ob peds exam II

Which behaviors would characterize a child adequately coping with a chronic illness? Select all that apply. 1 Behavior problems at home and school 2 Negative attitudes about his or her condition 3 Acceptance of his or her limitations and coping accordingly 4 Taking responsibility for his or her own physical care 5 Identification with other similarly affected people

3 4 There are two ways of coping with the illness. Children with healthy coping mechanisms accept their limitations and assume responsibility for their care. These children may also identify with other similarly affected people. Maladaptive coping is evident in behavior problems at home and school.

Which factors may influence how a family resolves a crisis? Select all that apply. Perception of the event Coping mechanisms Available support systems Other stressors Environmental conditions

A number of factors influence the way any family copes with a crisis. If the event is perceived as stressful, then it may take lot of time to resolve. The family's coping mechanisms always play an important role. Families with good support systems tend to adapt and cope well with any stressor. Concurrent stressors in the family may influence the type of coping mechanism used by the family. Environmental conditions play no role in the resolution of the crisis.

A nurse is caring for an infant with a suspected urinary tract infection (UTI). Based on the nurse's knowledge of UTIs, which clinical manifestation would be observed? (Select all that apply) A. Vomiting B. Jaundice C. Swelling of the face D. Persistent diaper rash E. Failure to gain weight

A. Vomiting D. Persistent diaper rash E. Failure to gain weight Vomiting is a clinical manifestation observed in an infant with a urinary tract infection (UTI) and can be related to poor feeding. Persistent diaper rash is a clinical manifestation of UTI in an infant. Failure to gain weight is a clinical manifestation of UTI in an infant related to poor feeding and vomiting.

A nurse is caring for a young infant with developmental dysplasia of the hip (DDH). Based on the nurse's knowledge of DDH, which clinical manifestation should the nurse expect to observe? Select all that apply. Select all that apply. Lordosis Negative Babinski sign Asymmetric thigh and gluteal folds Positive Ortolani and Barlow tests Shortening of limb on affected side

Asymmetric thigh and gluteal folds Positive Ortolani and Barlow tests Shortening of limb on affected side Asymmetric thigh and gluteal folds are a clinical manifestation of DDH and seen from birth to 2 months old. Positive Ortolani and Barlow tests are clinical manifestations of DDH. The Ortolani test is the abducting of the thighs to test for hip subluxation or dislocation.The Barlow test is the adducting to feel if the femoral head slips out of the socket posterolaterally. Shortening of limb on affected side is another clinical manifestation of DDH. Lordosis is the inward curve of the lumbar spine just above the buttocks and is not a clinical manifestation of DDH. A negative Babinski sign is not a clinical manifestation of DDH. It is a neurologic reflex.

What should the nurse include in the plan of care when teaching an adolescent with Crohn's disease? Nutritional guidance and preventing spread of illness to others Adjusting to chronic illness and preventing spread of illness to others Coping with stress and adjusting to chronic illness Nutritional guidance and preventing constipation

Coping with stress and adjusting to chronic illness The nursing interventions include helping the child cope with stress and learn how to adjust to the illness. Nutritional guidance is necessary, but Crohn's disease is not infectious. Adjustment to chronic illness is necessary. Crohn's disease is a chronic disease with life-threatening/life-altering complications. Nutritional guidance is necessary, but constipation is not an issue.

What is a family theory? Describes how the family's health is. Describes how supportive the family is. Describes how the family unit responds to events. Describes how the family health will be in 5 years.

Describes how the family unit responds to events.

During an assessment, the nurse finds that a child is depressed, frightened, and has low grades in school. By which age-group do children usually worry about school grades? 5 and 6 years of age 6 and 7 years of age 7 and 8 years of age 8 and 9 years of age

Worrying about school grades is an adaptive behavior in children that happens between 8 and 9 years of age. Children who are between 5 and 6 years of age are at their initial schooling age, and their development is not sophisticated enough to bother about the grading system at school. Children who are between 6 and 7 years of age try to be independent in their school environment. They are less bothered about grading. Children who are between 7 and 8 years of age are more involved in playing with their peers.

Cystic fibrosis may affect singular or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations? Hyperactivity of the sweat glands Hypoactivity of the autonomic nervous system Atrophic changes in the mucosal wall of intestines Mechanical obstruction caused by increased viscosity of mucous gland secretions

Mechanical obstruction caused by increased viscosity of mucous gland secretions Thick mucous secretions are the probable cause of the multiple body system involvement. There is an identified autonomic nervous system anomaly, but it is not hypoactivity. The sweat glands are not hyperactive. The child loses a greater amount of salt because of abnormal chloride movement. Children with cystic fibrosis have thick mucous gland secretions. The viscous secretions obstruct small passages in organs such as the pancreas.

Mechanical suffocation

Mechanical suffocation is the leading cause of death from injury in infants. Parents or caregivers of the infants should take all measures to prevent death of infants due to accidents. Accidental consumption of medicines can be dangerous, but it is not the most common cause of accidental death in infants. A car seat is recommended because motor vehicle accidents are the second most common cause of death in infants. The nurse is not teaching a management plan but teaching about taking preventive measures for accidents in this scenario.

What factor does the nurse expect to influence the development of teeth in neonates? Production of amylase in the infant Bacterial infections during pregnancy Epstein pearls present on the neonate's gums Medications taken by the mother during the pregnancy

Medications taken by the mother during the pregnancy The development of teeth in infant is influenced by the medications taken by the patient during pregnancy. Salivary glands produce amylase, which digests starch, but does not affect the development of an infant's teeth.

A preschool child watches a nurse pour medication from a tall, thin glass to a short, wide glass. Which statement is appropriate developmentally for this age group? The amount of medicine is less. Pouring medicine makes the medicine hot. The glass changed shape to accommodate the medicine. The amount of medicine did not change, only its appearance.

The amount of medicine is less. A preschool child does not have the ability to understand the concept of conservation. This concept is not developed until school age. Understanding conservation occurs between 7 to 10 years of age, when a child begins to realize that physical factors, such as volume, weight, and number, remain the same even though outward appearances are changed.

What are the general clinical manifestations of nasopharyngitis in younger children? Select all that apply. Fever Irritability Sneezing Vomiting Muscular aches Diarrhea

fever, irritability, sneezing, vomiting, diarrhea The general clinical manifestations of nasopharyngitis in younger children include fever, irritability, sneezing, vomiting, and diarrhea. Muscular aches are a clinical manifestation of nasopharyngitis for older children.

Which statement helps explain the growth and development of children? Development proceeds at a predictable rate. Rates of growth are consistent among children. The sequence of developmental milestones is predictable. At times of rapid growth, there is also acceleration of development.

the sequence of developmental milestones is predictable. There is a fixed, precise order to development. There are periods of both accelerated and decelerated growth and development. Each child develops at his or her own rate. Physical growth and development proceed at differing rates.

A parent expresses to the nurse that the parents delayed sending their child to school because the child did not want to leave home. What information should the nurse give to the parent to improve the child's adaptability to school? "Provide special care and a lot of attention to the child at home after school." "Let the child be at home until the child feels comfortable attending the school." "Enroll the child as well as the child's best friend in the school at the same time." "I know it is hard to see your child mature, but you need to let your child go to school."

"I know it is hard to see your child mature, but you need to let your child go to school." The child's adaptation to school is a major milestone for the developmental stage. The child's adaptation to school depends on various factors. Clinging behavior by the parents is a major factor. This behavior prevents the child from becoming mature and adapting to the school. It is not necessary to enroll the child with a friend; the child may develop relations once adapted to the school.

While assessing a newborn immediately after vaginal birth, the mother is concerned that the newborn's head has assumed an abnormal shape. What should the nurse inform the mother of the baby? Select all that apply. Select all that apply. "Your baby's head should assume a normal shape within 3 days." "Our physical therapist will be able to fix the shape of your baby's head." "Our experienced pediatric surgeon will need to perform surgery on your baby's head." "Applying baby oil daily for 2 weeks should help normalize the shape of your baby's head." "This molding of the head allowed your child to adapt to the shape of your pelvis during labor."

"Your baby's head should assume a normal shape within 3 days." "This molding of the head allowed your child to adapt to the shape of your pelvis during labor." A change in the shape of the newborn's head during delivery due to slight overlapping of the skull bones is called molding. The shape of the head becomes normal within 3 days. Molding allows the child's head to adapt to the shape of the mother's pelvis. Physical therapy, surgery, or application of baby oil is not required to fix the shape of the newborn's head.

A 12-year-old child being seen in the clinic has not received the hepatitis B (HBV) vaccine. What should the nurse recommend? One dose of HBV is needed at age 14. The three-dose series of HBV should be started. Only one dose of HBV will be needed sometime during adolescence. The three-dose series of HBV should be started at age 16 or sooner if the adolescent becomes sexually active.

*The three-dose series of HBV should be started. Adolescents should be vaccinated against hepatitis B at this age if not done previously. Three doses are necessary to achieve immunity. The recommendation is that the hepatitis B vaccine series be started at birth. The American Academy of Pediatrics recommends vaccination by age 13.

Often parents are confused by the terms growth and development and use the terms interchangeably. Based on the nurse's knowledge of growth and development, the most appropriate explanation of development is:? a child grows taller all through early childhood. a child learns to throw a ball overhand. a child's weight triples during the first year. a child's brain increases in size until school age.

*a child learns to throw a ball overhand. Development is the mental and cognitive attainment of skills.

In which order does the nurse take the history of the child who presents with a temperature of 102° F (38.8° C)? 1 Determining the child's identity 2 Chief complaints of the child 3 Present illness of the child 4Child's past medical history 5Child's family medical history 6Child's nutritional assessment

1 Determining the child's identity 2 Chief complaints of the child 3 Present illness of the child 4Child's past medical history 5Child's family medical history 6Child's nutritional assessment

When assessing for hypertension in an infant, which signs will the nurse expect the infant to exhibit? Select all that apply. Select all that apply. Irritability Dizziness Head rubbing Changes in vision Waking up screaming in the night

irritability, head banging or head rubbing, and waking up screaming in the night. Clinical manifestations of hypertension for adolescents and older children are frequent headaches, dizziness, and changes in vision. For infants or young children, clinical manifestations include irritability, head banging or head rubbing, and waking up screaming in the night.

The nurse is assessing a healthy newborn immediately after birth. Arrange the sequence of physiologic findings the nurse would observe during the first

After birth, newborns undergo various physiologic changes to get accustomed to the new environmental conditions. The major transitional changes occur during the first 8 hours after the birth. The first stage of the transition period lasts for 30 minutes and is the first period of reactivity after the birth. During this stage, the newborn's heart rate is usually 160 to 180 beats/minute to ensure rapid supply of blood. After 30 minutes, the heart rate reduces to 100 beats/minute. From 60 to 100 minutes after birth, the newborn either sleeps or shows reduced motor activity. During this time, the newborn has rapid respiration and appears to be pink in color. The newborn enters the second stage of transition 2 to 8 hours after birth, and in this phase the mucus production starts and the infant passes meconium.

The community nurse is educating a group of parents about sleep and rest requirements of school-age children. What information does the nurse provide? Select all that apply. Select all that apply. Children 5 years of age need approximately 11 hours of sleep a night. Children 6 years of age should be encouraged to read before bed time. Children 7 years of age should be encouraged to read before bed time. Children 12 years of age need approximately 6 hours of sleep per night. School-aged children need to have 1- to 2- hour long good naps per day.

Children 5 years of age need approximately 11 hours of sleep a night. Children 6 years of age should be encouraged to read before bed time. Children 7 years of age should be encouraged to read before bed time. Parents should be educated about good sleeping habits in school-aged children. A child who is 5 years of age needs about 11 hours sleep per night. Encouraging quiet activities like reading books or coloring before bedtime in children 6 or 7 years of age can help the children quiet down before going to bed. School-aged children usually do not need naps. Children 12 years of age need a minimum of 9 hours sleep per night.

While assessing an adolescent, the nurse learns that the client's parents are divorced and the child lives primarily with one parent who works double shifts and is frequently absent from home. In spite of these conditions, the client is well adjusted, in good health, and excelling at school. Which factor is likely to have the largest impact on the healthy development of this adolescent client? Culture Education Socialization Community support

Community support

The nurse is caring for a child with thalassemia. What does the nurse observe in this child? Prolonged bleeding from any part Complications due to blood transfusions Epistaxis and bleeding gums Complications from chemotherapy

Complications due to blood transfusions thalassemia = (A blood disorder involving less than normal amounts of an oxygen-carrying protein.)

A patient with multiple chronic health problems is admitted to the medical unit. What is required to keep the nursing practice dynamic rather than static throughout all phases of the nursing process? Slow continuous flow of intravenous fluids Continual assessment of the patient's status Change the bed linen every day or when required Nurses have to work in shifts to avoid caregiver stress

Continual assessment of the patient's status Throughout the five levels of the nursing process, continual assessment of the patient's status keeps the process dynamic rather than static. Slow continuous flow of intravenous fluids is not indicated for all patients. Changing the bed linen gives little opportunity to assess the status of the patient. Working in shifts can prevent caregiver stress, but it does not mean that the patient is under continual assessment.

The nurse is teaching a group of students about the midline-to-peripheral concept of growth. About which pattern of growth and development is the nurse teaching? Proximodistal Differentiation Cephalocaudal Sequential trend

Proximodistal is the development pattern in which the children master the ability to use their hands before they can use their fingers. Cephalocaudal development is the pattern in which development of the head comes before the tail portion is developed. Differentiation is the complex development of the body organs and organ systems. A sequential trend of development describes the development of a baby in a sequential order (e.g., a baby crawls before walking).

how is evidence-based practice, a current health care trend, best described? Gathering evidence of mortality and morbidity in children Using a professional code of ethics as a means for professional self-regulation Questioning why something is effective and whether there is a better approach Meeting physical and psychosocial needs of the child and family in all areas of practice

Questioning why something is effective and whether there is a better approach

The nurse is caring for a client with a slipped capital femoral epiphysis. Which clinical manifestations does the nurse observe in the client? Select all that apply. Select all that apply. Dehydration Loss of abduction Limp on affected side Elevated temperature Shortening of lower extremity

Shortening of lower extremity, Limp on affected side, Loss of abduction A slipped capital femoral epiphysis is a spontaneous displacement of the proximal femoral epiphysis in a posterior and inferior direction. This condition is most common in males and obese children. Due to the dislocation of the joint, the client will lose abduction, will limp on the affected side, and will show shortening of the lower extremity. Unlike acute osteomyelitis, a slipped capital femoral epiphysis is not associated with loss of fluids and hyperthermia, so a child with this condition should not have dehydration and fever.

The nurse is providing neonatal care to a newborn who is in the period of decreased responsiveness. Which physiologic and behavioral findings does the nurse expect in the newborn? Select all that apply. Select all that apply. The newborn is pink. The newborn will be asleep. The newborn has mucus production. The newborn has slow, labored respirations. The newborn's heart rate increases to 160 bpm.

The newborn is pink. The newborn will be asleep During the period of decreased responsiveness, the newborn sleeps or has a marked decrease in motor activity, and is pink. During the first period of reactivity, the newborn's heart rate increases rapidly to 160-180 bpm, but gradually falls after 30 minutes or so.

The nurse at an educational camp is explaining to parents about the growth and developmental changes in a preschooler. Which changes should the nurse mention? The preschool age child is incapable of differentiating gender. The preschool age child is curious about sexual reproduction. The preschool age child is uninterested in mingling with peers. The preschool age child is uninterested in playing indoor games.

The preschool age child is curious about sexual reproduction. A preschooler usually has increased curiosity about everything, including sexuality. As a result, the preschooler may ask questions about sexual reproduction.

The nurse is caring for a child dying from cancer. Physical signs that the child is approaching death include what? Rapid pulse change in respiratory pattern Sensation of cold, although body feels hot Loss of hearing followed by loss of other senses

change in respiratory pattern In the final hours of life the respiratory pattern may become labored, with periods of apnea. The pulse becomes weak and slowed. There is a sensation of heat, although the body feels cold. Hearing is the last sense to fail.