Peds practice questions test 2
The child and mother are receiving discharge instructions from the nurse. Which statements by the child's mother are "red flags" that the mother has poor health literacy skills? SATA A) I forgot my glasses today and can't seem to read this form B) I'm going to take some notes while you're teaching us C) The receptionist told me that we missed another appointment D) I guess I just forgot to give her the medication the way you told me to E) I'm going to take these instructions home to read them
A, C, D, E
The nurse is educating the parents of a 5 month old how to administer an oral antibiotic. Which response indicates a need for further teaching? A) We can mix the antibiotics into his formula or food B) We can follow his medicine with some applesauce or yogurt C) We can place the medicine along the inside of his cheek D) We should not forcibly squirt the medication in the back of his throat
A
The nurse is preparing to administer a medication via a syringe pump as ordered for a 2 month old girl. Which is a priority nursing action? A) Gather the medication B) Verify the medication order C)Gather the necessary equipment and supplies D) Wash hands and put gloves on
B
The nurse is examining a child with fetal alcohol syndrome. Which assessment finding should the nurse expect? A) Macrocephaly B) Low nasal bridge with short upturned nose C) Clubbing of fingers D) Short philtrum with thick upper lips
B (FAS includes: low nasal bridge with short upturned nose, flattened midface, long filtrum with narrow upper lip, microcephaly)
The physician ordered 70 mg PO every 4 hours for fever & discomfort. Calculate the correct dose for the child based on the recommended dosing for Tylenol of 10-15 mg/kg every 4-6 hours. Child weighs 6.80 kg. Is the physician's order safe & therapeutic?
68 mg/kg- 102 mg/kg Safe (6.8 kg x 10mg= 68 & 6.8kg x 15 mg=102)
The infant was born at 32 weeks gestation and is now 9 months old. What is the infants corrected age?
7 months (40 weeks minus 32 weeks= 8 weeks aka 2 months, subtract 2 from 9 months)
The nurse is preparing to administer medication to a 10 year old girl who weighs 32 kg. The prescribed single dose is 3-4 mg/kg/day. What is the dose range that is appropriate for this child?
96-128 mg (32kg x 3= 96; 32kg x4= 128)
The nurse is caring for a 15 year old boy with cystic fibrosis. Which intervention will help avert risky behavior? A) Assessing for signs of depression B) Encouraging participation in activities C) Monitoring compliance with treatment D) Urging that he join a support group
C (The child may be struggling to fit in with his peers by avoiding his treatment regimen in an effort to hide his illness. Monitoring his compliance would disclose this risky behavior.)
Substances that modify the perception of pain
Neuromodulators
Pain due to the activation of the A delta fibers and C fibers by noxious stimulant
Nociceptive pain
The nurse is preparing to assess the pain of a developmentally and cognitively delayed 8 year old. Which pain rating scales should the nurse choose? A) FACES B) Word-graphic C) APPT D) Visual analog and numerical scale
FACES
Which age group would you use a soothing voice?
Infants
Which age group would you prepare the child just before the procedure?
Preschoolers
Which age group would you use diagrams and illustrations?
School aged
Pain that develops in the tissues
Somatic pain
Which age group would you use storytelling and play?
Toddlers
Process of nociceptor activation
Transduction
The 18 month old toddler has been brought into the pediatricians office by his parents. The nurse interviews the parents regarding the child's abilities. Which findings are warning signs that the toddler may have autism spectrum disorder? SATA A) Has never "babbled" B) Does not exhibit attempts to communicate by pointing to objects C) Does not use any words D) Does not speak in short sentences E) Cannot stand on tiptoe
A, B, C
The nurse is preparing to educate the child about a procedure scheduled for the following morning. Which techniques should the nurse use when communicating with this child? SATA A) standing at the foot of the bed while teaching the child B) using terms the child will likely understand C) Looking for nonverbal cues D) Requesting the parents leave the room during education E) Being patient with the child
B, C, E
The nurse is caring for the a 14 year old girl with terminal cancer and her family. Which intervention provides best therapeutic communication? A) Recognizing the parents desire to use all options B) Supporting the child's desires for treatment C) Presenting options for treatment D) Informing the child in terms she can understand
D
The nurse is assessing the teaching needs of the parents of an 8 year old boy with leukemia. Which assessment should the nurse explore as a potential issues with the parents health literacy? A) The parents missed the last scheduled appointment B) The entire family is fluently bilingual C) The parents are taking notes on answers to their questions D) The mother seems to ask the most of the questions regarding care
A (Red flags include: Difficulty filling out forms, incomplete forms or incorrect & inaccurate forms Frequently missed appointments Noncompliance and lack of follow-up with treatment regimens Hx of medication errors Responses such as "I forgot my reading glasses" or "I'll read that when I get home" Inability to answer common questions about their treatment or medications Avoiding asking question for fear of looking "stupid")
The parents of an adolescent are concerned about his mental health and have brought the adolescent into the office. Which statement by the parents indicate that the child may have a mental health disorder? SATA A) He has started sleeping for only 3 hours each night B) He has lost 10 pounds over the last 4 months C) He hangs our with the same kinds he always has D) He used to be a straight A student and now he's bringing home C's and D's E) He still enjoys playing a lot of baseball
A, B, D (may also be changes in friendship groups and extracurricular activities)
The nurse is teaching a 7 year old boy about his upcoming tonsillectomy. Which techniques would be appropriate for this child? SATA A) Allowing the child to do as much self care as possible B) Explaining the procedure that will happen later in the day C) Offering choices of drinks and gelatin after the procedure D) Explaining that anesthesia is a lot like falling asleep E) Using play or puppets to help explain the procedure
A, C, D
The child life specialist has been assigned to assist the hospitalized child and the child's parents. Which interventions are appropriate for the CLS to perform? Select all that apply A) Talking to the family about the scheduled diagnostic test B) Giving the child a flu vaccination C) Starting the child's IV line D) Showing the child where the pediatric play room is located E) Speaking to the physician as the child's advocate
A, D, E
What age group would you define medical words as necessary?
Adolescents
The nurse is caring for a 14 year old boyd, and his parents, who has just been diagnosed with a malignant tumor on his liver. Which intervention is most important to this child and his family? A) arranging an additional meeting with the NP B) discussing treatment options with the child and parents C) involving the child and family in decision making D) describing postoperative home care for the child
C
The nurse is caring for a 5 year old child who underwent a painful surgical procedure earlier in the day. The nurse notes the child has not reported pain to any of the nursing staff. Which action by the nurse is indicated? A) Contact physician to report the child's condition B) Administer prophylactic analgesics C) Observe for behavioral cues consistent with pain D) Encourage the child to report pain
C (Children may underreport pain. The may assume that adults know how they are feeling or they may feel worried about appearing to lose control.)
The nurse is caring for a family and 9 year old boy with cerebral palsy. Which intervention will best improve communication between the nurse and the family? A) Giving direct, understandable answers B) Sharing cell phone numbers with the parents C) Using reflective listening techniques D) Saying the same thing in a different way
C (Reflective language shows the parents that their input is heard and valued.)
The child has been diagnosed with vulnerable child syndrome. Which statements by the child's parent are associated with the presence of this syndrome? SATA A) I discipline all three of my kids very fairly B) He was always a sweet and happy baby C) For the first few weeks of his life, he was so yellow I was afraid he would glow D) When she was a toddler she developed meningitis and the doctors told me they didn't think she would make it E) She was born with a cleft lip and palate I was so afraid she wasn't getting enough formula
C, D, E
It is difficult for the father of a technology dependent 7 year old girl to leave his work. Which nursing intervention would best involved him family-centered care? A) Leave a voicemail for the father at work B) Email a status report to the fathers office C) Urge the father to come to the hospital at lunch D) Schedule education sessions in the evening
D
The school aged child has been diagnosed with dysgraphia and dyslexia. Which tasks shoulder this child find difficult? SATA A) Hopping on one foot B) Adding and subtracting C) Jumping rope D) Writing words E) Spelling his name
D, E (have difficulty with reading, writing, spelling and producing written words)
Inhibition of prostaglandin synthesis
Ibuprofen
A nurse is caring for a child who requires IV fluid maintenance fluid. The child weighs 30 kg. What is the child's daily maintenance fluid requirement?
1,700 mL (10 x 100 mL= 1,000 ml; 10 x 50mL= 500 mL; 10 x 20 mL= 200; total 1,700)
The nurse is planning the care of a 5 year old child with developmental disabilities whose weight is on the 12th percentile for age. The care team and the child's parents have agreed that interventions are necessary. Which intervention should be added to the plan of care? A) Encourage the parents to maintain a detailed log of the child's food & fluid intake B) Facilitate insertion of TPN C) Allow the child to choose which foods to eat and which food to reject D) Encourage the family to provide a low fat, high carb diet
A
Age affects how the medication is distributed throughout the body. Which factors affect how medication is altered in infants and young children? SATA A) Infants and young children have an increased percentage of water in their bodies B) Infants and young children have an increased percentage of body fat C) Have increased number of plasma protein available for binding to drugs D) The livers of infants and young children are immature
A, D
The infant was born preterm. Which assessment findings may indicate that the child is suffering from a medical condition associated with being born preterm? SATA A) The child's parents stated the child began losing baby teether earlier than their other children B) The child's hearing is not WNL and the child requires a hearing aid C) The child eyes deviate inward D) The child is noted to be above the 95th percentile for height and at the 85th percentile for weight E) The child started speaking multiword sentences at 18 months old
B, C (Hearing deficits and strabismus are associated with being preterm)
EMLA cream should be applied ________ minutes before superficial procedure such as a heel stick or venipuncture.
60
The child has been hospitalized for failure to thrive. The child weighs 23.2 kg. The child is to receive 120 kcal/kg of weight per day. How many kcal should the child eat each day?
2784 kg (23.2 kg x 120 kcal)
The child has been diagnosed with a mental health disorder and the child's parents are beginning to incorporate behavior management techniques. Which statements by the child's parent indicate the need for further education? SATA A) I use a higher pitched voice when I communicate with her B) I am quick to point out the things that she does that make me crazy C) We have set some boundaries that are nonnegotiable D) We tell her when she is doing something well E) We're trying to make her accountable and responsible for her own behavior
A, B (Should use low pitched voices and should ignore inappropriate behaviors)
A nurse is caring for a 10 year old intellectually challenged girl hospitalized for a scheduled cholecystectomy. The girl expresses fear related to her hospitalization and unfamiliar surroundings. How should the nurse respond? A) Don't worry, you will be going home soon. B) Tell me about your typical day at home. C) Have you talked to your parents about this? D) Do you want some art supplies?
B
A nurse is caring for a 4 year old child who is exhibiting extreme anxiety and behavior upset prior to receiving stitches for a deep chin laceration. Which nursing intervention is priority? A) Ensuring the emergency equipment is readily available B) Serving as an advocate for the family to ensure appropriate pharmacologic agents are chosen C) Conducting an initial assessment of pain to serve as a baseline from which options for relief can be chosen D) Ensuring the lighting is adequate for the procedure nut not so bright to cause discomfort
B
A nurse is educating the parents how to administer daily oral medication to their 5 year old boy. Which response indicates a need for further teaching? A) I should never refer to the medicine as candy B) We should never bribe our child to take the medicine C) He needs to take his medicine or he will lose a privilege D) We checked that the medicine can be mixed with yogurt or applesauce
C
A ____________ nurse practioner helps ensure that children and families receive atraumatic care
Child life
Conscious sedation is medically controlled state of ___________ consciousness
Depressed
Situated within the spinal canal, on or outside the dura mater
Epidural
The nurse is preparing to assess the post-surgical pain level of a 6 year old boy. The child has appeared unwilling or unable to accurately evaluate his pain level. Which assessment tool is most appropriate for this child?
FLACC behavioral scale
Direct action of hypothalamic heat regulating center
Acetaminophen
Two of the most common used agents for conscious sedation are __________ and __________.
Midazolam & fentanyl
The nurse is caring for a 3 year old boy who must have a lumbar puncture. Which action provides the greatest contribution toward atraumatic care? A) Having a child life specialist play with the child B) Explaining the lumbar puncture procedure C) Letting the child take his teddy bear with him D) Keeping the parents calm in front of the child
A
A nurse is interviewing the mother of a sleeping 10 year old girl to assess the level of the child's postoperative pain. Which comment should trigger additional questions and necessitate further teaching? A) She's asleep, so she must not be in pain B) She has never had surgery before C) She is very articulate and will tell you how she feels D) She has a very easygoing temperament
A (Just because the girl is asleep doesn't mean she's not in pain. It could be a coping strategy or reflect excessive exhaustion due to coping with pain.)
A 6 month old girl is significantly underweight. Which of assessment finding points to an inorganic cause of failure to thrive? A) Infant refuses nipple B) Child avoids eye contact C) Premature birth D) Risk factors in health history
B (Watching the interaction between mother and child to see if the child maintains eye contact may indicate that child is being neglected which is an inorganic cause for FTT)
The nurse is preparing to remove an IV from the arm of a 6 year old girl. Which approach is best for minimizing fear and anxiety? A) This won't be painful; you'll just feel a tug and a pinch B) The first step is for you to help me remove this dressing from your IV C) Be sure to keep your hands clear of the scissors so I don't cut you D) Please be a big girl and don't cry when I remove this
B (gives child feelings of control and involves them in their care)
The child has been admitted to a pediatric unit in a hospital. Which nursing intervention use atraumatic care principles? SATA A) Requesting parents assist the nurse by "holding the child down" B) Applying numbing cream prior to starting the child's IV C) Asking the child if he would like to take a bath before or after he takes his medication D) Showing the parent how to unfold the chair to make it a bed
B, C, D, E
A nurse is providing a routine wellness check up and follow up with a 3 year old recently diagnosed with autism spectrum disorder. Which response indicates a need for additional referral or follow up? A) We have recently completed his individualized education plan B) We really like the treatment plan that has been created by his school C) We try to be flexible and change his routine from day to day D) We have a couple of babysitters who know how to handle his needs
B
The nurse is conducting a well-child assessment of a 3 year old. Which statement by the parents would warrant further investigation? A) He spends a lot of time playing with his little cars B) He spends hours repeatedly lining up his cars C) He is very active and keeps very busy D) He would rather run around than sit on my lap and read a book
B
The nurse is educating a 15 year old girl with Graves disease and her family about the disease and its treatment. Which method of evaluating learning is least effective? A) Having the child demonstrate skills B) Asking closed-ended questions C) Requesting the parent teach the child skills D) Setting up a scenario for them to talk through
B
Opioid agonist acting primarily at u-receptor sites
Morphine