Peds end of chapter questions
A family you are caring for on the pediatric unit asks you about nutrition for their baby. What facts will you want to include in this nutritional information? Select all that apply. a. Breastfeeding provides micronutrients and immunological properties. b. Eating preferences and attitudes related to food are established by family influences and culture. c. Most children establish lifelong eating habits by 18 months old. d. During adolescence, parental influence diminishes and adolescents make food choices related to peer acceptability and sociability. e. Due to the stress of returning to work, most mothers use this as a time to stop breastfeeding.
A B D
You are working with a family that brought their child into the pediatric clinic. The mother describes what may be a type of seizure. What subjective data will help you determine the type? Select all that apply. a. The presence or absence of an aura b. If the child appeared disoriented after the seizure c. Presence of vomiting after the seizure d. The duration of the seizure e. If the seizure was related to certain foods or occurred after a certain activity
A B D
Disordered eating patterns, which may be observed in the female athlete triad, may include which of the following? Select all that apply. a. Use of diet pills and laxatives b. Fasting c. Binge eating d. Restriction of certain foods e. Inadequate caloric intake f. Excessive vitamin consumption
A B D E
When discharging the pediatric patient from the outpatient setting, the nurse knows which of the following responses indicate a need for more teaching? Select all that apply. a. "The physician said my son can have clear liquids when we return home, which would include Jell-O, pudding, and apple juice." b. "The other nurse explained that I can use other things to help with the pain, such as distraction (reading a book, music, or a movie), after the pain medication is given." c. "I can get my child's prescription tomorrow, so I can go to my regular pharmacy where they can explain the medication to me." d. "I am waiting for my husband to come so he can drive us, and I can watch my son in the car on the way home." e. "I understand that I will be contacted tomorrow for follow-up on my child but that I should not hesitate to call if I have any concerns before then."
A C
Play is children's work, even in the hospital. Which of the following are functions of play? Select all that apply. a. Provides diversion and brings about relaxation b. Keeps the child occupied and directs concerns away from himself or herself c. Helps the child feel more secure in a strange environment d. Lessens the stress of separation and the feeling of homesickness e. Provides a means for release of tension and expression of feelings f. Allows the parents to have a break from the unit for a respite period
A C D E
A 3-month-old infant is seen in the clinic with the following symptoms: irritability, crying, refusal to nurse for more than 2 to 3 minutes, rhinitis, and a rectal temperature of 101.8° F (38.8° C). The labor, delivery, and postpartum history for this term infant is unremarkable. The nurse anticipates a diagnosis of: a. Acute otitis media (AOM) b. Otitis media with effusion (OME) c. Otitis externa d. Respiratory syncytial virus (RSV)
A
A common cause of accidental death in children 1 to 19 years old involves motor vehicle crashes. Evidence from test crashes indicates that the safest action to prevent accidental deaths in toddlers includes: a. Placing the child in a rear-facing weight-appropriate car restraint seat until 24 months old b. Allowing the child to ride in the front seat with a lap-shoulder seat restraint to avoid emotional outbursts c. Allowing the child to ride in a forward-facing booster restraint seat after 12 months old d. Placing the child in the regular seat using the lap-shoulder belt as long as the child weighs at least 45 pounds
A
The newest nurse on the pediatric unit is concerned about maintaining a professional distance in her relationship with a patient and the patient's family. Which comment indicates that she needs more mentoring regarding her patient-nurse relationship? a. "I realize that caring for the child means I can visit them on my days off if they ask me." b. "When the mother asks if I will care for her daughter every day, I explain that the assignments change based on the needs of the unit." c. "When the mother asks me questions about my family, I answer politely, but I offer only pertinent information." d. "I engage in multidisciplinary rounds and listen to the family's concerns."
A
The type of play in which infants engage is called: a. Solitary b. Parallel c. Associative d. Cooperative
A
The potential physiologic and psychological effects of prolonged immobilization on a 9-year-old child who has experienced significant trauma in a motor vehicle crash include which of the following? Select all that apply. a. Orthostatic intolerance b. Deep vein thrombosis (DVT) c. Pressure ulcer formation d. Pneumonia e. Diarrhea f. Kidney stones g. Sense of euphoria and elation h. Constipation
A B C D F H
A father calls the pediatrician's office concerned about his 5-year-old type 1 diabetic child who has been ill. He reports that upon checking the child's urine, it was positive for ketones. What is the nurse's best response to this father? a. "Come to the office immediately." b. "Encourage the child to drink calorie-free liquids." c. "Hold the next dose of insulin." d. "Administer an extra dose of insulin now."
B
The typical play activity in which toddlers engage is called: a. Solitary b. Parallel c. Associative d. Cooperative
B
Because injuries are the most common cause of death and disability in children in the United States, which stage of development correctly determines the type of injury that may occur? Select all that apply. a. A newborn may roll over and fall off an elevated surface. b. The need to conform and gain acceptance from his peers may make a child accept a dare. c. Toddlers who can run and climb may be susceptible to burns, falls, and collisions with objects. d. A preschooler may ride her two-wheel bike in a reckless manner. e. A crawling infant may aspirate due to the tendency to place objects in his mouth
B C E
Discharge teaching for parents of a school-age patient with diabetes insipidus (DI) should include which of the following? Select all that apply. a. Education and support regarding the rationale for fluid restrictions b. Information for school personnel regarding the diagnosis so that they can grant children unrestricted use of the lavatory c. A thorough explanation regarding the condition with specific clarification that DI is a different condition from diabetes mellitus (DM) d. Understanding that treatment will only be needed until the child reaches puberty e. Knowing that school-age children may assume full responsibility for their care
B C E
In relation to developmental milestones, the infant can be expected to roll over from back to abdomen at approximately: a. 2 months old b. 4 months old c. 6 months old d. 8 months old
C
You are caring for a child with hydrocephalus who is postoperative from a shunt revision. Which assessment finding is your priority for increased intracranial pressure (ICP)? a. Nausea and refusal to eat postoperatively b. Complaint of a headache 909 c. Irritability and wanting to sleep d. Decrease in heart rate over the last hour
D
A hallmark of cognitive development in the school-age child is in what Piaget describes as concrete operations. In this stage the child: a. Uses thought processes to experience events and actions b. Is unable to see things from another's point of view c. Has a limited perspective of how others' interpretations of a given event differ d. Makes judgments based on what he or she sees
a
School-age children are prone to accidental injury primarily because of: a. Peer pressure and risk-taking behaviors b. Physical awkwardness and clumsiness c. Parents' lack of supervision d. Attempts to impress members of the opposite sex
a
What is the most common source of unintentional injury and death in young people? a. Motor vehicle crashes b. Drowning c. Poisoning d. Chronic illnesses
a
The primary risk factor for the development of cerebral palsy (CP) is: a. Maternal chorioamnionitis b. Premature birth c. Birth asphyxia d. Intraventricular hemorrhage
b
According to Jean Piaget, adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following? Select all that apply. a. Believing that thoughts are all-powerful b. Thinking in abstract terms c. Thinking about hypotheses d. Using a future time perspective e. Thinking in the here and now
b c d
The most common complication that should be anticipated and observed for in an infant with myelomeningocele after surgical repair of the defect is: a. Urinary stress b. Chiari malformation c. Hydrocephalus d. Latex allergy
c
What factors should the nurse consider when interviewing an adolescent patient? a. Begin with sensitive issues then proceed with less sensitive topics b. Assume you understand the adolescent by including your own experiences c. Interview the adolescent with the parents to ensure accuracy d. Ask open-ended question
d
One indication that the toddler is ready to begin toilet training is: a. Child recognizes urge to let go and hold on and is able to communicate this sensation to the parent b. Child is able to stay dry all night c. Child demonstrates mastery of dressing and undressing self d. Child asks parent to have wet or soiled diaper changed
A
When assessing BP in a child: a. Knowledge of normal mean is important: newborn, 65/41; 1 month to 2 years old, 95/58; and 2 to 5 years old, 101/57. b. Cuff size is the most important variable and should be measured using limb length. c. The child is considered normotensive if the BP is below the 95th percentile. d. Check upper- and lower-extremity BP to look for abnormalities, such as aortic stenosis, which causes lower-extremity BP to be higher than upper-extremity BP.
A
When caring for a child with acute renal failure, which nursing measure requires immediate attention? a. Serum potassium concentrations in excess of 7 mEq/L b. Sodium level of 135 c. Transfusion for hemoglobin of 8 d. Mannitol and furosemide for a urine output of 2 ml/kg/hr
A
These general approaches can be helpful when performing a physical exam. Select all that apply. a. With toddlers, restraint may be necessary, and requesting a parent's assistance is appropriate. b. When examining a preschooler, giving a choice of which parts to examine may be helpful in gaining the child's cooperation. c. With a school-age child, it is always best to have the parents present when examining. d. Giving explanations about body systems can make adolescents nervous due to their egocentricities. e. An infant physical exam is done head to toe, similarly to the adult.
A B
A child with periorbital edema, decreased urine output, pallor, and fatigue is admitted to the pediatric unit. The child is being examined for acute glomerular nephritis. Which of the following nursing measures should be considered? Select all that apply. a. On examination, there is usually a mild to moderate elevation in blood pressure compared with normal values for age, although severe hypertension may be present. b. Urinalysis during the acute phase characteristically shows hematuria, proteinuria, and increased specific gravity, c. The primary objective is to reduce the excretion of urinary protein and maintain protein-free urine. d. Assessment of the child's appearance for signs of cerebral complications is an important nursing function because the severity of the acute phase is variable and unpredictable. e. Because these children are particularly vulnerable to upper respiratory tract infection, protect them from contact with infected roommates, family, or visitors.
A B D
Toddlers are often known to be finicky eaters and may exhibit abnormal eating patterns that may concern parents. Which of the following actions for feeding toddlers should be suggested so that adequate amounts of nutrients for growth and development are consumed? Select all that apply. a. Avoid placing large food portions on the toddler's plate. b. Allow the child to graze on nutritious (not "junk" food) snacks during the day. c. Insist that the child sit at the table until all persons have completed their meals. d. Allow the child to make certain food choices (within reasonable limits)—for example, would you like a half peanut butter or ham sandwich? e. Provide meals at the same time of day as much as possible so that the toddler has a sense of consistency. f. Make the child eat all of the food provided, and provide disciplinary actions, such as a "time-out" if the plate is not cleaned.
A B D E
Which of these statements accurately describes Duchenne muscular dystrophy (DMD)? Select all that apply. a. The absence of dystrophin leads to muscle fiber degeneration. b. DMD is inherited as an X-linked recessive trait. c. Cognitive and intellectual impairment are rare in children with DMD. d. Affected children have a waddling gait and lordosis and fall frequently. e. Ambulation usually becomes impossible by 12 years old, and affected children are confined to a wheelchair. f. Affected children must be hospitalized when ambulation becomes impossible.
A B D E
A 5-year-old is recovering from a tonsillectomy and adenoidectomy and is being discharged home with his mother. Home care instructions should include which of the following? Select all that apply. a. Observe the child for continuous swallowing. b. Encourage the child to take sips of cool, clear liquids. 686 c. Administer codeine elixir as necessary for throat pain. d. Observe the child for restlessness or difficulty breathing. e. Encourage the child to cough every 4 to 5 hours to prevent pneumonia. f. Administer an analgesic such as acetaminophen for pain.
A B D F
You tell the parent of a 4-year-old patient being admitted that you need to ask some questions. She asks, "Why do you have to ask so many questions?" Which explanations should you offer? Select all that apply. a. "It is something we are required to do for every child who is hospitalized." b. "By learning about your child's routines, we can try to minimize some of the changes he will be going through." c. "Knowing more about your child can help predict how the hospital stay will go and will also help us choose a good roommate for him when more children arrive at the hospital." d. "Gaining more information about your child, such as current medications she is taking, will help us provide the best care." e. "This will give you an opportunity to ask questions as well."
A B E
A 2-month-old formerly healthy infant born at term is seen in the urgent care clinic with intercostal retractions, respiratory rate of 62, heart rate of 128, refusal to breastfeed, abundant nasal secretions, and a pulse oximeter reading of 88% in room air. The diagnosis of respiratory syncytial virus (RSV) is made, and a bronchodilator is administered. The infant's oxygen saturation (SaO2) remains 95% in room air, and the respiratory rate is 54, with intercostal retractions; heart rate is 120 bpm. After 2 hours of observation and an intravenous (IV) bolus of fluids, the infant is being discharged home. The nurse provides which of the following home care instructions for this infant? Select all that apply. a. Continue breastfeeding infant. b. Discontinue breastfeeding and administer Pedialyte for 24 hours. c. Observe infant for labored breathing or apnea (cessation of breathing). d. Instill normal saline drops in both nares and suction thoroughly before feeding and before placing to sleep. e. Place infant to sleep on his side with the head of bed slightly elevated to facilitate breathing. f. Keep the infant out of daycare or nursery.
A C D F
The nurse is caring for a 4-year-old girl with a history of frequent urinary tract infections (UTIs). What should the nurse be aware of before obtaining a urine sample? Select all that apply. a. To obtain a clean-catch urine specimen, have the child sit on the toilet facing backward toward the tank. b. Because children who have a UTI will have painful urination, have the child drink a large amount of fluid before obtaining the sample. c. The specimen must be fresh—less than 1 hour after voiding with storage at room temperature or less than 4 hours after voiding with refrigeration. d. If a urinalysis obtained by a bag specimen is negative, a specimen still needs to be obtained by catheterization or suprapubic aspiration. e. The key to distinguishing a true UTI from asymptomatic bacteriuria is the presence of pyuria. f. Because the child is febrile, the nurse should immediately start an antimicrobial and then obtain a urine culture.
A C E
When giving discharge instructions to a parent post hypospadias repair, the nurse recognizes a need for more teaching when the mother says which of the following? Select all that apply. a. "I know that I should never clamp off the catheter." b. "My child can take a tub bath when we arrive home because it will soothe the area." c. "An antibacterial ointment may be applied to the penis daily for infection control." d. "Fluids should be monitored and rationed to prevent fluid overload." e. "My child should avoid straddle toys, sandboxes, swimming, and rough activities until allowed by the surgeon."
A C E
Growth measurement is a key element in children of their health status. One measurement for height is linear growth measurement. What should the nurse do to perfect this technique? Select all that apply. a. Understand the difference in measurement for children who can stand alone and for those who must lie recumbent. b. Use a length board and footboard or a stadiometer, which is the best technique, or use a tape measure. c. Two measurers are usually required for a recumbent child, although one measurer may be sufficient for a cooperative child. d. Reposition the child and repeat the procedure. Measure at least twice (ideally three times). Average the measurements for the final value. e. Demonstrate competency when measuring the growth of infants, children, and adolescents. Refresher sessions should be taken when a lack of standardization occurs.
A D E
As the nurse is getting Nathan ready for surgery, his doctor asked you to explain preemptive analgesic to Nathan's mother. Which response leads you to believe his mother needs more teaching? a. "I understand that preemptive analgesia is giving Nathan pain medication before he has pain and could be given before surgery." b. "This medication will control Nathan's pain so he doesn't feel anything." c. "Giving this medicine early may help prevent complications after surgery." d. "By controlling Nathan's pain, he will be more comfortable and may be able to go home sooner."
B
One of the primary reasons for monitoring the toddler's activities and intervening to prevent accidental injury is that: a. Toddlers have oppositional defiant behavior and negativism. b. Toddlers do not understand the concept of "cause and effect," so explaining that certain actions will result in serious injury is useless. c. Toddlers will often listen to reasoning about why an activity should be avoided. d. Toddlers enjoy making their parents worry about their safety and like to see the parents' reactions to the behavior.
B
Pain scales for infants and their uses include but are not limited to a. CRIES: Crying, Requiring increased oxygen, Inability to console, Expression, and Sleeplessness b. FLACC Pain Assessment Tool: Facial expression, Leg movement, Activity, Cry, and Consolability c. Non-Communicating Children's Pain Checklist (NCCPC): Parent and health care giver questionnaire assessing acute and chronic pain d. Neonatal Pain, Agitation, and Sedation Scale (NPASS): For infants from 3 to 6 months old
B
What is the 24-hour fluid requirement for a child weighing 32 kg? a. 1920 ml/day b. 1740 ml/day c. 1840 ml/day d. 1620 ml/day
B
What is the overriding goal of atraumatic care? a. Prevent or minimize the child's separation from the family b. Do no harm c. Promote a sense of control d. Prevent or minimize bodily injury and pain
B
You are working in the emergency department, and a 10-year-old child with type 1 diabetes mellitus (DM) has just been admitted. He has been diagnosed with diabetic ketoacidosis (DKA). Which assessment data will you expect to note in this child? a. Shallow or normal respirations, hypertension, and tachycardia b. Fruity breath odor and decreasing level of consciousness c. Headache, hunger, and excessive irritability d. Normal urine output with specific gravity less than 1.020 and a trace of ketones
B
You are working with a nurse who is new to your endocrine unit and has never worked with an infant born with congenital adrenal hyperplasia (CAH). You want to make sure he has a full understanding of this diagnosis. Which statement by the nurse indicates a need for further teaching? a. "Definitive diagnosis is confirmed by evidence of increased 17-ketosteroid levels in most types of CAH." b. "Blood studies to identify elevated calcium and decreased phosphorus levels are routinely performed." c. "Another test that can be used to visualize the presence of pelvic structures, such as female reproductive organs is ultrasonography." d. "This deficiency is an autosomal recessive disorder that results in improper steroid hormone synthesis."
B
You are working with a pediatric nurse who has just transferred to the pediatric clinic. You are role-playing phone triage related to a child with a head injury. You ascertain that the nurse needs more teaching based on what response? a. "After initial physical exam, if there was no loss of consciousness with the head injury, the child can be observed at home." b. "If there is a language barrier, written instructions can be given, followed by discharge." c. "Another physical exam should take place in 1 or 2 days." d. "Parents should call the doctor if their child has any of these signs: blurred vision, walking unsteadily, or is hard to awaken."
B
When teaching a 6-year-old child with sickle cell disease and his family about pain management, which of the following should the nurse discuss? Select all that apply. a. When pain medications are used, all pain will be eliminated. b. Nonpharmacologic methods of pain relief, including heat, massage, physical therapy, humor, and distraction. c. It is helpful to use a "passport card" that includes information about the diagnosis, any previous complications, and the pain regimen. d. Only the physician can decide the best course of treatment, and the other health care providers follow that plan. e. Long-term medication use considers many factors.
B C D
While interviewing parents who have just arrived in the health care clinic, the nurse begins the interview. Which statement below involves therapeutic communication techniques? Select all that apply. a. Allow the parents to direct the conversation so that they feel comfortable and in control. b. Use broad, open-ended questions so that parents can feel open to discuss issues. c. Redirect by asking guided questions to keep the parents on task. d. Use careful listening, which relies on the use of clues and verbal leads to help move the conversation along. e. Ask carefully worded, detailed questions to get accurate information.
B C D
Culture includes which of the following? Select all that apply. a. Cultural competence, which includes building skills in the health care provider, such as offering lists of common foods, health care beliefs, and important rituals b. Cultural humility, which requires that health care providers participate in a continual process of self-reflection and self-critique c. Recognizing the power of the health care provider role that views the patient and family as full members of the health care team d. A particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another e. A complex whole in which each part is interrelated, including beliefs, tradition, lifeways, and heritage
B C D E
What does Duvall's Developmental Stages of the Family include? Select all that apply. a. Stages an individual progresses through in their moral and spiritual development b. Stages families progress through in adulthood c. Stages that designate how parenting progresses as a child develops d. Stages that designate appropriate discipline related to developmental stages e. Stages that describe the journey a couple will take as their children mature
B C E
A 4-month-old infant is brought to the well-child clinic for immunizations. The mother indicates that the infant often strains to have a bowel movement, so she has been giving him honey and has stopped feeding him iron-fortified formula, based on her sister's recommendations. The nurse recognizes that the infant is at risk for the development of which of the following? Select all that apply. a. Obesity b. Iron-deficiency anemia c. Rickets d. Infant botulism e. Cow's milk allergy
B D
The National Children's Study is the largest prospective, long-term study of children's health and development in the United States. Which of these options are the goals of this study? Select all that apply. a. Ensure that every child is immunized at the appropriate age. b. Provide information for families to eradicate unhealthy diets, dental caries, and childhood obesity. c. Enlist the help of school lunch programs to reach the goal of vegetables and fruits as 30% of each lunch. d. Significantly reduce violence, substance abuse, and mental health disorders among the nation's children. e. Decrease tardiness and truancy and increase the high school graduation rate in each state over the next 5 years.
B D
How can the nurse prepare a child for a painful procedure? Select all that apply. a. Be honest and use correct terms so that the child trusts the nurse. b. Involve the child in the use of distraction, such as using bubbles, music, or playing a game. c. Kindly ask parents to leave the room so that they don't have to watch the painful procedure. d. Teach positive self-talk such as, "When you go home, you will feel better and be able to see your friends." 148 e. Use guided imagery that involves recalling a previous pleasurable event.
B D E
While orienting a new nurse to the ICU, she asks, "How do these children sleep and not become frightened with all the lights and noises?" How should you respond? Select all that apply. a. "These children are sicker than those on the pediatric unit, so the noises and lights are necessary." b. "We try to organize care into clusters so that infants and children can sleep and we can turn down lights." c. "We silence alarms to allow for periods of sleep, especially at night." d. "When possible, we allow for uninterrupted sleep cycles—for infants 90 minutes and for older children 60 minutes." e. "We encourage parents to sit with and touch their child as often as possible."
B E
A 2-day-old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip (DDH), and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include: a. Return to the orthopedist's office in 2 weeks to remove the hip spica cast. b. The infant's bilateral foot casts should be elevated on pillows as much as possible. c. Remove the Pavlik harness once a day for no more than 2 hours and inspect skin. d. Remove the Pavlik harness while the infant is awake to allow "tummy time.
C
A 5-year-old is seen in the urgent care clinic with the following history and symptoms: sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 102.2° F (39.0° C), clear breath sounds, and absence of cough. The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of: a. Group A beta-hemolytic streptococcus (GABHS) pharyngitis b. Acute tracheitis c. Acute epiglottitis d. Acute laryngotracheobronchitis (LTB)
C
A mother brings her 3-year-old daughter to the well-child clinic and expresses concern that the child's behavior is worrisome and possibly requires therapy or medication at minimum. The mother further explains that the child constantly responds to the mother's simple requests with a "no" answer even though the activity has been a favorite in the recent past. Furthermore, the child has had an increase in the number of temper tantrums at bedtime and refuses to go to bed. The mother is afraid her daughter will hurt herself during a temper tantrum because she holds her breath until the mother picks her up and gives in to her request. The nurse's best response to the mother is that: a. The child probably would benefit from some counseling with a trained therapist. b. The mother and father should evaluate their childrearing practices. c. The child's behavior is normal for a toddler and may represent frustration with control of her emotions; further exploration of events surrounding temper tantrums and possible interventions should be explored. d. The child's behavior is typical of toddlers, and the parents should just wait for the child to finish this phase because this will end soon as well.
C
A nurse looks over her assignment for the day that includes an infant, a preschool-age child, a third-grader, and a sophomore in high school. Which techniques take into consideration developmental stages when working with pediatric patients? a. Being aware that infants will become agitated due to stranger anxiety around 4 months old b. When a preschooler is getting blood drawn, giving a detailed explanation will be helpful c. Explaining and demonstrating what the BP machine does to the third-grader before taking her blood pressure d. Using a single consistent approach with the adolescent will help allay anger and hostility
C
A nurse working on a pediatric unit is assigned to an infant with hypothyroidism. She knows that the assessment may include: a. Thyroid function tests that are usually normal, although thyroid-stimulating hormone (TSH) levels may be slightly or moderately elevated b. Increased secretion of pituitary TSH in response to decreased circulating levels of thyroid hormone (TH) or from infiltrative neoplastic or inflammatory processes c. Dry skin, puffiness around the eyes, sparse hair, constipation, sleepiness, lethargy, and mental decline d. Clinical features, including irritability, hyperactivity, short attention span, tremors, insomnia, and emotional lability
C
An important milestone in the infant's life is the development of object permanence. This milestone is represented by which of these statements? a. The infant smiles at the mother when she talks to him. b. The infant repeatedly flexes and extends his arms and legs when the mother picks him up. c. The infant turns and looks for the mother when she walks out of his view. d. The infant cries when the mother hands him to a babysitter.
C
An important nutritional supplement recommended to prevent rickets in infants who are exclusively breastfeeding is: a. Vitamin A b. Fluoride c. Vitamin D d. Folic acid
C
As the nurse assigned to a child diagnosed with bacterial meningitis, you know that: a. The child will not need to be placed in isolation because antibiotics have been started. b. Enteric precautions will remain in place for up to 48 hours. c. Respiratory isolation will remain in place for 24 hours after antibiotics are started. d. Due to headache, the child will want the head of the bed elevated with two pillows.
C
Following the sudden death of a 14-year-old seemingly healthy basketball player, his parents ask the school administration to install an automatic external defibrillator (AED) in a central area of the athletic center. The school nurse is asked to participate in a meeting with the parents in which the administrators insist such a device is not necessary. The 977school nurse advocates by providing which information about AEDs and children? a. An AED should be used only by health care persons trained in its use. b. An AED provides too much of an energy shock dose for children younger than 12 years old. c. An AED can be effective in the resuscitation of a child or adolescent with a shockable rhythm. d. An AED is more commonly used in adults who have heart attacks than in children with undiagnosed heart conditions.
C
Separation anxiety is something that affects children when they are hospitalized. Each developmental stage has a somewhat different reaction as they deal with this difficulty. Which stage corresponds to the adolescent stage? a. May demonstrate separation anxiety by refusing to eat, experiencing difficulty in sleeping, crying quietly for their parents, continually asking when the parents will visit, or withdrawing from others. b. Separation anxiety comes in stages: protest, despair, and detachment. c. Loss of peer group contact may pose a severe emotional threat because of loss of group status, inability to exert group control or leadership, and loss of group acceptance. d. May need and desire parental guidance or support from other adult figures but may be unable or unwilling to ask for it.
C
The nurse is explaining the strategy of consequences to a parent he is working with. Which response by the parent indicates more teaching is needed when he describes the types of consequences? a. Natural: Those that occur without any intervention b. Logical: Those that are directly related to the rule c. Transforming: Allowing the child to come to the conclusion on his or her own d. Unrelated: Those that are imposed deliberately
C
What does family systems theory include? a. Direct causality, meaning each change affects the whole family b. Family systems react to changes as they take place, not initiate it c. A balance between morphogenesis and morphostasis is necessary 36 d. Theory is used primarily for family dysfunction and pathology
C
A 12-year-old who was in an all-terrain vehicle (ATV) accident has a long-leg fiberglass cast on his left leg for a tibia-fibula fracture. He requests pain medication at 2:00 AM for pain he rates at a 10/10 on the Numeric Scale. The nurse brings the pain medication and notes that he has removed the pillows that kept his leg elevated. He complains of pain in the left foot, and she notes that there is 3+ edema in the exposed leg and foot, and she is unable to slip a finger under the cast. The nurse's priority interventions in this situation should include: a. Administer the pain medication and elevate the child's leg on the pillows. b. Elevate the leg on the pillows and follow up within 2 to 3 hours to see if the edema has decreased. c. Let the child know that he cannot have any additional pain medication until 6:00 AM. d. Notify the surgeon of the findings immediately.
D
What is a way to integrate spiritual practices into nursing care? a. Explaining the religious practices you personally take part in b. Realizing that young children have little understanding regarding their spirituality c. Agreeing with children and their families when they explain their religious beliefs so that they are not offended d. Becoming knowledgeable about the religious worldviews of cultural groups found in the patients you care for
D
When caring for their infant, a parent asks you, "Is Emily in a lot of pain? How would you know since she can't really tell you?" The best answer to this question is a. "Infants don't feel pain as we do because their pain receptors are not fully developed yet." b. "The nurses give pain medication before she really feels the pain." c. "We assess her pain using an infant pain assessment tool and give the medicine as needed." d. "Although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain."
D
You are the nurse assigned to care for a child with a basilar skull fracture. Your most important nursing observation is change in level of consciousness (LOC). You will be highly alert for: a. Alterations in vital signs that often appear before alterations in consciousness or focal neurologic signs b. Bleeding from the ear, which is indicative of an anterior basal skull fracture c. Seizures, which are relatively uncommon in children at the time of head injury d. Changes in posturing, such as any signs of extension or flexion posturing, unusual response to stimuli, and random versus purposeful movement
D
A school nurse in middle school (grades 6, 7, and 8) is preparing an outline for a sex education class. Which of these statements represent important concepts to be covered in discussing this topic with this age group? Select all that apply. a. Consider separating the boys and girls into same-sex groups with a leader of the same sex. b. Answer questions in a matter-of-fact manner and honestly and appropriate to the children's level of understanding. c. Use vernacular or slang terms to describe human physiologic functions. d. Avoid discussing sexually transmitted diseases in this age group. e. Discuss common myths and misconceptions associated with sex and the reproductive process. f. Avoid controversial topics such as birth control.
a b e
The nurse caring for a preschool child understands which of the following developmental concepts? Select all that apply. a. Preschoolers have egocentric thought and believe that everyone thinks as they do. b. Play can be therapeutic and enlightening into a child's level of understanding. c. Explanations are helpful when using detail to allay the preschooler's stress. d. Preschoolers understand inferences and can relate to others' feelings with empathy. e. Preschoolers have magical thinking and believe their thoughts have power.
a b e
At the clinic appointment, a 4-year-old's mother wants to discuss several concerns. Which statements require more teaching by the nurse? Select all that apply. a. My husband feels that TV is okay as long as it is educational. b. I think it is okay for my son to play dress-up along with the girls. c. I told my son that his imaginary playmate moved away because it did not seem normal. d. My mother-in-law thinks I should be working around the house all the time, but I believe playing with my son is very important. e. My neighbor gave me some flash cards with letters and numbers for my son to use, but I said, "What's the rush? He's only 4."
a c e
in terms of social development, the school-age child does which of the following? Select all that apply. a. Begins to explore the environment beyond the family b. Has an increased interest in persons of the opposite sex (gender) c. May actively participate in same-sex groups or clubs d. Strives to be different from those in the peer group e. Begins to form strong relationships with persons of the same sex (gender)
a c e
A 14-year-old male with a spinal cord injury (SCI) is placed on a standing table and suddenly begins to sweat profusely and complain of a headache. The nurse takes a set of vital signs and notes a significant increase in systolic blood pressure and a heart rate of 50 bpm. The most helpful intervention in this situation would be for the nurse to: 1004 a. Place the adolescent back in his wheelchair and take him to his room b. Palpate the bladder for distention c. Administer a routine analgesic for his headache and discontinue the therapy d. Place the standing table in a horizontal position and allow the adolescent to rest for a few minutes
b
Characteristics of bullying include: a. Unintentional harm inflicted upon another person that is part of the socialization process in childhood b. The infliction of repetitive physical, verbal, or emotional abuse upon another person with intent to harm c. An attempt to gain acceptance and be liked by same-sex peers d. An early sign of a severely disturbed personality disorder that escalates in adulthood
b
One of the concerns of the preschool period is adequate nutrition. What can the nurse say to give anticipatory guidance to parents? a. Preschoolers are growing during this period and need to increase their caloric intake to 110 kcal/kg, for an average daily intake of 2200 calories. b. There is some evidence that children self-regulate their caloric intake. If they eat less at one meal, they compensate at another meal or snack. c. To monitor fat intake, dairy and meat should be limited to twice a day. d. For children who do not like milk, consumption of fruit juices is a healthy alternative.
b
Urinary system distress (neurogenic bladder) in children with spina bifida (SB) is managed by: a. DDAVP (1-deamino-8-D-arginine vasopressin) b. Clean intermittent catheterization (CIC) c. Continuous urinary catheterization d. Mitrofanoff procedure
b
When her preschool son is in the hospital, the parent tells the nurse, "I think there is something wrong with him because he is so skinny." The most appropriate answer by the nurse is: a. Most preschoolers weigh between 10 and 14 kilograms. b. The legs of a preschooler, rather than the trunk, increase in length, which may make him look slimmer. c. Preschoolers usually keep that pot-bellied appearance until about 4 years old. d. Most preschoolers gain 2 to 3 pounds per year.
b
Which of the following immunization booster vaccines should be considered for a 12-year-old adolescent who has completed all recommended routine childhood vaccinations? Select all that apply. a. DTaP vaccine b. Tdap vaccine c. Meningococcal vaccine d. Pneumococcal vaccine e. Hepatitis B vaccine
b c
As a nurse caring for children, an understanding of childhood depression is essential. Some important information about depression includes which of the following statements? Select all that apply. a. Authorities agree that childhood depression exists, and the manifestations are often similar to adult depression. b. Identification of the depressed child requires a careful history taking (e.g., health, growth and development, social and family health); interviews with the child; and observations by the nurse, parents, and teachers. c. If antidepressants are prescribed, the child and family need to know that antidepressants must be at a therapeutic level for 4 to 6 weeks to achieve a beneficial effect. d. Depressed children often exhibit a distinctive style of thinking characterized by low self-esteem, hopelessness, poor social engagement with peers, and a tendency to explain negative events in terms of personal shortcomings. e. Nurses should be aware that depression is a problem that can be easily overlooked in the school-age child and one that can interrupt normal growth and development.
b d e
A 12-year-old child is in the urgent care clinic with a complaint of fever, headache, and sore throat. A diagnosis of group A beta-hemolytic streptococcus (GABHS) pharyngitis is established with a rapid-strep test, and oral penicillin is prescribed. The nurse knows which of the following statements about GABHS is correct? a. Children with a GABHS infection are less likely to contract the illness again after the antibiotic regimen is completed. b. A follow-up throat culture is recommended following the completion of antibiotic therapy. c. Children with a GABHS infection are at increased risk for the development of rheumatic fever (RF) and glomerulonephritis. d. Children with a GABHS infection are at increased risk for the development of rheumatoid arthritis in adulthood.
c
At an appointment at the pediatrician's office, a patient's mother states, "My son gets rough with some of the neighborhood kids. I am worried that he is becoming a bully." Which statements by the mother need more teaching? Select all that apply. a. When my son becomes aggressive, I feel he needs to be punished. b. I think it is good for him to bond with his dad, so they often watch TV together. c. I am trying to get him to learn to say what he is upset about in words. d. Boys will be boys, so I think this can be considered a normal stage in development. e. I am thinking that a time-out would be a better strategy than spanking when my son shows this behavior.
c e
