Peds 2

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The nurse is the well-child clinic counsels the parent of the newborn about normal growth and development. The nurse determines teaching is effective if the parent makes which statements?

"My baby will double his birth weight at 5 months."

The nurse counsels the parent of a 12-year-old diagnosed with chickenpox about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement?

"My child can return to school when the lesions are crusted."

Which statement made to the nurse by the parent of an 8-month-old client, indicates a possible delay in growth an development?

"My child has almost doubled the birth weight"

The nurse assesses the child admitted with a diagnosis of acute asthma. The nurse determines which observation by the parents is significant when determining the cause of the acute asthma attack?

"My child slept on a new pillow last night."

The nurse counsels the parents of a child with Down syndrome. Which parental statement indicates to the nurse that further teaching is necessary?

"My child's development will become more rapid in time."

The home care nurse visits a preschool-age client diagnosed at birth with phenylketonuria. The nurse assesses the child's intake for the previous week. The nurse is most concerned if the child's parent makes which statement?

"My child's favorite lunch is a peanut butter and jelly sandwich.'

The nurse is asked to explain the major difference between a clubfoot and a positional deforming to a student nurse. Which statement, if made by the nurse, is appropriate?

"A clubfoot is corrected with surgery and casting, but a positional deformity can be passively corrected."

The 15-month-old client crawls but is not yet able to walk. The parents are concerned and ask the nurse if this is normal. Which response by the nurse is accurate?

"Children often set their own pace."

The 17-month-old client sucks the thumb, especially at night when quieting for sleep. Which is an appropriate suggestion by the nurse?

"Don't intervene; it will subside. The behavior usually peaks at 24 months."

The nurse counsels the mother of the child diagnosed with attention deficit disorder. Which statement by the nurse is most appropriate?

"Hug your child after a task is correctly performed."

The nurse in the well-child clinic receives a phone call from the parent of the 6-month-old who received the DTaP vaccine 3 days ago. The nurse is most concerned if the parent makes which statement?

"My baby is crying continuously."

The nurse interviews an adolescent client. Which statement causes the nurse concern if made by the adolescent during the health history interview?

"I don't perspire like other kids."

The 8-month-old child is about to receive an immunization injection when the child begins to cry. Which comment by the nurse is the most appropriate?

"I know you are frightened. It will be over with soon."

The nurse instructs the parent about the appropriate way to instill ear drops in the right ear of the 2-year-old child. The nurse determines teaching is effective if the parent makes which statement?

"I should pull my child's ear down and back."

The nurse visits the family with three small children who live in a three bedroom home built in 1952. The nurse counsels the family about how to avoid lead poisoning. The nurse determines that teaching is effective if the parents make which statement?

"I wet mop all of my floors and wash all of the window sills weekly."

A 1-week-old client diagnosed with hemophilia A. Neither parent has the disease. Which statement correctly describes the hemophilia trait?

"It is an X-linked recessive trait found primarily in males."

The 3-year-old child is seen in the local clinic for croup. The child's parent asks the nurse what to do for the child at home to alleviate symptoms. Which suggestion by the nurse is most appropriate?

"Stand with your child in front of an open freezer."

The woman delivers a healthy 8-lb, 2-oz infant She mentions to the nurse that her baby's "soft spot" seems very large. Which statement, if made by the nurse, is most appropriate?

"The baby's anterior "soft spot" will remain for approximately 1 1/2 years."

A brace is ordered for the adolescent to correct a scoliosis deformity. Which statement, if made by the parent to the nurse, indicates teaching is successful?

"The brace should be worn 23 hours a day"

The young child diagnosed with autism is admitted to the pediatric unit with a tracheotomy after swallowing a small toy. The unlicensed assistive personnel reports to the nurse that the child does not maintain eye contact. Which response by the nurse is best?

"The inability to maintain eye contact is a characteristic of autism."

The nurse talks with a group of adolescents about their nutritional needs. Which statement is most accurate?

"You have an increased need for most nutrients"

The neighbor of the nurse comes running to the nurse's house saying, "I just found my 2 year old in the kitchen surrounded by several bottles of cleaning solutions and the bottles are all open!" Which action by the nurse is best?

Call the poison control center

The nurse considers the developmental stage of a child before choosing a toy. A push-pull toy is appropriate for which age range?

18-20 months

A parent calls the clinic to report that the child has been exposed to varicella zoster (chickenpox). The nurse should tell the parent the the incubation period for chickenpox is which length of time?

2-3 weeks

The nurse observes the child walk up and down steps. The nurse notes the child has a steady gait and can use short sentences. The nurse estimates the child's age to be how many months?

24 months

The infant is able to assume a sitting position, plays a "peek-a-boo", and is starting to say "mama" and "dada". The nurse identifies these behaviors are characteristic of which age?

9 months

The nurse instructs the 10-year-old client about how to collect a 24-hour urine specimen at home using a clean, empty jar. The nurse recommends the client use which size jar?

48-ounce jar

The child with attention deficit hyperactive (ADHD) is taking methylphenidate. The nurse knows that methylphenidate is prescribed for the child for which effect?

Central nervous system stimulant

The nurse recognizes that which child is at greatest risk for poisoning?

A 2-year-old

The nurse provides care for clients in the pediatric clinic. The nurse investigates which pediatric client for a possible speech impairment?

A 5-year-old who uses single words.

The school nurse assesses children enrolled in the kindergarten class. The nurse is most concerned if which finding is observed?

A child walks down stairs by placing both feet on one step

Which medication does the nurse have available for the treatment of acetaminophen overdose?

Acetylcysteine

The nurse understands which principle serves as the basis for managing childhood weight problems?

Allow for slower weight gain compared to linear growth

The preschool-age client comes to the clinic for a routine exam. The parent reports the child like to jump and climb, questions everything, and often observed interacting with an "imaginary" best friend. The nurse advises the parent to take which action?

Allow the child to engage in imaginary play

The 18-month-old toddler diagnosed with cystic fibrosis is admitted to the hospital with a respiratory infection. The nurse should expect to see which characteristic feature of cystic fibrosis?

An altered viscosity of mucus

The child is admitted with lead poisoning. Which symptom does the nurse expect to see?

Anemia, hearing impairment, and distractibility

Prior to surgery for myelomeningocele, which action should the nurse perform to care for the area of the defect?

Applies a moist, sterile dressing

The nurse identifies which reaction as an adverse effect most often identified with the measles, mumps, and rubella (MMR) immunizations?

Arthritis

The nurse plans care for the infant diagnosed with myelomeingocele. Which principle of nursing care is most important to apply when caring for this infant?

Asepsis

A pediatric client who is 8 months of age comes to the clinic. The child has stunted growth, and chromosomal studies show the child has 45 chromosomes. The nurse identifies the child's condition is due to which diagnosis?

Turner syndrome

When assessing the 9-month-old child, the nurse expects which reflex to be present?

Babinski

The four-week-old infant is brought to health care provider by the parent. The infant is vomiting and has abdominal distention. The infant is diagnosed as having pyloric stenosis and is admitted to the hospital. The nurse should expect the infant's emesis to have which of these qualities?

Be projectile

After an aspirin overdose, it is most important for the nurse to assess for which problem?

Bleeding

Which artery should the nurse use to assess the pulse rate of an infant during cardiopulmonary resuscitation?

Brachial artery

The parent of the child diagnosed with frequent acute otitis media asks the nurse why this keeps happening to the child. The nurse's response should be based on which explanation?

Children have a shorter auditory, or eustachian, tube

The 6-month-old baby has a cyanotic congenital heart defect. The nurse knows that a cyanotic congenital heart defect is associated with which symptom?

Clubbing of the fingers

The 7-year-old child is admitted to the hospital with a diagnosis of idiopathic hypopituitarism. Which clinical manifestation is the nurse most likely to observe?

Delicate features

The home care nurse visits the home of the toddler diagnosed with non-organic failure to thrive (NFTT). The nurse instructs the toddler's parent about mealtimes. Which suggestion by the nurse is most appropriate?

Develop a structured routine for bathing, sleeping and playing

The clinic nurse teaches the parent how to care for a child with impetigo. The nurse knows that the greatest danger associated with an impetigo infection is the risk of which complication?

Developing glomerulonephritis secondary to streptococcus infection

The nurse knows DTaP vaccine protects against which diseases?

Diphtheria, pertussis, tetanus

To prevent disturbed parent-child interactions, the nurse completes which action?

Discusses with the parents any problems or fears about child rearing they may have

The 4-year-old child is brought to the emergency department with a diagnosis of acute epiglottis. Which assessment finding is most significant?

Drooling of saliva

The nurse understands that which food is most likely to cause an allergy in a 6-month-old infant?

Eggs

Surgical repair of a congenital heart defect is performed on the 5-month-old infant. Which measure is most important for the nurse to include in the postop care plan?

Elevate the client's head to reduce respiratory effort

The parent brings the 6month-old to the clinic for a check-up. The parent reports the baby had a check-up at 2 months of age and received the first DTaP. Which action by the nurse is most appropriate?

Give second DTaP

The nurse anticipates that the child with a diagnosis of idiopathic hypopituitarism will be given which hormone?

Growth hormone

The nurse observes parents interacting with their newborn shortly after birth. It is most important for the nurse to make which assessment during this observation?

Healthy or pathologic relationships

The nurse instructs the parents of a 7-year-old child diagnosed with cystic fibrosis about required dietary modifications. Which adjustment is likely to be made in a normal diet?

Increased protein

The 4-year-old child sustains a deep partial-thickness burn. Based on an understanding of growth and development, the nurse anticipates which hospital experiences will probably be the most upsetting to the child?

Intramusucular (IM) injections

The 18-mo-old child drinks some drain cleaner and is brought to the emergency department. Which piece of equipment is most essential for the nurse to have on hand?

Intubation tray

The adolescent is evaluated for scoliosis. The client asks the nurse, "What is scoliosis?" Which statement by the nurse best describes scoliosis?

It is a lateral curvature of a portion of the spine

Which action should the nurse take to minimize separation anxiety experienced by a toddler?

Keep toys from home in the bed with the child

The nurse is monitoring the client with an acetaminophen overdose. Which laboratory test result is most important for the nurse to follow?

Liver function test

The nurse knows MMR is a vaccine for which diseases?

Measles, mumps, rubella

The toddler has nausea, vomiting, and diarrhea. Which implementation is best for the nurse to use to maintain an adequate fluid intake?

Offer oral rehydration solutions (ORS) to re-hydrate

The nurse knows vitamin E is given to premature infants to prevent which condition?

Oxidation of red blood cells

The nurse cares for the newborn diagnosed with developmental dysplasia of the hip (DDH). The nurse expects which method of treatment to be used for the newborn?

Pavlik harness

The nurse observes the preschool-age child playing with several other children about the same age. The nurse identifies which play activity as one in which the child is most likely to engage?

Playing with a toy telephone and imitating the health care provider.

The nurse provides care for an infant client diagnosed with a cyanotic congenital heart defect. The nurse understands that chronic hypoxia from this disorder can result in which finding?

Polycythemia

The 3-day-old infant is born with a myelomeningocele. The nurse caring for the neonate places the infant in which position?

Prone

Which intervention does the nurse recognize as most important to promote maximum mobility in infants?

Provide a safe play area

The 4-year-old child was sitting near the fireplace when the clothing caught fire and developed the child in flames. The nurse was in the home. Which action dose the nurse take first?

Pushes the child to the ground and makes the child roll

The nurse knows which signs & symptoms of rubeola are exhibited before the appearance of the rash?

Runny nose, sneezing, and coughing

The nurse understands that, according to Erikson, adolescence is regarded as the period associated with establishment of which developmental goals?

Sense of identity and intimacy

The nurse knows that which type of feeding is most commonly used with infants who are intolerant of cow's milk?

Soy-based formula

The nurse counsels the parent of an infant diagnosed with non-organic failure to thrive (NFTT). The nurse notes the parent appears depressed and is expressing feelings of inadequacy and resentment toward the infant. Which approach by the nurse is most appropriate?

Structure environment so the parent feels accepted

The 3-year-old child is brought to the emergency department with a history of vomiting and diarrhea for the past 3 days. Which finding is the nurse most likely to see?

Sunken eyes

The nurse performs a home care visit for the child diagnosed with cystic fibrosis. The nurse should intervene if which finding is observed?

The child takes the pancreatic enzymes one hour after eating

Which guideline is appropriate for the nurse to give a parent concerning the normal development of the young school-age child?

The child's periods of shyness should be tolerated

The nurse performs assessments in the well-baby clinic. The nurse identifies which finding is a warning sign of cerebral palsy (CP)?

The infant has poor head control after 3 months

The 5-month-old infant is brought to the clinic by a parent for a well-baby check-up. The nurse expects to make which observation?

The infant puts the feet to the mouth when lying supine

The 4-month-old infant is seen in the well-child clinic. The nurse is concerned if which finding is observed?

The infant's head lags when pulled from a lying to a sitting position

The nurse cares for the infant immediately after insertion of a shunt due to hydrocephalus. Which observation by the nurse should be reported to health care provider immediately?

The infant's pupils are dilated

The 18-month-old child is admitted to the hospital. When the parents leave, the child starts to cry loudly, and the nurses attempt to console the child. After a while the child stops crying and becomes quiet and withdrawn. The nurse thinks that the child has accepted the situation and adjusted well to the separation. Which statement is true?

The nurse fails to see that the child has entered the second stage of separation anxiety

The nurse supervises the family caring for the child diagnosed with cerebral palsy. The nurse should intervene if which finding is observed?

The older sister places a toy in the child's hands

The home care nurse monitors the pediatric client diagnosed with a chronic seizure disorder. The nurse should intervene if which finding is observed?

The parent takes the child's temp using an oral electronic thermometer

The school nurse assesses the physical developmental of school-age children. Which is the most valuable tool for this assessment?

The weight and height compared to standard tables

The 2-year-old child is brought to the clinic for extensive facial burns. The child's parent states that they resulted from the child's running into a lighted cigarette. The child is holding on to the parent and doesn't want to let go to be examined. Which is the best rationale for the nurse to suspend this parent is abusing the child?

There is little relationship between the extent of the child's burns and the history

The 1-year-old child is admitted to the hospital for a bone marrow aspiration. The nurse expects the test to be performed using which site?

Tibia

An infant is found to have an excessive amount of oral secretions after birth. During the first feeding the infant has a choking episode accompanied by cyanosis. The nurse knows that these symptoms are indicative of which problem?

Tracheoesophageal defect


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