ATI: nursing care of children dynamic quiz

A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask?

"Does anyone smoke around or in the same house as your child?" Otitis media is an infection of the middle ear. Passive smoking promotes adherence of respiratory pathogens to the lining of the middle ear space and prolongs the inflammation and impedes drainage from the ear

A nurse is providing teaching to the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which statement by the parent indicates an understanding of the teaching?

"I should give this medication to my child half and hour before breakfast" administer on an empty stomach

The nurse is providing teaching to the parent of a 4yo child who stutters. What statement indicates the parent understands the teaching?

"I should ignore the stuttering and not interrupt her" stutter is expected part of speech development in preschool years, and will typically cease by age 5. Parents should not focus on the stutter so the behavior is not reinforced and does not prolong the stutter

A nurse is teaching the parents of a 4-month old infant who has gastroesophageal reflux. Which of the following statements indicates an understanding of the teaching?

"I will add 1 TBS of rice cereal per ounce to my baby's formula" The parents can give the infant thickened feedings with rice cereal to help decrease reflux. The added calories also can help infants who are underweight due to gastroesophageal reflux

A nurse is providing teaching to the guardian of a child who has Kawasaki disease. Which statement by the guardian indicates understanding?

"My child will likely be irritable for the next few weeks" "I will ensure my child does not receive any live vaccines for at least 18months" I will keep a record of my child's temperature until she has no fever for several days" doses given of gamma globulin might reduce adequate antibody production

A nurse is providing discharge teaching to parents whose infant had a ventriculoperitoneal shunt placement for the treatment of hydrocephalus. Which statements by the parents indicates understanding of the teaching?

"We will notify the provider right away if he has a fever" Infection is a risk after v shunt insertion, especially 1-2 months after placement. The parents should report fevers, vomiting, seizure activity, and decreased responsiveness, as these findings can indicate infection

A nurse is providing teaching to the parent of a 2yo toddler about nutrition. Which statement shows parent understanding?

"my child should consume 1000 calories per day" toddlers should have 2oz protein, 24oz(3cups) of milk, and 8oz(1cup) vegetables per day

A nurse is providing teaching to the guardians of an infant who has failure to thrive (FTT). What information should be included in the teaching?

Add fortified rice cereal to the infant's formula fortified cereal of vegetable oil added to formula will help promote weight gain

A nurse is caring for an infant who is breastfed and is receiving amoxicillin for an upper respiratory infection. AN assessment of the mouth reveals whitish patches on the tongue that will not scrape off. Which of the following actions should the nurse take?

Administer an antifungal medication after feedings This ensures adequate contact time with the oral mucosa and tongue to enhance treatment of the oral candidiasis

A nurse is providing discharge teaching to the guardian of an infant following a hypospadias repair. Which instructions should the nurse include?

Apply antibacterial ointment to the infant's penis once per day this will decrease risk for infection

A nurse is performing a physical assessment on a 6mo infant. which reflexes should the nurse expect to find?

Babinski (present until 1 year) stepping disappears at 4 weeks, extrusion disappears at 4 months, moro disappears at 3-4 months

A nurse is caring for a 7yo child who is in skeletal traction following a complete fracture of the femur. Which of the following diversional activities should the nurse offer to the child?

Chapter books Appropriate diversional activity for a school-age child with limited movement due to skeletal traction

A nurse is caring for an infant who is 6 mo and has moderate dehydration. which findings should the nurse expect?

Dry mucous membranes severe dehydration= absent tears, over 10% weight loss, and lethargy

A nurse is planning care for a 6yo child who is receiving chemotherapy. the child has a highlight platelet count of 20,000/mm^3. Based on this value, which intervention should the nurse provided in the plan of care?

Encourage quiet play this platelet count will predispose the client to excessive bleeding. Quit play will lessen the client's risk of injury, thereby reducing the chance of hemorrhage

A nurse is planning to use guided imagery for an early school-aged child who continues to have mild discomfort following the administration of an analgesic. Which techniques should the nurse plan to use?

Encourage the child to focus on a recent pleasurable experience this technique can also be combined with relaxation and breathing

A nurse in a pediatric clinic is caring for a 3yo child who has a blood lead level of 3 mcg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following pieces of information is appropriate for t he nurse to include?

Ensure the child's dietary intake of calcium and iron is adequate elevated blood lead level should have adequate intake of calcium and iron to reduce the absorption of and effects from the lead. Dietary recommendations should include milk as a good source of calcium

A nurse is caring for an 8yo child with sickle cell anemia. Which action should the nurse take?

Give the child flavored popsicles Maintaining hydration with a child who has sickle cell anemia is important to prevent sickling. Children often accept popsicles as a source of fluid

A nurse in a provider's office is assessing a client. The nurse determines the client's BMI is 21.2. This finding is classified as which of the following?

Healthy weight BMI from 18.5-24.9 is the healthy range

A nurse is providing teaching to an adolescent who was just diagnosed with type 1 DM. Which injection sites should the nurse recommend that the client use during basketball?

Hip with vigorous exercise the arms and legs should not be sued due to enhanced absorption of the insulin

A nurse is providing education to the parent of a toddler who is about to receive an MMR immunization. Which statement by the parent indicates an understanding of the teaching?

I will help my child to blow bubbles during the injection Providing distraction is a technique that can minimize pain and discomfort for the child

A nurse is providing discharge teaching to the parents of a child with nephrotic syndrome. Which should the nurse include in teaching?

Keep the child away from people who have an infection. children with n.s. are at an increased risj for infection

A nurse is caring for a 3yo child who has a cyanotic cardiac defect. The child cries when her parents leave the room, worsening her cyanosis and dyspnea. What position should the child be placed in to improve these manifestations?

Knee-chest similar to squatting, it facilitates the oxygenation of the lungs.

A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations and is planning to attend college. The nurse should recommend which of the following immunizations prior to moving into a campus dormitory?

Meningococcal polysaccharide used to prevent infection by m bacteria. This infection can cause life-threatening illness such as m meningitis and meningococcemia(blood). Both can be fatal. CDC recommends this for all incoming college students staying in dormitories.

A nurse is caring for an adolescent who has end-stage renal disease and is scheduled for peritoneal dialysis. Which action should the nurse take?

Obtain weight prior to procedure also obtain weight after procedure

A nurse is teaching a group of parents and guardians about otitis media. What should the nurse identify as a risk factor for this illness?

Passive smoking

A nurse is planning care for a child who has hyperthermia. Which action should the nurse take?

Position the child on a cooling blanket and cover her with a sheet a cooling blanket will lower temperature at the skin's surface, and the cooler blood will circulate to and lower temp of organs and tissues. Heat from internal organs will be circulated back t o skin and dispensed to the cooler outside surface

A nurse is providing teaching about poisoning prevention to a group of parents with toddlers. Which statement should the nurse make?

Put all cleaning supplies in a locked cabinet

A nurse is caring for an 18mo infant who has chronic otitis media. The nurse should recognize that this will affect which of the following?

Speech patterns chronic o.m. can result in hearing loss which can impair speech development

A nurse is evaluating the outcome of surgery for an infant who had a bile duct obstruction. Which findings indicate the surgery was successful?

The color of the infant's stool is yellowish-brown with biliary obstruction, stool is clay colored because intestinal tract is blocked. It will change after surgery to yellow and then brown in color

An 18month infant has pneumocystis carinii pneumonia. Results of ELISA test indicates she is HIV positive. when planning care, what factor should be considered?

The infant's mother is likely HIV positive mother-child transmission accounts for majority of cases in infants, although it is possible to acquire from sexual abuse

A nurse is performing a physical assessment on a 12mo infant. Which finding should be reported to the provider?

The infant's weight is double his birth weight At 12 months, it should be triple the birth weight

A nurse is talking with a parent of a preschooler. The parent reports that she struggles to get her child to go to bed at a consistent time. She explains that the child gets out of bed, enters parent's room, and cries when they tell him to stay in his own bed. What instruction should the nurse give the parent?

Use a stable, relaxing routine like a bath and story time before bed routines help child to settle down and anticipate bedtime

A nurse on a pediatric unit is planning care for a preschooler who will be having surgery in the morning. The child has been crying even with parents present. The nurse should encourage therapeutic play for which benefit?

allow the child to manipulate toy medical equipment use of toys enables transfer of anxiety and fear of objects rather than to people

A nurse is providing postop teaching to the parent of a 3mo infant who is recovering from an umbilical hernia repair. Which statement by the parent indicates understanding?

"I will fold my baby's diaper away from the incision" to prevent infection and protect the site from contamination

A nurse in the emergency department is caring for an unaccompanied infant after a MVA. The nurse notes that the infants anterior fontanel is almost closed. She has six teeth, is able to sit unsupported, and can drink from a cup. The child cries and asks for mama and dad. What is the nurses assessment on age?

12 months old must be less than 18 months old because anterior fontanel is still open. Around 12 months due to having 6 teeth. sitting unsupported (8months), drinking from cup (9 months), stranger anxiety (8 months), and saying two words (12 months)- all indicate age range

A nurse is discussing the cause of chronic diarrhea with a client. Which of the following conditions is caused by malabsorption?

Celiac disease CD causes chronic diarrhea due to malabsorption. Other malabsorption conditions include short-bowel syndrome, lactose intolerance and congenital enzyme deficiency

A charge nurse is providing education about child maltreatment to a group of newly licensed nurses. which information should be included in the teaching?

Children who were born prematurely are more likely to be maltreated premies often require prolonged hospitalization which can interrupt parent-child bonding, and often have increased care needs and cause caregiver fatigue

A nurse is caring for a 12-month-old infant following the surgical repair of a cleft palate. The nurse should plan to feed the infant using which of the following instruments?

Cup The infant should be fed clear liquids using a cup for 7-10 days following repair to prevent trauma and injury tot he suture line

A nurse is planning to teach a 9yo who has new diagnosis of DM. The nurse should identify that school-age children are attempting to master which developmental task?

Industry vs inferiority children in this age enjoy learning new skills and experiencing a sense of accomplishment that comes with the mastery of the skill

A nurse is assessing a toddler who has measles(rubeola). which finding is expected?

Koplik spots small irregular oral lesions with a bluish-white center, characteristic of measles. will appear 2 days before maculopapular rash and are accompanied by fever, malaise, conjunctivitis, and other cold manifestations

A nurse is assessing an adolescent who has a new diagnosis of anorexia nervosa. Which findings should the nurse expect?

Lanugo over the back lanugo may be present on the skin as a result of impaired metabolic activity. Other manifestations include hypothermia, hypotension, and dry skin

A nurse is assessing the fine motor skills of a 3yo preschooler. which finding should the nurse expect?

builds a tower of 9 blocks fine motor skills at 3 should be building a tower of 9-10 blocks

A nurse is teaching the parent of a school-age child who has celiac disease. Which foods selected by the parent indicate an understanding of the teaching?

corn tortilla with black beans gluten is found in wheat, rye, and barley.

A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. which findings should alert to possible epiglottitis?

drooling this disorder is rapid swelling of the epiglottis, which can obstruct breathing. drooling happens to due inability to swallow saliva

A nurse is planning preop teaching for a preschooler before a tonsillectomy. which intervention should the nurse include?

encourage preschooler to bring favorite toy to the hospital familiar object provides comfort and relieves fear

A nurse is assessing an infant who is at risk for increased intracranial pressure. Which findings should indicate that this complication is developing?

high-pitched cry other indications are bulging fontanel, and increased sleeping

A nurse is caring for an infant who has pertussis. Which actions should the nurse take?

maintain a cardiorespiratory monitor infants with p. typically present with apnea in response to coughing spasms and mucous plugs, Humidified oxygen and suction equipment should be used as needed

A nurse is reviewing laboratory findings of an adolescent with acute renal failure. which findings should the nurse expect?

metabolic acidosis

A school nurse is assessing a child who has been stung by a bee. The child's hand is swelling and the nurse notes that they are allergic to insect stings. what findings are expected if the child experiences anaphylaxis

nausea, urticaria(skin manifestation of histamine release), stridor

A school nurse is assessing an adolescent who returned to school after having mononucleosis. The child has a note excusing him from gym class. what is the reason for this excusal?

potential for sustaining abdominal trauma those with mono will have lymphadenopathy and often splenomegaly that can go on for months, therefore should avoid chance of trauma to enlarged spleen

A nurse is caring for a toddler who is postop after cleft palate repair. which actions should the nurse take?

restrain the toddlers arms at the elbows this will prevent toddler from rubbing or disrupting the sutured area

A nurse in a peds unit is talking with parent of a toddler who states that her child will not sit at the table to eat with the family. She asks the nurse what finger foods she can give, what should the nurse suggest

slices of ripe banana toddlers should have about 8oz/1cup of fruit per day. Bananas that are soft are not a choking hazard

A nurse is assessing the gross and fine motor behaviors of a toddler. Which skills are expected for a 3yo child?

standing on 1 foot for several seconds walking backward heel to toe(5yo), scissors to cut out shapes(4yo), printing letters (5yo)

A nurse is assessing the development of a 3yo child. which gross motor skills are expected?

standing on one foot skipping (4yo) hop on 1 foot (4yo) throwing ball overhead (4yo)

A nurse in an emergency department is assessing a school-aged child who is experiencing an acute asthma exacerbation. which finding is priority to report to provider?

sudden decrease in wheezing this can indicate that the child is experiencing decreased air movement/ ventilatory failure and imminent respiratory arrest. Always follow ABCs

A nurse in a provider's office is observing children playing in the waiting room. The nurse should identify parallel play in which age group?

toddlers solitary play for infants, preschool associative play, school-age cooperative play

A nurse is providing teaching to the guardian of a child about bicycle safety. What teaching should be included?

walk the bike through intersections -ride bike with the flow of traffic, helmet should not obstruct eyes and ears

A nurse in the emergency department is assessing a preschooler for indications of child maltreatment. The nurse should identify that which of the following is a manifestation of physical abuse?

Bruises at various stages of healing

A nurse is caring for a child who received penicillin IM 15 min ago. The child is now irritable and restless. Which of the following actions should the nurse take first?

Assess for laryngeal edema The greatest risk to this child is bronchoconstriction due to an anaphylactic reaction to penicillin. Therefore, the first action the nurse should take is to assess the child for laryngeal edema and implement interventions to maintain patent airway.

A nurse is admitting a child who has a UTI and history of myelomeningocele. After obtaining admission history, which action should the nurse plan to take?

Attach latex allergy alert ID band clients with neural tube defects are at risk of latex allergy

A nurse is caring for a preschooler who was brought to an outpatient clinic with a 2-day history of vesicular, honey- colored crusty region around the nose and mouth. If the provider determines the lesions to be impetigo contagiosa, what should the nurse anticipate teaching the parents?

- apply topical antibacterial ointment to the lesions -wash the child's bed linens daily with hot water -wash hands before and after contact with infected area i.c. is bacterial skin infection

A nurse is teaching a school-age child with asthma how to use a metered-dose inhaler. In which order should the nurse instruct the child to use the inhaler?

1-shake the inhaler while holding it upright 2-position the mouthpiece in the mouth and form a seal 3-slowly inhale the medication 4-hold breath for 5-10 seconds

A nurse is caring for a toddler. which objects are appropriate to take from playroom during the toddler's hospitalization?

10 piece wooden puzzle for toddler- puzzles, large crayons, blocks, picture books, push-pull toys, finger paints, modeling clay

A nurse is providing teaching to the guardian of an adolescent. The guardian reports that the adolescent sleeps about 10 hours on weekend nights. What response should the nurse provide?

Adolescents need more sleep due to rapid growth this age needs more sleep time than other age groups. Reasons for need for increased sleep include stress, busy schedules, and rapid physical growth

A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following labs should the nurse report to provider immediately?

O2 sat of 85% Apply ABC priority framework

A nurse is caring for an 8 yo child who has acute glomerulonephritis. which of the findings should the nurse expect?

Periorbital edema this is an expected finding. elevated BP is expected, stomatitis is expected with chronic renal failure. bloody diarrhea is expected with hemolytic uremic syndrome

A nurse is caring for an infant who has tetralogy of Fallot and is experiencing a hypercyanotic episode. which action should the nurse take?

Place in knee-chest position reduces the return of desaturated blood from legs through the venous system and promotes the diversion of blood into the pulmonary artery

The nurse is preparing to administer an oral medication to an 8mo infant. which actions should the nurse take?

Use an oral syringe to place the medication alongside the infant's tongue also give time to swallow between deposits

A nurse is assessing a 3 yo child who is 1 day postoperative following a tonsillectomy. which method should the nurse use to determine if the child is experiencing pain?

Use the FACES scale Pain is subjective, FACES can be used to determine pain in children as young as 3