Toddler- PREP U Women and Children
A child, age 2, with a history of recurrent ear infections is brought to the clinic with a fever and irritability. To elicit the most pertinent information about the child's ear problems, the nurse should ask the parent:
"Does your child tug at either ear?"
Which statement by the mother of a toddler with nephrotic syndrome indicates that the nurse's discharge teaching was effective?
"I've been checking the urine for protein so I'll be able to do it at home."
During a well-baby visit, a toddler's parent states that the parent keeps all medications out of the toddler's reach in the kitchen cabinet. Which is an appropriate response by the nurse?
"Medications should be kept in a locked location."
A parent expresses concern over a toddler's eating habits, stating the toddler eats very little and consumes only a single type of food for weeks on end. Which instruction is most appropriate?
"This is normal toddler behavior."
A 1-year-old infant is pale, but the physical examination is normal. Blood studies reveal the infant's hematocrit is 24%. Which question by the nurse to the parents would be most useful in helping to establish a diagnosis of anemia?
"What's the infant's usual daily diet?"
The physician prescribes 300,000 U of penicillin G I.M., for an 18-month-old child. What is the best site for the nurse to administer this injection?
: Thigh (vastus lateralis muscle)
A pediatric nurse preceptor working on an oncology floor goes to see if the new graduate nurse caring for a 3-year-old terminally ill child requires assistance. The preceptor finds the new nurse in the lounge crying. What is the preceptor's best action?
Ask graduate what has caused the crying
A 3-year-old child has had surgery to remove a Wilms tumor. Which action should the nurse take first when the parent asks for pain medication for the child?
Assess the child's pain using a smiley face pain scale.
For a child with a Wilms' tumor, which preoperative nursing intervention takes highest priority?
Avoiding abdominal palpation
Parents bring their 13-month-old toddler to the clinic. The toddler has erythema and small vesicles that ooze on the buttocks. Which instruction should the nurse give the parents?
Change diapers frequently and air-dry when possible.
A 2-year-old child comes to the emergency department with inspiratory stridor and a barking cough. What is the highest priority action by the nurse?
Establish and maintain the airway.
The nurse is teaching parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
Eustachian tubes
A client is admitted to the hospital for an asthma exacerbation. The nursing history reveals this client was exposed to varicella (chickenpox) 1 week ago. When, if at all, would this client require isolation?
Immediate isolation in a private room is required .
A 3-year-old child with Down syndrome is admitted to the pediatric unit with asthma. During assessment, it is noted that the child does not enunciate words well and holds onto furniture when walking. Which assessment question regarding development is most helpful?
Is this normal behavior for your child?
A 16-month-old with a history of hydrocephalus is admitted with an infected ventriculoperitoneal shunt. Which assessment takes priority in this toddler?
Monitor for signs of increased intracranial pressure.
A child, age 15 months, is admitted to the health care facility. During the initial data collection, which statement by the mother most strongly suggests that the child has a Wilms' tumor?
My child's abdomen seems bigger, and his diapers are much tighter."
A nurse is caring for an infant being treated for an upper respiratory infection. The physician would like to order a series of X-rays for the infant, who has been in a foster home for 4 months. How should the nurse obtain consent?
Obtain consent from the foster parents.
A toddler is hospitalized with multiple injuries. Although the parent states that the child fell down the stairs, the child's history and physical findings suggest abuse as the cause of the injuries. What is the nurse's first responsibility in caring for this child?
Report the incident to the proper authorities.
A child is seen at the health care provider's office. During the interview period the child's parent reports the child has a grade 1 heart murmur. The nurse is aware that this murmur has which characteristic?
a sound softer than the heart sounds
When caring for a 2-year-old child, the nurse should offer choices, when appropriate, about some aspects of care. According to Erikson, doing this helps the child achieve:
autonomy
An 18-month-old Hispanic toddler admitted to the hospital with bronchitis has red marks on his upper chest over both sides of his body. The mother states that she has been treating him at home. Which treatment has the mother most likely been administering to her toddler?
coin rubbing
The nurse is caring for a child whose mother is deaf and untrusting of staff. She frequently cries at the bedside, but refuses intervention from the social worker or the chaplain. Which issue is most important for the nurse to address with the mother to promote a trusting relationship?
communication barriers between the mother and staff
The nurse is caring for a toddler with right lower lobe pneumonia. In order to improve gas exchange, which position should the child be placed in?
left side-lying
A 3-year-old child is experiencing distress after having cardiac surgery. Which sign indicates cardiac tamponade?
muffled heart sounds
A 2-year-old child is being treated with rifampin for tuberculosis. Which expected finding does the nurse anticipate?
orange body secretions
A 2-year-old who's admitted to the pediatric unit for a tonsillectomy is in foster care. The nurse assists the physician in gaining informed consent. Who can legally give informed consent for this elective procedure?
parent or guardian
The nurse is planning a health teaching session for parents of a toddler. When describing a toddler's typical eating pattern, the nurse should mention that many children of this age exhibit:
strong food preferences
A registered nurse (RN) has been "care-paired" with a licensed practical nurse (LPN) during the evening shift. Whose care should the RN assign to the LPN?
the 2-year-old child who has started eating soft, solid foods following a tonsillectomy
A 1-year-old underwent hypospadias repair yesterday; he has a urethral catheter in place and an IV. Which rationale is appropriate for administering propantheline on an as-needed basis?
to prevent bladder spasms while the catheter is present
The nurse has auscultated the first heart sound. When does the nurse determine this sound is occurring?
with closure of the mitral and tricuspid valves
When reinforcing teaching the parents of a toddler with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction?
"Try to maintain your child's usual lifestyle to promote normal development."
When teaching the parents of a toddler with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction?
"Try to maintain your child's usual lifestyle to promote normal development."
A 3-year-old child is receiving ampicillin for acute epiglottitis. Which sign would lead the nurse to suspect that the child is experiencing a common adverse effect of this drug?
generalized rash
The nurse at a family health clinic is reinforcing educating a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1?
understands "no" and other simple commands
The parents of a 2-year-old scheduled for surgical repair of an inguinal hernia are fearful and their fears are affecting their child. A play therapist is consulted to help with the child's care. The nurse should explain to the parents that the play therapist will:
use puppets to gain insight into how the child feels about his hospitalization and fears.
The primary health care provider prescribes penicillin G, 300,000 units IM, for a child who is 18 months old. Which site does the nurse select to administer this injection?
vastus lateralis muscle
The charge nurse overhears a nurse complaining that she has been assigned to a toddler diagnosed with tetralogy of Fallot for the past 3 days and the mother is very demanding. Which response by the charge nurse is best?
"It's important for the child to have someone assigned to him who's familiar with his care."
The nurse is preparing to discharge a 3-year-old client with sickle cell disease. Which teaching will the nurse provide to the legal guardian?
"Report weakness, fever, and unsoothable crying to the health care provider right away."
The nurse is reinforcing education for the parents of a toddler with congenital heart disease. Which information should the nurse include when reinforcing education regarding care?
"Try to maintain your child's usual lifestyle to promote normal development."
A 15-month-old child is being discharged after treatment for severe otitis media and bacterial meningitis. Which statement by the parents indicates effective discharge teaching?
"We'll go to the physician if our child pulls on his ears or won't lie down."
A nurse is reinforcing education with parents on providing adequate nutrition for their toddler who has cerebral palsy. Which observation by the nurse indicates that the education has been effective?
The child eats finger foods independently.
The nurse should expect a 3-year-old child to be able to perform which action?
ride a tricycle
A 2-year-old is brought to the emergency department with suspected croup. The child appears frightened and cries as the nurse approaches. The nurse needs to auscultate the child's breath sounds. What is the most appropriate way for the nurse to approach the child?
Allow the child to handle the stethoscope before listening to the lungs.
When assisting in developing a plan of care for a toddler with a seizure disorder, which of the following would be inappropriate?
Arm restraints while asleep
When teaching the mother of a 17-month-old child about toilet training, which instruction would initially be most appropriate?
Be sure the child is ready before starting to toilet train.
For a child with a circumferential chest burn, what is the most important factor for the nurse to monitor?
Breathing pattern
The nurse is caring for a toddler with Down syndrome who is ordered serum blood work and IV therapy. Which nursing considerations are a component of atraumatic care for this toddler? Select all that apply.
Bring the toddler to the exam room for all invasive procedures. Allow a security object to decrease anxiety. Encourage a parent to remain with the child during procedures.
A mother says a 2-year-old child is up to date with vaccines. Which immunization should be included?
DTaP, IPV, MMR, hepatitis B, Haemophilus influenzae type b (Hib), varicella, PCV, rotavirus (Rota), and influenza
The nurse is caring for a toddler who is visually impaired. What is the most important action for the nurse to take to ensure the safety of the child?
Maintain a tidy environment around the child
Which nursing diagnosis takes highest priority for a child in the early stages of burn recovery?
Risk for infection
Which of the following objects poses the most serious safety threat to a 2-year-old child in the hospital?
Side rails in the halfway position
The nurse is teaching a group of mothers about normal toddler development. When talking about toddlers' play, the nurse should include which point?
They play with similar objects nearby other children rather than with them.
A 2-year-old child's parent informs the nurse of a concern that the child may have attention deficit hyperactivity disorder (ADHD) because "my child has so much energy, doesn't pay attention for long, and is always getting into things." Which response by the nurse would be best?
This behavior is normal. The child is exploring and learning about the world."
The parents of a 2-year-old child with chronic otitis media are concerned that the disorder has affected their child's hearing. Which behavior suggests that the child has a hearing impairment?
Using gestures to express desires
A nurse is leading a group of parents of toddlers in a discussion on home safety. The nurse should share what information about the most common cause of toddler deaths?
accidents
The nurse is caring for a 30-month-old client in the pediatrician's office. The client is being assessed for autism spectrum disorder. While assessing the client with the health care provider, which clinical characteristics does the nurse anticipate documenting in the medical record? Select all that apply.
avoiding eye-to-eye contact with others using repetitive behaviors throughout the session
A nurse is caring for a 3-year-old child diagnosed with viral meningitis. Which signs and symptoms does the nurse anticipate finding when gathering data? Select all that apply.
fever nuchal rigidity irritability photophobia
The nurse is caring for a 20-month-old toddler. The toddler's adoptive parent asks what kind of toy is good to give this child based on the toddler's age. Which toy would the nurse suggest that the parent give based on the growth and development of toddlers?
pull push toy
A 2-year-old child with bronchopulmonary dysplasia is placed on furosemide once per day. The nurse is reinforcement educating the parents on foods that are rich in potassium. Which food should the nurse recommend?
raisins
The nurse is gathering data regarding the physical development of a 33-month-old who is playing. Which of the following activities would the nurse anticipate the toddler being able to complete with minimal assistance? Select all that apply.
removing his or her jacket using a spoon for eating washing and drying hands
A 2-year-old child with a tracheostomy suddenly becomes diaphoretic and has an increased heart rate, an increased respiratory rate, and a decreased oxygen saturation level. Which of the following should be the nurse's first action?
suction the trach
