Final for Peds 2
Discharge instructions for the parents of a child with tympanostomy tubes are provided by the nurse and should include instructions to contact the health care provider if: (Select all that apply)
*
Which of the following Reportable Events should the parents report to the oncologist while the child is receiving chemotherapy? Select all that apply.
*
Which of the following nursing interventions are appropriate when caring for the child following a tonsillectomy and adenoidectomy? (Select all that apply).
* Assessing for frequent swallowing (bleeding), vital signs, hydration, fever, diet (give clear diet), pain, N & V
The nurse performs a neurological assessment on a 12-year-old child. Which of the following findings are early signs of increased intracranial pressure (ICP)? Select all that apply.
* Decreasing LOC, disorientation, restlessness, increased respiratory effort, mental confusion, pupillary changes, weakness on onside of the body or in one extremity, and constant, worsening headache
The nurse should be aware postural drainage is useful for three of the following respiratory conditions. Which condition is not usually treated with postural drainage?
* Epiglotitis
A 2-month-old infant is admitted to the pediatric unit presents with projectile vomiting, non-bilious vomitus, appears hungry especially after emesis, is irritable, fails to gain weight, and has fewer and smaller stools. The nurse recognizes these signs and symptoms are common in children with:
* Pyloric Stenosis
A 4-year-old, recently diagnosed with a severe allergy to tree nuts. The nurse instructs the family to not only avoid nuts to explains the need for:
* Responding to potential allergic reactions
A nurse is caring for a child in a hip spica cast that is in Buck extension traction. Which of the following is an appropriate action for the nurse to take?
* The nurse inspects the skin of the limb in traction at least once every 8 hours for irritation or Inflammation. Ensure skin integrity by avoiding pressure on heel, dorsum or foot, fibular head, or malleolus. Maintain counteraction by elevating foot of bed or keeping head of bed flat. Encourage independence with use of trapeze.
A parent asks why a child with suspected meningitis must have a lumbar puncture. The nurse's best response is:
* To diagnose viral meningitis, to obtain some of the fluid that normally surrounds the brain and spinal cord. (CSF).
The nurse is assessing a newborn and hears a cardiac murmur. The infant is alert, breastfeeding well with normal behavior, color and vital signs. The nurse's best action is to?
* Wait to see if the opening will close by 1 week of age
A nursing supervisor assigns a float nurse in an adult medical/surgical unit to work in a pediatric unit. This is the nurses first time in a pediatric setting. Which of the following is an appropriate assignment for the nurse? a. Care for postoperative school-age clients. b. Function as an assistive personnel (AP). c. Shadow an experienced pediatric nurse. d. Assist the unit clerk at the nurse's desk.
* a. Care for postoperative school-age clients. Hospitalized school-aged children tend to have similar medical-surgical diagnoses to adults and are in an age group that is easier to care for than younger children or adolescents. The float nurse should be able to handle this assignment with minimal guidance.
When taking an initial health history from an adolescent suspected of having scoliosis, the nurse would expect the adolescent to state that: a. "I can't find clothes that fit me properly". b. "I always have a backache" c. "I become short of breath easily" d. "I can't find clothes that fit me properly". " I haven't grown much lately"
* b. "I always have a backache"
A 7-year old child is hypokalemic. Which of the following foods would the nurse encourage from the menu?
*Ham & cheese baked potatoes with fruit plate
The recommended dose of Dilantin for a child is 5 mg/kg/24 hours given every 12 hours (weight: 11 pounds). The medication is supplied in 250 mg/10 ml. How many milliliters will be administered for each dose?
0.5 ml
A mother arrives at clinic with her 6-month-old child. While the nurse is assessing the child, the mother points to the umbilicus and says: "What am I going to do about this? When he cries, it looks like it's going to burst." The nurse's best response would be: A. "It's the best if you don't let him cry. Just let him do what he wants." B. "It probably wont rupture unless he gets real. I wouldn't worry about it." C. "I know it looks scary, but it really wont burst." D. "Put a binder around it, and that will keep it from bursting when he gets mad."
C. "I know it looks scary, but it really wont burst." It is a common finding that when the infant with an umbilical hernia cries, the hernia protrudes but will not rupture.
A nurse has collected 160 mL of urine output from a 3-year-old client during 8 hr. The client weighs 33 lb. What is the next nursing action?
Continue to monitor client
A newborn is capable of holding a rattle using the palmar grasp. The infant later demonstrates picking up small objects using the pincer grasps. This pattern of development is termed:
Fine motor development
The normal dose range for erythromycin, an antibiotic, is 30-50 mg/kg po 6h. The physician ordered 250 mg po q6h for a child who weighs 30 kg. This a safe dose for this child?
NO
Which statement is most therapeutic for the nurse to offer to a family of a child who has just died?
Offer a sincere condolence, Offer open-ended support, Offer silence
The nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. The initial therapy for a joint injury in this child is:
Provide intravenous (IV) infusion of factor VIII concentrates. If the child had MILD hemophilia elevation and application of ice to the applied joint would be sufficient. Parents are taught home infusion of factor VIII concentrate. For moderate and severe hemophilia, prompt IV administration is essential to prevent joint injury. NSAIDs are effective for pain relief. They must be given with caution because they inhibit platelet aggregation. A factor VIII level of 30% is necessary to stop bleeding. DDAVP can raise the factor VIII level fourfold. Moderate hemophilia is defined by a factor VIII activity of 4.9. A fourfold increase would not meet the 30% level. Ice and elevation are important adjunctive therapy, but factor VIII is necessary.
Parents of a child who will begin enteral feedings ask the nurse what advantage this type of feeding has over other methods. The nurse bases the response on what facts about enteral feedings? Select all that apply. a. "Enteral feeding is the closest to natural feeding methods." b. "The child must be able to absorb nutrients." c. "Enteral feeding is complex to administer." d. "Enteral feeding requires a central venous catheter." e. "Enteral feeding has a high success rate."
a. "Enteral feeding is the closest to natural feeding methods." b. "The child must be able to absorb nutrients." e. "Enteral feeding has a high success rate." Enteral feedings are the closest to natural feeding methods. The child must be able to absorb nutrients. Enteral feeding has a high success rate. It is not complex to administer, and does not require a central venous catheter.
An adolescent girl tells the nurse that she has suicidal thoughts. The nurse asks her if she has a specific plan. Asking this should be considered: a. An appropriate part of the assessment. b. Not a critical part of the assessment. c. Suggesting that the adolescent needs a plan. d. Encouraging the adolescent to devise a plan.
a. An appropriate part of the assessment. Routine health assessments of adolescents should include questions that assess the presence of suicidal ideation or intent. Questions such as "Have you ever developed a plan to hurt yourself or kill yourself?" should be part of that assessment. Threats of suicide should always be taken seriously and evaluated. Suggesting that the adolescent needs a plan and encouraging her to devise this plan would be inappropriate statements by the nurse.
A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma? a. Femur b. Humerus c. Pelvis d. Tibia
a. Femur Osteosarcoma is the most frequently encountered malignant bone cancer in children. The peak incidence is between ages 10 and 25 years. More than half occur in the femur. After the femur, most of the remaining sites are the humerus, tibia, pelvis, jaw, and phalanges.
A child with nephrotic syndrome has been placed on prednisone for several weeks. An important point of teaching with the parents should include a. Never stop the medication suddenly. b. This drug is taken once a week on Sunday. c. The child should always take the medication at night before bed. d. This drug should be taken with meals.
a. Never stop the medication suddenly.
Which of the following nursing interventions would be appropriate for a child with muscular dystrophy? (Select all that apply.) a. Suggest swimming as a good exercise for this child b. Teach the family proper body mechanics c. Immunize the child on the recommended schedule d. Encourage the child to perform as much self-care as possible e. Provide resources to the parents related to developmental norms for the child's age.
a. Suggest swimming as a good exercise for this child b. Teach the family proper body mechanics c. Immunize the child on the recommended schedule d. Encourage the child to perform as much self-care as possible Swimming can be good exercise for a child with muscular dystrophy. Lifting might be necessary for children with muscular dystrophy, and the family must know proper body mechanics. Immunizations on the recommended schedule are extremely important for this child to prevent illness. Encourage the child to perform as much self-care as possible.
A very concerned 14-year-old boy presents to the clinic because of an enlargement of his left breast. Except for the breast enlargement, the rest of the history and physical was reported as normal. The most appropriate intervention for the nurse to implement next would be to inform the child that a. This is a normal finding in adolescent males and that the breast tissue generally regresses by the time of full sexual maturity. b. His condition is related to a high-fat diet and that limiting fat intake usually will resolve the enlargement over a period of a couple of months. c. A pediatric endocrine consult is being arranged. d. The healthcare provider is arranging a surgical consult for him.
a. This is a normal finding in adolescent males and that the breast tissue generally regresses by the time of full sexual maturity.
The 9-year-old is hospitalized for neutropenia and is placed in reverse isolation. The child asks the nurse, "Why do you have to wear a gown and mask when you are in my room?" How should the nurse respond? a. "There are many forms of bacteria and germs in the hospital." b. "To protect you because you can get an infection very easily." c. "After taking medication for 24 hours a gown and mask won't be needed." d. "Your condition could be spread to staff and other clients in the hospital.
b. "To protect you because you can get an infection very easily." Reverse isolation precaution implement measures to protect the client from exposure to microorganisms from others (B). Although microbes are prevalent in all environments, (A) does not adequately answer the child's question. Reverse isolation should be implemented until the client's white blood cell increases (C). Neutropenia in this child does not place others (D) at risk for infection.
After teaching the parents of a 6-year-old child about caring for a sprained wrist, which statement by the parents indicates the need for additional teaching? a. "She'll need to limit any activity that involves the wrist." b. "We'll apply a warm moist compress to the wrist for 20 minutes at a time." c. "We'll make sure she keeps her arm above heart level." d. "We can wrap the wrist in an elastic bandage to help reduce the swelling."
b. "We'll apply a warm moist compress to the wrist for 20 minutes at a time." Care for a sprain includes rest, ice, compression, and elevation. Cold therapy, not heat, is used for 20 to 30 minutes at a time, then removed for 1 hour and repeated for the first 24 to 48 hours. Compression via an elastic bandage, elevating above heart level, and limiting activity are appropriate measures.
The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, "My child has a low platelet count and we are being discharged this afternoon. What do I need to do at home?" Which of the following statements would be most appropriate for the nurse to make? a. "You should give your child aspirin instead of acetaminophen for fever or pain." b. "Your child should avoid contact sports or activities that could cause bleeding." c. "You should feed your child a bland, soft, moist diet for the next week." d. "Your child should avoid large groups of people for the next week."
b. "Your child should avoid contact sports or activities that could cause bleeding." A child with a low platelet count needs to avoid activities that could cause bleeding such as playing contact sports, climbing trees, using playground equipment, or bike riding. The child should be given acetaminophen, not aspirin, for fever or pain; the child does not need to be on a soft, bland diet or avoid large groups of people because of the low platelet count.
A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session? (Select all that apply.) a. Bone fractures b. Abdominal mass c. Sore throat and ear pain d. Headache e. Ecchymosis of conjunctiva
b. Abdominal mass c. Sore throat and ear pain e. Ecchymosis of conjunctiva The initial signs and symptoms of rhabdomyosarcoma tumors are related to the site of the tumor and compression of adjacent organs. Some tumor locations, such as the orbit, manifest early in the course of the illness. Other tumors, such as those of the retroperitoneal area, only produce symptoms when they are relatively large and compress adjacent organs. Unfortunately, many of the signs and symptoms attributable to rhabdomyosarcoma are vague and frequently suggest a common childhood illness, such as "earache" or "runny nose." An abdominal mass, sore throat and ear pain, and ecchymosis of conjunctiva are signs of a rhabdomyosarcoma tumor. Bone fractures would be seen in osteosarcoma and a headache is a sign of a brain tumor.
After years of treatment with chemotherapy and radiation, a child with a brain tumor is shown to be refractory to treatment, and a DNR (Do Not Resuscitate) has been obtained. The mother has reached the stage of acceptance; the father is angry that the medical and nursing team has not been able to "save" his child. How would the multidisciplinary team best. a. Tell the father that he should have brought his child in earlier for treatment. b. Continue to include the family in planning care and assure them that the child will be kept comfortable in the days to come. c. Initiate a Social Services referral. d. Contact the on-call chaplain for consultation with the entire family and ask him to take the father aside for additional assistance.
b. Continue to include the family in planning care and assure them that the child will be kept comfortable in the days to come. Being informed and involved will be the best way to assist the father at this point. Families also might need repeated and ongoing reassurances throughout the death process.
A child is being discharged after surgery for a myelomeningocele repair. Before discharge, the nurse works with the parents to establish a catheterization schedule to prevent urinary tract infection. With what frequency should the nurse instruct the parents to catheterize the child? a. Every 1-2 hours. b. Every 3-4 hours. c. Every 6-8 hours. d. Every 10-12 hours.
b. Every 3-4 hours.
A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. The first action by the nurse is to: a. Administer 100% oxygen to relieve hypoxia. b. Notify the practitioner because chest syndrome is suspected. c. Infuse intravenous antibiotics as soon as cultures are obtained. d. Give ordered pain medication to relieve symptoms of pain episode.
b. Notify the practitioner because chest syndrome is suspected. These are the symptoms of chest syndrome, which is a medical emergency. Notifying the practitioner is the priority action. Oxygen may be indicated; however, it does not reverse the sickling that has occurred. Antibiotics are not indicated initially. Pain medications may be required, but evaluation by the practitioner is the priority.
Which is most important to document about immunizations in the child's health history? a. Dosage of immunizations received b. Occurrence of any reaction after an immunization c. The exact date the immunizations were received d. Practitioner who administered the immunizations
b. Occurrence of any reaction after an immunization The occurrence of any reaction after an immunization was given is the most important to document in a history because of possible future reactions, especially allergic reactions. Exact dosage of the immunization received may not be recorded on the immunization record. Exact dates are important to obtain but not as important as a history of reaction to an immunization. The practitioner who administered the immunization does not need to be recorded in the health history. A potentially severe physiologic response is the most threatening and most important information to document for safety reasons
A nurse is assessing a child after an open reduction of a fractured femur. Signs that compartment syndrome could be occurring would be (Select all that apply). a. Pink, warm extremity. b. Pain not relieved by pain medication. c. Dorsalis pedis pulse present. d. Prolonged capillary-refill time with paresthesia. e. Paresthesia of the leg
b. Pain not relieved by pain medication. d. Prolonged capillary-refill time with paresthesia. e. Paresthesia of the leg
A nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for? (Select all that apply.) a. Diarrhea b. Respiratory depression c. Hypertension d. Pruritus e. Sweating
b. Respiratory depression d. Pruritus e. Sweating Side effects of opioids include respiratory depression, pruritus, and sweating. Constipation may occur, not diarrhea, and orthostatic hypotension may occur but not hypertension.
What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness? a. Give the child half his regular morning dose of insulin. b. Substitute simple carbohydrates or calorie-containing liquids for solid foods. c. Give the child plenty of unsweetened, clear liquids to prevent dehydration. d. Take the child directly to the emergency department.
b. Substitute simple carbohydrates or calorie-containing liquids for solid foods. A sick-day diet of simple carbohydrates or calorie-containing liquids will maintain normal serum glucose levels and decrease the risk of hypoglycemia.
Several children arrived at the emergency room accompanied only by their fathers. The nurse knows the father who may legally sign emergency medical consent for treatment is: a. The non-biologic one from the heterosexual cohabitating family. b. The divorced one from the binuclear family. c. The divorced one when the single-parent mother has custody. d. The stepfather from the blended or reconstituted family.
b. The divorced one from the binuclear family. The divorced father from the binuclear family may sign informed consent because he has equal legal rights with the mother under joint custody arrangements.
The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD). The nurse knows that a transfusion reaction will most likely occur: a. Six hours after the transfusion is given b. Within the first 20 minutes of administration of the transfusion c. At the end of the administration of the transfusion d. Never; children with SCD do not have reactions
b. Within the first 20 minutes of administration of the transfusion Blood reactions can occur as soon as the blood transfusion begins or within the first 20 minutes. The nurse should remain with the child for the first 20 minutes of the transfusion.
A mother arrives at the pediatric clinic with her 6-month- old infant. While the nurse assesses the child, the mother points to the umbilicus and says: "What am I going to do about this? When he cries, it looks like it's going to burst." What is the best response by the nurse? a. "It's best if you don't let him cry." b. "It probably won't rupture unless he gets excessively upset. I wouldn't worry about it at this time." c. "I know it looks frightening, but it really won't burst." d. "Put a binder around it, and that will keep it from bursting when he
c. "I know it looks frightening, but it really won't burst." It is a common finding that when the infant with an umbilical hernia cries, the hernia protrudes but will not rupture.
The nurse is teaching home feeding guidelines to the mother of a child with nonorganic failure to thrive. Essential information for the nurse to include would be the importance of which item? a. Restricting eating except at mealtimes b. Allowing the child to eat alone to minimize distraction c. Allowing the child to snack on finger foods, such as circular oat cereal and bananas d. A relaxed mealtime with few limits on behavior
c. Allowing the child to snack on finger foods, such as circular oat cereal and bananas Finger foods are helpful in encouraging children with failure to thrive to increase food intake.
The nurse is caring for a 9-month-old who just returned from the PACU after a shunt placement for hydrocephalus. Which of the following physician's orders would the nurse question? a. Vital signs and neurologic checks hourly b. Small, frequent formula feedings c. Elevate head of bed d. Daily head circumference
c. Elevate head of bed The 9-month-old should be placed in a flat position so that cerebrospinal fluid drainage is not too rapid. The nine-month-old should be placed in a flat position so that CSF drainage is not too rapid.
A graduate nurse (GN) tells the RN preceptor, "I need to insert a nasogastric tube in a pediatric client, and though I was checked off on this procedure in my nursing school's simulation lab, I have never inserted one on a real person." What is most appropriate response from the preceptor? a. I must see documentation of successful check-off by your school's instructor. b. Performing the procedure on a simulator is different from performing it on a real person. c. Let us review the procedure, then I will supervise you while you perform the procedure. d. I will help you, but we need to inform the client that you are new at doing this.
c. Let us review the procedure, then I will supervise you while you perform the procedure. Reviewing the procedure with the GN allows the preceptor to assess the GN's knowledge of the procedure, and supervising this first-time procedure is the safest option for the client (C). Documentation of a simulated experience (A) does not negate the need to supervise the GN's first experience. The GN is already aware of (B), which is why the issue was presented to the preceptor. Informing the client that the nurse is new at performing the procedure (D) is not necessary, but reviewing the procedure and supervising the GN is necessary. Category: Management
A graduate nurse (GN) tells the RN preceptor, "I need to insert a nasogastric tubein a pediatric client, and though I was checked off on this procedure in my nursing school's simulation lab, I have never inserted one on a real person." What is most appropriate response from the preceptor? a. I must see documentation of successful check-off by your school's instructor. b. Performing the procedure on a simulator is different from performing it on a real person. c. Let us review the procedure, then I will supervise you while you perform the procedure. d. I will help you, but we need to inform the client that you are new at doing this.
c. Let us review the procedure, then I will supervise you while you perform the procedure. Reviewing the procedure with the GN allows the preceptor to assess the GN's knowledge of the procedure, and supervising this first-time procedure is the safest option for the client.
Parents are being taught how to feed their infant using a newly placed gastrostomy tube (G-tube). What is essential information for the parents to receive? a. Verify placement before each feeding. b. Use a syringe with a plunger to give the infant bolus feedings. c. Position the infant on the right side during and after the feeding. d. Beefy red tissue around the G-tube site must be reported to the practitioner.
c. Position the infant on the right side during and after the feeding.
Parents are being taught how to feed their infant using the newly placed gastrostomy tube (G-tube). Essential information includes: a. Verify placement before each feeding. b. Use a syringe with a plunger to give the infant bolus feedings. c. Position the infant on the right side during and after the feeding. d. Beefy red tissue around the G-tube site must be reported to the practitioner.
c. Position the infant on the right side during and after the feeding. Positioning on the right side during and after feedings helps minimize the risk of aspiration. It is not necessary to verify placement before each feeing. G-tubes are inserted into the stomach and sutured in place. If the tube is through the skin, it is in the stomach. Feedings should be given by gravity flow. The plunger may be used to initiate the feeding, but then the formula should be allowed to flow. Beefy red tissue around the G-tube site is normal granulation tissue that is expected.
A nurse has just administered a dose of diazepam (Valium) to a adolescent client. Which of the following actions should the nurse take before she leaves the client's room? a. Turn off the overhead lights. b. Reduce the ringer volume on the client's telephone. c. Put up the side rails on the client's bed. d. Turn off the client's television.
c. Put up the side rails on the client's bed. Diazepam is a benzodiazepine that causes sedation and has antianxiety and muscle relaxation properties. For the client's safety, the nurse should raise the side rails, place the bed in the lowest position, and make sure the client's call light access device is within reach.
While being comforted in the emergency room, the 7-year-old sibling of a pediatric trauma victim blurts out to the nurse, "It's all my fault! When we were fighting yesterday, I told him I wished he was dead!" The nurse, realizing that the child is experiencing "magical thinking," should respond by: a. Asking the child if he would like to sit down and drink some water. b. Sitting the child down in an empty room with markers and paper so that he can draw a picture. c. Reassuring the child that it is normal to get angry and say things that we do not mean, but that we have no control over whether an accident happens. d. Calmly discussing the catheters, tubes, and equipment that the patient requires, and explaining to the sibling why the patient needs them.
c. Reassuring the child that it is normal to get angry and say things that we do not mean, but that we have no control over whether an accident happens. Magical thinking is the belief that events occur because of one's thoughts or actions, and the most therapeutic way to respond to this is to correct any misconceptions that the child might have and reassure him that he is not to blame for any accident or illness.
A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering? a. Taking over total care of the child to reduce stress on the family b. Encouraging family dependence on health care system c. Recognizing that the family is the constant in a child's life d. Excluding families from the decision-making process
c. Recognizing that the family is the constant in a child's life The three key components of family-centered care are respect, collaboration, and support. Family-centered care recognizes the family as the constant in the child's life. Taking over total care does not include the family in the process and may increase stress instead of reducing stress. The family should be enabled and empowered to work with the health care system. The family is expected to be part of the decision-making process.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. The nurse should do which of the following? a. Administer oxygen. b. Record data on the nurses' notes. c. Report data to the practitioner. d. Place the child in the high Fowler position.
c. Report data to the practitioner. One of the earliest signs of HF is tachycardia (sleeping heart rate >160 beats/min) as a direct result of sympathetic stimulation. The practitioner needs to be notified for evaluation of possible HF. Although oxygen or a semiupright position may be indicated, the first action is to report the data to the practitioner.
The nurse is providing care for a 6-year-old boy who has a broken arm and multiple bruises. The boy tells the nurse that his father was mad and broke his arm so the boy remembers to be good. What is the best nursing action? a. Chart that the child is a victim of abuse. b. Do nothing because the nurse cannot prove the child was abused. c. Report the situation to the appropriate authorities. d. Ignore what the child said because little children often lie.
c. Report the situation to the appropriate authorities. States have many statutes that require health care providers to report certain incidences or occurrences. If the provider fails to report as required and a person is injured, there can be negligence per se. It important for nurses to be aware of the reporting statutes in the state in which they are practicing. In most states, it is the law to report evidence of child or adult abuse. It is not appropriate to chart a decision that the child is a victim of abuse but rather to accurately describe injuries and comments that are made. Nurses should listen to what the patient has to say—whether the patient is a child or adult.
The nurse observes excessive salivation and drooling accompanied by cyanosis, choking, and coughing in a neonate. The nurse recognizes that this is a medical emergency in infants with: a. Severe dehydration b. Gastroesophageal reflux c. Tracheoesophageal fistula d. Congenital diaphragmatic hernia
c. Tracheoesophageal fistula
A healthcare provider tells the nurse that a certain medication will be prescribed for a client. After the prescription is written, the nurse notes that the provider has prescribed another medication that sounds similar to the medication that the provider and nurse originally discussed. What action should the nurse implement? a. Write the correct prescription as a verbal order received from the healthcare provider. b. Correct the misspelled medication in the written prescription and initial the change. c. Consult with the pharmacist to determine the best medication for the client. d. Contact the healthcare provider to clarify the prescription intended for the client.
d. Contact the healthcare provider to clarify the prescription intended for the client. Since the nurse received contradictory information, the provider should be contacted (D) to clarify the intended prescription. (A) may result in a medication error. The nurse does not have the authority to alter prescriptions (B). The pharmacist (C) cannot determine the best medication for a client.
Which of the following immunizations should not be given to a child receiving chemotherapy for cancer? a. Tetanus vaccine b. Inactivated poliovirus vaccine c. Diphtheria, pertussis, tetanus (DPT) d. Measles, rubella, mumps
d. Measles, rubella, mumps The vaccine used for MMR is a live virus and can cause serious disease in immunocompromised children. The tetanus vaccine, inactivated poliovirus vaccine, and DPT are not live vaccines and can be given to immunosuppressed children. The immune response is likely to be suboptimum, so delaying vaccination is usually recommended.
A 2-year-old starts to have a tonic-clonic seizure while in a crib in the hospital. The child's jaws are clamped. The most important nursing action at this time is to a. Prepare the suction equipment. b. Restrain the child to prevent injury. c. Place a padded tongue blade between the child's jaws. d. Stay with the child and observe his respiratory status.
d. Stay with the child and observe his respiratory status.
A adolescent female client is angry due to separation from her infant at home with relatives and is leaving the hospital against medical advice (AMA). However the client demands to take her chart with her and states the chart is "hers" and she doesn't want any more contact with the hospital. How should the nurse respond? a. Because you are leaving against medical advice, you may not have your chart. b. The information in your chart is confidential and cannot leave this facility legally. c. This hospital does not need to keep it if you are leaving and not returning here. d. The chart is the property of the hospital but I will see that a copy is made for you.
d. The chart is the property of the hospital but I will see that a copy is made for you. The chart is the property of the facility, but the client has a legal right to the information in it, even if he is leaving AMA, so a copy of the record (D) should be provided. The client does not lose his legal rights to his medical record if he leaves AMA (A). The medical record is confidential, but the hospital protects the client's privacy by not allowing unauthorized access to the record, so the hospital may provide the client with a copy (B). The hospital must maintain records of the care provided and should not release the original record (C)
When caring for the child with Kawasaki disease, the nurse should know which of the following? a. Aspirin is contraindicated. b. Principal area of involvement is the joints. c. Child's fever is usually responsive to antibiotics within 48 hours. d. Therapeutic management includes administration of gamma globulin and salicylates.
d. Therapeutic management includes administration of gamma globulin and salicylates. High-dose intravenous gamma globulin and salicylate therapy is indicated to reduce the incidence of coronary artery abnormalities when given within the first 10 days of the illness. Aspirin is part of the therapy. Mucous membranes, conjunctiva, changes in the extremities, and cardiac involvement are seen. The fever of Kawasaki disease is unresponsive to antibiotics. It is responsive to anti-inflammatory doses of aspirin and antipyretics.
The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer. The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations? a. Unawareness of the illness and its severity b. Acceptance, especially if able to discuss the disease with children their own age c. Understanding of what cancer is and how it is treated d. Thoughts that they caused their illness and are being punished
d. Thoughts that they caused their illness and are being punished Preschool-age children are egocentric and have magical thinking, and thus they might believe they caused their own illness.
