Pediatric Success: Issues Related to Pediatric Health

29. Which instruction would be of highest priority for the mother of an infant receiving his first oral rotavirus vaccine?

"Call the physician if he develops a bloody stool or diarrhea."

39. What would be the most appropriate advice to give to the parent of a boy with slight visual blurring after being hit in the face with a basketball?

"Take him to the emergency department to ensure that he does not have any internal eye damage."

24. Which would be the nurse's best response if a mother asks if her baby still needs the Hib vaccine because he already had Hib?

"Yes, it is recommended that the baby still get the Hib vaccine."

27. Which is the nurse's best response when the mother of a 2-month-old who is going to get the IPV tells the nurse the older brother is immunocompromised?

"Your baby can be immunized with the IPV; he will not be contagious."

5. A child is diagnosed with erythema infectiosum (fifth disease). You observe the mother crying, and she says, "I am afraid. Will my unborn baby die? I have a planned cesarian section next week." Which statement would be the most therapeutic response?

"I understand you are afraid. Can we can talk about your concerns?"

9. The parents of a 12-month-old male with HIV are concerned about his receiving routine immunizations. What will the nurse tell them about immunizations?

"Your child will not receive routine immunizations today."

25. What would be the nurse's best response if the foster mother of a 15-month-old with an unknown immunization history comes to the clinic requesting immunizations?

"Your foster child will receive only the Hib and DTaP vaccines today."

12. Which treatment would the nurse anticipate for a 2-week-old boy diagnosed with PKU?

A low phenylalanine diet.

11. Expected nursing assessments of a newborn with suspected cystic fibrosis would include:

Observe frequency and nature of stools.

30. What would be the best plan of care for a newborn whose mother's hepatitis B antigen status is unknown?

Give the infant the hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth.

7. Which of the following would be the priority teaching to the parent of a child diagnosed with chickenpox (varicella) who was prescribed diphenhydramine (Benadryl) for itching?

Avoid Caladryl lotion while taking diphenhydramine (Benadryl).

14. Which teaching is most important for a child with PKU during a well-child visit?

Diet soda or anything with the sweetener aspartame should be avoided.

46. Which of the following would be appropriate anticipatory guidance for a well-care visit of a 17-year-old?

Discuss alcohol use and potential for alcohol poisoning.

40. Which would be the best response to the mother of a 13-year-old boy who continues to ask to ride his 16-year-old cousin's all-terrain vehicle?

Discuss that all-terrain vehicles are not recommended for those younger than 16 years of age.

21. What would be the priority nursing action on finding the varicella vaccine at room temperature on the shelf in the medication room?

Do not administer this batch of vaccine.

1. The mother of a 21-day-old male tells the nurse she is residing in a homeless shelter and is concerned about his mild cough, poor appetite, low-grade fever, weight loss, and irritability over the last 2 weeks. Which nursing intervention would be the nurse's highest priority?

Immediately initiate droplet face-mask precautions, and isolate the infant.

28. Which of the following would be the priority intervention for the newborn of a mother positive for hepatitis antigen?

The newborn should receive the hepatitis B vaccine and hepatitis B immune globulin within 24 hours of birth.

35. An adolescent male comes in for his yearly physical. Which would be the most appropriate injury prevention/safety teaching for him?

Inquire which are his favorite sports and discuss his knowledge and application of appropriate safety principles.

8. Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever?

Joint pain in ankles and knees.

20. Which intervention might the nurse anticipate in a 2-day-old infant diagnosed with maple syrup urine disease?

Low-protein, limited amino-acid diet.

23. Which nursing intervention should take place prior to all vaccination administrations?

Provide the vaccine information statement handout, and answer all questions.

55. Which assessment of a 2-year-old with burns on his feet would cause suspicion of child abuse?

Symmetrical burns on both feet.

4. The mother of an 18-month-old is discharged from the hospital after the child has a febrile seizure secondary to exanthem subitum (roseola). On discharge, the mother asks the nurse if her 6-year-old twins will get sick. Which teaching about the transmis- sion of roseola would be most accurate?

The child should be isolated in the home until the vesicles have dried.

22. What would the most therapeutic response if the mother of a 6-month-old female tells the nurse she does not want her infant to have the DTaP vaccine because the infant had localized redness the last time she received the vaccine?

"Would you mind if we discussed your concerns?"

13. Which teaching would be important to discuss with the family of a child born with PKU?

Consumption of decreased amounts of protein and dairy products is advised.

6. Which of the following would be the priority intervention the nurse should initiate for a child suspected of having varicella (chickenpox)?

Contact and droplet respiratory precautions.

18. Which of the following families would be appropriate to refer for genetic counseling?

Couple with a history of multiple miscarriages.

26. Which medication is most important to have available in all clinics and offices if immunizations are administered?

Epinephrine 1:1000 injection.