Test 1 Pediatric Nursing NCLEX Practice | Quiz #2: 50 Questions

Nurse Charlotte suspects that a child, age 4, is being neglected physically. To best assess the child's nutritional status, the nurse should ask the parents which question?

"What did your child eat for breakfast?" The nurse should obtain objective information about the child's nutritional intake, such as by asking about what the child ate for a specific meal. In order to assess the adequacy of a child's nutritional intake, dietitians require detailed information about all food and drink consumed. As all children admitted to the hospital are at risk of nutritional deficit, a dietary record should be started on all in-patients, although this may subsequently be discontinued when deemed appropriate.

Drinking cow's milk or fortified soy beverages is not recommended until your child is older than

12 months, but other cow's milk products, such as yogurt, can be introduced before 12 months.

Archie is a child with iron deficiency anemia. He is required to receive elemental iron therapy at 6 mg/kg/day in three divided doses. He weighs 44 lbs. How many milligrams of iron should he receive per dose?

40 mg/dose The child weighs 44 lbs, which is equal to 20 kg (1 kg=2.2 lb;44/2.2=20kg). Elemental iron therapy is ordered at 6 mg/kg/day in three doses. Therefore, the child receives 120 mg/day (6 mg/20 kg/day=120), divided into three doses (120/3), which is equal to 40 mg/dose.

Anticoagulants do not prevent sickling!

Adjuvant therapy includes hydroxyurea, antihistamines, anxiolytics, and antiemetics. It is prudent to maintain adequate hydration and be vigilant in identifying other causes of pain that may need additional treatment.

Sickle cell disease (SCD) primarily affects:

Both African descent and Hispanics of Caribbean ancestry and Middle-Eastern and Indian descent. Sickle cell disease primarily affects children of African descent and Hispanics of Caribbean ancestry. It also occurs in children of Middle-Eastern and Indian descent. Sickle cell anemia is the most common monogenic disorder. Prevalence of the disease is high among the people of Sub-Saharan Africa, South Asia, the Middle East, and the Mediterranean.

How should the nurse prepare a suspension before administration?

By shaking it so that all the drug particles are dispersed uniformly. The nurse should shake a suspension before administration to dispersed drug particles uniformly. First, the bottle should be tabbed a few times to loosen the powder, then approximately, half the volume of water should be added, the bottle is shaken vigorously, the remaining water should be added and shaken well.

Oral iron supplement is not used in the management of hemophilia.

Other pharmaceutical adjuvant therapies for hemophilia A-induced bleeding include desmopressin, tranexamic acid, epsilon aminocaproic acid, and management of factor VIII inhibitors.

Nurse Elizabeth is administering medication via the intraosseous route to a child. Intraosseous drug administration is typically used when a child is:

Critically ill and under age 3 In an emergency, intraosseous drug administration is typically used when a child is critically ill and under age 3. IO access provides a means of administering medications, glucose, and fluids, as well as (potentially) a means of obtaining blood samples. Such a situation would include any resuscitation; cardiopulmonary arrest; shock, regardless of etiology; life-threatening status epilepticus; or lack of venous access resulting from burns, edema, or obesity.

Mrs. Johnson tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother?

Do not give snacks to the child before meals. If the child is hungry he/she is more likely to finish his meals. Therefore, the mother should be advised not to give snacks to the child. Set times for meals and snacks and try to stick to them. A child who skips a meal finds it reassuring to know when to expect the next one. Avoid offering snacks or pacifying hungry kids with cups of milk or juice right before a meal — this can diminish their appetite and decrease their willingness to try a new food being offered.

Patient S is a sexually active adolescent. Which of the following instructions would be included in the preventive teaching plan about urinary tract infections?

Drinking acidic juices Drinking acidic juices, such as cranberry juice, helps keep the urine at its desired pH and reduces the chance of infection. Pure cranberry juice, cranberry extract, or cranberry supplements may help prevent repeated UTIs in women, but the benefit is small. It helps about as much as taking antibiotics to prevent another UTI.

A child with known hemophilia A was brought to the emergency room with complaints of nose bleeding and some bruises in the joints. Which of the following should the nurse anticipate to be given to the child?

Factor VIII Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective factor VIII, a clotting protein. The initial treatment is the administration of factor VIII to replace the missing factor and decrease the bleeding episode.

Which of the following is not true regarding the varicella vaccine?

Give aspirin for any injection-related pain. Children receiving the varicella vaccine should avoid aspirin or aspirin-containing products because of the risk of Reye's syndrome. After administration of the vaccine, it is recommended to avoid salicylates for five weeks due to the risk of Reye's syndrome and to avoid contact with susceptible high-risk individuals.

Which of the following organisms is responsible for the development of rheumatic fever?

Group A beta-hemolytic streptococcus Rheumatic fever results from a delayed reaction to inadequately treated group A ?-hemolytic streptococcal infection. In order for ARF to occur, it appears that a pharyngeal infection caused by S. pyogenes must occur in a host with a genetic susceptibility to the disease. Activation of the innate immune system begins with a pharyngeal infection that leads to the presentation of S. pyogenes antigens to T and B cells.

Nurse Christine is planning a client education program for sickle cell disease (SCD) in children. Which of the following interventions would be included in the care plan?

Health teaching to help reduce sickling crisis. Prevention is one of the principal goals of therapeutic management because there is no cure for sickle cell disease. Consequently, health education to help lessen the sickling crisis is key. Early detection and rapid initiation of appropriate treatment for several acute conditions including the vaso-occlusive crisis, aplastic crisis, sequestration crisis, and hemolytic crisis is needed. These crises, if not treated early, can result in mortality.

Whole-grain breads are good food source of iron and should be supported and encouraged.

It may be a good idea to choose iron-fortified cereals, bread products, orange juice, rice, and pasta. Also, fermented and sprouted grains and legumes are a better choice for people with iron deficiency because sprouting and fermenting break down anti-nutrient compounds that negatively impact iron absorption.

Nurse Dorothy is caring for a child with Category A Near Drowning; she should do which of the following? Select all that apply.

Plan for discharge in 12 to 24 hours. Check for electrolyte imbalances. Provide oxygen as ordered. Near-drowning is defined as survival for at least 24 hours from suffocation by submersion. Aspiration of water causes the plasma to be pulled into the lungs, resulting in hypoxemia, acidosis, and hypovolemia. Hypoxemia results from the decrease in pulmonary surfactant caused by the absorbed water that leads to damage of the pulmonary capillary membrane. Children with Category A Near Drowning are awake with minimal injury. Care includes checking electrolyte status, administering oxygen and warming, and preparing for discharge in 12 to 24 hours.

All meat and poultry contain heme iron.

Red meat, lamb, and venison are the best sources. Poultry and chicken have lower amounts. Eating meat or poultry with nonheme iron foods, such as leafy greens, along with vitamin C-rich fruit can increase iron absorption.

During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first?

Rice cereal Rice cereal is the first solid food an infant should receive because it is easy to digest and is associated with few allergies. Next, the infant can receive pureed fruits, such as bananas, applesauce, and pears, followed by pureed vegetables, egg yolks, cheese, yogurt, and finally, meat.

Some seafood provides heme iron.

Shellfish such as oysters, clams, scallops, crabs, and shrimp are good sources. Most fish contain iron. Although canned sardines are good sources of iron, they're also high in calcium. Calcium may bind with iron and reduce its absorption.

A nurse prepares to administer an intramuscular injection to a 6-month-old infant. The nurse selects which site to administer the medication?

Vastus lateralis Intramuscular injection sites are selected based on the child's age and muscle development. The vastus lateralis is the only safe muscle group to use for intramuscular injection in a 6 month-old infant. Muscle has fewer pain-sensing nerves than subcutaneous tissue and is less sensitive to irritating and viscous medications, so pain is lessened.

When administering an I.M. injection to an infant, the nurse in charge should use which site?

Vastus lateralis The recommended injection site for an infant is the vastus lateralis or rectus femoris muscles. Skeletal muscle can accommodate larger volumes of medication than subcutaneous tissue, and absorption is faster because muscle tissue is highly vascular. Muscle has fewer pain-sensing nerves than subcutaneous tissue and is less sensitive to irritating and viscous medications, so pain is lessened.

Mrs. Baker was instructed by the nurse on foods to encourage her child's diet concerning the latter's iron deficiency anemia. which of the following if stated by the mother would indicate the need for FURTHER instruction?

Yellow vegetables If a parent states that she should stress the intake of yellow vegetables, she needs additional teaching because yellow vegetables are not a good source of iron. Leafy greens, especially dark ones, are among the best sources of nonheme iron.

Delicious, digestible first fruits

include finely mashed bananas, baby applesauce, peaches, and pears. For something completely different, and completely baby-friendly, start with smoothed-down mashed or pureed ripe avocado — it's creamy, yummy, and loaded with healthy fats.

Fluids are encouraged to

increase fluid volume and prevent sickling. The key is rapid hydration and pain control. In addition, oxygenation should be monitored. It is important to find and treat the trigger of the crisis to prevent a recurrent crisis.

Streptococcus pneumoniae

is a gram-positive, lancet-shaped bacterium and a cause of community-acquired pneumonia. Pneumococcal infections are present throughout the world and are most prevalent during the winter and early spring months. Streptococcus pneumoniae is the bacterium that has historically been the most common pathogen to cause CAP worldwide.

Staphylococcus aureus

is a major bacterial human pathogen that causes a wide variety of clinical manifestations. Infections are common both in community-acquired as well as hospital-acquired settings and treatment remains challenging to manage due to the emergence of multi-drug resistant strains such as MRSA (Methicillin-Resistant Staphylococcus aureus).

Haemophilus influenzae disease

is a name collectively used for any kind of infection caused by the bacteria called Haemophilus influenzae. The most familiar and predominant form is H. influenzae type b (Hib), which infects mostly children and immunocompromised individuals.

Cyclosporine

is an immunosuppressive agent used to treat organ rejection post-transplant. It also has use in certain other autoimmune diseases, treatment of organ rejection in kidney, liver, and heart allogeneic transplants, rheumatoid arthritis when the condition has not adequately responded to methotrexate.

Hemophilia, which means love (philia) of blood (hemo)

is the most common severe hereditary hemorrhagic disorder. Both hemophilia A and B result from factor VIII and factor IX protein deficiency or dysfunction, respectively, and are characterized by prolonged and excessive bleeding after minor trauma or sometimes even spontaneously.

Sickle cell disease (SCD) affects

millions of people throughout the world and is particularly common among those whose ancestors came from sub-Saharan Africa; Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece, and Italy.

Sickle cell disease (SCD) is a

multisystem disorder and the most common genetic disease in the United States, affecting 1 in 500 African Americans. About 1 in 12 African Americans carry the autosomal recessive mutation, and approximately 300,000 infants are born with sickle cell anemia annually.

Egg whites should not be given until age 9 months because

they may trigger a food allergy. Potentially allergenic foods include cow's milk products, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and sesame. Introduce potentially allergenic foods when other foods are introduced.