Peds exam 2

The mother of a child with special needs states, "I should have stopped drinking soda when I was pregnant. Maybe if I had, everything would be OK." What is the nurse's interpretation of this remark?

feelings of guilt are being expressed

A nurse is preparing a presentation for a group of expectant parents about neural tube defects and prevention. Which would the nurse emphasize?

folic acid supplementation

A nurse is preparing a presentation for a health fair focusing on prevention of congenital neuromuscular disorders. What would the nurse emphasize as most important in preventing neural tube defects?

folic acid supplementation

The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure?

he gets sweaty when he eats

A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates an understanding of the information?

i should eat plenty of fresh fruit and vegetables

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?

assess the child's ability to convey information

A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction?

cataracts are only present in adults

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?

dramatic increase in head circumference

The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The client is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records?

elevated blood urea nitrogen (BUN) and creatinine levels

The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells?

he likes to stop and squat wherever he walks

The parents of an infant newly diagnosed with special needs ask the nurse, "Where is the optimal place for our infant to be cared for?" Which response by the nurse is appropriate?

in your home

An infant has been born and diagnosed with a meningocele. Which action will the nurse incorporate into each contact with this infant?

inspection of the cystic sac on the child's back for leakage

The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their child. What is the best response by the nurse?

"Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs."

The nurse is caring for a 14-year-old client in traction prior to surgery. The client has been in the hospital for 2 weeks and will require an additional 10 days in the hospital following surgery. The client states, "I feel isolated and I am refusing any more treatment." Which response by the nurse is most appropriate?

"Let's come up with things for you to do and see if your friends can come visit."

The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component?

American Sign Language

The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of the treatment?

"At least when I take a shower I have a few minutes out of this brace."

The nurse is caring for a male toddler with the genetic disorder of muscular dystrophy. The child has had numerous ear infections and is scheduled for pressure-equalizing (PE) tubes surgery. The parents state, "As if our child's muscular dystrophy isn't enough, now he has to endure ear surgery." What is the best response by the nurse?

"I know it is difficult but it's not unusual for children with genetic disorders to have ear structure problems. This will help prevent future ear infections."

The nurse is communicating with a preschooler with a chronic illness. Which statement by the child would indicate the child has a healthy sense of initiative?

"I like to play pretend hospital with mommy. She is the sick person and I am the nurse."

The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate?

"I will help you become comfortable in caring for your daughter."

While talking with the family of a child with special health needs, the family tells the nurse they are using a specific herb as adjunctive therapy for their child's illness. What is the best response by the nurse?

"Please tell me more about that herb and how it benefits your child, and let's be sure it doesn't interact with the other medications."

The nurse is talking with the parents of a dying child. The child's mother confides she is afraid to be with her child at the time of death. Which response by the nurse is appropriate?

"These fears are not uncommon."

The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate?

"Vaccinations are very effective at preventing serious disease and infection."

The nurse is speaking to the mother of a dying child about the best ways to manage pain and discomfort. Which is the best response by the nurse?

"We will provide pain medication around the clock to help prevent recurrence or escalation of pain."

A 9-year-old boy who is blind is admitted to the hospital. When serving him a meal in bed, which statement would be most appropriate to increase his self-esteem?

"You have a sandwich on your plate, a glass of milk to your right, and an apple to your left."

The nurse is speaking with the mother of an infant with special needs. The mother states she is not sure how she will afford the care her child will need. What is the best response by the nurse?

"Your child may qualify for Supplemental Security Income (SSI). This program is a cash assistance program and pays monthly benefits to the child."

A nurse has provided care to several children during their well-child visits. The nurse has assessed each child's neurologic status. Which assessment finding indicates a problem requiring intervention?

a 4-year-old preschool-age child who consistently walks on tiptoes

The parents of a 9-year-old girl who is dying from cancer are distraught and guilt-ridden when they find that treatment is no longer successful. What is the best way for the nurse to respond?

Assure the parents that expert care of their child will continue.

A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room?

a private room near the nurse's station

The nurse receives a report on a child admitted with severe muscular dystrophy. The nurse suspects the child has been diagnosed with the most severe form of the disease, known as:

Duchenne

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?

Encourage the child to take all the antibiotics if diagnosed with strep throat.

During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We're so focused on the baby that it seems like our 3-year-old is lost in the shuffle." Which nursing diagnosis would the nurse identify as most appropriate?

Interrupted family processes related to demands of caring for the ill child

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings?

Koplik spots

A nurse is giving discharge instructions to the parents of a newborn with a congenital heart disorder. What should the nurse instruct the parents to do in the event that the child becomes cyanotic?

Place him in a knee-chest position

An 8-year-old client presents with sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the child's health history, the nurse learns that the child had strep throat 9 days ago. Which condition does the nurse suspect?

acute glomerulonephritis

A mother asks why her infant with a cyanotic heart defect turns blue. What is the nurse's best explanation?

This is due to a decreased amount of oxygen to the peripheral tissue.

What finding is consistent with increased intracranial pressure (ICP) in an infant?

bulging fontanels

A child with a cardiac structural defect is receiving oxygen therapy. In which position should the child be placed to promote optimal benefits?

semi-Fowler

The parents of an 11-year-old boy who is dying from cancer are concerned that he is not eating. Which intervention would serve both the parents' and child's needs?

serving small meals of things the child likes

The nurse is working with a 6-year-old child recently diagnosed with Legg-Calvé-Perthes disease. The child's parents tells the nurse they understand exercise is important for their child but are not sure which activities are appropriate. Which activity will the nurse recommend for this client?

swimming

The nurse is caring for a family making end-of-life decisions for their child. How will the nurse educate the parents as to what is involved in end-of-life care?

the focus of care will be on comfort of the child

A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?

the foreskin is needed for repair

The nurse is assessing a 5-month-old infant. What would cause the nurse to be concerned about a possible visual impairment?

the infant does not imitate facial expressions

An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this client that clearly indicates scarlet fever?

the tongue has white or red "strawberry" appearance

The parents of a child requiring continual health care frequently change health care providers. The nurse would encourage the parents to develop a permanent relationship with one health care provider, a medical home, for what reason?

to promote trust and allow for continuity of care along with ease of communication

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?

Bull's-eye rash around the bite

The nurse is educating a group of caregivers about fractures seen in children. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in the:

epiphyseal plate