Peds Exam 2

The nurse has reinforced teaching for a school-age child who was given a brace to wear for the treatment of scoliosis. The nurse determines that the child needs further teaching if the child makes which statement? 1."This brace will correct my curve." 2."I will wear my brace under my clothes." 3."I may not need surgery if I wear my brace." 4."I will do back exercises at least five times a week."

1."This brace will correct my curve."

An ambulatory care nurse makes a follow-up telephone call to the mother of a child who underwent a myringotomy with insertion of tympanoplasty tubes on the previous day. The mother of the child tells the nurse that the child is complaining of discomfort. What should the nurse instruct the mother to do? 1.Administer acetaminophen. 2.Give one children's aspirin with water. 3.Call the pharmacist for a stronger analgesic. 4.Call the primary health care provider immediately.

1.Administer acetaminophen.

An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instructions on the list? Select all that apply. 1.Avoid hot fluids. 2.Avoid raw vegetables. 3.Consume pudding products. 4.Rest in bed or on a couch for 24 hours. 5.Drink cold milkshakes to soothe the throat.

1.Avoid hot fluids. 2.Avoid raw vegetables. 4.Rest in bed or on a couch for 24 hours.

The nurse is performing an assessment on a child with a head injury. The nurse notes an abnormal flexion of the upper extremities and an extension of the lower extremities. What should the nurse document that the child is experiencing? 1.Decorticate posturing 2.Decerebrate posturing 3.Flexion of the arms and legs 4.Normal expected positioning after head injury

1.Decorticate posturing

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as which finding? 1.Positive 2.Negative 3.Inconclusive 4.Definitive and requiring a repeat test

1.Positive

The nurse is providing home care instructions to the parents of a child with a seizure disorder. Which statement indicates to the nurse that the teaching regarding seizure disorders has been effective? 1."We're glad we only have to give our child the medication for 30 days." 2."We will make appointments for follow-up blood work and care as directed." 3."We're glad there are no side effects from taking the antiseizure medications." 4."After our child has been seizure free for 1 month, we can discontinue the medication."

2."We will make appointments for follow-up blood work and care as directed."

The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding? 1.Extreme fatigue 2.The presence of pain 3.An airway obstruction 4.The presence of dehydration

3.An airway obstruction

An alert child who is crying loudly is brought to the hospital emergency department for a simple fracture to the lower right arm that occurred after a fall off a bicycle. What is the nurse's priorityassessment? 1.Mobility 2.Skin integrity 3.Neurovascular 4.Level of consciousness

3.Neurovascular

A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate? 1."The child probably has an infection." 2."Have the child gargle with mouthwash every 4 hours." 3."You need to contact the health care provider immediately." 4."Bad mouth odor is normal and may be relieved by drinking more liquids."

4."Bad mouth odor is normal and may be relieved by drinking more liquids."

The nurse is performing an assessment of a 7-year-old child who is suspected of having episodes of absence seizures. Which assessment question to the mother will assist in providing information that will identify the symptoms associated with this type of seizure? 1."Does twitching occur in the face and neck?" 2."Does the muscle twitching occur on one side of the body?" 3."Does the muscle twitching occur on both sides of the body?" 4."Does the child have a blank expression during these episodes?"

4."Does the child have a blank expression during these episodes?"

A mother calls the primary health care provider's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother? 1."Is your child crying and irritable?" 2."Does your child have a productive cough?" 3."Did he have a temperature last night of greater than 100º F (37.8º C)?" 4."Is your child telling you at this time he is having trouble breathing?"

4."Is your child telling you at this time he is having trouble breathing?"

The nurse is assessing for Kernig's sign in a child with a suspected diagnosis of meningitis. Which action should the nurse perform for this test? 1.Tap the child's facial nerve and assess for spasm. 2.Compress the child's upper arm and assess for tetany. 3.Bend the child's head toward the knees and hips and assess for pain. 4.Raise the child's leg with the knee flexed and then extend the leg at the knee and assess for pain.

4.Raise the child's leg with the knee flexed and then extend the leg at the knee and assess for pain.

Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided? 1."Administer the antibiotics until they are gone." 2."Administer the antibiotics if the child has a fever." 3."Administer the antibiotics until the child feels better." 4."Begin to taper the antibiotics after 3 days of a full course."

"Administer the antibiotics until they are gone."

The nurse is monitoring a 7-year-old child who sustained a head injury in a motor vehicle crash for signs of increased intracranial pressure (ICP). The nurse should assess the child frequently for which early sign of increased ICP? 1.Nausea 2.Papilledema 3.Decerebrate posturing 4.Alterations in pupil size

1.Nausea

The nurse has a prescription to give eardrops to a 5-year-old child. Which position should the nurse use to pull the pinna of the ear? 1.Upward and outward 2.Upward and backward 3.Downward and outward 4.Downward and backward

2.Upward and backward

The nurse is caring for a child with a head injury. The nurse observes decerebrate posturing. What is the nurse's best action? 1.Document the finding. 2.Complete a head-to-toe examination. 3.Notify the primary health care provider. 4.Inform the family of the improved status.

3.Notify the primary health care provider.

The nurse is assisting a primary health care provider (PHCP) examine a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the PHCP to assess? 1.Babinski's sign 2.The Moro reflex 3.Ortolani's maneuver 4.The palmar-plantar grasp

3.Ortolani's maneuver

The nurse caring for an infant with a diagnosis of hydrocephalus should monitor the infant for which sign of increased intracranial pressure? 1.Proteinuria 2.Bradycardia 3.A drop in blood pressure 4.A bulging anterior fontanel

4.A bulging anterior fontanel

The nurse is caring for an infant with spina bifida (myelomeningocele type) who had the sac on the back containing cerebrospinal fluid, the meninges, and the nerves (gibbus) surgically removed. The nursing plan of care for the postoperative period should include which action to maintain the infant's safety? 1.Covering the back dressing with a binder 2.Placing the infant in a head-down position 3.Strapping the infant in a baby seat sitting up 4.Elevating the head with the infant in the prone position

4.Elevating the head with the infant in the prone position

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? 1.Assessing hearing loss 2.Monitoring urine output 3.Changing body position every 2 hours 4.Providing a quiet atmosphere with dimmed lighting

4.Providing a quiet atmosphere with dimmed lighting

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? 1.Turn the child to the side. 2.Administer the prescribed antiemetic. 3.Maintain NPO (nothing by mouth) status. 4.Notify the primary health care provider (PHCP)

Turn the child to the side.

The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF? 1.Transmitted as an autosomal dominant trait 2.A chronic multisystem disorder affecting the exocrine glands 3.A disease that causes the formation of multiple cysts in the lungs 4.A disease that causes dilation of the passageways of many organs

2.A chronic multisystem disorder affecting the exocrine glands

A child with developmental dysplasia of the hip is placed in a Pavlik harness. The nurse should demonstrate to the parents how to place the child in this harness by placing the child's legs in which position? 1.Prone 2.Abduction 3.Extension 4.Adduction

2.Abduction

A child has just returned from surgery and has a hip spica cast. What is the nurse's priority action for this client? 1.Elevate the head of the bed. 2.Assess the circulatory status. 3.Abduct the hips using pillows. 4.Turn the child onto the right side.

2.Assess the circulatory status.

A child must wear a brace for correction of scoliosis. The nurse creates a plan of care knowing the child is at risk for which problem? 1.Inability to ambulate 2.Breaks in skin integrity 3.Decreased oxygenation 4.Delayed growth and development

2.Breaks in skin integrity

A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1.Warm, dry skin 2.Decreased wheezing 3.Pulse rate of 90 beats per minute 4.Respirations of 18 breaths per minute

2.Decreased wheezing

The nurse is caring for a child after surgical removal of a brain tumor. The nurse should assess the child for which sign that would indicate that brainstem involvement occurred during the surgical procedure? 1.Inability to swallow 2.Elevated temperature 3.Altered hearing ability 4.Orthostatic hypotension

2.Elevated temperature

The nurse is caring for a child with a fracture who is placed in skeletal traction. The nurse should monitor for which sign of a serious complication associated with this type of traction? 1.Lack of appetite 2.Elevated temperature 3.Increase in the blood pressure 4.Decrease in the urinary output

2.Elevated temperature

The nurse is caring for a child who sustained a head injury after falling from a tree. On assessment of the child, the nurse notes the presence of a watery discharge from the child's nose. The nurse should immediately test the discharge for the presence of which substance? 1.Protein 2.Glucose 3.Neutrophils 4.White blood cells

2.Glucose

A pediatric nurse in the ambulatory surgery unit is caring for a child following a tonsillectomy. The child is complaining of a dry throat. Which item should the nurse offer to the child? 1.Ginger ale 2.Green gelatin 3.A glass of milk 4.Cherry Kool-Aid

2.Green gelatin

The nurse is caring for a newborn infant with spina bifida (myelomeningocele) who is scheduled for surgical closure of the sac. In the preoperative period, which is the priority problem? 1.Choking 2.Infection 3.Inability to tolerate stimulation 4.Delayed growth and development

2.Infection

The nurse is caring for a 2-year-old child with an ear infection who requires the administration of antibiotic eardrops. The nurse observes the mother administering the eardrops to the child. Which observation by the nurse indicates that the mother is performing the procedure correctly? 1.The mother pulls the earlobe up and back. 2.The mother pulls the earlobe down and back. 3.The mother holds the child in a sitting position. 4.The mother must wear gloves to administer the medication.

2.The mother pulls the earlobe down and back.

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? 1."The cast may feel warm as the cast dries." 2."I can use lotion or powder around the cast edges to relieve itching." 3."A small amount of white shoe polish can touch up a soiled white cast." 4."If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."

2."I can use lotion or powder around the cast edges to relieve itching."

The nurse is assisting in providing an educational session to new mothers regarding the methods that will decrease the risk of recurrent otitis media in infants. Which statement by a mother in the group indicates a need for further teaching? 1."I need to feed my infant in an upright position." 2."I need to stop breast-feeding as soon as possible." 3."Bottle-feeding should be stopped as soon as possible." 4."I should not provide my infant with a bottle during naptime."

2."I need to stop breast-feeding as soon as possible."

A child sustains a fall at home and is brought to the hospital emergency department by the child's mother. After a radiographic examination, the child is determined to have a fractured arm, and a plaster cast is applied. The nurse provides instructions to the mother regarding neurocirculatory assessment and function. Which statement by the mother indicates a need for further instruction? 1."I'll need to check her skin twice a day at the cast edges." 2."If her hand gets real cool and pale, I can apply the heating pad to it." 3."For the first couple of days, I should try to keep her hand higher than her heart most of the time using pillows." 4."If she seems way too fussy and her arm is painful even after I've given her the pain medication, it might be a problem, and I should call you for help to decide on what is happening."

2."If her hand gets real cool and pale, I can apply the heating pad to it."

A child with cerebral palsy is in a management program to achieve maximum potential for locomotion, self-care, and socialization in school. The nurse works with the child to meet these goals by performing which action? 1.Placing the child on a wheeled scooter board 2.Removing ankle-foot orthoses and braces once the child arrives at school 3.Keeping the child in a special education classroom with other children with similar disabilities 4.Placing the child in the supine position with a 30-degree elevation of the head of the bed to facilitate feeding

1.Placing the child on a wheeled scooter board

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding? 1.Frequent swallowing 2.A decreased pulse rate 3.Complaints of discomfort 4.An elevation in blood pressure

Frequent swallowing

After a tonsillectomy, the nurse reviews the surgeon's postoperative prescriptions. Which prescription should the nurse question? 1.Monitor for bleeding. 2.Suction every 2 hours. 3.Give no milk or milk products. 4.Give clear, cool liquids when awake and alert.

Suction every 2 hours

A child is scheduled for a tonsillectomy. The nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery? 1.Presence of loose teeth 2.Bleeding during surgery 3.Difficulty in swallowing 4.Exudate in the throat area

1.Presence of loose teeth

After a tonsillectomy, a child is brought to the pediatric unit. The nurse should appropriately place the child in which position? 1.Prone 2.Supine 3.High-Fowler's 4.Trendelenburg's

1.Prone

The nurse provides instructions to the parents of an infant with hip dysplasia regarding care of the Pavlik harness. Which statement by one of the parents indicates an understanding of the use of the harness? 1."I can remove the harness to bathe my infant." 2."I need to remove the harness to feed my infant." 3."I need to remove the harness to change the diaper." 4."My infant needs to remain in the harness at all times."

1."I can remove the harness to bathe my infant."

The nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching? 1."I should place a steam vaporizer in my child's room." 2."I will take my child out into the cool, humid night air." 3."I could place a cool-mist humidifier in my child's room." 4."I will have my child inhale the steam from warm running water."

1."I should place a steam vaporizer in my child's room."

The nurse is reinforcing instructions to the mother of a child who has a plaster cast applied to the left arm. Which statement by the mother indicates a need for further teaching? 1."I will have to use a heat lamp to help the cast dry." 2."I need to cover the cast with plastic during baths or showers." 3."I should call the primary health care provider if the cast feels warm or hot or has an unusual smell or odor." 4."I will keep small toys and sharp objects away from the cast and be sure that my child does not put anything inside the cast."

1."I will have to use a heat lamp to help the cast dry."

The nurse is performing an admission assessment on a child with a seizure disorder. The nurse is interviewing the child's parents to determine their adjustment to caring for their child who has a chronic illness. Which statement, if made by the parents, would indicate a need for further teaching? 1."Our child sleeps in our bedroom at night." 2."We worry about injuries when our child has a seizure." 3."Our child is involved in a swim program with neighbors and friends." 4."Our babysitter just completed cardiopulmonary resuscitation training."

1."Our child sleeps in our bedroom at night."

A nursing student is assisting a school nurse in performing scoliosis screening on the children in the school. The nurse assesses the student's preparation for conducting the screening. The nurse determines that the student demonstrates understanding of the disorder when the student states that scoliosis is characterized by which finding? 1.Abnormal lateral curvature of the spine 2.Abnormal anterior curvature of the lumbar spine 3.Excessive posterior curvature of the thoracic spine 4.Abnormal curvature of the spine caused by inflammation

1.Abnormal lateral curvature of the spine

The nurse is providing care to a child admitted for acute otitis media. What is the nurse's priorityconcern for this child? 1.Acute pain 2.Problems with skin integrity 3.Risk for interrupted breathing patterns 4.Mucous membrane dryness and cracking

1.Acute pain

A child is admitted to the hospital with a diagnosis of acute bacterial meningitis. In reviewing the primary health care provider's prescriptions, which would the nurse question as appropriate for a child with this diagnosis? 1.Administer an oral antibiotic. 2.Maintain strict intake and output. 3.Draw blood for a culture and sensitivity. 4.Place the child on droplet precautions in a private room.

1.Administer an oral antibiotic.

A 4-year-old child is diagnosed with otitis media. The mother asks the nurse about the causes of this illness. Which risk factors should the nurse include in response to this mother? Select all that apply. 1.Bottle-feeding 2.Household smoking 3.A history of urinary tract infections 4.Exposure to illness in other children 5.Congenital conditions such as cleft palate

1.Bottle-feeding 2.Household smoking 4.Exposure to illness in other children 5.Congenital conditions such as cleft palate

A school-age child with Down's syndrome is brought to the ambulatory care center by the mother. The child has bruising all over the body. To work most effectively with this child, the nurse first addresses which complication associated with Down's syndrome? 1.Children with Down's syndrome are more likely to develop acute leukemia than the average child. 2.Children with Down's syndrome fall down easily as a result of hyperflexibility and muscle weakness. 3.Children with Down's syndrome are at risk for physical abuse because of their low intellectual functioning. 4.Children with Down's syndrome scratch themselves a lot because of dry, cracked, and frequently fissuring skin.

1.Children with Down's syndrome are more likely to develop acute leukemia than the average child.

A child who sustained a fractured ankle has a short leg cast applied, and the nurse provides home care instructions to the mother. The mother returns to the emergency department 16 hours later because the child is complaining of severe pain. The nurse notes that the child's toes are cool, pale, and puffy, and that the child is agitated and crying loudly. The mother states, "I gave her the pain medication you sent with us just like you told us, and I have kept her foot up on two pillows since we left, except when she gets up to go to the bathroom. I don't understand why she hurts so much. Do something!" What is the most likely clinical situation that occurred? 1.Compartment syndrome 2.Inadequate pain medication 3.Skin breakdown around the cast edges 4.Noncompliance with home care instructions

1.Compartment syndrome

The nurse is assigned to care for a child with a brain injury who has a temporal lobe herniation and increasing intracranial pressure. Which signs should the nurse identify as indicative of this type of injury? Select all that apply. 1.Flaccid paralysis 2.Pupil response to light 3.Ipsilateral pupil dilation 4.Compression of the sixth cranial nerve 5.Shifting of the temporal lobe laterally across the tentorial notch

1.Flaccid paralysis 3.Ipsilateral pupil dilation 5.Shifting of the temporal lobe laterally across the tentorial notch

A neighborhood nurse is attending a soccer game at a local middle school. One of the students falls off the bleachers and sustains an injury to the left arm. The nurse quickly attends to the child and suspects that the child's arm may be broken. Which nursing action would be the prioritybefore transferring the child to the hospital emergency department? 1.Immobilize the arm. 2.Ask for the name of the child's pediatrician or family primary health care provider so that he or she can be contacted. 3.Have someone call the radiology department of the local hospital to let staff know that the child will be arriving. 4.Tell the child that the arm probably is fractured but not to worry because permanent damage to the arm will not occur.

1.Immobilize the arm.

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? 1.Limited range of motion in the affected hip 2.An apparent lengthened femur on the affected side 3.Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4.Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

1.Limited range of motion in the affected hip

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1.Meningitis 2.Spinal cord injury 3.Intracranial bleeding 4.Decreased cerebral blood flow

1.Meningitis

The nurse creates a plan of care for a child with Reye's syndrome. Which priority intervention should the nurse include in the plan of care? 1.Monitor for signs of increased intracranial pressure. 2.Immediately check the presence of protein in the urine. 3.Reassure the parents hyperglycemia is a common symptom. 4.Teach the parents signs and symptoms of a bacterial infection.

1.Monitor for signs of increased intracranial pressure.

The nurse is reviewing a chart for a child with a head injury. The nurse notes that the level of consciousness has been documented as obtunded. Which finding should the nurse expect to note on assessment of the child? 1.Not easily arousable and limited interaction 2.Loss of the ability to think clearly and rapidly 3.Loss of the ability to recognize place or person 4.Awake, alert, interacting with the environment

1.Not easily arousable and limited interaction

A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the primary health care provider, should the nurse question? 1.Obtain a throat culture. 2.Obtain axillary temperatures. 3.Administer humidified oxygen. 4.Administer acetaminophen for fever.

1.Obtain a throat culture.

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply. 1.Place the infant in a private room. 2.Ensure that the infant's head is in a flexed position. 3.Wear a mask, gown, and gloves when in contact with the infant. 4.Place the infant in a tent that delivers warm humidified air. 5.Position the infant on the side, with the head lower than the chest. 6.Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

1.Place the infant in a private room 3.Wear a mask, gown, and gloves when in contact with the infant. 6.Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

A child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? Select all that apply. 1.Provide a soft diet. 2.Position the child on the left side. 3.Administer an antihistamine twice daily. 4.Irrigate the right ear with normal saline every 8 hours. 5.Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

1.Provide a soft diet. 5.Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6.Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

A girl who is playing in the playroom experiences a tonic-clonic seizure. During the seizure, the nurse should take which actions? Select all that apply. 1.Remain calm. 2.Time the seizure. 3.Ease the child to the floor. 4.Loosen restrictive clothing. 5.Keep the child on her back.

1.Remain calm. 2.Time the seizure. 3.Ease the child to the floor. 4.Loosen restrictive clothing.

The nurse is reviewing the primary health care provider's prescriptions for a child following a tonsillectomy. Which prescription should the nurse question? 1.Suction the child frequently if coughing. 2.Discharge to home when alert and tolerating fluids. 3.Provide clear, cool liquids to the child when awake. 4.Instruct the parent not to give the child milk products.

1.Suction the child frequently if coughing.

A child is brought to the emergency department, and diagnostic x-rays of the child reveal that a fracture is present. The mother states that the child was rollerblading and attempted to break a fall with an outstretched arm. A plaster of Paris cast is applied to the arm. Which instructions should the nurse provide the mother? Select all that apply. 1.The cast will mold to the body part. 2.The cast should be dry in about 6 hours. 3.Keep the cast elevated on pillows for the first day. 4.Make sure that the child can frequently wiggle the fingers. 5.The cast is water-resistant, so the child is able to take a bath or a shower. 6.The cast needs to be kept dry because it will begin to disintegrate when wet.

1.The cast will mold to the body part. 3.Keep the cast elevated on pillows for the first day. 4.Make sure that the child can frequently wiggle the fingers. 6.The cast needs to be kept dry because it will begin to disintegrate when wet.

Cerebral palsy (CP) is suspected in a child, and the parents ask the nurse about the potential warning signs of CP. The nurse should provide which information? Select all that apply. 1.The infant's arms or legs are stiff or rigid. 2.A high risk factor for CP is very low birth weight. 3.By 8 months of age, the infant can sit without support. 4.The infant has strong head control but a limp body posture. 5.The infant has feeding difficulties, such as poor sucking and swallowing. 6.If the infant is able to crawl, only one side is used to propel himself or herself.

1.The infant's arms or legs are stiff or rigid. 2.A high risk factor for CP is very low birth weight. 5.The infant has feeding difficulties, such as poor sucking and swallowing. 6.If the infant is able to crawl, only one side is used to propel himself or herself.

Which nursing actions apply to the care of a child who is having a seizure? Select all that apply. 1.Time the seizure. 2.Restrain the child. 3.Stay with the child. 4.Insert an oral airway. 5.Loosen clothing around the child's neck. 6.Place the child in a lateral side-lying position.

1.Time the seizure. 3.Stay with the child. 5.Loosen clothing around the child's neck. 6.Place the child in a lateral side-lying position.

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1.Time the seizure. 2.Restrain the child. 3.Stay with the child. 4.Place the child in a prone position. 5.Move furniture away from the child. 6.Insert a padded tongue blade in the child's mouth.

1.Time the seizure. 3.Stay with the child. 5.Move furniture away from the child.

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? Select all that apply. 1.Use the fingertips to lift the cast while it is drying. 2.Keep small toys and sharp objects away from the cast. 3.Use a padded ruler or another padded object to scratch the skin under the cast if it itches. 4.Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold. 5.Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. 6.Contact the primary health care provider (PHCP) if the child complains of numbness or tingling in the extremity.

2.Keep small toys and sharp objects away from the cast. 5.Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. 6.Contact the primary health care provider (PHCP) if the child complains of numbness or tingling in the extremity.

The clinic nurse is assessing a child suspected of having juvenile rheumatoid arthritis (JRA). Which assessment findings should the nurse expect to note in a child who has been diagnosed with JRA? Select all that apply. 1.Hematuria 2.Morning stiffness 3.Painful, stiff, and swollen joints 4.Limited range of motion of the joints 5.Stiffness that develops later in the day 6.History of late-afternoon temperature

2.Morning stiffness 3.Painful, stiff, and swollen joints 4.Limited range of motion of the joints 6.History of late-afternoon temperature

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriatenursing action? 1.Initiate strict enteric precautions. 2.Move the infant to a private room. 3.Leave the infant in the present room, because RSV is not contagious. 4.Inform the staff that using standard precautions is all that is necessary when caring for the child.

2.Move the infant to a private room.

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriatenursing action? 1.Initiate strict enteric precautions. 2.Move the infant to a room with another child with RSV. 3.Leave the infant in the present room because RSV is not contagious. 4.Inform the staff that they must wear a mask, gloves, and a gown when caring for the child.

2.Move the infant to a room with another child with RSV.

A nursing student is conducting a clinical conference about measures that assist in preventing sudden infant death syndrome. The student plans to write on a handout that it is bestto place an infant in which position for sleep? 1.On the back, or prone 2.On the back, or supine 3.On the stomach, or prone 4.On the stomach, or supine

2.On the back, or supine

The primary health care provider prescribes patching for a child with strabismus of the right eye, and the nurse instructs the mother regarding this procedure. What should the nurse include in the instructions? 1.Place the patch on both eyes. 2.Place the patch on the left eye. 3.Place the patch on the right eye. 4.Alternate the patch from the right to the left eye hourly.

2.Place the patch on the left eye.

The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is mostsignificant to review? 1.Creatinine level 2.Prothrombin time 3.Sedimentation rate 4.Blood urea nitrogen level

2.Prothrombin time

Russell's traction is prescribed for a child with a lower leg fracture. The mother of the child asks the nurse about the purpose of the traction. The nurse explains to the mother that which is the primary action of this type of traction? 1.Relieves the child's pain 2.Reduces or realigns a fracture site 3.Provides a form of restraint for the child 4.Keeps the child from moving around in bed

2.Reduces or realigns a fracture site

The nurse is caring for a child who fractured the ulna bone and had a cast applied 24 hours ago. The child tells the nurse that the arm feels like it is falling asleep. Which nursing action is appropriate? 1.Encourage the child to keep the arm elevated. 2.Report the findings to the primary health care provider. 3.Document the findings and reassess the arm in 4 hours. 4.Tell the child that this is normal while the cast is drying.

2.Report the findings to the primary health care provider.

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the prioritynursing intervention in the preoperative period? 1.Test the urine for protein. 2.Reposition the infant frequently. 3.Provide a stimulating environment. 4.Assess blood pressure every 15 minutes.

2.Reposition the infant frequently.

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? 1.Supine 2.Side-lying 3.High-Fowler's 4.Trendelenburg's

2.Side-lying

The nurse is caring for a child following a tonsillectomy. The nurse should reposition the child on return from the operating room if the child is in which position? 1.Prone 2.Supine 3.Left side-lying 4.Right side-lying

2.Supine

A mother arrives at the clinic with her 3-year-old child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days and that this morning the child began to wheeze. Viral pneumonia is diagnosed. Based on the diagnosis, the nurse anticipates that which will be a component of the treatment plan? 1.Oral antibiotics 2.Supportive treatment 3.Hospitalization and IV antibiotics 4.Intravenous (IV) fluid administration

2.Supportive treatment

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation made by the nurse indicates the presence of this condition? 1.The child has difficulty hearing. 2.The child consistently tilts the head to see. 3.The child does not respond when spoken to. 4.The child consistently turns the head to hear.

2.The child consistently tilts the head to see.

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? 1.The child exhibits nasal flaring and bradycardia. 2.The child is leaning forward, with the chin thrust out. 3.The child has a low-grade fever and complains of a sore throat. 4.The child is leaning backward, supporting herself or himself with the hands and arms.

2.The child is leaning forward, with the chin thrust out.

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the pediatrician did not prescribe antibiotics. Which response should the nurse make? 1."The child may be allergic to antibiotics." 2."The child is too young to receive antibiotics." 3."Antibiotics are not indicated unless a bacterial infection is present." 4."The child still has the maternal antibodies from birth and does not need antibiotics."

3."Antibiotics are not indicated unless a bacterial infection is present."

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1."Avoid all exercise during painful periods." 2."Range-of-motion exercises must be performed every day." 3."Have the child perform simple isometric exercises during this time." 4."Administer additional pain medication before performing range-of-motion exercises."

3."Have the child perform simple isometric exercises during this time."

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1."Avoid all exercise during painful periods." 2."Range-of-motion exercises must be performed every day." 3."Have the child perform simple isometric exercises during this time." 4."Administer additional pain medication before performing range-of-motion exercises."

3."Have the child perform simple isometric exercises during this time."

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by a parent indicates a need for further teaching? 1."I cannot place powder under the brace." 2."I need to place a soft shirt on my child under the brace." 3."I need to be sure to apply lotion on the skin under the brace." 4."I need to encourage my child to perform prescribed exercises."

3."I need to be sure to apply lotion on the skin under the brace."

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1."Treatment needs to be started as soon as possible." 2."I realize my infant will require follow-up care until fully grown." 3."I need to bring my infant back to the clinic in 1 month for a new cast." 4."I need to come to the clinic every week with my infant for the casting."

3."I need to bring my infant back to the clinic in 1 month for a new cast."

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? 1."I will encourage my child to perform prescribed exercises." 2."I will have my child wear soft fabric clothing under the brace." 3."I should apply lotion under the brace to prevent skin breakdown." 4."I should avoid the use of powder because it will cake under the brace."

3."I should apply lotion under the brace to prevent skin breakdown."

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if stated by the mother, indicates a need for further teaching? 1."I need to wash my hands frequently." 2."I need to clean the eye as prescribed." 3."It is okay to share towels and washcloths." 4."I need to give the eye drops as prescribed."

3."It is okay to share towels and washcloths."

The nurse provides discharge instructions to the mother of a child following a myringotomy with insertion of tympanoplasty tubes. Which statement by the mother indicates the need for further teaching? 1."My child should not swim or dive in deep water." 2."I need to prevent my child from blowing the nose." 3."My child can swim in the lake or pool as long as the water is not too deep." 4."I will put Vaseline on cotton balls and place them in my child's ears before a bath."

3."My child can swim in the lake or pool as long as the water is not too deep."

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? 1.An infectious disease of the central nervous system 2.An inflammation of the brain as a result of a viral illness 3.A chronic disability characterized by impaired muscle movement and posture 4.A congenital condition that results in moderate to severe intellectual disabilities

3.A chronic disability characterized by impaired muscle movement and posture

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. Which assessment finding should the nurse expect if this type of posturing is present? 1.Flexion of the upper extremities and extension of the lower extremities. 2.Unilateral or bilateral postural change in which the extremities are rigid. 3.Abnormal extension of the upper and lower extremities with some internal rotation. 4.Arms are adducted with fists clenched, and the legs are flaccid with external rotation.

3.Abnormal extension of the upper and lower extremities with some internal rotation.

The nursing student is writing a plan of care for a child who presents with an acute head injury. The nursing instructor reviews the plan of care and praises the student for identifying which assessment as a priority? 1.Inspecting the scalp 2.Pupillary assessment 3.Airway and breathing 4.Palpating the child's head

3.Airway and breathing

The nurse is creating a plan of care for a newborn infant with spina bifida (myelomeningocele type). The nurse includes assessment measures in the plan to monitor for increased intracranial pressure. Which assessment technique should be performed that will best detect the presence of an increase in intracranial pressure? 1.Check urine for specific gravity. 2.Monitor for signs of dehydration. 3.Assess anterior fontanel for bulging. 4.Assess blood pressure for signs of hypotension.

3.Assess anterior fontanel for bulging.

The nurse is providing instructions to the parents of an infant with a ventriculoperitoneal shunt. The nurse should include which instruction? 1.Expect an increased urine output from the shunt. 2.Notify the primary health care provider if the infant is fussy. 3.Call the primary health care provider if the infant has a high-pitched cry. 4.Position the infant on the side of the shunt when the infant is put to bed.

3.Call the primary health care provider if the infant has a high-pitched cry.

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1.Clear CSF, decreased pressure, and elevated protein level 2.Clear CSF, elevated protein, and decreased glucose levels 3.Cloudy CSF, elevated protein, and decreased glucose levels 4.Cloudy CSF, decreased protein, and decreased glucose levels

3.Cloudy CSF, elevated protein, and decreased glucose levels

The nurse receives a telephone call from the admissions office and is told that a child with acute bacterial meningitis will be admitted to the pediatric unit. The nurse prepares for the child's arrival and plans to implement which type of precautions? 1.Enteric 2.Contact 3.Droplet 4.Neutropenic

3.Droplet

The nurse assists a primary health care provider in performing a lumbar puncture on a 3-year-old child with leukemia in whom central nervous system disease is suspected. In which position will the nurse place the child during this procedure? 1.Lithotomy position 2.Modified Sims' position 3.Lateral recumbent position with the knees flexed and chin resting on the chest 4.Prone with knees flexed to the abdomen and head bent with chin resting on the chest

3.Lateral recumbent position with the knees flexed and chin resting on the chest

The nurse is assessing a client with fragile X syndrome. The nurse anticipates noting which physical assessment finding? 1.Low, straight palate 2.Short, narrow protruding ears 3.Long, narrow face with a prominent jaw 4.Short, rounded face with an indiscernible jaw

3.Long, narrow face with a prominent jaw

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the pediatrician's prescriptions and should contact the pediatrician to question which prescription? 1.Obtain daily weight. 2.Provide clear liquid intake. 3.Nasotracheal suction as needed. 4.Maintain a patent intravenous line.

3.Nasotracheal suction as needed.

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the primary health care provider's (PHCP's) prescriptions and should contact the PHCP to question which prescription? 1.Obtain daily weight. 2.Provide clear liquid intake. 3.Nasotracheal suction as needed. 4.Maintain a patent intravenous line.

3.Nasotracheal suction as needed.

A 10-year-old child complains of ear pain that is aggravated by palpation of the auricle. A foul-smelling, tenacious yellow discharge is noted in the ear canal, and the child is diagnosed with acute otitis externa. In providing information to the child and parent, the nurse emphasizes which information? 1.Dizziness is common with this disorder. 2.Cotton-tipped applicators should be used to clean the ears. 3.Nothing smaller than the child's elbow should be placed in the ear. 4.Biannual ear testing must be done by a special primary health care provider.

3.Nothing smaller than the child's elbow should be placed in the ear.

The nurse is monitoring an infant for signs of increased intracranial pressure. On assessment of the fontanelles, the nurse notes that the anterior fontanelle bulges when the infant is sleeping. Based on this finding, which is the prioritynursing action? 1.Increase oral fluids. 2.Document the finding. 3.Notify the primary health care provider. 4.Place the infant supine in a side-lying position.

3.Notify the primary health care provider.

The nurse is assisting a primary health care provider (PHCP) examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the PHCP to assess? 1.Babinski's sign 2.The Moro reflex 3.Ortolani's maneuver 4.The palmar-plantar grasp

3.Ortolani's maneuver

Breathing exercises and postural drainage are prescribed for a hospitalized child with cystic fibrosis. What instruction should the nurse include in the client's teaching plan? 1.Schedule the procedures so they are 4 hours apart. 2.Perform the breathing exercises and then the postural drainage. 3.Perform the postural drainage first and then the breathing exercises. 4.Perform postural drainage in the morning and breathing exercises in the evening.

3.Perform the postural drainage first and then the breathing exercises

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1.Flaccid paralysis of all extremities 2.Adduction of the arms at the shoulders 3.Rigid extension and pronation of the arms and legs 4.Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3.Rigid extension and pronation of the arms and legs

On assessment during a well-baby visit, the nurse notes that a 6-month-old infant has crossed eyes. Which interpretation would the nurse make based on this finding? 1.The condition will resolve without treatment. 2.The condition is normal up to the age of 2 years. 3.Surgical intervention may be necessary to realign weak eye muscles. 4.Once the child begins to read, eye muscles strengthen and the condition will resolve.

3.Surgical intervention may be necessary to realign weak eye muscles.

During a clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF? 1.CF causes mucus that is formed to be abnormally thick. 2.It is a condition transmitted as an autosomal recessive trait. 3.This disease causes dilation of the passageways of many organs. 4.It is a chronic multisystem disorder affecting the exocrine glands.

3.This disease causes dilation of the passageways of many organs.

The nurse enters a child's room and discovers that the child is having a seizure. Which actions should the nurse take? Select all that apply. 1.Call a code. 2.Run to get the crash cart. 3.Turn the child on her side. 4.Loosen any restrictive clothing. 5.Check the child's respiratory status. 6.Place an airway into the child's mouth.

3.Turn the child on her side. 4.Loosen any restrictive clothing. 5.Check the child's respiratory status.

The nurse is implementing a teaching plan for a 4-month-old child who has been diagnosed with developmental dysplasia of the hip. The child will be placed in the Pavlik harness. Which statement by the family indicates that they understand the care of their child while placed in the Pavlik harness? 1."I know that the harness must be worn continuously." 2."I will bring my child back to the orthopedic office in a month or two so the straps can be checked." 3."I realize that I will also need to put two diapers on my child so that the harness will stay dry and does not get soiled." 4."I will watch for any redness or skin irritation where the straps are applied and call the primary health care provider for red areas."

4."I will watch for any redness or skin irritation where the straps are applied and call the primary health care provider for red areas."

The nurse is providing home care instructions to the mother of a 9-year-old child diagnosed with bacterial conjunctivitis. Topical antimicrobial therapy is prescribed for the child. Which statement by the mother indicates the teaching has been effective? 1."My child cannot return to school until seen by the pediatrician in 1 month." 2."My child can return to school immediately because my child is not contagious." 3."My child needs to stay at home from school for at least 3 weeks to complete the entire prescription of eyedrops." 4."My child will need to stay home from school until my child has received the eye medication for at least 24 to 48 hours."

4."My child will need to stay home from school until my child has received the eye medication for at least 24 to 48 hours."

The nurse caring for a child with suspected absence seizures is collecting data from the parents on how to manage the disorder. Which statement, if made by the parents, indicates the presence of signs congruent with this disorder? 1."My child does well with group activities." 2."My child leads the other children during group play." 3."My child is doing really well in school and has high grades." 4."My child's teacher mentioned that he seems to daydream a lot."

4."My child's teacher mentioned that he seems to daydream a lot."

An adolescent client is diagnosed with conjunctivitis, and the nurse provides information to the client about the use of contact lenses. Which client statement indicates the need for further information? 1."I should obtain new contact lenses." 2."I should not wear my contact lenses." 3."My old contact lenses should be discarded." 4."My contact lenses can be worn if they are cleaned as directed."

4."My contact lenses can be worn if they are cleaned as directed."

The nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) needs to be placed at the child's bedside? 1.Emergency cart 2.Tracheotomy set 3.Padded tongue blade 4.Suctioning equipment and oxygen

4.Suctioning equipment and oxygen

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1."The immunization schedule will need to be altered." 2."The child should not receive any hepatitis vaccines." 3."The child will receive all of the immunizations except for the polio series." 4."The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

4."The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures? 1."The diet needs to be low in fat." 2."The diet needs to be low in protein." 3."The diet needs to be low in calories." 4."The diet needs to be high in calories."

4."The diet needs to be high in calories."

The mother arrives at a well-baby clinic with her 1-month-old infant. She expresses concern because one of the infant's eyes appears to be crossed. What is the nurse's best response? 1."The infant will probably need surgery." 2."This condition is probably permanent." 3."It requires monitoring because the other eye may do the same thing." 4."This is normal in the young infant but should not be present after the age of about 4 months."

4."This is normal in the young infant but should not be present after the age of about 4 months."

The mother of a child who has undergone a myringotomy, with insertion of tympanoplasty tubes, telephones and tells the nurse that the tubes have fallen out. Which is the appropriate response to the mother? 1."Bring the child to the nearest emergency department." 2."Replace the tubes immediately so that the opening does not close." 3."Place the tubes in hydrogen peroxide for 1 hour before replacing them in the child's ears." 4."This is not an emergency. I will speak to the primary health care provider and call you right back."

4."This is not an emergency. I will speak to the primary health care provider and call you right back."

The nurse notes that an infant with the diagnosis of hydrocephalus has a head that is heavier than that of the average infant. The nurse should determine that special safety precautions are needed when moving the infant with hydrocephalus. Which statement should the nurse plan to include in the discharge teaching with the parents to reflect this safety need? 1."Feed your infant in a side-lying position." 2."Place a helmet on your infant when in bed." 3."Hyperextend your infant's head with a rolled blanket under the neck area." 4."When picking up your infant, support the infant's neck and head with the open palm of your hand."

4."When picking up your infant, support the infant's neck and head with the open palm of your hand."

The nurse is assisting a primary health care provider (PHCP) during the examination of an infant with developmental hip dysplasia. The PHCP performs the Ortolani maneuver. The nurse determines that the infant exhibits a positive response to this maneuver if which finding is noted? 1.A shrill cry from the infant 2.Asymmetry of the affected hip 3.Reduced range of motion in the right and left hip 4.A palpable click during abduction of the affected hip

4.A palpable click during abduction of the affected hip

An adolescent is seen in the emergency department for a suspected sprain of the ankle. X-rays have been obtained, and a fracture has been ruled out. Which instruction should the nurse provide to the adolescent regarding home care for treatment of the sprain? 1.Elevate the extremity, and maintain strict bed rest for a period of 7 days. 2.Immobilize the extremity, and maintain the extremity in a dependent position. 3.Apply heat to the injured area every 4 hours for the first 48 hours, and then begin to apply ice. 4.Apply ice to the injured area for a period of 30 minutes every 4 to 6 hours for the first 24 to 48 hours

4.Apply ice to the injured area for a period of 30 minutes every 4 to 6 hours for the first 24 to 48 hours

A school nurse is teaching parents about emergency treatment for epistaxis. Which bestaction should the nurse take to assist the parents in understanding the emergency treatment? 1.Tell the parents the steps to take when a nosebleed occurs. 2.Show the parents a video of the steps to take if a nosebleed occurs. 3.Give the parents a brochure about the emergency treatment for nosebleeds. 4.Ask the parents to demonstrate, on a mannequin, where to apply continuous pressure if a nosebleed occurs.

4.Ask the parents to demonstrate, on a mannequin, where to apply continuous pressure if a nosebleed occurs.

The nurse is reviewing the health care record of an infant suspected of having unilateral hip dysplasia. Which assessment finding should the nurse expect to note documented in the infant's record regarding this condition? 1.Full range of motion in the affected hip 2.An apparent short femur on the unaffected side 3.Asymmetrical adduction of the affected hip when placed supine, with the knees and hips flexed 4.Asymmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table

4.Asymmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table

A new parent expresses concern to the nurse regarding sudden infant death syndrome (SIDS). She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant? 1.Side or prone 2.Back or prone 3.Stomach with the face turned 4.Back rather than on the stomach

4.Back rather than on the stomach

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP? 1.Nausea 2.Irritability 3.Headache 4.Bradycardia

4.Bradycardia

The nurse caring for a child who has sustained a head injury in an automobile crash is monitoring the child for signs of increased intracranial pressure (ICP). For which early sign of increased ICP should the nurse monitor? 1.Increased systolic blood pressure 2.Abnormal posturing of extremities 3.Significant widening pulse pressure 4.Changes in level of consciousness

4.Changes in level of consciousness

A 9-year-old child fractures the left tibia along an epiphyseal line while using a skateboard. What is the nurse's priority concern during future growth? 1.Infection 2.Paralysis 3.Pressure ulcer 4.Uneven leg growth

4.Uneven leg growth

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1.Ensure that all ropes are outside the pulleys. 2.Ensure that the weights are resting lightly on the floor. 3.Restrict diversional and play activities until the child is out of traction. 4.Check the primary health care provider's (PHCP's) prescriptions for the amount of weight to be applied.

4.Check the primary health care provider's (PHCP's) prescriptions for the amount of weight to be applied.

The nurse is providing home care instructions to the mother of a child who is recovering from Reye's syndrome. Which instruction should the nurse provide to the mother? 1.Increase stimuli in the home environment. 2.Avoid daytime naps so that the child will sleep at night. 3.Give the child frequent small meals, if vomiting occurs. 4.Check the skin and eyes every day for a yellow discoloration.

4.Check the skin and eyes every day for a yellow discoloration.

The nurse is assessing a child with increased intracranial pressure. On assessment, the nurse notes that the child is now exhibiting decerebrate posturing. The nurse should modify the client's plan of care based on which interpretation of the client's change? 1.An insignificant finding 2.An improvement in condition 3.Decreasing intracranial pressure 4.Deteriorating neurological function

4.Deteriorating neurological function

The pediatric nurse educator provides a teaching session to the nursing staff regarding juvenile idiopathic arthritis (JIA). Which action by a nursing staff member in the care of a child with JIA indicates a need for further education? 1.Assesses for joint stiffness in the child 2.Encourages performance of isometric exercises 3.Administers nonsteroidal anti-inflammatory medication 4.Emphasizes the importance of rising quickly in the mornings

4.Emphasizes the importance of rising quickly in the mornings

The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? 1.Increase the dose of ibuprofen. 2.Increase the frequency of ibuprofen. 3.Encourage the child to lie on the left side. 4.Encourage the child to lie on the right side.

4.Encourage the child to lie on the right side.

The nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. In which position should the nurse place the infant? 1.Supine, side-lying position with the arms elevated 2.Prone with the head of the bed elevated 15 degrees 3.Trendelenburg's, at a 60-degree angle with pelvis higher than head 4.Head and chest at a 30-degree angle with the neck slightly extended

4.Head and chest at a 30-degree angle with the neck slightly extended

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying, and trying to climb out of the tent. Which is the most appropriate nursing action? 1.Tell the mother that the child must stay in the tent. 2.Place a toy in the tent to make the child feel more comfortable. 3.Call the pediatrician and obtain a prescription for a mild sedative. 4.Let the mother hold the child and direct the cool mist over the child's face.

4.Let the mother hold the child and direct the cool mist over the child's face.

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1.Maintain enteric precautions. 2.Maintain neutropenic precautions. 3.No precautions are required as long as antibiotics have been started. 4.Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

4.Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1.Maintain enteric precautions. 2.Maintain neutropenic precautions. 3.No precautions are required as long as antibiotics have been started. 4.Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

4.Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

The nurse is caring for a child diagnosed with Down's syndrome. Which explanation of this syndrome should the nurse provide the parents? 1.Subaverage intellectual functioning with a congenial nature 2.Above-average intellectual functioning with deficits in adaptive behavior 3.Average intellectual functioning and the absence of deficits in adaptive behavior 4.Moderate to severe intellectual disability and linkage to an extra chromosome 21, group G

4.Moderate to severe intellectual disability and linkage to an extra chromosome 21, group G

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1.Administer an analgesic. 2.Release the skin traction. 3.Apply ice to the extremity. 4.Notify the primary health care provider (PHCP).

4.Notify the primary health care provider (PHCP).

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? 1.Administer an antiemetic. 2.Increase the intravenous fluids. 3.Place the child in a Sims' position. 4.Notify the primary health care provider (PHCP).

4.Notify the primary health care provider (PHCP).

The community health nurse is providing information to parents of children in a local school regarding the signs of meningitis. The nurse informs the parents that the classic signs/symptoms of meningitis include which findings? 1.Nausea, delirium, and fever 2.Severe headache and back pain 3.Photophobia, fever, and confusion 4.Severe headache, fever, and a change in the level of consciousness

4.Severe headache, fever, and a change in the level of consciousness

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1.Emergency cart 2.Tracheotomy set 3.Padded tongue blade 4.Suctioning equipment and oxygen

4.Suctioning equipment and oxygen

The nurse in the health care clinic receives a telephone call from the mother of a child who reports that an insect has somehow flown into the child's ear. The mother reports that the child is complaining of a buzzing sound in the ear. Which priority instruction should the nurse provide to the mother? 1.Report to the clinic immediately. 2.Irrigate the ear with diluted alcohol. 3.Use tweezers to try to remove the insect. 4.Use a flashlight to coax the insect out of the ear.

4.Use a flashlight to coax the insect out of the ear.

The nurse in the ambulatory care unit is caring for a child after a tonsillectomy. The child's mother tells the nurse that the child is complaining of a dry throat and would like something to relieve the dryness. Which item should the nurse provide for the mother to give to the child? 1.Iced tea 2.A glass of milk 3.Cool cherry Kool-Aid 4.Yellow non-citrus Jell-O

4.Yellow non-citrus Jell-O