Peds Exam 6

The nurse cares for multiple clients planning to have children. Which client will the nurse identify as priority for needing a referral for prenatal genetic testing? a.) A male client with family history of sickle cell disease b.) A male client who is 45 years of age c.) A female client diagnosed with diabetes mellitus d.) A female client who is 38 years of age

a.) A male client with family history of sickle cell disease

A pediatric nurse is discussing accident prevention with a group of new parents. Which of the following are leading causes of mortality and morbidity in children? Select all that apply. a.) Falls b.) Burns c.) Accidental poisoning d.) Drowning e.) Complications of medical care

a.) Falls b.) Burns c.) Accidental poisoning d.) Drowning

The nurse prepares to assess the circulation status of a toddler in the emergency room following a near-drowning. What would the nurse specifically assess? Select all that apply. a.) apical and femoral pulse b.) tympanic or rectal temperature c.) respiration rate d.) heart rate via cardiac monitor e.) skin color and temperature f.) level of consciousness

a.) apical and femoral pulse e.) skin color and temperature f.) level of consciousness

The nurse is working with a family as they make decisions regarding their newborn's care following the diagnosis of a serious genetic disorder. What response by the nurse would be appropriate? a.) "What are some advantages and disadvantages of the decisions you are making for the baby?" b.) "Requesting input from your extended family will likely complicate your ability to make decisions." c.) "My niece has the same disorder so I can tell you what I think you should do about it." d.) "Are you sure your doctor has enough experience to help you care for your child?"

a.) "What are some advantages and disadvantages of the decisions you are making for the baby?"

A parent is observing a nurse provide care for the parent's 2-year-old toddler who was burned in a house fire. When the nurse is finished, the parent tells the nurse "I cannot believe this has happened. I should have been able to prevent this from happening." What is the best action for the nurse to take? a.) Encourage the parent to talk more about feelings. b.) Tell the parent he or she could not have prevented the fire .c.) Tell the parent to be thankful that the child is alive. d.) Give the parent a hug.

a.) Encourage the parent to talk more about feelings.

A nurse correctly identifies which data as needing to be obtained from an injured child in relation to his or her respiratory status? Select all that apply. a.) Skin color b.) Quality of respirations c.) Sound of obstruction d.) Pulse rate e.) Rate of respirations

a.) Skin color b.) Quality of respirations c.) Sound of obstruction e.) Rate of respirations

A child, accompanied by a parent, is brought to the emergency department after sustaining an injury from a fall. The nurse is assessing the child. Which question is important for the nurse to ask the parent first? a.) "What time did the injury occur?" b.) "How did your child get hurt?" c.) "Did your child lose consciousness?" d.) "Does your child have any allergies?"

b.) "How did your child get hurt?"

A client asks about a child inheriting an autosomal recessive disorder. What must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance? a.) One parent must have the disease. b.) Both parents must be carriers. c.) One parent, usually the mother, must be a carrier. d.) One parent, usually the father, must not be a carrier or have the disease.

b.) Both parents must be carriers.

During a home visit, a nurse determines that a child is experiencing psychological maltreatment based on which action by the parent? a.) The child is asked to play a song on the piano for the nurse. b.) The child is belittled in front of the nurse and older brother. c.) The child is punished for crossing the street without assistance. d.) The child is scolded for playing with matches.

b.) The child is belittled in front of the nurse and older brother

The nurse is caring for a family making end-of-life decisions for their child. How will the nurse educate the parents as to what is involved in end-of-life care? a.) The staff will complete care when parents request. b.) The focus of care will be on the comfort of the child. c.) The parents will be able to do complete care for child. d.) The child will be placed in hospice so the child is not alone.

b.) The focus of care will be on the comfort of the child.

A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify what common causes of respiratory arrest involving the upper airway? Select all that apply. a.) pertussis b.) epiglottitis c.) pneumothorax d.) croup e.) asthma

b.) epiglottitis d.) croup Common causes of respiratory arrest involving the upper airway include croup and epiglottitis. Asthma, pertussis, and pneumothorax are common causes involving the lower airway.

A child has been diagnosed with medical abuse by his mother. When setting goals, which goal is highest priority? a.) obtaining treatment for the mother b.) establishing the safety of the child c.) psychotherapy for the unaffected children in the family d.) therapy for the child

b.) establishing the safety of the child

A child, accompanied by a parent, is brought to the emergency department after sustaining an injury from a fall. The nurse is assessing the child. Which question is important for the nurse to ask the parent first? a.) "Did your child lose consciousness?" b.) "What time did the injury occur?" c.) "How did your child get hurt?" d.) "Does your child have any allergies?"

c.) "How did your child get hurt?" As part of the assessment, it is most important for the nurse to find out how the child was hurt, which will provide information on the type of injury. This will allow the nurse and other health care providers to prioritize interventions and treatments. Once the nature of the injury is determined, the nurse can inquire about the timeline, whether there was loss of consciousness, and the existence of medication allergies.

The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best? a.) "How could this accident have happened with you both there?" b.) "You must be so scared right now...especially since you were the one driving." c.) "I am here to answer your questions and be with you during this difficult time." d.) "I know this is overwhelming, but I want you to know he will be OK."

c.) "I am here to answer your questions and be with you during this difficult time."

The nurse is talking with the parents of a dying child. The child's mother confides she is afraid to be with her child at the time of death. Which response by the nurse is appropriate? a.) "If you cannot handle being present, your child will understand." b.) "If you need to leave your child at the time of death that will be fine." c.) "These fears are not uncommon." d.) "You will need to find a way to overcome this obstacle for your child."

c.) "These fears are not uncommon."

The nurse has administered IV adenosine as prescribed to a child with supraventricular tachycardia. Which action would the nurse do next? a.) Set up a continuous infusion for administration of adenosine. b.) Give five positive-pressure ventilations. c.) Administer a rapid, generous saline flush. d.) Monitor for ventricular arrhythmias.

c.) Administer a rapid, generous saline flush.

After interviewing the mother of a newborn and observing her actions, the nurse suspects that the newborn may be at risk for maltreatment. Which assessment finding would support the nurse's suspicion? a.) Mother helps to undress the newborn for the physical examination. b.) Mother quickly changes a dirty diaper using supplies from her diaper bag. c.) Mother fails to make eye contact with the newborn throughout the interview. d.) Mother reports that the father helps with feedings during the night.

c.) Mother fails to make eye contact with the newborn throughout the interview.

What is the main purpose of nurses having basic genetic knowledge? a.) to ensure proper medical diagnosis b.) to understand all genetic disorders, allowing for improved quality of life c.) to provide support and education to families d.) to advocate for a cure for genetic disorders

c.) to provide support and education to families

The student nurse is preparing a presentation on emergency care of the child. Determine the correct order of the American Heart Association's pediatric chain of survival that the student nurse should include.

1.) Prevention of cardiac arrest and injuries 2.) Early CPR 3.) Early access to emergency response system 4.) Early advanced care (pediatric advanced life support [PALS]) 5.) Integrated post-cardiac arrest care

A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement? a.) "A definitive cause can be found for every developmental disorder." b.) "Families should work to facilitate the child's progress." c.) "Families should not be blamed for causing a developmental delay." d.) "Families should be helped to accept the child's developmental delay."

a.) "A definitive cause can be found for every developmental disorder."

The parents bring their 3-year-old child to the emergency department after ingesting some of the parent's morphine liquid prescription. Which nursing assessment is the priority? a.) auscultating all lung fields for signs of edema b.) obtaining a complete set of vital signs c.) evaluating the child's mental status, skin moisture, and skin color d.) noting the child's pulse rate and quality

c.) evaluating the child's mental status, skin moisture, and skin color In cases of poisoning, clinical manifestations vary widely depending on the medication or chemical ingested. Therefore, it is important to place attention on the child's mental status, skin moisture/skin color, and bowel sounds. Mental status change, cold clammy skin, pallor, and/or cyanosis are classic signs of opiate overdose. Evaluating the effectiveness of the child's breathing and noting the child's pulse rate and quality are basic to any rapid cardiopulmonary assessment. Obtaining a full set of vital signs is important, but this can be obtained after mental status, skin color, and skin moisture have been checked. Auscultating all lung fields for signs of pulmonary edema would be critically important for a child who is a near-drowning victim.

The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? a.) "The handles of pots on the stove should face inward." b.) "We will leave fireworks displays to the professionals." c.) "All sleepwear should be flame retardant." d.) "I will set our water heater at 130°F (54°C)."

d.) "I will set our water heater at 130°F (54°C)." If the temperature of the water heater is set at 130°F (54°C) degrees, a child can be burned significantly in only 30 seconds. The recommended maximal home hot water heater temperature is 120°F (49°C) degrees.

When caring for a child newly diagnosed with special needs, which nursing action is priority? a.) Setting up respite care for the caregivers. b.) Explaining the diagnosis to the caregivers. c.) Providing resources for the family. d.) Answering the caregiver's questions.

d.) Answering the caregiver's questions. Answering questions and providing education to the caregivers is the priority to prevent unrealistic expectations of the child and the health care system. Accurate, kind explanations given promptly help to promote a more positive environment for all involved. The nurse will supplement education on the diagnosis as needed as this should have already been discussed with the primary health care provider who made the diagnosis. The nurse will also provide any resource material the family needs. Respite care may be needed once the caregivers feel fatigued.

A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be? a.) Remove the child's clothing to assess for injury. b.) Begin circulation/cardiac assessment and count the pulse. c.) Update the parent and obtain consent to treat. d.) Assess the child's airway and manage airway patency.

d.) Assess the child's airway and manage airway patency.

The parents of a 9-year-old girl who is dying from cancer are distraught and guilt-ridden when they find that treatment is no longer successful. What is the best way for the nurse to respond? a.) Ask the parents if they wish to fill out a do-not-resuscitate order. b.) Explain that it is not fair to the child to continue present treatment. c.) Tell the parents there is no more that can be done. d.) Assure the parents that expert care of their child will continue.

d.) Assure the parents that expert care of their child will continue.

Upon assessment, the nurse notices that the infant's ears are low-set. What is the priority action by the nurse? a.) Inform the parents that low-set ears are a sign of Down syndrome. b.) Give a vitamin B12 injection to combat the metabolic disorder. c.) Place the infant on a cardiac monitor. d.) Continue to assess the infant to look for other abnormalities.

d.) Continue to assess the infant to look for other abnormalities.

A hospitalized child has suddenly stopped breathing. The nurse opens the child's airway and assesses the child's pulse. The nurse will begin cardiopulmonary resuscitation (CPR) when which symptom is present? a.) The airway is not patent. b.) The respiratory rate is 8 breaths/min. c.) There is no respiratory effort. d.) The heart rate is 60 beats/min or lower.

d.) The heart rate is 60 beats/min or lower.

Which findings would alert the nurse to the risk for vulnerable child syndrome developing during a family assessment? a.) The child was born almost 2 weeks after the expected due date b.) The child eats well and has a good appetite c.) The parent indicate the child is their third child, following a set of twins d.) The parent reports a near drowning when the child was 18 months old

d.) The parent reports a near drowning when the child was 18 months old