PNU 133 PassPoint PrepU School-age Child

The parents of a 9-year-old child in the terminal phase of a fatal illness ask the nurse for guidance in discussing death with their child. Which response is appropriate?

"At this developmental stage, most children have an adult concept of death and should be encouraged to discuss it."

A school-age child has a fever, joint inflammation, and a nonpruritic rash. Knowing that these are signs of rheumatic fever, the nurse should ask the parents:

"Has your child had strep throat recently?"

A 10-year-old child monitors and adjusts insulin dosage independently. Which response reflects an understanding of appropriate adjustment of insulin dosage when the child has the flu?

"I'll do a fingerstick test first, then figure out how much insulin to take."

During chemotherapy, a boy, age 10, loses his appetite. When teaching the parents about his food intake, the nurse should include which instruction?

"Let your child eat any food he wants."

A child who had bacterial meningitis is scheduled to have his hearing tested before discharge. The parent asks the nurse why this test is necessary. Which response by the nurse is appropriate?

"Some children with bacterial meningitis suffer damage to the nerve responsible for hearing; this test screens for hearing loss."

A staffing agency is assigning a licensed practical/vocational nurse (LPN/VN) to cover a shift on a pediatric unit. Because the unit manager is unfamiliar with the nurse's skill level, what assignment is best for the LPN/VN?

9-year-old child receiving subcutaneous insulin for diabetes mellitus

The nurse is developing the plan of care for a 9-year-old client with Down syndrome. How can the nurse best apply age-appropriate interventions?

Assess the client's current developmental level.

A parent reports that their 6-year-old daughter recently started wetting the bed and running a low-grade fever. A urinalysis is positive for bacteria and protein. A diagnosis of a urinary tract infection (UTI) is made, and the child is prescribed antibiotics. Which interventions are appropriate? Select all that apply.

Assess the parent's understanding of UTI and its causes. Instruct the parent to administer the antibiotic as prescribed—even if the symptoms diminish. Discourage taking bubble baths

The nurse is caring for a terminally ill school-age child. Which resource might be most helpful in caring for this child?

Child life specialist

An 8-year-old child is brought to the clinic with watery eyes and clear nasal drainage that has lasted more than 10 days, without fever. The nurse observes that the child has dark circles under the eyes and a crease above the tip of the nose. Which intervention should be the nurse's priority?

Collect data about potential environmental allergy triggers.

The nurse is caring for a 10-year-old child with cystic fibrosis. The child's parents tell the nurse that they're having difficulty coping with their child's disease. Which action would be most appropriate for the nurse to take?

Consulting with the social worker to help the family find appropriate resources

A 9-year-old child presents to a school nurse and reports arm and leg pain. Upon assessment, the nurse identifies numerous purple to yellow ecchymotic areas. When asked, the child says that the bruises are the result of "being in trouble at home." Which action by the nurse is mostappropriate?

Contact the authorities immediately.

The nurse is caring for an 8-year old child with acute asthma. Which data collection finding should the nurse immediately report to the charge nurse?

During auscultation, breath sounds are diminished bilaterally and no wheezing is audible.

The nurse is caring for a child with a life-threatening illness. The parents of the child want to introduce acupuncture and herbal medicines into the treatment regime. What is the mosteffective way for the nurse to react to this request?

Have the family discuss the options with the physician.

A nurse is teaching newborn care to expectant parents. Which information about sleep should the nurse include in the teaching plan?

Infants should not sleep in a bed with another person.

A school-age client is seen by the school nurse who notices a bruise on the arm that looks like a hand imprint. The client reveals that a caregiver has been abusive. Which interventions are appropriate for the nurse at this time? Select all that apply.

Notify the state's child protective services department. Notify the principal of the school.

A school-age child begins to have a seizure while walking to the bathroom after an appendectomy. The nearby staff do not have the child's medical history. What is the nurse's first action?

Position the child on the side.

The nurse is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity would be most appropriate for the nurse to schedule in the care plan?

Reading books

A nurse is caring for a school-age child who is at risk for harming himself or herself when left alone. What is the nurse's most appropriate intervention?

Provide one-on-one observation.

A 6-year-old boy is admitted to a pediatric unit for the treatment of osteomyelitis. Which organism most commonly causes osteomyelitis?

S. aureus.

A child is admitted with a tentative diagnosis of clinical depression. Which data collection finding is most significant in confirming this diagnosis?

Sadness

A newer nurse is assigned to care for several children with advanced cancer. The nurse finds the assignment extremely challenging due to a lack of experience and is considering requesting a different assignment. What is the best course of action by the nurse to resolve the situation?

Suggest a shared assignment with a senior staff nurse.

A nurse is caring for a 10-year-old child hospitalized for treatment of acute osteomyelitis. The child's left leg is immobilized in a splint. What is the nurse's most appropriate action?

Support and handle the leg gently during turning and repositioning.

The school nurse learns that at least one of the children in the school has a new diagnosis of erythema infectiosum (human parvovirus) after developing a bright red facial rash. What interventions should be implemented to prevent a possible spread of the infection to other students in the school?

Teach everyone to implement hand hygiene.

The nurse is assessing a school-age child for whom sexual abuse is suspected. Which evidence will the nurse apply as warning sign(s) of possible sexual abuse? Select all that apply.

The child reacts negatively when needing to undress for bathing or changing clothing. The child seems to have developed a new fear of certain people or social situations. The caregivers note a change in how the child communicates in social situations.

Which behavior demonstrated by a 6-year-old would help the nurse recognize a learning disability as opposed to attention deficit hyperactivity disorder (ADHD)?

The child reverses letters and words while reading.

A pediatric nurse is providing discharge instructions for the family of a school-age child with idiopathic thrombocytopenia. Which activity should be restricted until further notice?

bicycle riding

When collecting data on a girl, age 10, the nurse keeps in mind that the first sign of sexual maturity in girls is:

breast bud development.

A child, age 6, is anxious and upset before a scheduled bone marrow aspiration. During client preparation, the nurse should keep in mind that:

describing what the child will hear, see, smell, and feel will help the child cope with the procedure.

A child with asthma is receiving theophylline. The nurse knows that theophylline is administered primarily to:

dilate the bronchioles.

When attempting to facilitate spiritual support for a school-age child with a life-threatening disease and the child's family, which action would hinder the nurse-client relationship?

promoting the nurse's personal values and beliefs if the nurse considers the family's to be inappropriate

A nurse working as part of a multidisciplinary team is caring for a school-age child who has cerebral palsy. The child has difficulty eating using regular utensils and requires extensive assistance. The nurse advocating for the child would seek out which team member to assist in promoting the child's independence?

occupational therapist

A parent of a 9-year-old-child scheduled to have surgery expresses concern about the potential for postoperative infection. A nurse provides the parent with information about the measures taken to maintain surgical asepsis. Typical surgical asepsis involves:

performing a preoperative surgical scrub for at least 3 to 5 minutes.

The nurse is collecting data from a school-age child recently diagnosed with growth hormone deficiency. Which finding would lead the nurse to suspect the child had been physically abused?

small circular burns on the back

The nurse is planning care for a school-age client. Which action is most appropriate for the nurse to include?

teaching the client about procedures and conditions using basic medical language

Several children in a kindergarten class have been treated for pinworm. To prevent the spread of pinworm, the school nurse meets with the parents and explains that they should:

tell the children not to bite their fingernails.

Which use of restraints in a school-age child should the nurse question?

to substitute for observation

A nurse is caring for a 9-year-old child who has a grave prognosis after receiving a closed injury from being struck by a car. Which health team member should approach the family about organ donation?

transplant coordinator

The mother of a child with chickenpox (varicella) asks the nurse when her child may return to school. The nurse responds correctly by telling the mother that the child can return:

when all of the lesions are crusted over.