Chapter 20 PrepU Resp Review

When the nurse is reinforcing teaching with the caregiver of a 3-year-old child being discharged following a tonsillectomy, the caregiver states to the nurse, "I understand why there might be bleeding in the first 24 hours, but I do not understand why there might be bleeding in 1 week or so." What is the most appropriate explanation for the nurse to give this caregiver? "Bleeding can occur at this time because the clots dissolve and new tissue is not yet present." "We do not usually do this surgery until the child is older, so postoperative bleeding is a possible complication because of the child's age." "By next week the child will be eating regular foods again, and the salt content may cause bleeding." "The child will have forgotten about the surgery by that time and might start coughing, and the pressure of coughing can cause bleeding."

"Bleeding can occur at this time because the clots dissolve and new tissue is not yet present."

A 4-week-old infant is diagnosed with acute bronchiolitis. The parent states, "I do not know how the baby got this!" How should the nurse respond? "Do you have allergies in the family?" "Do any family members have history of asthma?" "Do you have air conditioning in your house?" "Has your infant been around any crowds?"

"Has your infant been around any crowds?"

A child with asthma has been monitoring his peak expiratory flow rate (PEFR) and has been maintaining it within 90% of his personal best. Today, the child is experiencing symptoms and his PEFR is at 40% of his personal best. The child's mother calls the office and asks the nurse what she should do. What would the nurse instruct the mother to do first? "Have him use his short-acting bronchodilator right away." "You need to take him to the emergency department right away." "Continue to watch his PEFR readings and call back if they go below 40%." "Have him use his low-dose steroid inhaler now and again in 15 minutes."

"Have him use his short-acting bronchodilator right away."

The nurse is caring for a 9-month-old infant newly diagnosed with atopic dermatitis. The parents are concerned about the dry skin patches and abrasions caused by the infant scratching. The nurse instructs the parent regarding the use of hydrocortisone cream. Which parent statement demonstrates the priority information? "We will continue using the hydrocortisone cream until the rash goes away." "I can use the hydrocortisone cream as many times a day as necessary." "I know I have to follow all the directions while using the hydrocortisone cream." "If the cream does not seem to be helping, I will stop using it."

"I know I have to follow all the directions while using the hydrocortisone cream."

The nurse is caring for a child who weighs 44 lb (20 kg) experiencing an anaphylactic reaction. The health care provider has prescribed an epinephrine 0.01 mg/kg injection. Epinephrine is supplied at 1 mg in 10 ml. How many milliliters will the nurse administer? Record your answer using a whole number. 3 39 7 2

2

The health care provider has prescribed diphenhydramine 5 mg/kg/dose for a child with urticaria weighing 33 lb (15 kg). The medication is supplied as 12.5 mg/5 ml. How many milliliters will the nurse administer to the child for one dose? Round the answer to the nearest whole number. 32 22 10 30

30

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? Barium enema Surgery Upper endoscopy Endoscopic retrograde cholangiopancreatography

Barium enema

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply. Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh Oral candidiasis (thrush), persistent over the past 6 to 7 months Infected laceration requiring IV antibiotic 2 months ago; healed Pneumonia last spring; resolved with antibiotics

Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh Oral candidiasis (thrush), persistent over the past 6 to 7 months

The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved? Antidiuretic hormone Growth hormone Insulin Thyroxine

Antidiuretic hormone

The nurse is caring for a child diagnosed with tonsillitis. Which nursing action is most helpful prior to the tonsillectomy? Instruct on salt water gargling. Obtain blood cultures to determine the causative organism. Begin a 10-day course of antivirals to treat the infection. Use a warm-mist vaporizer as a comfort measure to relieve symptoms.

Instruct on salt water gargling.

The nurse is assisting in an emergency situation at a store. The child appears pale, has small quick respirations, exhibits stridor and is sitting in a tripod position. What action will the nurse take first? Obtain a heart and respiratory rate. Instruct the child to cough. Begin abdominal thrusts. Instruct someone to call 911 for emergency assistance.

Instruct someone to call 911 for emergency assistance.

The nurse is caring for a child with HIV admitted to the pediatric unit. Which assessment finding would alert the nurse that the child has most likely progressed from HIV to AIDS? Kaposi sarcomas observed on the skin hepatomegaly noted during percussion enlarged lymph nodes felt with palpation crackles noted in lower lobes of the lungs

Kaposi sarcomas observed on the skin

What statement is the most accurate regarding the structure and function of the newborn's respiratory system? The diameter of the child's trachea is the same as that of adults. Most infants are nasal breathers rather than mouth breathers. The respiratory tract in the child is fully developed by age 2. Infants and young children have smaller tongues in proportion to their mouths.

Most infants are nasal breathers rather than mouth breathers.

Which clinical manifestation of acute nasopharyngitis is more of a concern for the infant than the older child? Fever Vomiting Nasal congestion Diarrhea

Nasal congestion

The nursing instructor is describing the events of anaphylaxis. Place the assessment findings in the order that they would occur from first to last. Nausea, vomiting, diarrhea Bronchospasm Urticaria, angioedema Hypoxia Seizures

Nausea, vomiting, diarrhea Urticaria, angioedema Bronchospasm Hypoxia Seizures

Upon providing discharge instructions home after a tonsillectomy and adenoidectomy, which is most important? Provide acetaminophen for pain. Note any frequent swallowing. Allow the child an age-appropriate, quiet plan. Stress regular fluid consumption.

Note any frequent swallowing.

A child presents to the health clinic with a temperature of 101.8°F (38.8°C), dysphagia, headache, and a sore, erythematous throat. Which collaborative intervention will the nurse complete first? Obtain a throat culture. Begin saltwater gargles. Assess the child for a rash. Administer oral antibiotics.

Obtain a throat culture.

The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse tells the caregiver to increase the amount of which substance in the child's diet? Iodized salt Saturated fat Pancreatic enzymes Calories from protein

Pancreatic enzymes

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply. Abrupt onset of symptoms Marked weight loss Polyuria Polydipsia Polyphagia

Polyuria Polydipsia Polyphagia

A nurse is providing education to pregnant women diagnosed with HIV. Which statement indicates the need for further teaching? Pregnancy will accelerate the progression of the disease. It is not safe to breastfeed my baby, so I will use formula. Antiretroviral treatment is effective in reducing maternal-fetal transmission. My health care provider may want me to have a cesarean birth.

Pregnancy will accelerate the progression of the disease.

In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason? Relief of acute symptoms Management of chronic pain To stabilize the cell membranes Prevention of mild symptoms

Relief of acute symptoms

After teaching an adolescent how to use an epinephrine auto injector, the nurse observes the adolescent attempting to self-administer the medication. The adolescent indicates the site to be used, pointing to the abdomen just below the umbilicus. Which action should the nurse take next? Allow the adolescent to administer the auto injector at the site indicated. Tell the adolescent to choose the upper arm instead of the abdomen. Stop the adolescent from continuing and review the appropriate site to use. Explain that that site is used only if another site is not available.

Stop the adolescent from continuing and review the appropriate site to use.

A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? Syndrome of inappropriate antidiuretic hormone Diabetes insipidus Hyposecretion of somatotropin Hypersecretion of somatotropin

Syndrome of inappropriate antidiuretic hormone

A client in the fourth month of pregnancy has recently learned that the sexual partner is HIV-positive. The client agrees to be tested for the virus but asks, " If I am positive, how will it change my birth plan?" How will the nurse respond? You may want to consider a cesarean birth. You will be given antibiotics during labor to prevent transmission of HIV. You may need to consider having an epidural for your labor analgesia. The newborn will be taken to the neonatal intensive care unit (NICU) right away.

You may want to consider a cesarean birth.

The nurse is teaching a child with PKU about his or her special diet during a checkup visit. It would be appropriate to teach the child that he can eat which of the following foods? Select all that apply. a hamburger a milkshake a potato a banana a scrambled egg

a potato a banana

The nurse is caring for a child who is having bronchospasm. The nurse would expect to administer what medication? epinephrine corticosteroid albuterol diphenhydramine

albuterol

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breathe. The signs the nurse noted indicate the child likely has: epiglottitis. asthma. cystic fibrosis. tuberculosis (TB).

epiglottitis.

An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: gastroesophageal reflux disease. cystic fibrosis. Hirschsprung disease. inflammatory bowel disease.

gastroesophageal reflux disease.

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone? vasopressin antidiuretic hormone oxytocin growth hormone

growth hormone

The nurse is discussing the disease known as pellagra. This disease is due to a deficiency in which of the following? thiamine vitamin C niacin iron

niacin

A mother who is HIV positive is distraught when she learns that her 6-month-old baby is also HIV-positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was: placental spread during pregnancy. blood transfusion products contaminated with the virus. the mother kissing the baby on the forehead. breastfeeding.

placental spread during pregnancy.

A 5-year-old girl who was already admitted to the hospital for an unrelated condition suddenly becomes irritable, restless and anxious. These may be early signs of respiratory distress in a child if accompanied by: tachypnea. retractions. cyanosis. clubbing of fingers

tachypnea.

The nurse is collecting data on a child who has been nutritionally deprived. The nurse notes that the child is irritable and listless. The foster caregiver reports that the child says she is not hungry and has been vomiting. It is discovered that the child has beriberi. This disease is due to a deficiency in which of the following? thiamine vitamin C niacin iron

thiamine

A nurse is preparing to discharge a neonate diagnosed with maple syrup urine disease. Which nursing instruction is essential for care of the neonate in the home? reinforcing the need for the prescribed lifelong dietary regimen teaching the parents that crises increase with growth emphasizing the need to reduce calorie intake when the child is ill informing the parents that protein should be increased in times of crises

reinforcing the need for the prescribed lifelong dietary regimen

A school nurse is called to the school cafeteria after a 13-year-old child is reported to have sudden difficulty breathing. The child has a history of asthma and allergies to peanuts. The focused nursing assessment reveals difficulty breathing, inspiratory and expiratory wheezing, swelling of lips, and a rash on the face. The child reports feeling nauseated, having chest tightness, and feeling faint. Complete the following sentence(s) by choosing from the lists of options. The nurse should first address the child's Dropdown Item 1 then Dropdown Item 2. wheezing swelling of lips nausea chest tightness rash feeling faint

wheezing swelling of the lips

The nurse knows that which condition is caused by excessive levels of circulating cortisol? Addison disease Graves disease Turner syndrome Cushing syndrome

Cushing syndrome

A child receiving radiation therapy has a nursing diagnosis of Impaired skin integrity related to the effects of radiation therapy as manifested by erythema and dryness of the skin. Which would the nurse include in the child's plan of care? Select all that apply. Expose the skin to air frequently. Soak the area in warm water for 30 to 40 minutes frequently. Encourage snug-fitting clothing. Avoid application of creams and lotions. Use mild soap to clean the skin.

Expose the skin to air frequently. Avoid application of creams and lotions. Use mild soap to clean the skin.

The parents of a 5-week-old infant present to urgent care because the child is "throwing up forcefully with every feeding." What other assessment(s) will the nurse complete? Select all that apply. feeding technique family history of lactose and gluten intolerance vomiting description and pattern current weight and weight gain since birth mucous membranes and skin

vomiting description and pattern current weight and weight gain since birth mucous membranes and skin feeding technique

The nurse is providing education to a client newly diagnosed with asthma. Which statement by the parents indicates additional teaching is needed? "We will keep an albuterol inhaler with our child at all times." "It is okay for our child to do chores such as sweeping the floor." "We will both enroll in smoking cessation classes." "Our family dog will need to go live with a grandparent."

"It is okay for our child to do chores such as sweeping the floor."

When teaching about primary and secondary humoral responses, what should the nurse identify as the immunoglobin that is first to appear in the serum? IgG IgM IgD IgE

IgM

A child diagnosed with hemophilia presents with warm, swollen, painful joints. Which action will the nurse take first? Document the presence of hemarthrosis in the client's chart Notify the client's primary health care provider Assess the client's urine and stool for blood Prepare to administer factor replacement medication

Prepare to administer factor replacement medication

What nursing action should the nurse take when caring for a child with aplastic anemia? Assess the child's blood pressure every hour. Ensure the child is offered a low-fiber diet. Encourage visits from friends and family. Provide toys that do not have sharp corners or edges.

Provide toys that do not have sharp corners or edges.

A client presents to the clinic for allergy testing. The nurse is reviewing current medications taken within the past 5 to 7 days. Which classification of medication, if taken by the client, will cause the nurse to reschedule the allergy testing appointment? antipyretic antibiotic antihistamine corticosteroid

antihistamine

A 14-year-old girl who is a vegetarian has recently developed anemia. Blood smear results show large, fragile, immature erythrocytes. She claims to take an iron supplement regularly and is surprised to learn that she is anemic, as she is otherwise healthy. As the nurse considers all of the data in the case, which anemia will the nurse discuss when collaborating with the primary healthcare provider? vitamin B12 deficiency iron deficiency sickle-cell disorder acute blood loss

vitamin B12 deficiency

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect? Appendicitis Pancreatitis Gastroenteritis Hirschsprung disease

Gastroenteritis

Which immunizations are suggested at 2 months of age to prevent bacterial pneumonia? Select all that apply. Rubella Rotavirus Hib Varicella Pneumococcal

Hib Pneumococcal

The nurse is providing education regarding 2030 Health Goals to reduce the incidence of acquired immunodeficiency syndrome (AIDS) within the community. Which goal will the nurse choose as a primary prevention strategy? Refer at-risk community members to the clinic for HIV/AIDS screening. Increase the number of schools with an indoor air management system. Provide education to sexually active females about proper condom usage. Reduce the baseline level of allergens in dust within homes and buildings.

Provide education to sexually active females about proper condom usage.

The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning chemotherapy. What action would be the priority? Applying EMLA to the lumbar puncture site Educating the child and family about the testing procedures Administering promethazine as ordered for nausea Educating the family about chemotherapy and its side effects

Educating the child and family about the testing procedures

A nurse is preparing a presentation for a group of parents with children diagnosed with type 1 diabetes. The children are all adolescents. What issues would the nurse address related to their developmental level? Select all that apply. Self-monitoring of blood glucose levels Feelings of being different Deficient decision-making skills Body image conflicts Struggle for independence

Deficient decision-making skills Body image conflicts Struggle for independence

The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis? Deficient fluid volume related to dehydration Excess fluid volume related to edema Deficient knowledge related to fluid intake regimen Imbalanced nutrition, more than body requirements related to excess weight

Deficient fluid volume related to dehydration

A 9-year-old female child was brought to the emergency department after experiencing wheezing and shortness of breath while playing soccer. The parents administered two puffs of albuterol metered dose inhaler (MDI) with little effect, and 911 was notified. Paramedics applied oxygen 2 liters by nasal cannula for oxygen saturation of 90% on room air, and administered an albuterol nebulizer treatment. Audible wheezing was heard, and a 20-gauge intravenous (IV) catheter was inserted. Vital signs upon arrival at the emergency room: temperature, 98.8°F (37.1°C); heart rate, 125 beats/min; blood pressure, 88/50 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 92% on simple face mask. Child appears anxious. Complete the following sentence(s) by choosing from the lists of options. The emergency room nurse should first Dropdown Item 1 then Dropdown Item 2. assess airway administer intravenous (IV) methylprednisolone assess circulation administer albuterol MDI assess level of consciousness instruct client to use a peak flow meter

assess airway administer intravenous (IV) methylprednisolone

A child experiencing anaphylactic shock is being brought to the emergency room by ambulance. The nurse is preparing for the client's arrival. Epinephrine 1:1000 intramuscular (IM) was administered according to the child's body weight immediately before arrival. When preparing the assigned room, what will the nurse have ready? Select all that apply. second dose of epinephrine within the room oxygen equipment with an appropriate-sized oxygen mask intravenous pump with equipment to place an intravenous catheter added side rails with antiseizure medication in the department chairs or space for family to remain with the child

oxygen equipment with an appropriate-sized oxygen mask intravenous pump with equipment to place an intravenous catheter added side rails with antiseizure medication in the department chairs or space for family to remain with the child

A 7-year-old child is being discharged home after a tonsillectomy where the child will be cared for by the parents. Which information will the nurse include in the discharge teaching for the parents regarding pain control? Select all that apply. Give the full dose of pain medication prescribed. Make sure the child gets the recommended amount of fluids. Watch for any oral bleeding. Allow the child to have ice cream. Give half the dose of the medication between the full doses.

Give the full dose of pain medication prescribed. Make sure the child gets the recommended amount of fluids.