Peds Final

A 13-month-old child is undergoing a lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure, the nurse notes that the spinal fluid is cloudy. What does this finding indicate? a. Rising number of red blood cells b. Increased white blood cell count c. Healthy spinal fluid d. Increased glucose level

b. Increased white blood cell (WBC) count

The nurse is assessing the child. what condition does the nurse suspect after seeing the child "slapped look"

erythema infectiosum fifth disease

The nurse administers an initial dose of Haemophilus influenzae type b (Hib) vaccine to a 2-month-old infant. When should the nurse administer the final dose of the vaccine to the infant?

12-15 months

A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable? a. Newborn period b. When child starts to walk c. Preadolescent growth spurt d. Adolescence

ANS: C Idiopathic scoliosis is most noticeable during the preadolescent growth spurt. Idiopathic scoliosis is seldom apparent before age 10 years. Diagnosis usually occurs during the preadolescent growth spurt.

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and non-pitting edema of the face and pretrial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: A. Thyroid storm. B. Cretinism. C. myxedema coma. D. Hashimoto's thyroiditis.

C. myxedema coma.

An adolescent with Duchenne muscular dystrophy has received care at the pediatric clinic since early childhood. Of which body system should the nurse perform a focused assessment to identify life-threatening complications as the child ages? 1. neurologic 2. gastrointestinal 3. musculoskeletal 4. cardiopulmonary

Cardiopulmonary

Common side effects from the rotavirus vaccine include irritability, mild diarrhea, or vomiting. A small but increased risk for developing__________ has been noted after receiving the first dose of rotavirus vaccine.

Intussusception

When caring for a child with probable appendicitis, the nurse should be alert to recognize that which condition or symptom is a sign of perforation? a. Bradycardia b. Anorexia c. Sudden relief from pain d. Decreased abdominal distention

c. Sudden relief from pain

The parents of a 4-month-old infant with a diagnosis of acute otitis media and fever ask the nurse about the use of antibiotics to treat this condition. What is the best response by the nurse? a. "Antiinflammatory medications are recommended for this condition." b. "Typically antiviral medications are given to treat acute otitis media." c. "Current practice is to wait 72 hours to see whether the condition resolves." d. "Antibiotics are recommended for infants younger than 6 months with acute otitis media."

d. "Antibiotics are recommended for infants younger than 6 months with acute otitis media."

Which condition does the nurse suspect from this image? ______________ disease image is red circle (large) bulls eyes

lyme

An 18-month-old toddler who stepped on a rusty nail is brought to the emergency department a week later. The nurse determines that the family lives in a rural area and that the toddler has never received health care. The child shows signs of neck and jaw stiffness and facial muscle spasms. What disease does the nurse suspect?

tetanus

A nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which question to the mother should elicit data associated with the cause of this disease? 1." Has your child had any diarrhea?" 2."Have you noticed any rashes on your child?" 3."Did your child recently complain of a sore throat?" 4."Did your child sustain any injuries to the kidney area?"

1. "Did your child recently complain of a sore throat?

The nurse is teaching the parents of a child with growth hormone deficiency about preparing synthetic growth hormone and administering it to the child. Which statement, if made by the parents, would indicate an understanding of the procedure? 1. "We will rotate injection sites." 2. "We will give the injection weekly on Monday." 3. "We will administer the injection every morning." 4. "We will store the mixed growth hormone in the medicine cabinet."

1. "We will rotate injection sites."

A nurse is assessing an infant with suspected developmental dysplasia of the hip. What does the nurse expect the infant's orthopedic status to reveal? 1. apparent shortening of one leg 2. limited ability to adduct the affected leg 3. narrowing of the perineum with an anal stricture 4. inability to palpate movement of the femoral head.

1. apparent shortening of one leg

A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause? 1.Iodine 2.Calcium 3.Phosphorus 4.Magnesium

1.Iodine

A client with diabetes mellitus is at risk for a serious metabolic disorder from the breakdown of fats for conversion to glucose. The nurse plans care for the client, knowing that pathological fat metabolism is occurring if the client has elevated levels of which substance? 1.Glucose 2.Ketones 3.Glucagon 4.Lactate dehydrogenase

2 Ketones Rationale: Ketones are a by-product of fat metabolism. When this process occurs to an extreme, the resulting condition is called ketoacidosis. Options 1, 3, and 4 are not associated with the breakdown of fats.

A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction? 1. "I should leave the harness on during diaper changes." 2. "I will adjust the harness straps every 3-5 days." 3. "I will inspect the skin under the straps 2-3 times daily." 4. "The harness should keep my baby's legs bent a

2. "I will adjust the harness straps every 3-5 days."

A nursing student caring for a 6-month-old infant is asked to collect a sample for urinalysis from the infant. How should the student collect the specimen? .1. Catheterizing the infant using the smallest available Foley catheter 2. Attaching a urinary collection device to the infant's perineum for collection 3. Obtaining the specimen from the diaper by squeezing the diaper after the infant voids 4. Noting the time of the next expected voiding and then preparing a specimen cup for the urine

2. Attaching a urinary collection device to the infant's perineum for collection

The nurse is caring for a newborn male with hypospadias. His parents ask if circumcision is an option. Which is the nurse's best response? 1. "Circumcision is a fading practice and is now contraindicated in most children." 2. "Circumcision in children with hypospadias is recommended because it helps prevent infection." 3. "Circumcision is an option, but it cannot be done at this time." 4. "Circumcision can never be performed in a child with hypospadias."

3. "Circumcision is an option, but it cannot be done at this time."

The nursing student is writing a plan of care for a child who presents with an acute head injury. The nursing instructor reviews the plan of care and praises the student for identifying which assessment as a priority? 1.Inspecting the scalp 2.Pupillary assessment 3.Airway and breathing 4.Palpating the child's head

3.Airway and breathing

The parents of a newborn with a cleft lip are concerned and ask the nurse when the lip will be repaired. With which statement should the nurse respond? 1.Cleft lip cannot be repaired. 2.Cleft-lip repair is usually performed by 12 months of age. 3.Cleft-lip repair is usually performed during the first weeks of life. (3 to 6 months in age) 4.Cleft-lip repair is usually performed between 6 months and 2 years.

3.Cleft-lip repair is usually performed during the first weeks of life. (3 to 6 months in age)

The nurse is monitoring a client with diabetes mellitus for signs of hypoglycemia. Which manifestations are associated with this complication? 1.Slow pulse; lethargy; warm, dry skin 2.Elevated pulse; lethargy; warm, dry skin 3.Elevated pulse; shakiness; cool, clammy skin 4.Slow pulse, confusion, increased urine output

3.Elevated pulse; shakiness; cool, clammy skin

A pediatric nurse educator provides a teaching session to the nursing staff regarding phenylketonuria. Which statement should the nurse educator include in the session? 1. "Treatment includes dietary restriction of tyramine." 2. "Phenylketonuria is an autosomal dominant disorder." 3. "Phenylketonuria primarily affects the gastrointestinal system." 4. "All 50 states require routine screening of all newborn infants for phenylketonuria."

4. "All 50 states require routine screening of all newborn infants for phenylketonuria."

The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant 1. Diarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling ribbon-like stools

4.Foul-smelling ribbon-like stools

Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. What should the nurse do first? a. Notify the practitioner of the changes noted. b. Give the child medication to relieve the pain. c. Reposition the child and notify physician. d. Chart the observations and check the extremity

ANS: A The absence of a pulse and change in color of the foot must be reported immediately for evaluation by the practitioner.

A child with type 1 diabetes mellitus has been diagnosed with ketoacidosis. Which of the following laboratory findings is consistent with the diagnosis?A. Hemoglobin A1C: 5.5% b. Potassium level: 3.9 mEq/L c. Serum pH: 7.24 D. Fasting blood glucose: 124 mg/dL

C. Serum pH: 7.24

A nurse is assessing the glycemic status of a client with diabetes mellitus. Which sign or symptom would indicate that the client is developing hyperglycemia? 1.Polyuria 2.Diaphoresis 3.Hypertension 4.Increased pulse rate

Polyuria Classic signs and symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia. It is important to regularly assess the client for hyperglycemia to prevent the development of more serious complications, such as diabetic ketoacidosis. The remaining options are not manifestations of hyperglycemia.

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement? a. "We will be very careful handling the baby." b. "We will lift the baby by the buttocks when diapering." c. "We're glad there is a cure for this disorder." d. "We will schedule follow-up appointments as instructed."

c. "We're glad there is a cure for this disorder."

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing? A. Tachypnea b. Orthopnea c. Dyspnea d. Hypopnea

c. Dyspnea

which pathogen is the viral pathogen that frequently causes acute diarrhea in young children? a. Giardia organisms b. Shigella organisms c. Rotavirus d. Salmonella organisms

c. Rotavirus

A 12 month old receives a series of vaccinations which includes the Hepatitis A vaccine. When should the child receive the 2nd dose of this vaccine? A. in 3 months B. at the 18 month visit C. when the child is 4-6 years old D. in 2 months

B. at the 18 month visit

The nurse is teaching a 9-year-old child with asthma how to use a metered-dose inhaler (MDI). Place the instructions in the appropriate order.

1) First shake MDI and attach it to the spacer. 2) Exhale completely to optimize inhalation of the medication. 3) Place lips tightly around the mouth piece. 4) Deliver a single puff of medication into spacer. 5) Take a slow, deep breath and hold it for 10 seconds to allow for effective medication distribution. 6) After the dose, rinse mouth with water to remove any left-over medication from oral mucous membranes. Spit out the water to ensure no medication is swallowed.

The nurse is developing a plan of care for a 6-year-old child diagnosed with acute glomerulonephritis. The nurse should include which priority intervention in the plan of care? 1.Encourage limited activity and provide safety measures. 2.Catheterize the child to monitor intake and output strictly. 3.Encourage the child to talk about feelings related to illness. 4.Encourage classmates to visit and to keep the child informed of school events.

1. Encourage limited activity and provide safety measures.

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1.Time the seizure. 2.Restrain the child. 3.Stay with the child. 4.Place the child in a prone position. 5.Move furniture away from the child. 6.Insert a padded tongue blade in the child's mouth.

1.3.5 A seizure is a disorder that occurs as a result of excessive and unorganized neuronal discharges in the brain that activate associated motor and sensory organs. During a seizure, the child is placed on his or her side in a lateral position. Positioning on the side prevents aspiration because saliva drains out the corner of the child's mouth. The child is not restrained because this could cause injury to the child. The nurse would loosen clothing around the child's neck and ensure a patent airway. Nothing is placed into the child's mouth during a seizure because this action may cause injury to the child's mouth, gums, or teeth. The nurse would stay with the child to reduce the risk of injury and allow for observation and timing of the seizure.

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1.Rice 2.Oatmeal 3.Rye toast 4.Wheat bread

1.Rice

Inactivated Polio Virus (IPV) is administered every: a. 2 months, 4 months, 6-18 months, 4-6 years b. 2 months, 4 months, 6 months, 12-15 months c. 6 weeks d. 7 years

2 months, 4 months, 6-18 months, 4-6 years

The nurse provides instructions to the adolescent regarding the administration of insulin. The nurse should include which instruction? 1. Rotate each insulin injection site on a weekly basis. 2. Alternate between the thighs and hips for injections. 3. Check the blood glucose before administering insulin. 4. Avoid using the arms for injections because it is too difficult of a procedure to perform.

3. Check the blood glucose before administering insulin. Rationale:The nurse should teach the adolescent to check the blood glucose before administering insulin. This is important for the adolescent to know to help maintain euglycemia. To help decrease variations in absorption, the child should use different locations within a major inject site for one day. The next day, another major site may be used, depending on the site rotation schedule. The parent should give two or three injections a week in areas that are difficult for the child to reach but it is not necessary to avoid the arms and the adolescent can be taught how to self-administer in the arm.

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1.Flaccid paralysis of all extremities 2.Adduction of the arms at the shoulders 3.Rigid extension and pronation of the arms and legs 4.Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3.Rigid extension and pronation of the arms and legs

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 Rationale:Diabetic ketoacidosis is a complication of diabetes mellitus that develops when a severe insulin deficiency occurs. Hyperglycemia occurs with diabetic ketoacidosis. Rehydration is the initial step in resolving diabetic ketoacidosis. Normal saline is the initial IV rehydration fluid. NPH insulin is never administered by the IV route. Dextrose solutions are added to the treatment when the blood glucose level decreases to an acceptable level. Intravenously administered potassium may be required, depending on the potassium level, but would not be part of the initial treatment.

When collecting the history about a child who presents with signs of glomerulonephritis, the nurse should report which most important finding to the health care provider? 1. Child fell off a bike onto the handlebars 2. Nausea and vomiting for the last 24 hours 3. Urticaria and itching for 1 week before diagnosis 4. Streptococcal throat infection 2 weeks before diagnosis

4. Streptococcal throat infection 2 weeks before diagnosis Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A β-hemolytic streptococcal infection is a cause of glomerulonephritis. Often, a child becomes ill with a streptococcal infection of the upper respiratory tract and then develops symptoms of acute post-streptococcal glomerulonephritis after an interval of 1 to 2 weeks. The assessment data in the remaining options are unrelated to a diagnosis of glomerulonephritis.

A mother calls the pediatric clinic to ask when her daughter will receive the Varicella vaccine. Your answer to her question is: A. at 2, 4, and 6 months B. at 12 months and 4-6 years C. at 6 and 12 months D. at 4 months and 4-6 years

B. at 12 months and 4-6 years

A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder? 1."It is an acute bowel obstruction." 2."It is a condition that causes an acute inflammatory process in the bowel." 3."It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel." 4."It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

4."It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel." Intussusception occurs when a proximal segment of the bowel prolapses into a distal segment of the bowel. It is not an acute bowel obstruction, but it is a common cause of bowel obstruction in infants and young children. It is not an inflammatory process.

The nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1.Emergency cart 2.Tracheotomy set 3.Padded tongue blade 4.Suctioning equipment and oxygen

4.Suctioning equipment and oxygen

What is a Pavlik harness? A. A brace that holds the hip in the correct position b. A cast that holds the hip in the correct position c. A physical therapy treatment regimen d. A surgical procedure that corrects hip dysplasia

A. A brace that holds the hip in the correct position teaching: - Teach parents how to position & fasten the chest halter (leave room for 2 fingers to rotate under the strap) - Should be worn 23 hours of the day & removed only for bathing & skin checks - Teach parents to protect child's skins & legs under the harness, a long t-shirt or onsie under the halter can reduce harness rubbing

The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing? (Select all that apply.) a. NPO for 24 hours b. Administration of analgesics for pain c. Ice bag to the incisional area d. IV fluids continued until tolerating PO e. Clear liquids as the first feeding

ANS: B, D, E Administration of analgesics for pain IV fluids continued until tolerating PO Clear liquids as the first feeding Feedings are usually instituted soon after a pyloromyotomy surgery, beginning with clear liquids advancing to formula or breast milk as tolerated. IV fluids are administered until the infant is taking and retaining adequate amounts by mouth. Appropriate analgesics should be given around the clock because pain is continuous. Ice should not be applied to the incisional area as it vasoconstricts and would reduce circulation to the incisional area and impair healing.

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.) a. Palpable distal pulse b. Capillary refill to extremity less than 3 seconds c. Severe pain not relieved by analgesics d. Tingling of extremity e. Inability to move extremity

ANS: C, D, E Indications of compartment syndrome are severe pain not relieved by analgesics, tingling of extremity, and inability to move extremity. A palpable distal pulse and capillary refill to the extremity less than 3 seconds are expected findings.

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status? a. Metabolic rate increases b. Increased joint mobility leading to contractures c. Bone calcium increases, releasing excess calcium into the body (hypercalcemia) d. Venous stasis leading to thrombi or emboli formation

ANS: D The physiologic effects of immobilization, as a result of decreased muscle contraction, include venous stasis. This can lead to pulmonary emboli or thrombi. The metabolic rate decreases with immobilization. Loss of joint mobility leads to contractures. Bone demineralization with osteoporosis and hypercalcemia occur with immobilization.

A 4-month-old infant is to receive the second diphtheria/tetanus/pertussis (DTaP) immunization. The nurse reviews the infant's medical history before administering the vaccine. What information in the infant's history will influence the decision on whether to administer the vaccine? (two things)

Anaphylactic reaction after the first dose Allergy to eggs

Which of the following assessment findings would lead the nurse to suspect Down syndrome in an infant? A Large nose B Small tongue C Transverse palmar crease D Restricted joint movement

C Transverse palmar crease Rationale:Down syndrome is characterized by the following a transverse palmar crease (simian crease), separated sagittal suture, oblique palpebral fissures, small nose, depressed nasal bridge, high-arched palate, excess and lax skin, wide spacing and plantar crease between the second and big toes, hyperextensible and lax joints, large protruding tongue, and muscle weakness.

How long would the nurse maintain isolation of a child with bacterial meningitis?

For 24-48 hours after antibiotic therapy kicks in

Identify the clinical manifestations of Duchenne Muscular Dystrophy.

Frequent falls Large Calf muscles Muscle pain or weakness Walking on the toes Waddling gait Difficulty rising from a lying or sitting position

This vaccination is the first vaccine, given I.M. at birth (or before hospital discharge).

Hep B

A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care? a. Administer prescribed antibiotic immediately b. Maintain standard precautions c. Place in a warm, dry environment d. Allow parents and sibling into the room with the infant

Maintain standard and contact precautions.

The parent of a newborn asks a nurse why, except for hepatitis B vaccine, the immunization schedule does not start until the infant is 2 months old. Which response from the nurse is best? a. Passive immunity from the mother will be diminished by age 8 weeks (2 months) and will no longer interfere with the development of active immunity to most communicable diseases." b. The vaccine will cause the disease in the infant c. Infants younger than 2 months are rarely exposed to infectious diseases d. newborns are not at risk for the disease

Passive immunity from the mother will be diminished by age 8 weeks (2 months) and will no longer interfere with the development of active immunity to most communicable diseases."

During a clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF? a. It is a condition transmitted as an autosomal recessive trait b. This disease causes dilation of the passageways of many organs. c. It is a chronic multisystem disorder affecting the exocrine glands d. CF causes mucus that is formed to be abnormally thick

This disease causes dilation of the passageways of many organs.

An infant's parents ask the nurse about preventing otitis media (OM). What should the nurse recommend? a. Avoid tobacco smoke. b. Bottle-fed or breastfeed in a supine position c. Avoid children with OM d. Use nasel decongestant

a. Avoid tobacco smoke.

A child is admitted to the hospital with pneumonia. In addition to ensuring a patient airway, all of the following interventions are appropriate except: a. Exercise b. Rest promotion c. Pain and fever control d. Hydration

a. Exercise

Which term is used to describe a type of fracture that does not produce a break in the skin? a. Simple b. Compound c. Complicated d. Comminuted

a. Simple

Why is a lumbar puncture performed when meningitis is suspected? a. To determine the causative agent b. To identify the presence of t]blood c. To reduce the interracial pressure d. To measure spinal fluid glucose level

a. To determine the causative agent

What is the best description of pyloric stenosis? a. hypertrophy of the pyloric muscle b. Hypotonicity of the pyloric muscle c. Dilation of the pylorus d. Reduction of the tone in the pyloric muscle

a. hypertrophy of the pyloric muscle

The nurse is teaching a group of parents about the side effects of vaccines. Which side effect should the nurse include in teaching about the Haemophilus influenzae (Hib) vaccine? a. low-grade fever b. generalized rash c. Lethargy d. Malaise

a. low-grade fever

A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child's pulse oximetry status?a.Continuous b.Every 30 minutes c.Every hour d.Every 2 hours

a.Continuous ANS: A The child on supplemental oxygen requires intermittent or continuous oxygenation monitoring, depending on severity of respiratory compromise and initial oxygenation status. The child in status asthmaticus should be placed on continuous cardiorespiratory (including blood pressure) and pulse oximetry monitoring.

A mother calls the pediatric clinic to ask when her daughter will receive the Varicella vaccine. Your answer to her question is:

at 12 months, 4-6 years

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following? a. Healing is usually delayed in this type of fracture. b. Bone growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. This type of fracture is inconsistent with a fall.

b. Bone growth can be affected by this type of fracture. Detection of epiphyseal injuries is sometimes difficult, but fractures involving the epiphysis or epiphyseal plate present special problems in determining whether bone growth will be affected.

Which type of croup is always considered a medical emergency? a.Laryngitis b. Epiglottis c. Spasmodic croup d. Laryngotracheobronchitis (LTB)

b. Epiglottis ANS: B Epiglottitis is always a medical emergency needing antibiotics and airway support for treatment. Laryngitis is a common viral illness in older children and adolescents, with hoarseness and URI symptoms. Spasmodic croup is treated with humidity. LTB may progress to a medical emergency in some children.

The emergency department nurse is caring for a child diagnosed with epiglottis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? a. The child exhibits nasal flaring and bradycardia. b. The child is leaning forward, with the chin thrust out. c. The child has a low-grade fever and complains of a sore throat. d. The child is leaning backward, supporting him- self or herself with the hands and arms.

b. The child is leaning forward, with the chin-thrust out.

Which bite causes Rocky Mountain spotted fever? a. Flea b. Tick c. Mosquito d. Mouse or rat

b. Tick

β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. Which describes their action? a.Liquefy secretions. b.Dilate the bronchioles. c.Reduce inflammation of the lungs. d.Reduce infection.

b.Dilate the bronchioles. ANS: B β-Adrenergic agonists and methylxanthines work to dilate the bronchioles in acute exacerbations. These medications do not liquefy secretions or reduce infection. Corticosteroids and mast cell stabilizers reduce inflammation in the lungs.

The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching? a. Swelling of the fingers is to be expected for the next 48 hours. b. Immobilize the shoulder to decrease pain in the arm. c. Allow the affected limb to hang down for 1 hour each day. d. Elevate casted arm when resting and when sitting up.

d. Elevate cast arm when resting and when sitting up. The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return. Swelling of the fingers may indicate neurovascular damage and should be reported immediately. Permanent damage can occur within 6 to 8 hours. Joints above and below the cast on the affected extremity should be moved. The affected limb should not hang down for any length of time

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? a. Aspirin b. Corticosteroids c. Cytotoxic drugs such as methotrexate d. Nonsteroidal anti-inflammatory drugs (NSAIDs)

d. Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is caring for a hospitalized infant with bronchiolitis. Diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which should be the appropriate nursing action? a. Initiate strict enteric precautions b. Leave the infant in the present room because RSV is not contagious c. Inform the staff they must wear a mask, gloves, and a gown when caring for the child d. Plan to move the infant to a room with another child with RSV.

d. Plan to move the infant to a room with another child with RSV.

he nurse uses the palms of the hands when handling a wet cast for which reason? a. To assess dryness of the cast b. To facilitate easy turning c. To keep the patient's limb balanced d. To avoid indenting the cast

d. To avoid indenting the cast Wet casts should be handled by the palms of the hands, not the fingers, to avoid creating pressure points. Assessing dryness, facilitating easy turning, and keeping the patient's limb balanced are not reasons for using the palms of the hand rather than the fingers when handling a wet cast.