Peds 2

A 20 month old, Ally, has been in the hospital for 3 weeks. Her parents must leave the hospital to go to work. The parents discusses with the nurse how best to leave. What is the nurse's best response to minimize a common stressor in children of this age?

"It would be best to leave a favorite object from home"

A 5 year old is diagnosed with viral pharyngitis. The child is complaining of throat pain. Which of the following statements by the mother indicate that she needs more education regarding the care and treatment of her daughter's throat pain?

"I will call my doctor to request amoxicillin for her throat infection"

A 5 year old boy is being screened for developmental delays using the Denver Developmental Screening Test. The child's mother is explaining to the nurse her understanding of the test. The nurse knows the mom needs further education when she says?

"It screens my son's intelligence level"

A 2 year old girl has just become a big sister. Her mother has been a stay at home mom. Based on the developmental level of a 2 year old, which comment should the child's mother expect from her toddler about her new baby brother?

"Mommy, it is time to put him away so we can play"

A nurse is assessing the height of a 4 year old during his well-child visit. The child was 19 inches at birth. What height does the nurse expect the child will be?

38 inches

A young child is brought to the ED with dehydration secondary to acute diarrhea and vomiting. The nurse's assessment reveals a weight of 76 lb, poor skin turgor, dry mucous membranes, and cap refill of 3. Child usually weighs 80 lbs. What is the nurse's first intervention?

Encourage oral rehydration solutions

An infant is brought to the ED with the following clinical manifestations: severe vomiting, poor skin turgor, weight loss, lethargy, and tachycardia. These symptoms are suggestive of which of the following conditions?

Dehydration

What information should the nurse give a mother regarding the introduction of solid foods during infancy?

Food should be introduced one at a time, at intervals of 4 to 7 days

The nurse has obtained the following assessment information about a 3 year od who has just returned to the pediatric unit after tonsillectomy. Which finding requires the most immediate follow-up?

Frequent swallowing

Which of the following would indicate that a school-age is using a metered-dose inhaler correctly?

The child holds his breath for 10 seconds after the first puff

Mrs. Allen is crying in your office because she is afraid her toddler will be jealous of the baby she is about to deliver. Which of the strategies should the nurse suggest to decrease sibling rivalry?

"Encourage the toddler to feel the fetus move and help name the baby"

An adolescent patient has just had surgery and has a dressing on the abdomen. Which of the following questions would nurse expect the patient to ask initially?

"Will I have a scar?"

An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year?

21

Which is a key characteristic of the formal operations stage of cognitive development?

Ability to think in abstract terms and draw logical conclusions

Which of the following characteristics best describes the fine motor skills of a 5 month old infant?

Able to grasp object voluntarily

Jose is a 6 year old scheduled for a cardiac catheterization. What is important for the nurse to remember when delivering preoperative teaching?

Adapt the education to his level of development so that he can understand

Steven, 16 months old, falls down a few stairs. He gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following?

Animism

Which of the following defects results in increased pulmonary blood flow?

Atrial septal defect

The nurse is ready to begin a physical exam of an 8 month old infant. The child is sitting contentedly on his mother's lap, chewing on a toy. Which assessment should the nurse do first?

Auscultate heart and lungs

A nurse is preparing to care for a child with a diagnosis of intussusception. Which symptom does the nurse expect to see?

Bright red blood and mucus in the stools

A 5 year old is brought to the ED with copious drooling and a croaking sound on inspiration. Her mom says she is very agitated and only wants to sit upright and when the nurse enters the room the baby grew more agitated. What would be the nurse's first action?

Call the physician and prepare intubation equipment

The head-to-tail direction of growth is referred to as which of the following?

Cephalocaudal

An 8 year old and his chief complaints include headaches and epistaxis. The nurse notes bounding pulses in his upper extremities and faint pulses in his lower extremities. Which is the likely diagnosis for this child?

Coarctation of the aorta

Which of the following CHD's would require the nurse to take upper and lower extremity BP's?

Coartation of the aorta

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include which of the following?

Elevate head but give nothing by mouth

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should first include which of the following?

Encourage and assist mother to breastfeed

A newborn was admitted with a complete bilateral cleft lip and palate. The physician explains that with surgery the clefts will be nearly invisible. The mother refuses to see or hold the baby. What is the best initial approach for the mother?

Encourage her to express her feelings

The nurse needs to give an injection in the arm to a preschooler. Which of the following is the best approach to use?

Explain with a concrete term such as "putting medicine under the skin"

Which of the following interventions is appropriate for the infant hospitalized with bronchiolitis (RSV)?

Give cool, humidified oxygen

A 4 month old infant has GER but is thriving without other complications. Which of the following will the nurse teach the parents to minimize reflux?

Give smaller, more frequent meals

Which behavior by a preschool child indicates that the child is in the proper stage of growth and development?

He asks for a bandage after having blood drawn

A parent brings her 6 month old who was diagnosed with a VSD to the office for a well child check. The infant's birth weight is 3.5 kg. Current assessment: weight 5 kg, R 68, HR 170, increased work of breathing and nasal flaring. What type of diet should be suggested?

Increased calories

A child has a congenital heart defect where the lumen between the aorta and pulmonary artery remains open, allowing blood to shunt blood from the aorta to the pulmonary artery. Which of the following is the drug of choice to close the lumen?

Indocin

The nurse is observing parents playing with their 10 month old daughter. Which of the following should the nurse recognize as an example that the child is developing the concept of permanence?

Looks for the toy parents hide under the blanket

Which of the following inventions should be included in the plan of care for a child hospitalized for an exacerbation of cystic fibrosis?

Monitor stools for amount, consistency, and color

When assessing a 4 year old child's chest, which of the following should the nurse expect to see?

Movement of the chest wall to be symmetric bilaterally and coordinated with breathing

A 3 month old infant, born 38 weeks, will hold a rattle if it is placed in her hands, but she will not voluntarily grasp it. How should the nurse interpret this behavior?

Normal development

Which of the following is the single most important influence on growth?

Nutrition

A nursing responsibility when caring for an infant with suspected pyloric stenosis would be which of the following?

Observe for projectile vomiting

A 8 month old infant with Tetralogy of Fallot has hypercyanotic spell while blood is being drawn. The nurse's first action should be which of the following?

Place the child in the knee-chest position

Which of the following is a major clinical manifestation of rheumatic fever?

Polyarthritis

Closure of the ductus arteriosus at birth does which of the following?

Prevent the return of oxygenated blood to the lungs

A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is which of the following?

Reduced the opportunities for a "no" answer

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

Refer children with sore throats for throat cultures

A 3-year-old child is admitted to the hospital. Which of the following common stressors must the nurse be mindful when providing care for this child?

Resolving conflicts associated with independence

Which of the following is the viral pathogen that frequently causes acute diarrhea in young children under 5?

Rotavirus

A 10 year old is being discharged after treatment of acute spasmodic laryngitis (croup). Which of the following instructions will the nurse teach the parents about treating it at home?

Sit with the child in the bathroom with the shower on when an attack occurs

The nurse would teach parents of a child with cystic fibrosis to adjust enzyme dosage according to which indicator?

Stool formation

Which of the following findings would confirm a diagnosis of cystic fibrosis?

Sweat chloride is greater than 60 mEq/L

The nurse should expect the initial plan of care for a 9 month old child with an acute otitis media infection to include which of the following?

Symptomatic treatment and observation for 48 to 72 hours after diagnosis

When caring for the child with Kawasaki disease, the nurse should know which of the following?

Therapeutic management includes administration of gamma globulin and aspirin

Which nurse should not be assigned to care for a child receiving ribavirin?

Woman who is pregnant

The parent of a 2 year old says to the nurse "He pushe the teaspoon right out of my hand when I feed him. I can't let him feed himself; he makes too much mess." The nurse's best response is the following?

"He is at the age when he should begin to feed himself. Let's think of ways to make the mess more tolerable"

A mother tells the nurse that she will visit her 4 year old son tomorrow about noon. During the child's bath, he asks when Mommy's coming. Which is the nurse's best response?

"Mommy will be here around lunch time"

Which of the following statements best describes colic?

Colic manifests as paraoxysmal abdominal pain or cramping manifested by episodes of loud crying

A father tells the nurse that his child is "filling up the house with collections." The child may have collected seashells, bottle caps, baseball cards, and pennies. The nurse recognizes that the child is developing which of the following?

Concrete operational thinking

The nurse is evaluating and assessing a 6 month old patient with a diagnosis of cystic fibrosis. The patient is receiving oxygen at a flow rate of 5 L by nasel cannula. Which finding immediately concerns the nurse?

The patient's respiratory rate is 8 breaths/min

While the American Academy of Pediatrician's recommends breast-feeding for the first 6 months of a child's life, at which age may an infant be introduced to solid food?

4 to 6 months

What is normally the earliest age at which an infant begins teething with eruption of lower central incisors?

6 months

A 7 month old infant is taken to the pediatricians office with a low grade fever, nasal congestion, and a mild cough. Which should the nursing care management of this child include?

Instilling saline nose drops and bulb suctioning

How does the onset of the pubertal growth spurt compare to girls and boys?

It occurs earlier in girls

A 2 year old is experiencing the following symptoms: drooling, dysphagia, dysphonia, high fever, and dyspnea. What is the priority in the management of this child?

Maintain a patent airway

A child is hospitalized for persistent vomiting that results in severe dehydration. For which of the following should the nurse monitor?

Metabolic alkalosis

Which of the following factors indicates a potentially, undetected cardiac defect when assessing a 1 month old infant? (Select all that apply)

1. Tachypnea 2. Tachycardia 3. Poor nutritional intake

Which of the following characteristics of the infant affect the respiratory system? (Select all that apply)

1. Underdeveloped antibody production 2. Narrow trachea-bronchial lumen 3. Short and open Eustachian tube 4. Distance between structures is shorter

The use of Salmeterol (Servent) is ordered for children with asthma for which reason:

Prevention of acute episodes

Caring for the newborn with a cleft lip and palate before surgical repair includes which of the following?

Providing satisfaction of sucking needs

Which of the following structural defects constitute tetralogy of Fallot?

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

A 2 year old child comes to the hospital with anorexia, abdominal distention, chronic constipation, foul-smelling and ribbonlike stools. Which orders might the nurse anticipate? (select all that apply)

1. Administer enemas to clean bowel. 2. Preoperative care for a surgical removal of affected portion of bowel. 3. IV antibiotics

Miss Paul stays on the phone when the nurse brings her baby to her to feed and does not make eye contact with her baby. The nurse is concerned. Which nursing interventions are appropriate for the mom and baby relationship? (Select all that apply)

1. Encourage mom in breastfeeding attempts, providing the support needed for success 2. Encourage mom to nap, drink fluids, eat nutritiously, and implement pain control measure

The nurse is caring for a 5 year old child who is scheduled for a tonsillectomy in 2 hours. Which of the following actions should the nurse include in the child's postoperative care plan? (select all that apply)

1. Notify the surgeon if the child swallows frequently 2. Apply an ice collar to the child's neck for pain relief

A 2 year old patient is ordered Lanoxin (digoxin) therapy. What should the nurse teach the parents related to digoxin therapy? (select all that apply)

1. Report heart rate outside the range set by the health care prescriber 2. Instruct parents to take an apical pulse 3. Report nausea and vomiting to health care provider

A child's skeletal age is best determined by which of the following?

Radiographs of the hand/wrist

Which of the following refers to those times in the lifetime of an individual when he or she is more susceptible to positive or negative influences?

Sensitive period

Which classification of drugs is used to relieve an acute asthma episode by relaxing smooth muscle of bronchioles via beta 2 adrenergic stimulation?

Short acting B-Adrenergic agonists

A mother of a 2 year old child is frustrated because the child is trying to eat with a spoon and is making a mess. Which of the suggestions will the nurse give to the mom?

Offer ideas to limit the mess the child makes

A 16 year old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient's care?

Perform postural drainage and chest physiotherapy every 6 hours

The mother of an 11-month old infant brings her child to the doctor for a check up. The nurse assessed the infant and finds that the infant falls below the 3rd percentile for height and weight. The nurse suspects the child is suffering from which of the following?

Failure to thrive

Pancreatic enzymes are administered to the child with CF. Nursing considerations should include which of the following?

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

The nurse is caring for an infant with CHF. Which of the following interventions will the nurse implement to decrease cardiac demands on the infant? (Select all that apply)

1. Allow parents to hold and rock their child. 2. Change bed linens only when necessary. 3. Organize nursing care

The nurse teaches about risk factors for SIDS to a group of adults who will soon be parents. Which risk factors will the nurse be sure to include? (Select all that apply)

1. Smoking during pregnancy 2. Placing the baby in the prone position 3. Smoking near the infant