Passpoint Preschooler
A 4-year-old child is admitted for cardiac catheterization. Which is most important to include as the nurse teaches this child about cardiac catheterization?
the child's parents
For a child with hemophilia, what is the most important nursing goal?
Preventing bleeding episodes
A child is receiving peritoneal dialysis to treat renal failure. To detect early signs of peritonitis, the nurse should stay alert for
abdominal tenderness.
Which finding is expected when the nurse is assessing a child who has sustained full-thickness burns?
minimal pain
A child, age 4, is brought to the clinic for a routine examination. When observing the tympanic membrane, the nurse identifies which color as normal?
pinkish gray
The parent of a 4-year-old child asks about dental care for their child. "I help brush their teeth every day, and their teeth look healthy," the parent states. "When should I take them to see a dentist?" Which response would be most appropriate?
"A dental checkup is recommended even if no problems are noticeable."
A nurse is obtaining the history of a child, age 4. Which question best evaluates the child's developmental status?
"Can you ride a tricycle?"
A birth parent who is visibly upset tells the nurse they want to take her child home because the child is dying. What would be the nurse's best response?
"Can you tell me why you want to take your child home now?"
A parent of a child with a urinary tract infection calls the clinic and explains, "I'm concerned because my child refuses to obey me concerning the preventions you told me about. My child refuses to take the medication unless I buy them a present. I don't want to use discipline because of the illness, but I'm worried about the behavior." Which response by the nurse is best?
"I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible."
The health care provider (HCP) has prescribed a sterile urine specimen for a 3-year-old boy with a history of recurrent urinary tract infections. The family is upset because the last time the child was catheterized, the procedure was very painful and traumatic. What is the nurse's best response?
"I'll get a prescription for a numbing lubricant to make the procedure more comfortable."
The nurses teaches parents about the cause of ringworm of the scalp (tinea capitis). Which statement by a parent would indicate that teaching had been successful?
"It is a fungal infection of the scalp."
After being hospitalized for status asthmaticus, a child is discharged with prednisone and other oral medications. Two weeks later, when the child comes to the clinic for a checkup, the nurse instructs the parent to gradually decrease the dosage of prednisone, which will be discontinued. The parent asks why prednisone must be discontinued. How should the nurse respond?
"Long-term steroid therapy may interfere with a child's growth."
The nurse is teaching the parents of a young child who had surgery to form a colostomy what to expect when the child goes home. The parents express concern about the appearance of the stoma. Which of the following is the most appropriate response by the nurse?
"The size of the new stoma should stabilize in 6-8 weeks."
A nurse is preparing a child, age 4, for cardiac catheterization. Which explanation of the procedure is most appropriate?
"The special medicine will feel warm when it's put in the tubing."
The parent of a preschool-age child tells the nurse that the child is hyperactive and something needs to be done. Which response by the nurse would be most appropriate initially?
"What makes you think your child is hyperactive?"
The parent of a preschool child with juvenile idiopathic arthritis (JIA) is worried that their child will have to stop attending preschool because of the illness. Which response by the nurse would be most appropriate?
"Your child should be encouraged to attend school, but they will need extra time to work out early morning stiffness."
A 4-year-old child has recently been diagnosed with acute lymphocytic leukemia (ALL). Which statement, made by the parents, indicates the effectiveness of teaching? Select all that apply.
-"I understand that ALL affects all blood-forming organs and systems throughout the body." -"I realize that the adverse effects of chemotherapy includes sleepiness, loss of hair, and sores in the mouth." -"I am glad that there's a 95% chance of obtaining a first remission with treatment."
The nurse is interviewing a pediatric client and family in a clinic after the client had a fever at home. The parent said she gave the client one adult acetaminophen earlier in the day because she ran out of children's acetaminophen. What is the nurse's next action? Select all that apply.
-Continue to complete the physical assessment of the client. -Inform the healthcare provider of the acetaminophen dose. -Teach the parent not to use adult medications with children. -Document that the parent administered adult acetaminophen.
A nurse is finishing a shift on the pediatric unit. Because the shift is ending, which intervention takes priority?
documenting the care provided during the shift
When instilling ear drops on a 2-year-old child, the nurse should pull the pinna in which directions?
down and back
A 4-year-old child is ordered to receive 25 mL/hour of intravenous solution. The nurse is using a pediatric microdrip (60 gtt/mL) chamber to administer the medication. For how many drops per minute would the microdrip chamber be set? Record your answer using a whole number.
25
An initial bolus of crystalloid fluid replacement for a child in shock is 20 ml/kg. The nurse is preparing to administer how many milliliters of fluid for a child weighing 30 kg?
600 mL
A child experiences nausea and vomiting after receiving cancer chemotherapy drugs. What is most important for the nurse to include in the plan of care?
Administer an antiemetic 30 to 60 minutes before the next chemotherapy session.
The nurse is caring for a lethargic but arousable preschooler who is a victim of a near-drowning accident. What should the nurse do first?
Administer oxygen.
A parent tells the nurse that their 4-year-old boy has developed some strange eating habits, including not finishing meals and eating the same food for several days in a row. The parent would like to develop a plan to correct this situation. When developing such a plan, what should the nurse and parent do?
Allow the child to make some decisions about the foods they eat.
A nurse is preparing a 4-year-old child for surgery. Which is the best nursing intervention?
Allowing the child to wear underwear if desired.
The parents of a preschooler are refusing a blood transfusion to treat severe hypovolemia because they are Jehovah's Witnesses. The parents are aware of the potential consequences of refusing the treatment. What is the priority nursing intervention at this time?
Ask the healthcare provider about alternative treatments to blood transfusion.
The nurse must administer a unit of packed red blood cells to a 4-year-old child. The child's blood type is Type B Rh factor positive. When the unit of blood arrives, it is labeled as Type O Rh factor negative. What is the appropriate action for the nurse to take?
Begin the administration of the blood as ordered.
The nurse admits a 4-year-old with a possible meningococcal infection. Which type of isolation is indicated?
droplet precautions
Which method is reliable for identifying a preschooler before administering a medication?
Check the hospital identification bracelet.
A school nurse is conducting a seminar for parents of preschool children on the prevention of head injuries. What is the most appropriate information for the nurse to give the parents?
Children should always wear helmets when riding bicycles.
A child is admitted to the emergency department with an acute asthma attack. Which early assessment finding does the nurse expect?
expiratory wheezing
The nurse observes a parent of a child with cystic fibrosis performing chest percussion. The nurse determines that the skill is being done correctly when the parent uses which technique?
firmly but gently striking the chest wall to make a popping sound
A nurse realizes she is 1 hour and 30 minutes late in administering a dose of medication for a 4-year-old child. She gives the medication immediately, and assesses the child. The child isn't harmed by the delay. Which action should the nurse take next?
The nurse should follow facility procedures for reporting an error.
A parent brings a preschool child to the emergency department after the child ingested an unknown quantity of acetaminophen. Which treatment does the nurse anticipate?
gastric lavage and administration of activated charcoal
A parent of a child with hemophilia states that they worry whenever the child has a bump or cut. The nurse should explain that after the area is cleansed, the wound should be treated by applying which measure?
gentle pressure
When assessing a child for impetigo, the nurse expects which assessment findings?
honey-colored, crusted lesions
A 4-year-old child is brought to the clinic for a checkup. It is determined that the family does not have fluoridated water. The nurse should give which instruction about using fluoride supplements?
Do not eat or drink for 30 minutes after the supplement.
A child is in the emergency department with suspected epiglottitis and has been ordered an X-ray to confirm the diagnosis. The nurse would prepare the child for X-ray by which methods?
in the emergency department, by portable X-ray
A nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider?
incompatibility between the child's history and the injury
The nurse is caring for a child with an acute exacerbation of asthma. Oral methylprednisolone has been ordered. Which of the following actions is most important for the nurse to take when administering this medication?
Give the medication with food.
The nurse is inspecting a child's throat (see figure). How should the nurse proceed with the throat examination?
Guide the tongue blade while the child is holding it to depress the tongue to visualize the throat.
A preschooler has vomiting, diarrhea, and a potassium level of 3 mEq/L (3 mmol/L). Which prescribed order will the nurse implement first?
I.V. infusion of 500 ml of dextrose 5% in water and half-normal saline solution with 20 mEq (20 mmol/L) of potassium chloride at 100 ml/hr
A nurse is caring for a preschooler who sustained deep partial-thickness burns on the hands as a result of touching a hot pot on the stove. What is most important for the nurse to consider in discharge teaching?
Include the child in the teaching process.
A nurse is caring for a 4-year-old child with end-stage leukemia. The child's physician has ordered a lumbar puncture. His mother, who has legal custody, has refused to give consent for the child to undergo the procedure. However, the child's father is demanding that the procedure be performed. What should the nurse do first?
Inform the father that the procedure won't be performed because the mother didn't consent.
The parent of a 4-year-old child is concerned about their child's masturbating. What should the nurse tell the parent?
Masturbation is normal in children of this age.
A child is being discharged after being diagnosed with an asthma attack. What information regarding the rescue inhaler is most important for the nurse to include in discharge teaching?
Monitor heart rate.
After assessing a newly admitted 5-year-old child, the nurse makes the nursing diagnosis of parental role conflict related to child's hospitalization. Which defining characteristic suggests this diagnosis?
Parents express feelings of inadequacy in caring for child.
A nurse is assessing a 4-year-old child's peripheral IV line, observing that it is not infusing. What is the first action the nurse should take to correct this situation?
Reposition the child's extremity.
Parents of a 5-year-old child call the clinic to tell the nurse that they think their child has been abused by the daycare provider. What should the nurse advise them to do first?
Schedule an immediate appointment with their healthcare provider.
What recommendation should the nurse give a family about appropriate beverages for children?
Sugary drinks, including juice, should be avoided.
The nurse teaches a preschool-age child how to perform coughing and deep-breathing exercises before corrective surgery for tetralogy of Fallot. Which teaching and learning principles should the nurse address first?
building the teaching on the child's current level of knowledge
How should a nurse prepare a suspension before administration?
by shaking it so that all the drug particles are dispersed uniformly
When assessing a preschooler who has sustained a head trauma, the nurse notes that the child appears to be obtunded. Which finding supports this level of consciousness?
can be roused with stimulation
A nurse is preparing immunizations for a child being treated for leukemia. Which immunization will the nurse hold at this time?
chickenpox
A nurse is caring for a child who was involved in a bus accident on the way home from preschool. Several people were killed in the accident. When talking with the child's parents about normal reactions to a traumatic event, the nurse should tell them that
it is normal for the child to want to sleep with them at night.
When assessing a client with hemophilia, the nurse identifies which condition as an early sign of hemarthrosis?
joint stiffness
The nurse assesses a family's ability to cope with their child's cerebral palsy. Which action should alert the nurse to the possibility of their inability to cope with the disease?
limiting interaction with extended family and friends
The nurse is caring for a 3-year-old client being treated for severe status asthmaticus. After comparing clinical manifestations with laboratory results (reported below), a nurse determines evidence that this client has progressed to which condition?
respiratory acidosis
A 4-year-old has just returned from surgery. The child has a nasogastric (NG) tube in place and is attached to intermittent suction. The child says to the nurse, "I'm going to throw up." What should the nurse do first?
Irrigate the NG tube to ensure patency.
Which nursing action would be most successful in gaining a preschooler's cooperation in preparing for surgery?
Let the child choose whether to ride to the preoperative area on a stretcher or in a wagon.
Parents of a preschool-age child ask the nurse about nutrition. Which statement about a preschooler's nutritional requirements is accurate?
The quality of food that a preschooler consumes is more important than the quantity.
A nurse on the pediatric unit is caring for a group of preschool children. Which situation takes priority?
a child who develops a fever during a blood transfusion
A young child is returning to the pediatric unit after having surgery to form a colostomy. When assessing the stoma, the nurse becomes most concerned when what is observed?
a dark maroon stoma
A healthcare provider diagnoses leukemia in a 4-year-old child who complains of being tired and sleeps most of the day. Which nursing diagnosis should the nurse use to best reflect this physiologic effect of leukemia?
activity intolerance related to lack of normal blood cell production
A 4-year-old child who has been ill for 4 hours is admitted to the hospital with difficulty swallowing, a sore throat, and severe substernal retractions. The child's temperature is 104°F (40°C), and the apical pulse is 140 bpm. The white blood cell count is 16,000/mm3 (16 × 109/L). What is the priority for nursing intervention?
airway obstruction
A 4-year-old child continues to come to the nurses' station after being told children are not allowed there. What behavior is the child exhibiting?
attention-seeking behavior
A nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement?
decreased hematuria
A child is being seen in the emergency department for reports of severe sore throat, trouble swallowing, and fever. The child has swollen cervical lymph nodes and a fiery red pharynx on examination. Which assessment findings below should be reported immediately to the healthcare provider?
drooling and not swallowing
A hospitalized 5-year-old is pulseless, and after verifying the child is not breathing, the nurse begins chest compressions. Where should the nurse apply pressure?
on the lower sternum with the heel of one hand
A 3-year-old boy has arrived in the emergency department. The nurse documents the following assessment findings in the client's chart, knowing that they are consistent with which disease process?
pneumonia
When making ethical decisions about caring for preschoolers, a nurse should remember to
provide beneficial care and avoid harming the child.
A nurse is providing cardiopulmonary resuscitation (CPR) to a child, age 4. The nurse should
use the heel of one hand for sternal compressions.
The nurse teaches a pediatric client about an upcoming procedure. Which approach indicates that the nurse has selected the correct technique for the client's developmental level?
using puppets and storytelling to prepare a preschooler
A preschooler goes into cardiac arrest. When performing cardiopulmonary resuscitation (CPR) on a child, how should the nurse deliver chest compressions?
with the heel of one hand
What response by the nurse would be most appropriate for a mother who voices concern about her 4-year-old child's stuttering?
"This behavior is normal, and the child probably will stop soon."
The parent of a toddler tells the nurse their child is "fussy" and not as "easygoing" as their other children. The parent is having difficulty feeding the child because the child fusses and cries when served a meal. What instructions should the nurse give the parent?
Provide structured feeding times and routines.
A nurse is performing a respiratory assessment on a 5-year-old child diagnosed with pneumonia. Which assessment finding should be reported to the health care provider immediately?
moderate intercostal retractions
The nurse is caring for a 5-year-old child who had a hernia repair 1 day ago. The child is vomiting, has a nasogastric (NG) tube to low intermittent suction, and has diarrhea. Which of the following laboratory results would be the immediate priority for the nurse to assess?
potassium level
A parent tells the nurse that their 4½-year-old child "does not seem to know the difference between right and wrong." This behavior is typical of which level as described by Kohlberg's theory of levels of moral development?
preconventional
A client is having a nosebleed. What should the nurse do next?
Place the client in a sitting position with the neck bent forward and apply firm pressure on the nasal septum.
A child with sickle cell anemia is admitted to the healthcare facility in vaso-occlusive crisis after developing a fever and joint pain. What is the nurse's highest priority when caring for this child?
providing fluids
After the nurse has taught the parents of a 5-year-old client who has leukemia how to talk with their child about death and dying, which statement would indicate that the parents have age-appropriate expectations about their child's reaction to their impending death?
"They might think they've caused their death because they've misbehaved."
A 4-year-old postoperative child is found unresponsive. Place the following actions in the correct sequence to perform CPR after the child has been assessed for responsiveness and help has been called. All options must be used.
-Feel for the carotid pulse. -Perform 30 compressions. -Open the airway. -Check for breathing. -Provide 2 rescue breaths.
The public health nurse is teaching the parents of a 5-year-old client diagnosed with sickle cell disease. What education will the nurse include? Select all that apply.
-Keep the client's immunizations up to date. -Schedule regular appointments with a hematologist. -Monitor for abnormal skin color.
The nurse is caring for a very anxious child whose pain has not been manageable. The parents stay in the child's room, crying and yelling at each other. Grandparents and other family members are also constantly in attendance. To effectively help the child with pain management, which action should be a priority for the nurse?
Develop a visitation schedule with the family that allows the child to rest.
The parent asks the nurse why peanuts are one of the worst things a child can aspirate. What should the nurse include in the explanation as the main reason for the problem associated with aspirating peanuts?
They swell when wet.
The nurse is caring for a child with a new diagnosis of diabetes. The nurse teaches blood glucose monitoring by allowing the child to practice checking the blood sugar of a toy bear dressed in a hospital gown. The nurse recognizes this approach to be appropriate for what age level?
preschool age (3 to 5 years)
When interacting with the parent of a child who has Duchenne muscular dystrophy, the nurse observes behavior indicating that the parent may feel guilty about the child's condition. The nurse interprets this behavior as guilt stemming from which factor?
the genetic mode of transmission
A 3-year-old client is admitted to the pediatric unit with pneumonia. The child has a productive cough and appears to have difficulty breathing. The parents tell the nurse that the child has not been eating or drinking much and has been very inactive. Which interventions to improve airway clearance should the nurse include in the care plan? Select all that apply.
-Perform chest physiotherapy as ordered. -Encourage coughing and deep breathing. -Perform postural drainage. -Maintain humidification with a cool mist humidifier.
A community nurse is assessing a young child who has had a colostomy stoma for several years. The nurse notices that the stoma is dark pink and moist. What is the best response to the child's parents about the appearance of the stoma?
"The stoma looks healthy; continue your present care."
After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child's reaction is based on which factor?
lacking understanding of body integrity
A child with leukemia has just completed a course of methotrexate therapy. How soon should the nurse expect to see signs of bone marrow depression in this client?
within 2 weeks
A 4-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. The nurse should suspect that the child's I.V. fluid intake is excessive if assessment reveals
worsening dyspnea.
A child, age 5, is brought to the pediatrician's office for a routine visit. When inspecting the child's mouth, the nurse expects to find how many teeth?
Up to 20
A 5-year-old child returns to the pediatric unit following a cardiac catheterization using the right femoral vein. The child has a thick elastoplast dressing. Which assessment finding requires immediate intervention?
The pedal pulse of the right leg is not detectable.
A nurse manager of the pediatric unit discovers that she is overbudget on supplies. How could each nurse assigned to the unit help with cost containment?
Use care pathways to specify care and identify daily outcomes.
The nurse is instructing a 4-year-old child about an upcoming procedure. What approach should the nurse employ during teaching?
Use simple terms.
A school-age child with burns on the trunk and arms has no appetite. The nurse and the parent develop a plan of care to stimulate the child's appetite. Which suggestion made by the parent would indicate the need for additional teaching?
withholding dessert and treats unless meals are eaten
A client is admitted with a tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, the nurse suspects that the client has
coarctation of the aorta.
