Pediatrics: PrepU Quiz #1
The nurse is preparing the anticipatory guidance sheets that are provided to parents. When organizing the sheets, place the milestones in their proper sequence from earliest to latest. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Creep up stairs 2 Run and jump in place 3 Engage in parallel play 4 Name one color 5 Zip up their own jackets Chapter 26 Page 997
Creep up stairs Run and jump in place Engage in parallel play Name one color Zip up their own jackets A 15-month-old can creep upstairs. An 18-month-old can run and jump in place. A 24-month-old engages in parallel play; a 30-month-old can name one color. Zipping their jackets occurs around their third birthday.
The parents express concern about their child who has an imaginary friend. The nurse explains that as long as the imaginary friend does not become the center of attention and also the child has real friends, this can be beneficial. What benefits are discussed? Select all that apply. Encourages language development by conversation. Provides an outlet by which the child can express innermost feelings. Protects the child by separating from those who are unkind. Serves as someone to blame or decrease the child's guilt. Helps the child know what is real and what is not. Chapter 27 Page 1032
Encourages language development by conversation. Provides an outlet by which the child can express innermost feelings. Serves as someone to blame or decrease the child's guilt. Benefits of imaginary friends include that they can encourage language development, provide an outlet for a child to express innermost feelings, and serve as a handy "scapegoat" or decreasing guilt for behavior about which a child has some conflict. Preschoolers have vivid imaginations and they can use these imaginations to develop social skills and explore complex social ideas. The imaginary friend does not help the child know what is real or what is not. The child is still trying to develop one's place in the world.
A school-age child is scheduled for a diagnostic procedure. Which nursing approach is best for this age group? Explain the procedure and the theory and reason behind it. Encourage the parents to discuss the procedure with their child. Provide a brief overview of the procedure to reduce anxiety. Offer to bring the child a favorite snack after the procedure is over. Chapter 35 Page 1202
Explain the procedure and the theory and reason behind it. School-age children and adolescents are concrete thinkers and are interested in the theory and reason for procedures. It is best for the nurse to provide the instructions directly to the child and not expect parents to do so. A brief overview is appropriate for toddlers, and bribing the child with food is not an appropriate tool for teaching.
The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs? Gloves Gown N95 respirator Face mask Eye wear Chapter 37 Page 1358
Gloves Gown N95 respirator Transmission of chickenpox (Varicella zoster) occurs through direct contact with infected persons' nasopharyngeal secretions or via air-borne spread, to a lesser degree by contact with unscabbed lesions. Airborne and contact precautions (gloves, gown, N95 respirator) should be used with the hospitalized child for a minimum of 5 days after onset of rash and as long as vesicular lesions are present. A simple face mask is used for droplet precautions. Eye wear would only be necessary if splashing was likely.
Which assessment findings of the speech of a 5-year-old child warrant further follow-up? Select all that apply. The child is able to count to 15 without prompting. It is difficult for people outside of the household to understand his conversation. The child has a vocabulary of an estimated 1,200 words. The child is able to articulate his full name. The child is unable to provide his address when asked. Chapter 27 Page 1027
It is difficult for people outside of the household to understand his conversation. The child has a vocabulary of an estimated 1,200 words. The child is unable to provide his address when asked. By the age of 5 a child should have the ability to be understood in conversation by people outside of the immediate family even in the presence of some speech articulation issues. The child's vocabulary should exceed 2000 words. The child should be able to provide his address when asked.
The nurse is completing a care plan for a preschool child with the nursing diagnosis of imbalanced nutrition, less than body requirements. Which interventions should the nurse include? Select all that apply. Limit juice to 6 to 8 ounces per day. Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home. Feed the child whenever he wants to eat. Chapter 27 Page 1036
Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home. Limiting milk to 16 to 24 ounces, providing at least 3 meals and 2 healthy snacks and weekly weights are all appropriate intervention. Juice should be limited to 4 to 6 ounces daily. Feeding the child on a similar schedule daily rather than when the child is hungry will develop better eating habits.
A nursing instructor is describing the progression of signs and symptoms associated with varicella from earliest to latest. Place the signs and symptoms below in the sequence that the instructor would describe them. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Low-grade fever 2 Macular rash 3 Papular rash 4 Vesicle formation 5 Crusting Chapter 37: Page 1358
Low-grade fever Macular rash Papular rash Vesicle formation Crusting The disease is marked by a low-grade fever, malaise, and, in 24 hours, the appearance of a rash. The lesion begins as a macula, then progresses rapidly within 6 to 8 hours to a papule, then to a vesicle that first becomes umbilicated and then forms a crust.
The nurse is providing postoperative care to a school-age child after a splenectomy and notes the following: temperature 102.1ºF (39ºC), heart rate 120 bpm, respiratory rate 28 breaths/minute, blood pressure 78/36 mm Hg, and oxygen saturation 90%. Which nursing action is priority? Administer acetaminophen orally. Give recombinant erythropoietin. Reassess temperature in 30 minutes. Place the child in a supine position. Chapter 46 Page 1780
Place the child in a supine position. For a child showing signs of acute blood loss, a priority is to lay the child flat to provide adequate circulation to the brain. Administering acetaminophen and reassessing the temperature can be performed later. Erythropoietin may be given to increase RBC production, but this is not a priority in the immediate, acute blood loss period.
Which children will the nurse avoid immunizing with a live-virus vaccine? Select all that apply. Two-month-old infant Preschooler receiving radiation therapy School-age patient with fractured arm Pregnant teen Toddler with constipation Chapter 31: Page 1141
Preschooler receiving radiation therapy Pregnant teen The immune compromised child undergoing radiation therapy and the pregnant teen should not receive live-virus vaccines. The preschooler could contract the disease. In pregnancy, the virus could cross the placenta and infect the fetus. The other children can safely receive a live-virus vaccine.
The nurse is teaching a parent the correct procedure for taking a tympanic temperature reading. Which action by the mother indicates that the teaching was successful? Pulling the pinna up and back for all children under 6 Pulling the earlobe down and back in all children under 6 Pulling the earlobe down in children under 2 and pulling the pinna up in children over 2 Removing earwax in the child's ears prior to inserting the thermometer Chapter 35 Page 1167
Pulling the earlobe down in children under 2 and pulling the pinna up in children over 2
The community health nurse is providing a class to a group of teens training to become "safe babysitters". When discussing activities that are appropriate for 3-year-olds, which should be included? Select all that apply. Skipping Skating Riding a tricycle Playing tag Playing catch Chapter 27 Page 1026
Riding a tricycle Playing tag At the age of 3 years the preschool child is active. They are able to run and thus play tag. They are also able to pedal a tricycle. Skating and skipping are activities that are more appropriate for a 5-year-old child. Throwing a ball is more appropriate for a 4-year-old child.
A nurse is assessing a 3 year old at a well-child visit. Which developmental milestones would the nurse expect to assess? Select all that apply. Completes simple buttons Laces sneakers independently Undresses self without difficulty Stacks a tower of blocks Throws a ball overhand Chapter 27 Page 1026
Undresses self without difficulty Stacks a tower of blocks A 3 year old typically can undress himself or herself and stack a tower of blocks. Simple buttoning is more characteristic of 4 year olds. The ability to lace sneakers or shoes and throw overhand are typical of 5 year olds.
A nurse is preparing to administer vaccines to a child who is entering kindergarten. Which vaccines should the nurse anticipate administering to this child? Select all that apply. poliomyelitis (inactivated) hepatitis B varicella measles, mumps, and rubella (MMR) diphtheria, pertussis, and tetanus (DTaP) Chapter 27 Page 1146
poliomyelitis (inactivated) varicella measles, mumps, and rubella (MMR) diphtheria, pertussis, and tetanus (DTaP) The nurse should anticipate administering IPV, varicella, MMR, and DTaP, which, according to the CDC immunization schedule, are given between 5 and 6 years of age.
The parent of a preschool-aged child asks the nurse for ideas on preparing the child for abdominal surgery requiring general anesthesia. What would the nurse recommend for this parent? Select all that apply. Remind the child that parent will be there when the child wakes up. Encourage the child to ask questions and talk about fears Help the child select a couple of toys appropriate to take to the hospital Use play to demonstrate procedures on the child's toy dolls Assure the child that pain medication will take all the 'hurt' away Schedule a tour, specific for children, of the hospital and surgical area Chapter 30 Page 1209
Encourage the child to ask questions and talk about fears Help the child select a couple of toys appropriate to take to the hospital Use play to demonstrate procedures on the child's toy dolls Schedule a tour, specific for children, of the hospital and surgical area The preschooler will benefit by preparations such as play, touring, having familiar toys from home and being able to ask questions. Before promising to "be there when the child wakes up," the parent would need to verify that the hospital allows parents in the postanesthesia care unit (PACU), and if not, the parent would tell the child that he or she will be there when the child get into the room. Although pain medication will be used to reduce the child's pain postoperatively, the parent would avoid promising the child no pain, as the child will have some postoperative pain.
The nurse is educating foster parents regarding their recently fostered 9-year-old girl. What statement by the parents indicate the need for further assessment with regard to her age-appropriate growth and developmment? Select all that apply "She has been reluctant to go to school each morning." "She was very quiet when she was put into a new classroom at school." "She seems intent on being part of a club that has a secret password." "She gets agrumentative and refuses to follow the rules to board games and card games." "She is very concerned with cleanliness and showers two to three times a day most days." Chapter 28 Page 1051
"She gets agrumentative and refuses to follow the rules to board games and card games." "She is very concerned with cleanliness and showers two to three times a day most days." The lack of interest or willingness to attend school is not abnormal for a child of this age facing change. The parent indicating the child is not willing or interested in following the rules of a game is a concern. Typically, this age group enjoys learning the rules and are strict with them. This age group can do their own hygiene but do not place importance on showering as much as their parents. Showering twice per day is a concern as this isn't usually apparent until the child's teen years. This age group enjoys clubs with secret passwords, handshakes and languages. Depending on their temperament, they may be quiet when in a new or unfamiliar environment. If this is not a drastic change to their usual temperament, it is not a concern. Activities like sports are important for this age group for both physical development and for learning rules and teamwork.
A parent brings a child to the emergency department and states "Our neighbor's dog just bit my child!" The nurse interviews the parent as the child receives treatment. Which question(s) should the nurse ask to assist with the child's care? Select all that apply. "Were the authorities notified of the incident?" "What kind of dog bit your child?" "Are your child's immunizations up to date? "Did your child provoke the dog?" "Do you know if the dog has had its shots?" Chapter 45 Page 1769
"What kind of dog bit your child?" "Are your child's immunizations up to date? "Did your child provoke the dog?" "Do you know if the dog has had its shots?" To provide the child the best care, it is important to know the type of dog and whether the dog is up to dates on its immunizations particularly rabies. It is also important to determine if the dog was provoked or if the attack was unprovoked. If unprovoked, this may indicate the dog was ill. It is also important to know whether the child's immunizations are up to date. This will inform whether the child needs a tetanus shot. Lastly, it is appropriate to determine if the authorities were notified, but this is not most important as related to the child's care.
The nurse recognizes that a 12-year-old child who is admitted monthly for chemotherapy treatments for cancer is demonstrating behavior related to loss of control. What interventions can the nurse include in the plan of care to address this issue? Select all that apply. Allow the child to order their own meals from the hospital kitchen. Allow their child to determine what time they will receive their chemotherapy treatment. Allow the child to help the nurses organize the play times for younger children. Allow the child to chose if they wear their own pajamas or a hospital gown. Allow the child to choose their own diversional activity, such as headphones or television, during chemotherapy treatments. Chapter 33 Page 1200
Allow the child to order their own meals from the hospital kitchen. Allow the child to help the nurses organize the play times for younger children. Allow the child to chose if they wear their own pajamas or a hospital gown. Allow the child to choose their own diversional activity, such as headphones or television, during chemotherapy treatments. Choosing when chemotherapy will be administered is not a good way to facilitate control. There are many factors that influence when therapy will be administered, such as last dose received or when staff is available. All the other options allow the child to be in control of much of their care.
The nurse is caring for a child brought to the emergency department after an animal bite. Which action will the nurse perform first? Ask if the animal was provoked prior to the bite. Assess the child's height, weight, and temperature. Administer rabies vaccine and rabies immune globulin. Question the child about malaise, pain, and hydrophobia. Chaper 37 Page 1364
Ask if the animal was provoked prior to the bite. When a child presents with an animal bite, the nurse will ask the child if the animal was provoked prior to the bite. Animals with rabies will bite unprovoked. If the child states the animal bit without being provoked, and the animal is at risk for rabies, the nurse will administer the rabies vaccine and rabies immune globulin as prescribed by the health care provider and recommended by the local health department. Signs and symptoms of rabies, including fever, malaise, anorexia, pain, and hydrophobia, will occur on average 1 to 3 months after the bite. The nurse's priority is to gather history to help determine if the child needs treatment for rabies to avoid progression to the disease, which is almost always fatal.
A nurse is discussing a 9-year-old girl's obesity with her parents. Which nursing instructions are helpful? Select all that apply. Decrease intake of approximately 1,200 calories a day Limit time spent on sedentary activity Participate in a formal weight-control program Encourage fun exercise classes Prepare of a special meal just for the child Adhere to a high-protein diet Chapter 28 Page 1063
Decrease intake of approximately 1,200 calories a day Limit time spent on sedentary activity Participate in a formal weight-control program Encourage fun exercise classes The type of weight-reduction program that will probably work best is one that emphasizes long-term lifestyle changes. Such a program should include intake of about 1,200 calories a day (no more than 30% as fat), with lifestyle changes such as a structured family meal, eliminating eating or snacking in front of the television, decreased portion sizes, and elimination of sugar-rich drinks. It should also include an active exercise program, including monitoring and limiting time spent in physical inactivity (watching television, playing computer and video games, surfing the Internet, or texting). Overweight school-age children often do well if a dieters' club is formed; they are not too young to participate in formal weight-control organizations. As a way of increasing daily activity, preadolescents do well with formal exercise classes because, again, they enjoy the support from other children. Rather than preparing special meals for just the obese child, the entire family probably needs to eat in a healthier manner. Caution children not to try faddish high-protein diets (as most adults should not), because such diets do not supply enough carbohydrates and may produce a heavy renal solute load (the breakdown product of proteins) to the kidneys.
A nurse is conducting an assessment of a 16-year-old's cognitive development. The nurse determines that the adolescent's cognitive development is within acceptable parameters for the adolescent's age based on which assessment finding? Select all that apply. Demonstrates thinking that the adolescent is invincible. Uses scientific methods to solve verbal problems. Exhibits limited abstract thought processes Shows a beginning interest and concern with societal and political issues. Able to develop career plans Chapter 29 Page 1080 Table 29.2
Demonstrates thinking that the adolescent is invincible. Uses scientific methods to solve verbal problems. Shows a beginning interest and concern with societal and political issues. An adolescent between the ages of 14 to 17 years of age is able to solve verbal and mental problems using scientific methods, thinks he or she is invincible, and becomes involved in and concerned with society and politics. An adolescent between the ages of 11 to 14 years of age has limited abstract thought processes. An adolescent between 17 to 20 years of age develops realistic goals and career plans.
The nurse is reviewing literature about pain managment in children. Which statement(s) would the nurse identify as a misconception regarding pain in children? Select all that apply. Newborns typically do not feel pain due to immature nerve patterns. Narcotic pain medications should not be prescribed for young children due to side effects. Children will be truthful when asked if they are experiencing sensations of pain. Behavioral cues often correlate accurately with the intensity of the child's pain . A child who is sleeping or playing may still be experiencing pain. Chapter 36 Page 1298
Newborns typically do not feel pain due to immature nerve patterns. Narcotic pain medications should not be prescribed for young children due to side effects. Children will be truthful when asked if they are experiencing sensations of pain. Behavioral cues often correlate accurately with the intensity of the child's pain . Misconceptions about pain and pain management in children often lead to undertreating pain in children. Newborns have the same pain sensations as adults. The side effects of narcotic pain medications are the same for infants, children and adults when used in appropriate doses. Children may deny pain even when they have pain, to avoid an injection, taking medication or a procedure related to pain control. Children may fear pain is a punishment so they will not be truthful when asked about pain. Nurses may underestimate a child's pain level based on behavioral cues. A child who is sleeping or playing may still be feeling pain and playing or sleeping is used as a coping strategy.
The nurse is teaching injection techniques to a school-aged child newly diagnosed with type 1 diabetes. Which observation would be the best evaluation that learning was successful? The child developed a schedule for injection times and sites and has placed it on the refrigerator. The child needs occasional cueing during return demonstration of the injection technique. The child shows an eagerness to learn more about type 1 diabetes. The child explains the importance of performing the injections to keep feeling well. Chapter 30 Page 1122
The child needs occasional cueing during return demonstration of the injection technique. School-age children have a need to cooperate and achieve. Evaluation of learning should measure whether the child actually carries out the procedure or not. For a school-age child to only need occasional cueing, this is considered that learning is achieved. The purpose of the teaching was to ensure the child could properly inject and administer insulin. Understanding the disease process and schedules are not part of learning to inject insulin. Developing a schedule and posting it on the refrigerator would be above the developmental level of a school-ager.
The government initiative Healthy People 2020 has among its goals, to increase the numbers of persons counseled about their health behaviors. Which statements best describe how this goal will be achieved? Select all that apply. The health learning needs of women, children, and their families will be assessed. Health care education will be planned in collaboration with clients and their families. Health education will be provided at each client encounter. The work to develop materials and programs that are culturally competent will be developed with professionals. Bedside materials will be provided in the appropriate language and culture. Chapter 2 Page 68
The health learning needs of women, children, and their families will be assessed. Health care education will be planned in collaboration with clients and their families. Health education will be provided at each client encounter. The Healthy People 2020 initiative aims to increase the proportion of persons appropriately counseled about health behaviors. This will be done by assessing health learning needs of women, children, and their families; planning health care education in collaboration with clients and their families; and providing health education at each client encounter.
The nurse is assessing the neurological status of a 10-month-old infant. Which findings does the nurse determine to be abnormal when performing this assessment? Select all that apply. The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth The infant reflexively grasps when the nurse touches the palm The infant fans and extends the toes when the nurse strokes along the lateral aspect of the sole and across the plantar surface of the foot With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C" Chapter 25 Page 961
The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth The infant reflexively grasps when the nurse touches the palm With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C" The primitive reflexes (root, suck, palmar grasp, moro) should be absent by 10 months of age. The Babinski reflex persists until 12 months of age so the presence of this reflex would be considered a normal finding in the 10-month-old.
The nurse is writing a care plan for the nursing diagnosis "Knowledge deficit related to proper seat belt use, as evidenced by improper buckling of seat belt." Choose goals that are appropriate for this diagnosis. Select all that apply. The parents will voice an understanding that a rear-facing car seat should be used until at least the age of 2. The parents will demonstrate the proper use of a car seat with a harness strap for the child under the age of 2. The parents will voice an understanding that the child should not sit in the front seat of the vehicle. The parents will demonstrate the proper use of the seat belt for securing the child car seat. The parents will voice an understanding that in trucks the car seat will be placed in the back seat. Chapter 26 Page 1005
The parents will voice an understanding that a rear-facing car seat should be used until at least the age of 2. The parents will demonstrate the proper use of a car seat with a harness strap for the child under the age of 2. The parents will voice an understanding that the child should not sit in the front seat of the vehicle. The parents will demonstrate the proper use of the seat belt for securing the child car seat. The parents will voice an understanding that in trucks the car seat will be placed in the back seat. All of these goals are correctly written in measurable terms and are accurate in content.
