Jersey College Peds Exam 2/Final
The nurse is performing an assessment of a 6-year-old girl with Turner syndrome. What finding would the nurse most likely assess?
short stature and slow growth
The nurse is caring for a 3-year-old boy who is experiencing seizure activity. Which diagnostic test will determine the seizure area in the brain?
Video electroencephalogram
After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause?
Viruses
The nurse suspects sexual maltreatment in a 10-year-old girl. The nurse would assess which primary finding to help make this determination?
vaginal discharge
A 9-year-old boy was in a car accident. The child is suffering from posttraumatic stress disorder. Which would be the best approach for treatment?
Individual psychotherapy sessions
A nurse is explaining the difference between anorexia nervosa and bulimia nervosa. The nurse knows the teaching was effective when the parents make which statement?
Individuals with bulimia have a normal weight or are slightly overweight
A 3-year-old child and parent are in the office for a well visit. Which statement by the parent will the nurse highlight for the health care provider?
I have noticed my child does not look at people when talking to them
The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement?
I should be certain to use fabric softener in the care of the infant's clothes
The nurse is teaching the mother of a 5 year old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching?
I should position him on his abdomen with knees bent
The nurse is conducting a community educational program for parents of school-aged children. What would the nurse include in education plan in regards to the potential for drug and alcohol consumption in the school-age population?
Parental modeling of drug and alcohol avoidance is vital at this age
The nurse is caring for a 12-year-old child who has been categorized with profound intellectual disability (intellectual developmental disorder). Which task is the most challenging that the nurse should expect this client to be able to accomplish as an adult?
Perform tooth brushing
The nurse is educating the parents of a child requiring renal replacement therapy The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?
Peritoneal dialysis
The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?
Use this information to teach family and friends
A 10-year-old boy has just been treated for otitis externa and now the nurse is teaching the boy and his parents about prevention. Which recommendation should the nurse include?
Using a hair dryer on cool to dry the ears
The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal?
creatine kinase
After teaching a class of students about genetics and inheritance, the instructor determines that the teaching was successful when the students identify this as the basic unit of heredity.
Gene
What is a true statement regarding status epilepticus?
It is a common neurologic emergency in children.
A nurse explains to the family of an infant with an inguinal hernia that the surgeon will attempt manual reduction prior to surgical repair. Which statement describes this technique?
The client is sedated, the lower torse is elevated, and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity.
The nurse is conducting a wellness examination of a 6-month-old child. The mother points out some dimpling and skin discoloration in the child's lumbosacral area. How should the nurse respond?
This can be considered a normal variant with no indication of a problem; however, the doctor will want to take a closer look
The nurse is assessing a child diagnosed with Cushing syndrome. Which statement by the parents demonstrates a need for further teaching?
This disorder is most likely due to an infection my child had recently
The parent of an infant born with trisomy 18 says to the nurse, "I am so lost...I cannot even think about my baby not being healthy." Which is the best response from the nurse?
This is a sad time for you. I will sit with you quietly in case you want to talk.
The nurse is performing an assessment on a child who is 6 months of age. When assessing the eyes, the nurse notes the presence of a bluish tinge to the sclerae. What can the nurse infer about this finding?
This may signal a connective tissue disorder
The nurse is caring for a 5-year-old child with Guillain-Barre syndrome. Which would be the best way to assess the level of paralysis?
Gentle tickling
The nurse is caring for a 6-year-old child who has a history of febrile seizures and is admitted with a temperature of 102.2°F (39°C). What is the nurse's highest priority?
Institute safety precautions
In caring for a child in traction, which intervention is the highest priority for the nurse?
The nurse should monitor for decreased circulation every 4 hours
A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority?
serum glucose level
The nurse is providing client education to an adolescent newly diagnosed with type 1 diabetes mellitus. Which statement by the adolescent indicates that the nurse's teaching has been effective?
If I take my insulin, I can eat any kind of carbohydrate I want
The nurse is caring for a 2-month-old in a pediatric clinic. The mom states she is going on vacation in Florida in a month and she is concerned about sunburn. She asks if it is okay to use a sunscreen lotion made for children. What is the correct nursing response?
Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun
After a difficult birth, the nurse observes that a newborn has swelling on part of his head. Which sign suggests cephalohematoma?
Swelling does not cross the suture lines
Which sign or symptom suggests that a 5-year-old boy who does not maintain eye contact or speak may have autism spectrum disorder (ASD)?
The child constantly opens and closes his hands
A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?
Type 1 diabetes mellitus
A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement?
I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already
An 8-year-old boy comes to the emergency room with an eye injury after having a glass bottle shatter near his face. Which intervention should the nurse do first while assisting this client?
Instill a few drops of a topical anesthetic into the affected eye
Which statement about nondisjunction of a chromosome is true?
It is failure of the chromosomal pair to separate
A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?
The cause is unknown and there are many environmental factors that may contribute to it
The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?
The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?
Encourage high fluid intake
Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe?
Insensitivity to pain
An adolescent is diagnosed with psoriasis. After speaking with the nurse about treatment options suggested by the primary health care provider, the adolescent states, "Since ultraviolet rays help, I am going to buy a tanning package so I can tan year round." How will the nurse respond?
Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems
Atrophy is a _____ or wasting in size of a muscle
decrease
A 7-year-old child is diagnosed with a learning disability involving reading, writing, and spelling. The nurse identifies this as:
dyslexia
A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence.
Incubation, Prodrome, Illness, Convalescence
The parent of a 3-week-old infant brings the infant in for an evaluation. During the visit, the parent tells the nurse that the infant is spitting up after feedings. Which response by the nurse would be most appropriate?
Infants this age commonly spit up
A child is in traction and is at risk for impaired skin integrity. Which intervention is most effective?
Inspect the child's skin for rashes, redness, irritation, or pressure injuries
The nurse is performing a physical assessment for an 8-year-old child with an earache. Which sign or symptom indicates external otitis (acute otitis externa or swimmer's ear)?
The child cries out when the ear is grasped
A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?
The child does not have intravenous access
The young child has been diagnosed with a corneal abrasion. Which findings are most consistent with this diagnosis?
The child's pupils are equal, round, reactive to light and accommodation, the child reports that it hurts to look toward bright light, the child's eye is draining clear fluid and the child says it feels like it is full of tears
A 2-year-old child has been diagnosed with autism spectrum disorder. The parents ask the nurse for a treatment that will cure the disorder. Which is the best response by the nurse?
There are no medications available to cure autism spectrum disorder
The nurse is caring for an infant girl in an outpatient setting. The infant has just been diagnosed with developmental dysplasia of the hip (DDH). The mother is very upset about the diagnosis and blames herself for her daughter's condition. Which response best addresses the mother's concerns?
This is not your fault and we will help you with her care and treatment
An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have?
Type 2 diabetes mellitus
The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate?
Vaccinations are very effective at preventing serious disease and infection
The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching?
We should avoid using petroleum jelly
A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason?
detect Helicobacter pylori
A nurse is working with a child who has been psychologically neglected by the parents. The nurse would anticipate which complication for this child?
developmental delay and mental health issues
After teaching a group of students about neural tube disorders, the instructor determines that additional teaching is needed when the students identify which condition as a neural tube defect?
Hydrocephalus
When discussing congenital adrenal hyperplasia with a child's parents, the nurse would advise them that administration of which drug is anticipated?
Hydrocortisone
The nurse is developing a plan of care for a 5 year old child with severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likey assessed?
Immature emotional behavior
The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?
Improving hydration
The nurse is working with a 6-year-old child recently diagnosed with Legg-Calvé-Perthes disease. The child's parents tells the nurse they understand exercise is important for their child but are not sure which activities are appropriate. Which activity will the nurse recommend for this client?
Swimming
The nurse is providing teaching to the parents of a child with varicella. Which statement by the parents indicates the teaching was successful?
We need to make sure that our child washes their hands frequently
A young boy was involved in a motor vehicle accident and was admitted to the pediatric intensive care unit with changes in his level of consciousness and a high-pitched cry. Which are late signs of increased intracranial pressure?
The child's toes are pointed downward, his head and neck are arched backward, and his arms and legs are extended, the child's heart rate is 56 beats per minute, the child's pupils are fixed and dilated
The nurse is talking with a pregnant woman who is a carrier for a genetic disorder. The woman does not have any symptoms of the disorder. The pregnant woman asks the nurse about the risk to her unborn baby. What is the most appropriate response by the nurse?
We can only assess the potential risk after the baby's father undergoes genetic testing
Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest?
Wearing protective clothing when playing in wooded areas, Inspecting the skin closely for ticks after the child plays in wooded areas, Contacting the health care provider if there is any area of inflammation that might be a bite
The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond?
I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately
The nurse has finished teaching the parents of a 10-month-old male ways to prevent another acute otitis media (AOM) infection. Which statement by the mother indicates she has the correct understanding of the information provided?
I should continue to breastfeed my son because it lowers the incidence of acute otitis media
The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond?
I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection
The nurse is caring for an infant recently diagnosed with oral candidiasis (thrush) who has been prescribed nystatin. Which statement by the infant's mother would suggest a need for further education?
I will add the nystatin to her bottle four times per day
A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included?
IV fluid administration, monitor of intake and output, daily weight assessment
The nurse learns that the child has been admitted with clinical manifestations associated with a cholinergic crisis. Which findings are associated with this condition?
The child exhibits diaphoresis, the child's apical heart rate is 52 beats per minute, the child is complaining that his muscles are very weak, the child is drooling excessively
A 5-year-old child is in traction and at risk for impaired skin integrity due to pressure. Which intervention is most effective?
Inspect the child's skin for rashes, redness, irritation, or pressure sores
The young child has been diagnosed with bacterial meningitis. Which nursing interventions are appropriate?
Initiate droplet isolation, identify close contacts of the child who will require postexposure prophylactic medication, administer antibiotics as ordered, initiate seizure precautions
What is a macule?
A flat discolored area on the skin
What is a vesicle?
A fluid-filled bump on the skin
The nurse is caring for a child with a prescription for PO prednisone. Which statement by the child's mother would indicate a need for further education?
I will give it to ny child at least 1 hour before all meals
The student nurse is developing a care plan for a child who suffered a fractured tibia and will have a cast on his lower leg for approximately 6 weeks. Which nursing diagnosis would be the priority for this client?
Impaired physical mobility related to a cast on the leg
The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?
I hate to think that I will need to be worried about my child having seizures for the rest of his life
To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority?
Cerebral edema
The nurse is administering an enteral feeding to a child with a gastrostomy tube (G-tube). Which action will the nurse take when administering a prescribed feeding through the client's G-tube?
Check for gastric residual before starting feeding
The nurse is conducting a physical examination of a child with severe burns. Which internal physiologic manifestation should the nurse expect to occur first?
Decrease in cardiac output
The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38°C (100.4°F)?
7.5 mL
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?
Eyes
The nursing instructor is conducting a class on the various genetic anomalies which can occur. The instructor will determine the session was successful when the students correctly point out that Down syndrome is related to which factor?
3 copies of chromosome 21 have occurred instead of 2 copies
According to Healthy People 2020 what age should visual acuity testing begin?
3 years old
Systemic ____ are used to treat periorbital cellulitis
Antibiotics
B cells use what to attack specific foreign substances
Antibodies
The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved?
Antidiuretic hormone
Diabetes insipidus is a disorder of the posterior pituitary that results in deficient secretion of which hormone?
Antidiuretic hormone (ADH)
A family includes a parent and 9-year-old child. The nurse suspects that the child has medical child abuse (formerly Munchausen syndrome by proxy). Which nursing intervention is best when assessing the child and parent in the pediatrician's office?
Ask to speak to the child separate from the family
A 6-year-old boy is suspected of having late-stage Lyme disease. Which assessment should the nurse use to produce findings supporting this concern?
Asking the child if his knees hurt
The nurse is interviewing the mother of a 6-month-old being seen at a well-child visit. The mother reports she has used an over-the-counter topical ointment intended for adults on her child for a skin rash. What is the most appropriate response by the nurse?
Children have thin skin and can absorb medications differently than adults
A nurse is caring for an 11-year-old with an Ilizarov fixator and is providing teaching regarding pin care. The nurse should provide which instruction?
Cleansing by showering should be sufficient
A nurse is caring for an infant with meningocele. Which finding alerts the nurse that the lesion is increasing in size?
Constipation and bladder dysfunction
Kyphosis refers to what kind of curvature of the spine resulting in a humpback appearance?
Convex
The nurse is explaining information to the parents of a 3-year-old boy who may have strabismus. The nurse should explain that which examinations will be performed first to find out if he has strabismus?
Corneal light reflex test
Diaper wearing does what to the skin's pH, activating fecal enzymes that further contribute to skin maceration?
Decreases
A 15-year-old adolescent is scheduled for a pelvic ultrasound to evaluate for a possible ovarian cyst. Which instruction by the nurse would be most appropriate?
Drink plenty of fluids because you need to have a full bladder
Rubella
German measles, Transmission by direct or indirect contact with droplets, Nasopharyngeal secretions, Incubation 12-23 days, Communicable 7 days before to 7 days after onset of rash, Rash usually first sign. (face to feet by 3rd day.)
After hospital discharge, the parent of a child newly diagnosed with type 1 diabetes mellitus telephones the nurse because the child is acting confused and very sleepy. Which emergency measure would the nurse suggest the parent carry out before bringing the child to see the health care provider?
Give the child a glass of orange juice
A parent brings the child for a well-child visit. During the visit, the parents state the child appears to not be seeing well. To obtain information needed to aid in a diagnosis, which question(s) should the nurse ask the parents?
Has your child been reporting any blurred vision, Has your child's school work remained good, Does your child report a headache when reading, Have you noticed your child squinting
The nurse is educating parents of an toddler with Down syndrome. What would the nurse include in the teaching plan?
Have the child's thyroid function tested regularly
What is a decreased muscle tone called?
Hypotonia
The nurse is caring for a newborn with facial nerve palsy from birth trauma. The mother is very upset and concerned about the child's prognosis. Which response by the nurse would be most appropriate?
In most cases treatment is not necessary, only observation
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?
In this disorder the sphincter that leads into the stomach is relaxed
Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period?
Incubation period
A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings?
Koplik spots
The nurse will teach parents of children with myelomeningocele to maintain an environment free of what element?
Latex
Absence seizures are marked by what clinical manifestation?
Loss of motor activity accompanied by a blank stare
The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure?
Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency?
Monitor output
A nurse is assessing a child's vision. Which test should the nurse use to test for accommodation?
Moving a penlight toward the client's nose and observing whethe eyes can follow it
The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity?
Moving the infant's head every 2 hours
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease?
Mumps
The nurse is caring for a preschooler with a greenstick fracture. Which statement by a parent indicates an understanding of this type of fracture?
My child may need the arm broken completely prior to putting a cast on it
The nurse is teaching a group of caregivers of children diagnosed with diabetes. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur?
My child measures their own medication but sometimes doesn't administer the correct amount
The nursing instructor is teaching a student about the management of children with cognitive impairment. The student demonstrates understanding when making which statement?
No specific medical interventions exist for children with cognitive impairment
When teaching parents of a child with encopresis, what would the nurse stress?
Not punishing the child for encopresis
An infant with craniosynostosis from Apert syndrome becomes lethargic and starts to vomit. What is the priority nursing intervention?
Notify the doctor and prepare for surgery
The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take?
Notify the primary health care provider
The nurse is examining an 8-year-old boy with chromosomal abnormalities. Which sign or symptom suggests the boy has Angelman syndrome?
Observation shows jerky ataxic movement
The child with a surgically repaired myelomeningocele has a neurogenic bladder. How will the nurse best explain this problem to the parents?
Old urine remains in the bladder because of poor emptying or overfilling, putting your child at risk for urinary tract infection
The pediatric office nurse notes that several of the young children that are waiting to see the physician may have conjunctivitis. Which findings are consistent with bacterial conjunctivitis?
Only the right eye is involved, the drainage is yellow and thick
A 9-year-old child with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the parents make which statement?
Our child may have some side effects, like insomnia, headache, or stomach ache
An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do?
Premedicate the child before changing the dressing
The emergency department nurse is assessing a child who has presented with a 2-day history of nausea and vomiting with pain that is isolated to the right upper quadrant of the abdomen. Which action is most appropriate?
Prepare the child for admission to the hospital
What are coal tar preparations used for?
Psoriasis, atopic dermatitis
The nurse is caring for a 2-year-old girl with persistent otitis media with effusion. Which intervention is most important to the developmental health of the child?
Reassessing for language acquisition
An 18-year-old adolescent is exhibiting symptoms of mania and has been recently diagnosed with bipolar disorder. The parent is taking blame and is convinced the adolescent's life is now ruined. How should the nurse respond?
Reassure the parent that many people with bipolar disorder have positive outcomes
A nurse is caring for a child with tinea pedis. Which assessment finding should the nurse expect?
Red scaling rash on soles and between the toes
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?
Regular insulin
A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority?
Relieving the child's pain
The nurse is caring for a 10-month-old with a rash. The child's mother reports that the onset was abrupt. The nurse assesses diffuse erythema and skin tenderness with ruptured bullae in the axillary area with a red weeping surface. The nurse suspects which bacterial infection?
Scalded skin syndrome
The mother of a toddler with myelomeningocele is thinking about having another child. What is most important for the nurse to recommend to this mother?
Schedule a preconception appointment with the health care provider
The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?
Second-degree frostbite
What is a papule?
Small raised bump on the skin
After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question?
So, hypothyroidism can be treated by exposing our baby to a special light, right?
The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered?
Sodium bicarbonate tablets
What are involuntary muscle contractions that are not coordinated with other muscles?
Spasticity
A couple who are pregnant with their first child have made an appointment with a clinical geneticist to discuss prenatal screening. The man states that they, "just want to make sure that there is nothing wrong with our baby." How could the clinician best respond to this statement?
Testing the umbilical blood and performing amniocentesis can give us some information, but not a guarantee
Where does the ossification of bone take place?
The Epiphysis
During the trial period to determine the efficacy of an anticonvulsant drug, which caution should be explained to the parents?
The child shouldn't participate in activities that could be hazardous if a seizure occurs
The parents of a child diagnosed with Tay-Sachs inquire about progression of the disorder. Which statement by the nurse is accurate?
The child will experience decreased muscular and neurologic functioning until death occurs
The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?
The child will have a complete physical exam
The nurse is discussing the ears and hearing in a child with a group of peers. Which statement is most accurate related to this topic?
The eustachian tube in the infant is straighter and wider than in the adult.
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?
The foreskin is needed for repair
The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother?
The infant is born with immunity to some diseases, but those immunities decrease over the first year of life
A 6-month-old infant develops roseola. When obtaining information from the parent, what would the nurse expect the parent to report?
The infant's temperature fell when the rash appeared
A school-age child is diagnosed as having Cushing syndrome from long-term therapy with oral prednisone. What assessment finding is consistent with this child's diagnosis and treatment?
There are purple striae on the abdomen
The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse respond?
There are several things we can do to help you achieve this goal
A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition?
Vulvovaginitis
The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best?
Wash your hair with a gentle shampoo daily
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder?
Washing hands frequently
The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most important to emphasize to the boy and his parents?
You and your coaches need to understand that you cannot play soccer for at least six weeks
The nurse is caring for a 2-year-old boy with a burn. What finding would warrant referral to a burn unit?
a chemical burn
A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition?
acute glomerulonephritis
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:
acute glomerulonephritis
The nurse is developing a plan of care for a child newly diagnosed with phenylketonuria (PKU). Which expected outcome takes priority?
adhering to a diet low in phenylalanine
When caring for a child diagnosed with West Nile virus, the nurse will question which prescription from the primary health care provider?
amoxicillin 40 mg/kg/day orally every 8 hours
Which child will the nurse identify as at greatest risk for developing a urinary tract infection?
an 8-month-old bottle-fed female with HIV
A woman in her third trimester has just learned that her fetus has been diagnosed with cri-du-chat syndrome. The nurse recognizes that this child will likely have which characteristic?
an abnormal, cat-like cry
A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:
bacteria
The nurse is assessing a 10-year-old girl recently fitted with a cast on her wrist. Which assessment finding would alert the nurse to a possible infection?
drainage on the cast
The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as a possible trigger?
drinking three cans of diet cola
A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as:
fifth disease
A nurse is conducting a physical examination of an infant with suspected metatarsus adductus. Type II metatarsus adductus is indicated when the forefoot is:
flexible passively past neutral, but only to midline actively
A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?
fluid replacement
A nursing student learning about autism spectrum disorders correctly identifies which mannerisms as common in affected clients?
hand wringing, head banging, rocking, running in circles
The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?
hard, moveable "olive-like mass" in the upper right quadrant
The nurse is educating a female client about genetic disorders. Which statement by the client best describes the major risk factor for trisomy 21?
increasing maternal age
The parent reports that the health care provider said that the infant had a hernia but cannot remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated?
inguinal hernia
Most urinary tract infections seen in children are caused by:
intestinal bacteria
The nurse caring for a client with suspected muscular dystrophy would prepare her client for which diagnostic test?
muscle biopsy
The nurse is assessing a 2-week-old boy who was born at home and has not had metabolic screening. Which sign or symptom indicates phenylketonuria?
musty or mousy odor to the urine
Any individual taking phenobarbital for a seizure disorder should be taught:
never to discontinue the drug abruptly
A school nurse knows that most of the students in the community's elementary school have not received routine vision screening because the families live below the federal poverty threshold. What is the most effective method to promote vision screening for this client population?
offering vision screening to all students in kindergarten
The nurse is discussing nutritional requirements to the parents of a child diagnosed with phenylketonuria (PKU). Which food item would be appropriate to recommend?
orange slices
The history of a 2-year-old child reveals ingestion of clay over the past 6 weeks. The nurse documents this as:
pica
A nurse is assessing a child diagnosed with Sturge-Weber syndrome. What finding would the nurse expect to find when assessing the skin?
port wine stain
Decerebrate posturing
posturing in which the neck is extended with jaw clenched; arms are pronated, extended, and close to the sides; legs are extended straight out; more ominous sign of brain stem damage. Most Severe.
An 8-year-old girl presents to the clinic for moodiness and irritability. The child has begun to develop breasts and pubic hair and the parents are concerned that the child is at too early an age for this to begin. The nurse knows that these symptoms may be indicative of what disorder?
precocious puberty
A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who reports headaches. The child's grades have dropped, and the child is sleeping late and going to bed early every night. Which would the nurse identify as the priority?
scheduling an immediate history and physical examination
The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?
second-degree frostbite
A 7-year-old child being treated for depression will most likely be given which first-line pharmacologic treatment?
selective serotonin reuptake inhibitors (SSRIs)
A nurse is conducting a class for parents of adolescents on the topic of suicide prevention. What are the warning signs for suicide that the nurse will provide for this group?
statements of hopelessness, changes in behavior from feeling dejected to euphoric, displaying poor judgment, violence and truancy
Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n):
steroid
The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)?
stocking-glove pattern on hands or feet
The nurse suspects a newborn of having an inborn error of metabolism. What action would the nurse prepare for next?
stopping feedings until confirmation of the diagnosis
A nurse is assessing a newborn and observes webbing of the fingers and toes. The nurse documents this finding as:
syndactyly
The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time?
tetanus toxoid vaccine
During auscultation, a loud or localized what indicates the need for immediate further investigation?
Bruit
What is Isotretinoin used for?
Cystic acne
Which child needs to be seen immediately in the physician's office?
10-month-old with a fever and petechiae who is grunting
A nurse is assessing a little boy who has been diagnosed with Tourette syndrome. Which finding would the nurse expect to see?
Speaks sudden, fast phrases out of context
The infant is listless with sunken fontanels (fontanelles) and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift?
48
The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for how long?
7 to 14 days
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse (child mistreatment) in which situation?
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate
The nurse is talking with the mother of a 4-year-old boy who will soon be going to a pre-kindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision?
A child's vision is not completely developed by this age. Your child might outgrow this nearsightedness
A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement?
A definitive cause can be found for every developmental disorder
The nurse is caring for a near-term pregnant woman who has not taken prenatal vitamins or folic acid supplements. Which congenital defect is most likely to occur based on the mother's prenatal history?
A neural tube defect
A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease could be discovered this early. Which is the nurse's best answer?
A simple blood test to diagnose hypothyroidism is required in most states.
A child diagnosed with schizophrenia is taking clozapine. The nurse has instructed the parents to watch for side effects. Which symptom should the parents expect to see?
Abnormal twitches and movements
A child is hospitalized and diagnosed with bacterial meningitis. What can the nurse anticipate will be included in the plan of care and treatment?
Acetaminophen, tepid baths as needed, antibiotic therapy
A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform?
Administer diphenhydramine
The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child?
Apply ice to the affected area
A parent calls the clinic nurse to say the child has shin splints after playing soccer. What instructions should the nurse provide this parent?
Applying ice to the area will reduce the pain and swelling
What is Silver sulfadiazine 1% used for?
Burns
A 17-year-old child has been admitted with complications of anorexia nervosa. What diagnostic tests can be anticipated in the plan of care/treatment?
CBC, metabolic panel
Seborrhea in infants is referred to as what?
Cradle cap
The nurse is caring for a 7-year-old girl in an outpatient clinic diagnosed with amblyopia that is unrelated to any other disorder. Which intervention should be most helpful at this time?
Educating parents on how to use prescribed atropine drops
The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions?
Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion
What is scaling?
Flaking of the skin
Which collaborative intervention will the nurse provide when caring for an infant diagnosed with pertussis?
Have suction available in the room, Encourage small, frequent feedings, Administer erythromycin for 10 days, Utilize droplet and standard precautions
The nurse is caring for an 8-year-old boy with otitis media with effusion. Which situation may have caused this disorder?
He is experiencing recurrent nasal congestion
Acetaminophen and what administered at the appropriate dose and interval, are safe and effective for reducing fever in children?
Ibuprofen
A nurse is assisting the parents of a child who requires a Pavlik harness. The parents are apprehensive about how to care for their baby. The nurse should stress which teaching point?
It is important that the harness be worn continuously
What sign is an indication of meningitis?
Kernig sign
The nurse is caring for a child diagnosed with low functioning parathyroid. Which is a treatment goal of a child with hypoparathyroidism?
Maintain the child's calcium level at a normal level with calcium replacement as prescribed
Acne neonatorum occurs as a response to the presence of what?
Maternal androgens
What is Benzoyl peroxide used for?
Mild acne vulgaris
A 10-year-old child has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important?
Obtain specimen before antibiotics are given
The nurse is educating the parents of a client newly diagnosed with type 1 diabetes. Which statement by the parents indicates additional teaching is needed?
Our child should not participate in sports or physical activity
The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?
Our son's condition may resolve on its own
Lack of response to what stimuli can indicate a life-threatening conditions?
Painful
Monocytes use what as means to eliminate pathogens?
Phagocytosis
The parent of a 2-week-old infant with trisomy 21 presents to the clinic with concerns about poor feeding in the infant. What does the nurse understand about feeding concerns in infants with trisomy 21?
Poor muscle control contributes to the feeding difficulties, Nasal stuffiness contributes to the difficulty of sucking and breathing during feeding
A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?
Positive Kernig sign
The trigger of prostaglandins to increase the body's temperature set point is caused by what?
Pyrogens
During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take?
Report the findings to the pediatric healthcare provider
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?
Risk for infection
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause?
Staphylococcus aureus
A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms?
Steatorrhea, Constipation, diarrhea, failure to thrive
The student nurse is studying the genetics of clients who are seeking assistance from a genetic counseling center. The student nurse notes monogenic disorders have which characteristic?
The disorders are considered single-gene
The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment?
The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place
The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse?
The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be
The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification?
Type II
A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. What should the nurse do next?
The nurse should first ensure proper oxygenation followed by administer intravenous (IV) or intramuscular (IM) benzodiazepine
The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?
The nurse should help the caregivers to understand and help the child to effectively use the corrective devices
A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note?
The posterior spine when bending forward
A 1-year-old infant has just undergone surgery to correct craniosynostosis. Which comment is the best psychosocial intervention for the parents?
The surgery was successful. Do you have any questions?
The parent of a child having tympanoplasty tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer?
The tubes are inserted into a section of eardrum in which the hearing is not affected
A child having tympanostomy tubes placed asks, "How and when will the tubes be removed?" What is the nurse's best response?
The tubes remain in place for 6 to 12 months until they come out by themselves
A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education?
The use of cleansing towelettes may have caused the vulvovaginitis
The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures?
Understanding the side effects of medications
The nurse is caring for a 6-year-old girl who has been diagnosed with neurofibromatosis. What is the priority intervention?
Urging the parents to schedule yearly physical examinations
The nurse is caring for a child on the burn unit weighing 100 lb (45.5 kg) who has second-degree (partial-thickness) burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse?
Urine output of 15 ml per hour over the last 4 hours
The nurse is preparing a child experiencing new-onset seizures for an electroencephalogram (EEG) test. How can the nurse best explain this procedure to the child?
Use a doll with electrodes attached to the head
To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take?
Use a repetitive series of movements
The nurse is providing education to the parents of a 3-year-old girl with hydrocephalus who has just had an external ventricular drainage system placed. Which question is best to begin the teaching session?
What questions or concerns do you have about this device?
A 10-year-old girl with long hair is brought to the emergency room because she began acting irritable, reported a headache, and was very sleepy. Which question is most appropriate for the nurse to ask the parents?
What were you doing before she began to feel sick?
The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate?
What you are describing may be what is called myopia
A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction?
When I get home from school, I look forward to taking off my brace for a few hours before I go to bed
A nurse is educating a family about the Chvostek sign after their teen tested positive for Chvostek sign. Which statements by the caregivers shows the nurse that they understand the Chvostek sign?
When I tap on my child's facial nerve, the reaction is a facial muscle spasm
The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)?
While assessing the child's pupils, there is no change in diameter in response to a light
The mother of an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse?
While immunizations are highly effective they aren't 100% effective at preventing infectious diseases
The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunchtime dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond?
You may want to talk to your physician about an extended-release medication
When would the nurse screen newborns for inborn errors of metabolism?
before discharge and preferably between 24 and 72 hours of birth
Parents of a school-age child have begun a program of therapy that includes giving the child a token each time the child follows directions. Which theoretical framework provides the background for such a program?
behavioral theory
A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely?
cognitive impairment
A child with type 1 diabetes is brought to the emergency department. The nurse suspects diabetic ketoacidosis (DKA) based on which assessment findings?
fruity odor on the breath, decreased level of consciousness, poor skin turgor
Changes in ______, muscle tone, or strength may indicate certain neurologic problems
gait
The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?
head trauma
Rubeola
measles, Direct or indirect airborne, Communicable 1-2 days before onset, Prodromal Phase- 2-3 days, fever, cough, coryza, conjunctivitis, Koplik spots - before rash appears on buccal mucosa (grains of salt appearance)
A 15-year-old Vietnamese-American boy has been referred by his homeroom teacher to the school nurse for evaluation. The teacher is concerned that the adolescent may be suffering from major depression. When investigating these concerns at the family's primary care office, the nurse would use which person as the primary source of information?
the client
The parents of a preschool-age child learn their child is diagnosed with Duchenne muscular dystrophy (DMD), based on the nurse noting a Gower sign during a well-child visit. How should the nurse explain Gower sign to these parents?
the way the child stands up
The nurse is preparing a teaching session for the parents of a 1-month-old infant who has been diagnosed with Turner syndrome. Which factor should the nurse include in this teaching session?
timing and use of growth hormone
An adolescent wears a body brace for scoliosis. Which client education should the nurse provide?
to continue with age-appropriate activities
What is the main purpose of nurses having basic genetic knowledge?
to provide support and education to families
The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client?
use of anticonvulsant medications
The nursing diagnosis of risk for infection related to a disruption in the protective skin barrier is noted on a child's plan of care. Which action would be of greatest importance?
using appropriate hand hygiene
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder?
washing hands frequently
The nurse measures the client's blood glucose level prior to breakfast. The measurement obtained is 130 mg/dl. The orders read to administer 2 units of Humalog insulin for a blood glucose of 100 to 150 mg/dl. How soon should the nurse ensure that the client eats breakfast after receiving insulin?
within 15 to 30 minutes
A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?
Barium enema
An 18-year-old male is diagnosed with Klinefelter syndrome. What signs and symptoms are consistent with this diagnosis?
hypogonadism and gynecomastia
What is Annular?
In a circle or ring shape
The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which finding will the nurse expect to assess?
Indifferent attachment to a parent
Which child is at risk for acute glomerulonephritis?
7-year-old male with a recent history of an upper respiratory infection
The nurse works in a pediatrician's office. Which children, who have been diagnosed with acute otitis media, does the nurse expect the physician to treat with antibiotics?
8-year-old child who is crying due to ear pain and has a temp of 103, 2-month-old child who is having difficulty sleeping and has a fever of 102.6, 5-month-old child who is fussy and pulling at her ears, 22-month-old child who is irritable with the presence of purulent drainage from her right ear
The nurse is interviewing a depressed 13-year-old adolescent. During the course of the interview, the adolescent reveals that her best friend is thinking about committing suicide. How should the nurse respond?
Do you know how your friend is planning to commit suicide
A parent brings an infant to the clinic for a well child visit. During the assessment, the parent asks the nurse why the infant never seems to sweat. What action should the nurse take?
Explain that this normal mechanism keeps the infant from losing too much water through the skin
The nurse is preparing a plan to educate the parents of a 10-year-old boy with a learning disorder. What will be part of this plan?
Explain the child's strengths and weaknesses
The nurse is caring for an infant with temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, what would be most appropriate to promote healing and prevent further skin breakdown?
Apply a barrier/healing cream or paste on the skin
A school-aged child is brought to the office of the camp nurse with a small, superficial burn (first-degree burn). Which action by the nurse would be most appropriate to take first?
Apply cold compresses to the area
The rash in roseola is pruritic. Which measure would you teach the parent to provide comfort?
Apply cool compresses to the skin to stop local itching
A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. How should the nurse respond?
As endocrine functions become more stable throughout childhood, alterations become more apparent
A child has been diagnosed with a basilar skull fracture. The nurse identifies ecchymosis behind the child's ear. This would be documented as:
Battle sign
The nurse knows that which condition is caused by excessive levels of circulating cortisol?
Cushing syndrome
A nurse assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. Which should the nurse ask the mother?
Does she wear sleepers with metal snaps?
What is the leading cause of neonatal sepsis and death?
Group B streptococcus
What pressure is inversely related to the level of consciousness?
Intracranial
The vision impairment in which the child can see objects at close range but not at a distance is known as:
Myopia
Bordatella pertussis
Pertussis (whooping cough), Acute Resp Distress. Copious secretions, Usually less than 1 year old, Tdap vaccine can prevent, Paroxysmal coughing. Followed by a whooping cough, Redness in the face. Progressive cyanosis, protrusion of the tongue, Culture or PCR
Which condition is a part of normal newborn screening?
Phenylketonuria
A nurse is caring for a 14 year old girl scheduled for a barium swallow/upper gastrointestinal series. Before providing instructions, what would be the priority?
Screening the girl for pregnancy
A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer?
Second-degree or partial-thickness burn
The nurse is conducting a primary survey of a child with burns. Which assessment finding points to airway injury from burn or smoke inhalation?
Stridor
The nurse is educating parents of a male infant with Chiari type II malformation. Which statement about their child's condition is most accurate?
Take your time feeding your baby
The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?
Tea-colored urine
A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate?
Teach the child and his parents to keep a headache diary
The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be:
The child is in status epilepticus
The nurse is reviewing the assessment data from a 4-year-old admitted to the hospital for management of early-onset sepsis. Which finding supports the diagnosis?
The child is irritable
What finding would suggest that a 5-year-old boy might have a developmental disorder?
The child is not able to follow directions
In collecting data on a 7-year-old child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which would most likely be a cause of the child having school phobia?
The child may have a fear of being separated from the parent
The nurse is educating the parents of a newborn with freckling on the armpit and eight light brown spots approximately 7 mm in diameter on the newborn's skin. What would the nurse plan to include in the teaching plan?
The child will need follow-up for complications as they arise
The nurse is preparing a teaching plan for the parents of a child diagnosed with achondroplasia. What information would the nurse include?
The child will probably average about 4 feet in height, Middle ear infections may be a persistent problem, Limb-lengthening surgeries may need to be done
A nurse is caring for a 13-year-old boy with Duchenne muscular dystrophy. He says he feels isolated and that there is no one who understands the challenges of his disease. How should the nurse respond?
There are a lot of kids with the same type of muscular dystrophy you have at the MDA support group
The parents of an 18-month-old toddler are concerned that their toddler no longer makes eye contact, does not respond to their smiles or other facial expressions, does not point to toys, and no longer speaks. They said that their toddler used to be able to say "mama" or "dada." The parents started noticing these changes in behavior 3 months ago. Which information can be provided to the parents?
There are many behaviors that can be thought of as signs of autism spectrum disorders, but only a health care provider can confirm the diagnosis
The nurse is observing a group of 2- and 3-year-olds in a play group. Which behavior noted in one of the children indicates to the nurse that the child may have autism spectrum disorder (ASD)?
While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack
A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus?
a fasting blood glucose greater than 126 mg/dl
A group of nursing students are reviewing cerebral vascular disorders and risk factors in children. The students demonstrate understanding of the material when they identify which as a risk factor for hemorrhagic stroke?
arteriovenous malformations (AVMs)
The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect?
lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk
The nurse is examining a child with fetal alcohol spectrum disorder. Which assessment finding should the nurse expect?
low nasal bridge with short upturned nose
A pediatric client is newly diagnosed with Tourette syndrome. Which prescription will the nurse question?
may continue athletics
Which diagnostic measure is most accurate in detecting neural tube defects?
significant level of alpha-fetoprotein present in amniotic fluid
The nurse is caring for an infant whose genetic testing shows the results of nondisjunction during the formation of cells. Which trait is most likely to manifest?
protruding tongue
Rumination disorder is a poorly understood condition of young children. This refers to:
rechewing undigested food
A nurse is speaking with the parents of a child scheduled for a bone scan. Which statement by a parent indicates a need for further education?
Before the test, my child will drink a special liquid that will be absorbed into her bones
A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement?
Benzocaine drops should be placed in your ear to numb it and reduce pain
The nurse is caring for a 4 year old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation?
Can you blow this cotton ball across the tray?
The meningococcal vaccine should be offered to high-risk populations. If never fascinated, who has an increased risk of becoming infected with meningococcal meningitis?
18-year-old student who is preparing for college in the fall and has signed up to live in a dormitory with two other suitemates, 12-year-old child with asthma, 5-year-old child who routinely travels in the summer with her parents on mission trips to Haiti, 9-year-old child who was diagnosed with diabetes mellitus when he was 7 years old
The nurse recognizes that if the infant is following normal development, the infant will be able to focus and follow an object with the eyes by what age?
2 months of age
A nurse is caring for a child with a wasp sting. Which nursing intervention is the priority?
Administer diphenhydramine per protocol
The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?
Administer subcutaneous glucagon
The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder?
Administering antibiotics IV as ordered
The nurse is educating the parents of an 18-month-old child being prepared to receive cochlear implants. Which statement by the parents requires further teaching?
After the implant surgery our child will have normal hearing
A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care?
Airway remains patent
The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component?
American Sign Language
A mother brings her 4-month-old infant to the doctor's office due to vesicular lesions that have appeared on the child's scalp and face. The mother says that the child will not stop scratching at the lesions and that she is concerned that he is having some kind of allergic reaction. What should the nurse recommend to the mother to help reduce pruritus in this child?
Bathe the child twice a day
The nurse is caring for a child whose family recently emigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate?
Ask parents which immunizations have been given
The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?
Assess the child's ability to convey information
The nurse is caring for a child diagnosed with hydrocephalus following ventriculoperitoneal shunt placement. The child is currently on a ventilator. Which nursing action is priority?
Assess the client's respiratory status
A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform?
Assess the level of consciousness (LOC)
The nurse is caring for a 6-year-old boy with Russell traction applied to his left leg. Which intervention would be most appropriate to prevent complications?
Assess the popliteal region carefully for skin breakdown
The nurse is caring for a 24-month-old boy with regressed retinopathy of prematurity. Which intervention is priority for this child?
Assessing the child for asymmetric corneal light reflex
Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele?
Assuming the usual feeding position will be difficult
The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is:
Astigmatism
The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next?
Auscultate the child's lungs
Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?
Avoid making noise when in the child's room
A nurse is teaching an adolescent with type 1 diabetes about the disease. Which instruction by the nurse about how to prevent hypoglycemia would be most appropriate for the adolescent?
Carry crackers or fruit to eat before or during periods of increased activity
In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?
Cartilage
A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction?
Cataracts are only present in adults
The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect?
Cellulitis
The pediatric nurse knows that there are a number of anatomic and physiologic differences between children and adults. Which statement about the immune systems of infants and young children is true?
Children have an immature immune response
Antibiotic therapy to treat meningitis should be instituted immediately after which event?
Collection of cerebrospinal fluid (CSF) and blood for culture
The nurse is working with a group of caregivers of school-aged children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:
Complete
A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?
Creatinine clearance rate
The nurse is teaching the parents of a 9-year-old girl about the importance of wearing the prescribed glasses. Which subject is least important to promoting compliance?
Encouraging the use of eye protection for sports
Diphtheria
Corynebacterium diphtheriae, Can affect the nose, larynx, tonsils and pharynx, Psudomembrane forms over pharynx uvula, tonsils, and soft palate causing airway obstruction, Neck becomes edematous and lymphadenopathy develops.
The nurse cares for an infant with myelomeningocele before surgical intervention. What action will the nurse take?
Cover the sac with a saline-moistened dressing
A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?
Decrease environmental stimulation
A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?
Enlarged clitoris
Variation in what percentiles over time may indicate abnormal brain or skull growth?
Head circumference
The nurse is providing education to a teenage boy diagnosed with impetigo. Which statement by the boy indicates the need for further education?
I will need to cover my son's skin lesions with bandages until it has healed
The nurse is assessing a 1-year-old child with Down syndrome at a routine well-child visit. Which statement by the parents indicates that the nurse should provide further teaching?
I will need to delay any further immunizations
What serum may be elevated in the child with atopic dermatitis?
IgE
A mother has just given birth to an infant born with anencephaly. The mother states, "With all of the technological advances in medicine, I am hopeful of a good prognosis for my baby." How should the nurse respond?
It must be very difficult to deal with this diagnosis. Tell me what you know about the prognosis
The nurse is educating the parents of a premature newborn diagnosed with retinopathy of prematurity. Which comment will be part of the information provided?
It's an overgrowth of retinal blood vessels
What methods can a nurse use to evaluate extremity function in an 18-month-old?
Observe the child in developmentally appropriate play, Elicit from the parent a description of fine and gross motor activities, Look for symmetric motion in the arms and legs
A 10-year-old boy has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To ensure that the sensitivity results are accurate, which step is most important?
Obtain a specimen before antibiotics are given
While in a pediatric client's room, the nurse notes that the client is beginning to have a tonic-clonic seizure. Which nursing action is priority?
Protect the child from hitting the arms against the bed
The student nurse is preparing a presentation on celiac disease. What information should be included?
Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders, The only treatment for celiac disease is a strict gluten-free diet, Gluten is found in most wheat products, rye, barley and possibly oats
The nurse is caring for a 6-month-old infant who was admitted to the emergency department 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention?
Take a stool culture
The nurse is caring for a 5-year-old girl with scarlet fever. Which intervention will most likely be part of her care?
Teaching proper administration of penicillin V
While interviewing a depressed adolescent, it is revealed that the client has considered hurting oneself. What question is the nurse's priority?
Tell me exactly how you would hurt yourself
A 9-year-old child with Graves disease is seen at the pediatrician's office reporting sore throat and fever. The nurse notes in the history that the child is taking propylthiouracil. Which of the following would concern the nurse?
The child may have developed leukopenia
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?
The child recently had an ear infection
The nurse is caring for a child who has been hospitalized for child abuse (child mistreatment). When reviewing the child's records which findings may have placed the child at an increased risk for child abuse (child mistreatment)?
The child's mother has a history of substance use disorder, The child was born prematurely, The child has cerebral palsy
A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse?
There is a chance the testicles will descend on their own
What occurs in the gastrointestinal system of the child with Hirschsprung disease?
There is a partial or complete mechanical obstruction in the intestine
An adolescent comes to the clinic reporting vaginal discharge. When assessing the vaginal discharge, what would lead the nurse to suspect that the adolescent has candidiasis?
Thick, white cheese-like discharge
The nurse is administering a chicken pox vaccination to a 12-month-old girl. Which concern is unique to varicella?
This disease can reactivate years later and causes shingles
The nurse is preparing a client for surgery and the client asks, "What does it mean when they say they are going to reduce my abdominal hernia?" Which response by the nurse is most appropriate?
This means the hernia contents will be manipulated back into your peritoneal cavity during surgery
The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?
This medication must be given by injection
Which of these age groups has the highest actual rate of death from drowning?
Toddlers
The nurse is educating the parents of a newborn diagnosed with Tay-Sachs disease. Which parent statement would indicate additional teaching is needed?
We are happy he will eventually grow out of these symptoms
The nurse is caring for a newborn diagnosed with imperforate anus following delivery. The physician has discussed the treatment options and prognosis with the parents. The nurse is talking with the parents and determines that learning has occurred when the parents make which statement?
We are worried that our child may have other congenital problems that we aren't aware of
A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent?
Your child may return to school when all of the lesions have crusted over
A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy?
height increase of 4 inches
The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect?
Lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk
The nurse is caring for a 10-year-old child with a skin rash. The nurse should include which intervention to manage the associated pruritis?
Press the pruritic area
The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used?
Puncturing a vein on the dorsal side of the hand
The parent of a newborn diagnosed with Turner syndrome asks the nurse about the treatment that will be required for their newborn. The nurse should educate the parents on the primary treatments used in the treatment of Turner syndrome, which includes
Growth hormone and estrogen therapy
The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?
Handling the cast with open palms when moving the arm
The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first?
Has the child ever eaten shellfish before now?
A child has been having episodes of diarrhea. The health care provider prescribes stool collection to assess for parasites. Before obtaining the stool specimen, what question should the nurse ask?
Have you given your child any antidiarrheal medication containing bismuth?
An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first?
Have you traveled outside North America?
The nurse refers a 2-year-old child to a speech-language pathologist because of limited vocabulary and delayed speech. The speech therapy program requires hearing screening to be completed prior to admission into the program. How does the nurse explain the reason for this to the parents?
Hearing loss can be a cause of delayed speech, so we want to assess this and treat both the hearing and the speech delays if needed
What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn?
Hematocrit and white blood cell (WBC) counts increase
Through which mechanism is Duchenne muscular dystrophy acquired?
Heredity
Which sign is consistent with autism spectrum disorder (ASD) in a 2-year-old boy?
performs repetitive activity with toys
The school nurse is assessing a 12-year-old client suspected of having bulimia. Which assessment finding would the nurse expect to see?
Eroded dental enamel
A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the best way for the nurse respond?
Explain that children who have had a serious injury sometimes exhibit regressive behavior
A parent brings the 2-week-old infant to the office because the infant has been experiencing gastroesophageal reflux over the past week. Which intervention(s) should the nurse recommend to the parent at this point?
Feed the infant a formula thickened with rice cereal, Feed the infant while holding the infant in an upright position, Keep the infant upright by holding them and/or elevating the head of the crib after feeding.
The nurse is caring for a 12-year-old child with Crohn disease. What assessment finding will the nurse report to the health care provider when caring for the child?
Fever
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which finding(s) is consistent with the condition?
Hypotension, weak pulse, hypothermia
Which approach to drug education would be most effective for a group of school-age children?
providing the children with strategies of how to refuse offers of drugs
The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes and the parents. Which comment by a parent demonstrates a need for additional teaching?
During exercise we should wait to check blood sugars until after our child completes the activity
A pregnant client asks if there is any danger to the development of her fetus in the first few weeks of her pregnancy. How should the nurse respond?
During the first 3 to 4 weeks of pregnancy, brain and spinal cord development occur and are affected by nutrition, drugs, infection, or trauma
The nurse is assessing a 4-year-old girl with ambiguous genitalia. Which finding suggests congenital adrenal hyperplasia?
pubic hair and hirsutism
A pregnant client asks if there is any danger to the development of her fetus in the first few weeks of her pregnancy. How should the nurse respond?
During the first 3 to 4 weeks of pregnancy, the brain and spinal cord development occur and are affected by nutrition, drugs, infection, or trauma
Which laboratory or diagnostic test would the nurse anticipate to rule out complications related to Down syndrome?
Echocardiogram
The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?
Encourage rest and relaxation
The parents of a 4-year-old boy tell the nurse, "We're really worried that our child doesn't have 20/20 vision. It seems that he doesn't always see clearly at a distance." What is the best response by the nurse?
20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns
The nurse is caring for a pediatric client with idiopathic celiac disease. Which meal will the nurse select for this client?
Baked salmon, potato slices, vanilla ice cream, and apple juice
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?
Blood pressure 136/84
The nurse is conducting a physical examination of a newborn with suspected osteogenesis imperfecta. Which finding is common?
Blue sclera
A 10-year-old girl has been referred for evaluation due to difficulties integrating with her peers at her new school. The counselor believes she is at risk for situational low self-esteem due to problematic relationships with both family members and peers. What is the best approach?
Engage the girl in dialogue regarding feelings about self/personal appearance
The nurse is caring for a client with trisomy 21 scheduled for operative repair of a cardiac defect. Which intervention is most unique to this client?
Ensure cervical spine positioning precautions
The nurse is preparing to administer acetaminophen to a 4-year-old girl to provide comfort to the child. Which precaution is specific to antipyretics?
Ensure proper dose and interval
The nurse is caring for a child with a fractured femur in traction. Which action will the nurse complete while caring for this client?
Ensure traction weights are hanging freely, not touching the bed or floor
The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake." Which statement by the student would indicate a need for further education by the nursing instructor?
I will make sure there is plenty of orange juice available. It's her favorite juice
A child has been diagnosed with bacterial conjunctivitis. Which statement by the child's parent indicates the need for further teaching?
I'll continue to use eye drops to help with the redness, he can go back to school in 4 hours after that thick yellow drainage is gone
Nystagmus
Involuntary rapid eye movements
A nurse is caring for a 2-year-old girl with cerebral palsy. The child is having difficulty with proper nutrition and is not gaining adequate weight. How can the nurse elicit additional information to establish a diagnosis?
Let's offer her a snack now and you can tell me about her diet on a typical day
A nurse is caring for a 6-year-old boy with a fractured ulna. He is fearful about the casting process and is resisting treatment. How should the nurse respond?
Look over there are the neon fish in our aquarium
Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?
Low T4 level and high TSH level
A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?
Lower right
A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite?
Lyme disease, Rocky Mountain spotted fever
A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis?
Purulent drainage is a common symptom, It is highly contagious, Warm compresses are used to remove crusts that form on the eyes
A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?
Reassess the client's testes at 6 months of age
An 11-year-old child was recently diagnosed with chickenpox. His parents gave him aspirin for a fever and the child is now hospitalized. Which nursing interventions are appropriate for this child?
Request order for an antiemetic, assess intake and output, request order for an anticonvulsant
The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?
The adolescent telling the nurse purging occurs after each meal
An adolescent is diagnosed with hepatitis A. Which problem should be considered when planning care?
The adolescent will become fatigued easily.
The young boy has fractured his left leg and has had a cast applied. The nurse educates the boy and his parents prior to discharge from the hospital. The parents should call the physician when which findings occur?
The boy has had a fever greater than 102, new drainage is seeping out from under the cast, the boy's toes are light blue and very swollen
The pediatric nurse practitioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this?
The boy rises from the floor by walking his hands up his legs
A 16-year-old male who is diagnosed with tinea pedis questions the nurse about how he may have contracted the condition. How should the nurse respond?
You may have gotten the condition from a community shower or gym area
The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder?
esophageal atresia
The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess?
eye opening, verbal response, motor response
An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to:
gastroesophageal reflux disease
The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which set of assessment findings most likely led the nurse to this conclusion?
hemolytic anemia, thrombocytopenia, and acute kidney injury
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
pyloric stenosis
The nurse is caring for an adolescent diagnosed with anorexia nervosa. Which education will the nurse include in the client's discharge teaching?
referrals to counseling services
The nurse is working with a child diagnosed with encopresis. After a complete medical workup has been done, no organic cause has been found for the disorder. What follow-up will the nurse expect?
referred for counseling
A nurse is providing an in-service program on child abuse (child mistreatment) for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which as an indicator of possible child abuse (child mistreatment)?
sexual behavior that correlates with the child's developmental age
The nurse on a pediatric mental health unit notices one of the clients continually avoids joining the other clients in the dining room for meals. The nurse is aware that the client is demonstrating characteristics of which disorder?
social phobia
Which sign or symptom suggests depression in a child?
somatic complaints and acting-out behavior
The nurse helps position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure?
For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back
The young girl has been prescribed corticosteroids for dermatomyositis. Which statements by her mother indicate the need for further education?
I give it to her first thing in the morning before breakfast, We are taking her to Disney in the summer
The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education?
I guess my mom was right; she always put ice on our burns when we were kids
A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse?
I had our plumber lower our water heater temperature to 130°F (53°C)
During an assessment of an adolescent child, the nurse notes that the child has a protuberant tongue, fatigued appearance, poor muscle tone, and exophthalmos. What medical diagnosis would the nurse expect the child to have?
Graves disease
The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?
Greenstick
A nurse who is caring for a 7-year-old is providing client education to the child and caregiver. Which response by the caregiver demonstrates to the nurse that the caregiver understands the diagnosis of type 1 diabetes mellitus?
Her body doesn't have any insulin
The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?
encouraging the child to keep his hands away from his eyes
The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism?
enlarged tongue
The nurse has developed a nursing plan for the care of a 6-year-old girl with congenital hydrocephalus whose shunt has become infected. The most important discharge teaching point for this family is
ensuring the parents know how to properly give antibiotics
The nurse receives a report on a child admitted with severe muscular dystrophy. The nurse suspects the child has been diagnosed with the most severe form of the disease, known as:
Duchenne
The mother of a toddler tells the nurse during a routine well-child appointment that she is concerned because, "It seems like my son is falling and hitting his head all of the time." What is the best response by the nurse?
Due to the size of their heads and immature neck muscles falling is common, but I will let the physician know your concerns
A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders?
Eosinophils
A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication?
Decreased cognitive development of the fetus
A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this client?
Dehydration
A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?
Demonstrate love and acceptance at home
In reviewing the assessment findings of a young hospitalized adolescent female, the nurse would realize that which finding would be indicative of the diagnosis of anorexia nervosa?
Depression, lanugo over the back and arms, disposes of food in the trash or toilet
A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse?
Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output.
Permanent visual _____ can be averted with early identification and treatment of amblyopia
Deterioration
Vision or hearing impairment impedes what progress?
Developmental
The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. What would the nurse expect to administer if ordered?
Diazepam
A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question?
Did you use any medications, like aspirin, for the fever?
The spherical shape of the newborn's lens does not allow for what?
Distance accommodation
An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client?
Disturbed body image
The nurse is providing postoperative care for a boy who has undergone surgical correction for pectus excavatum. The nurse should emphasize which instruction to the child's parents?
Do not allow him to lie on either side
A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin?
Do not mix this insulin with other insulins
What maneuver can be helpful in assessing cranial nerves III, IV, and VI in an infant, uncooperative child, or comatose child
Doll's eye maneuver
The mother of an 8-year-old boy is concerned that her son has attention deficit hyperactivity disorder. She describes the symptoms he demonstrates. Which behavior should the nurse recognize as an example of impulsiveness?
Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission
The nurse is providing education to a teen who has tinea pedis. What information should be included in the discussion?
Keep feet clean and dry, Wear cotton socks
The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents?
Let's meet with the dietitian and plan some meals
What are the structural disorders of spina bifida occulta, meningocele, and myelomeningocele considered?
Neural tube defects
The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention?
Reservoir
In caring for a child with meningitis, the nurse recognizes which nursing diagnosis would be most important to include in this child's plan of care?
Risk for injury related to seizure activity
The nurse is caring for a school-aged child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2030 National Health Goals to reduce the long-term complications from this disease process?
Schedule the child and parents to attend diabetes education classes
A group of nursing students are reviewing the actions of various drugs used to treat mental health disorders in children. The students demonstrate understanding of the information when they identify which drug as potentiating the activity of serotonin in the brain?
Sertraline
The nurse is assessing a young boy who has been brought to the physician for mobility and balance issues by his parents. Which findings are positively associated with the presence of Duchenne muscular dystrophy?
Serum creatine kinase levels are elevated, an electromyogram demonstrates the problem is within the nerves, not the muscles, the child is unable to rise easily into a standing position when placed on the floor
The parents of a newborn diagnosed with neurofibromatosis 1 state to the nurse, "We don't understand this disorder and we are so upset!" What teaching would the nurse provide to the family?
Some cases are due to a new mutation and are therefore not inherited
The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris?
Sometimes I get acne when I use my sister's makeup
What is the most common cause of hip pain in children?
Transient synovitis of the hip
The nurse is working with a child with altered genitourinary status. Which intervention should be included in the plan of care for the client with excess fluid volume?
Weigh the child daily on the same scale
The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?
Weigh the old dialysate
An advance practice pediatric nurse practitioner (APPNP) is conducting a mental status examination with a 6-year-old girl. Which question would be most appropriate?
Why does your pink doll hit all the other dolls
A nurse is caring for a 13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?
Withhold his routine medication until after dialysis is completed
The nurse is reviewing the health records for several children at a health clinic. Which child would the nurse expect to be newly diagnosed with an inborn error of metabolism?
a newborn female
The nurse is obtaining a health history on a woman of childbearing age who wants to become pregnant. What information in her health history places her at high risk for having a child with a myelomeningocele?
history of a seizure disorder; taking phenobarbital
The nurse is examining a 2-year-old girl with VATER association. Which sign or symptom should be noted?
history of corrective surgery for anal atresia
Short length and _____ position of eustachian tubes leads to greater susceptibility of acute otitis media in children less than 2
horizontal
A toddler is diagnosed with acute otitis media and prescribed antipyretics and numbing ear drops. Which instruction is most important to teach the parents about treatment?
how to administer the ear drops
A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included?
oxygen gauge and tubing, suction at bedside, padding for side rails
The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:
painless rectal bleeding
Assessment findings for Encopresis
painless rectal bleeding, difficulty defecating, distended abdomen, abdominal pain, decreased appetite, liquid stool-soiled underwear, rectal pain, increased urinary tract infections (UTIs)
Which is the best way to control enzyme deficiencies?
special diet restrictions and synthetic medical foods
A 12-year-old client arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. The client is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder is most associated with these symptoms?
syndrome of inappropriate antidiuretic hormone (SIADH)
An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals?
It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms
The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion?
It seems like bright lights really bother him
A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?
My daughter can eat any kind of fruit
The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?
Obtain blood cultures
A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching?
Pale, cool, or blue skin coloration is to be expected
A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teachings?
Pale, cool, or blue skin coloration is to be expected
A parent brings a 10-year-old child to the emergency room with reports of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse suspect?
Pancreatitis
The nurse is conducting a physical examination of a child with suspected Crohn disease. Which finding would be the most suspicious of Crohn disease?
Perianal skin tags or fissures
A 13-year-old adolescent with hyperthyroidism who takes antithyroid medication has a sore throat and a fever. The parent calls the nurse and asks what to do. Which is the best response from the nurse?
Please take your child straight to the emergency department
The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider?
Positive culture for group A streptococcus
A nurse is providing care to a pediatric client hospitalized with a diagnosis of Duchenne muscular dystrophy (DMD). The nurse is reviewing the above laboratory results. Which laboratory result will have the greatest impact on the client's condition?
Potassium
The nurse is conducting a physical examination of a 9-month-old infant with a suspected neuromuscular disorder. Which finding would warrant further evaluation?
Presence of Moro reflex
The nurse is providing presurgical care for a newborn with myelomeningocele. Which action is the central nursing priority?
Prevent rupture or leaking of cerebrospinal fluid
A client has a diagnosis of type-1 neurofibromatosis. As part of the intake assessment protocol for the facility, the clinical educator is teaching the care staff about the diagnosis. Which statement most accurately conveys an aspect of neurofibromatosis?
Her diagnosis puts her at higher risk of developing a malignant neoplasm
When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?
Herpes zoster is a reactivation of a previous varicella zoster infection
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?
Hirschsprung disease
During physical assessment of a 2-month-old infant, the nurse suspects the child may have a lesion on the brain stem. Which symptom was observed?
Horizontal nystagmus
The child has a meningocele and a neurogenic bladder. Which topics should the nurse include in the teaching plan when educating the child and the child's caregivers?
How and when to administer oxybutynin chloride, how and when to perform clean intermittent urinary catheterization, signs and symptoms of a urinary tract infection, different types of surgeries used to treat this condition
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?
Hypertension
The mother of a school-age child is distraught over the ongoing oppositional behavior demonstrated by the child at home and at school. Which nursing diagnosis should the nurse select as appropriate for the child and family?
Interrupted family processes related to inability of child to follow instructions
The nurse is developing the plan of care for a 3-year-old child diagnosed with atopic dermatitis. Which client outcomes are common focuses for a child with this diagnosis?
Promotion of skin hydration, maintenance of skin integrity, prevention of infection
Which intervention is the most beneficial for a burn client undergoing a skin graft?
Provide around-the-clock pain medication as soon as pain is reported
The school nurse is instructing the classroom teacher regarding a student newly diagnosed with amblyopia. To prepare for classroom instruction, which concept is most important for the nurse to convey to the teacher?
Student placement in the room is important but all other teaching methods may remain the same
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?
Sudden onset of severe scrotal pain with significant hemorrhagic swelling
The nurse is caring for a 3-year-old child who experienced a febrile seizure for the first time. What statements by the parents of the child should the nurse address further?
I am afraid that our 10-year-old will start having febrile seizures, It is so scary to think that our child will likely develop epilepsy now
The nurse on the postpartum unit is educating the parents of an newborn diagnosed with an genetic disease. What statement by the parent would indicate to the nurse that family is receptive to additional teaching?
I am so glad we have this time of quiet to learn what we need to learn before we go home
The nurse is providing education to the parents of a 5-year-old with a fever. Which statements indicate the need for further instruction?
I can administer two baby aspirin tablets to my child every 4 to 6 hours for the fever, Sponging my child with cold water can be a soothing way to manage the fever, I should use a cooling fan in my child's room to keep the fever down
The father of a 14-year-old daughter reports she has been rebelling at home. The use of a contract for behaviors has been discussed. Which response from the father indicates the need for further discussion?
I can relax rules at home if she has had a bad day
The young child is experiencing muscle spasms and has been given lorazepam. Which statements by the child indicate that the child may be experiencing some common side effects?
I feel sort of dizzy, I need to take a nap
The nurse has performed client education for a 15-year-old boy with Crohn disease and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning has occurred?
I have to be careful because I am prone to not absorbing nutrients
The nurse is educating a parent of a toddler with Down syndrome. Which statement by the parent indicates teaching was effective?
I hope my child does well with the various therapies we have arranged
The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching?
I need to watch for any new bruises or bleeding and let my healthcare provider know about it
The nurse is educating the parent of a male child born with trisomy 21. Which statement by the parent indicates teaching has been effective?
I plan to make time for my child's multiple therapy appointments
The nurse is interpreting the negative feedback system that controls endocrine function. What secretion will the nurse correlate as decreasing while blood glucose levels decrease?
Insulin
The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy?
Gowers sign
A 12-year-old child has hyperthyroidism. The nurse understands that the most common cause of hyperthyroidism in children is:
Graves disease
A child is brought to the clinic experiencing symptoms of nervousness, tremors, fatigue, increased heart rate and blood pressure. Based on this assessment, the nurse would suspect a diagnosis of which condition?
Graves disease
Fever can increase the production of what and slow the growth of bacteria and viruses?
Neutrophils
A 14-year-old girl is brought to the emergency department saying she was sexually assaulted. She tells the nurse that she feels guilty for having gone to a party where alcohol was being served. What is the nurse's best response?
No one deserves to be raped, even going to a party with alcohol
The nurse is assessing a 7-year-old girl with a headache, irritability, and vomiting. Her health history reveals she has had meningitis. Which intervention is priority?
Notifying the physician of the neurologic findings
The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction?
Peanut butter and jelly sandwich
The parent of a 12-year-old child with Reye syndrome approaches the nurse wanting to know how this happened to the child, saying, "I never give my children aspirin!" What could the nurse say to begin educating the parent?
Sometimes it is hard to tell what products may contain aspirin
The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?
Spica cast
The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?
Tell me about the types of stools your child has been having
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?
Tenting of skin
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?
Testis cannot be "milked" down inguinal canal
A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents?
The VCUG will rule out vesicoureteral reflux
The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:
The child can live a more normal lifestyle
The child has been diagnosed with slipped capital femoral epiphysis. Which characteristics about the client are risk factors associated with the development of this condition?
The child is 13 years old, the child is African American, the child's parents state that the child has recently experienced a "growth spurt", the child is male
An 8-year-old child is admitted to a medical-surgical unit with a diagnosis of syndrome of inappropriate antidiuretic syndrome (SIADH). What will the nurse closely monitor?
client's fluid balance, serum sodium, and level of consciousness
A toddler has been diagnosed with otitis media with effusion. The parents tell the nurse, "We really don't understand what that diagnosis means." How should the nurse respond?
The diagnosis means unwanted fluid is within the middle ear space, and there may or may not be an infection present
A nurse is teaching the parents of a boy with a neurogenic bladder about clean intermittent catheterization. Which response indicates a need for further teaching?
The very first step is to apply water-based lubricant to the catheter.
The nurse is discussing the use of over-the-counter ointments to manage a mild case of diaper rash. What ingredients should the nurse instruct the parents to look for in a compound?
Vitamin A, Zinc, Vitamin D
When assessing sensory function in an infant, limit the examination to what or pain?
Touch
The nurse is caring for a 10-year-old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first?
Urinalysis
An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions?
Urine output
The nurse is taking a health history for an 8-year-old boy who is hospitalized. Which is a risk factor for sepsis in a hospitalized child?
Use of immunosuppression drugs
A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching?
We should bathe our child in hot water, twice a day
A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?
We should not stop this medication abruptly
The nurse is caring for an 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and reports shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on these reported symptoms, the nurse is aware that the disorder is most likely to be:
epiphysiolysis of the proximal humerus
A child is diagnosed with a mental health disorder and is receiving milieu therapy in an inpatient psychiatric setting. Which actions would the nurse likely include to maintain a therapeutic milieu?
making client rounds every 15 minutes, role modeling appropriate interactions with others, de-escalating aggressive or anxious behavior
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?
absence of a thrill
The nurse educates the parents regarding potential complications that their newborn is at higher risk for developing such as
autoimmune disorders, spinal problems, and endocrine disorders
Decorticate posturing
characterized by upper extremities flexed at the elbows and held closely to the body and lower extremities that are externally rotated and extended. occurs when the brainstem is not inhibited by the motor function of the cerebral cortex.
The nurse is teaching a child with type 1 diabetes mellitus to administer insulin. The child is receiving a combination of short-acting and long-acting insulin. The nurse knows that the child has appropriately learned the technique when the child:
draws up the short-acting insulin into the syringe first
The nurse is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to:
hypovolemic shock
The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding?
idiopathic scoliosis
The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the:
importance of patching as prescribed
The nurse is conducting a routine physical examination of a newborn to screen for DDH. The nurse correctly assesses the infant by placing the infant:
in a prone position, noting asymmetry of the thigh or gluteal folds
Preterm infants have more fragile capillaries in the periventricular area than term infants. This put these infants at risk for which problem?
intracranial hemorrhaging
A 5-year-old child has frequent visits to the school nurse's office. Which assessment data should alert the nurse that this child may be a victim of physical neglect?
malnourished with frequent absences from school
The nurse is caring for a child who has been hospitalized repeatedly at multiple hospitals. There is no clear medical diagnosis and the parent is threatening to leave the hospital against medical advice. The nurse suspects what issue?
medical child abuse (formerly Munchausen syndrome by proxy)
The nurse is performing a physical assessment of 16-year-old girl who is intellectually disabled. This client attended her local public elementary school through fifth grade and has since been enrolled at a special education school where she has received social and vocational training. She plans on getting a job in the coming month and on living independently in a few years. The nurse recognizes this client's level of intellectual disability as:
mild
The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?
mother age 42 with pregnancy
The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity?
moving the infant's head every 2 hours
An adolescent client has been diagnosed with bulimia nervosa. What does the nurse explain as the goal of treatment for this client?
restoring nutritional balance and a healthy self-image
Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele?
risk for infection
Assessment findings for Hirschsprung Disease
difficulty defecating, distended abdomen, abdominal pain, decreased appetite, liquid stool-soiled underwear
Assessment findings for Intussusception
difficulty defecating, distended abdomen, abdominal pain, decreased appetite, liquid stool-soiled underwear
The nurse is caring for a newborn girl with galactosemia. Which intervention will be necessary for her health?
eliminating dairy products from the diet
A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents state that ___________ is appropriate?
encouraging fluid intake after dinner
A nurse is preparing a presentation for a health fair focusing on prevention of congenital neuromuscular disorders. What would the nurse emphasize as most important in preventing neural tube defects?
folic acid supplementation
A parent brings a child to the pediatric clinic, stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptoms does the nurse anticipate finding with this child?
inattention, impulsive, and hyperactivity
A child comes to the clinic with a report of having trouble seeing. The nurse inspects the eyes and obtains a history from the child about the vision. Which question(s) will help the nurse determine if the child may have a refractive error?
Do you see the ball in the outfield when playing baseball, How far away do you have to hold a book to read, Do images look blurry when you play video games
The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101°F (38.3°C). Which statement by a parent indicates an understanding of fevers and their management in the ill child?
Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection
Five States of Consciousness
Full consciousness: the child is awake and alert; is oriented to time, place, and person; and exhibits age-appropriate behaviors. -Confusion: disorientation exists; the child may be alert but responds inappropriately to questions. -Obtunded: the child has limited responses to the environment and falls asleep unless stimulation is provided. -Stupor: the child only responds to vigorous stimulation. -Coma: the child cannot be aroused, even with painful stimuli.
From which pair of metabolic disorders must the nurse instruct the parents to eliminate breast and cow's milk from the diet?
Galactosemia and phenylketonuria
A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect?
Gastroenteritis
A nurse caring for an infant born with a cleft palate notices that the parents rarely interact with their child. The nurse overhears the mother telling her spouse that she "feels like crying" every time she looks at their infant. What would be the best response from the nurse?
I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?
The nurse has been teaching the parents of a child diagnosed with osteogenesis imperfecta about the use of bisphosphonates for this condition. What statement by a parent indicates a need for further education?
This medication will cure my child of this disorder
A 7-year-old client has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when she first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be the best response by the nurse?
This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome.
A nurse is discussing genetic screening with a client who gave birth yesterday. Which statement by the nurse best explains the reason for genetic screening?
This will help to detect for possible inborn errors of metabolism such as phenylketonuria (PKU)
The nurse is providing education to the parents of a child with trisomy 21. The parents ask the nurse about the purpose of early intervention therapy. Which response by the nurse best explains early intervention therapy?
To help you meet your child's specific needs and to encourage development
The nurse is caring for an 8-year-old girl who was in a car accident. Which symptom suggests the child has a cerebral contusion?
Trouble focusing when reading
A 6-year-old boy has a moon-face, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child?
Tumor of the adrenal cortex
Urticaria is what type of reaction?
Type I hypersensitivity
The nurse is taking the history of a 4-year-old boy. His mother mentions that he seems weaker and unable to keep up with his 6-year-old sister on the playground. Which questions should the nurse ask to elicit the most helpful information?
Would you please describe the weakness you are seeing in your son?
The nurse admits a 13-year-old client with possible appendicitis to the hospital, accompanied by the parent. The client and parent are both deaf and use sign language to communicate. The nurse needs to assess baseline vital signs and the intake assessment. What should the nurse do while awaiting the arrival of the sign language interpreter?
Write a note to explain the need to assess vital signs
An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate?
angry outbursts directed at authority figures
The nurse is teaching the parents of a young client who has recently been diagnosed with diabetes insipidus about the disease. The child is not secreting enough of which hormone?
antidiuretic hormone (ADH)
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. Which adverse effect of this medication should the nurse discuss with the parents?
appetite suppression
Which physical assessment finding would the physician be more likely to find in an examination of a client with Down syndrome than of other clients without Down syndrome?
congenital heart defects