Peds 20 31 28 29 10 21 part 1 &2 38

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The nurse knows additional teaching is needed if a parent makes which comment?

"I keep the medications in a drawer under papers."

A nurse has just given instructions to the parents of a 12-year-old about administering a prescribed otic medication. Which statement by the parents would indicate the need for further education concerning the medication?

"I will make sure that I pull her outer ear down and back before administering the medication."

A newborn has been diagnosed recently with transient tachypnea of the newborn. How should the nurse counsel the parents?

"I know it's scary now, but this condition most likely will resolve on its own without affecting your baby in the long run."

A 4-year-old child is admitted to the hospital for surgery. Before the nurse administers medicine, the best way to identify the child would be to:

read the Childs armband

A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately?

a sudden drop in hematocrit

The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.

boxes to put toys in and/or take out toys stacking blocks or small boxes nursery rhymes or sing-along songs on tape

The nurse is assessing the newborn male of a teen mother who was afraid to seek appropriate prenatal care. Which assessment finding should lead the nurse to question if this infant is preterm?

lanugo on the back and shoulders

A 13-month-old is having a dressing changed on a packed leg wound. Which action from the parents should be encouraged by the nurse during the treatment?

Encourage the father to talk quietly to the child.

The nurse is caring for a newborn client newly diagnosed with developmental dysplasia of the hip (DDH). Which response by the nurse educates the parents on the correct plan of treatment for this diagnosis?

"Treatment will begin immediately."

The nurse is caring for a pediatric client with idiopathic celiac disease. Which meal will the nurse select for this client?

Baked salmon, potato slices, vanilla ice cream, and apple juice

The nurse is teaching a 12-year-old girl with type 2 diabetes mellitus and her parents about dietary measures to control her glucose levels. Which comment by the child indicates a need for additional teaching?

"I can eat two small cookies with each meal."

The nurse needs to obtain a blood sample from a 7-year-old child. How should the nurse explain this procedure to the client?

"The doctor needs to look at your blood to see why you are sick; it will hurt for a second."

The nurse is providing discharge education to the parents of a 2-year-old who will be taking amoxicillin orally at home. The nurse would include which statement in the teaching?

"Use a dosing cap to measure the dosage."

Extremely low birth weight, or ELBW, describes a newborn who weighs less than _______ g.

1000

After birth, an infant experiences meconium aspiration. What does the nurse anticipate the primary care provider prescribing prophylactically to prevent pneumonia?

antibiotics

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?

Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?

Administer subcutaneous glucagon.

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first?

Administer the bronchodilator via a nebulizer.

A 6-month-old infant is admitted to the hospital because of a fever. When the nurse obtains a health history, what data would be obtained first?

Details about the fever

The nurse has an order to administer a rectal suppository to a 3-month-old child. In addition to lubricating the suppository, which intervention will help assure appropriate administration of the medication?

Holding the buttocks tightly together for 1 to 2 minutes after insertion

A urine specimen has been ordered for a 1-year-old girl. Which method would be the best way for the nurse to obtain this urine specimen?

Place a sterile cotton ball into the child's diaper; after the child has urinated, squeeze the urine from the cotton ball into a sterile container to be sent to the lab.

Which teaching is most helpful in preventing sudden infant death syndrome (SIDS)?

Place the infant on the back for sleep.

The nurse is caring for an infant immediately after pyloromyotomy surgery has been performed to treat pyloric stenosis. The infant's parents are understandably anxious about their child. Given the situation, what is the most appropriate way for the nurse to position the infant during the anesthesia recovery period?

Support the infant and place them on their side.

The treatment for children with a pinworm infection is to administer which classification of medication?

anthelmintics

What treatment can the nurse anticipate assisting with for a newborn with clubfoot (congenital talipes equinovarus)?

serial casting

What is the responsibility of the registered nurse (RN) after the delivery of the newborn? Select all that apply.

assessing the gestational age identifying potential complications initiating the plan of care

The nurse is assisting with the physical examination on a sleeping10-month-old infant being held by the parent against the parent's shoulder. In what sequence would the nurse complete the assessment?

back and extremities; head and neck; then the ears, nose, mouth, and eyes

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?

blood glucose level

Mike, age 8, is going home on medication after surgery. The nurse is preparing to review the discharge instructions with the mother. What basic information and/or instructions should be given to her to continue the drug therapy at home? Select all that apply.

generic and trade names of drugs schedule and duration of administration description of the intended therapeutic drug effect

The nurse is caring for a pregnant woman who is struggling with controlling gestational diabetes mellitus. What effect does the nurse predict this situation may have on the fetus?

grow to an unusually large size

The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

having nurses check their math calculations with a colleague before administering a drug

Which intervention is most important in assuring a child's cooperation and reducing his or her fear during an emergency room visit?

having the parent stay with the child

The nurse is caring for a 22-hour-old neonate male and notes on assessment at the beginning of the shift: Apgar score of 9, nursing without difficulty, and appeared healthy. As the nurse's shift goes on, subsequent assessment reveals his sclera and skin have begun to take on a yellow hue. The nurse would report this as a possible indication of what condition?

hemolytic disease

The charge nurse is assisting the new graduate nurse in administering eye drops to a child. The charge nurse would stop the new graduate if which action was observed?

holds the eyelids apart for about 30 seconds

A nursing instructor is teaching students about cardiac congenital disorders in newborns and informs them that, like other diseases, risk factors increase the incidence of heart defects. Which of these are considered risk factors? Select all that apply.

maternal alcoholism maternal irradiation ingestion of certain drugs during pregnancy maternal diabetes advanced maternal age (older than 40 years)

The nurse is helping the care provider with a scalp venipuncture on an infant. Which of the following restraints would be most appropriate for this procedure?

mummy restraint

What would the nurse suspect in a premature newborn who has difficulty feeding and maintaining a stable temperature and is vomiting bile?

necrotizing enterocolitis

When planning preoperative care for a newborn with a cleft lip and palate, the nurse would plan interventions for which major need?

nutrition

The most common source of lead poisoning in children comes from which of the following sources?

paint used in older homes

A young child has been admitted with a diagnosis of enterobiasis (pinworm infection). This child will most likely have a history of:

perianal itching.

When a fetus has chronic hypoxia in utero, what response does the nurse expect to see after birth?

polycythemia

A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?

preventing infection

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has:

severe dehydration.

Which preventable cause of intrauterine growth restriction (IUGR) is most common?

smoking

A group of nursing students is discussing the diagnosis of vitamin C deficiency. The students have an appropriate understanding of the need for appropriate dietary intake when they identify which vitamin C rich foods? Select all that apply.

strawberries potatoes peas

What medication does the nurse anticipate administering to the preterm newborn as an inhalant to improve the lungs' ability to mature?

surfactant

A 5-year-old scheduled for surgery in the morning wakes at 2 am and asks the nurse for something to eat and drink. What should the nurse tell this client?

that not having food or drink before surgery will prevent an upset stomach

The nurse is providing education to the parents of an infant who was just diagnosed with transposition of the great arteries. The parents ask, "Which vessels were involved?" The nurse is correct to educate about:

the aorta and pulmonary artery.

The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective?

"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."

Which statement by the parent lets the nurse know that teaching about antibiotics prescribed 3 times a day for the child with strep throat has been effective?

"It is important to give my child the full course of antibiotics."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?

"The treatment for the disorder will be a surgical procedure."

A newborn boy is diagnosed with esophageal atresia and tracheoesophageal fistula. After the nurse provides preoperative teaching, which statement indicates that the parents need additional teaching?

"We can probably start feeding him with the bottle about a day after the surgery."

An older infant is scheduled to have a cleft palate repair. The mother asks if she will still be able to breastfeed the baby during the postoperative phase. What is the best response by the nurse?

"You will not be able to breastfeed immediately after, but you can pump and feed the child with a cup."

A client comes to the clinic because she had positive home pregnancy test results. She tells the nurse that she has a brother with spina bifida and is concerned that her child may be born the same way. When does the nurse tell the client is the best time to perform tests for neural tube defects?

13 to 15 weeks' gestation

When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which finding in the child's fasting glucose levels?

220 mg/dl

Why is thermoregulation a problem for the preterm newborn?

A preterm infant is not born with brown fat.

A school-aged child will have an intravenous line inserted. His mother asks if he could have this placed in his left hand so that he can do homework. What is the nurse's best response?

A school-aged child will have an intravenous line inserted. His mother asks if he could have this placed in his left hand so that he can do homework. What is the nurse's best response?

A neonate is to receive a hepatitis B vaccine within a few hours after birth. What is the best approach for the nurse to take when giving this medication?

Administer the medication in the neonate's vastus lateralis with a 25-gauge needle.

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema

Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?

Barlow sign and Ortolani click

A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication?

Double-check the dose with another RN before giving.

The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stage of separation anxiety?

He sits quietly and is uninterested in playing and eating.

When an infant is scheduled for a painful procedure, what is the most important action by the nurse?

Help to soothe and comfort the baby before and after the procedure.

The nurse is preparing a nursing care plan for a preterm infant in the newborn nursery. Which nursing diagnoses could the nurse determine to be appropriate for this infant? Select all that apply

Ineffective breathing pattern Ineffective thermoregulation Risk for impaired skin integrity

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child?

Observe him for physical signs which might indicate pain.

The nurse is caring for a preterm infant and notes frothing and excessive drooling. Which additional assessment finding should the nurse prioritize and report immediately?

Severe cyanosis

To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?

Take the apical pulse

The nurse is teaching new parents about their premature newborn who was born with respiratory distress syndrome (RDS). The nurse determines the teaching session is successful when the parents correctly choose which explanation as being the cause of their newborn's condition?

The lungs are immature and deficient in surfactant.

The nurse is caring for a newborn who is large-for-gestational-age (LGA). Which characteristics are documented as a contributing factor? Select all that apply..

The mother has had previous large-for-gestational-age neonates. The mother has poorly controlled diabetes. Both parents are of a larger stature and size.

The nurse is mentoring a new graduate in the newborn nursery. Which statement regarding a neonate with hypospadias would require the mentoring nurse to clarify?

The neonate will be circumcised before discharge.

The nurse is caring for a neonate with an exstrophy of the bladder. When the nurse is planning care, which client goal is the priority?

The neonate will be free from infection.

The nurse is administering a PRN pain medication to a child. What is the highest priority for the nurse in this situation?

The nurse checks the last time the medication was given.

The nurse is gathering data on a child being admitted. Which would be considered collecting subjective data? Select all that apply.

The nurse interviews the child's caregiver. The nurse asks questions about the child's history. The nurse finds out the reason for the child's visit to the health care setting

The nurse is weighing a 20-month-old child who is in the clinic for a well-child visit. Which action by the nurse would be most appropriate for weighing this child?

The nurse should have the child sit on the scale while keeping a hand close to but not touching the child.

The nurse is caring for a preschool aged child following abdominal surgery. Of the following nursing actions, which is the highest priority?

The nurse uses pain assessment tools.

The nurse has brought a 3-year-old's oral medications into the room for administration. Upon approaching the child, the nurse said, "I have your medication. Would you rather have me hand it to you or Mommy?" In critiquing the nurse's actions, which is most accurate?

The nurse's behavior is correct. The nurse provided the child a choice between two acceptable options with the outcome of taking the medication.

A nursing instructor is preparing a discussion which will illustrate the different forms of spina bifida. The instructor determines the session is successful after the students correctly choose which form as being spina bifida with myelomeningocele?

The spinal cord, meninges, and nerve roots protrude out the lower back.

How will the nurse measure urine output in the hospitalized toddler who is partially potty trained?

Weigh the wet pull-up or diaper and subtract the weight of a dry diaper.

In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have:

a partial to complete paralysis in the lower extremities.

The pediatric nurse would use standard precautions in caring for which client on her floor?

an adolescent who has a broken arm

Which assessment is most important for determining an accurate dose of a pediatric medication?

body surface area

The nurse observes a newborn experiencing coughing, choking, and unexplained cyanosis during feeding. These are classic signs of what condition?

esophageal atresia

A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed by which method?

feeling the palate with a gloved finger or using a tongue blade

The nurse is preparing a presentation for a health fair that will illustrate various factors that contribute to preterm births. Which contributing factor should the nurse prioritize?

fertility treatments that are resulting in multiple births

The parent reports that the health care provider said that the infant had a hernia but cannot remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated?

inguinal hernia

The parents of an infant diagnosed with phenylketonuria are not sure they agree with the diagnosis and proposed treatment. The nurse should point out that this condition can result in which additional condition if left untreated?

intellectual disability

What is the most common reason why an infant will be small-for-gestational-age (SGA)?

intrauterine growth restriction

The nurse is working with the mother of a newborn. The mother asks why a baby needs small feedings at frequent intervals. The nurse explains to the mother that this is necessary because in the infant:

the enzymes secreted by the liver and pancreas are reduced.

All of the following are characteristics of a preterm newborn except:

the head is disproportionately small.

The nursing instructor is conducting a discussion centered on the various methods used to describe an infant. The instructor determines the session is successful when the students correctly choose which as an indication of gestational age?

the length of time between fertilization of the egg and birth

The nursing instructor is leading a discussion with a group of nursing students who are analyzing the preterm infant's physiologic immaturity and the associated difficulties the newborn and family must deal with. The instructor determines the session is successful when the students correctly choose which body system that presents with the most critical concerns related to this immaturity?

the respiratory system

The teeth, tongue, gallbladder, appendix, salivary glands, liver, and pancreas are referred to as accessory organs, and the purpose of these is:

to aid in the digestive process and to produce substances that aid in the digestive process.

The nurse is collecting data from the caregivers of a child who is suspected of having a food allergy. Which clinical manifestation would likely have been noted in this child?

urticaria and pruritus

A student nurse is learning about congenital heart defects in newborns and correctly identifies which of the following to be the most common intracardiac defect?

ventricular septal defect

The nurse is performing a cardiac assessment on a newborn and hears a loud, harsh murmur associated with a systolic thrill. What congenital heart defect does the nurse suspect?

ventricular septal defect

The nurse needs to transport her preschool client to radiology for a chest X-Ray. Which transportation device would be most appropriate?

wagon

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?

"It is important to increase the intake of protein for these children."

A school-aged child will have an intravenous line inserted. His mother asks if he could have this placed in his left hand so that he can do homework. What is the nurse's best response?

"Let's take a look at the left hand first."

A 14-year-old boy has come to his primary care physician's office for a routine well-child visit with his parent. Which statement by the parent should the nurse prioritize for further investigation after noting the father has a history of alcohol use disorder?

"Our next door neighbor is older than my son, and he drinks when they hang out together."

A newborn has ambiguous genitalia. The parents are quite emotional and do not know what to do, or if they should raise the child as a boy or girl. What is the best advice for the nurse to offer at this time?

"Research shows that it is best for anatomical structure to determine the sex of rearing."

The school nurse is working with a group of teachers who instruct children who are nutritionally deprived. As the teachers are talking with the nurse they make the following statements. Which statement most indicates a problem related to decreased nutrition?

"Several of the children in my class have such a hard time concentrating."

The nurse is caring for a 7-year-old diagnosed with pinworms. The nurse talks with the child's caregiver about proper treatment and prevention of future infections. Which statement made by the caregiver indicates a need for further teaching?

"Thank goodness my other children and I are not sick too."

Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage?

Apply a sterile dressing moistened in a warm, sterile saline solution.

The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old child with diabetes. What is the best method of medication administration?

Ask the child where the child would like to have the injection.

The pediatric nurse is bringing the prescribed medication for a child but notes that the identification band is missing. The parents are at the bedside holding the child. What is the best method for identifying the child?

Ask the parents to tell you the child's name and date of birth.

For which potential neonatal infection does the nurse anticipate using ophthalmic erythromycin?

Chlamydia trachomatis

What intervention can the nurse provide to reduce pain and stress in the preterm infant?

Create minimal stimulation and reduce procedures that cause pain.

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?

Currant jelly-like

The parent has brought a 2-year-old to the public clinic for immunizations. The nurse documents the following characteristics: A duck waddle gait Shortened extremity Asymmetry of the gluteal folds Protruding abdomen The nurse then refers the toddler to the health care provider for potential diagnosis of which?

Developmental dysplasia of the hip (DDH)

The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which clinical manifestations would the nurse most likely note in this child?

Drowsiness and fruity odor to breath

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child?

Effortless vomiting just after the child has eaten

An 8-month old infant has a colostomy placed following abdominal surgery for removal of a section of bowel. The stoma is 2/3 full, draining liquid stool and the bag appears inflated. What actions would the nurse take in caring for this client? Select all that apply.

Empty the bag and record the output. Examine the skin around the stoma site for redness or irritation. Look at the infant's intake to determine if any foods could be causing gas.

From which pair of metabolic disorders must the nurse instruct the parents to eliminate breast and cow's milk from the diet?

Galactosemia and phenylketonuria

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next?

Give 10 to 15 grams of a simple carbohydrate.

The nurse is giving discharge instructions to a parent of a 3-month-old infant. What is the best information to give the parent concerning oral medication administration?

Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright.

The nurse is caring for a neonate in the newborn nursery with clubfoot (congenital talipes equinovarus). If nonsurgical treatment is chosen, which nursing action is anticipated?

Holding feet/ankles in position for casting

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?

In this disorder the sphincter that leads into the stomach is relaxed.

The nurse has prepared an IM injection to give a 13-year-old child. After some searching, the nurse locates the child in the playroom in front of a video game. Which action is best for the nurse to take?

Inform the child that it is time for an injection. Explain why the injection is needed and have the child move to the treatment room.

The nurse caring for a newborn notes a distended abdomen approximately 24 hours after birth. Which action should the nurse take after review of the medical record reveals an apparent healthy newborn at birth but no documentation of a bowel movement?

Inform the health care provider immediately.

A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which condition?

Kwashiorkor

The nurse has been assigned to care for a child who is on transmission-based precautions. This nurse has not cared for this child before. Which action would be the best way to help the child feel comfortable with the nurse?

Let the child see the nurse's face before the mask is put on.

Which maternal screening during pregnancy indicates the possibility of Down syndrome?

Maternal serum alpha-fetoprotein test

As the nurse prepares to administer a medication to a preschooler, the nurse realizes that the child is extremely underweight for age. What action would the nurse take?

Measure the child's height and weight, and check whether the dose is correct for the child.

The nurse is admitting a newborn into the nursery and notes the newborn was born at 42 weeks' gestation. Which action should the nurse prioritize when caring for this infant?

Monitor the newborn's blood glucose levels.

A nurse is providing postoperative care to an infant who had a ventriculoarterial shunt placed. Approximately 8 hours after surgery, the nurse notes on assessment shrill crying and projective vomiting. Which response should the nurse prioritize at this time?

Notify the primary care provider immediately.

A nursing instructor is leading a group discussion on congenital hydrocephalus. The instructor determines the session is successful after the students correctly choose which factor that determines the noncommunicating type?

Obstruction that keeps CSF from passing between the ventricles and the spinal cord

After cleft palate repair at 18 months, a child will begin a liquid diet. Which method of initiating the diet is best?

Offer the child sips from a small glass.

The nurse is caring for a neonate with epispadias. In which location will the nurse assess the anomaly?

On the dorsal end of the penis

A team of nurses has been chosen to devise a program to help educate children and their families about the hospital and being hospitalized. Which activity should the nurses plan to best achieve this goal?

Plan an open house and invite the families of the community to come tour the hospital.

The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure? Select all that apply.

Pretend to perform the procedure on her doll. Teach her the steps of the procedure. Introduce her to the health care personnel.

The pediatric unit in the hospital is designed to make the child feel comfortable and secure. Which action will best accomplish this goal?

Procedures and treatments are done in a room other than the child's hospital room.

Which environmental consideration is most helpful to promoting comfort when the neonate is withdrawing from alcohol and drugs?

Provide a dark, quiet environment

An order for an intramuscular medication has been ordered for a 4-year-old. The nurse finds the child in the playroom with his caregiver. Which action by the nurse would be the best procedure to follow when administering this medication?

Take him to a separate treatment room to give him his injection. Praise his cooperation even if he cries. Take him back to the playroom. Complete all required documentation.

Which of the following is most correct regarding the gastrointestinal system of the child?

The child cannot break down and use complex carbohydrates in the same way the adult can.

What occurs in the gastrointestinal system of the child with Hirschsprung disease?

There is a partial or complete mechanical obstruction in the intestine.

A newborn is diagnosed with the communicating type of congenital hydrocephalus. Which explanation should the nurse prioritize when preparing a teaching session for the parents?

There is defective absorption of cerebrospinal fluid.

A nurse is providing information for a pregnant woman who has just discovered that the fetus she's carrying is likely to have Down syndrome. Which statement by the nurse is most accurate regarding the possible concerns for a child with Down syndrome?

They have a higher risk of developing leukemia than those in the general population.

In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of:

cerebrospinal fluid.

In caring for a child with lead poisoning, which method of treatment is used to remove the lead from the child's system?

chelating agents

What assessment should the nurse perform daily on an infant suspected of having hydrocephalus?

daily head circumference

In understanding the disease of marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following?

deficiency of protein and calories

Which assessment findings are most prominent in the infant with tetralogy of Fallot and significant pulmonary stenosis?

dyspnea on limited exertion, fatigue, cyanosis

The nurse is preparing to assess an infant who is diagnosed with a ventricular septal defect. Which assessment finding should the nurse be prepared to document?

loud, harsh murmur

In the infant born with a cleft lip and a cleft palate, the highest priority of the nurse is related to which intervention?

maintaining the nutritional needs of the infant

The nurse is preparing a nursing care plan for an infant who was born with spina bifida with myelomeningocele. Which nursing goal should the nurse prioritize for this child?

preventing infection

It would be best to place an infant with a meningomyelocele in which position prior to surgery?

prone

On the first postoperative day, a 4-year-old child who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?

protest

The nurse has administered a medication to a child. When documenting the dosage given, the nurse realizes that an incorrect dose has been administered. The nurse has taken the child's vital signs, and they are within normal range. The child does not appear to be in any distress and is acting normally. Which of the following would be the next action for the nurse to take?

Follow the facility policy regarding medication errors.

A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described?

Vomiting immediately after feeding

The nurse would be concerned about hemolytic disease of the newborn in which case?

a woman who has anti-D antibodies and her newborn is A positive

A nurse is caring for a child born with a tracheoesophageal fistula. Which finding during pregnancy would have caused the nurse to suspect this might be present?

hydramnios

the nurse is admitting to the nursery a newborn of a mother who continued to drink alcohol during her pregnancy. Which finding does the nurse predict to encounter on the newborn's assessment?

hyperactive and irritable

The nurse is preparing to give an oral medication to an 11-year-old client. Which of the following is the best approach for the nurse to take?

Allow independence from the parent in the process of medication administration.

A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states, "What did we do wrong? How will I ever love this child?" What is the priority action by the nurse?

Encourage the parents to express their feelings and emotions openly.

The nurse is monitoring a newborn who exhibited a large head at birth and is exhibiting an increasing head growth on continued assessment. Which additional findings on assessment should lead the nurse to suspect hydrocephalus in this infant?

Eyes appear to be pushed downward.

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply.

Polyuria Polyphagia Polydipsia

A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to facilitate drainage of mucus and secretions to prevent aspiration?

Position the child on the side.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply.

Skim milk Bananas Applesauce

Which congenital condition is an immediate emergency requiring notification of the health care provider?

Tracheoesophageal fistula

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

When examining a newborn for developmental dysplasia of the hip (DDH), which motion would the newborn's hip be unable to accomplish?

abduction

The nurse recognizes that in the disorder referred to as rickets, the child has a lack of vitamin D. Because of the lack of vitamin D, the absorption of which of the following is decreased?

calcium and phosphorus

The site most often used when administering a medication using the intradermal route is the:

forearm

A nursing student is learning about congenital disorders in newborns and correctly associates the causes for central nervous system defects to be which factors? Select all that apply.

imbalanced cerebrospinal fluid malformation of the neural tube during embryonic development

A newborn is diagnosed with congenital hypothyroidism prior to discharge from the hospital. What medication does the nurse anticipate administering to the newborn?

levothyroxine

A nurse notices a child chewing several pieces of something white. The child is also drooling and crying. A container that looks like an empty pill bottle is on the floor. The first action by the nurse would be to:

remove the substance from the child's mouth.

The student nurse is performing a Ballard scale on a newborn. The instructor assesses that the student understands methods to check neuromuscular maturity when she gently pulls the newborn's arm in front of and across the top portion of the body until resistance is met and identifies this action as:

scarf sign

Which technique should the nurse use to administer ear drops to a 18-month-old child?

Lift the pinna of the ear down and back.

The nursing instructor is teaching a session on techniques that the nursing students can use to properly address concerns of parents with children who are born with a cleft lip and palate. The instructor determines the session is successful when the students correctly choose which nursing intervention as being the most effective in these situations?

Use reflective listening with nonjudgmental support.

The nurse at a pediatric clinic is preparing a 5-year-old child for admission to the hospital for surgery. Which response should the nurse prioritize when asked by the child what happens at the hospital?

Some people go here to have babies, or when they're sick or hurt, so they can try to get better."

When preparing to apply a restraint to a child, what would be most important for the nurse to do?

Explain that safety, not punishment, is the reason for the restraint.

An 8-month-old infant in being held by her mother and the nurse needs to obtain the infant's vital signs. Which approach would most likely ensure accurate readings?

Allow the mother to continue to hold the infant, listen to the child's heart rate, count respirations by the abdominal rise, then take an axillary temperature.

The nurse is assessing the neonate shown. From the assessment, the nurse notes that there is paralysis of the lower extremities. For which condition does the nurse anticipate performing care?

Spina bifida with myelomeningocele

The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which statement indicates a need for further teaching?

"I can pinch her nose to make it easier to swallow."

A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?

"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."

The nurse is preparing to give a 4-month-old an oral medication. Which technique demonstrates the nurse's accurate knowledge of the infant's developmental level?

Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again.

A preschool teacher calls the hospital and wants to introduce the concept of a hospital to her preschool class in case they ever get sick and need to be admitted. What resources could the child life specialist provide for this group to aid in their learning? Select all that apply

Provide a room for the class with hospital gowns, masks and equipment used on children. Tour the hospital, including the playrooms on the pediatric floors. Let the children lie in the beds, use the call lights and practice being a patient.

The client brings her infant daughter to the pediatrician's office for her first visit since hospital discharge. At birth, the newborn was at the 8th percentile with a weight of 2,350 g. She was born at 36 weeks' gestation. Which documentation is most accurate?

The infant was a preterm, low-birth-weight and small-for-gestational-age neonate.

The community health nurse is preparing a presentation which will illustrate the various forms of spina bifida for a health fair. Which explanation should the nurse use to explain spina bifida with meningocele?

The spinal meninges protrude through the bony defect and form a cystic sac.


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