Pediatric Nursing - Preschooler

Parents of a 4-year-old child with sickle cell anemia express a desire to have a second child and question the probability of another child being affected by the disorder. What is the best response by the nurse? "Because you have a child with sickle cell anemia, you should speak with a genetic counselor before having another child." "Because you have a child with sickle cell anemia, there is a 50% chance of having another child affected." "Because you both are carriers of the sickle cell trait, the chances of your next child being affected increase by 50%." "Because you both are carriers of the sickle cell trait, there is a 25% chance that your next child will be affected."

"Because you both are carriers of the sickle cell trait, there is a 25% chance that your next child will be affected."

A nurse is caring for a child who is 1 day post-op after having a colostomy. The parents are concerned that the stoma has not drained any stool. What is the most appropriate response by the nurse? "I'm afraid your child will need more surgery." "We need to increase the child's feedings." "It may take several days for the stoma to function." "Constipation often occurs due to the anesthesia."

"It may take several days for the stoma to function."

A nurse is teaching the parents of a preschooler about the possibility of post-operative hemorrhage after a tonsillectomy and adenoidectomy. When should the nurse explain that the risk of bleeding is the greatest? 1 to 3 days after surgery 4 to 6 days after surgery 7 to 10 days after surgery 11 to 14 days after surgery

7 to 10 days after surgery

A 5-year-old child who weighs 44 lb (20 kg) is given penicillin V suspension for a throat culture positive for streptococcus. The dose is 40 mg/kg/day, divided into two doses. The pharmacy supplies penicillin V in a concentration of 250 mg/5 mL. The nurse should administer how many milliliters for each dose? Record your answer using a whole number.

8 Determine the dosage for 1 day:40 mg/kg/day x 20 kg = 800 mg/day or 400 mg/dose. Determine the volume for the dose:250 mg/5 mL = 400 mg/x. Cross multiply and solve for x:250x = 2000 mL.x = 8 mL.

While assessing a 3-year-old child who has had an injury to the leg, has pain, and refuses to walk, the nurse notes that the child's left thigh is swollen. What should the nurse do next? Assess the neurologic status of the toes. Determine the circulatory status of the upper thigh. Obtain the child's vital signs. Notify the health care provider (HCP) immediately.

Assess the neurologic status of the toes.

The nurse must administer a unit of packed red blood cells to a 4-year-old child. The child's blood type is Type B Rh factor positive. When the unit of blood arrives, it is labeled as Type O Rh factor negative. What is the appropriate action for the nurse to take? Begin the administration of the blood as ordered. Return the blood and order a new unit of Type B. Document the error with an incident report. Have the child's blood retested for blood type.

Begin the administration of the blood as ordered.

The nurse is caring for a 5-year-old child with a femur fracture. The parent explains that the fracture occurred from a fall. The child's recollection of the event conflicts with the parent's explanation. What is the nurse's immediate responsibility? Question the parent about the discrepancy in stories. Keep the child safe, and assess for abuse. Call the police department to report abuse. Restrict parental visitation until abuse is ruled out.

Keep the child safe, and assess for abuse.

A nurse realizes she is 1 hour and 30 minutes late in administering a dose of medication for a 4-year-old child. She gives the medication immediately, and assesses the child. The child isn't harmed by the delay. Which action should the nurse take next? No further action is necessary. The nurse should notify the physician of the error. The nurse should follow facility procedures for reporting an error. The nurse should document a medication error in the client's chart.

The nurse should follow facility procedures for reporting an error.

The mother asks the nurse why peanuts are one of the worst things a child can aspirate. What should the nurse include in the explanation as the main reason for the problem associated with aspirating peanuts? They swell when wet. They contain a fixed oil. They decompose when wet. They contain sodium.

They swell when wet.

A child is receiving peritoneal dialysis to treat renal failure. To detect early signs of peritonitis, the nurse should stay alert for redness at the catheter site. abdominal tenderness. abdominal fullness. headache.

abdominal tenderness.

A preschool-aged child with suspected epiglottitis is emitting no sounds during inhalation attempts and begins drooling. What is the nurse's priority action? administering oxygen by face mask administering parenteral antibiotics assisting with tracheotomy monitoring the electrocardiogram for arrhythmias

assisting with tracheotomy

A client is admitted with a tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, the nurse suspects that the client has patent ductus arteriosus. coarctation of the aorta. a ventricular septal defect. truncus arteriosus.

coarctation of the aorta.

A nurse is evaluating a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which finding typically is the earliest sign of improvement? decreased hematuria increased appetite increased energy level decreased diarrhea

decreased hematuria

When assessing a child for impetigo, the nurse expects which assessment findings? small, brown, benign lesions honey-colored, crusted lesions linear, threadlike burrows circular lesions that clear centrally

honey-colored, crusted lesions

A child is in the emergency department with suspected epiglottitis and has been ordered an X-ray to confirm the diagnosis. The nurse would prepare the child for X-ray by which methods? in radiology, transported by wheelchair, accompanied by a nurse in radiology, transported by stretcher, accompanied by a nurse in surgery, by portable X-ray in the emergency department, by portable X-ray

in the emergency department, by portable X-ray

A nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider? inappropriate parental concern for the degree of injury absence of parents to question about the injury inappropriate response of the child to the injury incompatibility between the child's history and the injury

incompatibility between the child's history and the injury

A school-age child with burns on the trunk and arms has no appetite. The nurse and the parent develop a plan of care to stimulate the child's appetite. Which suggestion made by the parent would indicate the need for additional teaching? deciding that the parent will feed the child withholding dessert and treats unless meals are eaten offering the child finger foods that the child likes serving smaller and more frequent meals

withholding dessert and treats unless meals are eaten

A 4-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. The nurse should suspect that the child's I.V. fluid intake is excessive if assessment reveals worsening dyspnea. gastric distention. nausea and vomiting. a temperature of 102° F (38.9° C).

worsening dyspnea.

The parent of a preschool-age child tells the nurse that the child is hyperactive and something needs to be done. Which response by the nurse would be most appropriate initially? "What makes you think your child is hyperactive?" "What do you think needs to be done?" "How does your child behave normally?" "Does the preschool teacher think your child is hyperactive?"

"What makes you think your child is hyperactive?"

A mother of a 5-year-old child who was admitted to the hospital has a Protection from Abuse order for the child against his father. A copy of the order is kept on the pediatric medical surgical unit where the child is being treated. The order prohibits the father from having any contact with the child. One night, the father approaches the nurse at the nurses' station, politely but insistently demanding to see his child, and refusing to leave until he does so. What should the nurse do first? Firmly tell the father he must leave. Notify hospital security or the local authorities. Notify the nursing coordinator on duty. Notify the nurse-manager.

Notify hospital security or the local authorities.

The nurse discovers that a young client has been given a dose of morphine four times the dose prescribed. What is the priority action of the nurse? Monitor the client's respiratory rate for 5 minutes. Follow the facility policy for reporting of the error. Obtain naloxone and assess the need for administration. Bring emergency resuscitation equipment to the child's room.

Obtain naloxone and assess the need for administration.

The nurse is assessing a 5-year-old client and wants to gain the client's cooperation. Which actions are appropriate for the nurse? Perform a head to toe assessment, just as for an adult. Tell the child not to be afraid because it will not hurt. Save the more intimidating or intrusive parts of the assessment, such as eyes, ears, and genitalia, until the end of the assessment. Tell the child that prizes are given for good behavior.

Save the more intimidating or intrusive parts of the assessment, such as eyes, ears, and genitalia, until the end of the assessment.

A 3-year-old with dehydration has vomited three times in the last hour and continues to have frequent diarrhea stools. The child was admitted 2 days ago with gastroenteritis caused by rotavirus. The child weighs 22 kg, has a normal saline lock in his right hand, and has had 30 mL of urine output in the last 4 hours. Using the situation-background-assessment-recommendation (SBAR) technique for communication, the nurse calls the health care provider (HCP) with the recommendation for which prescription? giving a dose of loperamide. starting a fluid bolus of normal saline. beginning an IV antibiotic. establishing an indwelling catheter.

starting a fluid bolus of normal saline.

A 4-year-old child is admitted for a cardiac catheterization. Which is most important to include as the nurse teaches this child about the cardiac catheterization? a plastic model of the heart a catheter that will be inserted into the artery the parents other children undergoing a catheterization

the parents

A preschooler goes into cardiac arrest. When performing cardiopulmonary resuscitation (CPR) on a child, how should the nurse deliver chest compressions? with the fingers of one hand with two fingertips with the palm of one hand with the heel of one hand

with the heel of one hand

After the nurse teaches the parents of a child with febrile seizures about methods to lower temperature other than using medication, which statement by the parents indicates successful teaching? "We will add extra blankets when he reports being cold." "We will wrap him in a blanket if he starts shivering." "We will make the bath water cold enough to make him shiver." "We will use a solution of half alcohol and half water when sponging him."

"We will wrap him in a blanket if he starts shivering."

A nurse manager of the pediatric unit discovers that she is overbudget on supplies. How could each nurse assigned to the unit help with cost containment? Order only brand-name supplies instead of the generic equivalent. Use the supply closet at work to stock personal medicine cabinets because the supplies are free. Order supplies that are soon to be expired. Use care pathways to specify care and identify daily outcomes.

Use care pathways to specify care and identify daily outcomes.

A parent calls the clinic after her 4-year-old choked on a peanut. The parent reports performing abdominal thrusts and the child is breathing normally now. What should the nurse tell the parent to do? Bring the child to the emergency department to check for airway obstruction. Test the child's urine for blood for internal bleeding. Call the primary care provider if the child begins to sweat and feels dizzy. Observe the child for difficulty breathing from a possible pneumothorax.

Bring the child to the emergency department to check for airway obstruction.

The nurse is caring for a young child whose parents are constantly arguing in front of the child. When the parents do this, the child becomes withdrawn and does not interact with anyone. Which of the following would be a priority intervention for the nurse to manage this situation? Ask the parents to leave the room when they are arguing. Explain the effect of arguing on the child's well-being. Consult a social worker to help the parents. Restrict the parents from visiting the child.

Explain the effect of arguing on the child's well-being.

The nurse in an outpatient clinic is conducting a follow-up assessment on a child who had a severe streptococcal infection 1 week ago. The client is doing better, and the nurse is providing teaching to the parents about continuing to monitor the client for possible complications of the infection. Which information is most important for the nurse to discuss with the parents? "Return immediately if acute flank or mid-abdominal pain occurs." "Expect the child's weight to decrease over the next 2 weeks." "Fevers may continue to occur as the body recovers from the infection." "The infection may cause the child to have some burning with urination."

"Return immediately if acute flank or mid-abdominal pain occurs." Acute glomerulonephritis is a major complication of streptococcal infections in children. The onset is often marked by a sudden occurrence of acute flank or mid-abdominal pain. The child may show signs of fluid retention, such as weight gain and edema. Hypertension also commonly occurs.

Which nursing action would be most successful in gaining a preschooler's cooperation in preparing for surgery? Have the child remove their own underwear. Encourage the child to use the hospital blanket as a transition object to make the child feel more secure. Let the child choose which parent can accompany the child to the preoperative waiting area. Let the child choose whether to ride to the preoperative area on a stretcher or in a wagon.

Let the child choose whether to ride to the preoperative area on a stretcher or in a wagon. Giving the child a choice would promote cooperation, and children commonly prefer a nonthreatening method of travel such as a wagon. Having the child take off their own underwear isn't appropriate, because preschoolers commonly have a fear of genital mutilation; the child would likely resist removing underwear. Children usually won't transfer feelings of security from personal objects to another object such as a hospital blanket. Both parents are encouraged to accompany the child to the preoperative area, so having the child choose one parent isn't appropriate.

Before performing an otoscopic examination on a child, where should the nurse palpate for tenderness? tragus, mastoid process, and helix helix, umbo, and tragus tragus, cochlea, and lobule mastoid process, incus, and malleus

tragus, mastoid process, and helix

The nurse teaches a pediatric client about an upcoming procedure. Which approach indicates that the nurse has selected the correct technique for the client's developmental level? using dolls and stories to prepare school-age children preparing an adolescent a few days in advance of the procedure using puppets and storytelling to prepare a preschooler preparing a toddler a few hours prior to the procedure

using puppets and storytelling to prepare a preschooler

Parents of a preschool-age child ask the nurse about nutrition. Which statement about a preschooler's nutritional requirements is accurate? Caloric requirements per kilogram of body weight increase slightly during the preschool-age period. The preschooler's nutritional requirements differ greatly from those of a toddler. The quality of food that a preschooler consumes is more important than the quantity. Protein should account for 25% of the preschooler's total caloric intake.

The quality of food that a preschooler consumes is more important than the quantity.