PEDS Lippincott Test 2

During a well-child visit, an 11-year-old girl states to the nurse that she looks different from her friends who are wearing bras. What is an appropriate response?

"It is normal for there to be differences in the time and rate girls your age develop."

What finding would the nurse most likely discover in a 10-year-old child in the period of concrete operational thought?

Ability to classify similar objects

The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment?

"Do you participate in any sports?"

The mother of an obese 10-year-old child asks the nurse what she can do at home to help the child have a more healthy weight. Which is the best response made by the nurse?

"Encourage the child to increase daily physical activity."

A nurse is teaching a class on genetic disorders for pregnant couples who have recently been told their unborn child has a genetic disorder. Which statement would be important for the nurse to include?

"Genetic disorders occur at the moment an ovum and sperm fuse."

The health care provider has prescribed oral tetracycline for an adolescent girl to help clear acne. What statement about the medication made by the girl would require additional teaching from the nurse?

"I need to take the medication with food every day."

Typical development for the school-aged child includes playing games with friends. At what age are children typically ready for games that include playing on a team that has a winner or loser?

10 years

When planning activities for school-age children, the nurse organizes games that include competition. At which age are these kinds of games preferred by children?

10 years old

A young couple expecting their first child comes to the clinic concerned that their baby will be born with Down syndrome. The nurse informs the couple that the incidence of Down syndrome is highest in women older than what age?

35 Years

A nurse is counseling a couple who have a 5-year-old daughter with Down syndrome. The nurse recognizes that their daughter's genome is represented by which chromosome combination?

47XX21+

A genetic nurse is taking a health history for a 1-month-old male client with Edwards syndrome. How will the nurse note this genetic disorder in the documentation?

47XY18+

The nurse knows that being able to tell time helps a child become more independent. At which age should the nurse expect a school-age child to begin to tell time?

7 years old

The parents of a 6-year-old have just been told that their child will die shortly. At which age does the nurse realize that children are capable of understanding death?

9 years

The nurse teaches a 14-year-old client's mother about the adolescent developmental task of identity versus role confusion. What is the best way for the mother to help her adolescent complete this task?

Allow the adolescent to participate in decisions.

A client asks about a child inheriting an autosomal recessive disorder. What must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance?

Both parents must be carriers.

The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation?

Boys grow at a slower, steadier rate than do girls.

An adolescent has been diagnosed with bulimia, and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent?

Develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals.

A nurse is teaching a class to new parents on how to prevent the spread of infection in their children. What is the best suggestion the nurse could offer to these parents?

Encourage frequent hand hygiene.

The nurse is providing discharge instructions to a child diagnosed with encopresis. Which of the following instructions would the nurse question?

Encourage positive reinforcement for the child's toilet habits.

Infectious mononucleosis ("mono") is caused by which of the following?

Epstein-Barr virus

Parents of a school-age child experiencing encopresis are discussing the problem with the child's health care team. Their understanding of this problem is indicated when the parents respond in what manner?

If there is no organic cause for the problem, the family may need to explore counseling for an emotional problem.

A nurse is instructing the parents of a child who is suspected of having pinworms how to check the child. Which instruction would be most appropriate?

Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep.

A couple has just learned that their unborn son has a chromosome disorder that results in an extra X chromosome. The primary care provider explains that secondary sex characteristics will not develop in this child at puberty and that his testes will remain small and produce ineffective sperm. The nurse recognizes that this child likely has:

Klinefelter syndrome.

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child?

Menstrual problems

When teaching parents of a child with encopresis, what would the nurse stress?

Not punishing the child for encopresis

The nurse is caring for a dying preschool-age child. Which action by the nurse is most appropriate?

Plan for someone to stay with the child as much as possible.

The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?

The child will have a complete physical exam.

An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this client that clearly indicates scarlet fever?

The tongue has a white or red "strawberry" appearance

A 15-year-old adolescent is seen at a health care facility for facial acne. When counseling the teen, the nurse would teach that the basic cause of acne is:

activation of androgen hormones.

A high school football player comes to the clinic with malaise, fever, headache, and anorexia that have been present for the last few days. Upon physical examination, the nurse notes that the cervical lymph nodes are firm and tender. Tonsils are red and enlarged and appear to have a white covering. What should the nurse suspect the diagnosis to be for this client?

mononucleosis

During a routine assessment, the nurse determines that a school-age child has head lice. What did the nurse assess in this child?

white flecks on hair shafts

The nurse is talking with a mother of a 6-year-old child who says, "I'm really concerned because my child seems really stressed and has been biting the fingernails since beginning the first grade. What can I do?" Which response by the nurse would be appropriate?

"Allow some time every day for your child to talk about things."

A parent asks how a 22-month-old understands death and dying. What is the nurse's best response?

"The child doesn't understand the concept of death."

A couple who has undergone genetic screening and testing is told that they have a 25% chance of having a child a with a genetic disorder. The nurse determines that the couple has understood the information based on which statement?

"With each pregnancy, we have a 25% chance that the child will have the disease."

A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted?

appropriate social development

The nurse is working with a group of caregivers who have children who are dying. Which of the following statements made by one of the caregivers indicates that this caregiver is in the bargaining stage of grief?

"I'll be able to handle my child's dying if she can just live until her next birthday."

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?

"My child sleeps between 11 and 12 hours a night."

The nurse is discussing an adolescent's development with the client's parents. Which statement by the parents indicate an understanding of the nurse's teaching?

"Our adolescent is working toward achieving a sense of personal identity."

During a child's last stage of dying, her parents ask, "Is she able to hear us?" What is your best response?

"Yes, she can hear and may also understand most of what is being said."

Following the death of a grandparent, a child is heard saying, "Gramma died and she is in heaven." Twenty minutes later the same child is heard saying, "Let's go have supper at Gramma's house." These statements would most likely have been said by a child of which age?

3 years old

A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?

After age 12 children can think in the abstract, including complex problem solving.

After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?

After the lesions have crusted

The nurse is educating a parent support group for teens with anorexia. Which of the following statements would the nurse suggest for the parents?

Avoid making comments about the teen's appearance.

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?

Bull's-eye rash around the bite

A toddler is treated for pinworms. To prevent reinfection, what advice would you give the mother?

Help the child wash hands before eating.

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?

Red, strawberry tongue

What information should be included in the teaching plan for a child with varicella?

Remind the child not to scratch the lesions.

The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?

Ring-like rash on lower leg

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

Scarlet fever

A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?

Severe erosion of teeth

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease?

Swollen lymph nodes

What is the best explanation of Erikson's theory of psychosocial development during adolescence?

The adolescent faces many different decisions during the teen years concerning the future and the adult world.

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?

The adolescent telling the nurse purging occurs after each meal.

The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructor determines the class is successful after the students correctly choose which milestone as the beginning of adolescence?

The beginning of puberty

The nurse is assessing developmental milestones for a 5-year-old girl. Which of the following activities is normal?

The child can button a shirt.

A 9-year-old boy is admitted into the hospital with a broken femur. What is important for the nurse to consider when caring for this child?

The child should be prepared for procedures and should be allowed to view and handle equipment that is going to be used when appropriate.

Which behavior best demonstrates an example of Erikson's developmental task for the school-age child?

The child spends a rainy day putting together a puzzle of a large jungle animal.

The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?

a sense of security as children gain independence

The nurse is educating an adolescent's parents on the importance of self-esteem. Which factor will the nurse include as being most important to an adolescent's self-esteem?

body image

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

contact precautions

In reviewing the assessment findings of a young hospitalized adolescent female, the nurse would realize that which finding would be indicative of the diagnosis of anorexia nervosa? Select all that apply.

depression lanugo over the back and arms disposes of food in the trash or toilet

Which nurse best fosters a school-aged child's adaptation to hospitalization? The nurse who:

explains procedures and shows the child equipment that will be used on them.

The nurse is caring for a preschool-age child who knows she is dying. Her reaction to her impending death is most likely to be demonstrated through:

fear of being separated from her parents.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as:

fifth disease

The nurse caring for children with fungal infections most often administers which medication?

griseofulvin

A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults?

herpes zoster

The nurse is doing a presentation on the diagnosis of bulimia to a group of pediatric nurses. Which clinical manifestation would the nurse teach this group to observe for in the adolescent with bulimia?

hypokalemia

According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as:

identity vs. role confusion.

The developmental task of the school-aged period, according to Erikson, is gaining a sense of:

industry versus inferiority.

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings?

koplik spots

The appearance of which hallmark clinical manifestation occurs in measles?

koplik spots

When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem?

low-set ears

A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:

make her child attend school every day.

The nurse is preparing teaching materials for the parents of a child with encopresis. What information should the nurse emphasize during this teaching?

not punishing the child for the condition

What is the priority nursing action for a dying child who is restless, moaning, and vomiting?

pain assessment and control

The nurse should be aware that the preschooler thinks of death as:

punishment for thoughts and actions.

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema?

redness of the skin produced by congestion of the capillaries

An adolescent client has been diagnosed with bulimia nervosa. What does the nurse explain as the goal of treatment for this client?

restoring nutritional balance and a healthy self-image

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

scarlet fever

Girls with Turner syndrome will usually exhibit:

short (stature)

A clinic nurse is asked by a client receiving genetic counseling about symptoms related to Turner syndrome. Which manifestation would the nurse most likely include? Select all that apply.

short stature streak ovaries infertility webbed neck

A nurse working as a member of a genetic counseling team understands that her careful assessment of which body areas in a newborn may provide important indications for structural genetic disorders?

space between the eyes, the shape of the ears, and the numbers of fingers and toes

Which condition is the most commonly occurring chromosomal disorder?

trisomy 21 (Down syndrome)

A nurse assesses that a 15-year-old female client has not developed secondary sexual characteristics, is short in stature, and has a webbed neck. The nurse identifies this as being most likely related to which diagnosis?

turner syndrome

The nurse is teaching safety to a group of adolescents. Which common cause of death among adolescents will the nurse include in the teaching?

unintentional injuries

Parents of a child who has been diagnosed with tinea capitis ask how the child got the infection. Which of the following would the nurse explain as the most likely cause?

using a friend's comb