Exam 2 Pediatrics

During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups?

"Acceptance by friends, especially of the same sex, is very important at this age."

When 12-year-old Chelsie comes in for her annual check-up, the nurse must take a health history and do a physical exam. What is the most appropriate manner for the nurse to obtain a health history?

Ask Chelsie if she minds if her mother is in the room with her.

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation?

Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment

A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be?

Assess the child's airway and manage airway patency

An injured child has been hospitalized. The physician orders an application to help constrict capillaries and therefore reduce capillary permeability and edema. Which does the nurse apply to the child?

Cold pack

A nurse is performing a neurological assessment on an adolescent. Which of the following is an appropriate reaction by the adolescent whe the nurse checks the trigeminal cranial nerve? (Select all that apply)

Detecting facial touches with eyes closed Clenching teeth together tightly

A nurse is caring for a child who is experiencing respiratory distress. Which of the following findings are early manifestations of respiratory distress? (Select all that apply)

Diaphoresis

The nurse is using blowing bubbles during a procedure with a child as an alternative pain-management technique. What type of alternative pain management is this considered?

Distraction

A nurse is taking care of a teenager who reports involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?

Educate the client about the changes that occur during adolescence.

A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development?

Encourage the teen's friends to visit him in the hospital.

A nurse is preparing a toddler for an intravenous catheter insertion using atraumatic care. Which of the following actions should the nurse take? (Select all that apply)

Explain the procedure using the child's favorite toy Apply lidocaine and prilocaine cream to the potential insertion site

The nurse is counseling a 13-year-old male about recent negative behaviors at school. Which individual is most likely the greatest influence on the teen's decision making?

Friends at school

A 9-year-old girl builds a clubhouse in her backyard. She hangs a sign outside her clubhouse that says "No boys allowed" printed on it. The child's parents are concerned that she is excluding their neighbor's son, and they are upset. What should the school nurse tell the child's parents?

Her behavior is common among young school-age children.

A toddler has come to the ER with a fever and cough. The nurse is thinking about the developmental considerations for the examination. The mother is with the toddler who is currently walking around on the ER floor. Due to his age and development for the assessment the nurse asks the mother to:

Hold the toddler on her lap

The nurse is assessing an infant who was a passenger in a car involved in a motor vehicle accident. During the assessment, the child's anterior fontanel is bulging. The nurse is aware that what may cause this assessment finding?

Increased intracranial pressure

Local topical anesthetic for pre-procedure such as starting IV's and other type of puncture procedures

Lidocaine

Ketorolac is being utilized for a 5 year-old child during a sickle cell anemia crisis. Nurses know that Ketorolac is what category of pain medication

NSAID

A 14-year-old child is brought to the emergency department. His parents state that they think he took "too many of his pain pills." The child had been prescribed oxycodone every 4 hours for pain secondary to a bone infection. Which agent would the nurse expect to be administered to counteract the analgesics?

Naloxone

When administering parenteral or epidural opioids, the nurse should always have ready access to which medication?

Naloxone

The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best?

"I am here to answer your questions and be with you during this difficult time."

The mother of 11-year-old fraternal twins tells the nurse at their well-child checkup that she is concerned because her daughter has gained more weight and height than her twin brother. The mother is concerned that there is something wrong with her son. The nurse's best response is:

"It is normal for girls to grow a little taller and gain more weight than boys at this age."

The mother of a 15-year-old is frustrated because he spends much of his weekend time sleeping. Which is the nurse's best response to the mother's frustration

"Teens require more sleep due to the rapid physical growth that is occurring."

The nurse is caring for a 9-year-old one-day post-op appendectomy client. She is due to receive a dose of IV meperidine. Her mother is at the bedside and asks why her daughter needs another dose of morphine when she received one just 4 hours ago. Which statement shows the nurse's understanding of pain management?

"The physician has ordered meperidine to be given around the clock in order to keep on top of your daughter's postoperative pain."

A teenage boy and his mother have come to the office for a routine visit. In the hallway, his mother confides that she is concerned because her son is playing games that the girls play, and she has noticed that when he plays any role-playing games his character is very feminine. She tells you that she is worried about his sexual orientation. What is the best response to her concerns?

"This behavior may be exploratory or reflect peer pressure, so do not make assumptions regarding sexual orientation."

The nurse caring for a 28-week pre-term infant prepares to obtain a capillary blood specimen for a routine bilirubin test via heel stick. The parents are at the bedside and ask the nurse if their infant will feel pain when he is stuck. Which is the best response for the nurse to make?

"Your son will experience pain for a brief moment when his heel is stuck."

A nurse is providing teaching to a parent about acetaminophen poisoning. Which of the following information should the nurse include in the teaching?

Pallor can appear as early as 2 hr after ingestion

A young client in the intensive care unit is in a coma after a severe head injury. The primary nurse is teaching a nursing student how to assess the client's level of consciousness using a coma scale. What type of scale could be used for this purpose?

Pediatric Glasgow scale

A nurse is assessing a 6-month-old infant. Which of the following reflexes should the infant exhibit?

Plantar grasp

A nurse is in the emergency department is caring for a child whose parent reports that the child has swallowed paint thinner. The child is lethargic, gagging, and cyanotic. Which of the following actions should the nurse take?

Prepare for intubation with a cuffed endotrachael tube.

A 10-year-old spends 2 hours by herself every afternoon before her parents arrive home. What would be the most appropriate safety measure to suggest that the parents teach the child?

Preparing a no-cook snack for herself

A school-age client is in the clinic for a sprained ankle and is ordered to take NSAIDs for pain control. What should the nurse inform the mother may be associated with long-term administration of any NSAID?

Severe gastric irritation

An adolescent with multiple tattoos and piercings comes to the health center at her school. She is complaining of feeling hot. In collecting further data the nurse finds that the child has a new piercing. The nurse recognizes the need for the adolescent to be given information related to personal health. Which topic would the nurse identify as the area that the adolescent needs immediate information about?

Signs of infection

A nurse is talking with a school-age child with asthma who expresses concerns that peers will not want to be friends because of the disease. What therapeutic communication technique would be beneficial for the nurse to use?

Sit at the child's level and allow the child time for self-expression.

A 13-year-old girl is at the clinic for a wellness visit. The nurse is updating the sexual development using a common scale known as:

Tanner Scale

A 4 year old is scheduled for a cardiac catheterization tomorrow. What type of teaching would be best for a preschooler having an invasive procedure?

Teaching with dolls or toys

The developmental task of the adolescent period, according to Erikson, is to form a sense of:

identity versus role confusion.

A child with hives is prescribed diphenhydramine (Benadryl) 5 mg/kg per day in divided doses every 6 hours. The child weighs 40 lb. How many milligrams should the nurse give for each dose?

22.75 mg.

A nurse is preparing to assess a preschool-age child. Which of the following is an appropriate action by the nurse to prepare the child?

Allow the child to role play using play equipment.

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction?

Body image changes

When a poison has been ingested by a child, what should the parents do first?

Call the local poison control center.

A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks you about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. As the nurse, what reminders should you give her for when she discusses sex?

Promote open lines of communication; listen instead of lecture; and share family values.

A nurse is checking the vital sings of a 3-year-old child during a well-child visit. Which of the following findings should the nurse report to the provider?

Respiration 30/min

A 10-year-old boy has just arrived by ambulance at the emergency room following a motor vehicle accident, and a nurse is assessing him. Which three body systems should the nurse evaluate fist?

Respiratory, cardiovascular, and neurologic

The mother of a 7-year-old girl tells the school nurse that her child is deathly afraid of going to school. What would be the best intervention the nurse could suggest in this situation?

Return the child to school and investigate the cause of the fear.

Which technique should the nurse suggest to the mother of an 8-year-old who does not want to complete her chores?

Reward system.

Amoxicillin (Amoxil) 250 mg PO q8h is prescribed for a child who weighs 42 lb to treat strep throat. The desired dose is 50 mg/kg/day. The nurse determines that:

The prescribed dose is too low.

A 13 year-old boy is hospitalized for a femur fracture. He was hit by a car while he and his friends were racing bikes near a major intersection. The child's parents are concerned about his judgment. The nurse should tell the parents that the behavior is:

Typical for young teen.

A nurse is planning care for an infant who is experiencing pain. Which of the following interventions should the nurse include in the plan of care? (Select all that apply)

Use swaddling Offer a pacifier Encourage kangaroo care

A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which action would be most appropriate?

Ventilating the child with a bag-valve-mask

The school nurse is discussing various topics with a group of adolescent girls. One of the girls states, "I just want to be pretty and to look like everyone else." The nurse recognizes that the girl's feelings about herself and her body relate to the development of:

self-esteem