peds 38 & 39

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea?

"Emotional stress can be a cause of this disorder."

The nurse is doing teaching with the caregivers of toddler and preschool age children. One of the caregivers tells the group that her child had diarrhea and she was told that it was caused by giardiasis. Which of the following statements made by the caregiver indicates the most likely situation in which the child contacted the disorder?

"He attends a day care center four days a week while I am at work."

The nurse is doing teaching with a group of caregivers of children diagnosed with diabetes mellitus. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur?

"He measures his own medication but we watch closely to make sure he gets the correct amount so he doesn't have an insulin reaction."

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

"It is important to increase the intake of protein for these children."

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."

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." Of the following statements, which would be the most appropriate response by the nurse?

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."

A 12-year-old girl who has not yet reached menarche comes to the pediatrician's office for her annual well-child check. As the nurse is weighing and measuring her, the child says emphatically that she does not want to get her period. Which of the following responses would be most appropriate for the nurse to make to this child?

"What have you heard about it that makes you worried?"

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)

1. Conserving energy 2. Preventing infection 3. Promoting coping

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)

1. Eggs 2. Corn 3. Oranges 4. Soybeans

A group of nursing students is discussing the diagnosis of vitamin C deficiency, and one of the students asks which foods would help increase the child's intake of vitamin C. Which of the following foods are high in vitamin C? (select all that apply)

1. Strawberries 2. Potatoes 3.Peas

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)

1. The nurse administers diuretics. 2. The nurse administers antihypertensives. 3. The nurse weighs the child every day using the same scale. 4. The nurse dipsticks the child's urine to test for protein.

When caring for a child who has a urinary tract infection, which of the following nursing interventions would be most appropriate. (select all that apply)

1. The nurse observes for signs of pain or burning on urination. 2. The nurse monitors intake and output. 3. The nurse administers antipyretics as needed.

If the child follows a normal development process, the child's kidneys will most likely have reached their full size and function by which of the following ages?

12 years of age

If the newborn is following a normal development process, the child will most likely void when which of the following amounts of urine is in the bladder?

15 mL

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

Anthelmintics

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

In understanding the disease of Marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following?

Deficiency of protein and calories

The nurse admits an infant who is nutritionally deprived. The infant is weak and seems somewhat uninterested in food. In developing the infant's plan of care, how often will the nurse most likely plan to feed this infant?

Every 2 or 3 hours

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?

Eyes

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 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 gastroesophageal reflux?

In this disorder the sphincter that leads into the stomach is relaxed.

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

Before their infant is admitted for cleft palate surgery, in an effort to help the infant adjust after surgery, it would be helpful for the nurse to encourage the family to

Let the infant become accustomed to being in elbow restraints

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 digestive process begins in which of the following organs of the gastrointestinal system?

Mouth

The child who has insufficient calcium in the diet is at risk for having hypocalcemia. Which of the following may be caused by hypocalcemia?

Neurologic damage

The nurse is discussing the disease known as pellagra. This disease is due to a deficiency in which of the following?

Niacin

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 teaching a group of nursing students about acute glomerulonephritis genitourinary conditions. A student asks the about a condition that occurs when there is a decreased volume of urine output. The condition the student is referring to is which of the following?

Oliguria

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 teaching a group of nursing students about genitourinary conditions. The nurse tells these students about a condition that occurs when there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to is which of the following?

Pyelonephritis

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 doing an in-service training with a group of peers on the topic of the genitourinary system. Which of the following is a major function of the kidneys?

Regulate blood pressure

A nurse stops at her friend's house one evening to visit. Her friend isn't home but a teenager watching TV says she is baby-sitting for the family's three children. The nurse notices that one of the children is chewing several pieces of something white. He is also drooling and crying. A container that looks like an empty pill bottle is on the floor. The first action by the nurse would be to

Remove the substance from the child's mouth

In caring for the child with esophageal atresia the nurse recognizes the highest concern for this child is the possibility of which of the following?

Respiratory distress

The major role of the endocrine system is to do which of the following?

Secrete hormones

The incidence of vitamin D deficiency in the United States is less than in many countries. The most likely reason for this is because of which of the following?

Some foods in the US have been fortified with vitamin D

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

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent complains of severe abdominal pain. A diagnosis of pelvic inflammatory disease is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. The most appropriate action by the nurse would be to

Take the child to a private room and interview her regarding her sexual history and partners

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

Which of the following is most correct regarding the gastrointestinal system of the child?

The child cannot break down and use complex carbohydrates in the same way the adult can.

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which of the following a greater likelihood in the child?

The child has a greater risk for trauma to the kidney

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 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 working with the mother of a newborn. The mother asks why a baby needs small feedings at frequent intervals. The nurse explains to the mother that this is necessary because in the infant

The enzymes secreted by the liver and pancreas are reduced

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.

The nurse is caring for a newborn diagnosed with a diaphragmatic hernia. The nurse will anticipate which of the following:

The newborn will likely have surgery immediately

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.

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as which of the following?

The pharynx and esopagus

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 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 collecting data on a child who has been nutritionally deprived. The nurse notes that the child is irritable and listless. The foster caregiver reports that the child says she is not hungry and has been vomiting. It is discovered that the child has beriberi. This disease is due to a deficiency in which of the following?

Thiamine

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

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 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 doing teaching with the caregivers of an infant diagnosed with hypospadias. Which of the following statements made by the caregivers is accurate regarding hypospadias?

"Being able to most likely correct this in one stage rather than several is reassuring."

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 caregiver of a 1-year-old son calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which of the following statements regarding the son's treatment?

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which of the following statements is the best explanation of the treatment for this diagnosis?

"The treatment for the disorder will be a surgical procedure."

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 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)

1. Bananas 2. Skim milk 3. Applesauce

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.

1. Call 911 for emergency help if the child has collapsed or stopped breathing. 2. Follow instructions given by the poison help line personnel. 3. Administer general supportive and symptomatic care. 4. Remove the obvious remnants of the poison. 5.Call the poison help line if child is conscious and alert. 6. Administer appropriate antidote if recommended.

A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is which of the following?

A dull, aching abdominal pain at ovulation

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 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 school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which of the following actions would be the most appropriate for the school nurse to do?

Administer subcutaneous glucagon

Urinary tract infections are usually successfully treated by which of the following?

Administering antibiotics

The nurse is discussing genitourinary conditions with a group of 16-year-old girls. One of the girls says she has heard about girls who have stopped taking birth control pills and now don't have periods. The condition the girl is referring to is which of the following?

Amenorrhea

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 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 collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which of the following vital signs would the nurse anticipate with this child's diagnosis?

Blood Pressure 136/84

The nurse recognizes that in the disorder referred to as Rickets, the child has a lack of vitamin D. Because of the lack of vitamin D the absorption of which of the following is decreased?

Calcium and phosphorus

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 nurse is caring for a child who has swallowed a foreign object and is attempting to cough but is making no coughing sounds. The nurse should perform the ____________ maneuver.

Heimlich

Most urinary tract infections seen in children are caused by which of the following?

Intestinal bacteria

The most common source of lead poisoning in children comes from which of the following sources?

Paint used in older homes

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

Persistent constipation

The nurse is interviewing the caregivers of a child admitted with a diagnosis of Type 1 Diabetes Mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has which of the following?

Polyphagia

The nurse is interviewing the caregivers of a child admitted with a diagnosis of Type 1 Diabetes Mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has which of the following?

Polyuria

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 caring for a child who is being evaluated for a possible nephroblastoma. Which of the following nursing interventions would be important for this child? The nurse should

Protect the child from having the abdomen palpated.

The school nurse is working with a group of teachers who teach in classrooms of children who are nutritionally deprived. As the teachers are talking with the nurse they make the following statements. Which statement most indicates a problem related to decreased nutrition?

Several of the children in my class have such a hard time concentrating."

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 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 teeth, tongue, gallbladder, appendix, salivary glands, liver, and pancreas are referred to as accessory organs, and the purpose of these is which of the following?

To aid in and to produce substances that aid in the digestive process

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 collecting data from the caregivers of a child who is suspected of having a food allergy. Which of the following clinical manifestations would likely have been noted in this child?

Urticaria and pruritus

The nurse is caring for a child admitted with a urinary tract infection. In addition to foul smelling urine, which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

Vomiting