Pediatrics Exam 2
Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis?
Signs of increased intracranial pressure (ICP)
The young child has been diagnosed with bacterial meningitis. Which nursing interventions are appropriate? Select all that apply.
Initiate droplet isolation, Administer antibiotics as ordered, Initiate seizure precautions, Identify close contacts of the child who will require post-exposure prophylactic medication
What is a true statement regarding varicella zoster virus infection?
Secondary bacterial infections of the skin can occur.
The nurse caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply.
Time the seizure started, Eye position and movement, Incontinence of urine or stool, Factors present before seizure started
An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform?
Observe the infant's respiratory effort
A child was just brought into the emergency department after falling off a skateboard. The parents report that their child lost consciousness briefly and they noticed watery drainage coming from the nose. What action should the nurse take first?
Notify the emergency department physician of the information the parents reported
A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply.
Oxygen gauge and tubing, Suction at bedside, Padding for side rails
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
A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?
Scarlet fever
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
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.
In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care?
Risk for injury related to seizure activity
The parents of a child diagnoses with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse?
"Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis."
The nurse is preparing an education plan for a pregnant woman who has venereal warts. What should the nurse include as teaching points for this client?
"During a vaginal birth, your newborn may develop warts in the throat."
The mother of a newborn with a caput succedaneum asks the nurse how this happened to her baby. Which response by the nurse would be most appropriate?
"During delivery, your vaginal wall put pressure on the baby's head."
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?
"I always keep phenobarbital with me in case of a fever."
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? Select all that apply.
"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."
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)."
The nurse has just admitted a 17-year-old diagnosed with bacterial meningitis. The parents of the adolescent tell the nurse, "We just don't understand how this could have happened. Our child has always been healthy and also 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 who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status?
"She has been irritable for the last hour....seems like she is just upset for some reason."
The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate?
"Small increments in dosage lead to sharp increases in plasma drug levels."
An adolescent with atopic dermatitis reports interest in using herbal preparations to help manage the condition. What response(s) is appropriate? Select all that apply.
"Some people find the use of chamomile beneficial in managing this condition.", "Evening primrose oil can be used for dermatitis."
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."
The emergency room nurse is taking a history of a 1-year-old child whose parent said that she had a "fit" at home. Which inquiry would be best to start with?
"What happened just before the seizures?"
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 prior to her beginning to feel sick?"
A child is diagnosed with early disseminated Lyme disease. The nurse informs the parents the child will most likely receive antibiotic therapy for which length of time?
14 to 28 days
A child is diagnosed with varicella zoster and has been prescribed acyclovir 15 mg/kg q 8 hours IV. The child weighs 61.7 lb (28 kg). How many milligrams should the nurse administer in each dose? Record your answer using a whole number.
420
A health care provider has prescribed cephalexin 30 mg/kg PO daily in 4 divided doses for a child diagnosed with impetigo. The child weighs 30 lb (14 kg). How many milligrams should the child receive each day?
420
The nurse is preparing an assessment guide for the emergency department staff regarding assessment of clients are admitted with burn injuries. What should the nurse be sure to include in the assessment guide for primary emergency assessment of burns?
Airway assessment, Presence of edema, Pulse strength
The nurse is educating a parent about the treatment for a child's tinea cruris. What medication class would the nurse include in the teaching plan?
Antifungal
The nurse is caring for a client who suffered burn injuries to the arms. The arms have blisters, moist red skin, blanching, and sensation is intact. What type(s)of treatment plan is expected for this type of burn injury? Select all that apply.
Application of cool, damp cloths, Use of moisturizers
The nurse is caring for an adolescent who suffered an injury during a diving accident. During assessment the client is demonstrating the posturing in the figure. The nurse is aware that this type of posturing is the result of injury to what area?
Brain stem
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.
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.
After teaching a group of students about neural tube disorders, the instructor determines that additional teaching is needed when the students identify this as a neural tube defect.
Arnold-Chiari malformation
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 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 child who had a seizure, fell to the ground, and hit and injured his face, head, and shoulders. When notifying the health care provider, which type of seizure is the nurse most likely to report?
Atonic
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.
An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse to recommend to relieve the itching?
Bathe with a product that is oatmeal-based.
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.
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
A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intracranial pressure?
Change in level of consciousness
Antibiotic therapy to treat meningitis should be instituted immediately after which event?
Collection of cerebrospinal fluid (CSF) and blood for culture
A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family?
Complete the prescribed antibiotics
A child is diagnosed with an enterovirus infection. Which type of infection control precaution would be most important for the nurse to use?
Contact
A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?
Contact precautions
The nurse is caring for a child with an infectious disorder and the following vital signs: temperature 103.1°F (39.5°C), pulse 106 bpm, respiratory rate 24 breath/minute, and oxygen saturation 93% on room air. The child reports pain 4/10 using the Wong-Baker FACES scale. Which nursing intervention is priority?
Don appropriate personal protective equipment (PPE).
During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?
Dramatic increase in head circumference
The parents of a child voice concern to the nurse that they believe their child has Lyme disease but their physician won't do the proper testing. The nurse reviews the chart to determine if specific testing for the disease has been performed. Which tests is the nurse looking for?
Enzyme immunoassay (EIA), Immunofluorescent assay (IFA), Western immunoblot
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.
A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially?
Institute droplet precautions in addition to standard precautions.
A 16-year-old is seen in the emergency department with symptoms including a high fever, chills, headache, nausea and vomiting, and painful joints. During the nursing history the teenager reports recently returning from a trip to a rain forest in South America. What infectious disease does the nurse suspect the client has contracted?
Malaria
A young client in the clinic has a rash, cough, and fever that the parent says spiked on day 5 of the rash. The client also had conjunctivitis. What illness would the nurse expect the health care provider to diagnose?
Measles
A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next?
Neck
At 36 weeks' gestation a client is scheduled for a biophysical profile. Before the client has the ultrasound examination, which component of the biophysical profile does the nurse complete?
Nonstress test
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 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 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
A nurse demonstrates understanding of the various levels of consciousness as they progress from most alert to least alert. Place the levels of consciousness in the order that reflects this progression.
Oriented to person, place, and time, Disorientation, Obtundation, Stupor, Coma
A child is diagnosed with scarlet fever. History reveals that the child has no known drug allergies. When preparing the child's plan of care, the nurse would anticipate administering which agent as the drug of choice?
Penicillin V
When the health care provider looks in a child's mouth during a sick-visit examination, the parent exclaims: "The tongue is bright red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis?
Penicillin to prevent acute glomerulonephritis
A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges?
Positive Kernig sign
A 10-year-old boy has been experiencing complex partial seizures and has not responded well to medication. Surgery is planned to remove brain tissue at the seizure foci. Which diagnostic test would be the most accurate in identifying the seizure foci?
Positron emission tomography (PET)
A nurse is obtaining a history from the parents of a child diagnosed with an infection. The parents report that the child started running a fever a couple of days ago and that he "just didn't seem like himself." Then this morning, the child started having yellow-green discharge from the nose. The nurse would identify the child has just completed which stage of an infectious disease?
Prodrome
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? Select all that apply.
Promotion of skin hydration, Maintenance of skin integrity, Prevention of infection
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.
What information should be included in the teaching plan for a child with varicella?
Remind the child not to scratch the lesions.
A child with a burn injury is scheduled for skin grafting. Which intervention would be most appropriate for the nurse to include in the child's plan of care?
Provide around the clock pain medication
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.
A toddler pulled a cup of hot coffee off the table, causing first-degree (superficial) burns on the hands. The parent calls the clinic and asks what actions to take. How should the nurse respond? Select all that apply.
Quickly run cool water over the toddler's hands., Cover the burns with a clean nonadhesive bandage., Set up an appointment with the health care provider.
The nurse is caring for a preschooler who has developed a high fever and has just had a seizure. What is the best action by the nurse?
Remove any blankets or heavy clothing and replace with a thin sheet
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
The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority?
Risk for injury
The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test?
Skin scrapings
A school-aged child with seizures is prescribed phenytoin sodium, 75 mg four times per day. What instruction would the nurse give the parents regarding this medication?
The child will have to adhere to good tooth brushing
The nurse is preparing discharge education for the caregivers of a child with a seizure disorder. Which goal of treatment is priority for this client?
The child will remain free from injury during a seizure.
What is a true statement regarding measles?
The incubation period is 10 to 12 days.
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing intervention is the highest priority for this child?
The nurse follows contact precautions.
The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child?
The nurse will administer oxygen.
The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply.
The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing."
After a difficult birth, the nurse observes that a newborn has swelling on part of his head. The nurse suspects caput succedaneum based on what evidence?
The swelling crosses the midline of the infant's scalp.
The nurse is caring for a child who has been diagnosed with Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). The parents of the child question how their child became infected. What information can be included in the information provided by the nurse? Select all that apply.
This infection can be caught from contaminated surfaces in the school., Respiratory spread of the infection is possible., Sharing personal care objects can be a source of contamination.
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
A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl subsequently played with. In this case, what is the portal of exit in the chain of infection?
Upper respiratory excretion
The nurse is caring for a child, weighing 100 lb (45.5 kg), on the burn unit who has partial-thickness or second-degree 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
A 12-year-old child has been prescribed phenytoin. What information should be included in discussion about this medication?
Use a soft toothbrush.
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
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 nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first?
a child with erythema infectiosum experiencing fatigue and confusion
A nurse is assessing a child with a tick-borne disease. What finding would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted fever?
absence of rash
A chief danger of scarlet fever is that children may develop:
acute glomerulonephritis.
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)?
an 18-month-old child receiving chemotherapy over 5 days
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)
In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder?
asthma
After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:
pinworm
The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child?
preventing spread of infection
A nurse is caring for a child with a wasp sting. Which nursing intervention is priority?
Administer diphenhydramine per protocol
A child is admitted to the acute care facility with a burn injury. The nurse would check the child's immunization status, specifically for which of the following?
Tetanus
What is one of the most commonly reported communicable diseases in the United States?
gonorrhea
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."
The most common complication of varicella is:
secondary bacterial infections.
The nurse is caring for a 10-year-old male in a pediatric clinic with presenting symptoms of small circular patches of hair loss on the scalp. Which skin condition does the child most likely have?
tinea capitis
Which of these age groups has the highest actual rate of death from drowning?
toddlers
Which intervention is the most effective in treating an infected burn wound?
topical antibiotics applied to the wound site
The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?
urine output of 10 ml over 3 hours
The nurse is caring for a 10-year-old boy with diphtheria. What would the nurse institute as a tier 2 precaution?
use of a protective mask
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
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 nurse is caring for a child with suspected child abuse-induced burns. Which assessment findings would support this?
A burn to the entire right hand up to 2 cm above wrist with consistent edges
The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take?
Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.
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.
A nurse is teaching a class to new parents on how to prevent the spread of infection in their children. What is the best suggestion the nurse could offer to these parents?
Encourage frequent hand hygiene.
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.
A nurse is providing care to a child with partial and full thickness burns over 26% of the body. In monitoring the child's output the nurse expects an output of 1 to 2 mL/kg/hr. The nurse has emptied 46 mL from the foley catheter for the past hour. The child weighs 62 lb (28 kg). What action should the nurse take?
Document the output and continue to monitor
A young child who has been reporting fatigue and having a low-grade fever for 4 days begins to have pustules over the entire body. The health care provider diagnoses chickenpox. When considering transmission to others, during which period would the nurse assess?
During the prodromal period
What information is most correct regarding the nervous system of the child?
As the child grows, the gross and fine motor skills increase.
The nurse is caring for a child with a second-degree (partial-thickness) burn. What assessment findings would the nurse expect to observe?
Edema with wet blistering skin
The nurse is assessing a child who pulled a boiling pot of soup off of the stove top. The child reports pain at a 9 on a scale of 0 to 10. The burn is red and edematous, and also shows areas of charred skin. The nurse is aware that these signs and symptoms are indicative of what kind of burn?
Full-thickness or third-degree
What is the leading cause of neonatal sepsis and death?
Group B streptococcus
A child is seen in the clinic because of a rash over the face and trunk area for the past 4 days. The nurse completes an assessment and suspects the child has rubeola. Which assessment finding best supports the nurse's suspicion?
Koplik spots
The appearance of which hallmark clinical manifestation occurs in measles?
Koplik spots
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
Absence seizures are marked by what clinical manifestation?
Loss of motor activity accompanied by a blank stare
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? Select all that apply.
Lyme disease Rocky Mountain spotted fever
A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder?
The child has had 8 ounces of formula in the past 24 hours.
The nurse is completing the care plan for a pediatric client with deep partial-thickness or second-degree burns on the back and back of the legs. Debridement of the burns is performed 2 to 3 times per week. What nursing diagnosis has the highest priority in regards to this treatment modality?
Pain
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
A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:
bacteria.
What is the best technique to perform an assessment of the skin?
Skin assessment involves inspection and palpation in a room with natural daylight.
An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants?
Staphylococcus aureus
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.
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.
A mother asks the nurse about bathing her child. Which response by the nurse would be most appropriate?
Use lukewarm water with a mild soap and allow the child to remain in the tub for a short time to avoid supersaturation
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 assesses a child and finds that the child's pupils are pinpoint. What does this finding indicate?
brain stem dysfunction
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
The nurse is caring for an infant with increased intracranial pressure. The mother is preparing to feed the child. What action by the mother indicates an understanding of the proper care of this infant?
placing the infant in an infant car seat after feeding the infant
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which condition best describes a papule?
small, circumscribed, solid elevation of the skin
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
When reviewing bathing habits for a child with dermatitis, which statements by the child's mother indicates the need for further instruction? Select all that apply.
"Antibacterial soap will be helpful in preventing infections at the site of the rash.", "I should use the warmest water my child can tolerate during the bath."
The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed?
"Antibiotics are needed to help our child recover from rubella."
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."
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."
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."
A pediatric client was brought to the emergency department by the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. Which statement by the parents indicate learning occurred?
"We need to get our child a medical alert bracelet as soon as possible in case this happens again."
The mother of an infant reports that her child is frequently choking when breastfeeding or taking a bottle. The nurse plans on assessing which cranial nerve when addressing the mother's concerns?
IX
Which interventions will the nurse include when caring for a child with an infectious disorder? Select all that apply.
Educate the child and family about infection control., Ensure immunization status is current., Use appropriate personal protective equipment., Provide information about disease transmission.
An intensive care nurse has received the above hand-off report from the emergency department nurse. Thirty minutes later, the nurse assesses the child again. Which assessment finding should the nurse investigate further?
Temperature 100.5°F (38.1°C)
The nurse is caring for a child admitted with simple partial motor seizures. Which clinical manifestation would likely have been noted in the child with this diagnosis?
The child had shaking movements on one side of the body.
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? Select all that apply.
Vitamin A, Zinc, Vitamin D
The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest?
Wash the face twice a day with a mild soap then pat dry.
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.
The nurse is caring for a 15-year-old boy with psoriasis. In addition to the plaques, what would the nurse expect to note?
fissures and scaling on palms and soles
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
The nurse is caring for a child with suspected increased intracranial pressure (ICP). Which assessment finding would indicate increased ICP?
hypertension
Any individual taking phenobarbital for a seizure disorder should be taught:
never to discontinue the drug abruptly.
The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is:
penicillin
A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:
scarlet fever.
A nurse is caring for an infant who has just undergone a ventricular tap. In what position should the nurse place the infant immediately after the procedure?
semi-Fowler position with a parent at the bedside
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 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 provides education to the parent of an infant being treated for hydrocephalus with a ventriculoperitoneal (VP) shunt. Which statement by the parent indicates the need for further instruction?
"This shunt is the only surgery my baby will need."
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."
What is a true statement regarding status epilepticus?
It is a common neurologic emergency in children.
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
The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity?
Moving the infant's head every 2 hours
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 6-year-old child is being treated for a parasitic infection. When reviewing results from the child's white blood cell count, which finding would be anticipated?
Increased eosinophils levels
A client is receiving a loop diuretic. The nurse should assess for which complication that's related to the administration of a diuretic.
Increased weakness and an irregular pulse
Preterm infants have more fragile capillaries in the periventricular area than term infants. This put these infants at risk for which problem?
Intracranial hemorrhaging
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
The nurse is caring for a client with generalized edema and fluid volume overload. Which nursing intervention would be the most accurate in evaluating the client's fluid balance?
Monitor changes in daily weight
A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition?
Mumps
A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child?
Mumps
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
A 3-week-old infant is diagnosed with pertussis. Which antimicrobial agent would the nurse expect the physician to prescribe?
azithromycin
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.
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
The nurse is taking a health history of a 6-year-old girl with suspected Stevens-Johnson syndrome. During the physical examination, the nurse would expect to note which physical findings?
erythema multiforme with inflammatory bullae of at least two types of mucosa
The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all that apply.
eye opening, verbal response, motor response
Gabapentin has been prescribed for a pediatric client. Which statement by the client indicates an understanding of teaching related to the medication?
"I can't take this medication within 2 hours of taking my antacid medication."
The nurse is caring for a mother and newborn on a postpartum unit. The mother asks if it OK to use baby powder on newborns. Which response by the nurse would be most appropriate?
"Baby powder should not be used on newborns because of the risk of aspiration upon application."
The nurse is caring for a mom and her baby on a postpartum unit. The mom states she has received advice not to use baby powder on newborns. She asks the nurse if this is true, and if so, why. Which nurse response is correct?
"Baby powder should not be used on newborns due to the risk of aspiration upon application."
The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101 degrees Fahrenheit. Which statement by a parent indicates an understanding about 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."
The nurse is evaluating the parents' understanding of atopic dermatitis. Which statement shows their understanding?
"Flare-ups of lesions are not uncommon following therapy."
The nurse is caring for a child diagnosed with hand-foot-mouth disease. When educating the family about this disease, which education by the nurse is most important?
"Make sure your child drinks plenty of nonirritating fluid."
The father of a child with mononucleosis is concerned with his child's fever and cough. The father asks when antibiotic therapy will begin. What is the best response by the nurse?
"Mononucleosis is a viral infection so an antibiotic isn't used. We address the symptoms with appropriate therapy."
The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply.
"It's important I get my CBC blood test when my doctor orders it.", "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her.", "If I am sexually active I need to let my doctor know."
A mother voices concern to the nurse that her child should not be using alcohol-based hand gels to help prevent the spread of infection. How should the nurse respond?
"Hand gels are actually very effective in preventing the spread of infection."
The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate?
"Handwashing is an effective way to prevent infection."
The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure?
"He was just staring into space and was totally unaware."
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."
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."
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 health care provider know about it."
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."
When doing teaching with a group of caregivers of infants, the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash?
"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."
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."
An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver?
"That's not an uncommon reaction, although it's hard on you and on your child."
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."
A child is home with the caregivers following a treatment for a head injury. The caregiver should contact the care provider if the child makes which statement?
"You look funny. Well, both of you do. I see two of you."
The nurse is discussing with a parent the difference between a breath-holding spell and a seizure. The nurse will be correct in telling the parent which information in regard to seizures?
Convulsive activity often occurs in seizures.
The nurse is assigned an infant with a possible neurological disorder. Which assessment finding would the nurse communicate to the health care provider as a late sign of increased intracranial pressure?
Decorticate posturing and fixed and dilated pupils
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
A child is hospitalized with burns over 25% of the body. The nurse is preparing to perform a dressing change. What aspect of changing the child's dressings is most important for the nurse to consider?
Infection prevention
The nurse is caring for a child who has suffered a head injury and has had an ICP monitor placed. Which prescription by the health care provider would the nurse question?
Initiate an IV of 0.9% NS to run at 250 ml/hr.
The wound care team has a need to improve the skin assessments in the pediatric population. What assessment(s) would be important for the nurses to implement in this multicultural community? Select all that apply.
Inspect the healing skin of a dark-skinned child for hypopigmentation., Inspect the skin of young children for pressure breakdown due to friction., Assess wound healing in dark-skinned children for hypertrophic responses., Monitor for increased vesicle production in dark-skinned children.
The nurse is caring for a 6-year-old child brought into the emergency department for burns from a house fire. The nurse notes burn areas surrounding the client's nose and mouth upon initial assessment. Which priority complication should the nurse be alert for?
airway obstruction related to upper respiratory swelling
The parents of a 10-month-old child bring the infant to the emergency department after finding the infant face down in the bathtub. The parent states, "I just left the bathroom to answer the phone." Which assessments are priority for the nurse to complete? Select all that apply.
airway, respiratory status, circulation
The school nurse is leading a discussion with a group of adolescents on the various sexually transmitted infections (STIs). The nurse determines the session is successful when the students correctly choose which STIs as considered curable with proper treatment? Select all that apply.
chlamydia, gonorrhea, trichomoniasis
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?
Institute droplet precautions in addition to standard precautions.
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 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 providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?
"We need to make sure that he washes his hands frequently."
The nurse is caring for a child with burns. The child is scheduled to be discharged the following day, and the nurse is going over discharge instructions with the parents. After teaching the parents about caring for the burn, the nurse determines that the teaching was successful when the parents make which statement about removing an old dressing?
"We need to soak the old dressing in tepid water just before we take it off."
A newborn has a generalized rash on the skin, which the nurse identifies as erythema toxicum neonatorum. Which information would the nurse include when explaining the condition to the newborn's parent?
"What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this."
The nurse is preparing a room for a child being admitted with meningitis. What is the appropriate action by the nurse?
Gather appropriate equipment and signage for respiratory isolation precautions.
The nurse is caring for a pediatric client with multiple wounds from a bike accident. What is the best method for cleansing or washing out the wound?
Use normal saline solution to wash the wound.
The nurse is caring for a child with an order for PO prednisone. Which statement by the child's mother would indicate a need for further education?
"I will give it to her at least 1 hour before all of her meals."
The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education?
"I will use rubber pants over the cloth diapers in the future."
While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education?
"I will cradle her in my arms after the procedure for at least 30 minutes."
A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful?
"I should not cover the area with plastic wrap after applying the cream."
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 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."
The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the charge nurse is the most accurate regarding the integumentary system?
"The largest organ of the body helps regulate body temperature."
A child who has been having seizures is admitted to the hospital for diagnostic testing. The child has had laboratory testing and an EEG, and is scheduled for a lumbar puncture. The parents voice concern to the nurse stating, "I don't understand why our child had to have a lumbar puncture since the EEG was negative." What is the best response by the nurse?
"The lumbar puncture can help rule out any infection in fluid surrounding the brain and spinal cord as the cause of the seizures."
The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated?
"The signs of disease will be noted in 1 to 3 weeks."
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 nurse is providing education to the parents of a female toddler with hydrocephalus who has just had a shunt placed. Which statement is the best to make during a teaching session?
Tell me your concerns about your child's shunt.
A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?
Provide instruction on how to care for a diaper rash.
The nurse is providing education to the parents of a 2-year-old boy with hydrocephalus who has just had a ventriculoperitoneal shunt placed. Which information is most important for the parents to be taught?
"Watch for changes in his behavior or eating patterns."
An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? Select all that apply.
burning, photosensitivity, dryness
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? Select all that apply.
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. Wearing protective clothing when playing in wooded areas.
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
