PEDS book chapter practice questions
A sleeping 5 month old is sleeping in the arms of her mother when the nurse comes in to do a physical examination. What assessment should be done initially?
counting the HR
during a well-child visist, the nurse observes the child saying no to her mother quite frequently. The mother asks the nurse " how do I deal with her saying no all the time?" What would be appropraite for the nurse to suggest?
-limit the number of questions you ask her -offer her two options from which to choose -make a statement instead of asking a question
sources of lead poisoning
-older toys that are newly painted -lead pipes into drinking water at schools and public facilites -soil -earthenware pottery
celiac disease
-this is an immunological disorder in which gluten damages the villi in the small intestine and affects reabsorption of nutrients -gluten damages the small intestine, therefore they cannot have common grains such as wheat, rye, and oats
A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent?
"Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily."
The nurse is providing family education about the administration of cyclosporine A. Which response by the family indicates a need for further teaching?
"The medication is best absorbed with the vitamin C in citrus juices."
The mother of a 3 month old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse?
"The tongue extrusion reflex disappears at 4-6 months, making it a good time to start solid foods"
A 7-year-old client has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when she first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be the best response by the nurse?
"This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome.
The nurse is providing anticipatory guidance to the mother of a 6 month old infant. What is the best instruction by the nurse in relation to the infant's oral health?
"clean your baby's gums, then new teeth, with a washcloth"
The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is:
"consistently meeting the infant's needs establishes a sense of trust"
The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority?
risk for injury
a child's height is 41 inches. convert the height to centimeters
104.14 cm
A child's weight is 35 pounds 7 ounces. Convert the weight to kilograms
16.074 kg
A chiis scheduled for bone marrow asipration at 4 pm. The nurse would apply EMLA cream to the intended site at which time?
1:30 pm. this is a cream for bone marrow aspiration, which is considered a deep procedure and the nurse should apply this cream 2 to 3 hours before the time of the procedure.
positional plagiocephaly
flattening of one side of an infant's head from prolonged lying in one position; child will wear a molded helmet for 23 hr a day
The nurse documents that a newborn is postterm based on the understanding that he was born after
42 weeks
The meningococcal vaccine should be offered to high-risk populations. If never vaccinated, who would be at risk?
8-year-old student who is preparing for college in the fall and has signed up to live in a dormitory with two other suite mates 12-year-old child with asthma 5-year-old child who routinely travels in the summer with her parents on mission trips to Haiti 9-year-old child who was diagnosed with diabetes when he was 7 years old
Which of the following are reasons that stealing occurs in school aged children? A. to escape punishment B. high self-esteem C. low expectations of family/ peers D. lack of sense of property E. strong desire to own something
A D E
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 assessing the sleepiness of the parents of a 4 month old infant who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?
they put her to bed when she falls asleep
colostomy instructions
Appliances and pouches can be left in place for 4 days as long as the appliance is intact; changing more frequently can lead to skin impairement. Regular soap, not antimicrobials and water is all that is needed to clean around the stoma site. Antimicrobial and perfumed soaps may be irritating to the skin. An ascending colostomy will produce unformed, thick liquid stools so emptying the pouch more frequently will be necessary. A pale stoma indicates poor perfusion, this should be reported to the physician
The nurse is preparing a 5 year old boy for surgery on his lower leg. His mother is elping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action?
Allow the boy to keep his underwear on
A 3 year old is hospitalized unexpectedly and is frightened about the experience. what action could the nurse take to minimize anxiety the child is experiencing?
Allow the child to handle the equipment before it is used on the child
The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?
Allow the child to touch and play with the nebulizer for a few minutes before the treatment
The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment?
Assess circulation and perfusion
a 5 year old child is not gaining weight appropriately. Organic problems have been rules out. What is the priority action by the nurse?
Assess the child's usual intake pattern at home
The nurse is caring for an 18 month old child. The nurse is aware that the child is in which stage according to Erickson?
Autonomy versus shame and doubt; this is the time when toddlers want to be independent
The mother of two sons, aged 6 and 9, states that they want to play on the same baseball team. As the school nurse, what advice would you give their mother?
B. levels of coordination and concentration differ, so the boys need to be on different teams.
which activities will promote weight loss in an obese school aged child?
B. role modeling by family C. becoming active in sports E. involving child in meal planning and grocery shopping
The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate?
Both your son's height and rate of growth are within normal limits for his age." Explanation: The average 4-year-old child is 40.5 in (103 cm). The average rate of growth per year is between 2.5 and 3 in (6.35 and 7.62 cm). The child in the scenario demonstrates normal stature and growth patterns.
a 9 month cold infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response?
Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.
As the school nurse is conducting screening for vision in a 6 year old child, you would refer the child to a specialist if the visual acuity in both eyes is
D. 20/50
The nurse is preparing to assess the pain of a 3 year old child who has surgery the day before. Which pain assessment method would be most appropriate for the nurse to use?
FACES pain rating scale, observation of the child, and parent report
The nurse is caring for a 12 year old cerebral palsy who is unable to communicate verbally. Which pain assessment tool is the most appropraite for the nurse to use when assessing pain in this client?
FLACC; if the child has cognitive defecits, use tools for pain assessments that are appropriate for developmental level. DO not use chronological age as a basis for pain assessment. When the child is unable cognitively to communicate pain, assessment methods used for infants may be employed, such as a flacc scale.
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?
I am so glad I can get rid of all those bath toys because they take up so much room.
which statement by a parent would best prepare the toddler for the parent's return if the parent leaves the hospital?
I will be back after you eat your dinner and spongebob goes off
The primary health care proider prescibes ketoconalzole for the child with a ringworm . Which statement by the parent indicates the nurse needs to provide additional teaching on the prescipriton
I will wrap the skin tighly after applying the medicaiton
What is kawasaki's disease
Kawasaki disease is an acute systemic vasculitis. It is the most common form of acquired heart disease in children. The treatment is directed to reduce the inflammation in the walls of the coronary arteries and prevent thrombosis. Children are given high-dose aspirin therapy four times a day and they receive an infusion of IV immunoglobulins (IVIG) to prevent cardiac complications. Joint pain is common but not necessarily a permanent problem associated with Kawasaki disease. Antibiotics and steroid creams are not used to treat this disorder
A child has been admitted to the acute care facility for the management of dehydration. The nurse is preparing to administer intravenous fluid replacement to the child. Which fluids are suitable for use?
LR normal saline the fluids must be isotonic
The nurse is administering an oral liquid medication to a 5 year old child. What would be the most appropriate for the nurse to do when administering this medication
Let the child hold the medication cup
A 3 day old infant presenting with physiologic jaundice is hospitalized and placed under phototherapy. Which response indicates to the nurse that the parent needs more teaching?
My infant has serious liver disease
The nurse is evaluating the effectiveness of nutrition counseling for new mothers. Which comments by the mothers indicate the need for more instruction?
No-spill sippy cups are a good wa to limit the amount of juice that comes into contact with the baby's teeth it is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better
The mother of a 4 year old asks for advice on using the time out discipline with her child. What advice should the nurse give the mother?
Place the child in time out for 4 minutes
tetralogy of fallot
Pulmonary stenosis, ventricular septal defect, overriding aorta, hypertrophy of right ventricle
Which assessment finding is considered normal in children?
Split S2 and sinus arrhythmia; infants and young children often display a split S2 heart sound and it is very common for children to have increased HR
A 4 year old child is drawing with crayons. Which creation by the child would most be reflective of the anticipated skill level of this age?
The child is able to draw shapes such as circles and sqaures
The nurse is educating an 8 year old client newly diagnosed with diabetes melitus on how to administer insulin. Which finding indicates the nurse's edcation was successful?
The client demonstrates good technique of self-injection
A nurse explains to the family of an infant with an inguinal hernia that the surgeon will attempt manual reduction prior to the surgical repair. Which statement describes this technique?
The client is sedated, the lower torso is elevated and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity.
The nurse is caring for a child with cystic fibrosis who recieves pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes?
The enzymes should be given at the beginning of each meal and snack
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
The infant's gumline will be tender.
A mother voices concern to the nurse that her daughter is an onyl child and she is worried that having no siblings may be detrimental to the child. The nurse can reassure the mother that an only child tends to excel in what areas?
advanced langauge development intellecutal achievement
The nurse is doing an asessment of a 10 year old girl. she whispers the girl's name from behind the girl. Which cranial nerve is the nurse assessing for?
VIII; acoustic nerve
The parents of a 5 year old call the nurse for advice about night terrors. The child has had them nightly for almost two weeks. What is the most appropriate intervention
Wake the child up nightly 30 to 45 minutes after going to sleep.
when collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 pounds and grown 2,5 inches in the last year. The nurse interprests these findings to indicate which situation?
Weight is above an expected range and height is within an expected range.
When developing the plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factor influencing pain?
anticipatory anxiety
The nurse is caring for a 3 month old infant with history of congenital heart disease. The infant is brought to the emergency department with nausea and vomiting for 3 days. Admission laboratory results confirm dehydration. The nurse realizes that the dehydrated infant is at risk for
a CVA; . If an infant with heart disease becomes dehydrated the infant can develop thrombi from the increased amounts of red blood cells and the viscosity of the blood. This places the infant at risk for a cerebrovascular accident (stroke).
physical development of toddlers
a toddler grounds 5-10 pounds per year and about 3 inches in height.
A toddler has moderate respiratory distress, is mildly cyanotic, and has increased work of breating, with a respiratory rate of 40. What is the priority nursing intervention?
airway maintenance and 100% oxygen by mask
Which is the best way for parents to aid in a toddler in achieving the developmental task?
allow the toddler to make simple decisions
treatment for rheumatic fever
antibiotics and the length of treament can last up 2 five years , corticosteroids and nSAIDS
A group of students are reviewing information about acute rheumatic fever. The students demonstrate a need for additional review when they identify what as a major Jones criterion
arthralgia
What information is most correct regarding the nervous system of the child?
as the child grows, fine and motor skills increase
The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach
ask if the child would like to take the medicine in a cup or through an oral syringe
A 10 year old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, french fries, an ice cream. what is the best nursing action?
ask that the child's desired foods be sent up from the kitchen.
A4 year old girl has begun studdering. Which practice by the parents would the nurse discourage?
asking the girl to slow down and to think before she talks
The nurse is educating the family for a 2 year old boy with broncholitis about the disorder and its treatment. THe family paretns speak onyl chinese. Which action, involving an interpreter, can jeoporadize the family's trust
asking the interpreter questions not meant for the family
Which suggestion by the nurse meant to promote good dental health in the 15 month old is inappropriate?
brush your child's teeth with a pea-sized amount of fluoride-containing toothpaste; Using fluoride toothpaste prior to age 2 years promotes development of fluorosis. The first dental visit should be made at 1 year. This check-up is overdue.
A parent wants to wait outside the room while a procedure is completed on his young child, saying, "I don't think I can see you do this" The nurses best response is
certainly. I will stay with your child during the procedure
parents share that their toddlers often need a snack between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries?
cheese slices orange slices yogurt
The nurse is caring for a 12 year old in sickle cell crisis. The nurse determines that the child is very tense and might benefit from relaxation techniques. Which is the best approach for the nurse to take when implementing this pain reduction technique?
close the door to the client's room, dim the lights, and close the curtains
A child needs a peripheral IV start as well as a venous blood sample for a laboratory test. The nurse will take what action
coordinate placing the peripheral IV and the lab blood draw
an adolescent who is a competitive swimmer comes to the emergency department complaining of localized aching pain in his shoulder. He states "ive been practicing really hard and long to get myself ready for my meet this weekend." The area is tender to touch. The nurse determines that the adolescent is most likely experiencing which type of pain?
deep somatic pain; his discription of a dull ache and evidence of tenderness suggest deep somatic pain which typically involves the muscles, tendons, joints, fascia, and bones.
A 9 month old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection. the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse?
delays are normal when a child is premature
the successful resolution of developmental tasks for the school-aged child, according to erickson would be identified by:
developing a sense of worth and competence
The nurse is aware of the special needs of children related to pain assessment. What is the priority for the nurse to consider when completing a pain assessment?
developmental age of child
A toddler requires 1.5 of an antibiotic given IV. How will the nurse administer the medication
divide the dose. Administer 0.75ml IM in each vastus lateralis ; the recommenede amount of solution a toddler should rceive in one IM injection should not exceed 1 mL
during the preschool years, female children may develop a strong attachment to their fathers. What is this attachment called?
electra complez
What is the best advice about nutrition for the toddler?
encourage cup drinking and give water between meals and snacks ; the toddler should wean to the cup by age 12 to 15 months. limit real fruit juice to 4 to 6 oz a day and milk 16 to 24 oz per day, and give it with meals and snacks. offer water between meals and snacks
In dealing with parents experiencing a perinatal loss, which of the following nursing interventions would be most appropraite?
encouraging them to participate in the newborn's care
An adolescent remarks rather sarcastically that she feels like a "lab rat". what is the priority nursing action
ensure information is shared and decisions about care are made with the teen and not for the teen
A nurse examining a neonate is unable to identify the fetal stomach. The nurse knows that this sign strongly indicates which condition?
esophageal atresia
what approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health?
explain what is going to happen in words the child can understand
The nurse is talking to the parent of a 19 month old toddler about setting limits and supervising activities. In which situation will the nurse recommend letting the toddler do as he or she pleases?
exploring of one's body
A mother brings her 6-month-old into the clinic. The child has been vomotting since early morning and has had diarrhea since the day before. His temp s 38, pulse 140, and 38RR. He has ;pst 6 oz since his well child visit 4 days ago. He cries before passing a bowel movement. He will not be breastfed today. What is the priority nursing diagnosis?
fluid volume deficit related to excessive lossess and inadequate intake
The parents of a 2 year old girl are concerned with her behavior. For which behavior would the nurse share their concern?
frequently babble to herself when playing ; by this age she should be using simple sentences with a vocabulary of 50 words.
Which nursing intervention demonstrates proper use of cutaneous stimulation to relieve pain in pediatric clients
gently massaging a preterm infant's legs for 2 minutes prior to obtaining a blood sample from a heel stick
The nurse is providing posturgical care for a 4 year old boy following hernia repair. Before surgery, the nurse taught the child to use the poker chip tool to rate his pain. When assessing the child's postsurgical pain, the boy refuses to touch the chips and clings to his mother. How should the nurse respond
give the mother the FACES pain rating scale to use with her son
A school nurse is caring for a child with a severe sore throat and fever. What is the nurse's best recommendation to the parent
have the child be seen by the primary care provider
The nurse is discussing sensory development with the mother of a 2 years old boy. Which parental comment suggests the child may have a sensory problem?
he does not respond if I wave to him
In assessing a preterm newborn, which of the following findings would be of greatest concern?
hear murmur; when a newborn is born too soon, fetal circulation may persist into extrauterine life. The ductus arteriosus and foramen ovale may remain open if pulmonary vascular resistance remains high and oxygen levels remain low.
The mother of a 3 year old is concerned about her child's speech. she describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?
hesitancy and dysfluency are normal during this period of developement
A nurse prepares a menu for a client with crohn disease. What is the focus of dietary management for this disease?
high carbohydrates and high protein; he goal of nutritional intervention is to provide adequate nutrient intake to optimize normal growth and development—including pubertal development, which is frequently delayed—and to prevent and correct nutrient deficiencies. Adequate nutrition with a high-protein and high-carbohydrate diet may be recommended.
Upon assessment of an infant the nurse suspects the child has positional plagiocephaly. WHat questions should the nruse ask the parent to help confirm if this is correct
how much tummy time do you plan each day for your infant "Besides transporting your infant in the car, how much time do you place your infant in the car seat every day?" "Do you follow the recommended guidelines of placing your infant on the back to sleep rather than the abdomen?"
Because subcutaneous and brown fat stores were used for survival in utero, the nurse would assess SGA newborn for which of the following?
hypothermia
SGA and LGA newborns have an excessive number of red blood cells related to
hypoxia; the fetus's body, in attempt to compensate for the low oxygen level, prouces more rbs to carry the limited amount of o2 available. Thus, polycythemia will be present at birth.
The client calls the healthcare provider's office stating that her preschooler drank laundry detergent from under the sink. Which statement by the parent needs further instruction?
i will use syrup of icepack to get it out of my child's system; The CDC no longer recommends that the syrup of ipecac be used in the home for treatment of poisoning and, furthermore, recommends that it be disposed of safely. All the other statements are accurate. Depending on the amount of detergent ingested, the parent is instructed to first terminate any exposure and then possibly transport the child to a health care facility.
Age affects how the medication is distributed throughout the body. Which factor affects how medication distrubution is altered in infants and young children?
infants and young children have an increased precentage of water in their bodies The liver of infants and young children are immature
which statement indicates the best sequence for the nurse is conduct an assessment in a nonemergent situation?
introduce yourself, ask abut any problems. take a history, and do the physical examination.
A 9 month old girl is brought to the emergenct room with what appears to be bouts of intense abdominal pain 15 minutes in whcih she draws u her legs and cries, often accompanied by vomiting. IN between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?
intussusception ; this is the invagination of one portion of the intestine into another usually occurs in the second half of the first year of life. What happens is the infant draws up their legs while crying because of the severe abdomnial pain and vomit within the peristaltic wave. After that is over, they are symptom free. blood can also be seen in the stool
An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse?
it will determine if the heart is enlarged
The nurse is providing care to several newborns with variations in gestational age and birthweight. When developing the plan of care for these newborns, the nurse focuses on energy conservation to promote growth and development. Which measures would the nurse include in the nursing plan of care?
keeping the handling od the newborn to a minimum maintaining a neutral thermal environment decreasing environmental stimuli rationale: minimal handling, maintaing a neutral thermal environment, and decreasing environmental stimuli are important measures to conserve energ in newborns with variations in birth weight and gestational age. `
to gain cooperation from a toddler, what is the best approach by the nurse?
kneel infront of the toddler while he or she sits on the mother's lap.
a 6 month old infant requires restraints to prevent removal of his NG tube. What is the priority nursing intervention?
leave the baby unrestrained when directly observed
When caring for a child with kawasaki disease, the nurse would know that
management includes the administration of aspirin and IVIG
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction?
maturation refers to the child's increase in body size
The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse idenity as a risk factor for this condition?
mother age 42 with pregnancy
The nurse is providing an in-service for parents of preschoolers regarding nutrition. Which comments by the parents demonstrate successful learning following the in-service?
my 4 year old should be ingesting at least 700 mg of calcium we very rarely feed our child fast food and when we do we try to keep it as healthy as possible with no soda I generally give my child choices about foods within each food category, ensuring all food groups are represented
During the toddler years, the child attempts to become autonomous. Which statement by a 3 year old toddler's caregiver indicates that the toddler is developing autonomy?
my toddler uses the potty chair and is dry all day long
A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location?
need to be transferred if overnight stay is required
The student nurse is caring for a 2 1/2 week old in the newborn intensive care unit. What is the proper term when discussing this client?
newborn (birth until 28 days of life)
The nurse is caring for a hospitalized 30 month old who is resistant to care, is angry, and yells no all the time. The nurse identifies this toddler's behavior as
normal for this stage of growth and development
The nurse is caring for a hospitalized 4 year old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as
normal for this stage of growth and development
The nurse is caring for a 6 year old child with burns on both hands. Which pain assessment technique provides the most accurate data for this client
obtain a self-report
Which of the following concepts would the nurse incorporate into the plan of care when assessing pain in a newborn with special needs?
pain assessments need to be comprehensive and frequent; this includes observing for changes in vital signs, behavior, facial expression, and body movement.
When educating the family of an ill infant with an atriventricular canal defect/septal defect, what information would be included in the education if the doctor is planning on performing palliative care until the infant is healthier
palliative pulmonary artery banding should help the infant grow
A parent brings a 10 uear old into the emergency room with reports of abdominal pain. The nurse performing a physical assessment ntoes the following symptoms: URQ pain that radiates to the back, fever, nausa and abdominal distension.
pancreatitis
An infant with tetralogy of fallot becomes cyanotic. Which nursing intervention would be the first priority
place the infant in the knee-chest position
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce simblings to a new member of the family. Which suggestion should the nurse prioritize to help other siblings, especially toddlers, understand the change in the family dynamics?
plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant
The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which examples as representing cooperative play?
playing in an organized fashion together
The mother of a child who just had abdominal surgery holds his hand and smooths his hair. When the nurse appears to administer a scheduled analgesic, the mother says she believes the child has been in pain the last hour or more. The nurse's best response is
please tell me and all of the nurses when you believe he is in pain
A 3 month old presents with a history of vomiting after eating. THe plan for the infant is to rule out FED, What information frolm the histpry would lead the nurse to believe that this infant may need further intervention?
poor weight gain
The nurse is preparing to give a 4 monght old an oral medicaiton. Which technique demonstrates the nurse's accurate knowedge of the infant's developmental level
position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medicaiton on the side of the tongue towards the cheek, then offer the infant tje bottle again.
rheumatic fever
precipitated by a streptococcal infection such as strep throat, tonsillitis, scarlet fever or pharyngitis ; this affects the connective tissue of the heart, joints, lungs, and brain
The nurse is about to assess the pain in the child and will use the QUESTT acronym as a guide to objective and subjective data collection. This acronym stands for what?
question the client use a reliable pain scale evaluate the child's behavior and physiologic changes and determine the effectiveness of the intervention secure parental involvement take cause of the pain into account when intervening take action
Parents of a toddler describe how they handle their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?
reasoned with the child to stop the behavior
a child presents with a 2 day history of fever, abdominal pain, occasional vomiting, and decreased oral intake. Which finding would prioritize for immediate reporting to the physician?
rebound tenderness with guarding
The mother of a 15 month old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information?
receptive language normally develops earlier than expressive languange
What behavioral responses to pain would a nurse observe from an infant younger than 1?
reflex withdrawal to stimulate and facial grimacing
Evidence-based practice refers to the use of which of the following to validate your practice?
research findings
The father of a toddler reports his son says no every time he attempts to correct him. What is the best advice the nurse can offer to the parent
saying no is your sons way of trying to exert his independence and is expected
The nurse is preparing a female toddler for the repair of an eyebrow laceration . The girl is most likely to demonstrate which response in anticipation of the procedure
scream and cling tightly asking to ''go potty"
parents of an 8 month old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior?
separation anxiety is normal at this age; the infant recognizes parents as separate beings
The nurse is caring for an 8 month old infant with a suspected congenital heart defect. The nurse examines the child and documents which expected finding
softening of the nail beds
The parent of a 12 year old child with reye syndrome approaches the nurse wanting to know how this happened to the child saying "I never give my children aspirin!" What could the nurse say to begin educating the parent
sometimes it is hard to tell what products may contain aspirin
An adolescent has hepatitis B. What would be the most important nursing action?
strict enforcement of standard precautions; this is spread through IV drug use, sec, contaminated blood and perinatal.
A 5 month old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate initial nursing intervention?
suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure.
The nurse is educating parents of a male infant with chiari type 2 malformation. Which statement about their child's condition is most accurate
take your time feeding the baby; One of the problems associated with Chiari type II malformation is poor gag and swallowing reflexes, so the infant must be fed slowly. There is a great risk of aspiration, requiring that the child be placed in an upright position after feeding. The goal of surgery is to prevent further symptoms, rather than to relieve existing ones. Infrequent urination is a problem associated with type I malformations.
The nurse is providing education to the parents of a female toddler with hydrocephalus who has just had a shunt placed. Which statement is the best to make during a teaching session
tell me your concerns about your child's shunt
The nurse is assessing a 10-day old infant for dehydration. Which finding indicates severe dehydration?
tenting of the skin; soft and flat fontanels indicate mild dehydration. The fontanels would be sunken.
A preschool-aged chil who is recieving g tube feedings occasionally vomits following a feeding. When the parent describes the feeding process, what does the nurse note as the likely cause of the vomiting
the mother does not check the gastric residual before the feeding
The nurse is mentoring a newly graduated nurse on the pediatric unit. Which action by the new nurse requires further instruction when preparing an intramuscular injection for a 6 month old
the nurse prepares to administer 0,7 ml of solution using one injection the nurse prepares to inject the medication into the ventrogluteal site; No more than 0.5 ml of medication should be administered intramuscularly to an infant, and the preferred site is the vastus lateralis muscle due to muscle development.
The nurse is making a home visit and observes the 7 month old pulling the family's dog hair and ears. Which parenting skill does the nurse determine is the most effective?
the parent tells the child "no" with a stern voice and pulls the child's hands away from the dog
The nurse is identifying outcomes for a family with a preschool-age who has broken fluency. Which initial outcome would be the most appropraite.
the parents will not call attention to the child's broken fluency.
a 2 year old is having a temper tantrum. What advice should the nurse give the mother?
the tantrum should be ignored as long as the toddler is safe
When assessing a toddler's language development, what is the standard against which you measure language in a 2 year old toddler?
the toddler should speak in two-word sentences "me go"
A nurse is caring for an infant who just had open heart surgery and the parents are asking why there are wires coming out of the infant's chest. What is the best response by the nurse?
these wires are connected to the heart and will detect if your infants heart gets out of rhythm
The adolescent has been diagnosed with GERD. Which statements by the teen idicates that learnming has occurred?
this famotidine may make me tired ; antacid the omeprazole could give me a headache it sounds like, the physiciam is reluctant to give me prokinetic because of my side effects Famotidine may cause fatigue. Omeprazole can cause headaches. Prokinetics use may result in side effects involving the central nervous system.
Hirschsprung disease
this is a gastrointestinal disorder where the infant cannot pass meconium within the first 24 hours. -the infant has abdominal distension and bilious vomiting
Which of these age groups has the highest actual rate of death from drowning
toddlers
The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:
transduction; Because the 4-year-old recently received an injection from a nurse in a flowered uniform, the girl believes that all nurses who wear flowered uniforms give shots.
Which of these factors contributes to infant's and children's increased risk for upper airway obstruction as compared with older adults?
underdeveloped circoid cartilage and narrow nasal passages
The parents of a 4 week old report that their infant has forcefull vomitting but seems very hungry immediately after vomitting. Upon further questioning, the nurse notifies the physician of the findings and pyloric stenosis is suspected. The nurse prepares the parents for the possiblity of which diagnostic procedures and treatement
upper GI series pyloric ultrasound physical examination of the abdomen surgical repair frequently, because the there is stiffening near the duodenum, there is a palable olive mass in the RUQ
The nurse cares for a 7 year old child with new onset seizure disorder. Which prescription will the nurse anticipate for this client
use of anticonvulsant med
A 5 year old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level?
using a screening tool during a follow-up visit
The registered nurse and LPN are caring for a adolescent clients. The RN will intervene the LPN if seen in which situation while caring for a client
using medical terminology to answer the client's questions
the nurse needs to transport her preschool client to radiology for a chest x-ray. Which transportation device would be most appropraite
wagon
After teaching a child's parents about the different methods of distraction that can be used for pain management, which statement by the parent indicates a need for additional teaching?
we'll have her imagine that she's at the beach this summer
The nurse is caring for an infant with down syndrome who has been diagnosed with atrioventricular canal defect. The parent asks the nurse "why do you not put oxygen on our baby more often when his lips and fingernails are blue?" What is the best response by the nurse?
while it seems that oxygen would help, it actually worsens this condition. treating the cause of the disease will help ; Oxygen acts as a pulmonary vasodilator. If pulmonary dilation occurs, pulmonary blood flow is even greater, causing tachypnea, increasing lung fluid retention, and eventually causing a much greater problem with oxygenation; therefore, preventing the development of pulmonary disease via early surgical correction is essential.
Which is the most appropriate treatment for epistasis?
with the child sitting up and leaning forward, pinch the lower third of the nose closed.