Peds Q's: Cognitive and Mental Health & Neurologic and Sensory Function
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A Anorexia B Sleepiness C Garbled speech D Rapid increase in height
A
A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent? Once the child is 6 to 9 months old a specialist will be able to drain the duct. Most of these conditions will spontaneously resolve. Antiviral therapy can be prescribed to manage this condition. Over-the-counter drops can be used sparingly.
B
A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make? "Your child will never need to wear the patch again." "Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye." "Your child will need to wear the patch for several months to keep the eye in alignment." "Your child will have to be in restraints for a week to keep him/her from rubbing the eye."
B
A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? Brief, sudden onset with muscles that become tense Loss of motor activity accompanied by a blank stare Sudden, brief jerking motions of a muscle group Loss of muscle tone and loss of consciousness
B
A nurse is caring for a 3-year-old girl with microcephaly. Which of the following actions is appropriate for the nurse to take? Playfully ask the child to touch her nose Teach the parents about ventriculoperitoneal (VP) shunts Prepare the child for the experience of cranial surgery Administer antipyretics as ordered
A
The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" Which response by the nurse would be most appropriate? "Sometimes it's hard to tell if a product contains aspirin." "Do you think that maybe your child took aspirin on his own?" "Don't worry; you're in good hands. We have it under control now." "Aspirin in combination with the virus will make the brain swell and the liver fail."
A
The nurse is caring for a 3-year-old girl who has just undergone a ventriculostomy. Which of the following would the nurse include in this child's plan of care to manage increased intracranial pressure (ICP)? Use pillows to support the child when lying on her side Support the parents in starting a ketogenic diet Pad the side rails on the bed Teach her to do deep breathing techniques
A
The nurse is educating parents of a male infant with Chiari type II malformation about the condition. Which of the following would be most important for the nurse to include? Taking time to feed the infant Laying the infant down after a feeding Being able to see major difference after surgery Not needing to change diapers as often
A
The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information? Process that requires the individual to view a situation from a different perspective Interventions that address family dynamics and family coping Individual exploration of the person's conflicts and stressors Use of play to explore problems, issues, and conflicts
A
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis? "He recently helped clean the basement. "He was exposed to several family members with an infection. He just recovered from an upper respiratory infection. We have a family history of conjunctivitis.
A
During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply. A Child reports abdominal pain. B Child has a change in school performance. C Child demonstrates anxiety or trouble sleeping. D Child does not want to be left alone with a certain adult. E Child spends a great deal of time with peer-group friends.
A B C D
After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply. A The parents recently divorced B The father is unemployed and mother is infrequently home C The child is learning to play the clarinet in music class in school D The child is expected to care for younger siblings while mother sleeps E There is history of multiple injuries obtained from a motor vehicle crash
A B D E
A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply. A "We need to set clear limits for our child's behavior." B "A reward system would be useful to give our child positive feedback." C "We need to limit the number of choices our child has." D "We need to give our child all directions at once in case the child gets distracted." E "If the child acts out, we can explain that this is being bad."
ABC
The nurse caring for a neonate experiencing seizures asks the charge nurse: "How can I tell if a baby is having a seizure or is just crying for attention?" Which response would be most appropriate? Select all that apply. A "You will not be able to stop a seizure with gentle restraint." B "The baby experiencing a seizure will be tachycardic." C "Stimulating the baby by singing to him will not stop a seizure." D "There will be no changes in the baby's vital signs with a seizure" E "The baby will become more active with sensory stimulation with a seizure." F. "The baby will stop the seizure activity when swaddled in a blanket."
ABC
The nurse is performing an assessment on an 8-year-old child during an annual well-child visit. Which finding requires further follow-up by the nurse? Shares concerns about the future Focuses more on self than on others Time spent reading increased by 30 to 60 minutes since last exam Has learned how to ride a bicycle
B
The school nurse is educating the parents of a child with infectious conjunctivitis. Which of the following statements by the nurse would be most helpful for the parents related to prevention? "Use all the medication as directed." "Don't use anything that touches her face." "This could have started with a head cold." "Place the ointment inside the lower eyelid."
B
A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply. A Inability to make eye contact B Hypersensitivity to touch C Lack of facial expression D Distinct interest in others around him E Easily distracted from playing
B C
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. A Hyperthermia B Orthostatic hypotension C Weak pulse D Hypertension E Hypothermia
B C E
An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient? Numbness of fingers and decreased temperature Increased pulse rate and decreased blood pressure Increased temperature and decreased respiratory rate Decreased level of consciousness and increased respiratory rate
C
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? "I have ibuprofen available in case it's needed." "My child will likely outgrow these seizures by age 5." "I always keep phenobarbital with me in case of a fever." "The most likely time for a seizure is when the fever is rising."
C
For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? An 8-month-old who cries when left with strangers A 7-year-old who withdraws from contact with all strangers An 8-year-old who will not stay overnight at a friend's house A 10-year-old who reports headaches if there is to be a test in school
C
The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required? The child pinches the skin together before inserting the needle. The child injects the appropriate amount of air into the vial before withdrawing medication. The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe. D. The child slowly pushes on the plunger to inject the medication before withdrawing the needle.
C
The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A Take photographs of the bruises. B Ask the child to provide a written statement of how he or she got the bruises. C Document the bruises and any statements made by the child relating to them. D Interview the child's parents about the origin of the bruises. E Interview the child's parents about the origin of the bruises.
C
The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? "A drop in the plasma drug level will lead to a toxic state." "The capacity to metabolize the drug becomes overwhelmed over time." "Small increments in dosage lead to sharp increases in plasma drug levels." "Large increments in dosage lead to a more rapid stabilizing therapeutic effect."
C
the nurse identify as being consistent with that of a person with anorexia nervosa? "I'd like to grow up to be a model." "I'd like to gain weight but just can't." "I feel chubby no matter what I wear." "I'm afraid that someone is poisoning my food."
C
The nurse is caring for a child recovering from surgery to correct strabismus. Which interventions should the nurse include when planning this child's care? Select all that apply. A Apply an eye patch. B Maintain on bed rest for 3 days. C Support for nausea and vomiting. D Provide pain medication as prescribed. E Apply antibiotic ointment as prescribed.
CDE
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? The child speaks in complete sentences. The child sleeps at least 12 out of every 24 hours. The child responds warmly to the father but not to the mother. The child constantly stares at a rotating wheel on the crib mobile.
D
The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion? A Learning disorders indicate lower intelligence. B Learning disorders are synonymous with learning deficits. C The disorder requires comprehensive special education. D The disorder is caused by a difference in brain architecture.
D
The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply. A "The cause of autism is largely considered to be related to immunizations administered in infancy." B "Concerns are often noted as early as 3 to 6 months of age." C "Once your child begins to speak it will be easier to make a determination." D "In infancy a lack of loving behaviors such as cuddling is concerning." E "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
D E