PEDS SPECIALTY
How should the nurse instruct the parents of a 4-month-old with seborrheic dermatitis (cradle cap) to shampoo the child's hair?
use a soft brush and gently scrub the area
A hospitalized child stiffens and starts to seize as the RN enters the room. What actions should the RN take? (Select All That Apply)
• Pad side rails with available pillows and blankets. • Monitor duration and progress of the seizure. • Turn client to the side if possible.
A school age child is brought to the emergency center with fever and joint pain and is diagnosed with rheumatic fever. Which explanation should the nurse provide the parents regarding the cause of this condition?
A previous bacterial infection causes a chronic condition that effects the heart valves.
When inspecting the spine of a 10-year-old, the nurse notes a concave curvature at the back of the neck. How should the findings be classified?
Abnormal
The RN is planning care for a newborn infant scheduled for a cardiac catheterization. Which occurrence poses the greatest risk for this child?
Acute hemorrhage from the entry site of the catheter after the procedure.
An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days after taking levofloxacin (Levaquin) 500 mg orally once daily and metronidazole (Flagyl) 500 mg twice daily. She asks the nurse; why do I have to be in the hospital? Why can't I get my treatment at home? Which purpose should the nurse provide that supports the effective outcome?
Administration of a supervised parenteral antibiotic protocol
The nurse is admitting a child with a diagnosis of untreated hypoparathyroidism. Which finding indicative of hypocalcemia should the nurse report to the healthcare provider?
Ans: Positive Chvostek sign
An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response?
Decreased periorbital edema
A 12-year old is admitted to the hospital with possible encephalitis and a lumbar puncture is scheduled. which information should the nurse provide this child concerning the procedure?
Describe the side lying knee to the chest position that must be assumed during the procedure.
A mother of an infant born with hypospadias is concerned because she has been told that her child cannot be circumcised according to her Jewish faith tradition. Which response is best for the nurse to provide?
During the surgery part of the foreskin is used to repair the meatus
A 12-year-old boy with hemophilia is hospitalized for hemarthrosis of his right knee. He is complaining of severe knee pain. Which intervention should the nurse implement?
Elevate and immobilized right knee in a fixated position
The nurse is assessing an adolescent who arrives at the clinic for a physical examination before high school starts. The adolescent reports trouble hearing and constant ringing in the ears. Which action should the nurse implement first?
Evaluate lying and standing blood pressure.
When obtaining an adolescents health history. Which intervention is most important of the nurse to implement?
Evaluate vital signs and lab findings
The nurse is planning care for a 16-year-old who has a juvenile idiopathic arthritis (JVA). The nurse includes activities to strengthen and mobilize the joints surrounding muscle. Which physical therapy regimen should the nurse encourage the adolescent to implement?
Exercise in a swimming pool.
an adolescents mother calls the primary healthcare provider's office to inquire about the results of her daughter's serum test results that was drawn last week. Since the teenagers 18th birthday, how should the nurse respond to this mother's inquiry?
Explain that the information cannot be released without the 18-year-old permission
A 1-year-old with respiratory syncytial (RSV) is admitted to the pediatric unit. The nurse observes the child who presents with rhinorrhea, frequent coughing and sneezing. Which additional findings should alert the nurse that the child is in acute respiratory distress?
Flaring of the nares.
Which nutritional information should the nurse plan to provide the mother of a 6-month-old regarding introduction of solid food?
Foods should be introduced into a child's diet once at a time at 4-7 day intervals.
A 10-year old is admitted to the emergency department. He is unresponsive and his laboratory values include a blood sugar of 800mg/dl. Potassium of 5 mEq/L, and arterial blood gas levels of pH 7.30, HCO3 15 mEq/L, PaCo2 37 mmHg. Which intervention has the highest priority?
Frequently assess the child's respiratory effort.
The nurse plans to screen only the highest risk children for scoliosis. Which group of children should the nurse screen first
Girls between ages 10 and 14
A 3- month- old with gastrointestinal reflux has been placed on enteral feedings. Which action should include in the infant plan of care?
Give the infant a pacifier during the feedings.
The mother of an 11-year old boy who has juvenile arthritis tells the nurse, "I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting." Which information is most important for the nurse to provide this mother?
Giving pain medication around the clock helps control the pain
A mother brings her 10- year- old boy who is holding his abdomen to the clinic because of fever, vomiting, and abdominal pain for the past 12 hours. Which assessment data most is important for the nurse to obtain?
His typical pattern and type of bowel movement
A father brings his 3-year-old daughter who has a history of asthma to the emergency department because her wheezing has increased over the past two days. The father has been giving the child's medication using a metered dose inhaler (MDI). Which information is most important for the nurse to obtain?
If a spacer device is attached to MDI.
The nurse is assessing an 8-month-old who has a cough, axillary temperature of 100 degree and rhinorrhea. Which information is most important for the nurse to obtain from the child's mother?
Immunization status of the infant
A 9-year-old boy is diagnosed with diabetes mellitus type 1. Which stage of Erickson's theory of psychosocial development is the nurse addressing when teaching the client about insulin injections?
Industry.
The nurse is caring for a 6 year old child with leukemia who had a recent bone marrow aspiration to evaluate response to chemotherapy. Lab results reveal a platelet count of 24, 500 cell/mm3. Which intervention should the nurse implement?
Initiate bleeding precaution due to myelosuppression
When caring for a child with sickle cell disease, the nurse knows that the child will most likely exhibit which sign when experiencing a sickle cell crisis?
Pain.
The nurse is teaching the parent of a child with cystic fibrosis about home care. Which interventions should the nurse ensure the parents understand about managing the child's respiratory secretions?
Percussion and postural drainage
The nurse is examining an infant for possible cryptorchidism. Which exam should be used?
Place the infant in a warm room and use a calm approach.
A 2-year-old girl is brought to the clinic by her 17-year-old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother? (Select all that apply)
-Drinking soda is related to childhood obesity. -Toddlers should be drinking from a cup by age 2. -Dental caries is associated with drinking soda.
During a routine clinic visit, the nurse determines that a 5-year-old girl systolic blood pressure is greater than the 90th percentile. Which action should the nurse implement next?
Take the blood pressure two more times during the visit and determine the average of the three readings.
The nurse is caring for a child with chronic kidney disease who is experiencing renal osteodystrophy. Which outcome should the nurse explain to the parents about sequela for their child with renal osteodystrophy?
Arrested growth.
A mother brings her 2 year old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F. Which intervention should the nurse implement?
Ask the mother if the child has had a runny nose
During a follow up clinical visit a mother tells the nurse that her 5 month old son who had surgical correction for tetralogy of fallot has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement?
Auscultate heart and lungs while infant is held
The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours and is now at 76 beats/minute, the previous reading 4 hours ago was 110 beats/minute. Which additional clinical finding should be reported immediately to the healthcare provider?
Blood pressure of 70/40
A 3-month-old with myelomeningocele and atonic bladder is characterized every 4 hours to prevent urinary retention. The home health nurse notes that the child has developed episodes of sneezing, urticaria, watery eyes and a rash in the diaper area. Which action is most important for the nurse to take?
Change to latex free gloves when handling infant.
A 3-year-old is receiving a weekly chemotherapy treatment. Which toy is best for the nurse to provide for this child?
Coloring book with crayons
Following admission for a cardiac catheterization the nurse is providing discharge teaching to the parents of a 2-year-old toddler with tetralogy of Fallot. Which action should the nurse give the parents if their child becomes pale, cool, lethargy?
Contact the healthcare provider immediately
While obtaining the vital signs of a 10-year-old child who had a tonsillectomy this morning the nurse observes the child swallowing every 2 to 3 minutes. Which assessment should the nurse implement?
Inspect the posterior oropharynx
A mother brings her 8 mo. old baby boy to clinic because he has been vomiting and had diarrhea for last 3 days. Which assessment is most important for nurse to make?
Measure the infant's pulse
A child is admitted to the hospital with diarrhea. The nurse can expect this child to exhibit which finding?
Metabolic acidosis.
A toddler is hospitalized with Kawasaki's disease. Pharmacological management includes Aspirin therapy. What is the benefit of the aspirin?
Minimize vascular inflammation.
The nurse is preparing a teaching plan for the parents of a 6 month-old infant with GERD. What instruction should the nurse include when teaching the parents measures to promote adequate nutrition?
Mix the formula with rice cereal
A mother brings her 3-year-son to the emergency room and tells the nurse he has an upper respiratory infection for the past two days. Assessment reveals a rectal temperature of 102 degrees. He is drooling and becoming increasingly more restless. What action should the nurse take first?
Notify the healthcare provider and obtain a tracheostomy tray.
The mother of a 4-month-old baby girl asks the nurse when she should introduce solid foods to her infant. The mother states, "My mother says I should put rice cereal in the baby's bottle now." The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?
Opens mouth when food comes her way
The nurse observes an 18-month-old toddler keeping a bottle of milk in the mouth throughout the history taking and assessment process during a well child visit. The mother confirms that the child has a bottle available most of the day and remarks that it makes a great pacifier. Which response should the nurse provide?
Prolonged bottle use can increase risk for cavities
A 9-week-old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
RBC 2.3 million/mm 3
A six-year-old is being admitted to the hospital for repair of an umbilical hernia. Which information collected by the admitting nurse is particularly helpful in planning care for this child?
Reactions to any previous hospitalizations
The parents of a 14-month-old child who is hospitalized due to febrile seizures tells the nurse that they fear their child will have lifelong seizures. Which information should the nurse convey to these parents?
Reassure the parents that febrile seizures decrease as the child grows older.
In assessing a 10 year old newly diagnosed with osteomyelitis, which information is most for the nurse to obtain
Recent recurrence of infections
Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which finding indicates to the nurse that the medications having the desired effect?
Reduction of edema
A 3-year-old girl who has been blind since birth is hospitalized because of a compound fracture of the femur and is now in traction. Which Intervention is best for the nurse to implement to address this child's blindness?
Request parents bring familiar objects such as a stuffed animal from home.
A 4-year-old child is admitted to the hospital after experiencing a febrile seizure with a two-day history of fever above 103 degrees, the nurse observes the child is hurtful with rapid deep respirations. Which acid base imbalances should the nurse anticipate the child developing?
Respiratory alkalosis
A nurse is teaching the parents about important dietary changes for their child who is newly diagnosed with celiac disease. Which foods should the nurse include in the list of allowed foods for this child?
Rice.
The nurse is caring for a 3-year old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction?
Right foot is cool to the touch and appears pale and blanched.
Parents bring their 8-month-old daughter to the clinic because they are concerned that she is not developing as her older brother did. Which developmental characteristic should the nurse expect an 8-month-old to exhibit?
Sits alone unsupported
Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse?
The child is placed in a supine position to begin percussion
The nurse is conducting an admission assessment of an 11-month old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta hat was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?
The lumen of the aorta reduces the volume of the blood flow to the lower extremities
The nurse is teaching a group of adolescents about the risk factors for hepatitis. Which risk factor is most important for the nurse to include in the teaching plan?
Unprotected sexual intercourse
which client requires immediate intervention by the RN
a child with acute renal failure and hyperkalemia
The nurse is caring for a school aged child after a born marrow aspiration for leukemia. The child's laboratory results include a platelet count of 26,000 cells/mm3. Which intervention is most important for the nurse to implement?
implement bleeding precautions.
A child that has been vomiting for the past 3 days is admitted for correction of fluid and electrolyte imbalances. What acid based imbalance is the child likely to exhibit?
metabolic alkalosis
A 3-year old male is seen in the outpatient clinic with reddish vesicles on his legs. The medical diagnosis is impetigo contagious. The child mother is concerned about the long-term effect of the condition. The nurse should inform the mother of which probable outcome?
no scarring
Several children at a day game return from playing in a tick infested field. Which action should the camp nurse take first?
observe the children's skin for attached ticks.
A child with possible Duchenne muscular dystrophy (MD) undergoes an electro myelogram (EMG). Following the procedure, the child's parents tell the nurse the child is complaining of sore muscles. How should the nurse respond?
offer reassurance that muscle soreness following this procedure is temporary and does not indicate a problem.
The nurse is discharging a school aged child who is newly diagnosed with congenital adrenal hyperplasia. Which information should the nurse instruct the parents to report to the healthcare provider immediately?
persistent vomiting.
