peds

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 teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which parent statement signifies successful child teaching?

'I will begin using the technique before he experiences pain.'

A mother confides to the nurse that she is thinking of divorce. Which suggestion by the nurse would help minimize the effects on the child?

"Tell the child together using appropriate terms."

After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching?

"When my 3-year-old asks 'why?' all the time, this is completely normal."

The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which comment provides the most compelling reason to get the vaccination?

"young children are especially susceptible to these bacteria"

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 assesses a child's level of consciousness, noting that the child falls asleep unless he is stimulated. The nurse documents this finding as:

Obtunded

When the nurse is assessing a child's pain, which is most important?

Using the same tool to assess the child's pain each time

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother?

"Have you spoken with your pediatrician about your observations?"

A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement?

"He will need more surgeries to replace the shunt as he grows."

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."

IIn addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are:

Suicide, homicide

A group of nursing students are reviewing information related to seizures that occur in infants and children. The students demonstrate a need for additional review when they identify which type as common in neonates?

Myoclonic

A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority?

Protecting the child from harm during the seizure

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 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child?

Provide age-appropriate toys and games.

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 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 developing a nursing care plan for a hospitalized 6-year-old. Which behavior would warrant nursing intervention?

The child does not want to play games with other children on the hospital ward.

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 knows that the school-age child is in Erikson's stage of industry versus inferiority. Which best examplifies a school-ager working toward accomplishing this developmental task?

The child signs up for after-school activities.

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 is caring for infants having the condition failure to thrive (FTT). Which infants would be at risk for this condition? Select all that apply.

-A newborn baby with tetralogy of Fallot -An infant with a cleft palate -An infant born to an impoverished mother -An infant with bronchopulmonary dysplasia

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 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

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

For which child would nonopioid analgesics be recommended?

A child with end-stage cancer

The nurse is administering pain medication for a child with continuous pain from internal injuries. Which method would be ordered to dispense the medication?

Administer the medication around the clock at timed intervals.

The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which characteristic regarding adult learning should the nurse incorporate into her plan?

Adults are problem focused.

After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?

After the lesions have crusted

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 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

As a result of seizure activity, a computed tomography (CT) scan was performed and showed that an 18-month-old child has intracranial arteriovenous malformation. When developing the child's plan of care, what would the nurse expect to implement actions to prevent?

Hemorrhagic stroke

Johnny a 5 year old is in your clinic for initial well check. You note he has not received any immunizations. Which of the following is not necessary at this age?

Hib

The nurse is caring for a neonate who is suspected of having sepsis. Which assessment findings would the nurse interpret as most indicative of sepsis?

Hypothermia

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.

Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug, causing most of the adverse effects?

Central nervous system

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.

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 leading cause of death in infants younger than 1 year is/ are:

Congenital anomalies. 180.

The nurse caring for young children in a hospice setting is aware of the following statistics related to the occurrence of death in children. Which statement accurately reflects one of these statistics?

Congenital defects and traumatic injuries are the more common causes of diseases leading to death.

The nurse is providing home care for a 1-year-old girl who is technologically dependent. Which intervention will best support the family process?

Creating schedules for therapies and interventions

Based on Erikson's developmental theory, what is the major developmental task of the adolescent?

Finding an identity

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.

The nurse is conducting an assessment of a high school track athlete. The client tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain?

Deep somatic

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 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 nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance?

Discouraging the addition of fruit juice to the diet

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 developing a teaching plan for the mother of a 4-year-old girl with cold and fever. What would the nurse include in this teaching plan?

Ensuring fluid intake to prevent dehydration

The most consistent indicator of pain in infants is:

Facial expression of discomfort.

A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion?

Febrile seizures are benign in nature.

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 caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding?

Indications of increased intracranial pressure

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

When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of what condition?

Intracranial hemorrhage

The nurse has applied EMLA cream as ordered. How does the nurse assess that the cream has achieved its purpose?

Lightly tap the area where the cream is.

Hydrocephalus is suspected in a 4-month-old infant. Which would the nurse expect to assess?

Lower extremity spasticity

A group of nursing students are reviewing the six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection to the susceptible host?

Maintaining skin integrity

The nurse determines that it is necessary to implement airborne precautions for children with which infection?

Measles

The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents?

Monitor their child's level of sedation.

The leading cause of death from unintentional injuries in children is:

Motor vehicle-related fatalities.

The 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 conducting a pain assessment of a 10-year-old boy who has been taking acetaminophen for chronic knee pain. The assessment indicates that the recommended dose is no longer providing adequate relief. What is the appropriate nursing action?

Obtain an order for a different medication.

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 nurse is using verbal skills to explain the nursing care plan to parents of a 10-year-old child with cancer. What describes a guideline the nurse should follow to provide appropriate verbal communication?

Paraphrase the child's or parent's feelings to demonstrate empathy.

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

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

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease?

Playing in the woods about a week ago

A mother and her 4-week-old infant have arrived for a health maintenance visit. Which activity will the nurse perform?

Plot the child's head circumference on a growth chart

What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure?

Projectile vomiting

The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse?

Riley Infant Pain Scale

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

A group of nursing students are reviewing information about childhood infectious diseases. The students demonstrate understanding of this information when they identify which disease as a common childhood exanthema?

Rubella

The nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. What advice might be helpful for these parents?

School-age children can think critically to interpret messages seen in advertising, media, and sports.

The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition?

Support for maintaining self-esteem because of his altered lifestyle

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

When describing organ donation to the family of a dying child, what would the nurse include in the discussion?

Tell them that their cultural and religious beliefs will be considered

The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child?

The newborn does not respond to a loud noise.

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 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.

An important consideration when using the FACES Pain Rating Scale with children is:

The scale can be used with most children as yourng as 3 years of age.

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 interviewing a 3-year-old girl who tells the nurse: 'Want go potty.' The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern?

This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech.'

During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve?

Trigeminal

The nurse teaching safety to teens knows that which of these is the leading cause of death among adolescents?

Unintentional injuries

The major cause of death for children older than 1 year is:

Unintentional injuries.

When the nurse is assessing a child's pain, which is most important

Using the same tool to assess the child's pain each time

A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions?

Wake him every 2 hours to check his movement and responses."

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."

After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time?

When the child is 4 to 6 years of age

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.'

infant 80 -150 toddler 70 - 120 preschool 65 - 110 school-age child 60 to 100 bpm.

infant 80 -150 toddler 70 - 120 preschool 65 - 110 school-age child 60 to 100 bpm.

The nurse uses the FLACC behavioral scale to assess a 6-year-old's level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing:

severe pain.