Pediatric Final EOC questions

What is the name of the type of rash seen in Lyme disease with a clear area in its center? _______ _______

""bull's eye", "bull's eye""

Symptoms of _________ _________ appear 3 to 7 days after exposure to the herpes simplex virus and include vesicles, swelling, pruritus, and severe pain of the affected fingers.

herpetic whitlow

______ _______ ______ should be considered in any infant with signs of increased intracranial pressure, with retinal hemorrhage, seizures, subtle hydrocephalus, and papilledema.

"Shaken baby syndrome (or shaken infant syndrome), Shaken baby syndrome (or shaken infant syndrome)"

The nurse is caring for a 12-year-old boy who sustained major burns when putting charcoal lighter on a campfire. The nurse observes that boy is "very brave" and appears to accept pain with little or no response. Based on the nurse's knowledge of burns, pain, and age-specific development, what is the most appropriate nursing action? A)Talk with the health care provider about the possibility of requesting a psychological consultation. B)Spend time with the child to better understand why he doesn't seem to respond to pain. C)Praise the child frequently for his ability to deal with the pain. D)Encourage continued bravery as a coping strategy.

A A. A psychological consultation will assist the child to verbalize fears. This age group is concerned with physical appearance. The psychologists can help integrate the issues that the child is facing. The nurse would talk with the health care provider and share the observations about this child, but ultimately the health care provider would be the one to decide if a consult is warranted. B. Further assessment is needed, but this child would probably benefit from the psychologist. It is likely that the child is having pain but not acknowledging it. C. If the child is feeling pain, the nurse should not praise him for hiding it. The nurse must act as an advocate and keep the child as comfortable as possible. D. Encouraging bravery may not be an effective coping strategy if the child is in severe pain.

What is the most common chronic behavioral disorder that emerges during childhood? Attention deficit-hyperactivity disorder Depression Eating disorders Sexual abuse

A A. ADHD is the most common chronic behavioral disorder that emerges during childhood. B. Depression can occur but it is not the most common chronic behavioral disorder that emerges during childhood. C. Eating disorders are not the most common chronic behavioral disorder that emerges during childhood. D. Sexual abuse is not a chronic behavioral disorder that emerges during childhood.

A 5-year-old child has an IQ of 80. The nurse would expect this child to exhibit which behaviors? Able to perform as most other 5-year-olds. Needs help walking. Has a noticeable delay in speech development. Delayed in all motor skills.

A A. An IQ of 80 is at the level of borderline intellectual disability (IQ 71-84). It may not be noticed until the child's school performance is monitored. B. A child who is at the level of profound intellectual disability (IQ C. A child with moderate intellectual disability (IQ 35-40 to 50-55) will have a noticeable delay in motor and speech development by preschool age. D. A child with severe intellectual disability (IQ 20-25 to 35-40) has early and marked delay in all motor skills.

A mother calls the pediatrician's office stating that her 4-year-old son looks like "someone slapped his cheeks" and he's runny a fever. What would the nurse suspect the child has based on the mother's description? A)Fifth disease B)Rubella C)Scarlet fever D)Roseola infantum

A A. Fifth disease is a relatively mild systemic disease. Typically the child may appear well but has an intense, fiery red, edematous rash on the cheeks, which gives a "slapped cheek" appearance or a history of a rash that "comes and goes." Before the appearance of the rash, many children are asymptomatic or have nonspecific symptoms such as headache runny nose, malaise, and mild fever. B. Rubella often has the following signs and symptoms: Older children may report profuse nasal drainage, diarrhea, malaise, sore throat, headache, low-grade fever, polyarthritis, eye pain, aches, chills, anorexia, and nausea. C. Scarlet fever is known for the " strawberry tongue" and a fine red papular rash in the axillae, groin, and neck, which feels like sandpaper to the touch. D. Roseola infantum causes a sudden high fever (103 to 106 °F [39.4 to 41.1 °C]), malaise, and irritability, a mild cough, runny nose, abdominal pain, headache, vomiting, and diarrhea and then several days later when the fever subsides a rash appears. The rash consists of rose-pink maculopapules or macules that blanch with pressure.

A group of teenage boys have just gotten on the basketball team and will be showering in the school's locker room after practice. What suggestions should the school nurse provide to these adolescents to decrease the chance of contracting athlete's foot (tinea pedis)? (Select all that apply.) A) Bring own soap and towel, and don't share them with others. B)Dry feet completely. C)Wear practice shoes home. D)Change socks every other day when not practicing. E)Use talcum powder or antifungal powder to keep feet dry. F)Make sure shoes are thoroughly dry before wearing them.

A,B,E,F A. Bringing their own soap and towel and not sharing them with others is necessary.<br>B. They should dry their feet completely. Fungus likes moist, dark areas.<br>C. They should not wear their practice shoes home because of the moisture and the fact that their feet were just washed and dried. This would undo the positive actions the adolescents have taken.<br>D. Changing socks every other day when not practicing is not often enough because of foot sweat and darkness. They should be changed at least daily.<br>E. Talcum powder or antifungal powder to keep feet dry as prevention of athlete&#8217;s foot is appropriate.<br>F. It is essential that their shoes be thoroughly dry before wearing them.</div>

The nurse educator is explaining characteristics of sexually abused children during a special class for pediatric nurses. Which of the statements should the nurse educator include in the presentation? (Select all that apply.) A)Children who are sexually abused may deny that the abuse happened, even with direct questioning. B)Children were less likely to delay disclosure if they were younger than 7 years old, if they were boys, or if the abuse occurred within the family. C)Previously toilet-trained children may experience accidents with stool. D)Children of sexual abuse may experience sleep disturbances, decreased appetite or sudden refusal to participate in gym. E) Sexually abused adolescents may be promiscuous.

A,D,E A. It is true that children who are sexually abused may deny that the abuse happened, even with direct questioning.<br>B. Children were more likely to delay disclosure if they were younger than 7 years old, were boys, or the abuse occurred within the family.<br>C. Previously toilet-trained children may experience urinary accidents.<br>D. Children of sexual abuse may experience sleep disturbances, decreased appetite, or sudden refusal to participate in gym.<br>E. Sexually abused adolescents may be promiscuous.

The nurse is listening to a mother trying to remember all of the health problems the pediatrician said her 3-week-old daughter with Down syndrome could develop. Which ones would the nurse reinforce as possible health concerns in the future? (Select all that apply.) A)Pyloric stenosis B)Tetralogy of Fallot C)Tracheoesophageal fistula D)Hypothyroidism E)Leukemia F)Ventricular septal defect

A,D,E,F A. Pyloric stenosis is seen when the child is more than a month old.<br>B. Tetralogy of Fallot would have been detected within the first few hours of life.<br>C. A tracheoesophageal fistula would have been detected within the first few hours of life.<br>D. Hypothyroidism can be a problem.<br>E. Leukemia or leukemia-like conditions are common in children with Down syndrome.<br>F. A small ventricular septal defect could manifest itself later on.

During the rehabilitative phase of care, the nurse would apply pressure dressings to the patient's severely burned areas to accomplish which goal? A) To relieve as much pain as possible. B)To decrease the development of scar tissue. C)To promote motion during the healing process. D) To protect underlying tissue by encouraging scar formation.

B A. The goal of the pressure dressing is to improve the appearance of scars. B. Uniform pressure to the scar decreases blood supply. The use of pressure garments serves to decrease the blood supply to the hypertrophic tissue. This is done to prevent scarring and contractures. C. Motion is encouraged because it prevents contractures, but this has nothing to do with the pressure dressing application. D. The goal of the pressure dressing is to minimize the development of scar tissue.

What is the time interval between early manifestations of disease and the overt clinical syndrome called? A) The incubation period B)The prodromal period C)The desquamation period D)The period of communicability

B A. The incubation period is the time from exposure to appearance of first symptom. B. The definition of prodromal period is the interval between early manifestations of the disease and the appearance of overt clinical symptoms. C. The "desquamation period" refers to the shedding of skin. D. The period of communicability is the time when the child is infectious.

A 9-year-old child with a known peanut allergy has an allergic reaction right after eating potato chips with his classmates served from a large bowl during a party. After the child has been cared for, what action is most important for the nurse to initiate? A)A further investigation of the potato chips. B)Asking if the child is allergic to potatoes. C)Washing the serving bowl with soap and hot water. D)Asking the child if this reaction happens often.

C A. More than likely the potato chips had nothing to do with the child's allergic reaction. B. At this age the child should know if there is an allergy to potatoes. C. For children with allergies to peanuts or other nuts, an anaphylactic reaction can occur with exposure to nut oils, surfaces contaminated with nuts, shell fragments, or cooking and serving utensils used previously for nut products. The bowl needs to be washed well. D. This would be helpful, but if the bowl still contains nut residue, the child would be in danger when consuming anything from this bowl.

The school nurse is discussing prevention of Human Immunodeficiency Virus (HIV) transmission with some adolescents. Which is appropriate to include? A)The virus is easily transmitted. B)The virus is only transmitted through blood. C) Intravenous drug users should not share needles. D)Condoms should be used for homosexual sex.

C A. The virus is not transmitted unless blood or body fluids directly contact nonintact skin or a mucous membrane. If those conditions exist, then transmission is indeed "easy." B. Body fluids may also transmit the virus. C. HIV is spread through blood and body fluids. Intravenous needles that have been used should not be shared. They may be contaminated with the virus. D. Condoms should be used for both heterosexual and homosexual sex.

A mother calls the pediatrician's office to talk about her 8-year-old daughter who complains of stomachaches or headaches almost every Tuesday morning an hour before she needs to leave for school. What response by the nurse would be most helpful? "Is there a chance your daughter is being bullied?" "On a 1-10 scale, how much pain does the child have?" "What activities occur either before during or after school on Tuesdays only? "Who takes care of your daughter when school is over?

C A. There is a chance the daughter is being bullied, but an open question needs to be used to obtain a full picture of what occurs on Tuesdays only, either before, during or after school. B. The pain level is not as important as the precipitating factor(s). C. This is the question which must be asked to obtain a full picture of what occurs on Tuesdays only, either before, during or after school. Consideration of this diagnosis should rule out precipitating factors such as fear of bullying, fatigue, boredom, learning challenges, upsetting incidents that occur in the school setting or upsets that are occurring in the home. D. There is no data that states the daughter is cared for someone else when school is over.

Which fungal infection are HIV-exposed infections particularly at risk of contracting? _________________

Candida"

What procedure would be correct for the nurse to use when applying wet compresses or dressings to the skin? A)Apply the dressing when it is saturated and dripping. B)Apply the dressing so that the area is totally immobilized. C) Pour new solution over a dressing that has become dry, or apply solution with a syringe. D) Apply the desired solution on soft gauze then squeeze the gauze to remove excess liquid.

D A. After immersion in the solution, the dressings are wrung out to avoid dripping. B. The moist dressing should be laid flat on the area with an attempt to avoid restriction of movement. C. As the evaporation begins to dry them, the dressings are removed, immersed in the solution again, and reapplied by using aseptic technique. When the solution dries, concentrated residue is left in the dressing. The addition of fluid may result in a more concentrated soak being placed on the sensitive tissue. D. The desired solution should be applied to soft gauze or soft cotton cloths, but the excess fluid must be removed, or the desired effects will not occur.

Which explanation of ringworm (tinea capitis) by the nurse is best? A)It is self-limiting and not contagious. B)It is a sign of uncleanliness. C)The patient should recover spontaneously without interventions. D)It is spread by direct and indirect contact.

D A. Ringworm is infectious and not self-limiting. B. Because ringworm is easily transmitted, it is not a sign of uncleanliness. It can be transmitted by theater seats, gym mats, and animal-to-human transmission. C. Treatment is required with the drug griseofulvin (Grisactin), which is indicated for a prolonged course, possibly several months. D. Ringworm is spread by both direct and indirect contact. Children should wear protective caps at night to avoid transfer of ringworm to bedding.

After the genetic testing of a child with Down syndrome (DS) showed that it was caused by translocation, the parents ask about further genetic testing. What recommendation should the nurse explain to the parents? No further genetic testing is indicated. The child should be retested to confirm diagnosis of DS. The mother should be tested if she is more than 35 years old. The parents can be tested themselves because the child's condition might be hereditary.

D A. The child does not require further genetic testing, but parents and siblings do. B. Retesting is not necessary because the diagnosis has been validated with chromosomal testing. C. Down syndrome occurs in children of parents of all ages. D. The parents and any siblings should be tested. Down syndrome resulting from a translocation may be inherited. This type of chromosomal abnormality presents issues for future pregnancies.

A child is being discharged home on a regimen of oral corticosteroids. What information is most important for the nurse to explain to the parents? A)Reduce the dosage as quickly as possible so dependence on the medication is avoided. B)Any new cuts should be washed with soap and water then covered with a bandage. C) All spurts of energy and increased appetite are interpreted as a positive response. D) If the child becomes ill, notify the physician who ordered the medication.

D A. The dosage should be tapered to allow for a gradual return of adrenal function. B. Any new cuts should be washed with soap and water then covered with a bandage, but this is true for most children and is not specific to taking corticosteroids. C. Energy spurts do not indicate anything especially and increased appetite is common with this type of medication. D. If the child becomes ill, the physician who ordered the medication should be notified because of the increased stress. Supplemental glucocorticoids might be necessary during times of increased stress to prevent adrenal insufficiency.

_________ ___ ________ is the most common inherited cause of cognitive impairment, and the most common known genetic cause of autism.

Fragile X syndrome

The nurse is planning care for a school-age child with bacterial meningitis. Which of nursing actions should be included? Keep environmental stimuli at a minimum. Avoid giving pain medications that could dull sensorium. Measure head circumference to assess developing complications. Have the child move his head side to side at least every 2 hours.

a A. Children with meningitis are sensitive to noise, bright lights, and other external stimuli. The nurse should keep the room as quiet as possible, with a minimum of external stimuli. B. After consultation with the physician, pain medications can be used if necessary. C. The child is placed in side-lying position with the head of the bed slightly elevated. The nurse should avoid measures such as lifting the child's head that would increase discomfort. D. A school-age child will have closed sutures. Head circumference should not change.

Which of the following is a clinical manifestation of increased intracranial pressure in infants? Irritability Photophobia Pulsating anterior fontanel Vomiting and diarrhea

a A. Irritability is one of the changes that may indicate increased intracranial pressure. B. Photophobia is not indicative of increased intracranial pressure in infants. C. Vomiting is one of the signs in children, but when present with diarrhea it is indicative of a gastrointestinal disturbance. D. Frequently, pulsations are visible in the anterior fontanel. It is not an indication of increased intracranial pressure.

A nurse is caring for a toddler status post surgery for a brain tumor. During an assessment the nurse notes that the toddler is becoming irritable and that the pupils are unequal and sluggish. What is the most appropriate nursing action? Notify the physician immediately. Assess for level of consciousness. Observe closely for signs of increased intracranial pressure (ICP). Administer pain medication and assess for response.

a A. The worsening of symptoms may indicate that the ICP is increasing. The physician should be notified immediately. B. Assessing for level of consciousness should be done as part of the overall assessment. C. Pain medication should not be given. Consultation with the physician should occur first. D. The nurse is noting signs of potentially increased ICP.

The nurse is caring for a child with the beginning ascending paralysis of Guillain-Barré Syndrome. What nursing actions should be implemented in the care of this child? (Select all that apply.) A) Use play as a means of assessing the child's neurological abilities. BAssess pulse oximetry measurements daily. C))Listen to lung sounds several times daily. D)Reposition the child every 4 hours. E)Allow the child to eat as long as the cranial nerves are intact. F) Measure each urine watching for decreasing amounts.

a,c,e,f A. Play can be used as a means of assessing the child&#8217;s neurological abilities, by having the child push with his feet, hands, hold an object, do puzzles, and so forth to determine his gross and fine motor abilities.<br>B. Pulse oximetry measurements should be done either continuously or every few hours.<br>C. Lung sounds should be checked several times daily, as well as chest excursion, depth of respirations, and energy expenditure needed to breathe.<br>D. The child should be repositioned every 2 hours.<br>E. The child may eat as long as the cranial nerves are intact. When aspiration is a potential problem, then enteral feedings will be instituted until the gag reflex returns.<br>F. Urine output must be watched to detect any inability to void.

A young child is having a seizure that has lasted 35 minutes with loss of consciousness. What type of seizure would the nurse document? An absence seizure. Status epilepticus. A generalized seizure. A simple partial seizure.

b A. Absence seizures are brief losses of consciousness. B. Status epilepticus is a generalized seizure that lasts more than 30 minutes. C. Generalized seizures are the most common of seizures. They have a tonic phase of approximately 10 to 20 seconds. They involve both hemispheres of the brain. D. Simple partial seizures are characterized by varying sensations.

A nurse is caring for a comatose child with multiple injuries. The nurse should recognize that pain Cannot occur if the child is comatose May occur if child regains consciousness Requires astute nursing assessment and management Is best assessed by family members who are familiar with the child

c A. Pain can occur in the comatose child. B. The child can be in pain while comatose. C. Because the child cannot communicate pain through one of the standard pain rating scales, the nurse must be focused on physiologic and behavioral manifestations. D. The family can provide insight into different responses, but the nurse should be monitoring physiologic and behavioral manifestations.

An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barré syndrome). When explaining this disease process to the parents, which should the nurse consider? Paralysis is progressive, with little hope for recovery. The disease is inherited as an autosomal, sex-linked, recessive gene. Muscle function will gradually return, and recovery is possible in most children. The disease results from an apparently toxic reaction to certain medications.

c A. The paralysis is progressive, but most children have full recovery. Supportive nursing care is essential. B. It is an immune-mediated disease associated with viral and bacterial infections. C. Most patients regain full muscle strength. The return of function is in reverse order of onset. D. It is an immune-mediated disease associated with viral and bacterial infections.

What is a neural tube defect that may not be visible externally in the lumbosacral area called? A meningocele A myelomeningocele Spina bifida cystica Spina bifida occulta

d A. A meningocele contains meninges and spinal fluid but no neural tissue. Unless there are associated cutaneous findings, it is often not identified until later. B. A myelomeningocele is a neural tube defect that contains meninges, spinal fluid, and nerves. C. Spina bifida cystica is a cystic formation with an external saclike protrusion. D. Spina bifida occulta is completely enclosed. Often this defect will not be noticed.

A woman 6 weeks pregnant tells the nurse that she is worried the baby might have spina bifida because of a family history. What response would be most helpful to the patient? "There is no definite genetic basis for the defect." "Low levels of folic acid at the time of conception has been strongly linked to neural tube defects." "Chromosomal studies done on amniotic fluid can diagnose the defect prenatally." "The concentration of alpha-fetoprotein in amniotic fluid can indicate the presence of the defect prenatally."

d A. The origin of neural tube defects has several factors, including deficient maternal levels of folic acid at the time of conception and a possible, but unproven genetic predisposition. B. This is true, but the woman is already 6 weeks pregnant and the neural tube is developing. C. There is one chromosomal study for spina bifida at this time. D. Fetal ultrasonography and elevated concentrations of alpha-fetoprotein in amniotic fluid may indicate the presence of neural tube defects.

What is a major goal of therapy for children with cerebral palsy? Reverse the degenerative processes that have occurred. Cure the underlying defect causing the disorder. Prevent spread to individuals in close contact with child. Promote optimal development by identifying the condition early.

d A. The underlying defect cannot be cured. B. It may not be possible to reverse degenerative processes. C. Cerebral palsy is not contagious. D. Because cerebral palsy is, so far as is known, a permanent disorder, the goal of therapy is to promote optimal development. This is done through early recognition and beginning of therapy.

A pre-teen is suspected of having bulimia nervosa by her parents. What findings would the nurse expect when doing an assessment on this patient? Erosion of the teeth. States she feels full after eating a small amount. Slightly hypertensive. Weight below normal parameters.

A A. Erosion of the teeth can occur because of the effects of the acidic stomach contents on the teeth from induced vomiting. B. Stating she feels full after eating a small amount is characteristic of anorexia nervosa. C. The patient could be hypotensive because of the loss of food and fluid. D. Weight would most likely be in within normal parameters.

A child with recurrent infections, facial edema, hypertension and delayed growth in height is seen in the pediatrician's office. Which question would be most important for the nurse to ask the mother? A) "What medications are being taken by your child?" B)"When did this current infection begin?" C)"Are your other children shorter than usual?" D) "Is your child having headaches?"

A A. Facial edema, hypertension, recurrent infections, and delayed growth in height are some of the clinical manifestations of excess steroid administered systemically. B. It would be important to know about when the infection began, but the child has a cluster of problems. C. It would be important to know if shortness in height runs in the family, but the child has a cluster of symptoms which can stem from systemic steroid use. D. Headaches can occur from hypertension, but the underlying problems, not the symptoms, need to be addressed.

Parents rush their 7-year-old child to a free standing emergency clinic because of the child's having been stung by several bees; the child is having rapid, labored breathing. What is the priority action by the nurse when the child gets into the examining room? A)Administer oxygen using a nasal cannula. B)Obtain a complete health history from the parents. C)Place a tourniquet distal to the area where the bee stings are. D)Get the code cart located down the hall in the locked treatment room.

A A. Initially, the nurse maintains an adequate airway by administering oxygen and assisting with aerosol treatments and intubation as necessary. B. A brief, focused health history is indicated related to the insect bites. C. In the case of an insect sting or injected medication, a tourniquet applied to the affected extremity just proximal to the site might help confine the allergen. D. The nurse should stay with the patient. Someone else can get the code cart.

An adolescent female with systemic lupus erythematosus (SLE) is trying to learn how to live with her illness. What teaching by the nurse is priority? A)Use protection against the sun whenever she is outside, regardless of the season. B)Maintain a high-protein diet to maintain healthy skin integrity and muscle fibers. C) Plan her schedule so she gets at least 10 hours of solid, deep sleep each night. D)Keep a diary so she can document her thoughts and feelings as she adjusts.

A A. Using protection against the sun whenever she is outside, regardless of the season, is a must to avoid triggers that cause exacerbations. B. A high-protein diet is usually contraindicated, because it places stress on the kidneys because protein molecules are large. C. Sleep and rest are important with prevention of fatigue, rather than a specific number of hours' being asleep as the priority. D. Keeping a diary so she can document her thoughts and feelings as she adjusts is important, but the physiological needs must be addressed before the psychological ones.

What is the primary goal in caring for the child with intellectual impairment? Encourage play. Develop vocational skills. Promote optimum development. Help families adjust to future care

C A. Guide the parents in the selection of developmentally appropriate activities, not just to encourage play. B. Vocational skills will be addressed as the child's capabilities are developing. C. A comprehensive approach is desirable to establish acceptable social behavior and feelings of self-worth in the child. D. Adjusting to future care is a continuing process that changes as the child meets developmental milestones.

What therapeutic management for the patient with systemic lupus erythematosus (SLE) would the nurse expect to include? A) A high-protein, low-sodium diet. B)Corticosteroids to control inflammation. C)Gold salts to suppress the inflammatory process. D)An exercise regimen to build up muscle strength and endurance.

B A. A balanced diet without exceeding caloric expenditures is recommended. B. Corticosteroids to control inflammation is the current primary mode of therapy. C. Gold salts are slow-acting anti-rheumatic agents used for those who do not respond to nonsteroidal anti-inflammatory drugs. D. Exercise should be done in moderation.

Which statement is correct about young children who report sexual abuse? A) In most cases, the child has fabricated the story. B)Younger children may exhibit various behavioral manifestations. C) Younger children's stories are not believed unless other evidence is apparent. D)Younger children should be able to retell the story the same way to another person.

B A. Adults are reluctant to believe children and sexual abuse goes unreported. Children should be taught to tell as many adults as it takes until they are believed. B. There is no diagnostic profile of the child who is being sexually abused. Many different behavioral manifestations may be exhibited. C. Physical examination is normal in 80% of abused children. D. The child will usually try to protect parents and may accept responsibility for the act rather than tell. Knowing this, the nurse should teach the child that inappropriate touching should be reported to as many adults as it takes to be heard and believed.

When teaching the adolescent about the management of acne, the nurse should include which intervention? A)Clean the face with an antibacterial soap twice each day. B)Clean the face gently with a mild soap once or twice each day. C)Avoid foods with a high fat content, such as French fries and chocolate. D)Express comedones by gentle squeezing; then cleanse with alcohol.

B A. Antibacterial soaps may be too drying when used in combination with topical medications. B. Cleansing the face with mild soap and water will remove surface dirt and oil. C. No relationship has been established between food intake and acne. D. Squeezing comedones, then cleansing with alcohol, can break down the ductal walls of the lesions and cause the acne to worsen

A child with a depressed immune system due to chemotherapy for cancer has been admitted to the pediatric unit because of possible measles. What would the nurse expect to assess if the child is in the prodrome period of the disease? A)Confusion, chorea, and conjunctivitis B)Coryza, cough, and conjunctivitis C)Coordination problems, clubbing, and contractures D)Croup, congestion, and crying

B A. Confusion doesn't occur unless the fever is very high. There are no uncoordinated movements, but conjunctivitis is present. B. Typically, children have a prodrome period with fever that rises gradually and the "three Cs" ([profuse runny nose], cough, and conjunctivitis) that lasts between 1 and 4 days. C. There are no coordination problems, clubbing of the digits, or contractures. D. Croup is a collection of problems and is not seen with measles. Crying is very vague, but there is some congestion.

The parents of a young boy with burns covering 40% of the total body surface area (TBSA) ask why he is receiving enteral feedings at night while he is sleeping and is eating during the day. Which response by the nurse is best? A)"His appetite is really poor right now." B) "Your son needs more protein and calories than he can eat." C) "Your child needs a large quantity of high carbohydrate and low protein." D)"His intestines are moving slowly, and this is easier on them."

B A. It is often true that appetites are diminished because of pain, Oral feedings are not contraindicated. This is encouraged; however, most children with burns are unable to consume sufficient calories by mouth. B. Enteral feedings can supply the protein, carbohydrate and calories that the child cannot ingest. The feedings are stopped during the day so the child is able to eat basically whatever he wants and then the minimum amount of nutrition can be ensured by the enteral feedings at night. C. A diet high in protein, carbohydrate and calories is recommended. D. The com nation of eating and enteral feedings allows the child to eat "kid food" during the day and receive the nutrients he needs at night. The hourly amount of the enteral feeding will also depend on how the child tolerates the feeding.

A 6-year-old male patient watches everything that is going on in his room, outside his room as well as sleeps very little. What might the nurse suspect the child is experiencing based on his behavior? Obsessive-compulsive disorder Post-traumatic stress disorder Bi-polar behavior Separation anxiety

B A. Obsessive-compulsive disorder (OCD) manifests as repetitive unwanted thoughts (obsessions) or ritualistic actions (compulsions), or both. Obsessions are recurrent intrusive thoughts, feelings, and ideas. Compulsions are behaviors or actions that are repetitive and recurrent. B. PTSD interferes with the child's ability to concentrate, may contribute to sleep problems, and may cause the child to be hypervigilant or agitated. C. Bipolar disorder is characterized by chronic, fluctuating, and extreme mood disturbances. D. Separation anxiety is disabling anxiety about being apart from one's parents or another significant person to whom the child is attached, or anxiety about being away from home.

When giving instructions to a parent whose child has scabies, what information should the school nurse include? A)Treat all of the family members if symptoms develop. B)Be prepared for symptoms to last 2 to 3 weeks. C)Notify your health care practitioner so an antibiotic can be prescribed. D)Carefully treat only those areas where there is a rash.

B A. Only the affected individuals need to be treated. B. The mite responsible for the scabies will most likely be killed with the administration of medications. It will take 2 to 3 weeks for the stratum corneum to heal. That is when the symptoms will abate. C. A scabicide is used. Permethrin (Nix) and Lindane (Kwell) are currently used for topical administration. D. Permethrin (Nix) is applied to all skin surfaces.

What is the causative agent for erythema infectiosum, also known as fifth disease? a)Paramyxovirus b)Parvovirus B19 Correct c) Human herpes virus types 1 and 2 d)Group A β-hemolytic streptococci

B A. Paramyxovirus causes mumps. B. Human parvovirus B19 is the causative agent. C. Human herpes virus types 1 and 2 are the major causes of herpetic infections in humans. D. Group A β-hemolytic streptococci are the causative agents for scarlet fever.

A toddler is repeated being seen by the pediatrician for a variety of ills, but nothing conclusive can ever be found on exam or in the blood work. When the toddler has been hospitalized, recovery has been rapid. What would the nurse case worker suspect in this family? Posttraumatic stress disorder. Munchausen syndrome by proxy occurs. A bipolar disorder. Obsessive-compulsive disorder.

B A. Posttraumatic stress disorder is a psychosocial disorder manifested in childhood but has other characteristics. B. Munchausen syndrome is a psychiatric disorder where people feign illness to gain attention. Munchausen syndrome by proxy occurs when a person with Munchausen syndrome falsifies illness in a child. C. A bipolar disorder is a psychosocial disorder manifested in childhood but has other characteristics. D. Obsessive-compulsive disorder is a psychosocial disorder manifested in childhood but has other characteristics.

A school-aged child is recovering from infectious mononucleosis. What information should the nurse give the mother about activities when he returns to school? A)The child should eat away from the other children in the lunchroom. B)Participation in his physical education class should be limited to non-contact sports. C)Allow the child to rest until he returns to school without worrying about homework. D)He will be able to return to school full-time when he has his medical release.

B A. There is no reason he needs to eat away from the other children in the lunchroom. However, he should not share any of his lunch or anything saliva has touched. B. Participation in his physical education class should be limited to non-contact sports and quiet activities to protect the child's enlarged spleen from rupture. C. Allowing the child to postpone homework until he returns to school could put the child behind and cause additional stress. D. He might need to return to school part-time when he has his medical release.

Which approach to the management of cellulitis would the nurse expect to be most beneficial? A)Damp to dry compresses using Burow's solutions. B)Administration of oral or parenteral antibiotics for several days. C)Topical application of an antibiotic cream to the involved area. D)Incision and drainage of severe cellulitis lesions.

B A. Warmed sterile water or sterile saline dressings may be indicated for limited cellulitis. B. Oral or parenteral antibiotics are indicated because the need to have the antibiotic infused systemically. C. The antibiotic needs to be administered systemically. D. Incision and drainage of severe cellulitis lesions is done only if it is determined that the cellulitis is localized enough. If this is done, there is a risk of spreading infection or making the lesion worse.

The camp nurse is telling a group of campers and their counselors how to avoid insect and tick bites. What information should the nurse include? (Select all that apply.) A)Dark, long-sleeved shirts should be worn. B)A hat is helpful when in wooded and grassy areas. C)Try to stay on paths rather than walking through dense areas. D)Apply insect repellent lightly on the hands. E)Ticks should be scraped off the skin. F)Shirts should be tucked into the pants.

B,C,F A. Light, long sleeved shirts should be worn because of being able to see insects and ticks.<br>B. A hat is very helpful to protect the head from insects getting in the hair when in wooded and grassy areas.<br>C. Trying to stay on paths rather than walking through dense areas is true.<br>D. Insect repellent should not be applied on the hands because the hands often touch the eyes and mouth.<br>E. Ticks should be removed with tweezers. The tick should be removed as close to the skin as possible using steady upward pressure. Ensure that all mouthparts are removed from the skin.<br>F. Shirts should be tucked into the pants to prevent insects and ticks getting to the skin

A child is experiencing intestinal cramping, diarrhea, and mucosal lesions. Which allergens would the nurse suspect are triggering these responses? (Select all that apply.) A)Pears B)Strawberries C)Apples D)Pollen E)Wheat F)Grass

B,E A. Pears do not generally trigger allergic reactions.<br>B. Foods which trigger as allergic reaction include milk, wheat, eggs, strawberries, tomatoes, oranges, chocolate, nuts, and shellfish.<br>C. Apples do not generally trigger allergic reactions.<br>D. Pollen is an environmental allergen and would not cause the symptoms listed. It would cause sneezing; red, itchy nose, eyes, pharynx, and palate; edematous nasal passages; tongue clicking; runny or congested nose; mouth breathing; chronic cough; dark circles under eyes; nose wrinkling; and pale, boggy nasal mucous membranes<br>E. Wheat is a common trigger for allergic reactions.<br>F. Grass would cause the same reaction as pollen

A 4-month-old infant is suspected of having failure to thrive (FTT) and is hospitalized for a comprehensive workup. The parents don't understand why the child needs to be hospitalized and wants to take their baby home. What explanation by the nurse would be most appropriate? "We need to see how you both interact with your baby." "This makes it easiest on the infant to be prepped for a variety of tests so that an organic problems can be ruled out." "We want to see your baby sleeping, eating, playing and looking at everything, and to make sure any diagnostic tests are completed." "This is the usual way we evaluate very underweight infants."

C A. Although watching the interaction between the parents and infant is a priority, there are other things which need to be observed. The nurse should avoid making the parents feel as though they are the problem. B. Being in a strange setting is not always easiest on an infant, but it is a way of getting tests done. There is a better explanation. C. The infant's behavior, eye contact, sleeping patterns, posture during feeding, interaction with parents and strangers. How the parents respond to their baby's cries and needs will give the multidisciplinary team insight as to what is happening. Any organic problems, such as malabsorption problems, will be determined during this time. D. This is a non-therapeutic response which doesn't address the parents

The school nurse is seeing a child who brought poison ivy to school in their leaf collection. The child says, "It only touched my hands." What is the most appropriate nursing action? A)Apply compresses using Burow's solution. B)Soak the child's hands in warm water. C)Rinse the child's hands in cold, running water. D)Scrub the child's hands thoroughly with antibacterial soap.

C A. Application of Burow's solution compresses is effective for soothing the skin lesions once the dermatitis has begun. B. Cold, running water, not warm, is effective in removing the oil. C. Rinsing the child's hands in cold, running water is the recommended first action. Once contact has been made, it is desirable to flush the skin with cold, running water within 15 minutes of exposure. This will neutralize the urushiol not yet bonded to the skin. D. The antibacterial soap removes protective skin oils and dilutes the urushiol, allowing it to spread.

The office nurse is taking a history on a child's illness from the parents. The nurse notes that the parents treated their 7-year-old child appropriately for a fever when they report that they provided what care? A)Gave aspirin (ASA) B) Bathed the child in cold water Incorrect C)Gave fluids at frequent intervals Correct D)Gave alternating dosages of acetaminophen (Tylenol) and ibuprofen (Motrin)

C A. Aspirin is associated with Reye's syndrome and should not be given to children with a fever. B. The cold bath will chill the child and cause shivering, which is a response that will increase the body temperature. C. Providing fluids at frequent intervals helps to meet the body's need for fluids during a febrile illness. D. Alternating acetaminophen (Tylenol) and ibuprofen (Motrin) might result in an overdose and has no real benefit.

Which is most descriptive of atopic dermatitis (eczema) in the infant? A) It is worse in summer. B)It is worse in humid climates. C)It is associated with hereditary allergies. D)It is associated with upper respiratory infections.

C A. Atopic dermatitis worsens in fall and winter. B. It improves in humid climates. C. The majority of children with atopic dermatitis have a family history of eczema, asthma, food allergies, or allergic rhinitis. This suggests a genetic predisposition. D. It is associated with allergies, not upper respiratory infections.

The school nurse is concerned about a recent outbreak of chickenpox in the school. There are two children at the school who are immunodeficient as a result of chemotherapy. Based on the nurse's knowledge of immunizations and immunocompromised states, what should the nurse recommend? A)Nothing; no precautions necessary. B)Administration of acyclovir (Zovirax) to minimize symptoms of chickenpox. C) Administration of varicella-zoster immune globulin (VZIG) to prevent chickenpox. D)Temporarily stopping chemotherapy to allow the children's immune systems to recover.

C A. Chickenpox can be a life-threatening event for a child who is immunocompromised. Precautions are necessary. B. Acyclovir is effective in reducing the number of lesions from the chickenpox, but in this population the disease should be prevented rather than just minimized. C. Varicella-zoster immune globulin (VZIG) is an antibody to the virus that causes chickenpox. Administration of VZIG can prevent the development of the disease. D. It would take too long for the children's' immune systems to recover; the administration of VZIG does not place them at any greater risk.

What is an appropriate nursing intervention to provide comfort for a child itching from chickenpox? A)Encourage frequent warm baths. B)Give acetaminophen (Tylenol). C) Give diphenhydramine (Benadryl). D)Apply a thick coat of Caladryl lotion over open lesions.

C A. Cool baths are recommended for relief of itching. B. Acetaminophen (Tylenol) has no anti-itching effects. C. Antipruritic medicines such as diphenhydramine (Benadryl) are useful for severe itching, which interferes with sleep and may contribute to secondary infection. D. Caladryl lotion (contains Benadryl) should be applied sparingly over open lesions to minimize absorption.

What does Standard Precautions for infection control include? A) Gloves being worn any time a patient is touched. B)Needles being capped immediately after use and disposed of in a special container. C)Gloves being worn to change diapers when there are loose or explosive stools. D)Masks used only when caring for patients with airborne infections.

C A. Gloves are not indicated unless there is potential for contact with body substances. B. Use needles should never be capped. They should be immediately disposed of in a rigid puncture proof container. C. Changing a diaper with loose or explosive stools has the greatest risk for exposure to body substances. D. Masks are a component of Transmission-Based Precautions and not Standard Precautions.

The parents of a cognitively impaired child ask the nurse for guidance with discipline. How should the nurse guide the parents on this topic? Explain that discipline is ineffective with cognitively impaired children. Cover the fact that discipline is not necessary for cognitively impaired children. Reinforce that physical punishment is the most appropriate form of discipline. Discuss the use of behavior modification as an excellent form of discipline.

D A. Behavior modification with positive reinforcement is effective in children with cognitive impairment. B. Discipline is essential to assisting the child in developing boundaries. C. Most children with cognitive impairment will not be able to understand the reason for the physical punishment and consequently behavior will not change as a result of the punishment. D. Positive behaviors and desirable actions should be reinforced.

Which of the following should the nurse include when giving parents guidelines about helping their children in school? A)Help children as much as possible with their homework. B)Punish children who fail to perform adequately. C)Communicate with teachers if there appears to be a problem. d)Accept responsibility for children's successes and failures.

D A. Discipline should be used to help children control behaviors. School-age children can use reasoning skills. B. Children need to do their own homework. This cultivates responsibility. C. Parents should communicate with teachers if there is a problem and not wait for a scheduled conference. D. School-age children need to develop responsibility. This helps with keeping promises and meeting deadlines, thereby laying successful foundations for adulthood.

The diagnosis of intellectual impairment is based on the presence of which criteria? Intelligence quotient (IQ) of 75 or less Intelligence quotient (IQ) of 70 or less Sub-average intellectual functioning, deficits in adaptive skills, and onset at any age Sub-average intellectual functioning, deficits in adaptive skills, and onset before 18 years of age

D A. IQ is only one component of the diagnosis of intellectual impairment. B. IQ is only one component of the diagnosis of intellectual impairment. C. The onset of the deficit must be before age 18 years to meet the diagnosis of intellectual impairment. D. The diagnosis of intellectual impairment has these components, including an onset before age 18 years.

A 2-week-old infant with Down syndrome is being seen in the clinic. The mother tells the nurse that the infant is difficult to hold and "feels like a rag doll and doesn't cuddle up to me like my other babies." What should the nurse explain to the mother about the baby's lack of clinging? This is a sign of maternal deprivation. The baby is showing signs of detachment and rejection. The behavior is suggestive of autism associated with Down syndrome. This behavior is part of the characteristics of Down syndrome

D A. Mothers may have difficulty with forming attachment to their children because of these characteristics of Down syndrome. The nurse should recommend swaddling and wrapping the baby before picking her up. B. Mothers may have difficulty with forming attachments to their children because of these characteristics of Down syndrome. The nurse should recommend swaddling and wrapping the babies before picking them up. C. Autism is not associated with Down syndrome. D. The lack of clinging is a result of the muscle hypotonicity and hyperextensibility of the joints associated with Down syndrome.

The nurse is conducting a program for parents with toddlers who have a variety of developmental disabilities. Other than the basic activities of daily living, what is the topic that the nurse should emphasize? Play activities Socialization activities The need for being held Safety needs

D A. Play activities would be individualized based on the ability of each toddler. B. Socialization activities would be individualized based on the ability of each toddler. C. Children with certain developmental needs do not want to be touched or held. This would be individualized based on each toddler. D. Safety is the priority regardless of the needs of the child. Whether in the home or outside of the home, the parents or caregivers must protect the child. After physiological needs, safety is next according to Maslow's hierarchy.

An occlusive dressing, Acu-Derm, is applied to a large abrasion. What is the reason the nurse would use this type of dressing? A.It delivers vitamin C to the wound. B. It provides an antiseptic for the wound. C.It promotes mechanical friction for healing. D. It maintains a moist environment for healing

D A. The dressing does not have vitamin C. B. The dressing does not have antiseptic capabilities. C. The dressing protects against friction. D. Occlusive dressings, such as Acu-Derm, provide a dressing that is non-adherent to the wound site. It provides a moist wound surface and insulates the wound.

An adolescent male realizes that he is developing strong homosexual feelings and is actually gay. When he tells his parents, they are worried about him more than they are about his sexual orientation. What is a major reason for their concern? He might decide to run away from home. His grades at school might deteriorate. He might get picked on by his friends. He is at greater risk for suicide.

D A. There's no data to support he might decide to run away from home. B. There's no data that his grades at school might deteriorate. C. It's true he might get picked on by his friends, but there's no evidence. D. Gay, lesbian, and bisexual, adolescents are two to seven times more likely to attempt suicide than are their heterosexual peers

A child with spina bifida has a latex allergy from exposure to numerous bladder catheterizations and surgeries. What is a priority nursing intervention in this child's care? Recommend allergy testing. Provide a latex-free environment. Use only powder-free latex gloves. Limit use of latex products as much as possible.

b A. Allergy testing may expose the child to the allergen; it is not recommended. B. Providing a latex-free environment is the most important nursing intervention. From birth on, the limitation of exposure to latex is essential in an attempt to minimize sensitization. C. The gloves contain latex and will contribute to sensitization. D. Latex products must be avoided.

Which is frequently associated with infant botulism? Contaminated soil Honey and corn syrup Commercial infant cereals Improperly sterilized bottles

b A. Contaminated soil is not usually associated with infants who have become affected. B. Unlike adult botulism, infant botulism is caused by ingesting spores of Clostridium botulinum and the resultant release of toxin. The bacterium has been found in honey and corn syrup that was fed to affected infants. C. Commercial infant cereals are not usually associated with infants who have become affected. D. Improperly sterilized bottles are not usually associated with infants who have become affected.

The nurse is admitting a young child to the hospital with possible bacterial meningitis. What is the major priority of nursing care? Initiate isolation precautions as soon as the diagnosis is confirmed. Administer antibiotic therapy as soon as it is ordered. Initiate isolation precautions as soon as the causative agent is identified. Administer sedatives/analgesics on a preventive schedule to manage pain.

b A. Isolation should be instituted as soon as a diagnosis is suspected. B. Administration of antibiotic therapy as soon as it is ordered is the priority action. Antibiotics are begun as soon as possible to prevent death and avoid resultant disabilities. C. Isolation should be instituted as soon as a diagnosis is suspected. D. Antibiotics are the priority function; pain should be managed if it occurs.

The nurse is discussing long-term care with the parents of a child with a ventriculoperitoneal shunt to correct hydrocephalus. What should the teaching plan include? Parental protection is essential until the child reaches adulthood. Shunt malfunction or infection requires immediate treatment. Intellectual impairment is to be expected with hydrocephalus. Most usual childhood activities must be restricted.

b A. Limits should be appropriate to the developmental age of the child. Except for contact sports, the child will have few restrictions. B. Because of the potentially severe sequelae, symptoms of shunt malfunction or infection must be assessed and treated immediately, if present. C. Mental retardation is dependent on the extent of damage before the shunt was placed. D. Limits should be appropriate to the developmental age of the child. Except for contact sports, the child will have few restrictions.

Which statement is most accurate in describing tetanus? It is an inflammatory disease that causes extreme, localized muscle spasm. It is an acute infectious disease caused by an exotoxin produced by an anaerobic gram-positive bacillus. It is a disease affecting the salivary gland with resultant stiffness of the jaw. It is an acute infection that causes meningeal inflammation, resulting in symptoms of generalized muscle spasm.

b A. Localized muscle spasms are caused by the effect of the toxins' becoming fixed on specific nerve cells. B. Tetanus is an acute, preventable disease caused by an exotoxin produced by an anaerobic spore-forming, gram-positive bacillus, Clostridium tetani. C. Stiffness of the jaw is caused by the effect of the toxins becoming fixed on specific nerve cells. D. Meningeal inflammation resulting in symptoms of generalized muscle spasm is caused by the effect of the toxins' becoming fixed on specific nerve cells.

The temperature of an adolescent who is unconscious is 105º F(ax). What is the priority nursing action? Initiate a pain assessment. Apply a hypothermia blanket. Continue to monitor temperature. Administer acetaminophen or ibuprofen.

b A. Pain assessment should be continuous; lowering the body temperature is the priority action. B. Brain damage can occur at temperatures this high. It is extremely important to institute temperature-lowering interventions, such as hypothermia blankets and tepid water baths. C. The temperature needs to be monitored, but it also needs to be lowered. D. Antipyretics are not useful in cases of hyperthermia.

A school-age child begins to have a tonic-clonic seizure in bed as the nurse walks into her room. What actions should the nurse take? (Select all that apply.) a)Gently place an oral airway in the child's mouth. b)Turn the child on her side. c)Hold the child's head so it doesn't hit the headboard. d)Get additional pillows to pad the siderails. e)Note how long the seizure lasts. f)Note whether any incontinence occurs during or after the seizure.

b,e,f A. Nothing should be placed in a patient&#8217;s mouth during a seizure.<br>B. The side should be placed on her side.<br>C. The child should not be restrained during the seizure.<br>D. The nurse should stay with the child during a seizure.<br>E. The nurse should note how long the seizure lasts, what body parts are involved, any vocalizations made during the seizure, presence or absence of incontinence, and level of consciousness after the seizure ends.<br>F. Presence or absence of incontinence should be noted, and if it occurs when, whether during the seizure or afterward.</div>

A child has a myelomeningocele at the L2 level. What degree of bowel control would be anticipated when toilet training is complete? Periodic incontinence Moderate control using enemas and laxatives Total fecal continence The need for a colostomy

c A. At the L2 level, the lower extremities, not the bowel, are affected. B. Enemas and laxatives should not be needed, because the bowel is not affected at this level. C. Total fecal continence should be present with the defect at the L2 level. D. A colostomy is not required.

What are two of the most common causes of cerebral palsy? A sex-linked recessive inheritance pattern and neonatal disease Birth-related brain anoxia and post-maturity status Prematurity and brain fragility/anomalies Faulty mother-infant bonding and neonatal meningitis

c A. Cerebral palsy is not genetic and neonatal disease is not a common cause. B. Birth-related brain anoxia at times has caused cerebral palsy but prematurity, not post-maturity, is the problem. C. Cerebral palsy results from faulty development (brain anomalies) during the prenatal period or from damage during the perinatal period, including brain anoxia and cerebral trauma during delivery and prematurity. D. Mother-infant bonding has nothing to do with the development of cerebral palsy, and meningitis in the newborn is very rare.

Which nursing intervention is important when caring for an infant with myelomeningocele in the preoperative stage? Place the child in the sidelying position to decrease pressure on the spinal cord. Apply a heat lamp to facilitate drying and toughening of the sac. Keep skin clean and dry to prevent irritation from diarrheal stools. Measure head circumference and examine fontanels for signs that might indicate developing hydrocephalus.

d A. Preoperatively, the child is kept in a prone position to decrease tension on the sac and reduce risk of trauma. B. The sac must be kept moist, so sterile, moist, non-adherent dressings are placed over the sac to prevent any leaks or tears from occurring. C. Most newborns do not have diarrheal stools. They are still expelling meconium. D. Hydrocephalus is frequently associated with myelomeningocele. Assessment of the fontanels and daily measurements of head circumference will aid in early detection.

A nursing intervention to prevent increased intracranial pressure (ICP) in an unconscious child includes Suctioning any secretions frequently. Providing environmental stimulation. Turning the head side to side every hour. Avoiding activities that cause pain.

d A. Suctioning is a distressing procedure. In addition, the resultant decrease in carbon dioxide can increase ICP. B. Environmental stimulation should be minimized. C. The child's head should not be turned side to side. If the jugular vein is compressed, ICP can rise. D. Nursing interventions should focus on assessments and interventions that minimize pain. The activities in the other options can cause the intracranial pressure to increase.