Book ?s Exam 4
A health care provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion? Select all that apply. Ventricular septal defect Patent ductus arteriosus Pulmonary stenosis Coarctation of the aorta Atrioventricular canal defect
Ventricular septal defect Patent ductus arteriosus Atrioventricular canal defect
A group of nurses is reviewing the cardiovascular system and its function. Which statement by one of the nurses demonstrates an understanding of a child's cardiovascular system? "At birth, the infant's right and left ventricle are about the same size." "The heart rate of the child decreases whenever the child experiences a fever." "Between the ages of 5 and 6, the child's left ventricle grows to about two times the size of the right." "At birth, the infant's right and left ventricle are about the same size."
"At birth, the infant's right and left ventricle are about the same size."
While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate? "Her kidneys are less well protected." "A girl's urethra is closer to the rectal opening." "Girls have a smaller bladder size than boys do." "A girl's urethra is longer than a boy's urethra."
"A girl's urethra is closer to the rectal opening."
The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother? "It is unlikely that your daughter is practicing good cleaning habits after she voids." "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's." "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C."
"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."
The nurse instructs the parents of a child with Guillain-Barré syndrome on care that will be needed once the child is discharged home. Which statement made by the parents indicates that teaching has been effective? "Our child might experience weakness even after recovering from the illness." "We need to be sure to change our child's body position at least twice a day." "It will take about 10 days for our child to be back normal and return to school." "This disease affects the heart and lungs, so our child will have limited ability going forward."
"Our child might experience weakness even after recovering from the illness."
The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care? IV fluids Abd palpation Foley catheter Supine positioning
Abd palpation
The school nurse is observing a child in the classroom. The child is speaking and then suddenly stops and stares for about 5 seconds and then continues speaking. The nurse charts this as what type of seizure? Absence Febrile Partial seizure Tonic-clonic
Absence
The nurse is educating the parents of a child newly diagnosed with avascular necrosis of the femoral head. The nurse would be correct in including which information in the teaching plan? Select all that apply. A limp and swelling at the groin/hip area is often the first symptom noted by parents. This condition is self-limiting, usually within 4 to 8 weeks. This disorder is most common in school-aged females who are gymnasts or play other sports. Treatment involves administration of strong antibiotics via a port or PICC line. The diagnosis involves imaging studies of the femoral head and hip joint to provide confirmation.
A limp and swelling at the groin/hip area is often the first symptom noted by parents. The diagnosis involves imaging studies of the femoral head and hip joint to provide confirmation.
An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect? Acute glomerulonephritis Polycystic kidney Nephrosis Kidney agenesis
Acute glomerulonephritis
Tea-color urine A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? Prune belly syndrome Renal failure UTI Acute glomerulonephritis
Acute glomerulonephritis
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: Rheumatic fever Acute glomerulonephritis UTI Lipoid nephrosis
Acute glomerulonephritis
The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS: 99 (F), 39.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate? Wilms tumor Acute glomerulonephritis Nephrotic syndrome UTI
Acute glomerulonephritis
The nurse is caring for a child who was injured in a bike accident. The nurse determines that a child is experiencing late signs of increased intracranial pressure based on which assessment findings? Select all that apply. Bradycardia Increased BP Fixed dilated pupils Irregular respirations Sunset eyes
Bradycardia Fixed dilated pupils Irregular respirations
A school-age child with pauciarticular juvenile idiopathic arthritis has extreme pain upon waking in the morning. Which intervention should the nurse suggest the parents try to help the child with the pain? Encourage bed rest until the pain is gone. Encourage a warm bath each morning before school. Provide 325 mg of aspirin immediately on arising. Perform isotonic exercises until the pain is gone.
Encourage a warm bath each morning before school.
A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? Tell parents to give ibuprofen if their child has a sore throat. All children in the child's class should be tested for strep throat if one child has a positive test. Prophylactic antibiotics after strep throat are important. Encourage the child to take all the antibiotics if diagnosed with strep throat.
Encourage the child to take all the antibiotics if diagnosed with strep throat.
A child with pauciarticular juvenile idiopathic arthritis is scheduled for an eye examination every 3 months. When stressing the importance of the visit, which instruction is most accurate? Continuous drug therapy causes corneal opacity. Iridocyclitis may occur as a basic symptom of the disease. The eye globe does not continue to grow, impacting sight. Eye infection may develop easily due to medication administration.
Iridocyclitis may occur as a basic symptom of the disease.
The nurse is caring for a child who had a cast on his lower leg placed two hours ago. When assessing the child's foot, the nurse notes that the toes are cool and the child reports extreme pain. What is the best action by the nurse? Notify the health care provider of the findings immediately. Administer prescribed pain medication. Reposition the leg on pillows so that it is above the level of the child's heart. Apply ice bags to the child's foot and ankle.
Notify the health care provider of the findings immediately.
A symptom often seen in the child diagnosed with Haemophilus influenzae meningitis occurs when the child has a stiff neck. This symptom is referred to as which of the following? Encephalopathy Purpuric rash Nuchal rigidity Opisthonos
Nuchal rigidity
When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? Leukopenia Increased platlet level Anemia Polycythemia
Polycythemia
The nurse is planning care for a preschool-aged child with spastic cerebral palsy. Which nursing diagnosis should the nurse identify to guide care for this client's musculoskeletal status? Risk for disuse syndrome related to spasticity of muscle groups Impaired verbal communication related to neurologic impairment Risk for delayed growth and development related to activity restriction Risk for self-care deficit related to impaired mobility
Risk for disuse syndrome related to spasticity of muscle groups
A nurse is examining a boy with cerebral palsy (CP). He has hypertonic muscles and abnormal clonus in his legs and walks on his toes. Which of the following is the type of cerebral palsy that this boy is demonstrating? Spastic Ataxic Athetoid Dyskinetic
Spastic
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? Macular rash Café au lait spots Strawberry Tongue Hirsutism or striae
Strawberry Tongue
The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis? Loose, dark stools Strawberry tongue Jaundice Tea-color urine
Tea-color urine
The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be: The child's history indicates she has infantile seizures. The child is in status epilepticus. The child is having generalized seizures. The child may begin to have absence seizures every day.
The child is in status epilepticus.
In caring for a child being treated for scoliosis, the highest priority goal is which of the following The child will participate in age-appropriate activities. The child will verbalize acceptance of the treatment. The child's skin integrity will be maintained. The child will remain free of injury.
The child will remain free of injury.
The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers? The nurse should be a contact person when the child is hospitalized. The nurse should provide information when the child or caregiver requests it. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices. The nurse should support the caregivers in restricting activity during the treatment.
The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.
A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply. Absent headache Vomiting Photophobia Complaints of stiff neck Negative Brudzinski sign
Vomiting Photophobia Complaints of stiff neck
The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care for the client with excess fluid volume? Measure the amount of nitrates present in the urine. Avoid administering IV therapies. Hold all medication until the fluid retention is improving. Weigh the child daily on the same scale.
Weigh the child daily on the same scale
Legg-Calvé-Perthes disease (LCPD) is more likely to be seen in which group? White boys Asain girls Hispanic girls Black boys
White boys
One of the children has an awkward and wide-based gait. The nurse recognizes this characteristic as common in which type of cerebral palsy? athetoid cerebral palsy rigid cerebral palsy spastic cerebral palsy ataxic cerebral palsy
ataxic cerebral palsy
The nurse is assessing a group of early adolescents for scoliosis. One of the teenagers asks the nurse what will be done. The nurse explains that which of the following will be included in the assessment? Select all that apply. examination of the shoulders for symmetry examination of the spine for curvature examination of leg length examination of the shoulder blades for symmetry examination of the hips for symmetry
examination of the shoulders for symmetry examination of the spine for curvature examination of the shoulder blades for symmetry examination of the hips for symmetry
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? Abd Fingers Eyes Sacrum
eyes
The nurse is caring for a child admitted with juvenile idiopathic arthritis (JIA). Which clinical manifestation would likely have been noted in the child with this diagnosis? difficulty standing and walking pain in the groin and a limp poor posture and malformed vertebrae inflammation of the joints
inflammation of the joints
Which intervention prevents a 17-month-old child with spastic cerebral palsy from going into a scissoring position? letting the child lie down as much as possible placing the child on your hip keeping the child in leg braces 23 hours per day trying to keep the child as quiet as possible
placing the child on your hip
The premise behind using plasmapheresis in a client diagnosed with Guillain-Barré syndrome includes which of the following? prevention of joint contractures prevention of deep vein thrombosis prevention of demyelination prevention of skin breakdown
prevention of demyelination
The nurse should support the caregivers in restricting activity during the treatment. The nurse is caring for a child diagnosed with Duchenne muscular dystrophy and notes the presence of a Gower sign on the assessment form. What action by the child would support this assessment? a short heel cord caused by walking on the toes meeting motor milestones such as sitting, walking, and standing but at a later age than the average child the presence of a waddling gait and difficulty climbing stairs when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand
when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand
The nurse is caring for a newborn diagnosed with patent ductus arteriosus. Which finding will the nurse assess that is consistent with this diagnosis? absent femoral pulses slow heart rate expiratory grunt wide pulse pressure
wide pulse pressure
The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of the treatment? Wearing this brace only during the night will not be so embarrassing." "When I start feeling tired, I can just take my brace off for a few minutes." "I am so glad I can take this brace off for the school dance." "At least when I take a shower I have a few minutes out of this brace."
"At least when I take a shower I have a few minutes out of this brace."
The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education? "The treatment for our child's scoliosis is anticipated to last between 3 to 4 months." "The most successful treatment for scoliosis is surgery before reaching adult age." "Because our child has scoliosis, treatment will include halo traction." "Because our child is being treated by using braces, the braces will have to be worn almost all the time."
"Because our child is being treated by using braces, the braces will have to be worn almost all the time."
Which statement about cerebral palsy would be accurate? "Cerebral palsy is a condition that doesn't get worse." "Cerebral palsy is a condition that runs in families." "Cerebral palsy occurs because of too much oxygen to the brain." "Cerebral palsy means there will be many disabilities."
"Cerebral palsy is a condition that doesn't get worse."
The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells? "He likes to stop and squat wherever he walks." "He walks very quickly and never stops moving." "He does not seem to have difficulty breathing." "He takes one nap a day and is fairly active."
"He likes to stop and squat wherever he walks."
The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure? "He usually is very coordinated, but he couldn't even walk without falling." "His arms had jerking movements in his legs and face." "He kept smacking his lips and rubbing his hands." "He was just staring into space and was totally unaware."
"He was just staring into space and was totally unaware."
Currently, the child's hips and knees are inflamed and painful. What statement by the parent would indicate a need for further education? "I will keep my child home from school when there is a flare up to help reduce the amount of time my child is in pain." "I will encourage my child to take a warm bath before school every morning." "I'm glad my mom saved her elevated toilet seat she used when she had her knee replacement surgery." "My child loves to dance so we can add exercises into a dance routine."
"I will encourage my child to take a warm bath before school every morning."
An adolescent client who has scoliosis and is wearing a Milwaukee brace tells the nurse that she is ugly and cannot wear the same clothing as her friends. Which response by the nurse best addresses this client's altered self-image? "You should not worry about what everyone else is wearing. You look fine." "Just hold your head up and be confident in how you look. Look for some after-school activities you can do wearing your brace." "Kids can be cruel sometimes. Has anyone told you that you look different?" "Let's look at some clothing that you can wear with the brace that will look like everyone else's clothes but cover it."
"Let's look at some clothing that you can wear with the brace that will look like everyone else's clothes but cover it."
The nurse is caring for a child diagnosed 3 months ago with juvenile idiopathic arthritis (JIA). The caregiver states that the child has recently reported little pain and is not currently taking aspirin or NSAIDs. The caregiver also tells the nurse that just to be on the safe side, she is continuing to keep the child from doing physical exercise. The mother states, "I think we have beaten this disease." In working with this child and the caregiver, which statement would be best for the nurse to make? "It sounds as though things are going well. Be sure to restart the medication as soon as there is any flare-up of pain." "I'm glad you're feeling optimistic. She should exercise now but give her aspirin before she does." "Let's review some of the instructions. She does need to take an anti-inflammatory every day." "That is not what is best. The medications aren't for pain; she needs to take aspirin every few days."
"Let's review some of the instructions. She does need to take an anti-inflammatory every day."
The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition? "My child's eyes appear sunken to me." "My child has recently reported urinary frequency." "My child's urine is pale yellow in color." "My child just got over a head cold with laryngitis."
"My child just got over a head cold with laryngitis."
A nursing instructor has completed a class session on Guillain-Barré syndrome. Which statement by a student indicates a need for further education? "Paralysis peaks at about 3 weeks before recovery, but most do not completely recover from the paralysis." "Children with this disorder may need mechanical ventilation as the disease progresses." "These children may need nutritional support if they are unable to eat." "There is no medication available to treat this disorder."
"Paralysis peaks at about 3 weeks before recovery, but most do not completely recover from the paralysis."
A parent is angry about the adolescent's diagnosis of osteosarcoma. The parent is telling the adolescent that if he hadn't played football last year and broken his leg, this would not have happened. What is the nurse's best response to the parent's statement? "Does bone cancer run in your family? Maybe your adolescent inherited it through genes." "When your adolescent broke the leg last year, it may have weakened the bone, allowing cancer to start there." "Cancer in the bone can result from old injuries so it probably was not caused from getting hurt last year, but an earlier injury." "Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though."
"Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though."
A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response? "The cause is unknown and there are many environmental factors that may contribute to it." "It's a common complication of amniocentesis." "It has been linked to maternal alcohol consumption during pregnancy." "Older age at conception is one of the major causes of the defect."
"The cause is unknown and there are many environmental factors that may contribute to it."
A parent of a child diagnosed with seizures states, "I've heard about a special diet that may control seizures, I think it's called ketogenic. What can you tell me about it?" Which are appropriate responses by the nurse? Select all that apply. "The diet consists of high fat foods." "Protein is limited in this diet." "About 40% to 50% of children who follow the diet have really good results." "Most families find this diet is easy to incorporate into their life." "Children are encouraged to eat a lot of breads and pasta on this diet."
"The diet consists of high fat foods." "Protein is limited in this diet." "About 40% to 50% of children who follow the diet have really good results."
The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse? "The newer braces only have to be worn while the child is asleep and don't have to be worn at school." "Unfortunately, bracing is the only option for treating this disorder. I'm sure your child will get used to it after a few weeks." "Braces have been replaced with surgical intervention. Your child will only wear a brace for a few weeks after the surgery." "The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."
"The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."
The nurse has been teaching the parents of a child diagnosed with osteogenesis imperfecta about the use of bisphosphonates for this condition. What statement by a parent indicates a need for further education? "This medication will help to increase bone mineral density." "My child's risk for fractures will hopefully be decreased as by taking this medication." "This medication doesn't prevent fractures from happening." "This medication will cure my child of this disorder."
"This medication will cure my child of this disorder."
A 7-year-old client has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when she first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be the best response by the nurse? "This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." "This might or might not be a problem. Watch your daughter for signs of nasal discharge, sneezing, itching of the nose, or dark circles under the eyes. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." "This is unlikely to be a problem. Half an aspirin is not enough to cause harm. Reye syndrome generally only develops from prolonged use of aspirin in connection with a virus." "This is a serious problem. Aspirin is likely to cause Reye syndrome, and she should be admitted to the hospital for observation as a precaution."
"This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome."
A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years." "If she needs dental surgery, we might need additional medication. "She needs to take the drug for the full 14 days." "We can stop the penicillin when her symptoms disappear."
"We can stop the penicillin when her symptoms disappear."
A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction? "I wear a t-shirt under my brace." "I check my brace daily to make sure there is no damage or change to it." "I do exercises after school." "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."
"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."
When assisting parents in a home care plan for a child with Legg-Calvé-Perthes disease (LCPD), the nurse would teach the parents that which is anticipated? Passive range-of-motion exercises 3x per day A non-weight-bearing period initially occurs. Exercise to increase muscle strength of the knee joint Surgery with supporting rods
A non-weight-bearing period initially occurs.
A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)? Abd pain Lymphadenopathy Leg pain Rash
Abd pain
Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage? Apply a sterile dressing moistened in a warm, sterile saline solution. Cover the sac with a water-soluble lubricant and a dry sterile dressing. Allow the sac to dry out to "toughen" it. Cover the sac with petroleum jelly and a dry sterile dressing.
Apply a sterile dressing moistened in a warm, sterile saline solution.
What information is most correct regarding the nervous system of the child? The child has underdeveloped gross motor skills and well-developed fine motor skills. The child's nervous system is fully developed at birth. The child has underdeveloped fine motor skills and well-developed gross motor skills. As the child grows, the gross and fine motor skills increase.
As the child grows, the gross and fine motor skills increase.
The nurse will administer what medication to children with Kawasaki disease both in the acute and later stages of the illness? Iron Penicillin Aspirin IVIG
Aspirin
Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition? Observe for excessive crying Asses for presence of femoral pulses Record an upper extremity BP Auscultate for a cardiac murmur
Asses for presence of femoral pulses
The nurse is assessing a 6-week-old at a pediatrician's appointment. What objective data gathered by the nurse indicates a diagnosis of possible developmental dysplasia of the hip? Select all that apply. Hip clicking Asymmetry of gluteal folds Adduction of hips Apparent shortening of femur Limited abduction of the affected hip
Asymmetry of gluteal folds Apparent shortening of femur Limited abduction of the affected hip
The nurse asks the caregivers of a child diagnosed with cerebral palsy whether the child, "seems to be in a state of constant motion." The question is designed to identify what form of cerebral palsy? Rigidity Ataxic Athetoid Spastic
Athetoid
The nurse is caring for a child who had a seizure, fell to the ground, and hit and injured his face, head, and shoulders. When notifying the health care provider, which type of seizure is the nurse most likely to report? Atonic Absence Myoclonic Infantile
Atonic
After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow? Tetralogy of Fallot Hypoplastic left heart syndrome Transposition of the great vessels Atrial septal defect
Atrial septal defect
The nurse is caring for a child who is having a seizure. What is the appropriate action by the nurse? Place a bite block or oral airway into the child's mouth to prevent biting of the tongue. Attempt to turn the child on their side to prevent aspiration. Attempt to place oxygen on the child so they don't become cyanotic. Hold the child's arms and legs still so they aren't injured.
Attempt to turn the child on their side to prevent aspiration.
Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn? Assessing leg kicks for extension Visual inspection of the hip Barlow sign and Ortolani click Full range of motion of the hip
Barlow sign and Ortolani click
What finding is consistent with increased ICP in the child? Narcolepsy Emotional lability Increased appetite Bulging fontanel
Bulging fontanel
The nurse is caring for a child diagnosed with rheumatic fever. When addressing the child's pain, the nurse should perform which intervention(s)? Select all that apply. Carefully handle the child's knees, ankles, elbows and wrists when moving the child. Teach the child how to use a patient-controlled analgesia system. Administer intravenous morphine as prescribed. Administer salicylates after meals or with milk. Prioritize nonpharmacologic interventions over pharmacologic interventions.
Carefully handle the child's knees, ankles, elbows and wrists when moving the child. Administer salicylates after meals or with milk.
To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority? Cerebral edema Renal failure Cardiogenic shock Left-sided heart failure
Cerebral edema
The nurse is collecting data on a child being evaluated for rheumatic fever. The caregiver reports that over the past several weeks the child seems to have lack of coordination, facial grimaces and repetitive involuntary movements. Based on these symptoms the nurse would suspect what condition? Arthralgia Polyarthritis Carditis Chorea
Chorea
The nurse is in the room when a child with a seizure disorder is having a seizure. The child is exhibiting generalized jerking muscle movement, and the nurse notes the bed appears to be wet with urine. The child is in which stage of the generalized seizure? Prodromal Tonic Clonic Postical
Clonic
A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)? Decreased pressure Elevated sugar Cloudy appearance Decreased leukocytes
Cloudy appearance
The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? Pale to clear urine Light orange to moderate yellow color Cloudy yellow Cola colored
Cola colored
When assessing an infant born at 32 weeks' gestation, which finding would lead the nurse to suspect that the newborn has a patent ductus arteriosus (PDA)? Weak, thread pulse, Continuous murmur on auscultation Decreased pulse rate High diastolic arterial pressure
Continuous murmur on auscultation
The nurse is assigned an infant with a possible neurological disorder. Which assessment finding would the nurse communicate to the health care provider as a late sign of increased intracranial pressure? Headache and sunset eyes Decreased pupil reaction and decreased respiration. Dizziness and irritability Decorticate posturing and fixed and dilated pupils
Decorticate posturing and fixed and dilated pupils
The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find? Hypoalbuminemia Hyperlipidemia Hypoproteinemia Decreased BUN
Decreased BUN
The nurse discovers a hypospadias during the physical assessment of a newborn. Which information is most important? Select all that apply. Delay the circumcision until the hypospadias is surgically repaired. Save the diapers so that output can be measured. Surgical repair is often completed between ages 6 and 12 months. This congenital anomaly will cause further problems for the child as he grows to an adult. Hypospadias does not need any medical intervention.
Delay the circumcision until the hypospadias is surgically repaired. Save the diapers so that output can be measured. Surgical repair is often completed between ages 6 and 12 months.
During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed? Dramatic increase in head circumference Pupil of one eye dilated and reactive Vertical nystagmus Posterior fontanel closed
Dramatic increase in head circumference
Haemophilus influenzae meningitis is usually spread by which method of transmission? Droplet Contact Fecal IV
Droplet
A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? Pseudomonas E. coli Klebsiella Staph aureus
E. coli
A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication? Alprostadil Spironolactone Heparin Indomethacin
Indomethacin
The nurse caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply. Number of seizures child has had in the last 48 hours Factors present before seizure started Persons in attendance during seizure Eye position and movement Incontinence of urine or stool Time seizure started.
Factors present before seizure started Eye position and movement Incontinence of urine or stool Time seizure started.
After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: Narrow pulse Femoral pulse weaker than brachial pulse Hepatomegaly Bounding pulse
Femoral pulse weaker than brachial pulse
The nurse is doing an examination on an infant with a diagnosis of developmental dysplasia of the hip (DDH). Which finding would be an indication of this diagnosis? Sac protruding on the lower back Gluteal fold higher on one side than the other Respiratory rate of 30 breaths per minute Head circumference of 18 inches (46 cm)
Gluteal fold higher on one side than the other
The child diagnosed with muscular dystrophy uses a method of rising from the floor which is referred to as which of the following? Legg-Calve-Perthes Boston brace Milwaukee brace Gowers sign
Gowers sign
The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure? He gets sweaty when he eats He does not seem short of breath He does not seem sick He seems to have a normal appetite
He gets sweaty when he eats
A school-aged child diagnosed with glomerulonephritis is in the physician's office for a 6-month follow-up visit. Hematuria is found in the urine. The parents are concerned and want to know why the glomerulonephritis is not gone. What is the best response by the nurse? This is probably related to a UTI and not glomerulonephritis. This is unusual and further testing will need to be done. The child will need treatment with antibiotics for strep throat. Hematuria can remain in the urine for up to one year.
Hematuria can remain in the urine for up to one year.
The nurse is checking a newborn for the presence of Ortolani maneuver and Barlow sign. For which health problem are these assessments used? Club foot Hip dysplasia Cleft palate Tracheoesophageal fistula
Hip dysplasia
An 8-month-old infant has a ventricular septal defect. Which nursing diagnosis would best apply? Impaired skin integrity related to poor peripheral circulation Ineffective tissue perfusion related to inefficiency of the heart as a pump Impaired gas exchange related to a right-to-left shunt Ineffective airway clearance related to altered pulmonary status
Ineffective tissue perfusion related to inefficiency of the heart as a pump
The nurse is planning care for an 8-month-old infant with a ventricular septal defect. Which nursing diagnosis should the nurse use to help guide the care for this client? Impaired skin integrity related to poor peripheral circulation Ineffective airway clearance related to altered pulmonary status Impaired gas exchange related to a right-to-left shunt Ineffective tissue perfusion related to inefficiency of the heart as a pump
Ineffective tissue perfusion related to inefficiency of the heart as a pump
The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority? Admin Tylenol Initiate IV Assess cervical lymph nodes Place child of soft diet
Initiate IV
The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for? Irritability, fever, vomiting, Jaundice, drowsiness, refusal to eat Negative Kernig sign Flat fontanel
Irritability, fever, vomiting,
An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse? It will determine if the heart is enlarged It will determine disturbances in the hearts condition It will show if blood is being shunted The image will clarify the structure of the heart
It will determine if the heart is enlarged
After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding? Jerky movements of the face and upper extremities Janeway lesions Osler nodes Black lines
Jerky movements of the face and upper extremities
The nurse is assessing a newborn and suspects developmental dysplasia of the hip (DDH). For which sign is the nurse prioritizing in this potential diagnosis? Symmetry of the gluteal skin folds Lengthening of the femur Limited abduction of the affected hip Bilateral adduction of the legs
Limited abduction of the affected hip
Absence seizures are marked by what clinical manifestation? Sudden, brief jerks of a muscle group Loss of motor activity accompanied by a blank stare Brief, sudden onset of increased tone of the extensor muscle Loss of muscle tone and loss of consciousness
Loss of motor activity accompanied by a blank stare
The nurse caring for a child diagnosed with juvenile idiopathic arthritis (JIA) should provide medication education to the caregivers for which first-choice medication to manage the child's pain and joint inflammation? Aspirin Naproxen Acetaminophen Codeine
Naproxen
Any individual taking phenobarbital for a seizure disorder should be taught: Brush teeth 4-5 times a day Never go swimming Avoid foods with caffeine Never disc abruptly
Never disc abruptly
The nurse meets a child with a slipped capital femoral epiphysis. In what type of child does this usually occur? Obese adolescent boys Tall, thin girls Active school-age children Preadolescent girls
Obese adolescent boys
A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome? Weight gain and high fever Dysuria and lethargy Oliguria and jaundice Polyuria and diarrhea
Oliguria and jaundice
The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated? Fatigue from viral infection onset 3 days ago Onset of a streptococcus infection last week A sports injury to the kidney two weeks ago Increased thirst, sweating and shakiness since yesterday
Onset of a streptococcus infection last week
A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? Irritability and dry mucous membranes Peel hands and feet, fever Decreased HR and impalpable pulse Low blood pressure and decreased HR
Peel hands and feet, fever
The prevention of cerebral palsy is the most important aspect of care. Which of the following are focus areas for the prevention of cerebral palsy? Select all that apply. Prenatal prevention of gestational diabetes Perinatal monitoring to decrease birth trauma Prenatal care to improve nutrition Postnatal prevention of rubella Postnatal prevention of infection
Perinatal monitoring to decrease birth trauma Prenatal care to improve nutrition Postnatal prevention of infection
A 1-year-old with tetralogy of Fallot turns blue during a temper tantrum. What will the nurse do first? Explain to the child the need to calm down. Listen for an increased respiratory rate. Place child in the knee-to-chest position. Assess for an irregular heart rate.
Place child in the knee-to-chest position.
A nurse is giving discharge instructions to the parents of a newborn with a congenital heart disorder. What should the nurse instruct the parents to do in the event that the child becomes cyanotic? Place him in a knee-chest position Perform hands-on CPR Administer low-dose aspirin Administer prescribed amoxicillin
Place him in a knee-chest position
A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges? Negative Brudzinski sign Positive Kernig sign Negative Chadwick sign Negative Kernig sign
Positive Kernig sign
The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider? Negative for respiratory syncytial virus (RSV) Positive culture for group A streptococcus White blood cells: 8,000/µL (8.0 ×109/L) Urine culture positive for contaminants
Positive culture for group A streptococcus
The nurse is preparing a nursing care plan for an infant who was born with spina bifida with myelomeningocele. Which nursing goal should the nurse prioritize for this child? Promote comfort measures Reduce family anxiety Provide caregiver teaching Prevent infection
Prevent infection
A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? Hematuria, proteinuria, and hyperalbuminemia Proteinuria, hyperalbuminemia, and hypocholesterolemia Proteinuria, hypoalbuminemia, and hypercholesterolemia Neutropenia, hematuria, and hypocholesterolemia
Proteinuria, hypoalbuminemia, and hypercholesterolemia
A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta? Cyanosis with crying Cyanoiss with feeding Pulses weaker in lower extremities Pulses weaker in upper extremities
Pulses weaker in lower extremities
The nurse is teaching a group of nursing students about genitourinary conditions. The nurse tells these students about a condition that occurs when there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to is: Pyelonephritis Ascites Oliguria Amenorrhea
Pyelonephritis
A child diagnosed with acute glomerulonephritis will most likely have a history of: Hearing loss with impaired speech Recent illness - strep throat Hemorrhage or history of bruising easily Sibling with the same disease
Recent illness - strep throat
The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which function is a major task of the kidneys? Produce WBC Circulate CSF Remove CO2 Regulate blood pressure
Regulate blood pressure
A nursing student is caring for a newborn with a defect in the neural arch where the posterior laminae of the vertebrae have failed to close. The nurse knows that this infant is suffering from which disorder? Esophageal atresia Hydrocephalus Cleft palate Spina bifida
Spina bifida
When assessing a newborn, the nurse observes dimpling and thickening of the newborn's skin over the lumbar spine and the presence of a tuft of hair. On further examination, the nurse notices no motor or sensory deficits in the newborn. The nurse interprets these findings as indicating which of the following? Meningocele Spina bifida occulta Myelomeningocele Hydrocephalus
Spina bifida occulta
The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: Decorticate posturing Doll's eye Nystagmus Sunsetting
Sunsetting
The nurse is working with a 6-year-old child recently diagnosed with Legg-Calvé-Perthes disease. The child's parents tells the nurse they understand exercise is important for their child but are not sure which activities are appropriate. Which activity will the nurse recommend for this client? Soccer Swimming Brisk walking Jumping jacks
Swimming
To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? Teach her to take frequent tub baths to clean her perineal area. Suggest she drink less fluid daily to concentrate urine. Encourage her to be more ambulatory to increase urine output. Teach her to wipe her perineum front to back after voiding.
Teach her to wipe her perineum front to back after voiding.
The nurse is assessing a child with suspected rheumatic fever. What assessment findings are consistent with the disease process? Select all that apply. Diastolic murmur Tender swollen joints Nonpalpable subcutaneous nodules Macular rash on trunk Involuntary limb movement
Tender swollen joints Macular rash on trunk Involuntary limb movement
A newborn has been diagnosed with congenital heart disease. Which of the following congenital heart diseases is associated with cyanosis? Coarctation of arorta Aortic stenosis Tetralogy of fallot Pulmonary stenosis
Tetralogy of fallot
The nurse is caring for a child who has just been diagnosed with nephrotic syndrome. What health education should the nurse provide to the child and family? The need to avoid high-sodium foods The need for hemodialysis The advantage of peritoneal dialysis The importance of increasing fluid intake
The need to avoid high-sodium foods
A child with a congenital heart defect is getting an echocardiogram. How would the nurse describe this test to the parent? This noninvasive test will check the electrical impulses in the heart. This test will only determine the size of the heart. This test will check how blood is flowing through the heart. This invasive test will measure the blockage in the heart.
This test will check how blood is flowing through the heart.
When caring for a child who has a diagnosis of acute glomerulonephritis, which nursing interventions would most likely be included in the child's plan of care? Select all that apply. The nurse dipsticks the child's urine to test for protein. The nurse weighs the child every day using the same scale. The nurse encourages ambulation several times a day. The nurse promotes increased fluid intake. The nurse administers diuretics. The nurse administers antihypertensives.
The nurse dipsticks the child's urine to test for protein. The nurse weighs the child every day using the same scale. The nurse administers diuretics. The nurse administers antihypertensives.
When caring for a child who has a history of seizures, which nursing interventions would be appropriate? Select all that apply. The nurse has oxygen available to use during a seizure. The nurse teaches the caregivers regarding seizure precautions. The nurse places a washcloth in the mouth to prevent injury during seizure. The nurse stays with the child and calls for help when a seizure begins The nurse pads the crib or side rails before a seizure. The nurse positions the child on the side during a seizure.
The nurse has oxygen available to use during a seizure. The nurse teaches the caregivers regarding seizure precautions. The nurse stays with the child and calls for help when a seizure begins The nurse pads the crib or side rails before a seizure. The nurse positions the child on the side during a seizure.
A nursing instructor is preparing a discussion which will illustrate the different forms of spina bifida. The instructor determines the session is successful after the students correctly choose which form as being spina bifida with myelomeningocele? The spinal cord, meninges, and nerve roots protrude out the lower back. There is a bony defect that occurs without soft-tissue involvement. There's a cystic sac containing the spinal meninges protruding out the back. There is only soft-tissue inflammation without protrusion.
The spinal cord, meninges, and nerve roots protrude out the lower back.
An infant is diagnosed as having cerebral palsy. When planning care, which would the nurse stress to the parents? The parent should be tested during future pregnancies to predict similar involvement. Their child probably will benefit from early schooling to increase ability for self-care. The infant's disease will cause progressive brain cell degeneration with age. Administering an anti-acetylcholinergic drug to decrease muscle spasms is crucial.
Their child probably will benefit from early schooling to increase ability for self-care.
Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family? This is a problem where the right side of the heart did not develop properly. This is a problem where the left side of the heart did not develop properly. The infant will have immediate surgery to completely correct the heart defect. There are no surgeries that can help the child live with this heart defect.
This is a problem where the left side of the heart did not develop properly.
A mother asks why her infant with a cyanotic heart defect turns blue. What is the nurse's best explanation? This is a sign of heart failure This is due to a decreased amount of oxygen to the peripheral tissue This is considered a medical emergency and the infant needs immediate surgery This is due to the lack of oxygen to the brain
This is due to a decreased amount of oxygen to the peripheral tissue
A child is having the urine checked for a routine well visit. When analyzing the results, what would positive leukocytes indicate? This may indicate a urinary tract infection. This determines the presence of red blood cells in the urine. This determines the presence of sugar in the urine. This indicates renal disease.
This may indicate a urinary tract infection.
A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education? This occurs when there is backflow of urine into the bladder and sometimes the kidneys. This is typically treated with a kidney transplant. This is diagnosed by abdominal x-ray. This occurs only when there is an obstruction of the ureteropelvic junction.
This occurs when there is backflow of urine into the bladder and sometimes the kidneys.
Which of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection? Urinalysis Chemical reagent strip Specific gravity BUN
Urinalysis
A female adolescent comes to the clinic for an evaluation. Assessment reveals a possible urinary tract infection. What would the nurse expect to be done to confirm this suspicion? Urine culture Kidney, ureter, bladder X-ray Renal ultrasound IV pyelogram
Urine culture
A nurse is providing information to the parents of a child diagnosed with absence seizures. What information would the nurse expect to include when describing this type of seizure? Select all that apply. You might have mistaken this type of seizure for lack of attention. This type of seizure is usually short, lasting for no more than 30 seconds. You might see a blank facial expression after a sudden stoppage of speech. This type of seizure is more common in girls than it is in boys. The child will commonly report a strange odor or sensation before the seizure. Your child will probably sleep deeply for ½ to 2 hours after the seizure.
You might have mistaken this type of seizure for lack of attention. This type of seizure is usually short, lasting for no more than 30 seconds. You might see a blank facial expression after a sudden stoppage of speech. This type of seizure is more common in girls than it is in boys.
A baby with developmental dysplasia of the hip is placed in a Pavlik harness. The harness positions the hip in which position? an extended, adducted position to relieve pressure from the femur against the acetabulum a flexed, abducted position to press the femur head against the acetabulum an extended, abducted position to stabilize the femur head and the acetabulum a flexed, adducted position to point the femur towards the acetabulum
a flexed, abducted position to press the femur head against the acetabulum
The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is to: dilute the urine and flush the bladder. prevent the child from developing a fever. fill the bladder so a specimen can be obtained. decrease the pain of urination.
dilute the urine and flush the bladder.
Assessment of a school-aged child reveals a sudden onset of hematuria. The parent states that the child has not felt well but the only recent past medical history is impetigo. Acute post-streptococcal glomerulonephritis is diagnosed and laboratory tests are performed. Which result would the nurse identify as supporting this diagnosis? Select all that apply. increased blood urea nitrogen level decreased erythrocyte sedimentation rate elevated antistreptolysin O titer decreased blood protein level increased blood creatinine level
increased blood urea nitrogen level decreased blood protein level increased blood creatinine level
When caring for a child with Kawasaki disease, the nurse would know that: joint pain is a permanent problem. antibiotics should be administered every 8 hours by IV. steroid creams are used for the hand peeling. management includes administration of aspirin and IVIG.
management includes administration of aspirin and IVIG
While assessing an infant, the nurse suspects developmental dysplasia of the hip (DDH) based on which findings? Select all that apply. prominence of the trochanter on the right side asymmetry of gluteal skin folds right knee lower than the left in supine position limited mobility of the right leg positive stepping reflex
prominence of the trochanter on the right side asymmetry of gluteal skin folds right knee lower than the left in supine position
The caregivers of a child who has had difficulty learning to walk notice that when the child attempts to pull himself up to stand, he can't seem to get his legs uncrossed and beside each other. When he is in a standing position, he stays up on his toes. This is different from what they saw with their older children and they are concerned. Further diagnostic tests indicate the child has cerebral palsy. When instructing on the types of cerebral palsy, which type will the nurse present? athetoid cerebral palsy ataxic cerebral palsy rigidity cerebral palsy spastic cerebral palsy
spastic cerebral palsy