Toddler
The nurse is conducting a comprehensive assessment on a school-age child. Which parent statement would suggest to the nurse that a child may have celiac disease? "His urine is so dark in color." "His stools are large and smelly." "His belly is so small." "He is so short."
"His stools are large and smelly."
The mother of a toilet-trained toddler who was admitted to the hospital for severe gastroenteritis and subsequent dehydration and is now at home asks the nurse why the child still wets the bed. What would be the nurse's best response? "Hospitalization is a traumatic experience for children. Regression is common, and it takes time for them to return to their former behavior." "The stress of hospitalization is hard for many children, but usually they have no problems when they return home." "After returning home from being hospitalized, children still feel they should be the center of attention." "Children do not feel comfortable in their home surroundings once they return home from being hospitalized."
"Hospitalization is a traumatic experience for children. Regression is common, and it takes time for them to return to their former behavior."
A parent tells the nurse that the parent wants to begin toilet training the 22-month-old child. Which statement by the parent indicates the greatest likelihood of success? "My child says "pee-pee" and runs to the potty chair." "I'm out of work right now so I'm home all day to work with my child." "My sister potty-trained her son at 22 months of age and it worked really well." "I bought a jar of candy to use when my child is successful."
"My child says "pee-pee" and runs to the potty chair."
A 2-year-old child is prescribed cyclosporine. The parent says the child doesn't like taking the liquid medication. Which statement by the nurse is most appropriate? "Give your child some control over what time the medication is taken during the day." "Offer the medication diluted with chocolate milk or orange juice to make it more palatable." "We can inquire about inserting a nasogastric (NG) tube to administer the medication." "Give the ordered dose in small amounts over 2 hours to make it less unpleasant."
"Offer the medication diluted with chocolate milk or orange juice to make it more palatable."
A nurse is teaching parents about accident prevention for a toddler. Which guideline is most appropriate? Always make the toddler wear a seat belt when riding in a car. Make sure all medications are kept in containers with childproof safety caps. Never leave a toddler unattended on a bed. Teach rules of the road for bicycle safety.
Make sure all medications are kept in containers with childproof safety caps.
Which of the following techniques is best for the nurse to use in evaluating the parents' ability to administer eardrops correctly? Observe the parents instilling the drops in the child's ear. Listen to the parents as they describe the procedure. Ask the parents to list the steps in the procedure. Ask the parents whether they have read the handout on the procedure.
Observe the parents instilling the drops in the child's ear.
A nurse is teaching accident prevention to the parents of a toddler. Which instruction is appropriate for the nurse to tell the parents? A bike helmet is needed once you remove training wheels. Place toxic substances out of the child's reach. Teach the toddler water safety. Don't allow the toddler to use pillows when sleeping.
Place toxic substances out of the child's reach.
Parents ask the nurse for advice about handling their 2-year-old's negativism. What is the best recommendation? Ignore this behavior because it is a stage the child is going through. Set realistic limits for the child, and then be sure to stick to them. Encourage the grandmother to visit frequently to relieve them. Punish the child for misbehaving or violating set, strict limits.
Set realistic limits for the child, and then be sure to stick to them.
A child with a tracheostomy suddenly becomes diaphoretic and has an increased heart rate, an increased work of breath, and a decreased oxygen saturation level. What should the nurse do first? Suction the tracheostomy. Turn the child to a side-lying position. Administer pain medication. Perform chest physiotherapy.
Suction the tracheostomy.
The parent of a 2-year-old is concerned because the child's right eye seems to turn in toward the nose when the child is tired. The nurse should: Assure the parent that this is a normal event when the child is tired. Advise the parent to continue to watch the child's eyes closely and, if the problem persists, to call the clinic. Test the child with the cover-uncover test and refer the parent and child to an ophthalmologist if the test is abnormal. Explain to the parent that the child will probably outgrow the weakness and the parent need not be concerned.
Test the child with the cover-uncover test and refer the parent and child to an ophthalmologist if the test is abnormal.
Which observation by the nurse should suggest that a 15-month-old toddler has been abused? The child appears happy when personnel work with him. The child plays alongside others contentedly. The child is underdeveloped for his age. The child sucks his thumb.
The child is underdeveloped for his age.
The nurse prepares a 3-year-old child to have blood specimens drawn for laboratory testing. What intervention should the nurse employ? Explain the procedure in advance. Explain why the blood needs to be drawn. Use distraction techniques during the procedure. Provide verbal explanations about what will occur.
Use distraction techniques during the procedure.
A toddler hospitalized with nephrotic syndrome has marked dependent edema and hypoalbuminemia. His urine is frothy. When assessing the child's vital signs, the nurse should report which finding to the health care provider? blood pressure of 80/45 mm Hg body temperature of 102.8° F (39.3° C) pulse rate of 85 bpm respiratory rate of 28 breaths/minute
body temperature of 102.8° F (39.3° C)
The emergency room nurse documents progress notes in the above note. When completing the documentation, which information would be included? Select all that apply. diagram of site of injuries information about parent's mental health description, including color and measurement, of injuries quotes from toddler of what happened documentation of notifying Children and Youth Services objective findings from a thorough head to toe assessment
diagram of site of injuries description, including color and measurement, of injuries objective findings from a thorough head to toe assessment
A nurse observes two 2-year-old children playing. The nurse documents what form of play as normal for this age group? playing a game of catch with a ball pretending to "race" toy cars with each other digging side-by-side in a sandbox riding tricycles near each other
digging side-by-side in a sandbox
A 14-month-old child returns from surgery for an undescended testicle. When planning for the child's discharge, the nurse should remind the parents to observe their child for which complication? redness or swelling at the incision site ability to take clear liquids well normal bowel movement within 24 hours ability to ambulate
redness or swelling at the incision site
When a child is able to grasp the idea that a ball continues to exist even though the child's parent placed the ball under a hat, the child is in which stage in the development of logical thinking, according to Piaget? sensorimotor preoperational concrete operations formal operations
sensorimotor
A child, age 2, with a history of recurrent ear infections is brought to the clinic with a fever and irritability. To elicit the most pertinent information about the child's ear problems, the nurse should ask the parent: "Does your child's ear hurt?" "Does your child have any hearing problems?" "Does your child tug at either ear?" "Does anyone in your family have hearing problems?"
"Does your child tug at either ear?"
The parents of a toddler do not want their child to have a varicella immunization, stating, "My child will have better immunity if he or she gets the disease now." Which is the nurse's best response? "You are correct and chicken pox is not fatal." "The antibodies in the vaccine are good for other communicable diseases as well." "If the child contracts the disease, it could be very serious, even life threatening." "Chicken pox is not very contagious, so it is unlikely your child will contract it naturally."
"If the child contracts the disease, it could be very serious, even life threatening."
The parent asks the nurse whether a child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which response by the nurse would be most appropriate? "Ask the health care provider what he thinks at your next appointment." "Being able to pull to a stand really only tells us his upper-body strength is good." "It is difficult to predict, but his ability to bear weight is a positive factor." "If he really wants to walk, and works hard, he probably will eventually."
"It is difficult to predict, but his ability to bear weight is a positive factor."
A toddler with a ventricular septal defect is receiving digoxin to treat heart failure. Which assessment finding should be the nurse's priority concern? bradycardia tachycardia hypertension hyperactivity
bradycardia
After teaching the parents of a 15-month-old child who has undergone cleft palate repair how to use elbow restraints, which statement by the parents indicates effective teaching? "We'll keep the restraints in place continuously until our health care provider says it's okay to remove them." "We can take off the restraints while our child is playing, but we'll make sure to put them back on at night." "The restraints should be taped directly to our child's arms so that they'll stay in one place." "We'll remove the restraints temporarily, one at a time, at least three times a day to check his skin, then put them right back on."
"We'll remove the restraints temporarily, one at a time, at least three times a day to check his skin, then put them right back on."
The father of a 2-year-old phones the emergency department on a Sunday night and informs the nurse that his son put a bead in his nose. What is the most appropriate recommendation by the nurse? "Try removing the bead at home as soon as possible. You might try using a pair of tweezers." "Be sure to take your child to the pediatrician in the morning so the pediatrician can remove the bead in the office." "You should bring your child to the emergency department tonight so the bead can be removed as soon as possible." "Ask your child to blow his nose several times; this should dislodge the bead."
"You should bring your child to the emergency department tonight so the bead can be removed as soon as possible."
What should the nurse do first when admitting a toddler with croup? Monitor vital signs. Assess respiratory status. Ensure adequate fluid intake. Place a tracheostomy set at the bedside.
Assess respiratory status.
A parent voices concern to the nurse that a 2-year-old toddler never seems to want to play with other children at the park. What would be the nurse's best response? "Don't worry, it's probably because your child is shy." "That is considered normal at this age." "You should arrange a play date with another toddler." "You should model playing behaviors for your child."
"That is considered normal at this age."
A toddler is in the hospital. The parents tell the nurse they are concerned about the seriousness of the child's illness. Which response to the parents is most appropriate? "Please try not to worry. Your child will be fine." "If you look around, you'll see other children who are much sicker." "What seems to concern you about your child being hospitalized?" "It must be difficult for you when your child is ill and hospitalized. Tell me your concerns."
"It must be difficult for you when your child is ill and hospitalized. Tell me your concerns."
While interviewing a preschool-age girl who has been sexually abused about the event, which approach would be most effective? Describe what happened during the abusive act. Draw a picture and explain what it means. "Play out" the event using anatomically correct dolls. Name the perpetrator.
"Play out" the event using anatomically correct dolls.
When teaching caregiver of a client with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction? "Reduce your child's caloric intake to decrease cardiac demand." "Relax discipline and limit-setting to prevent crying." "Make sure your child avoids contact with small children to reduce overstimulation." "Try to maintain your child's usual lifestyle to promote normal development."
"Try to maintain your child's usual lifestyle to promote normal development."
When performing a physical assessment on an 18-month-old child, which measure would be best? Have a parent hold the toddler. Assess the ears and mouth first. Carry out the assessment from head to toe. Assess motor function by having the child run and walk.
Have a parent hold the toddler.
A toddler has been admitted to the pediatric unit with pneumonia. While assessing a toddler the nurse finds bruise marks consistent with a belt buckle on the buttocks. The nurse suspects the toddler is being abused. What action should the nurse take? Talk with the toddler about what the nurse suspects. Confront the caregiver with the nurse's suspicions. Place the toddler in a monitored room Report the case to local authorities.
Report the case to local authorities.
An uncle is shopping for a toy to give his niece. He has no children of his own and asks his neighbor, a nurse, what would be the most appropriate toy to give a 15-month-old. Which toy should the nurse recommend to facilitate learning and development? a stuffed animal a music box a push-pull toy a nursery mobile
a push-pull toy
A 2-year-old always puts his teddy bear at the head of his bed before he goes to sleep. The parents ask the nurse if this behavior is normal. The nurse should explain to the parents that toddlers use ritualistic patterns to establish which factor? a sense of identity control over adults in their environment sequenced patterns of learning behavior a sense of security
a sense of security
The nurse caring for a 3-year-old with otitis media notes that the client has an allergy to amoxicillin that causes wheezing. Which prescription should the nurse question? azithromycin cephalexin trimethoprim-sulfamethoxazole cefdinir
cephalexin
Which is a priority nursing action for a child with croup? continually assessing respiratory status giving antipyretics to alleviate fever encouraging parents to stay with their child delivering oxygen as prescribed
continually assessing respiratory status
When developing the plan of care for a toddler who has taken an acetaminophen overdose, which intervention should the nurse expect to include as part of the initial treatment? frequent serum drug levels gastric lavage tracheostomy electrocardiogram
gastric lavage
The nurse is caring for a child in the early stages of burn recovery. Which nursing diagnosis does the nurse prioritize? impaired skin integrity impaired physical mobility disturbed body image constipation
impaired skin integrity
When assessing a 2-year-old child at the clinic for a routine checkup, which skill should the nurse expect the child to be able to perform? riding a tricycle tying shoelaces kicking a ball forward using blunt scissors
kicking a ball forward
The nurse is planning care for a toddler with a seizure disorder. Which item in the care plan should the nurse revise? padded side rails oxygen mask and bag system at bedside padded tongue blade at the bedside lorazepam for seizure lasting longer than 5 minutes
padded tongue blade at the bedside
During assessment of a child with celiac disease, the nurse should most likely note which physical finding? enlarged liver protuberant abdomen tender inguinal lymph nodes periorbital edema
protuberant abdomen
A nurse is planning a health teaching session for a group of parents with toddlers. When describing a toddler's typical eating pattern, the nurse should mention that many children of this age exhibit: consistent table manners. an increased appetite. strong food preferences. a preference for eating alone.
strong food preferences.
A nurse is caring for a toddler admitted for long-term treatment of a chronic illness. Which action should the nurse take to promote normal childhood growth and development? Allow the child to sleep for at least 12 hours per night. Consult with a play therapist about activities in which the child can participate. Make sure the child is continuously isolated because of the chronic illness and risk of infection. Maintain a diet high in carbohydrates and low in fats.
redness or swelling at the incision site
A registered nurse (RN) has been "care-paired" with a licensed practical nurse (LPN) during the evening shift. Whose care should the RN assign to the LPN? the 2-year-old child who has started eating soft, solid foods following a tonsillectomy a 12-month-old infant who has a white blood cell (WBC) count of 34/μl and a fever a 17-month-old infant with a contusion as a result of a motor vehicle accident 4 hours earlier a 22-month-old infant with type 1 diabetes who has a blood glucose level of 277 mg/dl (15.37 mmol/L).
the 2-year-old child who has started eating soft, solid foods following a tonsillectomy
A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse anticipates that the physician will order which laboratory test? hemoglobin (Hb) sweat test total protein total iron-binding capacity
total protein
A parent calls the pediatric clinic to express concern over the child's eating habits. The parent says the child eats very little and consumes only a single type of food for weeks on end. The nurse knows that this behavior is characteristic of: toddlers. preschool-age children. school-age children. adolescents.
toddlers.
A client is brought to the emergency department in respiratory distress caused by acute epiglottitis. Which assessment finding is most concerning for the nurse? severe sore throat, drooling, and inspiratory stridor low-grade fever, stridor, and a barking cough pulmonary congestion, a productive cough, and a fever sore throat, a fever, and general malaise
severe sore throat, drooling, and inspiratory stridor
A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. What should the nurse try first? Ask another nurse to assist. Allow a parent to assist. Wait until the child calms down. Restrain the child's arms.
Allow a parent to assist.
A toddler receiving chemotherapy after surgery for a Wilms' tumor has developed neutropenia. The parent is trying to encourage the child to eat by bringing extra foods to the room. Which food would the nurse discourage for this child? fudge french fries fresh strawberries a milk shake
fresh strawberries
The nurse is educating the parents of a 2-year-old child regarding immunizations. When the parents ask where the injections will be given the nurse answers that the most appropriate site for an intramuscular injection for a child this age is the: vastus lateralis muscle. dorsogluteal muscle. ventrogluteal muscle. deltoid muscle.
vastus lateralis muscle.
When developing a teaching plan for parents of toddlers about poisonous substances, the nurse should emphasize which safety points? Select all that apply. Toddlers should be adequately supervised at all times. All poisonous substances should be kept out of the reach of children and stored in a locked cabinet if necessary. The difference between pediatric and adult dosages of medicines is significant, and adult dosages given to children can have serious, harmful effects. Syrup of ipecac should be administered following all ingestions of poisonous substances. Following any poisoning, the parents should call the Poison Control Center for instructions for appropriate treatment.
All poisonous substances should be kept out of the reach of children and stored in a locked cabinet if necessary. The difference between pediatric and adult dosages of medicines is significant, and adult dosages given to children can have serious, harmful effects. Following any poisoning, the parents should call the Poison Control Center for instructions for appropriate treatment.
A preschool-age child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which comment by the nurse would be most appropriate? "It's okay to cry when something hurts." "That really didn't hurt, did it?" "We are mean to hurt you that way." "You were very good not to cry with the needle."
"It's okay to cry when something hurts."
