Peds exam 1

When assessing a child's neck, the nurse notes the cervical lymph nodes are non-palpable. Which of the following will the nurse suspect?

This is a normal finding in a growing child

The nurse should not palpate the abdomen if what is suspected?

Tumor, mass, or anything heard abnormally during auscultation

Which of the following does the nurse recognize as an example of cooperative play?

Two children playing a boardgame together

Colic is likely to start around what age if an infant is full term?

Two weeks

Infants should be faced rear facing in a car seat until what age?

Two years old

The flak pain scale should be used for children At what age?

Two years old to seven years old

Which action will the nurse observed in a preschooler who has developed moral reasoning at the preconventional level?

Understanding actions are either good or bad and come with consequences

What is The most common Deaths and adolescent age 15 to 19?

Unintentional accidents, MVA (car crashes), suicide/homicide

When teaching a preschool age child about a scheduled procedure, which nursing action is appropriate?

Use a doll to help explain the procedure

When performing a physical assessment on a toddler, which strategy will the nurse utilize to encourage the toddler cooperation?

Utilize play, allowing the toddler to touch equipment

What kind of breast sounds can you hear over the entire long surface?

Vesicular

What three things does the nurse needs a chart in a patient CHR for a pediatric assessment?

Vital signs, growth (height & weigth), head to toe assessment

For the nurse to assess gross motor skills in a three year old child the nurse should assess the child to do what?

Walk along, skip or gallop and walk backward, paddle across ago, catch a large bowl, jump with 2 feet

The nurse is teaching a six year old about having a chest radiograph. Which explanation is most appropriate for this child?

We are going to use a large camera to take a picture of the inside of your body

What breast sounds can you hear over the trachea near the suprasternal notch?

Bronchial

The nurse is assessing the lung sounds of a Child. Which sounds will the nurse expect to hear over the trachea and suprasternal notch

Bronchial sounds

What breath sounds can you hear over the manubrium in upper intrascapular area where the trachea and bronchi bifurcate?

Bronchovesicular

When talking to an adolescent about their sexual history and their social life what will ease the conversation?

Building trust and rapport with the teen and using open ended questions

What disease causes the body to become rigid, The head is thrown back, the back is arched, when laying supine only the back of the head and the hills touch the bear?

Cerebral palsy

The parents of a nine year old boy tells the nurse that their sons friend told him that soccer is a stupid game. Now the boy wants to play baseball. Which comment by the nurse best explains the effects of peer groups?

Peer acceptance is very important at this age

When assessing an adolescent clients sexual health history, which communication strategy will the nurse utilized to initiate a conversation about reproductive health and related concerns?

Tell me about your social life

Why can happen in a child who fractures the growth plate or epiphyseal cartilage plate and gets improper treatment?

The bone could end up crooked or shorter than the opposite Limb

The posterior fontanelle closes at what age?

1-2 months

Binocularity In a baby is that normal adult levels by what age?

12 months

The nurse is teaching a new parent about nutrition. The mother ask when it is appropriate to switch from formula to whole milk

12 months

Call it usually goes away on its own At what age?

3 to 4 months old

The anterior fontanelle closes at what age?

9-18 months

What breath sounds will you here in infants often times in the back?

Adventitious

The nurse should assess for what on a one-year-old child who is change from formula to regular whole milk?

Anemia

The school nurse is teaching a group of adolescents about safety. Which will the nurse identify as being the leading cause of death among adolescents?

Accidental injury

The nurse is talking with a parent of a school-age child diagnosed with ADHD who reports that the child's behavior has become increasingly out of control, and nothing has helped to calm the child. Which is a priority nursing action?

Actively listened to parents concern before developing a plan of care

What is the most important factor to an adolescent self-esteem?

Body image

At what age can the nurse start taking accurate radial pulses on a child?

Age 2

At what age should the HPV vaccine be given to girlsand boys?

Age 9 up to 26

Which of the following is important when engaging the adolescent client in discussing personal health concerns?

Allowing them to express feelings openly

When taking care of a client from a different culture Who does not speak English. What is the nurses priority action?

Always use an interpreter

What are some interactions the nurse can use to approach a toddler for a physical exam?

Approach at eye level, slow non-threatening movements, use play, touch hands or feet first, let parent hold child

At what age should the head and chest circumference be equal?

Around two years old

The nurse is caring for a 15-year-old male client. During the admission assessment the father states we are Buddhist. Which action by the nurse demonstrates appropriate culturally competent care?

Ask if there are preferences for care

The nurse enters a room to assess a nine month old client and notices the infant asleep in the mothers arms. Which action will the nurse take?

Assess respirations

Toby is a three shot series at what ages should the injections be given?

At least 12 hours after birth, 1 to 2 months, nine months

The nurse is evaluating the psychological and cognitive development of a pediatric client. Using Ericksons developmental stages, which stage should be documented for a toddler?

Autonomy versus shame/doubt

The mother of a six month old infant tells the nurse her baby needs constant watching because they put everything in their mouth. Based on Freud's theory, which is the nurses best response?

Babies at this age explore their world using their mouth

What type of specialist needs a bachelors degree in psychology and counseling and can provide emotional support to children and families to prepare for a procedure demonstrating with a doll?

Child life specialist

What is the number one nursing consideration for a preschool or school age child?

Childhood obesity

What would an infant have who is not sick or hungry but crust for more than three hours a day more than three days a week for more than three weeks?

Colic

What behavioral interventions can the nurse suggested the parents of a rebellious 16 year old client?

Collaborate with the client to establish limits and structure

A nine month old should be able to?

Crawl, sit on floor unsupported, pull up on furniture to standing position

Sequential trends is a predictable sequence or order in which we think that most milestones should happen such as?

Crawling, standing, walking

What kind of nurse look for an a child or a baby that they suspect is in pain?

Crying, grimacing, chin quiver, eyes closed tightly, Limb withdrawal, Child thrashing around

Which information will the nurse include when discussing sleep and rest with the parents of an adolescent?

During adolescence the opportunity asleep is affected by social and academic schedules

Based on Ericksons developmental theory, which is the infants most significant developmental task?

Establish a sense of trust

Where can you hear the mitral valve?

Fifth intercostal space, midclavicular line

Where can you hear the tricuspid valve?

Fifth right and left intercostal space close to the sternal border

Binocularity Is when a baby can focus with both eyes on the same object this is exhibited by what age?

Four months

What is the name of the HPV vaccination that is a three dose series?

Guardasil

The nurse is discussing the importance of immunizations with an adolescent and their parents. Which vaccination is recommended in the prevention of cervical cancer?

HPV

The nurse is preparing to perform a Nuro assessment on a school age child. Which action will the nurse instruct the client to do to assess their hypoglossal nerve

Stick their tongue out

The nurse is assessing the gross motor skills of a four year old client. Which activity will the nurse anticipate the child is able to perform successfully?

Hop on 1 foot

A mother Call the pediatricians office with concerns that her eight week old infant cries eight hours a day and it's difficult to console. She asked the nurse if this is normal. What is the nurses best response?

I will gather more information

When discussing parent child relationships, a parent states their 16 year old is continuously testing the boundaries at home. The nurse understands this as being a major conflict based on which of the following?

Independence and control

The nurse is examining the abdomen of a five year old. In which order should the nurse complete the abdominal assessment?

Inspect, auscultate, percuss, palpate

What order should the nurse assess the abdomen?

Inspect, auscultation, percuss,palpate

When they nurse is doing a physical assessment on a pediatric client in what order should the nurse do the assessment?

Least invasive to most invasive

The school nurse can help parents with a child that has medical issues such as ADHD and is becoming out of control by doing what?

Listening to the parents before creating a plan of care

The nurse is discussing healthy eating habits with the parent of an eight-year-old child. Which response by the parents indicates a need for further discussion?

My daughter must stay at the table until she eats everything on her plate

The nurse is discussing developmental milestones with a new parent. The nurse should explain that the child should pull themselves up to a standing position by which age

Nine months

What are four important topics the nurse should review with parents about childhood concerns

Nutrition, safety, firearms, vaccines

The nurse assessing an infant notices the babies chin is quivering, their fists are clenched, and are making thrashing movements. Which of the following does the nurse recognize the signs being related to?

Pain

What type of therapy should the nurse use to teach the child about a procedure or surgery before or is used to promote something that the child has been through such as trauma?

Play therapy

Visible peristalsis is a sign of what?

Pyloric stenosis

During a home visit with a school age child's family the nurse observes a hunting rifle leaned against the wall in the kitchen. Which nursing diagnosis is a priority?

Risk for injury

A five month old should be able to?

Roll from front to back, Able to sit longer went back is supported, put feet in mouth, grasp objects, first tooth irruption

Infants who are placed on their sides or tummies at bed or naptime are at increased risk for?

SIDS

Where can you hear the aortic valve?

Second intercostal space on the right side

Where can you hear the pulmonic valve?

Second intercostal space, left of sternal border

The nurse is preparing to explain the outcome of a child who successfully masters the trust versus miss trust of the psychosocial stages to a group of nursing students. Which characteristics should the nurse include?

Security and optimism

The nurse discusses growth and development with a new parent and explains there are predictable sequences that children pass through. Which pattern of growth and development is the nurse referring to?

Sequential trends

The school nurse has been informed that a 16 year old student and their family are experiencing significant life stressors including parental divorce. When speaking with the adolescent which action by the school nurse is appropriate?

Show interest in the adolescent by developing a rapport before questioning

The HPV vaccine contains two injections given how many months apart?

Six months apart

Because children are constantly fighting off new germs and infections and their lymphatic system quickly response to these antigens it is common for children to have what?

Slightly enlarged lymph nodes or non-palpable if there is no infection nearby

What are some risk factors that increase the risk of SIDS in an infant?

Soft or loose bedding, bed sharing, side/tummy lying, overheating, maternal cigarette smoking, second hand smoke, lack of prenatal care, mothers age less than 20, premature or low birth weight, males increased risk, Formula fed infants

What are some normal adjustments the school nurse will see in a school age child when his parents are getting a divorce?

Sorrow, crying, anger or aggression

For the nurse to assess gross motor skills on a child age 4 to 5 the nurse should assess the child to do what?

Stand on 1 foot, stand on tiptoes, jump forward, Hop on 1 foot

The parent of a school-age girl tells the nurse that they are uncomfortable speaking with their daughter about sex education. Which is an appropriate resource for the nurse to recommend to the parents?

The school nurse

Why do teenagers continuously test the boundaries set by their parents?

The teenager is fighting for their independence and to control their environment

When would be a good time for the nurse to assess respirations of a child?

While the child is being held or in a calm content state