Peds ATI final

A child returns from exploratory surgery following a GSW to the abdomen, which nursing intervention would be excluded from the plan of care.

Immediate initiation of oral feedings.

What is the priority nurse intervention for pediatric client diagnosed with bacterial meningitis?

Impaired airway exchange

Which clinical manifestation should the nurse suspect when conducting an assessment for a child diagnosed with hyperactivity disorder?

Impulsive behavior and sleep disturbances

A child has an appendectomy and was discharged, home 48 hrs postop. A week later the child was readmitted for delayed wound healing which causes of delayed wound healing should the nurse review before assessing the child?

Inadequate nutrition, infection of wound, predisposing chronic conditions, diabetes

Priority nursing diagnosis when planning care for an infant diagnosed with a severe case of oral thrush (candida)

Ineffective infant feeding

During a routine physical assessment for a 9 mos old, the nurse notes swelling of the ankle, the nurse presses the ankle bone for 5 sec and releases pressure and notices a remarkably slow appearance of indentation, which system requires a more indepth assessment, based on this data?

Kidney

The nurse is assessing a child with down syndrome. Which order should the nurse monitor for due to increased risk for children with down syndrome?

Leukemia

Which assessment data obtained by the nurse during the health hx portion of the assessment process supports the current diagnosis of Duschane's muscle dystrophy for an 18 mos old.

Looks ripped like they were lifting weights

The nurse is assessing abdominal girth for a pediatric client who presents with abdominal distention, which nursing action is appropriate?

Measure around at the level of umbilicus

Which assessment finding posterior fontanelle open 4 mos old infant would require further intervention by a nurse?

Measure head circumference

Which actions are appropriate when a nurse is performing general observation during the assessment process of an infant?

Monitor parent for fatigue, abnormal behavior, assess behavior that indicate appropriate bounding

Hospitalized child diagnosis with a syndrome of inappropriate antidiuretic hormone (SIADH, loose sodium), a complication of meningitis. Which lab data would the nurse anticipate for the child?

Na, hyponatremic - passing fluids

When assessment finding of an adolescence is post op spinal infusion surgery, what would you monitor?

Neuro, check pulse, feeling in fingers

Which items noted in a pediatric client's medical record indicates the child might be experiencing a learning disability?

Dyslexia

Which clinical manifestation should a nurse anticipate upon assessment for a preschool age child with a UTI

Hurts to pee, urgency and fever

Which urinalysis result should a nurse anticipate for a child with acute glomerulonephritis

Iv antibiotic (protein) blood

Which is the priority nursing action when providing care to a child bitten by a snake?

Monitor airway

The nurse is caring for a child with DKA which healthcare provider prescription order should the nurse question?

NPH IV insulin

Which clinical data noticed by the nurse during the shift assessments indicates that the pediatric patient may be experiencing compartment syndrome

Pain not relieved by pain meds, Paralysis of leg, prolonged cap refill

Which nursing actions are developmentally appropriate when providing hospital care for toddler age child?

Potty chair nearby, allowing to feed themselves

What teaching topics should the nurse include in the discharge instructions to the parents of a child diagnosed with sickle cell disease to prevent a crisis?

Respiratory

Hirschsprung Disease

is a birth defect in which some nerve cells are missing in the large intestine, so a child's intestine can't move stool and becomes blocked, recurrent

Which clinical manifestation should the nurse anticipate when assessing a child whos been admitted to the hospital unit with a diagnosis of nephrotic syndrome

(presents of edema retaining protein and hypoalbuminemia)

An infant with tetralogy of fallot is having an hypercyanotic episode, which nursing intervention is appropriate?

Oxygen, knees to chest, admin morphine and propranolol

Nurse providing care for a pediatric client in the ER dept which diagnoses of decreased level of consciousness secondary with increased intracranial pressure. Which healthcare provider order should the nurse question for the pediatric client?

Passive ROM exercises

Which data noted by the nurse during a physical assessment would indicate the need to refer an adolescent client for further treatment due to possible depression?

Poor self care, violent behavior, school grades

A neonate with meningeal myelocele is to have surgery in the morning, which nursing action is appropriate for this neonate?

Position Side lying or Prone

Nurse is unsuccessful in inserting a nasogastric tube on a newborn baby. The nurse suspects the newborn has esophageal atresia and tracheoesophageal fistula, which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

Position newborn in semi fowlers

Which factor noted by the nurse during a pediatric health hx portion assessment would indicate the patient is at risk for ADHD?

Prenatal exposure to smoke

Which should the nurse include in the plan of care with a child with minor burns to enhance nutrition and healing?

Protein

What would be the plan of care for a child diagnosed with intellectual disability?

Providing emotional support, safe environment, participate in individualized education

Which skin conditions should the nurse identify as having a genetic or inherited component, during a presentation of the integument unit?

Psoriasis, atopical dermatitis

Which are the priority nursing assessments for a pediatric client receiving sedation, what would you monitor?

RR effort, skin color, Level Of Consciousness

Which statement is true regarding the physical assessment the nurse conducts of an infant and toddler?

Remove clothes for baby, toddler ht, wt and head circumference, try assessment on parents before toddler

A child weighing 18.2 kg with a hx of diabetes insipidus has been admitted to the hospital. Which healthcare provider prescription should the nurse question?

Restrict fluids to every 24 hrs

Which is the priority nursing diagnosis for the planning care for a newborn, born with esophageal atresia and tracheoesophageal fistula. What is the risk for this child?

Risk for aspiration

School age child who presents with a history of abdominal pain, 3-4 times per week for the past couple months. Mother states the child usually complains on school days and always seems to be better by the afternoon, which mental health disorder does the nurse suspect?

School phobia

Which parental statement during scheduled health maintenance assessment of a preschool child would cause the nurse concern?

Screaming nightmares

A Teacher states to the school nurse, I have a student who often stares at me for 15 secs after asking a question and then ask me to repeat the question. Should I be concerned?

Seizures

A child diagnosed with altruism spectra disorder is admitted to the hospital with dehydration which should the nurse include in the plan of care for this child?

Single bed

For a school age child who must wear a brace to correct scoliosis, what is your priority nursing care?

Skin integrity

Which actions should the nurse implement when assessing the physical health of a child diagnosed with chronic renal failure?

Step on the scale, measure child height

Which teaching point should the nurse include when providing education to an adolescent client who participates in soccer regarding the plan of care for diabetes?

Track glucose, provide healthy snacks, and fluids

What is the priority nursing care to teach the family of an infant diagnosed with osteogenesis imperfecta?

Truck and extremity support during everyday care

Which gastrointestinal defects often diagnosed shortly after birth should the nurse include in the assessment process of all newborns?

Umbilical hernia,

The child with croup has increase PCO2 decrease PH and normal HCO3 blood gas which does the nurse report to the healthcare provider based on this data?

Uncompensated Resp acidosis

When conducting a scoliosis screening for a school age child what would you see?

Uneven shoulders and hip, one sided rib hump, and prominent scapula

Which nursing diagnosis should the nurse include in the plan for an infant diagnosed with acute bronchitis due to RSV?

Activity intolerance

Which parental statement indicates correct understanding of discharge instruction for pediatric clients after a Tonsillectomy?

Admin tylenol for pain

The nurse is providing care to a pediatric clinic diagnosed with IBD, who is prescribed daily prednisone whose parental statement regarding administration of the drug indicates correct understanding of teaching provided by the nurse.

Administer meds with meal (irritable to stomach)

A child with hx of seizures arrives to the ED with status epilepsy priority nursing action?

Airway

Which clean catch urinalysis findings should a nurse be most concerned for a child who's admitted to an urgent care to rule out UTI?

All of the above (+2 WBCs, 1+RBCs, urine that is cloudy, specific gravity 1.009)

Which is the priority nursing diagnosis during the acute phase of a 3rd degree circumferential burn of rt arm for a pediatric patient?

Altered tissue perfusion

Which pain interventions should the nurse include in the plan of care for a pediatric client who suffered a full thickness burn injury, using an age appropriate assessment scale?

Analgesics for wound care and cover skin

Which should the nurse include neurovascular assessment for infant following casting of the leg?

Warmth, cap refill, sensation and movement of toes

A child is prescribed oral steroids for a rash caused by grath, which should the nurse monitor the child for after administering the drug?

hyperglycemia

A child diagnosed with hemophilia presents to the ED with multiple injuries following a MVC, which injury is a priority when conducting an assessment?

occipital hematoma

A newborn diagnosed with omphalocele deficit (the infant's intestines stick outside of the belly through the belly button) is admitted into the intensive care nursery, which nursing action is appropriate based on the current data.

Cover normal saline dressing

Which of the following is the priority nursing action when preparing a neonate born with (Gastroschisis) during transport back?

Cover with normal saline

During a 4 mos infant well child check up the nurse discusses introduction of solid foods into the infant's diet, although the nurse recommends delaying the introduction, which foods will the nurse discuss delaying that causes an increase of food allergy.

Cows milk, eggs and peanuts

Which info should the nurse include in the teaching plan of a child diagnosed with autism disorder as a method to increase socialization?

Create a reward system when the child interacts with people

An adolescent client recurring abdominal pain, diarrhea and bloody stools, which IBD is this.

Crohn's Disease

Which activity should the nurse include in the plan of care for a child diagnosed with ADHD to Improve behavior and learning?

Develop consistent routine for classroom, limit decorations, determine areas where children work well and promotes self-esteem

Which nursing action assists in the diagnoses of mental health and cognitive disorder?

Developmental assessment

A neonate born with a bilateral cleft lip not detected during pregnancy, the parents are distressed about the appearance of their infant, which nursing actions are appropriate to assist the parents to bond with their newborn?

Discuss positive features, smile and talk to baby, call newborn by chosen name

An infant returns to a unit following surgical correction of bilateral congenital clubbed feet with a cast and the feet are edematous but there is color, sensitivity and movement, which action by the nurse is a priority?

Elevate legs on pillows

Which laboratory test should a nurse anticipate when admitting a pediatric minor with possible obstructive neuropathy

Elevated BUN and creatinine

The nurse is caring for a 9 mos old infant who just returned from the PACU after shunt replacement for hydrocephalus which healthcare provider order should the nurse question?

Elevating head of bed

Which intervention should the nurse include in the plan of care of an adolescent on complete bed rest after spinal fusion surgery secondary to scoliosis to repair complications of immobility?

Encourage use of Incentive spirometer, log roll every 2 hours, increase fruit and grains in diet

When the home health nurse visits the home of a 10 mos old she observes the environment for risk of injury to the child, which observation would the nurse discuss with the mother?

Filled mop bucket

Providing care to a 3 year old whose mother states "I'm not sure I have enough money for food for the rest of the month and the antibiotic for my child's ear infection?

Food pantry for children and suggest social work

Which is the appropriate nursing intervention when providing care to a child diagnosed with nephrotic syndrome and they are edematous and on bedrest?

Frequent position changes

Which parenting statement to the nurse indicates an accurate understanding about the care of their child with a ringworm of the scalp? (GRiseofulvin is medication)

Give med with food

Which parental statement would cause the nurse to provide further education for a child diagnosed with clubbed foot?

Happy this is the only cast our baby will need

Which statement from the parent of a child with ADHD indicates further need for education by the nurse?

Homework during tv

Which assessment question should the nurse include in the physiological assessment to determine if chronic renal failure treatments on the growth and development of a school age child?

How do you feel about dialysis, how do you feel about special diet, (ask open ended question)

The nurse is working with parents of child with chronic conditions. Which statement made by the child's parents indicate the need for intervention related to the overwhelming caregiver burden?

I have to care for my child day and night which leaves little time for me"

Which clinical therapy should the nurse anticipate when planning care for a toddler age client who is admitted to the hospital unit with cellulitis of the neck?

IV antibiotic

Which action by the nurse is appropriate for a child who presents in the ED with an ankle injury? What is the nursing action?

Ice

Which clinical manifestation should the nurse anticipate when providing care to an adolescent who presents with untreated hyperthyroidism?

Dehydration, acidotic, hypertension

Which children should the nurse identify as exhibiting delay in meeting developmental milestones?

6 year unable to sit still for a short period and 5 year that can't button shirt

Child in autism spectrum, what do you see in this child?

Arm flapping, ritualist behavior

A school age child diagnosed with congenital heart block codes in the ED, the parents witness it and are scared while the resuscitation scene unfolds before them, what is the best nursing intervention?

Ask to sit at the head of bed and touch child's face

An adolescent presents in the ER with confusion and the healthcare provider suspects DKA, a stat serum glucose is done, the result is 715, which should the nurse anticipate upon assessment of the client?

Blurred vision, weak muscle tone, dehydration, dry mucous membranes

Which should the nurse include in a teaching session for the parents of an infant who will be placed in a toddler harness for the treatment of developmental dysplasia ?

Check for skin breakdown

Which is the priority intervention of planning care of an infant when diagnosed with eczema?

Infection

Which pediatric group providing care for a client is at greatest risk for developing separation anxiety?

18 mos

Which child should the nurse refer for further assessment due to problem diagnoses of autism disorder?

4 year old who doesn't make eye with Mother and child interaction

A parent reports their 5 year child who has all recommended immunization, had a fever one week ago and now has bright red cheeks and rash on trunk and arms and which diagnosis does the nurse anticipate with the current data?

5ths disease

Hospitalized 3 year old child needs an IV inserted. The child begins to cry when carried into the treatment room by the mother. Which is the appropriate nursing diagnosis to address this situation?

Anxiety related to anticipated procedure

Which Instructions should be provided to the parents of a four year girl who has experienced chronic UTI in the last two years.

Wipe correctly, drink cranberry juice, urinate often

The toddler pulled a pot of boiling water off the stove and suffered partial and full thickness burns to the chest? Which common complication should the nurse assess for?

Wound Infection (odor, redness)