Peds exam 4

nursing considerations for epinephrine:

-observe reaction -reassess every 4 hrs -monitor BP and pulse -symptoms of allergic response

gross motor skills developed by 4 yrs old:

-skips and hops -catches a ball reliably

Management for scoliosis:

1st step bracing: -for mild scoliosis to align the spine -worn over the clothing -on for 24 hrs except for bathing -physical therapy along with bracing to help surgical intervention --> harrington rod -for severe scoliosis -patient gets up out of bed the day after surgery -patient should sit up right after surgery so they don't bend --> with hard back chair -patients receive a wallet card letting people know they have a metal rod -PCA will most likely be used for pain management and morphine Meds: -valium --> muscle relaxant -stool softener for constipation -tylenol and ibuprofen

what symptoms would you see with hemoplhilia? select all a. headache b. joint bleeding c. chest pain d. joint swelling

b. joint bleeding d. joint swelling

what vaccinations should a child receive at 4-6 yrs old?

-DTAP -IPV -varicella -yearly flu vaccine

vaccinations for 4-6 yrs old:

-DTap -IPV -MMR -Varicella -yearly influenza

Pain at 6 yrs old:

-FLACC and FACES -behavioral changes -pain relating to punishment -EMLA as an option to reduce pain during invasive procedures like IV

Spinal cord injuries:

-children have fewer spinal cord injuries than adults d/t resilience of the vertebrae -patient with spinal cord injuries need to be transffered via log roll

what interventions can help with encopresis? select all a. daily stool softener b. increase frequency of bathroom time c. punish if it happens frequently d. increase dairy

a. daily stool softener b. increase frequency of bathroom time

what safety measures should a 12 yr old meet to use a seat belt? a. ride in the back seat b. shoulder belt across the shoulder and chest c. feet on the floor of the car d. shoulder belt across the chest and neck

a. ride in the back seat b. shoulder belt across the shoulder and chest c. feet on the floor of the car

How are seizures diagnosed?

an EEG --> a test that measures electrical activity in the brain

how long should you apply emla cream before a procedure? a. 4 hrs b. 1 hr c. 15 min d. 30 min

b. 1 hr

when a preschooler asks why, what is a good response? a. ask them what they think b. because I said so c. simple answers d. give another meaning

c. simple answers

acute glomerulonephritis:

inflammation of the glomeruli of the kidney in children usually occurs d/t immune complex disease after an infection with strep -occurs 7-14 days after untreated strep infection

Eriksons stage for preschoolers:

initiative vs guilt -they achieve independence and realize they are separate humans from their parents -they become idependant with ADLs -they are egocentric about themselves guilt: -occurs when preschoolers believe they misbehaved or when they are unable to accomplish a task -also occurs when parents dont allow them to explore

what stage of Erikson's are 3 yr olds in?

initiative vs. guilt

Nursing considerations for factor VII:

monitor plasma factor VIII and monitor bleeding

mixed type CP:

most sever type, they have severe physical impairment and show symptoms of all types of CP

what is a soft locked restraint used for?

if the patient is a harm to themselves or they are sedated

Which factor influences acne in adolescent women the most? A.Stress B.Dietary intake C.Family history D.Hormonal imbalance

D.Hormonal imbalance

Encoporesis

repeated passage of feces at least once a month for a at least 3 months that are uncontrollable therapeutic management: -regimen to empty bowel of impacted stool (laxatives/ enemas) --> miralax is the most common and needs to be finished within 30 min behavior interventions: -focus on relearning -set aside dedicated time to use the bathroom -high fiber diet -daily stool softener -give them praise on the days that it doesnt occur

play for 5 yr olds:

-coloring books -drawing basic pictures -20 piece puzzle

what symptoms are present with celiac disease? select all a. distended abdomen b. FTT c. murmur d. steatorrhea

a. distended abdomen b. FTT d. steatorrhea

which type of fracture is common in preschool children? a. greenstick b. transverse c. compound d. comminuted

a. greenstick

how can parents promote initiative in their child? a. offer activities in their capabilities b. stopping them from playing dress up c. encourage them to play alone d. choose meals for them

a. offer activities in their capabilities

what can untreated group A beta-hemolytic strep infection lead to? select all a. rheumatic fever b. glomerulonephritis c. MIS-C d. appendicitis

a. rheumatic fever b. glomerulonephritis

what activities does a 4 yr old do easily? select all a. stand on one foot b. jump rope c. catch a ball easily d. skip

a. stand on one foot d. skip

which action would the nurse take after finding a child having a tonic-clonic seizure? a. applying restraints b. administering oxygen c. protecting the child from self-injury d. inserting a plastic airway in the child's mouth

c. protecting the child from self-injury

injury prevention for school aged children: helmets

wear a helmet because at this age they are riding bikes

nursing considerations for polythylene glycol:

-assess abdominal distention -assess presence of bowel sounds and usual bowel function -color and consistency of stool -take in 30 min in 8 oz of fluid -can take up to 2-4 days for a bowel movement

what toys and activities do early school aged children engage in?

-board games -jump ropes -bikes -collecting items ex. cards, rocks, and stamps

fine motor skills for 3 yrs old:

-building a tower of 9 blocks -opens containers -threading beads onto a string

s/s deficiency in growth hormone:

-delayed puberty -infantile face -crowded teeth -3rd percentile ht and wt

treatment for meningitis:

-dexamethasone --> for ICP -ceftriaxone --> for bacterial meningitis -acyclovir --> for viral meningitis -tylenol, motrin, and morphine --> for pain -mannitol/ steroids for worsening signs of ICP -decrease environmental stimuli

what toys and activities for late school aged children engage in?

-make crafts -build lego models -jigsaw puzzles

fine motor skills developed at 5 yrs old:

-ties shoes -prints letters -uses a preferred hand for activities

dyskinetic CP:

limp, flaccid, make slower movements, hard time speaking so its hard to understand what they are saying

indication for polythylene glycol:

treatment of occasional constipation and encoporesis

indication for baclofen:

treatment of spacticity d/t cerebral or spinal origin (in this case cerebral palsy)

what is a welcome sleeve?

they are elbow restraints

how should a car seat be facing at 5 yrs old:

forward facing

how should a car seat be positioned at 6 yrs old:

forward facing

what vaccinations are required at 11 yrs old? select all a. HPV b. varicella c. menACWAY d. Tdap

a. HPV c. menACWAY d. Tdap

vocabulary of a 4yr old:

3-4 word sentences

what is the first thing do develop in females experiencing puberty?

breast buds

what items are risks for choking in preschoolers? select all a. pea b. coins c. eggs d. batteries

b. coins d. batteries

S/S worsening ICP:

1st sign --> headache and lethargy (early) -bradycardia -abnormal breathing -low mean arterial pressure -irritability -decreased LOC

Which development-related activity is most important for the nurse to encourage for a hospitalized school-aged child? A.Family contact B.Peer interaction → this is adolescents C.Therapeutic play D.Academic studies

D.Academic studies

indication for factor VIII:

Hemophilia A -to prevent/ control bleeding episodes -perioperative management and routine prophylaxis of bleeding episodes

Febrile seizure

a high spike in temperature 102-104 F treatment: -tylenol or motrin depending on their age (best if suppository so it takes affect quickly) education: -dont put them in cold water because they can go into shock; we can use a cool cloth instead

Compartment syndrome:

compression causing patient to become ischemic because the cast is too tight and there is constant swelling

which immunizations would a child who has reveived all primary immunizations receive before starting kindergarten? a. IPV, Hep B, Td b. DTap, Hep B, Td c. MMR, DTap, Hib d. DTap, IPV, MMR

d. DTap, IPV, MMR

untreated rheumatic fever causes what? a. strep infection b. chorea c.liver failure d. cardiovascular mortality

d. cardiovascular mortality

what is the first thing to develop in males experiencing puberty?

enlarged testicles

ataxic CP:

harder for them to coordinate fine motor skills and have a wider gait

what virtue is developed at 6 yrs old?

virtue of confidence

vocabulary at 6 yrs old:

-2100 words

vocabulary for 5 yr olds:

-4-5 words -100% of speech understood -counts to 10

at 11 -12 yrs old what vaccinations should a child receive?

-HPV -Tdap -yearly influenza -MenACWY (meningitis vaccine)

causes of hemolytic uremic syndrome:

-unwashed vegetables -undercooked meats -public pools -poor hand hygiene

when do boys stop growing?

18-20 yrs old

Which parental statement would prompt the nurse to provide additional education to the parent of a preschool age client with a severe food allergy? A.I will send the self-injectable epinephrine device with my child to pre-school B.I have reviewed the symptoms of an anaphylactic reaction with the pre-school C.I have created an emergency action plan in case an anaphylactic reaction occurs D.I am going to create a food allergy plan wit the director to avoid the risk of an accidental exposure

A.I will send the self-injectable epinephrine device with my child to pre-school

Which statement describes scoliosis? ​​A.The concave lumbar curvature is exaggerates B.There are pathological changes in the vertebrae C.There is a rotary deformity of the lateral curvature of the spine D.The curvature of the thoracic spine has an increased convex angulation

C.There is a rotary deformity of the lateral curvature of the spine

Meningitis:

Droplet precautions S/S: -fever -headache -nuchal rigidity -diarrhea -photosensitivity -joint pain w/ hib -*brudzinski* sign (bend the neck and the knees involuntarily flex) -*Kernig's sign* (knees cant fully bend) -petechia rash --> mostly d/t septicemia

what interventions should be done if a preschooler has a bee/wasp sting? select all a. cool compress b. pull out stinger c. monitor for red bulls eye rash d. antibiotics

a. cool compress b. pull out stinger

if a parent is moving to a forward facing seat, what should they assess for? select all a. maxed ht b. maxed wt c. over 4 yrs old d. checked with HCP

a. maxed ht b. maxed wt

when caring for a preschool child with nephrotic syndrome, which clinical manifestation would the nurse be able to detect when monitoring the blood pressure and pulse rate quality? a. heart failure b. hypvolemia c. pulmonary embolus d. increased serum potassium

b. hypvolemia

what is the treatment for percocious puberty? a. begin birth control b. synthetic analog (lupron) c. surgery on sex organs d. begin androgen

b. synthetic analog (lupron)

all of these findings represent compensatory physiological changes in reaponse to increased ICP except: a. reduction in intracranial blood volume b. decrease in cerebrospinal fluid production c. shrinkage of brain mass by displacement of intracellular and extracellular fluid d. increase in intracranial blood volume to increase cerebral oxygenation

d. increase in intracranial blood volume to increase cerebral oxygenation

What should the nurse tell the parent concerning an exercise program for her child diagnosed with idiopathic scoliosis who has a mild structural curve? ​​A.Exercise is used in conjunction with a brace B.Exercise can be used if the child appears highly motivated C.Exercise might exaggerate the curvature if the curve is severe D.Exercise is needed to correct the curvature without the need for a brace

​​A.Exercise is used in conjunction with a brace

Rheumatic fever:

autoimmune disease reaction to strep A (group A beta hemolytic strep infection) -creates fibrin deposits on endocardium and valves -most common in poor and urban areas *causes inflammatory lesions on the heart and blood vessels --> endocarditis* treatment: -penicillin s/s: must have two major or one major and two minor manifestations -carditis -subcutaneous nodules -polyarthritis -chorea (temporary) --> treat with phenobarbitol -erythema margitum (macular rash) -fever labs: -elevated ESR and CRP -elevated antistreptolysin O (recent strep infection)

what is the concern with fractures in children? a. a lower force fraction b. a fracture at the epiphyseal line c. a greenstick fracture d. multiple fractures with a cause

b. a fracture at the epiphyseal line

a nurse notes orders of "no nasogastric tubes" and "no nasotracheal suctioning" for a pediatric patient with a severe head injury and skull fracture. what is the rationale for these orders? a. both of these interventions are contraindicated because both will cause an increase in intracranial pressure and could result in herniation b. both of these interventions are contraindicated because both could result in the catheter entering the brain c. both of these interventions are contraindicated because both would cause unnecessary procedural pain in this patient d. both of these interventions are contraindicated because both would cause an increase in systolic blood pressure and resultant increase in cerebral blood volume and pressure

b. both of these interventions are contraindicated because both could result in the catheter entering the brain

How do adolescents establish family identity during psychosocial development? select all a. by achieving marked physical changes b. by acting independently to make his or her own decisions c. by evaluating his or her own health with a feeling of well being d. by building close peer relationships to achieve acceptance in the society e. by fostering his or her own development within a balances family structure

b. by acting independently to make his or her own decisions e. by fostering his or her own development within a balances family structure

a child is admitted to the pediatric intensive care unit with acute bacterial meningitis. which intervention would the nurse include in the plan of care? a. offering clear fluids whenever the child is awake b. checking the child's level of consciousness hourly c. assessing the childs BP every 4 hrs d. administering the prescribed oral antibiotic medication

b. checking the child's level of consciousness hourly

In a patient with hemophilia A who has sustained a injury to their face, what is the priority nursing action? a. administer plasma as soon as possible b. control any bleeding c. monitor platelet count for 24 hrs d. administer blood products

b. control any bleeding

which clinical finding would the nurse expect when assessing a 4 yr old child admitted with nephrotic syndrome? a. severe lethargy b. dark, frothy urine c. chronic hypertension d. flushed, ruddy complexion

b. dark, frothy urine

what play is important in preschool stage of development? select all a. competitive sports b. dress up c. pretend play d. potty training play

b. dress up c. pretend play

what organisms cause strep pharyngitis? select all a. E.coli b. group A beta-hemolytic strep c. viral organisms d. group B strep

b. group A beta-hemolytic strep c. viral organisms

what is the treatment for enuresis? select all a. increase fluid throughout the day b. identify stressful triggers c. use toilet 10x a day d. fully wake up at night to use the bathroom

b. identify stressful triggers d. fully wake up at night to use the bathroom

which condition is commonly seen following manifestation with pediculosis capitis (head lice)? a. eczema b. impetigo c. cellulitus d. folliculitis

b. impetigo

what is the management for the treatment of iron deficiency anemia? a. iron for 2-4 weeks b. iron for 4-6 weeks c. iron for 6-8 weeks d. iron for 8-10 weeks

b. iron for 4-6 weeks

the nurse is teaching the parent of a toddler with a recent diagnosis if hemophilia about the disease. which area of the body would the nurse include as the most common site for bleeding? a. brain b. joints c. kidneys d. abdomen

b. joints

what safety measures should an 8yr old meet in a booster seat? select all a. lap belt on the stomach b. lap belt on the upper thighs c.position seat as far forward as possible d. ride in the back seat

b. lap belt on the upper thighs d. ride in the back seat

what are preschoolers more at risk for iron deficiency anemia? a. decrease of iron rich foods b. milk intake c. diet high in cereal d. menstruation

b. milk intake

which nursing action would be included in the plan of care for a child with acute streptococcal glomerulonephritis? a. encouraging fluids b. monitoring for seizures c. measuring abdominal girth d. checking for pupillary reactions

b. monitoring for seizures

allergic rhinitis symptoms include what? select all a. increased sleep b. nasal engorgement c. blackened eyes d. sneezing

b. nasal engorgement c. blackened eyes d. sneezing

what is the treatment for impetigo? select all a. wash linens in cold water b. oral antibiotics if severe c. cover lesions until crusting d. mupirocin ointment

b. oral antibiotics if severe c. cover lesions until crusting d. mupirocin ointment

what inpatient treatment would be used for anaphylactic shock? select all a. valium b. oxygen c. oxycodone d. albuterol

b. oxygen d. albuterol

which nursing intervention would be provided to a hospitalized client during the identity vs role confusion stage? a. choosing creative ways to promote social participation b. providing information to the client about the treatment plan c. encouraging the client to participate actively in treatment procedures d. involving the clients partners or family members in the caring process

b. providing information to the client about the treatment plan

which adolescent behavior increases the risk of injury? select all a. poor diet b. substance abuse c. unprotected sex d. sedentary lifestyle e. increased screen time

b. substance abuse c. unprotected sex

a toddler with hemophilia A is admitted for observation after a motor vehicle accident. the toddler has several bruises but no other apparent injuries. which complication would the nurse monitor the toddler for? a. possibility of falls b. undetected injury c. low fluid volume d. development of infection

b. undetected injury

which concern may be specifically seen in middle adolescents? a. growth and development b. violence within social environment c. school performance and future career d. physical appearance and peer group acceptance

d. physical appearance and peer group acceptance

which education would the nurse provide the parent of a preschool-aged child regarding injury prevention? a. preschool-aged children are more prone to falls than are toddlers b. preschool-aged children are at risk for injury because of their poor gross motor skills c. preschool-aged children are less likely to follow rules, which increases the risk for injury d. preschool-aged children are at risk for head injuries from riding a tricycle or balance bike

d. preschool-aged children are at risk for head injuries from riding a tricycle or balance bike

What medication is used during an active seizure?

dia-stat (benzodiazepine) --> a rescue medication -given rectally because we need it to absorb quickly -if seizure lasts longer than 5 min give med and call 911 -monitor for sedation after giving the med

enuresis:

involuntary passage of urine (not normal; it occurs after being fully potty trained) -2-3x during the day -4-6 x at night causes: -stress -nightmares -bladder stretch injury management: -bowel managment -timed voiding -hydration management -improved fiber management -behavior managment -biofeedback -drug therapy treatment: -pee and dont drink 2 hrs before bed -scheduled bathroom times (even at night fully wake them up to go) -DDVAP --> decreased urine output -take bath or shower in the morning so they dont smell for school

decorticate position:

late sign of increased ICP -flexed hands -adducted arms -internally rotated thighs -plantar flexion

Decerebrate Position:

late sign of increased ICP -pronated wrists -flexed hands -plantar flexed feet

Hemolytic Uremic Syndrome:

occurs from a strand of E.coli that comes from diarrhea causing inflammation in the GI tract. the E.coli enters through the inflammation and goes into the bodies circulation and damages the endothelial cells leading to destruction of platelets -thrombosis tends to form in our circulation system which destroys our RBCs and leads to anemia -diarrhea + = most common cause of hemolytic uremic syndrome 3 big signs: -homolytic anemia (low H&H) -thrombocytopenia -AKI (creatinine and BUN increases, LDH increases, will see protein in urine and hematuria) Other s/s: -dehydration -pale and weak -decreased urine output -HTN --> worse case scenario d/t severe damage in kidneys

indication for ferrous sulfate:

prevention or treatment or iron deficiency anemia

how should a car seat be facing for a 3 yr old?

rear facing

Scoliosis:

spine deformity characterized by lateral and rotational curvature of the spine functional --> -a non rotated spinal curve caused by a secondary problem such as length discrepancy (one leg shorter than the other) structural --> -primary deformity such as an underlying neuromuscular disorder dx --> -touch toes to see curvature and hip alignment

S/S of compartment syndrome:

the 5 P's -pain -paresthesia (not able to wiggle fingers or towa depending on what extremity is affected) -pulselessness --> in that extremity -paralysis -pale

vaccinations for preschoolers:

they get these once between the ages of 4 and 6 -5th DTap -IPV -yearly covid/flu -MMR -varicella

true or false: preschoolers think pain is a form of punishment

true

percocious puberty:

when puberty occurs too early causes: -pituitary tumor -gonadostat of the hypothalamus turns on many years too early -starting brith control S/S: -they dont develop pubic hair yet females: enlarged breasts and have menses males: have enlarges testicles, spermatogenesis, taller, deeper voice, more promiscuous, more at risk for fractures as they get older because they haven't had enough time to build calcium for their bones dx: -test hormones estrogen and androgen management: -synthetic analog to gonadotropin --> releases hormone to halt puberty

iron deficiency anemia:

without iron hemoglobin cant be incorporated into RBCs -most common cause of this in preschoolers is inadeqaute dietary intake s/s: -pale mucous membranes -enlarged heart and spleen -poor muscle tone and decreased activity -tachycardia -cool extremities -fatigue -SOB -chest pain -dizziness -headaches treatment: -iron supplement -11-16 mg/day -take with orange juice to help absorb vit D diet: -iron fortified cereals -dried beans -lentils -peanut butter -red meat labs: -low MCV -low ferritin -low RBC -low H&H

When planning long-term care for a 3.5 year old with cerebral palsy which is important for the nurse to consider? ​​A.CP is not progressively degenerative B.The effects of CP are unpredictable C.The child probably has some degree of cognitive impairment D.The child should have genetic counseling before planning a family

​​A.CP is not progressively degenerative

Which activities should be easier for the school age child due to changes in proportions from the preschool stage of development? Select all. ​​A.Climbing B.Handwriting C.Riding a bike D.Problem solving E.Cooperative play

​​A.Climbing B.Handwriting C.Riding a bike D.Problem solving E.Cooperative play

Which action would the school nurse take after identifying an adolescent at risk for smoking due to peer pressure? Select all. ​​A.Discuss alternatives to smoking B.Punish the peer group influencing the adolescent C.Mention immediate physiological consequences D.Suggest effective arguments to deal with peer pressure E.Recommend that the adolescent transfer to a different school

​​A.Discuss alternatives to smoking C.Mention immediate physiological consequences D.Suggest effective arguments to deal with peer pressure

at what age can a child switch to a booster seat?

7-8 yrs old

Which suggestion would the nurse provide to the parent whose child has been constipated for 3 days? Select all. A.Give laxatives to the child B.Reduce the child's fluid intake C.Include dairy products in the child's diet daily D.Increase the child's physical activity E.Include food with a high fiber content in the child's diet

A.Give laxatives to the child D.Increase the child's physical activity E.Include food with a high fiber content in the child's diet

Which laboratory finding would the nurse anticipate identifying in the repost of a client exposed to pollen who reports a runny, stuffy nose and itchy, watery eyes with the nasal examination revealing swollen and pink nasal mucosa? A.Immunoglobulin E level of 150 IU/mL B.Eosinophil count of 2% C.Percentage of neutrophils of 80% D.Total white blood cell count of 3 billion cells/L

A.Immunoglobulin E level of 150 IU/mL

Which manifestation would the nurse include when the parents of a child has just been diagnosed with hemophilia A ask what symptoms of bleeding should they look for in the future? Select all. A.Nosebleeds B.Blood in the urine C.Painful and swollen joints D.Easy bruising E.Frequent fevers F.Fast clotting of injuries G.Dark-colored tarry stools

A.Nosebleeds B.Blood in the urine C.Painful and swollen joints D.Easy bruising G.Dark-colored tarry stools

Which developmental achievements distinguish preschoolers from school age children? Select all. A.Preschoolers have imaginary playmates B.Preschoolers are able to relate events to their causes C.Preschoolers are curious to know about their surroundings D.Preschoolers understand that one object can exist in two shapes E.Preschooler believe that inanimate objects have lifelike qualities

A.Preschoolers have imaginary playmates E.Preschooler believe that inanimate objects have lifelike qualities

Which safety instruction would the nurse teach a child/parent with diminished sensation in the legs because of cerebral palsy? A.Test the temperature of the water before a bath B.Overtighten brace straps securely before ambulating C.Set the close twice during the night to change position D.Look down at the legs when crutch-walking to check how they are positioned

A.Test the temperature of the water before a bath

Which immunization would be required for a 12 year old client transferring to a new school? Select all. A.Tetanus B.Influenza C.Pertussis D.Diphtheria E.Meningococcal F.Human Papillomavirus

A.Tetanus B.Influenza C.Pertussis D.Diphtheria E.Meningococcal F.Human Papillomaviru

Which strategy would the nurse adopt while performing the health assessment of an adolescent? Select all. A.Treating adolescents as adults B.Addressing adolescents as Mr. or Mrs. C.Maintaining an adolescents right of confidentiality D.Performing the examination in a nonthreatening area E.Gathering all the history of an adolescent from their parent or guardian

A.Treating adolescents as adults C.Maintaining an adolescents right of confidentiality D.Performing the examination in a nonthreatening area

A client with iron-deficiency anemia is prescribed iron supplementation daily. To help the client increase iron absorption, the nurse would suggest the client eat foods/drink high in which substance? A.Vitamin C B.Fat content C.Water content D.Vitamin B complex

A.Vitamin C

The nurse is planning a presentation related to growth and development for the parents of school age children. Which topic is most appropriate related to the topic of sexual maturation? A.Methods to prevent pregnancy B.Typical questions and learning needs C.Safer sex practices to prevent infection D.Information relayed by one parent to the child

B.Typical questions and learning needs

Which language milestone would the nurse expect in preschoolers? Select all. ​​A.Starting to understand riddles and jokes B.Wanting to know the reason, asking "why" C.Having a vocabulary of 2,100 words D.Knowing that words may have arbitrary meanings E.Unable to distinguish between phonetically similar words

B.Wanting to know the reason, asking "why" C.Having a vocabulary of 2,100 words E.Unable to distinguish between phonetically similar words

The nurse teaches the parents of a child with celiac disease about the food that should be eliminated from the diet. Which foods do the parents name that indicate to the nurse that the teaching has been understood? Select all. ​​A.Milk B.Cheese C.Oatmeal D.Rice cakes E.Corn on the cob F.Whole wheat bread

C.Oatmeal F.Whole wheat bread

Which findings would the nurse conclude is related to a child's diagnosis of rheumatic heart disease? A.Negative c-reactive protein B.Increased reticulocyte count C.Positive antistreptolysin titer D.Low erythrocyte sedimentation rate

C.Positive antistreptolysin titer

Which nursing intervention would be contraindicated for a client who has a fracture and has compartment syndrome? Select all. ​​A.Splitting the cast in half B.Applying cold compress C.Reducing the traction weight D.Loosening the clients bandage E.Elevating the extremity above the heart

C.Reducing the traction weight → we wouldn't do this because it is holding the bone in place

Which education would the nurse provide the family of a preschool age child about normal growth patterns? ​​A.The rate of physical growth accelerates during this stage of development B.Muscle and bone development are mature during this stage of development C.You can expect your child to keep the potbelly appearance during this stage of development D.Your child's legs will grow in length versus the trunk of the body during this stage of development

D.Your child's legs will grow in length versus the trunk of the body during this stage of development

vaccinations for adolescents:

-Men B (at 16-18 yrs old) -menACAWAY booster age 16 -annual flu -HPV* --> if they didnt get it at 11-12 yrs old

growth hormone:

-affects how much we grow *S/S* -short stature but proportioned -delayed epiphyseal closure -increased insulin sensitivity -delayed detention -underdeveloped hips and jaws -delayed sexual development dx: -GH lab draw -X-ray to identify if the epiphyseal plates are open or closed -height, weight, and growth chart comparisons treatment: somatotropin

how to prevent compartment syndrome:

-allow initial swelling to go down before casting -bivalving --> cast is cute on either side of the cast to allow the flow of inflammation and eliminating it from cutting off circulation -put ice on the cast after its been applied and elevate extremity

treatment for acute glomerulonephritis:

-antibiotics -manage BP with abetalol -lasix for edema -fluid restriction -monitor for electrolyte imbalance --> potassium and phosphate

head injuries:

-concussion, lacerations, fracture 1st step --> protect C-spine 2nd step --> neuro assessment q 1hr -complete CT to make sure the brain is okay -complete glaucoma scale -to monitor BP internally --> foley with pressure sensor

play appropriate at 6 yrs old:

-dress up and pretend play -wants friendships -focuses on others instead of self -can ride a bike -lego models

treatment for hemolytic uremic syndrome:

-fluids --> daily wt -treat HTN is present -bowel rest -plasma --> for severe anemia -monitor urine to see how kidney function is

gross motor developed at 6 yrs old:

-jumping jacks -can kick a ball while moving and changing directions -dresses and toilets independently

gross motor skills developed at 5 yrs old:

-jumps rope -throws and catches ball with ease -can walk backwards -dresses themselves

Interventions for increased ICP:

-keep HOB no more than 30 degrees elevated -neuro assessment every 1 hr -frequent vitals -stool softeners to prevent straining -maintain midline/ straight body position --> flexion decreased drainage -provide a calm environment --> dim lights, minimal noise, minimal stimuli -treat fever + manage body temp -educate to avoid valsalva maneuver --> bearing down increases ICP

nursing care for head injuries:

-neuro checks q 1 hr -assess for clear fluid from the nose/ ear --> report immediately -HOB elevated midline helps decrease ICP --> no more than 30 degrees -monitor VS -safe and calm environment --> turn lights off, limit visitors, no phone -provide adequate fluids

post op care for tonsillectomy:

-no straws -start PO clear fluids SLOWLY then switch to soft foods -avoid red food -give constant pain medications -elevate HOB to facilitate drainage -cold liquids feel better on the throat than hot

autonomic dyreflexia:

-occurs secondary to a spinal cord injury -when the bladder becomes full it will cause a reflex reaction s/s: -extreme HTN -tachycardia -flushed face -and severe optical HA -sweating interventions: -immediately sit up or straight cath to decreased BP and pressure on the bladder

fine motor skills developed at 6 yrs old:

-pencil control -using knife and fork for soft foods

play appropriate for 4 yr olds:

-puppets - 8-12 piece puzzles

play for 3 yrs olds:

-rides a tricycle -dresses with large buttons -simple crafts

when to call 911 for seizures:

-seizure lasts longer than 5 min -child stops breathing -status epilepticus occurs -pupils are not equal after seizure -child vomits continuously for 30 min -child is unresponsive -seizure occurs in water - if its the child's 1st seizure

seizure precautions:

-seizure pads -bed in the lowest position -suction and oxygen at bedside -reduce environmental stimuli -monitor therapeutic drug levels

s/s acute tonsillitis:

-snoring sounds -halitosis -pain -white exudate -swelling -halitosis -tonsil stones

gross motor skills for 3 yr olds:

-stands on one foot -jumps off the bottom step

S/S excess growth hormone:

-tall -higher weight -more sexually mature -acromegaly -enlarged tongue management: -can give growth hormone antagonist; its not useful is the epiphyseal plates have already closed

tonic clonic seizures:

-these patients need long term meds and safety plans 3 phases: 1. tonic --> -hypertonic -extremities stiffen -can have apnea of cyanosis 2. clonic --> -jerky fast movements -lasts for about 20-30 seconds 3. post istal --> -sleepy -groggy -hard to wake up -can last 1-4 hrs -normally they dont remember the seizure occurring

nursing considerations for ferrous sulfate:

-toxicity and overdose education -make patient aware of S/S --> black stool, teeth staining, constipation -take with orange juice

seizure interventions:

-turn to the side -protect their airway -protect from injury -note time, length, precipitating factors, and characteristics -stay with them -NEVER hold them down or put something in their mouth

fine motor skills developed at 4 yrs old:

-uses a fork well -cuts along a line -writes their name

acne education:

-wash face -avoid sunlight -change pillowcase at least once a week -pimple patches/ spot treatment -dont pick -benzoyl peroxide --> (OTC treatment inhibits bacterial growth on skin) -birth control for girls goal of management: -decrease sebum -control bacteria prevent comedones

Impetigo:

Very contagious --> contact precautions causes: -strep A or staph (MRSA) s/s: -honey colored crusted lesions Interventions: -cover wounds -hand hygiene -likely to be sent home from school -a child can go back to school once they have been on antibiotics for at least 24 hrs -don't touch or share saliva -wash toys, bedding, and belongings in hot water treatment: -oral antibiotics dx: symptom rule out

what should parental discharge instructions include when a nurse is discharging a patient home after hospital admission for a closed head injury? a. a list of probable post-traumatic symptoms, observations they need to make, and the importance of follow up care b. school attendance and other restrictions and observations they need to make c. probable post-traumatic symptoms, referral to a child psychologist, and instruction on recognition of seizure activity d. observations they need to make and a referral to rehab services

a. a list of probable post-traumatic symptoms, observations they need to make, and the importance of follow up care

the mother of a school aged child diagnosed with meningitis has questions about the complications that may develop after the acute illness resolves. what is the most common complication of a bacterial meningitis infection? a. hearing impairment b. visual impairment c. permenent seizure disorder d. hydrocephalus

a. hearing impairment

which statement would the nurse include in teaching session for a school aged clients and their parents? select all a. parents of school aged children must learn to let go of control b. strict discipline is the priority over understanding and tolerance c. peer groups are highly influential during this stage of development d. your child may wish to be more involved with peer activities than family activities e. when a conflict between peers and parents occurs, family values will predominate

a. parents of school aged children must learn to let go of control c. peer groups are highly influential during this stage of development d. your child may wish to be more involved with peer activities than family activities e. when a conflict between peers and parents occurs, family values will predominate

which education would the nurse include when teaching a parent about various psychosocial changes common in preschoolers? select all a. preschoolers are fearful about bodily harm b. preschoolers experience a sense of autonomy c. preschoolers develop a close attachment to the caregivers d. preschoolers believe that inanimate objects have lifelike qualities e. preschoolers believe that punishment is automatically connected to an act

a. preschoolers are fearful about bodily harm e. preschoolers believe that punishment is automatically connected to an act

which developmental achievements distinguish preschoolers from school-aged children? select all a. preschoolers have imaginary play mates b. preschoolers are able to relate events to their causes c. preschoolers are curious to know about their surroundings d. preschoolers understand that one object can exist in two shapes e. preschoolers believe that inanimate objects have lifelike qualities

a. preschoolers have imaginary play mates e. preschoolers believe that inanimate objects have lifelike qualities

which would the nurse include in the plan of care to decrease the risk for injury related to motor vehicle accidents for a school age client? a. securing seat belts properly b. using a low heat setting when cooking c. recommending enrollment in swimming lessons d. making sure smoke detectors are installed in the home

a. securing seat belts properly

what symptoms are seen in a febrile seizure? select all a. sudden spike in temp b. tonic-clonic movements c. string spells d. results from a specific area of the brain

a. sudden spike in temp b. tonic-clonic movements

which strategy would the nurse adopt while performing the health assessment of an adolescent? select all a. treating adolescents as adults b. addressing adolescents as "Mr." or "Ms." c. maintaining an adolescents right of confidentiality d. performing the examination in a nonthreatening area e. gathering all the hx of an adolescent from their parent or guardian

a. treating adolescents as adults c. maintaining an adolescents right of confidentiality d. performing the examination in a nonthreatening area

Epstein-Barr virus (EBV) mononucleosis:

-"kissing disease" spread by saliva (sharing food/ beverages) S/S: the triad -fever -tonsilloropharyngitis -lymphadenopathy Other s/s: -lethargy -sore throat -loss of appetite -headache -increased WBC -splenomegaly (at risk for rupture) dx: mono spot test -IgG --> detects past exposure -IgM --> detects most recent infection that is occurring now

Which event is considered the first sign of puberty in girls? A.Breast development B.Pubic hair distribution C.First menstrual period D.Physiologic leukorrhea

A.Breast development

Which bacterial condition is suspected when a client with vesiculopustular lesions with honey-colored crusts in the face visits the primary HCP? A.Cellulitis B.Impetigo C.Carbuncle D.Varicella

B.Impetigo

Which measure would the nurse adopt while promoting health among adolescents? Select all. A. Insist that the adolescent discuss his or her concerns B. Have a discussion with the adolescent in front of the family C. Be sensitive to the emotional cues delivered by the adolescent D. Tell the parents immediately when a teen discloses his or her sexual orientation E. Provide counseling to the adolescent undergoing rehabilitation for substance abuse

C. Be sensitive to the emotional cues delivered by the adolescent E. Provide counseling to the adolescent undergoing rehabilitation for substance abuse

Which virus is responsible for causing infectious mononucleosis in clients? ​​ A.Parvovirus B.Coronavirus C.Rotavirus D.Epstein-Barr virus

D.Epstein-Barr virus

Allergic rhinitis:

IgG immune response -it is a risk factor for developing asthma as they get older s/s: -congestion -nasal engorgement -sneezing -watery discharge -headache -racoon eyes --> d/t increase pressure of blood circulation -conjunctival infections -eyelid edema -edematous bluish/red nasal turbinates -increased ear infections care: -avoid allergens -medications: antihistamine, luekotriene inhibitor, corticosteroids (need to be taken every day in order for them to work) common allergies: -dust -pollen -pet dander -smoke

what lab indicated muscle damage?

creatine kinase

s/s acute glomerulonephritis:

*reddish brown smokey colored urine* -because urine is full of WBC, RBC, epithelial cells, and protein -specific gravity is high

indication for epinephrine:

-severe allergic reactions -upper airway obstruction with croup

when do girls stop growing?

2 yrs after menses

vocabulary for 3 yr olds:

3-4 word sentences

what should you as a nurse do before reporting abuse?

ASSESS

Which fundamental biological change is observed to be similar during the growth of females and males? Select all. A.Detectable changes in voice during puberty B.Appearance of initial pubic hair during early puberty C.Progression of pubic hair growth mid-puberty D.Development of axillary hair and detectable facial hair during mid-puberty E.Obtaining peak height and weight velocities simultaneously during late puberty -peak isnt reached until early adolescents

B.Appearance of initial pubic hair during early puberty C.Progression of pubic hair growth mid-puberty

Which developmental intervention would the nurse provide to promote safety among adolescents? Select all. ​​A.Reducing the risk of physiological falls B.Guiding adolescents to make lifestyle modifications C.Helping parents minimize risks to their adolescent's safety D.Educating parents to protect their adolescents from life-threatening disease E.Teaching parents to serve as role models by guiding expectations and providing education

B.Guiding adolescents to make lifestyle modifications C.Helping parents minimize risks to their adolescent's safety E.Teaching parents to serve as role models by guiding expectations and providing education

Which symptom would the nurse expect in a 4 year old child with mild iron deficiency anemia and fatigue? A.Cold, clammy skin B.Increased pulse rate C.Increased blood pressure D.Cyanosis of the nail beds

B.Increased pulse rate

Which condition would the nurse suspect in a 10-year old child who was admitted with abdominal pain, guarding, nausea, anorexia and pain with palpation for the right lower quadrant? A.Viral infection B.Inflamed appendix C.Irritable bowel D.Parasitic infection

B.Inflamed appendix

Which vaccine would the nurse administer to provide protection from precancerous lesions and cancer of the vulva, cervix and vagina in young girls/women? A. Rotavirus vaccine B. Varicella virus vaccine C. HPV vaccine D. Meningococcal conjugate vaccine

C. HPV vaccine

Which is the most common cause of death among adolescents? A.Suicide B.Homicide C.Accidents D.Substance abuse

C.Accidents

When a client develops bacterial meningitis, which action is the nurse's priority? A.Monitoring for signs of intracranial pressure B.Adding pads to the side of the bed C.Administering prescribed antibiotics D.Administering glucocorticoids

C.Administering prescribed antibiotics

After a tonsillectomy, which early client assessment finding would alert the nurse to suspect a possible hemorrhage? ​​A.Noisy snoring B.Asking for water C.Frequent swallowing D.Gradual onset of pallor

C.Frequent swallowing

The nurse is counseling the parents of a 13 year old child with Duchenne muscular dystrophy about problems that may develop during adolescence. Which body system will the nurse expect to be affected? A.Neurological B.Integumentary C.Genitourinary D.Cardiopulmonary

D.Cardiopulmonary

Which explanation would the nurse provide for the lower overall height differences in girls compared with boys? A.Increase in muscle mass B.Hypertrophy of the laryngeal mucosa C.Maturation of structural appendages of the skin D.Closure of epiphyses because of estrogen secretion

D.Closure of epiphyses because of estrogen secretion

Which clotting factor would a nurse explain is deficient to the parents of a newly diagnosed child with hemophilia A? A.Factor II B.Factor XII C.Factor IX D.Factor VIII

D.Factor VIII

Which characteristic of adolescence is exemplified by risk taking behavior without fear of consequences? A.Animism B.Personal fable C.Imaginary audience D.Sense of invulnerability

D.Sense of invulnerability

school age vital signs:

HR --> 70-80 bpm BP --> 112/60 may see an innocent heart murmur that will eventually go away at the end of the school aged period increased oxygen-carbon dioxide exchange = increased stamina

appendicitis:

S/S: -belly button pain -fever and chills -N/V -bloating -constipation or diarrhea -rebound tenderness --> McBurneys point dx test --> ultrasound then CT treatment: -antibiotics or laprascopic appendectomy -shoulder pain is normal after surgery (usually occurs on the R side) -pain is controlled with tylenol or motrin -before they leave the hospital we want to make sure they have BS

a school aged child with acute glomerulonephritis has fluid intake restricted to the previous days output plus 40 mL. the child's output over the past 24 hrs was 140 mL from 3 PM to 11 PM the child is to receive one-third of the total daily fluid permitted. How much fluid would the nurse provide for the evening intake? a. 60 mL b. 70 mL c. 80 mL d. 90 mL

a. 60 mL

At what age do children understand the concept of past, present, and future? a. 8 yrs old b. 10 yrs old c. 6 yrs old d. 12 yrs old

a. 8 yrs old

when planning long term care for a 2 yr old child with cerebral palsy, which is important for the nurse to consider? a. CP is not progressively degenerative b. the effects of CP are unpredictable c. the child probably has some degree of cognitive impairment d. the child should have genetic counseling before planning a family

a. CP is not progressively degenerative

what are s/s of anaphylactic shock? select all a. anxiety b. wheezing c. nausea d. bradycardia

a. anxiety b. wheezing c. nausea d. bradycardia

what type of play fo preschoolers participate in? a. associative b. parallel c. competitive d. independent

a. associative

what toys are appropriate for 10-12 yr olds? select all a. building models b. jump rope c. hopscotch d. puzzles

a. building models d. puzzles

which play activities are the most appropriate for a 6 yr old child? select all a. coloring book b. small metal cars c. simple card game d. large jigsaw puzzle e. childrens magazine

a. coloring book b. small metal cars c. simple card game

what symptoms are included with rheumatic fever? select all a. erythema gravida b. joint pain c. conjuncitivits d. carditis

a. erythema gravida b. joint pain d. carditis

According to Erikson's theory which stage would the nurse expect a preschooler to start to pretend? a. initiative vs guilt b.integrity vs despair c.autonomy vs shame and doubt d.generativity vs self absorption and stagnation stage

a. initiative vs guilt

which postoperative nursing intervention is specifically related to spinal fusion performed in an adolescent with scoliosis? a. log-rolling every 2hrs b. checking the dressing frequently c. supervising deep-breathing exercises d. maintaining the adolescent in the supine position for 3 days

a. log-rolling every 2hrs

what restraint may be used for an MRI/ CT for a child? a. papoose b. locked restraint c. soft restraints d. welcome sleeve

a. papoose

how is hemophilia A treated? select all a. Platelet transfusion b. RICE c. replacing factor VIII d. desmopressing administration

b. RICE c. replacing factor VIII d. desmopressing administration

what is the first treatment of anaphylactic shock? a. oxygen b. epinephrine IM c. IVF d. dexamethasone

b. epinephrine IM

you are caring for a hemophilia A patient who's hematocrit and hemoglobin (H&H) are low from elevated blood loss. what can you do to help determine the impact of the dropping H&H? a. assess capillary refill from lower extremities b. monitor urinary output c. assess postural blood pressure readings d. assess gait strength

c. assess postural blood pressure readings

what interventions are included in the care of a child with cerebral palsy? select all a. skull helmet b. NG tube c. baclofen d. PT/ OT

c. baclofen d. PT/ OT

which hormone acts with luteinizing hormone to stimulate the production of sperm during puberty? a. somatropin b. testosterone c. follicle -stimulating hormone d. gonadotropin -releasing hormone

c. follicle -stimulating hormone

the nurse anticipates that the family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. which would the nurse conclude is the probable basis for this difficulty? a. lack of social support b. unrealistic expectations c. loss of expected healthy child d. having a child with cognitive impairment

c. loss of expected healthy child

after a seizure all of these safety precautions would be prudent for the nurse to take except: a. padding the bed rails b. ensuring that a suction device is operational at the bedside c. placing benzodiazepine at the bedside d. ensuring that the patient has a patent IV saline lock

c. placing benzodiazepine at the bedside

the nurse is making room assignments on the pediatric unit. who is the best choice roommate for a 10 yr old boy with juvenile idiopathic arthritis? a. an 11 yr old girl with colitis b. a 10 yr old boy with asthma c. a 10 yr old girls with a fractured femur d. a 11 yr old boy who has undergone splenectomy

d. a 11 yr old boy who has undergone splenectomy

which action by a parent of an adolescent indicates understanding of the vaccination school to prevent cervical cancer? a. had bloodwork obtained for titers b. client received first vaccination at 8 yrs of age c. client received booster dose at 16 yrs of age d. all three vaccinations were received at intervals

d. all three vaccinations were received at intervals

which stage described the will of an adolescent to achieve a goal according to the Erikson's theory? a. initiative vs guilt b. integrity versus despair c. intimacy versus isolation d. identity vs role confusion

d. identity vs role confusion

spastic CP:

excessive hypertonic tone, they cant be flat foot (often walk on tip toes), difficulty abducting hips, have a harder time swallowing and drool because of it

what is a papoose board restraint used for?

for a patient if they are getting at MRI/CT scan

what is a mummy device restraint used for?

if the the patient is getting a medication or injection

what Erikson's stage are school aged children in?

industry vs. inferiority -they begin to have hobbies and friendships -they gain *confidence* by doing things on their own, and getting praise from their teachers in the school setting inferiority: -occurs from bullying and cliques -occurs when they are not able to complete or master a task

what pain scale is used with the adolescent population?

numeric pain scale

how should a car seat be facing for a 4 yr old?

rear-facing

Absent seizures:

s/s: -blinking -rythmic twitching -staring dx: -we have them hyperventilate and count from 1-10 in the middle of counting they have a seizure and then pick up from where they left off

true or false: Adolescents think they are invincible and that nothing bad can happen to them

true

constipation:

two or less bowel movements in a week that causes distress to the child -as passing stool is painful the child represses the next urge to avoid the pain s/s: -hard abdomen -hyperactive or hypoactive BS -encopresis -nausea and decreased appetite management: -miralax --> in 8ox of fluid that needs to be finished within 30 min -milk of mag (2nd line treatment) -docusate -upper GI --> NG to suck poop out -sedation for manual disimpactation

Which nursing action would the nurse take when a child with a seizure disorder has a generalized seizure? Select all. ​​A. Assessing the seizure B. Taking the child's vital signs C. Turing the child on the side D. Pulling the padded side rails up E. Initiating oxygen administration → given after if they need it

​​A. Assessing the seizure C. Turing the child on the side D. Pulling the padded side rails up

Which parental statement indicates effective learning regarding management of nocturnal enuresis in a 6 year old child? Select all. ​​A.I should avoid giving my child fluids after dinner B.I should encourage my child to drink lots of water during the day C.I should make my child wear diapers during day hours while at pre-school D.I should give my child diet soda instead of regular soda in the evening E.I should wake my child at the same time every night to use the bathroom

​​A.I should avoid giving my child fluids after dinner B.I should encourage my child to drink lots of water during the day E.I should wake my child at the same time every night to use the bathroom

Which nursing action would be a priority for a client with a spinal cord injury who has developed sudden autonomic dysreflexia? ​​A.Place in a sitting position B.Give nifedipine as prescribed C.Examine for symptoms of pressure injuries D.Monitor blood pressure every 10-15 minutes

​​A.Place in a sitting position

bites and stings:

a local inflammatory response Bee sting: 1. take stinger out 2. ice 3. benadryl lyme disease: -s/s --> bullseye rash -treatment --> antibiotics

Duchenne muscular dystrophy

*Progressive* deterioration of symmetric skeletal muscle groups causing progressive muscle weakness and wasting -cannot be cured S/S: 3yrs old --> -waddling -difficulty climbing stairs -difficulty rising from sitting position -delayed growth -walks on tippie toes -sometimes has difficulty speaking and swallowing high school age --> -wheelchair bound -cardiac and respiratory issues management: -prednisone --> increases muscle strength and delays muscle degeneration -digoxin/ beta blocker --> for heart strength -surgery for contractures

What are the criteria for a seatbelt fitting properly?

1. feet have to be on the floor 2. should strap needs to be on the shoulder and not on the neck 3. strap should be over lower legs and and not on the abdomen

what the process of puberty in the body?

1. the hypothalamus starts producing gonadotropin releasing hormone 2. gonadotropin releasing hormone goes to the pituitary gland where it releases FSH and LH 3. FSH and LH travel to the sex hormones either ovaries or testes 4. these hormones trigger production of either testosterone or estrogen

Which change can be noticed in adolescents during the process of development of emotional autonomy? Select all. A.Adolescents do not run to their parents if they are upset B.Adolescents do not see their parents as an absolute authority C.Adolescents interact with their parents as peers D.Adolescents have not established emotional bonds with relationships outside the family E.Adolescents seek suggestions from others and critically weigh alternative courses before making a final judgment

A.Adolescents do not run to their parents if they are upset B.Adolescents do not see their parents as an absolute authority C.Adolescents interact with their parents as peers

Which strategies would the nurse apply when vaccinating a child to decrease pain and anxiety? Select all. A.Apply a topical anesthetic (EMLA) B.Injecting the most painful vaccine last C.Holding the child upright during the vaccination D.Administering intramuscular injections rapidly without prior aspiration E.Administering acetaminophen or ibuprofen after to vaccination → dont do this because it diminishes immune response

A.Apply a topical anesthetic (EMLA) B.Injecting the most painful vaccine last C.Holding the child upright during the vaccination D.Administering intramuscular injections rapidly without prior aspiration

Which first line medication would the nurse anticipate administering to a client to treat anaphylactic reactions? A.Epinephrine B.Norepinephrine C.Dexamethasone D.Diphenhydramine

A.Epinephrine

Which laboratory test result would the nurse expect to be decreased in a preschooler with iron-deficiency anemia? A.Ferritin level B.Platelet count C.White blood cell count D.Total iron-binding capacity

A.Ferritin level

Which statement would the nurse include in a teaching session for a school-age client and their parent? Select all. ​​A.Parents of school-age children must learn to let go of control B.Strict discipline is the priority over understanding and tolerance C.Peer groups are highly influential during this stage of development D.Your child may wish to be more involved with peer activities than family activities E.When a conflict between peers and parents occur, family values will predominate

A.Parents of school-age children must learn to let go of control C.Peer groups are highly influential during this stage of development D.Your child may wish to be more involved with peer activities than family activities E.When a conflict between peers and parents occur, family values will predominate

Which finding would help confirm the nurse's suspicion that a client may have meningitis after surgery for a brain tumor? A.Positive Kernig sign B.Glasgow coma score of 10/15 C.Absence of nuchal rigidity D.Negative Brudzinski sign

A.Positive Kernig sign

complex partial seizure:

a section of the brain experiences a seizure but more overall body movements occur s/s: -lip smacking -screaming -arm drooping -in the post ictal state they can be unconscious for awhile

Which assessment finding reflects increased intracranial pressure? A.Tachycardia B.Unequal pupil size C.Decreasing body temperature D.Decreasing systolic blood pressure

B.Unequal pupil size

An adolescent client is reported to have severe cystic acne lesions. What medication would the primary health care provider prescribe? A.Tazarotene B.Isotretinoin C.Dapsone gel and adapalene D.Erythromycin and benzoyl peroxide

B.Isotretinoin

Which early sign of increased intracranial pressure would the nurse monitor in a client who sustained a head injury while playing soccer? ​​A.Nausea B.Lethargy C.Sunset eyes D.Hyperthermia

B.Lethargy

After a 16 year old undergoes a craniotomy, the nurse performs a neurological assessment that includes level of consciousness, pupillary activity, and reflex activity. Which additional assessment would the nurse complete? A.Blood pressure B.Motor function C.Rectal temperature D.Head circumference

B.Motor function

Which complication will the nurse monitor for when caring for a client with an infection caused by group A beta-hemolytic streptococci? ​​A.Hepatitis A B.Rheumatic fever C.Spinal meningitis D.Rheumatoid arthritis

B.Rheumatic fever

A 7 year old child who is taking medication to prevent seizures has been seizure free for 2 years. The child's parent asks the nurse, "how much longer will my child need to take the medication? Which answer will the nurse provide? ​​A.Medications are continued for 3 years after the last seizure B.This is usually attempted after 2 years, but medications must be gradually decreased Most of the time seizures are able to be controlled unless its tonic clonic C.Children are usually able to stop seizure medication after puberty D.Seizure disorders are lifelong problems that require ongoing medications

B.This is usually attempted after 2 years, but medications must be gradually decreased Most of the time seizures are able to be controlled unless its tonic clonic

Which assessment would the nurse use to identify the possible origin of the problem when an adolescent who has been tardy to school twice in the past week comes to the school nurse complaining of a 2 day history of low grade fever, exhaustion, lack of energy and decreased appetite? A.Eliciting the Kernig sign B.Eliciting the Brudzinski sign C.Checking for lymphadenopathy D.Checking the pupillary response to light and accommodation

C.Checking for lymphadenopathy

Which intervention would the nurse implement immediately for an alert and oriented client who arrived at the emergency department after a head injury that occurred while playing basketball? A.Assess full range of motion to determine extent of injuries B.Call for immediate head computed tomography C.Immobilize the client's head and neck D.Open the airway with the head tilt chin lift maneuver

C.Immobilize the client's head and neck

What is the purpose of placing a child in cervical traction after sustaining a fractured cervical vertebrae? A.Hyperextending the neck maintains an open airway B.Flexing the head prevents stretching of the neck muscles C.Immobilizing the area minimizes injury to the spinal cord D.Aligning the body allows for cerebrospinal fluid to encircle the spinal cord

C.Immobilizing the area minimizes injury to the spinal cord

How does a family identity aid psychosocial development in the adolescent? A.It helps the adolescent evaluate his or her heath B.It helps the adolescent develop a sense of admiration and acceptance C.It helps the adolescent develop skills in decision-making and budgeting D.It helps assuage the adolescent's feelings of being different from his or her peers

C.It helps the adolescent develop skills in decision-making and budgeting

Which nursing intervention would be important for the nurse to implement when caring for an adolescent child with acute glomerulonephritis? A.Assess for dysuria B.Inspect for jaundice C.Monitor for hypertension D.Test vomitus for occult blood

C.Monitor for hypertension

how large is a 5 yr olds vocabulary? select all a. 900 words b. up to 5 word sentences c. 3 word sentences d. 2100 words

b. up to 5 word sentences d. 2100 words

Which intervention is appropriate for the nurse to teach the parent of a child with Duchenne muscular dystrophy? A.Maintain a high calorie diet B.Institute seizure precautions C.Restrict use of larger muscles D.Perform range of motion exercises

D.Perform range of motion exercises

A 6 year old has not been feeling well, is weak and lethargic, and has a poor appetite, headaches, and smoky-colored urine. Which additional information would the nurse obtain? ​​A.Rash on palms and feet B.Shoulder and knee pain C.Recent weight loss of 2 lb D.Strep throat in the past 2 weeks

D.Strep throat in the past 2 weeks

Which recommendation would the nurse make about safe transportation of an 8 year old? ​​A.You should borrow or buy a second car seat B.You should place padding under the child so the seatbelt fits C.You should buy a convertible car seat D.You should have your child in a booster seat in the back seat

D.You should have your child in a booster seat in the back seat

Pediculosis

Lice --> a noncommunicable disease S/S --> itchy scalp treatment: -permithrin shampoo steps for shampoo application: 1. apply to dry hair 2. let seat 3. comb through hair after it sits to comb out the eggs 4. if lice is still there after the first treatment another treatment must be done in 1 wk so they eggs have time to mature education: -wash linens and toys in hot water -bag items that cant be washed for 2 wks -DO NOT send home from school -DO NOT screen classroom -DO NOT share combs, hats, or helmets

which intervention is appropriate for the nurse to teach the parent of a child with duschenne muscular dystrophy? a. maintain a high calorie diet b. institute seizure precautions c. the use of larger muscles d. perform range of motion exercises

d. perform range of motion exercises

Anaphylactic shock:

a life threatening event caused by an allergen -hypersensitivity to a foreign substance that leads to massive vasodilation and airway constriction s/s: -hypotension -decreased peripheral pulses \ -clammy -swelling of conjunctiva -runny nose -swelling of lips, tongue, or throat -pelvic pain -hives, itching and flushing -lightheadedness -LOC -confusion -headache -anxiety -SOB -wheezes, stridor, or hoarseness -pain with swallowing -cough -loss of bladder control -N/V or diarrhea treatment: -#1 epinephrine (need to assess q 4 hrs) -2nd line treatment --> corticosteroids (methylprednisone) after giving epi patient needs to be brought to the hospital

Hemophilia A:

a genetic disorder that lacks clotting factor VII (8); bleeding time is extended d/t lack of factor required for blood to clot -females can carry it but only males show symptoms s/s: -swelling and warmth of joints (d/t bleeding in joints) -bleeding gums when brushing teeth -blood in stool -hematomas on lower extremities nursing interventions: -encourage rest and apply ice to affected joints -monitor urine, stool, and NG fluid for occult blood -prior to surgery --> give factor VII so they dont bleed out (can be given subcut or IV) medications: -DDVAP desmopressin --> helps the patients body create the factor -plasma factor VIII --> used to treat and prevent hemorrhages; needs to be given as close to the time of bleeding as possible safety: -helmets -no contact sports -soft tooth brush -medical alert bracelet

what labs are elevated with rheumatic fever? select all a. RBC b. strep titer c. CRP d. ESR

b. strep titer c. CRP d. ESR

if a nurse needs to administer a benzodiazepine, which statement about benzodiazepines would be important to know? a. IV diazepam is becoming the first drug of choice for the treatment of seizures in the hospitalized patient b. Fosphenytoin is preferred over a benzodiazepine for the treatment of status epilepticus because it has a better side effect profile c. the child should be on a cardiac monitor and pulse oximeter while receiving an IV benzodiazepine d. administration of benzodiazepines takes priority over any other intervention when caring for a child with status epilepticus

c. the child should be on a cardiac monitor and pulse oximeter while receiving an IV benzodiazepine

The mother of a child with acute poststreptococcal glomerulonephritis (APSGN) is concerned that a younger sibling may also have the disorder. what does the nurse recall when preparing to explain the cause of the disease process? a. a systematic infection causing clots in the small renal tubules b. a factor that is unknown and is difficult to prevent c.an immune complex disorder occurring after a group B-hemolytic streptococcus infection d. an autosomal recessive trait, meaning that there is an increased probability that a sibling will also have the disease

c.an immune complex disorder occurring after a group B-hemolytic streptococcus infection

how does a family identity aid psychosocial development in the adolescent? a. it helps the adolescent evaluate his/her health b. it helps the adolescent develop a sense of administration and acceptance c.it helps the adolescent develop skills in decision-making and budgeting d. it helps assuage the adolescents feeling of being different from his/ her peers

c.it helps the adolescent develop skills in decision-making and budgeting

pain in school aged children:

can used FACES and numeric pain scale -regression may still occur in this age group -describe the procedure to them and walk them through each step so they understand and describe why we need to do the said task

Accutane (isotretinoin)

for *severe* cystic acne -highly teratogenic so two forms of BC need to be used -need to have a pregnancy test and liver tests drawn -avoid multivitamins because they can interfere with the medication -avoid meds that contain alcohol and medicine that contains tetracycline (will increased LFTs and cholesterol as well as vomiting) Symptoms associated with the med: -dryness of mouth and eyes -decreased night vision -increased risk for depression and SI

iron supplements:

given 1 hr B4 meals or 2 hrs after milk or antacid -can make poop black -take liquid iron with a straw because it can stain the teeth -take with orange juice to help with absorption -can cause constipation so increase fluids and fiber -IV iron is painful to infuse so infuse at a slow rate (check ferritin levels 6-8 hrs after infusion)

what is the #1 thing we are concerned about after surgery for tonsillitis?

hemorrhaging; the most common sign that they are bleeding is excessive swallowing

what Erikson's stage are adolescents in?

identity vs role confusion -their virtue is fidelity -talk to them instead of their parents to obtain information at home: -talk about money and finances -support peer relationships -allow them to participate in competitive sports and clubs role confusion: -depression and anxiety may occur because they aren't fitting in with their peers and are different from their family -start to do suicide screenings at this age

Delayed puberty:

if they have not experienced puberty by ages 14 or 15 s/s: -short -less breast tissue in females -no development of deep voice or facial hair in males management: -can either allow for puberty to eventually come or initiate the sex hormones -can also change a social problem like being anorexic that has caused them not to get their period

cerebral palsy:

non progressive impairment od motor function (muscle control, coordination, and posture) causes: -abnormal brain damage or development to the developing brain leading to cell destruction on the motor tracts (ex. fetal hypoxia) dx: -suspected when the child isnt meeting infant and toddler milestones -MRI of the brain -EEG to check electrodes of the brain -skull x-ray if their is a skull abnormality care: -speech therapy -braces to help with stiff muscles and prevent contractures -aid with them at school -surgery to release contracted muscles -medications --> baclofen, diazepam (muscle relaxant), botulinum toxin A, antiepileptics (if they have seizures) complications: -aspiration and risk for injury -pressure injuries

food allergies:

s/s: -hives -itching -rash -swelling -sneezing -wheezing -throat tightness -N/V -diarrhea treatment: -epipen dx: -skin testing

management for mono:

symptom treatment: -IV fluids -rest -tylenol/motrin --> fever -corticosteroids --> for welling of lymph and tonsils -IVIG --> to replace blood count and normalize leukocytes

Which nursing interventions would the nurse perform during the administration of a medication to a school-age child? Select all. ​​A.Explaining to the child why the medication is necessary B.Making use of the child's beliefs of magical thinking C.Encouraging the child's participation in the procedure D.D. Providing outlets for the child to release any aggression and anger E.Teaching the child the relationship between the use of medication and its effect on the body

​​A.Explaining to the child why the medication is necessary C.Encouraging the child's participation in the procedure D.D. Providing outlets for the child to release any aggression and anger E.Teaching the child the relationship between the use of medication and its effect on the body

Which pain scale is used to measure the intensity of pain in preschoolers? ​​A.FACES scale B.Visual analog scale C.Numerical rating scale D.Verbal descriptor scale

​​A.FACES scale

Which statement about the teaching methods to be used for adolescents indicates a need for further teaching? Select all. ​​A.Keep teaching sessions short B.Use teaching as a collaborative activity C.Use problem solving to help adolescents make choices D.Encourage them to learn together, using pictures and short stories E.Help adolescents learn about feelings and the need for self- expression

​​A.Keep teaching sessions short D.Encourage them to learn together, using pictures and short stories

Which statement would the nurse make about the maturation of systems in a school-age child? ​​A.The heart grows slower in the school-age child than at any other period of life Because heart is working harder B.Physical maturity is the school-age child correlates with emotional and social maturity C.The school-age child has less efficient maintenance of blood sugar levels than a preschooler D.Facial proportions change in the school-age child because the face grows slower in relation to the remainder of the cranium

​​A.The heart grows slower in the school-age child than at any other period of life Because heart is working harder