RN Nursing Care of Children 2016 Bgood

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A nurse is preparing to administer a hep B vaccine to a 1-month-old. The nurse should plan to inject the medication at which location?

Thigh

A charge nurse is preparing to make a room assignment for a newly admitted school-age child. Which of the following considerations is the nurse's priority when making a room assignment Length of stay Treatment schedule Disease process Self-care ability

Disease proces The transmission of infectious diseases is the greatest risk to this child and other children on the unit; therefore, the child's disease process is the nurse's priority consideration.

A school nurse is assessing a school-age child who has erythema infectiosum (fifth disease). Which of the following findings should the nurse expect

Facial rash

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should teach the parent to apply which of the following to the affected area Zinc oxide Antibiotic ointment Talcum powder Antiseptic solution

Zinc oxide Diaper dermatitis is a common inflammatory skin disorder caused by contact with an irritant such as urine, feces, soap, or friction, and takes the form of scaling, blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide, against the irritants allows the skin to heal.

A nurse is admitting an infant who has intussusception. Which of the following findings should the nurse expect? (Select all that apply Steatorrhea Vomiting Lethargy Constipation Weight gain

vomiting, lethargy

A nurse is providing teaching to the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statements by the parent should the nurse identify as understanding the teaching

"I should keep my child indoors when I mow the yard

A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler Apple juice Peanut butter Chicken broth Oral rehydration solution

Oral rehydration solution A toddler who has acute diarrhea should consume an oral rehydration solution to replace electrolytes and water and promote recovery from dehydration.

A community health nurse is assessing an 18-month-old toddler in a community day care. Which of the following findings should the nurse identify as a potential indication of physical neglect Resists having an axillary temperature taken Exhibits withdrawal behaviors when her parent leaves Has multiple bruises on her knees Poor personal hygiene

Poor personal hygiene Poor personal hygiene in a toddler is a potential indication of physical neglect. Because toddlers are still dependent on their parents for help with hygiene needs, poor personal hygiene indicates a lack of supervision.

A nurse is assessing a 6-month-old infant at a well-infant visit. Which of the following findings should the nurse report to the provider Presence of strabismus Presence of corneal light reflex Presence of open anterior fontanel Presence of cerumen

Presence of strabismus trabismus, or crossing of the eyes, disappears at 3 to 4 months of age. Therefore, the nurse should report this finding to the provider.

A nurse is interviewing the parent of an 18-month-old toddler during a well-child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss The toddler has a vocabulary of 25 words. The toddler developed a mild rash following a recent varicella vaccine. The toddler's Moro reflex is absent. The toddler received tobramycin during a hospitalization 2 weeks ago.

The toddler received tobramycin during a hospitalization 2 weeks ago The nurse should identify tobramycin as an aminoglycoside, which is an ototoxic medication that can cause mild to moderate hearing loss, and should assess the toddler for a hearing impairment.

A nurse is teaching a school-age child who has a severe allergy to bee venom and his parent about epinephrine. Which of the following instructions should the nurse include in the teaching Use a second dose if the first dose of epinephrine does not completely reverse the symptoms. Store unused epinephrine syringes in the refrigerator. Shake the epinephrine syringe prior to use to dissolve the precipitate. Administer the medication subcutaneously in the back of the arm.

Use a second dose if the first dose of epinephrine does not completely reverse the symptom A biphasic response, in which the child will appear to recover and then experience a recurrence of symptoms, is possible with some allergic reactions. The nurse should instruct the parent and child to use a second dose if the first dose does not resolve all the symptoms.

A nurse is planning care for a school-age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the plan Use sterile scissors to remove the dressing from the site. Irrigate each lumen weekly with 10 mL of 0.9% sodium chloride solution when not in use. Access the site using a noncoring angled needle. Use a semipermeable transparent dressing to cover the site.

Use a semipermeable transparent dressing to cover the site The nurse should cover the site with a semipermeable transparent dressing to reduce the risk of infection.

A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first Prednisone Epinephrine Diphenhydramine Albuterol

epi This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence-based practice the nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the heart, causes vasoconstriction of blood vessels in the skin and mucous membranes, and triggers bronchodilation in the lungs.

A nurse is caring for a school-age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction Laryngeal edema Flank pain Distended neck veins Muscular weakness

flank pain The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic reaction to the blood transfusion.

A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of dehydration. Which of the following findings should the nurse address first Skin breakdown Hypotension Hyperpyrexia Tachypnea

tachypnea When using the airway, breathing, circulation approach to client care, the first finding the nurse should address is the toddler's tachypnea, which results when the kidneys are unable to excrete hydrogen ions and produce bicarbonate leading to metabolic acidosis.

A nurse is providing anticipatory guidance to the parents of an 8-month-old infant during a well-child visit. Which of the following statements should the nurse make "Your baby should be able to stand while holding on to furniture." "Your baby should be able to say one to two words." "Your baby should be able to sit unsupported." "Your baby should be able roll a ball to you."

"Your baby should be able to sit unsupported The nurse should recognize that an infant should sit unsupported at the age of 8 months.

A nurse is reviewing the laboratory report of a 6-year-old child who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider Hgb 8.5 g/dL WBC 9,500/mm3 Prealbumin18 mg/dL Platelets 300,000/mm3

hgb The child receiving chemotherapy is at risk for anemia due to the chemotherapy effects on the blood forming cells of the bone marrow. The development of anemia is diagnosed through laboratory testing of hemoglobin and hematocrit levels. The nurse should recognize that a hemoglobin level of 8.5 g/dL is below the expected reference range for a 6-year-old child and should be reported to the provider.

A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following? (Click on the audio button to listen to the clip Wheezes Crackles Pleural friction rub Rhonchi

wheezes The nurse should identify the sound during auscultation as wheezes, which are high-pitched, musical or whistling-like sounds heard primarily on expiration as air passes through and vibrates narrowed airways.

A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should the nurse identify as an indication the adolescent is rejecting the kidney Negative leukocyte esterase Serum creatinine 3.0 mg/dl Negative urine protein Urine output 40 ml/hr

Serum creatinine 3.0 mg/dt Creatinine is a byproduct of protein metabolism and is excreted from the body through the kidneys. An elevated serum creatinine level, therefore, can be an indication that the kidneys are not functioning. The nurse should identify that the adolescent's serum creatinine level is higher than the normal reference range and may indicate rejection of the kidney.

A nurse is assessing a toddler who has leukemia and is receiving his first round of chemotherapy. Which of the following findings is the priority for the nurse to report to the provide Urticaria Fatigue Vomiting Anorexia

urticaria The greatest risk to a toddler who is receiving his first round of chemotherapy is an anaphylactic reaction; therefore, urticaria is the priority finding for the nurse to report to the provider. The nurse should monitor the child for anaphylaxis during and up to 1 hr after the infusion is complete, and immediately report associated findings, such as urticaria, rash, angioedema, and wheezing to the provider.

A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school-age child who weighs 75 lb. Available is atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero

1

A nurse is assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure? Hypotension Hyperactivity Decreased attention span Tachycardia

Decreased attention span The nurse should recognize decreased attention span, inability to follow commands, and difficulty in school are manifestations of increased intracranial pressure because of the decreased blood flow within the brain.

A nurse in an emergency department is caring for a school-age child who has appendicitis and rates his abdominal pain at 7 on a 0 to 10 scale. Which of the following actions should the nurse take Instill a 500 mL tap water enema. Give morphine 0.05mg/kg IV. Administer polyethylene glycol 1g/kg PO. Apply a heating pad to the child's abdomen.

Give morphine 0.05mg/kg IV A pain level of 7 on a 0 to 10 scale is considered severe and the nurse should administer an analgesic medication for pain relief.

A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant Wrist Great toe Index finger Heel

Great toe The nurse should secure the sensor to the great toe of the infant and then place a snug-fitting sock on the foot to hold the sensor in place. The nurse should also check the skin under the sensor site frequently for pulses, temperature, and color.

A nurse is planning care for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan Administer pancreatic enzymes 2 hr after meals. Decrease pancreatic enzymes if steatorrhea develops. Limit fluid intake to 750 mL per day. Increase fat content in the child's diet to 40% of total calories.

Increase fat content in the child's diet to 40% of total calories A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of pancreatic enzymes. The nurse should increase the child's fat intake to equal 40% of total caloric intake.

A nurse is assessing an 8-year-old child who has early indications of shock. After establishing an airway and stabilizing the child's respirations, which of the following actions should the nurse take next Insert an indwelling urinary catheter. Measure weight and height. Initiate IV access. Maintain ECG monitoring.

Initiate IV access Since the child's airway is established and respirations are stabilized, the next action the nurse should take using the airway, breathing, circulation approach to client care is to establish IV access to maintain the child's circulatory volume.

A nurse in an emergency department suspects that a toddler has epiglottitis. Which of the following actions should the nurse take Obtain a culture from the toddler's throat. Prepare the toddler for nasotracheal intubation. Visually inspect the epiglottis using a tongue depressor. Administer the Haemophilus influenzae type B conjugate vaccine.

Prepare the toddler for nasotracheal intubation When epiglottitis is suspected the nurse should prepare for nasotracheal intubation or a tracheostomy, which might be required if the toddler begins to experience severe respiratory distress.

A nurse is caring for a newly-admitted school-age child who has hypopituitarism. Which of the following medications should the nurse expect the provider to recommend to the parents for treating the child's condition Desmopressin Luteinizing hormone-releasing hormone Recombinant growth hormone Levothyroxine

Recombinant growth hormone Recombinant growth hormone injections are used to treat hypopituitarism, which inhibits cell growth and results in growth failure. The nurse should expect the provider to recommend this treatment to the child's parents. The nurse's role is to provide emotional support for the parents as they make a decision about the treatment they feel is best for their child.

A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. The nurse should identify which of the following statements by the child as understanding the teaching "I will puncture the pad of my finger when I am testing my blood glucose." "I will give myself a shot of regular insulin 30 minutes before I eat breakfast." "I will eat a snack of 5 grams of carbohydrates if my blood glucose is low." "I will decrease the amount of fluids I drink when I am sick."

"I will give myself a shot of regular insulin 30 minutes before I eat breakfast The child should administer regular insulin 30 min before meals so that the onset coincides with food intake.

A hospice nurse is caring for a preschooler who has a terminal illness. The father tells the nurse that he cannot cope anymore and has decided to move out of the house. Which of the following statements should the nurse make

"Let's talk about some of the ways you have handled previous stressors in your life

A nurse is teaching a school-age child and his parent about postoperative care following cardiac catheterization. Which of the following instructions should the nurse include "Stay home from school for 1 week following the procedure." "Follow a diet that is low in fiber for 1 week." "Wait 3 days before taking a tub bath." "Apply a pressure dressing to the site for 3 days."

"Wait 3 days before taking a tub bath The child should keep the site clean and dry for at least 3 days to reduce the risk of infection. He should not take a tub bath for 3 days to avoid immersion of the incision in water.

A nurse is caring for a school-age child who has diabetes mellitus and was admitted with a diagnosis of diabetic ketoacidosis. When performing the respiratory assessment, which of the following findings should the nurse expect Deep respirations of 32/min Shallow respirations of 10/min Paradoxic respirations of 26/min Periods of apnea lasting for 20 seconds

Deep respirations of 32/min The nurse should expect deep and rapid respirations in a child who has diabetic ketoacidosis. This respiratory rhythm is the body's attempt to blow off excess carbon dioxide and achieve a state of homeostasis.

A nurse is providing anticipatory guidance to the parents of a 2-week-old infant about risk factors for sudden infant death syndrome (SIDS). Which of the following risk factors should the nurse include in the teaching Covering the sleeping infant with a blanket Supine sleeping Maternal history of milk allergy Pacifier use during sleep

Covering the sleeping infant with a blanket The use of quilts or blankets to cover the sleeping infant increases the risk of SIDS due to the potential for suffocation. The nurse should recommend the parents dress the infant warmly and increase the temperature in the home.

A nurse is admitting a 4-month-old infant who has heart failure. Which of the following findings is the nurse's priority? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data Episodes of vomiting Formula consumption Weight Temperature

Episodes of vomit When using the urgent vs. nonurgent approach to client care, the nurse determines that the priority finding is three episodes of vomiting. This can indicate digoxin toxicity, which requires immediate intervention; therefore, this is the priority finding.

A nurse is reviewing laboratory results of a school-age child who is 1 week postoperative following an open fracture repair. Which of the following values should the nurse identify as an indication of a potential complication

Erythrocyte sedimentation rate 18 mm/hr

A nurse is discussing organ donation with the parents of a school-age child who has sustained brain death due to a bicycling accident. Which of the following actions should the nurse take first Inform the parents that written consent is required prior to organ donation. Provide written information to the parents about organ donation. Ask the provider to explain misconceptions of organ donation to the parents. Explore the parents' feelings and wishes regarding organ donation.

Explore the parents' feelings and wishes regarding organ donation The first action the nurse should take when using the nursing process is assessment. Exploring the parents' feelings and wishes regarding organ donation will assist the nurse in determining if organ donation is appropriate for this family and should be done prior to taking other actions.

A nurse is admitting a school-age child who has pertussis. Which of the following actions should the nurse take Place the child in a room with positive-pressure airflow. Place the child in a room with negative-pressure airflow. Initiate contact precautions for the child. Initiate droplet precautions for the child.

Initiate droplet precautions for the child The nurse should initiate droplet precautions for a child who has pertussis, also known as whooping cough. Pertussis is transmitted through contact with infected large-droplet nuclei that are suspended in the air when the child coughs, sneezes, or talks.

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan Administer ibuprofen to the child for a temperature greater than 38ºC(101º F). Assess the child's blood pressure every 8 hr. Weigh the child weekly at various times of the day. Initiate seizure precautions for the child.

Initiate seizure precautions for the child A sodium level of 129 mEq/L indicates hyponatremia and places the child at increased risk for neurological deficits and seizure activity. The nurse should complete a neurologic assessment and implement seizure precautions in order to maintain the child's safety.

A nurse is caring for a school-age child who has experienced a tonic-clonic seizure. Which of the following actions should the nurse take during the immediate postictal period Place the child in a lateral position. Delay documentation until the child is fully alert. Give the child a high-carbohydrate snack. Administer an oral sedative to the child.

Place the child in a lateral position The nurse should place the child in a lateral position to prevent aspiration.

A nurse is creating a plan of care for a school-age child who has heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan

Provide small, frequent meals to the child

A nurse is providing discharge teaching to the parents of a Caucasian toddler who had a lower leg cast applied 24 hr ago. The nurse should instruct the parents to report which of the following findings to the provider Capillary refill time less than 2 seconds Restricted ability to move the toes Swelling of the casted foot when the leg is dependent Toes that are deep pink in color

Restricted ability to move the toe The nurse should inform the parents that a restricted ability of the toddler to move his toes is a sign of neurovascular compromise and requires immediate notification of the provider. Permanent muscle and tissue damage may occur in just a few hours.

A nurse in an emergency department is caring for a school-age child who has sustained a superficial minor burn from fireworks on his forearm. Which of the following actions should the nurse take Administer a tetanus toxoid if more than 1 year since prior dose. Use an antimicrobial ointment on the affected area. Leave the burn area open to air. Place an ice pack on the affected area.

Use an antimicrobial ointment on the affected area The nurse should apply an antimicrobial ointment to the burned area to prevent infection.

A school nurse is assessing an adolescent who has scoliosis. Which of the following findings should the nurse expect Increase in anterior convexity of the lumbar spine Increased curvature of the thoracic spine Lateral flexion of the neck A unilateral rib hump

a unilateral rib hump When assessing an adolescent for scoliosis, the school nurse should expect to see a unilateral rib hump with hip flexion. This results from a lateral S- or C-shaped curvature to the thoracic spine resulting in asymmetry of the ribs, shoulders, hips, or pelvis. Scoliosis can be the result of a neuromuscular or connective tissue disorder, or it can be congenital in nature.

A nurse is teaching the parent of an infant who has a Pavlik harness to treat developmental dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates an understanding of the teaching "I should remove the harness at night to allow my infant to stretch her legs." "I will need to adjust the straps on the harness once each week." "I should apply baby powder to my infant's skin twice daily." "I will place my infant's diapers under the harness straps."

"I will place my infant's diapers under the harness straps To prevent soiling of the harness the parent should apply the infant's diaper under the straps.

A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent should the nurse identify as understanding the teaching "Mononucleosis is caused by an infection with the Epstein-Barr virus." "Mononucleosis is a bacterial infection requiring 14 days of antibiotics." "A Monospot is a throat culture used to diagnosis mononucleosis." "Children who get mononucleosis will need to refrain from sports for 6 months."

"Mononucleosis is caused by an infection with the Epstein-Barr virus Mononucleosis is a mildly contagious illness that occurs sporadically or in groups and is primarily caused by the Epstein-Barr virus.

A nurse is teaching the mother of a 6-month-old infant about teething. Which of the following statements should the nurse make "Your baby may pull at her ears when she is teething." "Rub your baby's gums with an aspirin to decrease her discomfort." "Place a beaded teething necklace around your baby's neck." "Your baby's upper middle teeth will erupt first."

"Your baby may pull at her ears when she is teething The nurse should inform the mother that teething can result in discomfort for the infant. Therefore, the mother should look for indications such as pulling on the ears, difficulty sleeping, increased drooling, or increased fussiness.

A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should the nurse expect Loud, harsh murmur Dysrhythmias Weak femoral pulses High blood pressure

Loud, harsh murmur The nurse should expect to hear a loud, harsh murmur with a ventricular septal defect due to the left-to-right shunting of blood, which contributes to hypertrophy of the infant's heart muscle.

A nurse is assessing a school-age child who has appendicitis with possible perforation. The nurse should identify which of the following as a manifestation of peritonitis Hyperactive bowel sounds Abdominal distention Bradycardia Polyuria

abd distention The nurse should recognize that abdominal distention is a manifestation of peritonitis. Peritonitis is an inflammation of the lining of the abdominal wall. This inflammation in the abdomen, along with the ileus that develops, causes abdominal distention.

A nurse is assessing a 4-year-old child at a well-child visit. Which of the following developmental milestones should the nurse expect to observe Identifies right from left hand Uses a utensil to spread butter Cuts a shape using scissors Draws a stick figure with seven body parts

Cuts a shape using scissor The nurse should recognize that an expected developmental milestone for a 4-year-old child is using scissors to cut out a shape.

A nurse is providing discharge teaching to the parent of a school-age child who has undergone a tonsillectomy. Which of the following statements by the parent should the nurse identify as understanding the teaching "My child may resume usual activities since this was just an outpatient surgery." "My child will be able to drink the chocolate milkshake I promised to get for her tonight." "I will notify the doctor if I notice that my child is swallowing frequently." "I will have my child gargle with warm salt water to relieve her sore throat."

"I will notify the doctor if I notice that my child is swallowing frequently The nurse should instruct the parent that frequent swallowing is a sign of bleeding and, if it is observed, to notify the primary care provider immediately.

A nurse is caring for a 2-week-old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize the infant's pain Instruct the mother not to breastfeed for 1 hr after the procedure. Undress the infant and place him under a radiant warmer prior to the procedure. Administer sucrose to the infant prior to the procedure. Recommend the mother avoid placing the infant in the kangaroo hold after the procedure.

Administer sucrose to the infant prior to the procedure The nurse should administer sucrose to the infant prior to the procedure. Evidence-based practice indicates that sucrose, as well as non-nutritive sucking with a pacifier, can provide non-pharmacological pain management in infants.

A nurse is caring for a toddler who has acute otitis media and a temperature of 40º C (104º F). After administering acetaminophen, which of the following actions should the nurse plan to take to reduce the toddler's temperature Apply a cooling blanket to the toddler. Dress the toddler in minimal clothing. Give the toddler a tepid bath. Administer diphenhydramine to the toddler.

Dress the toddler in minimal clothing The nurse should recognize that dressing the toddler in minimal clothing will expose the skin to air and maximize heat evaporation from the skin, thus reducing the toddler's temperature.

A nurse is providing discharge teaching to the parents of a 6-month-old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instructions should the nurse include in the teaching You may bathe your infant in an infant bathtub when you go home." "Apply hydrocortisone cream to your infant's penis daily." "You should clamp your infant's stent twice daily." "Allow the stent to drain directly into your infant's diaper."

"Allow the stent to drain directly into your infant's diaper The nurse should instruct the parents to ensure that the stent drains directly into the infant's diaper to prevent kinking or twisting that can interfere with urine flow.

A nurse is caring for a school-age child who has acute rheumatic fever. Which of the following actions should the nurse take Limit the child's sodium intake. Place a "no visitors" sign on the child's door. Maintain the child on bed rest. Avoid administering salicylates to the child.

Maintain the child on bed rest The nurse should maintain the child on bed rest as well as limit the child's activity during the acute phase of rheumatic fever to assist with the prevention of cardiac damage.

A nurse is caring for an infant who is receiving IV fluids for the treatment of Tetralogy of Fallot and begins to have a hypercyanotic spell. Which of the following actions should the nurse take Place the infant in a knee-chest position. Administer a dose of meperidine IV. Discontinue administration of IV fluids. Apply oxygen at 2 L/min via nasal cannula.

Place the infant in a knee-chest position The nurse should place the infant in a knee-chest position during a hypercyanotic spell to decrease the return of desaturated venous blood from the legs and to direct more blood into the pulmonary artery by increasing systemic vascular resistance.

A nurse is preparing to suction an infant who has a tracheostomy. Which of the following actions should the nurse take Routinely suction every 30 min. Instill 0.9% sodium chloride prior to suctioning. Limit suctioning pressure to 40 mm Hg. Suction for 5 seconds or less.

Suction for 5 seconds or less The nurse should suction an infant who has a tracheostomy for 5 seconds or less to prevent hypoxia.

A nurse is planning an educational program for school-age children and their parents about bicycle safety. Which of the following information should the nurse plan to include The child should be able to stand on the balls of her feet when sitting on the bike. The child should ride her bike 2 feet to the side of other bike riders. The child should wear dark-colored clothing with a fluorescent stripe when riding at night. The child should ride the bike facing traffic when it is necessary to ride in the street.

The child should be able to stand on the balls of her feet when sitting on the bike To decrease the risk for injury, parents should ensure that the bike is the correct size for the child. When seated on the bike, the child should be able to stand with the ball of each foot touching the ground and should be able to stand with each foot flat on the ground when straddling the bike's center bar.

A nurse is reviewing the lumbar puncture results of a school-age child suspected of having bacterial meningitis. Which of the following results should the nurse identify as a finding associated with bacterial meningitis Decreased cerebrospinal fluid pressure Decreased WBC count Increased protein concentration Increased glucose level

increased protein concentration The nurse should recognize that an increased protein concentration in the spinal fluid is a finding associated with bacterial meningitis.

A nurse in the emergency department is assessing a toddler who has Kawasaki disease. Which of the following findings should the nurse expect? (Select all that apply Increased temperature Gingival hyperplasia Xerophthalmia Bradycardia Cervical lymphadenopathy

increased temperature, xerophthalmia, cervical lymphadenopathy

A nurse is caring for a school-age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions should the nurse take Use surgical asepsis when providing routine care for the child. Administer the measles, mumps, rubella (MMR) vaccine to the child. Screen the child's visitors for indications of infection. Infuse packed RBCs.

Screen the child's visitors for indications of infection The child who is severely immunocompromised is unable to adequately respond to infectious organisms resulting in the potential for overwhelming infection; therefore, the nurse should screen the child's visitors for indications of infection.


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