Pediatrics 2

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTI's). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which of the following statements would be accurate for the nurse to tell this mother?

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with otitis media. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of otitis media?

"After the eardrum ruptures, the child's pain is relieved."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of urinary tract infection. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask?

"Has your child complained of pain?"

The nurse is collecting data on an 18-month-old child admitted with a diagnosis of possible seizures. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask?

"Have you checked your child's temperature?"

The nurse is collecting data from the caregivers of a child admitted with seizures. Which of the following statements indicates the child most likely had an absence seizure?

"He was just staring into space and was totally unaware."

The nurse is discussing skin disorders with a group of caregivers. The caregivers make the following statements. Which statement indicates an understanding of tinea capitis?

"I always tell my daughter to use her own hairbrush."

The nurse is talking with the caregiver of a 13-year-old diagnosed with scoliosis. The child has come to the clinic to be fitted with a brace to begin her treatment. The child appears upset and angry and states, "I hate this brace; I hate it already." In an effort to support this child, which of the following statements would be the most appropriate for the nurse to make to this child's caregiver?

"If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."

The nurse is caring for a child diagnosed three months ago with juvenile rheumatoid arthritis (JRA). The caregiver reports that the child has recently complained of little pain and is not currently taking aspirin or NSAIDs. The caregiver also tells the nurse that just to be on the safe side, she is continuing to keep the child from doing physical exercise. The mother states, "I think we have beaten this disease." In working with this child and the caregiver, which of the following statements would be best for the nurse to say?

"Let's review some of the instructions. She does need to take an anti-inflammatory every day."

When doing teaching with a group of caregivers of infants the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash.

"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."

The caregiver of a 2-year-old who has a polyurethane resin cast on her arm calls the clinic to report that her child is crying and says that the cast has sand in it. The caregiver states that she has had casts of her own and knows how badly they can itch. She says she always used a hanger to scratch but is worried that it will be too sharp for the child. Which of the following statements would be appropriate for the nurse to make to this caregiver?

"Nothing should be put into the cast. You can blow cool air into it with a hair dryer."

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome?

"She loves hotdogs, and we always cut hers up into small pieces."

The nurse is caring for a 7-year-old diagnosed with pinworms. The nurse talks with the child's caregiver about proper treatment and prevention of future infections. Which of the following statements made by the caregiver indicates a need for further teaching?

"Thank goodness my other children and I are not sick too."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with nephrotic syndrome. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of nephrotic syndrome?

"The child may look chubby, but they really are malnourished."

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which of the following statements would be the most appropriate statement for the nurse to make to this mother?

"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life."

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be which of the following?

"These make a smooth edge on the cast so the skin is better protected."

The nurse is collecting data on a 2 ½ year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask?

"What foods has your child eaten during the last few days."

The nurse is administering acetaminophen to a child with a history of febrile seizures who has an elevated temperature. The dosage for this child is 15mg/kg/dose. The child weighs 20 lb. How many milligrams (mg) of medication with the nurse administer? (Round to the nearest tenth) ______________________

135mg

The health-care provider orders Amoxicillin 35 mg/kg/day in three divided doses for a child with otitis media. The child weighs 44 lb and the medication is available in a suspension of 50 mg/mL. What is the total daily dosage in mL for this child?

14.0mL

A pediatric patient who has been seriously burned is being given IV fluid replacements. It has been determined that the patient will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received

18 ounces of IV fluid replacement by 6:00 PM

The nurse is administering aspirin to an 8-year-old child with severe juvenile rheumatoid arthritis. The child weighs 35 pounds. The dosage is 120 mg/kg/day in two divided doses. The medication comes in chewable tablets 80mg/tab. How many tabs per day will this child receive? (round to the nearest whole number)

24 tabs

When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which of the following findings in the child's fasting glucose levels?

240 mg/dL

The health-care provider orders Phenytoin (Dilantin) 4 mg/kg/day in three divided doses for a child who has a seizure disorder. The child weighs 35 lb and the medication is available at 30mg/5mL. What is the amount in mL for one dose of this child's medication? (Round to the nearest tenth)

3.5 mL

The nurse is administering rocephin (ceftriaxone) IM to a 14-year-old with a diagnosis of gonorrhea. The child weighs 110 pounds. The dosage prescribed is 25 mg/kg. The medication comes in a powder for injection, which after being reconstituted is 1gram/3 mL. How many mL will this child be given? ____________________ (do not round answer)

3.75mL

The health care provider orders Prenisolone 2 mg/kg/day to be given every 8 hours for a child diagnosed with nephrotic syndrome. The child weighs 42 lb. The medication is available in a solution of 3mg/mL. What is the amount per dosage in mL for this child?

4.2 mL

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with acute glomerulonephritis. In which of the following age ranges is the peak incidence of this disorder noted?

6 to 7 years of age

The nurse is caring for a child with a possible diagnosis of muscular dystrophy. The nurse explains to the parents that which of the following will likely be used to confirm this child's diagnosis?

A muscle biopsy

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon?

A partial or complete intestinal obstruction occurs.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of pyloric stenosis?

A thickened, elongated muscle causes an obstruction at the end of the stomach.

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also complains of a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have

Acute glomerulonephritis

The treatment for children with a pinworm infection is to administer which of the following classifications of medications?

Anthelmintics

The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which of the following should be reported if they occur or are seen related to this child? (Select all that apply)

Any area on the cast that is warm to the touch A foul odor under the cast Drainage from under the cast Looseness of the cast on the extremity

A school-age child is brought to the office of the camp nurse with a small, superficial burn. Which of the following actions by the nurse would be the most appropriate action for the nurse to do first?

Apply cold compresses to the area

The nurse is caring for a child admitted with nephrotic syndrome. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Ascites

The nurse is caring for a child with juvenile rheumatoid arthritis. Which of the following medications would the nurse most likely be administering to this child to manage the symptoms of this disorder?

Aspirin

The nurse is observing a group of children diagnosed with various types of cerebral palsy. One of the children has an awkward and wide-based gait. The nurse recognizes this characteristic as common in which type of cerebral palsy?

Ataxic cerebral palsy

The nurse is caring for a child who had a seizure, fell to the ground, and hit and injured his face, head, and shoulders. This information indicates the child likely had which of the following types of seizures?

Atonic

The nurse is presenting an in-service to a group of peers on the topic of traction. The nurse asks the group to give examples of types of skin traction. The following types were named by the nurses. Which of the following is an example of a type of skeletal traction?

Balanced suspension traction

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following food for the party. Which of the following foods would the nurse suggest would be appropriate for the diet this child is on?

Banana splits

The nurse is presenting a post-conference to a group of nursing students discussing the topic of children and poisoning. One student asks what steps you should take if you observe a child eating a substance you believe to be poisonous. Place the following steps to be completed in the order of importance.

Call 911 for emergency help if the child has collapsed or stopped breathing. Follow instructions given by the poison help line personnel. Administer general supportive and symptomatic care. Remove the obvious remnants of the poison. Call the poison help line if child is conscious and alert Administer appropriate antidote if recommended.

When caring for an infant who is hospitalized with Haemophilus influenzae meningitis, an important nursing intervention for the child would be for the nurse to

Check the child's neurological status every two hours

In treating the child with lead poisoning which of the following is used to remove the lead from the child's system?

Chelating agents

The father of a 7-year-old boy reports to the nurse that two or three times over the past weeks he has observed his son seemingly staring into space and rubbing his hands. The behavior lasts for a minute or so, followed by an inability of the child to understand what's being said to him. When the nurse asks the child about his experience, he says he doesn't know what his father is talking about. The symptoms this child is exhibiting might indicate the child is having

Complex partial seizures

The LPN is working with the RN to develop a plan of care for a child with nephrotic syndrome. Which of the following would be appropriate goals of treatment for this child? (Select all that apply)

Conserving energy Preventing infection Promoting coping

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes a macule?

Discolored skin spot not elevated at the surface

Haemophilus Influenzae Meningitis is usually spread by which of the following methods of transmission?

Droplet

In children with otitis media, a procedure known as a myringotomy may be performed. Which of the following statements are most accurate regarding this procedure?

During this procedure small tubes are inserted into the typmpanic membrane.

The nurse is discussing fractures seen in children with a group of caregivers. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in which of the following?

Epiphyseal plate

Infectious mononucleosis ("mono") is caused which of the following?

Epstein-Barr virus

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which of the following symptoms might be an early warning signal that the child has developed compartment syndrome? The child

Feels increasing severe pain

The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other patients, the nurse should

Follow standard precautions

The nurse is caring for a child diagnosed with Hepatitis B. Which of the following systems are most likely to have complications from this diagnosis?

Gastrointestinal

The child diagnosed with muscular dystrophy uses a method of rising from the floor which is referred to as which of the following?

Gowers sign

The nurse caring for children with fungal infections most often administers which of the following medications?

Griseofulvin

A type of traction sometimes used in the treatment of the child with scoliosis is called which of the following?

Halo traction

The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in doing which of the following with this child?

Handling the cast with open palms when moving the arm.

The nurse admits a 9-year-old who is complaining of pain in the lower right quadrant of the abdomen, nausea, and constipation. She also has a fever of 101 degrees Fahrenheit. Of the following nursing actions, which will most likely be done at this time for this child? The nurse will

Help her find a comfortable position

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. Which of the following goal has the highest priority at this time?

Improving hydration

The caregiver of a 17-year-old boy reports that her normally active son has a temperature of 101 degrees Fahrenheit, a sore throat, a headache, and seems completely exhausted. He has just had a nosebleed. The care provider sees the child and makes a diagnosis of infectious mononucleosis. The treatment most likely to be recommended for this child would include

Increased fluids, bed rest, analgesics

The nurse is caring for a child admitted with juvenile rheumatoid arthritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Inflammation of the joints

The caregivers of a child just diagnosed with diabetes express concern that they won't remember the different signs and symptoms of hyperglycemia and hypoglycemia. As a result, they are afraid they won't handle an emergency correctly. The best initial response by the nurse would be to

Instruct them to treat the reaction as if it's hypoglycemia, which is more likely

The school nurse is teaching a group of teachers about various skin disorders seen in children. One of the teachers asks what to look for if they think a child in their class has head lice. Which of the following signs is the most obvious symptom of head lice?

Itching of the scalp

The child diagnosed with muscular dystrophy often exhibits a forward curvature of the lumbar spine. This description is accurate regarding which of the following?

Lordosis

A group of camp nurses is discussing various types of tick bites. One of the nurses states that deer ticks are carried by white-footed mice and white-tailed deer, and can carry the organism that causes which of the following diseases?

Lyme disease

The nurse is caring for an 8-year-old hospitalized child with nephrotic syndrome. Which of the following nursing interventions would be appropriate for this child?

Measure the abdominal girth daily.

The nurse is caring for a child admitted with a severe burn. Which of the following nursing interventions will the nurse most likely perform in the first one to two days following the child's injury?

Monitor nasogastric suctioning

A symptom often seen in the child diagnosed with Haemophilus Influenzae Meningitis occurs when the child has a stiff neck. This symptom is referred to as which of the following?

Nuchal rigidity

The nurse is discussing medications to be given to a child who has been diagnosed with Candidiasis. Which of the following medications would most likely be prescribed for the child?

Nystatin

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is which of the following?

Obtaining a clean catch voided urine

The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which of the following symptoms?

Paresthesia

A young child has been admitted with a diagnosis of enterobiasis (pinworm infection). This child will most likely have a history of which of the following?

Perianal itching

The caregiver of a child who has a history of seizures reports that her child was complaining of being dizzy, and the caregiver noted the child seemed drowsy and was clumsy. The nurse recognizes that the description of the child's behavior was most likely which stage of a tonic-clonic seizure?

Prodromal

The nurse is caring for a child admitted with pyloric stenosis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Projectile vomiting

The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which of the following vital signs might indicate the possibility of an infection?

Pulse rate 135 bpm

The nurse is caring for a 3-year-old diagnosed with diabetes mellitus. The child's eating patterns are unpredictable. One day the child will eat almost nothing, the next day the child eats everything on her tray. The nurse recognizes that which of the following types of insulin would most likely be used in treating this child?

Rapid-acting insulin

The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which of the following clinical manifestations would the nurse most likely note in this child?

Red lips and fruity odor to breath

The nurse is caring for a 1-year-old hospitalized child who is in Bryant's traction. Which of the following nursing interventions would be the highest priority for this child?

Report continuous loud crying or irritability

In caring for the child with meningitis, the nurse recognizes that which of the following nursing diagnoses would be the most important to include in this child's plan of care?

Risk for injury related to seizure activity

The school nurse is doing a presentation to a group of caregivers of children diagnosed with scoliosis. One of the caregivers asks the nurse about structural scoliosis. The nurse explains that which of the following is involved with the diagnosis of structural scoliosis?

Rotated and malformed vertebrae

The caregiver of a fifth-grade boy calls the pediatrician's office and reports that her son has been scratching at his groin for a week or so. Despite his need for privacy, he's finally allowed the caregiver to look at the groin area. The caregiver describes the area to the nurse saying, "It looks like black pin dots that seem to have dark tails." The nurse suspects that the child may have which of the following?

Scabies

The nurse recognizes that which of the following would be a likely physiologic cause for a child to have enuresis?

Sleeping too soundly

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which of the following best describes pustule?

Small elevation of epidermis filled with a viscous fluid

The nurse is caring for a child admitted with acute glomerulonephritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Smoky colored urine

The caregivers of a child who has had difficulty learning to walk notice that when the child attempts to pull himself up to stand, he can't seem to get his legs uncrossed and beside each other. When he is in a standing position, he stays up on his toes. This is different from what they saw with their older children and they are concerned. Further diagnostic tests indicate the child has cerebral palsy. Which type of cerebral palsy do these symptoms indicate? The child has

Spastic cerebral palsy

The nurse is collecting data for a child with idiopathic celiac disease. The caregiver tells the nurse that her child has bulky and greasy stools. The nurse recognizes that the child has which of the following?

Steatorrhea

The nurse is caring for an infant immediately after a pyloromyotomy surgery has been performed to treat pyloric stenosis. The infant's parents are understandably anxious about their child. Given the situation, what is the most appropriate way for the nurse to position the infant during the anesthesia recovery period? The nurse should

Support him and place him on his side

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to do which of the following actions?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

The nurse working with the child diagnosed with Type 2 Diabetes Mellitus recognizes that most often the disorder can be managed by which of the following?

Taking oral hypoglycemic agents

The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. Which of the following would be the best action for the caregiver to follow in removing the tick?

The caregiver should apply isopropyl alcohol to the tick and the child's arm, then use sterilized tweezers to carefully remove the tick without crushing it.

The nurse is caring for a child admitted with simple partial motor seizures. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

The child had shaking movements on one side of the body.

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a one week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out which of the following?

The child has been sexually abused, maybe on the fishing trip

The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be which of the following?

The child is in status epilepticus.

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. Which of the following would the nurse likely find in this child's history?

The child recently had an ear infection.

The nurse is caring for a child admitted with complex partial seizures. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

The child was rubbing the hands and smacking the lips.

In caring for a child with a seizure disorder, the highest priority goal is which of the following?

The child will be free from injury during a seizure.

The nurse is collecting data on a child admitted to the burn unit with a partial-thickness burn. Which of the following is most accurate regarding this type of burn?

The child will likely have blisters.

The nurse is collecting data on a 4-year-old child admitted to the burn unit. The nurse is concerned about the possibility of the child going into hypovolemic shock. Which of the following data would the nurse recognize as an indication that this may be occurring?

The child's apical pulse is 140 bpm.

In caring for a child being treated for scoliosis, the highest priority goal is which of the following?

The child's will remain free of injury.

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which of the following is the most accurate regarding urinary tract infection seen in children?

The most common age for UTI's in children is 2 to 6 years of age.

When caring for a child who has a diagnosis of acute glomerulohephritis which of the following nursing interventions would most likely be included in the child's plan of care. (select all that apply)

The nurse administers diuretics. The nurse administers antihypertensives. The nurse weighs the child every day using the same scale. The nurse dipsticks the child's urine to test for protein.

The nurse is caring for a child admitted with acute appendicitis. Prior to the child going to the operating room for emergency surgery, which of the following nursing interventions would the nurse most likely perform?

The nurse encourages the child and family to express their fears.

The nurse is caring for a child diagnosed with Haemophilus Influenzae type B. Which of the following nursing interventions would be the highest priority in the prevention of complications seen with this disorder?

The nurse will administer antibiotics.

The nurse is caring for a child hospitalized with pertussis. Which of the following nursing interventions would be the highest priority for this child?

The nurse will administer oxygen.

The nurse is discussing the diagnosis of intussuseption with a group of peers. Which of the following is an accurate statement regarding this disorder?

The stools of the infant are called currant jelly stools and consist of blood and mucuous.

The nurse is reinforcing teaching regarding the treatment for head lice with the caregiver of a child who has the disorder. Which of the following is most accurate related to the treatment for the child with an infection of head lice?

The treatment will need to be repeated in about two weeks.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of colic?

There are recurrent paroxysmal bouts of abdominal pain.

The nurse is caring for a child who has had a cast applied to treat a fracture of the fibula. To monitor the pulse of the child's involved extremity the nurse will monitor which of the following?

Tibial pulse

The nurse is caring for a 3-year-old child with a history of seizures and observes the child having a seizure. Following the seizure activity, the nurse documents which of the following? (Select all that apply)

Time the seizure started Factors present before seizure started Eye position and movement Incontinence of urine or stool

Which of the following infections is often contracted by having contact with an infected dog or cat?

Tinea corporis

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is for which of the following reasons?

To dilute the urine and flush the bladder.

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet?

bananas

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which of the following foods would be permitted in the diet of the child with celiac syndrome? (Select all that apply)

bananas, skim milk, applesauce

In working with children who have food allergies the nurse recognizes that which of the following foods are frequently the cause of a food allergy. (Select all that apply)

eggs, corn, oranges, and soybeans