Study study study

Oh 14-year-old brought to the emergency room with right lower quadrant pain is tentatively diagnosed with acute appendicitis. The nurse should further assess the client for which sign or symptom?

Low grade fever

At a six month well child check An infant has a high fever and cold symptoms and is diagnosed with otitis media. She is scheduled to receive her six month immunizations. The mother asked the nurse if she will receive them. What is the nurses best response?

Make an appointment to come back to get her immunizations when she's finished with anabiotics

The mother of a four-year-old child is concerned about her child's masturbating. What should the nurse to the mother?

Masturbation is normal in children of this age

Which intervention should the nurse suggest to a parent to relieve itching in a child with chickenpox?

Oatmeal preparation baths Because of the colloidal properties

Which measures should the nurse include in the care plan for a child who is receiving high dose methotrexate therapy?

Obtain a white blood cell count May cause leukopenia at high doses

After receiving report, the nurse is making out assignments. Which client would be appropriate to assign the unlicensed assistive personnel?

An eight-month-old with pneumonia will be discharged today

Which nursing action is most appropriate to include in the plan of care to meet the emotional needs of a dying shower during the last days of life?

Answer the child's questions about illness and death honestly

Which over-the-counter medication should the nurse tell the mother of a child with hemophilia to avoid using?

Aspirin

What is appropriate to include in the teaching plan for a nine-year-old child who has had diabetes for several years?

Beginning to be able to self administer injections with adult supervision

A 9 month old, well nourished who lives with his extensive extended family test positive for tuberculosis. What is a risk factor for tuberculosis in this child?

Being an infant

Which toys to the nurse give to a toddler to use in the hospital playroom?

Blocks

A four-year-old child with meningitis exhibits a decreased level of consciousness and he's increasing intercranial pressure. The nurse should report which finding to the healthcare provider?

Blood pressure of 112/84 mmHg

The nurse admits an eight-year-old child who is unconscious secondary to keto acidosis. During the admission history, which parental statement is most consistent with a diagnosis of insulin dependent diabetes?

He started to wet his bed at night for the first time in 3 years

When determining the effective teaching a child's mother about sickle cell disease, which statement by the case the need for additional teaching?

He's going to be playing on a soccer team when he's feeling better

On observing a parent propping a bottle for a two month old child in the waiting room, the nurse explained the dangers to the parents. Which statement indicates that the parent has understood the nurse's teaching?

I can see how it might cause choking and cause tooth decay

Which statement by the mother of a child who is receiving pancreatic enzymes for the treatment of cystic fibrosis indicates that the mother understands the teaching?

I can sprinkle the enzymes on food

A child has discomfort and swelling around the IV insertion site. Which assessment should the nurse make first?

If the angiocatheter has come out of the vein

Nurses on a pediatric unit have developed a program to decrease the infection rate on the unit. What is an expected outcome of this quality improvement program?

Improvement in client outcomes

The nurse is planning care with the parents of a four-month-old infant with heart failure and congenital heart disease. The parents report that their child tires easily. Which intervention is a priority for this child?

Increase the number of rest periods

A male neonate with a 3 X 5 cm sac in the lumbar region of his back is diagnosed with myelomeningocele. What should the buses expect to find when inspecting this sac?

Spinal fluid, nerve tissue, and spinal bony defect

When teaching the parents about an echocardiogram scheduled for the child, The nurse should explain that the primary reason for this procedure is to determine which factor?

Cardiac muscle structure

The primary care provider prescribes cefepime 250 MG every six hours for a child weighing 25 KG who had infected burns. The normal dosage for this antibiotic and condition is 20 to 50 mg/kg per 24 hours which actions would be most appropriate?

Carry out the prescription because the prescribed dose is acceptable

Which action Should the nurse take in the immediate. Following application of a plaster cast to correct a Child's congenital club foot?

Change the child's position at least every two hours Helps the cast dry uniformly

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color?

Cola colored

While attending an arts and craft session at a diabetic camp, a child with insulin-dependent diabetes begins to behave strangely. What should the nurse do first?

Give the child a form of easily digested simple sugar

The nurse provides a neonate with an initial feeding. The nurse would suspect a tracheoesophageal fistula if the neonate demonstrated which behavior?

Coughing, choking, and a cyanosis that occurs after several swallows of formula

My mother asked the nurse when she should wean her four month old and fat from breast-feeding and begin using a cup. What with the nurse explain as best indication of the infants readiness to be weaned?

Decreased interest in nursing

10 month old child with bronchiolitis with the prescription to wean oxygen has weaned to room air 2 hours ago. During a feeding, the nurse notes that the child is exhibiting increased respiratory rate, is becoming more irritable, it is using accessory muscles to breathe. The pulse oximeter is reading 91%. What should the nurse do first?

Discontinue the feeding and placed a job back on oxygen

An abused child is admitted to the hospital, and the nurse is aware that a court appearance may be necessary. To plan for this eventuality, what should be the priority?

Document physical findings and behaviors observed during the child's admission

The infant with hemophilia A experience is bleeding in the elbow and as seen in the emergency department. Which nursing intervention would be most appropriate to minimize bleeding in the affected area?

Elevate the elbow above the level of the heart

Which intervention should the nurse implement to help reduce eyelid a demon and a child with nephrotic syndrome?

Elevate the head of the child's bed

What intervention should the nurse include in the plan of care for a child with a fracture in the skeletal traction to prevent osteomyelitis?

Encourage the child to eat nutritious food Nutritious food is essential to ensure bone repair and healing thereby minimizing the risk of infection

When developing the post operative plan of care for a child who is scheduled to have a tympanostomy Tube inserted into the right ear, which intervention should the nurse identify her to facilitate drainage?

Position the child to lie on the right side

The mother tells the nurse that are 4 1/2-year-old child does not seem to know the difference between right and wrong. This behavior is typical of which level described by Kohlberg's theory of levels of moral development?

Preconventional Stage one behaviors of this preconventional level have a punish obedience orientation

What recommendation should the nurse give a family about appropriate beverages for children?

Sugary drinks, including juice, should be avoided.

A nurse offers to meet with the mother and the teacher of a nine-year-old child with insulin-dependent diabetes before school to discuss the teacher's responsibility is in relation to the child's diabetes. What should the nurse discussed at the meeting?

Signs and symptoms of hypoglycemia

At 0300 the mother of a three-year-old child called the emergency department nurse and reports that the child has a temperature of 101 F a runny nose and a barky cough that gets going and will not stop. The mother states that she just gave the child acetaminophen what should the nurse recommend next?

Sit with the child in a steamy warm bathroom

The nurse is assessing the development of a seven month old. The child should be able to perform which skill?

Sit without support

The nurse teaches the mother of a child newly diagnosed with insulin dependent diabetes about the principles of a healthy eating plan. Which statement by the mother indicates effective teaching?

Snacks are used to keep blood glucose at an acceptable levels during times when the insulin level peaks

What is the priority intervention for the care of a six-year-old child admitted with third-degree burns?

Start an IV line

When teaching the mother of an infant diagnosed with congenital hypothyroidism about daily or levothyroxine sodium therapy, which manifestations should the nurse include as possibly indicating an overdose?

Sweating

After having trouble breast-feeding, a six week old female and for exhibits dry, scaly skin and a protruding tongue. A diagnosis of congenital hypothyroidism is made. The mother asked the nurse why the child was not diagnosed with this condition at birth. What would the nurse's best response?

Symptoms are not present at birth because newborns have thyroid hormone from the mother still in their system

A 2 year old child is brought to the emergency department with a broken arm. Which funding should lead the nurse to suspect child abuse?

The child's father altered the story of the injury each time he tells it

When discussing the use of a fluticasone and salmeterol inhaler with the parents of a child diagnosed with asthma, the nurse should teach the parents that the medication will be most effective if it is administered at which time?

Twice daily

An infant wing 10 kg is receiving an IV fluid replacement. The nurse should suspect that the infant is receiving two little IV fluid replacement when the child exhibits which clinical manifestation?

Urine specific gravity of 1.033

The nurse teaches appropriate care measures to the parents of a five-year-old child who has been given trimethoprim/sulfamethoxazole for a urinal tract infection. What directives should be included in the teaching plan? Select all that apply

Use a sunscreen Keep medication out of the sunlight Report any rash Keep the child well hydrated

A four month old infant is brought to the emergency department following a seizure. What findings with the would lead the nurse to suspect the infant has experienced abusive head trauma or shaken baby syndrome? Select all that apply.

Vomiting, difficulty breathing, lack of vocalization Indicates a change in level of consciousness

Because both parents are near sighted, The mother is concerned that her four-year-old child may be nearsighted. She says that he likes to look at books and knows some of the alphabet. Which assessment techniques should the nurse use to test the child's visual acuity?

Allen pitcture cards

When making rounds, the nurse should assess Which client first?

A 10-year-old child who had just been admitted in sickle cell crisis

What nursing action is appropriate to perform first one preparing a child with appendicitis for surgery?

Obtain vital signs

When preparing to admit it in for diagnosed with diarrhea to the pediatric unit, the nurse assigned and fit to which room?

A private room

The nurse is caring for a child away tracheostomy. What should the nurse do when section in the tracheostomy?

Insert the catheter slightly beyond the end of the tracheostomy tube To prevent damage to the carina, The catheter should only be inserted just slightly beyond the end of the tracheostomy tube

A child and second grade with no remarkable medical history experience a generalized tonic clonic seizure in the classroom. Immediately after the seizure, the nurse arrives and notices that the child has been incontinent of urine and it's difficult to arouse. Which action would be most appropriate at this time?

Stay with the child, and allow her to sleep in a sideline position The sideline position is best to prevent possible aspiration

The mother of a child with tetralogy of fallot I asked the nurse why her child has club fingers. The nurse bases is the response on the understanding that clubbing is due to which factor?

Peripheral hypoxia

What should the nurse teach the parents of a three-year-old child with eczema to remove from the child's environment at home?

Stuffed animals

I nurse overhears a fellow staff member talking about the mother of a child whom the staff nurse is caring. The nurse is telling others private information that the mother had shared. What is the best response by the nurse overhearing the conversation?

Talk to the staff member privately about this

For the child diagnosed with an asthma attack, which manifestation would best correlate with the child's arterial blood gas results, which include pH of 7.46, bicarbonate of 21 mEq/L, and a partial pressure of carbon dioxide PCO2 of 33 Hg 4.4 kPa?

Tingling sensation in the fingertips

What is the primary reason that the nurse inserts an indwelling urinary catheter in a trial with severe burns?

To measure your an output accurately

When assessing a toddler diagnosed with a spastic cerebral palsy, which signs to the nurse expect to find?

Toe walking

The nurse reviews the BMI for age growth chart for a six-year-old girl who's BMI is charted at the 90th percentile. How does the nurse classify the girls BMI?

overweight

A mother calls the clinic after a four-year-old choked on a peanut. The nurse reports that she performed abdominal thrusts and the child is breathing normally now. What should the nurse should tell the mother to do?

Bring the child to the emergency department to check for airway obstruction If aspirated nuts may swell leading to an airway obstruction after the initial event an endoscopy may be required to remove remaining fragments

When developing a plan of care that includes interventions aimed at preventing complications of a low platelet count in a child with leukemia, which intervention is most appropriate?

Consult with a primary care provider about the use of stool softener

An 18-year-old tells the nurse, everyone does it, so it's all right, to justify rule breaking behavior. The nurse realizes this is an example of which level or stage of moral reasoning development as described by Kohlberg?

Conventional

The nurse is caring for a 4-year-old with a suspected urinary tract infection. Which of the following would be most appropriate when obtaining a urine specimen from the child?

"Let your mom help you tinkle in this cup."

A five-year-old child has been placed on phenytoin for tonic clonic seizures. The child weighs 19.1 kg and the maintenance dose prescribed for this child is 7.5 mg per day. How many milligrams should the hold receive each day?

143 mg/day

A child is to receive IV fluids at a rate 95 ML's/H. The tubing for the fusion delivers 10 drops/ML. Which drop rates for the nurse infused a solution?

16 drops/MIN

A child has a prescription to receive 250 mL of IV fluids every 4 hours. The nurse should set the infusion pump using the run at which flow rate?

63 mL/h

Which families or should the nurse determine as most in need of follow up?

A single parent with a toddler who has third-degree burns over 20% of the body

The parent of 7 month old infant who has had an inguinal herniorrhaphy and is fully recovered from anesthesia asks the nurse when the infant be able to leave the day surgery unit. What should the nurse use as a criterion for discharge?

Ability to retain an oral feeding

A preterm neonate is having frequent blood draws for a laboratory specimens what is most important for the nurse a document about the blood draws?

Amount of blood drawn for each specimen

The nurse reviews the plan of care for a child with leukemia who is at risk for bleeding. Which intervention with the nurse question?

IM injections

The mother of an infant feels like her infant has flat feet and ask the nurse what can she do about the problem. What response from the nurse is most appropriate?

Infants have a fat pad below the arch, making it look like flat fee when they are not

The nurse conducts the discharge teaching with a family of a child recovering from sickle cell crisis. Which condition does the nurse tell the family to report immediately to the healthcare provider?

Sore throat and fever The child with sickle cell anemia develop signs of infection such as sore throat and fever prompt evaluation is necessary because infection can precipitate a crisis

Which statement would indicate that the parents of a child being treated with antibiotics for a second air infection in two months understand the reason for a follow up visit after the child completes the course of therapy?

We need to make sure that her ear infection has completely cleared

During a routine health assessment, a mother tells the nurse that it's with your own child is using the potty seat but is still having problems toilet training. Which suggestion would be most appropriate?

Defer a training on to the child is developmentally ready

The nurse admits a 4 year old with a possible meningococcal infection. Which type of isolation is indicated?

Droplet precautions Spread to close mucous membranes or respiratory contact with large respiratory droplets

What intervention should the nurse implement when caring for a four-year-old girl who is just had a lumbar puncture?

Encourage the parents to hold the child

The nurse teaches the parents of a neonate who has undergone correct of surgery for tracheoesophageal fistula about the need for a long-term health care the nurse base is the teaching on the child's high risk for which condition?

Esophageal stricture

Assessment of a six week old infant reveals weight and length in the 50th percentile for his age and head circumference at the 95th percentile. What should the nurse do first?

Examine the fontanelles and sutures

A child with rheumatic fever has chorea. Which of the following actions should the nurse consider to be most important?

Explaining to the child and family that the CHOREA will disappear over time

When performing an assessment on a one day old newborn which finding would most suggestive of an imperforate anus?

Failure to pass a meconium stool

The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. Which of the following would the nurse most likely expect to assess after the first dose is administered?

Fever with chills, chest tightness

Three weeks after an infant receives a spica cast, the mother calls the nurse because the infants toes are swollen and cool to the touch. What should the nurse instruct the mother to do?

Have the child fitted for a larger cast

When performing a physical assessment on an 18-month-old child, which measure would be best?

Have the parent hold the toddler

Which nursing intervention would be most effective in helping a two-year-old stay quiet after a bronchoscopy?

Have the parents stay at the bedside

A parent asked the nurse if the lesions around her child's mouth could be impetigo. What manifestations would verify the parents suspicion?

Honey colored crust, vesicles, and reddish maculae on the skin

A child is receiving methyl prednisone IV as treatment for a severe asthmatic attack. The nurse closely monitors the flow rate of the IV infusion to percent of which problem?

Hypertension

The parents of a three-month-old infant have been told that the infant has died of sudden infant death syndrome. Which intervention is most important to include in the plan of care to assist the parents with their grieving process?

Provide an opportunity for them to see the infant The parent should be given the opportunity to say their final farewells to their infant this last contact helps them focus on the reality of the infants death

A 2 1/2-year-old child and his two month or siblings are brought to the clinic by their father, who explains that the older child says no whatever accident something the nurse should explain that the negativism demonstrated by toddlers is frequently an expression of which characteristic?

Pursuit of autonomy

Which instruction would be most appropriate for the nurse to include in the teaching plan for the mother of a one-year-old child who is to receive iron therapy with ferrous sulfate drops?

Put the drops in the child's mouth, then follow with juice Absorption of iron is enhanced in an Acid environment

A 14 month old child returns from surgery for an undescended testicle when filing for a child's discharge the nurse should remind the parents to observe their job for which complication?

Redness or swelling at the incision site

A young child has Undergone a tonsillectomy and refuses to let the nurse look at the tonsillar bed to check for bleeding. To assess whether the child is bleeding from the tonsillar beds, which measure would be most appropriate?

Observe for frequent swallowing

Which technique would be most appropriate to use when determining whether teaching the parents about how to administer airdrops correctly has been successful?

Observe the parents instilling the drops in child's ear

On reviewing a child's laboratory results, the nurse notes a serum potassium level of 3.3. What should the nurse encouraged a child to drink?

Orange juice

When the nurse asked such as suspected of being physically abused her his shoulder was hurt, he replies, it was my fault. I was bad. What would be the nurse best response?

Perhaps it wasn't your fault. Can we talk about what happened?

The nurse teaches the parent of a child with sickle cell anemia about managing the disease in preventing complications. Which statement by the parent indicates a need for further education about sickle cell anemia?

I know she doesn't have as much pain as she actually she has

In the infant and made it to the hospital with an acute rotavirus infection has been having frequent diarrhea stools. On assessment, the nurse notes 40 to 60 bowel sounds per minute. The shower has poor skin turgor and dry mucous membranes. The nurse determines the infants dehydration is related to which factor?

Increased GI motility

The nurse helps the parents plan strategies that will allow the shower insulin-dependent diabetes to participate in an early morning tennis program at school. Which interventions are appropriate? Select all that apply

Inject the morning insulin dose in an area away from major muscles used in playing tennis, have the chart eat more calories for breakfast on tennis days, have the child carry a source of quickly absorbed carbohydrate to the program

Which serum electrolytes findings should the nurse expect to find in an infant with persistent vomiting?

K+, 3.2; Cl-,92; Na+, 120

Which intervention should the nurse implement to help minimize joint pain and a child with rheumatic fever?

Limit movement of the affected joints