Ass

The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply.

Cuts and bruises on the hands Burns on the dorsal surface of the hand A curved laceration on the back Linear lesions across the chest and abdomen

An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?

"Tell me what makes you think the medication is not working"

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching?

"I can use the egg white when baking, but not the yolk."

A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child?

"Is there anything that you do over and over again and can't resist doing?"

A nurse is teaching parents of a child with a nursing diagnosis of pain related to pruritus from skin lesions. Which of the following would the nurse include in the instructions? Select all that apply

"Keep the child's fingernails short." "Bathe the child in lukewarm water and baking soda." "Have the child press on the itching area instead of scratching it."

The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder?

"My child does not say more than one or two words and grunts to indicate needs."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

"We need to make sure that he washes his hands frequently."

A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply.

"We need to set clear limits for our child's behavior." "A reward system would be useful to give our child positive feedback." "We need to limit the number of choices our child has."

. The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level?

1300/mm3

Immunizations:

Complete HPV 2nd Meningococcal at 16 yrs Tdap

The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate?

Document the bruises and any statements made by the child relating to them

When educating parents of preschoolers what is most important to include in your presentation?

Keep chemicals in a locked cabinet.

A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning?

Keep cleaning solutions locked up

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease?

Mumps

A nurse is preparing a class for a group of adolescents about sexuality and sexual activity. The nurse understands that which of the following are often the biggest influences on an adolescent's actions related to sexual activity? Select all that apply.

Peer pressure Self esteem

A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which medications are potentially ordered with instructions placed on the discharge summary? Select all that apply.

Penicillin Erythromycin Mupirocin

Gross motor:

Speed, coordination, and endurance increase. Tend to narrow focus on desired sport

The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply.

Substance abuse History of previous suicide attempt Mental health changes Poor family dynamics

Speech:

Use slang => difficult for parents to understand Use text speak

A nursing instructor teaching a class about immunity asks the students to identify the organs of the immune system. Which would the nursing instructor want them to include? (Select all that apply.)

lymph nodes bone marrow thymus spleen tonsils

Nursing students correctly label the group of cells whose job is to ingest, engulf, and neutralize pathogens as:

macrophages.

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed?

"Antibiotics are needed to help our child recover from rubella."

The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen?

"Corticosteroids help the inflammation that goes along with an allergy." "I may have to undergo intradermal testing to determine what I am allergic to." "Once we figure out what I am allergic to, it is important for me to avoid that allergen."

A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl?

"Have you noticed any hair loss or redness on your face?"

The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best?

"I am here to answer your questions and be with you during this difficult time."

The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education?

"If we need to use the EpiPen® we will need to notify her physician's office the next business day."

The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply.

"In infancy a lack of loving behaviors such as cuddling is concerning." "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."

The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following?

"We will make sure to remind him not to scratch the lesions."

A male adolescent comes to the clinic for a routine health care followup accompanied by the parents. During the visit, the parents tell the nurse, "Our son just doesn't seem to listen to us anymore. It's like he's tuning us out. Is there anything we can do to get him to hear what we're saying to him?" Which suggestions would be appropriate for the nurse to offer? Select all that apply.

"When you talk to him, speak to him face to face and be careful of your body language." "Choose words carefully to make sure that he understands you." "Talk to you son as an equal and don't talk down to him." "Don't be afraid to ask him questions about why he feels a certain way."

The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse?

"While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them

1. Fever and headache 2. Intense red rash on the face 3. Rash on extremity extensor surfaces 4. Rash on the flexor surfaces of extremities and trunk 5. Lace-like lesion appearance

Suicide:

3rd leading cause of death Remove firearms and meds and monitor social media accounts

An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?

Acetylcysteine

A 7-year-old child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? Select all that apply.

Administer epinephrine as ordered. Administer oxygen. Initiate intravenous access

Which nursing intervention is priority when caring for a child with HIV?

Administer prescribed medications.

A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority?

Administering 100% oxygen by mask

The nurse is caring for a 24-month-old child with a fever of 101°F. The child also exhibits a toxic appearance. Which of the following would the nurse expect to implement?

Administering antibiotics as ordered

Substance abuse:

Affect brain development (prefrontal cortex) Use CRAFFT and SBIRT tools to determine risk

The nurse is instructing parents on how atopic disorders affect the child. For which disorder would the nurse provide information and counseling? Select all that apply.

Allergic rhinitis Asthma Eczema Hay fever

For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder?

An 8-year-old who will not stay overnight at a friend's house

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication?

Anorexia

A group of nursing students are reviewing information about alcohol use in adolescents. The students demonstrate understanding of the information when they identify which of the following personality characteristics as associated with drinking at an early age? Select all that apply.

Anxiety Aggressiveness Hyperactivity

A child is exhibiting symptomatic bradycardia that has been unresponsive to ventilation and oxygenation. Which of the following would the nurse expect to be administered?

Atropine

A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?

Avoid unattended baths for the toddler

The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective?

Child drinks a glass of water every 1 to 2 hours throughout the day

During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply.

Child reports abdominal pain. Child has a change in school performance. Child demonstrates anxiety or trouble sleeping. Child does not want to be left alone with a certain adult.

Fine motor:

Dexterity improves for musical instruments, painting, drawing, sewing Improved hand-eye coordination

Female puberty changes

Early (10-13) - Breast buds, pubic hair, axillary hair, growth spurt, menarche Middle (14-17) - Peak growth velocity Late (18-21) - Increased muscle mass

Male puberty changes

Early (10-13) - Testicular enlargement and start of penile growth Middle (14-17) - Growth spurt, nocturnal emissions, body hair, facial hair Late (18-21) - Lean muscle mass

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Encourage rest and relaxation.

A young child is brought to the emergency department and requires advanced life support. The nurse is preparing to administer medication to maintain the child blood pressure and systemic perfusion. Which of the following might the nurse administer?

Epinephrine Dopamine Dobutamine

Adolescent assessment privacy:

Have parents leave Keep body covered Explain everything

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation?

Head lice are becoming very resistant to treatment.

A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply.

Hypersensitivity to touch Lack of facial expression

Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply

Impaired skin integrity related to skin barrier function Anxiety related to continuing or uncontrolled allergic response Powerlessness related to difficulty determining cause of allergy

Piaget Stage - Formal operational

Implications: Develops abstract thoughts Feels invulnerable Better impulse control See other's perspectives

Erickson Stage - Identity vs Role confusion

Implications: Self-conscious about changing body Concerned with attractiveness More stable body image Forming identity

A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back, which of the following would be most appropriate to do?

Logroll the child to the side

The school nurse is preparing an educational session for adolescents to address the 2020 National Health Goals for healthy habits. What should the nurse include in this presentation? Select all that apply.

Maintaining a healthy body weight Avoidance of tobacco products Refusing to participate in substance abuse Abstaining from alcohol

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition?

Mumps

The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply.

Normal saline Lactated Ringer's

Nutrition

Obesity

The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply.

Orthostatic hypotension Weak pulse Hypothermia

The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply.

Pneumococcal vaccination can be given. The varicella vaccine should not be given if the child is symptomatic. If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.

A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time?

Preparation for an emergency endoscopy to remove the batteries

A 10-year-old boy has just arrived by ambulance at the emergency room following a motor vehicle accident, and a nurse is assessing him. Which three body systems should the nurse evaluate fist?

Respiratory, cardiovascular, and neurologic

A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?

Severe erosion of teeth

The nurse is caring for a pediatric client who has a compromised immune system. When reviewing laboratory results, which bone marrow component identifies a dysfunction in bone marrow production? Select all that apply.

T lymphocytes B lymphocytes

. A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug?

That the infant's skin has greater permeability than that of an adult

The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?

The child constantly opens and closes the hands.

The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder?

The child constantly stares at a rotating wheel on the crib mobile.

The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern?

The child is immune to further attacks of the disease.

The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply.

The child states that his tongue feels "too big" for his mouth. The child has developed hives on his face and trunk. The child states he feels like he might "throw up". The child states that he feels like he might faint.

The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply.

The child's mother has a history of substance use disorder. The child was born prematurely. The child has cerebral palsy.

The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion?

The disorder is caused by a difference in brain architecture.

Which characteristic of the adolescent should the nurse consider abnormal? Select all that apply.

Third molars erupting at age 13 Heart Rate of 114

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be:

as soon as all lesions are crusted.

A child is brought into the emergency department. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next?

Assess level of consciousness.

The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority?

Assess lung sounds bilaterally.

A young client is admitted to the hospital directly from the clinic. The physician suspects a problem with the child's immune system. What test does the nurse anticipate the physician will order for this client?

Blood analysis

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule?

Discolored skin spot not elevated at the surface

An unconscious client is brought to the emergency department after ingesting too much prescribed medication. What is the highest priority nursing intervention?

Establish a patent airway

A 12-year-old boy has broken his arm and is showing signs and symptoms of shock. Which of the following would the nurse do first?

Establish a suitable IV site.

Social Emotional:

Frontal lobe (prefrontal cortex) is last to develop => Responsible for impulse control => risky behavior Role confusion leads to risky behaviors Egocentrism leads to feelings of invincibility

The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs?

Gloves Gown N95 respirator

A nurse is conducting an assessment of a 16-year-old's cognitive development. The nurse determines that the adolescent's cognitive development is within acceptable parameters for the adolescent's age based on which assessment finding? Select all that apply.

Has a beginning interest and concern with societal and political issues. Uses scientific methods to solve verbal problems. Demonstrates thinking that the adolescent is invincible.

The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information?

Process that requires the individual to view a situation from a different perspective

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge?

"I can't believe it. We're not unclean, poor people."

An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa?

"I feel chubby no matter what I wear."

The school nurse has just completed a presentation about normal adolescent physical growth to a group of adolescent students. Which comments by the adolescents indicate understanding of the nurse's presentation? Select all that apply.

"Our hormones are sure going to cause us to change a lot over our teenage years." "Since I'm a 15-year-old guy, I still have a chance to get taller over the next couple of years." "It doesn't seem fair that girls typically have more fat than boys." "Since I just had my first period and I am 14 years old, I probably haven't reached by peak height yet." "It's strange how girls start getting taller before boys start getting taller."

An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE?

"SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms."

The nurse is called into a toddler's room. The child's mother says "he's having trouble breathing." What should the nurse do first?

Assess patency of the child's airway

A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be?

Assess the child's airway and manage airway patency

Acne Vulgaris

Comedonal acne (involves follicular sacs filled w/ keratinous material & bacteria) most common form First sign of puberty Open and closed comedones (Treated w/ topical retinoid) Papules Pustules Nodular cysts (Treated w/ isotretinoin)

An adolescent comes to the clinic reporting a sore throat and chills. The nurse suspects that the adolescent has infectious mononucleosis based on assessment of which? Select all that apply.

Fever Lymphadenopathy Splenomegaly Pharyngitis Extreme fatigue

Secondary sex characteristics stimulated by gonadotropin-releasing hormone (GnRH):

GnRH stimulates pituitary gland to release luteinizing hormone (LH) and follicle stimulating hormone (FSH) LH and FSH stimulate the release of androgens and estrogens

A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon?

It causes an increase in nasal secretions after an initial decrease.

The nurse is performing CPR on a child who is a victim of a near-drowning experience. How should the nurse open the child's airway to provide breaths?

Jaw-thrust maneuver

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema?

Redness of the skin produced by congestion of the capillaries

After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply

The parents recently divorced The father is unemployed and mother is infrequently home The child is expected to care for younger siblings while mother sleeps There is history of multiple injuries obtained from a motor vehicle crash

The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply.

Two or more episodes of severe sinusitis in 1 year. Failure to thrive in an infant. Two or more serious infections such as sepsis. History of infections requiring IV antibiotics to clear.

A 7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. The is having trouble breathing. Which type of hypersensitivity response is the child experiencing?

Type I: anaphylaxis

The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection?

Various stages of lesions present at the same time

Infectious Mononucleosis

Virus from Epstein-Barr virus Spread through oral secretions (kissing disease) for 6 months Fever, pharyngitis, enlarged tonsils, hepatomegaly & splenomegaly present

To teach an adolescent how to prevent the recurrence of a sexually transmitted disease, the nurse would include which information in the teaching plan?

Wash genitals well with soap and water after sexual activity. Abstinence is the best protection against sexually transmitted infection. Use a condom with every sexual encounter.

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse?

When providing health information to a child of this age it should be simplistic and at the child's level of understanding