NRS 384 powerpoint

Toddlers need at least ___ minutes of structured physical activity per day

30

Absence of bowel sounds can be determined after a ___ minute period of auscultation

5

A nurse is assessing a child with suspected osteomylitis. Which finding would help support the suspicion? A. swelling and point tenderness B. Decreased erythrocyte sedimentation C. Coolness of affected site D. Increased range of motion

A

The nurse is teaching the mother of a 5-year-old body with a history of impaction how to administer enemas at home. Which of the following responses from the mother indicates a need for further teaching? A. I should position him on his abdomen with knees bent B. He will require 250 ml to 500 ml of enema solution C. I should wash my hands and then wear gloves D. He would retain the solution for 5 to 10 minutes

A

When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A. Skeletal traction B. Physical therapy C. Orthotics D. Occupational therapy

A

When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse least likely to note? A. Parallel play B. Cooperative play C. Dramatic play D. Fantasy play

A Toddlers are more likely to cooperate in parallel play than preschoolers

A nurse is conducting a physical examination of a child with suspected cardiovascular disorder. Which of the following findings would the nurse most likely expect to assess if the child has transposition of the great vessels? A. significant cyanosis without presence of a murmur B. Abrupt cessation of chest output with an increase in heart rate/filling pressure C. Soft systolic ejection D. holosystolic murmur

A pulmonary artery and aorta are switched from their normal position; poorly oxygenated blood returning to the right atrium and ventricle is then pumped out to the aorta and back to the body

The parents of a 4-year-old who is a picky eater asks the nurse what foods to include in their child's diet to provide adequate iron consumption. Which of the following foods would the nurse recommend? A. Cooked lentils B. Whole milk C. Oranges D. Sweet potatoes

A Other foods include raisins, apricots, red meat, poultry, pork, dark leafy greens

An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A. Notifying the doctor immediately B. Applying ice C. elevating the arm D. Giving additional pain medication as ordered

A.

A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A. We should give this drug before he eats anything B. We need to keep a close eye for possible infection C. The drug should not be stopped suddenly D. He might gain some weight with this drug

B

After teaching the parents of a child who has hydrocele about this condition, which statement indicates that the teaching was successful? A. If this gets worse and we don't treat it, our son could become infertile B. This condition should gradually go away on its own C. The surgeon is going to operate on him immediately D. It's going to be difficult putting ice packs on his scrotum

B

During a health history, the nurse explores the sleeping habits of a 3 year old boy by interviewing his parents. Which of the following statements from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A. Our son sleeps through the night and we insist that he takes 2 naps a day B. We keep a strict bedtime ritual for our son, which includes a bath and bedtime story C. Our song still sleeps in a crib because we feel it is the safest place for him at night D. Our son occasionally experiences night walking so we allow him to stay up later when this happens

B

The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond? A. "It is best to just ignore this and to not respond to his questions." B. "This is normal; children his age do not understand the permanence of death." C. "You have to keep repeating that his grandfather is never coming back." D "He will eventually figure this out on his own."

B

The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A. Deep-breathing exercises B. Upright positioning C. Coughing D. Chest percussion

B

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? A. They increase liver enzymes B. They mask signs of infection C. They cause bone marrow suppression D. They decrease renal function

B

The nurse is caring for an infant with osteogensis imperfecta and is providing instruction on how to reduce the risk of injurt. Which response from the mother indicates a need for further teaching. A. I need to avoid pushing or pulling on an arm or leg B. I must carefully lift the baby under the armpits C. I should not bend an arm or leg into an awkward position D. We must avoid lifting the legs by ankles to change diapers

B

The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency (SCID). Which statement by the parents best indicates that they understand their child's condition? A. He'll need to receive intravenous immunoglobulin routinely B. We'll need to prepare him and ourselves for a bone marrow transplant C. He'll need to receive several different types of antiviral medications D. We'll make sure that he has his EpiPen with him at all times

B

The school nurse is working with a 10 year old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond? A. be patient; she is trying some new medication B the pain she is having is real C. the family is working toward improvement D. please do not add to this family's stress

B

When conducting a physical examination of a child with suspected Kawasaki disease, which of the following would the nurse expect to assess? A. Hirsutism or striae B. strawberry tongue C. malar rash D. cafe au lait spots

B

When instructing the parents of a toddler about appropriate nutrition, which of the following would the nurse recommend? A. about 12-16 oz of fruit juice per day B. Approximately 16-24 oz of milk per day C. Fat intake of 30% - 40% of total calories D. An average of 10 to 12 grams of fiber per day

B Toddlers should only have 4-6 oz of fruit juice per day (preferably no juice at all) fat intake of 20-30% of total calories average of 19 grams of fiber per day

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which of the following responses would alert the nurse to a confirmed risk factor for this condition? A. She has been very healthy up to now B. He just got over a head cold with laryngitis C. My child is just 18 months old D. My child has not been sick at all

B acute post-streptococcal glomerulonephritis usually follows an upper respiratory or skin infection

The nurse is assessing a 2 year old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A. The mother is suffering from depression B. The child is homeless and has no toys C. The mother describes an inadequate diet D. The child is unperturbed by loud noises

B no routine, no toys

The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writing, and twisting movements. Which of the following would the nurse use when documenting these observation A. Spastic B. Athetoid C. Ataxic D. Mixed

B. Spastic: Poor control posture, balance, and movement; exaggeration of deep tendon reflex, hypertonicity of affected extremities; continuation of primitive reflexes Athetoid: limp and flaccid, uncontrolled, slow, worm-like writhing or twisting movements, affects all four extremities and possible involvement of face, neck and tongue, movement increase during period of stress, dysarthria and drooling may be present Ataxic: rare form, poor coordination, unsteady gait, wide-based gait Mixed: combination of above, most common is spastic and athetoid

The nurse if caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate? A. I know it is boring, but you must remain immobile for 2 more weeks B. If there are no complications, you only have 2 more weeks here C. Lets come up with things to do like books, movies, games, and friends to visit D. If you resist your treatment, your condition will only get worse

C

The nurse is applying a urine bag to a 15 month old boy to collect a urine specimen. Which of the following would the nurse do first? A. apply benzoin to the scrotal area B. tuck the bag downward inside the diaper C. pat the perineal area dry after cleaning D. apply the narrow portion of the bag on the perineal space

C

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would document the stool's appearance most likely as which of the following? A. greasy B. clay colored C. currant jelly-like D. bloody

C

The school nurse is walking through the lunchroom when one of the children says she feels strange after switching her lunch with her friend. Which assessment would be most important? A. Asking if she has a rash anywhere B. Checking if she has any nausea C. Determining if her throat itches D. Asking if she has abdominal pain

C

____ is an abnormal enlargement of the distal phalanges usually associated with cyanotic heart disease or advanced chronic pulmonary disease

Clubbing

A femora pulse that is weak or absent in comparison to the brachial pulse is associated with ___ of the aorta

Coarction

The nurse is caring for a 4 year old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation? A. can you cough for me please? B. you must blow in this or you might get pneumonia C. if you don't try, I will have to get the doctor D. can you blow this cotton ball across the tray?

D

The nurse is performing a cognitive assessment of a 2-year-old. Which of the following behaviors would alert the nurse to a developmental delay in this area? A. a child cannot say name, age, and gender B. the child cannot follow a series of two independent commands C. The child has a vocabulary of 40 to 50 words D. The child does not point to named body parts

D

The nurse is providing postsurigcal care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing? A. Keeping the drainage tube taped in an upright position B. administering antibiotics as ordered C. Administering analgesics as prescribed D. using a double-diapering technique

D

The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parent to do? A. Place her in a booster seat with lap and shoulder belts in the front seat B. Place her in the back seat with lap and shoulder belts in place C. place her in forward facing car seat with a harness and top tether D. Place her in a booster seat with lap and shoulder belts in the back seat

D

Epispadias refers to a urethral defect resulting in the opening occurring on the ___ surface of the penis

Dorsal

___ is the inability to swallow or difficulty swallowing

Dysphagia

Nephrotic syndrome results in significant proteinuria and ____

Edema

Hydrocele is characterized by ___ in the scrotal sac

Fluid

During a ___, a toddler desires to eat one certain food and refuses others

Food jag

Tetralogy of fallout is a congenital heart defect that refers to the combination of ___ heart defects occurring together

Four Pulmonary stenosis, VSD, overriding aorta and right ventricular hypertrophy

The most common anomalies associated with cleft lip and palate include ____ defects, ear malformations, skeletal deformities, and genitourinary abnormalities

Heart

___ is an acute, systemic vasculitis occurring mostly in infants and young children

Kawasaki disease

About one third of all children with urologic malformations are at high risk for the development of ___ allergy

Latex

A nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A. Magical thinking B. Centration C. Transduction D. Animism

Magical Thinking

The GI tract includes all of he structures from the ___ to the anus

Mouth

When ___ of the spinal cord occurs around age 2, the toddler is capable of exercising voluntary control over the sphincters

Myelination

Fruit juice should be limited to 4-6 ___ per day

Ounces

Physical examination of the genitourinary system includes inspection and observation, auscultation, ___ and palpation

Percussion

The ____is the lower orifice of the stomach opening into the duodenum

Pylorus

Edema of the lower extremities is characteristic of ___ ventricular heart failure in older children

Right

The nurse is assessing a child with suspected infective endocarditis. Which of the following assessment findings would the nurse interpret as a sign of extra cardiac emboli? A. Pruritus B. Roth spots C. Delayed capillary refill D. Erythema marginatum

Roth spots other signs of endocarditis are osler nodes, janeway lesions, and black lines (splinter hemorrhages) under the nails

When toddlers with only essential words that are demonstrating __ speech

Telegraphic