peds final
The nurse is caring for a 4-year-old with acute lymphoblastic leukemia. The child weighs 38 lbs. The medication order are: ondansetron 2.6 mg IV every 8 hours for chemotherapy-related nausea/vomiting. Ondansetron is supplied as 4mg/2mL. How many milliliters will the nurse administer? Round to the nearest 10th.
1.3 mL
Pediatric healthcare provider prescription: Dosage: Acetaminophen elixir 10mg/kg PO Available: Acetaminophen elixir 160 mg/ 5mL Childs weight: 10 pounds How much acetaminophen will you administer?
1.4 mL
The healthcare provider writes a prescription for medication to be given X 2.5mg/kg/day. The child weighs 100 pounds. How many mgs will the nurse give?
113.62 mg
A parent seems concerned about the fact that the infants soft spot is still open which of the following would the nurse include when explaining the usual age for closure of the soft spot near the front of the infants head
12 to 18months
A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5mg/kg PO every 12 hr for 5 days. The client weighs 88lbs. How many mg should the nurse administer per dose?
200 mg
The parents ask the nurse why their child just diagnosed with leukemia needs a "spinal tap." Which is the best response by the nurse?
Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system
The nurse caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate?
Since dry heat treatment of the factor began in 1986, there have been no reports of virus transmission.
the nurses caring for an infant with suspected patent ductus arteriosus which assessment findings would the nurse use helping to confirm this suspicion
Tachycardia, bounding peripheral pulses
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?
Tenting of skin
A newborn has been diagnosed with congenital heart disease which congenital heart disease is associated with cyanosis during crying or feeding?
Teratology of fallot
the nurse is assessing a child with acute post streptococcal glomerulonephritis. what would the nurse expect to assess select all that apply
abdominal pain crackles hypertension
A 6year old child begins thumb sucking after surgery. This was not the childs behavior preoperatively. What is the best action for the nurse to take?
accept the thumb sucking
The student nurse is learning about pediatric growth and development. The student nurse learned which developmental stage is unstable and challenging regarding personal identity development?
adolescence
the nurse in the clinic regularly works with children of all ages which of the following age groups does the nurse know has a tendency to have eating disorders?
adolescents
The mother of a child, who is 2 years six months in age, has arranged a playdate with the neighbor whose child is 2 years nine months old period during the play date, the mother should expect the children to do which of the following?
alongside one another but not actively with one another
A mother brings her 18 month old to the clinic because the child eats ashes crayons and paper which of the following about the toddler would the nurse assess first
any changes in the home environment
a nurse is instituting neutropenic precautions for a child. What information would the nurse most likely include select all that apply
avoid rectal exams, suppositories, enemas placing a mask on the child when outside the room discouraging fresh flowers in the child's room
The nurse on the pediatric unit is discussing Kohlberg's theory with a nursing student. Which of the following statements reflects Kohlberg's theory of moral development of the preschool age child
behavior is determined by consequences
a mother brings her child in for a well child check and the nurse is teaching the mother about a toy that is the best choice for a 2 year old which toy is the best selection?
blocks
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 body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between patients?
contact precautions
The nurse is caring for a school age child with tinea capitis the child has open lesions from the disease and has lost hair in the areas affected. which nursing diagnosis would be part of this client care plan select all that apply
impaired skin integrity disturbed body image risk for infection
A nurse is preparing a plan of care for a child with primary immunodeficiency. Which nursing diagnosis is the priority?
ineffective protection related to impaired humoral defenses
A nurse explains to parents of a 2 1/2 year old to expect which of the following comments from the toddler about a new baby sibling
it is time to put the baby away so we can play
A nurse is working with children and adolescents on the pediatric unit in the hospital. The nurse knows the individuals development of distinguishing right and wrong and developing ethical values is based on which of the following
moral development
The nurse is assessing a four month old infant who has meningitis. which of the following manifestations should the nurse expect?
muscle rigidity
which statement by the mother of an 18 month old would lead the nurse to believe the child should be referred for further evaluation for the developmental delay
my child should be able to stand but not yet taking steps independently
when the nurse assesses pain in the toddler which of the following methods would be the most appropriate
observe the child for restlessness
After teaching the parents of a child diagnosed with celiac disease about nutrition the nurse determines that the teaching was effective when the parents have identified which foods as appropriate for their child? Select all that apply
peanut butter carbonated drinks shellfish jelly
the nurse is providing atraumatic care to children in a pediatric unit what are the principles of this philosophy of care select all that apply
promote a sense of control prevent or minimize physical stressors prevent or minimize parent-child separation
A nurse is teaching a group of parents about possible manifestations of Down syndrome. Which of the following findings does the nurse include in the teaching? Select all that apply
protruding abdomen broad, short feet and hands hypotonia
The nurse is caring for a child admitted with gastroesophageal reflux (GER) which clinical manifestation would likely be seen in this child?
recurrent vomiting or regurgitation
The nurse is examining a 17 month old child who was able to walk at the last visit and now can no longer walk. What would be the nurses best intervention in this situation?
schedule an immediate full evaluation
the nurse in the pediatric intensive care unit (PICU) is caring for an infant diagnosed with hydrocephalus when teaching the parents about treatments for hydrocephalus. Which of the following does the nurse inform their parents as a possible treatment?
shunt placement
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess
strawberry tongue
Which exercise would the nurse suggest as most helpful to maintain mobility and a child with juvenile idiopathic arthritis
swimming
The nurse is caring for a 5 year old child with special care needs. Which intervention would have the most positive effect on this child
taking the child on an adventure down the hall
The nurse is questioning the 12 year old who has frequent headaches and nosebleeds. which focused assessment should the nurse include to rule out coaraction of the aorta? select all that apply
temperature and color of extremities bp in all four extremities pulse quality of all four extremities
The nurse is teaching a class about childhood development. Which of the following describes Piaget's stage of concrete operations?
thought processes become more logical and coherent
the nurse in a clinic is assessing the communication patterns of a four month old child. The nurse has determined the highest level of development has been achieved if the child:
uses monosyllabic babbling
A child is admitted to the pediatric ICU following an appendectomy. When the nurse is assessing the childs pain which action by the nurse is most important?
using the same tool to assess the child's pain each time.
The parents of a 10 year old boy with cystic fibrosis restrict him from camping, sleepovers with friends, and school field trips. They time his respiratory treatments and log his diet, choosing most foods for him. they have him seen medically between scheduled appointments and call their health care provider frequently with concerns. The nurse considers these behaviors indicative of
vulnerable child syndrome
the nurse is preparing a presentation to a local parent group about pediatric health supervision period which would the nurse emphasize as the focus?
wellness
The nurse is caring for a child with a suspected head injury the nurse observes for what response to the child eye reflex examination would indicate potential increased in cranial pressure
while assessing the child's pupils there is no change in diameter in response to a light
the nurse is providing care for an infant with special needs. Which intervention will be most important in helping the child reach his or her maximum developmental potential?
Directing the parents to an early intervention program
The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a variety of tests including a lumbar puncture before beginning chemotherapy what action would be the priority
educating the child and family about the testing procedures
A nurse is providing care for a child exhibiting separation anxiety. What should the nurse do to prevent separation anxiety in a hospitalized toddler?
establish a routine similar to that of the child's home
the nurse is caring for a 6 month old with a cleft lip and palate the mother of the child demonstrates an understanding of the disorder when making the following appropriate statements select all that apply
"I know my baby takes a lot longer to feed than most children his age." "It really worries me that my baby may have some other disorders that haven't been detected yet." "I wonder if my baby will develop speech problems when language development begins?" "Thankfully there are doctors that specialize in correcting this type of disorder."
The mother of a 2 year old child tells the nurse in the clinic that her child is rebellious and throws temper tantrums. Which response by the nurse is most appropriate?
"We can talk about how to set limits on your childs behavior."
A 9year old boy is seen by the school nurse for the third time this week with a report of stomach ache and requests to go home. the child tells the nurse of bullying for the past month because they know his father is out of work and he has no lunch money. He said they make fun of him on the playground and in the cafeteria. What information would the school nurse share with the staff about the characteristics of bullying? Select all that apply
-emotional abuse can be harmful as any other type of abuse -attempt to intimidate someone who is seen as vulnerable -the infliction of repetitive physical, verbal, or emotional abuse upon another person with the intent to harm
The nurse needs to give 15 units of insulin subcutaneously. The insulin vial reads 100 units per mL. How many mL will the nurse need to give the client?
0.15 mL
A 10 year old child is scheduled for open reduction and internal fixation of the tibia following a skateboard accident. The nurse anticipates which pain medication and administration method will best provide post surgical pain relief for the child immediately after surgery?
Morphine given as an intravenous injection
A nurse is preparing to administer Ringers lactate 500 mL IV bolus to infuse over 3 hours. The drop factor of the manual IV tubing is 20gtt/mL. The nurse should set the IV infusion to deliver how many gtt/min? (round to the nearest whole number)
56 gtt/min
A nurse receives an order to give an IV solution at 250 mL per hour. The nurse has an IV delivery set that delivers 15 drops per mL. Which drops per minute is closest to what will be needed to deliver the desired amount of fluid?
60 drops per min.
The nursing student on the pediatric unit is learning about development. Which of the following does the student identify as development?
7 month old pulls up to a standing position
The nurse is caring for a 13 year old girl with delayed puberty. based on the nurses knowledge of this condition, The nurse would include which nursing diagnosis and a plan of care?
Deficient knowledge related to the administration of estradiol.
a 15 year old client has been admitted to the hospital for acute appendicitis and is recovering from appendectomy. which intervention is most appropriate regarding the facilitation of normal growth and development
Allow the client to participate in group activities with the same- age individuals when stable
A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition?
Amblyopia
The school nurse is walking through the lunchroom when one of the children says she starts to feel strange after trading lunches with a friend. Which assessment would be most important?
Determining if her throat itches
The school nurse is gathering registration data for a 6 year old child who is entering first grade. which of the following immunizations should the school nurse verify that the child has had? (select all that apply)
Diptheria-tetanus-pertussis series Haemophilus influenzae type b series varicella vaccine
In performing the physical examination of a child with cystic fibrosis what would the nurse expect to assess?
Decreased tactile fremitus
The nurse is providing care for an infant with Wiskott-Aldrich syndrome and expects to find which of the following during the childs care?
Eczema
The nurse is preparing a teaching plan for the family and their six year old son who has just been diagnosed with diabetes mellitus. What would the nurse identify as the most important initial goal for the teaching plan?
Educating the patients about diabetes mellitus type 1.
The nurse is using the pediatric Glasgow coma scale to assess a child level of consciousness. What would the nurse assess? Select all that apply
Eye opening verbal response motor response
The nurse is caring for a 12 year old with cerebral palsy who is unable to communicate verbally. Which pain assessment tool is most appropriate for the nurse to use when assessing pain in this client?
Face, leg activity, cry, and consolability (FLACC) descriptors
A nurse is providing care for a child with herpes zoster (shingles), the parents asked the nurse how the child contracted this disorder. Which response by the nurse is most appropriate?
Herpes zoster is a reactivation of the previous varicella zoster infection
The parent of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis?
Hyperkalemia
The nurse has performed client teaching to a 15-year-old boy with Crohns disease, and his parents regarding the cobblestone lesions in his small intestines. Which comment by the client indicates learning occured?
I have to be careful because I am prone to not absorbing nutrients.
The nurse is providing care for an adolescent client who is receiving gentamicin sulfate (Garamycin). Which of the following statements by the adolescent would cause the nurse to interpret as indicating toxicity of the drug?
I'm feeling dizzy
A child diagnosed with stage IV neuroblastoma has undergone abdominal surgery to remove the tumor. He is now receiving chemotherapy. Which nursing diagnosis would be most important?
Imbalanced nutrition related to adverse effects of chemotherapy
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
A newborn is diagnosed with metatarsus adductus. the parents ask the nurse how this occurred which response by the nurse would be most appropriate?
Its most likely from how the baby was positioned in utero
A healthy 2 month old infant is being seen in the pediatric clinic for a well child checkup and immunizations which immunizations should the nurse anticipate administering at this appointment select all that apply
PCV (pneumonia) Hib (Haemophilus influenzae vaccine) DTaP (diptheria, tetanus, and pertusis)
The nurse is planning immediate preoperative care for an infant after a cleft lip repair. Which of the following should the plan of care include?
Pain medication should be given on a routine basis.
A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back, fever, nausea, and abdominal distention. Which disease would the nurse consider a diagnosis?
Pancreatitis
A nurse is caring for a child who has hirschsprung's disease which of the following actions should the nurse take?
Prepare the family for surgery.
the nurse on the pediatric medical surgical unit is caring for an adolescent admitted for fractures the nurse knows the adolescent's developmental needs are best met by which of the following interventions?
explaining procedures and including the adolescents and the decision making process
The nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to the chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The healthcare provider elects to give an enema. The parents ask the purpose of the enema. Which is the nurses most appropriate response?
The enema will help confirm the diagnosis and has a good chance of fixing the intussusception.
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?
The foreskin is needed for repair.
The nurse is discussing the infants diagnosis of hypoplastic left heart syndrome with the parents. The father asks shouldn't this get better when the heart grows in size with the baby? How should the nurse respond to the father?
The growth of the heart does not repair the problem of the small left ventricles
The nurse is administering a gavage feeding through a nasogastric feeding tube which nursing intervention is highest priority?
The nurse verifies the position of the feeding tube.
the nurse is caring for a child with juvenile arthritis who reports chronic pain what is the priority nursing assessment?
The pain history, onset, intensity, duration, and location
The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest the child has neuroblastoma?
The parents report that their son is vomiting and not eating well.
The mother of a 15 month old is questioning the nurse about the need for hepatitis B vaccination. Which comment provides the most compelling reason for the vaccine?
This protects your child from infection that can cause liver disease.
a nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? Select all that apply.
Toxin exposure hypoglycemia febrile seizures
a mother of a one month old infant states that she is curious as to whether her infant is developing normally. Which of the following developmental milestones with the nurse expect the infant to perform
Turning the head from side to side
the nurse knows that obesity in children is an ever increasing problem. what should a nurse consider before confronting the problem with individual children?
familial and cultural influences are deciding factors in eating
The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?
We should administer desmopressin as often as needed.
The nurse is caring for a 9 year old boy with episodes of chronic pain. The nurse is educating the parents on how to help the boy manage pain nonpharmacologicaly which statement indicates a need for further teaching?
We should start the method after he feels pain.
A nurse is assessing a child who has asthma. Which of the following are indications of deterioration of the child's respiratory status select all that apply.
Wheezing Nasal flaring Retraction of sternal muscles
A 7year old child is expressing fear concerning an uncomfortable sterile dressing change. what should the nurse say to be most therapeutic?
Will you help hold the package of bandages for me?
What would be the nurse's best response if the foster mother of a 15-month-old with an unknown immunization history comes to the clinic requesting immunizations?
Your foster child will receive only the Hib and DTap vaccines today.
The nurse is teaching a community class to a group of parents. She assumes that all the children of the parents have achieved normal cognitive and emotional development. Which of the following children is at greatest risk for accidental poisoning?
a four year old
The nurse is educating the parents of a four year old boy with wilms tumor who is about to have chemotherapy prior to surgery. Which statement by the parents indicates that the nurse should review the instructions about preventing infection
he takes his antibiotics twice a day
the nurse is caring for a neonate who is suspected of having sepsis. Which assessment findings would the nurse interpret as most indicative of sepsis
hypothermia
the nurse is developing a plan of care for a 5 year old child with severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed?
immature emotional behavior
The nurse is reviewing the laboratory test results of a child with nephrotic syndrome what would the nurse least likely expect to find
decreased blood urea nitrogen (BUN)
a nurse is inspecting a child with atopic dermatitis what would the nurse expect to observe?
dry red scaly rash with lichenification
A nurse is caring for a child who has a fracture. Which of the following are manifestations of a fracture? Select all that apply
edema pain ecchymosis
