Peds FINAL!!!
A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute" and "I'm not ready." The nurse should recognize this as which description? a. This is normal behavior for a school-age child. b. The behavior is not seen past the preschool years. c. The child thinks the nurse is punishing her. d. The child has successfully manipulated the nurse in the past.
A
A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child? a.Maintain a structured routine and keep stimulation to a minimum. b.Place the child in a room with a roommate of the same age. c.Maintain frequent touch and eye contact with the child. d.Take the child frequently to the playroom to play with other children.
A
A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents that this is normal because of which reason? a. Regression is seen during hospitalization. b. Developmental delays occur because of the hospitalization. c. The child is experiencing urinary urgency because of hospitalization. d. The child was too young to be "potty-trained."
A
The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? a. The United States is ranked last among 27 countries. b. The United States is ranked similar to 20 other developed countries. c. The United States is ranked in the middle of 20 other developed countries. d. The United States is ranked highest among 27 other industrialized countries.
A
While teaching the expectant mother about personal hygiene during pregnancy, maternity nurses should be aware that: a.Tub bathing is permitted even in late pregnancy unless membranes have ruptured. b.The perineum should be wiped from back to front. c.Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath. d.Expectant mothers should use specially treated soap to cleanse the nipples
A
A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what? a. Indicative of maladjustment b. A common reaction to divorce c. Suggestive of a lack of adequate parenting d. An unusual response that indicates a need for referral
B
An appropriate nursing intervention when caring for a child in traction would be which of the following? a. Remove adhesive traction straps daily to prevent skin breakdown. b. Assess for tightness, weakness, or contractures in uninvolved joints and muscles. c. Provide active range-of-motion exercises to affected extremity three times a day. d. Keep child in one position to maintain good alignment.
B
Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows that may be characterized by what reaction? a. Anger b. Over-protectiveness c. Social reintegration d. Guilt
B
Guidelines for intramuscular administration of medication in school-age children include a. Inject medication as rapidly as possible. b. Insert needle quickly, using a dart-like motion. c. Penetrate skin immediately after cleansing site, before skin has dried. d. Have child stand, if possible, and if child is cooperative.
B
Kelly, age 8 years, will soon be able to return to school after an injury that resulted in several severe, chronic disabilities. Which of the following is the most appropriate action by the school nurse? a. Recommend that Kelly's parents attend school at first to prevent teasing. b. Prepare Kelly's classmates and teachers for changes they can expect. c. Refer Kelly to a school where the children have chronic disabilities similar to hers .d. Discuss with Kelly and her parents the fact that her classmates will not accept her as they did before.
B
Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following? a. Healing is usually delayed in this type of fracture. b. Bone growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. This type of fracture is inconsistent with a fall.
B
Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. The best interpretation of this situation is that: a.this is a sign parents are in denial. b.this is a normal anticipated time of parental stress. c.the parents need to learn more about cerebral palsy. d.the parents are used to having expectations that are too high.
B
The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. What type of play is this? a. Solitary b. Parallel c. Associative d. Cooperative
B
The nurse observes some children in the playroom. Which of the following play situations exhibits the characteristics of parallel play? a. Kimberly and Amanda sharing clay to each make things b. Brian playing with his truck next to Kristina playing with her truck c. Adam playing a board game with Kyle, Steven, and Erich d. Danielle playing with a music box on her mother's lap
B
Using knowledge of child development, the best approach when preparing a toddler for a procedure is to: a. Avoid asking the child to make choices. b. Demonstrate the procedure on a doll. c. Plan for the teaching session to last about 20 minutes. d. Show necessary equipment without allowing child to handle it.
B
Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy? a. Instructions for a low-calorie diet b. Arrangements for tutoring and schoolwork c. Instructions for a high-fat, low-protein diet d. Instructions for the parent to return the child to team sports immediately
B
Which of the following vitamins increases the absorption of iron? a. A b. C c. D d. Biotin
B
A nurse is preparing to complete an admission assessment on a 2-year-old child. The child is sitting on the parent's lap. Which technique should the nurse implement to complete the physical exam? a. Ask the parent to place the child in the hospital crib. b. Take the child and parent to the exam room. c. Perform the exam while the child is on the parent's lap. d. Ask the child to stand by the parent while completing the exam.
C
A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure? a. Verbally explain what will be done. b. Have the child watch a video on dressing changes. c. Demonstrate a dressing change on a doll. d. Explain the importance of keeping the burn area clean.
C
An adolescent has been taught to administer replacement factors for bleeding episodes related to hemophilia. What action by the teen indicates that further instruction is needed? A. Disposes of sharps in an approved container B. Reconstitutes the medication with sterile water C. Selects the appropriate needle for an IM injection D. Washes hands prior to working with the drug
C
By what age does birth length usually double? a. 1 year b. 2 years c. 4 years d. 6 years
C
Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. Which of the following is the most appropriate way to collect small amounts of urine for these tests?a. Apply a urine-collection bag to perineal area. b. Tape a small medicine cup to inside of diaper.c. Aspirate urine from cotton balls inside diaper with a syringe.d. Aspirate urine from superabsorbent disposable diaper with a syringe.
C
Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that: a. venipuncture discomfort is very brief. b. only one venipuncture will be needed. c. topical application of local anesthetic can eliminate venipuncture pain. d. most blood tests on children require only a finger puncture because a small amount of blood is needed.
C
The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child's illness and its management. Which of the following is the best action for the nurse? a. Determine why family is easily frustrated. b. Refer family to child's primary care practitioner. c. Clarify family's request, and provide information they want. d. Answer only questions that family needs to know about.
C
The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Who should the nurse invite to the conference? a.Family and nursing staff b.Social worker, nursing staff, and primary care physician c.Family and key health professionals involved in child's care d.Primary care physician and key health professionals involved in the child's care
C
The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent would be expected about separation anxiety? a. I wish my parents could spend the night with me while I am in the hospital. b. I think I would like for my siblings to visit me but not my friends. c. I hope my friends dont forget about visiting me. d. I will be embarrassed if my friends come to the hospital to visit.
C
What should the nurse keep in mind when planning to communicate with a child who has autism? a.The child has normal verbal communication. b.The child is expected to use sign language. c.The child may exhibit monotone speech and echolalia. d.The child is not listening if she is not looking at the nurse.
C
Which meal would provide the most absorbable iron? a.Toasted cheese sandwich, celery sticks, tomato slices, and a grape drink b.Oatmeal, whole wheat toast, jelly, and low-fat milk c.Black bean soup, wheat crackers, orange sections, and prunes d.Red beans and rice, cornbread, mixed greens, and decaffeinated tea
C
forces to keep the bones aligned. Which type of traction uses skin traction on the lower leg and a padded sling under the knee? a. Dunlop c. Russell b. Bryant's d. Buck's extension
C
An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? a. 14 b. 16 c. 18 d. 21
D
Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power? a. Infants b. Toddlers c. Preschoolers d. School-age children
D
Chris, age 9 years, has several physical disabilities. His father explains to the nurse that his son concentrates on what he can rather than cannot do and is as independent as possible. The nurse's best interpretation of this is: a.The father is experiencing denial. b.The father is expressing his own views. c.Chris is using a maladaptive coping style. d.Chris is using an adaptive coping style
D
Contraception failure rate varies from couple to couple depending on the method and users
D
For a patient who is to be placed in Russell's traction, the nurse prepares the: a.occipital area. b.arm and forearm. c.back and abdomen. d.lower extremities.
D
In comparison with other similar industrialized countries, the U.S. health care system results ina. Outcomes very similar to outcomes in other industrialized countries.b. Superb outcomes, perhaps because of the advanced research and technology.c. The highest life expectancy and lowest infant mortality.d. The lowest life expectancy and highest infant mortality.
D
The nurse is doing a prehospitalization orientation for Kayla, age 7, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that Kayla will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is: a. Unnecessary. b. The surgeon's responsibility. c. Too stressful for a young child. d. An appropriate part of the child's preparation.
D
The nurse is observing two toddlers playing in the pediatric play room. They are playing side by side but not interacting with each other. What type of play does the nurse determine this is? a. cooperative play b. fantasy play c. solitary play d. parallel play
D
The nurse uses the palms of the hands when handling a wet cast for which of the following reasons? a. To assess dryness of the cast b. To facilitate easy turning c. To keep the patient's limb balanced d. To avoid indenting the cast
D
Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm? a.The degree of motion and ability to position the extremity. b.The length, diameter, and shape of the extremity. c.The amount of swelling noted in the extremity and pain intensity. d.The skin color, temperature, movement, sensation, and capillary refill of the extremity.
D
Which of the following medications is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? a. Aspirin b. Corticosteroids c. Cytotoxic drugs such as methotrexate d. Nonsteroidal antiinflammatory drugs (NSAIDs)
D
Which statement is true about the term contraceptive failure rate? a. It refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. b. It refers to the minimum level that must be achieved to receive a government license. c. It increases over time as couples become more careless. d. It varies from couple to couple, depending on the method and the users.
D
Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider? a. Nausea with occasional vomiting c. Urinary frequency b. Fatigue d. Vaginal bleeding
D
Which teaching about reducing the risk of sexually transmitted infections (STIs) should the nurse provide to sexually active adolescent male clients? a "Natural or animal-skinned condoms feel more comfortable than latex versions. b "An initial HIV test result needs to be followed up with a retest exactly 1 month after the initial test. c "Application of petroleum jelly to the condom provides an additional barrier. d "Condoms should be used for every sexual encounter.
D
Autism spectrum disorder should be placed by the nurses station and have as much personal stimulation as possible
NO They need a structured environment and to keep stimulation to a minimum
A child was placed on a blood transfusion and is now having a transfusion reaction. What would be done First? Second? Third? Fourth?
Stop the transfusion, Take VS, Maintain a patent IV line with normal saline, Notify the practitioner
Epiphyseal fractures affect what?
The growth of the bone
The father of a 9 year old states that his child focuses on what they can do, not what they cannot do and is as independent as possible
This is an adaptive coping style.
The nurse has initiated a blood transfusion on a preschool child. The child begins to exhibit signs of a transfusion reaction. Place in order the interventions the nurse should implement sequencing from the highest priority to the lowest. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d). a. Take the vital signs. b. Stop the transfusion. c. Notify the practitioner. d. Maintain a patent IV line with normal saline.
b, a, d, c
For a child with hemophilia, the nurse would avoid injections and finger or heel sticks to obtain blood samples, Give the child acetaminophen (Tylenol) for pain or fever relief, provide a soft toothbrush for dental care and assure factor replacement is available for any injury resulting in bruising or bleeding.
true
For newly placed casts, the nurses uses the flats of their hands to avoid indenting the cast and creating any pressure points.
true
For school aged children, injections should be done with a quick dart like movement
true
For the child in traction, the nurse needs to assess for tightness, weakness or contractures in uninvolved joints or muscles as well as those that are involved in the injury requiring traction.
true
In a prehospital orientation for a school aged child having cardiac surgery, the nurse tells the child and family that the child will not be able to speak until the endotracheal tube is removed. This is an appropriate teaching topic.
true
Infant mortality In the United States is the highest of any developed nation.
true
Neurovascular competency is assessed to identify compartment syndrome and consists of assessing skin color, temperature, movement, sensation and capillary refill.
true
Non-steroidal anti-inflammatory drugs (Naproxen, Ibuprofen and Tolmetin) are tried first to treat children with JIA.
true
Pediatric family centered care acknowledges that the family is the constant in the child's life
true
Recently, a child has not been doing well in school and has trouble sleeping. The school nurse discovers that the parents are getting a divorce. This is a common reaction of a child to divorce
true
Russell's traction is a skin traction with a padding under the knee that uses longitudinal and perpendicular forces to keep the bones aligned.
true
School aged children are particularly vulnerable in events where they feel they have a loss of control and power.
true
School nurses can help a child who has had a traumatic injury re-enter school by educating the teacher and the class about what to expect (abilities, special needs and condition) and how to interact with the child.
true
Susceptibility to injury is based on developmental age
true
Therapeutic relationships between nurses, families and children involve asking questions when families are not participating in care, clarifying information for families, and learning about family religious preferences
true
To desensitize preschoolers and early school aged children to procedures, it may help to demonstrate (practice performing) the procedure on a doll or stuffed animal first (example, dressing changes).
true
To improve the use of barrier precautions in people who are at risk and sexually active, it is important to discuss ways to enhance condom use.
true
Topical anesthetic (EMLA cream) can decrease the pain for venipunctures, lumbar punctures and blood draws. Children need to be aware of this, especially if they have had a painful procedure in the past.
true
Tub baths are permitted even in late pregnancy as long as membranes have not ruptured
true
Urine testing for an infant can be accomplished by putting cotton balls by the urethra in the infant's diaper. Once saturated, the cotton balls can then be put in a syringe to squeeze the urine into a container or onto a urine testing strip (to check for SG, glucose, blood, protein,...).
true
Warning signs for women who are pregnant include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding and should be reported to the physician immediately.
true
When time allows, unfamiliar treatments or procedures can be demonstrated on stuffed animals or dolls to decrease anxiety in children
true
Women with inadequate weight gain are at risk for having infants with intrauterine growth restriction.
true
A newborn weighs 8 pounds at birth. On average, what should the infant weigh at 1 year of age? A. 16 pounds B. 20 pounds C. 24 pounds D. 28 pound
C
A nurse is conducting a wellness seminar on healthy eating and prevention of iron deficiency anemia. The food the nurse would describe as being high in iron is a.citrus fruits. b.grains. c.green leafy vegetables. d.milk products.
C
The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which of the following interventions should the nurse include? Prepare the child for separation from parents during hospitalization by reviewing a video. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal. Help the child accept the loss of control associated with hospitalization. Help the child accept pain that is connected with a treatment or procedure.
2
A nurse is caring for a 2-year-old child diagnosed with nephrotic syndrome who is in diapers and has red, edematous genitals. Which collection technique is appropriate for the nurse to obtain daily urine specimens for proteinuria testing with a urine dipstick? 1. Apply adhesive urine collection bag and wait for child to void 2. Intermittently cathterize the child every morning 3. Place cotton balls in a dry diaper; when wet, squeeze urine onto dipstick 4. Place urine dipstick in the child's diaper overnight and check results in morning
3
Which statement accurately describes the best method for assessing a 12-month-old? 1. The nurse should assess the child on the examining table. 2. The nurse should assess the child in a head-to-toe sequence. 3. The nurse should have the child's mother assist in holding her down. 4. The nurse should assess the child while she is in her mother's lap.
4
For a child with a diagnosed chronic illness, after a period of shock comes common reactions of overprotectiveness, rejection, denial, or gradual acceptance. Then comes a period of adjustment with social integration.
true
Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include (Select all that apply): a.Fellatio. b.Unprotected anal intercourse. c.Multiple sex partners. d.Dry kissing. e.Abstinence.
A, B, C
Signs and symptoms that a woman should report immediately to her health care provider include (Select all that apply): a.Vaginal bleeding. b.Rupture of membranes. c.Heartburn accompanied by severe headache. d.Decreased libido. e.Urinary frequency.
A, B, C
Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors (Select all that apply). a.Poor nutrition b.Maternal collagen disease c.Gestational hypertension d.Premature rupture of membranes e.Smoking
A, B, C, E
A child with autism is hospitalized with asthma. The nurse should plan care so that the: a. Parents' expectations are met. b. Child's routine habits and preferences are maintained. c. Child is supported through the autistic crisis. d. Parents need not be at the hospital.
B
A child with autism is hospitalized with asthma. The nurse should plan care so that the: a.Parents' expectations are met. b.Child's routine habits and preferences are maintained. c.Child is supported through the autistic crisis. d.Parents need not be at the hospital.
B
A nurse in the emergency department is assessing a 5-year-old child with symptoms of pneumonia and a fever of 102° F. Which intervention can the nurse implement to promote a sense of control for the child? a.None, this is an emergency and the child should not participate in care. b.Allow the child to hold the digital thermometer while taking the child's blood pressure. c.Ask the child if it is OK to take a temperature in the ear. d.Have parents wait in the waiting room.
B
What symptom reported by a pregnant patient would lead the nurse to suspect pyelonephritis? a. Frequency and urgency of urination b. Nausea and weight loss c. Burning sensation when voiding d. Tenderness in the flank area
ANS: D Pyelonephritis is a particularly serious infection in pregnancy. Signs and symptoms include high fever, chills, flank pain or tenderness, nausea, and vomiting.
The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child? (Select all that apply.) a. Finger sticks for blood work instead of venipunctures b. Avoidance of IM injections c. Acetaminophen (Tylenol) for mild pain control d. Soft tooth brush for dental hygienee. Administration of packed red blood cells
B, C, D
Which behaviors by the nurse indicate a therapeutic relationship with children and families? (Select all thatapply.) a. Spending off-duty time with children and families b. Asking questions if families are not participating in the care c. Clarifying information for families d. Buying toys for a hospitalized child e. Learning about the familys religious preferences
B, C, E
The nurse is preparing to start an intravenous (IV) line in a preschool-age child. After applying a eutectic mixture of local anesthetics, what will the nurse do to prepare the child? a. Describe what the IV line will feel like and how long it will be in place. b. Explain the purpose of the procedure. c. Give the child equipment to handle and practice on a doll. d. Reassure the child that the pain will only last a few minutes.
c
A 10 year old needs a second IV and keeps stating,"Wait a minute" and "I'm not ready". This is normal behavior for a school aged child. What can you do to give this child a sense of control.
true
A 2 year old is on the parent's lap. It is a good idea to do the assessment while the parent is holding the child.
true
A 5 year old with cerebral palsy is beginning school in a special needs program. The parents are teary and state they did not realize the severity of their child's disorder. This is a normal parental response.
true
A child weighs 8 pounds at birth and is expected to weigh 16 pounds at 6 months and 24 pounds at 1 year.
true
A potty trained 32 month old child is hospitalized and has begun bedwetting in the hospital. This is regression and should return to normal once the child gets better.
true
Adolescents concerned about their friends forgetting them is an indication of adolescent separation anxiety.
true
An autistic child needs to have their routines and preferences maintained.
true
Arrangements for tutoring and schoolwork are appropriate parts of discharge instructions for children sent home on long term IV therapy.
true
At risk behaviors for sexually transmitted diseases include but are not limited to oral sex, unprotected anal sex, wet kissing, and multiple sexual partners
true
Birth length usually doubles at about 4 years
true
Black beans, red meats, spinach, bok choy, whole grain wheat, cashews and dried fruits are high in iron. Vitamin C in oranges or orange juice increases iron absorption
true
Children with Autism spectrum disorder may have echolalia (repetitive speech), monotone voice, inappropriate rate, rhythm, intonation or volume of speech as well as reluctance to make direct eye contact.
true
For a child who has complex health care needs who is being discharged, the nursing case manager needs to include family, and key health care professionals who are involved in the child's care
true