Quiz 5: Caring for Children

A nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. Which of the following are manifestations of rhabdomyosarcoma? (Select all that apply.) A. Enlarged neck lymph nodes B. Pain C. Vomiting D. Epistaxis E. Diplopia

A. CORRECT: Palpable neck lymph nodes are a manifestation of rhabdomyosarcoma of the nasopharynx. B. CORRECT: Pain is a manifestation of rhabdomyosarcoma of the nasopharynx. D. CORRECT: Epistaxis is a manifestation of rhabdomyosarcoma of the nasopharynx.

A nurse is caring for a child who has contact dermatitis due to poison ivy. Which of the following actions should the nurse take? (Select all that apply.) A. Remove the clothing over the rash. B. Initiate contact isolation precautions while the rash is present. C. Expose the rash to a heat lamp for 15 min. D. Cleanse the affected skin with hydrogen peroxide solution. E. Apply calamine lotion to the skin.

A. CORRECT: Removing the irritant from the skin will decrease the child's exposure. The nurse should remove the clothing over the affected area. E. CORRECT: The nurse should apply calamine lotion to assist in relieving discomfort.

A nurse is caring for a 10‑year‑old child who has nephrotic syndrome. Which of the following findings should the nurse report to the provider? A. Serum protein 5.0 g/dL B. Hgb 14.5 g/dL C. Hct 40% D. Platelet 200,000 mm3

A. CORRECT: Serum protein 5.0 g/dL is out of the expected reference range for a 10‑year‑old child and should be reported to the provider.

A nurse is assessing a child who has a urinary tract infection. Which of the following are manifestations of a urinary tract infection? (Select all that apply.) A. Night sweats B. Swelling of the face C. Pallor D. Pale‑colored urine E. Fatigue

B. CORRECT: Swelling of the face is a manifestation in child who has a urinary tract infection. C. CORRECT: Pallor is a manifestation in child who has a urinary tract infection. E. CORRECT: Fatigue is a manifestation in child who has a urinary tract infection.

A nurse is caring for a child who has short stature. Which of the following diagnostic tests should be completed to confirm growth hormone (GH) deficiency? (Select all that apply.) A. CT scan of the head B. Bone age scan C. GH stimulation test D. Serum IGF‑1 E. DNA testing

A. CORRECT: A CT scan of the head is conducted to determine whether there is a structural component to the short stature. B. CORRECT: A bone age scan is conducted to determine the development of the bones. C. CORRECT: A GH stimulation test is conducted to confirm diagnosis of GH deficiency. D. CORRECT: A serum IGF‑1 is obtained as a preliminary test to determine GH deficiency.

A nurse is assessing a child who has rhabdomyosarcoma of the upper arm. Which of the following findings should the nurse expect? (Select all that apply.) A. Pain B. Discoloration of the skin C. Lymph node enlargement D. Easy bruising E. Palpable mass

A. CORRECT: Pain is an expected finding in a child who has rhabdomyosarcoma. C. CORRECT: Lymph node enlargement is an expected finding of rhabdomyosarcoma of an extremity. E. CORRECT: Palpable mass is an expected finding of rhabdomyosarcoma of an extremity.

A nurse is reviewing sick‑day management with a parent of a child who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Monitor blood glucose levels every 3 hr. B. Discontinue taking insulin until feeling better. C. Drink 8 oz. of fruit juice every hour. D. Test urine for ketones. E. Call the provider if blood glucose is greater than 240 mg/dL.

A. CORRECT: A client who is experiencing illness can have waning blood glucose levels. Frequent monitoring of blood glucose levels is done to identify hyperglycemic or hypoglycemic episodes. D. CORRECT: A client who is experiencing an illness should test her urine for ketones to assist in early detection of ketoacidosis. E. CORRECT: A client who is experiencing illness should notify the provider of blood glucose levels greater than 240 mg/dL to obtain further instructions in caring for the hyperglycemia.

A nurse is teaching the parent of a child who has a growth hormone deficiency. Which of the following are complications of untreated growth hormone deficiency? (Select all that apply.) A. Delayed sexual development B. Premature aging C. Advanced bone age D. Short stature E. Increased epiphyseal closure

A. CORRECT: A complication of untreated growth hormone deficiency includes delayed sexual development. B. CORRECT: A complication of untreated growth hormone deficiency includes premature aging. D. CORRECT: A complication of untreated growth hormone deficiency includes short stature.

A nurse is caring for an adolescent who has acne and a prescription for isotretinoin from the dermatologist. Which of the following laboratory findings should the nurse plan to monitor? A. Cholesterol and triglycerides B. BUN and creatinine C. Serum potassium D. Serum sodium

A. CORRECT: Adverse effects of isotretinoin include elevated cholesterol and triglycerides. The nurse should plan to monitor these laboratory values during treatment.

A nurse is caring for a male infant who has an epispadias. Which of the following findings should the nurse expect? (Select all that apply.) A. Bladder exstrophy B. Inability to retract foreskin C. Widened pubic symphysis D. Broad, spade-like penis E. Pain

A. CORRECT: Bladder exstrophy is a manifestation of a male infant who has epispadias. C. CORRECT: Widened pubic symphysis is a manifestation of a male infant who has epispadias. D. CORRECT: Broad, spade-like penis is a manifestation of a male infant who has epispadias.

A nurse is providing home care instructions to a parent of a child who is receiving chemotherapy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Manifestations of infection B. Bleeding precautions C. Hand hygiene D. Homeschooling E. Airborne precautions

A. CORRECT: Chemotherapy destroys healthy WBCs, which increases the risk of infection. Manifestations of infection should be included in the teaching. B. CORRECT: Chemotherapy destroys healthy platelets, which increases the risk of bleeding. Bleeding precautions should be included in the teaching. C. CORRECT: Chemotherapy destroys healthy WBCs, which increases the risk of infection. Hand hygiene should be included in the teaching.

A nurse is assessing a child who has short stature. Which of the following findings would indicate a growth hormone deficiency? A. Proportional height to weight B. Height proportionally greater than weight C. Weight proportionally greater than height D. BMI greater than height/weight ratio

A. CORRECT: Children who have growth hormone deficiency present with short stature with proportional height and weight.

A nurse is caring for a child who is experiencing neuropathy due to chemotherapy. Which of the following are manifestations of neuropathy? (Select all that apply.) A. Constipation B. Skin breakdown C. Foot drop D. Jaw pain E. Hemorrhage cystitis

A. CORRECT: Constipation is a manifestation of neuropathy. C. CORRECT: Foot drop is a manifestation of neuropathy. D. CORRECT: Jaw pain is a manifestation of neuropathy.

A nurse is assessing an infant who has eczema. Which of the following findings should the nurse expect? (Select all that apply.) A. Generalized distribution of lesions B. Papules C. Ecchymosis in flexural areas D. Crusting lesions E. Keratosis pilaris

A. CORRECT: Generalized distribution of lesions is an expected finding in infants who have eczema. B. CORRECT: Papules are an expected finding in infants who have eczema. D. CORRECT: Crusting lesions are an expected finding in infants who have eczema.

A nurse is caring for a client who has major burns and suspected septic shock. Which of the following findings are consistent with septic shock? (Select all that apply.) A. Increased body temperature B. Altered sensorium C. Decreased capillary refill D. Decreased urine output E. Increased bowel sounds

A. CORRECT: Increased body temperature is a manifestation of septic shock. B. CORRECT: Altered sensorium is a manifestation of septic shock. D. CORRECT: Decreased urine output is a manifestation of septic shock.

A nurse is caring for an infant who has ambiguous genitalia. Which of the following actions should the nurse take? (Select all that apply.) A. Prepare the child for surgery. B. Obtain a detailed family history. C. Gather supplies for a circumcision. D. Refer the family for genetic counseling. E. Explain the need for a chromosomal analysis.

A. CORRECT: Infants who have ambiguous genitalia will need surgery. Preparing the family for surgery is an appropriate action for the nurse to take. B. CORRECT: A detailed family history is used for gender assignment, and is therefore an appropriate action for the nurse to take. D. CORRECT: Families with an infant who has ambiguous genitalia will need ongoing support. Referring to genetic counseling is an appropriate action for the nurse to take. E. CORRECT: Chromosomal analysis is used for gender assignment, and is therefore an appropriate action for the nurse to take.

A nurse is caring for a client who has a major burn and is experiencing severe pain. Which of the following actions should the nurse implement to manage this client's pain? A. Administer morphine sulfate IV via continuous infusion. B. Administer meperidine IM as needed. C. Administer acetaminophen PO every 4 hr. D. Administer hydrocodone PO every 6 hr.

A. CORRECT: Opioids administered IV via continuous infusion are recommended for clients who have major burns.

A nurse is caring for a child who has cellulitis on the hand. Which of the following actions should the nurse take? A. Administer oral antibiotics. B. Cleanse area using Burrow solution. C. Prepare for cryotherapy. D. Apply a topical antifungal medication.

A. CORRECT: Oral antibiotics are often prescribed for the treatment of cellulitis.

A nurse is caring for a child who has thrombocytopenia. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor for signs of bleeding. B. Administer routine immunizations. C. Obtain rectal temperatures. D. Avoid peripheral venipunctures. E. Limit visitors.

A. CORRECT: The child who has thrombocytopenia is at risk for hemorrhage. Monitoring for findings of bleeding is an appropriate action for the nurse to take. D. CORRECT: The child who has thrombocytopenia is at risk for bleeding. Avoiding venipunctures is an appropriate action for the nurse to take.

A nurse is teaching the parent of an infant who has seborrheic dermatitis of the scalp. Which of the following instructions should the nurse include in the teaching? A. "You can use petrolatum to help soften and remove patches from your infant's scalp." B. "When patches are present, you should keep your infant away from others." C. "You should avoid washing your infant's hair while patches are present on the scalp." D. "When patches are present, it indicates that your infant has a systemic infection."

A. CORRECT: The nurse should recommend that the parent use petrolatum, vegetable oil, or mineral oil to help soften and remove scales and crusted areas.

A nurse is planning care for a child who has tinea capitis. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Treat infected house pets. B. Use selenium sulfide shampoo. C. Cleanse area with Burrow solution. D. Administer antiviral medication. E. Use moist, warm compresses.

A. CORRECT: Tinea capitis can be transmitted from household pets, especially cats, to persons. Pets should be treated, if infected. B. CORRECT: Selenium sulfide shampoo is recommended for use for children who have tinea capitis.

A nurse is caring for a child who has poststreptococcal glomerulonephritis (APSGN). Which of the following manifestations should the nurse expect? (Select all that apply.) A. Frothy urine B. Periorbital edema C. Ill appearance D. Decreased creatinine E. Hypertension

B. CORRECT: A client who has APSGN will exhibit periorbital edema due to decrease in plasma filtration. C. CORRECT: A client who has APSGN will exhibit an ill appearance due to the manifestations experienced from the inadequate functioning of the kidneys. E. CORRECT: A client who has APSGN will exhibit hypertension due to inadequate function of the kidneys and possibly edema.

A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect? (Select all that apply.) A. Dipstick protein of 1+ B. Edema in the ankles C. Hyperlipidemia D. Weight loss E. Anorexia

B. CORRECT: A client who has nephrotic syndrome will exhibit edema in the ankles due to the decreasing colloidal osmotic pressure in the capillaries. C. CORRECT: A client who has nephrotic syndrome will exhibit hyperlipidemia due to the increased hepatic synthesis of proteins and lipids. E. CORRECT: A client who has nephrotic syndrome will exhibit anorexia due to the edema of the intestinal mucosa.

A nurse is planning care for an infant who has diaper dermatitis. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Apply talcum powder with every diaper change. B. Allow the buttocks to air dry. C. Use commercial baby wipes to cleanse the area. D. Use cloth diapers until the rash is gone. E. Apply zinc oxide ointment to the affected area.

B. CORRECT: Allowing the buttocks to air dry facilitates thorough drying of the skin and should be included in the plan of care. E. CORRECT: Zinc oxide ointment protects the skin from moisture and irritation and should be included in the plan of care.

A nurse is assessing a child who has leukemia. Which of the following are early manifestations of leukemia? (Select all that apply.) A. Hematuria B. Anorexia C. Petechiae D. Ulcerations in the mouth E. Unsteady gait

B. CORRECT: Anorexia is an early manifestation of leukemia. C. CORRECT: Petechiae is an early manifestation of leukemia. E. CORRECT: Unsteady gait is an early manifestation of leukemia.

A nurse is caring for a client who has a superficial partial-thickness burn. Which of the following actions should the nurse take? A. Administer IV infusion of 0.9% sodium chloride. B. Apply cool, wet compresses to the affected area. C. Clean the affected area using a soft-bristle brush. D. Administer morphine sulfate.

B. CORRECT: Applying cool, wet compresses stops the burn process.

A nurse is caring for a child who has enuresis. Which of the following is a complication of enuresis? A. Urinary tract infections B. Emotional problems C. Urosepsis D. Progressive kidney disease

B. CORRECT: Emotional problems are a complication of enuresis.

A nurse is teaching an adolescent who has diabetes mellitus about manifestations of hypoglycemia. Which of the following findings should the nurse include in the teaching? (Select all that apply.) A. Increased urination B. Hunger C. Signs of dehydration D. Irritability E. Sweating and pallor F. Kussmaul respirations

B. CORRECT: Hunger is a manifestation of hypoglycemia because of the increased adrenergic nervous system activity. D. CORRECT: Irritability is a manifestation of hypoglycemia because of the depleted glucose in the CNS. E. CORRECT: Sweating and pallor is a manifestation of hypoglycemia because of the increased adrenergic nervous system activity.

A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take? A. Prepare the child for surgery. B. Explain to the parents that the issue will self-resolve. C. Retract the foreskin and cleanse several times daily. D. Refer the family for genetic counseling.

B. CORRECT: Hydrocele is fluid in the scrotum and resolves spontaneously in the majority of cases.

A nurse is teaching a group of parents about preventing insect bites. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Wear perfumes when outside. B. Avoid areas of tall grass. C. Wear bright‑colored clothing. D. Wear insect repellent. E. Check house pets frequently.

B. CORRECT: Insects live in tall grasses; these areas should be avoided. D. CORRECT: Insect repellent should be applied to prevent insect bites. E. CORRECT: House pets should be inspected and treated for insects to prevent exposing family members.

A nurse is assessing an infant who has a suspected urinary tract infection. Which of the following are anticipated findings? (Select all that apply.) A. Increase in hunger B. Irritability C. Decrease in urination D. Vomiting E. Fever

B. CORRECT: Irritability is a manifestation in an infant who has a urinary tract infection. D. CORRECT: Vomiting is a manifestation in an infant who has a urinary tract infection. E. CORRECT: Fever is a manifestation in an infant who has a urinary tract infection.

A nurse is assessing an infant who has scabies. Which of the following findings should the nurse expect? (Select all that apply.) A. Presence of nits on the hair shaft B. Pencil‑like marks on hands C. Blisters on the soles of the feet D. Small, red bumps on the scalp E. Pimples on the trunk

B. CORRECT: Pencil‑like marks on hands is a manifestation of scabies. C. CORRECT: Blisters on the soles of the feet is a manifestation of scabies. E. CORRECT: Pimples on the trunk is a manifestation of scabies.

A nurse is caring for a 10‑year‑old child who has acute glomerulonephritis. Which of the following findings should the nurse report to the provider? A. Serum BUN 8 mg/dL B. Serum creatinine 1.3 mg/dL C. Blood pressure 100/74 mm Hg D. Urine output 550 mL in 24 hr.

B. CORRECT: Serum creatinine 1.3 mg/dL is out of the expected reference range for a 10‑year‑old child, and should be reported to the provider.

A nurse is teaching a parent of a child who has a urinary tract infection. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Wear nylon underpants. B. Avoid bubble baths. C. Empty bladder completely with each void. D. Provide information about manifestations of infection. E. Wipe perineal area back to front.

B. CORRECT: The nurse should discuss avoiding bubble baths. C. CORRECT: The nurse should discuss the need to completely empty the bladder with each void. D. CORRECT: The nurse should review the manifestations of infection.

A nurse is caring for a client who has a skin graft. Which of the following manifestations indicate infection? (Select all that apply.) A. Pink color to subcutaneous fat B. Unstable body temperature C. Generation of granulation tissue D. Subeschar hemorrhage E. Change in skin color around the affected area

B. CORRECT: Unstable body temperature is a manifestation of infection. D. CORRECT: Subeschar hemorrhage is a manifestation of infection. E. CORRECT: A discoloration of the skin around the burn is a manifestation of infection.

A nurse is caring for an infant who has obstructive uropathy. Which of the following findings should the nurse expect? (Select all that apply.) A. Decreased urine flow B. Urinary tract infection C. Metabolic alkalosis D. Concentrated urine E. Hydronephrosis

B. CORRECT: Urinary tract infection is a manifestation of obstructive uropathy. E. CORRECT: Hydronephrosis is a manifestation of obstructive uropathy.

A nurse is caring for a client who has a moderate burn. Which of the following actions should the nurse take? A. Maintain immobilization of the affected area. B. Expose affected area to the air. C. Initiate a high-protein, high-calorie diet. D. Implement contact isolation.

C. CORRECT: A high-protein, high-calorie diet is initiated to meet increased metabolic demands and promote healing.

A nurse is teaching a child who has type 1 diabetes mellitus about self‑care. Which of the following statements by the child indicates understanding of the teaching? A. "I should skip breakfast when I am not hungry." B. "I should increase my insulin with exercise." C. "I should drink a glass of milk when I am feeling irritable." D. "I should draw up the NPH insulin into the syringe before the regular insulin."

C. CORRECT: An early manifestation of hypoglycemia is irritability. Drinking a glass of milk, which is approximately 15 g of carbohydrates, indicates understanding of the teaching.

A nurse is caring for a child who has type 1 diabetes mellitus. Which of the following are manifestations of diabetic ketoacidosis? (Select all that apply.) A. Blood glucose 58 mg/dL B. Weight gain C. Dehydration D. Mental confusion E. Fruity breath

C. CORRECT: Clients who have diabetic ketoacidosis experience osmotic diuresis because of the electrolyte shift. D. CORRECT: Clients who have diabetic ketoacidosis experience mental confusion because of the electrolyte shift. E. CORRECT: Clients who have diabetic ketoacidosis experience fruity breath because of the body's attempt to eliminate ketones.

A parent of a school‑age child who has GH deficiency asks the nurse how long the child will need to take injections for growth delay. Which of the following responses should the nurse make? A. "Injections are usually continued until age 10 for girls and age 12 for boys." B. "Injections continue until your child reaches the fifth percentile on the growth chart." C. "Injections should be continued until there is evidence of epiphyseal closure." D. "The injections will need to be administered throughout your child's entire life."

C. CORRECT: Injections are continued until there is evidence of epiphyseal closure on radiographic tests.

A nurse is caring for a child who has oral mucositis. Which of the following actions should the nurse take? (Select all that apply.) A. Swab the mucosa with lemon glycerin swabs. B. Apply viscous lidocaine. C. Offer soft foods. D. Use a soft, disposable toothbrush for oral care. E. Encourage gargling with a warm saline mouthwash.

C. CORRECT: Offering soft foods decreases the amount of chewing needed and possible irritation. D. CORRECT: A soft toothbrush allows for adequate cleaning of the mouth and decreases irritation. E. CORRECT: A warm saline mouthwash is effective in soothing mucositis.

A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching? A. Apply mayonnaise to the affected area at night. B. Treat all household pets. C. Use an over‑the‑counter medication containing 1% permethrin. D. Discard the child's stuffed animals.

C. CORRECT: Pediculosis capitis is treated with 1% permethrin, which can be purchased over the counter.

A nurse is planning care for an infant who is scheduled to have a lumbar puncture. Which of the following actions should the nurse include in the plan of care? A. Cleanse the thoracic area of the infant's back with an antiseptic solution. B. Apply a eutectic mixture of local anesthetic cream just before the procedure begins. C. Restrain the infant during the procedure to prevent movement. D. Position the infant with his head extended and chin raised.

C. CORRECT: Restraining the infant during the procedure to prevent movement will decrease the potential for injury. It is an appropriate action for the nurse to take.

A nurse is caring for a child following an above‑the‑knee left‑leg amputation. Which of the following actions should the nurse take? A. Avoid discussing the amputation. B. Administer aspirin for phantom pain. C. Prepare the child for a prosthesis fitting. D. Maintain the affected limb in the dependent position.

C. CORRECT: Temporary prostheses are fitted soon after surgery. Preparing the child for a prosthesis is an appropriate action for the nurse to take.

A nurse is caring for an adolescent who has a new diagnosis of osteosarcoma. Which of the following actions should the nurse take? A. Ensure that the adolescent has a referral for a psychiatrist visit. B. Prepare a teaching plan to educate the adolescent in detail about his diagnosis and treatment. C. Spend time with the adolescent to answer any questions he can have. D. Perform a mental status examination to assess the adolescent's thought patterns.

C. CORRECT: The nurse should be available to answer the client's questions and to listen as he talks about his feelings.

A nurse is planning care of a child who has a urinary tract infection. Which of the following should the nurse include? A. Administer an antidiuretic. B. Restrict fluids. C. Evaluate the child's self‑esteem. D. Encourage frequent voiding.

D. CORRECT: It's important to encourage frequent voiding. This assists in flushing the bacteria through the urinary system.

A nurse is assessing a child who has chronic renal failure. Which of the following findings should the nurse expect? A. Flushed face B. Hyperactivity C. Weight gain D. Delayed growth

D. CORRECT: The nurse should expect the child to exhibit delayed growth.

A nurse is teaching a school‑age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching? A. "You should inject the needle at a 30‑degree angle." B. "You should combine your glargine and regular insulin in the same syringe." C."You should aspirate for blood before injecting the insulin." D. "You should give four or five injections in one area before switching sites."

D. CORRECT: The nurse should instruct the client to administer four or five injections about 2.5 cm (1 in) apart before switching to another site.