Peds Exam 4

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis which, if stated by the mother, indicates a need for further teaching? A." I need to wash my hands frequently" B."I need to clean the eye as prescribed" C."It is okay to share towels and washcloths" D."I need to give the eye drops as prescribed"

C."It is okay to share towels and washcloths"

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include? A) Encourage the child to take a 45 minute nap daily. B) Allow the child to stay at home on days when her joints are painful. C) Apply cool compresses for 20 minutes every hour. D) Administer prednisone on an alternate day schedule.

D) Administer prednisone on an alternate day schedule.

what is screened for hypothyroidism

TSH

A nurse is teaching parents the difference between pediatric fractures and adult fractures.Which observation is true about pediatric fractures? a. They seldom are complete breaks. b. They are often compound fractures. c. They are often at the epiphyseal plate. d. They are often the result of decreased mobility of the bones

a. They seldom are complete breaks.

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? a. Identity crisis b. Body image changes c. Feelings of displacement d. Loss of privacy

b. Body image changes

The nurse should implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply. 1. Administer regular insulin. 2. Encourage the child to ambulate. 3. Give the child a teaspoon of honey. 4. Provide electrolyte replacement therapy intravenously. 5. Wait 30 minutes and confirm the blood glucose reading. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

3. Give the child a teaspoon of honey. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation which of the following intervention should the nurse include in the plan of care? A) Keep the head of the bed at a 30° angle. B) Reposition the client by logrolling every four hours. C) Place the client in protective isolation. D) Initiate the use of a PCA pump for pain control.

D) Initiate the use of a PCA pump for pain control.

During painful episodes of juvenile arthritis, a plan of care should include what nursing intervention? a. A weight-control diet to decrease stress on the joints b. Proper positioning of the affected joints to prevent musculoskeletal complications c. Complete bed rest to decrease stress to joints d. High-resistance exercises to maintain muscular tone in the affected joints

b. Proper positioning of the affected joints to prevent musculoskeletal complications

Which statement is accurate concerning a child's musculoskeletal system and how it maybe different from an adult's? a. Growth occurs in children as a result of an increase in the number of musclefibers. b. Infants are at greater risk for fractures because their epiphyseal plates are notfused. c. Because soft tissues are resilient in children, dislocations and sprains are lesscommon than in adults. d. Their bones have less blood flow.

c. Because soft tissues are resilient in children, dislocations and sprains are lesscommon than in adults.

A neonate is born with mild clubfeet. When the parents ask the nurse how this will becorrected, the nurse should explain that a. Traction is tried first. b. Surgical intervention is needed. c. Frequent, serial casting is tried first. d. Children outgrow this condition when they learn to walk.

c. Frequent, serial casting is tried first.

When providing education for the parents of a child with Duchenne muscular dystrophy,the nurse plans to include a. Testing all female children for the disease b. Testing the father for the presence of the trait on the Y chromosome c. Genetic counseling for all female children d. Testing the parents to determine the carrier

c. Genetic counseling for all female children

A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care? a. Place the client in a semi-Fowler's position b. Admit the client to a private room c. Measure head circumference every shift d. Implement seizure precautions

c. Measure head circumference every shift

Which factor is important to include in the teaching plan for parents of a child withLegg-Calvé-Perthes disease? a. It is an acute illness lasting 1 to 2 weeks. b. It affects primarily adolescents. c. There is a disturbance in the blood supply to the femoral epiphysis. d. It is caused by a virus.

c. There is a disturbance in the blood supply to the femoral epiphysis.

A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development? a. Tie colorful latex balloons to the side of the crib b. Provide a small electronic toy c. Change the infant's diaper as soon as soiling occurs d. Allow the infant to stand in the crib

d. Allow the infant to stand in the crib

During a 14-year-old's physical examination, the nurse identifies that he plays soccer andfootball and is complaining of knee pain when he rises from a squatting position, anddifficulty with weight bearing. The nurse should suspect a. Legg-Calvé-Perthes disease b. Osteomyelitis c. Duchenne muscular dystrophy d. Osgood-Schlatter disease

d. Osgood-Schlatter disease

in diabetes mellitus what do you do for hypoglycemia

give glucagon

how do patients with increased ICP present with

headache

what medication is given for graves disease and what education is needed

levothyroxine take 30 min before a meal

what do you do for myelomeningicele repair

measure circumference of head

A primary health care provider prescribes "eye patching" for a child with strabismus of the right eye. The nurse reinforces instructions to the mother to use which procedure for eye patching?

Place the patch on the left eye.

plan of care for child with hemiplegic cerebral palsy

modify the environment maintaining safety is the highest priority for this client. Modification of the environment includes making the child's home accessible and safe from hazards that could cause injury.

are any type of posturing good with ICP

no

Tissue ischemia and nerve damage are serious complications that may result fromimmobilization in a cast or from traction. The five Ps of vascular impairment can be usedas a guide when assessing for neurovascular problems. List the five Ps.

pain, pallor, pulselessness, paresthesia, paralysis

if a patient has a fractured femur what do you want their weight bearing status to be

partial

what do you do for a cleft lip post surgery

provide comfort and pain medication

During a lumbar puncture to r/o meningitis

the infant is positioned on her side in a fetal position (knees curled to abdomen and chin tucked to chest) to open up the subarachnoid space.

child is wetting the bed at night. what kind of communication do you use when talking to the parents and what do you tell them

therapeutic they will grow out of it

what do you do for influenza

treat the symptoms

The nurse has provided instructions to the mother of a child who has been diagnosed with bacterial conjunctivitis. Which statement by the mother would indicate the need for further teaching?

"I need to use hot compresses to relieve the eye irritation."

The nurse is instructing a mother of a 1-year-old child with strabismus about the treatment options. Which statement by the mother would indicate the need for further teaching?

"My child will outgrow this by the time he is 2 years old and be able to see just fine."

Reye's syndrome patients are allergic

aspirin

A home health nurse is developing a plan of care for a child who has hemiplegic cerebral palsy. Which of the following goals is the priority for the nurse to include in the plan of care? A. provide respite services for the parents B. improve client communication skills C. foster self-care activities D. modify environment

D. modify environment

Spastic Cerebral Palsy, expect

ankle clonus exaggerated stretch reflexes contractures

A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation? 1. It is positive. 2. It is negative. 3. It is inconclusive. 4. It requires rescreening at age 6 weeks.

2. It is negative.

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears. 2. Urine specific gravity is 1.035. 3. Capillary refill is less than 2 seconds. 4. Urine output is less than 1 mL/kg/hour.

3. Capillary refill is less than 2 seconds.

The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquids. 4. Administer an additional dose of regular insulin.

3. Encourage the child to drink liquids.

The nurse has taught a patient with type 2 diabetes mellitus about the clinical manifestations and evaluates that learning has occurred if the patient makes which statement? A. "I can expect that my blood sugars will increase when I am sick or under stress." B. "If I follow the diabetic diet, I will be able to control my symptoms of both hyperglycemia and hypoglycemia." C. "This darkening of the skin on the back of my neck is a result of high blood sugars and is nothing to worry about." D. "I understand that yeast infection, frequent urination, and high levels of energy are common in the diabetic patient."

A. "I can expect that my blood sugars will increase when I am sick or under stress."

3. A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following results indicate viral meningitis? (Select all that apply.) A. Negative gram stain B. Normal glucose content C. Cloudy color D. Decreased WBC count E. Normal protein content

A. Negative gram stain B. Normal glucose content E. Normal protein content

A lumbar puncture is performed on a child suspected of having bacterial menigitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis? A. Cloudy CSF, decreased protein, and decreased glucose. B. Cloudy CSF, elevated protein, and decreased glucose. C. Clear CSF, elevated protein, and decreased glucose. D. Clear CSF, decreased pressure, and elevated protein.

B. Cloudy CSF, elevated protein, and decreased glucose.

The blood glucose of a patient newly diagnosed with Type 1 diabetes mellitus has a blood glucose level of 310 mg/dL. Which type of insulin would the nurse expect to be ordered at this time? A. NPH B. Regular C.Lantus D. NPH + regular

B. Regular

A nurse is assessing an infant following a MVA. Which of the following findings should the nurse monitor to ID increased intracranial pressure? A. brisk pupillary reaction to light B. increased sleeping C. tachycardia D. depressed fontanels

B. increased sleeping

A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority? A. place pillow under head B. position side-lying C. loosen restrictive clothing D. clear area of hazard

B. position side-lying

A nurse is assessing an 8 mo for cerebral palsy. Which of the following findings is a manifestation of the condition? A. tracks objects with eyes B. sits with pillow props C. smiles when parent appears D. uses pincer grasp to pick up toy

B. sits with pillow props

A nurse is caring for a 2 yo who is hospitalized and throws a tantrum when his parents leave. Which of the following toys should the nurse provide to alleviate the child's stress? A. set of building blocks B. toy hammer and pounding board C. picture book about hospitals D. stuffed animal

B. toy hammer and pounding board

The mother of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation? A.Possible trauma. B.Possible sexual abuse. C.Presence of an allergy. D.Presence of a respiratory infection.

B.Possible sexual abuse.

The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review? A.Creatinine Level B.Prothrombin time. C.Sedimentation rate. D.Blood urea nitrogen level

B.Prothrombin time.

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? A.Supine B.Side-lying C.High Fowler's D.Trendelenburg

B.Side-lying

After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question? A.Monitor for bleeding B.Suction every 2 hours C.Give no milk or milk products D.Give clear, cool liquids when awake and alert.

B.Suction every 2 hours

A pre-school child newly diagnosed with Type 1 DM and parent meet with the nurse. Which statement best explains why play therapy can be effective in dealing with diabetes mellitus when meeting with the patient? A. "Play therapy with other children helps the child act out frustration." B. "Play therapy is appropriate for this age for normal development." C. "Play therapy with dolls and diabetes equipment helps the child express concerns regarding injections and finger sticks." D. "Play therapy with age-appropriate toys can distract the child from thinking about the need for insulin and special diet."

C. "Play therapy with dolls and diabetes equipment helps the child express concerns regarding injections and finger sticks."

A mother of a child who underwent a myringotomy with insertion of tympanostomy tubes calls the nurse and reports that the child is complaining of discomfort. Which should the nurse instruct the mother to do?

Give the child acetaminophen for the discomfort as per discharge instructions.

post op scoliosis repair

Initiate the use of a PCA pump for pain control. The nurse should initiate the use of a PCA pump for an adolescent who is postoperative following scoliosis repair. The PCA pump allows the client to control the delivery of pain medications.

Injecting insulin

It is not necessary to aspirate before injecting the insulin.

school-age child w/ T1DM, nurse should teach illness management

Test the urine for ketones. "The parent or child should test the urine for ketones and report the presence of them in the urine. Ketonuria can indicate that the child does not have enough glucose for energy and is breaking down fats to provide glucose to cells.

Which factor should the nurse include when teaching a parent about the care of a newborn in a Pavlik harness for hip dysplasia? a. The harness may be removed with every diaper change. b. The harness is used to maintain the infant's hips in flexion and abduction and external rotation. c. The harness is only the first step of treatment. d. The harness is worn for 2 weeks.

b. The harness is used to maintain the infant's hips in flexion and abduction and external rotation.

You note otorrhea and rhinorrhea as well as bruising around their eyes and mastoid. What is the likely diagnosis

basilar skull fracture

Late sign of increased ICP

bradycardia

tonic-clonic seizure. nurse should first

check respiratory rate

The nurse knows that treatment of Osgood-Schlatter disease includes a. Limitation of knee bending or kneeling b. Increasing range of motion (ROM) of the knee c. Encouraging flexion of the hip d. Limitation of adduction of the hip

a. Limitation of knee bending or kneeling

What is the most appropriate intervention for an adolescent with a mild scoliosis? a. Long-term monitoring b. Surgical intervention c. Bracing d. No follow-up

a. Long-term monitoring

Discharge planning for the child with juvenile arthritis includes the need for a. Routine ophthalmologic examinations to assess for visual problems b. A low-calorie diet to decrease or control weight in the less mobile child c. Avoiding the use of aspirin to decrease gastric irritation d. Immobilizing the painful joints, which is the result of the inflammatory process

a. Routine ophthalmologic examinations to assess for visual problems

what would the ph be of a patient with insulin dependent diabetes mellitus in dka

acidotic

The home care nurse is visiting a child newly diagnosed with diabetes mellitus. The nurse is instructing the child and parents regarding actions to take if hypoglycemic reactions occur. The nurse should tell the child to take which action?

Carry hard candies whenever leaving home in case a hypoglycemic reaction occurs.

patient with diabetes mellitus and hypoglycemic appears

cold and clammy

A nurse is assisting with a routine physical examination of an adolescent. The provider observed a lateral curvature of the spine. The nurse should expect the provider to document which of the following disorders? A) Scoliosis B) Kyphosis C) Lordosis D) Torticollis

A) Scoliosis

A nurse in a special education program is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care? A. allow for adjustment of rules to correlate with the child's behavior B. provide flexible schedule that adjusts to the child's interests C. allow for imaginative play with peers without supervision D. establish a reward system for positive behavior

D. establish a reward system for positive behavior

A nurse is caring for a child who is post-op following ventriculoperitoneal (VP) shunt placement. In which of the following positions should the nurse place the client? A. trendelenburg B. semi-folwers C. prone D. on un-operated side

D. on un-operated side

a child is in bryant's traction, what should you look for to know that it is appropriate

The buttocks is elevated slightly off of the bed.Having the buttocks elevated slightly off of the bed is appropriate for Bryant traction. The child's hips are flexed at a 90° angle with the legs suspended by pulleys and weights. The weights must hang freely from the bed to maintain alignment.

sign of hypoglycemia

shaky feeling"My son might complain of feeling shaky when he has a low blood glucose level."

What is the major concern guiding treatment for the child with Legg-Calvé-Perthesdisease? a. Avoid permanent deformity. b. Minimize pain. c. Maintain normal activities. d. Encourage new hobbies.

a. Avoid permanent deformity.

if there is a deficiency in growth hormone how will the patients blood sugar be

hypoglycemic

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding? A.Frequent swallowing B.A decreased pulse rate C.complaints of discomfort D.An elevation in blood pressure

A.Frequent swallowing

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? A.Turn the child to the side. B.Administer the prescribed antiemetic. C.Notify the health care provider (HCP). D.Maintain NPO (nothing by mouth) status.

A.Turn the child to the side.

what do you educate about cast care

dont stick anything down it

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

The nurse has just administered ibuprofen to a cild with a temperature of 102F. The nurse should also take which action? 1. Withhold oral fluids for 8 hours. 2. Sponge the child with cold water. 3. Plan to administer salicylate in 4 hours. 4. Remove excess clothing and blankets from the child.

4. Remove excess clothing and blankets from the child.

A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse and need for further teaching? A) I only need to catheterize myself twice every day. B) I carry a water bottle with me because I drink a lot of water. C) I use a suppository every night to have a bowel movement. D) I do wheelchair exercises while watching TV.

A) I only need to catheterize myself twice every day.

The patient is managed with NPH and regular insulin before breakfast, lunch, and dinner. When is the patient most likely to experience a hypoglycemic reaction? A. Never B. Mid-day C. Before lunch D. Before breakfast

C. Before lunch

child w/ temp of 40 C (104 F)

dress the child in minimal clothing

patient with acute bacterial meningitis is placed on what precautions

droplet

A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4. Checks the amount of urine output

A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunchtime. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.

Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided?A."Administer the antibiotics until they are gone" B."Administer the antibiotics if the child has a fever" C."Administer the antibiotics until the child feels better" D."Begin to taper the antibiotics after 3 days of a full course"

A."Administer the antibiotics until they are gone"

A child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? Select all that apply. A.Provide a soft diet. B.Position the child on the left side. C.Administer an antihistamine twice daily. D.Irrigate the right ear with normal saline every 8 hours. E.Administer ibuprofen for fever every 6 hours as prescribed and as needed. F.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

A.Provide a soft diet. E.Administer ibuprofen for fever every 6 hours as prescribed and as needed. F.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

A child is using regular insulin according to blood glucose monitoring results. At 2 pm, the child has a blood glucose of 185 mg/dl, for which the patient received 8 units of regular insulin. The nurse should expect the dose's onset and peak to be at which times?A. Onset 2:15 pm and peak 4:00-5:00 pm B. Onset 2:15:00 pm and peak 2:30-3:30 pm C. Onset 2:30-3:00 pm and peak 4:00-5:00 pm D. Onset 2:30-3:00 pm and peak 10:00-11:00 pm

C. Onset 2:30-3:00 pm and peak 4:00-5:00 pm

A nurse is caring for a 4-month-old infant who has meningitis. Which of the following findings isassociated with this diagnosis? A. Depressed anterior fontanel B. Constipation C. Presence of the rooting reflex D. High-pitched cry

D. High-pitched cry

A child has been diagnosed with bacterial conjunctivitis. Which clinical manifestations of bacterial conjunctivitis should the nurse expect to note? Select all that apply.

Swollen lids Inflamed conjunctiva Crusting on eyelids, especially in the morning