peds chapter 50 and 49

27. The nurse is assessing a 2-day-old newborn and suspects Down syndrome based on which of the following? Select all answers that apply.

A) Flat facial profile

The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions?

Attention deficit/hyperactivity disorder

8. The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?

C) Grieving related to the child's poor prognosis

The nurse is caring for a 13-year-old boy with a history of inappropriate behavior.Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder?

"He has frequent temper tantrums."

The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability?

"He seems to be speaking words less and less frequently."

After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state which of the following?

"If he misbehaves, we need to punish him instead of reward him."

The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching?

"Just because his friends are experimenting does not mean that he will."

A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. Which of the following would the nurse include when teaching the child and his parents about this drug?

"Take this drug every day in the morning when you wake up."

The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate?

"You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea."

A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. Which of the following would the nurse identify as characteristic of this disorder? Select all answers that apply.

- Truancy - Arrest for arson - Initiator of physical fights

3. The nurse is caring for 3-day-old girl with Down syndrome whose mother had no prenatal care. Which of the following will be the priority nursing diagnosis?

A) Imbalanced nutrition, less than body requirements related to the effects of hypotonia

A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, which of the following would the nurse include as being involved? Select all answers that apply.

A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity

11. When teaching a class about trisomy 21, the instructor would identify this disorder as due to which of the following?

A) Nondisjunction

15. Which of the following would lead the nurse to suspect that a child has Turner syndrome?

A) Webbed neck

20. A group of students are reviewing information about major and minor congenital disorders. The students demonstrate understanding of the information when they identify which of the following as a minor disorder?

A) Webbed neck

A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply.

Allowing for breaks when tics occur, Using a tape recorder to take notes

10. The nurse is teaching a couple about X-linked disorders. They are concerned that they might pass on hemophilia to their children. Which of the following responses indicates the need for further teaching?

B) "If the father doesn't have it, then his kids won't either."

5. The nurse is teaching the parents of a 1-month-old girl with Down syndrome how to maintain good health for the child. Which instruction would the nurse be least likely to include?

B) Adhering to the special dietary needs of the child

19. When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, which of the following would be the highest priority?

B) Establishing a trusting relationship

18. When teaching the parents of a child with phenylketonuria, the nurse would instruct them to include which of the following foods in the child's diet?

B) Oranges

4. The nurse is assessing a 4-year-old boy whose mother was 40 years old when he was born. Which of the following findings suggests this child has a genetic disorder?

C) Inspection reveals low-set ears with lobe creases.

21. The nurse is assessing an infant and notes that the infant's urine has a musty odor. Which of the following would the nurse suspect?

C) Phenylketonuria

Which of the following would lead the nurse to suspect that an adolescent has bulimia?

Calluses on back of knuckles

A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy?

Cognitive therapy

6. The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. Which of the following would be most important for the nurse to incorporate into the plan of care when working with this family?

D) Presenting the information in a nondirective manner

14. When providing guidance to the parents of a child with Down syndrome, which of the following would be most appropriate?

D) Teach the parents about the need for a high-fiber diet.

A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. Which of the following would be most important for the nurse to do first?

Encourage a discussion of the child's thoughts and feelings

A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. Which of the following would the nurse be least likely to include?

Focus the child's attention on the negative behavior.

The nurse is caring for an adolescent girl with anorexia nervosa. Which of the following findings would indicate to the nurse that the girl requires hospitalization?

Food refusal

A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign?

Inability to say a single word by 16 months

When reviewing the medical record of a child, which of the following would the nurse interpret as the most sensitive indicator of intellectual disability?

Language delay

A school-age child diagnosed with depression is receiving antidepressant therapy. The nurse would instruct the parents to notify the physician immediately if the child demonstrates which of the following?

Loss of interest

The nurse is reviewing the medical record of a child who has dyspraxia. The nurse understands that this child experiences difficulty with which of the following?

Manual dexterity and coordination

The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason?

Minimize stimuli that exacerbate the child's undesired behaviors

A child is prescribed trazodone. Which of the following would the nurse be least likely to include in the plan of care related to this drug?

Monitoring for tardive dyskinesia

When assessing the adolescent with anorexia, which of the following would the nurse expect to find?

Murmur

The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which of the following?

Obsessive-compulsive disorder

A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist specializing in which type of therapy?

Play therapy

A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs?

Selective serotonin reuptake inhibitor

The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which of the following?

Sensory integration dysfunction

A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which of the following as an indicator of possible child abuse?

Sexual behavior that correlates with the child's developmental age