Pediatrics Quiz 4

A 12-month-old client has a high blood lead level of 18 mcg/dL (0.87 µmol/L). The nurse educates the parents about lead poisoning. Which statements made by the parent indicate that teaching is successful? Select all that apply.

"I should get our home inspected for the source of the lead." "I will wash my child's hands often, especially before eating." "We will have to return for a follow-up lead level."

The nurse assesses a child with intussusception. Which assessment findings require priority intervention?

Abdominal rigidity with guarding (42%)

The nurse plans care for a pediatric client who has just undergone a cleft palate repair. Which of the following interventions should the nurse include in the plan of care? Select all that apply.

Assist and encourage caregivers to hold and comfort the child Position the child supine with an elevated head of bed after feedings Remove elbow restraints per policy for skin and circulatory assessment

A nurse is evaluating a client's understanding about infant formula preparation. Which of the following client statements indicate proper understanding? Select all that apply.

"I must wash the top of concentrated formula cans before opening." "Unused, prepared formula should be kept in the refrigerator and discarded after 48 hours."

The registered nurse is teaching the parent of a 6-year-old about behavioral strategies for treating fecal incontinence due to functional constipation. Which statement by the parent indicates a need for further teaching?

"I will give my child a reward for each bowel movement while sitting on the toilet."

The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon. Which statement by the parent indicates the need for further teaching?

"I'll organize playdates to keep my child's spirits up during relapses."

The clinic nurse is interviewing the parents of a 6-month-old client about the infant's diet. Which statement by the parents is most concerning?

"Infant oatmeal sweetened with fresh honey is our baby's favorite breakfast."

The nurse is reinforcing education with the parents of a 2-year-old child about diet choices to promote growth. The family observes a strict vegan diet. Which of the following statements by the nurse are appropriate? Select all that apply.

"It is important to feed your child fortified breads and cereals to help with iron intake." "Try to pair foods high in iron with foods high in vitamin C to aid iron absorption." "Your child may require calcium and vitamin D supplementation due to lack of dairy intake."

The mother of a 6-year-old child with cystic fibrosis (CF) has received instruction on the use of pancreatic enzymes. Which statement made by the mother indicates a need for further teaching?

"It is okay for my child to chew this medication." (61%)

Which of the following statements made by the mother of a child recently diagnosed with celiac disease indicates a need for further teaching?

"My child can have small amounts of foods containing wheat as long as she remains symptom free."

The nurse is discussing feeding and eating practices with the mother of a 1-year-old. Which statement made by the mother indicates a need for further instruction?

"My child is fussy at bedtime so I put him to sleep with a bottle of milk."

A nurse in the neonatal intensive care unit discovers a cyanotic newborn with excessive frothy mucus in the mouth. What should be the nurse's first action?

*Suction the infants mouth The initial nursing action for a client experiencing cyanosis and excess oral secretions is oropharyngeal suctioning to ensure airway patency.

The nurse is reviewing anticipatory guidance with the parents of a 6-month-old infant with phenylketonuria. Which statements by the nurse are appropriate? Select all that apply.

"A low-phenylalanine diet is required." "Meat and dairy products should not be introduced into the diet." "Special infant formula is required."

The nurse is educating the parents of a 6-month-old about introducing solid foods into the infant's diet. Which parental statement indicates a need for further teaching?

"I can offer a variety of foods within the first week of introducing solids." (80%)

The nurse is performing a physical examination on a 10-year-old client with abdominal discomfort. Which actions would be appropriate during the examination? Select all that apply.

Ask the client to describe the chief symptom Conduct a head-to-toe assessment in the same manner as an adult assessment Honor the client's request to be examined without a parent present

The parent of a 21-day-old male infant reports that the infant is "throwing up a lot." Which assessments should the nurse make to help determine if pyloric stenosis is an issue? Select all that apply.

Assess the parent's feeding technique Check if the vomiting is projectile Compare current weight to birth weight

The nurse is reinforcing discharge teaching for the parents of a 1-year-old with a newly diagnosed cow's milk allergy. Which nutrients normally provided by milk should be obtained from other sources? Select all that apply.

Calcium Vitamin D

The school nurse is teaching a class of 10-year-old children about prevention of dental caries. Which recommendations would be part of the nurse's teaching plan? Select all that apply.

Chew sugar-free gum Include milk, yogurt, and cheese in dietary intake Minimize consumption of sweet, sticky foods Rinse mouth with water after meals when brushing is not possible

The nurse has assessed 4 children. Which finding requires immediate follow-up with the health care provider?

Child who had a surgical repair of hypospadias earlier today with no urinary output in the past two hours

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula. Which finding is the nurse most likely to observe?

Choking and cyanosis during feeding

The parent of a 7-month-old reports that the child has been crying and vomiting with a distended belly for the past 4 hours. The infant is now lying quietly in the parent's arms with a pulse of 200/min and respirations of 60/min. Which of the following components of SBAR (situation, background, assessment, recommendation/read-back) communication is most important for the nurse to report to the health care provider?

Client is now lethargic with abnormal vital signs

A client diagnosed with acute glomerulonephritis has pitting edema in both lower extremities, blood pressure of 170/80 mm Hg, and proteinuria. When developing a plan of care for this client, the nurse should include which most accurate indicator of fluid loss or gain?

Daily weight measurements

During a routine assessment of a developmentally normal 18-month-old, the parent expresses concern about the small amount of food the child consumes. What is the nurse's priority intervention?

Educate the parent about physiologic anorexia (41%)

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery. Which assessment finding requires the nurse's immediate action?

Episode of foul-smelling diarrhea and fever (26%)

An overweight toddler is diagnosed with iron deficiency anemia. Which is the most likely explanation for the anemia?

Excessive intake of milk

The clinic nurse supervises a graduate nurse who is teaching the parents of a 2-year-old with acute diarrhea about home management. The nurse would need to intervene when the graduate nurse provides which instruction?

Follow the bananas, rice, apple sauce, and toast diet for the next few days

A parent brings a 6-month-old child to the primary health care provider after the child abruptly started crying and grabbing intermittently at the abdomen. The client's stool has a red, currant jelly appearance. What intervention does the nurse anticipate?

Give air (pneumatic) enema

A nurse is reviewing the laboratory values for a 3-year-old client with nephrotic syndrome. The nurse interprets the results to most clearly reflect which physiologic process related to nephrotic syndrome? Click on the exhibit button for additional information. Laboratory results Serum albumin 2.0 g/dL (20 g/L) Serum total cholesterol 275 mg/dL (7.1 mmol/L) Urinalysis, protein 3+

Glomerular injury

The school nurse creates a cafeteria menu for a newly enrolled child with celiac disease. Which lunches would be appropriate for this child? Select all that apply.

Grilled chicken, baked potato, and strawberry yogurt Mexican corn tacos with ground beef and cheese Rice noodles with chicken and broccoli

The nurse is gathering data on a 5-week-old admitted with a suspected diagnosis of pyloric stenosis. The nurse should expect to find which laboratory value?

Hematocrit of 57%

The nurse teaching the parents of a child diagnosed with cystic fibrosis will advise the parents to choose foods that satisfy which recommended diet?

High calorie, high protein, high fat

A 3-month-old infant has irritability, facial edema, a 1-day history of diarrhea with adequate oral intake, and seizure activity. During assessment, the parents state that they have recently been diluting formula to save money. Which is the most likely cause for the infant's symptoms?

Hyponatremia due to water intoxication (63%

The nurse is admitting a 4-year-old diagnosed with Wilms tumor. The child is scheduled for a right nephrectomy in the morning. Which action is a priority in the preoperative care plan?

Instructions not to palpate the abdomen

The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? Select all that apply.

Palpable sausage-shaped abdominal mass Screaming and drawing of the knees up to the chest Stool mixed with blood and mucus

The nurse is caring for a 2-year-old who is receiving a saline enema for treatment of intussusception. Reporting which client finding to the health care provider (HCP) is most important?

Passed a normal brown stool

The nurse assesses a pediatric client who was diagnosed with diarrhea caused by Escherichia coli. The nurse is most concerned with which finding?

Petechiae noted on the trunk

The clinic nurse is caring for several clients during well-child visits. The nurse should recognize which client as being the most at risk for anemia?

3-month-old infant born at preterm gestation who is exclusively bottle-fed with breastmilk

A nurse is caring for a child with acute glomerulonephritis. Frequent monitoring of which of the following is a priority?

Blood pressure

The nurse is teaching a class on nutrition and feeding practices for young children. What should the nurse recommend as the best snack for a toddler?

Slices of cheese

A newborn had a bowel resection with temporary colostomy for Hirschsprung's disease. The nurse should alert the health care provider (HCP) for which assessment finding postoperatively?

Stoma is gray-tinged at the edges but pink at the center on postoperative day 5

A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding should the nurse expect?

Stools mixed with blood and mucus