Chapter 39 (PEDS)

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is which of the following? a) Placing an indwelling urinary catherter b) Placing a cotton ball in the underwear to catch urine c) Performing a suprapubic aspiration d) Obtaining a clean catch voided urine

Obtaining a clean catch voided urine

The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure. The nurse documents this finding as which of the following? a) Ecchymosis b) Purpura c) Petechiae d) Poikilocytosis

Petechiae

A child admitted with immune (idiopathic) thrombocytopenic purpura. What will the nurse anticipate the history to include? a) Petechial rash following a viral infection b) Frequent urinary tract infections c) Recent asapirin use d) Recent transfusion of platelets

Petechial rash following a viral infection

The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which of the following vital signs might indicate the possibility of an infection? a) Blood Pressure 100/70 b) Pulse oximetry 93% on room air c) Respirations 22 per minute d) Pulse rate 135 bpm

Pulse rate 135 bpm

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which of the following is the most accurate regarding urinary tract infection seen in children? a) Males between the ages of 10 to 12 years of age commonly get UTI's. b) Girls who have gone through puberty most commonly get UTI's. c) The most common age for UTI's in children is 2 to 6 years of age. d) Urinary tract infections are rarely seen after toilet training.

The most common age for UTI's in children is 2 to 6 years of age.

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is for which of the following reasons? a) To dilute the urine and flush the bladder. b) To decrease the pain of urination. c) To fill the bladder so a specimen can be obtained. d) To prevent the child from developing a fever.

To dilute the urine and flush the bladder.

A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state which of the following? a) "We should administer the drug on an empty stomach." b) "He might develop a rounded face from this drug." c) "We should check our son's urine for glucose." d) "We will need to gradually decrease the dosage."

We should administer the drug on an empty stomach."

What is the best response by the nurse to the parents of a child with leukemia who express guilt because they did not take immediate action when their child seemed to develop one respiratory infection after another? a) "Don't feel bad. Children get lots of colds." b) "Young children develop minor illness easily and often. Stop being hard on yourselves." c) "You need to focus on the present treatment now and not worry about the past." d) "Keep in mind that the signs of leukemia are often subtle and difficult to recognize."

"Keep in mind that the signs of leukemia are often subtle and difficult to recognize."

A child abruptly develops miniature petechiae over his legs, along with epistaxis and bleeding into the joints. Laboratory results reveal a platelet count of 20,000/mm3. The child is eventually diagnosed with idiopathic thrombocytopenic purpura (ITP). The mother of the child is distraught and asks the nurse what the course of this disorder typically is. Which of the following should the nurse mention? a) 4 to 6 weeks b) 1 to 3 months c) Chronic condition d) Terminal condition

1 to 3 months

Urinary tract infections are usually successfully treated by which of the following? a) Increasing fluids, such as cranberry juice b) Administering diuretics c) Administering antibiotics d) Performing bladder irrigations

Administering antibiotics

The nurse is admitting to an examination room a child with the diagnosis of "probable acute lymphoblastic leukemia." What will confirm this diagnosis? a) Complete white blood count b) History of leukemia in twin c) Lethargy, bruising, and pallor d) Bone marrow aspiration

Bone marrow aspiration

The nurse explains to the teenager that which alterations may occur when steroids are added to the cancer therapy regimen? a) Nighttime itching b) Loss of appetite c) Facial changes d) Urinary incontinence

Facial changes

A nurse is performing an assessment on a child. Which of the following would be indicative of a potential for a urinary tract infection? a) Holding urine while at school. b) Washing the genital area with water daily. c) Not using cleansing towelettes routinely. d) Not using soap when cleaning the urethral area.

Holding urine while at school.

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which of the following sites should she prepare? a) Sternum b) Femur c) Iliac crest d) Anterior tibia

Iliac crest

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered? a) Intravenous immune globulin b) Folic acid c) Deferoxamine d) Dimercaprol

Intravenous immune globulin

When planning care for a child with idiopathic thrombocytopenic purpura, you plan to teach her a) what foods are high in folic acid. b) not to pick or irritate her nose. c) to use mainly cold water to wash. d) to apply a soothing cream to lesions.

not to pick or irritate her nose.