Introduction to Pediatrics
A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory tract infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. What is the nurse's best response?
"From your description, medications are not necessary. They should be avoided in children at this age." "The doses are close enough; it doesn't really matter which one is given." "It is not appropriate to use dosages based on age because children have a wide range of weights at different ages." The nurse practitioner ordered the drug based on weight, which is a more accurate way of determining a therapeutic dose."(correct?)
A physician's prescription reads, "ampicillin sodium 125 mg IV every 6 hours." The medication label reads, "1 g = 7.4 ml." A nurse prepares to draw up __ milliliters to administer one dose. (Round your answer to two decimal places.)
0.93
The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play?
Adam playing a board game with Kyle, Steven, and Erich Kimberly and Amanda sharing clay to each make things Danielle playing with a music box on her mother's lap Brian playing with his truck next to Kristina playing with her truck (correct?)
When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?
Administer the medication with a syringe (without needle) placed along the side of the infant's tongue. (correct?) Keep the child upright with the nasal passages blocked for a minute after administration. Mix the medication with the infant's regular formula or juice and administer by bottle. Administer the medication as rapidly as possible with the infant securely restrained
A nurse recognizes which physiologic responses as a manifestation of pain in a neonate? SAP
Decreased SaO2 (correct?) Decreased blood pressure Diaphoresis (correct?) Decreased respirations Increased heart rate (correct?)
Which refers to those times in an individual's life when he or she is more susceptible to positive or negative influences?
Differentiation points Sequential period Sensitive period (correct?) Terminal points
Which is the preferred site for intramuscular injections in infants?
Dorsogluteal Vastus lateralis (correct?) Deltoid Ventral gluteral
Which is probably the single most important influence on growth at all stages of development?
Environment Heredity Culture Nutrition (correct?)
Guidelines for intramuscular administration of medication in school-age children include which action?
Have child stand, if possible, and if child is cooperative. Inject medication as rapidly as possible. Insert needle quickly, using a dart like motion. (correct?) Penetrate skin immediately after cleansing site, before skin has dried.
Which is the major cause of death for children older than 1 year?
Heart disease Unintentional injuries (correct?) Cancer Congenital anomalies
All of the following risk factors except one places a child at risk for increased morbidity. Which answer does not fit?
Homelessness High birth weight (correct?) Adoption from a foreign country Time spend in day care centers
When teaching a mother how to administer eye drops, where should the nurse tell her to place them?
In the conjunctival sac that is formed when the lower lid is pulled down (correct?) On the sclera while the child looks to the side Carefully under the eye lid while it is gently pulled upward Anywhere as long as drops contact the eye's surface
A 12-year-old child enjoys collecting stamps, playing soccer, and participating in Boy Scout activities. The nurse recognizes that the child is displaying which developmental task?
Integrity Industry (correct?) Identity Intimacy
Play serves many purposes. In teaching parents about appropriate activities, the nurse should inform them that play serves which of the following function? SAP
Intellectual development (correct?) Physical development Socialization (correct?) Creativity (correct?) Temperament development
A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started?
It is less painful for small children Antibiotics must be started immediately Rapid venous access is not possible (correct?) Long-term venous access is not possible
What is an appropriate method for administering oral medications that are bitter to an infant or small child?
Mix in a bottle of formula or milk. Mix with any food the child is going to eat. Mix with a small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream. (correct?) Mix with large amounts of water to dilute medication sufficiently.
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
Morphine(correct?) Meperidine Metadone Codeine
A nurse is assessing a family's structure. Which describes a family in which a mother, her children, and a stepfather live together?
Nuclear Blended Binuclear (correct?) Extended
A father tells the nurse that his child is "filling up the house with collections" like seashells, bottle caps, baseball cards, and pennies. What should the nurse recognize the child is developing?
Object permanence Ability to use abstract symbols Concrete operational thinking (correct?) Preoperational thinking
What should the nurse do when caring for a child with an intravenous infusion?
Observe the insertion site frequently for signs of infiltration. (correct?) Avoid restraining the child to prevent undue emotional stress. Change the insertion site every 24 hours. Use a macrodropper to facilitate reaching the prescribed flow rate.
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?
Oucher Scale FLACC tool (correct?) FACES pain rating tool Numeric scale
Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
Race Culture (correct?) Ethnocentrism Social group
Which is the leading cause of death in infants younger than 1 year?
Respiratory distress syndrome Sudden infant death syndrome Congenital anomalies (correct?) Bacterial sepsis of the newborn
An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development?
Sequential Proximodistal Cephalocaudal (correct?) Mass to specific
STAGES OF PLAY -Solitary -Parallel -Cooperative -Associative
Solitary : Lasts from just a few months old until about 18 months old. Tend to play alone or possibly with adults, with limited interest in interacting with same-age peers. Generally prefer basic cause-and-effect toys that meet their sensory needs, including those that spin, light up, and make sounds, and toys they can easily mouth. Parallel : Occurs between 18 to 36 months old. Children are able to play alongside one another and may even be playing with the same toy or game, but show minimal ability to appropriately interact with one another. Cooperative : between the ages of 4 and 5. Involves children playing and working with others towards a common goal or purpose. Associative : Around age 3-4. Play with one another but don't organize their play toward a common goal. Might be talking, laughing, and playing together but have totally different ideas about the outcome of the game they're each playing
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. What is the priority nursing action?
Stimulate child by calling name, shaking gently, and asking to breathe deeply Administer naloxone (Narcan) ((correct?)) Discontinue IV infusion Discontinue morphine until child is fully awake
A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering?
Taking over total care of the child to reduce stress on the family Excluding families from the decision-making process Recognizing that the family is the constant in a child's life (correct?) Encouraging family dependence on health care systems
