Peds 3
A nurse reviews the preoperative instructions for a 3½-year-old child who is to undergo follow-up cleft palate surgery. Which instruction should the nurse question? 1 "Tapwater enema until clear this pm." 2 "Start IV of D5% 0.45% NS at 6 am." 3 "Nothing by mouth after 12 midnight." 4 "Draw blood for HgB and Hct this pm."
1 "tap water enema until clear this pm."
A 4-year-old child with nephrotic syndrome has repeated relapses. As the child gets older, what is the most important attribute for the child to develop? 1 A positive body image 2 The ability to test urine 3 Fine muscle coordination 4 Acceptance of possible sterility
1 a positive body image
A nurse is teaching the parents of a 3-year-old child with a diagnosis of cystic fibrosis about their child's special needs. What statement indicates that the parents need further teaching about the issues related to cystic fibrosis? 1 "We'll have to air-condition the whole house." 2 "We'll have to move to a very warm climate." 3 "Our child will be taking pancreatic enzymes with meals." 4 "Our child will need skin care after each bowel movement."
2 "we'll have to move to a very warm climate."
The nurse discusses discipline with parents of a 4-year-old child. Which parental statement regarding time-out reflects an appropriate application of this method of discipline? 1 "I send her to her room for misbehaving." 2 "We limit time-out to 20 minutes per incident." 3 "Putting him in a dark closet for time-out is very effective." 4 "I explain the reason for the time-out before and after disciplining him."
4 "explain the reason for the time out before and after disciplining him."
Which belief should a nurse expect a preschooler to hold regarding the concept of death? 1 A temporary condition 2 Results from certain illnesses 3 Something that happens in the hospital 4 An event that eventually happens to everyone
1 a temporary condition
A preschooler is to have a peripheral intravenous catheter inserted. How can the nurse make the experience minimally traumatic for the child? 1 By applying an epidermal analgesic before the procedure 2 By telling the child that the procedure will not cause pain 3 By having the parents leave the room during the procedure 4 By describing the procedure several hours before the catheter is inserted
1 by applying an epidermal analgesic before the procedure
When a nurse brings a dinner tray to a 4-year-old child hospitalized with pneumonia, the child says, "I'm too sick to feed myself." What is the best response by the nurse? 1 "Try to eat as much as you can." 2 "You can eat later when you feel better." 3 "Wait a few minutes, and I will be back to help you." 4 "You're really not that sick, and I'm sure you can feed yourself."
3 "wait a few minutes, and I will be back to help you."
A nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. What clinical findings does the nurse anticipate when caring for the child? (Select all that apply.) 1 Pallor 2 Fatigue 3 Jaundice 4 Multiple bruises 5 Generalized edema
1 pallor, 2 fatigue, 4 multiple bruises
What concept of death should a nurse expect a 4-year-old child to have? 1 Cessation of life 2 Reversible separation 3 Only affects old people 4 Force takes one away from family
2 reversible separation
Which skill, if it cannot be performed by a 3-year-old child, should alert the nurse that the child may be developmentally delayed? 1 Catching a ball 2 Copying a square 3 Balancing on one foot 4 Using a spoon effectively
4 using a spoon effectively
Which statement is accurate regarding the typical growth and development of preschoolers? 1 Preschoolers need more time for toilet training. 2 Preschoolers believe they are the center of the world. 3 Preschoolers are able to distinguish reality from fantasy. 4 Preschoolers are able to identify and anticipate dangers around them.
2 preschoolers believe they are the center of the world
A 4-year-old child who has never been separated from parents or siblings is admitted to the hospital. What is most important for the nurse to encourage the parents to do? 1 Have one of them stay with the child 2 Visit the child during regular visiting hours 3 Bring a favorite toy to the hospital for the child 4 Allow the nurse to be the child's major caregiver
1 have one of them stay with the child
A parent of three young children has contracted tuberculosis. Which should the nurse expect the health care provider to prescribe for members of the family who have a positive reaction to the tuberculin skin test and are candidates for treatment? 1 Isoniazid 2 Multiple-puncture test 3 Bacille Calmette-Guèrin 4 Purified protein derivative
1 isoniazid
A 4-year-old child is admitted to the pediatric unit for a tonsillectomy. During preoperative planning a nurse reviews the child's laboratory report. Which lab value is of most significance in this situation? 1 Potassium level 2 Coagulation studies 3 Red blood cell (RBC) count 4 Erythrocyte sedimentation rate (ESR)
2 coagulation studies
A nurse is caring for a preschooler who is being prepared for surgery. What does the nurse expect to have the most influence on the child's response to hospitalization? 1 Fear of separation 2 Fear of bodily harm 3 Belief in death's finality 4 Belief in the supernatural
2 fear of bodily harm
A nurse accompanies a 3-year-old child to the pediatric unit's playroom. The toddler seems reluctant to select a toy or activity. Which toy is most appropriate for the nurse to offer as a means of fostering creativity? 1 Plastic animal 2 Molding clay 3 Pencil and paper 4 Simple video game
2 molding clay
What should the nurse do to meet the emotional needs of a 4-year-old child who is receiving daily injections? 1 Allow the child to play with a needle and syringe and encourage acting out 2 Provide the child with a doll and related equipment, and observe what happens 3 Encourage the child to draw pictures about what is happening and associated feelings 4 Explain the procedure to the child in simple terms and allow an hour before an injection is scheduled
2 provide the child with a doll and related equipment, and observe what happens
A 3½-year-old boy from Central America who has tetralogy of Fallot attends the pediatric cardiac clinic for a diagnostic workup before corrective surgery is scheduled. The nurse's evaluation of the child's motor ability demonstrates that he is just beginning to walk unsupported. When comparing this child with other 3½-year-old children, the nurse determines that the child: 1 Has started to walk at the appropriate age 2 Should have started to walk about 2 years earlier 3 Demonstrates an insignificant delay in starting to walk 4 Probably walked by holding on at 24 to 30 months of age
2 should have started to walk about 2 years earlier
A preschool child is found to have chickenpox during the acute phase. The nurse tells the parents, "It's important not to expose your child to anyone undergoing certain types of prolonged medication therapy." What medication therapy puts a person at risk? 1 Anticonvulsant 2 Systemic steroid 3 Antihypertensive 4 Topical antibiotic
2 systemic steroid
A nurse in the child life center encourages preschool children to engage in role play. Why does the nurse consider this an important part of socialization? 1 It helps children think about careers. 2 It teaches children about stereotypes. 3 It encourages expression of concerns. 4 It provides guidelines for adult behavior.
3 it encourahes expression of concerns.
A health care provider writes prescriptions for a young child with a tentative diagnosis of Wilms tumor. Which prescription should the nurse question? 1 MRI 2 CT scan 3 Renal biopsy 4 Abdominal ultrasound
3 renal biopsy
With which roommate should the nurse place a 4-year-old boy who has been admitted to the hospital with nephrotic syndrome? 1 A 2-year-old boy with croup 2 A 3-year-old boy with impetigo 3 A 4-year-old girl with conjunctivitis 4 A 5-year-old girl with acute glomerulonephritis
4 a 5 year old girl with acute glomerulonephritis
The parents of a 4-year-old child call the health center and report that their child has a fever of 102.6° F (39.2° C), is complaining of a sore throat, and will not lie down, preferring to sit up and lean forward. The child is drooling and looks ill and agitated. In light of this information, what guidance should the nurse provide the family? 1 The child needs to be seen immediately by a health care provider. 2 The parents should provide cool mist and continue to give fluids to the child. 3 The child should receive ibuprofen in an appropriate dose to decrease the fever. 4 The parents should call back in several hours and update the health center on the child's condition.
1 the child needs to be seen immediately by a health care provider.
To confirm a tentative diagnosis of leukemia a bone marrow aspiration and biopsy are to be performed on a 4-year-old boy. The nurse gives an age-appropriate explanation of the procedure to the child. What else is involved in caring for this child? 1 Telling the child that there will be pressure without pain 2 Explaining to the child that he will sleep during the procedure 3 Placing the child in the semi-Fowler position supported by pillows 4 Asking the child to hold some nonsterile equipment during the test
2 explaining to the child that he will sleep during the procedure
A 4-year-old child begins screaming and kicking when the laboratory technician arrives to draw blood. What does the nurse identify as the most likely cause of the child's behavior? 1 Inability to localize pain 2 Fear of intrusive procedures 3 Anger caused by loss of control 4 Past experience with other procedures
2 fear of intrusive procedures
A 3-year-old child is seen in the emergency department after a fall off a swing, and a possible concussion is diagnosed. When using the Glasgow Coma Scale, the nurse should remember that most children 3 years of age: 1 Can state their name and address 2 May not respond to strangers asking questions 3 Will be able to clearly state the time and place 4 Should be assessed without their parents present
2 may not respond to strangers asking questions
A 3-year-old child is to receive a liquid iron preparation. What should the nurse teach the mother regarding this medication? 1 Monitor the stools for diarrhea. 2 Administer the iron at least an hour before meals. 3 Avoid giving the child orange juice with the iron preparation. 4 Have the child drink the diluted iron preparation through a straw.
4 have the child drink the diluted iron preparation through a straw
A nurse is preparing an intramuscular injection to be administered to a 2-year-old child. What approach is the most therapeutic? 1 "This might hurt, but it's important that you be very still." 2 "You're afraid of getting a shot because you think it will hurt." 3 "Don't worry—Daddy and Mommy will be back after it's over." 4 "Act like a big child and we can get this done as quickly as possible."
1 "this might hurt, but it's important that you be very still."
A 4½-year-old child is brought to the emergency department with a fractured tibia. Which type of fracture is most common in children of this age? 1 Greenstick 2 Transverse 3 Compound 4 Comminuted
1 green stick
A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102° F (38.8° C), is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect? 1 Measles 2 Chickenpox 3 Fifth disease 4 Scarlet fever
1 measles
A nurse is planning to give a preschool child an immunization consisting of bacterial cells that have been modified. What is the substance called? 1 A toxoid 2 A vaccine 3 An allergen 4 An antitoxin
2 a vaccine
A 4-year-old child is admitted to the pediatric unit with a tentative diagnosis of acute lymphocytic leukemia (ALL). The mother states that changes in her child's behavior and the "black and blue" marks were noticed several days ago. She blames herself for not bringing her child to the clinic sooner. On what information about the pathophysiology of leukemia should the nurse base a response? 1 The diagnosis can be certain only after a blood smear is analyzed. 2 If leukemia is diagnosed, the child's prognosis is probably guarded. 3 Early signs and symptoms of leukemia are similar to those of other mild illnesses of childhood. 4 The description of the clinical findings indicates that the child has been ill for longer than a single week.
3 early signs and symptoms of leukemia are similar to those of other mild illnesses of childhood.
A preschool-age boy has been restricted to bedrest since being admitted to the hospital. As he begins to recover, he becomes interested in playing. In light of his developmental level and activity restriction, what should the nurse provide for him? 1 Television viewing time 2 Squeaky stuffed animals 3 Little cars and a shoebox garage 4 Simple three- or four-piece wooden puzzles
3 little cars and a shoebox garage
A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. What is the priority nursing intervention? 1 Having the child rest as much as possible 2 Checking the child's eosinophil count daily 3 Preventing exposure of the child to infection 4 Offering nothing by mouth to the child except oral medications
3 preventing exposure of the child to infection
What is the average duration of sleep per night for a preschooler? 1 7 hours 2 9 hours 3 12 hours 4 15 hours
3: 12 hours
A 4-year-old boy with Reye syndrome is beginning to show signs of recovery. The intracranial pressure has receded, the vital signs are stable, the fever has subsided, and urine output is within the acceptable range for the child's weight and fluid intake. What should the nurse tell the parents about their son's recovery? 1 "The illness has resolved." 2 "Your son is out of danger now." 3 "Your son seems free of complications." 4 "The recovery is now progressing as we'd hoped."
4 "the recovery is now progressing as we'd hoped."
A 3-year-old child is hospitalized with nephrotic syndrome. The child has oliguria and generalized edema. What factor does the nurse identify that will have the greatest effect on the child's adjustment to hospitalization? 1 Lack of parental visits 2 Inability to select a variety of foods 3 Response of peers to the edematous appearance 4 Willingness to participate in cooperative play activities
1 lack of parental visits
When planning discharge teaching for the parents of a child with asthma, what information should be included? 1 Avoid foods high in fat. 2 Stay at home for 2 weeks. 3 Increase protein and calorie intake. 4 Minimize exertion and exposure to cold.
4 minimize exertion and exposure to cold
The health care provider prescribes mebendazole (Vermox) for a 4-year-old child with pinworms. For which expected response to the medication does the nurse teach the parents to be alert? 1 Blood 2 Constipation 3 Yellow stools 4 Passage of worms
4 passage of worms
A 3-year-old child with the diagnosis of tetralogy of Fallot is brought to the United States by a charitable organization for cardiac surgery. What should the nurse expect to observe when caring for the child? 1 Clubbing of fingers 2 Increased temperature 3 Slow, irregular respirations 4 Subcutaneous hemorrhages
1 clubbing of fingers
The mother of a preschool-age child tells the nurse that her husband is dying of cancer and that she is worried about how her child will cope. As part of their discussion, the nurse includes that preschool-age children view death as: 1 Universal 2 Irreversible 3 A form of sleep 4 A frightening ghost
3 a form of sleep
An IV catheter is to be inserted into a 3-year-old toddler's peripheral vein. As local topical anesthetic is applied, the toddler starts to cry and asks whether the insertion is going to hurt. How should the nurse respond? 1 "Yes, it may hurt, but not for very long." 2 "Maybe it will hurt, but remember that big kids don't cry." 3 "Yes, it may hurt, but if you hold still it won't hurt too much." 4 "It will hurt a little, but I'm good at getting the needle into your arm."
1 "yes, it may hurt, but not for very long."
A young child with acute nonlymphoid leukemia is admitted to the pediatric unit with a fever and neutropenia. What are the most appropriate nursing interventions to minimize the complications associated with neutropenia? 1 Placing the child in a private room, restricting ill visitors, and using strict handwashing techniques 2 Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion 3 Avoiding rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture 4 Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes
1 placing the child in a private room, restricting ill visitors, and using strict hand washing techniques
A 4-year-old child is brought to the emergency department after falling on the handlebars of a tricycle. The child is guarding the abdomen, crying, and not allowing any physical contact with the staff. What is the best action by the nurse? 1 Medicating the child for pain before proceeding 2 Allowing the child to guide the examiner's hand to the area that hurts 3 Having the parents restrain the child while the abdomen is auscultated 4 Suggesting that the health care provider prescribe computed tomography of the child's abdomen
2 allowing the child to guide the examiners hand to the area that hurts
A nurse who volunteers in a daycare for preschoolers has been asked to give a presentation to parents about health promotion. Which topics should the nurse include? 1 Nutrition and bullying 2 Injury prevention and dental health 3 Organized sports and immunizations 4 Toilet-training and attention deficit disorder
2 injury prevention and dental health
A 3½ -year-old child has been ill with nephrotic syndrome. The child has been toilet-trained for longer than a year but has been incontinent lately. The child's parents express concern over this behavior. What is the most therapeutic response by the nurse to the parents? 1 "Your child is wetting the bed to get attention. Set limits when this occurs." 2 "The incontinence is caused by the renal disease. It'll stop with physical improvement." 3 "This is an expected response to hospitalization. Ignore the regressive behavior and be supportive." 4 "Your child is using this regressive behavior to help cope with hospitalization; just use diapers and say nothing."
3 "this is an expected response to hospitalization. Ignore the regressive behavior and be supportive."
Parents express concerns to the nurse that their 4-year-old child is spending a large amount of time playing with an imaginary friend. What is the best response by the nurse? 1 "Perhaps your child needs more interaction with friends." 2 "You have good reason to be concerned. This is not typical." 3 "Imaginary playmates are an important part of a young child's life." 4 "This is a sign of social immaturity. I recommend psychological counseling."
3 "imaginary playmates are an important part of a young child's life."
A preschool child is found to have atopic dermatitis. The nurse emphasizes that the child should be discouraged from scratching. The child's mother asks why scratching should be prevented. The nurse responds: 1 "Scratching causes lesions to become more contagious." 2 "Scratching spreads dermatitis to other areas of the body." 3 "Scratching results in skin breaks that can lead to infection." 4 "Scratching produces changes that are precursors to skin cancer."
3 "scratching results in skin breaks that can lead to infection."
The nurse finds a 4½ -year-old hospitalized girl, who has several siblings, crying and shouting at her teddy bear, "There! You bad girl! Don't be mad at your brother! Go to the hospital!" An understanding of preschooler development leads the nurse to believe that this behavior is based on the fact that the child: 1 Believes the parents love the brother more 2 Is angry at the brother and wishes that he were sick 3 Is missing the brother and wishes that they could be together 4 Thinks that being sick is related to bad thoughts about the brother
4 thinks that being sick is related to bad thoughts about the brother
How should parents practice "time-out" with preschoolers? 1 By instructing the child to take a nap 2 By asking the child to study for an hour 3 By allowing the child to watch television 4 By encouraging quiet time alone without toys
4 by encouraging quiet time alone without toys
A preschool child with a spinal cord injury will be on prolonged bedrest. The nurse explains to the parents that certain foods will be restricted to prevent complications associated with immobility. What food should be noted as restricted in the teaching plan? 1 Fish 2 Fruit 3 Beef 4 Cheese
4 cheese
A 4-year-old child is admitted to the pediatric unit with a diagnosis of Wilms tumor. Considering the unique needs of a child with this diagnosis, the nurse should place a sign on the child's bed that states: 1 Keep NPO 2 No IV medications 3 Record intake and output 4 Do not palpate the abdomen
4 do not palpate the abdomen
After several days of bedrest, a preschool-age boy with the diagnosis of a liver laceration becomes demanding and will not listen to the nurses. The child was found in the playroom twice on the previous shift. How can the nurse best meet the needs of this child? 1 Tell the child why remaining in bed will enhance his recovery 2 Have a television set moved into the child's room as soon as possible 3 Place soft restraints on the child when family members cannot be present 4 Move the child into a room with another preschooler with whom he can play
4 move the child into a room with another preschooler with whom he can play
During a clinic visit a 4-year-old girl suddenly yells, "Don't sit on Erin!" The parent whispers that Erin is an imaginary friend. What is the nurse's best action? 1 Referring the parents to classes on parenting 2 Providing special instructions for appropriate discipline 3 Avoiding sitting where the child says her imaginary friend is located 4 Making a referral to a child psychologist regarding the imaginary friend
3 avoiding sitting where the child says her imaginary friend is located
The parents of a 4½-year-old child are concerned about the effects of hospitalization on the child. Which behavior should the nurse expect the child to exhibit? 1 Refusing to cooperate with the nurses when the parents are absent 2 Demonstrating despair if the parents do not visit at least once a day 3 Crying when the parents leave and return but not during their absence 4 Being unable to relate to children in the playroom if other parents are present
3 crying when the parents leave and return but not during their absence
A 3-year-old child with sickle cell anemia is admitted to the child health unit during a painful episode. Splenomegaly is identified. The nurse explains to the parents that splenomegaly is: 1 Common in infancy 2 Difficult to palpate in children 3 Triggered by a vaso-occlusive crisis 4 Most common during late childhood
3 triggered by a vaso occlusive crisis
A preschooler who is allergic to environmental pollutants is to be given a hyposensitization injection. What clinical finding prompts the nurse to withhold the injection? 1 Serous otitis media 2 Allergic conjunctivitis 3 Wheezing and dyspnea 4 Rash on the face and neck
3 wheezing and dyspnea
A 4-year-old child with newly diagnosed leukemia is admitted for chemotherapy. While assisting with morning care the nurse observes bloody expectorant after the child has brushed the teeth. How should the nurse respond to this occurrence? 1 By securing a smaller toothbrush for the child to use 2 By documenting the incident without alarming the child 3 By telling the child to be more careful when brushing the teeth 4 By rinsing the child's mouth with half-strength hydrogen peroxide
2 by documenting the incident without alarming the child.
What age-related fear should the nurse expect when preparing a 4-year-old child for surgery? 1 Adult strangers 2 Intrusive procedures 3 Disruption of routines 4 Separation from parents
2 intrusive procedures
On return to the pediatric unit after a tonsillectomy, a nurse notes that a 4-year-old child is swallowing frequently. What is the probable cause of this response? 1 Pharyngeal edema 2 Postoperative bleeding 3 Tenacious oral secretions 4 Increased saliva production
2 postoperative bleeding
A nurse is caring for a 4-year-old child who is terminally ill. The 4-year-old child's concept of death is based on a sense of causality. In what stage of Piaget's cognitive development is this child? 1 Formal operations 2 Preoperational thought 3 Sensorimotor operations 4 Concrete operational thought
2 preoperational thought
A nurse is planning to foster independence in a group of 4-year-old children. What self-care skill does the nurse expect 4-year-olds to be capable of performing? 1 Parting and combing hair 2 Putting on a shirt and buttoning it 3 Cutting meat with a fork and knife 4 Slipping into shoes and tying shoelaces
2 putting on a shirt and buttoning it
