Pediatric Final

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever?

"Children who have this diagnosis may have had strep throat."

The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure?

"He gets sweaty when he eats."

The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells?

"He likes to stop and squat wherever he walks."

The parents of a child recently diagnosed with atopic dermatitis voice concern to the nurse that their child may develop asthma at some point. How should the nurse respond?

"I can understand your concern. We will closely monitor your child for asthma development."

An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug?

"I have to make sure that I do not become pregnant while taking this drug." Adolescent girls taking this drug who are sexually active must be on a pregnancy prevention program because the drug causes defects in fetal development. Monthly complete blood counts are required when taking isotretinoin. Isotretinoin is not associated with lung problems, so a chest radiograph is not necessary. Coal tar preparations are associated with staining of the clothing or fabrics. Isotretinoin does not stain clothes or fabrics.

The parents of a 2-year-old toddler newly diagnosed with tricuspid atresia ask the nurse, "I do not understand why our toddler's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is best?

"The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed?

"We can stop the penicillin when her symptoms disappear."

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 parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond?

"Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

Which assessment finding by the nurse would warrant immediate action?

A child with periorbital cellulitis reports changes in vision and pain with eye movement.

The nurse is teaching a group of peers regarding different types of fractures seen in children. Which statement best describes a complete fracture?

A fracture in which the bone breaks into two pieces

The nurse is teaching a health and wellness course to young women of childbearing age. Which vitamin will the nurse encourage all to take daily?

Assess the fingers for warmth, pain, and function

The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level?

Digoxin

The nurse is teaching a health and wellness course to young women of childbearing age. Which vitamin will the nurse encourage all to take daily?

Folic Acid

The community nurse receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo. Which information related to impetigo will the nurse provide to the day care center?

Impetigo is highly contagious and can spread quickly.

A 6-year-old girl is diagnosed with aortic stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother?

Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority?

Place the child in a knee to chest position

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?

Strawberry Tongue

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 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. Gowers' sign is a hallmark finding of Duchenne muscular dystrophy as muscles weaken. The boy cannot rise from the floor in the usual way and needs to turn to hands and knees, move feet under the body, and "walk" hands up his legs to stand. The other options do not describe Gowers' sign, although lordosis is often a manifestation of Duchenne muscular dystrophy.

Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family?

This is a problem where the left side of the heart did not develop properly. This is a problem where the left side of the heart did not develop properly. There is a three-step palliative surgery that can be implemented or the child will need a heart transplant.

A nurse has provided care to several children during their well-child visits. The nurse has assessed each child's neurologic status. Which assessment finding indicates a problem requiring intervention?

a 4-year-old preschool-age child who consistently walks on tiptoes At 4 years of age, a child should not consistently walk on tiptoes. This is a common manifestation of muscular dystrophy and requires intervention. At 2 months of age, an infant's movements are uncoordinated and it may take several attempts to touch objects the infant reaches for. Infants begin to walk between 9 and 18 months of age, and may begin by walking while holding a caregiver's hands. At 2 years of age, a toddler is able to walk up the steps one step at a time.

The nurse is caring for an infant with a candida diaper rash. Which topical agent would the nurse expect the physician to order?

antifungals

A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client?

bracing

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 nurse is educating a group of caregivers about fractures seen in children. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in the:

epiphyseal plate. Fractures in the area of the epiphyseal plate (growth plate) can cause permanent damage and severely impair growth.

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

The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?

impetigo

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child?

lower extremities

Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele?

risk for infection

A child with a cardiac structural defect is receiving oxygen therapy. In which position should the child be placed to promote optimal benefits?

semi fowler

A 10-year-old child is brought to the clinic by the parent. Assessment reveals small circular patches of hair loss on the scalp. The nurse suspects which condition?

tinea capitis