peds 2
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance?s
Discouraging the addition of fruit juice to the diet
The nurse is caring for a child brought to the emergency department by a babysitter. The child needs an emergency appendectomy and the parents cannot be contacted. What would be the nurse's best response to this situation?
Document failed attempts to obtain consent to allow emergency care.
The mother of a 4-year-old is discussing discipline methods with the nurse. She states that she has never tried using "time-outs" with her child and wonders how and if this method works. Which responses from the nurse are appropriate? Select all that apply.
"Time-out is a way of removing positive reinforcement of an unwanted or inappropriate behavior." "If you decide to try this method= be sure to use time-out in a nonthreatening safe area where no interaction occurs with you.""Time-out is a method that is recognized by many pediatricians and experts in pediatrics.
The nurse is teaching discipline strategies to the parents of a 4-year-old boy. Which response from the parents indicates a need for more teaching?
"We should let him know he makes us angry with bad behavior."
The parents of a child with physical and developmental special needs state
"We wish our child could get some kind of educational experience." How should the nurse respond?= This must be difficult for you. Let's talk with the social worker to see what programs are available for your child."
The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which comment provides the most compelling reason for the vaccine?
" This protects your child from infection that can cause liver disease."
The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which of the following statements would indicate that the boy is having nightmares instead of night terrors?
"He will tell us about what happened in his dream."
The parents of a child with a developmental disability tell the nurse that they feel guilty because they sometimes find themselves feeling sad and wondering how their child would be without the disability. Which response by the nurse best shows empathy and encourages the parents to vent their feelings?
"I can only imagine how hard it is for you. You should know that it is common for parents to have these feelings when having a child with special needs."
The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last?
Throat
The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. What would be the best teaching method for this child and his family?
Provide a trial period of home care.
The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting?
Regression
The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area?
The child does not point to named body parts.
The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem?
The child does not vocally respond to voices.
The nurse is performing a physical examination of an 11-year-old girl. What observations would be expected?
The child has grown 2.5 inches since last year.
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays?
The child is homeless and has no toys.
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?
The child is unable to push a toy lawnmower.
The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based?
The family is the constant in the child's life and the primary source of strength.
When describing the various changes that occur in organ systems during adolescence
what would the nurse include?= Decrease in heart rate
A mother brings her 3-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature
which method would be least appropriate?= Rectal
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which measures might the nurse consider when caring for this child? Select all that apply.
Avoid leaving small objects that can be swallowed in the bed ( Encourage parents to stay to prevent separation anxiety.
The nurse in charge of the quality department is reviewing cases regarding HIPAA compliance. In which cases does the nurse correctly determine that HIPAA standards were followed? Select all that apply.
)A child is diagnosed with an inner ear infection and follow-up care instructions are given to the child's aunt who provides a medical consent form from the parents who are on vacation.
The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever?
100.8° F (38.2° C)
The nurse is assessing the developmental milestones of an infant. The infant was born 8 weeks ago and was 4 weeks premature. The nurse anticipates that the infant will be meeting milestones for what age of child? Record your answer in weeks.
4t o determine adjusted age= subtract the number of weeks that the infant was premature (4 weeks) from the infant's chronological age (8 weeks).
The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in what ranges?
60 to 100 bpm
The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up the child weighed 80 pounds. According to average growth for this age group what would be his expected current weight?
87 pounds
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.
=Around 2 months the infant exhibits a first real smile. Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. Around 3 months the infant will mimic the parent's facial movements= such as sticking out the tongue. Separation anxiety may also start in the last few months of infancy.
The nurse is performing developmental surveillance for children at a medical home. Which infants are most at risk for developmental delays? Select all that apply.
A child whose parent has a mental illness. A child raised by a single parent. A child with a lead level above 10 mg/dL. A child with hypertonia or hypotonia
DThe nurse is assessing the temperature of a diaphoretic toddler who is crying and being uncooperative. What would be the best method to assess temperature in this child?
Axillary method
The nurse is consulting with a child life specialist (CLS) to help minimize the stress of hospitalization for a child. Which services would the CLS provide? Select all answers that apply.
Activities to support normal growth and development Grief and bereavement support Emergency room interventions for children and families
The nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level?
Allow the child extra time to complete thoughts.
The nurse is performing risk assessments on adolescents in the school setting. Which teen should the nurse screen for hypertension?
An African American male
The nurse is assessing heart rate for children on the pediatric ward. What is a normal finding based on developmental age?
An infant's rate is 90 bpm.
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.
Around 2 months the infant exhibits a first real smile.(Around 3 months the infant smiles widely and gurgles when interacting with the caregiver.(Around 3 months the infant will mimic the parent's facial movements= such as sticking out the tongue.(Separation anxiety may also start in the last few months of infancy.
The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a developmental milestone occurring in infancy?
By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months= the brain weighs 2.5 times what it did at birth.
The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue?
Before answering questions= find out what the child thinks about the subject.
The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination?
Chief complaint
The nurse knows that effective communication with children and their parents is critical to providing atraumatic quality nursing care. Which statement accurately describes the communication patterns of children?
Children rely more on nonverbal communication and silence.
An adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent the nurse would expect that she would also receive treatment for what?
Chlamydia
A 3-year-old child is scheduled for a hearing screening. The nurse would prepare the child for screening by which method?
Conditioned play audiometry
The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan?
Continuous peer relationships provide the most important social interaction for school-age children.
The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS?
Decrease anxiety and fear during hospitalization and painful procedure.
When describing the various changes that occur in organ systems during adolescence what would the nurse include?
Decrease in heart rate
A nursing instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students identify which action as the primary action?
Decrease the temperature set point
The nurse is caring for a special needs infant. Which intervention will be most important in helping the child reach her maximum developmental potential?
Directing her parents to an early intervention program
The school nurse is performing a physical examination on a 13-year-old boy who is on the soccer team. What is a physical quality that develops during these early adolescent years?
Endurance
The nurse is teaching parents of a 2-year-old about the extinction method of discipline. What is an example of this method of discipline?-
Enforcing a 'time-out'
A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which is the best action for the nurse to take?
Immediately schedule the infant for a newborn hearing screening.
The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which statements accurately describes a recommended guideline for setting the tone of the examination for a school-age child?
Include the child in all parts of the examination; speak to the caregiver before and after the examination.
The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order?
Inspection palpation percussion auscultation
The nurse is conducting a well-child assessment for a 5-year-old boy in preparation for kindergarten. The boy's grandmother is his primary caregiver because the boy's mother has suffered from depression and substance abuse issues. The nurse understands that the child is at increased risk for which developmental problem?
Lack of social and emotional readiness for school
The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.
Mental health changes History of previous suicide attempt Family disorganization Substance abuse
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description?
Myelinization of the brain and spinal cord is complete at about 24 months.
How to go with planning education for parentsThe nurse is caring for a child who is scheduled to begin chemotherapy. When planning education for the parents what action by the nurse is most correct?
Obtain a small conference room and arrange the chairs in a circle for both the nurse and family members to sit.
The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl?
Occurrence of first menstrual period
A child with increased intracranial pressure is being treated with hyperventilation. The nurse understands the need for this treatment is based on what?
PaCO2 levels decrease causing vasoconstriction.
The pediatric nurse knows that the children she is treating are considered minors. Which statement accurately describes the regulations related to consent for medical treatment?
Parents ultimately are the decision makers regarding medical treatment for their children younger than the age of 18.
A nurse suspects that an adolescent may have community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). What would the nurse expect to assess? Select all that apply.
Participation in contact sport.Recent cut on the lower leg. Raised fluctuant lesions.
The school nurse is performing health assessments on students in middle school. Of what developmental milestone should the nurse be aware?
Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche
When providing anticipatory guidance to a group of parents with school-aged children what would the nurse describe as the most important aspect of social interaction?
Peer relationships
The nurse is teaching a group of parents with premature infants about the various medical and developmental problems that may occur. The nurse determines that additional teaching is needed when the group identifies what as a problem?
Peptic ulcer
A 10-year-old girl is living with a foster family. Which intervention is the priority for the child in this family structure?
Performing a comprehensive health assessment
What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure?
Projectile vomiting
The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative?
Reward the child for initiative in order to build self-esteem.
The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?
Ring-like rash on lower leg
The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors?
Sewing puppets with needles
The nurse is caring for a 12-year-old child hospitalized for internal injuries following a motor vehicle accident. For which medical treatment would the nurse ensure that an informed consent is completed beyond the one signed at admission?
Spinal tap
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply.
Sweet potatoes. Spinach.Carrots
The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease?
Swollen lymph nodes
The nurse is teaching discipline strategies to the parents of a 14-year-old girl. Which topic is an example of positive reinforcement discipline?
Taking a chore away from her for a week
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which guidelines might the nurse recommend? Select all that apply.
Talk face to face and be aware of body language. Ask questions to see why he or she feels that way. Don't pretend you know all the answers.
Which would be least effective in gaining the cooperation of a toddler during a physical examination?
Tell the child that another child the same age wasn't afraid.
The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply.
The nasal passages are narrower. The larynx is more funnel shaped.there are significantly fewer alveoli.
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior?
The need for separation and control
A child needs a consent form signed for a minor surgical procedure. Which statement accurately describes the responsibilities of the health care providers when obtaining the consent?
The nurse is responsible for determining that the parents or legal guardians understand what they are signing by asking them pertinent questions.
The nurse is caring for a newborn infant who has Down syndrome. Which nursing action reflects the nurse's use of the ethical principle of nonmaleficence?
The nurse provides safe competent nursing care to avoid harming the infant.
The nurse is caring for a child involved in an automobile accident whose family has been informed that the child is brain dead. What teaching might the nurse provide the family regarding organ donation?
The nurse should explain that written consent is necessary for the organ donation.
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development?
The toddler does not respond to commands whispered in his ear.
The nurse of a preschool child is helping parents develop a healthy meal plan for their child. What nutritional requirements for this age group should the nurse consider?
The typical preschooler requires about 85 kcal/kg of body weight.
The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which criteria must occur to ensure proper use of these restraints? Select all answers that apply.
Use a clove-hitch type of knot to secure the restraints with ties. Remove the restraint every 2 hours to allow for range of motion and repositioning.Encourage parent participation= providing continuous explanations about the reasons and time frame for restraints.
The child life specialist (CLS) is preparing a 6-year-old child for a magnetic resonance imaging (MRI) scan. Which statement reflects the use of atraumatic principles when explaining the procedure?
You may hear some loud noises when you are lying in the machine= but they won't hurt you.'
The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration?
a less discriminating sense of taste
The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs?
developing language and motor skills
The nurse working in the emergency room monitors the admission of children. Statistically
for which disorder would children younger than 5 years most commonly be admitted?=Respiratory disorder
The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play
reading= and schoolwork. What would be the best intervention?= Enlist the aid of a child life specialist.
The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case?
schedule a full evaluation since this may indicate a neurologic disorder.
The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors?
sewing puppets with needles
The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage
the girl is at risk of what happening?=Viewing her baby sister's illness as her fault
While obtaining a health history from a male adolescent during a well check-up
the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information= the nurse plans to teach the adolescent about using a condom. What would the nurse include in the teaching plan?="Put the condom on before engaging in any genital contact."
During a physical assessment of a 5-month-old child
the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. When is the correct time for the dentist visit?=
The parents of a 7-month-old child with an infection ask the nurse about how to treat their child's fever. After providing teaching
the parents voice understanding with which statements? Select all that apply.= "Unless my child develops a fever over 102.2°F = I don't need to make an appointment with the physician." "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." "Even though people get frightened= fevers are not a bad thing during an infection unless it gets too high."
The nurse is caring for an infant who had hyperbilirubinemia requiring exchange transfusion. Based on this information
this infant is at risk for what type of disorder?= Hearing loss
The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In order to get an accurate reading
what does the nurse need to do?= Direct the infrared sensor at the tympanic membrane
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's 'negativism.' Based on Erickson's theory of development
what would be an appropriate intervention for this child?=Encourage the child to pick out his own clothes.
The nurse is designing a nursing care plan for a toddler with lymphoma
who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan?= Monitoring the toddler for developmental delays
The nurse is conducting a well-child examination of a 5-year-old girl
who was 40 inches tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler?= 43 inches