PEDS EAQ
A 15-month-old child is hospitalized after ingesting toilet bowl cleaner. The mother confides that she feels guilty about leaving the cleaner where her child could get it. What is the best response by the nurse? "Anyone could make a mistake. Don't dwell on it." "Let's not worry about the past. Your child is going to get better." "It was an accident, but you should consider special locks on your closets." "That was careless of you. Please make sure that you poison-proof your house."
"It was an accident, but you should consider special locks on your closets." Describing the incident as an accident and recommending locks on closets accepts the mother's statement and helps the mother express her guilt while providing directions to safeguard her child. Poisoning is not an everyday occurrence; teaching should be incorporated to protect the child. Telling the mother that the child will get better is false reassurance; the child's condition is still in question. Calling the mother careless only increases the mother's guilt and provides nothing more than a vague suggestion of how to remedy the problem.
The parent of a newborn asks a nurse why, except for hepatitis B vaccine, the immunization schedule does not start until the infant is 2 months old. How should the nurse respond? "A newborn's spleen can't produce efficient antibodies." "Infants younger than 2 months are rarely exposed to infectious disease." "The immunization will attack the infant's immature immune system and cause the disease." "Maternal antibodies interfere with the development of active antibodies by the infant when immunized."
"Maternal antibodies interfere with the development of active antibodies by the infant when immunized." Passive antibodies received from the mother will be diminished by age 8 weeks and will no longer interfere with the development of active immunity to most communicable diseases. The spleen does not produce antibodies. Infants often are exposed to infectious diseases. The viruses in immunizations are inactivated or attenuated; they may cause irritability and fever but will not cause the related disease.
How should a nurse respond to parents who are concerned about separation anxiety in their 15-month-old toddler? "This is an expected developmental reaction." "You may be spending too much time with your child." "It might be helpful to leave your child with someone once in a while." "Toddlers who have separation anxiety may have difficulty when they start school."
"This is an expected developmental reaction." Understanding that separation anxiety is an expected developmental occurrence will be reassuring to the parents. Commenting that the parents may be spending too much time with their child is a value judgment and does not address this expected stage of development. Giving advice is not therapeutic and does not address the child's separation anxiety. There is no connection between separation anxiety in a 15-month-old child and difficulty starting school.
Which is a goal for organized athletics for school-age children? A life-long enjoyment of fitness. A physical examination every two years. The use of appropriate safety equipment. Participation in warm-up exercises prior to physical activity.
A life-long enjoyment of fitness. A goal for organized athletics for school-age children is a life-long enjoyment of fitness. A physical examination every two years, the use of appropriate safety equipment, and participating in warm-up exercises prior to physical activity are all safe guards for athletic programs.
A 3-year-old child is admitted to the pediatric unit with a tentative diagnosis of Wilms tumor. The nurse obtains the child's health history from the parents. What does the child's history reveal that will help establish the diagnosis? Periorbital edema Projectile vomiting Abdominal swelling Low-grade temperature
Abdominal swelling Wilms tumor is a nephroblastoma that is first observed as a firm, painless intraabdominal mass located on one side of the abdomen. Periorbital edema is a sign of glomerulonephritis, not Wilms tumor. Projectile vomiting is indicative of central nervous system problems or a gastrointestinal obstruction, not Wilms tumor. A low-grade fever is a nonspecific sign of many illnesses, not necessarily Wilms tumor.
An adolescent displaying low self-esteem complains of inflamed, red, and painful lesions on his forehead. What condition does he have?
Acne vulgaris Acne vulgaris is a common skin problem that adolescents experience. It is an inflammatory manifestation to the proliferation of Propionibacterium acnes. A varicocele is a collection of elongated and twisted superficial veins near the spermatic cord, superior to the testicle. Comedones are noninflammatory lesions.
What is the reason for calculating a body mass index (BMI)-for-age during a health maintenance assessment for school-age clients? Assessing for bulimia nervosa Monitoring for failure to thrive Monitoring for anorexia nervosa Assessing for obesity or overweight
Assessing for obesity or overweight Due to the increasing number of overweight children in the United States, the BMI charts are a critical component of children's physical assessment. BMI-for-age may be used to identify children and adolescents at the upper end of the distribution who are either overweight (at or above 95th percentile) or at risk for being overweight (at or above the 85th percentile and below the 95th percentile). Assessing for bulimia nervosa and anorexia nervosa is more appropriate for an adolescent versus a school-age child. Assessing for failure to thrive (FTT) is more appropriate for the infant, toddler, and preschool-age child.
What is the most appropriate approach for the school nurse to take regarding children who are to be given medications while in school? Assuring the children that their privacy will be respected Teaching each class about taking medications in the school setting Encouraging the children to tell their friends that they are taking a medication Asking teachers to answer questions when other students ask about medications given in school
Assuring the children that their privacy will be respected Children's and adults' confidentiality is protected by privacy laws. Although health classes may address medication as part of its curriculum, the information should be taught on a general, not a personal, level. Children and their teachers should not be encouraged to divulge private information.
A preschool-aged child with leukemia who is undergoing chemotherapy is susceptible to rectal ulcerations. What should the nurse recommend to the parents that will lessen the severity of this problem? Encourage lying on the abdomen when in bed. Have the child wear cotton underpants at night. Apply rectal ointment liberally four times a day. Clean the child's perianal area after each bowel movement.
Clean the child's perianal area after each bowel movement. Meticulous toilet hygiene is essential to prevent infection and promote comfort. Changing positions in bed is preferable. Underpants keep the area moist and promote bacterial growth; it is preferable to leave the area exposed to air, even if it remains under bed linens. Ointments tend to occlude and trap organisms, thus promoting infection.
Which statement describes the latency stage of Freud's psychoanalytic model of personality development? During this stage, genital organs are the focus of pleasure. During this stage, sexual urges are repressed and channeled into productive activities. During this stage, an infant begins to think that his or her parent is separate from the self. During this stage, sexual urges reawaken and are directed to an individual outside the family circle.
During this stage, sexual urges are repressed and channeled into productive activities. During the latency stage, Freud believed that sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable. During the phallic stage, the genital organs are the focus of pleasure. During the oral stage, infants begin to think that the parent is something separate from the self. During the genital stage, sexual urges reawaken and are directed to an individual outside the family circle.
Which Korotkoff sound represents the diastolic blood pressure in an adolescent? First Third Fifth Fourth
Fifth In adolescents, the fifth Korotkoff sound corresponds to the diastolic pressure. The first Korotkoff sound, which is sharp, represents systolic blood pressure, which is heard in all individuals. The third Korotkoff sound is a crisper, more intense tapping. The fourth Korotkoff sound is muffled and low. This sound corresponds to diastolic pressure in the toddler.
The parent of a 5-month-old infant with heart failure questions the necessity of weighing the baby every morning. What does the nurse say that this daily information is important in determining? Fluid retention Kidney function Nutritional status Medication dosage
Fluid retention Fluid retention is reflected by an excessive weight gain in a short period. Inadequate cardiac output decreases blood flow to the kidneys and thus leads to increased intracellular fluid and hypervolemia. Although this assessment may add information to the data regarding kidney function, other assessments, such as hourly urine output, blood urea nitrogen concentration, and creatinine level more significantly reflect kidney function. Weight gain resulting from nutritional intake is gradual and will not vary greatly on a day-to-day basis. Although weight is used to determine medication dosages, dosages do not need to be recalculated according to changes in daily weights.
What is the maximum recommended length for enema tube insertion in an adolescent? Record your answer using a whole number.
In adolescents, the maximum length for insertion of an enema tube is 10 cm.
A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend? Ear drops Myringotomy Mastoidectomy Steroid therapy
Myringotomy Myringotomy is a surgical opening into the eardrum to permit drainage of accumulated fluid associated with otitis media. Ear drops are not used because they will obscure the view of the tympanic membrane. Removal of the mastoid will not relieve pressure within inflamed ears. Antibiotics, not steroids, are used for an infectious process.
Which of these statements about the transition from intrauterine to extrauterine life is true? Hyperthermia is observed in the newborn. Newborns are susceptible to heat loss and cold stress. Apgar assessments are conducted 5 and 10 minutes after birth. Physiological changes in the newborn occur during the first 12 hours of life.
Newborns are susceptible to heat loss and cold stress. During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.
Which stage of the development should the nurse document for an infant when using Freud's theory of psychosexual development? Oral Anal Phallic Latent
Oral According to Freud, an infant is in the oral stage of development. The toddler is in the anal stage of development. The preschool-age child is in the phallic stage of development. The middle childhood client is in the latent stage of development.
The parent of a 4-week-old boy reports, "He cries all the time and always acts hungry, but he throws up everything. He looks like a skinny old man." In light of this information, what is the focus of the nurse's assessment? Inspecting the anus to confirm rectal prolapse Obtaining the elimination history to confirm celiac disease Noting the color of vomitus to confirm a bile duct obstruction Palpating the abdomen to confirm hypertrophic pyloric stenosis
Palpating the abdomen to confirm hypertrophic pyloric stenosis With a history that strongly suggests hypertrophic pyloric stenosis (HPS), the nurse should assess the abdomen for an olive-shaped mass and visible peristalsis. The data presented are not consistent with rectal prolapse. The data are not consistent with celiac disease, which involves diarrhea resulting from a reaction to gluten; the infant is too young to have ingested grains. Although the color of vomitus is important for a diagnosis of HPS, bile duct obstruction is not indicated by the history.
Which stage describes the Oedipus complex, according to Freud's theory? Stage 2 Stage 3 Stage 4 Stage 5
Stage 3 According to Freud's theory, there are five stages in a child's development. Stage 3 is the Oedipal stage, which is also known as the phallic stage. Stage 2 is the anal stage. Stage 4 is the latency stage. Stage 5 is the genital stage.
To prevent skin breakdown on the scalp of an infant with hydrocephalus, how should the nurse position the infant? On either side and flat Supine and Trendelenburg Prone, with the legs elevated about 30 degrees Supine, with the head elevated about 45 degrees
Supine, with the head elevated about 45 degrees The head should be elevated, allowing gravity to minimize intracranial pressure. The Trendelenburg position is contraindicated because it can increase intracranial pressure. The infant may be positioned on the back or side to allow routine changes in head position.
Which description provided by the parent of a preschool-age client would suggest to the nurse that the child is experiencing sleep terrors? Sweating profusely Calling out after a dream Awakening during the second half of the night Being aware that others are in the room after awakening
Sweating profusely Profuse sweating is a characteristic that would cause the nurse to believe that the child is experiencing a sleep terror versus a bad dream. Calling out after the dream is over, awakening during the second half of the night, and being aware that others are with them after the dream is over are characteristics associated with a bad dream, not a sleep terror.
What is true about the preoperational period of Piaget's theory? The child develops a scheme for dealing with the environment. The child is able to describe a process without actually doing it. The child has the capacity to reason with respect to possibilities. The child believes that everyone experiences the world exactly as he or she does.
The child believes that everyone experiences the world exactly as he or she does. According to Piaget's theory, children believe that everyone experiences the world exactly as they do during the preoperational period. Children develop a scheme for dealing with the environment during the sensorimotor period. Children are able to describe a process without actually doing it during the concrete operations period. Children have the capacity to reason with respect to possibilities during the formal operations period.
A nurse is obtaining the health history of a 5-year-old child who has been admitted to the child health unit with acute glomerulonephritis. What does the nurse expect the child's mother to report? The child had a sore throat a few weeks ago. The child has just recovered from the measles. The child's father has a family history of urinary tract infections. The child's immunizations were administered at the start of school.
The child had a sore throat a few weeks ago. Acute poststreptococcal glomerulonephritis (APSGN) is associated with a history of streptococcal infection of the throat. The measles virus is not associated with the development of APSGN. APSGN is not an inherited disease. No immunizations can cause glomerulonephritis.
A nurse is teaching the parents of a school-aged child with celiac disease about the nutrients that must be avoided in a gluten-free diet. What nutrients should the nurse teach the parents to avoid? Saturated oils and fats Milk and hard cheeses Corn and rice products Wheat and oat products
Wheat and oat products Wheat, oats, rye, and barley are major dietary sources of gluten; the gliadin fraction of these grains is not tolerated by individuals with celiac disease. There is no gluten in oils and fats. There is no gluten in cheeses and milk. Corn and rice are used as substitute grains because they do not contain gluten.