Pediatrics Exam 2

The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?

"I have to stay on strict bed rest for 3 days."

An 18-month-old child is seen in the clinic is diagnosed with acute otitis media (AOM). Oral amoxicillin is prescribed. Which statement made by the parent indicates a correct understanding of the instructions?

"I should administer all the prescribed medication."

What is the most appropriate statement for the nurse to make to a 5-year-old child who is undergoing a venipuncture?

"This will hurt like a pinch. I'll get someone to help hold your arm still so it will be over fast and hurt less."

Parents have understood teaching about prevention of childhood otitis media if they make which statement?

"We will be sure to keep immunizations up to date."

The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?

"You may need to increase the caloric density of your infant's formula."

A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?

"Your child must lie quietly; sometimes a mild sedative is administered before the procedure."

A child with congestive heart failure is placed on a maintenance dosage of digoxin. The dosage is 0.07 mg/kg/day, and the child's weight is 7.2 kg. The physician prescribes the digoxin to be given once a day by mouth. Each dose will be mg. Record your answer using one decimal place.

0.5

Abdominal thrusts are recommended for airway obstruction in children older than

1 year

Which is the acceptable mg/dL level, or below this level, low-density lipoprotein (LDL) cholesterol level for a child from a family with heart disease? (Record your answer as a whole number.)

110

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL/8 hr is being infused rather than the ordered amount of 300 mL/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?

300 mL

A 14-year-old boy is being admitted to the hospital for an appendectomy. Which roommate should the nurse assign with this patient?

A 15-year-old boy admitted with a vaso-occlusive sickle cell crisis

The nurse administering a bitter oral medication to an infant or small child should mix the medication with what substance?

A teaspoon of jam or ice cream

A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session?

Abdominal mass Sore throat and ear pain Ecchymosis of conjunctiva

The nurse is admitting a child with a Wilms' tumor. Which is the initial assessment finding associated with this tumor?

Abdominal swelling

What is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia?

Activity Intolerance related to generalized weakness.

José is 4 year old. Preoperative teaching for a 4-year-old child scheduled for a cardiac catheterization should be done with what primary consideration in mind?

Adapted to his level of development so that he can understand.

When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that information?

Adequate dosage will turn the stools a tarry green color.

A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include which intervention? (Select all that apply.)

Adequate hydration Pain management

A school-age child diagnosed with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Administer an antiemetic at least 30 minutes before chemotherapy begins.

What intervention should be implemented prior to the removal of a child's chest tubes?

Administer analgesics before the procedure

What is an important nursing consideration when suctioning a young child who has had heart surgery?

Administer supplemental oxygen before and after suctioning.

The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?

Administering penicillin

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

Administering the medication with a syringe (without needle) placed along the side of the infant's tongue

When it is generally recommended that a child being treated for acute streptococcal pharyngitis may return to school?

After taking antibiotics for 24 hours.

A youngster will receive a bone marrow transplant (BMT) made possible because an older sibling is a histocompatible donor. Which is this type of BMT called?

Allogeneic

A nurse in the emergency department is assessing a 5-year-old child with symptoms of pneumonia and a fever of 102 F. Which intervention can the nurse implement to promote a sense of control for the child?

Allow the child to hold the digital thermometer while taking the child's blood pressure.

The most appropriate nursing action to implement when a preschooler being prepped for outpatient surgery refused to allow the parent to remove his/her underwear?

Allow the child to wear their underpants

A nurse plans therapeutic play time for a hospitalized child. Which are the benefits of therapeutic play (select all that apply)?

Allows the child to express feelings The nurse can gain insight into the child's feelings The child can deal with concerns and feelings

An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurse's approach should include which action?

Answering questions with straightforward honesty

What intervention should the nurse implement when a 5 year old tells the nurse, ―I need a Band-Aid after having an injection

Apply a Band-Aid

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is ―too wet. The nurse finds the bandage and bed soaked with blood. What is the most appropriate initial nursing action?

Apply direct pressure above the catheterization site.

The school nurse is caring. What emergency treatment is appropriate for a child with a penetrating eye injury?

Applying a Fox shield to the affected eye and any type of patch to the other eye

What nursing consideration is related to the administration of oxygen (O2) in an infant?

Arterial oxygen saturation (SaO2) readings are used to guide O2 therapy.

When should a child diagnosed with cognitive impairment be referred for stimulation and educational programs?

As young as possible

The nurse needs to take a blood pressure on the child playing in the playroom. Which is the appropriate procedure for obtaining the blood pressure?

Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom.

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. How should the nurse collect small amounts of urine for these tests?

Aspirate urine from cotton balls inside the diaper with a syringe.

Nursing interventions for the child after a cardiac catheterization include which of the following? (Select all that apply.)

Assess the affected extremity for temperature and color. Maintain a patent peripheral intravenous catheter until discharge.

What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (CHD)?

Assess the parents' anxiety level and readiness to learn.

Emma, age 3 years, is being admitted for about 1 week of hospitalization. The parents of a 3 year old being admitted tell the nurse that they are going to buy their child ―a lot of new toys to help during the hospital. The nurse's reply should be based on an understanding of comfort measures for that age-group?

At this age children often need the comfort and reassurance of familiar toys from home

The child diagnosed with Down syndrome should be evaluated for which characteristic before participating in some sports?

Atlantoaxial instability

An infant's parents ask the nurse about preventing otitis media (OM). What intervention should the nurse recommend?

Avoid tobacco smoke.

The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child? (Select all that apply.)

Avoidance of intramuscular (IM) injections Acetaminophen (Tylenol) for mild pain control Soft toothbrush for dental hygiene

Instructions for decongestant nose drops should include what recommendation?

Avoiding use for more than 3 days.

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

Before chest physiotherapy (CPT)

Prevention of hearing impairment in children is a major goal for the nurse. How can this be best achieved?

Being involved in immunization clinics for children

It is important to make certain that sensory connectors and oximeters are compatible since wiring that is incompatible increases the risk of which injury?

Burns under sensors

Which drug is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

Which term refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?

Cataract

A 9 year old diagnosed with Down syndrome is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurse's recommendation should be based on what knowledge?

Children with Down syndrome have the same need for socialization as other children

A nurse is preparing a teaching session for parents on the prevention of childhood hearing loss. The nurse identify what as being the most common cause of hearing impairment in children?

Chronic otitis media

What information should the nurse include when teaching parents how to care for a child's gastrostomy tube at home?

Clean around the insertion site daily with soap and water

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

Complete obstruction

What term is used to identify the most common type of hearing loss, which results from interference of transmission of sound to the middle ear?

Conductive

Which clinical manifestations would the nurse expect to see as shock progresses in a child and decompensated develops? (Select all that apply.)

Cool extremities and decreased skin turgor Confusion and somnolence Tachypnea and poor capillary refill time

What is the primary nursing intervention necessary to prevent bacterial endocarditis?

Counsel parents of high-risk children about prophylactic antibiotics.

The teaching plan for the parents of a 3-year-old child with amblyopia should include which instruction?

Cover the good eye completely with a patch

A school-age child, admitted for intravenous antibiotic therapy for osteomyelitis, reports difficulty in going to sleep at night. Which intervention should the nurse implement to assist the child in going to sleep at bedtime?

Create a schedule similar to the one the child follows at home.

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

Decreased urinary output Sweating (inappropriate) Anorexia

A young child with human immunodeficiency virus is receiving several antiretroviral drugs. What is the expected outcome of these drug therapies?

Delay disease progression

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?

Demonstrate a dressing change on a doll

Using knowledge of child development, what is the best approach when preparing a toddler for a procedure?

Demonstrate the procedure on a doll.

In providing nourishment for a child with cystic fibrosis (CF), what diet consideration should be stressed to both the child and caregivers?

Diet should be high in carbohydrates and protein.

Beta-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack for what resulting action?

Dilation of the bronchioles

A child is being discharged from an ambulatory care center after an inguinal hernia repair. Which discharge interventions should the nurse implement? (Select all that apply.)

Discuss dietary restrictions. Send a pain scale home with the family. Discuss complications that may occur.

What is an expected assessment finding in a child with coarctation of the aorta?

Disparity in blood pressure between the upper and lower extremities

The nurse gives an injection in a patient's room. Which method should the nurse use to dispose of the needle?

Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room.

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of

Down syndrome

Chelation therapy is begun on a child with B-thalassemia major with what expected result?

Elimination of excess iron

Which situation poses the greatest challenge to the nurse working with a child and family?

Emergency hospitalization

The nurse is caring for a 10-month-old infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? (Select all that apply.)

Encourage infant to drink 8 ounces of formula every 4 hours. Institute cluster care to encourage adequate rest. Place on noninvasive oxygen monitoring.

What is an age-appropriate nursing intervention to facilitate psychologic adjustment for an adolescent expected to have a prolonged hospitalization? (Select all that apply.)

Encourage parents to bring in homework and schedule study times. Allow the adolescent to wear street clothes. Encourage parents to bring in favorite foods.

Which action is contraindicated when a child diagnosed with Down syndrome is hospitalized?

Encourage parents to leave the child alone at night

What is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?

Encourage parents to room in

Which is a common clinical manifestation of Hodgkin disease?

Enlarged, firm, nontender lymph nodes

What intervention should the nurse implement when suctioning a child with a tracheostomy?

Ensuring that each pass of the suction catheter take no longer than 10 seconds

Which type of croup is always considered a medical emergency?

Epiglottitis

Latasha, age 8 years, is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help an 8 year old most in adjusting to a hospital admission?

Explain hospital schedules such as mealtimes

The nurse is preparing a child for possible alopecia from chemotherapy. Which intervention should be included?

Explain to child that when hair regrows, it may have a slightly different color or texture.

A nurse providing care to a child diagnosed with chronic otitis media with effusion (OME) will assess for which sign/symptom?

Feeling of fullness in the ear

A 3 year old has a 102 F fever associated with a viral illness that has not responded to acetaminophen. The nurse's action should be based on what knowledge about fevers in children?

Fevers such as this are common with viral illnesses.

The parents of a child diagnosed with aplastic anemia tell the nurse that a bone marrow transplant (BMT) may be necessary. What should the nurse recognize as important when discussing this with the family?

Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.

Which information should the nurse stress to workers at a day care center about respiratory syncytial virus (RSV)?

Frequent hand washing can decrease the spread of the virus.

What is an appropriate intervention to encourage food and fluid intake in a hospitalized child?

Give high-quality foods and snacks whenever child expresses hunger.

When caring for an infant with an upper respiratory tract infection and elevated temperature, which appropriate nursing intervention should the nurse implement?

Give small amounts of favorite fluids frequently to prevent dehydration.

What is the most common clinical manifestation(s) of brain tumors in children?

Headaches and vomiting

Which assessment findings help confirm a diagnosis of Down syndrome? (Select all that apply.)

High-arched, narrow palate Protruding tongue Transverse palmar crease

When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease?

High-density lipoproteins (HDLs)

The nurse is talking to the parent of a 13-month-old child. The mother states, ―My child does not make noises like dada' or mama' like my sister's baby, who is only 9 months old.‖ Which statement by the nurse would be most appropriate to make?

I am going to request a referral to a hearing specialist

The nurse is caring for an adolescent hospitalized after a bicycle accident. Which statement by the adolescent would be expected about separation anxiety?

I hope my friends don't forget about visiting me

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

If it is present in a child, both parents are carriers of this defective gene.

The nurse is caring for a child after heart surgery. What intervention should the nurse implement immediately if evidence is found of cardiac tamponade?

Immediately report this to the physician.

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia?

Immobilization and elevation of the affected joint

When teaching a mother how to administer eyedrops, where should the nurse instruct to place them?

In the conjunctival sac that is formed when the lower lid is pulled down

Which clinical changes occur as a result of septic shock?

Increased cardiac output

Which statement correctly describes Beta-thalassemia major (Cooley's anemia)?

Increased incidence occurs in families of Mediterranean extraction.

Which statement most accurately describes the pathologic changes of sickle cell anemia?

Increased red blood cell destruction occurs.

The nurse is discussing sexuality with the parents of an adolescent with moderate cognitive impairment. Which should the nurse consider when dealing with this issue?

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct

The nurse assesses a toddler for excessive tearing and corneal haziness to confirm which medical diagnosis?

Infantile glaucoma

Iron dextran is ordered for a young child with severe iron deficiency anemia. What nursing consideration should be considered?

Injecting deeply into a large muscle

What is an important nursing consideration when performing a bladder catheterization on a young boy?

Insert 2% lidocaine lubricant into the urethra.

Guidelines for intramuscular administration of medication in school-age children include what instruction?

Insert needle quickly, using a dart like motion.

What intervention should the nurse share with parents on how to prevent iron deficiency anemia in a healthy, term, breastfed infant?

Iron-fortified infant cereal can be introduced at approximately 6 months of age.

A father calls the emergency department nurse saying that his child's eyes burn after getting some dishwasher detergent in them. What should the nurse recommend before the child is transported to the emergency department?

Irrigate eyes copiously with tap water for 20 minutes

A parent whose child has been diagnosed with a cognitive deficit should be counseled about what fact related to intellectual impairment?

Is likely caused by a variety of factors

What distinguishing manifestation of spasmodic croup should parents be taught to identify?

It has a harsh, barky cough.

The nurse is doing a prehospitalization orientation for a 7 year old, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that he/she will not be able to talk until the endotracheal tube is removed. What is the assessment of this explanation?

It is an appropriate part of the child's preparation

Which statement appropriately describes a neuroblastoma?

It is considered to be a "silent" tumor.

Which statement accurately describes fragile X syndrome?

It is the second most common genetic cause of cognitive impairment

A 6 year old, hospitalized again because of a chronic illness, is told by school-age siblings that, ―We are sick of Mom always sitting with you in the hospital and playing with you. It is not fair that you get everything and we have to stay with the neighbors. What is the nurse's best assessment of the cause of the siblings' resentment?

Jealousy and resentment are common reactions to the illness or hospitalization of a sibling

After collecting blood by venipuncture in the antecubital fossa, what intervention should the nurse implement in order to assure control of any bleeding?

Keep arm extended, and apply pressure to the site for a few minutes.

Which interventions should the nurse plan when caring for a child with a visual impairment? (Select all that apply.)

Keep items in the room in the same location Describe the placement of the eating utensils on the meal tray Identify noises for the child

Which postoperative intervention should be questioned for a child after a cardiac catheterization?

Keep the affected leg flexed and elevated.

What is the primary disadvantage associated with outpatient and day facility care?

Lack of physical connection to the hospital

The advantages of the ventrogluteal muscle as an injection site in young children include which of the following? (Select all that apply.)

Less painful than vastus lateralis Free of important nerves and vascular structures Easily identified by major landmarks

What is the best action for the nurse to take when a 5-year-old child who requires another 2 days of intravenous (IV) antibiotics cries, screams, and resists having the IV restarted?

Let the child decide which color arm board to use with the IV.

What should the nurse consider when preparing a school-age child and the family for heart surgery?

Letting child hear the sounds of an electrocardiograph monitor.

The nurse is preparing for the admission of an infant who will have several procedures performed. In which situation is informed consent required? (Select all that apply.)

Lumbar puncture bone marrow aspiration

A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?

Maintain a structured routine and keep stimulation to a minimum

Which nursing action is the most appropriate when applying a face mask to a child prescribed oxygen therapy?

Make sure the mask fits properly.

A child diagnosed with cystic fibrosis is prescribed recombinant human deoxyribonuclease (rhDNase). What information should be included in the medication education provided the child and family?

May cause minor voice alterations

Which immunization should be considered carefully before being given to a child receiving chemotherapy for cancer?

Measles, rubella, mumps

Which statement best explains why iron deficiency anemia is common during toddlerhood?

Milk is a poor source of iron.

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this child's care?

Monitor arterial blood gases (ABGs).

What nursing intervention should be included in the plan of care for a young child diagnosed with pneumonia?

Monitor for abdominal pain

The nurse is caring for a child diagnosed with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing intervention should be included in the plan of care?

Monitor pulse oximetry.

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Mucus and edema obstruct small airways.

An adolescent male visits his primary care provider complaining of difficulty with his vision. When the nurse asks the adolescent to explain what visual deficits he/she is experiencing, the adolescent states, ―I am having difficulty seeing distant objects; they are less clear than things that are close.‖ What disorder does the nurse suspect the adolescent has?

Myopia

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should provide what explanation in response to the parent's concern?

Narcotics rarely cause addiction when they are medically indicated.

In preparing to give ―enemas until clear to a young child, the nurse should select which solution?

Normal saline

What intervention should the nurse implement when noting gross bleeding in a child's eye after being hit in the eye?

Notify parents that adolescent needs to see an ophthalmologist

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease? (Select all that apply.)

Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs. Give penicillin as prescribed. Notify the health care provider if your child begins to develop symptoms of a cold.

When caring for a child with an intravenous infusion, the nurse should include which intervention in the plan of care?

Observing the insertion site frequently for signs of infiltration

The nurse is caring for an infant diagnosed with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands?

Organize nursing activities to allow for uninterrupted sleep.

An 8-year-old child is diagnosed with influenza, probably type A disease. What intervention should be included in the plan of care?

Oseltamivir to reduce symptoms

What term is used to describe the painful, tender, pea-sized nodules that may appear on the pads of the fingers or toes in cases of bacterial endocarditis?

Osler's nodes

Which clinical manifestation should the nurse expect when a child diagnosed with sickle cell anemia experiences an acute vaso-occlusive crisis?

Painful swelling of hands and feet, painful joints

Pancreatic enzymes are administered to the child with cystic fibrosis. What information should be included in patient education concerning the administration of these enzymes?

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

The parents of a young child with congestive heart failure tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on knowing what information?

Parents must learn specific, important guidelines for administration of digoxin.

A nurse is preparing to complete an admission assessment on a 2-year-old child who is sitting on the parent's lap. Which technique should the nurse implement to complete the physical examination?

Perform the examination while the child is on the parent's lap.

An 8 month old infant becomes hypercyanotic while blood is being drawn. What should be the nurse's first action?

Place the child in the knee-chest position.

A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this child's laboratory values, the nurse is not surprised to notice which abnormality?

Polycythemia

When administering a gavage feeding to a school-age child, the nurse should implement what intervention to assure safety?

Position the child on the right side after administering the feeding.

As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in what electrolyte?

Potassium

Surgical closure of the ductus arteriosus would bring about what desired effect?

Prevent the return of oxygenated blood to the lungs.

A nurse is teaching an adolescent about essential hypertension. The nurse knows that which of the following is correct?

Primary hypertension may be treated with weight reduction.

Which intervention is focused on facilitating socialization of the cognitively impaired child?

Provide peer experiences such as Special Olympics when older

Which structural defects constitute tetralogy of Fallot?

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

When a preschool child is hospitalized without adequate preparation, what is the child may likely see hospitalization as?

Punishment

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child?

Puppet play in the child's room

A 2-year-old child comes to the emergency department demonstrating signs of dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started?

Rapid venous access is not possible.

Which action by the school nurse is important in the prevention of rheumatic fever?

Refer children with sore throats for throat cultures.

A previously ―potty-trained 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents based on what knowledge concerning regressive behaviors?

Regression is seen during hospitalization

A young child diagnosed with leukemia is experiencing anorexia and severe stomatitis. The nurse should suggest that the parents try which intervention?

Relax any eating pressures.

Which statement best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

Which information should the nurse teach families about reducing exposure to pollens and dust? (Select all that apply.)

Replace wall-to-wall carpeting with wood and tile floors. Use an air conditioner. Put dust-proof covers on pillows and mattresses.

Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101 F). The nurse should initially implement which intervention?

Report findings to physician.

A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his ―regular diet‖ trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action?

Request these favorite foods for him

What important consideration in providing atraumatic care should the nurse consider when preforming a venipuncture on a 6-year-old child?

Restrain the child only as needed to perform venipuncture safely.

The nurse is caring for a child with aplastic anemia. Which nursing diagnoses are appropriate? (Select all that apply.)

Risk for Infection related to inadequate secondary defenses or immunosuppression Ineffective Protection related to thrombocytopenia Ineffective Tissue Perfusion related to anemia

What is the major consideration when selecting toys for a child who is cognitively impaired?

Safety

Because of their striving for independence and productivity, which age-group of children is particularly vulnerable to events that may lessen their feeling of control and power?

School-age children

Distortion of sound and problems in discrimination are characteristic of which type of hearing loss?

Sensorineural

What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years?

Separation anxiety

Which is the most common congenital anomaly associated with Down syndrome?

Septal defects

When should the parent of an infant with nasopharyngitis be instructed to notify the health care professional?

Shows signs of an earache.

A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip-reads. Which techniques should the nurse include? (Select all that apply.)

Speak at eye level Use facial expressions while speaking Keep sentences short

Which action best facilitates lipreading by the hearing-impaired child?

Speaking at an even rate

The nurse is administering an IV chemotherapeutic agent to a child diagnosed with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?

Stop drug infusion immediately.

What intervention is appropriate when administering tepid water or sponge baths prescribed for hyperthermia in children?

Stop the bath if the child begins to chill.

What is the most common causative agent of bacterial endocarditis?

Streptococcus viridans

The nurse is talking with a 10 year old who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. What is the most appropriate nursing action to address this issue?

Suggest that the child reinsert the hearing aid

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Sweat chloride test

Parents of a school-age child with hemophilia ask the nurse, ―Which sports are recommended for children with hemophilia?‖ Which sports should the nurse recommend? (Select all that apply.)

Swimming Golf Bowling

Which intervention for treating croup at home should be taught to parents?

Take the child outside if air is cool and moist.

The nurse is cleaning multiple facial abrasions on a 9-year-old who was brought to the emergency department by his/her mother. When the child begins crying and screaming loudly, what intervention should the nurse implement to best manage this situation?

Tell the child it is okay to cry and scream

The nurse is planning how to best prepare a 4-year-old child for some diagnostic procedures. What guideline should the nurse consider when preparing a preschooler for a diagnostic procedure?

Telling the child that procedures are never a form of punishment.

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what conditions occur? (Select all that apply.)

Temperature above 37.7° C (100° F) New, frequent coughing Turning blue or bluer than normal

A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?

Tetralogy of Fallot

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on what knowledge about such routine developmental assessments?

The best method for early detection of cognitive disorders

During the first 4 days of hospitalization, an 18 month old cried inconsolably when his/her parents left and he/she refused the staff's attention. Now the nurse observes that the child appears to be ―settled in‖ and unconcerned about seeing his/her parents. How should the nurse interpret this change in behavior?

The child may be experiencing detachment, which is the third stage of separation anxiety

What should the nurse keep in mind when planning to communicate with a child who is diagnosed with an autism spectrum disorder (ASD)?

The child may exhibit monotone speech and echolalia

Parents of a 3-year-old child diagnosed with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on what knowledge?

The child needs opportunities to play with peers.

Which expected appearance will the nurse explain to parents of an infant returning from surgery after an enucleation was performed to treat retinoblastoma? (Select all that apply.)

The face may be edematous or ecchymotic. There will be an eye pad dressing taped over the surgical site. The implanted sphere is covered with conjunctiva and resembles the lining of the mouth.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse's primary rationale for this action?

The mother's presence will reduce anxiety and ease the child's respiratory efforts.

A nurse is providing a parent information regarding autism spectrum disorder (ASD). Which statement made by the parent indicates understanding of the teaching?

The onset of autism usually occurs before toddler stage

What should the nurse consider when having consent forms signed for surgery and procedures on children?

The risks and benefits of a procedure are part of the consent process.

When caring for the child with Kawasaki disease, the nurse should understand that principle of care?

Therapeutic management includes administration of gamma globulin and aspirin.

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?

There is heightened airway reactivity.

A 10 year old, who needs to have another intravenous (IV) line started, keeps telling the nurse, ―Wait a minute and, ―I'm not ready. How should the nurse interpret these requests?

This is normal behavior for a school-age child

Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that

Topical application of local anesthetic can eliminate venipuncture pain.

What is the initial goal for the treatment of secondary hypertension?

Treating the underlying disease

The nurse is taking care of an adolescent with osteosarcoma. The parents ask the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma?

Treatment usually consists of surgery and chemotherapy.

In which situation is there the greatest risk that a newborn infant will have a congenital heart defect (CHD)?

Trisomy 21 detected on amniocentesis

A child has just been unexpectedly admitted to the intensive care unit after abdominal surgery. The nursing staff has completed the admission process, and the child's condition is beginning to stabilize. When speaking with the parents, the nurses should expect which stressors to be evident? (Select all that apply.)

Unfamiliar environment Strange smells Inadequate knowledge of condition and routine

Which is most descriptive of the pathophysiology of leukemia?

Unrestricted proliferation of immature white blood cells (WBCs) occurs.

What nursing action is appropriate for specimen collection?

Use Standard Precautions when handling body fluids.

What critical information should the nurse incorporate into care when using restraints on a child?

Use the least restrictive type of restraint.

The nurse is caring. What skin care interventions for an unconscious child should be included in the plan of care?

Using drawsheet to move child in bed to reduce friction and shearing injuries

A 5 year old is being prepared for surgery to remove a brain tumor. Nursing actions should be based on which statement?

Usually the postoperative dressing covers the entire scalp.

Which is the preferred site for intramuscular injections in infants?

Vastus lateralis

Which vitamin supplements are necessary for children with cystic fibrosis?

Vitamins A, D, E, and K

Which teaching guideline helps prevent eye injuries during sports and play activities?

Wear eye protection when participating in high risk sports such as paintball

Which intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure?

Weigh the infant every day on the same scale at the same time.

Which statement by a parent about a child's conjunctivitis indicates that further teaching is needed?

When the eye drainage improves, we'll stop giving the antibiotic ointment

What procedure is recommended to facilitate a heelstick on an ill neonate to obtain a blood sample?

Wrap foot in a warm washcloth.

As related to inherited disorders, which statement is descriptive of most cases of hemophilia?

X-linked recessive inherited disorder in which a blood-clotting factor is deficient

Which condition is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T-cells?

acquired immunodeficiency syndrome (AIDS)

What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

anaphylactic shock

In which condition are all the formed elements of the blood simultaneously depressed?

aplastic anemia

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which respiratory condition?

asthma

Which defect results in increased pulmonary blood flow?

atrial septal defect

What is one of the most frequent causes of hypovolemic shock in children?

blood loss

A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probable cause of this pain?

bone involvement

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This assessment is most suggestive of what respiratory airway disorder?

bronchitis

Which complication should the nurse asses for when caring for a child post cardiac catheterization?

cardiac arrhythmia

What is a common, serious complication of rheumatic fever?

cardiac valve damage

A child with autism is hospitalized with asthma. The nurse should plan care so that the

child's routine habits and preferences are maintained

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what associated adverse reaction

circulatory overload

An implanted ear prosthesis for children with sensorineural hearing loss is a(n)

cochlear implant

Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia can cause bleeding tendencies because of what resulting outcome?

decrease in blood platelets

What is the primary result of anemia?

decreased oxygen carrying capacity of blood

What beneficial effect is achieved by administering digoxin?

decreases edema

A nurse is charting that a hospitalized child has labored breathing. Which medical term describes labored breathing?

dyspnea

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration?

epinephrine

A nurse would suspect possible visual impairment in a child who displays

excessive rubbing of the eyes

A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma?

femur

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

heart failure

What name is given to identify an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets?

immune thrombocytopenia

What are the earliest recognizable clinical manifestations of cystic fibrosis (CF)?

meconium ileus

The nurse monitoring a child for signs and symptoms of malignant hyperthermia should be alert for which early sign of this disorder?

muscle rigidity

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect?

patent ductus arteriosus

What is the most common mode of transmission of human immunodeficiency virus (HIV) in the pediatric population?

perinatal transmission

Which term is used to describe a clinical manifestation of the systemic venous congestion that can occur with congestive heart failure?

peripheral edema

Which is often administered to prevent or control hemorrhage in a child diagnosed with cancer?

platelets

What is a major clinical manifestation of rheumatic fever?

polyarthritis

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is to achieve what result?

prevent dehydration

What is the leading cause of death after heart transplantation?

rejection

What term is used to identify the condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?

sickle cell anemia

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for what increased risk?

slowed growth

The treatment of brain tumors in children consists of which therapies? (Select all that apply.)

surgery chemotherapy radiation

A parent whose two school-age children diagnosed with exercise-induced bronchospasm (EIB) asks the nurse in what sports, if any, they can participate. The nurse should recommend which sport?

swimming

Which immunization should be given with caution to children infected with human immunodeficiency virus?

varicella

What is a common sign of digoxin toxicity?

vomiting

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should perform which initial action?

wash hands thoroughly