PEDI Study Guide Ch. 6, 12, 13, 14, 16, 18, 32

The HBsAg negative mother of Daniella, a premature infant weighing 4 pounds and born 6 hours ago, asks, "Have you already given Daniella her hepatitis B vaccine?" What is your correct response?

"Because Daniella only weighs 4 pounds, she will not receive her vaccine until she is 1 month of age."

Diptheria Agent: Corynebacterium diphtheriae

- Agent: Corynebacterium diphtheriae - Transmission: Direct contact - Clinical manifestations: URI-like symptoms which progress. • "Bull's neck" • White or gray mucous membranes, fever, cough * this membrane compromises airway - Treatment: Antibiotics, bed rest, and support - Precautions:

Identify 3 functions served by imaginary playmates.

- Become friends in time of loneliness - They accomplish what the child is still attempting - They experience what the child wants to forget or remember - Can be blamed for any wrongdoings

Most common Intestinal Parasites in the United States

- Giardiasis - Pinworms

Live vaccine contraindications

- Pregnancy - Immunosuppression - Live vaccines if not given simultaneously must be separated by 28days - 1 months

List at least 2 strategies parents may use to help their child prepare for the preschool or kindergarten experience.

- Present ideas as exciting - Talk to child about activities s/he will be involved with - Behave confidently on the first day

What are six common fears of preschoolers?

- fear of loss of body parts - fear of the dark - fear of being left alone - fear of ghosts - fear of castration - fear of painful interventions

the causes of childhood schizophrenia is unknown. list 3 risk factors that have been identified with schizophrenia

1. genetic characteristics 2. gestational & birth complications 3. winter birth

obesity and overweight nutritional counseling is aimed at preventing an increase in body fat during growth. list the 4 aspects of changing eating habits that can be accomplish this.

1. switch low calorie foods to high calorie foods 2. eat regular meals/snacks 3. purchase and prepare and serve smaller portions of meals 4. altering situations by severing associations between eating and watching TV

The toddler years cover the period from ________ to ________ months of age

12-36

When is the Hep B Vax given

1st dose At Birth before discharge 2nd dose 1-2 months 8 weeks after 1st dose 6-18 months 16 week after 2nd dose

The average annual weight gain during the preschool years is _____ to _____ kg, or _____ to _____ lbs?

2 - 3 (kg); 4.5 - 6.5 (lb)

Hep A vaccine schedule

2 doses 12-24 months

The average child can be expected to have a vocabulary of more than _____ words by the age of 6 years.

2100

33 Serving size may affect toddler feeding habits. What would be an appropriate feeding serving Size of a vegetable tor a 3-vear-old:

3 tablespoons

The approximate age range for the preschool period begins at age _________ and ends at age ________ years.

3, 5

By _____ years of age, the child skips on alternate feet, jumps rope and begins to skate and swim.

5

Secondary amenorrhea

6-months or more irregular menses in a previous menstruating female

44. i n 2014, NHTSA made a recommendation to use the lap-shoulder seat restraint instead of the LATCH sustem if the child's and restraint seat's combined weight is more than_____

65 lbs

When is the Dtap Vax given

< 7yrs old first dose at 2 month second dose 4 months third dose 6 months

Barbara has been diagnosed with ADHD and placed on methylphenidate by her PCP. which of the following statements, made by the nurse to Barbara's parents is correct? a. "Barbara's appetite may decrease with the drug" b. "dosage is usually unchanged until adolescence" c. "this medication takes 2-3 weeks to achieve an effect" d. Barbara's appetite will be increased with this drug

A

Cindy is 12 years old and is brought to the clinic because of a bald spot developing on her head. Cindy wears her hair tightly braided with beads. Which of the following should the nurse suspect? a. Alopecia from trauma b. Tinea capitis c. Psoriasis d. Urticaria

A

During wound healing, immature connective tissue cells migrate to the healing site and begin to secrete collagen into the meshwork spaces. What is this phase called? a. Fibroplasia b. Scar contracture c. Inflammation d. Scar maturation

A

Management of brown recluse spider bites includes: a. possible skin graft. b. administration of antivenin. c. applying lemon juice mixed with baking soda directly to the bite. d. administering epinephrine and corticosteroids for impending shock.

A

Mary, age 7 years, fell and sustained a laceration to her chin. She was taken to the emergency department, where the laceration was sutured with the edges well approximated. The nurse expects the repair healing to take place by: a. primary intention. b. secondary intention. c. tertiary intention.

A

The most effective method for tick removal in a child is to: a. use tweezers and grasp close to the point of attachment; then pull straight out using steady, even pressure. b. apply mineral oil to the back of the tick and wait for it to back out. c. use the fingers to pull the tick out with a straight, steady, even pressure. d. place a hot match on the back of the tick and pick it up with gloved hands when the tick falls off.

A

The practitioner has prescribed tretinoin cream (Retin-A) for Nancy's acne. Nancy has been using the cream for 2 weeks and is concerned she is not improving. Nancy tells the nurse that she has "done everything" that she was told to do and asks, "Why is my acne no better?" The nurse's best reply is: a. "It is normal for it to take weeks to months to see improvement with acne medications." b. "You must not be using the medication right. Show me how you apply it to your face." c. "Acne is caused by dirt or oil on the surface of the skin. You will need to increase the number of times you wash these areas each day." d. "You will probably need to ask the practitioner about changing your medicine as soon as possible."

A

Typical treatment of poison ivy contact dermatitis to the arm does not include which of the following? a. Oral corticosteroids b. Calamine lotion c. Aveeno baths d. Topical corticosteroid gel

A

Which of the following does the nurse include in the educational plan when instructing parents about the use of topical corticosteroids? a. Do not use this cream on a fungal infection. b. Apply a thick layer of the cream and rub into the skin well. c. Do not use for longer than 3 days in chronic conditions. d. All of the above should be included.

A

Which of the following is a fungal infection that lives on the skin? a. Tinea corporis b. Herpes simplex type 1 c. Scabies d. Warts

A

Which of the following is not recommended in the treatment of scabies? a. Treat only household members who are symptomatic. b. The drug of choice in children and infants over 2 months is permethrin 5% cream. c. All persons in close contact with affected child should be treated. d. Ivermectin is indicated for those who do not respond to scabicide.

A

Which of the following is the most common symptom of atopic dermatitis (eczema)? a. Pruritis b. Lichenified plaques c. Hyperpigmentation d. Vesicular lesions

A

conversion reaction: a. is a psychophysiologic disorder associated with sudden onset b. is more common in girls during childhood and adolescence c. has an organic cause d. is diagnosed on the basis of seizures and abnormal electroencephalogram

A

the best approach to the management of obesity in children and adolescents is: a. prevention b. pharmacologic agents sibutramine & orlistat c. bariatric surgery d. behavior modification

A

when initiating a treatment plan for an obese child, the nurse should do which of the following? a. defer treatment until family is ready to begin b. proceed with the plan regardless of the family's readiness if the child is ready c. understand that the child cannot take personal responsibility for dietary habits and become motivated d. understand that children who are forced by their parents to seek help can easily become motivated

A

Which of the following conditions may lead to the development of obesity in children? SATA A. physical inactivity B. low socioeconomic status C. use of food as a positive reinforcement of desired behaviors D. consumption of energy dense food & drinks E. positive self esteem

A B C D

The proper use of isotretinoin 12-cis-retinoic acid (Accutane) for adolescents includes: SATA A. reserving its use for severe, cystic acne that has not responded to other treatments. B. limiting treatment to 20 weeks. C. watching for side effects, including mood changes, depression, and suicidal ideation. D. watching for detrimental effects on bone mineralization. E. recognizing that it is contraindicated in pregnancy and in sexually active females not using an effective contraceptive method. F. monitoring for elevated cholesterol and triglyceride levels before and during treatment.

A B C E F

a good understanding of enuresis will help the nurse work w/ children & their families. Which of the following teaching points should be included? SATA A. enuresis is primarily an alteration of neuromuscular bladder functioning and as such is benign and self-limiting B. spontaneous remission of nocturnal enuresis occurs in approx 35% of cases C. normal bladder capacity (in ounces) is the child's age +4; therefore normal bladder capacity for a 6 yr old is 10 ounces (600ml) D. success has also been achieved w/ desmopressin acetate nasal spray, which reduces nighttime urinary output to a volume less than functional bladder capacity E. parents need reassurance that bedwetting is not a manifestation of emotional disturbance but just represents willful misbehavior

A D

you are working w/ a family who's 7 yr old had just been diagnosed w/ ADHD. which statement by the mother indicate a need for further teaching? SATA A. my child will respond best to verbal instructions, since that will help him learn to pay attention and listen intently B. a consistent schedule for homework and activities will help him be organized C. i need to bring him for routine checkups while he is taking his meds cause the meds can affect is appetite and growth D. i am going to ask the principle if my son can change classrooms because his current teacher has to many rules and he seems to get in trouble E. we might consider counseling cause this has been stressful for the whole fam

A D

The nurse is conducting an educational session with Cindy and her parents on medications used for acne. Which of the following is correct information? SATA A. Benzoyl peroxide gel has a bleaching effect on bed coverings and towels. B. Topical clindamycin is applied only to the individual lesions. C. Oral contraceptive medications contain estrogen, which will increase acne formation and should be avoided. D. Tretinoin requires that Cindy protect herself from sun exposure. E. Oral antibiotic side effects may include GI upset, photosensitivity, or vaginal candidiasis. F. Results are better if systemic antibiotics are combined with topical antibiotic creams. G. Early intervention with topical medications may prevent development of severe acne.

A D E G

TRUE

A person may be physically dependent on a narcotic without being addicted

14. one recommended method to foster language development in the toddler is to a. read books together. b. watch an educational program on the television. c. increase the toddler's exposure to a large number of adults and older chidren d. encourage the toddler to watch at least 2 hours of children's television shows per day.

A read books together

C (Nonsteroidal anti-inflammatory drugs)

A treatment of choice for adolescents with dysmenorrhea is: A. acetaminophen B. oral contraceptives C. non-steroidal anti-inflammatory drugs D. estrogen-suppression drugs

fungal infections

A) tinea capitis B) Tinea corporis

Piaget's theory of cognitive development depicts the toddler as a child who a. repeatedly explores the same object each time it appears in a new place b. is able to transfer information from one situation to another. c.has a persistent negative response to any request. d. has the rudimentarv beginning of a superego

A. repeatedly explores the same object each time it appears in a new place

as the child moves through the toddler period, there is a decrease in the frequency of. a. solitary play b. imitative play c. tactile plav d. parallel play.

A. solitary play

REMOVAL OF SUPERFICIAL LAYORS OF SKIN BY SCRAPING

ABRASION

MOST COMMON SKIN PROBLEM DURING ADOLECENSE

ACNE VULGARIS

HEALS UNEVENTFULLY WITHIN 2-3 WEEKS

ACUTE WOUND

physical inactivity has been linked with overweight children. which of the following explain this decrease in childhood activity? i. decrease in physical activity in secondary and elementary schools ii. parental obesity and low levels of physical activity iii. increased time spent with TV, video games, computers and internet iv. lack of sidewalks, parks, and bike paths in low-income communities

ALL i. decrease in physical activity in secondary and elementary schools ii. parental obesity and low levels of physical activity iii. increased time spent with TV, video games, computers and internet iv. lack of sidewalks, parks, and bike paths in low-income communities

SENSATION OF PAIN FROM NORMALLY NON PAINFUL STIMULI

ALLODYNA

ABSENCE OF SENSATION

ANESTHESIA

FORCIBLE PULLING OUT OF EXTRACTION OF TISSUE

AVULSION

Pertussis (Whooping Cough)

Agent: Bordetella pertussis • Transmission: Direct contact from droplets • Clinical manifestations: - Catarrhal stage: URI symptoms 1-2 weeks - Paroxysmal stage: short, rapid cough bought followed by high-pitched crowing, "whoop" or gasp 4-6 weeks cyanosis may occur during episode gasp for air, hear the whoop • Treatment: Prevention - Supportive during hospitalization with suction, humidity, careful oral feeding, and hydration • Precautions: Droplet

Scarlet Fever

Agent: Group A Beta-hemolytic streptococci • Transmission: Direct contact from droplets • Clinical manifestations: - Prodromal stage: abrupt high fever, halitosis - Enanthema: tonsils large, edematous, covered with exudate - "Strawberry tongue"- starts white / pale then very strawberry - Exanthema: sandpaper-like pink rash becomes most present in axilla/ under arm • Treatment: Penicillin and supportive care

Erythema Infectiosum (Fifth Disease)

Agent: Human herpesvirus type 6 - Transmission: probably droplet or direct contact - Clinical manifestations: • Persistent fever for 3-7 days in child who is otherwise well appearing • "Slapped Cheek" appearance • Mild URI symptoms, cough - Treatment: Supportive care - Precautions: Standard

Influenza (Flu)

Agent: Influenza Virus (varies from year to year) ** 1 st dose vaccine given at 6 months • Transmission: Direct contact • Clinical manifestations: - Abrupt Fever - URI-like symptoms which progress - Malaise, anorexia • Treatment: PREVENTION, antiviral treatment if detected early, supportive care

Rubella (German Measles)

Agent: Rubella virus • Transmission: Direct contact from droplets • Clinical manifestations: Low-grade fever, headache, malaise, sore throat, RASH- appears on face, then neck, then trunk. disappears in the order it appears • Treatment: Supportive care • Precautions: Droplet

Lyme Disease

Agent: Spirochete Borrelia burgdorferi • Transmission: Infected deer tick bite • Clinical manifestations: - Stage 1: "Bull's Eye" • Fever, HA, malaise - Stage 2: rash on hands and feet 3-10 weeks after inoculation • Fever, fatigue, lymphadenopathy, cough - Stage 3: Systemic involvement 2- 12 mo • Diagnosis: history and serologic testing • Treatment: - Doxycycline >8 yrs - Amox < 8 yrs • Nursing implications: - PREVENTION - Tick removal and insect repellent - Supportive care - Completion of ABX

Pneumococcal Disease

Agent: Streptococcal pneumococci • Transmission: Direct contact affecting children under 2 years most commonly • Clinical manifestations: - Pneumonia, otitis media, sinusitis, localized infections. • Treatment: PREVENTION, Antibiotics, supportive care

Measles (Rubeola)

Agent: Viral • Transmission: Direct contact from respiratory system • Clinical manifestations: - Prodromal state: fever, malaise coryza, cough, conjunctivitis - "Koplick Spots" on mucosa - Rash appears on day 3-4 of illness • Treatment: Antibiotics, bed rest, and support

Cat Scratch Disease

Agent: bacteria Bartonella henselae • Transmission: scratch from kitten or cat • Clinical manifestations: - Painless nonpruritic papule - Regional lymphadenitis • Treatment: Usually supportive without need for ABX • Nursing implications: - Support child and family without disposal of pet

Enterobiasis (Pinworms)

Agent: nematode Enterobius vermicularis * most commomen helminthic infection in US • Transmission: Inhalation or ingestion of eggs from contaminated hands S/S Nocturnal perianal irritation/ itching • DX: Tape Test: tape pressed against outside anus before morning defecation or bath • Treatment: - Pyrantel Pamoate or Albendazole x 1, then again in 2 weeks. - Treat family members - Prevention of reoccurrence - clean under nails, eggs can live under peaks at 5-14 y/o age prevent reinfection hot water wash, short nails wash hands

Giardiasis

Agent: protozoan Giardia intestinalis • Transmission: Direct contact with contaminated water or food most offten in woodland creature fecees/ bodies of water ***precnetion needed in day cares requires sanitary practices during diaper changes and covered reciptlace/ changin papers.. handwashing!! S/S: diarrage vomiting anormies failure to thirve if chronic exposure, abdominal cramps loose stool, constipation • Treatment: Flagyl or Tindamax and prevention of reoccurrence Flagyl has a metallic taste

Rocky Mountain Spotted Fever

Agent: spirochete Rickettsia rickettsii • Transmission: Infected tick bite, rodent or dog • Clinical manifestations: - Gradual or abrupt onset of fever, malaise, HA - Rash on palms, soles of feet • Treatment: - Tetracycline - Supportive therapy • Nursing implications: - Prevention of exposure - Education of family - Supportive care

Chicken Pox (Varicella)

Agent: varicella-zoster virus - Transmission: Direct contact and respiratory secretions *** highly communicable - Clinical manifestations: • Prodromal stage—slight fever, malaise. • Pruritic rash begins a macule vesicle then erupts • Rash is typically centripetal- extremities, face • Treatment: Supportive - Precautions: Standard * child should wait 11 months before receiving blood products - Child is contagious a day before rash appears and until vesicles are crusted - Prevention: Secondary skin infection and complications

Designed to reduce the transmission of infectious agents that remain suspended in air or by dust particles containing the infectious agent

Airborne Precautions

D (it is available to women age 17 and older without a prescription. it must be taken within 120 hours of the unprotected sex)

Amanda, age 18, comes to the school nurses office early in the morning, visibly upset. she tells the nurse that she and her boyfriend were having sexual relations last night and the condom broke. she asks the nurse about a new pill she has read about that will keep her from becoming pregnant. she wants the nurse to give her more information about this pill. which of the following statements made to amanda provides the best info about levonorgestrel? A. it is available without a prescription and must be taken within 24 hours of the unprotected sexual intercourse B. it is very effective but has side effects, so you will need to be out of school at least 1 day C. it contains estrogen, so you will need to have a pregnancy test before it can be administered D. it is available to women age 17 and older without a prescription. it must be taken within 120 hours of the unprotected sex

D (Arrange for Ana's parents to be present when Ana is given the news)

Ana, age 16, has not had a period for the past 3 months, and her pregnancy test is positive. which of the following is NOT an appropriate action for the nurse to take at this time? A. inform ana privately that her test is positive B. review with ana the facts about the pregnancy, including the duration of pregnancy and anticipated due date C. understand that ana's reaction may be one of ambivalence, shock, fear or apathy D. arrange for ana's parents to be present when she is given the news

Primary DYSmenorrhea

Associated with ovulatory cycles; arises from the release of prostaglandins with menses

Billy has been stung by a bee. A small reaction has occurred at the site. What is the most appropriate action at this time? a. Wait until Billy is at home to completely remove the stinger with forceps. b. Remove the stinger as soon as possible by scraping it off the skin. c. Wash the area with hot water and soap. d. Arrange for Billy to undergo skin testing.

B

Dog bites in children occur most often: a. on the upper extremities in young children. b. from dogs owned by the family or by a neighbor. c. from stray dogs. d. in schoolyards and neighborhood parks.

B

During middle childhood: a. children are less susceptible to development of dental caries b. plasticized sealant, applied to deep fissures and grooves of healthy teeth, can prevent cavity formation c. periodontal disease contributes to childhood tooth loss d. regular administration of fluoride dental varnish is no longer recommended

B

During the physical exam of 8-year-old Kevin, the nurse sees a rash at the umbilicus and surrounding area. Kevin tells the nurse that the rash "comes and goes" but "does itch." The nurse recognizes the rash as contact dermatitis. Which of the following is the most likely cause of this rash? a. Insect bite b. Nickel used in Kevin's belt c. Laundry detergent used to clean Kevin's clothes d. A food allergy

B

Erythema migrans is associated with which of the following conditions? a. Contact dermatitis b. Lyme disease c. Cat scratch disease d. Stevens-Johnson syndrome

B

In caring for the child with frostbite, the nurse remembers that: a. slow thawing is associated with less tissue necrosis. b. the frostbitten part appears white or blanched, feels solid, and is without sensation. c. rewarming produces a small return of sensation with a small amount of pain. d. rewarming is accomplished by rubbing the injured tissue.

B

Jimmy, age 9 years, has fallen and scraped his knee at school. He is brought to the school nurse for treatment. Which of the following does the nurse recognize as being least likely to promote healing? a. Changing the dressing when it becomes loose or soiled. b. Washing the injury with hydrogen peroxide and applying a dry gauze dressing. c. Applying an occlusive dressing. d. Washing the area with mild soap and water and applying a topical antibiotic with a nonadherent dressing.

B

Johnny's mother is calling the clinic because Johnny has developed a rash over his entire body. Two days ago he was prescribed amoxicillin for an ear infection, and now his mother tells the nurse she thinks Johnny may have gotten a small rash with this medication when he took it before. Which of the following would be the best intervention by the nurse at this time? a. Question the mother about other symptoms that Johnny may have developed. b. Continue the medication and have Johnny come in tomorrow to see the practitioner. c. Stop the medication and inform the practitioner. d. Tell the mother to give only half the prescribed dose of the medication until Johnny can return to the clinic to see the practitioner.

B

Major aims of skin treatment include all of the following except: a. eliminate the cause. b. obtain an accurate account of child's symptoms. c. effective treatment and symptom relief. d. prevent complications.

B

Neurofibromatosis: i. is an autosomal dominant genetic disorder. ii. is suspected café-au-lait spots. iii. is suspected when the infant develops axillary or inguinal freckling. iv. is associated with learning disabilities. v. has the risk of being transmitted to 100% of the offspring. vi. therapy is limited to excision of tumors that produce pain or impair function and symptomatic management of symptoms. a. i, ii, iii, iv, and v b. i, ii, iii, iv, and vi c. i, iii, v, and vi d. ii, iii, iv, v, and vi

B

Nora has been brought to the emergency department by her father after having been bitten by the family dog. Examination reveals three puncture wounds of the hand. Expected therapeutic management for these wounds includes: a. suturing the wounds. b. administering prophylactic antibiotics. c. irrigating with hydrogen peroxide. d. administering a tetanus toxoid booster, since Nora's last booster was given 13 months ago.

B

Skin in the infant and small child, as compared with skin in older children and adults: a. is tightly bound to the dermis. b. is more likely to have blister formation from an inflammatory process. c. is more likely to react to a sensitizing allergen than to a primary irritant. d. is less susceptible to superficial bacterial infection.

B

Stevens-Johnson syndrome a. is rare and occurs most often in females. b. is a hypersensitivity reaction to certain drugs. c. begins with generalized rash over the entire body except for palms, soles, and extensor surfaces. d. is caused by a bite from a flea.

B

The major goal in treatment of contact dermatitis is: a. reverse the associated immunologic changes. b. prevent further exposure to offending substance. c. educate on management of symptoms. d. prevent transmission.

B

The nurse is assisting Billy, aged 10 years, in applying an all-purpose insect repellent that contains the active ingredient DEET. Which of the following should be included in the nurse's discussion with Billy? a. DEET is effective against most insects and arachnids, but not ticks. b. After returning indoors, treated skin needs to be washed off with soap and water before he goes to bed tonight. c. DEET should be applied to the whole body including the face and hands for better protection. d. DEET should be heavily applied and frequent reapplication is necessary.

B

The nurse knows that with drug reaction rashes, which of the following is true? a. It is usually localized. b. It may be delayed or immediate. c. It is more common with oral drugs. d. It usually has no associated symptoms.

B

Which of the following is true about topical therapy for acute treatment of dermatologic problems? a. Application of heat to the area will relieve itching. b. Apply the topical application in a systematic manner following the contour of the body surface. c. Chemicals that are nonirritating to intact skin will be nonirritating to inflamed skin. d. Emollient action of soaks, baths, or lotions increases skin irritation.

B

childhood depression: a. is easily detected because children tend to act out their problems and feelings b. has characteristics that are determined by parallel developments in symbolism, language, and cognitive development c. does not interrupt normal growth and development d. treatment consists of antidepressants that must be at a therapeutic level for at least 6-8 weeks to achieve beneficial effect

B

the major nursing consideration in assisting the family of a child with nocturnal enuresis is to prevent the child from developing alterations in: a. body image b. self esteem c. autonomy d. peer acceptance

B

when caring for the child diagnosed with functional abdominal pain (FAP), the nurse recognizes which of the following is correct? a. children with FAP have imagined pain usually located in the periumbilical and/or epigastric region of the abdomen b. children at high risk for FAP are those with high expectations and extensive personal goals or whose parents have unusually high expectations for them c. diagnosis is based on physical, laboratory, and radiographic findings d. initial efforts for therapeutic management include dietary modifications and cognitive-behavioral therapy and biofeedback

B

which of the following describes the onset of secondary enuresis? a. occurs following established stool continence b. occurs after a period of established urinary continence c. occurs following a GI illness d. occurs as a result of behavioral acting out

B

Which child should receive further diagnostic testing for chronic abdominal pain? SATA A. an 11 year old boy w/ a 1 month history of generalized peri-umbilical pain B. an 8 yr old girl w/ a 1 week hx of RLQ pain C. a 12 yr old w/ 6 week hx of constipation D. a 6 yr old boy w/ a 1 month of diarrhea and a rectal fistula

B D

as a nurse caring for children, an understanding of childhood depression is essential. some important information about depression includes which of the following statements? SATA A. authorities agree that childhood depression exists & are often similar to adult depression B. identification of the depressed kid requires a careful history, interviews, observations by nurse, parents and teachers C. if antidepressants are prescribed, the child and fam need to know that antidepressants must be at therapeutic level for 4-6 weeks to achieve a beneficial effect D. depressed kids often exhibit a distinctive style of thinking characterized by low self-esteem, hopelessness, poor social engagement with peers, and a tendency to explain negative events in terms of personal shortcomings E. nurses should be aware that depression is a problem that can be easily overlooked in the school-aged child and one that can interrupt normal growth & development

B D E

12 Which of the following skills is not necessary for the toddler to acquire before separation and individuation can be achieved? a. Obiect permanence b. Lack of concern about parental whereabouts c. Delayed gratification d. Ability to tolerate a moderate amount of frustration

B lack of concern about parental whereabouts

Bedbugs, although once considered to be practically nonexistent, have remerged within the past decade as troublesome. Which of the following does the nurse recognize as incorrect information about bedbugs? a. They tend to inhabit warm, dark areas such as furniture and emerge at night to feed. b. They act as vectors for disease transmission. c. The treatment of bedbugs should focus on proper identification, treatment of symptoms, and eradication. d. Their bites are often misdiagnosed as scabies, spider bites, or mosquito bites.

B.

ANTIBACTERIAL AGENT INHIBITS GROWTH OF ACNE

BEZOYL PEROXIDE

Gynecomastia

Benign and temporary disease that occurs in about 70% of adolescent boys

Designed to reduced the risk of transmission of pathogens from moist body substances

Body substance isolation

Gynecomastia

Brest enlargement that occurs during pregnancy

Care of bacterial skin infections in children may include all of the following except: a. good hand washing. b. changing clothes daily and washing in hot water. c. puncturing the surface of the pustule. d. applying topical antibiotics.

C

Epidermal necrosis and erythema multiforme are associated with which of the following conditions? a. Neurofibromatosis b. Alopecia areata c. Stevens-Johnson syndrome d. Intertrigo

C

Epithelial wound healing: a. begins 72 hours after the wound is incurred. b. occurs by autolysis of epithelial cells from the wound center toward the wound margins. c. occurs more rapidly when the wound is moist and crust-free. d. occurs more rapidly when the skin is allowed to dry and to form an eschar, or scab.

C

Skin disorder assessment includes the objective data collected by inspection and palpation. Which of the following is not an example of objective data? a. The lesion has an increased erythematous margin edge. b. The rash appears as macules and papules. c. The lesion is painful and itches. d. The lesion is moist.

C

Steve, age 8, has been diagnosed with tinea capitis. Which of the following does the nurse include in the teaching plan for Steve and his parents? a. No animal-to-person transmission is associated with this infection. b. Steve can continue to share hair-grooming articles with his younger brother. c. Griseofulvin should be administered with high-fat foods. d. Treatment may be discontinued once symptoms subside.

C

Which of the following current beliefs about acne formation is true? a. Cosmetics containing lanolin and lauryl alcohol are not known to contribute to acne formation. b. There is scientific research to support the theory that stress will cause an acne outbreak. c. Exposure to oils in cooking grease can be a precursor to acne in adolescents working over fast-food restaurant oils. d. Acne usually worsens with dietary intake of chocolates and other foods high in sugars.

C

the most common cause of malocclusion is: a. thumb sucking b. tongue thrusting c. hereditary factors d. abnormal growth patterns

C

therapeutic management for a child with a tic disorder primarily consists of: a. behavioral modification to teach children to suppress the tic disorder b. administration of haloperidol to suppress the tic disorder c. education and support for the child and family with reassurance about the prognosis d. genetic counseling for the parents

C

which of the following statements about school phobia is correct? a. school phobia is most common in boys over the age of 12 b. school phobia produces symptoms in children that are unrelieved when the student stays home from school c. students with school phobia that have separation anxiety are not typically afraid to go to school, but rather are afraid to leave home d. school phobia fear is helped by a close intense relationship between the child and mother

C

13 the typical number of words acquired by the age of 2 years 1s: a.50 b. 100 C. 300 d. 500

C 300

Which of the following statements is most characteristic of a 24-month-old child in regard to motor development a. Motor skills are fully developed but occur in isolation from the environment b. The toddler walks alone but falls easilv. c. The toddler's activities begin to produce purposeful results d. The toddler is able to grasp small obiects but cannot release them at will.

C The toddlers acitivites begin to produce purposeful results

11 by the age of 2, the toddler generally: a. has clear body boundaries. b. participates Willingly in most procedures. C. has a sense or maleness or femaleness. d. is unable to learn correct terms for body parts.

C has a sense of maleness or femaleness

Using Erikson's theory as a foundation, the primary developmenital task of the toddler period is a. satisfy the need tor basic trust b. to achieve a sense of accompleshment C. learn to give up dependence for independence d. acquire language or mental symbolism.

C. learn to give up dependence for independence

DOES NOT HEAL IN THE EXPECTED TIME FRAME AND CAN BE ASSOCIATED WITH COMPLICATIONS

CHRONIC WOUND

WHITE HEAD.

CLOSED COMEDONE

FORMATION OF COMEDONES

COMEDOGENESIS

SIZE, SHAPE, ARRANGEMENT OF LESION OR GROUPS OF LESIONS

CONFIGURATION & ARRANGEMENT

3 ETIOLOGIC FACTORS THAT CAN RESULT IN LESIONS OF SKIN IN CHILDREN:

CONTACT W/ INFECTIOUS AGENTS HEREDITARY FACTORS EXTERNAL FACTORS (ALLERGENS) SYSTEMIC DISEASES SUCH AS VARICELLA, LUPUS ERYTH..

Epididymitis

Characterized by unilateral scrotal pain, redness, and swelling; may include urethral discharge, dysuria, fever, and pyuria; treated with antibiotics

Briefly define the concept of animism.

Child ascribes lifelike qualities to inanimate objects

Bulls Neck

Clinical Manifestation of Diptheria Corynebacterium diphtheriae * extreme Lymphedema

Strategy of protecting infants from pertussis by vaccinating all persons who come in close contact with the infant

Cocooning

Bedbugs

Condition: Bedbugs • Infestation agent: Cimex lectularius • Transmission: Contact/sleep in infested mattress mite burrows into the epidermis to feed on blood. • Clinical manifestations: - Intense pruritus, inflammation/rash - May progress to folliculitis/cellulitis - May trigger asthma exacerbation, anaphylaxis • Treatment: - Identification and eradication of bedbug (professional extermination) - Topical application of steroids - Hygiene of linens and clothing - Supportive care for pruritus 2-3 weeks.

A carrier protein with proven immunologic potential combined with a less antigenic polysaccharide antigen to enhance the type and magnitude of the immune response; Hib

Conjugate vaccine

Designed to reduce the risk for transmission of microorganisms transmitted by direct or indirect contact

Contact Precautions

Billy has come in contact with poison ivy on a school picnic. The best intervention for the nurse to implement at this time is to: a. wash the area with a strong soap and water solution. b. apply Calamine lotion to the area. c. prevent spread by instructing Billy not to scratch the lesions. d. flush the area immediately with cold water.

D

Causes of diaper dermatitis include prolonged contact with: a. urine. b. feces. c. detergents. d. all of the above.

D

Cindy, age 8 years, is brought to the clinic with a sore on her arm. She tells the nurse that she scratched it on a piece of metal at the playground about 1 week ago. Which of the following signs would the nurse expect to find if the sore has become infected? a. Itching at the site of the sore b. Rough edges around the sore c. No pain at the site d. Increased erythema, especially around the sore

D

Human bites: a. are treatable at home. b. do not require tetanus immunization. c. should not have ice applied to the area. d. should receive medical attention.

D

Increased obesity among children is related to: a. high birth weight b. underlying disease c. enzyme abnormalities and metabolic defects d. overeating

D

Nancy, age 16 years, comes to see the nurse because of acne on her face and shoulders. After talking with Nancy, the nurse makes a nursing diagnosis of knowledge deficit related to proper skin care. Which of the following would the nurse include in the instruction plan for Nancy? a. Wash the areas vigorously with antibacterial soaps. b. Brush the hair down on the forehead to conceal the acne areas. c. Avoid the use of all cosmetics. d. Gently wash the areas with a mild soap once or twice daily.

D

The nurse is conducting a review of health records for incoming fifth-grade students and discovers that Mary has a history of having had a severe life-threatening systemic response to a Hymenoptera sting. Which of the following is most important for the nurse to do at this time? a. Make sure that Mary has an identification bracelet to alert others of her allergy. b. Contact Mary's parents about which hospital Mary should be taken to if a sting occurs at school. c. Talk to Mary and see if she has had skin testing to confirm her allergy. d. Contact Mary's parents and provider to obtain emergency medication for Mary to use if necessary at school.

D

The nurse recognizes that which of the following is not indicated for use in promoting wound healing? a. Nutrition with sufficient protein, calories, vitamins C and D, and zinc b. Irrigation of wounds with normal saline c. Application of an occlusive dressing d. Application of povidone-iodine (Betadine) solution

D

Which of the following foreign bodies is least likely to be successfully removed with tweezers? a. Pieces of glass b. Spines of cactus c. Embedded needle in the foot d. All of the above

D

Which of the following statements about use of topical therapy in the pediatric population is true? a. Use of silver impregnated in dressing as foam decreases the bacterial burden and bioburden of the wound and has little absorption effect in the pediatric population. b. Application of heat provides a soothing effect to reduce inflammatory processes. c. The use of immunomodulators is suggested as first-line treatment in children younger than 2 years of age. d. Topical immunomodulators have been linked to possible skin cancer and lymphoma in children younger than 2 years.

D

Which of the following would the nurse not include while educating the family about managing atopic dermatitis? a. Keep fingernails cut short. b. Long sleeves and long pants are recommended. c. Avoid irritating products. d. Use fabric softeners to decrease fabric irritation.

D

Wound care instructions to parents should include which of the following? a. Use betadine, alcohol, and hydrogen peroxide to prevent infection. b. Use hydrocolloid dressing that just covers the wound with little overlap. c. Formation of yellow gel with a fruity odor under hydrocolloid dressings is a sign of infection. d. Apply topical antibiotics after washing with mild soap and water.

D

emergency care for tooth avulsion includes: a. replanting the tooth after bleeding has stopped b. storing the tooth in tap water until it and the child can be transported to the dentist c. holding the tooth by the root d. rinsing the dirty tooth gently under running water before replanting

D

the nurse is assisting the family of a child with a history of encopresis. which of the following should be included in the nurse's discussion with this family? a. instructing the parents to sit the child on the toilet at two daily routine intervals b. instructing the parents that the child will probably need to have daily enemas for the next year c. suggesting the use of stimulant cathartics weekly d. reassuring the family that most problems resolve successfully, with some relapses during periods of stress

D

which of the following statements about PTSD is true? a. PTSD is the development of characteristic symptoms after exposure to a traumatic experience or event that is usually not life threatening b. the second phase of PTSD lasts approximately 4 weeks and is one of coping c. the third phase of PTSD extends over 6 months and is a period of direct injury. The victim wants to know what happened and appears to be getting better when actually getting worse d. any child exhibiting a sudden change in behavior needs to be assessed for exposure to a traumatic event

D

which of the following statements about Tourette syndrome (TS) is true? a. manifestations are stable in intensity and rarely chance once developed b. children with TS have no associated obsessive compulsive SX c. tics lead to physical deterioration and affect the expectancy d. behaviors are involuntary

D

which of the following statements about children with orthodontic braces is true? a. there is pain when the child has the braces applies or adjusted, which lasts about 30 minutes b. the bands and brackets offer protection and prevent plaque c. if an arch with breaks, cover the broken wire with dental wax and keep the regularly scheduled appointment with the orthodontist d. forbidden foods during orthodontic treatment including chewing gum, ice, nuts, uncut apples, corn on the cob, hard candy, hard taco shells, nachos, and popcorn

D

10 According to Kohlberg, the best way to discipline children 1s to: a. use a punishment and obedience orientation b. withhold privileges c. use power to control benavior. d. give explanations and help the child change

D give explenations and help the child change

Which of the following is not an influenza vaccine recommendation? a. The vaccine is administered in early fall before the flu season begins and is repeated yearly. b. Trivalent inactivated influenza vaccine is approved for vaccine use in children ages 6 months and older. c. Children with severe egg allergy history should not routinely receive the influenza vaccine. d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma.

D. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma.

PATTERN OF LESION DISTRIBUTION

DISTRIBUTION PATTERN

The nurse is administering immunizations to 2-month-old Brian. Describe what should be documented on the medical record

Day, month, and year of administration of the vaccine; name of the vaccine given and the manufacturer of the vaccine with lot number of each vaccine; name and title of the person administering the vaccine and the location (address) where the vaccine was given; site and route of administration for each vaccine; evidence that the parent or legal guardian gave informed consent before the immunization was administered; VIS (vaccine information sheet) was given for each vaccine before it was administered and the publication date of the VIS

SUICIDE ATTEMPT

Deliberate but unsuccessful act of self-injury.

Tonsillar pharyngeal areas are covered with white or gray membrane; complications include myocarditis and neuritis.

Diptheria

involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person

Direct contact transmission

51 Dora Jackson shares with the nurse that she is concerned about toilet training Tasha before bringing the new baby home. List major points to discuss with Dora about toilet training Tasha and the birth of a new sibling.

Discuss the signs that signal Dora's readiness to toilet train. Also explore Ms. Jackson's ideas about when it is appropriate to toilet train a child (determines the method used). Discuss the common methods and explain that Dora may become toilet trained before the new baby arrives but may regress with the arrival of the new baby.

52 Dora Jackson also tells the nurse in a side comment that Tasha has become a very picky eater and Dora is concerned that she has lost some weight. How should the nurse address these concerns?

Discuss toddler's eating habits, including picky eating and the need for fewer calories during this period. Obtain a weight and plot Dora's growth on an appropriate reference chart and discuss results with Ms. Jackson. Identify Ms. Jackson's knowledge about child nutrition and discuss some points on providing nutritious snacks for Dora to eat.

Rickettsial Infection

Disorders transmitted to humans via arthropods - Ticks, infected fleas, mites - More common in temperate and tropical climates - Bite or exposure may occur without knowledge to family and child - Illness ranges from self-limiting to fatal

Designed to reduce the risk for transmission of infectious agents that are spread when large particles generated during coughing, sneezing, or talking come into contact with the conjunctiva or the mucous membrane of the nose or mouth of a susceptible person; suctioning or bronchoscopy generates these particles

Droplet Precautions

LOCALIZED RED OR PURPLE DISCOLORATIONS

ECCHYMOSES

REDDENED AREA

ERYTHEMA

T or F: Herpetic gingivostomatitis is associated with sexual transmission.

F

T or F: Topical anesthetics like lidocaine (Xylocaine Viscous) can be prescribed for children who are old enough to keep the drug in the mouth for 2 to 3 minutes and then swallow the drug.

F

T or F: Treatment for stomatitis is aimed at relief of complications.

F

T or F: When examining herpetic lesions, the nurse uses her uncovered index finger to check for cracks in the skin surface.

F

T/F Lead-containing pottery or leaded dishes do not contribute to lead poisoning, because food does not absorb lead.

False

Rash appears in three stages; stage I is erythema on face, chiefly on cheeks.

Fifth Disease

48. For each of the following potentially hazardous categories, give an example of an item that could cause aspiration or suffocation in the toddler (e.g., foods: hard candy). Foods: Play objects: Common household obiects:

Foods: Hot dogs, nuts, dried beans, pits from fruit, bones, gum Play objects: Anything with small parts Common household objects: Drawstring jackets or hoods, thumbtacks, nails, screws, coins, jewelry, old refrigerators, storage chests

Fungal skin infections

Fungal Agents: typically dermatophystoses; tinea or candidia • Transmission: Invasion in susceptible skin, corneum, hair, or nails • May be transmitted from infected animals • DX: Microscopic exam • Treatment: - Topical or systemic antifungal Disorders include: - Tinea capitis (scalp) - Tinea corporis (body or nails) - Tinea cruris (groin) - Tinea pedis (feet) - Thrush (oral) - Candidiasis (vaginal, diaper dermatitis)

EXCESSIVE SENSITIVITY

HYPERESTHESIA

DIMINISHED SENSATION

HYPESTHESIA

Infections occur when there is interaction among patients, health care personnel, equipment, and bacteria

Hospital-acquired infection

B (has lesions that typically resolve on their own without treatment)

Human papillomavirus (HPV): A. has 10 serotypes associated with causing genital worts B. has lesions that typically resolve on their own without treatment C. has lesion that decrease in size or disappear during pregnancy D. has lesions always visible to the naked eye on the cervix

DIVISION OF THE SKIN MADE WITH A SHARP OBJECT

INCISION

Involves contact of a susceptible host with a contaminated intermediate object, usually an inanimate object in the patient's environment

Indirect contact transmission

C (adolescents often lack knowledge about normal infant growth and development)

Infants of adolescents are at risk because: A. teenage mothers often neglect their infants, leaving them for long periods with grandparents B. teenage mothers supply excessive amounts of cognitive stimulation to their infants C. adolescents often lack knowledge about normal infant growth and development D. adolescents are less likely to treat their infant as love objects or playthings

Pelvic inflammatory disease (PID)

Infection of the upper genital tract (endometrium, fallopian tubes, and ovaries) most commonly cause by sexually transmitted bacteria, such as Neisseria gonorrhoeae , Chlamydia trachomatis, and variety of other anaerobic bacteria

Condition: Pediculosis Capitis (head lice)

Infestation agent: Pediculus humanus capitis • Transmission: Prolonged close contact when a female louse is able to obtain blood meal at scalp and deposit eggs on hair shaft at night. • Clinical manifestations: - Intense pruritus of scalp (behind ears or nape of neck) - Nits attached to hair shaft • Treatment: - Pediculicide and removal of nits: - Permethrin 1% cream (OTC *NIX*), repeat in a week, treat affected family - Family may attempt other treatment regimens - Education and support to families - Advocacy and support for school attendance Common parasite school age children • Louse blood-sucking organism requires 5 meals/ day • Lays eggs at junction of hair shaft ** look behind ear and base of scalp • Hatch 1-2 weeks leave chitin (empty sacs) Read and follow directions carefully • Wash clothes very hot water • Drier 20 min • Seal nonwashable x2 weeks • No sharing hair accessories, scarfs, hats

Epididymitis

Inflammation that is a result of infection, local trauma, or chemical irritant

Rapid loss of consciousness and respiratory arrest

Inhalant abuse usually gives the child an inexpensive euphoria but is extremely dangerous and can cause two immediate life threatening consequences. These consequences are:

D (Take Jim seriously, allow time for him to verbalize his feelings, and stay with him until referral.)

Jim, who has no history of previous suicide attempts, is talking with the school nurse about his feelings of despair and hopelessness about the future. he tells the nurse he would be better off dead. the nurse's best response is which? A. recognize that jim is going through a common phase of adolescence B. recognize that jim is at low risk for suicide because he has not previously attempted C. explain to jim that suicide never solved anything and that he will feel better tomorrow D. take Jim seriously, allow time for him to verbalize his feelings and stay with him until refferal

Flunitrazepam (Rohypnol)

Known as the "date rape drug" is 10x more powerful than diazepam and produces short term memory loss

ACCIDENTAL CUT, WITH EITHER TORN OR JAGGED EDGES

LACERATION

A (ectopic pregnancy)

Lesley is a sexually active adolescent. She comes to the clinic with abdominal pain and vaginal bleeding. the nurse recognizes that which of the following must be ruled out immediately? A. ectopic pregnancy B. ovarian cyst C. STIs D. Endometriosis

- decrease the intensity or duration of her training - modify her diet to include the appropriate nutrition for her age (a daily calcium intake of 1200 to 1500 mg plus400 to 800 International Units of vitamin D and 60 to 90 mg of potassium and a 20% increase in caloric intake) - explain the consequences of low bone density, osteoporosis, and stress fractures - discuss ways to prevent stress in her life and possible lifestyle changes

Linda, age 16, started her menses at age 13. She comes into the school-based clinic with a hx of secondary amenorrhea. Linda is an honor student and long distance runner who runs an average of 50 miles per week. The physical examination and lab testing results are normal with a negative pregnancy test. Linda's exercise program is thought to contribute to her amenorrhea. DISCUSS OPTIONS FOR MANAGEMENT

Testicular torsion

Manifested by scrotum that is swollen, painful, red, and warm; pain radiating to groin, accompanied by nausea, vomiting, and abdominal pain; typically, an absence of fever and urinary symptoms; immediate surgery required to treat

Testicular torsion

Marked by the testis hanging free from its vascular structure; results in partial or complete venous occlusion

34. the main source of of calcium and phosphorus in a toddler is _________, which should optimally average ______ to ______ oz per day

Milk, 24, 30

designed to vaccinate against a single antigen or organism

Monovalent vaccine

This condition results in earache that is aggravated by chewing.

Mumps

An illness that one person fabricates or induces on behalf of the child

Munchausen syndrome by proxy

HPV & Hep B

Name two STIs for which there is a vaccine

innate resistance to infection

Natural immunity

BLACKHEAD:

OPEN COMEDONE

ABNORMAL SENSATION SUCH AS BURNING OR PRICKLING

PARESTHESIA

DISRUPTION OF THE SKIN THAT EXTENDS INTO THE UNDERLYING TISSUE OR INTO A BODY CAVITY

PENETRATING

3 MOST FREQUENT CAUSES OF CONTACT DERMATITIS:

PLANTS ANIMALS METAL IRRITANTS

SKIN CHANGES CAUSED BY CAUSATIVE FACTOR

PRIMARY LESION

WOUND WITH AN OPENING THAT IS SMALL COMPARED WITH ITS DEPTH

PUNCTURE

ITCHING

PURITIS

Dysmenorrhea

Pain during or shortly after menstruation

In hospitals, which of the following is the most significant source of methicillin-resistant Staphylococcus aureus (MRSA) and the major mode of transport?

Patient to patient via the hands of the health care provider

Cough occurs at night, and inspirations sound like crowing.

Pertussis

CONTAGION SUICIDE

Phenomenon resulting from excessive media coverage after an adolescent suicide.

list at least five characteristics in a toddler that would indicate readiness for toilet training.

Physical characteristics: Voluntary control of anal and urethral sphincters; ability to stay dry for 2 hours; regular bowel movements; gross motor skills of sitting, walking, and squatting; fine motor skills to remove clothing Mental characteristics: Recognizes urge to defecate or urinate; communicative skills to indicate needs; cognitive skills to imitate behavior and follow directions Psychologic characteristics: Expresses willingness to please parent; able to sit for 5 to 10 minutes; demonstrates curiosity about toilet habits; impatient with soiled or wet diapers

Designed to vaccinate against multiple antigens or organisms; meningococcaterm-27l polysaccharide vaccine

Polyvalent vaccine

Critical thinking. case study Tasha Jackson is a 14-month-old infant who is visiting the clinic for her well-baby checkup. Tasha's mother, Dora, is expecting her second child in 3 months. Dora works full time and will be home for 6 weeks with the new baby. Tasha has been in daycare since she was a baby. Dora's husband also works full time during the day. 49 List four areas that the nurse should assess to obtain the information necessary to adequately provide anticipatory guidane for a toddler Tasha's age

Possible answers: Psychosocial development, achievement of major fine and gross motor skills, language, nutrition, sleep and activity, dental health, injury prevention

characterized by hypogonadism; slow intellectual development; short stature; they lack the internal mechanism that regulates food satiety and as a result go to great lengths to obtain food

Prader-Willi syndrome

Priapism

Prolonged penile erection

RAPID REPLACEMENT BY SIMILAR CELLS

REGENRATION

INTERUPPTS ABNORMAL FOLLICULAR KERATINIZATION THAT PRODUCES MICROCOMEDONES

RETIN-A

Rash composed of rose-pink macules or maculopapules, appearing first on trunk, then spreading to neck, face, and extremities; rash is nonpruritic.

Roseola

Discrete pinkish red maculopapular rash appears on face and then spreads downward to neck, arms, trunk, and legs; greatest danger is teratogenic effect on fetus.

Rubella

Rash appears 3 to 4 days after onset and maculopapular eruption on face with gradual spread downward; Koplik spots are present before the rash.

Rubeola

Penile fracture

Rupture of the corpus cavernosum as a result of trauma to the erect penis

CHANGES RESULTING FROM ALTERATION OF LESION (RUBBING/ SCRATCHING)

SECONDARY LESION

Trichomonas vaginitis

STI caused by an anaerobic parasitic protozoa

USED WITH MODERATE TO SEVERE ACNE

SYSTEMIC ANTIBIOTIC THERAPY

Tonsils are enlarged, edematous, reddened, and covered with patches of exudate; rash is absent on face; desquamation occurs.

Scarlet Fever

Interventions that synthesize the major features of Universal (blood and body fluid) Precautions and body substance isolation; involve the use of barrier protection; designed for the care of all patients to reduce the risk for transmission of microorganism from both recognized and unrecognized sources of infection

Standard Precautions

T or F: Aphthous stomatitis is characterized by painful, small, whitish ulcerations that heal without complication in 4 to 12 days.

T

T or F: Aphthous stomatitis may be associated with mild traumatic injury, allergy, and emotional stress.

T

T or F: Herpetic gingivostomatitis is caused by herpes simplex virus, usually type 1.

T

T or F: Herpetic gingivostomatitis is commonly called "cold sores" or "fever blisters."

T

T or F: Treatment for children with severe cases of herpetic gingivostomatitis includes oral acyclovir.

T

USED TO PREVENT NEW INFLAMMATORY LESIONS

TOPICAL ANTIBACTERIAL AGENT

Primary amenorrhea

The absence of menses by 15 years, regardless of normal growth and development

Amenorrhea

The absence of menstrual flow

A (Tender, painful swelling of the testes)

The adolescent with testicular torsion is most likely to be initially seen with which of the following signs and symptoms? A. Tender, painful swelling of the testes B. A mass in the posterior aspect of the scrotum that an be transilluminated C. A heavy, hard, painless mass palpable on the anterior or lateral surface of the testicle D. An asymptomatic scrotal mass that aches, especially after exercise or penile erection

Varicocele

The most common treatable cause of male-related impaired fertility

D (Is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems.)

The pelvic examination in the adolescent: A. Should be performed on all females who are sexually active B. Should only be conducted when there is suspicion of a sexually transmitted disease C. Is always conducted with a parent or guardian in the room D. Is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems

constricted pupils, respiratory depression, cyanosis and needle marks

The physical signs of narcotic abuse are

A (to not inflict further stress on the victim)

The primary goal of nursing care for the adolescent rape victim is: A. Not to inflict further stress on the victim B. Obtaining a complete history of the incident C. Assisting in the physical examination D. Notifying the police and the parents of the victim before proceeding with assessment

A (doxycycline)

Therapeutic management for chlamydia includes: A. doxycycline B. intramuscular injection of ceftriaxone (rocephin) C. intramuscular injection of penicillin D. clarithromycin

Paraphimosis

Tight foreskin of the penis that cannot be contracted

32 Briefly describe the role of ritualism in relation to feeding behaviors in toddlers.

Toddlers like to have the sample plate, spoon or fork, cup and food to eat at almost every meal. If some of these change, the toddler may refuse to eat

Modified bacterial toxin that has been made nontoxic but retains its ability to stimulate the formation of antitoxin

Toxoid

Designed for patients documented or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens for which interventions beyond Standard Precautions are needed to interrupt transmission in hospitals

Transmission-Based Precautions

Stomatitis:

Two types: - Aphthous ulcers (canker sore) cause unknown usually associated with minor trauma - Herpetic gingivostomatitis (cold sores/ fever blister) caused by HSV • Goal is to relieve pain - NSAIDs - Topical anesthetics • Prevent spread of illness - Oral transmission - Meticulous handwashing generally viral in nature, typically will be present down the throat and into GI leads to poor feeding and dehydration swish and swallow medications - viscous lidocaine, diphendrydramine, maalox applied with sponges in the babies mouth ok to swallow apply before feeding to minimize pain

Blood and body fluid precautions designed to reduce the risk of transmission of blood borne pathogens

Universal Precautions

This condition has a rash that begins as macules, rapidly progressing to papules and then to vesicles, eventually breaking and forming crusts.

Varicella

Viral Skin Infections

Viral Agents: viruses • Transmission: Invasion and toxicity in susceptible skin or oropharyngeal mucosa following contact with droplets • Treatment: - Antiviral medications for HSV - Hand-washing and hygiene to prevent spread - Destruction of warts Disorders include: - Verruca (warts) - Herpes simplex I and II - Varicella - Molluscum

In scheduling immunizations, the nurse knows which of the following is correct?

When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine, DTaP, IPV, MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites

B (Firearms)

Which of the following is the most common method of successful suicide among adolescents? A. Overdose of drugs B. Firearms C. Self-inflicted lacerations D. Hanging

Varicocele

Wormlike mass that is palpated above the testicle and becomes smaller when the adolescent lies down

The American Academy of Pediatrics has recommended vitamin A supplements for certain pediatric patients with measles. Correct dosage of vitamin A and instructions to parents of these children include: i. single oral dose of 200,000 international units in children 1 year old. ii. single oral dose of 100,000 international units in children 6 to 12 months old. iii. dosage may be associated with vomiting and headache for a few hours. iv. safe storage of the drug to prevent accidental overdose. a. i, ii, iii, and iv b. i, ii, and iv c. i, iii, and iv d. ii and iv

a

TRUE

a 2014 survey found that weed use and acceptance of weed rose from 2006 to 2011 and then leveled from 2011 to 2013, while alcohol use has been on the decline since the early 1980s

A (the drug binds progesterone receptors and blocks the action of progesterone)

a drug approved for medical abortion is mifepristone. which of the following statements about this drug is true? A. the drug binds progesterone receptors and blocks the action of progesterone B. the drug acts directly on the cervix to soften and dilate and on the uterine muscle to stimulate contractions C. the abortion completion rate is 100% in pregnancies if used correct D. the drug is administered IM up to 49 days after the last menstrual period

Any physical sexual activity between family members a. Incest b. Molestation conduct c. Exhibitionism d. Pedophilia e. Sexual abuse sexual excitement

a incest

A drug used to treat children diagnosed with giardiasis is: a. metronidazole (Flagyl). b. amoxicillin. c. erythromycin. d. tetracycline.

a.

Children with pinworm infections are seen with the principal symptom of: a. perianal itching. b. diarrhea with blood. c. evidence of small, ricelike worms in their stool and urine. d. abdominal pain.

a.

Clinical manifestations differentiate bacterial conjunctivitis from viral conjunctivitis. Which of the following is present with bacterial conjunctivitis but not usually found with viral conjunctivitis? a. Child awakens with crusting of eyelids. b. Child has increase in watery drainage from eyes. c. Child has inflamed conjunctiva. d. Child has swollen eyelids.

a.

For which of the following populations is pertussis vaccine currently recommended? i. All children from 6 weeks to the seventh birthday ii. Children ages 11 to 12 years who have completed the DTaP/DTP childhood series iii. A second booster for previously immunized adolescents and adults iv. Children ages 7 through 10 years who are not fully vaccinated for pertussis (i.e., did not receive five doses of DTaP, or who received four doses of DTaP with the fourth dose being administered on or after the fourth birthday) v. Pregnant adolescents between 27 and 36 weeks' gestation, if not previously protected a. i, ii, iv, and v b. i, iii, and iv c. ii, iii, and v e. i, ii, iii, and iv

a.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands. Based on the information provided, the nurse suspects that Jimmy has: a. bacterial conjunctivitis. b. viral conjunctivitis. c. allergic conjunctivitis. d. conjunctivitis caused by a foreign body.

a.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands. It is important to include what information in the teaching plan for Jimmy's parents? a. Jimmy needs to have his own face cloth and towel. b. Eye medication will need to be administered before the eyes are cleaned. c. Jimmy cannot return to school until all symptoms have stopped. d. Jimmy will need his own eating utensils.

a.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands. The effectiveness of nursing interventions for Jimmy's condition is best demonstrated by which one of the following evaluations? a. There is no spread of the disease within the school and family. b. Parents are able to demonstrate appropriate eye care. c. Jimmy reports no eye discomfort. d. Child engages in normal activities.

a.

Meningococcal conjugate vaccines (MCV4) are not recommended for which of the following populations? a. Routinely for children ages 9 months to 10 years b. Children aged 2 years to 18 years who travel to or reside in countries where N. meningitidis is hyperendemic or epidemic c. Children and adolescents 11 to 12 years of age d. College freshmen living in dormitories

a.

Primary prevention of communicable disease is best accomplished by: a. immunization. b. control of the disease spread. c. adequate water supply. d. implementing good hand-washing practices among hospital personnel.

a.

Rubella vaccine administration: a. is given as protection for the unborn child rather than for the recipient of the immunization. b. is recommended for all children beginning at 4 to 6 years of age. c. is given to all pregnant women if not previously immunized. d. is not given to children whose mother is currently pregnant.

a.

Which of the following statements about Haemophilus influenzae type b (Hib) vaccine is true? a. The vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. b. The vaccine protects against the virus that produces influenza. c. Only two doses of Hib vaccine should be given to children 15 months of age or older who have not been previously vaccinated. d. Hiberix is a conjugate vaccine licensed for use in infants over the age of 2 months

a.

Which of the following statements about rotavirus disease or immunization against rotavirus is correct? a. Rotavirus is one of the leading causes of diarrhea in infants and young children. b. Rotavirus is one of the leading causes of otitis media in young children. c. One vaccine for rotavirus is RotaTeq, which is approved for children 32 weeks of age or older. d. Rotavirus vaccine usually causes only mild reaction, redness, and soreness at the site of injection.

a.

Which of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. Select a 1 inch needle to deposit vaccine deep into the vastus lateralis. b. Use an air bubble to clear the needle before injection. c. Use the deltoid muscle. d. Use the EMLA patch before administration.

a.

38. Which of the following would be an inappropriate method to help a toddler adjust to the initial dental checkuo? a. Explain to the child that a checkup will not hurt b. Have the child observe his or her sibling's examination. C. Have the child perform a checkuo on a doll. d. Ask the dentist to reserve a thorough examination for another VisIt

a. Explain to the child that a checkup will not hurt

Which of the following actions taken by the nurse is least likely to prevent recurrence of poisonings? a. In the emergency department, begin a discussion of ways to injury-proof the home. b. Do a home visit to assess safety before the child is discharged. c. Administer questionnaire for poison prevention to the parents when the child is discharged. d. Advise parents to kneel down to the child's level when determining what products need to be placed out of reach,

a. In the emergency department, begin a discussion of ways to injury-proof the home

Based on the information provided, which of the following is the best analysis? a. Jacob needs some preparations for this new preschool experience b. Jacob will have less trouble adjusting than a child who has never attended daycare c. Jacob is too young for such a drastic change. d. Jacob needs the individual attention he is getting at the daycare.

a. Jacob needs some preparations for this new preschool experience

17 of the following techniques, which is the best to use when toilet training a toddler a.Limit sessions to 5 to 8 minutes of practice. b. Remove child from the bathroom to flush the tollet c. Ensure the toddler's privacy during the sessions. d. Place potty chair near a television to help distract the child during sessions

a. Limit sessions to 5 to 8 minutes of practice

Which one of the following statements is false? a. Most reporting of abuse has been from the middle socioeconomic population. b. One child is usually the victim in an abusive family; removal of this child often places the other sibling(s) at risk. c. The abusive family environment is often one of chronic stress, including problems of divorce, poverty, unemployment, and poor housing. d. Child abuse is a problem of all socioeconomic groups.

a. Most reporting of abuse has been from the middle socioeconomic population.

which of the of the follwing characteristics most likely predisposes a toddler to frequent infections? a. Short straight internal ear canal and enlarged lymph tissue b. Slower pulse and respiratory rate and higher blood pressure C. Abdominal respirations d. Less efficient defense mechanisms

a. Short straight internal ear canal and enlarged lymph tissue

The best way for parents to respond to a child's questions about sexuality is to give the child: a. an honest answer and find out what the child thinks b. one or two sentences that answer specific questions only c. an honest, short, and to-the-point answer d. an honest answer but a little less information than the child expects

a. an honest answer and find out what the child thinks

18 Which of the following statements is false in regard to toilet training? a. bowel training is usuallv accomplished after bladder training b. Nighttime bladder training is usually accomplished after bowel training c. The toddler who is impatient with soled diapers is demonstrating readiness for toilet training. d. Fewer wet diapers signal that the toddler is physically ready for toilet training.

a. bowel training is usuallv accomplished after bladder training

Gastric lavage for pediatric poison ingestions: a. can be associated with serious complications of gastrointestinal perforation, hypoxia, and aspiration. b. is recommended in the emergency department for all cases of ingestion. c. has been proven to decrease morbidity. d. is most useful when the child comes to the emergency department within 3 hours of ingestion of the toxin,

a. can be associated with serious complications of gastrointestinal perforation, hypoxia, and aspiration

Discharge planning for children with lead poisoning includes: a. confirmation that the child will be discharged to a home without lead hazards b. immediate referral for development and speech therapy. c. visiting nurse care for continuation of intravenous treatment at home. d. explanation that there is little need for follow-up, because lead levels have returned to normal

a. confirmation that the child will be discharged to a home without lead hazards

35. Studies in adults which presumably may apply to chidren as well indicate the benifits of an adequate intake of dietary fiber: i. decrease constipation ii increase body weignt iii. decrease body weight. ivprevent toe 2 diabetes mellitus V. preventtype 1 diabetes mellitus. a. i. iii. and iv b. i iii. and v C. ii and iv d. iii. iv. and v

a. i. iii. and iv

The resolution of the Oedipus/Electra complex occurs when the child: a. identifies with the same-sex parent b. realizes that the same-sex parent is more powerful c. wishes that the same-sex parent were dead d. notices physical sexual differences

a. identifies with the same-sex parent

Language during the preschool years: a. includes telegraphic speech b. is simple and concrete c. uses phrases, not sentences d. includes the ability to follow complex commands

a. includes telegraphic speech

The goal of the physical assessment for child physical abuse: a. is to identify all injuries. b. always begins with rapid assessment of airway, breathing, circulation, and neurologic systems. c. should recognize that all forms of physical abuse have obvious signs. d. should occur only after legal authorities have been notified.

a. is to identify all injuries.

Diagnostic evaluations for lead poisoning include: a. lead concentration from a venous blood specimen to confirm diagnosis. b. recommended universal screening for all children, with those ages 6 years or older given priority. c. identifying children at high risk for anemia, since these children will most likely have higher lead levels. d. understanding that a blood level for lead in the 3 to 5 mcg/dl range is normal and the child should be rescreened in 1 year unless exposure status changes.

a. lead concentration from a venous blood specimen to confirm diagnosis.

36. Which of the following is not considered a complementary and alternative medicine therapy: a. multivitamin b. St johns wort (herb) C. Massage therapy d. Probiotic

a. multivitamin

Identified characteristics of parents who are at higher risk for abusing their children do not include: a. older parents who waited until their mid-30s before having their first child. b. isolated parents with few supportive relationships. c. parents who grew up with poor role models. d. single-parent family.

a. older parents who waited until their mid-30s before having their first child.

Dysfunctional uterine bleeding

abnormal vaginal bleeding that does not have a pathogenic cause

Violent shaking of infant that can cause traumatic brain injury

abusive head trauma

Occurs from exposure to the invading agent

acquired immunity

Immune bodies are actively formed against specific antigens by having had the disease or by introducing the antigen into the individual

active immunity

TRUE

adolescents who have at least one supportive parent engage in less risky behavior

TRUE

adolescents with alcoholism seldom drink alone

C (It occurs because of shifts in phosphate from extracellular to intracellular spaces in persons with total body phosphorus depletion.)

adolescents with anorexia nervosa are at risk for refeeding syndrome. which of the following best describes refeeding syndrome? A. it reduces the risk for osteoporosis and returns the menses to normal B. the risk for heart failure is greatest during the first 2 days of treatment C. it occurs because of shifts in phosphate from extracell to intracell spaces in persons with total body phosphorus depletion D. it cause mitral valve prolapse and signifiant electrolyte imbalance

fear of becoming fat

anorexia nervosa is characterized by:

produce signals that promote cessation of appetite

anorexigenic

A solution of antibodies derived from the serum of animals immunized with specific antigens and used to confer passive immunity

antitoxin

Identify the general guidelines for emergency treatment of poisoning.

assess the victim terminate exposure to the poison identify the poison call poison control center for immediate advice

To reduce the virulence of a pathogenic microorganism by treating it or cultivating it on a certain medium

attenuate

The developmental task of toddlers

autonomy vs shame and doubt

Bryan, age 6 months, is starting daycare as his mother is returning to work. Bryan has had no immunizations. Which of the following statements provided by the nurse to the mother is the most appropriate at this time? a. "Since Bryan has not started his immunizations for streptococcal pneumococcipneumococci yet, it is best to wait until after he gets established at daycare before beginning his injections." b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away." c. "Why has Bryan not received any immunizations? He is past due. Don't you care about his health?" d. "Pneumococcal vaccine (PCV13) is the only vaccine recommended for Bryan at this time."

b.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands Based on knowledge of communicable diseases, the nurse identifies which of the following as the priority goal for Jimmy's plan of care? a. Patient will not become infected. b. Patient will not spread disease. c. Patient will experience minimal discomfort. d. Patient will maintain skin integrity.

b.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands. The nurse calls Jimmy's parents to request that they come and pick Jimmy up from school. What is the best rationale for this action? a. Jimmy is tired and needs additional rest because of the infection. b. Jimmy is at high risk for spreading the disease because of his age and inability to wash his hands after touching his eyes. c. Jimmy needs immediate medical attention to prevent complications. d. The nurse needs to discuss causes of this disease with Jimmy's mother so that its recurrence can be prevented.

b.

Jimmy is a 4-year-old preschool student who is brought to the school nurse's office by his teacher. She is concerned because Jimmy has purulent discharge in the corner of both eyes, with inflamed conjunctiva. The nurse observes Jimmy wiping his eyes frequently with his hands. The nurse can expect treatment for Jimmy's condition to include: a. use of continuous warm compresses held in place on each infected eye. b. application of fluoroquinolone ophthalmic agents. c. oral broad-spectrum antibiotics. d. all of the above.

b.

Mumps immunization: a. is recommended for children ages 4 years of age or older. b. is typically given in combination with measles and rubella. c. can be administered to infants as young as 6 months of age. d. is correct for all of the above.

b.

The nurse knows, regarding pertussis, that: a. the incidence has decreased in infants younger than 6 months of age. b. a booster vaccine (Tdap) is now recommended for all children 11 to 12 years of age. c. treatment should begin as soon as exposure is confirmed and includes the antibiotic amoxicillin. d. the disease is not contagious, so close household members do not need treatment.

b.

What antiviral agent is used to treat varicella infections in children at increased risk for complications associated with varicella? a. Varicella-zoster immune globulin b. Acyclovir c. Salicylates d. Steroids

b.

When administering the pertussis vaccine, the nurse recognizes which of the following as incorrect? a. Can be given any time during pregnancy b. Cannot be given to the postpartum mother who is breastfeeding c. The acellular pertussis vaccine, from the same manufacturer, is recommended for the first three immunizations and is given along with diphtheria and tetanus at 2, 4, and 6 months of age. d. Is recommended for health care workers having close contact with infants under the age of 12 months

b.

When educating the public about diphtheria vaccine, the nurse recognizes which of the following as correct? i. Diphtheria vaccine is commonly administered in combination with tetanus and pertussis vaccines (DTaP) or DTaP and Hib vaccines for children under 7 years of age. ii. Diphtheria vaccine is administered with tetanus and acellular pertussin (Tdap) for children 11 years and older. iii. Diphtheria vaccine produces absolute immunity after three doses. iv. Several vaccines contain diphtheria toxoid (Hib, meningococcal, pneumococcal), which confers immunity to the disease. a. i, ii, iii, and iv b. i and ii c. i, ii, and iii d. iii and iv

b.

25 Which of the following statements is true in regard to nutritional changes from the infant to the toddler years: a. Growth rate increases b. Caloric requirements decrease. C. Protein regurements are minimal. d. Fluid requirements increase.

b. Caloric requirements decrease.

Which of the following statements about ipecac use for poisonous substance ingestion is true? a. Ipecac helps absorb the toxin, b. Ipecac is no longer recommended for routine home treatment of poisoning. c. Ipecac is useful when a corrosive substance has been ingested. d. Ipecac is useful when an overdose of a calcium channel blocker has been ingested.

b. Ipecac is no longer recommended for routine home treatment of poisoning

The nurse is to give an injection of the chelation drug calcium disodium edentate. Which of the following does the nurse recognize as most appropriate? a. Keeping the child NPO for 24 hours after administration of the drug b. Mixing the drug with procaine to lessen the pain associated with the injection c. Maintaining seizure precautions at the bedside d. Making certain the patient has no peanut allergy before injection

b. Mixing the drug with procaine to lessen the pain associated with the injection

"Indecent liberties," such as touching or fondling a. Incest b. Molestation conduct c. Exhibitionism d. Pedophilia e. Sexual abuse sexual excitement

b. Molestation conduct

Which of the following statements about the preschooler's physical proportions is true? a. Preschoolers have a squat and potbellied frame. b. Preschoolers have a slender but sturdy frame. c. The muscle and bones of the preschooler have matured. d. Sexual characteristics can be differentiated in the preschooler.

b. Preschoolers have a slender but sturdy frame.

The nurse expects to assist with administration of a specific antidote for poisoning in which one of the following pediatric patients? a. The 8-month-old child admitted to the emergency department after eating 8 or 10 holly berries b. The 13-year-old girl who ingested an overdose of diazepam (Valium) c. The 8-year-old child who ingested three of his mother's birth control pills d. The 6-year-old child who ingested an overdose of an unidentified corrosive substance

b. The 13-year-old girl who ingested an overdose of diazepam (Valium)

In regard to the development of temperament in the preschool years, which of the following statements is true? a. Temperamental characteristics change considerably during the preschool years. b. The effect of temperament on adjustment in a group becomes important during the preschool years c. Children need to be treated the same regardless of differences in temperament. d. There really is no tool that will adequately identify temperamental characteristics during the preschool years.

b. The effect of temperament on adjustment in a group becomes important during the preschool years

The following statements are about hepatitis A illness or vaccination. Which one is correct? a. The illness has a gradual onset, with often dark urine and jaundice being the only symptoms. b. The vaccine is recommended for all children at age 1 year. c. The vaccine consists of a series of three injections timed 2 months apart. d. The illness is spread by all body secretions.

b. The vaccine is recommended for all children at age 1 year.

A child who unintentionally contributes to an abusive situation most likely: a. fits into the "easy-child pattern." . b. has demands, both physical and emotional, that contribute to caregiver fatigue. c. has low self-esteem. d. comes from a low socioeconomic background.

b. has demands, both physical and emotional, that contribute to caregiver fatigue.

The principal characteristics of Piaget's preoperational phase are. i dependence on perception in problem solving ii. egocentric use of language iii. the ability to manipulate Objects in relation to one another in a logical manner. iv. the ability to problem solve based on what is recalled about objects and events. a. i. ii. and iii b. i and ii c. ii and iii d. ii, ii, and iv

b. i and ii

6. Ingestion of injurious agents by children: a. Occurs most frequently at grandparents' or a friend's home, b. occurs because infants and toddlers explore their environment through oral experimentation. c. has increased despite the use of child-resistant containers. d. can be avoided by teaching preschoolers which substances are dangerous.

b. occurs because infants and toddlers explore their environment through oral experimentation

28. hlealthy ways of serving food to toddlers include: a. establlishing a pattern of sitting at a table for meals b. permitting nutritious snacks in lieu of meals. c. discouraging between-meal snacking. d. allowing the toddler to choose preferred foods at every meal

b. permitting nutritious snacks in lieu of meals.

43. studies indicate that toddlers up to 24 months of age are safest when they are: a. placed in a car restraint seat in the front seat of the car. b. placed in a car restraint seat facing the rear in the back c. laced in a tront passenger seat with a deactivated airbag d allowed to stand in the back seat holding on to a shoulder belt

b. placed in a car restraint seat facing the rear in the back

Because of the preschooler's egocentric thought, the best approach for effective communication is through: a. speech b. play c. drawing d. actions

b. play

26children on strict vegetarian and macrobiotic diets should be evaluated for: a. constipation and heart disease. b. rickets and iron-deficiency anemia C. scurvy d. severe acute malnutrition

b. rickets and iron-deficiency anemia

46 Burn iniuries in the toddler age-group are most often the result of: a. flame burns trom playing with matches b. scald burn from hot liquids. C. hot object burns trom cigarettes or irons. d. electric burns from electrical outlets.

b. scald burn from hot liquids.

In comparison to toddlers, preschoolers eat: a. slightly less b. slightly more c. remain the same

b. slightly more

47-Accidental poisonings in toddlers can be best prevented by a. consistently using safety caps. b. storing poisonous substances in a locked cabinet. C. Keeping ipecac syrup in the home d. storing poisonous substances out of reach

b. storing poisonous substances in a locked cabinet.

Which of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschooler? a. lisp b. stuttering c. nystagmus d. echolalia

b. stuttering

45. One of the best was to prevent drowning in the toddler group is for parents to: a. learn cardiopulmonarv resuscitation (CPR) b. supervise children within arm's they are near any source or water c. enroll the toddler in a swimming program. d. not allow the child to swim

b. supervise children within arm's they are near any source or water

40. to prevent fluorosis, parents of toddlers should use all of the following strategies except. a.supervise tne use of toothoaste b. use fluoride mouthrinses. c. store fluoride products out of reach d. administer fluoride supplements on an empty stomach.

b. use fluoride mouthrinses

One of the most important digestive system changes completed during the toddler period IS: a. increased aciditv of the gastric contents b. voluntary control of the sphincters c. the protective function of the gastric contents. d. increased capacity of the stomach

b. voluntary control of the sphincters

By age of 2 years, most toddlers demonstrate increased gross motor skills by: a. jumping using both feet b.walking up and down stairs c. running and skipping on alternate feet d.jumping from a height of 3 feet without falling

b. walking up and down stairs

Impetig Contagiosa -

bacterial skin infection

PARASUICIDE

behaviors range from gestures to attempts to kill oneself

episodes of binge eating and inappropriate compensatory behavior

bulimia nervosa is characterized by:

Anne, an 8-year-old, has been diagnosed with giardiasis. The nurse would expect Anne to have most likely been seen initially with which of the following signs and symptoms? a. Diarrhea with blood in the stools b. Nausea and vomiting with a mild fever c. Abdominal cramps with intermittent loose stools d. Weight loss of 5 lb in the past month

c.

Human papillomavirus (HPV) vaccine is recommended for all of the following populations except: a. female adolescents to prevent HPV-related cervical cancer. b. boys and men (9 to 26 years) to reduce the likelihood of genital warts. c. female preadolescents ages 6 to 8 years. d. female adolescents who are not sexually active.

c.

The nurse is conducting an educational session for the parents of a child diagnosed with varicella. Which one of the following is not an appropriate comfort measure to include in this session? a. Promote skin care including daily bathing and changing clothes. b. Use Caladryl lotion on rash to decrease itching. c. Use hot bath water to promote skin rash healing. d. Keep nails short and smooth to decrease chances of infection from scratching.

c.

Which of the following does the nurse recognize as contraindicated in providing comfort measures to children with communicable diseases? a. Use of acetaminophen or ibuprofen for control of elevated temperature in children with varicella b. Use of diphenhydramine (Benadryl) or hydroxyzine (Atarax) for itching c. Use of aspirin to control elevated temperature and/or symptoms with varicella d. Use of lozenges and saline rinses in an 8-year-old child with sore throat

c.

Which of the following statements about varicella vaccine is correct? a. Varicella vaccine is recommended for all children regardless of past disease history. b. A single dose of 0.5 ml of varicella vaccine should be given by deep intramuscular injection. c. The first dose of varicella vaccine is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age. d. Varicella vaccine should not be administered simultaneously with MMR.

c.

Indecent exposure a. Incest b. Molestation conduct c. Exhibitionism d. Pedophilia e. Sexual abuse sexual excitement

c. Exhibitionism

The nurse, while conducting a home visit, finds that the mother of 4-year-old Nathan is using a mercury thermometer to take his axillary temperature. Which of the following is the best intervention for the nurse at this time? a. Tell the mother to stop using mercury thermometers because if the mercury is ingested, it can cause mercury toxicity. b. Explain to the mother that mercury poisoning can cause acrodynia, c. Explain to the mother that mercury thermometers are no longer recommended and that if broken, the inhaled vapors can cause toxicity. d. Reassure the mother that as long as the mercury thermometer is not broken, it is okay to continue to use it.

c. Explain to the mother that mercury thermometers are no longer recommended and that if broken, the inhaled vapors can cause toxicity.

Which of the following does not contribute to sleep disturbances during preschool years? a. Evening media use b. Inconsistent bedtime routines c. Growing pains d. Nighttime fears

c. Growing pains

Which of the following statements about polio vaccine and immunization is not correct? a. Inactivated poliovirus vaccine (IPV) is now recommended for routine childhood vaccination in the United States. b. Oral polio vaccine (OPV) has been associated with vaccine-associated polio paralysis. c. KINRIX contains DTaP, hepatitis B, and IPV and may be used only in children aged 4 years or older as the fourth dose. d. The combination vaccine PEDIARIX (containing DTaP, hepatitis B, and IPV) may be used as the primary immunization beginning at 2 months of age.

c. KINRIX contains DTaP, hepatitis B, and IPV and may be used only in children aged 4 years or older as the fourth dose.

26-Which nutritional requirement may be difficult to meet in the toddler years: a. Calories b. Proteins c. Minerals d. fluids

c. Minerals

Which of the following expected outcomes would be most reasonable to establish? a. The nurse will help Ms. Roth assess Jacob's readiness for preschool b. Jacob will attend preschool without any behavioral indications of stress c. Ms. Roth will verbalize at least five strategies that can be used to help prepare Jacob for his preschool experience d. Jacob will demonstrate behavior that indicates he is adjusting to his preschool experience

c. Ms. Roth will verbalize at least five strategies that can be used to help prepare Jacob for his preschool experience

19.of the following strategies, which is most appropriate for parents to use to prepare a toddler for the birth of a sibling? a. Explain the upcoming birth as early in the pregnancy as possible D. Move the toddler to his or her own new room c. Provide a doll for the toddler to imitate parenting d. Tell the toddler that a new plavmate will come home soon

c. Provide a doll for the toddler to imitate parenting

22 Of the following techniques, which is the best one to deal with the negativism of the toddler: a. quietly and calmly ask the child to comply b. Provide few or no choices for the child c. Reduce the number of opportunities for "no" d. Remain serious and intent

c. Reduce the number of opportunities for "no"

On routine physical examination, 2-year-old Zach is found to have an elevated blood lead level. The most likely cause for this finding is: a. Zach is allowed to play in the local sandbox at the park. b. Zach lives in a house built after 1980. c. Zach is fed from pottery that the family makes themselves d. Zach's father is an artist and works at home.

c. Zach is fed from pottery that the family makes themselves

Sex typing involves the process by which the preschooler develops: a. a strong attachment to the same-sex parent b. an identification with the opposite-sex parent c. behavior and beliefs for his or her culture and sex d. all of the above

c. behavior and beliefs for his or her culture and sex

The first action parents should be taught to initiate in a poisoning is to: a. induce vomiting. b. take the child to the family physician's office or emergency center. c. call the poison control center. d. follow the instructions on the label of the product.

c. call the poison control center.

29 Developmentally by 12 months of age most children: a. use a spoon adeptly. D. relinquish the bottle voluntarllv. c. eat the same food as the rest of the familv d. reject all solid food in preference for the bottle.

c. eat the same food as the rest of the familv

The preschooler's body image has developed to include: a. a well-defined body boundary b. knowledge about his or her internal anatomy c. fear of intrusive experiences d. anxiety and fear of separation

c. fear of intrusive experiences

30Adequate intakes (Als), a category of the Dietary Reference Intakes, are based on nutrient intake of: a. preterm breast-fed infants b. preterm bottle-fed infants. c. full-term breast-fed infants d. full_term bottle-fed infants

c. full-term breast-fed infants

Sexual abusers: i. can be anyone but most often a male who is known by the victim. ii. can hold full-time jobs and are active in community affairs. iii. are most often not family members. iv. often spend time with the victims to gain their trust before initiating any sexual contact. v. rarely abuse the younger child if the older child is not present. a. ii, iii, iv, and v b. i, iii, and iv c. i, ii, and iv d. iii, iv, and v

c. i, ii, and iv i. can be anyone but most often a male who is known by the victim. ii. can hold full-time jobs and are active in community affairs. iv. often spend time with the victims to gain their trust before initiating any sexual contact.

Physical assessment for child sexual abuse: a. includes documentation of only abnormal genital findings. b. includes collecting forensic evidence obtained directly from a prepubertal victim's body within 3 days of the incident c. includes examination of the anal area d. includes documentation of the size of the hymenal opening, since it is predictive of sexual abuse.

c. includes examination of the anal area

Activated charcoal: a. is odorless, tasteless, and delivered with fewer complications via gastric lavage. b. stimulates the gastric mucosa. c. is often mixed with cola drinks and served through a straw from an opaque container. d. has a bitter taste.

c. is often mixed with cola drinks and served through a straw from an opaque container

Which of the following sources of stress is a typical of a 3-year-old? a. insecurity b. masturbation c. jealousy d. sexuality

c. jealousy

Research has shown that when two languages are presented to children simultaneously in early childhood, bilingual children are most likely to experience: a. adverse effects in their receptive language development b. adverse effects in performance in the majority language c. language milestones at similar stages to monolinguals d. adverse effects to areas in addition to language

c. language milestones at similar stages to monolinguals

Which of the following characteristics is not typically seen in a gifted or talented child: a. asynchrony across developmental domains b. insatiable curiosity c. less need for attention than other children d. intensity of feelings and emotions

c. less need for attention than other children

One way to decrease total fat intake in the preschooler is to: a. drink less milk b. eat fewer quantities of dairy products c. substitute for low-fat food sources d. consume more fruit juice

c. substitute for low-fat food sources

Magical thinking, according to Piaget, is the belief that: a. events have cause and effect b. God is an imaginary friend c. thoughts are all-powerful d. if the skin is broken, the child's insides will come out

c. thoughts are all-powerful

Syphilis

characterized by primary lesion, the chancre, which appears 14-21 days after infection

Intentional physical abuse or neglect, emotional abuse or neglect, and sexual abuse or neglect

child maltreatment

Failure to provide for the child's basic needs and adequate level of care

child neglect

TRUE

cig smoking is the chief avoidable cause of death

C (The plan needs to be firm but flexible.)

cindy has been dx with anorexia nervosa. her therapeutic management plan includes dietary interventions combine with family psychotherapy. which of the following would the nurse recognize as appropriate? A. weight gain is a sign that the patient is not relapsing from the plan B. the patient is only allowed to participate in setting up a food plan as a reward for weight gain C. the plan needs to be firm by flexible D. a reasonable goal for weight gain is about 4 lb per week

D (is present at meals and appears to family and friends to be eating appropriately)

cindy, age 16, has been sent to the school nurse because her gym teacher has noticed a marked decrease in cindy's weight since vacation. which of the following does the nurse recognize as a common finding in an adolescent girl with anorexia nervosa? A. wears form fitting clothes like tank tops and jeans B. has strong peer relationships with classmates and several best friends C. has poor schoolwork performance because of little interest in school D. is present at meals and appears to family and friends to be eating appropriately

Leukorrhea

clear to cloudy vaginal discharge

Multiple vaccines into one parenteral form

combination vaccine

Premenstrual syndrome

condition that has more than 150 associated physical, psychologic, and behavioral symptoms that start with ovulation and then reoccur during the luteal phase of the menstrual cycle

Endometriosis

condition that may be caused by the presence of endometrial tissue outside the uterine cavity

Vulvovaginal candidiasis

condition that may manifest with vaginal pruritus and dysuria and is not a sexually transmitted infection (STI); treated with over-the-counter topical antifungal creams; characterized by "cottage cheese-like" discharge

20. The best approach toward tapering temper tantrums requires _________ and developmentallv aporopriate expectations and rewards.

consistency

TRUE

contraception use increases among girls as the duration of the relationship increase

When administering vaccines, a(n) ___________________________ is considered a condition in a person that does increase the risk for a serious adverse reaction (e.g., not administering a live virus vaccine to a severely immune-compromised child). When administering vaccines, a(n) ___________________________ is a condition in a person that might increase the risk for a serious adverse reaction or that might compromise compromise the ability of the vaccine to produce immunity.

contraindication; precaution

TRUE

cough and cold preps such as nyquil, coricidin and robitussin are common substances abused by adolescents and young adults

Preference for a prepubertal child by an adult as a means of achieving sexual excitement a. Incest b. Molestation conduct c. Exhibitionism d. Pedophilia e. Sexual abuse sexual excitement

d pedophilia

Assessment of which of the following is not helpful in identifying potentially communicable diseases? a. Prodromal symptoms b. Immunization history c. Past medical history d. Family history

d.

Certain groups of children are at risk for serious complications from communicable diseases. These children do not include which of the following groups? a. Children with an immunodeficiency or immunologic disorder b. Children receiving steroid therapy c. Children with leukemia d. Children who have recently undergone a surgical procedure

d.

Joey, a 14-year-old adolescent, has recently relocated from Mexico to the United States. While helping his dad do farm work, Joey suffered a laceration in the horse barn. Review of Joey's immunization record from Mexico shows that Joey has had two previous tetanus and diphtheria vaccine immunization shots, the last one being at the age of 6 years. Which of the following would the nurse in the emergency department expect to give at this time? a. Tdap b. DTaP c. Td booster d. Tetanus immunoglobulin (TIG) human and Tdap

d.

Measles immunization includes which of the following? a. Given at 12 to 15 months of age with a second dose given at age 4 to 6 years of age and revaccination at 11 to 12 years of age b. Child vaccinated before 12 months of age should receive two additional doses beginning at 12 to 15 months and separated by at least 4 weeks c. Revaccination of all individuals born after 1956 who have not received two doses of measles vaccine after 12 months of age d. All of the above

d.

Standard Precautions involve the use of barrier protection to prevent contamination from: a. blood. b. body fluids. c. mucous membranes. d. all of the above.

d.

The general contraindication for all immunizations is: a. minor illness such as common cold. b. breastfeeding. c. pregnancy. d. severe febrile illness.

d.

The nurse is instructing parents on the test-tape diagnostic procedure for enterobiasis. Which of the following is included in the explanation? a. Use a flashlight to inspect the anal area while the child sleeps. b. Perform the test 2 days after the child receives the first dose of antiparasitic medication. c. Test all members of the family at the same time using frosted tape. d. Collect the tape in the morning before the child has a bowel movement or bath.

d.

When instructing the parents caring for an infant with conjunctivitis, the nurse will include which of the following in the plan? a. Accumulated secretions are removed by wiping from outer canthus inward. b. Hydrogen peroxide placed on cotton swabs is helpful in removing crusts from eyelids. c. Compresses of warm tap water are kept in place on the eye to prevent crusting. d. Washcloth and towel used by the infant are kept separate and not used by others.

d.

Which of the following parental behavioral responses should alert the nurse to the possibility of maltreatment of the child? a. Parent displays extreme care for the child, not wanting to leave the child's side. b. Parent displays signs of guilt, not being able to eat or sleep. c. Parent displays abnormal interest in the incident, going over each detail repeatedly. d. Parent belittles the child for being injured.

d. Parent belittles the child for being injured.

Which of the following statements about social development of the preschooler is FALSE? a. Imaginary playmates are a normal part of the preschooler's play b. Preschoolers have overcome much of their anxiety regarding strangers. c. Preschoolers use the telegraphic speech between the ages of 3 and 4 years d. Preschoolers particularly enjoy parallel play

d. Preschoolers particularly enjoy parallel play

23 Which of the following statements about stress in toddlers is true? a. Toddlers are rarelv exposed to stress or the results of stress. b. Anvystress is destructive because toddlers have a limited ability to cope c. Most children are exposed to a stress-tree environment d. Small amounts of stress help toddlers develop effective coping skills

d. Small amounts of stress help toddlers develop effective coping skills

The nurse has conducted an assessment of the sleep patterns of Janie and found that Janie delays going to bed each night. Which of the following interventions does the nurse recognize as least helpful? a. Consistent bedtime ritual, like reading a book before bedtime b. Not allowing the child to stay up past a reasonable hour c. Keeping a light on in the room d. Taking the child into the parents' bed

d. Taking the child into the parents' bed

The moral development of the preschooler is characterized by: a. concern for why something is wrong b. actions that are directed toward satisfying the needs of others c. thoughts of loyalty and gratitude d. a very concrete sense of justice

d. a very concrete sense of justice

24 Regression in toddlers occurs when there is: a. stress b. a threat to their autonomv. c. a need to revert to dependency d. all of the above

d. all of the above

27 phvsiologic anorexia in toddlers is characterized by. a. Strong taste preferences b. extreme changes in appetite from day to day. c. heightened awareness of social aspects of meals. d. all or the above

d. all of the above

39 Flossing is necessary: a.to remove plaque from below the gum margin b. to remove debris trom between the teeth. C. to reach areas Where brushing is ineffective. d. all of the above

d. all of the above

41 Earlv childhood caries may result from: a. using a pacifier coated with honey b. feeding the last bottle iust before bedtime c. long, frequent nocturnal breastfeeding d. all of the above

d. all of the above

Uninhibited scribbling and drawing can help the child develop: a. symbolic language b. fine muscle skills c. eye-hand coordination d. all of the above

d. all of the above

Which of the following characteristics would indicate that Jacob is ready for preschool? a. social maturity b. good attention span c. academic readiness d. all of the above

d. all of the above

Which of the following factors influences aggressive behavior? a. frustration b. modeling c. gender d. all of the above

d. all of the above

In obtaining a history pertaining to an incident of abuse, the nurse should: a. expect the child to betray the parents by admitting to the abuse received. b. expect the child to defend the parents out of a sense of loyalty. c. recognize that the child will have a sense of relief after telling someone about the abuse. d. avoid biasing the child's retelling of the events.

d. avoid biasing the child's retelling of the events.

When educating the preschool child about injury preventions, the parents' emphasis should be on: a. setting a good example b. helping children establish basic safety habits c. protection and education for injury prevention d. doing all of the above

d. doing all of the above

Reduction of poisonings in children and infants can be accomplished by: a. use of child-resistant containers. b. educating parents and grandparents to place products out of reach of small children. c. educating parents to relocate plants out of reach of infants, toddlers, and small children. d. doing all of the above.

d. doing all of the above.

The most appropriate initial nursing intervention would be to: a. allow Mrs. Jackson to express her feelings. b. provide Mrs. Jackson advice about daycare. c. provide Mrs. Jackson advice about sibling rivalry. d. evaluate Mrs. Jackson's knowledge about growth, development, and behavior in toddlers

d. evaluate Mrs. Jackson's knowledge about growth, development, and behavior in toddlers

34. The nurse working with the abused child and family: i. should view the parent and child as victims. ii. should teach the parents through demonstration and example rather than lecture. iii. recognizes that parents need to correct abnormal behavior in the child (e.g., "We told you not to go with strangers"), iv. recognizes that the goal of the nurse-child relationship is to provide a role model for the parents in helping them relate positively to their child. a. i, ii, iii, and iv b. ii, iii, and iv c. i and iii d. ii and iv

d. ii and iv ii. should teach the parents through demonstration and example rather than lecture. iv. recognizes that the goal of the nurse-child relationship is to provide a role model for the parents in helping them relate positively to their child.

In identification of the abused child, the nurse knows: a. physical abuse can be readily identified during the physical examination. b. specific behavioral problems will be seen in the abused child. c. maltreated children easily admit to the abuse they received from their parents. ; d. incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

d. incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

Therapeutic interventions for lead poisoning do not include: a. removal of the source of lead. b. improving nutrition. c. using chelation therapy. d. intravenous administration of dimercaprol.

d. intravenous administration of dimercaprol.

21 The best approach stop a Toddler's head banging is to a. ignore the behavior D. provide time-out C. offer a toy to calm the child. d. protect the child from iniury

d. protect the child from iniury

Janie, age 3 years, has inadequate sleep patterns. The nurse, in preparing the care plan, recognizes seven consequences associated with inadequate sleep. List them.

daytime tiredness behavior changes hyperactivity difficulty concentrating impaired learning ability poor control of emotions and impulses strain on family relationships

SUICIDE

deliberate act of self injury with death as a result

imitation of household activity

domestic mimicry

FALSE

during a second pregnancy for a teenager, obstetric risk and risk to the infant are lower

difficulty with calculation

dyscalculia

difficulty with writing

dysgraphia

reading letters in reverse

dyslexia

The use, persuasion, or coercion of any child to engage in sexually explicit a. Incest b. Molestation conduct c. Exhibitionism d. Pedophilia e. Sexual abuse

e sexual abuse

TRUE

easy access to cars, unsupervised time at home and changing family composition have contributef to the incidence of sexual experimentation among adolescents

TRUE

effective parent-child communication about sexuality can delay the onset of first sexual intercourse

consists of repeating words and sounds for the pleasure of hearing oneself and not intended for communication

egocentric speech

the inability to invision situations from another perspective other than one's self

egocentrisim

Deliberate attempt to destroy a child's self-esteem

emotional abuse

Failure to meet the child's needs for affection

emotional neglect

T/F A level of lead not harmful to the pregnant woman is also not harmful to the fetus.

false

T/F At the cellular level, lead assists the regulating action of calcium.

false

T/F High lead levels are of most concern when they occur in children who are ages 12 and under.

false

T/F Sexual abuse by relatives who have a strong emotional bond with the victim is the least devastating to child.

false

T/F The incestuous relationship between stepfather and daughter is generally shorter and more often reported than the incestuous relationship between biologic father and daughter.

false

T/F The youngest daughter is typically the child in the incestuous relationship.

false

The typical abuser is a male who is unknown to the victim.

false

MMR and varicella vaccine

first dose at 12-18 month second dose 4-6 years

Inactive polio vaccine (IPV) given

first dose at 2 month second dose 4 months third dose 6 -18 months fourth dose 4-6 yrs old

When is the rotavirus Vax given

first dose at 2 month second dose 4 months third dose 6 months

HIB

first dose at 2 month second dose 4 months third dose 6 months 3/4th dose: vary depending on age of first dose

Pneomoccocal Conjugate Vaccine

first dose at 2 month second dose 4 months third dose 6 months fourth dose 12-16 months

CRACK

form of cocaine known as the purer and more menacing form

HPV vaccine

given at 11-12 years

Influenza vaccine

given at 6 months, then annually

The majority of the population is vaccinated and the spread of disease stopped without the rest of the population getting vaccinated

herd immunity

A sterile solution containing antibodies from large pools of human blood plasma

immunoglobulin

D (Latex condoms)

in discussing prevention of STIs, the nurse tells the adolescent that which of the following is most effective? A. birth control pills B. natural skin condoms with nonoxynol-9 C. spermicides D. latex condoms

D (psychotherapy is aimed at resolving adolescent identity crises and distorted body image)

in treating eating disorders: A. weight gain is a reliable sign of positive progress B. when a therapeutic environment is removed, relapses seldom occur C. antianxiety or antidepressant drug use has has not been proven effective D. psychotherapy is aimed at resolving adolescent identity crises and distorted body image

Those achievements that mark children's assumption of their individual characteristics in the environment.

individuation

According to Erikson, the chief psychosocial task of the preschool period is acquiring a sense of _____.

initiative

FALSE

instruction in the skills needed to resist sexual intercourse has less influence on reducing sexual activity than does providing information on the dangers associated with sexual activity (STIs, preg)

the final sensirimotor phase that occurs during ages 19-24 months

inventions of new means through mental combinations

D (Impulse control and satiety regulation are problems in bulimic adolescents)

karen is suspected of having bulimia nervosa. the nurse recognizes which of the following as clinically characteristic of the disease A. bulimia often begins with decreased dietary intake associated with poor relationships with family members B. once started, the bingeing decreases in frequency to only about once per day C. insulin production is decreased because of excessive self-induced vomiting D. impulse control and satiety regulation are problems in bulimic adolescents

Potential causes of heavy metal poisoning in children include (3 things)

lead, mercury, iron

(i & ii) the type and amount of drug taken the time the drug was taken and mode of administration

mark, age 14, has been rushed to the ED because of illegal drug ingestion at a party. which of the following are most important for the nurse to collect to assist in the treatment plan? i. the type and amount of drug taken ii. the time the drug was taken and mode of admin iii. number of times mark has previously overdosed iv. why the drug was taken

Live Vaccines

measles, mumps, rubella, varicella, Rotavirus, TB /BCG

42 _______ _________ injuries cause a Significant number or accidental deaths in all pediatric age-groups

motor vehicle

persistant negative response to request; characteristic of toddler behavior

negativismn

A scary dream taking place during REM (rapid-eye-movement) sleep

nightmares

Crying in younger children and fright in all children; behaviors persistent when child is awake

nightmares

Return to sleep may be considerably delayed because of persistent fear

nightmares

- antibiotics - diabetes - obesity

numerous factors have been identified as predisposing a woman to a vaginal yeast infection DESCRIBE THEM

increase in body weight resulting from excessive accumulation of body fat relative to lean body mass

obesity

produce signals that increase appetite

orexigenic

refers to state of weighing more than average for height and body build

overweight

Dyspareunia

painful sexual intercourse

play alongside, not with, other children

parallel play

Temporary immunity obtained by transfusing immunoglobulin or antitoxins from a person or animal that has been actively immunized against the antigen

passive immunity

Fifth Disease

phase 1 is slapped check persistent fever, cant break Child isolation is not necessary pregnancy women needed to excluded from workplace, or not sole care provide due to fetal demise risk

Deliberate infliction of physical injury on a child

physical abuse

Deprivation of necessities such as food and clothing

physical neglect

31 the toddler's decreased nutritional requirements are manifested in a phenomenon known as _______

physiologic anorexia

Permanent paralysis may occur.

poliomyelitis

preventing subsequent pregnancies

postpartum care of adolescents should be directed toward what goal?

TRUE

pregnant adolescents often have diets deficient in iron, calcium, and folic acid

SUICIDAL IDEATION

preoccupation with thoughts about committing suicide

Spans ages 2 to 7 years; characterized by egocentrism, transductive reasoning, magical thinking and inability to conserve

preoperational phase

Implies that children think primarily based on their own perception of an event; phase in which problem solving is based on what children see or hear directly, rather than on what they recall about objects and events.

preoperational thinking

Bacterial conjunctivitis - pink eye

purulent drainage crusting of eyelids especially on awaking inflamed conjunctiva swollen lids contact precaution, keep eye clean and dry, administer meds, after cleaned *** administer eye drops, block the puncta, for 1 minute to depress lacrimal duct to prevent drainage and unpleasant taste

D (All of the above)

rape victims display a variety of manifestations. which of the following might the nurse see in 16y Sally as she arrives at the ED for treatment after being raped? A. hysterical crying or giggling B. calm and controlled behavior C. anger and rage alternating with helplessness and agitation D. all of the above

A retreat from a present pattern of functioning to past levels of behavior; usually occurs in instance of stress, when the child attempts to cope by reverting to patterns of behavior that were succesful in earlier stages of development; common in toddlers

regression

TRUE

reports show that adolescents believe that prescription meds, although not taken under practitioner orders, are safer that illicit substances

The toddler's need to maintain sameness and reliability; provides a sense of comfort

ritualism

Critical thinking case study: Sheila Roth arrives at the office for a routine preschool physical. Her son Jacob, who is almost 3, will attend the 3-yr-old preschool program at a local private school this year. Since he was a baby, Jacob has attended a home daycare program, while his mother managed her own business. The daycare where Jacob will attend is run by an older woman who treats the 12 children in her program as if they are family. The helper at the daycare also seems very loving. The program is highly structured in regard to schedule and routines. Ms. Roth tells the nurse that she is looking forward to Jacob's new environment. His teacher is very creative and approaches the classroom from the perspective of the child's development. There will be a lot of choices for activities during the day.

see questions 30-33 below

The child's emergence from a symbiotic fusion with the mother.

seperation

natural jealousy and resentment of children to a new child in the family

sibling rivalry

A partial arousal from very deep REM sleep

sleep terrors

Initially may sit up, thrash, or run in bizarre manner, scream, talk, show anger or obvious confusion, which disappears when child is fully awake

sleep terrors

Return to sleep is usually rapid, often difficult to keep child awake

sleep terrors

Usually occurs 1 to 4 hours after falling asleep

sleep terrors

TRUE

smokeless tobacco has been proven to be carcinogenic and regular use can cause dental problems, foul breath and tooth erosions or loss

One of the two types of speech used by children in the toddler years; used for communication; egocentric in that children communicate about themselves to others.

socialized speech

Bacterial Agents:

staphylococci and streptococci • MRSA on the rise • Transmission: Invasion and toxicity in susceptible skin (self-inoculation is common) • Treatment: - Topical or systemic ABX - Hand-washing and hygiene - Dilute bleach baths - May require hospitalization Disorders include: - Impetigo (common) - Folliculitis - Cellulitis - Scalded skin syndrome

Chicken Pox (Varicella) rash

starts as papule, blisters with honey crust then ulcerates starts on chest and spread, remains confluent highly pruritic, prevent secondary infection from scratching

Methamphetamine

street names of "crank" and "crystal", produces more stimulation than cocaine and the user can remain "up" for hours

Bacterial Vaginosis (BV)

symptoms that include thin, malodorous, "fishy" vaginal discharge; Dx confirmed by clue cells on microscopic examination

TRUE

teens between 12 and 16 are at high risk for prolonged labor related to fetopelvic incompatibility

The fifth stage of the sensorimotor phase of development, when the child uses active experimentation to achieve previously unattainable goals

tertiary circular reactions

TRUE

the abuse of prescription and synthetic drugs like xanax and oxycodone has increased among adolescents

B (to assist the pregnant teen in obtaining healthcare)

the first goal in nursing care of the pregnant teenager is: A. to arrange for them to register for food supplement programs to ensure proper nutrition B. to assist in obtaining healthcare C. to involve the boyfriend and parents in the pregnancy so that the teen will have support D. to educate the pregnant teen regarding child care

FALSE

the less familiar an adolescent is with his or her partner, the more likely he or she is to use contraception during intercourse

D (all of the above)

the nurse has been asked to present an edu program on prevention of adolescent stress and suicide. in planning the program, the nurse should include: A. importance of being supportive and establishing positive communication patterns between family and teens B. the precipitating factors of suicide C. effective coping mechanisms and problem-solving skills D. all of the above

allowing adolescents to role play refusal skills

the nurse is conducting a sex edu program. what technique has been found helpful when dealing with the subject of sexual abstinence?

(i, ii, v & vi) C. trachomatis is a common cause using IUDs for birth control with more than one sexual partner increases the risk of developing PID all pregnant women with PID should be hospitalized and treated with parenteral antibiotics

the nurse is discussing PID with a group of sexually active adolescent females. Which of the following is correct information? i. C. trachomatis is a common cause ii. using IUDs for birth control with more than one sexual partner increases the risk of developing PID iii. pain is not always found in patients presenting with PID iv. after a single episode of PID, infertility occurs because of tubal scarring v. after a single episode of PID, the reisk for ectopic pregnancy increases vi. all pregnant women with PID should be hospitalized and treated with parenteral antibiotics

FALSE

the pregnancies of adolescents under 15 years old are less frequently complicated by obstetric problems

C (Use peer-led programs that emphasize social consequences.)

the school nurse is planning an edu program centered on smoking prevention for high schoolers. which of the following methods does the nurse recognize as the most effective way to present this program? A. focus on the negative long term effects of smoking on health B. teach methods of resistance to peer pressure C. use peer led programs that emphasize social consequences D. use media, videotapes and films on smoking prevention

FALSE

the teenage pregnancy rate continues to increase for all age-groups

FALSE

the usual goal for the compulsive drug user is peer acceptance

TRUE

there is evidence that alcohol, marijuana, and cigarette use are associated with sexual intercourse at a young age

T/F Boys are less likely to report both intrafamilial and extrafamilial abuse than are girls.

true

T/F Chelation treatment works by the use of a chemical compound that combines with the metal for excretion.

true

T/F Children may not reveal the truth about the abuse because they fear their parents would not believe them.

true

T/F Children who are iron deficient absorb lead more readily than those with sufficient iron stores.

true

T/F If the venous blood value is below 5 mcg/dl of lead, the child is considered to have a safe blood lead value.

true

T/F Lead-based nonintact paint in structures built before 1978 remains a frequent source of lead poisoning in children.

true

T/F Many sexual offenders are active in the community and hold full-time jobs.

true

T/F Mercury thermometers can cause toxicity if they are broken and vapors are inhaled.

true

T/F Mild to moderate lead poisoning can cause a number of cognitive and behavioral problems in young children, including aggression, hyperactivity, impulsivity, disinterest, and withdrawal.

true

T/F The neurologic system is of most concern when young children are exposed to lead, since the developing brain is very vulnerable.

true

T/F The primary nursing goal in lead exposure is to prevent the child's initial contact.

true

T/F Universal screening guidelines for blood lead level testing include all children between 1 and 2 years of age and between the ages of 3 and 6 years who have not been previously screened.

true

Abnormal uterine bleeding

uterine bleeding that is irregular in amount, duration, or timing and is not related to regular menstrual bleeding

Molluscum Contagiosum

viral skin infection last 18 months- 1.5yrs flesh colored but umblicated

To prevent spread of contamination from one patient to another after procedures, the most important strategy the nurse can use is to:

wash the hands routinely after each patient contact and after removing gloves

1. Reinstitution of normal nutrition or reversal of the severe state of malnutrition 2. resolution of disturbed patterns of family interaction 3. individual psychotherapy to correct deficits and distortions in physiologic functioning

what are the 3 main focus goals for the therapeutic management of anorexia nervosa?

D (Cesarean delivery is recommended for women in labor or ruptured membranes with visible lesions present)

which of the following about herpes simplex virus (HSV) is true? A. it presents with a less severe clinical course in men than women B. it is treated with acyclovir, famciclovir and valacyclovir for cure of the disease C. it is treated with ointments containing coritisone to help reduce inflammation D. cesarean birth is recommended for women in labor or ruptured membranes with visible lesions present

A (Johnny, age 16, whose father quit smoking 2 years ago)

which of the following adolescents does the nurse recognize as LEAST likely to begin smoking? A. johnny, age 16, whose father quit smoking 2 years ago B. karen, age 15, whose older sister smokes C. ted, age 17, who smoked a cig at home in front of his parents D. lilly, age 12, who feels uncomfortable with her early maturing body

A (begin the psychotherapy immediately before the contract is developed and before weight gain)

which of the following is LEAST appropriate when developing an outpatient contract between the pt with an eating disorder and the therapist? A. begin the psychotherapy immediately before the contract is developed and before weight gain B. develop the contract so that the patient's feeling of control and responsibility toward recover is established C. specify in the contract the weight at which tube feeding will be implemented D. specify in the contact when rewards for achievement will be implemented

B (HPV Type 16)

which of the following is associated with 75% of all penile neoplasias? A. Human papillomavirus (HPV) types 6 and 11 B. HPV type 16 C. Uncircumcised males D. Paraphimosis

A (presence of distinctive lesions on the hands (russell sign)

which of the following physical exam findings is suggestive of self-induced vomiting A. presence of distinctive lesions on the hands B. hypertension, weakness and cool skin C. elevated potassium, magnesium and erythrocyte sedimentation rate D. a heart murmur dx as mitral valve prolapse

Condition: Scabies

• Infestation agent: Sarcoptes scabiei • Transmission: Prolonged close personal contact where the mite burrows into the epidermis and deposits eggs. • Clinical manifestations: - Intense pruritus - Excoriation and burrows - Discrete inflammation between finger webs, neck folds, groin s/s: Bullae ( a blister filled with fluid more than 5mm) • Pustules • Wheals (raised itchy welt) • Papules (solid elevated growth vary in size) • Vesicles ( a blister filled with serous fluid) • Eczematuos dermatitis (scalp, feet, hands) • Treatment: - Scabicide: Older than 2 mo Permethrin 5% cream x 8-14 hours * neurotoxic - Hygiene of linens and clothing with high heat - Supportive care for pruritus 2-3 weeks. Lindane - Neurotoxic not recommended by AAP (2012) the longer you are with the patient the more likely to get it highly pruritic, you will see the burrow, and see a dot and thats the scabies must cover the entire body and leave it..