Block 9: Module 6-9 Practice Questions

A nurse is caring for a child who has rubeola. The nurse should monitor for which of the following complications? (SATA) a. Otitis media b. Constipation c. Laryngitis d. Arthralgia e. Syncope

a. Otitis media c. Laryngitis D is complication of fifth disease, E of pertussis

A school nurse identifies that a child has pediculosis capitis and educates the child's parents about the condition. Which of the following statements by the parents indicates an understanding of the teaching? A. "All recently used clothing, bedding, and towels must be washed in hot water." B. "My child must be free from nits before returning to school." C. "I will treat all the family members to be on the safe side." D. "Toys that can't be dry cleaned or washed must be thrown out."

A. "All recently used clothing, bedding, and towels must be washed in hot water." Rationale:Pediculosis capitis is commonly referred to as head lice. All recently used clothing, bed sheets, and towels need to be washed in hot water. Anything that cannot be washed should be sealed in a plastic bag for 10 to 14 days. Unwashable items can include jackets, sweaters, hats, pillows, bicycle helmets, and stuffed animals. Furniture, carpets, and car seats can be sprayed with a variety of over-the-counter products. The American Academy of Pediatrics opposes requiring children to stay out of school until all nits are gone and instead recommends allowing children to return to school after treatment. Only family members who actually have lice should be treated because there are potential adverse effects associated with the treatment. Items that cannot be dry cleaned or washed can be closed up inside a plastic bag for 10 to 14 days.

A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for FURTHER teaching? A. "I only need to catheterize myself twice every day" B. "I carry a water bottle with me because I drink a lot of water" C. I use a suppository every night to have a BM D. "I do wheelchair exercises while watching TV"

A. "I only need to catheterize myself twice every day" Should be performed every 4 hours*

A nurse is providing teaching to the parent of an infant who has developmental hip dysplasia and a new prescription for a Pavlik harness. Which of the following parent statement indicates an understanding of the teaching? A. "I will buy the harness over a T-shirt and knee socks." B. "I will put my babies diaper over the harness." C. "I will make the required harness adjustments as my baby grows." D. "I will buy powder around the harness buckles each day."

A. "I will buy the harness over a T-shirt and knee socks." Applying the harness over a T-shirt and kneesocks indicates that the parent understands instructions. This step will prevent the harness straps from rubbing against and causing irritation to the infant's skin. Putting the infant diaper over the harness will cause soiling of the harness and allow direct contact of the harness with the skin, which can lead to skin irritation and breakdown. The parent should return to the clinic for harness adjustments. Parents cannot make any adjustments to the harness without supervision of a healthcare professional. Lotions and powders should not be applied due to the possibility of causing irritation to the skin around the buckles.

A nurse is teaching the mother of a 5-year-old child who has cystic fibrosis about pancreatic enzymes. The nurse should understand that further teaching is necessary when the mother states which of the following? A. "I will give my son the enzymes between meals." B. "The enzymes probably won't cause many adverse effects." C. "The enzymes help him digest fat." D. "I will put the enzyme crystals in his applesauce."

A. "I will give my son the enzymes between meals." Rationale: The parent should give the child pancreatic enzymes with every meal and snack. Pancreatic enzymes rarely cause adverse effects. In inappropriately large doses, they can cause nausea and diarrhea. Pancreatic enzymes improve digestion, particularly of fats. The parent can sprinkle the contents of the pancreatic enzyme capsules on a variety of foods, including applesauce.

A nurse is caring for a child who has sickle cell anemia and is experiencing a Vaso occlusive crisis. Which of the following action should the nurse take? A. Administer ibuprofen B. Limit daily fluid intake C. Apply cold compresses to painful joints D. Withhold live virus immunizations

A. Administer ibuprofen The nurse should administer ibuprofen or acetaminophen for a while mild to moderate pain. If pain is not relieved, the nurse should administer an opioid analgesic. The nurse should encourage the child to increase daily fluid intake to reduce blood of the viscosity and preventing sickling of red blood cells. Cold compresses increase vasoconstriction and increase pain. Therefore the nurse should apply warm compresses to painful joints. The nurse should ensure the child receives all immunizations for the infection. Infection is a major cause of death in children with sickle cell anemia.

A nurse is reviewing data for four children. Which of the following children should the nurse assess first? A. A 10-year-old child who has sickle cell anemia who reports severe chest pain. B. A 7-year-old child who has a diabetes insipidus and a urine specific gravity of 1.016 C. A 1 year old toddler who has roseola and a temperature of 39 C (102.2 F) D. A 4-year-old who has asthma a PCO2 of 37 mm Hg

A. A 10-year-old child who has sickle cell anemia who reports severe chest pain.

A nurse is assessing a school-age child after a ventriculoperitoneal (VP) shunt replacement. Which of the following findings indicate a complication of this procedure? A. Abdominal distention B. Unequal peripheral pulses C. Pinpoint pupils D. Frontal bossing

A. Abdominal distention A VP shunt allows excess cerebrospinal fluid from the ventricles to drain into the peritoneal cavity and be reabsorbed. Abdominal distention can indicate the presence of peritonitis due to the draining cerebral spinal fluid or post op ileus. Unequal peripheral pulses is a complication that can occur following a cardiac catheterization. ICP would cause dilation of pupils. Frontal bossing can be observed in fangs with hydrocephalus but is not complication of the procedure.

A nurse is assisting with the admission of a child who has measles. Which of the following isolation precautions should the nurse initiate? A. Airborne B. Contact C. Protective environment D. Droplet

A. Airborne Rationale: The nurse should initiate airborne precautions for a child who has measles, which is transmitted via droplet nuclei smaller than 5 microns. The nurse should place the child in a negative-pressure airflow room and wear a mask when providing client care. The nurse should initiate contact precautions for clients who have infections such as Clostridium difficile, scabies, and shigella. The nurse should wear gloves and a gown when providing client care. The nurse should initiate a protective environment for a child who is immunocompromised, such as while undergoing a stem cell transplant. The nurse should place the client in a positive-pressure airflow room. The nurse should initiate droplet precautions for clients who have an infection spread by droplet nuclei larger than 5 microns. These infections include rubella, pertussis, and mumps.

A nurse is providing teaching to a parent of a preschooler who has eczema. Which of the following instructions should the nurse include in the teaching? A. Apply a topical corticosteroid ointment to the affected area. B. Launder the child's clothing with fabric softener. C. Give the child a bubble baths every day. D. Dress the child in woolen clothes during cold months.

A. Apply a topical corticosteroid ointment to the affected area. Rationale: The child might require a topical corticosteroid ointment to use during flare-ups to decrease inflammation. The parent should wash the child's clothing and sheets in a mild detergent and then rinse them in clear water. The parent can also put the clothing through a second wash cycle without detergent to further reduce harmful substances. The parent should give the child a bath in tepid water with mild soap and should not use bubble baths, oils, or powders. The parent can also give the child a colloidal bath and then apply an emollient to the skin. Rationale: The parent should dress the child in synthetic fabrics, rather than wool, for outerwear during cold weather and dress the child in soft cotton fabrics at night to prevent pruritus.

A nurse is caring for a child who is a having a seizure. Which of the following actions should the nurse take? (Select all that apply) A. Assess the client's airway patency B. Place a tongue depressor in the client's mouth C. Remove objects from the client's bed D. Place the client in a side-lying position E. Restrain the client

A. Assess the client's airway patency C. Remove objects from the client's bed D. Place the client in a side-lying position

A nurse is caring for a child who has red marks across his cheeks. Which of the following actions should the nurse take? A. Assess the rest of the child's body for a rash. B. Refer the family to child protective services. C. Question the parents about how the marks occurred on the child's cheeks. D. Obtain the child's temperature.

A. Assess the rest of the child's body for a rash. Rationale: Fifth disease presents with erythema on the face, which resembles slap marks. The nurse should further assess the child's body and extremities to determine if the child has Fifth disease. Referring the family to child protective services without further assessment is not an appropriate action for the nurse to take. Questioning the parents about the red marks prior to further assessment is not an appropriate action for the nurse to take. A fever is sometimes the first sign of a childhood disease. However, after a rash becomes apparent the child's temperature returns to normal.

A nurse is admitting a child who has a urinary tract infection and a history of myeomeningocele. After completing the admission history, which of the following actions should the nurse plan to take? A. Attach a latex allergy alert identification band B. Initiate contact precautions C. Post signs in the clients bathroom to strain the client's urine D. Administer folic acid with meals

A. Attach a latex allergy alert identification band Myelomeningocele, A serious complication of spina bifida, is an neural tube defect in which the spinal cord and meninges are in a cerebral spinal fluid filled sack at birth. Clients who have neural tube defects are at risk of latex allergy, therefore, the nurse should avoid the use of common medical product containing latex such as latex gloves for this quietent. Contact precautions are not required for the UTI. Straining urine is essential for urinary calculi or stones in the urinary system not for a UTI. Women should take folic acid during pregnancy to reduce the risk of neural tube defects.

A nurse is caring for a preschool or has a terminal illness. The nurse should expect the preschoolers have which of the following perspectives about death? A. Believes that her own thoughts cause death B. Has an understanding of the finality of death C. Exhibits curiosity about what happens to the body after death D. Views funeral services as unnecessary

A. Believes that her own thoughts cause death The nurse should expect preschoolers to believe that their own thoughts or actions can cause death, and they might believe that death is a punishment for wrongdoing. The nursery expect a preschooler to do death as temporary like sleeping. The preschool might believe the person can wake up again. The nurse should expect school-age children to be curious about what happens to a body following death. The nurse should expect an adolescent to reject traditions surrounding deaths such as funeral services as unnecessary or unimportant.

A nurse is preparing to teach about communicable diseases. During which of the following stages is the period in which a disease is contagious? A. Communicability period B. Convalescent period C. Incubation period D. Prodromal period

A. Communicability period Rationale:The communicability period is the time when a disease is contagious and can be transmitted to others. The convalescent period is the time between when the disease manifestations disappear and the client becomes well. The incubation period is the time between when the organism infects the client and the onset of the illness. The prodromal period is the time between the onset of nonspecific manifestations and the onset disease-specific manifestations.

A nurse is caring for a child who is 2 hr postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time? A. Crushed ice B. Orange juice C. Vanilla milkshake D. Cranberry juice

A. Crushed ice Rationale: Cold, clear liquids are well-tolerated following a tonsillectomy. Liquids that are brown or red should be avoided in order to tell the difference between the liquid and fresh or old blood. Citrus juices should be avoided as they can be irritating to the throat. Dairy products should be avoided as they increase the viscosity of the mucus, causing the child to frequently clear her throat, which can lead to bleeding. Acidic fluids should be avoided as they can be irritating to the throat. Liquids that are red should be avoided in order to tell the difference between the liquid and fresh or old blood.

A nurse out of clinic as preparing to administer immunizations to a five-year-old child. Which of the following immunizations should the nurse plan to give? A. DTaP B. PCV C. Hib D. Hep B

A. DTaP Children should receive booster doses of the DTaP immunization between the ages of four and six. Around his age, blood titters drop due to decrease of antibodies. Infants should receive the PCV and Hib immunizations at two months, four months, and six months, as well as the fourth those between 12 to 18 months. Hep B is at birth, 1-2 mos, and 6-18 mos.

A child is admitted with a suspected diagnosis of Wilms' tumor. The nurse should place a sign with which of the following warnings over the child's bed? A. Do not palpate abdomen B. No venipuncture or blood pressure in left arm C. Contact precautions D. Collect all urine

A. Do not palpate abdomen

Nurse is providing teaching about homecare to the guardian of an adolescent who has hemophilia. Which of the following pieces of information should the nurse provide? A. Encourage adolescent to participate in noncontact sport B. Provide the adolescent with a firm bristled toothbrush C. Administer aspirin to the adolescent for episodes of pain D. Provide disposable razors to the adolescent for shaving

A. Encourage adolescent to participate in noncontact sport The nurse should instruct the guardian that the adolescent should be allowed to participate in noncontact sport such as walking, bowling, and golf. Contact sports may be allowed at the adolescent where is protective gear and receives routine recombinant factor VII infusions. The nurse instruct the parents provide the adolescent with a soft bristle toothbrush or sponge to decrease the risk of bleeding. The nurse should instruct the parents administer the acetaminophen for pain. Aspirin increases the risk of bleeding. The nurse should instruct the parent to provide an electric razor for shaving to decrease the risk of bleeding.

I nurse is planning care for a preschool age child who has autism and is being admitted to the facility. Which of the following action should the nurse plan to take? A. Encourage the parents to bring the child stuffed animal B. Give the child choices when planning daily activities C. Administer phenytoin 3 times per day D. Provide a shared room with another child his age

A. Encourage the parents to bring the child stuffed animal Encouraging parents to bring in a child's favorite stuffed animal may lessen the disruptiveness of hospitalization. Children with ASD have difficulty organizing behaviors therefore it's best to not give them choices. Phenytoin is taken by children who have seizure disorders. Children with ASD need decreased stimulation and avoidance of auditory or visual distraction. A private room is preferable.

A nurse is caring for an adolescent who has sickle cell anemia. Which of the following manifestation is/are the result of chronic vaso-occlusive phenomena? Select all that apply A. Enlarged heart B. Enuresis C. Leg ulcers D. Extrahepatic cholestasis E. Retinal detachment

A. Enlarged heart B. Enuresis C. Leg ulcers E. Retinal detachment Chronic vaso-occlusive phenomenon results from the obstruction of organs by red blood cells, leading to stasis enlargement of the organs, infarction dude ischemia, and scarring. Enlarged heart, and you racist, lay all stars, and retinal detachment or manifestations of Connick vaso-occlusive phenomenon. Intrahepatic chill stasis is a manifestation of chronic vaso-occlusive phenomena. Extrahepatic cholestasis is caused by the blockage of bile flow from the liver due to a source outside of the liver, usually stones in the common bile duct. Intrahepatic close stasis is caused by the blockage of bile flow from the liver due to a source outside of the liver such as scarring.

A school nurse is assessing a child for pediculosis capitis. Which of the following manifestations should the nurse recognize as an indication of this condition? A. Firmly attached white particles on the hair B. Itching and scratching of the head C. Patchy areas of hair loss D. Thick yellow crusted lesion on a red base

A. Firmly attached white particles on the hair Pediculus capitis, or head lice, are tiny parasitic insects that live on the scalp and can be spread by close contact with other people. Their eggs (nits) appear much like flakes of dandruff but stick firmly to the hair shaft instead of flaking off of the scalp. There are many causes of scalp itching, so this is not a definitive indication of pediculosis capitis.Alopecia, or patchy areas of hair loss, is a typical finding in ringworm, a superficial infection of the scalp by a fungus. Thick golden yellow crusted lesions on a red base are a typical finding in impetigo contagiosa, a superficial infection of the skin that often involves the face or scalp.

A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor? A. Headache B. Dependent edema C. Polyuria D. Photosensitivity

A. Headache

A nurse is assessing an infant who at risk for increased intracranial pressure (ICP). Which of the following findings should indicate to the nurse that this complication is developing? A. High pitched cry B. Sunken fontanel C. Tachycardia D. Increased awake time

A. High pitched cry High pitched cry, bulging fontanel and increased sleeping are all findings in increased ICP. Bradycardia would be more likely.

A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? Select all that apply. A. Hoarseness and difficulty speaking B. Difficulty swallowing C. Low-grade fever D. Drooling E. Dry, barking cough F. Stridor

A. Hoarseness and difficulty speaking B. Difficulty swallowing D. Drooling F. Stridor Hoarseness and difficulty speaking, difficulty swallowing, drooling, and stridor are all manifestations of epiglottitis. You would also see a high fever with epiglottitis rather than a low-grade fever. Dry barking cough is a manifestation of croup.

A nurse is teaching a newly hired nurse about caring for an infant who is postop following myelomeningocele repair. The nurse should teach the newly hired nurse to monitor the infant for which of the following complications? A. Hydrocephalus B. Congenital hypotonia C. Otitis media D. Osteomyelitis

A. Hydrocephalus In the surgical repair of the myelomeningocele, The pathway for the cerebral spinal fluid is altered. Therefore, the infant is at risk for Hydrocephalus, and the nurse should monitor the infant for this condition. Congenital hypotonia is a paralytic form of spinal muscular trophy that is characterized by progressive weakness and wasting of skeletal muscles, therefore, the infant should not be monitored for this complication. Otitis media results from a blocked eustachian tube and is not related to a neural tube defect. Osteomyelitis results from an organism gaining access to the bone and is not related to this condition.

A nurse is preparing to administer routine immunizations to a six-year-old child. In addition to the DTAP, MMR, and the various of vaccine, which of the following immunizations should the nurse plan to administer? A. IPV B. Hib C. PCV D. Hep B

A. IPV The 4th dose of IPV happens 4-6 yrs old and the first 3 are administered between 2-18 mos of age. The nurse should verify that the child received Hib vaccine and PCV at 2 mos, 4 mos, 6 mos and 12-15 months. Hep B is at birth, 2 mos, and 6-18 months.

A nurse is preparing to administer routine immunizations to a 6 yr old child. In addition to the DTaP, MMR, and Varicella vaccine. Which of the following immunizations should the nurse plan to administer? A. Inactivated poliovirus vaccine (IPV) B. Haemophilus influenza type B (Hib) C. Pneumococcal conjugate vaccine (PCV) D. Hep B vaccine

A. Inactivated poliovirus vaccine (IPV) The nursery plan to administer the force dose of the IPV between 4 to 6 years of age. The first 3 doses are administered between 2- 18 months of age. Hib vaccine and PCV is given at 2,4,6 months and then 12-15 mos. Hep B is at birth, 2 mos, then 6-18 mos.

A nurse is creating a plan of care for a child who has aplastic anemia. Which of the following intervention should the nurse include? A. Initiate protective environment isolation for the child B. Apply pressure for 1 to 2 minutes at the puncture site following a blood specimen collection C. Mix the child ferrous sulfate elixir twice per day into a glass of milk for administration D. Check the child's blood glucose level every four hours

A. Initiate protective environment isolation for the child The nurse should suggest protective environment isolation for the child, which consists of a private room with positive air pressure and no live flowers, nurses must don a respiratory mask, gloves, and gown prior to entering the child's room. A child who has a plastic anemia has decreased RBC's, platelets, and WBC, causing immune suppression and increasing suspect to sesibility to infection. The nurse should apply pressure to peripheral puncture sites for a minimum of 5 minutes to prevent bleeding following blood specimen collection. Ferrous sulfate is required medication for a child who has iron deficiency anemia so this is not a necessary intervention for this client. Aplastic anemia does not affect the child's blood glucose level, so this is not a necessary intervention.

A nurse is assessing a toddlers who has measles (rubeola). Which of the following findings should the nurse expect? A. Koplik spots B. Parotitis C. Strawberry tongue D. Paroxysmal coughing

A. Koplik spots Koplik spots are small, irregular oral lesions with a bluish white center. They are characteristics of measles. Koplik spots appear about two days before the maculopapular rash and accompanied by fevers, malaise, conjunctivitis, and other cold manifestations. Swollen parotid glands are an expected finding with mumps. Strawberry tongue is an expected finding in scarlet fever. Paroxysmal coughing is an expected finding in a child who has pertussis.

A nurse is caring for a client who is 1-day postoperative following spinal fusion. Which of the following actions should the nurse take? A. Log roll the client every 2 hr B. Assist the client to sit upright in a chair for 4 hr at a time C. Expect clear drainage on the spinal dressing D. Elevate the client's legs when he is sitting in a chair

A. Log roll the client every 2 hr

A nurse is caring for a client who is experiencing a seizure. Which of the following actions should the nurse take? (Select all that apply) A. Loosen restrictive clothing B. Insert a bite stick into the client's mouth C. Place the client into a supine position D. Place a pillow under the client's head E. Apply restraints

A. Loosen restrictive clothing D. Place a pillow under the client's head

A nurse is caring for a newborn who has myelomeningocele. Which of the following nursing goals has the priority in the care of this infant? A. Maintain the integrity of the sac B. Promote maternal-infant bonding C. Educate the parents about the defect D. Provide age-appropriate stimulation

A. Maintain the integrity of the sac

A nurse is creating a plan of care for a child who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is a priority for the nurse to include? A. Monitor the child's oxygen saturation level B. Administer prescribed antibiotics to the child C. Increase the child's fluid intake D. Apply warm compresses to the child's affected joints

A. Monitor the child's oxygen saturation level ABCS! The priority intervention is to monitor the child's oxygen saturation level. Promoting oxygen utilization prevents further sick of the child's red blood cells and allows adequate oxygen of surrounding tissue. The other interventions are helpful but they are not the priority.

A nurse is caring for a two day old infant who has myelomeningocele. Which of the following action should the nurse take? A. Monitor the infants head circumference B. Position the infant supine C. Place the infant under radiant warmer D. Tape a piece of plastic over the protruding membranes

A. Monitor the infants head circumference Infants with myelomeningocele have an increased risk of hydrocephalus. Measuring the infants heads or conference helps determine any increase of fluid. The nurse should place the infant improme position to minimize risk of trauma or tension on the sack. The nurse should not place infant in a radiant warmer because this may dry the lesions and cause cracking. Placing a piece of plastic over the protruding membranes will exert pressure on the area. The nurse should place a wet gauze over the lesion to provide moisture.

A nurse is caring for the family of a preschooler who has a terminal illness. The nurse should teach the family to expect the preschooler to have which of the following concepts of death? A. People can come back to life after they die B. Death eventually occurs for all people C. Death is a scary monster that causes people to die D. People are unable to be anything but alive

A. People can come back to life after they die A preschooler typically views death as temporary and interchangeable life. I understanding that death is inevitable is usually not achieved until the ages of 9 to 10. School-age children might view death as a monster. Toddlers are typically unable to comprehend the meaning of death, however, a preschooler has usually moved beyond this level of egocentricity.

A school nurse is assessing and adolescent who returned to school following a case of mononucleosis. The child has a note from his provider excusing him from gym class. Which of the following finding should the nurse identify as a reason for this excusal? A. Potential for sustaining abdominal trauma B. Deficient dietary intake C. Exposing peers to the illness D. Straining sore joints

A. Potential for sustaining abdominal trauma An adolescent who has mononucleosis will have a lymphadenopathy and often splenomegaly, which can persist for months. For this reason, even after the adolescence is able to maintain his usual energy level and return to school, it is important for him to avoid activities that might result in trauma to the enlarged spleen. Although difficulty swallowing may have been prevalent in early phases of the illness, after returning to school, he should not have deficient dietary intake. Epstein-Barr virus causes mononucleosis and it is spread primarily through direct contact with saliva of an infected individual. Casual contact during gym and recess would not be more hazardous than having a child in the classroom. Mononucleosis will not cause joint inflammation.

A nurse is caring for a school-age child who has sickle cell anemia. Which of the following action should the nurse plan to take to help decrease the risk of a vaso-occlusive crisis? A. Provide adequate fluid intake throughout the day B. Provide oxygen at 2 l/min via a nasal cannula C Administer a blood transfusion D. Give ibuprofen to manage pain

A. Provide adequate fluid intake throughout the day Adequate hydration is an effective strategy to help prevent sickle cell crisis. Maintaining adequate hydration can reduce the risk of sickle cell formation. Oxygen might be necessary to manage a sickle cell crisis, but it is not routinely used to prevent a crisis. A blood transfusion might be necessary to manage a sickle cell crisis, but it is not routinely used to prevent a crisis. The nurse can administer ibuprofen to manage pain of sickle cell crisis, but this measure will not prevent a crisis from occurring.

A nurse is preparing a school-aged child for a tonsillectomy. Which of the following action should the nurse take? A. Schedule the child for preop visit to the facility B. Inform the child he will be put to sleep for the procedure C. Read the child a story about a cartoon character having a similar operation D. Tell the child the appointment is to have his throat checked

A. Schedule the child for preop visit to the facility Preoperative visit to the facility allows the child to observe perioperative processes. This education helps the child feel at ease prior to the surgical procedure. After the age of nine, a child understands concepts of death. The nurse should inform the child that he is taking a special nap not being put to sleep. Children who have pets might regard being put to sleep as an experience similar to death. Reading a cartoon book is developmentally appropriate for a preschool age child or a toddler. Participating in therapeutic play has benefits for those age groups. Children need factual information and explanations about what will happen during hospitalization.

A nurse is assisting with a routine examination of an adolescent. The provider observes a lateral curvature of the spine. The nurse should expect the provider to document which of the following disorders? A. Scoliosis B. Kyphosis C. Lordosis E. Torticollis

A. Scoliosis kyphosis=hunchbacl, lordosis=swayback and torticollis is limited neck motion

A nurse is caring for a school-age child who has sickle cell anemia and was admitted for a vaso-occlusive crisis. Which of the following findings should the nurse report to the provider immediately? A. Slurred speech B. Hemoglobin level of 9g/dL C. Hematuria D. Pain level of 7 on FACES scale

A. Slurred speech The nurse identify that slur speech and a child has sickle cilanemia is an indication of a stroke. The nursery report this finding to the provider immediately. The other are expected findings for a child with sickle cell anemia and would require interventions for comfort but are note reported immediately.

A nurse is caring for a child who has a suspected diagnosis of cystic fibrosis. Which of the following diagnostic tests will confirm the diagnosis? A. Sweat chloride test B. A sputum culture C. A stool fat content analysis D. Pulmonary function tests

A. Sweat chloride test Rationale: Clients who have cystic fibrosis have an increase of sodium and chloride in both saliva and sweat. Therefore, a sweat chloride test can definitively confirm a diagnosis of cystic fibrosis. A sputum culture determines a specific organism infecting the lungs, but it is not a diagnostic test that determines a diagnosis of cystic fibrosis. A stool fat content analysis determines the amount of fat within a stool, but it is not a diagnostic test that determines a diagnosis of cystic fibrosis. Pulmonary function tests determine the lung capability, but they are not a diagnostic tests that determine a diagnosis of cystic fibrosis.

A nurse is caring for a preschool age child who is dying. Which of the following finding is an age appropriate reaction to death by the child? Select all that apply A. The child view death as similar to sleep B. The child is interested in what happens to the body after death C. The child recognizes the death is permanent D. The child believes his thoughts can cause death E. The child thinks death is a punishment

A. The child view death as similar to sleep D. The child believes his thoughts can cause death E. The child thinks death is a punishment Preschool age children may think of death like sleep. Preschool age should also believe that their thoughts and wishes can make things happen since there are egoticentric. This is part of why death of a family member could be difficult for a child at this age. Finally, prescriade should sometimes believe that death is a result of guilt or a punishment for something they did, said, or thought. A school-age child will be interested in post death services and what happens to the body after death due to an improved ability to comprehend what is happening. Preschool age children have a difficulty understanding the concept of time and are therefore not likely going to believe that death is permanent. Instead they perceive as reversible.

A nurse is preparing to discharge a child who has a new prescription for an oral antibiotic. Which of following information should the nurse include in the discharge instructions? (Select all that apply.) A. The reason why the child is taking the medication B. Written information about the medication C. Stopping the medication when the child feels better D. The adverse effects of the medication E. Using a kitchen spoon to administer the medication

A. The reason why the child is taking the medication B. Written information about the medication D. The adverse effects of the medication Rationale: The reason why the child is taking the medication is correct. The nurse should include the reason why the child is taking the medication in the discharge instructions.Written information about the medication is correct. The nurse should include written information about the medication in the discharge instructions.Stopping the medication when the child feels better is incorrect. The child should finish taking the medication.The adverse effects of the medication is correct. The nurse should include the adverse effects of the medication in the discharge instructions.Using a kitchen spoon to administer the medication is incorrect. A kitchen spoon should not be used to administer the medication.

A hospice nurse is conducting a support group for parents of toddlers who have a terminal illness. Which of the following pieces of information should nursing include and the teaching? A. Toddlers will react to the parents anxiety and sadness B. Toddlers view death as punishment for bad behavior C. Toddlers view death as permanent and irreversible D. Toddlers have a realistic concept of death

A. Toddlers will react to the parents anxiety and sadness The nurse should identify that toddlers have a little understanding of death. Very action Israel related to the changes in routine and the parents emotion. Preschoolers might perceive death as punishment for bad behavior. A recognition of the permanence of death and a realistic concept of death is often not achieved until age 9 or 10.

A nurse is presenting an in-service about the use of postural drainage for infants who have cystic fibrosis. Which of the following positions should the nurse identify as being contraindicated for the infant? A. Trendelenburg B. Sitting on a nurse's lap leaning forward C. Supine D. Sitting on a nurse's lap leaning backward

A. Trendelenburg Rationale:Infants who have cystic fibrosis are placed in various positions to allow gravity to facilitate the removal of tenacious secretions. The nurse should identify the Trendelenburg position (head lower than body) as being contraindicated for the infant because infants do not have autonomic regulation of blood flow to the head. This position is also contraindicated for children who have head injuries. In order to percuss the apical segments of the infant's lungs, the nurse should place the infant in a forward leaning position onto the nurse's lap. All percussion must be done only over the rib cage and it should not cause pain to the infant. Placing the infant on the nurse's lap in a supine position with a small pillow supporting the back assists in draining of the anterior segments of the lungs. The nurse should gently strike the anterior chest wall with a cupped hand or use a percussion cup to loosen secretions. Percussing the middle anterior segments of the infant's lungs is done by placing the infant on the nurse's lap and leaning the infant's body against the nurse. The anterior section of the chest is then percussed.

A nurse is providing teaching about lice to the parents of a school-age child at a well-child visit. Which of the following information should the nurse include in the teaching? A. "Lice can jump from one child to another." B. "Encourage your child to avoid sharing hats with other children." C. "Live lice can survive for 2 weeks away from the host." D. "Washing your child's hair daily will prevent lice."

B. "Encourage your child to avoid sharing hats with other children." Rationale:Lice are transmitted from person to person on personal items, such as hats, hair ornaments, scarves, combs, and brushes.Lice are not able to jump or fly. Live lice can survive for up to 48 hr away from the host. Washing the child's hair daily will not prevent lice. The only way to prevent a lice infestation is to avoid head-to-head contact and the sharing of personal items.

A nurse is teaching an adolescent about managing asthma and using a peak expiratory flow meter. Which of the following statements by the client demonstrates an understanding of the teaching? A. "I will use my peak flow meter whenever I feel short of breath." B. "I will continue to take my medication when my peak flow rate is in the green zone." C. "I need to use the average of 3 reading when I measure my flow rate." D. "My asthma is being controlled if my flow rate is in the yellow zone."

B. "I will continue to take my medication when my peak flow rate is in the green zone." A peak flow rate and the green zone indicates the current treatment has been effective, therefore, the adolescent should continue with their current medication regimen. Feeling short of breath could be a manifestation of an acute attack which would require a rescue medication. You do obtain three readings but you record the highest of the 3 readings rather than the average. Yellow zone indicates inadequate control of asthma.

A nurse is providing discharge teaching to parents who's infant had a ventriculoperitoneal shunt placement for the treatment of hydrocephalus. Which of the following statements by the parents indicates an understanding of the teaching? A. "We will check his abdomen daily for signs of fluid accumulation." B. "We will notify the doctor right away if he has a fever." C. "We should keep a helmet on him when he's awake." D. "We can expect him to have occasional seizure episodes."

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

A nurse is reviewing recommended immunizations with the guardian of a 2 month old infant. Which of the following statements does a nurse make? A. "Your baby can receive a varicella vaccine at 6 months of age." B. "Your baby can start the pneumococcal vaccine now. " C. "Your baby should receive the flu vaccine before 6 months of age." D. "Your baby can start the measles, mumps, and rubella vaccine now."

B. "Your baby can start the pneumococcal vaccine now. " The infant can receive the first dose of the pneumococcal vaccine now, with 2 additional doses at 4 months and 12 months of age. Varicella is not until 1 year of age, flu vaccine cannot start until after 6 mos, and MMR begins at 12 months.

A home health nurse is teaching a child's parents about endotracheal suctioning. Which of the following information should the nurse include in the teaching? A. Apply suction when inserting the catheter B. Apply suction fro less than 10 seconds C. Set suction pressure to 110mm Hg D. Allow child to rest for 10-15 seconds after each suctioning attempt

B. Apply suction fro less than 10 seconds Prolonged suctioning can cause damage to tissue and induce hypoxia

A nurse is caring for a child who has tinea pedis. The child's parent asks the nurse what this infection is commonly called. The nurse should respond with which of the following common names? A. Shingles B. Athlete's foot C. Fever blister D. Valley fever

B. Athlete's foot Rationale:Athlete's foot is the common name for tinea pedis. Shingles is the common name for varicella zoster. Fever blister is the common name for herpes simplex virus type I. Valley fever is the common name for coccidioidomycosis.

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? A. Identity crisis B. Body image changes C. Feelings of displacement D. Loss of privacy

B. Body image changes

A nurse is monitoring an infant who is 3 months old and has sneezing, coughing, nasal congestion, intermittent fever, and apneic spells. These nurse should recognize these findings are associated with which of the following diagnoses? A. Influenza B. Bronchiolitis C. Croup D. Epiglottitis

B. Bronchiolitis Rationale:A client who has bronchiolitis often has sneezing, coughing, nasal congestion, intermittent fever, and in severe cases, apneic spells. Bronchiolitis is also most common in infants between 2 and 12 months of age. A client who has croup typically has stridor (not wheezing) and a barky cough. Croup is often seen in children who are between 6 months to 3 years of age. A client who has influenza typically has a flushed face, high fever with chills, and myalgia. A client who has epiglottitis typically has drooling, agitation, lethargy, no cough, and prefers to sit in the tripod position.

A nurse is providing discharge teaching to the guardian of an adolescent who is postop following a tonsillectomy. Which of the following manifestations should the guardian report to the provider? A. Nasal secretions containing dark brown blood B. Constant clearing of the throat C. Unpleasant odor from the oral cavity D. Temperature of 37.7 Celsius 99.8 Fahrenheit at 48 hour postop

B. Constant clearing of the throat A manifestation of hemorrhage following a tonsillectomy is the constant clearing of blood that is draining in the back of the throat. Therefore, it should be reported to the provider if the adolescent begins constantly clearing the throat following a tonsillectomy. Some secretions can contain old blood. Old blood is a dark brown color, and fresh blood is bright red. Nasal secretions containing dark brown blood should not be reported to provider because this is an expected finding. Unpleasant odor from the oral cavity for several days postop is also an expected manifestation. Low-grade fever for several days is also an expected manifestation.

A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.) A. Symptoms are continuous throughout the day. B. Daytime symptoms occur more than twice a week. C. Nighttime symptoms occur approximately twice a month. D. Minor limitations occur with normal activity. E. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value.

B. Daytime symptoms occur more than twice a week. D. Minor limitations occur with normal activity. E. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value. Rationale: Symptoms are continual throughout the day is incorrect. Continual asthma symptoms throughout the day are seen with severe persistent asthma.Daytime symptoms occur more than twice per week is correct. A child who has mild persistent asthma will typically have daytime symptoms more than twice per week, but not daily.Nighttime symptoms occur approximately twice per month is incorrect. Nighttime symptoms occurring approximately twice per month is typical of intermittent asthma.Minor limitations occur with normal activity is correct. A child who has mild persistent asthma will have some minor limitations with normal daily activities.Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value is correct. A child who has mild persistent asthma will have a PEF greater than or equal to 80% of the predicted value.

A nurse is caring for a child who has autism spectrum disorder. Which of the following findings should the nurse expect? (Select all that apply) A. Short attention span B. Delayed language development C. Spinning a toy repetitively D. Ritualistic behavior E. Consistent limit testing

B. Delayed language development C. Spinning a toy repetitively D. Ritualistic behavior

A nurse is assessing a preschooler who has a recurrent and persistent otitis media. When obtaining the child history from her parent, which of the following questions to the nurse asked? A. Does your child wear a hat outdoors in cold weather? B. Does anyone smoke around or in the same house as your child? C. Have you given your child any aspirin recently? D. Is your child's diet high in gluten?

B. 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 prolong inflammation and impede the drainage from the air. Tightest media is an infection of the middle ear and is not caused by exposure to cold weather. aspirin has some implications for Ray's syndrome if taken during a viral illness, but it does not end itself cause Otitis media. Gluten has some association with a variety of gastrointestinal and allergic disorders, but otitis media.

A nurse is caring for a school-aged child who begins to have a tonic clinic seizure when leaving the bathroom. Which of the following actions should the nurse take first? A. Obtain a portable suction machine and suction tubing B. Ease the child to the floor in Sims position C. Time the length of the seizure D. Notify the child's parents

B. Ease the child to the floor in Sims position The greatest risk to the child is an injury resulting from a fall, therefore, the nurse should first gently ease the child to the floor to decrease the chance of injury and turn the child on the left side to prevent aspiration. All the other actions are correct but they are not priority.

A nurse is providing immediate postop care for a preschooler who's had a tonsillectomy. Which of the following action should the nurse take? A. Offer ice cream or pudding when the child is fully awake B. Eliminate the use of a straw when offering fluids C. Apply heating pad to the neck area D. Instruct the child to blow his nose to clear bloody secretions

B. Eliminate the use of a straw when offering fluids Straws can accidentally enter the surgical site and cause bleeding. There you should be avoided in the immediate postop period. Dairy product should be avoided an immediate postop period because they coat the mouth and throat and induce coughing. Coughing can lead to increased bleeding from Operative site. The nurse should offer an ice cars provide a non-cart Pharma logical pain relief. The pressure from nose blowing can increase bleeding from the surgical site.

A nurse is monitoring a child for manifestations of hemorrhage following a tonsillectomy. Which of the following findings is a manifestation of this postoperative complication? A. Mouth breathing B. Frequent swallowing C. Reports of thirst D. Reports of pain

B. Frequent swallowing Rationale: Frequent swallowing and throat clearing are signs of hemorrhage after a tonsillectomy. Thirst is expected after a tonsillectomy due to fluid restriction. Moderate pain is expected after a tonsillectomy due to the trauma of the surgical procedure. Mouth breathing is common after a tonsillectomy, as there can be secretions and old blood in the nasal passages.

A nurse is assessing a 6-year-old child who began treatment for a pneumococcal pneumonia 4 days ago. Which of the following findings should the nurse identify as an indication that the treatment is effective? A. Dullness with chest percussion B. Heart rate of 118/minute C. Conjunctival discharge D. Respiratory rate of 28/minute

B. Heart rate of 118/minute The nurse should identify that the heart rate of 118/min is within the expected reference range for a 6-year-old child. A child who has an acute pneumococcal pneumonia infection will exhibit tachycardia. Dullness with chest percussion is an indication of consolidation of infection. Conjunctival discharge is a manifestation of allergic rhinitis or conjunctivitis. A respiratory rate of 28/MIN is above the expected range for a six year old. A child with pneumococcal pneumonia will exhibit tachypnea and shallow respirations. 6 yr old 60-110/120 hr, 20-25 resp rate in expected ranges

Hey nurses reviewing the lab report of a toddler hose receiving chemotherapy for leukemia. Which of the following laboratory value should the the air report to the provider? A. Platelets 150,000/mm^3 B. Hgb 6 g/dL C. WBC 6000/mm^3 D. Potassium 4. 5 mEq/L

B. Hgb 6 g/dL The hemoglobin level is below the expected reference rage and is indicative of anemia, therefore, the nursery report this finding to the provider. All the other values are within the expected reference range.

A nurses providing teaching to an adolescent who has scoliosis and a new prescription for a Boston brace. Which of the following responses by the adolescent indicates and understanding of the teaching? A. I can take my brace off to sleep every night at bedtime. B. I can take my brace off for about 1 hour daily to shower. C. I should loosen the straps on my brace if it is rubbing against my skin. D. I should place the pads of the brace against my skin with the T-shirt over them.

B. I can take my brace off for about 1 hour daily to shower. The nurse should instruct the child to wear the brace for 23 hours each day and only to remove it for showering or participating in physical therapy. At night, the child might be prescribed a bending brace that confines to the spine to an over corrected position but will still need to be in a brace. The nurse should instruct the adolescent to avoid loosening the straps of the brace if rubbing occurs because this can decrease compression and contraction. The brace should be worn over and T-shirts prevent the plastic pads from touching the skin and causing breakdown.

A nurse is teaching the parents of a 10-year-old who has iron deficiency anemia. Which of the following statements by a parent indicates an understanding of the teaching? A. I will give my child an iron tablet once each day at bedtime. B. I will administer the iron tablet with orange juice. C. I will encourage my child to take an anti-acid with the iron tablet. D. I will crush the iron tablet prior to giving it to my child.

B. I will administer the iron tablet with orange juice. The intake a citrus juice with the iron will increase the irons absorption. The parents should spread the iron doses throughout the day to prevent gastric upset. Antacids decrease absorption of iron. Crushing the tablet interferes with absorption and distribution.

A nurse is providing teaching about disease management to the parent of a preschooler who has a new diagnosis of asthma. Which of the following parents statements indicates an understanding of the teaching? A. My child should not receive a live virus vaccine B. I will encourage my child to participate in Sports C. I will give my child aspirin when she has a fever D. My child will outgrow asthma by adulthood

B. I will encourage my child to participate in Sports The parents should encourage the child remain physically active because this promotes lung expansion and air exchange. The clients immunization schedule must be kept. Vaccine preventable and illnesses such as influenza and pneumonia can be dangerous for a child with asthma. Parents should not administer aspirin to a child who has asthma due to the risk of Reyes syndrome and increased risk of a hypersensitivity response to aspirin. Approximately 2/3 of children with asthma continue to have manifestations into adulthood.

A nurse is caring for a 4-year-old child who has pneumonia. The child's mother left two hours ago, and he is currently experiencing the separation anxiety stage of despair. Which of the following findings should the nurse expect? A. Crying and screaming B. Inactivity and thumbsucking C. Showing interest in nearby toys D. Attempting to escape and find the parent

B. Inactivity and thumbsucking A child who is sucking his thumb and refusing to eat or drink is displaying manifestations of the second stage of separation anxiety, which is despair. Protest is the first stage of separation anxiety, which includes crying and screaming and attempting to escape and find the parent. Then I'll order attachment is the third stage of separation anxiety, and which the child appears happy and interacts with strangers.

A nurse is assessing an infant following a motor vehicle crash. Which of the following findings should the nurse monitor to identify increased ICP? A. Brisk pupillary reaction to light B. Increased sleeping C. Tachycardia D. Depressed fontanels

B. Increased sleeping Following a head injury, an infants level of consciousness can deteriorate, show signs of excessive sleeping, and eventually go into a coma

A home health nurse is developing a plan of care for a toddler glass hemophilia. Which of the following instructions for the parents should the nurse include in the plan? A. Administer low dose aspirin for pain B. Inspect the toddlers toys for sharp edges C. Perform passive range of motion of the affected joint during a bleeding episode D. Avoid contact with people have respiratory infections

B. Inspect the toddlers toys for sharp edges The nurse should instruct the parents to inspect the toddler toys for sharp edges or parts to decrease the risk of injury and bleeding to the toddler. The nurse should not instruct the parent's administer aspirin or medications that contain aspirin, as this could increase the toddlers risk of bleeding. The nurse should instruct the parents to elevate and rest the toddlers affected joint during bleeding episodes. The risk of infection is a concern for a toddler who has an immunodeficiency disorder, but not hemophilia.

A nurse is caring for a preschool age child who has mucosal ulceration after receiving chemotherapy. Which of the following action should the nurse take? A. Place viscous lidocaine on the child's oral lesions B. Instruct the child to use a soft sponge toothbrush when brushing her teeth C. Encourage the child to rinse her mouth with hydrogen peroxide every 2 to 4 hours D. Give the child lemon glycerin swabs to use after each meal

B. Instruct the child to use a soft sponge toothbrush when brushing her teeth The child should use a soft sponge toothbrush when brushing her teeth because a regular toothbrush may cause further irritation to the mucosal ulcers. Preschool age children should not take the viscous lidocaine because it depresses the gag reflex, increasing the risk of aspiration. Children who have mucosal ulcers should not use hydrogen peroxide as a mouth rents because the drying effects on the mucosa may further ulceration. They also should avoid using lemon glycerin swabs because they are irritating, especially on eroded tissues.

A nurse is admitting a toddler who has respiratory syncytial virus (RSV). Which of the following actions should the nurse take? A. Initiate airborne precautions. B. Keep thermometer in the toddler's room. C. Allow the toddler to play in the common room. D. Place the toddler in a room that has negative air pressure.

B. Keep thermometer in the toddler's room. Rationale: The nurse should keep and use dedicated equipment, such as blood pressure monitor, stethoscope, and thermometer in the client's room to prevent the spread of infection from client to client. The nurse should initiate contact precautions for a toddler who has RSV because the toddler can transmit the disease to others who come in contact with body fluids or contaminated items in the environment. The nurse should minimize the client's movement outside of the room to prevent possible contamination of other children. The nurse should place clients who have an illness that can be transmitted by airborne droplets nuclei smaller than 5 microns, such as rubella and varicella, in a negative air pressure room.

A nurse is caring for an infant who is post following a myelomeningocele repair. Which of the following is the priority action the nurse should take? A. Measure the infants intake and output B. Measure the infants head circumference C. Check the infants lower extremity function D. Monitor the infant blood pressure

B. Measure the infants head circumference Increase head circumference is an indication of the infant is at greater risk of increased intercranial pressure, therefore, measuring the infants head circumference is the priority nursing action. Hydrocephalus can occur as a complication of a myelomeningocele repair and is monitored using head circumference measurements. Measuring the infants intake and output, blood pressure and lower extremity function are all essential component of postop care however not the priority.

A nurse is creating a plan of care for a child has leukopenia secondary to chemotherapy. Which of the following intervention should the nurse include in the plan? A. Maintain the child on bedrest B. Monitor the child for increased temperature C. Administer oxygen to the child D. Monitor the child for bleeding

B. Monitor the child for increased temperature Leukopenia place is a child at risk for infection, therefore, the nurse should monitor the child for a fever. The nurse should maintain bedrest for the child who has decreased RBCs. The nurse administer oxygen to a child has decreased RBCs and low oxygen saturation. The nurse should monitor a child who has a low platelet level for bleeding.

A nurse is providing teaching about balcofen to the guardian of a toddler who has cerebral palsy. Which of the following adverse effects should the nurse include? A. Bradycardia B. Muscle weakness C. Diarrhea D. Dry skin

B. Muscle weakness Muscle weakness, hyportension, constipation, sweating, dizziness, drowsiness and nausea ar e adverse effects of balcofen.

A nurse is caring for a 17 year old client who is experiencing a relapse of leukemia and is refusing treatment. The client's mother insists that the client receive treatment. Which of the following actions should the nurse take? A. Initiative the IV per the patient's request B. Notify the provider of the situation C. Administer a sedative to calm the client D. Offer the client an antiemetic

B. Notify the provider of the situation

A nurse is caring for a client immediately following application of a plaster cast. The nurse should monitor for and report which of the following findings as an indication of compartment syndrome? A. Sensation of heat on the surface of the cast B. Paresthesias of the extremity C. Pruritus of the extremity D. Musty odor noted from cast materials

B. Paresthesias of the extremity The nurse identify Paris DC as a finding of compartment syndrome. Compartments and drum involves the compression of nerves and blood vessels and enclosed space, leading to impaired blood flow and nerd damage. Other findings include numbness, tingling, weakness, and pain that does not respond to medication. 6 Ps ATI pg 172

A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take? A. Obtain a throat culture. B. Place the child in an upright position. C. Transport the child to radiology for a throat xray. D. Visualize the epiglottis with a tongue depressor.

B. Place the child in an upright position. Rationale: Placing the child in an upright position will assist in maintaining a patent airway. The airway of a child who has suspected epiglottitis can become obstructed easily; therefore, transferring the child to radiology for a throat x-ray is not an appropriate action for the nurse to take. Visualizing the epiglottis of a child who has suspected epiglottitis using a tongue depressor can precipitate an obstruction of the airway and should be avoided. Obtaining a throat culture from a child who has suspected epiglottitis can precipitate an obstruction of the airway and should be avoided.

A nurse is admitting a child who has acute lymphocyc leukemia. Which of the following laboratory values should the nurse expect? A. Platelets 500,000 mm^3 B. RBC's 2.5 million/uL C. WBC's 4000/mm^3 D. Hct 60%

B. RBC's 2.5 million/uL An RBC count of 2.5 million is below the expected reference range. A child who has acute lymphocytic leukemia has a low RBC count. A platelet count of 500,000 is above the expected reference range. A child who has acute lymphocytic leukemia would have a low platelet count. WBC count of 4000 is below the expected reference range. A child has acute lymphocytic leukemia has a very high WBC count. Hct level of 60% is above the expected reference range. A child who has acute lymphocytic leukemia has a low Hct level.

A nurse is assessing an 8-month-old infant for cerebral palsy. Which of the following findings is a manifestation of the condition? A. Tracks an object with eyes B. Sits with pillow props C. Smiles when a parent appears D. Uses a pincer grasp to pick up a toy

B. Sits with pillow props Infants who have cerebral palsy require support when sitting up

A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen? A. Take the medication with an aspirin to increase effectiveness B. Take the medication with food C. Taking the maximum dose will offer stroke prevention D. Sustained-release forms may be crushed for easier administration

B. Take the medication with food

A nurse is providing teaching about immunizations to the parents of a severely immunocompromise child who has HIV. Which of the following statements to the nurse include in the teaching? A. Your child's immunizations today will be half doses. B. The pneumococcal and influenza vaccines are recommended for your child. C. Immunizations will be delayed until your child tests HIV negative. D. Your child will need to restart the immunization schedule once your child's lab values are within the reference range.

B. The pneumococcal and influenza vaccines are recommended for your child. Immunization against common childhood illnesses, including influenza a pneumococcal disease, is recommended for all children exposed to an infected with HIV. Half doses of immunization do not provide them in any necessary to protect the child from common childhood illnesses. Delaying immunization places the child at risk for contracting an illness. Immunizations do not need to be restarted once the client is no longer immunocompromise.

A nurse is preparing to teach a parent how to care for a child who has impetigo contagiosa. Which of the following information should the nurse plan to include in the teaching? A. Keep the child on droplet precautions at home B. Wash clothing in hot water. C. Immunize household contacts for the disease. D. Give the child a chlorine bath twice daily.

B. Wash clothing in hot water. Rationale: The nurse should teach the parent to ensure the child changes her clothes every day and to wash all clothing in hot water. There is no vaccination for impetigo contagiosa available. The nurse should teach the parent that a chlorine bath is sometimes given once or twice weekly, but twice daily is too often and can increase skin irritation.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6 F). The nurse suspects mild croup and should recommend which intervention? A. controlling fever with acetaminophen and calling if the cough gets worse during the night. B. provide fluids that the child likes and use comfort measures. C. trying over-the-counter cough medicine and coming to the clinic in the morning if there is no improvement. D. admitting to the hospital and observing for impending epiglottitis.

B. provide fluids that the child likes and use comfort measures. In mild croup, therapeutic interventions include adequate hydration (as long as the child can easily drink) and comfort measures to minimize distress. The child is not exhibiting signs of epiglottitis, the temp is wnl, and the mother should return if the child develops noisy respirations or drooling.

A nurse is providing teaching to a parent of a preschooler who has impetigo. Which of the following statements by the parent indicates an understanding of the teaching? A. "Impetigo is caused by a virus." B. "Impetigo is contagious for 48 hours after vesicles rupture." C. "I will wash my child's clothes in hot water." D. "My child now has immunity against Impetigo."

C. "I will wash my child's clothes in hot water." The parent should wash the child's clothes in hot water to kill bacteria. The parent should also keep the child's towels and washcloths separate from those of other members in the family. Impetigo is a bacterial infection of the skin caused by staphylococci or streptococci bacteria. Impetigo is spread via direct contact and is contagious from the time of initial appearance of lesions until all lesions have healed. Impetigo does not cause the formation of antibodies that prevent re-infection. Therefore the child can get Impetigo again in the future.

A nurse is teaching the mother of a child who has cystic fibrosis and has a prescription for pancreatic enzymes three times per day. Which of the following statements indicates that the mother understands the teaching? A. "My child will take the enzymes to improve her metabolism." B. "My child will take the enzymes following meals." C. "My child will take the enzymes to help digest the fat in foods." = D. "My child will take the enzymes 2 hours before meals."

C. "My child will take the enzymes to help digest the fat in foods." Rationale:Pancreatic enzymes help the body to digest fat in foods. A. "My child will take the enzymes to improve her metabolism." Rationale:Pancreatic enzymes improve the digestive system's ability to breakdown fats; they do not improve metabolism. The child should take pancreatic enzymes prior to ingesting food, not following meals. The child should take pancreatic enzymes immediately before meals.

A nurse is teaching the parents of a child who has cerebral palsy. Which of the following statements should the nurse make? A. "Your child will be able to eat by mouth." B. "Your child will be unable to participate in recreational activities." C. "Your child will need botulinum toxin A injection to reduce muscle spasticity." D. "Your child will need to throw rugs placed over non-carpeted areas."

C. "Your child will need botulinum toxin A injection to reduce muscle spasticity." Children who have cerebral palsy have spasticity in their muscles. The child can receive botulism toxin type A injections into affected muscles, which reduce spasticity. They may eat food by mouth, however, the parents might need to use special feeding techniques. They also are able to participate in recreational activities, many facilities have special activities for children with disabilities. The parents should not use the rugs because children have cerebral palsy have an increased risk of falls.

A nurse is assessing a 1 week old infant at a well child visit. The nurse should notify the provider about which of the following assessment findings? A. A flat, dark pink area between the eyes that blanches. B. An area of deep blue pigmentation over the buttocks. C. A blue coloring of the sclera. D. A patchy, red rash with raised centers.

C. A blue coloring of the sclera. This discoloration is associated with osteogenesis imperfecta, a genetic disorder that results in bone fragility. The nurse should notify the provider of this finding. Flat, dark pink area between the eyes that blanches, is a discoloration known as nervous simplex. It becomes more prominent with crying and the fighting does not require notification to the provider. Deep blue pigmentation over the buttocks is a Mongolian spot and does not require notifying the provider. A patchy red rash with raised centers is known as erythema toxicum or newborn rash. It is benign, and does not require a notify the provider.

A nurse is planning care for a child who has cystic fibrosis and a prescription to receive chest physiotherapy (CPT). Which of the following actions should the nurse plan to take? A. Percuss each lung segment for 15 min. B. Perform CPT immediately after the child eats. C. Administer albuterol prior to CPT. D. Perform vibration during the client's inspirations.

C. Administer albuterol prior to CPT. Rationale:Albuterol is a bronchodilator that relaxes and dilates the airway to promote air exchange. The nurse should administer the medication prior to implementing CPT to improve airway clearance. Albuterol facilitates the removal of the secretions as the chest wall is being percussed. CPT is recommended for conditions that cause atelectasis or increased sputum. The therapy consists of percussion, vibration, and postural drainage. Percussion is the forceful striking of the skin with a cupped hand. Each lung segment should be percussed for 1 to 2 min. The nurse should not perform CPT immediately after the child eats. It is preferable for the nurse to wait 2 hr following a meal. During CPT, the nurse will gently but firmly strike the chest wall with a cupped hand. Often, the child will have an increased cough after CPT. The child is prone to vomiting if CPT is performed immediately after eating. Vibration is performed during expirations to loosen secretions by creating turbulence in the airflow within the lungs.

A nurse is caring for an infant who is breast-fed 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 action should the nurse take? A. Offer the infant water before feedings B. Discontinue amoxicillin C. Administer an anti-fungal medication after feedings D. Give the infant formula instead of breastmilk

C. Administer an anti-fungal medication after feedings The nurse administer an antifungal medication to the infant after feedings to ensure adequate contact time with the oral mucosal and tongue to enhance treatment of the oral candidiasis. The nurse should rinse the infants mouth with water after feedings and prior to the application of the anti-fungal medication. The nurse should identify that oral candidiasis is an adverse effects of antibiotic therapy. The nurse should implement measures to treat the candidiasis rather than discontinue treatment of the respiratory infection. The nurse should identify the need to treat both the infant and the mother for candidiasis simultaneously rather than discontinuing breast-feeding.

A nurse is caring for a child who is postop following a tonsillectomy. Which of the following action should the nurse take? A. Encourage the child to cough frequently to clear congestion from anesthesia B. Placed a heating pad on the child's neck for comfort C. Administer analgesics to the child on a routine schedule throughout the day and night D. Provide the child with ice cream when oral intake is initiated

C. Administer analgesics to the child on a routine schedule throughout the day and night Tuesday is the clients throat following a tonsillectomy, the nurse should administer pain medication routinely. The nurse can provide the medication rectally or intravenously to avoid the oral route. The child should be discouraged from coughing or clearing the throat following a tonsillectomy because these actions can contribute to bleeding. The nurse should offer an ice collar not a heating pad to ease the child's pain. Milk products such as ice cream and pudding are usually avoided because they coat the mouth and throat, causing the child to clear the throat and potentially leading to bleeding. Ice chips and ice pops are usually the first items offered following a tonsillectomy.

A nurse is caring for a four-month-old child who has acute otitis media and a fever of 38.3 C (101 F). Which of the following medication should the nurse administer? A. Diphenhydramine B. Furosemide C. Amoxicillin D. Ibuprofen

C. Amoxicillin A child who has acute otitis media should take an antibiotic to help alleviate infection. Diphenhydramine is an antihistamine used for allergic reactions. Furosemide is a diuretic used to decrease edema. Children who are younger than 6 months old should not take ibuprofen. Acetaminophen is the preferred choice for children at this age.

A nurse is caring for a child who has a tracheostomy. After suctioning the trach, the nurse should use which of the following findings to determine that the procedure was effective? A. Increased respiratory rate B. Stable oxygen saturation C. Clear breath sounds D. Brisk capillary refill

C. Clear breath sounds Indicates that there are no remaining secretions obstructing the airway

A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following findings indicates that the treatment has been effective? A. Barking cough B. Improved hydration C. Decreased stridor D. Decreased temperature

C. Decreased stridor Rationale:Laryngotracheobronchitis, or croup, is a condition caused by an infection of the upper airway (larynx, trachea, and bronchus) and is characterized by a barking cough. Edema and obstruction in the upper airways cause the characteristic cough and stridor (noisy breathing). The direct purpose of a cool mist tent is to humidify the inspired air, which decreases respiratory effort. A decrease in the child's temperature does not indicate the effectiveness of the treatment. Improved hydration is not a purpose of a cool mist treatment. A barking cough is a manifestation of the disease, nor an indication of the treatments' effectiveness.

A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. Which of the following findings should alert the nurse to the possibility of epiglottitis? A. Lethargic B. Spontaneous coughing C. Drooling D. Hoarseness

C. Drooling Epiglottis is a disorder caused by the inflammation of the epiglottis. It results in rapid swelling of the epiglottis, which can obstruct breathing. Drooling is an expected finding due to the toddlers inability to swallow saliva. A toddler who has epiglottis is restless and appears anxious rather than lethargic, they would also present with an absence of spontaneous coughing due to the inflammation of the epiglottis. Hoarseness would be present in a toddler who has acute spasmodic laryngitis rather than epiglottis.

A nurse is caring for an 8-year-old child who has sickle cell anemia. Which of the following action should the nurse take? A. Apply cold compresses to the painful area B. Initiate contact isolation precautions C. Give the child flavored Popsicles D. Administer phytonadione

C. Give the child flavored Popsicles Maintaining hydration with a child who has sickle cell anemia is important to prevent sickling. Children often accept flavored Popsicles as a source of fluid. Cool compresses cause vasoconstriction it might prompt further occlusions. A child who has an infection transmitted by direct contact such as C. Diff requires contact precautions, not sickle cell anemia. A client who has a warfarin overdose should receive phytonadione. A child who has sickle cell anemia should not receive a warfarin antidote.

A nurse is preparing to administer recommended immunizations to 2-month-old infant. Which of the following immunizations to the nurse plan to administer? A. HPV and Hep A B. MMR and TDaP C. Hib and IPV D. Varicella and live attenuated influenza vaccine (LAIV)

C. Hib and IPV Hib series consists of 3-4 doses at 2 mos, 4 mos, 12-15 mos and IPV is 4 doses at 2 mos, 4 mos, 18 mos, and 4-6 yrs old HPV happens between 9-11 yrs of age and Hep A starts at 12 mos. MMR starts 12-15 mos and TDaP starts 11-12 yrs. Varicella is not administered under the age of 12 mos and LAIV under the age of 2 yrs

A nurse is providing discharge teaching for the parent of a newborn who is prescribed a Pavlik harness for developmental dysplasia of the hip. Which of the following responses indicates an understanding of the teaching? A. I should apply powder to the folds of the skin on my babies knees and thighs. B. I should adjust the straps on the harness once a week as my baby grows. C. I should lightly massage my baby underneath the straps once a day. D. I should place my baby's diaper over the straps of the harness.

C. I should lightly massage my baby underneath the straps once a day. The parents should lightly massage the skin under the harness daily de circulation. The parent should avoid using powders and lotions because they can accumulate in the skin bolds and cause irritation. The parent should never adjust the length of the straps on the harness. This drop should only be adjusted by provider. The diaper should be placed under the harness to maintain cleanliness.

B A nurse is providing discharge teaching to the parent of a school-aged child who has leukemia and is receiving chemotherapy. Which of the following statements by the parent indicates an understanding of the teaching? A. I will take my child's rectal temperature daily B. I will make sure my child gets his MMR vaccine this week. C. I will inspect my child mouth every day for sores D. I will allow my child to ride his bicycle tomorrow

C. I will inspect my child mouth every day for sores A child who has leukemia is at an increased risk of mucositis, therefore, the parent should inspect the child's mouth daily for lesions or alterations. The parent should avoid taking rectal temperatures to prevent trauma to the child. A child who has leukemia will have a compromised immune system and should not receive the MMR vaccine. The nurse should advise the parents to avoid any activities that can cause injury or bleeding, such as riding bicycles or climbing on playground equipment.

The nurse is assessing a 24 month old toddler who has a new diagnosis of autism spectrum disorder (ASD). Which of the following findings should the nurse expect? A. Wanting to be held frequently B. Ability to build a tower of 10 cubes C. Impaired language skills D. Ability to stand on 1 foot

C. Impaired language skills The nurse should expect a 24 month old toddler who has ASD to exhibit impaired language skills, such as, failing to respond to his or her name or pointing to objects instead of speaking. Physical contact and being held will often upset children with ASD. The nurse would expect a toddler with ASD to avoid physical touch. The nurse should identify that building a tower of 10 cubes or standing on 1 foot for a few seconds are expected findings of a 3-year-old preschooler.

A nurse is planning care for a child who has mumps. Which of the following instructions should the nurse include in the plan? A. Initiate standard precautions. B. Initiate airborne precautions. C. Initiate droplet precautions. D. Initiate contact precautions.

C. Initiate droplet precautions. Rationale: Mumps is a contagious infection transmitted by large droplets. Therefore, initiating droplet precautions is appropriate for the nurse to include in the plan of care.

A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following intervention should the nurse include in the plan? A. Apply cold compresses to the child's extremities B. Administer meperidine every 4 hours until the crisis has resolved C. Maintain the child on bedrest D. Decrease the child's fluid intake for 8 hours

C. Maintain the child on bedrest The nurse should maintain bed rest for the child who is experiencing a vaso-occlusive crisis to minimize energy expenditure and avoid additional oxygen needs. Cold compresses are contraindicated because they can enhance sickling and vasoconstriction. Meperidine is not recommended because a central nervous system stimulant can produce anxiety, tremors, and generalized seizures. A child who has sickle cell anemia and is in a vaso-occlusive crisis requires increase fluid intake to prevent sickling.

A nurse is caring for a preschooler who is immediately postop following the removal of a brainstem tumor. Which of the following action should the nurse take? A. Have a child deep breathe and cough every hour B. Offer the child clear liquids four hours after the procedure C. Monitor the child's temperature every 30 minutes D. Placed the child in Trendelenburg position

C. Monitor the child's temperature every 30 minutes The nurse should monitor the child's temperature every 15 to 30 minutes. Surgery on the brainstem can cause hyperthermia. The nurse should have the child avoid coughing because that can increase ICP. The nurse should not offer the child clear liquids for at least 24 hours following the procedure. The gag and swallow reflexes are frequently depressed, increasing the risk of aspiration. The nurse should not place the child in the Trendelenburg position because it increases ICP and raises the risk of postop hemorrhage.

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching? A. Monitor your child's temperature daily B. Restrict outdoor play activity to 1 hour per day C. Offer fluids to your child multiple times every day D. Apply cold compresses when your child expresses pain

C. Offer fluids to your child multiple times every day Preventing dehydration is an important step in preventing sickle cell crisis. Nurse should provide parents with a specific fluid goal each day

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? A. High Fever B. Bradycardia C. Pain D. Constipation

C. Pain A patient who is in sickle cell crisis has severe pain resulting from tissue hypoxia and necrosis

A nurse is planning care for an infant with an unrepaired myelomeningocele. Which of the following actions should the nurse take? A. Fasten the diaper loosely B. Cleanse the meningeal sac with providing-iodine daily C. Palpate the abdomen for bladder distention D. Cover the sac with a dry, sterile gauze dressing

C. Palpate the abdomen for bladder distention A neurogenic bladder is a common complication of a Myelomeningocele. Even if the infant is having wet diapers, the nurse should assess for bladder distention due to the possibility of incomplete emptying of the bladder. The nurse should not place a diaper on the infant until after the defect has been repaired and healed due to the risk of tearing the sac. The nurse should place padding under the infant to absorb urine and stool and provide frequent skin care. Povidone iodine is neurotoxic and should not come in contact with a spinal malformation. The nurse should keep the sac from drying by applying sterile non-adherent dressing's moisten with 0.9% sodium chloride every 2 to 4 hours. A dry dressing might stick to the sack and cause tearing.

A nurse is caring for an infant who is preop for the treatment of an intact myelomeningocele sac. In which of the following position should the nurse place the infant? A. Side lying B. Supine C. Prone D. Semi Fowler's

C. Prone The position reduces pressure and the risk of trauma to the sac and is the appropriate position preop.

A nurse is admitting a child has Wilms tumor. Which of the following action should the nurse take? A. Initiate contact precautions for the child. B. Explain to the child's parents that chemotherapy will start three months after surgery. C. Put a "no abdominal palpation" sign over the child's bed. D. Prepare the child for a spinal tap

C. Put a "no abdominal palpation" sign over the child's bed. The nurse should place a sign over the child's bed stating "no abdominal palpation" because palpation is not necessary to confirm diagnosis and could prompt metastasis. Contact precautions are indicated for children or suspected to have illnesses transmitted by client contact or contact with items in the clients environment. Radiology and chemotherapy are begun immediately following surgery. A spinal tap is a diagnostic test that provides samples of spinal fluid to confirm infection or abnormal cells.

A nurse is caring for a newborn who has spina bifida. The newborns parents are upset by the diagnosis. Which of the following action should the nurse take? A. Discuss placement options for the newborn B. Encourage the parents to touch and care for the newborn C. Reassure the parents that everything will be fine D. Avoid talking about the newborns defect until the parents bring up the subject

C. Reassure the parents that everything will be fine

A nurse is providing teaching to a parent of a child who has acute group A ß-hemolytic streptococci. Which of the following information should the nurse include in the teaching? A. Avoid the use of warm compresses around the head or neck. B. Intramuscular injections will be required monthly. C. Replace the child's toothbrush after 24 hr on antibiotics. D. Keep the child home from school for at least 1 week.

C. Replace the child's toothbrush after 24 hr on antibiotics. Rationale: The child's toothbrush should be replaced after 24 hr on antibiotics to prevent the spread of infection or re-infection. After taking antibiotics for 24 hr and remaining free of fever, the child can return to school. Both warm and cold compresses can provide pain relief and should not be avoided. Monthly intramuscular injections are not required for an acute group A ß-hemolytic streptococci infection.

.A school nurse conducting a screening for pediculosis capitis identifies several children who require treatment. Which of the following instructions should the nurse give the children's parents? A. Soak all combs and hairbrushes in alcohol. B. Inspect any dogs or cats at home for lice. C. Seal nonwashable items in airtight plastic bags. D. Spray countertops and sinks with insecticide.

C. Seal nonwashable items in airtight plastic bags. Parents should seal items they cannot wash, vacuum, or dry clean in airtight plastic bags for 14 days to kill any lice on them. Parents should soak all combs, brushes, and hair clips in a commercial pediculicide (lice-killing product) for 1 hr or in boiling water for 10 min. Pets do not carry or transmit lice. Parents should not spray insecticides in the home because they can pose a hazard to children and pets. Cleaning hard surfaces with household cleaners or disinfectants is appropriate.

A nurse is caring for a 1-year-old infant who has chronic Otitis media. The nurse should identify that which of the following areas is at risk for a delay in development? A. Find motor skills B. Visual acuity C. Speech patterns D. Hand to eye coordination

C. Speech patterns Speech patterns are developed through auditory experiences. Chronic otitis media is a common cause of hearing impairment, which can delay the development of speech. Besides communication difficulties, complications of otitis media includes meningitis, labyrinthitis , and other various types of abscesses and thromboses. However it does not generally affect fine motor skill development, visual acuity, or hand to eye coordination.

A nurse is assessing a preschooler who has influenza and reports the new onset of a sore throat and difficulty swallowing. Which of the following findings as a priority for the nurse to report to the provider? A. The child's temperature is 39C (102F) B. The child skin is sallow C. The child is drooling D. The child's voice is hoarse

C. The child is drooling When using the urgent versus not urgent approach to client care, the nurse should determine the presence of drooling is the priority finding because it can indicate the child might have to develop epiglottis, a medical emergency. Left untreated, the child can develop a complete respiratory obstruction. Sallow skin is an expected finding in a child who is ill. Elevated temperature is an expected finding for a child with influenza. Hoarse voice is also an expected finding for a child who has a sore throat.

A nurse is providing teaching to the parent of a toddler who's undergoing insertion of tympanostomy tubes. Which of the following statements to the nurse include? A. The doctor will replace the tubes routinely about every two years. B. If your child gets water in her ears, it will not cause any further problems. C. The tubes should stay in place until they fall out on their own. D. Now that the tubes are in place, she should not have any further problems hearing.

C. The tubes should stay in place until they fall out on their own. Tympanostomy tubes allow drainage from and ventilation to the middle ear. They usually fall out on their own within 6 to 12 months after insertion. Most children do not need tubes for longer than 1 year. When the tubes are in place, the child should wear earplugs whenever there's a possibility of getting contaminated or soapy water inside her ears. Hearing impairment is common with recurrent otitis media and can continue after the tubes are in place.

Nurses creating a plan of care for an 18 month old toddler who has cerebral palsy. Which of the following intervention should the nurse include? A. Use a mobile walker for the toddler B. Discourage activities involving repetitive joint movement C. Use manual jaw control when feeding the toddler D. Discouraged the use of wrist splits

C. Use manual jaw control when feeding the toddler The nurse should encourage the parent to include the use of manual jaw control during feedings. Children diagnosed with cerebral palsy can lose jaw control, and more effective control can be achieved by providing stability to the jaws during feeding.

A nurse is preparing to administer a vaccine to a 4-year-old child. Which of the following vaccines should the nurse administer? A. Haemophilus influenza type b (Hib) B. Hepatitis B (HepB) C. Varicella (VAR) D. Meningococcal (MCV4)

C. Varicella (VAR) Rationale: The child should have received the first dose between 12 to 15 months of age. The child should then receive a second dose between 4 and 6 years of age. The child should have received the initial dose by age 6 months and a booster dose between 12 and 15 months of age. The child should have received the first dose of the HepB vaccine at birth before going home from the hospital. The child should have received subsequent doses between 1 and 2 months, and the final dose between 6 and 18 months of age. The child should receive the MCV4 vaccine between 11 and 12 years of age.

A nurses is providing teaching to the family of a child has autism spectrum disorder. Which of the following statements indicates the family understands the teaching? A. Donepezil might slow the progression of the disorder. B. My child would prefer a group therapy with other children. C. We can help our child by structuring our daily routine. D. Our child probably has this condition as a result of prematurity.

C. We can help our child by structuring our daily routine. Children have autism spectrum disorder benefit from structured routine. This environment can minimize anxiety the child might have with sudden schedule changes and socialization requirements and satisfy a preference for ritualistic behavior. Donepezil might slow progression of early onset Alzheimer's but not autism spectrum disorder. Children with ASD have limited interests in others and might struggle with interpersonal interactions. Individual therapy is usually preferred. No evidence autism is caused by prematurity.

A nurse in a PACU is admitting a client who is postoperative following a tonsillectomy. Which of the following actions should the nurse plan to take to prevent aspiration? A. Place a bedside humidifier at the head of the client's bed. B. Suction the nasopharynx as needed. C. Withhold fluids until the client demonstrates a gag reflex. D. Perform chest physiotherapy.

C. Withhold fluids until the client demonstrates a gag reflex. Rationale: Following a tonsillectomy, the client's gag reflex can be suppressed by local anesthetics or edema. To prevent aspiration, the gag reflex must be present before the client is allowed have fluids. The purpose of chest physiotherapy is to loosen secretions in the airways; it does not prevent aspiration. A. Place a bedside humidifier at the head of the client's bed. Rationale: This action does not prevent aspiration. B. Suction the nasopharynx as needed. -This action can cause trauma to the denuded tonsil sockets, leading to hemorrhage. Although suction equipment should always be available at the client's bedside in case of hemorrhage or aspiration, it should only be used in an emergency and in the presence of the provider.

A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care? A. Keep the head of the bed at a 30 degree angle B. Reposition the client by log rolling every 4 hr C. Place the client in protective isolation D. Initiative the use of PCA pump for pain control

D. Initiative the use of PCA pump for pain control

A nurse is providing education to a school-age child who has a new diagnosis of asthma. Which of the following statements should the nurse include in the teaching? A. "Take cromolyn sodium at the first sign of breathing difficulty." B. "You should stop playing basketball, but you can swim instead." C. "Use the peak expiratory flow meter once per week." D. "Avoid triggers that cause an attack."

D. "Avoid triggers that cause an attack." Rationale: The nurse should emphasize that the ability to prevent asthma attacks can be improved by avoiding allergens that the child is sensitive to. Triggers can include animals, dust, certain foods, pollen, and grass. Clients who have asthma manifestations throughout the year should receive allergy testing to determine specific triggers. Cromolyn sodium is a mast cell stabilizer that is used for long-term management of asthma. It should not be used as a rescue medication. The child should use a rescue medication, such as albuterol, at the first sign of an asthma attack. Although swimming is an excellent activity for children who have asthma, participation in other sports activities is not prohibited when asthma is adequately controlled. The peak expiratory flow meter measures the amount of air that the child can be expel over a short amount of time and is an indicator of worsening conditions. The child should use the peak expiratory flow meter once or twice per day.

A nurse is teaching an adolescent who has asthma about how to use a peak expiratory flow meter(PEFM). Which of the following responses by the adolescent indicates an understanding of the teaching? A. "I will breathe in through the mouth piece, hold my breath for 5 sec, and then exhale." B. "If I get a reading in the green zone, I will tell my parents to call the provider." C. "I will slowly exhale through the mouthpiece over a 10 sec interval." D. "I will record the highest reading of three attempts."

D. "I will record the highest reading of three attempts." After establishing a personal best, the client should routinely check the PEFM by performing 3 attempts and recording the highest of the 3. The client would take a deep breath, place lips around mouthpiece, and then blow in to mouthpiece as hard and as fast as possible.

A nurse is providing teaching about home carry to the guardian of a school-age child who has seizures. Which of the following statements by the guardian indicates an understanding of the teaching? A. "I will call an ambulance at my child's seizure last more than 10 minutes." B. "I will offer my child clear liquids immediately following the seizure." C. "I will tightly hold my child to restraint her during the seizure." D. "I will turn my child onto her side when a seizure begins."

D. "I will turn my child onto her side when a seizure begins." Reduces risk of aspiration

A nurse is providing teaching to the parents of a child who has streptococcal pharyngitis about ways to prevent disease transmission. Which of the following responses by the parents indicates an understanding of the teaching? A. "We'll continue to encourage him to drink lots of fluids." B. "We'll take his temperature every 4 hours." C. "We'll give him Tylenol for the pain." Rationale: D. "We'll discard his toothbrush and buy another."

D. "We'll discard his toothbrush and buy another." Rationale: Children who have positive throat cultures for streptococcal infection should replace their toothbrush after they have been taking antibiotics for 24 hr. Using a contaminated toothbrush can re-introduce the bacteria and spread it to others if others handle the toothbrush. The child should drink plenty of fluids, but this will not prevent transmission of the infection. Monitoring the child's temperature will not prevent transmission of the infection. The parents can give the child acetaminophen for pain and fever, but this will not prevent transmission of the infection.

A nurse is caring for a toddler who has otitis media and a temperature of 39.1 C1 102.4 F. Which of the following action should the nurse take first? A. Reduce the temperature of the child's room B. Redress the child in minimal clothing C. Apply cold compresses to the child's forehead D. Administer an antipyretic to the child

D. Administer an antipyretic to the child When using the urgent versus non-urgent approach to client care, the nurse should first administer an anti-pyretic to decrease the toddlers body temperature. Reducing the room temperature, redressing the child in minimal clothing, and applying cold compresses are all effective methods of reducing the toddlers temperature when implemented about an hour after the administration of an anti-pyretic. However the antipyretic is first.

A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse expect to administer first? A. Fluticasone B. Budesonide C. Montelukast D. Albuterol

D. Albuterol Rationale:Albuterol is considered a "rescue" medication due to its rapid onset of action. Asthma is a chronic inflammatory disorder of the airways. Asthmatic episodes are associated with airflow limitation or reversible obstruction. Albuterol is a beta2 adrenergic agonist used for the treatment of acute exacerbations of asthma by promoting bronchodilation and suppressing histamine release in the lungs. This medication can be given by inhalation, orally, or as a parenteral preparation. The inhaled medication has a more rapid onset of action than the oral form and also reduces the risk for the adverse effects of irritability, tremor, nervousness, and insomnia. Fluticasone is a glucocorticoid used for long-term control and prophylaxis of chronic asthma. It is not considered a "rescue" medication. Budesonide is a glucocorticoid used for long-term control and prophylaxis of chronic asthma. It is not considered a "rescue'" medication. Montelukast should not be used for quick relief of an asthma attack because its therapeutic effects develop too slowly. Montelukast is the most commonly prescribed leukotriene modifier, used as prophylaxis and maintenance therapy for asthma and as a preventative for exercise-induced bronchospasm. It is not considered a "rescue" medication.

A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development? A. The colorful latex balloons to the side of the crib B. Provide a small electronic toy C. Change the infant's diaper as as soiling occurs D. Allow the infant to stand in the crib

D. Allow the infant to stand in the crib Child should participate in regular developmental activities

A nurse is caring for a school-age child who has hemophilia and fell on the playground. The child reports pain level of 4 on a scale of 0-10. Which of the following action should the nurse take? A. Administer an NSAID B. Perform passive range of motion exercises on the joint C. Administer cryoprecitate D. Apply an ice pack to the joint

D. Apply an ice pack to the joint RICE!****Immediately following an injury, a joint should be rested, elevated, and have ice applied to minimize bleeding into the joint. The nurse should avoid giving clients with hemophilia aspirin or NSAIDs because these medication's can interfere with the action of platelets. Passive range of motion exercises should never be performed on a client with hemophilia. Overstretching and tearing could inadvertently occur, resulting in further joint bleeding. Cryoprecipitate is no longer used to treat clients with hemophilia due to the inability to remove hepatitis and HIV completely from the product. Hemophilia is currently treated with factor VIII replacement products or a synthetic form of vasopressin.

A nurse is planning care for a 6 yr old child who is receiving chemotherapy. The child has a highlight platelet count of 20,000/mm^3. Based on this laboratory value, which of the following interventions should the nurse include in the plan of care? A. Provide foods high in iron B. Avoid people who have infections C. Administer PRN oxygen D. Encourage quiet play

D. Encourage quiet play A platelet count of 20,000/mm^3 will predispose the client to excessive bleeding. Quiet play will lessen the clients risk of injury, thereby reducing the chance of hemorrhage. The priority is preventing bleeding. Iron is given to a child who has anemia. A platelet count of 20,000/MM3 is not an indication of an anemic condition. Platelets are the blood component associated with clotting. RBCs are the blood component responsible for carrying oxygen to body tissues.

A nurse is caring for a child who is in skeletal traction. Which of the following actions is a nurses priority? A. Perform passive range of motion for unaffected joints B. Massage the child's pressure areas C. Increase the child fluid intake D. Encourage the child to use an incentive sperometer.

D. Encourage the child to use an incentive sperometer. ABCs! Encouraging the child to use an incentive spermeter will promote adequate oxygenation and is the priority nursing action. Circulation is the third highest priority because the delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of effectiently caring oxygen to them. The other actions are all correct but this is the priority.

A nurse on a pediatric unit is caring for a child wise autism spectrum disorder. Which of the following action should the nurse take? A. Provide activities to stimulate the child's interest in the environment B. Make frequent eye contact when talking to the child C. Offer the child choices when scheduling planned care D. Ensure that staff visits with the child are kept short

D. Ensure that staff visits with the child are kept short Children who have ASD have difficulty adjusting to new situations. The staff members should keep interactions with the child as brief as possible. The nurse should assign this child to a private room with decreased auditory and visual stimulation to assist the child adaptation. Children with ASD prefer minimal physical contact. The nurse should refrain from holding a restraining the child and should reduce eye contact as much as possible to prevent outbursts. Children with ASD have difficulty redirecting their focus and changing activities. The nurse should clearly state expectations and instructions at the appropriate developmental level and should not provide choices about scheduling planned care.

A nurse is assessing pain and a three-year-old child following a tonsillectomy. Which of the following rating scales should the nurse use to determine the child's pain level? A. Word graphic rating scale B. Color tool C. Numeric pain scale D. Faces Rating Scale

D. Faces rating scale The nurse should use the faces rating scale to assess this child's pain level. The scale is appropriate for a three year old and provides a series of facial expressions representing the amounts of pain. Word graphic rating scale is used to measure pain in children who are 4 to 17 years old and the color tool is used for children as young as 4 who know how to recognize colors and the numeric scale is used for children who understand numbers typically age 5 and older.

a nurse is providing teaching to a 17 year old female client who has severe acne about the use of isotretinoin. which of the following adverse effects should the nurse instruct the client is the priority to report to the provider? A. Frequent nosebleeds B. Itching of skin C. Back pain D. Feelings of isolation

D. Feelings of isolation

A nurse is providing teaching to a parent of a preschooler who has tinea capitis. Which of the following instructions to the nurse include in the teaching? A. Apply aluminum acetate solution compresses to the lesions B. Apply hydrocortisone cream to the lesions twice daily C. Seal non-washable toys in a plastic bag for 2 weeks D. Leave the medicated shampoo on the scalp for 5 to 10 minutes

D. Leave the medicated shampoo on the scalp for 5 to 10 minutes The nurse should instruct the patient to use a shampoo made of 2% ketoconazole or 1% selenium sulfide for the treatment of tinea capitis. For the shampoo to be affective, the parent should leave it on the child scout for 5 to 10 minutes prior to rinsing. Aluminum acetate solution compresses are useful in the treatment of lesions caused by herpes simplex virus type 1 or for tinea pedis. Tinea infections are caused by fungi and require anti-fungal treatment and medication's. Sealing non-washable toys in a plastic bag for 2 weeks for the treatment of pediculosis or head lice

A nurse is caring for an infant who has pertestssis. Which of the following actions should the nurse take? A. Assess for edema of the extremities B. Apply warm compresses to the neck area C. Initiate airborne precautions D. Maintain a cardiorespiratory monitor

D. Maintain a cardiorespiratory monitor Infants with pertussis typically present with apnea and response to coughing spasms and mucus plugs. Humidified oxygen and suction equipment should be used as needed. Infants who have pertussis are at risk for volume fluid deficit due to frequent vomiting. Pertussis is not airborne precautions, it is droplet. A warm compress to the neck area would be more therapeutic for a child who has the mumps infection due to enlarged painful parotid glands.

A home health nurse is developing a place of care for a child who has hemiplegic cerebral palsy. Which of the following foals is the priority for the nurse to include in the plan of care? A. Provide respite services for the parents B. Improve the client's communication skills C. Foster self-care activities D. Modify the environment

D. Modify the environment

A nurse is caring for a pre-school age child who has epiglottitis with a barking cough. Which of the following actions should the nurse take? A. Initiate airborne precautions. B. Obtain a throat culture. C. Use a tongue depressor to observe the epiglottis. D. Monitor oxygen saturation.

D. Monitor oxygen saturation. Rationale: The nurse should monitor the child's oxygen saturation levels to check for indications of respiratory distress or a decline child's condition. The nurse should implement and maintain droplet precautions for 24 hr after a child who has epiglottitis begins antibiotic therapy. Attempting to obtain a throat culture can cause an airway obstruction. Using a tongue depressor to observe the epiglottis can cause an airway obstruction.

A nurse is caring for a pre-school age child who has epiglottitis with a barking cough. Which of the following actions should the nurse take? A. Initiate airborne precautions. B. Obtain a throat culture. C. Use a tongue depressor to observe the epiglottis. D. Monitor oxygen saturation.

D. Monitor oxygen saturation. Rationale: The nurse should monitor the child's oxygen saturation levels to check for indications of respiratory distress or a decline child's condition.The nurse should implement and maintain droplet precautions for 24 hr after a child who has epiglottitis begins antibiotic therapy. Attempting to obtain a throat culture can cause an airway obstruction. Using a tongue depressor to observe the epiglottis can cause an airway obstruction.

A nurse is caring for a toddler who has a fever, a high pitched cry, irritability, and vomiting. Which of the following actions should the nurse take? A. Administer 81 mg of aspirin to the toddler B. Give the toddler a cold bath C. Place the toddler in a supine position D. Pad the rails of the toddler's bed

D. Pad the rails of the toddler's bed When caring for a toddler who has manifestations of bacterial meningitis, the nurse should implement seizure precautions, which includes padding the rails. Acetaminophen for fever and avoid cold baths.Keep head of bed slightly elevated to decrease intracranial pressure.

A nurse is teaching a group of parents and guardians about otitis media. Which of the following should the nurse identify as a risk factor for this illness? A. Summer months B. Breast-feeding C. Ages 7 to 10 years D. Passive smoking

D. Passive smoking The nurse should identify passive smoking as a risk factor for otitis media. Exposure to secondhand smoke promotes the attachment of pathogens to the middle ear, extend the inflammatory response, and impairs drainage through the Eustachian tube. Each of these effects increase the risk for development of otitis media. Winter and spring months, bottle feeing and ages 2-6 are risk factors.

I nurses is caring for a 5-year-old child who has a fever and begins to have a seizure. Which of the following actions should the nurse take? A. Give us acetaminophen 240 mg PO immediately following the seizure B. Sponge the child skin with a mixture of cold water and rubbing alcohol C. Administer rectal diazepam if the seizure lasts longer than 2 minutes D. Place the child and a side-lying position

D. Place the child and a side-lying position The nurse should place the child and a side lying position to facilitate drainage of oral secretions, which decrease the risk of aspiration. The nurse should not administer oral acetaminophen during the postictal phase of seizure because the child could aspirate the medication. The nurse should administer rectal diazepam if the seizure last longer than five minutes. The nurse should not sponge the child's skin with cold water or rubbing alcohol because this can cause shivering, which will further increase the body's temperature.

A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority? A. Prepare the child for a lumbar puncture B. Administer an intravenous antibiotic C. Obtain blood cultures D. Place the child in isolation

D. Place the child in isolation

The nurse is caring for a school age child who has skeletal traction apply to repair a pelvic fracture. Which of the following action should the nurse take? A. Rest the child's traction weights on the floor for 8 hours during the night B. Ensure the child's meal tray contains no high-fiber foods C. Performed passive range of motion exercises on the child's involved joints every 4 hours D. Place the child on a pressure reduction mattress

D. Place the child on a pressure reduction mattress Placing the child on a pressure reduction mattress will alleviate the pressure on bony prominences, which decreases the risk of skin breakdown. The nurse should not release or lift weights that are applying the traction for any reason. If an issue should arise in which the weights require adjustment, the nurse should contact provider or the physical therapist. The immobility associated with traction causes constipation. Therefore the nurse should promote an intake of a high fiber diet. The body should be maintained in correct alignment, and the joints should be kept at an angle set by the provider and physical therapist that is dependent on the child's injuries. Performing passive range of motion exercises on the child's involved joints could cause further injury to the extremities. However, active and passive range of motion exercises should be performed on uninvolved joints.

A nurse in an emergency department is assessing a 3-year-old child who has a high fever, severe dyspnea, and is drooling. Which of the following actions is the nurse's priority? A. Insert an IV catheter. B. Obtain blood culture specimens. C. Administer an antipyretic. D. Prepare for nasotracheal intubation.

D. Prepare for nasotracheal intubation. Rationale: The client's manifestations suggest epiglottitis, which is a respiratory emergency. Airway obstruction is imminent, and that is the greatest risk to the client's safety at this time, so the priority action is to prepare for intubation to maintain airway patency. The client will require IV access to administer fluids, but this is not the priority action. The client will require culture and sensitivity testing, but this is not the priority action. The client will require antipyretics, but this is not the priority action.

A nurse is preparing to administer immunizations to a 4 month old infant. Which of the following actions should the nurse take to provide atraumatic care? A. Administer 81 mg of aspirin B. Use the Z-track method when injecting C. Ask the parents to leave the room during the injection D. Provide sucrose solution on the pacifier

D. Provide sucrose solution on the pacifier Allow an infant to suck on a pacifier with sucrose solution can decrease pain with immunization and is an appropriate action. Aspirin can result in Reyes syndrome. Ztrack is not recommended.

A nurse suspects that a client admitted for treatment of bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse supports this suspicion? A. Photophobia B. Nuchal rigidity C. Positive Kernig's sign D. Restlessness

D. Restlessness Photophobia, nuchal rigidity and a positive kernig sign are all expected findings with bacterial meningitis. Restlessness is a sign of ICP.

A nurse in an emergency department is assessing a school age child who is experiencing an acute asthma exacerbation. Which of the following findings as a priority for the nurse to report to the provider? A. Excessively prolonged expiration B. Increased diaphoresis C. Increased production of frothy sputum D. Sudden decrease in wheezing

D. Sudden decrease in wheezing A sudden decrease and wheezing can indicate that the child is experiencing decreased air movement and should be reported to the provider. The nurse also can refer to Maslow's hierarchy of needs, the ABC priority setting framework, and or nursing also identify which finding is most urgent. A sudden decrease in wheezing a.k.a. silent chest indicates mental Atori failure and eminent respiratory arrest. The other options should be reported to the provider but this is the priority.

A nurse in the ER is caring for an 8 yr old who is up to date on immunizations and has a deep puncture injury. Which of the following should the nurse anticipate administering? A. DTaP B. TIG w/ DT C. Tdap D. Td (adult tetanus booster)

D. Td (tetanus booster) Td is recommended for wound prophylaxis in children over at 7 and also recommended every 10 yrs after age 18. DTaP and Tdap are not recommended for wound prophylaxis. TIG and DT may be given for wound prophylaxis but DT is for children under the age of 7.

A nurse on a pediatric unit has just received reports for four newly admitted clients. For which of the following children should the nurse plan to initiate droplet precautions? A. The child who has Rocky Mountain spotted fever B. The child who has roseola C. The child who has molescum contagiosum D. The child who has pertussis

D. The child who has pertussis The nurse should initiate droplet precautions for a child who has pertussis to decrease the risk of transmitting infection to others on the unit. Pertussis or whooping cough, is a bacterial infection that is transmitted via exposure or direct contact with respiratory secretions from the infected person. Manifestations of pertussis include a fever, sneezing, and a severe productive cough that generally becomes worse before getting better. Standard precautions would be used in Rocky Mountain spotted fever and Roseola. Mollusca contagiosum would be using contact precautions.

A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child's parent ask the nurse to explain the purpose of the test. Which of the following responses should the nurse provide? A. The test determines a level of antibiotics in your child's blood B. The test tells us if your child ever had measles C. The test verifies the amount of albumin in your child's blood D. The test shows if your child had a recent strep infection

D. The test shows if your child had a recent strep infection An ASO titer indicates the child had a recent strep infection. When determining a definitive diagnosis for acute glomerulonephritis, this must be documented because the condition is usually the result of this type of infection, strep throat. ATI pg 94, 159

A nurse is caring for a child with a vasecular rash that has been present for 6 days. The nurse should expect that the child has which of the following conditions? A. Measles B. Fifth disease C. Tetanus D. Varicella

D. Varicella Children who have Varicella may present first with a maculopapular rash that progresses into vesicles on erythematous bases, which eventually rupture and crust over. Measles hallmark is KOPLIK spots, fifth disease hallmark is the the slapped cheek rash, and a child with tetanus will develop lockjaw and muscle rigidity and no rash.

A nurse is providing teaching to a 12-year-old client who is recovering from an acute episode of hemophilia a. Which of the following statements are the nurse include in the teaching? A. Have your parent stretch and move your legs for you B. Apply heat to joints that become painful,stiff, and swollen. C. Take aspirin at the first sign of headache. D. You will be able to participate in physical exercises.

D. You will be able to participate in physical exercises. Physical exercise is important for the maintenance of joint mobility and muscle strengthening. Participation in noncontact sports in the use of protective equipment such as kneepads are encouraged, although high impact athletic activities such as karate should be avoided. Passive range of motion exercises are not done after a bleeding episode because of the bleeding can occur. Active motion is best to allow activity to be tailored to the child's pain level. A manifestation of hemophilia A is hemoarthrosis or bleeding into the joint capsule. This can result in numbness, tingling, or pain, along with discoloration, warm, and swelling of the effect of joint. The nurse should instruct the child to rest the joint, elevated above the level of the heart, and apply ice to decrease the rate of bleeding into the joint capsule. Intracranial hemorrhage is a leading cause of death and client to have hemophilia a. The nurse should instruct the child to avoid the use of aspirin because it has anti-platelet properties that can increase bleeding.

A nurse is teaching the guardian of an infant who has seborrheic dermatitis of the scalp. Which of the following instructions should the nurse include in the teaching? a. "You can use petrolatum to help soften and remove the patches from your infants scalp." b. "When patches are present, you should keep your infant away from others." c. "You should avoid washing your infant's hair while patches are present on the scalp." d. "When patches are present, it indicates that your child has a systemic infection"

a. "You can use petrolatum to help soften and remove the patches from your infants scalp." Recommend that the guardian use petrolatum, vegetable oil or mineral oil to help soften and remove scaled and crusted areas. It is not contagious. Washing hair daily with a antiseborrheic shampoo is recommended. The cause is unknown.

Which vitamin supplementation has been found to reduce both morbidity and mortality in measles? a. A b. B1 c. C d. Zinc

a. A Evidence suggests that Vitamin A supplementation reduces both morbidity and mortality in measles.

An 18 month old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should the parent be given? a. Administer all of the prescribed medication b. Continue medication until all symptoms subside c. Immediately stop giving the medication if hearing loss develops d. Stop giving the medication and come back to clinic if fever is still present in 24 hrs

a. Administer all of the prescribed medication Antibiotics should be given for their full course to prevent recurrence of infection w/ persistent bacteria. It could take 24-48 hours to make symptoms subside and hearing loss is a complication of OM.

A nurse is caring for a child postop following a spinal fusion. pain is being managed with IV morphine. the nurse enters the room to find the patient unresponsive. Which is the priority action? a. Administer narcan b. Raise HOB c. Notify provider d. Administer ibuprofen

a. Administer narcan

A nurse is caring for a child who has cellulitis on the hand. Which of the following actions should the nurse take? a. Administer oral antibiotics b. Cleanse area using burrow solution c. Prepare for cryotherapy d. Apply a topical antifungal medication

a. Administer oral antibiotics Oral antibiotics are often prescribed for cellulitis. Burrow solution is used for herpes simplex virus or staphylococcal scalded skin syndrome or herpes simplex virus. Cryotherapy is recommended for human papilomavirus. Topical antifungal meds are indicated for the tx of candidiasis or tinea corporis.

An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which intervention? a. Administration of antibiotics b. Frequent complete assessment of the infant c. Round-the-clock administration of antitussive agents d. Strict monitoring of intake and output to avoid congestive heart failure

a. Administration of antibiotics Antibiotics are indicated for bacterial pneumonia.

In which condition are all the formed elements of the blood simultaneously depressed? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Iron deficiency anemia

a. Aplastic anemia Aplastic anemia refers to a bone marrow failure condition in which the formed elements of the blood are simultaneously depressed. Sickle cell anemia is a hemoglobinopathy in which normal adult hemoglobin is partly or completely replaced by abnormal sickled hemoglobin. Thalassemia major is a group of blood disorders characterized by the deficiency in the production rate of specific hemoglobin chains. Iron deficiency anemia results in a decreased amount of circulation red blood cells.

A nurse is caring for a preschooler who is brought to an outpatient clinic with a two day history of vascular, honey color crusted region around the nose and mouth. If the provider determines the lesions to be in Pedigo contagiosum, what should the nurse anticipate teaching the child's parents about the illness? Select all that apply a. Apply a topical antibacterial ointment to the lesions b. Wash the child's bed linens daily with hot water c. Administer Acyclovir oral suspension to prevent recurrence d. Allow the crust covering the infected lesions to remain intact e. Wash hands before and after contact with the affected area

a. Apply a topical antibacterial ointment to the lesions b. Wash the child's bed linens daily with hot water e. Wash hands before and after contact with the affected area Impetigo contagious a is a bacterial infection of the skin. Therefore, the nurse should plan on teaching the child's parents about topical application of antibacterial ointment. The parents should wash their hands before and after contact with the affected area and wash the child's bed linens daily and hot water to decrease the risk of infection or transmission. Acyclovir is an antiviral medication used for the treatment of viral skin infections. The nurse should plan on teaching the child's parents to wash crust each day with water and soap to promote healing.

A nurse is caring for an adolescent who has acne and a prescription for isotretinoin from the dermatologist. Which of the following lab findings should the nurse plan to monitor? a. Cholesterol and triglycerides b. BUN and creatinine c. Blood potassium d. Blood sodium

a. Cholesterol and triglycerides Adverse effects of isotretinoin include elevated cholesterol and triglycerides. Plan to monitor these lab values during treatment.

A 4 month old infant comes to the clinic for a checkup. Immunizations should receive are DTaP and IPV. She is recovering from a cold but is otherwise health and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which? a. DTaP and IPV can be safely given b. DTaP and IPV are contraindicated because she has a cold c. IPV is contraindicated because her sister is immunocompromised d. DTaP and IPV are contraindicated because her sister is immunocompromised

a. DTaP and IPV can be safely given These immunizations can be safely given. Serious illness is a contraindication. Mild illness w/ or w/o fever is not a contraindication. These are not live vaccines, so they do not pose a risk to her sister.

A nurse is discussing risk factors of asthma with a group of newly licensed nurses. Which of the following conditions should the nurse include in the teaching? (SATA) a. Family hx of asthma b. Family hx of allergies c. Exposure to smoke d. Low birth weight e. Being underweight

a. Family hx of asthma b. Family hx of allergies c. Exposure to smoke d. Low birth weight Risk factors for asthma include: -Family hx of asthma or allergies -Exposure to smoke -Low birth weight -Being overweight (not under) -Boys are more affected than girls until adolescence then it is greater among girls ATI pg 99

A nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? (select all that apply) a. Febrile episodes b. Hypoglycemia c. Sodium imbalances d. Low blood lead levels e. Presence of diphtheria

a. Febrile episodes b. Hypoglycemia c. Sodium imbalances Febrile episodes can cause general tonic clonic seizures in infants and young children. Seizures are a late manifestation of hypoglycemia, hyponatremia, or hypernatremia. High blood lead levels are a risk factor for seizures. Diphtheria is not a risk factor for seizures, it is a resp illness that causes difficulty breathing. ATI pg 70

A nurse is planning care for an infant who has diaper dermatitis. Which of the following findings should the nurse expect? (SATA) a. Generalized distribution of lesions b. Papules c. Ecchymosis in flexural areas d. Crusting lesions E. Keratosis pilaris

a. Generalized distribution of lesions b. Papules d. Crusting lesions All expected findings of an infant who has eczema. Lesions rather than ecchymosis in the flexural areas and keratosis pilaris is an expected finding in ages 2 yr<

After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention? a. Hydration b. Oxygenation c. Corticosteroids d. Pain management

a. Hydration Acute tumor lysis syndrome results from the release of intracellular metabolites during the initial treatment of leukemia. Hyperuricemia, hypocalcemia, hyperphosphatemia and hyperkalemia can result. Hydration is used to reduce the metabolic consequence of the tumor lysis. Oxygenation is not helpful in preventing acute tumor lysis syndrome. Allopurinol, not corticosteroids, is indicated for pharm management. Pain management may be indicated for supportive therapy, but doesn't prevent tumor lysis syndrome.

A school age child is admitted in vasoocclusive sickle cell crisis (pain episode). The child's care should include which therapeutic interventions? a. Hydration and pain management b. Oxygenation and factor VIII replacement c. Electrolyte replacement and administration of heparin d. Correction of alkalosis and reduction of energy expenditure

a. Hydration and pain management The management of crises include adequate hydration, pain management, minimization of energy expenditures, electrolyte replacement, and blood component therapy if indicated. Factor VIII is not indicated in the treatment of vaso occlusive sickle cell crisis. Oxygen may prevent further sickling but it is not effective in reversing sickling because it cannot reach the clogged blood vessels. Also, prolonged oxygen can reduce bone marrow activity. Heparin is not indicated in the treatment of vaso occlusive sickle cell crisis. Electrolyte replacement should accompany hydration. Heparin is not indicated in this treatment. The acidosis will be corrected as the crisis is treated. Energy expenditure should be minimized to improve oxygen utilization. Acidosis, not alkalosis, results from hypoxia, which also promotes sickling.

A nurse is planning to administer recommended immunizations to a 4 yr old. Which of the following vaccines should the nurse plan to give? (SATA) a. IPV b. Hib c. MMR d. VAR e. Hep B f. DTaP

a. IPV c. MMR d. VAR f. DTaP Hib vaccines complete by 15 mos. HepB vaccine is complete by 18 months.

What does impetigo ordinarily results in? a. No scarring b. Pigmented spots c. Atrophic white scars d. Slightly depressed scars

a. No scarring Impetigo tends to heal without scarring unless a secondary infection occurs.

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take? a. Position the client side lying b. Try to determine the seizure trigger c. Reorient the child to the environment d. Note the time of the postictal period

a. Position the client side lying

A nurse is planning to administer recommended immunizations to a 2 month old. Which of the following vaccines should the nurse plan to give? (SATA) a. Rotavirus (RV) b. DTaP c. Hib d. Pneumococcal conjugate (PCV13) e. Hep A f. IPV

a. Rotavirus (RV) b. DTaP c. Hib d. Pneumococcal conjugate (PCV13) f. IPV Hep A is given in 2 doses starting at 12 mos

A nurse is assessing a client who has pertussis. Which of the following findings should the nurse expect? a. Runny nose b. Mild fever c. Cough with whooping sound d. Swollen salivary glands e. Red rash

a. Runny nose b. Mild fever c. Cough with whooping sound A client w/ pertussis will present w/ cold like symptoms including runny nose, congestion and mild fever plus coughing fits and a whooping sound. Mumps causes enlarged lymph nodes and measles will cause a red rash.

A nurse is teaching an adolescent to self administer a corticosteroid medication using a metered dose inhaler (MDI). Which of the following instructions should the nurse include? (SATA) a. Shake the device prior to use b. Rinse and expectorate after administration c. Inhale slowly with medication administration d. Exhale quickly after medication administration e. Wait 30 sec between puffs

a. Shake the device prior to use b. Rinse and expectorate after administration c. Inhale slowly with medication administration MDIs require shaking for 3-4 secs prior to use, corticosteroids can cause oral fungal infections so client should rinse and expectorate after, and the client wants to breathe in slowly (3-5 sec) to administer med, after the client should hold the breath for 5-10 seconds not exhale quickly. The client should wait 1 min between puffs.

A nurse is reviewing the diagnostic findings for a preschool age child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of cystic fibrosis? a. Sweat chloride content 85 mEq/L b. Increased blood levels of fat soluble vitamins c. 72 hr stool analysis sample indicating hard, packed stools d. Chest x-ray negative for atelectasis

a. Sweat chloride content 85 mEq/L Children who have cystic fibrosis excrete an excessive amt of sodium and chloride in their sweat, DECREASED levels of fat soluble vitamins, large bulky frothy greasy foul-smelling stools (steatorrhea), and will have obstructive emphysema and atelectasis on a chest x ray. ATI pg 105

A nurse is admitting a child who has cystic fibrosis. Which of the following medications should the nurse expect to include in the plan of care? (SATA) a. Tobramycin b. Loperamide c. Fat soluble vitamins d. Albuterol e. Dornase alfa

a. Tobramycin c. Fat soluble vitamins d. Albuterol e. Dornase alfa Tobramycin for pulmonary infection and should be part of car. Fat soluble vitamins should be included due to the difficulty they have absorbing fat, Albuterol included because mucus plugs could lead to the need of a bronchodilator, and dornase alfa is included because it helps decrease the viscosity of the mucus. B is wrong because they often have constipation and need laxatives or stool softeners, not an anti-diarrheal med like loperamide.

A nurse is planning care for a child who has tinea capitis. Which of the following actions should the nurse include in the plan of care? (SATA) a. Treat infected house pets b. Use selenium sulfide shampoo c. Cleanse area with burrow solution d. Administer antiviral medication e. Use moist, warm compresses

a. Treat infected house pets b. Use selenium sulfide shampoo Pets should be treated and selenium sulfide shampoo should be used. Topical antifungal meds is recommended for children who have tinea capitis. Moist warm compresses are for bacterial skin infections.

A nurse is performing an admission assessment for a child with cystic fibrosis. Which of the following findings should the nurse expect? (SATA) a. Wheezing b. Clubbing of fingers and toes c. Barrel shaped chest d. Thin, watery mucus e. Rapid growth spurts

a. Wheezing b. Clubbing of fingers and toes c. Barrel shaped chest All expected assessment findings in a child with CF. Delayed growth and thick, viscous mucus are other expected findings.

A nurse is teaching a child who has asthma how to use the peak flow meter. Which of the following information should the nurse include in the teaching? (SATA) a. Zero the meter before each use b. Record the average of the attempts c. Perform three attempts d. Deliver long, slow breath into the meter e. Sit in a chair with feet on the floor

a. Zero the meter before each use c. Perform three attempts Zero meter before each use, perform 3 attempts, record the highest attempt of 3, breath hard and fast into the meter, and stand upright when using it.

Lymphangitis ("streaking") is frequently seen in: a. cellulitis. b. folliculitis. c. impetigo contagiosa. d. staphylococcal scalded skin.

a. cellulitis. Frequently seen in cellulitis and in hospitalization will require parenteral antibiotics. Lymphangitis is not associated with folliculitis, impetigo or staphylococcal scaled skin

When caring for a child after a tonsillectomy, what intervention should the nurse do? a. watch for continuous swallowing b. encourage gargling to reduce discomfort c. Apply warm compresses to the throat d. Position the child on the back for sleeping

a. watch for continuous swallowing Continuous swallowing, especially while sleeping, is an early sign of bleeding. The child swallows the blood that is trickling from the operative site. Gargling is discouraged because it could irritate the operative site. Ice compresseses are recommended to reduce inflammation. The child should be positioned on the side or abdomen to facilitate drainage of secretions.

A nurse is teaching the parent of an infant who has Down syndrome. Which of the following statements by the parent indicates an understanding of the teaching? a. "I should expect him to have frequent diarrhea" b. "I should place a cool mist humidifier in his room" c. "I should avoid the use of lotion on his skin" d. "I should expect him to grow faster in length than other infants"

b. "I should place a cool mist humidifier in his room" Teach parents that down syndrome increases the risk of resp infections. Using a cool mist humidifier in the room will help with prevention. Also increases the risk for constipation, not diarrhea, therefore include lots of fluid and fiber in the diet. Also causes dry skin so good skin car, including applying lotion, is encouraged. Down syndrome results in reduced growth in height.

A nurse is caring for a toddler who has had rhinitis, cough, and diarrhea for 2 days. Upon assessment, it is noted that the tympanic membrane has an orange discoloration and decreased movement. Which of the following statements should the nurse make? a. "Your child has an ear infection that requires antibiotics." b. "Your child could experience transient hearing loss." c. "Your child will need to be on a decongestant until this clears." d. "Your child will need to have a myringotomy."

b. "Your child could experience transient hearing loss." Transient hearing loss is a complication of OME (noted by orange and immobile tympanic membrane). No antibiotics, that would be for AOM. Decongestants aren't indicated for OM and myringotomy is only for those with chronic OM.

Pertussis vaccination should begin at which age? a. birth b. 2 mos c. 6 mos d. 12 mos

b. 2 mos Dtap at 2 mos. Infants are at greater risk for complications of pertussis.

A nurse is caring for a child who is post op tonsillectomy. Which of the following actions should the nurse take? a. Encourage the child to blow her nose gently b. Administer analgesics on a schedule c. Offer orange juice D. Position child in supine

b. Administer analgesics on a schedule Analgesics should be administered on schedule to provide pain relief. Blowing nose is a bleeding risk. Citrus juices will cause discomfort. The client should be positioned in side lying position or on the abdomen following a tonsillectomy.

A nurse is discharging a child with cystic fibrosis. Which should be included in the discharge instructions? a. provide low cal, low protein diet b. Administer pancreatic enzymes before snacks and meals c. Implement fluid restriction during times of infection d. Restrict physical activity

b. Administer pancreatic enzymes before snacks and meals Nurse would advise that the child has high fat, high protein, high calorie diet, give pancreatic enzymes 30 min before eating, increase fluids to thin thick mucus, and encourage physical activity to assist w/ lung expansion and stimulate mucus expectoration.

A nurse is caring for a child who is in a skeletal traction. Which of the following actions should the nurse take? SATA a. Remove the weights to reposition the client b. Assess pin sites every 4 hr c. Ensure the weights are hanging freely d. Assess the child's position frequently e. Ensure the rope's know is in contact with the pullet

b. Assess pin sites every 4 hr c. Ensure the weights are hanging freely d. Assess the child's position frequently Pin sites should be assessed frequently to monitor for the development of infection or loosening of the pins. Freely hanging weights allow for prescribed traction. Assess the child's position frequently to ensure proper alignment is present. This avoids putting stress on the pinned areas and other areas of the body causing pain. Weights should only be removed by providers or in an emergency. The knot in the rope should not touch the pulley as this will alter the weight of the traction.

A nurse is caring for an infant who has manifestations of acute otitis media (AOM). Which of the following factors places the infant at risk for otitis media? (select all that apply) a. Breastfeeds w/o formula supplementation b. Attends day care 4 days per week c. Immunizations are up to date d. History of cleft palate repair e. Parents smoke cigarettes outside

b. Attends day care 4 days per week d. History of cleft palate repair e. Parents smoke cigarettes outside Daycare increases chances due to exposure, cleft palate is a risk factor due to micro-organisms be able to more easily enter the Eustachian tubes, and exposure to 2nd hand smoke is a risk factor. Breastfeeding and immunizations help prevent AOM.

A nurse is caring for an infant whose screening test reveals a potential diagnosis of sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait of the disease? a. Sickle solubility test b. Hemoglobin electrophoresis c. Complete blood count d. Transcranial doppler

b. Hemoglobin electrophoresis ATI pg 127

The nurse is discussing the management of atopic dermatitis (eczema) with a parent. What should be included? a. Dress infants warmly to prevent chilling b. Keep infants fingernails and toenails cut short and clean. c. Give bubble baths instead of washing lesions with soap d. Launder clothes in mild detergent, use fabric softener in the urine

b. Keep infants fingernails and toenails cut short and clean. The infant's nails should be kept short and clean have no sharp edges. Gloves or cotton socks can be placed over the child's hands and pinned to the shirt sleeves. Heat and humidity increase perspiration, which can exacerbate the eczema. The child should be dressed properly for the climate. Synthetic material (not wool) should be used for the child's clothing during cold months. Baths are given as prescribed with tepid water, and emollients such as aquaphor, cetaphil, and eucerin are applied within 3 minutes. Soap, bubble bath oils, and powders are avoided. Fabric softener should be avoided because of the irritant effects of some of its components.

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following actions should the nurse take? (SATA) a. Instruct child that treatment will last 30 min b. Obtain vital signs prior to procedure c. Tell the child to take slow deep breaths d. Determine if the child should use mask e. Attach the device to an air source

b. Obtain vital signs prior to procedure c. Tell the child to take slow deep breaths d. Determine if the child should use mask e. Attach the device to an air source Take 10-15 min, baseline vitals prior to compare how meds were tolerated, slow deep breaths should be taken to inhale meds into resp tract, Nebulizer medication can be delivered by mask, mouthpiece or blow by so determining which way is important, and they need an air source to break the medication into small particles for inhalation.

A nurse is developing an educational program about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? (SATA) a. IPV b. PCV c. DTaP d. Hib E. TIV

b. PCV d. Hib ATI pg 61

A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? (SATA) a. Perform chest percussion b. Place the child in an upright position c. Monitor oxygen saturation d. Administer bronchodilators e. Administer dornase alfa daily

b. Place the child in an upright position c. Monitor oxygen saturation d. Administer bronchodilators A&E= intervention for cystic fibrosis not asthma

A nurse is assessing an infant. Which of the following findings are clinical manifestations of acute otitis media? (select all that apply) a. Decreased pain in the supine position b. Rolling head side to side c. Loss of appetite d. Increased sensitivity to sound e. Crying

b. Rolling head side to side c. Loss of appetite e. Crying Infants with OM will have INCREASED pain in supine and a decreased sensitivity to sound. They roll side to side because of the pain and pressure in their ears, causing them to loss their appetite as well as cry from the pain.

A nurse is teaching a group of family members about the complications of communicable diseases. Which of the following communicable disease can lead to pneumonia? (SATA) a. Rubella (german measles) b. Rubeola (measles) c. Pertussis (whooping cough) d. Varicella (chickenpox) e. Mumps

b. Rubeola (measles) c. Pertussis (whooping cough) d. Varicella (chickenpox) Rubeola complications include ear infections, pneumonia, diarrhea, encephalitis, and death. Pertussis complications include pneumonia, convulsions, apnea, encephalopathy and death in infants Varicella complications include dehydration, pneumonia, bleeding problems, bacterial infection of the skin, sepsis, toxic shock syndrome, bone and joint infections and death. Rubella complications include birth defects and Mumps complications include orchitis, encephalitis, meningitis, oophoritis, mastitis and deafness.

A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (Select all that apply) a. O2 saturation 95% b. Wheezing c. Retraction of sternal muscles d. Warm extremities e. Nasal flaring

b. Wheezing c. Retraction of sternal muscles e. Nasal flaring O2 stat UNDER reference range not 95%, wheezing, sternal retractions, and nasal flaring are all indications of deterioration in resp status.

A child with cystic fibrosis is admitted to the pediatric unit with MRSA (methicillin-resistant staphylococcus aureus) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions? a. droplet b. contact c. airborne d. standard

b. contact MRSA is an increasingly significant source of hospital-acquired infections. This organism meets the criteria of being epidemiologically important and can be transmitted by direct contact. Gowns and gloves should be worn when exposed to potentially contagious materials, and meticulous mechanisms. Additional precautions, beyond standar are needed to prevent spread of this organism.

What is the most important in the management of cellulitis? a. burrow solution compresses b. oral or parenteral antibiotics c. topical application of an antibiotic d. incision and drainage of severe lesions

b. oral or parenteral antibiotics Warm water compresses may be indicated for limited cellulitis. The antibiotic needs to be administered systemically. Incision and drainage of severe lesions presents a risk of spreading infection or making lesions worse.

A nurse is assessing an infant who has scabies. Which of the following findings should the nurse expect? (SATA) a. presence of nits on the hair shaft b. pencil like marks on hands c. blisters on the soles of the feet d. small, red bumps on the scalp e. pimples on the trunk

b. pencil like marks on hands c. blisters on the soles of the feet e. pimples on the trunk All manifestations of scabies. The presence of nits on hair shaft and small, red bumps on scalp are manifestations of pediculosis capitis.

The best technique to use to prevent spread of nasopharyngitis is a. antibiotic administration b. to avoid contact with infected persons c. mist vaporization d. to ensure adequate fluid intake

b. to avoid contact with infected persons not writing out the explanation for this one lol

A nurse is preparing to administer the varicella vaccine to an adolescent. Which of the following questions should the nurse ask to determine whether there is a contraindication to administering the vaccine? a. "Do you have an allergy to eggs?" b. "Have you ever had encephalopathy?" c. "Are you currently taking corticosteroid medication?" d. "Have you ever had an anaphylactic reaction to yeast?"

c. "Are you currently taking corticosteroid medication?" Varicella vaccine is contraindicated for clients who have been taking corticosteroids or other meds that affect the immune system for 2 wks or longer. Gelatin or neomycin allergy is also a contraindication. encephalopathy is contraindications for DTaP. Hep B vaccine is contraindicated for someone with a yeast allergy.

A 7 month old child has been diagnosed with nasopharyngitis. The parent is concerned because the child has had little or no appetite for the last 24 hours. Which is the nurse's best response? a. "Do not be concerned; it is common for children to have a decreased appetite during a respiratory illness." b. "Be sure your child is taking in an adequate amount of fluids. Their appetite should return soon." c. "Try offering the child some favorite foods. It could help improve their appetite." d. "You need to force your child to eat whenever you canl adequate nutrition is essential."

c. "Try offering the child some favorite foods. It could help improve their appetite." Although a child's appetite for solid foods is usually diminished for for several days it is important to offer appropriate fluids and food if tolerated. Gelatins, popsicles, soups or broths are good options (from wong pg 625). Be sure to be addressing the parent's concern.

A nurse is caring for a child who has bronchiolitis. Which of the following actions should the nurse take? SATA a. Administer prednisone b. Initiate chest percussion and postural drainage c. Administer humidified oxygen d. Suction the nasopharynx prn e. Administer oral penicillin

c. Administer humidified oxygen d. Suction the nasopharynx prn Humidified o2 and nasopharynx suction indicated. Corticosteroids (prednisone), chest percussion/postural drainage and antibiotics (only indicated for secondary infection) not indicated for this client.

The nurse is examining an infant, age 10 mos, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is most likely the cause? a. Impetigo b .Urine and feces c. Candida albicans infection d. Infrequent diapering

c. Candida albicans infection C. albaicans produces perianal inflammation and a maculopapular rash

The nurse is assessing a child with croup in the ER. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition? a. Sore throat b. Inspiratory c. Complete obstruction d. Respiratory tract infection

c. Complete obstruction If a child has acute epiglottitis, examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place. Sore throat and pain on swallowing are early signs of epiglottitis. Stridor is aggravated when a child with epiglottitis is supine. Epiglottitis is caused by Haemophilus influenzae in the respiratory tract.

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? a. Low-pitched cry b. Sunken fontanel c. Diplopia, blurred vision d. Increased blood pressure

c. Diplopia, blurred vision Diplopia and blurred vision are signs of increased ICP in children. A high pitched cry and tense or bulging fontanel are also a s/s of increasing ICP. increased BP is common in adults but rarely seen in children.

A nurse is caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first? a. Increase the oxygen flow rate b. Encourage child to take deep breaths c. Ensure proper placement of the sensor probe d. Place the child in fowler's position

c. Ensure proper placement of the sensor probe The first action should be to asses and ensure the probe sensor is on properly before the next action.

A nurse is caring for a child who is in the postoperative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding? a. Hgb 11.6 and Hct 37% b. Inflamed and reddened throat c. Frequent swallowing and clearing of throat d. Blood tinged mucus

c. Frequent swallowing and clearing of throat

A 4 year old girl is brought to the emergency department. She has a frog like croaking sound on inspiration, is agitated and is drooling. She insists on sitting upright. The nurse should intervene in which manner? a. Make her lie down and rest quietly b. Notify the physician immediately and put her on droplet isolation precautions c. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation d. Auscultate her lungs and prepare for placement in a mist tent

c. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation Croaking or a frog like sound on inspiration with drooling is a sign of acute epiglottitis which is an emergency. Immediate intubation or tracheostomy or endotracheal intubation for a child with severe respiratory distress are interventions a nurse can anticipate for acute epiglottitis. Droplet isolation precautions are indicated for 24 hours with the initiation of antibiotics but not the priority. (wong pg 635)

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do? a. Set up a tray with equipment the same size as for adults b. Apply EMLA to the puncture site 15 min before the procedure c. Prepare the child for conscious sedation being used for the procedure d. Reassure the parents that the test is simple, painless and risk free

c. Prepare the child for conscious sedation being used for the procedure Because of the urgency of the child's condition, conscious sedation should be used for the procedure. Pediatric spinal trays have smaller needles than adult ones. EMLA should be applied 60 min before the procedure; the emergency nature of the spinal tap precludes its use. A spinal tap is not a simple procedure and analgesics will be given for pain.

A nurse is teaching a group of parents about possible manifestations of Down syndrome. Which of the following findings should the nurse include in the teaching? (select all that apply) a. A large head with bulging fontanels b. Larger ears that are set back c. Protruding abdomen d. Broad, short feet and hands e. Hypotonia

c. Protruding abdomen d. Broad, short feet and hands e. Hypotonia A child who has down syndrome will exhibit small ears with short pinna, broad short feed and hands, hyperflexibility, hypotonia and a protruding abdomen. Large head with bulging fontanels is a finding in hydrocephalus.

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition? a. Has a cough b. Becomes fussy c. Show signs of an earache d. Has a fever higher than 37.5 C(99 F)

c. Show signs of an earache If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory complications and possibly secondary bacterial infection. The health professional should be contacted to evaluate the infant. Cough can be a sign of nasopharyngitis. Irritability is common in an infant with a viral illness. Fever is common in viral illnesses. *Otitis media is usually triggered by a bacterial infection, a viral infection, allergies or enlarged adenoids (ATI pg 239)

A nurse is caring for a toddler who has had 3 ear infections in the past 5 months. Which of the following long term complications is the child at risk for developing? a. Balance difficulties b. Rash c. Speech delays d. Mastoiditis

c. Speech delays Speech delays is common complication of OM. Balance difficulties can be present as a symptom of OM but it is not a long term complication. Mastoiditis can be a result of OM, but not a complication. Rash can indicate antibiotic sensitivity but not a complication of OM.

A nurse in the ER is assessing a newly admitted infant. Which of the following findings is an early indication of hypoxia? a. Nonproductive cough b. Hypoventilation c. Tachypnea d. Nasal stuffiness

c. Tachypnea Tachypnea is an early indication of hypoxia in an infant. A= s/s of resp infection, B=s/s of oxygen toxicity, D= s/s resp infection

The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurence is most likely responsible for the presenting signs? a. Gastrointestinal perforation may have occurred b. The object may have been aspirated c. The object may be lodged in the esophagus d. The object may be embedded in stomach wall

c. The object may be lodged in the esophagus Gagging and drooling may be the signs of an esophageal obstruction. The child is unable to swallow saliva, which contributes to the drooling. Signs of gastrointestinal (GI) perforation include chest or abdominal pain and evidence of bleeding in the GI tract. If the object was aspirated, the child would most likely have coughing, choking, inability to speak, or difficulty breathing. If the object was embedded in the stomach wall, it would not result in symptoms of gagging and drooling.

A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching? a. Apply mayo to the affected area at night b. Treat all household pets c. Use an over the counter medication containing permethrin d. Discard the child's stuffed animals

c. Use an over the counter medication containing permethrin Pediculosis capitis is treated with 1% permethrin which can be purchased OTC. It is only transmitted person to person. Home remedies such as mayo increase the risk of infection and should be avoided. Items that cannot be placed in the laundry can be placed in a sealed bag for 14 days to kill the lice.

A new parent asks the nurse, "How can diaper rash be prevented?" What should the nurse recommend? a. Wash the infant with soap before applying a thin layer of oil. b. Clean the infant with soap and water every time diaper is changed. c. Wipe stool from the skin using water and a mild cleanser. d. When changing the diaper, wipe the buttocks with oil and powder the creases.

c. Wipe stool from the skin using water and a mild cleanser. Change the diaper as soon as it becomes soiled. Gently wipe stool from skin with water and mild soap. The skin should be thoroughly dried after washing. Applying oils does not create effective barrier. Overwashing skin should be avoided. Baby powder should not be used due to risk of aspiration.

An infant with bronchiolitis is hospitalized. The causative organism is RSV. The nurse knows that a child infected with RSV requires what type of isolation? a. reverse isolation b. airborne isolation c. contact precautions d. standard precautions

c. contact precautions RSV is transmitted through droplets. Droplet and contact precautions can both be used. Gloves and gowns are ppe used and they are placed in private room or room with other children with RSV. Reverse isolation is to keep bacteria way from the infant. With RSV other children need protected. The virus is not airborne and requires more than standard precautions.

The treatment for herpes simplex virus (type 1 or 2) includes which? a. corticosteroids b. oral griseofulvin c. oral antiviral agent d. topical or systemic antibiotic

c. oral antiviral agent Oral antiviral agents are effective for viral infections such as herpes. The others are not effective for viral infections.

What information should the nurse provide a parent of a child diagnosed with nasopharyngitis? a. complete the entire prescription of antibiotics b. avoid sending the child to daycare c. use comfort measures for the child d. restrict the child to clear liquids for 24 hours

c. use comfort measures for the child Nasopharyngitis is managed at home and it is very important to teach parents about the best comfort measures since there is no specific treatment and it can vary. Antibiotics aren't used. Avoiding daycare is important for the spread but not the most important for care. Fluids do not have to be restricted to clear according to the info presented. Wong pg 625

A nurse is providing teaching to the parent of a child who has a new prescription for liquid oral iron supplements. Which of the following statements by the parent indicates an understanding of the teaching? a. "I should take my child to the ER if his stool becomes dark." b. "My child should avoid eating citrus fruits while taking the supplements." c. "I should give iron with milk to help prevent an upset stomach." d. "My child should take the supplement through a straw."

d. "My child should take the supplement through a straw." Taking the supplement through a straw minimizes the staining of the teeth. Dark stools (typically tarry-green) are expected and mean the does is adequate. Milk prevents absorption and Vitamin C is encourage and shouldn't be avoided as it enhances the absorption.

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent this condition? a. Otitis media b. Diabetes insipidus (DI) c. Nephrotic syndrome d. Acute rheumatic fever

d. Acute rheumatic fever Group A beta-hemolytic streptococci (GABHS) infection of the upper airway (strep throat) is not in itself a serious disease, but affected children are at risk for serious sequelae: acute rheumatic fever, acute glomerulonephritis, impetigo, pyoderma, or scarlet fever. (wong pg 625-626)

A nurse is caring for a toddler who has acute otitis media. Which of the following is the priority action for the nurse to take? a. Provide emotional support to the family b. Educate the family on care of the child c. Provide diversional activity d. Administer analgesics

d. Administer analgesics Maslow's hierarchy-need to alleviate pain first. Then do the rest.

A nurse is teaching an adolescent about appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise? a. Fluticasone/salmeterol b. Montelukast c. Prednisone d. Albuterol

d. Albuterol Albuterol is a beta2 agonist used for bronchodilation. Instruct adolescent the medication is quick acting, should be administered prior to exercise and is used to provide immediate relief to bronchoconstriction. LABAs and montelukast are for maintenance. Prednisone is only used short term as an anti-inflammatory. ATI pg 100

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? a. Suction the child frequently b. Turn the child's head side to side every hour c. Provide environmental stimulation d. Avoid activities that cause pain or crying

d. Avoid activities that cause pain or crying Unrelieved pain, crying and emotional stress all contribute to increasing ICP.

Parents bring their 15 month old infant to the ER at 3 am because the toddler has a temp of 39 C (102.2F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse anticipates what other medication? a. Decongestants to ease stuffy nose b. Antihistamines to help the child sleep c. Aspirin for pain and fever management d. Benzocaine ear drops for topical pain relief

d. Benzocaine ear drops for topical pain relief Analgesic ear drops can provide topical relief for the intense pain of OM. Decongestants and antihistamines are not recommended treatment of OM. Aspirin is contraindicated in young children due to it's association of Reye's syndrome.

Which statement best represents infectious mononucleosis? a. Herpes simplex type 2 is the principal cause b. A complete blood count shows a characteristic leukopenia c. A short course of ampicillin is used when pharyngitis is present d. Clinical signs and symptoms and blood tests are both needed to establish the diagnosis

d. Clinical signs and symptoms and blood tests are both needed to establish the diagnosis The charecteristics of the disease are malaise, sore throat, lympadenopathy, central nervous system manifestation, and skin lesions are similar to presenting symptoms in other diseases. Therefore hematologic analysis (heterophil antibody and monospot) can help confirm the diagnosis. However not all young children develop the expected lab findings. Herpes like epstein barr virus is the principle cause. Usually an increase in lymphocytes is observed, Penicillin, not ampicillin is indicated. Ampicillin is linked with a discrete macular eruption in mono.

What immunization should not be given to a child receiving chemotherapy? a. Tetanus vaccine b. Inactivated poliovirus vaccine c. Diphtheria, pertussis, tetanus (DPT) d. Measles, mumps, rubella (MMR)

d. Measles, mumps, rubella (MMR) The vaccine used for MMR is a live virus and can cause serious disease in immunocompromised children. The others are not live and can be given.

The nurse should include that which of the following is the best method to prevent a communicable disease? a. Hand washing b. Avoiding persons who have active disease c. Covering your cough d. Obtaining immunizations

d. Obtaining immunizations Obtaining immunizations is the best way to prevent spread of communicable diseases and have decreased the occurrence of them. The rest help spread infection but not the best to prevent communicable diseases.

A nurse is teaching a group of guardians about influenza. Which of the following information should the nurse include in the teaching? a. Amantadine will prevent this illness b. Rimantadine is administered IM c. Zanamivir can be given to children 1 yr< d. Oseltamivir should be given within 48 hrs of onset of manifestations

d. Oseltamivir should be given within 48 hrs of onset of manifestations -Oseltamivir decreases flu manifestations in clients who have findings in less than 48 hr -Amantadine can shorten the illness, --Rimantadine is oral 2x a day for 7 days -Zanamivir is for over ages of 5 yrs

A nurse is reviewing the medical records of a client who has Reye syndrome. Which of the following findings should the nurse identify as a risk factor for Reye syndrome? a. Recent history of infectious cystitis caused by Candida b. Recent history of bacterial otitis media c. Recent episode of H. influenzae meningitis d. Recent episode of gastroenteritis

d. Recent episode of gastroenteritis ATI pg 61

What often causes cellulitis? a. Herpes zoster b. Candida albicans c. Human papillomavirus d. Streptococci or staphylococci

d. Streptococci or staphylococci

The mother of a 1 month old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information? a. Meningitis rarely occurs during infancy b. Often a genetic predisposition to meningitis is found c. Vaccination to prevent all types of meningitis is now available d. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.

d. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available. H. influenzae type b meningitis has been virtually eradicated in areas of the world where the vaccine is administered routinely. Bacterial meningitis remains a serious illness in children. It is significant because of the residual damage caused by undiagnosed and untreated or inadequately treated cases. Group b streptococci and E. coli are the leading neonatal causes. Meningitis is an extension of a variety of bacterial infections. No genetic predisposition exists. Vaccinations are not available for all of the potential causative.