NUR410 PrepU PEDS

The nurse is approaching a preschooler to complete a physical assessment. The preschooler smiles at the nurse in a receptive manner and appears cooperative. Please in order how the nurse will proceed. Use all options.

Inspection Palpation Percussion Auscultation

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?

Iron deficiency

A 6 year old who does not speak English is on bed rest at home and being seen by a home health nurse who speaks only English. The child's mother informs the nurse that her son is very bored, which makes it hard to keep him in bed. What could the nurse do for this patient?

Stack/build blocks with him.

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?

"At this age it is helpful to remind children to go to the bathroom."

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply.

"Do not refer to medicines as candy." "Do not allow your child to approach strange dogs." "Have your child hold hands with a grown-up in parking lots." "Role-model bicycle safety by wearing a helmet too."

The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which statement would indicate that the boy is having nightmares instead of night terrors?

"He will tell us about what happened in his dream."

A nurse is caring for a very shy 4-year-old girl. During the course of a well child assessment, the nurse must take the girl's blood pressure. Which approach is best?

"Help me take your doll's blood pressure"

The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?

"I am so glad I can get rid of all of those bath toys because they take up so much room."

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

"I usually have him in time-out for about 10 minutes."

The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?

"Set a good example. Wear your own seat belt every time you drive."

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?

"She screams and thrashes when we try to touch her."

The parents of a 5-year-old are concerned that their son is too short for his age. The nurse measures the child's height at 40 inches (101.6 cm). How should the nurse respond?

"The average height for a 5-year-old is 43 inches tall (118.5cm), so your son is within the normal range for height."

A 5-year-old is scheduled for a tonsillectomy. Which statement to the child by the nurse is mosttherapeutic?

"The doctor is going to fix your tonsils while you are at the hospital."

The nurse is conducting a well-child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?

2.5 to 3 inches (6.35 to 7.62 cm)

During a well-child visit, a mother tells the nurse that she uses timeout to discipline her 2 year old. The nurse determines that the mother understands the concept of timeout when the mother states that she keeps the toddler in time out for _______ minutes.

2min

A 3-year-old girl is admitted to the hospital for eye surgery. You provide her with a doll and syringe for therapeutic play. She sticks the doll in the eye with the syringe and says, "You won't watch TV again when I tell you not to!" What is your best response to this?

Ask her if she thinks having surgery is punishing her.

Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers?

Compares his soccer abilities with his peers.

The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play?

Cooperative play

A 4-year-old tells the nurse he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which nursing diagnosis is most applicable for his family?

Deficient knowledge of normal preschool development

The nurse is organizing an indoor play area for preschoolers. What play materials are least important?

Electronic teaching toys

The nurse is providing postsurgical care for a 4-year-old boy following hernia repair. Before surgery, the nurse taught the child to use the poker chip tool to rate his pain. When assessing the child's postsurgical pain, the boy refuses to touch the chips and clings to his mother. How should the nurse respond?

Give the mother the FACES pain rating scale to use with her son.

A 4-year-old child reports having ear pain. To examine the child's ear, how should the nurse proceed?

Grasp the pinna and pull up and back.

The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?

Hop on one foot

The nurse is assessing a 4-year-old child. The child tells the nurse about her friend, Nancy, who lives in her room at home. The mother tells the nurse that Nancy is not a real person. The nurse would use which term when documenting this assessment finding?

Imaginary friend

The home care nurse is observing a mother prepare mupirocin to treat a preschool-age child's skin rash. At which point should the nurse stop the mother during the preparation of the medication?

Mother measures out a teaspoon of the medication for the child to take orally.

The nurse is caring for a 5-year-old child who underwent a painful surgical procedure earlier in the day. The nurse notes the child has not reported pain to any of the nursing staff. Which action by the nurse is indicated?

Observe for behavioral cues consistent with pain

A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family?

Parental anxiety related to lack of understanding of childhood development

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?

Presence of 10 deciduous teeth

A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply.

Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

The nurse is assessing a 5-year-old child's genitourinary system. Which findings would the nurse document as normal? Select all that apply.

Round abdomen Positive bowel sounds Dullness over the spleen

A 5-year-old arrives at the emergency department and reports abdominal pain. After performing an assessment and laboratory work, the health care provider diagnoses appendicitis. The nurse knows that this child is experiencing which type of pain?

Visceral

When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?

Weight is above an expected range and height is within an expected range.

The nurse is providing postsurgical care for a 5-year-old. The nurse knows to avoid which question when assessing the child's pain level?

Would you say that the pain you are feeling is sharp or dull?

During therapeutic play, a 4-year-old child draws a girl with a head and body but no arms or legs. Your best action in response to this would be to

appreciate that 4-year-olds often draw people with only three or four body parts.

The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach?

ask if the child would like to take the medicine in a cup or through an oral syringe

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:

having the child wear a personal flotation device whenever near or on the water.

A 3-year-old is admitted to the hospital suddenly after an automobile accident. His mother cannot stay with him because she is injured herself. A personal object you would suggest his mother leave with him when she leaves is

her key ring emblem he has noticed many times.

A nursing instructor is teaching students about changes in the preschool-aged child. One such change is genu valgum, which refers to:

knock-knees.

A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents?

some discomfort at the surgery site

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to:

testing and identification of group role.

Where is the point of maximal impulse (PMI) found in a 5-year-old child?

the fourth intercostal space

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:

transduction.

A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond?

"It's best to answer his questions using accurate anatomical names and keep your answers simple."

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.

"Try using a night light in the child's room." "Set up some familiar bedtime rituals for your child." "Avoid having your child watch frightening shows on TV before bedtime." "Try reading a favorite story before bedtime."

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior?

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior."

The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on this child?

Taking her on an adventure down the hall

The nurse is caring for a preschool child who is receiving palliative care for end-stage cancer. What would be the focus of age-appropriate interventions for this child?

Teaching the child that death is not punishment

A mother expresses surprise to the nurse that her daughter has begun masturbating. The most important initial nursing response is that:

This is a normal and expected activity best treated matter-of-factly.

The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. What is an appropriate response to this concern?

Treat the action in a matter-of-fact manner, emphasizing safety.