RN Pediatric Nursing Online practice 2023A

A nurse in a pediatric emergency department is planning care for an adolescent. Based on the information in the adolescence medical record, which of the following actions should the nurse plan to take? SATA

apply supplemental oxygen prepare for chest tube insertion Apply supplemental oxygen is correct. According to the medical record and chest x-ray report, the adolescent could potentially have a pneumothorax. Also according to the medical record and chest x-ray report, the adolescent's oxygen saturation level is decreasing, which indicates hypoxia. Therefore, the nurse should plan to administer supplemental oxygen. Prepare for chest tube insertion is correct. According to the medical record and chest x-ray report, the adolescent could potentially have a pneumothorax. A pneumothorax is the presence of air in the pleural cavity, which results in decreased lung expansion. The adolescent could experience dyspnea, tachypnea, tachycardia, hypoxia, and pain. This requires prompt intervention by the provider, such as the placement of a chest tube into the thoracic cavity to remove air and fluid from the pleural space, if present, allowing the lung to re-expand.

Charge nurse prepares to make room assignment for newly admitted school age child. Which considerations is the nurse's priority?

disease process 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 nurse in an urgent care clinic is assessing an adolescent who has an upper respiratory tract infection. Which of the following findings should the nurse identify as a manifestation of pertussis?

dry, hacking cough The nurse should identify that a dry, hacking cough is a manifestation of pertussis. This disease usually begins with indications of an upper respiratory tract infection, which includes a dry, hacking cough that is sometimes more severe at night.

Nurse gives discharge teaching to parents of 3 month old infant following cheiloplasty. Which instructions should the nurse include?

"Apply a thin layer of antibiotic ointment on your baby's suture line daily for the next 3 days." The nurse should instruct the parents to apply a thin layer of antibiotic ointment on the infant's suture line daily for 3 days and then continue to apply petroleum jelly to the area for several weeks to promote healing.

Nurse teaches family of school age child with juvenile idiotpathic arthritis. Which instructions should the nurse include in teaching?

"Encourage the child to perform independent self-care.": The nurse should teach the family the importance of encouraging the child to perform independent self-care. This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for independence will also increase their self-esteem.

A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statements by the parent indicates an understanding of the teaching?

"I house keep my child indoors when I mow the yard." The nurse should instruct the parent to keep the preschooler indoors during lawn maintenance or when the pollen count is increased. Guarding against exposure to known allergens found outdoors, such as grass, tree, and weed pollen, will decrease the frequency of the preschooler's asthma attacks.

Nurse reviews dietary choices of adolescent with iron deficiency anemia. Nurse should ID which menu items has highest amount of nonheme iron?

1/2 cup raisins The nurse should encourage the adolescent to eat raisins because they contain the highest amount of nonheme iron.

A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia?

A low hematocrit level The nurse should identify that a low hematocrit level indicates anemia. A child who has anemia can exhibit fatigue, lightheadedness, tachycardia, dyspnea, and pallor due to the decreased oxygen-carrying capacity of the blood cells.

A nurse is receiving change-of-shift report on four children. Which of the following children should the nurse assess first?

A school age child who has sickle cell anemia and reports decreased vision in the left eye When using the urgent vs. nonurgent approach to client care, the nurse should determine the priority finding is a report of decreased vision in the left eye. This finding indicates that the child is experiencing a vaso-occlusive crisis and should be reported to the provider immediately. Therefore, the nurse should see this child first.

McBurney's point "hot spot" is located:

A, Right lower quadrant

A nurse is caring for a preschooler who is scheduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the following actions should the nurse take prior to the procedure?

Administer an analgesic to the child Hydrotherapy for debridement of a wound is an extremely painful procedure that requires analgesia and/or sedation. Controlling pain leads to reduced physiological demands on the body caused by stress and decreases the likelihood of children developing depression and post-traumatic stress disorder

A nurse in an emergency department is caring for a school age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

Administer epinephrine IM to the child When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority action is administering epinephrine IM to the child. During an anaphylactic reaction, histamine release causes bronchoconstriction and vasodilation. This is an emergency because ultimately it causes decreased blood return to the heart.

A nurse on a pediatric unit is caring for a toddler. Which of the following potential provider prescriptions should the nurse identify as anticipated or contraindicated?

Administer factor VI-anticipated Apply ice packs to the affected joints-anticipated administer morphine PRN pain- anticipated to perform passive range of motion exercises during the first 12 hours following injury- contraindicated elevate the effected joint- anticipated

Nurse caring for 1 month old infant who's breastfeeding and requires heel stick. Which actions should the nurse take to minimize infant's pain?

Allow the mother to breastfeed while the sample is being obtained The nurse should allow the mother to breastfeed the infant prior to or during the procedure. Evidence-based practice indicates breastfeeding or non-nutritive sucking with a pacifier can provide nonpharmacological pain management in infants.

A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take?

Apply a topical analgesic cream to the site 1 hr prior to the procedure. The nurse should apply a topical analgesic to the lumbar site 1 hr prior to the procedure to decrease the adolescent's pain while the lumbar needle is inserted.

A nurse is caring for a school-age child who is in Buck's traction following a leg fracture 24 hours ago. Which of the following actions should the nurse take?

Assess peripheral pulses once every 4 hours Buck's traction is a type of skin traction that can be used to immobilize extremities prior to surgery. The nurse should provide frequent neurovascular checks at least every 4 hr after the first 24 hr of placement in Buck's traction. The nurse should monitor and report signs of neurovascular impairment in the extremities such as cyanosis, edema, pain, absent pulses, and tingling.

Nurse creating POC (plan of care) for preschooler with Wilms' tumor and scheduled for surgery. Which interventions should the nurse include?

Avoid palpating the abdomen when bathing the child before surgery The nurse should avoid palpating the abdomen when bathing the child before surgery because movement of the tumor can cause cancer cells to disseminate to other sites, adjacent and distant to the tumor site.

On nurses caring for a preschooler who has neutropenia. Which of the following statements should the nurse make to the child's guardians?

Avoid using it your child's daycare center Children who have neutropenia are immunocompromised and susceptible to infection. Therefore, places where large groups of people gather, such as daycare centers, should be avoided.

The nurse has reviewed the child's nurses notes, assessment, vital science, providers prescriptions and laboratory results from the 0800 one month ago visit. The nurse is planning care for the child. For each potential provider prescription Click to specify if the prescription is anticipated or contraindicated for the client.

Consult social services-anticipated limit intake of calcium rich foods-contra succimer capsule 100 milligram PO every eight hours for five days-anticipated consult the dietician-anticipated check blood lead level in one week-contra ferrous sulfate elixer34 milligrams PO three times per day-anticipated Restrict oral fluids-contra

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?

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

A nurses 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 When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is three episodes of vomiting. This can indicate digoxin toxicity, which requires immediate intervention. Therefore, this is the nurse's priority finding.

Nurse is reviewing lab results of a school age child 1 week postop following an open fracture repair. Which findings should nurse ID as indication of potential complication?

Erythrocyte sedimentation rate 18 mm/hr

Nurse discussing organ donation with parents of school age child who has sustained brain death due to bicycle crash. Which actions should the nurse take first?

Explore the parents' feelings and wishes regarding organ donation: The first action the nurse should take when using the nursing process is assessment. The nurse should first explore the parents' feelings and wishes regarding organ donation to assist in determining if organ donation is the right choice for the family.

The nurse has reviewed the childs nurses notes, assessment, vital signs, providers prescriptions and laboratory results for todays visit. Which of the following conditions are improving since the childs visit 1 month ago? Select 4 of the following conditions

Exposure to lead Lead level Nutritional status Kidney function

A nurse is providing anticipatory guidance to the guardian of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include?

Expresses likes and dislikes Rationale: The nurse should include that expressing likes and dislikes is an expected behavior of toddlers. This is the time in life when a toddler is developing autonomy and self-concept. They will try to assert themselves and frequently refuse to comply. The guardian should allow the child to have some control, but also set limits for them so they learn from their behavior and learn to control their actions.

Nurse in health department is caring for emancipated adolescent with STI and unaccompanied by guardian. Which actions should the nurse take?

Have the adolescent sign a consent form for treatment The nurse should identify that an emancipated minor can sign the consent form for treatment of an STI or any other form of medical treatment requiring consent.

A nurse is assessing a 6 y/o child immediately following a perforated appendix repair. Which of the following findings should the nurse expect?

Hypoactive bowel sounds MY ANSWER The nurse should expect hypoactive bowel sounds following appendiceal rupture or if the child has developed peritonitis. Additionally, hypoactive bowel sounds are an expected finding immediately following abdominal surgery, until full peristalsis resumes.

A nurse is providing discharge teaching to the parent of an 18-month-old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching?

I will monitor my child's number of wet diapers The nurse should teach the parent to closely monitor the child's number of wet diapers. Monitoring the number of wet diapers per day is an effective way for the parent to monitor adequate output and hydration status.

A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury. Which of the following interventions should the nurse include in the plan?

Implement seizure precautions for the infant An infant who has an epidural hematoma is at great risk for seizure activity. Therefore, the nurse should implement seizure precautions for the child.

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?

Increased creatine level Creatinine is a byproduct of protein metabolism and is excreted from the body through the kidneys. An elevated serum creatinine level can indicate an alteration in kidney function. Therefore, the nurse should identify this finding as an indication of organ rejection.

a nurse is caring for a 10 year old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus

Increased sodium level A child who has a head injury can develop diabetes insipidus because of pituitary hypofunction leading to a deficiency of antidiuretic hormone. Underexcretion of antidiuretic hormone leads to polyuria and polydipsia, and dehydration. With the excessive loss of free water, sodium levels increase

Upon evaluation of the infant status at 0630, the nurse should identify which of the following as signs of improvement question? Click to highlight the statements in the nurses notes that indicate the infant is improving.

Infant is sleeping in parents arms is correct SP O2 is 96% with 100% cool mist oxygen is correct breath sounds are present and equal bilaterally in the basis is correct infant voided 34 ML is correct. Audible inspiratory stridor noted is incorrect. The continued presence of audible inspiratory stridor is an indication that the infant has a narrowing of the upper airway due to inflammation from a viral infection. Therefore, this is not an indication that the infant's condition has improved. Infant is sleeping in parent's arms is correct. Restlessness and irritability are potential indications of hypoxia and impending airway obstruction. The infant was restless and irritable on admission, even when the parent was holding them. Therefore, this finding is an indication that the infant's condition has improved. SpO2 is 96% with 100% cool mist oxygen via blow-by is correct. A low SpO2 is an indication of hypoxia. The infant's SpO2 has increased from 89% to 96%, which is within the expected reference range. Therefore, this finding is an indication that the infant's condition has improved. Respiratory rate is 68/min with moderate suprasternal and intercostal retractions and nasal flaring is incorrect. This finding indicates the infant is experiencing continued respiratory distress. Therefore, this is not an indication that the infant's condition has improved. Has occasional barky cough with a hoarse cry is incorrect. The continued presence of occasional barky cough is characteristic of LTB. Therefore, this is not an indication that the infant's condition has improved. Breath sounds are present and equal bilaterally in the bases is correct. This finding indicates increased air movement compared to the 0600 assessment. Therefore, this finding is an indication that the infant's condition has improved. Infant voided 34 mL i

Nurse assesses 8 y/o child with early indications of shock. After establishing airway and stabilizing child's resp, which actions should the nurse take next?

Initiate IV access After establishing an airway and stabilizing the child's respirations, the next action the nurse should take when using the airway, breathing, and circulation approach to client care is to establish IV access to maintain the child's circulatory volume.

A nurse is admitting a school-age child who has pertussis. Which of the following actions should the nurse take?

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.

Nurse teaching group of parents about infectious mononucleosis. Which statements by parent indicates understanding of teaching?

Mononucleosis is caused by an infection with the Epstein-Barr virus. The nurse should identify that mononucleosis is a mildly contagious illness that occurs sporadically or in groups, and is primarily caused by the Epstein-Barr virus.

The nurse has reviewed the provider prescriptions for the 0900, 1 month ago visit. The nurse is providing discharge teaching to the parent. Which of the following information should the nurse include? Select all that apply.

Open succimer capsule Wet cloth Use a straw Offer orange juice Monitor wet diapers Prevent child from playing in soil

Nurse assesses 6 month old during well-child visit. Which findings should the nurse report to HCP?

Presence of strabismus: MY ANSWER Strabismus, or crossing of the eyes, typically disappears at 3 to 4 months of age. If not corrected early, this can lead to blindness. Therefore, the nurse should report this finding to the provider

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 for the child. The metabolic rate of a child who has heart failure is high because of poor cardiac function. Therefore, the nurse should provide small, frequent meals for the child because it helps to conserve energy.

A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL. Which of the following actions should the nurse plan to take?

Schedule the toddler for a yearly rescreening

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?

Screen the child's visitors for indications of infection A 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.

A charge nurse in an emergency department is preparing an in-service for a group of newly licensed nurses on the clinical manifestations of child maltreatment. Which of the following clinical manifestations should the charge nurse include as suggestive of potential physical abuse?

Symmetric burns of the lower extremities The nurse should include that symmetric burns to the lower extremities can indicate physical abuse. The patterns are usually characteristic of the method or object used, such as cigar or cigarette burns, or burns in the shape of an iron.

A nurse is caring for a preschooler who was recently admitted to pediatric unit. The nurse is reviewing the information in the child's electronic medical record(EMR). For each EMR finding, click to specify if the finding is consistent with nephrotic syndrome, post streptococcal glomerulonephritis, or hemolytic uremic syndrome. Each finding may support more than one disease process.

Temperature is consistent with APG and HUS bun level is consistent with APG and HUS platelet count is consistent with HUS blood pressure is consistent with NS, APG, and HUS cholesterol level is consistent with NS

Nurse is planning educational program for school age children and parents about bicycle safety. Which info should the nurse plan to include?

The child should be able to stand on the balls of their 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

After reviewing the information in the child's medical record, which of the following findings should the nurse address first? Complete the following sentence by using the list of options.

The nurse should first address the child's oxygen saturation followed by the child pain

A nurse is caring for a client who is receiving IV fluids via a peripheral IV catheter. When preparing to discontinue the IV fluids and catheter, which of the following actions should the nurse plan to take? Put steps in order.

Turn off the IV pump Occlude the IV tubing Remove the tape securing the catheter apply pressure over the catheter insertion site

Select the three findings from the child's medical record that the nurse should identify as a potential complication?

WBC count Abdomen assessment temperature WBC count is correct. The child's WBC count has increased significantly following the procedure. The nurse should identify that this is a potential indication of a postoperative infection. Oxygen saturation level is incorrect. The child's oxygen saturation level is within the expected reference range. Therefore this finding does not indicate a potential complication. Platelets is incorrect. The child's platelet count is within the expected reference range. Therefore this finding does not indicate a potential complication. Abdomen assessment is correct. The child's abdomen is rigid and distended and they are reporting increased pain. The nurse should identify that this is a potential indication of a postoperative infection. Temperature is correct. One day following surgery, the child's temperature has increased and is above the expected reference range. The nurse should identify that this is a potential indication of a postoperative infection. Abdominal dressings assessment is incorrect. The child's abdominal dressings have scant serous drainage present, which is an expected finding following surgery. Therefore this finding does not indicate a potential complication

A nurse in the outpatient pediatric clinic is caring for a 2-year-old child. Drag words from the choices below to fill in each blank in the following sentence.Nurses' Notes - 2 months ago:The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to Nurses' Notes.

When analyzing cues, the nurse should identify that the child is a risk for developing intellectual deficits, such as a decreased IQ, due to the increase in membrane permeability of the brain tissue resulting in increased intracranial pressure, tissue ischemia, and atrophy. The nurse should also identify that the child is at risk for decreased kidney function due to the damage of the proximal tubules caused by the elevated blood lead level.

a nurse is teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin twice daily. which of the instructions should the nurse include?

brush the child's teeth after giving the medication The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste.

A nurse in the outpatient pediatric clinic is caring for a 2 year old child. Click to highlight the findings that require follow up.

click to select: When recognizing cues, the nurse should identify that pale pink mucous membranes, living in an older urban house that is being renovated, and the parent's report that the toddler seems less active and gets tired more quickly are findings that require follow-up. These findings are associated with lead poisoning, and the child's blood lead level should be determined. Pale pink membranes, decreased activity, and tiring more quickly are manifestations of anemia, which can result from increased blood lead levels. Older urban homes are a common source of lead, especially during renovation, which may aerosolize the lead particles.

And there's his assessing the school age child who has an acute spinal cord injury following a sports injury one week ago. Identify the area the nurse should tap to illicit the bicep reflex

inner elbow

A nurse in the outpatient pediatric clinic is caring for a 2 year old child. Drag words from the choices below to fill in each blank in the following sentence

intellectual deficits and decreased kidney function

A nurse is providing teaching about play activities for social development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child?

playing dress up The nurse should instruct the guardians that at the preschool age, play should focus on social, mental, and physical development. Therefore, playing dress-up is a recommended play activity for this child.

A nurse is caring for a 15-year-old client following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

mental confusion A child who has a head injury can develop SIADH as a result of altered pituitary function, leading to an oversecretion of antidiuretic hormone. Oversecretion of antidiuretic hormone leads to a decrease in urine output, hyponatremia, and hyperosmolality due to overhydration. As the hyponatremia becomes more severe, mental confusion and other neurologic manifestations such as seizures can occur.

a nurse is caring for a school-age child who has epiglottitis. Which of the following actions should the nurse take?

monitor the child's oxygen saturation The nurse should monitor the child's oxygen saturation level because the child is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment.

Community health nurse assesses 18 month old toddler in community day care. Which findings should the nurse ID as potential indication of physical neglect?

poor personal hygiene A toddler's poor personal hygiene can be a potential indication of physical neglect. Because toddlers are still dependent on their parents or guardians for help with hygiene needs, poor personal hygiene can indicate a lack of supervision.

A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication?

serum potassium level is 4.1 mEq/L The nurse should monitor the adolescent's blood potassium level following the administration of sodium polystyrene sulfonate. This medication is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestine. Therefore, a potassium level within the expected reference range indicates the effectiveness of the medication.

A nurse is providing teaching to the parent of a school-age child who has a new prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nurse include?

shake prior to admin The nurse should instruct the parent to shake the medication prior to administration to disperse the medication evenly within the suspension.

The nurse has reviewed the child's nurses notes, assessment, vital science, providers prescriptions and laboratory results from the 0800 one month ago visit. Complete the following sentence by using the list of options

the nurse should first address the child's blood lead levels, followed by the child's hemoglobin. When prioritizing hypotheses, the nurse should first address the child's elevated BLL, followed by the child's hemoglobin. Using the priority framework of safety and risk reduction, the nurse should recognize that the child's BLL presents an increased risk for long-term cognitive impairment and behavioral issues and should be addressed first. Lead interferes with heme synthesis, which causes anemia, as evidenced by the child's low hemoglobin. Addressing the lead level first will cause the hemoglobin level to improve. Kidney damage (ketonuria and glycosuria) is reversible once the lead level has been addressed.

A nurse in a providers office is preparing to administer immunizations to a toddler during a well child visit. Which of the following actions should the nurse plan to take? (Click on the exhibit button for additional information about the client. There are three tabs that contain separate categories of data)

withhold the measles, mumps, and rubella(MMR) vaccine The nurse should recognize that an allergy to neomycin with an anaphylactic reaction is a contraindication for receiving the MMR vaccine. Clients who have a severe allergy to eggs or gelatin should not receive this vaccine.

A nurse is caring for a preschooler whose father is going home for a few hours while another relative stays with the child. Which of the following statements should the nurse make to explain to the child when their father will return?

your guardian will be back after you eat." Preschoolers make sense of time best when they can associate it with an expected daily routine, such as meals and bedtime. Therefore, the child comprehends time best when it is explained to them in relation to an event they are familiar with, such as eating.

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area.

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.