Peds Sherpath Questions

The mother of a 10-year-old questions the nurse regarding the method of chemotherapy administration and is concerned the child will require frequent IV insertions. With which statement should the nurse respond?

"A central venous catheter (CVC) may be implanted for long-term chemotherapy administration."

A child is dying of sickle cell disease and parents are expressing concern over the large amounts of opiates needed to control the child's pain. The father states, "I am worried that my child will become addicted to the medication." Which statement by the nurse addresses this parent's concern?

"Our goal with your child is to effectively manage the pain and maintain an acceptable comfort level which may include using larger doses of opiates."

The nurse is discussing the surgical closure of a myelomeningocele with the parents of a newborn patient. Which statement by the parents indicates the need for further teaching?

"Surgically closing this defect will ensure my baby can walk at the right age."

The hospice nurse is caring for a school-aged child who has a glioblastoma with metastasis throughout the body. The toddler has been declining in health for the past 7 days, has had no oral intake, has a labored, irregular respiratory rate of 6 breaths per minute and is bradycardic at 50 bpm. The parents ask the nurse what they can do to help the child through the process. Which is an appropriate response by the nurse?

"Tell the child it is ok to die."

The nurse is caring for an adolescent with a moderate intellectual disability. How should the nurse best communicate with the adolescent?

"The floors get very slippery when they are wet, so if you spill or get water on the floor, just let me know, and we can get it cleaned up, so you don't fall."

The nurse is preparing a 3-year-old patient for a positron emission tomography (PET) scan to diagnose a neck mass. The child's caregiver asks what will be done to prevent potential discomfort and restlessness of the child during the procedure. What should the nurse respond?

"Your child will be sedated prior to the procedure."

A parent of a child who has terminal cancer is concerned with the child's weight loss due to a decrease in appetite. The parent becomes frustrated and expresses to the nurse, "My child needs to be fed; she is starving!" What is the best response?

"Your child's lack of interest in food is a normal part of the dying process."

A patient has type 1 diabetes mellitus and receives insulin. The patient asks the nurse why she cannot take pills instead. What is the best explanation by the nurse?

"Your pancreas is unable to secrete an adequate amount of insulin."

The nurse receives a report on multiple patients newly admitted to the pediatric unit. Which patient should the nurse assess first?

6-month-old with a fractured left femur

A non-English speaking family member of a child is having difficulty understanding the child's diagnosis. What is the most appropriate action by the nurse?

Allow an interpreter to translate for the family members.

What information can be obtained by observing the integumentary system during a cardiac assessment?

Evidence of cyanosis

What is a child at the concrete operational stage able to understand?

Fact vs. fiction

The nurse is auscultating the chest of a pediatric patient and identifies a clear heart murmur. Palpation does not identify a thrill. The nurse should note this as which grade of murmur?

Grade 3

How does Erickson's theory of child development influence pediatric nursing?

It provides a theoretical basis for the emotional care required for nursing.

A 3-year-old female presents with a persistent cough, rhonchi and poor oral intake. The nurse reviews the health care provider's prescription. Which prescription would the nurse question?

Antibiotics

The nurse is caring for a child receiving chemotherapy and notes bruising on the arms and legs. Which test will help identify the cause for bruising?

Platelet levels

After obtaining an ECG on a child admitted for dehydration, the nurse notices a decreased ST segment along with a flattened T wave. What lab value would be the cause of this finding?

Potassium level of 2.2

If a child has low blood pressure in their afferent arteriole, which process describes the body's attempt to increase the blood pressure (BP)?

Release of renin from the kidney

The nurse is caring for a 7-year-old child with a suspected left radius/ulna fracture who presents to the pediatric emergency room. The nurse notes a painful, bruised, edematous area on the left lower arm, but the assessment is otherwise normal. Which provider orders would the nurse anticipate?

Single view radiograph of the left arm Assess pain level every 1 hour and as needed

A child who plays soccer is brought to the clinic by the mom who suggests her child is not acting right. Which associated finding does the nurse evaluate further?

The child cannot recall yesterday's events.

Which mechanism immediately follows tissue injury?

Vessel spasm

The mother of a 14-year-old child who recently died tells the nurse that the 10-year-old sibling has become very withdrawn, angry, and aggressive. The child has said to the mother, "It should have been me." The mother asks the nurse how to respond to the child. Which responses by the nurse are appropriate?

"A child's response to death is varied because of age and developmental level." "Your child is working through the stages of grief. Sometimes a child stays in one stage longer than others." "Your child may be experiencing survivor's guilt related to the death of your child and needs to express feelings."

A parent tells the nurse, "My daughter has been diagnosed with autism spectrum disorder (ASD), but she does not act anything like my niece who also has ASD. I don't understand how they can behave so differently." How should the nurse respond?

"ASD is a spectrum of disorders with a wide range of manifestations and severity. Each child is unique, and no two children have the exact same symptoms."

The nurse teaches a patient about brain structure and function. Which statement by the nurse is true regarding the child's brain anatomy and physiology?

"Cerebral spinal fluid reduces injury to the brain in the case of a fall."

While meeting with an adolescent to address diabetes management, which statement by the adolescent regarding compliance with insulin usage would be concerning to the nurse?

"I roll out of bed 10 minutes before my ride comes in the morning. Sometimes I don't have time for breakfast."

A home care nurse is teaching a parent and 16-year-old patient with type 1 diabetes mellitus about insulin administration and rotating sites. Which statement, if made by the patient, would indicate effective teaching?

"I rotate sites between areas of my abdomen and arms."

A parent is reporting that the child has redness and pus around the gastrostomy tube site. Which statement indicates that the parent has an adequate understanding of gastrostomy tubes?

"I should apply antibiotics to the gastrostomy tube."

The nurse is providing discharge instructions to the parent of the pediatric patient and states, "your child may resume regular activities after discharge." Which statement by the parent indicates a need for further teaching?

"I will try to avoid bathing the child until the child feels better." "I will not allow my child to attend his gymnastics class tomorrow."

A dying child, who has been unresponsive for the past two days in hospice at the hospital, opens his eyes and softly talks to his mother. He asks his mother how she is and where his siblings are and can he see them. The mother tells the nurse, "I think he is getting better." Which response by the nurse is appropriate?

"It is not uncommon to be more alert and interested in the family right before a child dies."

A 12-year-old patient has been in hospice for one month and expresses feelings of discontent and would like to go back to the hospital. The patient states missing being with other children and liking the food there better. How will the nurse respond?

"It is okay to change your mind." "Tell me more about how you are feeling." "I'll let your parents know you want to go back to the hospital."

The nurse is assessing a 13-year-old patient brought into the primary care clinic by the parent. The parent states, "I'm certain my child is bipolar; every day, a different mood!" Which is the best response by the nurse?

"It's normal for children this age to have mood swings, and they may not be caused by bipolar disorder."

Which statement by the nurse can explain the normal function of joints in the pediatric patient?

"Joints help your bones move."

A 4-year-old child with chronic sickle cell crisis is terminal and unable to walk, requires continuous oxygen administration, is moaning and crying with position changes, and has refused to eat meals for the last 2 days. The parents ask the nurse how they will care for their child and what they should do now. Which response by the nurse is appropriate?

"Learning about hospice care services would be appropriate at this time."

An adolescent with moderate intellectual disability states, "I want to live on my own when I become an adult." What is the nurse's best response?

"Let's talk about how we can work together to prepare you for more independence."

The patient with Type 2 DM receives metformin (Glucophage). What statements would the nurse include when educating the patient about the drug?

"Metformin does not cause the body to make more insulin. As such, it rarely causes low blood glucose when used alone." "Side effects like diarrhea, nausea, and upset stomach are mild but common, and should go away after your body gets used to the medications."

During an exercise class for patients with type 2 diabetes, the nurse instructs the patients and parents on recommended daily activity. The nurse notes the need to reinforce teaching when a parent makes which statement?

"My son spends hours outside drawing and then plays his video games in his room for no more than 40 minutes."

When providing education to the parents of a toddler with Type 1 DM, the nurse should include which statement related to hypoglycemia?

"The toddler has varied intake from day to day. Better to allow for more food choices and work toward carbohydrate consistency."

A four-year-child with 6 months to live tells parents about angels who come to visit her at night. The parents are concerned and ask the nurse how they should handle this. What is the nurse's best response?

"This is a normal response for a 4-year-old child who is terminally ill. Continue to allow the child to share the experiences with you."

The nurse cares for a five-year-old patient involved in a motor vehicle accident. The paralysis extends from the naval downward. In performing discharge teaching, the nurse knows further teaching is needed when the parents make which statements?

"We need to catheterize him every 8 hours for urine." "We need to make sure he has a bowel movement often." "He will need to eat every meal that we prepare for him." "He will enjoy sitting outside all morning in his wheelchair."

The nurse is providing education to the parents of a child experiencing spinal shock after a spinal cord injury. Which statements by the nurse are correct?

"We will not know what permanent injuries exist for one to two months." "Currently, the child appears to have no function below the level of injury." "Some complications, such as low blood pressure, will resolve within a few weeks."

The parent of a child with intellectual disability states, "I thought she would be doing more by now. They said her condition is only mild. I think she is just difficult on purpose and doesn't try." What should be the nurse's priority assessment question?

"What are your expectations for your child?"

The mother of young child with fetal alcohol spectrum disorder (FASD) asks, "What does this disorder mean for my plan to have a big family?" What would be the most therapeutic response?

"You can have more children. Let's discuss pregnancy planning and alcohol avoidance in order to prevent having another child with FASD."

A parent is taking care of her child dying of cancer and asks the nurse about oral care since the child often complains of a dry mouth. What education on oral care can the nurse provide to this parent?

"You can moisten her lips with this sponge swab." "Use the artificial saliva drops as needed to provide comfort." "Petroleum jelly on the lips provides moisture for a longer period of time."

The parent of a 15-year-old with terminal cancer approaches the nurse and asks what care options are available for when the child is dying. The parent states the child is very close to family and siblings and loves to be around the pet dogs. Which is the best response?

"You could use home hospice care so the child is in a comfortable and relaxed environment."

The nurse is caring for a group of adolescents in the mental health unit and needs to complete initial morning assessments. Which patient can the nurse assess last?

A 7-year-old boy with severe separation anxiety disorder whose parents are at the bedside.

A 6-month-old infant is brought to the clinic and after assessing the child's head circumference, the nurse notes that the head circumference for this baby has gone from the 50th percentile to 10th percentile since the 2-month visit. What might this indicate?

A delay in skull growth Disturbances in nutrition intake A problem with brain development

A nurse is caring for several adolescent patients in the mental health unit. Which patient should the nurse evaluate first?

A patient with severe major depressive disorder

The nurse is assessing an infant with fetal alcohol spectrum disorder (FASD). The nurse performs a thorough head-to-toe assessment. What is the primary reason for this assessment?

A thorough assessment is completed because other abnormalities are often present in an infant with FASD.

The nurse observes that the ten-year-old patient is becoming increasingly restless. Knowing that the child suffered a concussion playing football, what does the nurse do next?

Calculate Glasgow coma score. Perform bilateral pupil examination. Ask patient about nausea and headache. Check vital signs and oxygen saturation.

Place the sections of the colon in the order in which they appear along the gastrointestinal tract.

Cecum Ascending colon Transverse colon Descending colon Sigmoid colon

A patient with type 2 diabetes mellitus complains of nausea, vomiting, diaphoresis and headache. Which of the following nursing actions should the nurse perform first?

Check the patient's blood glucose level.

The nurse is providing diet teaching to a patient with impaired renal function. The nurse reviews the lunch menu and instructs the patient to avoid which food item?

Chicken nuggets, french fries, and whole milk Canned beef and noodle soup, toast, and a sports drink

The nurse assesses a two-year-old child with papilledema related to hydrocephalus. Which finding causes the nurse the most concern?

Child has an increased head circumference

Match Freud's stage of psychosexual development to the corresponding activity.

Child is found playing with contents of diaper-Anal stage Child has an increased interest in genitals-Phallic stage Child's superego represses thoughts of sexuality- Latency stage Child experiences personal and family turmoil-Puberty stage

When providing teaching to the family of a child recently diagnosed with a respiratory illness, which component of differences in the pediatric respiratory system would the nurse emphasize?

Children have increased resistance to air flow during respiratory illnesses.

A nursing student asks the instructor, "How can I tell whether someone has autism spectrum disorder (ASD) or intellectual disability?" How should the instructor respond?

Children with intellectual disability usually imitate others, but children with ASD lack imitative skills.

How is pilocarpine iontophoresis (sweat test) used to diagnose cystic fibrosis?

Chloride levels in sweat are measured.

Match the hospital unit setting with the correct description.

Chronic illness Medical-surgical unit Life threatening illness Intensive care unit Acute illness Observation unit

How does the respiratory system facilitate movement of mucous?

Cilia move mucous to the pharynx.

Closure of the ductus arteriosus occurs shortly after birth. Children born with right-to left shunts begin to experience an increase in cyanosis with this closure. Which explanation describes the pathophysiology of this clinical manifestation?

Closure of ductus arteriosus decreases the volume of blood going to the lungs for oxygenation

An infant is brought to the emergency department with retinal hemorrhages, increased irritability, and a burn mark on the arm. Once stabilized, what is the nurse's priority intervention for this patient?

Consult with child protective services.

A child has been diagnosed with hypoplastic left heart syndrome. Which action by the nurse will be a priority for providing long term management of this child?

Contact provider as surgical consult is needed

A 17-year-old is diagnosed with an internalizing disorder and is having difficulty coping with the diagnosis. Which nursing intervention is the priority for this patient?

Contact the health care provider to obtain a referral for cognitive-behavioral therapy (CBT).

Which test result would the nurse use to assess the likelihood of worsening respiratory distress in a child with asthma?

Continuous pulse oximetry

What physiological changes are augmented by strenuous exercise and high altitudes in the patient with pulmonary arterial hypertension (PAH)?

Cyanosis Peripheral edema Right-sided heart hypertrophy

Which genitourinary assessment should be used prior to the removal of renal stones or tumors from the urinary bladder?

Cystoscopy

In doing the respiratory assessment in a patient with heart failure (HF), which assessment findings should the nurse expect to see?

Distinctive cough Abnormal lung sounds Deep breaths with activity Increased number of respirations

A client has +3 pitting edema in the legs and potassium of 2.3 mEq/L. The nurse should anticipate which order from the health care provider?

Diuretic

Which cardiac complication should cause changes in cardiac output (CO) after catheterization?

Dysrhythmias

A child with type 1 diabetes mellitus who is taking insulin is seen in the school's clinic. The nurse develops a teaching plan for the child regarding food and exercise because the child has told the nurse that she will begin basketball practice. Which instruction should the nurse provide to the child?

Eat an extra snack of carbohydrates before the basketball practice starts.

Which diagnostic test can be used for real-time visualization of both heart structures and function?

Echocardiography (ECHO)

The nurse notices that the parents of a child admitted with congenital diaphragmatic hernia are not holding the child. Which nursing intervention is appropriate to assist in resolution of the problem?

Educate the parents about the condition and the treatment.

Match the period of cognitive development with the appropriate characteristic.

Egocentric view of the world- Sensorimotor Thinking is magical and dominated by perception- Preoperational Thinking becomes logical- Concrete operational Situations can be analyzed- Formal operational

A 5-year-old child who was admitted for chills, fever, breathing difficulties, and chest pain, begins coughing and is restless. Which action by the nurse is a priority?

Elevate the head of bed

A patient with a history of sickle cell anemia presents to the ER with acute abdominal pain and will require long-term care. After being assessed in the ER, what type of inpatient admission will the patient receive?

Emergency admission

Choose the conditions that affect motility in the pediatric gastrointestinal system.

Encopresis Constipation Gastroesophageal reflux disease

A 6-year-old patient with leukemia has been admitted to the intensive care unit (ICU). After the first day, the child begins to feel overwhelmed and expresses fear and anxiety. Which action can help the child feel more comfortable?

Encourage the family to visit often. Provide adequate emotional support. Play games to help distract from the medical technology. Bring personal items from home to make the child feel comfortable.

The community mental health nurse is caring for a teenaged patient with internalizing disorder. The nurse notes that the patient demonstrates socially isolating behaviors. Which is the best action by the nurse?

Encourage the patient to express any feelings.

A patient admitted to the pediatric unit is upset because she misses playing with her sister, who's at home. What is the most appropriate action by the nurse?

Encourage the sibling to visit and to engage in activities with the patient.

he nurse is caring for a pediatric patient with abnormal laboratory values for rheumatoid factor (RF), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Which assessment findings correspond with the abnormal laboratory results?

Enlarged knee joints Limping when walking Pain when moving joints

Match the term with its definition.

Erythrocyte red blood cells Erythropoietin hormone that stimulates red blood cell production and maturation Polycythemia increased production of red blood cells Hematopoiesis red blood cell production

The nurse is performing the initial assessment of a 6-year-old pediatric patient. Which components of the nursing process should be included in the musculoskeletal assessment?

Evaluating motor development Checking proper movement of the eyes Plotting the child's height on a growth chart Comparing child's current weight to previous results

Which statement appropriately describes the primary role of the alveoli?

Exchange of oxygen for carbon dioxide takes place in the alveoli.

What are some of the clinical manifestations associated with left-sided obstructive lesions?

Exercise intolerance Pulmonary hypertension Left ventricular hypertrophy

During a procedure in the pediatric outpatient center, the nurse notices the patient's sibling is looking on with both concern and curiosity. Which action by the nurse would be most appropriate?

Explain the procedure to the sibling. Ask the sibling if she has any questions pertaining to the procedure.

Which situation identifies an environment in which a child may be at increased risk of developing cancer?

Exposure to radiation from repeated computed tomography (CT) scans

Which findings should the nurse expect to observe during the admission assessment of a child with a history of separation anxiety disorder?

Fear of being harmed Fear of harm being done to family members or loved ones

Match the bone with the appropriate classification.

Flat bones Ribs Long bones Femur Short bones Carpals Irregular bones Vertebrae Sesamoid bones Patella

A mother is concerned that her child suffering from heart failure (HF) has started to experience abdominal pain. What explanation by the nurse can be provided to the mother to help her understand this coexisting condition?

Fluid overload causing congestion can lead to abdominal pain.

Which of the following statements regarding hypertonic (hypernatremic) dehydration is correct?

Fluids shift from ICF to ECF. Seizure monitoring should be implemented. Serum sodium level is above normal limits.

A rapid pace of growth is common in which age group?

From birth to 2 years From puberty to 15 years

A patient reports nausea, vomiting, and upper right quadrant pain. Which gastrointestinal organs may be involved?

Gallbladder

Multifactorial birth defects result because of a combination of which two factors?

Genetics Environment

A child falls from a two-story building and presents to the emergency department appearing drowsy. Which assessment should be performed by the nurse first?

Glasgow coma scale

A twelve-year-old child has begun experiencing difficulty in playing at recess and states, "I just can't run as fast or throw and catch the ball like I could before, so I just don't play now." On what should the nurse focus the neurologic assessment?

Gross and fine motor skills

The function of the RBC is to carry oxygen to the tissues. Which factor is essential for the RBC to complete this task?

Hemoglobin

Match each term with its definition.

Hemostasis Prevention of blood loss Fibrinogen Protein necessary for clotting Thrombocyte Small, irregular shaped, non-nucleated fragments Megakaryocyte Precursor to platelets Vasoconstriction Blood vessels decrease in diameter

Blood supply to the liver comes from which sources?

Hepatic artery Hepatic portal vein

A 9-month-old infant is brought to the hospital by the parents because the infant is "breathing fast." Assessment reveals retractions, wheezing, rhinorrhea, and oxygen saturation is 89%. Which question would help the nurse determine the next intervention?

How many wet diapers has the infant had today?

The nurse is treating a newborn and the mother confides in the nurse that she drank alcohol socially throughout the pregnancy. The nurse should be careful to assess for which specific signs and symptoms?

Hypotonia Weak suck with bottle feeds Head circumference below target for age Incessant crying despite soothing attempts

In isotonic dehydration the greatest fluid loss is from the ECF. The nurse understands that this fluid loss from the ECF can result in which manifestation?

Hypovolemic shock

The diabetes educator is meeting with school nurses to discuss ways to increase diabetes management in the schools, allowing for students with diabetes to take part in everyday activities, before, during, and after school. The school nurses provide scenarios of their involvement with diabetes management. Which statement indicates a safe nursing action on the part of the school nurse?

I had a 14-year-old diabetic child come to my office yesterday after school. Her coach asked that she see me because of irritability, pallor, and clammy skin. The child reported that after running 1 mile as warm-up, these symptoms developed. We tested her blood glucose.

The nurse is creating a plan of care for a patent who has been diagnosed with an internalizing disorder. Which instruction for the patient is most important for the nurse to include?

Identify trusted adults with whom you can talk.

Which two influences on growth and development increase the risk of occurrence of multifactorial birth defects?

If one close relative has a severe form of the defect, then the risk for multifactorial birth defects increases. If several close relatives have the defect, whether mild or severe, it will increase the risk for multifactorial birth defects.

The nurse is assessing a pediatric patient with rhythm disturbance and decreased cardiac output (CO). What action should the nurse take?

Immediately notify the health care provider

Pulmonary arterial hypertension (PAH) management is designed to treat the symptoms of heart failure (HF). How does treating HF symptoms facilitate the management of PAH?

Improving right-sided heart function and fluid management will decrease the symptoms of PAH. Increasing afterload will force the heart to increase contractility and therefore decrease PAH.

What is the relationship between right-sided heart failure and pulmonary artery stenosis?

Increased pressure developed in the right ventricle can cause hypertrophy and eventual failure of the right side of the heart.

What change in the neonate is directly responsible for the closure of foramen ovale?

Increased pressure in left ventricle

A 7-year-old child has recently died after being treated for leukemia for the past 5 years. The child was unresponsive for days prior to dying and the parents were at the bedside the entire time. The nurse overhears the parents say statements such as, "I feel like this is a dream. I don't know what to do now." "Thank God it is finally over; he's at peace." "Is it wrong to feel this way?" Which emotions or reactions are being expressed?

Indifference to activities of daily living Relief that the child is no longer suffering Numbness to any emotions when around others Guilt related to being relieved over the death of the child

A patient with Type 1 diabetes mellitus is admitted to the emergency department in DKA. Which action should the nurse take first?

Initiate fluid replacement with 0.9% saline

A mother presents to the nurse and states, "just recently my child has developed a positive, 'can-do' attitude towards all of her tasks." Based on this comment the child has recently reached which stage of psychosocial development according to Erikson?

Initiative vs guilt

A 6-month-old is sleeping in the parent's arms. The mother reports the infant has been "breathing fast," coughing repeatedly, and crying more often than usual. Which component of the respiratory assessment should the nurse perform first?

Inspection

The nurse is caring for a 7-year-old child who presents with enlarged tonsils, abdominal breathing, respiratory rate 34, and irregular breathing pattern. Which assessment finding is most concerning?

Irregular breathing pattern

Urine culture results show >100,000 colonies/mL of urine, indicating an infection. What is the next best step in the assessment?

Isolate and identify the pathogenic bacteria.

What is the purpose in allowing family members to interact with the body after the patient dies?

It allows the family members to say their final good-byes.

The parent of a patient with aortic stenosis would like more information about a new diagnosis of pulmonary venous hypertension. What information should the nurse provide regarding treatment and outcomes?

Keep regular follow-up appointments for observation Interventional correction of the stenotic valve will improve cardiac output and decrease the pulmonary hypertension.

A child prefers to be with friends rather than with parents. The child is demonstrating which of Kohlberg's levels of morality?

Level of self-accepted moral principles

A child has been diagnosed with cleft palate, and the nurse is meeting with the caregivers. What are appropriate interventions by the nurse?

Listen to the caregivers' questions. Teach the effectiveness of verbalizing concerns. Ensure consent forms for surgery have been signed.

A 3-year-old male presents with drooling, retractions, and oxygen saturation of 88% on room air. The parents report the child became sick over the past few hours and cries quietly when disturbed. Which action by the nurse is priority?

Anticipate emergency support.

The nurse is treating a child who is approaching death within hours. Which respiratory responses are likely findings in a child who is approaching death?

Apneic episodes of 40 seconds between respirations Retraction of muscles under the sternum and ribcage Loud sighing at the end of each respiration with a loud rattle noise

A 6-year-old child is brought to the hospital due to chills, fever, chest pain, and breathing difficulties. The nurse obtains the following vital signs: temperature 101.8o F, HR 110, RR 30, and oxygen saturation 90% on room air. Order the nursing interventions based on priority, with the highestpriority being placed first.

Apply Oxygen Reassess oxygen saturation Administer antibiotics Provide oral fluids

Match the musculoskeletal diagnostic procedure with the appropriate nursing consideration. A and C correcrt

Arthroscopy Administer prophylactic antibiotics Arthrography Check for allergy to iodine Magnetic Resonance Imaging (MRI) Assess for presence of prosthesis or other metal Radionuclide Scintigraphy (Bone Scan) Encourage fluids prior to procedure

At the end of every shift a nurse feels drained and begins crying, grieving the loss of patients. What can the nurse do to increase coping mechanisms?

Ask a more experienced pediatric nurse to mentor the nurse. Obtain at least 8 hours of uninterrupted sleep every night. Meet monthly with other pediatric nurses to discuss the past month's events.

A patient draws a picture of her parents with anger expressed in their faces. What is the priority nursing action?

Ask the child what the drawing means.

Place the steps in the order the nurse should take to determine more about a patient's chief complaint.

Ask the patient. Ask the family members. Review the patient's chart Review the healthcare provider's notes.

The nurse is caring for a child who has sustained an acceleration-deceleration head injury. Which actions should the nurse take in assessing this patient?

Assess child for retinal injury. Check child for burns and bruising. Assess for associated extremity sprain. Contact health care provider because child needs head computed tomography (CT).

The nurse assesses a pediatric patient and finds deficits in speech. What additional assessment does the nurse perform to gather more data about the patient's speech deficit?

Assess for drowsiness and jitteriness. Evaluate for hearing loss and deafness. Determine if oral-motor weakness is present. Observe interactions between child and parents.

A newborn infant presents to the emergency department with papilledema. Which assessment does the nurse perform first?

Assess for patent fontanels.

The nurse is caring for a newborn delivered at 30-weeks gestation. Order the nursing interventions based on pediatric differences in the respiratory system by priority with the highest priority being placed first.

Assess respiratory status Suction the nose Provide oxygen Administer surfactant

A 14-year-old child who was admitted due to fever, night sweats, mild cough, and weight loss, with a positive Mantoux test, is being prepared for discharge. Which actions should the nurse consider doing next?

Assess the family's financial status. Coordinate care with health department.

If appendicitis were suspected, in which area of the abdomen would the nurse expect the patient to report pain?

Lower right quadrant

In a child with a complete spinal cord injury at T6, which interventions should the nurse implement to prevent complications?

Maintain patient's bed position at 45-degree angle. Notify health care provider for BP of 162/89 mm Hg.

A newborn infant has pulmonary atresia with intact ventricular septum. The parents want to know why the health care provider said it was important to keep fetal structures open. How can the nurse explain the rationale for maintaining fetal structures in the newborn infant?

Maintaining open fetal structures will allow blood to make its way to the lungs. This will allow for oxygenation of the blood for the baby.

In response to the pathophysiology of heart failure (HF), there is activation of the sympathetic nervous system and the release of hormones in an effort to maintain cardiac output (CO). How do these two systems synergistically increase cardiac output?

Sympathetic nervous system activity increases heart rate. Sympathetic nervous system activity increases stroke volume. Endocrine function of the hormones of renin-angiotensin-aldosterone-system (RAAS) leads to increased intravascular volume.

Match the white blood cell with its function.

T-cell cell-mediated immunity B-cell humoral immunity (antibody production) Basophil activate inflammatory response Monocyte fight chronic infection

The health care provider examines a 7-year-old child, revealing increased deep tendon reflexes, hypertonia, flexion, and a scissors gait. Which intervention does the nurse include in this patient's plan of care?

Teach the child and parents how to monitor for and address learning difficulties.

Match each component of the musculoskeletal system with the connecting tissue that helps it to function.

Tendons Connect muscle to bone Ligaments Connect bone to bone Skeletal muscles Contractile structure Articular cartilage Shock absorbing structure

The blood glucose of a patient newly diagnosed with Type 1 diabetes mellitus has a blood glucose level of 310 mg/dL. Which type of insulin would the nurse expect to be ordered at this time?

Regular

The nurse is caring for a child with autism spectrum disorder (ASD). What should the nurse do to best assist the child's tolerance of the hospitalization?

Regularly assess for any changes in the child's behavior, such as withdrawal or self-injury. Provide the child with her favorite stuffed animal each time that she needs to recognize that it is time to get ready for bed. Speak with the parents about the usual routines the child prefers for getting ready for the day ahead in the morning and going to bed at night.

An infant in the 5th percentile for weight is brought in to the health care provider's office because of failure to thrive. The mother reports that the child is fed every 3 to 4 hours and has no obvious symptoms of gastrointestinal (GI) distress. Which type of GI condition would the nurse suspect?

Malabsorption disorder

Which statement explains how cerebral spinal fluid (CSF) maintains homeostasis?

Removes wastes from the brain

A patient with DKA is given normal saline and intravenous regular insulin. The nurse checks blood glucose level hourly. Which other assessment data is the best indicator of clinical improvement?

Respiration rate of 12 to 15 and normal BP in the standing position

A child presents to the emergency department with sudden bilateral ascending weakness and is diagnosed with Guillain-Barré syndrome. What should the nurse most closely monitor?

Respiratory status

Atrial septal defects are conservatively treated as many spontaneously close. What assumptions can be made regarding the possible outcomes if the defect does not close?

Right-sided pressures will increase. Right side of heart will be volume overloaded. There will be increased pulmonary blood flow. There will be increased oxygen saturation on right side of the heart.

How do the rugae of the bladder function to accommodate the movement of urine?

Rugae can distend or refold dependent on the volume in the urinary bladder.

A patient is having a tympanostomy tube placement in a hospital outpatient facility. Which instructions are important to include in the patient's discharge teaching?

Schedule a follow-up appointment. Provide instructions for homecare to reduce complications. Provide instructions on medications and dietary restrictions. Provide instructions about who to contact in case of an emergency.

A child arrives in the emergency department several days after experiencing a sports-related concussion. The child is experiencing feelings of sadness and a mild lapse in memory. Which phrase describes the relationship of the injury to the child's symptoms?

Secondary development of an internalizing disorder

The patient is diagnosed with Guillain-Barré syndrome. The nurse expects which findings in the cerebral spinal fluid (CSF) analysis?

Normal glucose level Clear cerebral spinal fluid Elevated protein concentration Normal white blood cell level (WBC)

A nurse is measuring the height and weight of a 4-year-old child during the well-child visit. The child's parents comment that they are concerned that the child's growth seems to have slowed down since the child was a toddler. The nurse knows that this is because of which factors?

Normal growth slows down in this age group.

Which serum test should provide the nurse with the most information regarding hydration status of a patient?

Serum osmolality

The structure of red blood cells supports ease of flow through the blood vessels. Which patient condition is most likely to inhibit blood flow?

Sickle cell anemia

The progression of function in infants can be described by which patterns of growth and development?

Simple to complex General to specific

In the electrical conduction system of the heart, where does the initial impulse start?

Sinus (SA) node

An infant is being evaluated for bacterial meningitis. The nurse holds the patient in which position for the sampling of cerebrospinal fluid (CSF)?

Sitting Side-lying

Which is the main element behind the cause of dehydration?

Sodium

Which technique by the nurse is appropriate while conducting respiratory assessment on a 2-year-old child?

Stand at the side of the child to palpate the chest.

The nurse is caring for a child who presents with tachypnea, cyanosis, and periods of apnea. ABG results show pH 7.32, CO2 35, HCO3 18, paO2 78. The nurse also notes diminished breath sounds bilaterally. Labs are obtained. Which action should the nurse take?

Start oxygen inhalation.

A 10-year-old child with leukemia is dying after a failed bone marrow transplant. The child is anxious when approached by the nurses, expresses fear about going to sleep at night, and cries when the parents are not present in the room. The nurse is concerned with the child's ability to cope with dying. Which actions should the nurse take next?

Stay in the room with the child while they fall asleep. Have a volunteer stay with the child while the parents are gone.

A young child presents to the primary care clinic for a well-visit. During the cardiac assessment, the nurse hears a murmur during S2 and a heart rate of 90 bpm. The nurse notes that the child is below average height. Based on this information, what is the likely cause of the child's murmur?

Structural defect

A mother brings her 3-week-old infant in to be examined. The child has nasal congestion and difficulty with breathing. Which action should the nurse do next?

Suction the infant's nose.

According to Piaget's cognitive theory, which concept is demonstrated by an infant looking for a pacifier that has fallen out of the crib?

Object permanence

A 4-year-old patient presents to a busy urban emergency room (ER) center with an acute case of viral diarrhea with no other significant medical history. This patient is best suited for which hospital unit?

Observation unit

A family has decided to gather in the room of a child who has impending death. A prayer has started and then all the family members begin praying and laying their hands on the patient. What action will the nurse take?

Observe the child for restlessness, moaning, or increased muscle tension.

A patient presents to an inpatient unit expecting a long-term hospital stay. The nurse performs the initial, and focused, assessment of the patient. Which other actions taken by the nurse will be important at this time?

Obtain a code status Consult with social workers, if necessary Apply an allergy band to the patient's wrist Provide ample emotional care for the child since hospital settings can be overwhelming for him or her

A 2-year-old child is brought to the hospital for persistent coughing, weight loss, and appearing malnourished. While gathering history, the mother reports the child has a positive Mantoux test "a few months ago." Which action should the nurse take?

Obtain a medication history.

The nurse cares for a child with Guillain-Barré syndrome. The nurse notes a frequent, weak cough and decreased bilateral hand grips. What actions should the nurse take?

Obtain a pillow nurse call light for patient's use. Raise head of the bed to a semi-Fowler's position. Do not allow patient to have anything to eat or drink. Explain to patient what was assessed and the meaning.

A 19-year-old with Type 1 DM is taking 30 units of NPH insulin each morning and 15 units at night. Because of persistent morning glycosuria with some ketonuria, the evening dose is increased to 20 units. This worsens the morning glycosuria, and now moderate ketones are noted in urine. The patient complains of sweats and headaches at night. The next step in management is:

Obtain blood glucose levels at 2 a.m.

The nurse is caring for a 3-year-old child who presents with persistent cough, weight loss, fever, and night sweats. Organize the nursing actions by priority, with the highestpriority being placed first.

Obtain history and physical exam. Perform Mantoux skin test. Administer prescribed anti-tuberculosis medications. Coordinate care with local health department.

The nurse classifies the eight-month-old patient as having a severe injury based on what findings?

Opens eyes to pain, motor extension, and moans to pain

Order the stage of psychosexual development as they occur in chronological order.

Oral Stage—infancy Anal Stage—toddlerhood Phallic Stage—pre-school Latency Stage—school-age Puberty—adolescence

A 2-year-old child presents to ER due to chills, fever, chest pain on left side, productive cough, and difficulty breathing. The health care provider prescribes therapies for the child. Which prescription should the nurse question?

Oral antihistamines

Which patient findings would have an associated effect on the white blood cell function?

Osteosarcoma Bacterial Pneumonia Enlarged cervical lymph nodes

How can a nurse distinguish between a patient with hypoplastic left heart syndrome and truncus arteriosus?

Oxygenated blood flows to left atrium in hypoplastic left heart syndrome, whereas oxygenated blood flows into left ventricle where blood mixing occurs in truncus arteriosus.

A 1-year-old female presents with restlessness, rhinorrhea, retractions, and poor feeding. The nurse reviews the health care provider's prescription. Which treatment would the nurse question?

Palivizumab IM

Following cardiac catheterization, what nursing assessments are necessary?

Palpate pulses Inspect catheter insertion site

What is the relationship between the fetal cardiac anatomical features and the survivability of complex cardiac lesions in the early neonatal stage?

Patent fetal structures maintain pathways for the movement of blood and allow for mixing of oxygenated and deoxygenated blood.

After performing an assessment on a 7-year-old patient recovering from acute kidney injury, the nurse notes the following: proper skin integrity, increased urine output, decreased edema, and decreased general anxiety. What conclusion can be made regarding the assessment findings and the status of the acute kidney injury?

Patient is regaining renal function as evidenced by proper skin turgor, increased urine production, and decreased fluid overload.

What conclusions can be drawn regarding clinical manifestations for a patient with a right-to-left shunt and decreased pulmonary blood flow?

Patient may have polycythemia. Patient may be hypoxemic, resulting in cyanosis. Patient may have increased cardiac workload and ventricular strain.

What force best describes the movement of urine from the renal pelvis to the urinary bladder?

Peristalsis

A school-age child asks the school nurse about sexual development, which indicates that the child is in which Freudian stage of development?

Phallic or Oedipal/Electra stage

The hospitalized child with spina bifida has broken out in a rash. What actions should the nurse take?

Place a precautions sign on the door and in the room. Change out the gloves in the room and outside the door. Request that the health care provider prescribe a steroid. Check the patient's vital signs for a temperature elevation.

The nurse is assessing a child with a tracheoesophageal fistula who has been coughing and choking during feeding. The child is in the 45th percentile for weight, and vital signs are normal. Which nursing intervention is appropriate to ensure that the expected outcome is achieved for this patient?

Place child on a chalasia board.

A child is diagnosed with early stage hydrocephalus. What actions should the nurse perform?

Place padding on all four of bed rails Administer ondansetron (Zofran) for vomiting. Provide orientation to the room, call light, and personnel. Consult dietician for dietary supplement recommendations.

What findings during the cardiac assessment provide information about possible cardiac dysfunction?

Poor weight gain Decreased feeding Respiratory pattern alterations

Match the scenarios with the corresponding stages or levels of morality as stated by Kohlberg.

Premorality or preconventional morality, stage 0Decisions are made on the basis of what pleases the child. Morality of conventional role conformityMorality is based on avoiding disapproval or disturbing the conscience. Morality of self-accepted moral principlesRight is determined by what is best for the majority. Premorality or preconventional morality, stage 2Child conforms to rules out of self-interest.

A 5-year-old who steals money from his or her mother's purse and does not understand consequences is likely at which stage of morality?

Premorality/preconventional morality Instrumental hedonism and concrete reciprocity

A child is brought to the clinic with suspected fetal alcohol spectrum disorder (FASD). What action taken by the nurse will be a priority in caring for this patient and the family?

Prepare the family for the necessity of a workup to determine the symptoms and other conditions associated with the disorder.

A nurse assesses the growth of a 1-month-old infant and prepares to measure the head circumference and assess the fontanels. The nurse knows that which aspect(s) of this infant's head anatomy should be an expected finding?

Presence of a posterior fontanel Presence of an anterior fontanel

The nurse is caring for a child with incomplete closure of the aortic semilunar valve. How does the nurse describe the normal function of this valve to the patient's family?

Prevents blood from flowing back into the ventricle

The nurse is caring for an 11-year-old patient who is overweight. They are in the school setting and the nurse provides the patient and patient's parents with instructions on healthy-eating habits. The nurse is demonstrating which strategies central to outpatient care?

Promoting health Providing preventive care Providing effective patient education

Which type of care would be expected in rehabilitative care outpatient setting?

Provide encouragement and support for the patient Work with patient to regain muscle function

A patient has had an extended hospital stay and is demonstrating symptoms of low self-esteem. Which action by the nurse would allow the child to gain a sense of autonomy?

Provide the child instruction on his wound care Allow the child to decide on times of medication administration Encourage the patient to discuss feelings about low self-esteem and personal experiences in the hospital

A school nurse is providing education to a group of teachers regarding working with intellectually disabled school-aged children. What information is most important for the nurse to emphasize?

Put a stop sign picture on any object or area that you do not want the children to touch or enter.

The nurse is caring for a patient with dysthymic disorder who has been admitted to the day observation unit. When formulating the patient's care plan, which nursing action would be most effective in monitoring the patient's mood?

Record the activity level of the patient.

The nurse is demonstrating appropriate oral hygiene for a repaired cleft lip before patient discharge. Which actions does the nurse demonstrate to protect the repair site from complications or infection while it is healing?

Use a cotton swab to clean the mouth.

When caring for a child with a right-to-left shunt, what precaution is essential when obtaining IV access?

Use meticulous attention to avoid introducing air bubbles in tubing of IV line.

An arterial blood gas is drawn on a patient and it shows a decrease in the arterial partial pressure of carbon dioxide (PaCO2). The nurse should expect which response of the cerebral vasculature?

Vasoconstriction, decreased blood flow

A nurse is concerned that a child with an upper gastrointestinal hernia is experiencing an imbalance in nutrition. Which symptom should the nurse document?

Vomiting

When preparing a child to receive chemotherapy, the nurse can expect to see which values in the patient's electronic health record?

WBC levels

Which are the best resources to find an appropriate growth chart in assessing growth for a 1-year-old child?

World Health Organization (WHO) growth standards for this age group

Which statement reflects a child's ability to develop autonomy according to Erikson?

The child is able to pour milk from a cup.

The parents of a child with a neurologic disorder and severe intellectual disability are concerned about the child's frequent emotional changes and anger. How might the nurse interpret these changes in emotion?

The child may be frustrated and unable to appropriately express needs.

A 10-year-old patient with a history of fetal alcohol spectrum disorder (FASD) without any identifiable intellectual or physical impairments comes into the clinic with the parents. The parents want to know what impairments might be expected as their child continues to grow. What information should the nurse share with this family?

The child may start to experience joint pain or stiffness.

A twelve-year-old child's spina bifida lesion affects the upper lumbar vertebrae. The nurse evaluates that the child is meeting therapeutic goals when the child demonstrates which behaviors?

The child participates in exercise activities daily. The child has successful attempts at bladder emptying. The child bathes, dresses, and puts on shoes without help.

The nurse received report about a child experiencing early signs of difficulties associated with mild intellectual disability. What behaviors should the nurse anticipate from the child?

The child spends time alone and rarely makes eye contact.

The nurse wishes to educate parents on what to expect as the child is approaching death. Which response regarding the child's breathing pattern is most appropriate?

The child will have Cheyne-Stokes respirations, leading to respiratory arrest.

Acid secretion into the kidneys is a necessary process to prevent acidemia. Why would an infant present with a low blood pH despite the ability to regulate acid/base balance at the rate of an adult?

The child's kidneys lack the ability to effectively acidify urine via secretion in the distal tubule and collecting duct.

A young nurse who does not deal well with death is looking for support. What is the best way a more experienced nurse can respond?

The experienced nurse offers to mentor the young nurse. Inform the young nurse about availability and time to talk. The experienced nurse refers the young nurse to grief programs offered at the hospital.

A mother discusses options about hospice care for an only child who has three months to live. The child has osteosarcoma (bone cancer) and has had frequent admissions to the hospital for pain control. The mother states they live on a farm 30 miles from the hospital. Which piece of information is most important in influencing the decision for hospital-based hospice care?

The family lives 30 miles from the hospital.

Which scenario reflects the type of interaction allowed in the hospital moments after a child passes away?

The family members remain in the room with the child immediately following the death of the child and the nurse provides privacy.

How do pressures in the fetal heart and pulmonary vasculature compare to neonatal?

The fetal heart has lower left ventricular pressure. The pulmonary vasculature has increased pressure. The fetal heart has higher right ventricular pressure

Which statement best summarizes the differences between the fetal and neonatal heart in terms of oxygen saturation?

The fetal heart has moderate oxygen saturation throughout, whereas the neonatal heart has low oxygen saturation on the right side & high oxygen saturation on the left side.

A young nurse developed a friendship with a teenaged patient who died. What can this nurse expect during the grieving process?

The grieving process for the nurse may take a lot longer to get over.

The nurse notes that QP/QS ratio (pulmonary-to-systemic ratio) is normal, however the right side of the heart has increased saturation. What conclusion can be drawn from this data?

There is a left-to-right shunt.

For what reasons is it essential to assess all four extremities while performing a cardiac assessment?

To determine temperature differences To assess capillary filling in the extremities To determine differences between the central and peripheral pulses To determine differences in blood pressure between upper and lower extremities

A child with asthma, who has been intubated and confined in ICU, is prescribed to undergo arterial blood gas (ABG) testing due to which reasons?

To determine the acid-base balance To measure the level of carbon dioxide

In patients with coarctation of the aorta, infusion of prostaglandin E1 may be used to keep the ductus arteriosus open. What is the rationale for facilitating patent ductus arteriosus (PDA) when the patient has coarctation of the aorta?

To increase blood flow to descending aorta by allowing deoxygenated blood from pulmonary trunk to mix with blood distal to lesion

What is the rationale for administering potent vasoconstriction agents to a child experiencing a hypercyanotic episode?

To increase systemic vascular resistance To decrease the degree of right-to-left shunting To increase blood flow into the pulmonary circulation

he nurse is caring for a child recently admitted to the hospital with upper respiratory infection and "whooping" cough. Which prescription would the nurse question?

Ambulate in hall daily

A 2-year-old female presents with stridor, restlessness, and a hoarse cry. The nurse reviews the health care provider's prescription. Which medication would the nurse question?

Ampicillin intravenous

Which enzyme in the pancreas is used to convert carbohydrates to disaccharides?

Amylase

Why do infants have an increased risk for diarrhea?

Increased peristalsis Less water absorbed from fecal mass

A 10-year old girl tells the nurse that she is nervous at school. During the initial nursing assessment, what questions should the nurse ask the child to assess for possible generalized social anxiety disorder?

"Do you experience nervousness in any other situations?"

Parents come to the clinic with their infant who was recently diagnosed with autism spectrum disorder (ASD). The parents state that they think their child is "just fine." What questions can the nurse ask to assess for signs of ASD?

"Does your infant look at you when you speak to him or her?" "Does your infant seem to do the same actions over and over again with toys?" "Has your child shown behaviors that indicate that he or she misses you when you are gone?" "If your child appears distressed, does he or she come to you and climb on your lap and look for comfort?"

During a well-child visit, a three-year-old patient being examined exhibits unsteady gait and poorly developed speech. The health care provider suspects cerebral palsy (CP). How should the nurse guide the parents?

"Ensure that your home is free of sharp edges to protect the child in case of falling while walking." "The speech-language pathologist will work with you to evaluate reasons for the poorly developed speech." "The physical therapist will show you some exercises to improve coordination and strengthen the child's muscles."

The nurse is providing education to a child and family during a sports physical examination to explain the differences in the pediatric musculoskeletal system compared to adults. Which statement by the child indicates correct understanding of the education?

"I am not as likely to sprain my ankle when playing sports, but I should be careful."

A child has recently been diagnosed with Guillain- Barré syndrome. Which patient statements require follow-up by the nurse?

"I had a nasty cold two weeks ago, but mom said it was not a big deal." "I had a red rash a while back with a fever. It only lasted about three days." "I hate getting the flu-shot, but dad insisted this year since I've been sick so much."

A typical dietary pattern for optimal growth and development includes which proportions of fat, carbohydrate, and protein?

20% fat, 50% carbohydrate, and 30% protein

The mother of a 5-year-old patient reports unexplained weight loss in the child over the past month, frequent epistaxis, and persistent diarrhea. Which other findings support a possible diagnosis of cancer?

Anemia Mass in the child's neck

A 4-year-old patient starts expressing fear whenever she needs to get her blood drawn. Which action can a nurse take to help the pediatric patient cope during an uncomfortable procedure?

Allow the parents to participate in the procedure. Instruct the patient in performing breathing exercises.

Which radiographic examination could be used to examine gas patterns after complaints of abdominal pain?

Abdominal flat plate

How does the upper airway prevent bacterial infections?

Adenoids filter lymph fluid.

A 9-month-old infant has a "whooping" cough after having a runny nose, low-grade fever, and mild cough. Which action should the nurse consider doing next?

Administer antibiotics as prescribed.

A 6-year-old child presents with anxiety, stridor, and becomes agitated when asked questions. The parents report the child had a high fever. Which action by the nurse is a priority?

Administer humidified oxygen.

The mother of a 6-month-old infant who was recently admitted for a "whooping" cough, rhinorrhea, and fever, reports that she has two other children age 3 and 5 at home. Which action should do the nurse take?

Advise to consult these children with a health care provider

Which structure can dilate to increase blood flow to the nephron?

Afferent arteriole

A 5-year old child is diagnosed with an internalizing disorder after sustaining a traumatic head injury (THI). The nurse understands that which factors play a role in the development of internalizing disorders?

Age of the child How the injury was treated Location of the brain injury

A patient's chest x-ray reveals inflammation of the bronchi and a sputum culture is positive for streptococcus. Which white blood cells may be active?

B-cells T cells Monocytes Lymphocytes Natural killer cells

A nurse has been working with a patient in the therapeutic-play setting for two weeks and notices an improvement in the child's ability to cope with painful procedures. Which is the next effective strategy to continuing improving the child's ability to tolerate painful procedures?

Begin to incorporate more unstructured play.

Administration of diphenhydramine can help with which physiologic response expected near the time of death?

Death rattle

List the steps of RBC production in the proper order.

Decrease in circulating oxygen Kidneys produce erythropoietin RBC precursors produced in the bone marrow Rapid maturation leads to development of RBCs

A child is diagnosed with esophageal atresia and is not gaining weight as expected. Which finding on a follow-up examination indicates that the expected outcomes for this patient have not been met?

Decreased urinary output

Which patients are at risk for impaired clotting?

Diagnosis of osteosarcoma Diagnosis of liver failure cirrhosis A patient with Von Willebrand disease

A nurse is caring for a child and notices that as the child's last days are approaching, the family is becoming more withdrawn. Which action is most important to ensure the child is not left alone during the dying process?

Discuss the need to talk to the child, touch the child, and remain at the bedside of the child during the last days.

The nurse is evaluating a patient with cleft lip to determine whether collaborative care was able to achieve the expected outcome. Which action should the nurse take to determine whether a child with cleft lip and palate is achieving adequate nutrition?

Measure height and weight.

A nurse is performing a follow-up respiratory assessment for a 7-year-old child who had pneumonia of the right middle lobe. Which anatomical landmark should the nurse use to assist in auscultation of the right upper lobe?

Midclavicular line

Which cardiac valve is responsible for regulating the flow of oxygenated blood between ventricle and atrium?

Mitral valve

The provider writes orders for a patient with Type 1 DM admitted with DKA. Which order should the nurse question?

Monitor blood glucose every 3-4 hours during IV insulin infusion.

The provider writes orders for a patient with Type 1 DM admitted with elevated blood glucose levels. Which order should the nurse question?

Monitor blood glucose every 3-4 hours during IV insulin infusion.

A young patient newly diagnosed with diabetes is admitted with a BP of 85/58 mm Hg, pulse of 120 bpm, respirations 42, blood glucose level of 450 mg/dL, pH of 7.07 and bicarbonate level of 13 mEq/L. The patient is lethargic and slow to respond to touch. Which conditions will the nurse need to monitor?

Monitor blood pH Check level of consciousness Monitor level of potassium Maintain Fluid intake and output

The nurse is caring for a patient diagnosed with a hiatal hernia. Which assessments should be performed to determine that treatment has been effective?

Monitor intake and output. Assess the patient for vomiting.

The nurse is admitting a 2-year-old for dehydration. What nursing interventions should the nurse implement for a patient with an electrolyte imbalance?

Monitor intake and output. Monitor neurological status. Monitor acid-base balance. Monitor the child's ECG.

The nurse is assessing a newborn and notes that the head circumference is 13 inches and the chest circumference is 11 inches. What conclusion can be made by the nurse about this ratio?

The newborn is presenting with a normal growth pattern.

The nurse evaluates a three-year-old child for developmental delays. When the nurse notes that the child has difficulty maintaining balance while walking, what other assessments does the nurse perform?

The nurse assesses overall muscle tone and strength. The nurse assesses for speech impairments and delays. The nurse assesses deep tendon and primitive reflexes. The nurse assesses for developmental milestone variances.

A nurse is working for the first time with a 17-year-old diagnosed with autism spectrum disorder (ASD). The adolescent seems very attached to a sibling. The parents encourage the 15-year-old sibling to spend the night in the hospital. Allowing a sibling to spend the night is against the policy of the hospital unit. Which is the nurse's best response?

The nurse should discuss the policy with the parents of the patient and develop a plan that meets the requirements of the facility and the needs of the adolescent.

Organize the stages of separation anxiety in a 9-month-old patient.

The parents exit the room and the child becomes angry and upset. The child begins crying and rejecting the nurse. The child's crying decreases and the child becomes apathetic. The child is happy and begins to play with the nurse.

he nurse would most likely expect which finding in a 12-year-old patient with an internalizing disorder?

The patient reports physical pain in the absence of a physical condition

A sibling is noticeably upset at the death of a sister. Which is an example of an activity that allows the sibling to assist in the immediate care of the body?

The sibling washes the hands and face of the sibling alongside the nurse during death care.