Peds Exam 3 Practice Questions

The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis: There are strict diet and fluid restrictions. The child can live a more normal lifestyle. Therapy is only 3 to 4 days per week. The child must go into a facility to get peritoneal dialysis.

The child can live a more normal lifestyle. (The child can live a more normal lifestyle with peritoneal dialysis. This is a 7-day-a-week procedure, but there are less diet restrictions and more freedom with this type of procedure. Peritoneal dialysis can be performed at home.)

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history? The child had a congenital heart defect. The child recently had an ear infection. The child has a sibling with the same diagnosis. The child is being treated for asthma.

The child recently had an ear infection.

The nurse is assessing an 8-year-old boy who is performing academically at a second-grade level. The mother reports that the boy states feeling weak and tired and has had a weight increase of 6 pounds (13.2 kg) in 3 months. Which additional data would fit with a possible diagnosis of hypothyroidism? Oral cavity assessment shows two of the 6-year molars. The child states that the exam room is cold. The child has a faint rash on the trunk of the body. The mother reports that the boy is always thirsty.

The child states that the exam room is cold.

Navi does not seem concerned about the possibility she could contract gonorrhea again. What additional health teaching does she need to better understand how this disease is spread? The microorganism of gonorrhea can be spread via anal, oral, and vaginal intercourse. It is possible for the gonorrhea organism to be spread by anal/penile contact. The low pH of saliva prevents this from being spread by oral/penile contact. Gonorrhea is a virus that can be treated effectively if diagnosed early.

The microorganism of gonorrhea can be spread via anal, oral, and vaginal intercourse.

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the most accurate regarding urinary tract infection seen in children? Males between the ages of 10 to 12 years of age commonly get UTIs. The most common age for UTIs in children is 2 to 6 years of age. Urinary tract infections are rarely seen after toilet training. Girls who have gone through puberty most commonly get UTIs.

The most common age for UTIs in children is 2 to 6 years of age.

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? The nurse will administer oxygen. The nurse will administer antibiotics. The nurse will monitor caloric intake. The nurse will encourage bed rest.

The nurse will administer oxygen

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 a white or red "strawberry" appearance Fever blisters on the lips There is pain along the jawline just in front of the ear lobe Vesicles that become purulent, ooze, and form honey-colored crusts

The tongue has a white or red "strawberry" appearance

A 6-year-old boy has a moon-faced, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child? Tumor of the pancreas Tumor of the parathyroid Tumor of the adrenal cortex Tumor of the thyroid

Tumor of the adrenal cortex

An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have? Inflammatory bowel disorder Type 2 diabetes mellitus Gastrointestinal reflux Type 1 diabetes mellitus

Type 2 diabetes mellitus

After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause? Fungi Bacteria Viruses Parasites

Viruses

What finding would the nurse expect to assess in a child with hypothyroidism? Weight gain Smooth velvety skin Heat intolerance Nervousness

Weight gain

The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding? Irritation of labia and vaginal opening Thin gray vaginal discharge with fishy odor White cottage cheese-like discharge Foul yellow-gray discharge

White cottage cheese-like discharge

Candidal vaginal infections can occur as an opportunistic infection when adolescents are prescribed antibiotics. A nurse would refer an adolescent for medical treatment of this problem if she reported which of the following? Many yellow pinpoint vaginal lesions Green-tinged pruritic vaginal walls White, cheese-like vaginal discharge Vaginal atrophy with final scarring

White, cheese-like vaginal discharge

A nurse is providing care to a child with HIV who is prescribed therapy with a nucleoside reverse transcriptase inhibitor. What would the nurse expect to administer? Ritonavir Zidovudine Efavirenz Nevirapine

Zidovudine

The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication? Zidovudine Lopinavir Ritonavir Nevirapine

Zidovudine

A nurse is educating the family of a small child with phenylketonuria about meal choices. Which meal choice by the parents indicates to the nurse that they understand the dietary management of this disease? a hamburger and a diet pop sweetened with aspartame a bowl of dry cereal with strawberries and apple juice a steak, mashed potatoes, and orange juice a milkshake and a grilled cheese sandwich

a bowl of dry cereal with strawberries and apple juice

The nurse has received the morning report on a group of pediatric clients. Which pediatric client will the nurse see first? a child reporting dark brown urine and a fine sandpaper rash a child exposed to Zika virus reporting headache, fever, and arthralgia a child experiencing a rash with honey-colored crusts on the mouth a child with a positive monospot test reporting pharyngitis

a child reporting dark brown urine and a fine sandpaper rash (The child with a fine sandpaper rash and dark brown urine may be experiencing renal complications secondary to scarlet fever (group A streptococcus), and will be seen first. Treatment with penicillin or another antibiotic is needed. Pharyngitis is an expected symptom of mononucleosis, and treatment for mononucleosis consists of supportive measures. A child with a rash with honey-colored crusts most likely has impetigo (a skin infection). Headache, fever, and arthralgia are expected symptoms of Zika virus. Treatment for Zika virus consists of supportive measures.)

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is: ceftriaxone acyclovir penicillin griseofluvin

acyclovir

In caring for children with reproductive disorders, which would the nurse identify as altered reproductive development? Select all that apply. ambiguous genitalia bilateral breast growth delayed puberty pubic hair development precocious puberty descended testes

ambiguous genitalia delayed puberty precocious puberty

The nurse is discussing food allergies with parents of a young child, explaining that a very effective way to determine which foods a child may be allergic to is to implement: a food diary. allergy skin testing. an elimination diet. a raw food diet.

an elimination diet (The food diary may identify foods the child does not tolerate well, but it lacks the objectivity of the elimination diet. Skin testing usually involves whole proteins and will not test for reactions to food breakdown products. A raw food diet does not apply to allergy identification.)

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client? headache weight loss fluid replacement polydipsia

fluid replacement

A nurse is reviewing the diagnostic test findings of a client with a metabolic disorder. Which finding is indicative of galactosemia? decreased blood galactose level decreased SGPT/SGOT and bilirubin high glucose level galactosuria

galactosuria

A nurse caring for a client diagnosed with Chlamydia trachomatis can expect which subsequent tests? candidiasis syphilis gonorrhea trichomoniasis

gonorrhea

The nurse is assessing a female client with genital herpes. Which finding would the nurse expect? multiple vesicles on the introitus lower abdominal pain soft fleshy growths on the perineum painful genital ulcer

multiple vesicles on the introitus (Genital herpes causes single or multiple vesicles on the penis, prepuce, buttocks, thighs, introitus, or cervix that burn and itch before becoming fluid filled blisters. Lower abdominal pain is typically associated with chlamydia infection. Soft fleshy growths on the perineum suggest genital warts. A painful genital ulcer suggests chancroid.)

The nurse is discussing the disease known as pellagra. This disease is due to a deficiency in which of the following? vitamin C thiamine niacin iron

niacin

The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis (thrush). Which medication would most likely be prescribed for the child? aspirin ampicillin acetaminophen nystatin

nystatin

A pediatric client is admitted to the hospital. The primary health care provider suspects a problem with the child's immune system. The nurse anticipates preparing this client for which test initially? serum blood testing lumbar puncture stem cell analysis bone marrow biopsy

serum blood testing

A child is diagnosed with intussusception. The nurse would prepare the child and family for which of the following? upper endoscopy abdominal computed tomography barium swallow surgery

surgery

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning? white blood cell count 18,000/mm3 apical heart rate 120 beats per minute urine output of 10 ml over 3 hours oral temperature 102.3°F (39°C)

urine output of 10 ml over 3 hours

A nurse is assessing a woman of childbearing age complaining of intense vaginal itching and suspects bacterial vaginosis. Which finding would the nurse interpret as supporting this suspicion? frothy white vaginal discharge purulent vaginal discharge with urination yellow-green vaginal discharge vaginal discharge with a fishlike odor

vaginal discharge with a fishlike odor

A nurse is teaching parents of an adolescent who developed salmonella-caused gastroenteritis. The nurse determines that the teaching was successful when the parents state which of the following? Select all that apply. "We'll make sure that he avoids deli-prepared salads." "We will make sure to wash our hands well before preparing any foods." "We should prepare chicken first before preparing other foods." "We need to avoid giving him cream cheese but not feta cheese." "We will cook eggs well, for at least 3 minutes."

"We'll make sure that he avoids deli-prepared salads." "We will make sure to wash our hands well before preparing any foods." "We will cook eggs well, for at least 3 minutes."

A nurse is educating a family about the Chvostek sign after their teen tested positive for Chvostek sign. Which statements by the caregivers shows the nurse that they understand the Chvostek sign? "The sign occurs because my child is having increased intracranial pressure." "The sign means my child is not getting enough vitamin D." "When I tap on my child's facial nerve, the reaction is a facial muscle spasm." "The sign occurs when there is muscle pain and the muscle is stimulated."

"When I tap on my child's facial nerve, the reaction is a facial muscle spasm."

Any child can have an anaphylactic reaction to a food, drug, or insect sting, and Dexter is at risk because of his allergy history. If Dexter, who weighs 48 kg, had an anaphylactic reaction after a beesting, what is the correct dose of epinephrine for a school nurse or staff member to give him? 0.03 mg 0.15 mg 0.3 mg 3.0 mg

0.3 mg

A child is undergoing skin testing for allergies. About 10 minutes after a scratch test with an allergen, the child develops signs and symptoms of anaphylaxis. The nurse prepares to administer epinephrine subcutaneously. The child weighs 88 pounds. The nurse would administer which dosage of epinephrine? 1 mg 0.2 mg 0.8 mg 0.4 mg

0.4 mg (88 lb = 40 kg x 0.01 = 0.4 mg)

The nurse is monitoring the fluid balance of a 9-year-old child. When evaluating urine output for the day, which output would the nurse identify as being within normal limits? 2000 mL 800 mL 600 mL 1200 mL

1200 mL

When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which finding in the child's fasting glucose levels? 60 mg/dl 100 mg/dl 220 mg/dl 140 mg/dl

220 mg/dl (Explanation:If the blood glucose level is elevated or ketonuria is present, a fasting blood sugar (FBS) is performed. An FBS result of 200 mg/dL or higher almost certainly is diagnostic for diabetes when other signs such as polyuria and weight loss, despite polyphagia, are present.)

The nurse is caring for a child who weighs 44 lb (20 kg). The health care provider has prescribed amoxicillin 50 mg/kg/day in equally divided doses every 6 hours. How many milligrams will the nurse administer for the 0600 dose? Record your answer using a whole number.

250

The health care provider has prescribed diphenhydramine 5 mg/kg/dose for a child with urticaria weighing 33 lb (15 kg). The medication is supplied as 12.5 mg/5 ml. How many milliliters will the nurse administer to the child for one dose? Record your answer using a whole number.

30

The nurse is preparing to perform ostomy care on a pediatric client. The nurse has explained the procedure to the child and caregiver. Place the remaining steps of the procedure in the order the nurse will complete them. Use all options.

4Obtain and set up equipment. 1Remove the old pouch. 2Assess the stoma and surrounding skin. 3Clean the stoma and skin as needed, allowing it to dry thoroughly. 5Measure the stoma. 7Mark the new pouch backing, and cut the new backing to size. 6Apply the new pouch.

A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)? Abdominal pain Lymphadenopathy Leg pain Rash

Abdominal pain

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS: 99 (F), 37.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate? Nephrotic syndrome Urinary tract infection Acute glomerulonephritis Wilms tumor

Acute glomerulonephritis

A child is admitted to the emergency room with dyspnea and hypoxia immediately following a bee sting. What is the first action made by the nurse? Administer oral prednisolone Administer oral cetirizine Administer IM diphenhydramine Administer IM epinephrine

Administer IM epinephrine

Which nursing intervention is priority when caring for a child with HIV? Assist the child with daily activities. Review laboratory CD4 counts daily. Assess pain after invasive procedures. Administer prescribed medications.

Administer prescribed medications.

A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure? Amoxicillin Co-trimoxazole Gentamicin Vancomycin

Amoxicillin

Which child has the highest risk of urinary tract infection? An 18-year-old female who is sexually active A 3-year-old female who is not potty trained A 2-year-old male who has not been circumcised A 15-month-old male who has been circumcised

An 18-year-old female who is sexually active

Rob has his adrenal gland function assessed through diagnostic testing. What is the effect on a child when sufficient aldosterone cannot be produced? Substantially fewer red blood cells are produced. There is an overall decreased urine output. An excessive amount of sodium is lost in urine. The child's growth rate increases abnormally

An excessive amount of sodium is lost in urine.

The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, what would be most appropriate to promote healing and prevent further skin breakdown? Apply a barrier/healing cream or paste on the skin. Use a barrier wafer to attach the appliance. Clean the area well with a scented diaper wipe. Sanitize the area with an alcohol wipe after each diaper change.

Apply a barrier/healing cream or paste on the skin.

**The nurse is caring for a child whose family recently emigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate? Document that immunizations are up to date in the chart. Request parents follow WHO vaccine recommendations. Ask parents which immunizations have been given. Administer varicella and meningococcal vaccines.

Ask parents which immunizations have been given.

The nurse completes a 1-month-old's feeding and sits the infant up to burp. The infant vomits back the feeding. Which is the nurse's primary concern? Stomach irritation Nutritional deficiency Aspiration Stunted growth

Aspiration

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? Upper endoscopy Barium enema Endoscopic retrograde cholangiopancreatography Surgery

Barium enema (A barium enema is successful in reducing a large percentage of intussusception cases. Other cases are reduced surgically. Upper endoscopy is used to visualize the upper gastrointestinal tract from the mouth to the upper jejunum. Endoscopic retrograde cholangiopancreatography is used to view the hepatobiliary system.)

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? Pulse rate 112 bpm Blood pressure 136/84 Pulse oximetry 93% on room air Respirations 24 per minute

Blood pressure 136/84

The nurse is providing postoperative care for a child with a new suprapubic catheter. The child begins to moan in pain suddenly. Which nursing intervention is the priority? Ask the child for a pain score. Assess the child's vital signs. Reposition the child for comfort. Check the catheter for patency.

Check the catheter for patency.

A child is born with ambiguous genitalia. Which of the following assessments establishes whether the child is genetically male or female? DNA analysis pyelography laparoscopy ultrasound

DNA analysis

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important? Asking if she has a rash anywhere Determining if her throat itches Checking if she has any nausea Asking if she has abdominal pain

Determining if her throat itches

Dexter is prone to allergies. When planning his care, what desired outcome should the nurse prioritize? Dexter states that his symptoms do not interfere with being able to play with his friends. Dexter is able to describe the cause of his allergic response. Dexter states that he no longer has allergies. Dexter states he enjoys taking medicine to prevent his allergy symptoms.

Dexter states that his symptoms do not interfere with being able to play with his friends.

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? All children in the child's class should be tested for strep throat if one child has a positive test. Encourage the child to take all the antibiotics if diagnosed with strep throat. Tell parents to give ibuprofen if their child has a sore throat. Prophylactic antibiotics after strep throat are important.

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

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? Sacrum Eyes Abdomen Fingers

Eyes

**An INFANT is diagnosed with a urinary tract infection (UTI). What corroborating finding would the nurse expect on assessment? Abdominal pain Dysuria Failure to thrive Urinary urgency

Failure to thrive

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next? Offer a complex carbohydrate snack. Administer a sliding-scale dose of insulin. Give 10 to 15 grams of a simple carbohydrate. Administer glucagon intramuscularly.

Give 10 to 15 grams of a simple carbohydrate.

A 12-year-old is being seen in the office and has hyperthyroidism; the nurse knows that the most common cause of hyperthyroidism is: Plummer disease Graves disease Addison disease Cushing disease

Graves disease

A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? Heat intolerance Facial edema Weight gain Constipation

Heat intolerance

The nurse admits a 7-year-old child who reports pain in the lower right quadrant of the abdomen, nausea, and constipation. An assessment shows that the child has a fever of 101℉ (38.3℃). Which nursing intervention should the nurse implement to safely address the child's reported pain? Help the child find a comfortable position. Place a heating pad or hot water bottle on the abdomen. Give the child an analgesic such as acetaminophen. Request a prescription for a laxative.

Help the child find a comfortable position.

Barry's family likes to celebrate family events by eating crab, lobster, and shrimp. The nurse recognizes which form of hepatitis is most apt to be contracted by eating contaminated shellfish? Hepatitis B Hepatitis A Hepatitis E Hepatitis C

Hepatitis A

The nurse is caring for a child who is receiving a skin test to determine the presence of allergies. A positive skin test for one particular allergen shows the mediation of which type of immune globulin? IgM IgG IgA IgE

IgE

A mother brings her 8-year-old daughter who has precocious puberty to the clinic and asks for birth control pills for her. She states, "I do not want to take the chance of her getting pregnant at such an early age ... you know she looks like she is 16." Which of the following is the best reason that birth control pills are not recommended for someone that young? Increased estrogen hastens the closing of epiphyseal lines of long bones too early. The client is too young to remember to take the pills every day. Too much estrogen that young can cause cancer at an early age. The insurance company might not cover the cost.

Increased estrogen hastens the closing of epiphyseal lines of long bones too early.

A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence.

Incubation Prodrome Illness Convalescence

Rob has a cousin who has developed hyperthyroidism with puberty. Which of the effects of this health problem might a school nurse need to support Rob's cousin in dealing with? Slow, lethargic movements Swollen, protuberant abdomen Jittery, nervous mannerisms Reduced intellectual processing

Jittery, nervous mannerisms

The nurse is caring for a child diagnosed with low functioning parathyroid. Which is a treatment goal of a child with hypoparathyroidism? Assure the parents have a plan in place for periods of low glucose levels if noted. Provide the parents a specific dietary plan for high-phosphorus foods to be eaten. Maintain the child's calcium level at a normal level with calcium replacement as prescribed. Provide the child and parent with a referral to a pediatric gastrointestinal specialist.

Maintain the child's calcium level at a normal level with calcium replacement as prescribed.

A nurse is preparing to enter Jack's room. Because his infection involves potential airborne transmission, what isolation precautions should the nurse use? Goggles and nonsterile gloves Gown and nonsterile gloves Mask, gown, and nonsterile gloves No precautions provided Jack wears a mask

Mask, gown, and nonsterile gloves

Barry has frequent bouts of vomiting. If the nurse is caring for Barry in a hospital setting after repeated bouts of vomiting, the nurse would expect the diagnostic testing to reveal which health problem? Respiratory acidosis Fluid volume excess Metabolic alkalosis Hyperchlorosis

Metabolic alkalosis

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? Measles Mumps Mononucleosis Fifth disease

Mumps

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? Whooping cough Scabies Measles Mumps

Mumps

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? Place the child on contact precautions. Obtain an electrocardiography (ECG). Notify the primary health care provider. Clean the rash with rubbing alcohol.

Notify the primary health care provider.

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child? Penicillin V Doxycycline Ibuprofen Acyclovir

Penicillin V

**The nurse is triaging clients as they come in to an express care facility. Which assessment finding is clinically significant for early nephrotic syndrome? Sacral edema Edema in the hands Periorbital edema Facial puffiness

Periorbital edema

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a fingerstick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention? Prevention of hypoglycemia Prevention of T-cell rejection of the transplanted liver Reduction of hypertension Maintenance of electrolyte balance

Prevention of hypoglycemia

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? Neutropenia, hematuria, and hypocholesterolemia Proteinuria, hypoalbuminemia, and hypercholesterolemia Hematuria, proteinuria, and hyperalbuminemia Proteinuria, hyperalbuminemia, and hypocholesterolemia

Proteinuria, hypoalbuminemia, and hypercholesterolemia

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? An enanthematous rash Red, strawberry tongue White exudate on the tonsils Severity of the sore throat

Red, strawberry tongue

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer? NPH Detemir Lispro Regular insulin

Regular insulin

The parent of 6-month-old girl is concerned about the child getting a urinary tract infection. What should the nurse mention to the parent regarding this concern? Discontinue prescribed antibiotics once symptoms of UTI have disappeared. Wipe from back to front when changing the girl's diaper. Report any abnormally colored urine to the child's primary care provider. Bathe the child with bubble bath once a week.

Report any abnormally colored urine to the child's primary care provider.

**When preparing discharge instructions for the parents of an infant who has been diagnosed with hypospadias, the nurse should include which instruction in the teaching plan? Select all that apply. Monitor voiding patterns. Report any burning, itching, or discharge to a health care provider. Follow up with a primary care provider. Encourage circumcision. Increase fluid intake.

Report any burning, itching, or discharge to a health care provider. Follow up with a primary care provider.

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? Activity intolerance Risk for infection Imbalanced nutrition less than body requirements Excess fluid volume

Risk for infection

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention? Administer IV potassium Administer antibiotic therapy Take a stool culture Feed the child a cracker

Take a stool culture

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother? "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's." "It is unlikely that your daughter is practicing good cleaning habits after she voids."

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Herpes zoster is a reactivation of a previous varicella zoster infection." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders." "Your child must have been exposed to someone with herpes zoster

"Herpes zoster is a reactivation of a previous varicella zoster infection."

Which client will the nurse assess first after receiving shift report? A client with serum sickness stating, "I just feel bad all over." A client with contact dermatitis who has blisters and mild edema on the lower extremities A client newly diagnosed with allergic rhinitis prescribed loratadine 10 mg A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C)

A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C) (Of the immunologic disorders, HIV infection is the most serious. This client is also exhibiting an unexpected manifestation, which could indicate an infection. The clients with serum sickness and dermatitis are exhibiting expected findings and would be seen last. The client newly diagnosed needs to be seen second to have the medication started and receive education.)

What information should be included in the teaching plan for a child with varicella? Place the child in a warm bath for skin discomfort. Utilize salt solutions to assist in healing oral lesions. Administer aspirin for fever. Remind the child not to scratch the lesions.

Remind the child not to scratch the lesions.

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis? The client wets only when involved in an activity. The client remains continent throughout the night. The child wakes up once during the night for a glass of water. The parent takes the client to the bathroom at night.

The client remains continent throughout the night.

The nurse is working with a child with impaired urinary elimination. What is the purpose of monitoring the electrolytes and arterial blood gases (ABGs)? This will determine the chance of stone formation. This will help determine if the child is having glomerulonephritis. This will determine if there is an acid-base problem. This will help determine if the child is having a urinary tract infection.

This will determine if there is an acid-base problem.

A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply. Transfusion of contaminated blood Exposure to blood and body fluids through sexual contact Through breastfeeding Sharing the same bathroom Sharing contaminated needles Perinatally from mother to fetus

Transfusion of contaminated blood Exposure to blood and body fluids through sexual contact Through breastfeeding Sharing contaminated needles Perinatally from mother to fetus

Suppose Navi, 15 years of age, had undergone diagnostic testing and been diagnosed with precocious puberty. What advice would a nurse give her parents? Restrict the amount of physical and mental stimulation she receives daily to halt abnormal growth. Although her sexual appearance is advanced, she is not able to conceive. Treat her appropriately for her chronologic age rather than her physical appearance. Do not allow her to eat processed meats, which contain growth hormones.

Treat her appropriately for her chronologic age rather than her physical appearance.

**A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect? Hypothyroidism Diabetes insipidus Syndrome of inappropriate diuretic hormone Type 1 diabetes mellitus

Type I Diabetes (Signs and symptoms of type 1 diabetes mellitus include polyuria, polydipsia, polyphagia, enuresis, and weight loss.)

7-year-old girl is seen in the clinic for a sports physical. Upon assessment, the nurse notices pubic hair and increased breast tissue in both breasts. What should the nurse suspect? precocious puberty balanitis delayed puberty ambiguous genitalia

precocious puberty

A 9-year-old boy who is uncircumcised has developed balanoposthitis. There is no sign of phimosis. Which of the following recommendations should the nurse give the boy and his parents to help prevent future occurrences? to become circumcised to pull back the foreskin and clean the penis thoroughly when showering to apply a local antibiotic ointment daily to avoid warm baths

to pull back the foreskin and clean the penis thoroughly when showering

When the nurse is instructing on disease transmission, which is noted as the smallest infectious agent known? fungus bacteria yeast virus

virus

***Which collaborative interventions will the nurse implement for a child with acute herpetic gingivostomatitis? Select all that apply. Initiate contact precautions. Give an oral dose of acyclovir. Administer acetaminophen. Provide popsicles and ice. Assess intake and output.

Initiate contact precautions. Give an oral dose of acyclovir. Administer acetaminophen. Provide popsicles and ice. Assess intake and output.

A child's mother asks the nurse how likely it is the child will develop asthma because the child's father has asthma. Which response by the nurse is most appropriate? "Immune responses can be genetic and run in the family." "Your child will develop asthma since the father has asthma." "Asthma can be prevented by avoiding any family allergens." "We don't know why children develop immune disorders."

"Immune responses can be genetic and run in the family."

The nurse is educating the mother of a child who will receive a kidney transplant. Which statement made by the mother indicates further teaching is needed? "My child will need to take medication for life." "My child will need dialysis until the new kidney is placed." "This surgery will cure my child's condition." "This surgery will give my child a chance at a normal life."

"This surgery will cure my child's condition."

A 2-year-old client is at the office for a follow-up visit. The client has had excessive hormone levels in recent bloodwork and the parents question why this was not found sooner. What is the best response by the nurse? "It takes time to determine the level of functioning of endocrine glands." "Endocrine disorders are hard to detect and you are lucky that we have found it when we did." "Have there been signs and symptoms that you should have reported to the doctor?" "As endocrine functions become more stable throughout childhood, alterations become more apparent."

"As endocrine functions become more stable throughout childhood, alterations become more apparent."

After teaching a class about humoral and cellular immunity, the nurse recognizes that additional teaching is needed when a client asks which question? "Does cellular immunity recognize antigens?" "Does humoral immunity cross the placenta?" "Does humoral immunity not destroy the foreign cell?" "Does cellular immunity involve the T lymphocytes?"

"Does cellular immunity recognize antigens?" (Humoral immunity recognizes antigens and cellular immunity does not. Humoral immunity crosses the placenta in the form of IgG. Cellular immunity involves the action of T lymphocytes, and humoral immunity does not destroy the foreign cell)

***The nurse is discharging a client diagnosed with bacterial vaginosis. Which statement would indicate to the nurse that the client has a correct understanding of the discharge instructions? "I will always use a condom with any further sexual encounters." "I do not have to worry about speeding this infection to my partner." "I do not need to see my health care provider for this infection." "If I suspect anything, I will be sure to use soap and water after sex."

"I will always use a condom with any further sexual encounters."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor? "These children have a severe deficiency of vitamin D." "The highest incidence of this disease is seen in children who are adolescents." "The cause of this disease can be treated very simply." "It is important to increase the intake of protein for these children."

"It is important to increase the intake of protein for these children."

The nurse is teaching the mother of a child with phenylketonuria (PKU) about diet and realizes the mother needs further instruction when she makes which statement? "Some vegetables are good." "Most fruits are good." "'Free foods' are allowed." "Lots of fish and meat will help him."

"Lots of fish and meat will help him."

A 13-year-old adolescent with hyperthyroidism who takes antithyroid medication has a sore throat and a fever. The parent calls the nurse and asks what to do. Which is the best response from the nurse? "Please take your child straight to the emergency department." "Give your child ibuprofen according to the instructions on the box." "Offer your child at least 8 ounces of clear fluids and call back tomorrow." "Fever and sore throat may be side effects of the medication."

"Please take your child straight to the emergency department."

A parent asks the nurse, "What is precocious puberty?" The nurse's response should be based on which statement? "Precocious puberty only occurs in boys, not girls." "Precocious puberty is when girls experience a heavy period." "Precocious puberty is early sexual development." "Precocious puberty is when children are going through puberty."

"Precocious puberty is early sexual development."

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. Which response by the nurse would be most appropriate? "Skin testing using a patch is probably the easiest method." "The best way is to eliminate the food from the diet and then look for improvement." "We can inject an extract of the food under the skin and see if there is a reaction." "We can check the level of antibodies in the blood to confirm the allergy."

"The best way is to eliminate the food from the diet and then look for improvement."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? "If he has a fever, we can give him some aspirin." "We need to make sure that he washes his hands frequently." "The lesions should eventually form soft crusts that drain." "We should apply alcohol to the lesions every four hours."

"We need to make sure that he washes his hands frequently."

**The nurse is interviewing parents of a child who has been diagnosed with severe combined immune deficiency (SCID). Which statement by the parents best indicates an understanding of their child's condition? "Our child will receive antibiotic therapy until the stem cell transplant is completed." "We will make sure that our child carries the epinephrine autoinjector at all times." "Our child will need to receive several different types of antiviral medications." "We will need to prepare our child and ourselves for a bone marrow transplant."

"We will need to prepare our child and ourselves for a bone marrow transplant." (SCID is a potentially fatal disorder requiring emergency intervention at the time of diagnosis. Gene therapy provides some promise for the future treatment of SCID, but until then bone marrow or stem cell transplantation is necessary. Intravenous immunoglobulin (IVIG) may be used to help decrease the number of infections until bone marrow or stem cell transplantation can be done. Antibiotic therapy is not initiated unless there is a bacterial infection present. Antiviral medications are used to treat HIV infection. An epinephrine autoinjector is used for anaphylaxis.)

A 15-year-old male client diagnosed with gonorrhea states, "I can't tell my partner about this." What is the best response by the nurse? "If you can have sex, you can tell your partner." "What concerns you about telling your partner?" "You may develop serious long-term complications if this condition is left untreated." "Gonorrhea is a reportable disease, and you are legally obligated to tell your partner."

"What concerns you about telling your partner?"

A nursing student correctly informs a 14-year-old client that a pelvic examination becomes a part of routine health care for all adolescent girls at which age? 12 to 13 years 16 to 17 years 18 to 20 years 14 to 15 years

18 to 20 years

To teach an adolescent how to prevent the recurrence of a sexually transmitted infection, the nurse would include which information in the teaching plan? Select all that apply. After getting a sexually transmitted infection, one cannot be reinfected. Abstinence is the best protection against sexually transmitted infection. Wash genitals well with soap and water after sexual activity. Use a condom with every sexual encounter. Use of oral contraceptive pills (OCPs) prevents sexually transmitted infections.

Abstinence is the best protection against sexually transmitted infection. Wash genitals well with soap and water after sexual activity. Use a condom with every sexual encounter.

Jack's rash is causing him to scratch his skin. To maintain skin integrity and promote comfort, which action should the nurse prioritize in his plan of care? Allow him to keep his nails long. Administer an antihistamine as prescribed. Instruct Jack not to ever scratch the lesions. Cover his hands and fingernails with mittens

Administer an antihistamine as prescribed.

After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? When the rash is completely healed Once the rash appears After day 5 of the rash After the lesions have crusted

After the lesions have crusted

The nurse is caring for a child who is having bronchospasm. The nurse would expect to administer what medication? albuterol corticosteroid diphenhydramine epinephrine

Albuterol (The nurse would expect to administer bronchodilation inhalation treatment (albuterol) if bronchospasm is present. Epinephrine, diphenhydramine, and/or corticosteroids are administered to reverse the allergic process.)

The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved? Thyroxine Growth hormone Insulin Antidiuretic hormone

Antidiuretic hormone

The doctor orders a vaginal examination for a 16-year-old female client who is complaining of severe lower abdominal pain and heavy vaginal bleeding. Which action should the nurse take first to prepare the adolescent for the procedure? Explain the procedure to the parents to ensure support for the child. Reassure the adolescent that the procedure will be quick and painless. Assess past sexual history to determine the appropriate speculum size. Assess previous experiences with pelvic examinations.

Assess previous experiences with pelvic examinations.

Nursing students are learning about accessory nipples in females. They demonstrate a need for further instruction when making which of the following statements? Accessory nipples are additional breast nipples. Breast tissue under an accessory nipple can never be cancerous. Actual breast tissue is not always present under an accessory nipple. Accessory nipples are present at birth.

Breast tissue under an accessory nipple can never be cancerous.

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? Computed tomography scan Creatinine clearance rate Urinalysis Kidneys, ureter, and bladder x-ray

Creatinine clearance rate

A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure? Practicing bladder-stretching exercises Engaging the child in stress-reduction measures Encouraging fluid intake after dinner Giving desmopressin intranasally

Encouraging fluid intake after dinner

A nurse is preparing to discharge Josephine, a neonate diagnosed with maple syrup urine disease. Which one of the following is recommended teaching for home care of Josephine? Inform the parents that protein should be increased in times of crises. Teach the parents to expect the severity of crises to increase with growth. Focus on reinforcing the need for the prescribed lifelong dietary regimen. Emphasize the need to reduce calorie intake when the child is ill.

Focus on reinforcing the need for the prescribed lifelong dietary regimen.

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect? Hirschsprung disease Gastroenteritis Appendicitis Pancreatitis

Gastroenteritis

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? It is difficult to keep the child awake. The skin is pink and healthy looking. The child has above-normal growth for his age. The child is active and playful.

It is difficult to keep the child awake.

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? Stomach Arms Neck Legs

Neck

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? Neutrophils Eosinophils Lymphocytes Basophils

Neutrophils

The nurse is reviewing lab work prior to shift handoff on a client with a subnormal urine output. Which is the nurse most correct to report? Pyuria Polyuria Oliguria Glycosuria

Oliguria

When examining the abdomen of a child, which technique would the nurse use last? Inspection Palpation Auscultation Percussion

Palpation

*The nurse is preparing an informational brochure about risk factors for immune disorders. Which disease process can indicate a potential underlying immunologic disorder? Select all that apply. Illness with a high-grade fever Persistent oral thrush Extensive eczema Occasional rhinorrhea Chronic cough

Persistent oral thrush Extensive eczema Chronic cough

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease? Playing in the woods about a week ago High fever occurring about 4 days before the rash Reports of extreme pruritus with visible nits Rash is papular and vesicular

Playing in the woods about a week ago

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication? Signs of infection Weight loss Hair loss Hypotension

Signs of infection

A newborn is found to have DiGeorge syndrome and has misshaped ears, a small mandible, and an absent thymus. The nurse recognizes that this condition is associated with which of the following types of immunodeficiency disorders? secondary immunodeficiency T-lymphocyte deficiency combined T- and B-lymphocyte deficiency B-lymphocyte deficiency

T-lymphocyte deficiency

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered? The child develops a passive immunity. The child becomes a carrier of the disease. The child becomes a host for the disease. The child develops an active immunity.

The child develops an active immunity.

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child? The child has more frequent urges to empty the bladder. The child has a greater risk for trauma to the kidney. The adult has a greater chance of retaining fluids than the child. The adult has less fat to cushion the kidney.

The child has a greater risk for trauma to the kidney.

A child with severe diarrhea cannot drink and requires intravenous rehydration. After beginning the therapy, the nurse determines that potassium can be added to the intravenous fluid because which of the following has occurred? The child's stool is becoming soft. The child is now vomiting. The child has voided. The child has dry mucous membranes.

The child has voided.

The nurse is caring for a child admitted with acute appendicitis. Prior to the child going to the operating room for emergency surgery, which nursing intervention would the nurse most likely perform? The nurse applies a heating pad to the abdomen to manage pain. The nurse encourages the child and family to express their fears. The nurse administers oral fluids to prevent dehydration. The nurse gives the child laxatives to evacuate the colon.

The nurse encourages the child and family to express their fears.

An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions? Temperature and heart rate Oral intake Urine output Color of mucous membranes

Urine output (An infant with diabetes insipidus has a decrease in antidiuretic hormone. Strict fluid precautions will not alter urine formation. This assessment is important because the infant will be at great risk for dehydration and electrolyte imbalance. It is part of a basic assessment to monitor heart rate, temperature, skin turgor, and mucous membranes. These are important but may not indicate the infant's overall health. On fluid restriction, oral intake will be specified.)

A nursing instructor teaching about allergies in children informs students that the underlying cause of all allergic disorders appears to be an excessive antigen-antibody response when the invading organism is which of the following? immunogen antibody allergen mast cells

allergen

A female child is diagnosed with precocious puberty and is to receive leuprolide acetate. The nurse instructs the parents that this medication is given at which frequency? monthly weekly bi-monthly daily

daily (Leuprolide acetate is administered subcutaneously every day. It is discontinued at age 12 or 13, after which puberty progresses normally.)

A 17-year-old girl comes to the clinic for her first check-up and informs the physician that she has yet to have a period. After ruling out any pathology problems, which treatment would the nurse suspect the physician to order? progestin estrogen testosterone growth hormone

estrogen

The nurse caring for children with fungal infections most often administers which medication? griseofulvin benadryl prednisone acetaminophen

griseofulvin

Most urinary tract infections seen in children are caused by: intestinal bacteria. fungal infections. dietary insufficiencies. hereditary causes.

intestinal bacteria.

A child is diagnosed with giardiasis. The physician prescribes medication to treat the infection. Which of the following would the nurse anticipate being prescribed? clotrimazole mebendazole metronidazole griseofulvin

metronidazole

The nurse is reviewing a pediatric client's laboratory results. An elevation in which type of cells indicates that white blood cells are actively involved with phagocytosis? Select all that apply. monocytes lymphocytes eosinophils basophils neutrophils

monocytes neutrophils

The nurse would document which finding as part of the gynecologic history of a 13-year-old female client? sporting habits breastfed by parent moodiness, headache, or diarrhea before menses frequency of epigastric pain

moodiness, headache, or diarrhea before menses

The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia? muscle tone pulse rate and rhythm abdominal pain blood pressure

pulse rate and rhythm

The nurse is assessing a 5-year-old child whose parent reports the child has been vomiting lately, has no appetite, and has had an extreme thirst. Laboratory work for diabetes mellitus is being completed. Which symptom would differentiate between type 1 diabetes mellitus from type 2 diabetes mellitus? recent weight loss slow healing wounds blood pressure of 142/92 mm Hg loose stools

recent weight loss

A child weighs 15 kg. How many milliliters of fluid per 24 hours does this child require? Record your answer using a whole number.

1250

The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered? Sodium bicarbonate tablets Erythropoietin Vitamin D Ferrous sulfate

Sodium bicarbonate tablets

The nurse is caring for a child who reports constant rhinitis during the spring months. Which education is most appropriate for the nurse to provide to the child? "Your indoor cat may be the reason for your allergy." "You may have an allergy to household dust mites." "An allergy to seasonal pollen may be the cause." "This could be related to a change in laundry detergent."

"An allergy to seasonal pollen may be the cause."

Which question would be most important for a nurse to ask when taking a history from a client who is suspected of having amenorrhea? "Are you sexually active?" "How many times a week do you exercise?" "What foods do you eat?" "When did you last see your medical provider?"

"Are you sexually active?"

The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention? Administration of a high-calorie diet Administration of thiamine supplements Increased protein intake Administration of adequate vitamin D

Administration of adequate vitamin D

A nurse educating a 13-year-old adolescent with diabetes about how to self-monitor and control the disease. Which statement by the nurse would promote a healthy way to self-control the disease? "You will need to have your glycosylated hemoglobin checked every 3 months." "Do not check your glucose level as long as you feel good." "Check your glucose level twice a day and the glycosylated hemoglobin every 3 months." "Check your urine glucose at least 3 times per week."

"Check your glucose level twice a day and the glycosylated hemoglobin every 3 months."

The nurse is doing teaching with the caregivers of toddler and preschool aged-children. One of the caregivers tells the group that her child had diarrhea and she was told that it was caused by giardiasis. Which statement made by the caregiver indicates the most likely situation in which the child contacted the disorder? "I won't let his sister take bubble baths but I do let him take one a few times a week." "He attends a day care center four days a week while I am at work." "My mother is in a nursing home but I always make the kids wash their hands before we leave her." "My son spent time with a neighbor who was diagnosed with pinworms."

"He attends a day care center four days a week while I am at work."

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg (55 lb). How much fluid would the child need per day? 1,600 ml 1,650 ml 1,560 ml 1,700 ml

1,600 ml

The nurse is caring for a child who weighs 44 lb (20 kg) experiencing an anaphylactic reaction. The health care provider has prescribed epinephrine 0.01 mg/kg injection. Epinephrine is supplied at 1mg in 10 ml. How many milliliters will the nurse administer? Record your answer using a whole number.

2

The nurse is teaching an in-service program to a group of colleagues on the topic of children diagnosed with acute glomerulonephritis. In which age range is the peak incidence of this disorder noted? 12 to 13 years of age 2 to 4 years of age 6 to 7 years of age 15 to 17 years of age

6 to 7 years of age

Rob needs to adjust his regular insulin dose to the amount of carbohydrates he eats in order to prevent dangerous complications of his disease. If his insulin-to-carbohydrate ratio is 1:10, how many units of insulin should he inject if his lunch will consist of a hotdog on a bun (24 g), 1 cup chicken noodle soup (7 g), an apple (19 g), and a glass of milk (25 g)? 3 units 7.5 units 9 units 12 units

7.5 units

he nurse is caring for a child with an infectious disorder and the following vital signs: temperature 103.1°F (39.5°C), pulse 106 bpm, respiratory rate 24 breath/minute, and oxygen saturation 93% on room air. The child reports pain 4/10 using the Wong-Baker FACES scale. Which nursing intervention is priority? Administer acetaminophen orally for fever. Provide ibuprofen orally as needed for pain. Apply oxygen via nasal cannula at 2 L/min. Don appropriate personal protective equipment (PPE).

Don appropriate personal protective equipment (PPE).

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? Effortless vomiting just after the child has eaten Severe constipation with occasional ribbon-like stools Bouts of diarrhea with failure to gain weight Forceful vomiting followed by the child being eager to eat again

Effortless vomiting just after the child has eaten

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply. Use bubble bath to wash. Finish all antibiotics prescribed. Encourage fluids throughout the day. Limit bathing to once a week. Wipe from front to back.

Finish all antibiotics prescribed. Encourage fluids throughout the day. Wipe from front to back.

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin? IgA IgG IgE IgM

IgE

When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? IgE IgG IgA IgM

IgG

Which immunoglobin occurs most frequently in plasma and is the major immunoglobulin synthesized during secondary response? IgD IgM IgG IgA

IgG

When teaching about primary and secondary humoral responses, what should the nurse identify as the immunoglobin that is first to appear in the serum? IgD IgE IgM IgG

IgM

A 12-year-old child suddenly experiences an extreme drop in blood pressure following discontinuation of prednisone. The child appears gray and has no detectable pulse. Which is the priority nursing intervention in this situation? Administration of epinephrine Administration of insulin Immediate replacement of cortisol Cardiopulmonary resuscitation

Immediate replacement of cortisol

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? Maintaining skin integrity Preparing family for home care Promoting comfort Improving hydration

Improving hydration

A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which condition? Vitamin C deficiency Marasmus Vitamin D deficiency Kwashiorkor Thiamine deficiency

Kwashiorkor

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? Encouraging milk products to boost caloric intake Offering Kool-Aid or popsicles as tolerated Encouraging consumption of fruit juice Maintaining the intravenous (IV) fluid rate as ordered

Maintaining the intravenous (IV) fluid rate as ordered

The nurse is performing an assessment on a child suspected of having an inguinal hernia. Which assessment technique(s) should be used to assess for the presence of the hernia? Select all that apply. Palpate the inguinal canal and ask the child to turn the head and cough. Palpate the inguinal canal while the child blows up a balloon. Ask the child to inhale forcefully while the inguinal canal is palpated. Ask the child to hold the breath and grunt forcefully. Press the palm of one hand on the abdomen and then withdraw the hand.

Palpate the inguinal canal and ask the child to turn the head and cough. Palpate the inguinal canal while the child blows up a balloon.

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply. Marked weight loss Polyuria Abrupt onset of symptoms Polyphagia Polydipsia

Polyuria Polyphagia Polydipsia

A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client? Reassess the client's testes at 6 months of age. Administer low-dose human chorionic gonadotropin hormone. Schedule emergency orchiopexy to correct the condition. Perform karyotyping to establish the client's gender.

Reassess the client's testes at 6 months of age.

A 2-day-old infant is diagnosed with galactosemia. Which of the following interventions should the nurse prepare the parents to do? Remove all milk and lactose-containing foods. Encourage the mom to breastfeed as long as she can. Avoid feeding the infant soy protein formula. Encourage use of lactose-containing formulas.

Remove all milk and lactose-containing foods

Multiple studies reported the effectiveness of hand hygiene in the reduction of infection. As a result, the WHO and the CDC have endorsed the importance of hand hygiene to reduce infection (WHO, 2016a). A study Chittleborough, Nicholson, Basker, et al. (2012) conducted in the primary school setting found that proper hand hygiene correlated positively with student observations of teaching practicing hand hygiene. Based on this study, the nurse determines which action is most effective to ensure Jack, a 10-year-old, consistently washes his hands before meals? Continue to remind him to wash his hands as often as possible. Talk to Jack's mother about the importance of modeling good hand hygiene practices. Explain to Jack the role that bacteria play in the transmission of illness. Stress that washing his hands makes him look grown-up and responsible.

Talk to Jack's mother about the importance of modeling good hand hygiene practices.

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet? popcorn banana splits potato chips orange soda

banana splits

A high school football player comes to the clinic with malaise, fever, headache, and anorexia that have been present for the last few days. Upon physical examination, the nurse notes that the cervical lymph nodes are firm and tender. Tonsils are red and enlarged and appear to have a white covering. What should the nurse suspect the diagnosis to be for this client? mumps rubella mononucleosis fifth disease

mononucleosis

Which condition is a risk factor for the development of pelvic inflammatory disease (PID)? multiple sexual partners history of dysmenorrhea oral contraceptive use recurrent urinary infections

multiple sexual partners

A client diagnosed with dysmenorrhea has several medications prescribed. Which medication should the nurse question? acetaminophen oral contraceptives oxycodone ibuprofen

oxycodone

*The nurse is completing a head to toe assessment on a male. Which diagnosis requires immediate treatment to prevent circulatory compromise to the penile glans? testicular torsion hydrocele paraphimosis phimosis

paraphimosis

**A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of: scarlet fever. pneumonia. osteomyelitis. impetigo.

scarlet fever.

The nurse is preparing for client admission. For which disease processes would the nurse gather supplies to administer intravenous antibiotic therapy for a client with a bacterial infection? Select all that apply. infectious mononucleosis severe Impetigo epidemic parotitis anthrax pertussis cellulitis

severe Impetigo anthrax pertussis cellulitis

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system? Hormonal secretion Growth stimulation Cellular metabolism Regulation of water balance

Hormonal secretion

**The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? Swollen neck Strawberry tongue Swollen lymph nodes Infected tonsils

Swollen lymph nodes

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? "I can't believe it. We're not unclean, poor people." "That explains his complaints of itching on his neck." "We'll have to get that special shampoo." "Everybody in the house will need to be checked."

"I can't believe it. We're not unclean, poor people."

A nursing instructor is teaching about reproductive disorders in pediatric clients. Which of the following statements made by a student demonstrates a need for further teaching? "Reproductive disorders in children can be congenital or acquired." "A child can acquire a reproductive disorder." "Reproductive disorders in children are always congenital." "Assessments for reproductive disorders in children need to be ongoing."

"Reproductive disorders in children are always congenital."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? "How long has your child been toilet trained?" "How many times a day does your child urinate?" "What foods has your child eaten during the last few days?" "Tell me about the types of stools your child has been having."

"Tell me about the types of stools your child has been having."

The school nurse is working with a 10-year-old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond? "Please do not add to this family's stress." "The pain she is having is real." "Be patient; she is trying some new medication." "The family is working toward improvement."

"The pain she is having is real."

The nurse is taking a history on a 10-year-old child who has a diagnosis of hypopituitarism. Which question is important for the nurse to ask the parents? "How often do you test your child's blood glucose?" "Does your child get upset about being taller than friends?" "Is your child taking vasopressin IM or SC?" "What time each day does your child take his growth hormone?"

"What time each day does your child take his growth hormone?"

The nurse reviews a 6-year-old client's laboratory results and notes the client's hemoglobin A1C level is 7.7% (0.077). Which action by the nurse is appropriate? Continue to monitor. Notify the primary health care provider. Perform a serum glucose check. Administer insulin.

Administer insulin.

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority? Encourage the child to wear a medical alert bracelet for penicillin. Advise the parents to have their child evaluated for atopic diseases. Question the child about the amount of penicillin that was taken. Educate the parents about possible side effects of penicillin in children.

Encourage the child to wear a medical alert bracelet for penicillin.

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Convalescent period Incubation period Prodromal period Illness period

Incubation period

***A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority? Risk for delayed growth and development related to chronic illness Acute pain related to inflammatory processes Imbalanced nutrition, less than body requirements related to poor appetite Ineffective protection related to impaired humoral defenses

Ineffective protection related to impaired humoral defenses

A nurse is instructing the parents of a child who is suspected of having pinworms how to check the child. Which instruction would be most appropriate? Observe the characteristics of the child's stool, which will be watery. Look on the child's bed linens for evidence of black dots. Check the washcloth after having the child wipe himself during bathing. Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep.

Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep.

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? Volvulus with malrotation Intussusception Short-bowel/short-gut syndrome Necrotizing enterocolitis

Intussusception

Jack, who has varicella, is missing his school friends so is eager to return to school. When should the nurse inform the school nurse that it would be safe for Jack to return to school? Whenever he feels that he is strong enough When all the lesions have dried and there are no new lesions As soon as his fever is within normal range One week after he began the antibiotic

One week after he began the antibiotic

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting? Is projected 1 ft away from infant Is curdled and extremely sour smelling Only occurs with feeding Continues until stomach is empty

Only occurs with feeding

**Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of: ketonuria. glucosuria. ketone bodies. diabetic ketoacidosis.

diabetic ketoacidosis.

A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? Syndrome of inappropriate antidiuretic hormone Hyposecretion of somatotropin Diabetes insipidus Hypersecretion of somatotropin

Syndrome of inappropriate antidiuretic hormone

*A nurse caring for clients in a free women's health clinic counsels women on infant nutrition and formula preparation. Which of the following is an appropriate guideline for the proper use of infant formula? Maintain a normal caloric density of 35 calories per ounce. Never dilute infant formula. Mix powdered formula with oral electrolytes for better nutrition. Use a soy-based formula for infants with lactase deficiency.

Use a soy-based formula for infants with lactase deficiency.

***A 13-year-old boy who recently immigrated to the United States from India is found to be infected by a strain of the poliovirus. After initial symptoms of fever, headache, nausea, vomiting and abdominal pain subside, the virus proceeds to his central nervous system. Which of the following would be the best intervention for this client at this point? antibiotics bed rest, analgesia, and application of moist hot packs salicylic acid solution vaccination

bed rest, analgesia, and application of moist hot packs (Treatment for poliomyelitis is bed rest with analgesia and moist hot packs to relieve pain. Vaccination would be too late at this point, as the infection has already occurred. Antibiotics would be ineffective as this is a viral, not a bacterial, infection. Salicylic acid solution is used to treat warts.)

A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults? measles herpes zoster smallpox mumps

herpes zoster (shingles)

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens. humoral; viral killer; viral killer; bacterial humoral; bacterial

humoral; bacterial

The nurse is interpreting the negative feedback system that controls endocrine function. What secretion will the nurse correlate as decreasing while blood glucose levels decrease? glycogen glucagon adrenocorticotropic hormone insulin

insulin

***Parents report that their child has been vomiting for the past several hours. The nurse determines that the parents' terminology is accurate when they describe the vomiting in which manner? Select all that apply. "It seems to be quite forceful." "It seems to occur with feedings." "The amount is about 1 to 2 teaspoons at a time." "It is really sour and curdled." "He seems to cry just before it occurs."

"It seems to be quite forceful." "It is really sour and curdled." "He seems to cry just before it occurs."

The parents are concerned their child with atopic dermatitis is having an allergic reaction to diphenhydramine because the child became "sleepy and has a dry throat" after receiving the medication. Which education provided to the parents by the nurse is most important? "Side effects, such as drowsiness and dryness, do not indicate an allergy." "Toxic amounts of diphenhydramine can cause this response in children." "Children with eczema are more likely to have a medication allergy." "Your child is exhibiting signs and symptoms of an allergic reaction."

"Side effects, such as drowsiness and dryness, do not indicate an allergy."

The nurse is assisting with skin testing for allergies in a pediatric client. What will the nurse do to ensure the results are accurate? Inject the allergens into the muscle of the child's forearm. Apply a topical diphenhydramine cream to the site following each injection. Be certain the child has not received an antihistamine in the past 8 hours Read the test results within 40 minutes of administration.

Be certain the child has not received an antihistamine in the past 8 hours (Must read w/i 15-20 min)

**A child comes into the emergency room after falling on his back onto a stick. Which test would be the best indication of renal trauma? CT scan electrolyte panel urinalysis kidney x-ray

CT scan

***A young girl is diagnosed with acute poststreptococcal glomerulonephritis. Which medication classifications would the nurse expect to administer? Select all that apply. potassium removing resin antibiotics calcium channel blocker desmopressin acetate phosphate binder

Calcium channel blocker Phosphate binder Potassium removing resin

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test? Screening her for pregnancy Giving the girl an enema Checking with the parents for any allergies Ensuring adequate hydration

Checking with the parents for any allergies

The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis? Deficient knowledge related to fluid intake regimen Deficient fluid volume related to dehydration Imbalanced nutrition, more than body requirements related to excess weight Excess fluid volume related to edema

Deficient fluid volume related to dehydration

A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse? Take away a toy every time the child urinates in his or her pants. Demonstrate how to urinate in the bathroom every time the child has an occurrence. Discuss how the child can continue to go to the bathroom instead of in his or her underwear. Demonstrate love and acceptance at home.

Demonstrate love and acceptance at home.

Dexter's mother asks the nurse about the potential risks and benefits of immunotherapy, stating that some websites she has consulted convey dire warnings against the practice. What potential benefit could the nurse describe to Dexter's mother to alleviate her anxiety? Dexter will recover more quickly from infections. Dexter will be protected against secondary infections. Dexter's level of helpful immunoglobulins will be increased. The overall health of Dexter's immune system will be increased.

Dexter's level of helpful immunoglobulins will be increased.

A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin? Discard any opened vials after a week. Store the insulin in the refrigerator until just before giving it. Do not mix this insulin with other insulins. Give the dose first thing in the morning.

Do not mix this insulin with other insulins

A child is admitted with a temperature, 101.2°F (38.4°C); pulse rate 100 beats/min; respirations 24 breaths/min. On admission the pain is localized in right lower quadrant. Legs are drawn up against the abdomen. Bowel sounds are sluggish. Rebound tenderness is present. White blood cell count of 17,000/mm3. Ultrasound confirms appendicitis. Which instruction would the nurse give to the child and the parent? Drink cool fluids to reduce the temperature. Place an ice pack over the place of the discomfort. Use a heating pad to decrease the abdominal discomfort. Do not rub or put pressure on the abdomen.

Do not rub or put pressure on the abdomen.

Barry's mother is concerned her new baby will develop pyloric stenosis. To detect vomiting from this, the nurse would assess the infant at what time? Immediately after feeding An hour after feeding On arising in the morning When the infant cries

Immediately after feeding

The nurse is caring for a child with HIV admitted to the pediatric unit. Which assessment finding would alert the nurse that the child has most likely progressed from HIV to AIDS? Kaposi sarcomas observed on the skin enlarged lymph nodes felt with palpation crackles noted in lower lobes of the lungs hepatomegaly noted during percussion

Kaposi sarcomas observed on the skin

The appearance of which hallmark clinical manifestation occurs in measles? Conjunctivitis Cough Koplik spots Fever

Koplik spots

*The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated? Fatigue from viral infection onset 3 days ago A sports injury to the kidney two weeks ago Increased thirst, sweating and shakiness since yesterday Onset of a streptococcus infection last week

Onset of a streptococcus infection last week

A nurse is providing education to pregnant women diagnosed with HIV. Which statement indicates the need for further teaching? My health care provider may want me to have a cesarean birth. Antiretroviral treatment is effective in reducing maternal-fetal transmission. Pregnancy will accelerate the progression of the disease. It is not safe to breastfeed my baby, so I will use formula.

Pregnancy will accelerate the progression of the disease.

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? Medicate the infant with analgesics. Change the infant's diet to one that is lactose-free. Assist in doing a barium enema procedure on the infant. Prepare the infant for surgery.

Prepare the infant for surgery.

Barry's aunt and uncle adopted a toddler from a developing country. The nurse learns that a dietitian has been working with the family because of the child's history of kwashiorkor. The nurse would expect the dietitian to prioritize what nutrient in this child's diet? Water-soluble vitamins Fats and triglycerides Quality protein Vitamin K

Quality protein

What is a true statement regarding varicella zoster virus infection? The incubation period is 7 days. It tends to be more severe in children. Secondary bacterial infections of the skin can occur. It is transmitted by fecal-oral route.

Secondary bacterial infections of the skin can occur

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action? Weigh the child in the same clothes she had been weighed in the day before and report the two weights to the nurse while the nurse is on the phone. Give the child fluids and report back to the nurse in a few hours. Give the child a diuretic and report back to the nurse in a few hours. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

Dexter is at his primary care provider's office and the nurse had been asked to assist with his PE. What safety intervention should the nurse use with Dexter because he's known to have many allergies? Assess his blood pressure using a new blood pressure cuff. Distract him by showing him a tropical fish tank. Spot-check his oxygen saturation using pulse oximetry. Use nonlatex gloves to conduct the examination

Use nonlatex gloves to conduct the examination

A young adult female is suspected of having gonorrhea. The nurse would anticipate additional testing for which sexually transmitted infection? trichomoniasis genital herpes chlamydia syphilis

chlamydia

A public health nurse is instructing on the short-term and long-term effects of sexually transmitted infections. Which effects would be included? Select all that apply. emotional stress implications for fertility risk for developing diabetes risk for hypertension relationships with future partners

emotional stress implications for fertility relationships with future partners

A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with no improvement. What underlying condition should be assessed for in this client at this point? mittelschmerz amenorrhea toxic shock syndrome endometriosis

endometriosis

**Which would lead the nurse to suspect that the adolescent has pelvic inflammatory disease? Select all that apply. fever mild lower abdominal cramping dysmenorrhea clear watery vaginal discharge pain when cervix is manipulated

fever dysmenorrhea pain when cervix is manipulated

Which symptom is not consistent with a diagnosis of polycystic ovary syndrome (POS)? acne hirsutism missed menses weight loss

weight loss

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema? amount of protein in the urine urine output, every shift abdominal circumference weight, daily

weight, daily

An older adolescent is scheduled to undergo surgical augmentation of her breasts. After teaching the adolescent about what to expect after the surgery, the nurse determines that the teaching was successful when the adolescent states which of the following? "Because my breast tissue is being replaced, breast cancer isn't a concern." "I'll have an incision on the side of my chest." "I won't be able to breastfeed when I have a baby." "I might notice a decrease in the sensation in my nipples for a bit."

"I might notice a decrease in the sensation in my nipples for a bit."

**The nurse is providing client education to an adolescent newly diagnosed with type 1 diabetes mellitus. Which statement by the adolescent indicates that the nurse's teaching has been effective? "I will pack a snack to eat right after my gym class." "If I take my insulin, I can eat any kind of carbohydrate I want." "I will have to decrease my carbohydrates and increase the amount of protein that I eat." "Since I will be losing lots of weight, I probably won't have to take so much insulin."

"If I take my insulin, I can eat any kind of carbohydrate I want."

The parent of a 16-year-old female states, "I know she's pregnant because she missed her period for the second time." What is the best response by the nurse? "It is normal for teenagers to have unpredictable menstrual cycles." "I hear your concerns about pregnancy. There may be some other causes we need to explore." "Have you done a pregnancy test?" "Who do you think is the father?"

"I hear your concerns about pregnancy. There may be some other causes we need to explore."

A nurse is conducting a class for high school-aged girls about reproductive health. During the class, one of the girls asks, "When should a girl have a pelvic examination?" Which response by the nurse would be most appropriate? "Typically, girls have their first pelvic examination when they enter puberty." "Usually a girl begins having a pelvic examination around the same time her mother did." "You need to wait until you become sexually active." "If you are not sexually active and have no problems, typically it occurs around the age of 18."

"If you are not sexually active and have no problems, typically it occurs around the age of 18."

*The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate? "IgA deficiency is usually found when evaluating for another illness." "This is associated with allergies, which may not be noted prior to 5 months." "Maternal antibodies crossed the placenta and that prevented infections until now." "There is no treatment or cure specific for IgA deficiency in children."

"Maternal antibodies crossed the placenta and that prevented infections until now."

The nurse is instructing the parents of an infant boy with cryptorchidism. Which nursing statement is correct? "Corrective surgery will be performed immediately." "A 5-day trial of estrogen will be given to correct the defect." "No treatment is needed unless no change is noted by 6 to 12 months." "The child will develop testicular cancer; therefore, scrotal removal is necessary."

"No treatment is needed unless no change is noted by 6 to 12 months."

*A nurse is providing care to a child who is HIV positive and prescribed IV zidovudine. Which nursing actions would be appropriate when administering the drug? Select all that apply. Adhere to droplet precautions. Give the drug in the morning and after lunch. Infuse the drug over 60 minutes. Monitor the child for paresthesias. Reinforce use of meticulous handwashing.

Give the drug in the morning and after lunch. Infuse the drug over 60 minutes. Monitor the child for paresthesias. Reinforce use of meticulous handwashing. (When administering IV zidovudine, the nurse should administer the drug over 60 minutes to prevent too rapid an infusion and give the drug around the clock for maximum effectiveness. The nurse should also monitor the child for paresthesias and institute safety precautions if they occur. The drug does not reduce the risk for HIV transmission, so the nurse should reinforce the need for meticulous handwashing and standard precautions. Droplet precautions are not necessary.)

**The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find? Abdominal pain in the epigastric or umbilical region Sausage-shaped mass in the upper mid-abdomen Tenderness over the McBurney point in the right lower quadrant Hard, moveable, olive-shaped mass in the right upper quadrant

Hard, moveable, olive-shaped mass in the right upper quadrant

Rob tells the nurse that he experienced a "honeymoon" period when he was first diagnosed with diabetes mellitus. The nurse recognizes that this would be demonstrated by which of the following signs? He developed an unnatural craving for sweets. His metabolism increased because of glucose stimulation. He became light-headed or "giddy" every afternoon. HHis need for injected insulin was drastically reduced.

His need for injected insulin was drastically reduced.

A nurse caring for a child with Graves disease is administering propylthiouracil (PTU). The child has been on this drug for a few weeks and now has sudden symptoms of a sore throat. What is the priority intervention for the nurse? Offer throat lozenges to soothe the throat. Continue medication to relieve the signs of Graves disease. Hold the dose and call the health care provider. Ask the child if there is a reason he or she does not want to go back to school.

Hold the dose and call the health care provider.

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? Disease-modifying antirheumatic drugs (DMARDs) Corticosteroids Cytotoxic drugs Protease inhibitors

Protease inhibitors

The nurse is providing education regarding 2020 Health Goals to reduce the incidence of acquired immunodeficiency syndrome (AIDS) within the community. Which goal will the nurse choose as a primary prevention strategy? Reduce the baseline level of allergens in dust within homes and buildings. Increase the number of schools with an indoor air management system. Refer at-risk community members to the clinic for HIV/AIDS screening. Provide education to sexually active females about proper condom usage.

Provide education to sexually active females about proper condom usage.

A 9-year-old child with Graves disease is seen at the pediatrician's office reporting sore throat and fever. The nurse notes in the history that the child is taking propylthiouracil. Which of the following would concern the nurse? The child must be participating in sports. The child may have developed leukopenia. The child needs to be started on an antibiotic drug. The child may not be taking the medication.

The child may have developed leukopenia (Graves disease is defined as an overproduction of thyroid hormones. Propylthiouracil is used to suppress thyroid function. A complication of Graves disease is leukopenia.)

The symptoms of PCOS can begin with adolescence. If Navi had this, which of the following facts would a nurse want her to describe after an educational session? PCOS can be easily treated with an antibiotic. This condition can cause both obesity and interfere with future fertility. The condition usually fades with full maturity at the end of adolescence. Polycystic ovaries are easy to identify because they are so painful.

This condition can cause both obesity and interfere with future fertility.

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a child diagnosed with measles experiencing photophobia and coryza a child with erythema infectiosum experiencing fatigue and confusion a child with herpes simplex who is reporting mouth pain and pruritis a child diagnosed with chicken pox reporting nausea and malaise

a child with erythema infectiosum experiencing fatigue and confusion (A child with erythema infectiosum experiencing fatigue and confusion is showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus. A child with signs and symptoms of decreased oxygenation should be seen first. Nausea and malaise are symptoms of chicken pox. A child with herpes simplex will most likely report pain an pruritis. Signs and symptoms of measles include photophobia and coryza.)

The nurse recognizes that in the disorder referred to as rickets, the child has a lack of vitamin D. Because of the lack of vitamin D, the absorption of which of the following is decreased? vitamin C and thiamine calcium and phosphorus riboflavin and niacin iron and potassium

calcium and phosphorus

**The nurse admits an infant who is nutritionally deprived. The infant is weak and seems somewhat uninterested in food. In developing the infant's plan of care, how often will the nurse most likely plan to feed this infant? on demand every 2 or 3 hours every hour every 4 hours

every 2 or 3 hours

A nursing instructor is teaching students about breast disorders in children. The instructor determines that the teaching was successful when the students identify which of the following as the most common benign breast condition in women, regardless of age? mastitis fibrocystic breast disease accessory nipples fibroadenoma

fibrocystic breast disease

An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: cystic fibrosis. inflammatory bowel disease. Hirschsprung disease. gastroesophageal reflux disease.

gastroesophageal reflux disease.

A teenager comes to the clinic and tells the nurse that she thinks she has cancer. When the nurse asks why the client says that she has been bleeding between periods ever since starting birth control pills 3 months ago. What should the nurse tell this client? "I'm sure it's not cancer because you are so young, but we will investigate to find out what it could be." "You are right to be concerned; it is not normal to bleed between periods." "Bleeding between periods can happen while using oral contraceptives, especially during the first few months." "Let's run some tests to see if you have cancer."

"Bleeding between periods can happen while using oral contraceptives, especially during the first few months."

The nurse is working with a pregnant client who is HIV positive and has been prescribed oral zidovudine. Which statement by the nurse explains the primary rationale for taking this medication? "This will help halt the growth of your Kaposi sarcoma." "Zidovudine will help stimulate your fetus's growth during pregnancy." "It is to help prevent transmission of the disease to your infant." "This medication will help to restore your coagulation ability before labor."

"It is to help prevent transmission of the disease to your infant."

A newborn has just been diagnosed with phenylketonuria (PKU). The physician and nurse have taught the parents about the defect. What statement by the parents demonstrates a need for further instruction? "PKU can lead to severe damage to the central nervous system." "Nothing can be done medically to manage this condition." "Both of us must have carried the gene for PKU." "Incidence of PKU is about 1 in every 16,000 births in the United States."

"Nothing can be done medically to manage this condition."

The school nurse is working with a group of teachers who instruct children who are nutritionally deprived. As the teachers are talking with the nurse they make the following statements. Which statement most indicates a problem related to decreased nutrition? "One of my students is taller than several of the other children in the class." "I am really glad that during this quarter the absence rate in my classroom has dropped." "The grades of the children in my class are higher than in the classroom next to me." "Several of the children in my class have such a hard time concentrating."

"Several of the children in my class have such a hard time concentrating."

Sandy, Rob's 14-year-old girlfriend, often comes to the pediatric clinic with him. Sandy has hypopituitarism, and she and Rob first met at the endocrine clinic. Which of Sandy's statements would make the nurse believe she needs more education about her disorder? Select all that apply. "Taking growth hormone subcutaneously is a bother; I hope I'll be changed to pills soon." "I know I have to take growth hormone for life but it's okay; I'll be all right." "Growth hormone makes me pee a lot; I asked for a locker near the bathroom." "Growth hormone turned my cheeks red, but I cover it with makeup so it's okay." "I'm determined not to let this take away my quality of life."

"Taking growth hormone subcutaneously is a bother; I hope I'll be changed to pills soon." "I know I have to take growth hormone for life but it's okay; I'll be all right."

The nurse is discussing the treatment of congenital aganglionic megacolon (Hirschsprung Disease) with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? "The treatment for the disorder will be a surgical procedure." "We will give enemas until clear and then teach you how to do these at home." "Your child will be treated with oral iron preparations to correct the anemia." "Your child will receive counseling so the underlying concerns will be addressed."

"The treatment for the disorder will be a surgical procedure."

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take? Dissolve a piece of candy in the child's mouth. Request that someone call 911. Anticipate that the child will need intravenous glucose. Administer subcutaneous glucagon.

Administer subcutaneous glucagon.

The neonatal nurse is caring for children with inborn errors of metabolism. Which treatment is recommended for these conditions? undergoing liver or bone marrow transplant to increase deficient enzymes replacing deficient enzymes through intravenous administration increasing substrates preceding the enzymatic block eliminating the deficient product from the child's diet

replacing deficient enzymes through intravenous administration

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? There are recurrent paroxysmal bouts of abdominal pain. A thickened, elongated muscle causes an obstruction at the end of the stomach. A partial or complete intestinal obstruction occurs. In this disorder the sphincter that leads into the stomach is relaxed.

In this disorder the sphincter that leads into the stomach is relaxed.

Nonpharmacologic interventions are being used with increasing frequency to help reduce the pain of dysmenorrhea. To discover whether participating in a yoga program could decrease the symptoms related to primary dysmenorrhea, a research team recruited 40 undergraduate female students. Half were in a control group, and the other half were assigned to the exercise group. Those in the exercise group participated in an hour-long yoga session once a week for 12 weeks. Results of the study showed that a yoga program can improve menstrual pain intensity and menstrual distress. Based on this study, what would the nurse recommend to Navi? Make a list of menstrual symptoms each month because listing them helps reduce discomfort. Nonpharmacologic measures can help with coping psychologically with pain. Some exercise programs can genuinely help reduce menstrual pain. The more vigorous the exercise, the less pain the patient is likely to have

Some exercise programs can genuinely help reduce menstrual pain

A nurse is teaching a child with type 1 diabetes mellitus how to self-inject insulin. Which method should she recommend to the child for regular doses? Intravenously in the chest Subcutaneously in the outer thigh Intramuscularly in the abdomen Intradermally in the outer arm

Subcutaneously in the outer thigh

The nurse is caring for an infant immediately after pyloromyotomy surgery has been performed to treat pyloric stenosis. The infant's parents are understandably anxious about their child. Given the situation, what is the most appropriate way for the nurse to position the infant during the anesthesia recovery period? Place the infant on the back. Lay the infant on their stomach. Allow the parents to hold their infant Support the infant and place them on their side.

Support the infant and place them on their side.

Nurses will need to teach the parents of the infant being treated for Hirschsprung disease (aganglionic megacolon) to: thicken formula feedings. avoid use of a pacifier. carefully monitor heart rate. care for a temporary colostomy.

care for a temporary colostomy.

A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which is the priority intervention for this child? check vital signs measure urine output weigh the client encourage increased fluid intake

check vital signs

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply. Oral candidiasis (thrush), persistent over the past 6 to 7 months Acute otitis media, one episode every 3 to 4 weeks over the past year. Pneumonia last spring; resolved with antibiotics Infected laceration requiring IV antibiotic 2 months ago; healed Recurrent deep abscess of the thigh

Oral candidiasis (thrush), persistent over the past 6 to 7 months Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh

**Which congenital condition leads to the infant being hungry, irritable, losing weight and rapidly becoming dehydrated with the potential of metabolic alkalosis? Aganglionic megacolon Colic Pyloric stenosis Intussusception

Pyloric Stenosis (This clinical picture includes assessment findings consistent with pyloric stenosis. Theses infants are very hungry yet once they eat, regurgitate the feeding leading to the infant being irritable, losing weight, and decoming dehydrated. The infant with aganglionic megacolon has a main symptom of constipation. Intussusception is a painful telescoping of the bowel. Colic has similar symptoms but primarily includes bouts of abdominal pain.)

The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for a pediatric client with an immune disorder receiving a stem cell transplant. Which action by the UAP will cause the RN to intervene? The UAP assists the client to ambulate in the room. The UAP wears a mask when entering the client's room. The UAP places a lunch tray in the client's room. The UAP takes a rectal temperature on the client.

The UAP takes a rectal temperature on the client. (Precautions must be taken to protect the client from infection. The RN would intervene if the UAP takes a rectal temperature because this increases the client's risk for infection. The client should not receive rectal suppositories as well. The RN would ensure meticulous oral care is provided and encourage appropriate and adequate nutrition. Delivering a meal tray, wearing a mask when entering the room, and assisting the client to ambulate in the room are all appropriate actions by the UAP.)

What occurs in the gastrointestinal system of the child with Hirschsprung disease? There is an invagination or telescoping of one portion of the bowel into a distal portion. There is a severe narrowing of the lumen of the pylorus. There is a relaxed sphincter in the lower portion of the esophagus. There is a partial or complete mechanical obstruction in the intestine.

There is a partial or complete mechanical obstruction in the intestine.

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom? itchy mouth constipation anxiety nausea

constipation

In understanding the disease of marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following? deficiency of vitamin C and iron excess of vitamin C and iron deficiency of protein and calories excess of protein and calories

deficiency of protein and calories

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? Infected tonsils Strawberry tongue Swollen neck Swollen lymph nodes

Swollen lymph nodes

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone? vasopressin oxytocin growth hormone antidiuretic hormone

growth hormone

A 16-year-old girl has had several cases of cystitis in the past year. Which of the following should the nurse suspect as the cause, based on this finding? wiping from front to back after voiding frequent voiding sexual activity regular participation in a strenuous sport

sexual activity

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is: steatorrhea. currant jelly stools. projectile stools. severe diarrhea.

steatorrhea.

A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition? testicular infection testicular torsion hydrocele varicocele

testicular torsion

Food allergies are an important concern for nurses working in childcare or preschool settings because such sites may be where a child eats allergenic food and experiences a possibly fatal reaction. Early, appropriate administration of epinephrine for the treatment of the symptoms of anaphylaxis can significantly reduce the likelihood of anaphylaxis-related hospital admission. Delayed administration of epinephrine contributes to anaphylaxis-related fatalities. Epinephrine is significantly less likely to be injected in food-induced anaphylaxis than in venom-induced anaphylaxis. Reasons for failure to administer epinephrine include poor perception of the severity of symptoms or patient refusal. Based on the previous study and the fact that Dexter is allergic to peanuts, which statement by Dexter's mother should cause a nurse the most concern? "I pack his lunch every day so I'll know what he eats." "He doesn't need one of those EpiPen things. They are too expensive, and it's not like he has a beesting allergy. If he goes to a party, I'll ask if peanuts will be served." "I know how to read food labels to limit Dexter's food to things I know are safe."

"He doesn't need one of those EpiPen things. They are too expensive, and it's not like he has a beesting allergy. If he goes to a party, I'll ask if peanuts will be served."

A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true? "This will rectify itself if you follow all of the doctor's directions." "You are lucky that you did not have to learn how to give yourself a shot." "Kids can usually be managed with an oral agent, meal planning, and exercise." "A weight-loss program should be implemented and maintained."

"Kids can usually be managed with an oral agent, meal planning, and exercise."

The nurse is caring for a child diagnosed with hand-foot-mouth disease. When educating the family about this disease, which education by the nurse is most important? "Hand-foot-mouth disease is associated with a high fever." "The lesions should disappear in a few days without scarring." "Make sure your child drinks plenty of nonirritating fluid." "You can give acetaminophen every 4 to 6 hours for pain."

"Make sure your child drinks plenty of nonirritating fluid."

The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next? Administer an antipyretic. Auscultate the child's lungs. Begin physical therapy. Place the child on bed rest.

Auscultate the child's lungs.

Carey's grandmother tells the nurse that Carey had symptoms of acute glomerulonephritis last week that were greatly distressing. The nurse identifies which reported symptom as a typical first symptom of glomerulonephritis? Carey said her left knee hurt, although she didn't remember bumping it. Carey asked her grandmother why there was blood in the toilet bowl. Carey cried because she was starting to experience cramps. Carey told her grandmother her stomach hurt after using the bathroom

Carey asked her grandmother why there was blood in the toilet bowl

**While assessing a child brought to the hospital with fever and headache, the nurse notes trismus and swelling above the child's jawline. Which collaborative interventions will the nurse begin? Select all that apply. Don a surgical mask. Ask if vaccinations are current. Monitor for fever reduction. Administer ibuprofen. Begin airborne precautions.

Don a surgical mask. Ask if vaccinations are current. Monitor for fever reduction. Administer ibuprofen.

A nurse is reviewing with an 8-year-old how to self-administer insulin. Which of the following is the proper injection technique for insulin injections? Elevate the subcutaneous tissue before the injection. Spread the skin before the injection. Place the needle with the bevel facing down before the injection. Aspirate the syringe for blood return before the injection.

Elevate the subcutaneous tissue before the injection. (Insulin injections are always given subcutaneously. Elevating the skin tissue prevents injection into muscles when subcutaneous injections are given. The needle bevel should face upward. The skin is spread in intramuscular, not subcutaneous, injections. It is no longer recommended to aspirate blood for subcutaneous injections.)

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? Peptic ulcer disease Gastroesophageal reflux Appendicitis Pyloric stenosis

Pyloric stenosis

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply. Rocky Mountain spotted fever Ascariasis Psittacosis Scabies Lyme disease

Rocky Mountain spotted fever Lyme disease

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting? Prophylactic treatment for HIV Screening for HIV Screening for sexually transmitted infections (STIs) Proper nutrition

Screening for HIV

A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse? This problem needs to be corrected immediately in the newborn period. There is a chance the testicles will descend on their own. Surgery is not needed for this type of problem. If the infant is having swelling or pain, then surgery will be performed.

There is a chance the testicles will descend on their own.

A teenage client active on the high school football team comes to the clinic with a cut on his leg that looks infected. The culture report returns information that leads to a diagnosis of methicillin-resistant Staphylococcus aureus (MRSA). What should the nurse use as preventive measures in this case? contact precautions wearing a mask droplet precautions gloves handwashing

contact precautions gloves handwashing

**A 15-year-old male complains of persistent scrotal pain, edema, and nausea since being hit in the groin by a baseball 3 hours ago. Which is the priority action by the nurse? administering pain medications as ordered ensuring that the teen is assessed by the physician immediately applying an ice pack to alleviate the pain documenting the swelling and discoloration

ensuring that the teen is assessed by the physician immediately

**The nurse is caring for a child diagnosed with hepatitis B. Which system is most likely to have complications from this diagnosis? respiratory neurologic cardiovascular gastrointestinal

gastrointestinal (Complications of hepatitis B can be fatal; in particular, issues related to the liver and chronic conditions are concerns.)

A mother who is HIV positive is distraught when she learns that her 6-month-old baby is also HIV-positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was: breastfeeding. placental spread during pregnancy. blood transfusion products contaminated with the virus. the mother kissing the baby on the forehead.

placental spread during pregnancy. (Although it is decreasing in incidence, transmission of HIV from mother to child by placental spread is still the most common reason for childhood HIV infection in the United States. Children with hemophilia no longer have a high incidence of the disease because blood products are now screened for the virus. HIV is not transmitted by animals or through usual casual contact, such as shaking hands or kissing, or in households, day care centers, or schools. Infection via breast milk is possible but less likely than via placental spread.)

The nurse is reviewing a child's chart and notes hypersensitivity reactions under the diagnosis section. Which additional diagnosis would confirm a type III hypersensitivity reaction? Select all that apply. systemic lupus erythematosus asthma atopic dermatitis rheumatoid arthritis contact dermatitis

systemic lupus erythematosus rheumatoid arthritis

The nurse working with the child diagnosed with type 2 diabetes mellitus recognizes the disorder can be managed by: taking oral hypoglycemic agents. decreasing amounts of daily insulin. increasing carbohydrates in the diet, especially in the evening. conserving energy with rest periods during the day.

taking oral hypoglycemic agents.

The nurse is collecting data on a child who has been nutritionally deprived. The nurse notes that the child is irritable and listless. The foster caregiver reports that the child says she is not hungry and has been vomiting. It is discovered that the child has beriberi. This disease is due to a deficiency in which of the following? iron thiamine vitamin C niacin

thiamine

A nurse should recognize that which symptom would be most consistent with a diagnosis of candidiasis? bloody discharge no discharge thick, white discharge brownish discharge

thick, white discharge

A teenager comes to the clinic with fever, muscle pain, and a macular rash on the palms and soles of the feet. Based on these findings, what diagnosis would the nurse anticipate for this client? premenstrual dysmorphic disorder toxic shock syndrome polycystic ovary syndrome (PCOS) amenorrhea

toxic shock syndrome

Carey is undergoing a VCUG to help diagnose whether she has vesicoureteral reflux. A nurse collaborates with the radiology technician to ensure an accurate test that does not cause distress for Carey. What should the nurse emphasize in order to achieve these goals? The technician will have to read the instructions for the test to Carey. Lying in a large, metal tube is frightening for most children. Children often feel uncomfortable voiding in public. The dye capsules may be too large for Carey to swallow.

Children often feel uncomfortable voiding in public.

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients? Contact precautions Airborne precautions Droplet precautions Standard precautions

Contact precautions

Which of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection? urinalysis chemical reagent strip specific gravity blood urea nitrogen (BUN)

urinalysis

**A nurse is reviewing the medical record of a client diagnosed with bacterial vaginosis. The nurse identifies which criterion as necessary for this diagnosis? Select all that apply. vaginal pH of 4.5 whitish, thick, curdlike vaginal discharge cervical petechiae clue cells present on wet mount positive whiff test

vaginal pH of 4.5 clue cells present on wet mount positive whiff test (To diagnose bacterial vaginosis, three of the following four criteria must be met: thin, grayish white homogenous vaginal discharge that adheres to the vaginal mucosa; vaginal pH of 4.5; positive whiff test; and presence of clue cells on wet mount examination.)

*The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate? Contact the health care provider to request treatment. Encourage parents to avoid feeding the infant peanuts. Advise the parents to change the infant's formula. Instruct the parents to soak the lesions in mineral oil.

Contact the health care provider to request treatment.

Carey's grandmother is deeply concerned that Carey will develop chronic kidney disease later in life. What findings in Carey's laboratory workup would suggest that her kidneys are failing? (Select all that apply.) She has an elevated serum phosphorus level. She is developing a normocytic anemia. Her serum vitamin D level is below normal. Her serum creatinine level is steadily falling. Her blood pressure is steadily increasing.

She has an elevated serum phosphorus level. She is developing a normocytic anemia. Her serum vitamin D level is below normal. Her blood pressure is steadily increasing (fluid overload)

A school-aged child with an infectious disease is placed on transmission-based precautions. If the child is not dehydrated or otherwise in distress, which nursing diagnosis would be the priority? Deficient knowledge related to how infection is transmitted Fluid volume deficit related to increased metabolic demands and insensible losses Impaired skin integrity related to trauma secondary to pruritus and scratching Social isolation related to infectivity and inability to go to the playroom

Social isolation related to infectivity and inability to go to the playroom

A nurse on the care team calls off work because she's worried she has contracted mumps (infectious parotitis). Which of the following symptoms is most associated with mumps? A productive cough and a severe runny nose Pronounced swelling behind both of her ears Swelling above the jaw line in front of the ear, obscuring the jaw line Adenoid tonsils are reddened and swollen and hur

Swelling above the jaw line in front of the ear, obscuring the jaw line

A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition? Syndrome of inappropriate antidiuretic hormone (SIADH) Vitamin D toxicity Thyroid storm Cushing syndrome

Syndrome of inappropriate antidiuretic hormone (SIADH)

The registered nurse (RN) and an unlicensed assistive personnel (UAP) are providing care to a client receiving IV immune globulin (IVIG) for the treatment of Kawasaki disease. Which task will the RN delegate to the UAP? Disconnect the client from the IV to assist the client to the bathroom. Take the client's meal tray into the room. Watch the client for signs of an adverse reaction. Administer the medication intramuscularly to the client.

Take the client's meal tray into the room.

The nurse is teaching a group of caregivers of children diagnosed with diabetes mellitus. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur? "My child monitors their glucose levels to keep them from going too high." "If my child eats as much as their older brother eats they could have an insulin reaction." "My child measures their own medication but sometimes doesn't administer the correct amount." "On the weekends we encourage our child to participate in lots of sports activities and stay busy so they don't have an insulin reaction."

"My child measures their own medication but sometimes doesn't administer the correct amount."

Which of the following is the drug of choice for multidrug-resistant strains of infection? trimethoprim/sulfamethoxazole clindamycin vancomycin erythromycin

vancomycin

**The onset of appendicitis is sudden and parents may be unable to arrange to room-in with their hospitalized child. Despite being encouraged and often included in medical rounds as a means to improve communication and increase their knowledge of and participation in their child's care, work responsibilities, care of siblings, a long commute to the hospital, and other types of situations may prevent parents from being with their child during the entire stay. Having daily interaction with the healthcare team lessens parental anxiety about their child's health (Yager, Clark, Cummings, et al., 2017). A study conducted by Yager et al. (2017) found that providing access to medical rounds through telemedicine to parents had a positive effect. It offered them reassurance regarding their child's care and increased their communication with the healthcare team. Based on this study, the nurse determines which strategy is most effective to decrease parental anxiety when parents are unable to stay with their child for several hours during the day? Offer to take notes on the medical rounds and verbally provide them to the parents when they arrive. Offer to call them during medical team rounds, so they can participate. Reassure them their child may receive more attentive care than a child whose parent is present. Ensure the parents their child will be well cared for and they can call anytime to check on them.

Offer to take notes on the medical rounds and verbally provide them to the parents when they arrive.

Nursing students are learning about female reproductive disorders and problems. What does the instructor explain is why circumcised females might have difficulty with childbirth? inflammation of the ovaries vulvar scarring and contraction scarring of the uterus occlusion of the vagina

vulvar scarring and contraction

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea, the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea? "Emotional stress can be a cause of this disorder." "It is caused from taking birth control pills when a girl is younger than 13 years old." "This disorder is usually seen after a girl has had a spontaneous abortion." "This is what happens if a 16-year-old girl has never had any periods at all."

"Emotional stress can be a cause of this disorder."

The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment? "Without the treatment your child's gonads will not reach normal size." "Your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do." "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." "Without the hormone your son will have fluid that will collect in his scrotum."

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

A child presents with intermittent abdominal pain, severe anorexia, and diarrhea. The child's height and weight are significantly behind standards for age. There is skin breakdown in the anal region. The nurse explains that this presentation is consistent with which diagnosis? Crohn disease Hirschsprung disease ulcerative colitis food poisoning

Crohn disease

**A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication? Spina bifida in the fetus Decreased cognitive development of the fetus Gestational diabetes in the mother Congenital heart defects in the fetus

Decreased cognitive development of the fetus (If acquired hypothyroidism exists in a woman during pregnancy, her infant can be born intellectually disabled, because there was not enough iodine present for fetal growth. It is important, therefore, that girls with this syndrome be identified before they reach childbearing age.)

A 16-year-old girl visits her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she was prescribed an oral contraceptive at her last visit. Which intervention should the nurse implement in this situation? Recommend that she ask the gynecologist about endometrium ablation to halt the metrorrhagia. Refer the client to her primary care physician for examination for possible uterine or cervical cancer. Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that. Recommend that she ask the gynecologist to change her prescription to a different oral contraceptive.

Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that.

A nurse is giving a talk to nursing students about women's health. What does the nurse tell the students is the main cause of dysmenorrhea in adolescents? premenstrual dysphoric disorder endometriosis metrorrhagia amenorrhea

endometriosis

**A young couple seeks pregnancy counseling in the women's health clinic. They tell the nurse performing a focused health history that they are of Jewish descent and are worried about conceiving a baby with Tay-Sachs disease. No known metabolic disorders exist in the family medical history. What is the nurse's best response to this couple's concerns? "Carrier testing is warranted for couples who have an elevated risk for Tay-Sachs disease due to their ethnic origin." "Neonatal screening is available to diagnose Tay-Sachs in an otherwise asymptomatic neonate in as little as two weeks." "Early diagnosis of the disease can be made in utero and a decision can be made at that time to maintain or terminate the pregnancy." "Since neither of you have a metabolic disorder, you should not be concerned about conceiving a baby with Tay-Sachs.

"Carrier testing is warranted for couples who have an elevated risk for Tay-Sachs disease due to their ethnic origin."

The nurse is caring for an infant brought to the clinic for a rash. The nurse notes a blanchable, rose-pink macular rash on the trunk. The nurse obtains the following vital signs: temperature 99.0°F (37°C), pulse 100 bpm, respiratory rate 22 breaths/minute, and oxygen saturation 100% on room air. Which question by the nurse will be most helpful when planning interventions? "Do you have family history of seizures?" "Is your child more fussy than normal?" "Has your child had a recent fever?" "Are your child's vaccinations up to date?"

"Has your child had a recent fever?"

A 10-year-old child has been diagnosed with type 1 diabetes mellitus. The child is curious about the cause of the disease and asks the nurse to explain it. Which explanation will the nurse provide? "The part of your body called the pancreas is broken and produces too much chemical called glucagon, which makes you really thirsty and have to go to the bathroom a lot." "The alpha and beta cells in your pancreas are fighting against each other; that is why your blood sugar stays high and you need insulin injection." "The pancreas inside your belly makes enough chemical called insulin, but your body does not want to use it to keep your blood sugar level normal." "Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood."

"Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood."

A mother tells the clinic nurse that her family wants to go on vacation this year, but that they are afraid to go to their usual spot because their young daughter has problems with pollen-related allergies. What should the nurse recommend to this mother? Go on vacation in the winter to a cold place. Do not plan a vacation--allergies will make it unpleasant for everyone. Plan the vacation anytime, but bring along plenty of antihistamines. Plan the vacation at a time when the pollen count is lowest.

Plan the vacation at a time when the pollen count is lowest.

Navi, 15 years of age, asks whether it would be safe for her to have breast augmentation. What advice should the nurse give her? She would not likely be able to breastfeed after undergoing augmentation. Breast implants increase her risk of developing fibrocystic disease. It is safe for girls her age to have this surgery, but careful consideration is needed. Implants increase her risk of breast cancer in later life.

It is safe for girls her age to have this surgery, but careful consideration is needed.

***A school-aged child has come to the clinic with symptoms of a urinary tract infection. The child reports dysuria, frequency and hesitancy. What nursing assessment is most important for the nurse to complete? Assess for bladder distention. Measure the urine output. Monitor the temperature. Assess for flank pain.

Assess for bladder distention. (In school-aged and older children, a urinary tract infection can be manifested by fever, vomiting, dysuria, frequency, hesitancy, urgency, flank pain and poor appetite. Because there are dysuria and hesitancy, the bladder may not empty fully. It is most important for the nurse to palpate the bladder for distention. Keeping a distended bladder can cause reflux and continue to harbor bacteria. The urine output can be measured to determine the amount, but the urine also provides a look at the color for hematuria. The temperature should be measured, and antipyretics administered if necessary. Pain medication may be prescribed by the health care provider. The nurse can also recommend warm sitz baths and the use of a heating pad over the flank area for pain relief.)

What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy? Children show an increased need for insulin during the first months after glucose control is established. All children should be on at least two types of insulin to establish glucose control. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. Once glucose control is established, there will never be a need for an increase in the amount of insulin administered.

It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.

A 10-year-old girl with an intestinal virus has been vomiting and has become dehydrated. She says she is mildly thirsty, her skin turgor is poor, and her skin is dry and cool. Her serum sodium level is normal. The nurse recognizes that she has which type of dehydration? acidotic hypotonic hypertonic isotonic

isotonic

The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which function is a major task of the kidneys? regulate blood pressure produce white blood cells circulate cerebrospinal fluid remove carbon dioxide

regulate blood pressure

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of pyloric stenosis? A thickened, elongated muscle causes an obstruction at the end of the stomach. A partial or complete intestinal obstruction occurs. There are recurrent paroxysmal bouts of abdominal pain. In this disorder the sphincter that leads into the stomach is relaxed.

A thickened, elongated muscle causes an obstruction at the end of the stomach.

Barry's mother tells that the nurse she is anxious about the possibility of "food poisoning" and that she particularly wants to prevent Salmonella poisoning in her family. Which actions would the nurse suggest? Urge family members to keep their immunizations up to date. Avoid excessive intake of dairy products. Don't cut vegetables on a cutting board used to cut raw chicken. Wash fruits such as strawberries and grapes with soap & water before eating.

Don't cut vegetables on a cutting board used to cut raw chicken.

Carey is subsequently diagnosed with nephrotic syndrome. The nurse determines which action is best to provide patient education for the grandmother? Caution her grandmother to not feed her foods high in salt because salt irritates glomeruli. Encourage her to walk to school daily for exercise. Teach her grandmother to test Carey's urine for protein using a dipstick. Teach her grandmother how to take Carey's tympanic temperature daily

Teach her grandmother to test Carey's urine for protein using a dipstick.

***A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting? The child has been sexually abused, maybe on the fishing trip. The child has a urinary tract infection due to not bathing while on the fishing trip. The child did not want to go on the fishing trip and is now retaliating against being made to go. The child is out of the habit of waking himself up during the night to void.

The child has been sexually abused, maybe on the fishing trip

A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl subsequently played with. In this case, what is the portal of exit in the chain of infection? Toy The 5-year-old girl Upper respiratory excretion The friend

Upper respiratory excretion (The portal of exit is the route by which an organism leaves an infected child's body to be spread to others. An organism can be carried out of the body by upper respiratory excretions, feces, vomitus, saliva, urine, vaginal secretions, blood, or lesion secretions. The friend would be the reservoir, which is the container or place in which an organism grows and reproduces. The toy would be the means of transmission. The 5-year-old girl would be the susceptible host.)

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply. Removing ticks by rubbing them away from the skin with a credit card. Wearing protective clothing when playing in wooded areas. Dressing the child in dark clothing when going outdoors. Inspecting the skin closely for ticks after the child plays in wooded areas. Contacting the health care provider if there is any area of inflammation that might be a bite.

Wearing protective clothing when playing in wooded areas. Inspecting the skin closely for ticks after the child plays in wooded areas. Contacting the health care provider if there is any area of inflammation that might be a bite

An older school-aged child is allergic to wasp stings. The nurse is teaching the child and the parents about ways to minimize the child's risk. Which of the following would the nurse include in the teaching plan? Select all that apply. having a readily available fast-acting insecticide when outdoors avoiding household chores like dusting or vacuuming wearing scented lotions to ward off the insects not drinking from open soda cans when outside wearing appropriate footwear when going outside

having a readily available fast-acting insecticide when outdoors not drinking from open soda cans when outside wearing appropriate footwear when going outside

When Dexter's mother heard he had another allergic diagnosis, she wanted Dexter worked up for an immune system disorder "because he has colds all of the time." When reviewing the blood work of a child with allergic rhinitis, what results are most helpful? Select all that apply. Specific IgE levels to cat, dog, tree, grass, and weed mix Serum immunoglobulins (IgG, IgA, and IgM) Complete blood count with differential Basic metabolic panel

Specific IgE levels to cat, dog, tree, grass, and weed mix Complete blood count with differential (A CBC w/ differential is always the best starting point to evaluate a child like Dexter. Allergic children generally have a higher number or proportion of eosinophils in the blood. Children with immunodeficiencies may have elevated neutrophil counts if they have an active bacterial infection. At baseline, a reduced lymphocyte count or percentage may be a "red flag" for an immunodeficiency. Allergic children generally have elevated IgE levels, both the overall serum IgE as well as allergen-specific IgE.)

Carey's grandmother is concerned because Carey had two UTIs last year. Which of the following statements best shows that Carey's grandmother received adequate patient education on the prevention of UTIs? "I won't allow Carey to drink too much milk or eat foods like yogurt." "I'll try to have Carey bathe with bath salts to discourage bacteria in her groin area." "I'll be certain to administer all of the antibiotic pills that the doctor prescribes." "I'll make sure that Carey doesn't overexert herself when she's playing with her friends."

"I'll be certain to administer all of the antibiotic pills that the doctor prescribes."

Because parents have so much influence on how children adjust to having a long-term illness, researchers administered a questionnaire to a total of 185 parents with children 1 to 19 years of age divided into three groups: one where the children had either PKU or galactosemia; one where the children were healthy; and a third group where the children had a chronic illness, which was likely to interfere with longevity. Results of the study revealed that the parents of children with PKU or galactosemia rated their quality of life equal with that of parents of healthy children and far above that of parents whose child could have a short life span. Factors that influenced the children's quality of life most were the presence of support people (a positive effect) and loss of friends (a negative effect) Based on this study, which comment by LaRoya, a 12-year-old girl who comes to the clinic because she has galactosemia, would make the nurse believe LaRoya's family's quality life is not ideal? "My mother still loves to cook, although no one comes over anymore." "We go to church every Sunday; my dad helps teach church school." "We've lived in the same house for 10 years; the carpet is getting old." "My grandmother is hard of hearing, so we have to shout so she hears us."

"My mother still loves to cook, although no one comes over anymore."

When kidney disease becomes chronic, it places a great burden on caregivers' energy and finances. To investigate how parents feel about caring for a child with chronic kidney disease, researchers interviewed parents of 20 children with chronic kidney disease recruited from two pediatric hospitals. Results of the study revealed four major themes: parents had to struggle to accept the diagnosis and permanence of their child's disorder; parents found continuous caregiving stressful, exhausting, and overwhelming; spousal tension and sibling neglect occurred; and parents felt they needed support from their healthcare providers (Tong, Lowe, Sainsbury, et al., 2010). In addition, a recent first-of-its-kind meta-analysis examining caregiver stress in pediatric chronic conditions indicates that caregivers of children with chronic illness endorse greater general parenting stress than caregivers of healthy children (Cousino & Hazen, 2013). Based on these studies, if Carey developed chronic kidney disease, which action by a nurse would be most helpful? Assure the grandmother she can call the clinic at any time if she has a concern. Ask the grandmother to keep a daily record of conversations she has with Carey. Review with the grandmother ways that Carey will require even more care in the future. Help the grandmother learn to say "no" when other family members ask her to help them.

Assure the grandmother she can call the clinic at any time if she has a concern.