Final Peds

The nurse is interviewing the mother of an infant. She reports, I had a difficult delivery, and my baby was born prematurely. This information should be recorded under which heading?

Birth history

Which statement best describes the infants physical development?

Birth weight doubles by age 5 months and triples by age 1 year.

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given:

Commercial iron-fortified formula.

What term is used to describe breath sounds that are produced as air passes through narrowed passageways?

Wheezes

Austin, age 6 months, has six teeth. The nurse should recognize that this is:

Earlier-than-normal tooth eruption.

Pacifiers can be extremely dangerous because of the frequency of use and the intensity of the infants suck. In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have which characteristics (select all that apply)?

Easily grasped handle One-piece construction Sturdy, flexible material

A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter (Select all that apply)?

Elicit one answer at a time. Arrange for the family to speak with the same interpreter, if possible. Introduce the interpreter to the family.

A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan?

Eliminate all secondhand smoke contact.

A parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. The nurses best action is:

Encourage parent to verbalize feelings.

Which is the most appropriate action when an infant becomes apneic?

Gently stimulate trunk by patting or rubbing.

The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurses reply should be based on knowing that

Hot dogs must be cut into small, irregular pieces to prevent aspiration.

Sara, age 4 months, was born at 35 weeks gestation. She seems to be developing normally, but her parents are concerned because she is a more difficult baby than their other child, who was term. The nurse should explain that:

Infants temperaments are part of their unique characteristics.

When palpating the childs cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is:

Infection or inflammation close to the site.

The nurse must assess 10-month-old infant. The infant is sitting on the fathers lap and appears to be afraid of the nurse and of what may happen next. Which initial action by the nurse would be most appropriate?

Initiate a game of peek-a-boo.

The nurse is seeing an adolescent boy and his parents in the clinic for the first time. What should the nurse do first?

Introduce himself or herself

The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says No firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan:

Is old enough to understand the word No.

The nurse has a 2-year-old boy sit in tailor position during palpation for the testes. The rationale for this position is that:

It prevents cremasteric reflex

A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infants risk of a SIDS incident(select all that apply)?

Low Apgar scores Male sex Recent viral illness

An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to:

Make a follow-up home visit to parents as soon as possible after the infants death.

When doing a nutritional assessment on an Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet:

May provide sufficient amino acids.

A parent asks the nurse whether her infant is susceptible to pertussis. The nurses response should be based on which statement concerning susceptibility to pertussis?

Most children are highly susceptible from birth.

What heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?

Murmur

The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the babys formula faster. The nurse should recommend:

Never heating a bottle in a microwave oven.

During examination of a toddlers extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is:

Normal because the lower back and leg muscles are not yet well developed.

A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she will not voluntarily grasp it. The nurse should interpret this as:

Normal development.

Where is the best place to observe for the presence of petechiae in dark-skinned individuals?

Oral mucosa

The nurse must assess a childs capillary filling time. This can be accomplished by:

Palpating the skin to produce a slight blanching.

With the goal of preventing plagiocephaly, the nurse should teach new parents to:

Place the infant prone for 30 to 60 minutes per day.

Where in the health history should the nurse describe all details related to the chief complaint?

Present illness

What describes a toddlers cognitive development at age 20 months?

Realizes that out of sight is not out of reach

The clinic is lending a federally approved car seat to an infants family. The nurse should explain that the safest place to put the car seat is:

Rear facing in back seat.

Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that Latasha recently began to suck her thumb. The best nursing intervention is to:

Reassure the mother that this is very normal at this age.

The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the childs head (opisthotonos) with pain on flexion. The most appropriate action is to:

Refer for immediate medical evaluation.

During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurses most appropriate action?

Refer the child for further evaluation.

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do?

Roll from abdomen to back.

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do (select all that apply)?

Roll from abdomen to back. Put feet in mouth when supine.

According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase?

Secondary circular reactions

The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that:

Soft and flexible shoes are generally better.

The nurse is planning care for a 17-month-old child. According to Piaget, in what stage would the nurse expect the child to be?

Tertiary circular reaction

The nurse is using the NCHS growth chart for an African-American child. The nurse should consider that:

The NCHS charts are accurate for U.S. African-American children.

When introducing hospital equipment to a preschooler who seems afraid, the nurses approach should be based on which principle?

The child may think the equipment is alive.

What is the single most important factor to consider when communicating with children?

The childs developmental level

The nurse must check vital signs on a 2-year-old boy who is brought to the clinic for his 24-month checkup. Which criteria should the nurse use in determining the appropriate-size blood pressure cuff (Select all that apply)?

The cuff bladder width is approximately 40% of the circumference of the upper arm. The cuff bladder length covers 80% to 100% of the circumference of the upper arm.

An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the emergency department. Which is an appropriate question to ask the parents?

What time did you find the infant?

A child has a total cholesterol level of 180 mg/dL. What dietary recommendations should the nurse make to the child and the childs parents (Select all that apply)?

. Replace whole milk with 2% or 1% milk c. Increase servings of fish d. Avoid excessive intake of fruit juices

By what age do the head and chest circumferences generally become equal?

1 to 2 years

Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older than:

1 year.

Generally the earliest age at which puberty begins is:

10 years in girls, 12 years in boys.

The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula?

12 months

The nurse should expect the anterior fontanel to close at age:

12 to 18 months

The mean age of menarche in the United States is:

12.5 years

By what age should concerns about pubertal delay be considered in boys?

13.5 to 14 years

Which child should the nurse document as being anemic?

14-year-old child with a hemoglobin of 10 g/dL

The nurse is performing a Glasgow Coma Scale (GCS) on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record?

15

The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately:

15 pounds.

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

2 months

Kimberlys parents have been using a rearward-facing, convertible car seat since she was born. The parents should be taught that most car seats can be safely switched to the forward-facing position when the child reaches which age?

2 years

The earliest age at which a satisfactory radial pulse can be taken in children is:

2 years

Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is normally present by what age

3 to 4 months

The nurse is testing an infants visual acuity. By what age should the infant be able to fix on and follow a target?

3 to 4 months

When is the best age for solid food to be introduced into the infants diet?

4 to 6 months

By what age would the nurse expect that most children could understand prepositional phrases such as under, on top of, beside, and in back of?

4 years

A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is human immunodeficiency virus (HIV) positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test?

5 mm

A parent asks the nurse At what age do most babies begin to fear strangers? The nurse responds that most infants begin to fear strangers at age:

6 months.

By what age does the posterior fontanel usually close?

6 to 8 weeks

At which age can most infants sit steadily unsupported?

8 months

With the National Center for Health Statistics (NCHS) criteria, which body mass index (BMI)for-age percentile indicates a risk for being overweight?

85th percentile

Parents of a 12-year-old child ask the clinic nurse, How many hours of sleep should our child get? The nurse should respond that 12-year-old children need how many hours of sleep at night?

9

By what age should the nurse expect that an infant will be able to pull to a standing position?

9 months

At what age do most children have an adult concept of death as being inevitable, universal, and irreversible?

9 to 11 years

An 8-year-old girl tells the nurse that she has cancer because God is punishing her for being bad. She shares her concern that, if she dies, she will go to hell. The nurse should interpret this as being:

A belief common at this age.

Which statement accurately describes physical development during the school-age years?

A child grows an average of 2 inches per year.

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:

A feeling of fullness in the ear.

For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia?

A nasogastric tube fails to pass at birth.

The nurse has received report on four children. Which child should the nurse assess first?

A preschool child with a head injury and decreasing level of consciousness

Which best describes how preschoolers react to the death of a loved one?

A preschooler is likely to feel guilty and responsible for the death.

Which toy is the most developmentally appropriate for an 18- to 24-month-old child?

A push-pull toy

An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with:

A small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream.

A child has been seizure-free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. The nurse includes which intervention in the response?

A stepwise approach will be used to reduce the dosage gradually.

A mother tells the nurse that she doesnt want her infant immunized because of the discomfort associated with injections. The nurse should explain that:

A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be applied before injections are given.

The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as:

A way to establish rapport.

The nurse is discussing various sites used for insulin injections with a child and her family. Which site usually has the fastest rate of absorption?

Abdomen

Which clinical manifestation would most suggest acute appendicitis?

Abdominal pain that is most intense at McBurneys point

A nurse planning care for a school-age child should take into account that which thought process is seen at this age?

Ability to conserve

The psychosocial developmental tasks of toddlerhood include:

Ability to withstand delayed gratification

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses. She states that the other children at her school call her four-eyes. Contact lenses should be prescribed for a child who is:

Able to independently care for the lenses in a responsible manner.

When a child with mild cognitive impairment reaches the end of adolescence, what characteristic would be expected?

Achieves a mental age of 8 to 12 years

Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when:

Acne has not responded to other treatments.

Which condition is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T-cells?

Acquired immunodeficiency syndrome (AIDS)

Preschoolers fears can best be dealt with by which intervention?

Actively involving them in finding practical methods to deal with the frightening experience

The most appropriate nursing diagnosis for a child with anemia is:

Activity Intolerance related to generalized weakness.

Jos is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

Adapted to his level of development so that he can understand.

When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that:

Adequate dosage will turn the stools a tarry green color.

A school-age child is admitted in vaso-occlusive sickle cell crisis. The childs care should include:

Adequate hydration and pain management.

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. The most appropriate nursing action to prevent or minimize these reactions with subsequent treatments is to:

Administer an antiemetic before chemotherapy begins.

An important nursing consideration when chest tubes will be removed from a child is to:

Administer analgesics before the procedure.

The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to:

Administer naloxone (Narcan).

An important nursing consideration when suctioning a young child who has had heart surgery is to:

Administer supplemental oxygen before and after suctioning.

The nurse is caring for a school-age child with a tinea capitis (ringworm) infection. The nurse should expect that therapeutic management for this child includes:

Administering oral griseofulvin.

The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement

Administering penicillin

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

Administering the medication with a syringe (without needle) placed along the side of the infants tongue

The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing (Select all that apply)?

Administration of analgesics for pain Intravenous (IV) fluids continued until tolerating fluids by mouth e. Clear liquids as the first feeding

At what developmental period do children have the most difficulty coping with death, particularly if it is their own?

Adolescence

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to:

Adolescents often resenting the control and enforced dependence imposed by dialysis.

A school nurse is teaching dental health practices to a group of sixth-grade children. How often should the nurse recommend the children brush their teeth?

After meals and snacks, and at bedtime

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

After taking antibiotics for 24 hours

What is characteristic of the immune-mediated type 1 diabetes mellitus?

Age at onset is usually younger than 18 years.

What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well?

Alert the physician.

When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure?

All four extremities

The parent of 16-month-old Chris asks, What is the best way to keep Chris from getting into our medicines at home? The nurse should advise that:

All medicines should be locked securely away.

A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. This type of BMT is termed:

Allogeneic.

Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is to:

Allow her to wear her underpants.

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased ICP in an infant (Select all that apply)?

Alteration in pupil size and reactivity d. Extension or flexion posturing e. Cheyne-Stokes respirations

A child is diagnosed with influenza, probably type A disease. Management includes:

Amantadine hydrochloride to reduce symptoms.

An adolescent girl tells the nurse that she has suicidal thoughts. The nurse asks her if she has a specific plan. Asking this should be considered:

An appropriate part of the assessment.

When interviewing the mother of a 3-year-old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered because these milestones are:

An important part of the childs past growth and development.

A child is admitted with extensive burns. The nurse notes that there are burns on the childs lips and singed nasal hairs. The nurse should suspect that the child has:

An inhalation injury.

What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

Anaphylactic shock

A nurse is reviewing hormone changes that occur during adolescence. The hormone that is responsible for the growth of beard, mustache, and body hair in the male is:

Androgen.

Steven, 16 months old, falls down a few stairs. He gets up and scolds the stairs as if they caused him to fall. This is an example of which of the following?

Animism

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurses approach should include:

Answering questions with straightforward honesty.

Acute diarrhea is often caused by:

Antibiotic therapy.

Approach behaviors are coping mechanisms that result in a familys movement toward adjustment and resolution of the crisis of having a child with a chronic illness or disability. What is considered an approach behavior in parents?

Anticipate future problems and seek guidance and answers

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by:

Antihistamines.

A young childs parents call the nurse after their child was bitten by a raccoon in the woods. The nurses recommendation should be based on knowing that:

Antirabies prophylaxis must be initiated.

In which condition are all the formed elements of the blood simultaneously depressed?

Aplastic anemia

Steve, 14 years old, mentions that he now has to use deodorant but never had to before. The nurses response should be based on knowledge that:

Apocrine sweat glands reach secretory capacity during puberty.

A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria. Which dietary menu items should be allowed for this child (Select all that apply)?

Apples d. Carrot sticks e. Strawberries

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:

Apply direct pressure above the catheterization site.

A young girl has just injured her ankle at school. In addition to calling the childs parents, the most appropriate immediate action by the school nurse is to:

Apply ice.

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes:

Applying a Fox shield to the affected eye and any type of patch to the other eye.

A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?

Appropriate use of car seat restraints

. A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics:

Are of no value in treating hyperthermia.

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy?

Arrangements for tutoring and schoolwork

When should children with cognitive impairment be referred for stimulation and educational programs?

As young as possible

The nurse is taking a sexual history on an adolescent girl. The best way to determine whether she is sexually active is to:

Ask her, Are you having sex with anyone?

The nurse is taking a health history on an adolescent. What best describes how the chief complaint should be determined?

Ask the adolescent, Why did you come here today?

The nurse is having difficulty communicating with a hospitalized 6-year-old child. What technique may be most helpful?

Ask the child to draw a picture.

Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all that apply.)

Asking questions if families are not participating in the care Clarifying information for families Learning about the familys religious preferences

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. The most appropriate way to collect small amounts of urine for these tests is to:

Aspirate urine from cotton balls inside the diaper with a syringe.

When infants are seen for fractures, which nursing intervention is a priority?

Assess for child abuse. Fractures in infants are often nonaccidental.

An appropriate nursing intervention when caring for a child in traction is to:

Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

Nursing interventions for the child after a cardiac catheterization include which of the following (Select all that apply)?

Assess the affected extremity for temperature and color. Maintain a patent peripheral intravenous catheter until discharge.

What is the nurses first action when planning to teach the parents of an infant with a congenital heart defect (CHD)?

Assess the parents anxiety level and readiness to learn.

What is descriptive of the preschoolers understanding of time?

Associates time with events

Which type of play is most typical of the preschool period?

Associative

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

Asthma.

A child with growth hormone (GH) deficiency is receiving GH therapy. The best time for the GH to be administered is:

At bedtime.

The child with Down syndrome should be evaluated for what characteristic before participating in some sports?

Atlantoaxial instability

Which defect results in increased pulmonary blood flow?

Atrial septal defect

The nurse uses the palms of the hands when handling a wet cast to:

Avoid indenting the cast.

A high-protein diet for the child with major burns is ordered to:

Avoid protein breakdown.

An infants parents ask the nurse about preventing otitis media (OM). What should the nurse recommend?

Avoid tobacco smoke.

What action may be beneficial in reducing the risk of Reyes syndrome?

Avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include:

Avoiding use for more than 3 days.

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition?

Bacterial gastroenteritis

Which accomplishment would the nurse expect of a healthy 3-year-old child?

Balance on one foot for a few seconds

Which statement is accurate concerning a childs musculoskeletal system and how it may be different from an adults?

Because soft tissues are resilient in children, dislocations and sprains are less common than in adults.

Imaginary playmates are beneficial to the preschool child because they:

Become friends in times of loneliness.

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

Before chest physiotherapy (CPT)

Which is now referred to as the new morbidity?

Behavioral, social, and educational problems that alter health

The nurse comes into the room of a child who was just diagnosed with a chronic disability. The childs parents begin to yell at the nurse about a variety of concerns. The nurses best response is:

Being angry is only natural.

Prevention of hearing impairment in children is a major goal for the nurse. This can be achieved through:

Being involved in immunization clinics for children.

Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to:

Bind phosphorus.

Which statement best describes a subdural hematoma?

Bleeding occurs between the dura and the cerebrum.

One of the most frequent causes of hypovolemic shock in children is:

Blood loss.

What should the nurse identify as major fears in the preschool child who is hospitalized with a chronic illness (select all that apply)?

Bodily injury d. Mutilation e. Being left alone

A boy with leukemia screams whenever he needs to be turned or moved. The most probable cause of this pain is:

Bone involvement.

The nurse is evaluating a child who is taking digoxin for her cardiac condition. The nurse is cognizant that a common sign of digoxin toxicity is:

Bradypnea.

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. What type of head injury should the nurse suspect?

Brainstem

Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration (Select all that apply)?

Bran cereal Prune juice Vegetables

In girls, the initial indication of puberty is:

Breast development.

Which play item should the nurse bring from the playroom to a hospitalized toddler in isolation?

Brightly colored balloon

A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of:

Bronchitis.

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include:

Brushing teeth or rinsing mouth after vomit

Which clinical manifestations would suggest hydrocephalus in a neonate?

Bulging fontanel and dilated scalp veins

It is important to make certain that sensory connectors and oximeters are compatible since wiring that is incompatible can cause:

Burns under sensors.

Which tool measures body fat most accurately?

Calipers

Teasing can be common during the school-age years. Which of the following does the nurse recognize as applying most to teasing?

Can have a lasting effect on children

The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by:

Candida albicans.

Which aspect of cognition develops during adolescence?

Capability to use a future time perspective

Which drug is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

The nurse is assessing a child postcardiac catheterization. Which complication might the nurse anticipate?

Cardiac arrhythmia

The nurse is caring for a child with acute renal failure. What clinical manifestation should he or she recognize as a sign of hyperkalemia?

Cardiac arrhythmia

A common, serious complication of rheumatic fever is:

Cardiac valve damage.

The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention?

Carefully follow universal precautions.

An important nursing consideration when caring for a child with impetigo contagiosa is to:

Carefully wash hands and maintain cleanliness when caring for an infected child.

Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?

Carotid

Which term refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?

Cataract

The nurse should understand that Lyme disease is:

Caused by a spirochete that enters the skin through a tick bite

A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent:

Central nervous system (CNS) disease.

Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the finger-to-nose test. The nurse is testing for:

Cerebellar function.

Parent guidelines for relieving colic in an infant include:

Changing the infants position frequently.

A group of boys ages 9 and 10 years have formed a boys-only club that is open to neighborhood and school friends who have skateboards. This should be interpreted as:

Characteristic of social development of this age.

The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should:

Check the patients identification name band.

The treatment of brain tumors in children consists of which therapies (Select all that apply)?

Chemotherapy Radiation Surgery

Which myth may interfere with the treatment of pain in infants and children?

Children and infants are more susceptible to respiratory depression from narcotics.

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on knowing that:

Children are better able to manage the diabetes.

Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurses recommendation should be based on knowing that:

Children with Down syndrome have the same need for socialization as other children.

Which represents a common best practice in the provision of services to children with chronic or complex conditions?

Children with complex conditions are integrated into regular classrooms.

A child with autism is hospitalized with asthma. The nurse should plan care so that the:

Childs routine habits and preferences are maintained.

The nurse is preparing to give oral care to a school-age child with mucositis secondary to chemotherapy administered to treat leukemia. Which preparations should the nurse use for oral care on this child (Select all that apply)?

Chlorhexidine gluconate (Peridex) c. Antifungal troches (lozenges) d. Lip balm (Aquaphor)

Chris, age 9 years, has several physical disabilities. His father explains to the nurse that his son concentrates on what he can rather than cannot do and is as independent as possible. The nurses best interpretation of this is:

Chris is using an adaptive coping style.

A nurse is preparing a teaching session for parents on prevention of childhood hearing loss. The nurse should include that the most common cause of hearing impairment in children is:

Chronic otitis media.

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of:

Circulatory overload.

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include:

Cleansing of suture line, supine and side-lying positions, and arm restraints.

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply).

Cluster care to conserve energy Administration of antibiotics

An implanted ear prosthesis for children with sensorineural hearing loss is a(n):

Cochlear implant.

A child has an evulsed (knocked-out) tooth. In which medium should the nurse instruct the parents to place the tooth for transport to the dentist?

Cold milk

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was bad. The nurses best interpretation of this comment is that it is:

Common at this age

The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or condition?

Complete obstruction

Which neurologic diagnostic test gives a visualized horizontal and vertical cross section of the brain at any axis?

Computed tomography (CT) scan

The ability to mentally understand that 1 + 3 = 4 and 4 3 = 1 occurs in which stage of cognitive development?

Concrete operations stage

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called:

Conductive.

The nurse should recommend medical attention if a child with a slight head injury experiences:

Confusion or abnormal behavior.

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is:

Congenital heart disease.

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

Congestive heart failure

The management of a child who has just been stung by a bee or wasp should include the application of:

Cool compresses.

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis?

Coping with stress and avoiding triggers

In terms of fine motor development, what could the 3-year-old child be expected to do?

Copy (draw) a circle.

What is used to treat moderate-to-severe inflammatory bowel disease?

Corticosteroids

The primary nursing intervention necessary to prevent bacterial endocarditis is to:

Counsel parents of high risk children about prophylactic antibiotics.

The teaching plan for the parents of a 3-year-old child with amblyopia (lazy eye) should include what instruction?

Cover the good eye completely with a patch.

The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?

Creatinine clearance

What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus?

Crohns disease

When pain is assessed in an infant, it is inappropriate for the nurse to assess for:

Crying.

Which description of a stool is characteristic of intussusception?

Currant jelly stools

Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds. Which is the primary purpose of hydrotherapy?

Debride the wounds.

Myelosuppression associated with chemotherapeutic agents or some malignancies such as leukemia can cause bleeding tendencies because of a/an:

Decrease in blood platelets.

Acyclovir (Zovirax) is given to children with chickenpox to:

Decrease the number of lesions.

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor?

Decreased metabolic rate

A beneficial effect of administering digoxin (Lanoxin) is that it:

Decreases edema.

An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of:

Dehydration.

A young child with human immunodeficiency virus is receiving several antiretroviral drugs. The purpose of these drugs is to:

Delay disease progression.

A nurse is performing an assessment on a school-age child. Which findings suggest the child is receiving an excess of vitamin A (Select all that apply)?

Delayed sexual development Pruritus Jaundice

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?

Demonstrate a dressing change on a doll.

Using knowledge of child development, the best approach when preparing a toddler for a procedure is to:

Demonstrate the procedure on a doll.

One of the clinical manifestations of chronic renal failure is uremic frost. What best describes this term?

Deposits of urea crystals on skin

An important nursing intervention when caring for a child who is experiencing a seizure is to:

Describe and record the seizure activity observed.

Which of the following best describes a full-thickness (third-degree) burn?

Destruction of all layers of skin evident with extension into subcutaneous tissue

The nurse is discussing with a parent group the importance of fluoride for healthy teeth. The nurse should recommend that the parents:

Determine whether water supply is fluoridated.

The type of injury a child is especially susceptible to at a specific age is most closely related to:

Developmental level of the child.

Which statement best describes a neuroblastoma?

Diagnosis is usually made after metastasis occurs.

Which type of fracture describes traumatic separation of cranial sutures?

Diastatic

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

Diet should be high in carbohydrates and protein.

b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?

Dilate the bronchioles

Which should the nurse teach to parents of toddlers about accidental poison prevention (select all that apply)?

Discard empty poison containers. c. Know the number of the nearest poison control center. Caution child against eating nonedible items, such as plants.

When assessing the child with osteogenesis imperfecta, the nurse should expect to observe:

Discolored teeth.

A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The childs level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to:

Discuss with practitioner what analgesia can be safely administered.

One of the first signs of overwhelming sepsis in a child with burn injuries is:

Disorientation.

What is an expected assessment finding in a child with coarctation of the aorta?

Disparity in blood pressure between the upper and lower extremities

The nurse gives an injection in a patients room. What should the nurse do with the needle for disposal?

Dispose of syringe and needle in a rigid, puncture-resistant container in patients room.

A nurse is planning palliative care for a child with severe pain. Which should the nurse expect to be prescribed for pain relief?

Distraction and relaxation techniques

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of:

Down syndrome.

Which activity is most appropriate for developing fine motor skills in the school-age child?

Drawing

An advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast:

Dries rapidly.

A possible cause of acquired aplastic anemia in children is:

Drugs.

The community health nurse is teaching parents about prevention of the spread and reoccurrence of pediculosis (head lice). Which should the nurse include in the teaching session (Select all that apply)?

Dry-clean nonwashable items. d. Boil combs and brushes for 10 minutes. e. Discourage sharing of personal items.

The parents of a 15-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make?

During adolescence this behavior is not unusual.

When does idiopathic scoliosis become most noticeable?

During preadolescent growth spurt

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?

Dyspnea

A nurse is recommending strategies to a group of school-age children for prevention of obesity. Which should the nurse include (select all that apply)?

Eat breakfast daily. Have frequent family meals with parents present. Limit television viewing to 2 hours a day.

Developmentally, most children at age 12 months:

Eat the same food as the rest of the family.

A normal characteristic of the language development of a preschool-age child is:

Echolalia.

During the preschool period, the emphasis of injury prevention should be placed on:

Education for safety and potential hazards.

A nurse is planning care for a hospitalized toddler in the preoperational thinking stage. Which characteristics should the nurse expect in this stage (select all that apply)?

Egocentrism c. Animism Magical thinking

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching?

Elevate casted arm when resting and when sitting up.

A nurse should expect which cerebrospinal fluid (CSF) laboratory results on a child diagnosed with bacterial meningitis (Select all that apply)?

Elevated white blood cell (WBC) count c. Decreased glucose d. Cloudy in color

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

Elevating the head but giving nothing by mouth.

Chelation therapy is begun on a child with b-thalassemia major. The purpose of this therapy is to:

Eliminate excess iron.

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initialtherapeutic approach to the mother should be to:

Encourage her to express her feelings.

Which action is contraindicated when a child with Down syndrome is hospitalized?

Encourage parents to leave the child alone for extended periods of time.

An appropriate nursing intervention when caring for a child with pneumonia is to:

Encourage rest.

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply):

Encouraging and helping mother to breastfeed. Recommending use of a breast pump to maintain lactation until infant can suck.

Which intervention will encourage a sense of autonomy in a toddler with disabilities?

Encouraging independence in as many areas as possible

Which behavior is not normally demonstrated in the 8-year-old child?

Engages in fantasy and magical thinking

A common clinical manifestation of Hodgkins disease is:

Enlarged, firm, nontender lymph nodes.

The nurse must suction a child with a tracheostomy. Interventions should include:

Ensuring that each pass of the suction catheter take no longer than 5 seconds.

Which type of croup is always considered a medical emergency?

Epiglottitis

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration?

Epinephrine

Bismuth subsalicylate, clarithromycin, and metronidazole are prescribed for a child with a peptic ulcer to:

Eradicate Helicobacter pylori.

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurses response should be based on knowledge that discipline is:

Essential for the child.

Which is an important nursing consideration when caring for an infant with failure to thrive?

Establish a structured routine and follow it consistently.

The priority nursing intervention when a child is unconscious after a fall is to:

Establish an adequate airway.

Which nursing intervention is the highest priority in the initial care of a child with a major burn injury?

Establishing and maintaining the childs airway

A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply:

Eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure.

What is the most appropriate response to a school-age child who asks if she can talk to her dying sister?

Even though she will probably not answer you, she can still hear what you say to her.

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is:

Excess Fluid Volume related to decreased plasma filtration.

A nurse would suspect possible visual impairment in a child who displays:

Excessive rubbing of the eyes.

An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to:

Explain in simple terms how it works.

The father of 12-year-old Ryan tells the nurse that he is concerned about his son getting fat. Ryans body mass index for age is at the 60th percentile. The most appropriate nursing action is to:

Explain that this is typical of the growth pattern of boys at this age.

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include:

Explaining that medication should not be applied until at least 20 to 30 minutes after washing.

The nurse is preparing a child for possible alopecia from chemotherapy. Which suggestion should be included in the teaching?

Explaining to the child that, when hair regrows, it may have a slightly different color or texture.

At the time of a childs death, the nurse tells his mother, We will miss him so much. The best interpretation of this is that the nurse is:

Expressing personal feelings of loss.

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should explain that:

Extra snacks are needed before exercise.

The Glasgow Coma Scale consists of an assessment of:

Eye opening and verbal and motor responses.

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?

FLACC tool

A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess (Select all that apply)?

Facial edema Fatigue Frothy-appearing urine

The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Whom should the nurse invite to the conference?

Family and key health professionals involved in childs care

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

Femur

The nurse is conducting an assessment on a school-age child with urosepsis. Which assessment finding should the nurse expect?

Fever with a positive blood culture

Nurses must be alert for increased fluid requirements when a child has:

Fever.

Kimberly, age 3 years, has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102 F even though Kimberly had acetaminophen 2 hours ago. The nurses action should be based on knowing that:

Fevers such as this are common with viral illnesses.

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What should the nurse recognize as important when discussing this with the family?

Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.

The most fatal type of burn in the toddler age-group is:

Flame burn from playing with matches.

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits (select all that apply)?

Follow directional commands. Tell exaggerated stories.

In terms of language and cognitive development, a 4-year-old child would be expected to:

Follow simple commands.

According to Piaget, the adolescent is in the fourth stage of cognitive development, or period of:

Formal operations.

Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)?

Frequent hand washing can decrease the spread of the virus.

Which symptom is considered a cardinal sign of diabetes mellitus?

Frequent urination

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that:

Frequent, serial casting is tried first.

. Ringworm, frequently found in schoolchildren, is caused by:

Fungus.

Which type of seizure involves both hemispheres of the brain?

Generalized

A parasite that causes acute diarrhea is:

Giardia lamblia.

Which is the most appropriate nursing intervention to promote normalization in a school-age child with a chronic illness?

Give child as much control as possible.

Parents tell the nurse that their toddler daughter eats little at mealtimes, only sits at the table with the family briefly, and wants snacks all the time. The nurse should recommend that the parents:

Give her planned, frequent, and nutritious snacks.

An appropriate intervention to encourage food and fluid intake in a hospitalized child is to:

Give high-quality foods and snacks whenever child expresses hunger.

When planning care for adolescents, the nurse should

Give information privately to adolescents about how they can manage the specific problems that they identify.

Which information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age?

Give large push-pull toys for kinesthetic stimulation.

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

Give small amounts of favorite fluids frequently to prevent dehydration.

Which intervention should be included in the nurses plan of care for a 7-year-old child with encopresis who has cleared the initial impaction?

Give the child a choice of beverage to mix with a laxative.

An effective strategy to reduce the stress of burn dressing procedures is to:

Give the child as many choices as possible.

A common parental reaction to a child with special needs is parental overprotection. Parental behavior suggestive of this includes:

Giving inconsistent discipline.

The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells the nurse that she wants her mother with her like before. The most appropriate nursing action is to:

Grant her request.

The nurse is caring for a child who has just died. The parents ask to be left alone so that they can rock their child one more time. The nurse should:

Grant their request.

Which is the causative agent of scarlet fever?

Group A b-hemolytic streptococci (GABHS)

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

Growth can be affected by this type of fracture.

Children receiving long-term systemic corticosteroid therapy are most at risk for:

Growth delays.

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by:

Guilt and anger.

Parents have learned that their 6-year-old child has autism. The nurse may help the parents to cope by explaining that the child may:

Have an extremely developed skill in a particular area.

What describes the cognitive abilities of school-age children?

Have the ability to classify, group and sort, and hold a concept in their minds while making decisions based on that concept

The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes. What should be included in the teaching plan for daily injections?

He is old enough to give most of his own injections.

An important consideration for the school nurse who is planning a class on bicycle safety is:

Head injuries are the major causes of bicycle-related fatalities.

The most common clinical manifestation of brain tumors in children is:

Headaches and vomiting.

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show:

Hematuria and proteinuria.

Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings?

Hepatitis A

Which vaccine is now recommended for the immunization of all newborns?

Hepatitis B vaccine

Which statement is correct about childhood obesity?

Heredity is an important factor in the development of obesity.

Which assessment findings indicate to the nurse a child has Down syndrome (select all that apply)?

High-arched, narrow palate b. Protruding tongue Transverse palmar crease

When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease?

High-density lipoproteins (HDLs).

A toddler sustains a minor burn on the hand from hot coffee. The first action in treating this burn is to:

Hold the burned area under cool running water.

In addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are:

Homicide, suicide

What would cause a nurse to suspect that an infection has developed under a cast?

Hot spots felt on cast surface

Which type of dehydration results from water loss in excess of electrolyte loss?

Hypertonic dehydration

The nurse is conducting teaching for an adolescent being discharged to home after a renal transplantation. The adolescent needs further teaching if which statement is made?

I am glad I only have to take the immunosuppressant medication for two weeks.

The nurse is talking to the parent of a 13-month-old child. The mother states, My child does not make noises like da or na like my sisters baby, who is only 9 months old. Which statement by the nurse would be most appropriate to make?

I am going to request a referral to a hearing specialist.

The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?

I have to stay on strict bed rest for 3 days.

An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions?

I should administer all the prescribed medication.

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching?

I should expect my child to have some behavioral changes after the accident.

The nurse is teaching a class on preventing diaper rash in newborns to a group of new parents. Which statement made by a parent indicates a correct understanding of the teaching?

I will wash with a mild soap and water and dry thoroughly whenever my infant has a bowel movement.

Which medications are the most effective choices for treating pain associated with inflammation in children (Select all that apply)?

Ibuprofen (Advil) Ketorolac (Toradol)

According to Erikson, the psychosocial task of adolescence is developing

Identity.

An acquired hemorrhagic disorder that is characterized by excessive destruction of platelets is:

Idiopathic thrombocytopenic purpura.

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

If it is present in a child, both parents are carriers of this defective gene.

The parents of a 2-year-old tell the nurse that they are concerned because the toddler has started to use baby talk since the arrival of their new baby. The nurse should recommend that the parents:

Ignore the baby talk.

A toddlers parent asks the nurse for suggestions on dealing with temper tantrums. The most appropriate recommendation is to:

Ignore the behavior, provided that it is not injurious.

The nurse is caring for a child after heart surgery. What should she or he do if evidence is found of cardiac tamponade?

Immediately report this to the physician.

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia?

Immobilization and elevation of the affected joint

The school nurse tells adolescents in the clinic that confidentiality and privacy will be maintained unless a life-threatening situation arises. This practice is:

Important in establishing trusting relationships.

When teaching a mother how to administer eyedrops, where should the nurse tell her to place them?

In the conjunctival sac that is formed when the lower lid is pulled down

A nurse places some x-ray contrast the toddler is to drink in a small cup instead of a large cup. Which concept of a toddlers preoperational thinking is the nurse using?

Inability to conserve

The mother of a toddler yells to the nurse, Help! He is choking to death on his food. The nurse determines that lifesaving measures are necessary based on:

Inability to speak.

Which is probably the most important criterion on which to base the decision to report suspected child abuse?

Incompatibility between the history and injury observed

Which physiologic change causes the edema formation that occurs with burns?

Increased capillary permeability

Which clinical changes occur as a result of septic shock?

Increased cardiac output

Which statement best describes b-thalassemia major (Cooleys anemia)?

Increased incidence occurs in families of Mediterranean extraction.

Which statement most accurately describes the pathologic changes of sickle cell anemia?

Increased red blood cell destruction occurs.

Which should the nurse expect for a toddlers language development at age 18 months?

Increasing level of comprehension

The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which should the nurse consider when dealing with this issue?

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.

A 2-year-old girl has excessive tearing and corneal haziness. The nurse knows that these symptoms may indicate

Infantile glaucoma.

After the acute stage and during the healing process, the primary complication from burn injury is:

Infection

The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to detect an early sign of:

Infection.

Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include:

Injecting deeply into a large muscle.

The leading cause of death during the toddler period is:

Injuries.

An important nursing consideration when performing a bladder catheterization on a young boy is to:

Insert 2% lidocaine lubricant into the urethra.

Guidelines for intramuscular administration of medication in school-age children include to:

Insert the needle quickly, using a dartlike motion.

Which statement is most descriptive of Meckels diverticulum?

Intestinal bleeding may be mild or profuse.

The primary method of treating osteomyelitis is:

Intravenous antibiotic therapy

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with:

Intravenous fluids.

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which route?

Intravenous infusion

The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breastfed infant. What should she or he suggest?

Iron-fortified infant cereal can be introduced at approximately 6 months of age.

A father calls the emergency department nurse saying that his daughters eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. What should the nurse recommend before the child is transported?

Irrigate eyes copiously with tap water for 20 minutes.

From a worldwide perspective, infant mortality in the United States:

Is the highest of the other developed nations

What is most descriptive of a school-age childs reaction to death?

Is very interested in funerals and burials

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup?

It has a harsh, barky cough.

Which statement is most descriptive of a concussion?

It is a transient, reversible neuronal dysfunction.

Which statement regarding atopic dermatitis (eczema) in the infant is most accurate?

It is associated with allergy with a hereditary tendency.

What is the primary purpose of a transitional object?

It is effective in decreasing anxiety in the toddler.

The mother of a 14-month-old child is concerned because the childs appetite has decreased. The best response for the nurse to make to the mother is:

It is not unusual for toddlers to eat less.

Which statement is descriptive of renal transplantation in children?

It is preferred means of renal replacement therapy in children.

Which statement best describes the process of critical thinking?

It is purposeful and goal directed.

Which statement is characteristic of acute otitis media (AOM)?

It is treated with a broad range of antibiotics

Which statement is most descriptive of pediatric family-centered care?

It recognizes that the family is the constant in a childs life.

The only symptom of pediculosis capitis (head lice) is usually:

Itching

The earliest clinical manifestation of biliary atresia is:

Jaundice.

Which comment is most developmentally typical of a 7-year-old boy?

Jimmy is my best friend.

Which gross motor milestones should the nurse assess in an 18-month-old child (select all that apply)?

Jumps in place with both feet Throws ball overhand without falling d. Pulls and pushes toys

Which interventions should the nurse plan when caring for a child with a visual impairment (select all that apply)?

Keep items in the room in the same location. c. Describe the placement of the eating utensils on the meal tray. Identify noises for the child.

Which postoperative intervention should be questioned for a child after a cardiac catheterization?

Keep the affected leg flexed and elevated.

The family of a 4-month-old infant will be vacationing at the beach. The best recommendation to this family is to:

Keep the infant in total shade at all times.

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend:

Keeping the child quiet and coming to emergency department.

What is descriptive of the play of school-age children?

Knowing the rules of a game gives an important sense of belonging.

Which term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

Kyphosis

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests:

Leaking of cerebrospinal fluid (CSF).

A nurse teaches parents that team play is important for school-age children. Which can children develop by experiencing team play (select all that apply)?

Learn complex rules. c. Experience competition. d. Learn about division of labor.

When preparing a school-age child and the family for heart surgery, the nurse should consider:

Letting child hear the sounds of an electrocardiograph monitor.

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is:

Level of consciousness.

An appropriate nursing intervention when providing comfort and support for a child whose death is imminent is to:

Limit care to essentials.

The best chance of survival for a child with cirrhosis is:

Liver transplantation.

Which primary treatment will the nurse implement for a child with warts?

Local destruction

Kyle, age 6 months, is brought to the clinic. His parent says, I think he hurts. He cries and rolls his head from side to side a lot. This most likely suggests which feature of pain?

Location

The initial clinical manifestation of generalized seizures is:

Losing consciousness.

The diet of a child with chronic renal failure is usually characterized as:

Low in phosphorus.

A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?

Maintain a structured routine and keep stimulation to a minimum.

Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema?

Mannitol

A parent whose child has been diagnosed with a cognitive deficit should be counseled that intellectual impairment:

May be caused by a variety of factors.

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug:

May cause voice alterations.

A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she seems fine. The nurse should explain that the toddler:

May have a brain injury.

A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this:

May help the child relax.

The pediatric nurse understands that nonpharmacologic strategies for pain management:

May reduce pain perception.

The nurse is performing an assessment on a child and notes the presence of Kopliks spots. In which communicable disease are Kopliks spots present?

Measles (rubeola)

Vitamin A supplementation may be recommended for the young child who has:

Measles (rubeola).

Which immunization should not be given to a child receiving chemotherapy for cancer?

Measles, rubella, mumps

The earliest recognizable clinical manifestation of cystic fibrosis (CF) is:

Meconium ileus.

An infant with pyloric stenosis experiences excessive vomiting that can result in:

Metabolic alkalosis

Which statement best explains why iron deficiency anemia is common during toddlerhood?

Milk is a poor source of iron.

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection should include the:

Mode of administration.

A young child who has an intelligence quotient (IQ) of 45 would be described as:

Moderately cognitively impaired but trainable.

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this childs care?

Monitor arterial blood gases.

An appropriate nursing intervention when caring for an unconscious child should be to:

Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema.

When caring for the child with Reyes syndrome, the priority nursing intervention is to:

Monitor intake and output.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

Monitor pulse oximetry.

A 17-year-old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area?

Moral development

Which statement regarding childhood morbidity is the most accurate?

Morbidity is not distributed randomly.

Which of the following is descriptive of deaths caused by unintentional injuries?

More deaths occur in males.

What medication is the most effective choice for treating pain associated with sickle cell crisis in a newly admitted 5-year-old child?

Morphine

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

Morphine

The vector reservoir for agents causing viral encephalitis in the United States is:

Mosquitoes and ticks.

Which statement best describes fear in school-age children?

Most of the new fears that trouble them are related to school and family.

The leading cause of death from unintentional injuries in children is:

Motor vehiclerelated fatalities.

The most common cause of death in the adolescent age-group involves:

Motor vehicles.

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Mucus and edema obstruct small airways.

In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is:

Muscle rigidity.

The nurse caring for the child in pain understands that distraction:

Must be developmentally appropriate to refocus attention.

Which comments indicate that the mother of a toddler needs further teaching about dental care?

My child will not need a dental checkup until his permanent teeth come in.

Which statement, made by a 4-year-old childs father, is true about the care of the preschoolers teeth?

My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth.

An adolescent male visits his primary care provider complaining of difficulty with his vision. When the nurse asks the adolescent to explain what visual deficits he is experiencing, the adolescent states, I am having difficulty seeing distant objects; they are less clear than things that are close. What disorder does the nurse suspect the adolescent has?

Myopia

The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include?

Nasogastric intubation and urinary catheter may be required.

A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:

Necessary because it will be an adjustment.

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make?

Neither condone nor condemn the curiosity.

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as:

Neurosurgical emergency.

The nurse is teaching parents of a 3-year-old with impetigo that they can anticipate:

No scarring.

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

Nonsteroidal antiinflammatory drugs (NSAIDs)

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurses response should be based on knowledge that this drug is

Not indicated.

An adolescent gets hit in the eye during a fight. The school nurse, using a flashlight, notes the presence of gross hyphema (hemorrhage into anterior chamber). The nurse should:

Notify parents that adolescent needs to see an ophthalmologist.

Four-year-old David is placed in Bucks extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. What should the nurse do first?

Notify the practitioner of the changes noted.

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to:

Notify the practitioner.

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching?

Oatmeal

When caring for a child with an intravenous infusion, the nurse should:

Observe the insertion site frequently for signs of infiltration.

Biologic dressings are applied to a child with partial-thickness burns of both legs. Nursing actions related to this include:

Observing wounds for signs of infection.

Which term is used to describe a childs level of consciousness when the child can be aroused with stimulation?

Obtundation

Which test is never performed on a child who is awake?

Oculovestibular response

Physiologic measurements in childrens pain assessment are:

Of limited value as sole indicator of pain.

The primary clinical manifestations of acute renal failure are:

Oliguria and hypertension.

Which statement best characterizes hepatitis A?

Onset is usually rapid and acute.

The nurse is caring for a 7-year-old with herpes simplex virus. Which prescribed medication should the nurse expect to be included in the treatment plan?

Oral antiviral agent

Therapeutic management of the child with acute diarrhea and dehydration usually begins with:

Oral rehydration solution (ORS).

The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands?

Organize nursing activities to allow for uninterrupted sleep.

Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

Oslers nodes

Which condition can result from the bone demineralization associated with immobility?

Osteoporosis

An appropriate tool to assess pain in a 3-year-old child is the (Select all that apply):

Oucher tool Poker Chip Tool FACES pain rating scale

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?

Painful swelling of hands and feet, painful joints

Which term best describes a multidisciplinary approach to the management of a terminal illness that focuses on symptom control and support?

Palliative care

The nurse and a new nurse are caring for a child who will require palliative care. Which statement made by the new nurse would indicate a correct understanding of palliative care?

Palliative care provides pain and symptom management for the child.

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include:

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

A nurse is planning care for a 7-year-old child hospitalized with osteomyelitis. Which activities should the nurse plan to bring from the playroom for the child (select all that apply)?

Paper and some paints b. Board games Computer games

The most effective way to clean a toddlers teeth is for the:

Parent to stabilize the chin with one hand and brush with the other.

An advantage of peritoneal dialysis is that:

Parents and older children can perform treatments.

The parents of a young child with congestive heart failure tell the nurse that they are nervous about giving digoxin. The nurses response should be based on knowing that:

Parents must learn specific, important guidelines for administration of digoxin.

The nurse is talking with the parent of a child newly diagnosed with a chronic illness. The parent is upset and tearful. The nurse asks, With whom do you talk when something is worrying you? This should be interpreted as:

Part of assessing parents available support system.

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect?

Patent ductus arteriosus

The nurse is providing support to parents at the time their child is diagnosed with chronic disabilities. The nurse notices that the parents keep asking the same questions. The nurse should:

Patiently continue to answer questions.

What is the most common mode of transmission of human immunodeficiency virus (HIV) in the pediatric population?

Perinatal transmission

The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

Periodic and irregular breathing

Skin testing for tuberculosis (the Mantoux test) is recommended:

Periodically for children who reside in high-prevalence regions.

Most parents of children with special needs tend to experience chronic sorrow. This is characterized by:

Periods of intensified sorrow and loss that occur in waves over time.

A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is:

Peripheral edema.

Which consideration is the most important in managing tuberculosis (TB) in children?

Pharmacotherapy

The narrowing of the preputial opening of the foreskin is called:

Phimosis.

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurses first action should be to:

Place the child in the knee-chest position.

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child (select all that apply)?

Plastic telephone Hand puppets Farm animals and equipment

An appropriate play activity for a 7-month-old infant to encourage visual stimulation is:

Playing peek-a-boo.

A major clinical manifestation of rheumatic fever is:

Polyarthritis.

A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this childs laboratory values, the nurse is not surprised to notice which abnormality?

Polycythemia

The nurse is caring for a child with suspected diabetes insipidus. Which clinical manifestation would she or he expect to observe?

Polyuria and polydipsia

The psychologic effects of being obese during adolescence include:

Poor body image

Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present?

Poor wound healing

A high-fiber food that the nurse could recommend for a child with chronic constipation is:

Popcorn.

Diabetes insipidus is a disorder of the:

Posterior pituitary.

Herpes zoster is caused by the varicella virus and has an affinity for:

Posterior root ganglia and the posterior horn of the spinal cord.

As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in:

Potassium.

The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging?

Predictable stages of puberty that are based on primary and secondary sexual characteristics

The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which intervention should the nurse include?

Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.

Kelly, age 8 years, will soon be able to return to school after an injury that resulted in several severe, chronic disabilities. What is the most appropriate action by the school nurse?

Preparing Kellys classmates and teachers for changes they can expect

In which developmental stage is the child first able to localize pain and describe both the amount and the intensity of the pain felt?

Preschool stage

The feeling of guilt that the child caused the disability or illness is especially critical in which child?

Preschooler

A 4-year-old child tells the nurse that she does not want another blood sample drawn because I need all my insides, and I dont want anyone taking them out. Which is the nurses best interpretation of this?

Preschoolers have poorly defined body boundaries.

A common characteristic of those who sexually abuse children is that they:

Pressure the victim into secrecy.

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is to:

Prevent dehydration.

The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. The priority nursing goal is to:

Prevent infection.

. Surgical closure of the ductus arteriosus would:

Prevent the return of oxygenated blood to the lungs

Nursing care of the infant with atopic dermatitis focuses on:

Preventing infection.

which are characteristic of the physical development of a 30-month-old child (select all that apply)?

Primary dentition is complete. c. Sphincter control is achieved.

A nurse is teaching an adolescent about primary hypertension. The nurse knows that which of the following is correct?

Primary hypertension may be treated with weight reduction.

Which diagnostic finding is present when a child has primary nephrotic syndrome?

Proteinuria

The nurse is completing a health history with a 16-year-old male. He informs the nurse that he has started using smokeless tobacco after he plays baseball. Which information regarding smokeless tobacco would be most correct for the nurse to provide to this teen?

Proven to be carcinogenic.

Which interventions should a nurse implement when caring for a child with hepatitis (Select all that apply)?

Provide a well-balanced, low-fat diet. Teach parents not to administer any over-the-counter medications. Instruct parents on the importance of good hand washing.

Fentanyl and midazolam (Versed) are given before debridement of a childs burn wounds. These drugs are important to:

Provide pain relief.

Appropriate interventions to facilitate socialization of the cognitively impaired child include to:

Provide peer experiences such as Special Olympics when older.

The role of the peer group in the life of school-age children is that it:

Provides them with security as they gain independence from their parents.

Caring for the newborn with a cleft lip and palate before surgical repair includes:

Providing satisfaction of sucking needs.

Which structural defects constitute tetralogy of Fallot?

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child?

Puppet play in the childs room

Which action by the nurse demonstrates use of evidence-based practice (EBP)?

Questioning the use of daily central line dressing changes

Which predisposes the adolescent to feel an increased need for sleep?

Rapid physical growth

A child experiences frostbite of the fingers after prolonged exposure to the cold. Which intervention would the nurse implement first?

Rapid rewarming of the fingers by placing in warm water

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. What best explains why an intraosseous infusion is started?

Rapid venous access is not possible.

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics:

Rarely cause addiction because they are medically indicated.

A preschooler is found digging up a pet bird that was recently buried after it died. The best explanation for this behavior is that:

Reassurance is needed that the pet has not gone somewhere else.

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, I have been getting a migraine every 2 or 3 months for the last year. The nurse documents this as which type of pain?

Recurrent

An objective of care for the child with nephrosis is to:

Reduce excretion of urinary protein.

A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to:

Reduce gastric acid production.

A child with extensive burns requires debridement. The nurse should anticipate that a priority goal related to this procedure is to:

Reduce pain.

A parent asks the nurse about how to respond to negativism in toddlers. The most appropriate recommendation is to:

Reduce the opportunities for a no answer.

Which action by the school nurse is important in the prevention of rheumatic fever?

Refer children with sore throats for throat cultures.

An important nursing consideration in the care of a child with celiac disease is to:

Refer to a nutritionist for detailed dietary instructions and education.

Which describe avoidance behaviors a parent may exhibit when learning that his or her child has a chronic condition (select all that apply)?

Refuses to agree to treatment Withdraws from outside world Punishes self because of guilt and shame

The leading cause of death after heart transplantation is:

Rejection.

A young child with leukemia has anorexia and severe stomatitis. The nurse should suggest that the parents try which intervention?

Relax any eating pressures.

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. What is important in her immediate care?

Remove her burned clothing and jewelry

During the first few days after surgery for cleft lip, which intervention should the nurse do?

Remove restraints periodically to cuddle infant.

An 8-month-old infant is restrained to prevent interference with the intravenous infusion. The nurse should:

Remove the restraints whenever possible.

Which diagnostic test allows visualization of the renal parenchyma and renal pelvis without exposure to external beam radiation or radioactive isotopes?

Renal ultrasound

Which statement best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101 F). The nurse should:

Report findings to physician.

A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his regular diet trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action?

Request these favorite foods for him.

The nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for (Select all that apply)?

Respiratory depression Pruritus Sweating

A nurse must do a venipuncture on a 6-year-old child. An important consideration in providing atraumatic care is to:

Restrain the child only as needed to perform venipuncture safely.

Anorexia nervosa may best be described as:

Resulting in severe weight loss in the absence of obvious physical causes.

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included?

Return to the clinic every 1 to 2 weeks.

What is a priority nursing diagnosis for the preschool child with chronic illness?

Risk for Delayed Growth and Development related to chronic illness or disability

An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a limited ability to anticipate danger is:

Risk for Injury.

A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is:

Ritualism, common at this age.

The viral pathogen that frequently causes acute diarrhea in young children is:

Rotavirus.

Discharge planning for the child with juvenile arthritis includes the need for:

Routine ophthalmologic examinations to assess for visual problems.

Which common childhood communicable disease may cause severe defects in the fetus when it occurs in its congenital form?

Rubella

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Russell

The major consideration when selecting toys for a child who is cognitively impaired is:

Safety.

The diet of a child with nephrosis usually includes:

Salt restriction.

Which age group is most concerned with body integrity?

School-age child

Matts mother tells the nurse that he keeps scratching the areas where he has poison ivy. The nurses response should be based on knowing that:

Scratching the lesions may cause them to become secondarily infected.

Motor vehicle injuries are a significant threat to young children. Knowing this, the nurse plans a teaching session with a toddlers parents on car safety. Which will she teach (select all that apply)?

Secure in a rear-facing, upright, car safety seat. Harness safety straps should be fit snugly. After the age of 2 years, toddlers can be placed in a forward-facing car seat.

Distortion of sound and problems in discrimination are characteristic of which type of hearing loss?

Sensorineural

An appropriate recommendation in preventing tooth decay in young children is to:

Serve sweets after a meal.

An inherited immunodeficiency disorder characterized by absence of both humoral and cell-mediated immunity is:

Severe combined immunodeficiency syndrome (SCIDS).

The most common cause of acute renal failure in children is:

Severe dehydration.

The school nurse has been asked to begin teaching sex education in the 5th grade. The nurse should recognize that:

Sex can be presented as a normal part of growth and development.

The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements because she is exclusively breastfed. The nurses best response is:

She may need to begin taking them at age 6 months.

The most immediate threat to life in children with thermal injuries is:

Shock

Which factor predisposes a child to urinary tract infections?

Short urethra in young girls

Which factor is most important in predisposing toddlers to frequent infections such as otitis media, tonsillitis, and upper respiratory tract infections?

Short, straight internal ear/throat structures and large tonsil/adenoid lymph tissue are present.

The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant:

Shows signs of an earache.

A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is:

Sickle cell anemia.

A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says that she is completing her schoolwork satisfactorily, but lately she has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as:

Signs of stress.

Which term is used to describe a type of fracture that does not produce a break in the skin?

Simple

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition?

Sinusitis

Which statement best describes hypopituitarism?

Skeletal proportions are normal for age.

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop:

Slowed growth.

Which statement is true about smoking in adolescence?

Smoking is related to other high-risk behaviors.

The most frequently used test for measuring visual acuity is the:

Snellen letter chart.

A child steps on a nail and sustains a puncture wound of the foot. The most appropriate method for cleansing this wound is to:

Soak foot in warm water and soap.

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material?

Soak in a bathtub.

A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to administer?

Sodium polystyrene sulfonate (Kayexalate)

A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip-reads. Which techniques should the nurse include (select all that apply)?

Speak at eye level. b. Use facial expressions while speaking. e. Keep sentences short.

Which action best facilitates lipreading by the hearing-impaired child?

Speaking at an even rate

A 10-year-old boy has been hit by a car while riding his bicycle in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be to:

Stabilize neck and spine.

The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?

Stop drug infusion immediately.

Tepid water or sponge baths are indicated for hyperthermia in children. The nurse should:

Stop the bath if the child begins to chill.

Which type of hernia has an impaired blood supply to the herniated organ?

Strangulated hernia

Cellulitis is often caused by:

Streptococcus or Staphylococcus organisms.

The most common causative agent of bacterial endocarditis is:

Streptococcus viridans.

Which behavior by parents or teachers will best assist the child in negotiating the developmental task of industry?

Structuring the environment so the child can master tasks

Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?

Stupor

Several complications can occur when a child receives a blood transfusion. An immediate sign or symptom of an air embolus is:

Sudden difficulty in breathing.

When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is:

Sudden relief from pain.

The parent of a 4-year-old son tells the nurse that the child believes monsters and the boogeyman are in his bedroom at night. The nurses best suggestion for coping with this problem is to:

Suggest involving the child to find a practical solution such as a night-light.

The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. The most appropriate nursing action is to

Suggest that he reinsert the hearing aid.

Nursing interventions to help the siblings of a child with a complex or chronic condition cope include:

Suggesting to the parents ways of showing gratitude to the siblings who help care for the child with a disability or chronic condition.

Therapeutic management of most children with Hirschsprungs disease is primarily:

Surgical removal of affected section of bowel.

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Sweat chloride test

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend:

Swimming.

A nurse is caring for a child who is near death. Which physical signs indicate the child is approaching death (select all that apply)?

Tactile sensation decreasing Change in respiratory pattern Difficulty swallowing

Which intervention for treating croup at home should be taught to parents?

Take the child outside.

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to:

Take the child to emergency department.

Which characteristic best describes the language of a 3-year-old child?

Talks incessantly, regardless of whether anyone is listening

Which prescribed treatment should the nurse plan to implement for a child with psoriasis?

Tar and exposure to sunlight and ultraviolet light

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to:

Teach child and family the correct administration of medications.

What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux?

Teach the parents how to do infant cardiopulmonary resuscitation (CPR)

The nurse is teaching parents of toddlers about animal safety. Which information should be included in the teaching session?

Teach your toddler not to disturb an animal that is eating.

The nurse is guiding parents in selecting a day care facility for their child. When making the selection, it is especially important to consider:

Teachers knowledgeable about development.

When teaching injury prevention during the school-age years, the nurse should include:

Teaching basic rules of water safety.

What is the major focus of the therapeutic management for a child with lactose intolerance?

Teaching dietary modifications

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

Teaching the family signs of central venous catheter infection.

A 4-year-old child is newly diagnosed with Legg-Calv-Perthes disease. Nursing considerations should include which action?

Teaching the family the care and management of the corrective appliance

The emergency department nurse is cleaning multiple facial abrasions on 9-year-old Mike. His mother is present. He is crying and screaming loudly. The nurse should:

Tell him it is okay to cry and scream.

The nurse is planning how to best prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include:

Telling the child that procedures are never a form of punishment.

The nurse is assessing parental knowledge of temper tantrums. Which are true statements regarding temper tantrums (select all that apply)?

Temper tantrums are a common response to anger and frustration in toddlers. b. Temper tantrums often include screaming, kicking, throwing things, and head banging. d. Children having temper tantrums should be safely isolated and ignored. e. Parents can learn to anticipate times when tantrums are more likely to occur.

A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should explain that:

Terminally ill children know when they are seriously ill.

A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is:

Testicular enlargement.

A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?

Tetralogy of Fallot

The parents of a newborn say that their toddler hates the baby . . . he suggested that we put him in the trash can so the trash truck could take him away. The nurses best reply is:

That is a normal response to the birth of a sibling. Lets look at ways to deal with this.

Which behavior suggests appropriate psychosocial development in the adolescent?

The adolescent is self-absorbed and self-centered and has sudden mood swing

An adolescent boy tells the nurse that he has recently had homosexual feelings. The nurses response should be based on knowledge that:

The adolescent should be encouraged to share his feelings and experiences.

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on the knowledge that routine developmental assessments during well-child visits are:

The best method for early detection of cognitive disorders.

Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication?

The child is lying rigidly in bed and not moving.

What should the nurse keep in mind when planning to communicate with a child who has autism?

The child may exhibit monotone speech and echolalia.

Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurses reply should be based on knowing that:

The child needs opportunities to play with peers.

Peer victimization is becoming a significant problem for school-age children and adolescents in the United States. Parents should be educated regarding signs that a child is being bullied. These might include (select all that apply):

The child spends an inordinate amount of time in the nurses office. b. Belongings frequently go missing or are damaged. c. The child wants to be driven to school.

A nurse is assessing an older school-age child recently admitted to the hospital. Which assessment indicates that the child is in an appropriate stage of cognitive development?

The childs ability to classify

When assessing pain in any child, the nurse should consider that:

The childs behavioral, physiologic, and verbal responses are valuable when assessing pain.

A cure is no longer possible for a young child with cancer. The nursing staff recognizes that the goal of treatment must shift from cure to palliation. Which is an important consideration at this time?

The family is included in the decision to shift the goals of treatment.

What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux?

The importance of taking prophylactic antibiotics

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurses rationale for this action is primarily that:

The mothers presence will reduce anxiety and ease the childs respiratory efforts.

A nurse is providing a parent information regarding autism. Which statement made by the parent indicates understanding of the teaching?

The onset of autism usually occurs before 3 years of age.

In providing anticipatory guidance to parents whose child will soon be entering kindergarten, which is a critical factor in preparing a child for kindergarten entry?

The parents interactions and responsiveness to the child

A 3-year-old child is hospitalized after a near-drowning accident. The childs mother complains to the nurse, This seems unnecessary when he is perfectly fine. The nurses best reply is:

The reason for this is that complications could still occur.

The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching?

The red blood cell count should begin to improve with these injections.

What should the nurse consider when having consent forms signed for surgery and procedures on children?

The risks and benefits of a procedure are part of the consent process.

The nurse is preparing a school-age child for a computed tomography (CT) scan to assess cerebral function. When preparing the child for the scan, which statement should the nurse include?

The scan will not hurt.

Identify the statement that is the most accurate about moral development in the 9-year-old school-age child.

The school-age child conforms to rules to please others.

Which demonstrates the school-age childs developing logic in the stage of concrete operations (select all that apply)?

The school-age child is able to recognize that he can be a son, brother, or nephew at the same time. b. The school-age child understands the principles of adding, subtracting, and reversibility. c. The school-age child understands the principles of adding, subtracting, and reversibility.

A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurses best response is:

The seizure may or may not mean that your child has epilepsy.

Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm?

The skin color, temperature, movement, sensation, and capillary refill of the extremity.

When caring for the child with Kawasaki disease, the nurse should understand that:

Therapeutic management includes administration of gamma globulin and aspirin.

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?

There is heightened airway reactivity.

The nurse is talking with the parents of a child who died 6 months ago. They sometimes still hear the childs voice and have trouble sleeping. They describe feeling empty and depressed. The nurse should recognize that:

These are normal grief responses.

Which statement characterizes moral development in older school-age children?

They are able to judge an act by the intentions that prompted it rather than just by the consequences.

The nurse recommends to parents that peanuts are not a good snack food for toddlers. The nurses rationale for this action is that:

They can be easily aspirated.

What describes moral development in younger school-age children?

They know the rules and behaviors expected of them but do not understand the reasons behind them.

What is characteristic of dishonest behavior in children ages 8 to 10 years?

They may lie to meet expectations set by others that they have been unable to attain.

he parents of a 14-year-old girl express concerns about the number of hours their daughter spends with her friends. The nurse explains that peer relationships become more important during adolescence because:

They provide adolescents with a feeling of belonging.

The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurses best response is:

They will come after dinner.

A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux?

Thicken formula with rice cereal.

Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize that her disability was so severe. The best interpretation of this situation is that:

This is a normal anticipated time of parental stress.

Matt, age 14 years, seems to be always eating, although his weight is appropriate for his height. The best explanation for this is:

This is normal because of increase in body mass.

A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. The nurse should explain to his parents that:

This is part of normal adolescence.

Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. The best interpretation of this behavior is that:

This is typical behavior because toddlers are egocentric.

A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurses discussion of this should be based on knowing that:

This is usually benign and temporary.

What is the most appropriate statement for the nurse to make to a 5-year-old child who is undergoing a venipuncture?

This will hurt like a pinch. Ill get someone to help hold your arm still so it will be over fast and hurt less.

A useful skill that the nurse should expect a 5-year-old child to be able to master is to:

Tie shoelaces.

For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E1?

To improve oxygenation

In the clinic waiting room, a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks. In this situation the nurse should recognize that:

Toddlers are capable of building a tower of blocks.

Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that:

Topical application of local anesthetic can eliminate venipuncture pain.

The weight loss of anorexia nervosa is often triggered by:

Traumatic interpersonal conflict.

An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension. On further testing, it is discovered the child has a cardiac abnormality. The initial treatment of secondary hypertension initially involves:

Treating the underlying disease.

What is most descriptive of the therapeutic management of osteosarcoma?

Treatment usually consists of surgery and chemotherapy.

In which situation is there the greatest risk that a newborn infant will have a congenital heart defect (CHD)?

Trisomy 21 detected on amniocentesis

A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?

Type II diabetes

The major cause of death for children older than 1 year is:

Unintentional injuries.

Which statement best describes a child who is abused by the parent(s)?

Unintentionally contributes to the abusing situation

Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant uremic breath odor

What is most descriptive of the pathophysiology of leukemia?

Unrestricted proliferation of immature white blood cells (WBCs) occurs.

Which parameter correlates best with measurements of the bodys total protein stores?

Upper arm circumference

When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as:

Uremia.

The nurse is assisting the pediatric provider with a newborn examination. The provider notes that the infant has hypospadias. The nurse understands that hypospadias refers to:

Urethral opening along ventral surface of penis.

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. The nurses best response should be that the:

Urinary output will increase.

To best assess the child with severe burns for adequate perfusion, the nurse monitors:

Urine output.

What nursing action is appropriate for specimen collection?

Use Standard Precautions when handling body fluids.

What is helpful to tell a mother who is concerned about preventing sleep problems in her 2-year-old child?

Use a night-light in the childs room.

In terms of cognitive development, the 5-year-old child would be expected to:

Use magical thinking.

What is critical information for the nurse to incorporate into her care when using restraints on a child?

Use the least restrictive type of restraint.

The nurse is caring for an unconscious child. Skin care should include:

Using draw sheet to move child in bed to reduce friction and shearing injuries.

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that:

Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children.

Which immunization should be given with caution to children infected with human immunodeficiency virus?

Varicella

Which medication may be given to high risk children after exposure to chickenpox to prevent varicella?

Varicella zoster immune globulin (VZIG)

When taking the history of a child hospitalized with Reyes syndrome, the nurse should not be surprised that a week ago the child had recovered from:

Varicella.

Which is the preferred site for intramuscular injections in infants?

Vastus lateralis

What effect does immobilization have on the cardiovascular system?

Venous stasis

The nurse should expect to assess which causative agent in a child who has warts?

Virus

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss

. Which vitamin supplements are necessary for children with cystic fibrosis?

Vitamins A, D, E, and K

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations would be observed (Select all that apply)?

Vomiting Failure to gain weight Persistent diaper rash

A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions?

WBC >2; specific gravity 1.030

Which characteristic best describes the gross motor skills of a 24-month-old child?

Walks up and down stairs

Which statement about toilet training is correct?

Wanting to please the parent helps motivate the child to use the toilet.

Which intervention is appropriate when examining a male infant for cryptorchidism?

Warming the room

An important consideration for the nurse when changing dressings and applying topical medication to a childs abdomen and leg burns is to:

Wash hands and forearms before and after dressing change.

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should:

Wash hands thoroughly.

A child falls on the playground and has a small laceration on the forearm. What should the school nurse do to cleanse the wound?

Wash wound gently with mild soap and water for several minutes.

A major complication in a child with chronic renal failure is:

Water and sodium retention.

Which are appropriate statements the nurse should make to parents after the death of their child (select all that apply)?

We feel so sorry that we couldnt save your child. Youre feeling all the pain of losing a child.

Parents have understood teaching about prevention of childhood otitis media if they make which statement?

We will be sure to keep immunizations up to date.

A nurse is teaching parents of first-grade children general guidelines to assist their children in adapting to school. Which statement by the parents indicates they understand the teaching?

We will plan a trip to the library as often as possible.

Parents need further teaching about the use of car safety seats if they make which statement?

We wont need to use the car seat on short trips to the store.

Which teaching guideline helps prevent eye injuries during sports and play activities?

Wear eye protection when participating in high-risk sports such as paintball

What should the nurse recommend to prevent urinary tract infections in young girls?

Wearing cotton underpants

Which intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure?

Weigh the infant every day on the same scale at the same time.

Which statement is most descriptive of bulimia during adolescence?

Weight that can be normal, slightly above normal, or below normal

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

Were glad there is a cure for this disorder.

When is a child with chickenpox considered to be no longer contagious?

When lesions are crusted

Which statement by a parent about a childs conjunctivitis indicates that further teaching is needed?

When the eye drainage improves, well stop giving the antibiotic ointment.

The most common clinical manifestation of retinoblastoma is

White eye reflex.

As related to inherited disorders, which statement is descriptive of most cases of hemophilia?

X-linked recessive inherited disorder in which a blood-clotting factor is deficient

The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?

You may need to increase the caloric density of your infants formula.

Which statement is the most appropriate advice to give parents of a 16-year-old girl who is rebellious?

You need to collaborate with your daughter and set limits that are perceived as being reasonable.

How should the nurse explain positioning for a lumbar puncture to a 5-year-old child?

You will lie on your side and bend your knees so that they touch your chin.

The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching?

You will need to avoid adding salt to your childs food.

The nurse is speaking with the parent of an infant with severe atopic dermatitis. What information should the nurse reinforce with the parent (Select all that apply)?

You will need to keep your infants skin well hydrated by using a mild soap in the bath. You will need to prevent your baby from scratching the area by using a mild antihistamine. You should apply an emollient to the skin immediately after a bath.

The nurse is talking to the parents of a child with pediculosis capitis. Which should the nurse include when explaining how to manage pediculosis capitis?

You will need to remove nits with an extra-fine tooth comb or tweezers.

A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?

Your child must lie quietly; sometimes a mild sedative is administered before the procedure.

Which statement by the nurse is most appropriate to a 15-year-old whose friend has mentioned suicide?

Your friends threat needs to be taken seriously and immediate help for your friend is important.

Which information should the nurse give to a child who is to have magnetic resonance imaging (MRI) of the brain?

Your head will be restrained during the procedure.

The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. The five steps include (Select all that apply):

a. Assessment. b. Diagnosis. c. Planning. e. Implementation. f. Evaluation

Where do the lesions of atopic dermatitis most commonly occur in the infant (Select all that apply)?

a. Cheeks c. Extensor surfaces of arms and legs e. Trunk f. Scalp

Which home care instructions should the nurse provide to the parents of a child with acquired immunodeficiency syndrome (AIDS) (Select all that apply)?

a. Give supplemental vitamins as prescribed. c. Administer trimethoprim-sulfamethoxazole (Bactrim) as prescribed. d. Notify the physician if the child develops a cough or congestion.

Which play patterns does a 3-year-old child typically display (select all that apply)?

a. Imaginary play b. Parallel play c. Cooperative play e. Associative play

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child (Select all that apply)?

a. Instructions to avoid exposure to sunlight b. Teaching about body changes associated with SLE

Which should the nurse include when teaching parents about preventing childhood burn injuries (Select all that apply)?

a. Keep hot liquids out of reach. b. Baby-proof electrical outlets. Test water temperature before placing your child in the tub bath.

Strict isolation is required for a child who is hospitalized with (select all that apply):

a. Mumps. b. Chickenpox. c. Exanthema subitum (roseola). d. Erythema infectiosum (fifth disease).

The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe (Select all that apply)?

a. Positive Ortolani sign b. Unequal gluteal folds

Which information should the nurse teach families about reducing exposure to pollens and dust (Select all that apply)?

a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses.

Which data would be included in a health history (Select all that apply)?

a. Review of systems b. Physical assessment c. Sexual history e. Nutritional assessment f. Family medical history

Which type of seizure may be difficult to detect?

absence

A clinic nurse is conducting a staff in-service for other clinic staff regarding the signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session (Select all that apply)?

b. Abdominal mass c. Sore throat and ear pain Ecchymosis of conjunctiva

The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child (Select all that apply)?

b. Avoidance of intramuscular (IM) injections c. Acetaminophen (Tylenol) for mild pain control d. Soft toothbrush for dental hygiene

Which statements regarding hepatitis B are correct (Select all that apply)?

b. Hepatitis B can be prevented by hepatitis B virus vaccine. c. Hepatitis B can be transferred to an infant of a breastfeeding mother. d. The onset of hepatitis B is insidious. e. Immunity to hepatitis B occurs after one attack.

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease (Select all that apply)?

b. Notify the health care provider if a fever of 38.5 C (101.3 F) or greater occurs. c. Give penicillin as prescribed. e. Notify the health care provider if your child begins to develop symptoms of a cold.

The nurse is caring for a child with aplastic anemia. Which nursing diagnoses are appropriate (Select all that apply)?

b. Risk for Infection related to inadequate secondary defenses or immunosuppression c. Ineffective Protection related to thrombocytopenia d. Ineffective Tissue Perfusion related to anemia

Parents of a school-age child with hemophilia ask the nurse, Which sports are recommended for children with hemophilia? Which sports should the nurse recommend (Select all that apply)?

b. Swimming d. Golf e. Bowling

The nurse is caring for a neonate with suspected meningitis. Which clinical manifestations should the nurse prepare to assess if meningitis is confirmed (Select all that apply)?

c. Bulging anterior fontanel d. Weak cry e. Poor muscle tone

Which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock (Select all that apply)?

c. Cool extremities and decreased skin turgor d. Confusion and somnolence f. Tachypnea and poor capillary refill time

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include (Select all that apply)?

c. Decreased urinary output d. Sweating (inappropriate) e. Fatigue

Clinical manifestations of increased intracranial pressure (ICP) in infants are (Select all that apply):

c. Diplopia and blurred vision. d. Irritability. e. Distended scalp veins.

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the childs care (Select all that apply)?

c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome (Select all that apply)?

c. Severe pain not relieved by analgesics d. Tingling of extremity e. Inability to move extremity

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what conditions occur (Select all that apply)?

c. Temperature above 37.7 C (100 F) d. New, frequent coughing e. Turning blue or bluer than normal

A nurse is conducting dietary teaching on high-fiber foods for parents of a child with constipation. Which foods should the nurse include as being high in fiber (Select all that apply)?

c. Whole grain breads d. Bran pancakes e. Raw carrots

Lymphangitis (streaking) is frequently seen in:

cellulitis

Therapeutic management of nephrosis includes:

corticosteroids

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what condition (Select all that apply)?

d. Urinary tract infection (UTI) e. Diabetes mellitus

An accurate description of anemia is:

decreased oxygen carrying capacity of blood

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the childs postoperative care (Select all that apply)?

e. Maintain an accurate record of intake and output. f. Monitor for abdominal distention.Observe closely for signs of infection.

A common side effect of corticosteroid therapy is:

increased appetite

The primary clinical manifestation of scabies is:

pruritus

Rocky Mountain spotted fever is caused by the bite of a:

tick

Asthma in infants is usually triggered by:

viral infection

What is an important consideration for the nurse who is communicating with a very young child?

Use transition objects such as a doll.

What type of breath sound is normally heard over the entire surface of the lungs, except for the upper intrascapular area and the area beneath the manubrium?

Vesicular

An infant experienced an apparent life-threatening event and is being placed on home apnea monitoring. The parents have understood the instructions for use of a home apnea monitor when they state:

We will check the monitor several times a day to be sure the alarm is working.

A nurse has completed a teaching session for parents about baby-proofing the home. Which statements made by the parents indicate an understanding of the teaching (select all that apply)?

We will put plastic fillers in all electrical plugs. We will place a gate at the top and bottom of stairways. We will remove front knobs from the stove.

During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is:

A normal finding.

The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as:

A normal finding.

A school nurse is screening children for scoliosis. Which assessment findings should the nurse expect to observe for scoliosis (Select all that apply)?

Asymmetry of the shoulders An uneven hemline Unequal waist angles

Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:

Avoidance of eye contact.

The best play activity to provide tactile stimulation for a 6-month-old infant is to:

Allow to splash in bath.

Which action is most likely to encourage parents to talk about their feelings related to their childs illness?

Use open-ended questions.

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurses response should be based on knowledge that this is:

Acceptable to encourage head control and turning over.

Which behavior indicates that an infant has developed object permanence?

Actively searches for a hidden object

The appropriate placement of a tongue blade for assessment of the mouth and throat is the:

Against the soft palate.

When the nurse interviews an adolescent, it is especially important to:

Allow an opportunity to express feelings.

Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant (select all that apply)?

Allow parents to say goodbye to their infant. Arrange for someone to take the parents home from the hospital. Conduct a debriefing session with the parents before they leave the hospital.

Parents tell the nurse that their 1-year-old son often sleeps with them. They seem unconcerned about this. The nurses response should be based on the knowledge that:

This is a common and accepted practice, especially in some cultural groups

The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infants stool. The nurse bases her explanation on knowing that:

This is normal because of the immaturity of digestive processes at this age.

A parent of an 18-month-old boy tells the nurse that he says no to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. The nurses best interpretation of this behavior is that:

This is normal behavior for his age.

Although a 14-month-old girl received a shock from an electrical outlet recently, her parents find her about to place a paper clip in another outlet. The best interpretation of this behavior is that:

This is typical behavior because of inability to transfer knowledge to new situations.

In terms of fine motor development, the infant of 7 months should be able to:

Transfer objects from one hand to the other.

An appropriate approach to performing a physical assessment on a toddler is to:

Use minimal physical contact initially.