pedi 16&22

When a new mother calls the clinic and reports that her newborn has white patches in her mouth and will not nurse, the alert nurse should respond:

"Are you breastfeeding?"

The statement made by a parent that indicates an understanding of the topical application of medications for atopic dermatitis is:

"I apply the corticosteroid before any other medication."

The dying 16-year-old patient threw her food tray on the floor and yelled, "I can't eat this slop! I want some real food!" The nurse's best response to this episode would be:

"I imagine you are pretty mad. Do you want to tell me what you might like?"

The statement made by a parent that indicates the need for further teaching about strategies to control itching for the infant with atopic dermatitis is:

"I should use lotions with alcohol to dry the lesions."

A grieving mother sobs "All this is just so useless...I am useless...nothing I am doing is going to make my baby well." The nurse's most therapeutic response would be:

"Your constant loving care does more for your baby than any medicine."

The home health nurse instructs the parents of a 1-month-old child with thrush that when administering nystatin they should: (Select all that apply.)

-Apply the solution slowly to the interior of each cheek -Swab the mouth 3 to 4 times per day -After swabbing, deposit the rest of the dose in the infant's mouth -Observe for dehydration

To avoid diaper rash, the nurse at the well-child clinic would instruct the parents to: (Select all that apply.)

-Apply zinc oxide ointment as a barrier -Use disposable diapers -Remove feces with mild soap and water -Change diapers frequently

After the death of the child, the nurse prepares the body for viewing. This includes: (Select all that apply.)

-Bathing the child -Dressing the child in a clean gown -Changing the linens -Removing medical equipment

Place the Kübler-Ross stages of dying in the appropriate order.

-Denial -Anger -Bargaining -Depression -Acceptance

The well-child clinic nurse reminds the parents of an infant who has atopic dermatitis to be especially careful when introducing new foods to the child as these children frequently have sensitivities to such foods as: (Select all that apply.)

-Eggs -Wheat products -Peanuts

While discussing the option of hospice care, a mother says, "It just makes me feel like we are giving up. I don't see how this can help." The nurse's response is based on the knowledge that hospice care is designed to: (Select all that apply.)

-Encourage day-to-day communication -Provide durable medical equipment -Support in the grieving process

The emergency department nurse is aware that burns that must be referred to a specialized setting are those that involve: (Select all that apply.)

-Inhalation burns -Chemical burns -Joints -Face -Genitalia

The nurse is aware that the characteristics of a full-thickness burn include: (Select all that apply.)

-Leathery appearance -Necessitates debridement -Pain only at the edges of the burn

The nurse caring for a child with cellulitis of the ankle is aware that the inflammatory reaction may be caused by: (Select all that apply.)

-Staphylococcus -Streptococcus -Haemophilus influenzae

The nurse explains that the Candidiasis infection of thrush can cause lesions in the baby's mouth that can be seen on the: (Select all that apply.)

-Tongue -Inner lips -Gums -Oral mucosa

A 10-year-old girl is brought to the emergency department with a second-degree burn on her entire right arm and hand, anterior trunk, and genital area. The nurse assesses the BSA percentage burn as ___________.

22%

The nurse observes that a dying child is experiencing dyspnea. The nurse can perform which of the following interventions to help?

Administering oxygen

When the dying child who is experiencing anorexia asks for ice cream, the nurse can:

Allow the child to eat anything desired

The nurse is aware that many parents experience a sense of loss and grief called __________ grief before the death of their child occurs.

Anticipatory

The nurse clarifies to the family that a(n) __________ drug such as a bronchodilator will be administered to decrease dyspnea.

Anxiolytic

As a support to the antibiotic therapy prescribed for a child's cellulitis of the lower leg, the nurse would suggest that the parent:

Apply warm, moist compresses to the area

The complementary method of guided imagery for pain relief is used with a 5-year-old when the nurse:

Asks the child to close her eyes and tell about Christmas

A child is brought to the emergency department with burns on the face and chest. The nurse's first priority is:

Assessing respiratory status

The nurse cautions parents that children who have been diagnosed with infantile eczema have an increased risk of:

Asthma

The nurse takes into consideration that as a precaution the teenage girl who is to receive Accutane (13-cis-retinoic acid) would also be given a prescription for:

Birth control pills

The nurse warns the teenager who is to start on a protocol of tetracycline for acne that these drugs can interfere with the effectiveness of:

Birth control pills

The nurse includes in the plan of care for a 2-year-old child adequate oral care such as: (Select all that apply.)

Brushing the teeth with soft-bristled brush

The infant has had a peaceful death. The nurse's next responsibility is to:

Call the hospital chaplain

The nurse is aware that the organization supporting hospice care for children is __________.

Children's Hospice International (CHI)

The home health nurse shows the mother how to rid nits from the eyebrows and eyelashes by:

Coating the brows and lashes with petrolatum and removing the nits

The 14-year-old child who is dying of leukemia is trying to comb her thinning hair and is having a great deal of difficulty due to weakness. The nurse should:

Compliment the child on the appearance of her hair

The parents and family of a Jewish child are at the bedside praying at the time of death. The culturally sensitive nurse will:

Cover the child's face with a sheet

The nurse working with a 15-year-old patient who is dying understands that the adolescent's concept of death is that:

Death can be understood in a logical manner

When the 17-year-old leukemic child says, "I am going to the Mayo Clinic so we can get the correct diagnosis. I do not have leukemia!" the nurse recognizes that the patient is in the Kübler-Ross grief stage of:

Denial

The nurse uses a picture to demonstrate a full-thickness burn that involves destruction of the:

Dermis, epidermis, and underlying soft tissues

The nurse explains that in assessing the burn area of a child, the "rule of nines" is not a useful tool because small children have:

Different body proportions

When the nurse is preparing to give the dyspneic 1-year-old child a dose of liquid morphine, the father requests that the morphine not be given as it may cause addiction. The nurse's most informative response will be based on the knowledge that morphine:

Diminishes the feelings of air hunger

A dying 8-year-old child tells the nurse that she is still in pain even though the nurse has administered the maximum dosage of pain medication only 1 hour ago. The nurse's most effective initial intervention would be to:

Distract the child by reading a story

When teaching about general measures that could help prevent acne, the nurse would include:

Eat a balanced diet, and get sufficient rest

A 10-year-old child has lapsed into a coma. In order to let the child know he is not alone, the nurse would:

Encourage the parents to speak to the child

The teenager who is taking Accutane (13-cis-retinoic acid) would be discouraged from planning a recreational outing, such as:

Going to the beach in July

The nurse includes in the discharge instructions to parents of a child with atopic dermatitis that this child should not be exposed to adults who:

Have "cold sores"

When a family member asks the nurse where his terminally ill loved one might receive hospice care, the nurse's most helpful response would be based on the knowledge that hospice services are provided:

In the home or hospital

Which intervention would help the child with a serious burn meet nutritional needs during the subacute phase of recovery:

Increase calories and protein to compensate for the healing process

The parents of a dying child are concerned about the jealousy expressed by the two siblings of the patient. They ask the nurse how to deal with the sibling's feelings. The most realistic suggestion the nurse could make would be:

Involve the siblings in the care of the dying child

A dying child's parents have told the nurse that they do not want their child to know that she is dying. The nurse reminds the parents that this choice might cause the child to feel:

Isolated and suffering alone

The teenager under treatment for acne with tetracycline should be warned about the development of:

Monilial vaginitis

The nurse cautions that if thrush is untreated it can cause:

Painful diaper rash

As the dying 6-year-old child becomes incontinent of bowel and bladder, the nurse focuses care on methods to:

Protect skin integrity

The nurse caring for a child on palliative care would include in the plan of care to:

Reassure the child that death will not hurt

On the first day post-burn, the body's fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. The nurse monitors the burn victim very closely for:

Reduced urine output

When the nurse in the well-baby clinic notes that a 2-day-old has small pustules on her skin, the nurse should:

Report it immediately to the clinic physician

When the lesions of atopic dermatitis break down the dermal cells and form intradermal vesicles, this stage of the condition is called ___________.

Spongiosis

An allergy to which of the following would contraindicate the use of Silvadene as a topical agent for burns?

Sulfa

The family has viewed the body. The body is moved when:

The family is ready and has given permission

A student nurse complains to the charge nurse about the mother of a Hispanic child who refuses to make the decision about hospice care until her husband comes to the hospital. The charge nurse explains that:

The male head of the family makes health care decisions

The parents of a dying 2-year old child are showing signs of tension when the wife says, "Oh, go on to your office. You have a place to run away to. I am the one here with our dying child!" The nurse can help by:

Understanding that the father may feel the need to conceal his emotions

The pediatric nurse reminds the ancillary personnel that cultural needs and customs of the dying patient from an Asian culture are:

Unique to a given culture

As the dying child becomes weak and fatigued, the nurse should alter the plan of care to include:

Using a wheelchair or wagon for transportation

The home health nurse discovers a family infected with pediculosis and helps the mother to start eradication of the lice, such as:

Using over-the-counter pediculosis shampoos

The Haitian mother asks to bring a large picture of St. Jude into her child's isolation room. The nurse's best intervention would be to:

Wrap the picture in plastic and prop it against the wall

The nurse notes on the chart that a patient with Wilms tumor is to receive palliative care only. The nurse knows this means:

d. The child will achieve a comfortable and dignified death