Peds: Chapters 13, 15, 19, & 20

A child has just been diagnosed with cystic fibrosis (CF). The nurse is teaching the client and their family about the importance of maintaining proper nutrition. Which statement made by the nurse is accurate? "The diet of a child with CF should be low calorie and low protein." "A gastrostomy tube may be required if failure to thrive occurs." "It is okay to eat whatever you want as long as you eat something." "It is important for you to take vitamin B & C since you have trouble absorbing them."

"A gastrostomy tube may be required if failure to thrive occurs."

The nurse is explaining the similarities and differences between Crohn's disease and ulcerative colitis to a group of student nurses. Which statement is most accurate in explaining a similarity or difference between the two? "Corticosteroids are used only in Crohn's to induce remission." "Surgery is always required with Crohn's." "Both Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease." "Taking antidiarrheals will cure ulcerative colitis but not Crohn's disease."

"Both Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease."

A school-age child with acute diarrhea from gastroenteritis has mild dehydration and is being given oral rehydration solutions (ORS). The client's parent calls the clinic nurse because their child is also occasionally vomiting. The nurse should recommend which intervention to the parent? "Bring the child to the hospital immediately for intravenous fluids." "Alternate between giving oral rehydration solutions (ORS) and carbonated drinks, as they soothe the stomach." "Continue to give oral rehydration solutions (ORS) frequently in small amounts." "Recommend making the child nothing by mouth (NPO) for 8 hours and resume oral rehydration solutions (ORS) if vomiting has subsided."

"Continue to give oral rehydration solutions (ORS) frequently in small amounts."

The nurse is teaching a client about their Crohn's disease diagnosis. Which responses determine that the client understands the education provided? Select all that apply. "Crohn's disease is an immune response to injured tissue." "Crohn's disease is an acute one-time inflammatory disorder." "Crohn's disease can affect any part of the GI tract from the mouth to the anus." "Crohn's disease is more commonly found in the small intestine." "Crohn's disease may extend through the entire thickness of the bowel."

"Crohn's disease is an immune response to injured tissue." "Crohn's disease can affect any part of the GI tract from the mouth to the anus." "Crohn's disease is more commonly found in the small intestine." "Crohn's disease may extend through the entire thickness of the bowel."

A child is diagnosed with cystic fibrosis (CF). The nurse is educating the family about pancreatic enzymes. The nurse would determine that education has been successful if the family states: "Pancreatic enzymes can be skipped from time to time." "Enzymes work for about 4 hours after eating." "Lower doses of enzymes may be required for foods high in fat." "Enzymes are not needed with foods like fruits, juice, soft drinks, or sports drinks."

"Enzymes are not needed with foods like fruits, juice, soft drinks, or sports drinks."

A newborn had a repair of Type I tracheoesophageal fistula (TEF). Which statement would be correct in educating the family of what to expect in the immediate post-operative period? Select that apply. "Frequent suctioning with a pre-measured catheter is required." "The head of bed should be elevated 30-45 degrees." "If there is no leak 5-7 days after the surgical repair, oral feedings will be started." "This type of TEF cannot be surgically repaired." "The baby will be on acid suppression therapy using a proton pump inhibitor (PPI), such as Lansoprazole postoperatively."

"Frequent suctioning with a pre-measured catheter is required." "The head of bed should be elevated 30-45 degrees." "If there is no leak 5-7 days after the surgical repair, oral feedings will be started." "The baby will be on acid suppression therapy using a proton pump inhibitor (PPI), such as Lansoprazole postoperatively."

A nurse is attempting to differentiate between gastroschisis and an omphalocele to a group of nursing students. Which statement is correct? "Malrotation is not present in either defect." "An omphalocele is contained in a membranous sac." "Gastroschisis is usually located at the umbilicus." "Gastroschisis is an abdominal wall defect where the intestinal contents are outside of the abdominal wall in a newborn."

"Gastroschisis is an abdominal wall defect where the intestinal contents are outside of the abdominal wall in a newborn."

A nurse in the emergency department (ED) is assessing a pre-school age client who had a febrile seizure at home. The parent is very concerned and asks the nurse if this is very serious. How should the nurse respond? "Yes, the child is likely to get brain damage when a fever gets too high." "Generally they are not. But it is best to treat a fever when it starts." "No, they don't cause any issues." "Yes, you should consider this a medical emergency any time something like this occurs."

"Generally they are not. But it is best to treat a fever when it starts."

A 2-month-old presents to the emergency department (ED). The parent states, "I was feeding my child a bottle and he just turned blue. He frequently does this, but this time I had to rub his chest to get him to breathe. I notice a lot of crying after eating too." What further questions might the nurse ask the parent to assess if the infant has reflux? Select all that apply. "Does he arch? If he does, it is definitely reflux." "Have you noticed your baby spit up after feedings and, if so, how much?' "Can you tell me how often during the feeding you burp your baby?" "Tell me more about these episodes of turning blue. Is it always after he eats?" "What position do you feed your baby in? Is he lying flat, or do you have his head slightly elevated when feeding?"

"Have you noticed your baby spit up after feedings and, if so, how much?' "Can you tell me how often during the feeding you burp your baby?" "Tell me more about these episodes of turning blue. Is it always after he eats?" "What position do you feed your baby in? Is he lying flat, or do you have his head slightly elevated when feeding?"

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 atonic seizure? "He fell down and his whole body started shaking." "His arms had rapid jerking movements." "He was just staring into space and was totally unaware." "He usually is very coordinated, but he couldn\"t even walk without falling."

"He usually is very coordinated, but he couldn\"t even walk without falling."

The nurse is educating a family about hepatitis. Which statements are true about hepatitis? Select all that apply. "Hepatitis B is caused by the oral-fecal route." "Hepatitis A, B, & C may not exhibit symptoms early on in the disease process." "Hepatitis C is caused by exposure to infected blood or blood products through sexual contact." "Good hand hygiene is important in hepatitis B." "In children older than 12 years of age, Ledipasvir/sofosbuvir (Harvoni) is an antiviral treatment that can treat Hepatitis C."

"Hepatitis A, B, & C may not exhibit symptoms early on in the disease process." "Hepatitis C is caused by exposure to infected blood or blood products through sexual contact." "In children older than 12 years of age, Ledipasvir/sofosbuvir (Harvoni) is an antiviral treatment that can treat Hepatitis C."

The nurse is assessing a child who presents with diarrhea. Which questions would be important to ask the caregivers? Select all that apply. "How frequent is the diarrhea?" "Are the stools bloody?" "Did you insert anything in the rectum to cause this?" "Is the stool watery?" "Don't you make your child wash their hands so they don't get sick?"

"How frequent is the diarrhea?" "Are the stools bloody?" "Is the stool watery?"

At a well checkup, the parent reports that her child is constipated. What questions should the nurse ask to gain knowledge about the child's stool pattern? Select all that apply. "Do you force your child to go to the bathroom?" "How often does your child have a bowel movement?" "What is the consistency of the stool when they have one? Is it hard, soft, or liquid?" "Does your child have a ritual when they go to the bathroom?" "Does your child strain when having a bowel movement?"

"How often does your child have a bowel movement?" "What is the consistency of the stool when they have one? Is it hard, soft, or liquid?" "Does your child have a ritual when they go to the bathroom?" "Does your child strain when having a bowel movement?"

The nurse is educating a client diagnosed with Irritable Bowel Syndrome (IBS). What statement indicates that the client understands the education provided? "IBS does not cause changes in bowel tissue." "IBS increases the risk of colorectal cancer." "This is a condition that is acute, temporary, and usually only occurs once in a life-time." "Abdominal pain is limited with IBS."

"IBS does not cause changes in bowel tissue."

The nurse is caring for a school-age client who was recently diagnosed with Guillain-Barré syndrome. The parent asks, "What happens with this disease?" How should the nurse respond? "It involves ascending paralysis; weakness occurs in the lower limbs and spreads upward." "It involves your muscles; they become spastic and difficult to control. " "It involves the blood; you get an overproduction of immature white blood cells." "It involves your nerve endings; you lose feeling and sensation in your extremities."

"It involves ascending paralysis; weakness occurs in the lower limbs and spreads upward."

The parent of a client who had a ruptured appendix thought their child was just constipated. The parent is now verbalizing feelings of guilt. What should the nurse say in order to reassure the parent? "Perhaps you should have brought the child in sooner." "Would you like me to call your husband, as children and youth services have been notified?" "It's OK, there was no way for you to know that it was his appendix." "He has a fever. Did he have cold recently? It could be related to that."

"It's OK, there was no way for you to know that it was his appendix."

The nurse is providing education to a parent whose toddler is diagnosed with Duchenne muscular dystrophy. Which statement by the parent indicates the teaching was understood? "I am glad that my child's disability will not progress beyond where it is now." "It is acquired related to a maternal infection." "This disorder is characterized by muscle spasticity and mental deficits." "Life expectancy is in the twenties and death is usually caused by respiratory or cardiac failure."

"Life expectancy is in the twenties and death is usually caused by respiratory or cardiac failure."

A mother is talking to the nurse and is concerned that her infant will get meningitis and die like her cousin's child did many years ago. The mother asks the nurse, "What is the best way I can protect my child?" How should the nurse respond? "There is no way to prevent it, unfortunately, but you must be quick to respond to any symptoms." "You should avoid taking your baby anywhere." "Many strains are vaccine-preventable, so getting all your vaccinations is a good start." "Keep your baby away from anyone who is sick."

"Many strains are vaccine-preventable, so getting all your vaccinations is a good start."

A nurse is providing education to a pregnant woman who is believed to have been exposed to the Zika virus. The woman asks, "What is the biggest complication babies born with this syndrome often experience?" How should the nurse respond? "Most babies born with this syndrome suffer with paralysis." "Most babies born with this syndrome suffer with hydrocephalus." "Most babies born with this syndrome suffer with microcephaly." "Most babies born with this syndrome suffer with Down syndrome."

"Most babies born with this syndrome suffer with microcephaly."

The nurse is discussing treatments for intussusception with a client. Which statement made by the nurse is correct? Select all that apply. "Intussusception most often resolves on its own without intervention." "Reduction may be performed with barium or air insufflation." "Intussusception can block blood supply to the affected portion of the intestine." "This is the most common cause of intestinal obstruction in children less than 3 years of age." "Surgical intervention may be required if the initial attempt at reduction fails."

"Reduction may be performed with barium or air insufflation." "Intussusception can block blood supply to the affected portion of the intestine." "This is the most common cause of intestinal obstruction in children less than 3 years of age." "Surgical intervention may be required if the initial attempt at reduction fails."

A child is diagnosed with nonalcoholic fatty liver disease (NAFLD). When explaining what this is to the parents, which statement would be most accurate? "This condition leads to liver disease and your child may need a liver transplant." "There is fat in the liver but little or no inflammation or liver cell damage." "Nonalcoholic steatohepatitis (NASH) is a type of NAFLD that can be diagnosed in utero." "Left lower quadrant pain frequently occurs with NAFLD."

"There is fat in the liver but little or no inflammation or liver cell damage."

The nurse is providing education to a family who recently delivered a child with a myelomeningocele and the parents ask, "What issues can this cause?" How should the nurse respond? "This can cause paralysis of the legs, flaccid muscles, and problems with control of the bowel and bladder." "This can cause progressive muscle deterioration and mild mental delays." "This can cause spastic muscles, which can prompt difficulty with ambulation and cognitive deficits." "This can cause problems with mental abilities, a lack of coordination, and uncoordinated, jerky body movements."

"This can cause paralysis of the legs, flaccid muscles, and problems with control of the bowel and bladder."

The parent reports that a 3-year-old child receiving Lamotrigine for partial seizures has developed a rash. Which response should the nurse make to the parent? "Stop the medication immediately." "This means the dose needs to be doubled." "Take the client to the nearest medical facility." "This is something that occurs within the first 6 weeks of treatment."

"This is something that occurs within the first 6 weeks of treatment."

In educating parents of an adolescent diagnosed with ulcerative colitis, which statement would indicate that the learner understands what the most important part of care is? "We should take them to the emergency department with signs of bleeding or pain." "We should make sure they eat when having a flare in order to optimize their nutrition." "Stress reduction techniques like visualization and relaxation should be avoided when dealing with ulcerative colitis." "If side effects occur, we should try to cope with them, since the medications are important to take."

"We should take them to the emergency department with signs of bleeding or pain."

A child is diagnosed with ulcerative colitis (UC). The child states, "Why do I have this disease? It is not fair." Which statement by the nurse would be best to help this child cope? "I'm sorry but no one knows why, so you will just have to make the best of it." "At least you will be able to eat anything you want and not gain weight." "Why don't you go to a camp with other children who have ulcerative colitis?" "I will be here every time you come into the hospital, so don't worry."

"Why don't you go to a camp with other children who have ulcerative colitis?"

The nurse is teaching a family about bilirubin encephalopathy (kernicterus). Which statement would be accurate in educating the family? Select all that apply. "Your baby may exhibit a high-pitched cry." "Hypotonia or hypertonia may be present." "Seizures are not common with this condition." "Your baby will have no problems sucking or taking a bottle." "Opisthonic posturing or arching can happen with this condition."

"Your baby may exhibit a high-pitched cry." "Hypotonia or hypertonia may be present." "Opisthonic posturing or arching can happen with this condition."

The mother of a newborn diagnosed with tracheoesophageal fistula (TEF) asks the nurse about the condition. Which statement is correct in educating this mother about TEF? "This was caused because of you not taking enough folic acid in the first trimester of your pregnancy." "Your child will most likely be prone to frequent fractures of the extremities." "Your child will need to be on antibiotics of invasive procedures prophylactically." "Your baby should be able to start tube feedings in 2 to 3 days after the surgical repair."

"Your baby should be able to start tube feedings in 2 to 3 days after the surgical repair."

The nurse is teaching about Crohn's disease. Which symptoms would the nurse include in explaining the clinical presentation of Crohn's disease? Constipation Diarrhea Symptoms of gastric reflux Weight gain

Diarrhea

A 5-year-old client has been experiencing seizure activity for the last 20 minutes. What medication should the nurse prepare to administer to this client? Diazepam Clonazepam Ethosuximide Carbamazepine

Diazepam

A nurse is caring for an infant admitted with pyloric stenosis. What are some of the assessment findings the nurse would expect? Select all that apply. Bilious vomiting Failure to thrive (FTT) Irritability Metabolic alkalosis Diarrhea

Failure to thrive (FTT) Irritability Metabolic alkalosis

The nurse is educating the client about "trigger" foods associated with irritable bowel syndrome (IBS). What do some of these foods include? Select all that apply. Fatty foods Dairy Carbonated beverages Caffeine Spaghetti/pasta

Fatty foods Dairy Carbonated beverages Caffeine

A 1-month-old infant is noted to have significant jaundice. The mother states the urine in the infant's diapers appear very dark. She also noticed the color of the stool is gray in color. What might the nurse suspect this infant has? Malabsorption syndrome Dehydration Biliary atresia Nonalcoholic fatty liver disease (NAFLD)

Biliary atresia

A child is being followed at the pediatric clinic for poor weight gain. What exemplifies that a child may have non-organic failure to thrive (FTT)? A child that has food rituals Abdominal distention Diarrhea Vomiting of feeds

A child that has food rituals

Which choice describes spina bifida cystica, also known as myelomeningocele? A section of the spinal cord and the nerves that come from the cord are exposed and visible on the outside of the body. It causes partial or complete paralysis below the spinal opening. The membrane that surrounds the spinal cord is enlarged, creating a cyst-like sac. The sac that is present usually on the lower back contains meninges, which are the membranes covering the spinal cord. A section of the spinal vertebrae is malformed, but the spinal cord and nerves are normal. The defect is not visible, though newborns may display dimpling, hair, or hemangioma in the lumbar sacral area. Tissue attachments limit the movement of the spinal cord within the spinal column.

A section of the spinal cord and the nerves that come from the cord are exposed and visible on the outside of the body. It causes partial or complete paralysis below the spinal opening.

An infant is suspected of having neonatal jaundice. What symptoms would the nurse expect to see that would correlate with neonatal jaundice? Blue sclera Hyper-excitability and tremors Poor feeding by mouth Present with anemia from red blood cell breakdown

Poor feeding by mouth

The school nurse is being consulted by a teacher with concerns about a student who is doing poorly in class. The student stares off into space regularly and is unable to recall information that was just discussed. What disorder should the nurse suspect? Myoclonic seizures Absence seizures Febrile seizures Tonic-clonic seizures

Absence seizures

A premature infant is diagnosed with severe necrotizing enterocolitis (NEC). The infant had surgery to remove all but 12 inches of bowel and now has short bowel syndrome (SBS). What actions would be appropriate for the nurse to take for an infant with severe SBS in the immediate post-operative period? Administer total parenteral nutrition (TPN) to provide immediate nutrition Start PO feeds in small quantities immediately postoperatively Prepare for a colostomy Administer laxatives to maintain bowel patency

Administer total parenteral nutrition (TPN) to provide immediate nutrition

An adolescent is admitted and diagnosed with irritable bowel syndrome (IBS). The nursing providing discharge instructions should instruct the child to avoid which foods? Select all that apply. Caffeinated soda Milk and cheese Kiwi and strawberries Oranges and grapefruit Lean chicken and fish

Caffeinated soda Milk and cheese Oranges and grapefruit

Peptic ulcers are usually treated with "triple therapy." What does "triple therapy" consist of? Select all that apply. Proton pump inhibitor (PPI) Vancomycin Amoxicillin Clarithromycin Milk of magnesia

Amoxicillin Clarithromycin Proton pump inhibitor (PPI)

The nurse is assessing a full-term newborn infant and notes the lack of a Moro reflex. What should this finding represent to the nurse? A birth defect A normal finding An impairment of the central nervous system A dysfunction of the neuromuscular junction

An impairment of the central nervous system

The nurse is with a family as the mother is receiving an ultrasound. The test reveals a defect in the fetus in which the unborn child is missing a large part of the brain and skull. Which defect would the nurse identify this as being? Anencephaly Encephalocele Chiari malformation Microcephaly

Anencephaly

The nurse suspects that a preadolescent client is experiencing migraine headaches. Which finding caused the nurse to make this clinical determination? Select all that apply. Begins to vomit Reports dizziness Asks for the lights to be turned off Turns the volume up on the television Asks for something to stop the "head pounding"

Begins to vomit Reports dizziness Asks for the lights to be turned off Asks for something to stop the "head pounding"

A school-age child is reported as experiencing sleepwalking at home. Which behavior should the nurse anticipate this client demonstrating? Select all that apply. Wakes up screaming in fear Appears awake with the eyes open Conversation does not makes sense Found sleeping on the floor near the window Appears confused and disoriented when awakened

Appears awake with the eyes open Conversation does not makes sense Found sleeping on the floor near the window Appears confused and disoriented when awakened

An 8-year-old reports right lower quadrant (RLQ) abdominal pain. The parent states, "He is just not himself. He's not playing and just lays on the sofa in a fetal position." Upon physical exam, he has rebound pain and pain in the RLQ when jumping. What does the assessment data indicate may be occurring with this child? Celiac disease Appendicitis Rotavirus Inflammatory bowel disease

Appendicitis

A preschool-age child is diagnosed with type 1 neurofibromatosis. What should the nurse expect to assess in this client? Rash Café au lait spots Edematous lower extremities Tiny red veins that appear in the corners of the eyes

Café au lait spots

The nurse is caring for an adolescent client with myasthenia gravis. What issues should the nurse be vigilant and monitor for due to the complications it causes? Blood clots Heart failure Aspiration Hemorrhage

Aspiration

The nurse notes that a client with cerebral palsy has difficulty with balance and illegible writing. For which type of cerebral palsy should the nurse plan care for this client? Ataxic Mixed Spastic Athetoid

Ataxic

The nurse observes a newborn become cyanotic when feeding. What procedure will the nurse perform as prescribed to assess for a tracheoesophageal fistula (TEF)? Feed the newborn with smaller, frequent feedings Attempt to pass a nasogastric tube (NG tube) Check for simian creases on the palms of the hands Administer a saline lavage

Attempt to pass a nasogastric tube (NG tube)

The nurse is preparing an education program on the Zika virus for a community health fair. Which information should the nurse include? Sleep in a room that is not air-conditioned. Apply insect repellant to the skin of all children. Avoid travelling to areas with outbreaks if pregnant. Spray porches and lawn areas with water at nightfall.

Avoid travelling to areas with outbreaks if pregnant.

The nurse, caring for a school-age client recovering from a ventriculoperitoneal (VP) shunt implant, completes an assessment and immediately notifies the healthcare provider. Which assessment finding caused the nurse to be concerned? Poor appetite Blood pressure 110/70 mm Hg Pain level 4 on a scale from 1 to 10 Blood tinged spot on the pillowcase encircled by a lighter ring

Blood tinged spot on the pillowcase encircled by a lighter ring

The nurse is caring for a newborn after delivery and recognizes that the child was with born with a myelomeningocele. What action should the nurse take? Clean the area and leave it open to air. Clean the defect and cover with impregnated gauze. Cover the defect with a sterile dressing moistened with warm and sterile normal saline. Cover the defect with a simple dressing until the infant can go directly into surgery.

Cover the defect with a sterile dressing moistened with warm and sterile normal saline.

The nurse is visiting the home of a school-age child who is recovering from shunt placement for hydrocephalus. Which assessment finding indicates that the shunt is draining too aggressively? Fever Lethargy Dizziness Severe headache

Dizziness

A 5-year-old client is being tested for muscular dystrophy. Which type of this disorder should the nurse expect the client to perform Gowers' sign? Becker muscular dystrophy Acquired muscular dystrophy Duchenne muscular dystrophy Facioscapulohumeral muscular dystrophy

Duchenne muscular dystrophy

A nurse is describing nursing interventions for a client that is obese. Which interventions would be accurate? Select all that apply. Educating client for symptoms of heart disease Monitoring for uncontrolled hypertension Checking blood sugars only if there is a family history of diabetes Suggesting a sleep study Urging parents to give children whatever they want to eat when they become upset in order to enhance emotional well-being

Educating client for symptoms of heart disease Monitoring for uncontrolled hypertension Suggesting a sleep study

The nurse is discharging a newborn that was diagnosed with pediatric gastroesophageal reflux disease (GERD). Upon discharge, what information should the nurse provide to the parent? Elevate HOB during feedings Avoid laying infant down after feeding Provide large, frequent feedings Use a concentrated formula for feeding Discontinue breastfeeding

Elevate HOB during feedings Avoid laying infant down after feeding

The nurse is asked to prepare a teaching tool about acquired hydrocephalus in pediatric clients. Which type should the nurse include? Select all that apply. Ex-vacuo Incomplete Communicating Normal pressure Non-communicating

Ex-vacuo Communicating Non-communicating

A newborn has been diagnosed with Hirschsprung's disease. The parents are confused and ask the nurse what symptoms lead to this diagnosis. The nurse should explain the most common symptoms as: Development of acute diarrhea and dehydration Currant, jelly-like gelatinous stools Severe projectile vomiting and electrolyte imbalance Failure to pass a meconium stool with abdominal distention

Failure to pass a meconium stool with abdominal distention

Celiac disease is suspected in a 6-month-old child. What signs and symptoms would this child most likely experience? Select all that apply. Abdominal bloating Constipation Accelerated growth and development Flatulence Dental enamel defects in the teeth

Flatulence Dental enamel defects in the teeth Abdominal bloating

The nurse is doing health promotion education with a group of young women. Because of the risk of neural tube defects, the nurse should stress the importance of taking which supplement daily while of childbearing age? Calcium Magnesium Folic acid Iron

Folic acid

A 1-month-old infant is demonstrating tremulous movements. Which action should the nurse take to determine if the client is experiencing a seizure? Place in a side-lying position Assess heart and breath sounds Count the number of respirations Gently grasp the tremulous extremity

Gently grasp the tremulous extremity

The nurse is assigned an adolescent client with newly diagnosed meningitis and is going in the client's room to hang the antibiotics. What personal protective equipment (PPE) should the nurse put on? Gown and gloves Gown, mask, and gloves Gown, goggles, mask, and gloves Gloves

Gown, mask, and gloves

The nurse in a pain clinic is seeing an adolescent about recurrent headaches. What is an initial step the nurse could suggest that would help manage the client's headache pain? Have the client keep a headache diary. Give samples of some new medications targeted for migraines. Administer a pain injection. Have the client avoid gluten.

Have the client keep a headache diary.

The nurse is caring for an adolescent with a head injury and suspects increased intracranial pressure (ICP). What findings support that belief? Select all that apply. Headache Vomiting that can increase to projectile Sunsetting Eyes Papilledema or Blurred Vision Petechial hemorrhages

Headache Vomiting that can increase to projectile Sunsetting Eyes Papilledema or Blurred Vision

The nurse is educating the client about peptic ulcer disease. Which are the most common causes of peptic ulcer disease that should be emphasized? Select all that apply. Helicobacter pylori (H Pylori) Long-term acetaminophen usage Stress Spicy food Chronic aspirin use

Helicobacter pylori (H Pylori) Chronic aspirin use

The nursing students asks the nurse what the main causes of failure to thrive (FTT) are. What should the nurse include as some of the main causes? Select all that apply. Intermittent diarrhea Inadequate intake for age Inadequate caloric absorption Excessive calorie expenditure with poor intake An infant being fed every 4 ounces of formula 3-4 hours

Inadequate intake for age Inadequate caloric absorption Excessive calorie expenditure with poor intake

The nurse is educating the parent about non-medicinal measures that can be tried to treat constipation in children. Which measures are accurate? Increase fruits and vegetables in the diet Decrease fluid intake Decrease daily fiber intake Use behavior modification and have the child sit on the toilet until they defecate, even if it takes an hour

Increase fruits and vegetables in the diet

A 9-year-old is admitted with an inguinal hernia. In assessing this child, what signs would indicate incarceration? Select all that apply. Increase in pain Bilious vomiting Bradycardia Diarrhea Presence of a hydrocele

Increase in pain Bilious vomiting

A 3-year-old child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting from gastroenteritis. The child is listless and lethargic. What action by the nurse would assist in the management of the child's condition? Administer oral rehydration solutions Administer clear liquids by mouth, 1 to 2 ounces at a time Initiate intravenous (IV) fluids Administer of antidiarrheal medications

Initiate intravenous (IV) fluids

The nurse is caring for a newborn who was born with gastroschisis. Which nursing interventions are accurate in the care of and newborn born with this condition? Select all that apply. Insert an orogastric tube to decompress the intestines Place the newborn in a prone position Cover the defect with sterile normal saline non-adherent dressing after delivery Observe closely for defecation Support the newborn with fluids and parenteral nutrition

Insert an orogastric tube to decompress the intestines Cover the defect with sterile normal saline non-adherent dressing after delivery Observe closely for defecation Support the newborn with fluids and parenteral nutrition

The parent of a 3-month-old client is concerned because the child's eyes are deviating downward. What additional assessment should the nurse complete with this client? Oral intake Urine output Status of reflexes Integrity of the fontanelles

Integrity of the fontanelles

The nurse knows the emergent care for clients with Crohn's disease include which of the following? Select all that apply. High dose corticosteroid therapy Encourage the client to eat solids Diet high in potassium Intravenous (IV) fluid therapy Treatment with aspirin to decrease inflammation

Intravenous (IV) fluid therapy High dose corticosteroid therapy

A young child is suspected of having intussusception. Which assessment findings correlate with this condition? Legs extended when crying Severe gastroesophageal reflux Irritability Bloody diarrhea

Irritability

A premature infant is diagnosed with necrotizing enterocolitis (NEC). What assessment findings would the nurse expect to see? Select all that apply. Large nasogastric residuals (> 2mls) Stool positive for occult blood Distended, tense abdomen No issues with apnea Good temperature stability and thermoregulation

Large nasogastric residuals (> 2mls) Stool positive for occult blood Distended, tense abdomen

The nurse recognizes which symptoms as typical signs of dehydration? Select all that apply. Little to no urine output Crying without tears Urine specific gravity of 1.005 Sunken fontanel Heart palpitations

Little to no urine output Crying without tears Sunken fontanel

A school-age client is experiencing bilateral lower extremity weakness that is spreading to the hands and arms. Which diagnostic test should the nurse expect to prepare this client? MRI of the spine Lumbar puncture CT scan of the head Electroencephalogram

Lumbar puncture

A preschool-age child requires an MRI of the brain and spinal cord. Which action should the nurse take when caring for this client? Select all that apply. Remove earrings from both ears. Provide age-appropriate sedation. Restrict oral fluids after the study. Monitor level of responsiveness after the study. Report crying after the study to the health care provider.

Monitor level of responsiveness after the study. Remove earrings from both ears. Provide age-appropriate sedation.

The nurse is giving medications to an adolescent with cerebral palsy (CP). What symptom(s) do a majority of the CP medications target? Decreased cardiac output Muscle spasm and spasticity Respiratory compromise Muscle atrophy

Muscle spasm and spasticity

The nurse is performing a home assessment on a preschool-age child. The nurse notices that when in a squatting position, the child has to use his hands and arms to "walk up" his own body, pushing as he goes, in order to stand. What condition should the nurse investigate further? Cerebral palsy Muscular dystrophy Myasthenia gravis Guillain-Barré

Muscular dystrophy

The nurse in the clinic is assessing a school-age child brought in by his parent with reports of prolonged muscle weakness and fatigue. The nurse notes ptosis of the eyelids and an inability to smile. What condition should the nurse investigate further? Cerebral palsy Muscular dystrophy Myasthenia gravis Guillain-Barré

Myasthenia gravis

A 2-month-old has severe reflux disease (GERD) and is not gaining weight. Which surgical intervention would be indicated that entails wrapping the stomach around the esophagus to prevent reflux? Hiatal hernia repair Nissen fundoplication Pyloromyotomy Cardiac sphincterotomy

Nissen fundoplication

The nurse is providing education to the parent of a child about how medications are used to treat constipation in children. What is the most commonly used, well-tolerated medication that the nurse suggests? Mineral oil Polyethylene glycol Lactulose Bisacodyl

Polyethylene glycol

The nurse is preparing a school-age child for magnetic resonance imaging (MRI). What considerations should the nurse identify as important when preparing a pediatric client for an MRI? Select all that apply. Ensure age appropriate sedation is given. Children should be encouraged to eat and drink prior to going into the MRI due to the long length of time they may be in the test. Nursing care is aimed at alleviating anxiety and complications. Any metallic piercings or jewelry must be removed from the child prior to the procedure. Intake and output must be monitored.

Nursing care is aimed at alleviating anxiety and complications. Any metallic piercings or jewelry must be removed from the child prior to the procedure. Intake and output must be monitored. Ensure age appropriate sedation is given.

The nurse in the emergency department (ED) is assessing a school-age child with a new ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting, severe headache, and a fever of 102.4°. What initial action should the nurse expect would be taken? An admission to the hospital for IV fluids and monitoring Give mannitol for increased intracranial pressure. Obtain a CT scan of the brain with X-rays of the chest and abdomen. A surgical intervention for hydrocephalus

Obtain a CT scan of the brain with X-rays of the chest and abdomen.

The nurse is assessing motor skills of a preschool-age child. What method would best accomplish this goal? Ask the parent what the child is able to do. Offer age-appropriate toys to see if the child manipulates the toy appropriately. Ask the child questions to determine the level of capability. Give the child a physical exam.

Offer age-appropriate toys to see if the child manipulates the toy appropriately.

The nurse is teaching a group of parents about the common medications used in children with stomach ulcers. Which medication should the nurse include in the teaching? Select all that apply. Omeprazole Lansoprazole Ranitidine Bisacodyl Mineral oil

Omeprazole Lansoprazole Ranitidine

A school-age client who has been on bed rest for several days becomes dizzy when moving to a sitting position. What type of hypotension should the nurse document in this client's medical record? Cardiac Vasovagal Orthostatic Psychogenic

Orthostatic

The nurse recognizes that the most common symptom of a peptic ulcer is: Pain Bleeding Vomiting Diarrhea

Pain

The nurse is performing an abdominal assessment on a child. Why is it important to perform auscultation before palpation? Children don't like the coldness of the stethoscope and this will alter the exam. Bowel sounds are a priority in abdominal assessment. Palpation will change the quality of bowel sounds and therefore alter the assessment. Children view palpation as tickling, so this should be done last.

Palpation will change the quality of bowel sounds and therefore alter the assessment.

A 10-year-old presents with epigastric pain and nausea, and states they have pain that wakes them up at night. They say they feel better if they eat cookies or crackers. What condition does the nurse suspect the symptoms indicate? Ulcerative colitis Lactose intolerance Peptic ulcer disease Intussusception

Peptic ulcer disease

The nurse enters the room of an infant who is being admitted for severe dehydration. What order of care should the nurse provide for the infant? Perform a quick assessment of the child Administer 20 ml/kg or isotonic normal saline solution Obtain the infant's weight Start an IV

Perform a quick assessment of the child Obtain the infant's weight Start an IV Administer 20 ml/kg or isotonic normal saline solution

An infant is born with an open spinal cord defect. Which action should the nurse take when caring for this client? Select all that apply. Position the client prone. Position the client supine. Keep the defect open to air. Place the client on an open diaper. Cover the defect with a moist, sterile dressing.

Place the client on an open diaper. Cover the defect with a moist, sterile dressing. Position the client prone.

A hospitalized preadolescent client is having difficulty waking up in the morning. Which observation should the nurse identify as contributing to this client's issue with sleep? Reading a book before bed Playing computer games until after midnight Eating a light snack with milk before bedtime Talking with the parents before turning out the light

Playing computer games until after midnight

A preschool-age client begins to experience a tonic-clonic seizure. What action should the nurse take first? Apply oxygen. Support the head. Position the client on the side. Place a padded tongue blade in the mouth.

Position the client on the side.

A parent visits the clinic and tells the nurse that her 5-week-old male infant has had projectile vomiting that smells sour for the past two days. The nurse should refer the family to a health care provider for a possible diagnosis of: Pyloric stenosis Hiatal hernia Peptic ulcer Intestinal atresia

Pyloric stenosis

An 8-week-old infant is diagnosed with reflux (GERD) and has been started on medications. What medications will the nurse administer to decrease stomach acid and help with the symptoms of reflux? Select all that apply. Ranitidine Metoclopramide Omeprazole Prevenique Promethazine

Ranitidine Metoclopramide Omeprazole

The nurse is assessing an infant for hydrocephalus. What signs and symptoms should the nurse identify to support this potential diagnosis? Select all that apply. Rapid increase in head circumference or an unusually large head size Bulging fontanel with crying Vomiting A high-pitched, shrill cry Sunsetting eyes

Rapid increase in head circumference or an unusually large head size Vomiting A high-pitched, shrill cry Sunsetting eyes

A school-age child requires a lumbar puncture. In what order should the nurse provide care to this client? Assess the puncture site for bleeding. Support in a lateral side-lying position. Apply a dry dressing to the puncture site. Maintain strict bed rest for 4 to 24 hours.

Support in a lateral side-lying position. Apply a dry dressing to the puncture site. Maintain strict bed rest for 4 to 24 hours. Assess the puncture site for bleeding.

The nurse is educating a client with celiac disease about nutrition. Which diet would be the best choice? Tuna on wheat toast Ham and Swiss cheese on rye bread Rice and beans Chicken salad on a croissant

Rice and beans

The nurse is preparing an educational poster on reflexes present in a newborn. In what order should the nurse identify that the reflexes disappear? Rooting reflex Moro reflex Babinski sign Placing reflex

Rooting reflex Placing reflex Moro reflex Babinski sign

A parent brings a child to the emergency department (ED). The client has been reporting abdominal pain for over a week and reports feeling constipated. Admission vital signs are: Temp 102.1, HR 110, RR 30, BP 115/84. An abdominal ultrasound revealed free fluid in the abdomen. What would most likely be the child's issue? Constipation Intussusception Crohn's disease Ruptured appendix

Ruptured appendix

An 8-month-old client is diagnosed with microcephaly. What should the nurse expect to assess in this client? Select all that apply. Seizures Hyperactivity Dysmorphic facial features Paralysis on one side of the body Circumference more than two standard deviations below normal

Seizures Hyperactivity Dysmorphic facial features Circumference more than two standard deviations below normal

The nurse is providing education to a school-age client and her family on how to avoid headache triggers when possible, along with a list of some common headache triggers. What should the nurse include in that list? Select all that apply. Sleep deprivation Inadequate fluid intake Eating too many sugary sweets Stress Skipping meals, most commonly breakfast

Sleep deprivation Inadequate fluid intake Stress Skipping meals, most commonly breakfast

A nurse is caring for a severely dehydrated child. The child has had nausea and vomiting for three days. The health care provider orders a 20 ml/kg bolus of intravenous (IV) fluid of an isotonic crystalloid. Which IV fluid would be the best choice? Sodium Chloride 0.9% (normal saline) Dextrose 10% and water (D10W) Dextrose 5% and 0.45% normal saline (D5 ½ NSS) Dextrose 5% and 0.9% normal saline (D5NSS)

Sodium Chloride 0.9% (normal saline)

A school-age child is reported as having a seizure at school. Which finding should indicate to the nurse that the client is experiencing focal seizures? Select all that apply. Spasms Muscle rigidity Head turning Loss of muscle tone Jerking of the extremities

Spasms Muscle rigidity Head turning Jerking of the extremities

The nurse is reviewing the plan of care for an adolescent child with cerebral palsy. Which treatment modalities would the nurse expect? Select all that apply. Speech therapy Physical therapy Respiratory therapy Occupational therapy Educational therapy

Speech therapy Physical therapy Occupational therapy Educational therapy

The nurse is admitting a toddler with suspected meningitis. In what order should the nurse perform these tasks? Start an IV. Start antibiotics. Obtain the lumbar puncture. Begin IV fluids as ordered.

Start an IV Obtain the lumbar puncture Begin fluids as ordered Start antibiotics

A school-age child is diagnosed with meningitis. What should the nurse expect to assess in this client? Select all that apply. Stiff neck Photosensitivity Severe headache Lower extremity weakness Elevated body temperature

Stiff neck Photosensitivity Severe headache Elevated body temperature

A preadolescent client experiences severe migraine headaches. Which medication should the nurse expect to be prescribed to treat this client's health problem? Valproate Propranolol Sumatriptan Nortriptyline

Sumatriptan

The parent of a school-age child who is recovering from a concussion that took place several weeks ago reports the child fell off a bicycle and hit the head again. What direction should the nurse provide to the parent? Place on bed rest. Monitor for orientation. Take to the nearest medical facility. Provide an over-the-counter analgesic.

Take to the nearest medical facility.

The nurse is providing anticipatory guidance to a family with a toddler who is getting ready to sleep in his own bed. What information should the nurse share with the parents to help establish healthy sleep patterns? Select all that apply. Put the child to bed at the same time each night through the week, with more freedom on the weekends. The child should only sleep in bed. The bedroom should be dark, quiet, and cool. Establish a bedtime routine. Perform vigorous activity before bed to burn off extra energy.

The child should only sleep in bed. The bedroom should be dark, quiet, and cool. Establish a bedtime routine.

The nurse is doing post-procedure education with a school-age child after a lumbar puncture. What factor is important for the nurse to emphasize? The child will be NPO for 6 hours post-procedure. The child will need to lay flat for 4 to 24 hours. The child will need hourly vital signs for the first 6 hours post-procedure. The child will need to be assessed for adequate urinary elimination within 4 hours post-procedure.

The child will need to lay flat for 4 to 24 hours.

Which choice describes meningocele? A section of the spinal cord and the nerves that come from the cord are exposed and visible on the outside of the body. It causes partial or complete paralysis below the spinal opening. The membrane that surrounds the spinal cord is enlarged, creating a cyst-like sac. The sac that is present usually on the lower back contains meninges, which are the membranes covering the spinal cord. A section of the spinal vertebrae is malformed, but the spinal cord and nerves are normal. The defect is not visible, though newborns may display dimpling, hair, or hemangioma in the lumbar sacral area. Tissue attachments limit the movement of the spinal cord within the spinal column.

The membrane that surrounds the spinal cord is enlarged, creating a cyst-like sac. The sac that is present usually on the lower back contains meninges, which are the membranes covering the spinal cord.

A 3-month-old infant has gastroesophageal reflux disease (GERD), but is thriving without complications. Which interventions should the nurse suggest to minimize reflux? Give continuous nasogastric feedings Give larger, less frequent feedings Thicken formula with rice cereal Place infant in a car seat after feeding

Thicken formula with rice cereal

The nurse notes that a preschool-age client makes sudden repetitive shoulder movements. The nurse should assess this client for which health problem? Tic Chorea Tremor Dystonia

Tic

An 18-month-old client is scheduled for an electroencephalogram (EEG). What should the nurse do to facilitate this diagnostic test? Wash the client's hair before the test. Provide a sedative 30 minutes prior to the test. Withhold food and fluids for 2 hours before the test. Transport the client to the testing site during naptime.

Transport the client to the testing site during naptime.

A preadolescent client with a history of Chiari malformation type II arrives for a sports physical. What information is essential for the nurse to collect before beginning the physical assessment? Type of sport Head circumference Grade level in school Current height and weight

Type of sport

A 6-year-old is admitted with suspected appendicitis. The client reports abdominal pain. What would be the best way to quantify the child's pain? Use the FLACC scale Use the revised FACES scale Use the 0 to 10 numeric scale Ask the child to describe the pain

Use the revised FACES scale

The nurse is talking to a group of adolescents who are overweight. Which verbalized behavior is an example of the best exercise plan for weight loss? Walking for 30 minutes 6 or 7 days/week Playing soccer for an hour on the weekend Lifting weights 15 minutes a day, 3 times a week Playing an interactive video game every day for an hour

Walking for 30 minutes 6 or 7 days/week

A toddler is scheduled for a routine wellness examination. What should the nurse do before beginning the assessment? Encourage the parent to hold the child. Ask the child to state his or her name and age. Allow the child to manipulate the stethoscope. Watch the child play with an age-appropriate toy.

Watch the child play with an age-appropriate toy.