse to ask the parent?

"How does your child's condition today differ from their normal condition?"

What is a normal systolic blood pressure for a 3-year-old child?

86 mm Hg

When gathering data on a preschool-age child, the nurse finds multiple contusions over the body. Which statement indicates the findings that should be documented?

All lesions, including location, shape, and color, should be documented.

During a clinic visit, the nurse notes that a 3-year-old preschooler, who measured 27 inches at the age of 2, now measures 29.5 inches. Based on the preschooler's measurement, how would the nurse proceed?

Document the finding.

A preschool-age child underwent a tonsillectomy 4 hours ago. Which data collection finding would make the nurse suspect postoperative hemorrhage?

Frequent swallowing

A mother brings her preschool child to the emergency department after he ingested an unknown quantity of acetaminophen. Which treatment will the physician probably prescribe next?

Gastric lavage and administration of acetylcysteine

The nurse is caring for a 4-year-old with a full-thickness burn. Before sending the child to hydrotherapy for a scheduled wound debridement, which nursing action is a priority?

Implement pain control measures

The nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider?

Incompatibility between the history and the injury

A 4-year-old child had a subungual hemorrhage of the toe after a jar fell on the foot. Which statement regarding the rationale for using electrocautery to treat the injury is most accurate?

It's used to relieve pain and reduce the risk of infection.

When collecting data on a 5-year-old child with hemophilia, the nurse identifies which of the following as an early sign of hemarthrosis?

Joint stiffness

The nurse has just administered a drug to a child. Which organ is most responsible for drug excretion in children?

Kidneys

A preschool child is admitted to the pediatric unit with acute nephritis. Which electrolyte replacement agent is used as an adjunct to treatment for this condition?

Magnesium sulfate

The mother of a preschooler recently diagnosed with type 1 diabetes mellitus makes an urgent call to the pediatrician's office. She says her child had an uncontrollable temper tantrum while playing and now is lethargic and hard to arouse. The nurse should instruct the mother to take which action first?

Measure the child's blood glucose level.

A parent asks the nurse for advice on disciplining a 4-year-old child. During the teaching session, which fact should the nurse emphasize?

Parental control should be firm and consistent.

After collecting data on a newly admitted 5-year-old child, the nurse assists in making the nursing diagnosis of Parental role conflict related to child's hospitalization. Which defining characteristic would most suggest this diagnosis?

Parents' failure to use available support systems or agencies to assist in coping

Encouraging children to engage in fantasy play and participate in their own care is a useful developmental approach for which pediatric age-group?

Preschool age (3 to 5 years)

When collecting data on a child with bronchiolitis, which finding does the nurse expect?

Productive cough

The parents of a 5-year-old call the clinic to report that they think their child has been abused by a day care provider. Which suggestion would be most appropriate in this situation?

Take the child to the emergency department of the local hospital.

The nurse is caring for a preschool child just diagnosed with impetigo. What is the most important action the nurse should take to prevent the spread of impetigo to others?

Teach child and family good handwashing techniques.

The nurse realizes she's 1 hour late in administering a dose of medication for her 4-year-old client. She gives the medication immediately and assesses the client. The client isn't harmed by the delay. Which action should the nurse take next?

The nurse should follow facility procedures for reporting an error.

The nurse is observing the parents of a 4-year-old child who has been admitted to the hospital. Which actions indicate that the parents understand how to best minimize anxiety during their child's hospitalization? Select all that apply.

The parents bring the child's favorite toy to the hospital. The parents remain at the child's side during the hospitalization. The parents bring the child's siblings for a brief visit.

When collecting data on a child's cultural background, the nurse should keep in mind that:

behavioral patterns are learned within a culture.

A preschool child presents to the emergency department pale and listless with history of vomiting and diarrhea for 3 days. Which client data are reported to the health care provider as indication that the client is in the late stage of shock? Select all that apply.

weak pulses with capillary refill over 3 seconds bradycardia and hypotension cool, clammy skin

The grandmother of a preschool-age child calls the clinic to report that the child has had a fever, has been fussy, and now has a rash that started on the neck and has spread to the rest of the child's body. The child was exposed to chickenpox about 3 weeks ago. What advice would be most important to give to the grandmother?

"You can help relieve the child's itching by giving him oatmeal baths."

Which instruction should the nurse include in teaching about diet to parents of a preschool-age child who's prescribed corticosteroids?

"You need to make sure your child consumes a low-sodium diet."

A nurse is caring preoperatively for a preschooler scheduled for a Wilms' tumor removal. When explaining the location of the tumor to the parents, identify the area of the urinary system impacted.

*** Wilms' tumor, also known as a nephroblastoma, is located on the kidney. The most common intra-abdominal tumor in children, Wilms' tumor, usually affects children ages 6 months to 4 years and favors the left kidney.

At a wellness visit, the parents report that their daughter, age 4, resists going to bed at night. After instruction by the nurse, which statement by the parents indicates effective teaching?

"We'll read her a story and let her play quietly in her bed until she falls asleep."

A child, age 3, who tests positive for the human immunodeficiency virus (HIV) is placed in foster care. The foster parents ask the nurse how to prevent HIV transmission to other family members. How should the nurse respond?

"Wear gloves when you're likely to come into contact with the child's blood or body fluids."

The nurse suspects that a child, age 4, is being neglected physically. To best collect data on the child's nutritional status, the nurse should ask the parents which question?

"What did your child eat for breakfast?"

When administering gentamicin to a preschooler, which of the following monitoring schedules is best for determining the drug's effectiveness?

A serum trough and peak level with the third dose

A preschooler is returned to the pediatric department following surgery. Postoperative pain management orders include meperidine 25 mg I.M. every 6 hours. When administering this injection, which nursing action is best?

Let the child choose which leg will receive the injection.

A 4-year-old girl has a urinary tract infection (UTI). When teaching the parents how to help her avoid recurrent UTIs, the nurse should emphasize which preventive measure?

Making sure she avoids bubble baths

A nurse is reinforce educating the parents of a 5-year-old child admitted to the pediatric unit with cystic fibrosis. Which statement concerning steatorrheaic stools is most accurate?

They're frothy, foul-smelling, and fatty.

The nurse is caring for a child in Buck traction. What is the priority intervention for the nurse to perform each day?

Provide daily pin site care.

A 4-year-old is hospitalized following alleged sexual abuse. The child is withdrawn and exhibits poor eye contact. Which nursing strategies encourage client communication?

Provide paper and crayons and encourage coloring. Engage in play with toys and dolls. Read a book to establish a rapport.

The licensed practical nurse (LPN) is assigned to care for a 4-year-old child who had a Harrington rod inserted the day before and notices the client is receiving antibiotics by a syringe pump. The nurse is IV certified, but uncomfortable because they are unfamiliar with the equipment. What would be the best course of action?

Request in-service education for use of the syringe pump.

The parent of an 8-year-old client tells the nurse that when the child plays with other children, the child does not seem to interact with them, but simply plays alongside. What does the nurse determine about the child?

This is a parallel play typical of toddlers, not preschool children.

A child experiences nausea and vomiting after receiving cancer chemotherapy drugs. To help prevent these problems from recurring, the nurse should:

administer an antiemetic 30 to 60 minutes before the next chemotherapy session.

A 5-year-old child sustained third-degree burns to the right upper extremity after tipping over a frying pan. Which skin structures would the nurse include when explaining a third-degree burn to the child's parent?

all skin layers and nerve endings

A child is diagnosed with Wilms' tumor. During data collection, the nurse expects to detect:

an abdominal mass.

A nurse is collecting data on a 3-year-old who has ingested toilet bowl cleaner. What is the priority when gathering data from this child?

evaluating the airway patency and respiratory status

When telling a 4-year-old child about an upcoming procedure, the nurse's most important consideration is to:

use simple terms.

A child, age 5, is brought to the pediatrician's office for a routine visit. When inspecting the child's mouth, the nurse expects to find how many teeth?

Up to 20

A 5-year-old arrives in the clinic for a physical to enter school. Which potential child abuse findings should be brought to the health care provider's attention? Select all that apply.

A patterned bruise is noted on the back. Parental description of accident does not match injury. Injuries in various stages of healing are documented.

When collecting data on a child with impetigo, the nurse expects which findings?

Honey-colored, crusted lesions

Which documentation is most important when preparing a preschool-age child for surgery?

Informed consent

The mother of a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons and that recently she had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to which of the following?

Latex

A 4-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Upon morning nursing rounds, which assessment finding indicates the client is in fluid overload?

Rales noted on lung auscultation and worsening dyspnea

A preschool-age child refuses to take prescribed medication. Which nursing strategy would be most appropriate?

Showing trust in the child's ability to cooperate even with an unpleasant procedure

For a child with tracheobronchitis, the nurse formulates a nursing diagnosis of Ineffective airway clearance related to thick secretions. After implementing interventions, the nurse expects which client outcome?

The child exhibits clear breath sounds.

The nurse is teaching the parents of a young child how to handle suspected poisoning. If the child ingests poison, the parents should first:

call the poison control center.

A preschool-age child scheduled for surgery in the morning is admitted to the facility for the first time. Which nursing action would ease the child's anxiety?

Having the child act out the surgical experience using dolls and medical equipment

A child, age 4, who has been hospitalized with asthma is to receive oral theophylline at home. Before discharge, the nurse teaches the parents about signs and symptoms of theophylline toxicity and the need to report these promptly. Which statement by the parents indicates effective teaching?

"We will report irritability and restlessness."