Peds Finals Review
The nurse stops to assist an adolescent who has experienced severe trauma when hit by a motorcycle. The emergency medical system (EMS) has been activated. The first person who provided assistance applied a tourniquet to the child's leg because of arterial bleeding. What should the nurse do related to the tourniquet?
Leave the tourniquet in place.
After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience?
Lethargy and confusion
The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome?
Low Set ears
A school-age child with diabetes gets 30 units of NPH insulin at 0800. According to when this insulin peaks, the child should be at greatest risk for a hypoglycemic episode between when?
Lunch and dinner
A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. What nursing intervention is a priority for this child?
Monitoring and maintaining systemic blood pressure
The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
More deaths occur in males
One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what?
Muscle cramps and tetany
What refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column?
Myelomeningocele
What is the most common form of child maltreatment?
Neglect
A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child?
Negotiate a daily schedule that incorporates hospital routine, therapy, and free time.
Cerebral palsy (CP) may result from a variety of causes. It is now known that the most common cause of CP is which of the following?
Neonatal encephalopathy
The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How should the nurse interpret this?
Neurosurgical emergency
What is a major premise of family-centered care?
Parents are the experts in caring for their child
The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge?
Parents need to learn specific, important guidelines for administration of digoxin.
During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy's birthday is close to the cut-off date, and he has not attended preschool. What is the nurse's best recommendation?
Perform developmental screening
When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which?
Permissive
The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which?
Place the infant on the side to decrease pressure on the spinal sac
What is a primary goal in caring for a child with cognitive impairment?
Promoting optimum development
What is the role of the peer group in the life of school-age children?
Provides them with security as they gain independence from their parents
One of the goals for children with asthma is to maintain the child's normal functioning. What principle of treatment helps to accomplish this goal?
Reduce underlying inflammation
A child with hypopituitarism is being started on growth hormone (GH) therapy. Nursing considerations should be based on which knowledge?
Replacement therapy requires daily subcutaneous injections.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?
Report data to the practitioner.
What nursing care should be included for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?
Restrict fluids
What clinical manifestation occurs with hypoglycemia?
Shaky feeling and dizziness (weakness and dizziness)
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material?
Soak in a bathtub.
The nurse understands that blocks to therapeutic communication include what?
Socializing Using clichés Defending a situation
A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents' discharge teaching?
Specially designed car restraints are necessary.
A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child?
Stabilize the child's jaw with one hand (either from a front or side position) to facilitate swallowing.
An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
Stimulate adaptation of the small intestine
The nurse is caring for an immobilized preschool child. Which of the following is helpful during this period of immobilization?.
Take child for a "walk" by wagon outside the room.
An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) would be which of the following
Teach child and family correct administration of medications.
In boys, what is the initial indication of puberty?
Testicular enlargement
The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?
The child has a disorder that causes a deficient immune system.
The nurse's approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?
The child may think the equipment is alive
What statement applies to the current focus of the dietary management of children with diabetes?
The intake ensures day-to-day consistency in total calories, protein, carbohydrates, and moderate fat while allowing for a wide variety of foods.
The nurse is teaching the family of an infant with cerebral palsy how to administer a diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session?
The pill should be crushed and mixed with small amount of water
A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
The pump can deliver baseline and bolus dosages
The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse's response should be based on which characteristic about preterm infants' pain?
They perceive and react to pain in much the same manner as children and adults
An adolescent diabetic is admitted to the emergency department for treatment of hyperglycemia and pneumonia. What are characteristics of diabetic hyperglycemia?
Thirst, being flushed, and fruity breath
A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on what?
This is usually benign and temporary
What factor is most important in predisposing toddlers to frequent infections?
Toddlers have a short, straight internal ear canal and large lymph tissue.
The clinic nurse is assessing infant reflexes. What assessment indicates a persistence of primitive reflexes?
Tonic neck reflex at 8 month of age
What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency?
Type 1 DM
The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include?
Type 1 DM abrupt onset Type 1 DM occurs in Caucasians Type 2 DM has familial history Type 2 DM occurs in overweight
The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?
United State is ranked last among 27 countries
Which is considered a block to effective communication?
Using clichés
Deficiency of which vitamin or mineral results in an inadequate inflammatory response?
Vitamin A
A child with hypoparathyroidism is receiving vitamin D therapy. The parents should be advised to watch for which signs or symptoms of vitamin D toxicity?
Weakness and lassitude
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially?
Apply direct pressure above catheterization site.
A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate?
Assesses the severity of asthma
The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?
Assign her to the same nurse as much as possible.
What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?
Avoid activities that cause pain or crying
A 3-year-old child with a tracheostomy will soon be discharged. What recommendation should the nurse share with the family?
Avoid exposure to noxious fumes such as paint or varnish
When a child develops latex allergy, which food may also cause an allergic reaction?
Bananas
When giving instructions to a parent whose child has scabies, what should the nurse include:
Be prepared for symptoms to last 2 to 3 weeks.
The school nurse practitioner is consulted by a fifth-grade teacher about a student who has become increasingly inattentive and hyperactive in the classroom. The nurse notes that the child's weight has changed from the 50th percentile to the 30th percentile. The nurse is concerned about possible hyperthyroidism. What additional sign or symptom should the nurse anticipate?
Blurred vision and loss acuity
What is a common clinical manifestation of juvenile hypothyroidism?
Dry skin
A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?
Elevate casted arm when both upright and resting.
The nurse is taking care of a child who had a thyroidectomy. The nurse recognizes what as a positive Chvostek sign?
Facial muscle spasm elicited by tapping the facial nerve in the region of the parotid gland
Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?
Focus communication on the child
A recommendation to prevent neural tube defects (NTDs) is the supplementation of what?
Folic acid for all women of childbearing age
What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness?
Give the child as much control as possible
An 8-year-old child is hit by a motor vehicle in the school parking lot. The school nurse notes that the child is responding to verbal stimulation but is not moving his extremities when requested. What is the first action the nurse should take?
Have someone notify the emergency medical services (EMS) system.
The nurse is caring for a family whose infant was just born with anencephaly. What is the most important nursing intervention?
Help the family cope with the birth of an infant with a fatal defect
After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
Hydration
Spastic cerebral palsy (CP) is characterized by which clinical manifestations?
Hypertonicity; poor control of posture, balance, and coordinated motion
The nurse is caring for an adolescent with anorexia nervosa. What pituitary dysfunction should the nurse assess for in the adolescent?
Hypopituitarism
What factor predisposes an infant to fluid imbalances?
Immature kidney functioning
What is the primary method of treating osteomyelitis?
Intravenous antibiotic therapy
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
Introduce himself or herself
The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?
"I can use a music box and soft mobiles as appropriate play activities for my baby."
The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching?
"I will use precautions when administering oral medications to a school-age child."
The nurse should suspect a child has cerebral palsy (CP) if the parent says what?
"My 4-month-old doesn't lift his head when on his tummy."
Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?
"No hurt"
A father with an X-linked recessive disorder asks the nurse what the probability is that his sons will have the disorder. Which response should the nurse make?
"None of the sons will have the disorder."
The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what?
"We're happy this is the only cast our baby will need."
Pertussis vaccination should begin at which age?
2 months
Which statement best describes colic?
A paroxysmal abdominal pain or cramping manifested by episodes of loud crying
A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
A topical anesthetic, EMLA, can be applied before injections are given.
Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend?
Invite the siblings to attend meetings to develop plans for the child with special needs.
What statement is descriptive of a concussion?
It is a transient and reversible neuronal dysfunction.
What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?
It is characterized by presence of Gower sign, waddling gait, and lordosis.
The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurse's response should be based on which knowledge?
About 45% of affected children have normal intelligence.
What are characteristics of diabetic ketoacidosis?
Acidosis Dehydration Electrolyte imbalance
What is a condition that can result if hypersecretion of growth hormone (GH) occurs after epiphyseal closure?
Acromegaly
When the nurse interviews an adolescent, which is especially important?
Allow an opportunity to express feelings
The nurse is caring for a child after a parathyroidectomy. What medication should the nurse have available if hypocalcemia occurs?
Calcium Gluconate
The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have?
Chickenpox
What is a physiologic effect of immobilization on children?
Circulatory stasis can lead to thrombus and embolus formation.
A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by which dietary intervention?
Complex carbohydrate and protein (Milk and peanut butter on bread)
What explanation provides the rationale for why iron-deficiency anemia is common during infancy?
Cow's milk is a poor source of iron.
What measure of fluid balance status is most useful in a child with acute glomerulonephritis?
Daily weight
The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session?
Diabetic supplies should not be left in a hot environment Insulin is good for up to 28 to 30 days Opened Insulin bottles should be stored at room temperature or refrigerated
The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?
adapt as necessary cultural practices to health needs.
Glucocorticoids, mineralocorticoids, and sex steroids are secreted by which gland?
adrenal cortex.
Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time
calmly ask the child to point to where the pain is worst and to wiggle fingers
The nurse is teaching parents the proper use of a hip-knee-ankle-foot orthosis (HKAFO) for their 4-year-old child. The parents demonstrate basic essential knowledge by making what statement?
condition of the skin in contact with the brace should be checked every 4 hours.
Exophthalmos (protruding eyeballs) may occur in children with which condition?
hyperthyroidism
A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention?
provide a latex-free environment.
A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he "heard a pop," that the pain is "pretty bad," and the ankle feels "as if it is coming apart." Based on this description, the nurse suspects a:
sprain.