PEDS EXAM 3 TB's
A 9-year-old girl has just been diagnosed with Grave's disease. Which symptom should the nurse expect in this child? Select all that apply. A.Exophthalmos (protruding eyes) B.Moist skin C.Nervousness D.Increased basal metabolic rate E.Obesity F.Lethargy
a,b,c,d
A 9-year-old child with leukemia is scheduled to undergo an allogenic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? A."We'll need to have a match to a donor." B."The risk for rejection is much less with this type of transplant." C."You won't need to receive the high doses of chemotherapy before the transplant." D."You'll need to have an incision in your hip area to instill the cells."
A, "We'll need to have a match to a donor." An allogenic hematopoietic stem cell transplantation (HSCT) refers to transplantation using stem cells from another individual that are harvested from the bone marrow, peripheral blood, or umbilical cord blood.
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? Select all that apply. A.Lactated Ringer B.Normal saline C.5% dextrose in water D.0.45% saline E.10% dextrose in water
A,B
The nurse caring for a young adolescent with Crohn's disease. After teaching the adolescent and her family about this condition, the nurse determines that the teaching was successful when they identify which of the following as a possible complication? Select all that apply. A.Stricture B.Fistula C.Intra-abdominal abscess formation D.Gallstones E.Pancreatitis
A,B,C
The nurse is caring for a teenager recently diagnosed with Addison disease. Which findings can be anticipated by the nurse? Select all that apply. A.Sodium level 128 mEq/L B.Potassium level 5.6 mEq/L C.Muscular weakness D.Rapid weight gain E.Facial acne
A,B,C
After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply. A.The parents recently divorced B.The father is unemployed and mother is infrequently home C.The child is learning to play the clarinet in music class in school D.The child is expected to care for younger siblings while mother sleeps E.There is history of multiple injuries obtained from a motor vehicle crash
A,B,D,E
The young child has been diagnosed with hepatitis B. Which of the following statements by the child's mother indicates that further education is required? A."We went swimming in a local lake 2 months ago and I just knew she drank some of the lake water." B."Could I have this virus in my body, too?" C."The virus is the reason her skin looks a little yellowish." D."The only way you can get this virus is from intravenous drug use." E."Her fever and rash are probably related to this virus."
A,D
A panicked mother calls the health care provider's office and reports that her 5-year-old has a high fever and just had a seizure. The mother asks the nurse what she should do. Which is the nurse's best response? A.Report to the emergency room for medical evaluation B.Immerse the child in a bathtub of tepid water C.Administer oral acetaminophen per package directions D.Remove any heavy clothing and cover with a thin sheet
A.Report to the emergency room for medical evaluation
The nurse is caring for a 3-year-old girl who has just undergone a ventriculostomy. Which of the following would the nurse include in this child's plan of care to manage increased intracranial pressure (ICP)? A.Use pillows to support the child when lying on her side B.Support the parents in starting a ketogenic diet C.Pad the side rails on the bed D.Teach her to do deep breathing techniques
A.Use pillows to support the child when lying on her side
A child receiving chemotherapy wants to have a large birthday party and invite all the classmates. When theparent asks the nurse about this, what is the nurse's best response? A."That will be a good way to cheer your child up!" B."It is better to avoid large groups right now." C."What about taking your child to a movie instead?" D."We can have the party here in the hospital play room.
B, "It is better to avoid large groups right now." A child receiving chemotherapy is particularly susceptible to contracting an infection and thus should be kept away from people with known infections.
A nurse suspects that a child is experiencing isotonic dehydration based on which assessment findings? Select all that apply. A.Extreme thirst B.Cool skin temperature C.Irritability D.Normal serum sodium level E.Clammy skin
B,C,D
The nurse realizes that the chemotherapy agents and radiation that a child is receiving are likely to irritate the bladder. What are the best measures that the nurse can take to diminish this risk? A.Administer chemotherapy during sleep periods, including naps and overnight B.Have the child wait to void until the bladder becomes full C.Keep intravenous(IV) fluids running to maintain excellent hydration and frequent voids D.Promote drinking of cranberry juice, making it an attractive oral fluid option
C, Keep intravenous (IV) fluids running to maintain excellent hydration and frequent voids
An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient? A.Numbness of fingers and decreased temperature B.Increased pulse rate and decreased blood pressure C.Increased temperature and decreased respiratory rate D.Decreased level of consciousness and increased respiratory rate
C.Increased temp and decreased resp rate
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone?' A.Vasopressin B.Antidiuretic hormone C.Oxytocin D.Growth hormone
D,.Growth hormone
The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion? A.Learning disorders indicate lower intelligence. B.Learning disorders are synonymous with learning deficits. C.The disorder requires comprehensive special education. D.The disorder is caused by a difference in brain architecture.
D.The disorder is caused by a difference in brain architecture.
The nurse is caring for a newborn with a cleft palate. Which findings in the maternal medical record are considered to be contributing factors? Select all that apply. A.Maternal tobacco use. B.Moderate maternal alcohol use prior to pregnancy. C.Maternal age less than 18 years. D.Anticonvulsant therapy used to manage a seizure disorder. E.Reports of marijuana use in early pregnancy.
A,D
A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication if she becomes pregnant. The nurse integrates understanding of which of the following when responding to the client? A.Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy B.There is no need to take a thyroid medication because the fetus's thyroid produces thyroid stimulating hormone C.It is more difficult to maintain thyroid regulation during pregnancy due to the slowing of metabolism D.Fetal growth is arrested if the thyroid medications are continued during pregnancy.
A.Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy
The nurse is conducting a physical examination of a child with suspected Crohn disease. Which finding would be the most suspicious of Crohn disease? A.Normal growth patterns B.Perianal skin tags or fissures C.Increased hunger D.Abdominal tenderness
B.Perianal skin tags or fissures
A 16-year-old child suffering from alopecia related to chemotherapy treatment is refusing to let friends visit. Which action by the nurse is most appropriate? A.Respect the child's wishes and document refusal B.Have the parents explain the importance of letting friends visit C.Provide opportunities for the child to discuss his or her body image changes D.Allow friends to visit because socialization is important for adolescents
C, Provide opportunities for the child to discuss his or her body image changes
Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications? A.Administer the antiemetic before starting chemotherapy B.Provide the antiemetic as needed (PRN) when nausea and vomiting are reported C.Use the antiemetic after it is clear that nonpharmacologic methods are not effective D.Start the antiemetic on a scheduled basis when the chemotherapy begins to cause nausea
A, Administer the antiemetic before starting chemotherapy most effective when given before chemotherapy begins and then on a regular schedule to prevent nausea and vomiting
A nurse is communicating with a family about palliative care. Which of the following would be the best approach to take? A.Ask the family what they know, what they wish to know and be prepared to repeat the information you give to them several times B.Give the family as much information as possible to promote better decision-making C.Provide information during a crisis when the parent's senses are heightened and memory is improved D.Avoid pushing the family by asking too many questions.
A, Ask the family what they know, what they wish to know and be prepared to repeat the information you give to them several times
The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? A.Calling the doctor if the child gets a sore throat B.Keeping a written copy of the treatment plan C.Writing down phone numbers and appointments D.Using acetaminophen if the child needs an analgesic
A, Calling the doctor if the child gets a sore throat Calling the doctor if the child gets a sore throat is the priority. Because of the child's impaired immune system, any sign of potential infection, such as sore throat, must be evaluated by a physician
The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system? A.Child reports of facial palsy and vision problems B.Observing petechiae, purpura, or unusual bruising C.Noting adventitious breath sounds during auscultation D.Palpation of abdomen reveals enlarged liver and spleen
A, Child reports of facial palsy and vision problems The presence of facial palsy and vision problems indicates that the central nervous system has been infiltrated by leukemia cells.
The nurse identifies the nursing diagnosis of risk for infection related to chemotherapy-induced immunosuppression. What would the nurse include in the teaching plan for the child and parents about reducing the child's risk? Select all that apply. A.Having the child sleep in a single bed and room B.Encouraging frequent, thorough handwashing C.Providing a low-carbohydrate, low-protein diet D.Encouraging frequent close contact with numerous visitors E.Cheering up the environment with fresh flowers and plants
A,B
A child is diagnosed with short bowel syndrome. What would the nurse expect to be included in the child'splan of care? Select all that apply. A.Antibiotics B.Vitamin supplements C.Total parenteral nutrition D.Laxatives E.Immunosuppressants
A,B,C
A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply. A."We need to set clear limits for our child's behavior." B."A reward system would be useful to give our child positive feedback." C."We need to limit the number of choices our child has." D."We need to give our child all directions at once in case the child gets distracted." E."If the child acts out, we can explain that this is being bad."
A,B,C
The nurse caring for a neonate experiencing seizures asks the charge nurse: "How can I tell if a baby is having a seizure or is just crying for attention?" Which response would be most appropriate? Select all that apply. A."You will not be able to stop a seizure with gentle restraint." B."The baby experiencing a seizure will be tachycardic." C."Stimulating the baby by singing to him will not stop a seizure." D."There will be no changes in the baby's vital signs with a seizure" E."The baby will become more active with sensory stimulation with a seizure." F."The baby will stop the seizure activity when swaddled in a blanket."
A,B,C
During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply. A.Child reports abdominal pain. B.Child has a change in school performance. C.Child demonstrates anxiety or trouble sleeping. D.Child does not want to be left alone with a certain adult. E.Child spends a great deal of time with peer-group friends.
A,B,C,D
The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply. A.Cuts and bruises on the hands B.Burns on the dorsal surface of the hand C.A curved laceration on the back D.Linear lesions across the chest and abdomen E.A bruise on the child's knee F.A scab on the child's elbow
A,B,C,D
The nurse is caring for a child with a gastrointestinal disorder and measuring intake and output. The nurse observes that the child is demonstrating symptoms of adequate hydration when she/he has which of the following? Select all that apply. A.Fontanelles with normal tension B.Adequate skin turgor C.Oral intake D.Pink and moist mucous membranesE.Loose stools
A,B,D
The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply. A.The child's mother has a history of substance use disorder. B.Both parents work outside of the home. C.The child was born prematurely. D.The child has cerebral palsy. E.The child's father is the primary care taker.
A,C,D
The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching?A."Encourage a bland diet." B."Implement clear liquids." C."Provide plenty of 100% fruit juice." D."Offer flavored gelatin if hungry."
A."Encourage a bland diet."
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis? A."He recently helped clean the basement. B."He was exposed to several family members with an infection .C.He just recovered from an upper respiratory infection. D.We have a family history of conjunctivitis.
A."He recently helped clean the basement.
The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? A."If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." B."When my son's breath smells fruity, it almost always indicates high blood sugar." C."If my son says he feels shaky, his blood sugar may be low." D."Dry flushed skin may be a sign if high blood sugar."
A."If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."
An adolescent is recovering from surgery, radiation, and chemotherapy following a diagnosis of Ewing sarcoma. Which statement by the family indicates that reteaching is needed? A."Our child is looking forward to playing football again." B."We will remind our child to care for the skin following radiation." C."Our child's friends shaved their heads in solidarity to show their support." D."We will watch for signs of infection and report it to our health care provider."
A."Our child is looking forward to playing football again." Caution adolescents to continue to be careful about activities that cause stress on an extremity that has received radiation (for example, football or weight lifting) because it may not be as strong as usual afterward
The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" Which response by the nurse would be most appropriate? A."Sometimes it's hard to tell if a product contains aspirin." B."Do you think that maybe your child took aspirin on his own?" C."Don't worry; you're in good hands. We have it under control now." D."Aspirin in combination with the virus will make the brain swell and the liver fail."
A."Sometimes it's hard to tell if a product contains aspirin."
The nurse is providing education to the parents of a female with hydrocephalus who has just had a shunt inserted. When discussing the child's condition with the parents, which of the following would be most appropriate? A."Tell me your concerns about your child's shunt." B."Be sure to call the doctor if she gets a persistent headache." C."Her autoregulation mechanism to absorb spinal fluid has failed." D."Always keep her head raised 30 degrees."
A."Tell me your concerns about your child's shunt."
Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone? A.Antidiuretic hormone B.Adrenocorticotropic hormone C.Thyroid stimulating hormone D.Luteinizing hormone
A.Antidiuretic hormone
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? A.Blood glucose level B.CT scan C.Arterial blood gases D.Blood cultures
A.Blood glucose level
Which type of diet should be included in the plan of care for a child diagnosed with Addison disease? A.High-protein, low-carbohydrate, high-sodium diet B.High-protein, high-carbohydrate, low-sodium diet C.Low-calorie, low-carbohydrate, low-sodium diet D.Low-calorie, low-cholesterol, low-saturated fat diet
A.High-protein, low-carbohydrate, high-sodium diet In Addison disease, the body produces inadequate hepatic glucagons. A high-protein, low-carbohydrate, and high-sodium diet prevents fatigue, hypoglycemia, and hyponatremia
The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which finding would the nurse identify as contributing to this current complaint? A.Overproduction of cerumen B.Soreness of the outer ear C.History of a normal term birth D.The eardrum responds to a puff of air
A.Overproduction of cerumen
A nurse is caring for a 3-year-old girl with microcephaly. Which of the following actions is appropriate for the nurse to take? A.Playfully ask the child to touch her nose B.Teach the parents about ventriculoperitoneal (VP) shunts C.Prepare the child for the experience of cranial surgery D.Administer antipyretics as ordered
A.Playfully ask the child to touch her nose Having the child touch her nose will assist the nurse in assessing probable neurologic and cognitive deficits.
The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information?A.Process that requires the individual to view a situation from a different perspective B.Interventions that address family dynamics and family coping C.Individual exploration of the person's conflicts and stressors D.Use of play to explore problems, issues, and conflicts
A.Process that requires the individual to view a situation from a different perspective Cognitive behavioral therapy helps the individual reframe perceptions, change ideas about a situation, or view a situation from a different perspective. Next, the patient is helped to see the relations among his or her thoughts and beliefs and his or her emotional responses. Finally, the patient is encouraged to use problem solving to identify alternative solutions or ways of behaving.
A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?A.Severe erosion of teeth B.Hypertension C.Diabetes mellitus D.Atherosclerosis
A.Severe erosion of teeth Bulimia refers to recurrent and episodic binge eating and purging by vomiting, accompanied by awareness that the eating pattern is abnormal yet the child is not able to stop the pattern. Adolescents with bulimia may develop severe erosion of their teeth because of the constant exposure to acidic gastrointestinal juices from vomiting. Esophageal tears may also result from forceful vomiting.
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms?A.Syndrome of inappropriate antidiuretic hormone B.Diabetes insipidus C.Hyposecretion of somatotropin D.Hypersecretion of somatotropin
A.Syndrome of inappropriate antidiuretic hormone
A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement?A.Take glucometer readings as ordered B.Measure intake and output C.Monitor sodium and potassium levels D.Weigh daily
A.Take glucometer readings as ordered IV glucocorticoids raise the glucose levels and often require coverage with insulin.
The nurseis conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?A.The child constantly opens and closes the hands. B.The child is highly active and inattentive. C.The child has a slight decrease in head circumference. D.The child has a long face and prominent jaw.
A.The child constantly opens and closes the hands.
An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? A.The child should maintain an active lifestyle. B.Immediately provide medication if a seizure begins. C.Have the child carry a padded tongue blade with her at all times. D.Ensure quiet time late in the day, when seizure activity is most likely to occur.
A.The child should maintain an active lifestyle. children with seizures should attend regular school and participate in physical education classes and active sports.
The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? A.This medication must be given by injection. B.This medication must be given in the morning before school. C.Hip or knee pain is an expected adverse effect of this medication. D.This medication does not interact with any other types of medication.
A.This medication must be given by injection. Somatropin is administered by injection. It is best given at hour of sleep because that is when growth hormone is released
A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply. A.Inability to make eye contact B.Hypersensitivity to touch C.Lack of facial expression D.Distinct interest in others around him E.Easily distracted from playing
B, C Symptoms associated with autism spectrum disorder include deficits innonverbal communicative behaviors such as abnormalities in eye contact and lack of facial expression and hyper-or hyposensitivity to sensory input such as touch
A 6-month-old girl is seen with retinoblastoma. When taking a health history from her father, which symptom would you expect him to report he has noticed? A.The infant always keeps her eyes tightly closed. B.He has noticed one pupil appears white. C.His daughter tugs and pulls at one ear. D.His daughter's eye appears to be protruding.
B, He has noticed one pupil appears white. As the tumor grows against the retina of the eye, the red reflex is no longer visible; the pupil appears white.
A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important?A.Restricting the child's visitors B.Placing a "no abdominal palpation" sign above the child's bed C.Ensuring that the child be allowed nothing by mouth D.Preparing the child for chemotherapy E.Preventing weight-bearing activities
B, Placing a "no abdominal palpation" sign above the child's bed Nephroblastoma (Wilms' tumor) metastasizes rapidly, so it is important that the child's abdomen not be palpated any more than necessary for diagnosis, because handling appears to aid metastasis
The nurse is reviewing the history of an adolescent with peptic ulcer disease. Which client activity would the nurse identify as an associated contributing factor? Select all that apply. A.Use of acetaminophen B.Ingestion of diet colas C.High coffee intake D.Cigarette smoking E.High-fat diet
B,C,D
A child is receiving chemotherapy and develops stomatitis. The nurse identifies a nursing diagnosis of impaired oral mucous membranes related to the effects of chemotherapy. What instructions would the nurse include in the child's plan of care? Select all that apply.A.Vigorously rub the child's gums with gauze to clean them. B.Provide various soft and bland foods to minimize further irritation. C.Have the child rinse the mouth with lukewarm water three times a day. D.Give the child acidic foods (e.g., orange juice) to cleanse the mouth. E.Apply a lip balm or petroleum jelly to prevent cracking.
B,C,E
A nurse is developing a teaching plan for an adolescent diagnosed with gastroesophageal reflux disease. Which would the nurse include? Select all that apply .A."Try sitting upright for an hour after eating." B."You need to avoid acidic foods like oranges and grapefruits." C."Eating smaller portions might be helpful." D."You'll need to take your prescribed medications for about 6 to 8 weeks." E."Try sleeping with your upper body elevated on a foam wedge."
B,C,E
The nurse is caring for a pediatric client newly diagnosed with Crohn's disease. When reviewing the client's subjective and objective data, which is consistent with the diagnostic criteria? Select all that apply. A.Severe bloody diarrhea B.Significant weight loss C.Perianal lesions D.Lesions limited to the colon and rectum E.Cobblestone appearance of intestinal surface
B,C,E
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. A.Hyperthermia B.Orthostatic hypotension C.Weak pulse D.Hypertension E.Hypothermia
B,C,E
The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond? A."There is a good chance that you will be able to breastfeed almost immediately." B."Breastfeeding is likely to be possible, but check with the surgeon." C."After the suture line heals, breastfeeding can resume." D."We will have to wait and see what happens after the surgery
B."Breastfeeding is likely to be possible, but check with the surgeon."
The school nurse is educating the parents of a child with infectious conjunctivitis. Which of the following statements by the nurse would be most helpful for the parents related to prevention? A."Use all the medication as directed." B."Don't use anything that touches her face." C."This could have started with a head cold." D."Place the ointment inside the lower eyelid."
B."Don't use anything that touches her face." Warning the parents how infectious conjunctivitis is spread is most valuable for preventing infection within the family.
A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make? A."Your child will never need to wear the patch again." B."Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye." C."Your child will need to wear the patch for several months to keep the eye in alignment." D."Your child will have to be in restraints for a week to keep him/her from rubbing the eye."
B."Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye."
A 6-year-old is dealing with the death of a sibling. Which action should the nurse suggest to the family to best support the child with the grieving process? A.Having the child stay with a family friend instead of attending the funeral B.Assisting the child in drawing a picture to be placed in the sibling's casket C.Having the sibling stand in the receiving line with the parents at the funeral home D.Discouraging the child from interacting with family and friends while they express their sympathy
B.Assisting the child in drawing a picture to be placed in the sibling's casket
A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? A.Brief, sudden onset with muscles that become tense B.Loss of motor activity accompanied by a blank stare C.Sudden, brief jerking motions of a muscle group D.Loss of muscle tone and loss of consciousness
B.Loss of motor activity accompanied by a blank stare An absence seizure consists of a sudden, brief arrest of the child's motor activity accompanied by a blank stare and loss of awareness. A tonic seizure consists of a brief onset of increased tone. A myoclonic seizure is characterized by sudden, brief jerks of muscle groups. An atonic seizure involves a sudden loss of muscle tone and loss of consciousness.
A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent? A.Once the child is 6 to 9 months old a specialist will be able to drain the duct. B.Most of these conditions will spontaneously resolve. C.Antiviral therapy can be prescribed to manage this condition. D.Over-the-counter drops can be used sparingly.
B.Most of these conditions will spontaneously resolve.
A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care for an omphalocele? A.At birth, protect the exposed bowel by gently manipulating it back into the abdominal cavity. B.Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. C.Administer corticosteroids as prescribed—either oral prednisone or prednisolone or as IV methylprednisolone. D.Insert an NG tube to decompress the stomach and to prevent gastric distention.
B.Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities.
A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan? A.Help her ambulate with the bottles. B.Provide some time to talk to her several times a day. C.Help her give the bottles nicknames and personalities. D.Explain that TPN substitutes for normal food.
B.Provide some time to talk to her several times a day.
A high-school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told the adolescent not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and parents? A.Osteosarcoma often follows trauma, such as a football injury. B.You can expect some discoloration of the leg following chemotherapy. C.Football injuries do not contribute to the development of a tumor. D.Tumor growth is related to your dislike of milk.
C, Football injuries do not contribute to the development of a tumor. Osteosarcoma is the most malignant form of bone cancer. football injury may predispose more scrutiny of a lesion but it will not be the cause of the cancer, nor will the dislike of milk. Osteosarcoma may be treated with chemotherapy and radiation. It may also involve an amputation.
A preschooler who received chemotherapy in the pediatric oncology outpatient department 1 week ago now has a temperature of 101.5°F (38.6°C). Which is the most appropriate response by the nurse? A.Tell the parent to administer acetaminophen every 4 hours until the fever dissipates. B.Ask whether any family members or other close associates are ill. C.Have the parent bring the child to the pediatric oncology clinic as soon as possible. D.Instruct the parent to immediately obtain and give the antibiotic that the oncologist will order.
C, Have the parent bring the child to the pediatric oncology clinic as soon as possible. The preschooler is considered immune suppressed following recent chemotherapy. A fever can mean sepsis
The nurse is examining a child with hypoparathyroidism. The nurse would expect to assess which signs and symptoms? Select all that apply. A.Capillary refill B.Polyphagia 'C.Chvostek D.Babinski E.Trousseau
C,E both of which indicate hypocalcemia. To test for the Chvostek sign, tap sharply over the facial nerve below the temple and anteriorly to the ear. The sign is positive when the mouth twitches (contraction of the lateral facial muscles). To check for the Trousseau sign, apply a blood pressure cuff to the child's upper arm. Inflate the cuff until the blood supply is occluded. If doing so causes carpal spasm (the fingers contract and the child is unable to open the hand), the Trousseau sign is positive.
A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? A.A room with a 12-month-old infant with a urinary tract infection B.A room with an 8-month-old infant with failure to thrive C.A private room near the nurses' station D.A two-bed room in the middle of the hall
C. A private room near the nurses' station until that child has received I.V. antibiotics for 24 hours because the child is considered contagious
A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be mostappropriate? A."It takes time to determine the level of functioning of endocrine glands." B."Have there been signs and symptoms that you should have reported to the doctor?" C."As endocrine functions become more stable throughout childhood, alterations become more apparent." D."Endocrine disorders are hard to detect and you are lucky that we have found it when we did."
C."As endocrine functions become more stable throughout childhood, alterations become more apparent."
An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa? A."I'd like to grow up to be a model." B."I'd like to gain weight but just can't." C."I feel chubby no matter what I wear." D."I'm afraid that someone is poisoning my food."
C."I feel chubby no matter what I wear." Characteristics of a child with anorexia nervosa include a severely distorted body image with an intense fear of gaining weight or becoming fat.
A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child? A."Are you having any recurring dreams about the trauma you experienced?" B."Has anything happened at home recently that has upset you?" C."Is there anything that you do over and over again and can't resist doing?" D."Do you have times when you wake up during the night without any reason?"
C."Is there anything that you do over and over again and can't resist doing?"
For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A.An 8-month-old who cries when left with strangers B.A 7-year-old who withdraws from contact with all strangers C.An 8-year-old who will not stay overnight at a friend's house D.A 10-year-old who reports headaches if there is to be a test in school
C.An 8-year-old who will not stay overnight at a friend's house
The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A.Take photographs of the bruises. B.Ask the child to provide a written statement of how he or she got the bruises. C.Document the bruises and any statements made by the child relating to them. D.Interview the child's parents about the origin of the bruises. E.Interview the child's parents about the origin of the bruises.
C.Document the bruises and any statements made by the child relating to them.
What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy? A.Children show an increased need for insulin during the first months after glucose control is established. B.Once glucose control is established, there will never be a need for an increase in the amount of insulin administered. C.It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. D.All children should be on at least two types of insulin to establish glucose control.
C.It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.
The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required? A.The child pinches the skin together before inserting the needle. B.The child injects the appropriate amount of air into the vial before withdrawing medication. C.The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe. D.The child slowly pushes on the plunger to inject the medication before withdrawing the needle.
C.The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe.
The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert thenurse to further assess for a learning disorder? A."My child seems to prefer playing with certain toys and will not play with other toys very much." B."My child likes a certain type of food and does not want to try new foods very often." C."My child gets restless when we go to a restaurant to eat and we have to wait for our food." D "My child does not say more than one or two words and grunts to indicate needs."
D "My child does not say more than one or two words and grunts to indicate needs."
The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply. A."The cause of autism is largely considered to be related to immunizations administered in infancy." B."Concerns are often noted as early as 3 to 6 months of age." C."Once your child begins to speak it will be easier to make a determination." D."In infancy a lack of loving behaviors such as cuddling is concerning." E."Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
D."In infancy a lack of loving behaviors such as cuddling is concerning." E."Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client? A.Delayed growth and development B.Imbalanced nutrition: More than body requirements C.Noncompliance D.Excess fluid volume
D.Excess fluid volume
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? A.The child speaks in complete sentences. B.The child sleeps at least 12 out of every 24 hours. C.The child responds warmly to the father but not to the mother. D.The child constantly stares at a rotating wheel on the crib mobile.
D.The child constantly stares at a rotating wheel on the crib mobile.
