PEDS Evolve

An obese adolescent who has short stature and is hyperphagic is diagnosed with hypogonadism. Which congenital disorder may be present in this adolescent?

Prader-Willi

A nurse teaches the mother of a child with a pinworm infestation how pinworms are transmitted. Which statement indicates that the teaching has been effective?

"I'll have to reinforce her hand washing habits, especially before she handles food." Pinworms are transferred by way of the anal-oral route; hand washing is the most effective method for preventing transmission.

A 5-year-old girl is undergoing a course of chemotherapy. One day the nurse sees the child crying. The child tells the nurse, "All my hair is gone, and everyone stares at me." What is the best response by the nurse?

"Let's ask your mother to bring in a hat for you to wear until your hair grows back."

A school nurse is teaching a health class of 12-year-olds about hepatitis C. Which statement by a student indicates an understanding of the origin of the disease?

"You can catch it while getting a tattoo" Hepatitis C is a blood-borne pathogen

On an average, how many hours of sleep would the nurse state a preschooler needs during the night? Record your answer using a whole number. _____ hours

12 Preschoolers need an average of 12 hours of sleep a night for proper development of mental and physical health.

What is the recommended length of insertion of the enema tube in a child of 3 years?

5 to 7.5 cm

What should the nurse teach parents about their newborn's diagnosis of phenylketonuria (PKU)?

A low phenylalanine diet is required.

Which characteristics does the nurse observe in a client who has secondary amenorrhea?

Absence of menstrual bleeding for three cycles after menarche

How can a school nurse help determine a young child's readiness to learn?

Assessing vision and hearing

A teenage mother is diagnosed with syphilis. What would be the drug of choice for this client if she wishes to continue breast-feeding?

Benzathine penicillin

Extremely Low Birth Weight (ELBW)

Birth weight <1,000 g

Very Low Birth Weight (VLBW):

Birth weight <1,500 g

During a clinical assessment, what secondary sex characteristics does the nurse observe in a teenage client? Select all that apply.

Change in voice Development of facial hair Secondary sex characteristics are the changes observed in various parts of the body from hormonal alterations.

A child becomes cyanotic during a generalized tonic-clonic seizure. What is the most appropriate action by the nurse?

Continue to observe The child's status and the progression of the seizure should be monitored; the child will not breathe until the seizure is over, and cyanosis should subside at that time. Attempting to open a clenched jaw may result in injury to the child. Oxygen is useless until the child breathes when the seizure is over. The practitioner may be notified later; provisions for the child's safety and observation are the priorities.

A 2-year-old child who is hospitalized for repair of tetralogy of Fallot is seen squatting in the playroom. In response to this behavior, what should the nurse do?

Continue to observe the child if there are no other signs of distress. Squatting is a physiologic adaptation for children with tetralogy of Fallot. By squatting, the child decreases the amount of arterial blood that is flowing to the extremities, which in turn decreases venous return to the heart and reduces preload.

After assessing a 3-year-old child, a nurse concludes that the child has extraordinary fine motor skills that are seldom seen at that age. Which ability of the child supports the nurse's conclusion?

Cutting with scissors Using scissors to cut out pictures is a fine motor skill that can be seen in 4-year-old children, not in a 3-year-old child. A 3-year-old child can draw a circle with facial features, build a tower using 9 to 10 cubes, and place small pellets in a narrow-necked bottle.

A parent asks the nurse about physical changes to expect in the 3-year-old child. What physical changes should the nurse explain? Select all that apply.

Draw stick people Stack a tower of blocks

Primary sex characteristics

Enlargement of breasts Beginning of menstruation Primary sex characteristics are the changes that occur in the internal and external organs involved in reproductive functions.

Which statement about language development in preschoolers is correct?

Find "die" and "dye" confusing

Which fears should the nurse include in a teaching session for the parents of a preschool-age client during a scheduled health maintenance visit? Select all that apply.

Ghosts, the dark, large dogs, objects associated with pain

The nurse explains to the parent of a 2-year-old child that the toddler's negativism is expected at this age. What need is this behavior meeting?

Independence

During the course of treatment a toddler is to receive an intramuscular injection. What is the priority nursing intervention that should be included in the plan of care to comfort the child?

Involving the parents in comforting the toddler after the injection

Which gonadotropin-releasing hormone agonists are used to treat endometriosis? Select all that apply.

Leuprolide; nafarelin acetate

A nurse is assessing an 18-month-old toddler with suspected developmental dysplasia of the left hip. In what position should the nurse place the toddler to elicit the Trendelenburg sign?

Standing on the affected side

An infant with a diagnosis of hydrocephalus has just had a ventriculoperitoneal shunt inserted. In what position should the nurse place the infant?

Supine on the unaffected side

What would the nurse explain is true about the sleep pattern of toddlers?

They sleep for about 12 hours a day.

When assessing the reflexes of a 4-month-old, the nurse observes that the child is extending an arm to the side while the head is turned. Which reflex does the nurse observe?

Tonic neck reflex

Which activities can a child perform at 3 years of age? Select all that apply.

Turning doorknobs Holding crayons with fingers Eating a spoon without rotating it

Which should the nurse share with the parents of a toddler-age client regarding a predominant change that occurs to the gastrointestinal system during this stage of development?

Voluntary control of elimination This is important to share with the parents because this is the stage of development where toilet training occurs.

A 3.5-year-old child has been ill with nephrotic syndrome. The child has been toilet trained for longer than 1 year but has been incontinent lately. The child's parents express concern over this behavior. What is the most therapeutic response by the nurse to the parents?

"This is an expected response to hospitalization. Ignore the regressive behavior and be supportive."

When a nurse brings a dinner tray to a 4-year-old child hospitalized with pneumonia, the child says, "I'm too sick to feed myself." What is the best response by the nurse?

"Wait a few minutes and I'll be back to help you" A few minutes will be enough time for the child to begin self-feeding. The nurse should provide both physical and emotional support because the child's request for help indicates regression and the need for dependence during a period of stress.

What is the average increase in height of preschoolers per year?

2.5 to 3 inches (6.2 to 7.5 cm)

A 9-year-old child who has successfully completed the emergency (resuscitative) phase of treatment for a severe burn injury is started on a high-protein, high-calorie diet. Which snacks should the nurse encourage between meals? Select all that apply.

Crackers + cheese Banana pudding + whipped cream Frozen yogurt + chocolate sprinkles The cheese increases protein intake, which is needed for tissue repair, and the crackers contain carbohydrates that provide calories for the increased metabolism. The milk in the pudding contains protein, and whipped cream contains fat. The banana is high in potassium. All of these nutrients are essential for tissue repair. Frozen yogurt contains both protein and calories. Although bread and honey increase caloric intake, they furnish little of the protein needed for tissue repair. Although orange juice and cookies increase vitamin and fluid intake, they do not supply protein.

A primary healthcare provider prescribes a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question this prescription?

It could cause a fluid/electrolyte imbalance.

A 15-year-old adolescent is found to have type 1 diabetes. What should the nurse include when teaching the adolescent about type 1 diabetes?

It has a more rapid onset that type 2 diabetes

Which chemicals, when ingested by a child, can cause severe pneumonia?

Lighter fluid

A nurse notes the weights attached to a 7-year-old child in traction are touching the floor. What action should the nurse take?

Moving child towards head of the bed.

A male client with small overgrowths on the skin in the cervical region arrives at the hospital. The laboratory report reveals the presence of human papillomavirus type 16. Which condition is associated with this virus?

Penile carcinoma Human papillomavirus type 16 is commonly associated with penile carcinoma. Uncircumcised males may be at higher risk for infections such as balanitis and prosthitis. Human papillomavirus types 11 and 6 are commonly associated with genital warts.

A 17-year-old female who reports irregularity of menses and weight loss is diagnosed with hypothyroidism. Which type of menstrual disorder does this client have?

Hypogonadotropic amenorrhea

Which assessment question should the nurse ask the parents of a 1-year-old client to assess language development?

Does your child say 3-5 words?

Which should the nurse anticipate for a 5-year-old client related to play? Select all that apply.

Dress up & cooperative play The 5-year-old preschool-age client would be expected to participate in dress-up play due to the preoccupation with magical thinking and the beginnings of cooperative play. Solitary play is expected for the infant and toddler. Parallel play is expected for the toddler and young preschool-age client. Team sport play is expected for the school-age client.

A nurse is teaching the parents of an infant with eczema about the foods that are most allergenic. What foods should the nurse instruct the parents to eliminate from the diet?

Milk, eggs, peanuts. Milk and eggs contain protein to which the eczematous child may be allergic.

A nurse accompanies a 3-year-old child to the pediatric unit's playroom. The toddler seems reluctant to select a toy or activity. Which toy is most appropriate for the nurse to offer as a means of fostering creativity?

Mold and clay Three-year-olds are entering the developmental stage of creative and imaginative play; using clay to make shapes, both with and without molds, enhances their creativity and improves their fine motor coordination. A plastic animal will probably be a boring toy for a 3-year-old child; a plastic animal is more appropriate for a 6- to 12-month-old child. A 3-year-old is too young to manipulate a pen or a pencil and may cause a self-injury or an injury to others. Pens and pencils should not be left in a playroom. A 3-year-old does not have the cognitive ability or the fine motor coordination to play even simple video games.

Which assessment data would cause a nurse to initiate treatment for a potential aspirin overdose for a preschool-age child who presents in the emergency department (ED)? Select all that apply.

Nausea/vomiting Tinnitus

A nurse is assessing a toddler with plumbism (lead poisoning). Which organ system is of most concern because of the condition's irreversible effects?

Nervous system

When assessing a child's reflexes, the nurse places the child in the prone position and presses a thumb along the child's spine from sacrum to neck. The nurse finds that the child starts crying and urinates while flexing the extremities. Which reflex is the nurse assessing in the child?

Perez reflex