peds final

The nurse is assessing a 5-month-old infant. Which vital sign should be LOWER for a healthy infant than for a healthy adult?

blood pressure

The nurse is assessing an 18-month-old child. Which statement by the mother would concern the nurse and indicate evaluating the child for possible developmental delay?

"My child is able to stand but is not taking any steps independently.

The nurse is assessing a child who has had cold symptoms for more than 2 weeks. Current symptoms include a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. What respiratory condition should the nurse recognize?

sinusitis

The nurse is reviewing safety information with a class of high-school students in a Developmental class. Which of the following is important to discuss with this age group that is NOT a common concern with toddlers?

suicide

Which of the following is an expected finding in Mumps?

swollen parotid glands

The nurse receives a phone call from a parent who says her child developed chickenpox (varicella) the day after attending a classmate's birthday party. Which information is MOST important for the nurse to give the parent?

tell the parents of the other children that your child has chicken pox

The nurse is assessing an adolescent who is hospitalized on the pediatric unit. Which of the following would NOT be an expected finding for this child's cognitive development?

the adolescent can not follow directions for lowering the bed rail

The nurse is assessing fine motor skills for an 18-month-old toddler. Which of the following would be an expected finding to acquire in toddler skill age range?

the child can hold a spoon to eat

An experienced pediatric nurse is training a new RN on the unit. What should the nurse explain is the single MOST important factor to consider when communicating with children?

the childs developmental level

The nurse is assessing a toddler who fell out of a second-story window. She had a brief loss of consciousness and vomited four times, but she has been alert and oriented since admission. The mother asks why a CT scan is required when the child "seems fine." What would be the nurse's BEST explanation?

the ct scan will evaluate your child for brain injury

The school nurse is reviewing records for a child with human immunodeficiency virus who takes several antiretroviral drugs. What is the purpose of these drugs?

they delay the disease progression

The nurse is caring for a 4-year-old boy whose parents say they will return to the pediatric unit at 1:00 PM. How should the nurse BEST respond at 10:00 AM when the boy asks when his parents are coming?

they will come after lunch

The nurse is assessing an infant whose parents report a recent upper respiratory illness. Which of the following findings would indicate respiratory distress? Select all that apply

Grunting on expiration Nasal flaring Respiratory rate of 80 breaths per minute

The nurse is caring for an infant in the clinic whose parents say they do not want the child to be immunized, preferring instead that the child develop natural immunity by contracting the illnesses. How should the nurse BEST respond?

"These diseases have many serious consequences. I will review the immunizations that are suggested today with you."

The nurse is providing nutrition information to parents being discharged from the Birthing Unit with their newborn. At what age is it safe to give infants cow's milk instead of commercial infant formula?

12 months

The nurse is planning care for a 4-year-old child who will be hospitalized for several days. Which of the following toys and activities would be MOST appropriate?

painting and drawing simple puzzles pretend play like dress up

The school nurse is assessing a teenager who reports fever, chills, sore throat with "kissing tonsils", and extreme fatigue for the past two weeks. Which focused assessment is MOST appropriate to perform?

palpate the abdomen

The nurse is assessing several children in the Emergency Department. Which child should the nurse be MOST concerned about possible abuse?

4 month old with left fractured femur

The nurse is assessing an infant at a well-child exam. By which age can most infants sit steadily unsupported?

7-8 months

The nurse is assessing a child during a home visit. At what age should the nurse expect the infant will be able to pull to a standing positio

8-10 months

The nurse is planning care for a 7-month-old child. Which play activity is MOST appropriate to encourage the child's development of object permanence?

playing peekaboo

The nurse is caring for several children on the pediatric unit who have head injuries or brain infections. Which child requires the nurse's MOST immediate attention?

A child who was alert an hour ago, now responds only to painful stimuli with a Pediatric Glasgow Coma Scale score of 9

The nurse is planning care for an adolescent who has a long hospital stay. What should the nurse know about the cognitive development of adolescents? Select all that apply

Adolescents can evaluate the quality of their own thinking Adolescents can use formal logic to make decisions Adolescents think beyond current situations to consider future plans

The nurse is planning care for a 4-year-old child who will be in the hospital for several days. In order to reduce the child's stress during this time, which interventions should the nurse include? Select all that apply

Allow the child choices whenever possible Demonstrate procedures on a doll or stuffed animal Encourage the parents to stay with the child Bring familiar objects from home

The nurse is caring for a child with a suspected Wilms' tumor. Which of the following interventions should the nurse anticipate?

Chemotherapy and radiation may be necessary The tumor usually involves only one kidney surgery to remove the tumor

The nurse is preparing routine immunizations for a 2-month-old child being seen at the clinic for a well-health exam. Which immunizations should the nurse expect to be given at this visit?

Dtap, HIB, and IPV

The nurse is reviewing safety interventions with parents of an 8-year-old child. Which of the following information is MOST appropriate at this age? Select all that apply

Helmets should be worn when riding a bicycle or skateboard Guns and bullets should be kept separate and locked Knowing how to swim is important for safety

The nurse is caring for a child with severe heart failure from a congenital cardiac anomaly. Which cardiac condition MOST likely requires a heart transplant?

Hypoplastic left heart syndrome

The nurse is assessing a 15-month-old child whose mother states, "My child does not make noises like 'da' or 'ma' like his cousin, who is only 9 months old." Which statement by the nurse would be the MOST appropriate response?

I am going to request a refferal from a hearing speacialist

The nurse is reviewing appropriate activities for children who are hospitalized on the pediatric unit. Which of the following statements should the nurse use to guide decisions about age-related activities?

Infants engage in solitary play without regard for other children Cooperative play includes games with designated rules and goals Preschoolers engage in associative play with loosely organized games

The nurse is providing teaching to parents of a child recently diagnosed with leukemia. Which of the following should the nurse include when BEST explaining the pathophysiology of this disease?

Leukemia causes excess proliferation of immature white blood cells

The nurse is caring for a child who is having a tonic clinic (grand mal) seizure. Which of the following are appropriate interventions?

Loosen restrictive clothing Maintain the child in side-lying position to facilitate airway/drainage of secretions Note the onset and duration of the seizure

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." How should the nurse BEST respond?

Order the child a vegetarian meal ensuring it meets protein and caloric needs

hich of the following statements are FACTS (true) statements about communicable illnesses?

Patients with Fifth Disease are contagious until the "slapped cheek" rash appears. Pertussis can induce seizure activity in infants and children but not in teens and adults. A complication of mumps is deafness

The nurse is discharging a child at high risk for bacterial endocarditis due to a cardiac condition. Which of the following is priority preventive information to include in the discharge teaching?

Prophylactic antibiotics are needed before dental procedures

The school nurse has been asked to teach puberty and sex education in the 5th grade class. Which statement BEST reflects this situation?

Puberty and sex should be presented as part of normal growth and development

The nurse in a pediatric clinic suspects that a child might have been abused. Which nursing action is the PRIORITY?

Report the concerns to the state child protective agency

The nurse is reviewing normal toddler behavior with parents of a child who has been having temper tantrums. What explanation should the nurse give about toddlers' psychosocial development?

Temper tantrums are one way toddlers show their developing autonomy

The nurse is caring for a 2-year-old child in the clinic whose parents think he may have autism spectrum disorder. What is an important consideration when discussing the parents' concerns?

a refferral should be made for further evaluation

The nurse is assessing several children at the clinic for well-child exams. Which child should the nurse be MOST concerned about?

a six month infant who can not lift his head while lying on his belly

A child in the second grade has been having episodes of dropping her pencil and daydreaming during class. Which type of seizure should the school nurse suspect?

absence seizure

The nurse is providing education to parents of a child with hemophilia A. Which of the following actions should the parents be instructed to do FIRST if the child sustains a serious injury to the joint and is actively bleeding a large amount?

administer factor VIII

The nurse is caring for a child who arrives in the Emergency Department with sickle cell crisis. Which intervention should the nurse perform FIRST?

administer oxygen

The nurse is caring for a school-age child with leukemia who experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the MOST appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

administer the antimetic before chemotherapy begins

The school nurse is discussing a student with the guidance counselor. Which behavior described by the nurse suggests normal psycho-social development in the adolescent?

adolescence are self absorbed and have frequent mood swings

The parents of a 16-month-old ask, "How should we keep our child from getting into our medicines at home?" What is the BEST response for the nurse to give?

all medication should be locked securely away

The nurse is providing teaching to new parents. What should the nurse suggest as the BEST time for introducing solid food into the infant's diet?

around 6 months

The nurse is taking a health history on an adolescent. How should the nurse BEST determine the adolescent's main concern?

ask the adolescent directly for their main concern

The school nurse is providing parents with information on pediatric illnesses. Which action would help reduce the risk of Reye's syndrome?

avoid aspirin for children with influenza

The nurse is caring for a child with spina bifida and a suspected latex allergy. Which nursing intervention is MOST appropriate to include?

avoid using any latex products

The nurse is caring for a young child with leukemia who screams whenever he needs to be turned or moved. What is the MOST likely cause of his pain?

bone marrow involvement from leukemia cells

he nurse is teaching a class on nutrition to parents of young children. Which of the following statements should the nurse include in the presentation? Select all that apply

children less than 12 months should not eat honey Solid food can be introduced between 4-6 months of age oung children should always be supervised when eating

The nurse is assessing a child with acute epiglottitis and avoids using a tongue depressor to visualize the throat. What condition is the nurse trying to prevent from occurring?

complete obstruction

The nurse is reviewing the care plan with parents of a child who has tuberculosis. Which consideration is the MOST important for managing this disease?

consistent medication administration

The nurse is caring for an infant with a myelomeningocele scheduled for surgical closure in the morning. Which intervention would be the MOST appropriate care of the myelomeningocele sac?

cover the sac with a sterile, moist, non adherent dressing

The nurse is assessing a toddler with suspected otitis media. Which symptoms would the nurse expect to find?

crying/irritability tugging or rubbing at the ear history of recent upper respiratory infection

The nurse is caring for a toddler who needs a procedure. What would be the BEST approach to help prepare the toddler?

demonstrate the procedure on a doll

The nurse is caring for a child with a neuroblastoma. When explaining this disorder to the child's parents, what information should the nurse include?

diagnosis is usually made after metastasis has occurred

The nurse is explaining to parents why b-Adrenergic agonists are often prescribed for a child with an asthma attack. Which statement BEST explains the action of these medications?

dialate bronchioles

The nurse is assessing a 3-year-old child's progress toward developmental milestones during a home visit. What fine motor skills should the nurse expect this child to do?

draw a circle

The nurse is caring for a child with a significant ventricular septal defect (VSD). Which finding would NOT be expected for this condition?

elevated blood pressure in the upper extremities

The nurse is caring for a child who has mucositis as a side effect of chemotherapy. Which nursing intervention will MOST help alleviate this problem?

encourage soft non acidic foods

The nurse is assessing pain in a 12-month-old child using the FLACC pain scale. What categories does this scale measure?

face, legs, activity, cry, consoulability

The nurse is planning care for a child who was admitted to the pediatric unit with neutropenia. Which of the following is MOST important to include in the information given to the child's parents?

flowers, plants, and fresh produce are not allowed

The nurse is planning care for an 8-year-old child following surgery. In addition to scheduled pain medication, which of the following would be the MOST appropriate intervention to help manage pain for this age child?

games and riddles

The nurse is providing teaching for parents of a child who has cystic fibrosis. Which of the following instructions should the nurse include?

give pancreatic enzymes with meals and snacks

The nurse is planning to give liquid medication to a crying 10-month-old infant. What is the BEST approach to minimize the possibility of aspiration?

give the medication slowly in small amounts with an oral syringe

The nurse is reviewing immunization information with a parent. Which of the following reactions to routine vaccinations should the parent report to the provider?

high fever and seizure

The nurse is planning care for an adolescent in the hospital. Which of the following concerns would NOT be typical for this age child?

hospitalization is a punishment

The nurse needs to assess a 10-month-old infant who is sitting on the father's lap, appears to be afraid of the nurse and of what may happen next. What should the nurse do FIRST?

initiate a game of peekaboo

The nurse is planning care for a toddler on the pediatric unit. Which factors are commonly most stressful for hospitalized children in this age group? Select all that apply

interrupted routine sleep disturbances fear of being hurt

The school nurse tells adolescents who come for care that confidentiality and privacy will be maintained unless a life-threatening situation arises. How should this practice be interpreted?

it is important in establishing trusting relationships

The nurse is caring for a 10-month-old during a well-child check. The child's parent asks if the nurse can give the first MMR vaccine during the visit. What is the nurse's BEST response?

its too soon to give that vaccine today

The nurse is planning activities for three school-age children who are hospitalized on the pediatric unit. What should the nurse know about play for this age group?

knowing the rules of the game provides an important sense of belonging

The school nurse is meeting with the parents and teacher of a 9 year-old child to plan strategies for improving the child's school performance. What is the MOST appropriate way to support this child's healthy psycho-social development?

mastery of appropriate skills should be encouraged and rewarded

The school nurse is assessing a child whose teacher referred him for a vision check due to excessive eye rubbing during class, difficulty reading the board and reports of frequent headaches. Which alteration in visual acuity should the nurse suspect?

myopia (nearsightedness)

The nurse is assessing a 5 year-old child for possible bacterial meningitis. Which of the following findings would NOT be associated with meningitis?

negative brudzinskis sign

The nurse is caring for a child who is two hours postoperative following resection for a brain tumor. Which assessment should be the PRIORITY?

o2 sat assessment

A 4-year-old child tells the nurse that she does not want another blood sample drawn because "I need all my insides, and I don't want anyone taking them out." How should the nurse BEST interpret this statement?

preschoolers have poor understanding of body boundaries

The nurse is caring for a child with persistent hypoxia secondary to tricuspid atresia cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. Which of the following is MOST important to decrease this risk?

prevent dehydration

The nurse is caring for an 8-month-old infant who is restrained to prevent interference with the intravenous infusion. Which is the BEST action of the nurse?

remove the restraints whenever possible, assessing the site at least every hour

The nurse in the outpatient clinic is caring for a 16-year-old who requests an IUD insertion for contraception following the birth of her infant. What should the nurse consider when needing consent forms signed for this procedure?

risks and benefits of a procedure are part of the consent process

The nurse is caring for a child admitted to the hospital with RSV, respiratory syncytial virus. Which of the following statements best explains the illness to the child's parents?

rsv is treated by managing the symptoms with oxygen and fluids

The nurse is planning care for a toddler who is hospitalized on isolation. Which play item should the nurse bring from the playroom?

set of large plastic building blocks

The school nurse was told about a group of boys ages 9 and 10 who formed a "boys-only" club for neighborhood and school friends with skateboards. How should the nurse BEST interpret this behavior?

this behavior is a normal characteristic of social development

The nurse is assessing a 14-years-old male whose parents are worried because he seems to be always eating, although his weight is appropriate for his height. How should the nurse explain this situation to the child and his parents?

this eating pattern is normal because of increased growth

A nurse supervising two toddlers in the playroom on the pediatric unit observes one child suddenly grab a toy from the other child. How should the nurse MOST accurately interpret this behavior?

this is typical behavior because toddlers are egocentric

The nurse is caring for a 5-year-old child who needs a venipuncture to start an IV infusion. What is the MOST appropriate statement for the nurse to make?

this will feel like a pinch, we can hold your arm still to help you

The nurse is caring for a child with Kawasaki disease. What should the nurse know about managing this illness?

treatment gamma globulin and aspirin

The nurse is assessing a 24-month-old toddler in the clinic. Which gross motor skill should the nurse expect for this child?

walking up and down stairs with both feet on step