NUR404 Exam 3 Pediatrics

A school-age child comes into the emergency clinic complaining of knee pain that started while playing soccer. What will the nurse most likely observe when assessing this child's knee? A. edema B. erythema C. contusions D. mottled skin

A. edema

The nurse is preparing to assess a school-age child who is experiencing pain in the left femur area. When conducting this assessment, at which point should the nurse assess the painful region? A. last B. first C. after measuring vital signs D. before the abdominal assessment

A. last

The nurse is caring for a child with a broken wrist that has just been placed in a cast. The nurse would elevate the arm to: A. promote healing. B. prevent edema. C. discourage infection. D. ensure proper bone alignment.

B. prevent edema.

The nurse suspects that a child is demonstrating signs of attention deficit hyperactivity disorder (ADHD). What behavior did the nurse most likely assess in this child? A. Unrealistic fears B. A lack of concentration C. Persistent disobedience D. A lack of affection for others

B. A lack of concentration

The nurse notes that a child with a burn injury is prescribed daily debridement. What should the nurse instruct the child and parents about the purpose of this treatment? A. relieves pain B. prevents infection C. maintains mobility of extremities D. decreases the need for skin grafts

B. prevents infection

The nurse is caring for a child immediately following a tonsillectomy. The child requests something to drink. Which action by the nurse is best? A. Inform the child he or she can have nothing to drink for a few hours. B. Provide the child with a red popsicle to eat. C. Give the child a few ice chips to consume. D. Assess the child's gag reflex before giving oral fluids.

C. Give the child a few ice chips to consume.

Fractures in children are always potentially serious injuries. Which child with a fracture would you observe most closely for complication? A. one who has a greenstick radial injury B. one who has an ulnar fracture C. one who has a fractured patella D. one who has an elbow fracture

D. one who has an elbow fracture

A child with burns requires daily whirlpool with débridement treatment. The purpose of this treatment is to: A. relieve pain. B. maintain mobility of extremities. C. decrease the need for skin grafts. D. prevent infection.

D. prevent infection.

Chapter 54 Rumination disorder is a poorly understood condition of young children. This refers to: A. a habit of eating nonfood substances. B. excessive worrying about friendships. C. fear of moving objects. D. rechewing undigested food.

D. rechewing undigested food.

A 9-year-old is hospitalized for a long-term illness. The best project to give the to help achieve the child's developmental task would be: A. a scrapbook that will take 3 weeks to complete. B. a puppet show that will take 2 weeks to plan. C. watching her favorite program on television. D. sewing a purse that will take one afternoon.

D. sewing a purse that will take one afternoon.

A 10-year-old child spends 2 hours alone every afternoon before the parents arrive home from work. Which safety measure should the nurse suggest the parents teach the child? A. preparing a no-cook snack after school B. lighting candles in case there is a power failure C. wearing the house key prominently around the neck D. telling people at school about being home alone for added safety

A. preparing a no-cook snack after school

The nurse is concerned that a school-age child is developing pneumonia. What did the nurse most likely assess in this client? Select all that apply. A. rales B. wheezing C. elevated temperature D. paroxysmal dry cough E. productive, harsh cough

A. rales C. elevated temperature E. productive, harsh cough

A parent of a child diagnosed with seizures states, "I've heard about a special diet that may control seizures, I think it's called ketogenic. What can you tell me about it?" Which are appropriate responses by the nurse? Select all that apply. A. "About 40% to 50% of children who follow the diet have really good results." B. "The diet consists of high fat foods." C. "Children are encouraged to eat a lot of breads and pasta on this diet." D. "Most families find this diet is easy to incorporate in

A. "About 40% to 50% of children who follow the diet have really good results." B. "The diet consists of high fat foods." E. "Protein is limited in this diet."

The nurse is instructing the mother of a school-age child with a leg cast about cast care at home. What should the nurse include in this teaching? Select all that apply. A. Cover the cast with a plastic bag to bathe. B. Remind the mother that nothing is to be put down the cast. C. Recommend using magic markers for autographs. D. Use the cool setting on a hair dryer to ease itchy skin. E. Encourage usual activities but restrict strenuous actions.

A. Cover the cast with a plastic bag to bathe. B. Remind the mother that nothing is to be put down the cast. D. Use the cool setting on a hair dryer to ease itchy skin. E. Encourage usual activities but restrict strenuous actions.

The nurse is caring for a child who has just received a cast for a broken wrist. The parents ask, "Why do we need to keep the arm up on a pillow?" Which response by the nurse is appropriate? A. "Keeping the arm raised helps to lessen the swelling." B. "Using a pillow helps to promote healing." C. "There is less chance of infection when the arm is kept elevated." D. "Positioning the arm like upward helps to make sure the bones stay aligned."

A. "Keeping the arm raised helps to lessen the swelling."

A 7-year-old child has taken money from a sibling's dresser on two occasions. When counseling the parent about this behavior, what would the nurse advise? A. "You may need to remind your child about property rights." B. "You should buy your other child a bank that cannot be opened." C. "Stealing is unusual for a 7-year-old child." D. You should talk to the child's teacher about putting less pressure on your child."

A. "You may need to remind your child about property rights."

The nurse is teaching a group of novice nurses how to assess bowel sounds. Which statement will the nurse include in the education? A. "You should auscultate all four quadrants for a full minute each." B. "Hypoactive bowel sounds are expected in a client with diarrhea." C. "Bowel sounds should be present within the first few days of life." D. "Bowel sounds will be audible by the naked ear unless distention is present."

A. "You should auscultate all four quadrants for a full minute each."

A school-age child is brought to the emergency department after being hit in the mouth with a baseball bat during Little League. The child has lost two deciduous teeth, and one permanent front tooth is loose. What care should the nurse prepare to provide to this client? Select all that apply. A. Administer prescribed oral antibiotic. B. Wash the deciduous teeth with saline to be wired into place. C. Instruct the parents and the child that the jaw will need to be wired shut. D. Explain that an X-

A. Administer prescribed oral antibiotic. D. Explain that an X-ray may be done to make sure that the jaw was not fractured.

What measure at home could help a child with an upper respiratory infection breathe more easily? A. Increasing room humidity B. Limiting fluid intake C. Enforcing strict bed rest D. Playing "rapid breathing" games

A. Increasing room humidity

The nurse is caring for a school-age child newly diagnosed with juvenile idiopathic arthritis. Which diagnosis would be a priority for this client? A. Knowledge deficit related to care needs B. Risk for inefficient peripheral tissue perfusion C. Ineffective coping related to physical limitations D. Imbalanced nutrition: less than body requirements

A. Knowledge deficit related to care needs

After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply. A. The parents recently divorced B. The father is unemployed and mother is infrequently home C. The child is learning to play the clarinet in music class in school D. The child is expected to care for younger siblings while mother sleeps E. There is history of multiple injuries

A. The parents recently divorced B. The father is unemployed and mother is infrequently home D. The child is expected to care for younger siblings while mother sleeps E. There is history of multiple injuries obtained from a motor vehicle crash

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? A. This medication must be given by injection. B. This medication must be given in the morning before school. C. Hip or knee pain is an expected adverse effect of this medication. D. This medication does not interact with any other types of medication.

A. This medication must be given by injection.

A child with pauciarticular juvenile idiopathic arthritis is scheduled for an eye examination every 6months. When stressing the importance of the visit, which instruction is most accurate? A. Uveitis is possible, leading to severe blindness. B. The eye globe does not continue to grow, impacting sight. C. Continuous drug therapy causes corneal opacity. D. Eye infection may develop easily due to medication administration.

A. Uveitis is possible, leading to severe blindness.

A nurse is preparing to conduct a class for a group of parents with school-age children about healthy nutrition. Which nutrients would the nurse include as especially important for this age group? Select all that apply . A. calcium B. iron C. flouride D. vitamin B E. vitamin C

A. calcium B. iron C. flouride

A 7-year-old child is diagnosed as having type 1 diabetes. What is one of the first symptoms usually noticed by parents when this illness develops? A. loss of weight B. craving for sweets C. severe itching D. swelling of soft tissue

A. loss of weight

The community health nurse is working with the school district to provide an educational program on the 2030 National Health Goals to address cognitive and mental health disorders in children. Which topics should the nurse emphasize in this program? Select all that apply. A. stress-reduction techniques B. manifestations of stress in children C. recognizing depression in children D. strategies for oppositional behavior E. nutrition and adequate weight gain

A. stress-reduction techniques B. manifestations of stress in children C. recognizing depression in children E. nutrition and adequate weight gain

Chapter 51 A 7-year-old is seen with pauciarticular juvenile idiopathic arthritis. She notices extreme pain when she wakes in the morning. The best advice the nurse can give her parents would be to: A. have her take 325 mg of aspirin immediately on arising. B. encourage her to take a warm bath each morning before school. C. have her do isotonic exercises until the pain is gone. D. encourage her to remain in bed until the pain is gone.

B. encourage her to take a warm bath each morning before school.

Before discharging a school-age child being treated for a snake bite, the nurse instructs the child in ways to prevent additional bites in the future. Which statement indicates that teaching provided to this child has been effective? A. "I should wear long pants when outdoors." B. "I should look at and under rocks before touching them." C. "I should stay away from going outside in case there are snakes." D. "I should bring a snake deterrent when on walks."

B. "I should look at and under rocks before touching them."

The nurse instructs the parents of a child with Guillain-Barré syndrome on care that will be needed once the child is discharged home. Which statement made by the parents indicates that teaching has been effective? A. "We need to be sure to change our child's body position at least twice a day." B. "Our child might experience weakness even after recovering from the illness." C. "It will take about 10 days for our child to be back normal and return to school." D. "This disease affects the heart

B. "Our child might experience weakness even after recovering from the illness."

The nurse is discussing home safety with the parents of a 10-year-old client. Which statement by the client's parents most concerns the nurse? A. "Our child is home alone for an hour each day." B. "Our child swims alone before we get home from work." C. "Our child refuses to eat any green vegetables." D. "We do our best to keep no-cook snacks in the home."

B. "Our child swims alone before we get home from work."

A preadolescent girl with scoliosis is prescribed a body brace. What should the nurse teach the child about the purpose of the brace? A. prevents torticollis B. improves spinal stability C. corrects existing spinal curvature D. prevents herniation of a spinal disk

B. improves spinal stability

A nurse is teaching the parents of a child with frequent nosebleeds how to care for the child. Which statement by the parents indicate that the parents have understood the teaching? A. "We should put the child in bed, elevate the head slightly and press on the forehead," B. "We will sit the child upright and foward and apply pressure to the sides of the nose." C. "We shoudl turn the child's head to the side and press on the nasal ridge." D. "We should have the child lie flat and apply pressure t

B. "We will sit the child upright and foward and apply pressure to the sides of the nose."

Chapter 52 At which age is a child most likely to ingest a poison? A. 10 to 12 years old B. 1 to 5 years old C. 7 to 9 years old D. 13 to 15 years old

B. 1 to 5 years old

The nurse is preparing to conduct the cover test with a preschool-age child. Which body system is the nurse preparing to assess? A. Ears B. Eyes C. Nose D. Neck

B. Eyes

Chapter 45 A school-aged girl with Crohn disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan? A. Help her ambulate with the bottles. B. Provide some time to talk to her several times a day. C. Help her give the bottles nicknames and personalities. D. Explain that TPN substitutes for normal food.

B. Provide some time to talk to her several times a day.

The nurse suspects that a school-age child has Tourette syndrome. What did the nurse most likely assess in this client? A. Flat affect B. Shouting obscenities C. Playing quietly alone D. Running wildly in circles

B. Shouting obscenities

A school-aged child develops a nosebleed (epistaxis). Which action should the nurse take? A. Elevate the head of the bed slightly and apply pressure to the forehead. B. Sit the child upright and apply pressure to the sides of the nose. C. Turn the child's head to the side and press on the nasal ridge. D. Keep the child flat and apply pressure to the bridge of the nose.

B. Sit the child upright and apply pressure to the sides of the nose.

How is wheezing in children best heard? A. with the child supine B. as the child exhales C. as the child cries D. without a stethoscope

B. as the child exhales

A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to: A. keep her child home until this fear passes. B. make her child attend school every day. C. allow her child to decide daily if she wants to go to school or not. D. ask the teacher to decide if the child should come to school or not each day.

B. make her child attend school every day.

Any individual taking phenobarbital for a seizure disorder should be taught: A. to brush his or her teeth four times a day. B. never to discontinue the drug abruptly. C. never to go swimming. D. to avoid foods containing caffeine.

B. never to discontinue the drug abruptly.

A child with extensive burns is permitted to eat. Which nutrient should the nurse ensure is of a high amount when the child's meals are being prepared? A. fats B. protein C. minerals D. carbohydrates

B. protein

The school nurse is planning a presentation to be given during the next parent/teacher conference to include the 2020 National Health Goals to prevent unintentional injuries in children. What should the nurse include in this presentation? Select all that apply. A. legal aspects of child abuse B. recognize signs of self-injury C. provide information on home safety D. ways to determine intentional injuries E. emphasize safety with sports activities

B. recognize signs of self-injury C. provide information on home safety D. ways to determine intentional injuries E. emphasize safety with sports activities

The nurse is caring for a child diagnosed with scoliosis. What actions by the child would indicate a need for intervention by the nurse? Select all that apply. A. placement of the brace over a t-shirt B. removal of the brace at bedtime C. Reports of, "I feel taller with the brace on." D. Loosening of the straps on the brace prior to bedtime. E. removal of the brace while playing a soccer game

B. removal of the brace at bedtime D. Loosening of the straps on the brace prior to bedtime.

While making a visit to the home of a family with a school-age child, the nurse observes a hunting rifle leaning against the wall in the dining room. Which nursing diagnosis should the nurse use to guide interventions for the family at this time? A. anxiety B. risk for injury C. health-seeking behaviors D. readiness for enhanced parenting

B. risk for injury

It is determined that 30% of a child's body is burned. Burned areas are assessed as partial-thickness or second-degree when they involve: A. only the epithelium. B. the epithelium and part of the dermis. C. subcutaneous tissue. D. striated muscle.

B. the epithelium and part of the dermis.

A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior? A. Encourage the child to drink more milk for stronger nails. B. Distract the child by teaching a new skill, such as whistling. C. Allow some time every day for the child to talk about new experiences D. Allow the child to choose a reward for not biting t

C. Allow some time every day for the child to talk about new experiences

An extremely thin preadolescent is being assessed by the nurse. Which client statement will cause the nurse to suspect the client is experiencing anorexia nervosa? A. "I would like to grow up to be a model." B. "My mom says I am obsessed with fashion." C. "I feel chubby no matter what I wear." D. "I am afraid that someone is poisoning my food."

C. "I feel chubby no matter what I wear."

The parents of a child with a thoracic-level spinal injury are anxious to know what the long-term prognosis is for their son. They ask, "Will our son walk again?" What is your best response? A. "It is most unlikely that your son will ever walk again." B. "Damage usually progresses after the first week." C. "It will be several weeks before an answer to your question is possible." D. "What has the physician said about your son's recovery?"

C. "It will be several weeks before an answer to your question is possible."

A child's parent calls the clinic nurse and states, "My child just drank an unknown amount of a cleaning solution. What should I do?" Which statement by the nurse is best? A. "You need to give your child ipecac syrup to induce vomiting." B. "Immediately take your child to your local emergency facility." C. "You need to hang up with me and call the poison control center now." D. "Monitor your child's breathing and heart rate closely for the next 24 hours."

C. "You need to hang up with me and call the poison control center now."

The nurse calculates that a child with a burn injury is to receive 3,600 ml of intravenous fluid over the next 24 hours. How much of this fluid should the nurse provide to the client during the first 8 hours? A. 900 ml B. 1,200 ml C. 1,800 ml D. 2,700 ml

C. 1,800 ml

Typical development for the school-aged child includes playing games with friends. At what age are children typically ready for games that include playing on a team that has a winner or loser? A. 5 years B. 7 years C. 10 years D. 13 years

C. 10 years

When planning activities for school-age children, the nurse organizes games that include competition. At which age are these kinds of games preferred by children? A. 7 years old B. 8 years old C. 10 years old D. 12 years old

C. 10 years old

A nurse is reviewing the blood sugar test results of a child diagnosed with type 1 diabetes: • Before meal: 84 mg/dL (4.66 mmol/l) • 1 hour after meal: 160 mg/dL (8.88 mmol/l) • 2 hours after meal: 180 mg/dL (9.99 mmol/l) • Middle of the night: 92 mg/dL (5.11 mmol/l) Which result would lead the nurse to notify the health care provider? A. before meal B. 1 hour after meal C. 2 hours after meal D. middle of the night

C. 2 hours after meal

For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A. An 8-month-old who cries when left with strangers B. A 7-year-old who withdraws from contact with all strangers C. An 8-year-old who will not stay overnight at a friend's house D. A 10-year-old who reports headaches if there is to be a test in school

C. An 8-year-old who will not stay overnight at a friend's house

The nurse is caring for a child who is having a seizure. What is the appropriate action by the nurse? A. Attempt to place oxygen on the child so they don't become cyanotic. B. Hold the child's arms and legs still so they aren't injured. C. Attempt to turn the child on their side to prevent aspiration. D. Place a bite block or oral airway into the child's mouth to prevent biting of the tongue.

C. Attempt to turn the child on their side to prevent aspiration.

A pediatric client has just been diagnosed with diabetes. What would the nurse do first? A. Educate the client on stress management. B. Regulate nutrition. C. Check blood glucose levels. D. Administer insulin.

C. Check blood glucose levels.

The nurse notices that a child is spitting up small amounts of blood in the immediate postoperative period after a tonsillectomy. What would be the best intervention? A. Suction the back of the throat. B. Encourage the child to cough. C. Continue to assess for bleeding. D. Notify the health care immediately.

C. Continue to assess for bleeding.

When discussing congenital adrenal hyperplasia with a child's parents, the nurse would advise them that administration of which drug is anticipated? A. Calcium B. Vitamin D C. Hydrocortisone D. Growth hormone

C. Hydrocortisone

The nurse is assessing a school-aged child with asthma. Which assessment finding indicates that this client's asthma is well controlled? A. Dry mucous membranes B. Presence of a dry, hacking cough C. Peak flow meter reading in the green zone D. Audible wheezes present over upper lobes

C. Peak flow meter reading in the green zone

The nurse observes a school-age child categorize specific desk and clothing items in his hospital room. What cognitive behavior has this child mastered? A. decentering B. conservation C. class inclusion D. accommodation

C. class inclusion

The nurse is assessing eye alignment in a 6-year-old child. Which assessment method is most appropriate? A. asking the child to stare at a distant mark B. asking the child to touch the finger to the nose C. covering one eye and then removing the cover D. turning a bright light on and then off

C. covering one eye and then removing the cover

A 6-year-old child was diagnosed as having streptococcal pharyngitis. At the follow-up visit, the nurse will assess the child for which potential complication? A. swollen lymph nodes that obstruct the airway B. infection that may cause a tooth abscess C. development of rheumatic fever D. nephrosis of the kidney

C. development of rheumatic fever

A nurse is developing a teaching plan for the parents about medications prescribed to address the pulmonary issues for their child diagnosed with cystic fibrosis. Medication therapy focuses on keeping the lungs clear and treating infection. Which medication(s) will the nurse likely include in this plan? Select all that apply. A. dextromethorphan B. codeine C. dicloxacillin D. albuterol E. dornase alfa

C. dicloxacillin D. albuterol E. dornase alfa

Chapter 32 The developmental task of the school-aged period, according to Erikson, is gaining a sense of: A. autonomy versus shame. B. independence versus dependence. C. industry versus inferiority. D. identity versus failure.

C. industry versus inferiority.

The nurse is completing the health history for the parents of school-age child admitted with a ruptured spleen. For which activity should the nurse assess as the possible cause for this child's injury? A. shooting pool B. skateboarding C. playing baseball D. playing basketball

C. playing baseball

The nurse is talking with a mother of a 6-year-old child who says, "I"m really concerned because my child seems really stressed and has been biting the fingernails since beginning the first grade.What can I do?" Which response by the nurse would be appropriate? A. "Encourage your child to drink more milk for stronger nails." B. "Allow your child to pick out a reward for not biting the nails." C. "Distract your child by teaching a new skill such as whistling." D. "Allow some time every day for yo

D. "Allow some time every day for your child to talk about things."

During a visit, the parents of a school-age child diagnosed with pauciarticular juvenile idiopathic arthritis tell the nurse, "There are times when the joint pain is really severe, Is there anything that might help?" Which response by the nurse would be appropriate? A. "Have your child lie still for about 1/2 hour when the pain gets bad." B. "Let me show you how to do sotonic exercises until the pain is gone." C. "Give your child a dose of aspirin on an empty stomach immediately when the pain oc

D. "Apply a warm moist compress or heating pad to the area for 20 minutes."

The nurse receives a report from the admission department that a child with a slipped capital femoral epiphysis is in route to the care area. The nurse would likely have received which description of the child to plan care? A. tall, thin female B. preadolescent female C. active school-age male D. obese preadolescent male

D. obese preadolescent male

A nursing is caring for a child who had a complete spinal cord injury at lumbar 2 (L-2). The parent reports seing the child move the left leg twice. What response is best? A. "Leg function is not impaired with this type of injury." B. "You have observed something very important." C. "That is wonderful. Function must be returning." D. "That is most likely only a reflex. I am sorry."

D. "That is most likely only a reflex. I am sorry."

A nurse is preparing a class for a group of parents of school-age children about language development and problems with speech articulation, specifically difficulty pronouncing specific letters. The nurse would inform the parents that a referral for initiating speech therapy may be necessary for these problems after which which age? A. 5 years B. 6 years C. 7 years D. 8 years

D. 8 years

The nurse assists with the application of a full-body plaster cast to a child. The child immediately becomes diaphoretic and reports feeling hot. Which nursing intervention would be indicated? A. Observe the child for infection. B. Suggest removal of the cast to the orthopedist. C. Moisten the cast with cool water. D. Advise the child that this is to be expected.

D. Advise the child that this is to be expected.

Chapter 40 Which measure would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis? A. Urging the child to continue to take oral fluids B. Administering an oral analgesic C. Teaching the child to take long, slow breaths D. Assisting with racemic epinephrine nebulizer therapy

D. Assisting with racemic epinephrine nebulizer therapy

A school-aged child is diagnosed with streptococcal pharyngitis. What should the nurse teach the parents about the care that this child will need at home? A. Expect the lymph nodes to swell and obstruct the airway. B. Regular activity level should be encouraged as soon as possible. C. Be aware that the infection may spread and cause a tooth abscess. D. Complete the entire course of antibiotics to prevent rheumatic fever.

D. Complete the entire course of antibiotics to prevent rheumatic fever.

To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take? A. Allow the child to ask questions about the procedure. B. Use an authoritarian manner to gain control. C. Do not allow the child to see the spoon approach the mouth. D. Use a repetitive series of movements.

D. Use a repetitive series of movements.

Chapter 49 Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n): A. diuretic. B. antihistamine. C. anticonvulsant. D. steroid.

D. steroid.

A nurse is working with the parents of a child just diagnosed with attention deficit hyperactivity disorder (ADHD). Which aspect will the nurse emphasize as crucial for the child? A. medication therapy B. ongoing counseling C. varying level of discipline D. structured learning environment

D. structured learning environment

When auscultating bowel sounds, which of the following frequencies would the nurse identify as normal? A. One to two per minute B. Five to 10 per minute C. Thirty to 40 per minute D. Sixty per minute

B. Five to 10 per minute

An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? A. The child should maintain an active lifestyle. B. Immediately provide medication if a seizure begins. C. Have the child carry a padded tongue blade with her at all times. D. Ensure quiet time late in the day, when seizure activity is most likely to occur.

A. The child should maintain an active lifestyle.

Which statement best explains the principle behind a Rinne test for determining hearing loss? A. Air conduction of sound is normally better than bone conduction of sound. B. Conduction of sound is intensified in the middle of the forehead. C. A tuning-fork vibration will not be heard as sound in a child under 2 years of age. D. Bone conduction of sound is normally better than air conduction of sound.

A. Air conduction of sound is normally better than bone conduction of sound.

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A. Anorexia B. Sleepiness C. Garbled speech D. Rapid increase in height

A. Anorexia

While planning care for a 7-year-old client, the nurse reminds the parents that children at this age are experiencing the "eraser" year. What does this mean? A. The child wants to perform well. B. The child believes in magical thinking. C. The child is learning to write during this year. D. The child tends to "erase" misdeeds or lie excessively.

A. The child wants to perform well.

A preadolescent child sprains the right ankle while inline skating. What should the nurse instruct the child and parents about the care that the child will need at home? Select all that apply. A. Apply ice pack for 20-minute intervals. B. Maintain ice pack application on the ankle for several days. C. Keep wrapped in an elastic bandage. D. Remind to use crutches to walk for 3 to 4 days. E. Apply heat to the ankle beginning the first day after injury.

A. Apply ice pack for 20-minute intervals. B. Maintain ice pack application on the ankle for several days. C. Keep wrapped in an elastic bandage. D. Remind to use crutches to walk for 3 to 4 days.

A mother is concerned that a school-age child will pick up the habit of smoking because so many children in the school smoke. What should the nurse instruct the mother about this behavior? A. Be a role model and do not smoke. B. Remind the child that smoking costs money. C. Discuss other tobacco choices that can be used instead. D. Explain that the child can experiment with smoking when older.

A. Be a role model and do not smoke.

The nurse is identifying ways to support the 2030 National Health Goals during the upcoming preschool health screening program. What should the nurse include when conducting the program? Select all that apply. A. Conduct vision tests. B. Conduct hearing tests. C. Listen to heart sounds. D. Measure gait and balance. E. Review immunizations received.

A. Conduct vision tests. B. Conduct hearing tests. E. Review immunizations received.

The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate? A. Consistently reinforce the child's self-worth. B. Discourage the child from assisting with dressing change. C. Correct each of the child's mistakes to ensure learning. D. Structure a competitive environment between clients.

A. Consistently reinforce the child's self-worth.

A preadolescent child with ataxia-telangiectasia is demonstrating an exacerbation of choreoathetosis. What should the nurse do to help this client? A. Provide comfort measures. B. Assist the client to walk several times a day. C. Encourage the client to increase independence. D. Recommend transferring the client to a rehabilitation facility.

A. Provide comfort measures.

The nurse is planning educational materials to help the parents care for an intellectually disabled child at home. What should the nurse include in this teaching? Select all that apply. A. Provide generous praise. B. Reduce environmental stimulation. C. Scold for not learning abstract concepts. D. Break a large task down into smaller steps. E. Demonstrate the skill that the child is to perform.

A. Provide generous praise. B. Reduce environmental stimulation. D. Break a large task down into smaller steps. E. Demonstrate the skill that the child is to perform.

On physical examination, the nurse discovers that a 6-year-old child's palatine tonsils are somewhat enlarged in the back of the throat. What would be the nurse's best action? A. Record this as a normal finding in an early school-age child. B. Suggest the health care provider examine the child for breathing difficulty. C. Take the child's temperature; this must be tonsillitis. D. Give the child something for pain.

A. Record this as a normal finding in an early school-age child.

The nurse is working with a school district to ensure students do not develop food-borne illnesses. Which intervention should the nurse emphasize that supports the 2030 National Health Goals regarding food preparation? A. Refrigerate foods promptly. B. Provide fresh fruits and vegetables. C. Ensure all students are appropriately immunized. D. Examine the number of students who contract food-borne illnesses.

A. Refrigerate foods promptly.

The nurse is planning care for a school-age child diagnosed with growth hormone deficiency. Which diagnosis should the nurse select to help the child with this health problem? A. Risk for situational low self-esteem related to short stature B. Ineffective tissue perfusion related to infantile blood vessels C. Impaired skin integrity related to overproduction of melanin D. Risk for self-directed violence related to oversecretion of epinephrine

A. Risk for situational low self-esteem related to short stature

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? A. Schedule the child and parents to attend diabetes education classes. B. Explain how the child's physical abilities will be affected during school. C. Recommend homeschooling so the mother can provide the needed medications. D. Discuss admission to a rehabilitation facility to lea

A. Schedule the child and parents to attend diabetes education classes.

The nurse is caring for an 8-year-old girl who is hospitalized. To promote acievement of the child's developmental task, which activity would the nurse encourage? A. Sewing a pillow that can be completed in one afternoon. B. Downloading the child's favorite movies for watching over the next few days. C. Planning and designing a puppet show over the next 2 weeks. D. Working on creating a scrapbook that will take 3 weeks to complete.

A. Sewing a pillow that can be completed in one afternoon.

The nurse is caring for a child who has been brought to the clinic for the third time in a week for asthma symptoms. If the goal is to have the parents better manage the child's care, which information will the nurse emphasize? Select all that apply. A. adhering to the recommended immunization schedule B. engaging in sedentary age-appropriate activity daily C. importance of keeping child away from cigarette smokers D. instruction on peak flow meters and nebulizer treatments E. role of good handw

A. adhering to the recommended immunization schedule C. importance of keeping child away from cigarette smokers D. instruction on peak flow meters and nebulizer treatments E. role of good handwashing to reduce transmission of disease

A 9-year-old girl tells the nurse about belonging to a girls' social media club. How does belonging to this group support the child's development? A. fulfills peer group needs B. teaches the child leadership skills C. helps the child develop autonomy D. encourages the child to learn rules

A. fulfills peer group needs

A nurse is conducting an information session for a group of parents with children who have varying levels of intellectual disabilities. One of the parents asks, "What causes this to happen?" Which information would the nurse include as a potential cause? Select all that apply. A. lack of oxygen at birth B. macrosomia C. chromosomal abnormality D. uterine infection during pregnancy E. spinal cord injury

A. lack of oxygen at birth C. chromosomal abnormality D. uterine infection during pregnancy

The nurse is caring for a school-age child recovering from an open reduction for a fractured femur. Which assessment findings indicate that the child is developing an infection? Select all that apply. A. lethargy B. increased pulse rate C. reduced pulse in the ankle D. cyanosis of the casted foot E. increased body temperature

A. lethargy B. increased pulse rate E. increased body temperature

A school-age child is admitted to the mental health unit with the diagnosis of schizophrenia. What manifestations of this disorder should the nurse recognize when assessing this client? Select all that apply. A. paranoia B. quiet but responsive C. talking about suicide D. illogical speech pattern E. auditory hallucinations

A. paranoia D. illogical speech pattern E. auditory hallucinations

The nurse is preparing discharge instructions for a school-aged child with a tracheostomy. On what should the nurse focus when teaching the parents about the child's care needs at home? Select all that apply. A. performing the tracheostomy care independently B. ensuring parent's comfort level with the suctioning C. minimizing perfumes and eliminating room freshener sprays D. encouraging independence in the child as soon as possible E. obtaining a spare tracheostomy tube and inserter for the home

A. performing the tracheostomy care independently B. ensuring parent's comfort level with the suctioning C. minimizing perfumes and eliminating room freshener sprays E. obtaining a spare tracheostomy tube and inserter for the home

A child living in a high-risk area for tuberculosis is tested and the interferon- gamma release assay (IGRA) result is positive. The child's parent asks, "So what happens next?" Which response by the nurse is appropriate? A. "Your child will be retested to make sure the results are correct." B. "Your child will need to have a chest x-ray as a follow-up." C. "Your child will need to start medicines right away," D. "Your child needs to be isolated at home for 2 weeks."

B. "Your child will need to have a chest x-ray as a follow-up."

The nurse knows that being able to tell time helps a child become more independent. At which age should the nurse expect a school-age child to begin to tell time? A. 6 years old B. 7 years old C. 8 years old D. 9 years old

B. 7 years old

The nurse is caring for a 7-year-old who is in the second stage of recovery from a spinal cord injury. When evaluating the child's status, which is noted as the result of consistent care by the family? A. The child has had no urinary infections. B. All joints are movable without contractures. C. The client has not had a fever. D. The client has clear lung sounds.

B. All joints are movable without contractures.

The parents of a school-aged child with school refusal have received professional guidance by the school psychologist, pediatrician, and three different psychiatrists. Based on this, which nursing diagnosis would be most appropriate? A. Disturbed thought processes related to delusional behavior B. Compromised parental coping related to inability to assist with school fears C. Noncompliance with expected school behavior related to school phobia D. Ineffective tissue perfusion, cerebral, related t

B. Compromised parental coping related to inability to assist with school fears

A school-aged child with Crohn disease will receive enteral nutrition for the next 6 weeks. What parental teaching is needed to support this child's needs? A. Provide feedings during regular meal times. B. Encourage the child to be with the family during meals. C. Provide diversional activities during routine family meal times. D. Explain to the child that this may be a permanent way to eat.

B. Encourage the child to be with the family during meals.

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? A. Give the child one unit of regular insulin. B. Give the child a glass of orange juice. C. Give the child nothing by mouth so that a blood sugar can be drawn at the health care provider's office. D. Gi

B. Give the child a glass of orange juice.

Chapter 48 The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would you anticipate will be prescribed for the child? A. Short-term aldosterone provocation B. Injections of GH C. Oral administration of somatotropin D. Long-term blocking of beta cells

B. Injections of GH

Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe? A. A fascination with bright colors B. Insensitivity to pain C. A craving for salt D. Loss of hearing for high frequencies

B. Insensitivity to pain

The mother of a school-age child is distraught because the child has been diagnosed with obesity. What actions should the nurse suggest to the mother to help the child with this problem? Select all that apply. A. Explain that obesity will lead to an early death. B. Maintain a balanced eating approach in the home. C. Purchase books explaining the latest ways to lose weight. D. Seek out a preteen weight loss group for the child to participate in. E. Encourage increased activity such as walking the

B. Maintain a balanced eating approach in the home. D. Seek out a preteen weight loss group for the child to participate in. E. Encourage increased activity such as walking the dog after school.

The nurse meets a child with a slipped capital femoral epiphysis. In what type of child does this usually occur? A. Tall, thin girls B. Obese adolescent boys C. Preadolescent girls D. Active school-age children

B. Obese adolescent boys

The school nurse is reviewing content to include in an assembly planned for school-age children that focuses on the 2020 National Health Goals for safety. What should the school nurse include in this presentation? Select all that apply. A. Encourage the children to play outdoors and get exercise every day. B. Stress the need to sit in age-appropriate seats in cars and wear seatbelts. C. Remind children how important it is to brush the teeth and see the dentist. D. Explain how important it is for

B. Stress the need to sit in age-appropriate seats in cars and wear seatbelts. D. Explain how important it is for children to wear safety helmets when bicycling.

The nurse has been caring for a family with a school-age child who has school phobia. Which observation indicates that interventions have been successful? A. The child stays home from school. B. The child attends school every day. C. The child decides daily about attending school. D. The child's teacher is asked if attending school is a requirement.

B. The child attends school every day.

The nurse is evaluating teaching provided to a school-age child and parents about the medication pancrelipase for cystic fibrosis. Which observation indicates that the teaching has been effective? A. The child chews an enteric form of the medication. B. The child takes a dose before having an afternoon snack. C. The father tells the child that diarrhea is expected with this medication. D. The mother opens the capsule and some medication spills on the fingers.

B. The child takes a dose before having an afternoon snack.

The nurse is planning teaching for the parents of a child with Legg-Calvé- Perthes disease. On what should the nurse emphasize when conducting this teaching? A. Surgery is needed with supporting rods. B. The child will have a non-weight-bearing period. C. The child will need passive range-of-motion exercises three times a day. D. The child will need to exercise to increase muscle strength of the knee joint.

B. The child will have a non-weight-bearing period.

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? A. Child appears pale and fatigued. B. There are purple striae on the abdomen. C. The child is excessively tall for chronologic age. D. The child is demonstrating signs of hypoglycemia.

B. There are purple striae on the abdomen.

A 6-year-old child is brought to the facility by the parents who report that the child has had a fever for the past 2 days and now is reporting ear pain and pressure. The nurse conducts an otoscopic exam and suspects an inner ear infection based on which assessment finding? A. dark-brown substance lining the ear canal B. bulging tympanic membrane C. clearly discernible malleus D. presence of cone of light

B. bulging tympanic membrane

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: A. administers the insulin into a doll at a 30-degree angle. B. draws up the short-acting insulin into the syringe first. C. wipes off the needle with an alcohol swab. D. administers the insulin intramuscularly into rotating sites.

B. draws up the short-acting insulin into the syringe first.

While caring for a child recovering from viral pneumonia, the nurse examines the child's lungs for evidence of exudate and fluid. Which finding would suggest cause for concern? A. a respiratory rate of 20 heard on auscultation B. dullness of his lower lobes heard on percussion C. a longer inspiratory than expiratory rate noticed by inspection D. fine rhonchi heard in the upper lobe on auscultation

B. dullness of his lower lobes heard on percussion

The nurse is planning a program for a community that focuses on the 2030 National Health Goals for neurologic health. Which topics should the nurse include in this presentation? Select all that apply. A. ensuring a diet adequate in vitamins and protein B. use of helmets for bicycle and motorcycle safety C. learning the signs and symptoms of inflammatory disorders D. practicing good handwashing technique and infection control E. importance of proper emergency care to protect the head and neck

B. use of helmets for bicycle and motorcycle safety D. practicing good handwashing technique and infection control E. importance of proper emergency care to protect the head and neck

When assisting parents in a home care plan for a child with Legg-Calvé-Perthes disease (LCPD), the nurse would teach the parents that which is anticipated? A. Surgery with supporting rods B. Passive range-of-motion exercises 3x per day C. A non-weight-bearing period initially occurs. D. Exercise to increase muscle strength of the knee joint

C. A non-weight-bearing period initially occurs.

A 6-year-old is seen in a mental health clinic for possible hyperactivity. His mother reports that he is just "all boy." He has always been active and does not like to sit still for more than a minute. Which data would be most important to assess to help evaluate his behavior? A. Whether he was breastfed or bottle-fed as an infant B. Family medical history for circulatory illnesses C. A review of the boy's typical day D. Medical history for communicable diseases

C. A review of the boy's typical day

A child with a head injury is demonstrating signs of cognitive deficits. The parents are concerned about how well the child will recover. Which nursing diagnosis should the nurse identify as the most appropriate for the family at this time? A. Anxiety related to extent of required hospitalization B. Risk for long-term learning deficits related to head injury C. Parental fear related to outcome after head injury in child D. Ineffective coping related to care of a child with a head injury

C. Parental fear related to outcome after head injury in child

The community nurse is visiting the home of a family with a child with mild intellectual disability. Which observation indicates that the family is adjusting to this child's learning capacity? A. Older sibling teases the child and uses the term "dummy." B. Father tells the child to play with a toy while the adults talk. C. Parents support and engage the child in family conversation. D. Mother tells the child to stop making a mess on the kitchen table.

C. Parents support and engage the child in family conversation.

A nurse in an emergent setting is caring for a school-age child with partial- thickness (second-degree) burns to the legs and groin. The child is admitted and a parent is at the bedside. When planning care, which client goal is the immediate priority? A. The client will have decreased anxiety about procedures. B. The client will maintain lower-extremity pedal pulses. C. The client will express a pain level less then 2 out of 10 on the pain scale. D. The client will state no respiratory difficult

C. The client will express a pain level less then 2 out of 10 on the pain scale.

A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus? A. proteinuria B. a fasting blood glucose less than 126 mg/dl C. a fasting blood glucose greater than 126 mg/dl D. glucose in the urine

C. a fasting blood glucose greater than 126 mg/dl

The school nurse is observing a child in the classroom. The child is speaking and then suddenly stops and stares for about 5 seconds and then continues speaking. The nurse charts this as what type of seizure? A. tonic-clonic B. febrile C. absence D. partial (focal) seizures

C. absence

The most important assessment of neurovascular status to make after spinal surgical instrumentation is: A. check the nailbeds of the fingers for capillary refill. B. determine the presence of brachial pulses. C. assess the legs for warmth. D. ask if the child has pain.

C. assess the legs for warmth.

In the emergency department, the nurse is asked to administer a histamine-2 receptor antagonist to a child with extensive burns. Which therapeutic outcome is desired? A. reduced scarring of a burned esophagus B. regulation of electrolyte balance C. prevention of a stress ulcer D. decreased child discomfort

C. prevention of a stress ulcer

Chapter 34 Which finding would the nurse interpret as least significant when assessing a child's lungs? A. stridor B. crackles C. rhonchi D. wheezing

C. rhonchi

A common cause of poisoning in the young family is the ingestion of iron pills. You would inform parents that: A. this is rarely a serious poisoning incident. B. if the child can survive the immediate symptoms of nausea and vomiting, the child is usually fine. C. the ingestion of iron can cause serious problems if the child is not treated immediately. D. an immediate effect of iron poisoning is apt to be a seizure.

C. the ingestion of iron can cause serious problems if the child is not treated immediately.

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? A. Risk for self-directed violence related to impulsivity B. Situational low self-esteem related to lack of successful coping strategies C. Impaired social interaction related to short attention span and distractibility D. Interrupted family processes related to inability of

D. Interrupted family processes related to inability of child to follow instructions

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? A. Administer lorazepam rectally to the client. B. Refer the client to a neurologist. C. Discuss dietary therapy with the client's caregivers. D. Protect the child from hitting the arms against the bed.

D. Protect the child from hitting the arms against the bed.

The nurse is caring for a 7-year-old client who suffered extensive burns from a house fire. Which finding in the client's history most concerns the nurse? A. The child appears withdrawn and frightened. B. The child's clothing was burned when exiting the home. C. The child was home alone when the fire started. D. The child was trapped in a burning bedroom.

D. The child was trapped in a burning bedroom.

The nurse instructs a preadolescent child with type 1 diabetes mellitus how to self-administer an injection of short-acting and long-acting insulin. Which observation indicates to the nurse that teaching has been successful? A. administers the insulin intramuscularly B. wipes off the needle with an alcohol swab C. administers the insulin at a 30-degree angle D. draws up the short-acting insulin into the syringe first

D. draws up the short-acting insulin into the syringe first

The physician of a child with juvenile idiopathic arthritis asks the nurse to telephone the school to arrange a new activity program for her. A change the nurse would anticipate arranging for the child is to: A. be excused from all extracurricular activities. B. begin school earlier in the day than other children. C. be excused from all swimming classes. D. modify her physical exercise program.

D. modify her physical exercise program.

The nurse is evaluating a school-age child's ability to crutch walk so that no weight is placed on an injured leg. Which walking technique indicates that teaching has been effective? A. walking gait B. two-point gait C. single-crutch support gait D. three-point swing-through gait

D. three-point swing-through gait