Practicum - Pediatrics
a healthy 2-month old infant is being seen in the local clinic for a well-child checkup and initial immunizations. When analyzing the pediatric record which immunizations would the nurse anticipate administering at this appointment?
1. DTaP 3. IPV 5. Hib 6. PCV
a 10 year old child visits the health care providers office for an annual sports examination. When a nurse asks how he is doing, he becomes quiet and states that his grandmother died last week. Which statements by the child show that he understands the concept of death?
1. I am mad that she is gone 2. my grandmother is an angel watching over me 3. my grandmothers death has been hard to understand 4. my grandmother died because she was sick and nothing could make her better
a nurse is caring for a group of toddlers in a large urban hospital. When considering providing care, which client requires contact precautions?
1. a toddler with scabies 5. a toddler with a multi-drug resistant organism
a nurse is teaching a 16 year old female client with inflammatory bowel disease about corticosteroid treatment. Which adverse effects are likely to be concerns for this client?
1. acne 2. hirsuitism 3. mood swings 4. osteoporosis 6. adrenal suppression
the nurse is caring for an 11 year old client experiencing status epilepticus. When providing and delegating immediate nursing care, which nursing actions would be completed?
1. administer oxygen via NC 2. pad side rails with cushions/pillows 5. instruct the LPN to obtain vital signs
a 4 year old postoperative child is found unresponsive. Place the following actions in the correct sequence to perform CPR after the child has been assessed for responsiveness and help has been called.
1. check the carotid pulse 2. perform 30 compressions 3. open the airway 4. check for breathing 5. provide 2 rescue breaths
a nurse on the pediatric unit, received shift handoff on a 15-month old with the following needs. Using Maslow's hierarchy framework, prioritize the following nursing care activities for the toddler.
1. clearing the airway of thick secretions 2. notifying the health care provider about suspected compartment syndrome 3. changing a soiled diaper 4. administering antipyretics for an axillary temperature of 103 F 5. progressing the diet after surgery
a 5-year old child is admitted to the pediatric unit with a diagnosis of possible inussuception. Which assessment data supports this diagnosis?
1. currant jelly stools 3. abdominal pain 5. abdominal distention
a nurse is caring for a 34-month old who is hospitalized for a lengthy illness. Which behaviors would the nurse identify as examples of expected development regression for the child's age group?
1. enuresis 2. encopresis 3. one to two word expressions
a nurse is caring for an 8 year old postoperative tonsillectomy client. When performing a postoperative assessment, which signs and symptoms of bleeding would be monitored by the nurse?
1. frequent clearing of the throat 3. frequent swallowing 6. blood red vomitus
a nurse is assessing a 10-month old infant during a checkup. Which developmental milestones would the nurse expect the infant to display?
1. holding the head erect 4. sitting on a firm surface without support 5. bearing the majority of weight on legs
the nurse is preparing to insert an intravenous catheter into an acutely ill toddler. Place the following steps in the order the nurse would following.
1. inform the parents of the procedure 2. wash hands and gather supplies 3. prepare the equipment 4. inform the toddler of the procedure 5. select and prep the appropriate site 6. insert the intravenous catheter and secure it appropriately
the nurse is caring for a 15 year old client with myelogenous leukemia whose platelet count is 26,000. Which nursing interventions would be included in the poc?
1. instruct the client to not use a razor for shaving 4. assess the client for pain in the joints
a nurse is caring for an adolescent who was admitted to the hospital's medical unit after attempting suicide by ingesting acetaminophen. Which interventions would the nurse incorporate into the client's care plan?
1. inventory all personal items upon arrival to the unit 2. ask the client's parents if they keep firearms in their home 3. ask the client if he/she is having suicidal thoughts 4. assist the client with bathing and grooming as needed 5. inspect the client's mouth after giving oral meds
a 6 year old child who reports fever, malaise and anorexia is diagnosed with varicella. The nurse explains to the parents how skin lesions will develop. Place the following descriptions in the order that they will occur as the disease progresses.
1. itchy red macule on the face, scalp and trunk progress to papule 2. papule develop into clear vesicles on an erythematous base 3. vesicles become cloudy and break easily 4. scabs form 5. as initial lesions progress, additional lesions form on the trunk and extremities
a 15-month old has just received routine immunizations including DTaP, IPV, and MMR, what information would the nurse include before the parents leave the office?
1. minor symptoms can be treated with acetaminophen 3. call the office if the toddler develops a fever above 103, seizures or difficulty breathing 4. discomfort at the immunization site and mild fever are common
a mother brings her child to the health care provider's office for evaluation of a chronic stomach pain. The mother states that the pain seems to go away when she keeps the child home from school. The healthcare provider diagnoses the child with school phobia, what other symptoms can be expected?
1. nausesa 2, headaches 4. dizziness
a nurse is caring for a 4-year old child who developed acute renal failure after a traumatic injury with hemorrhaging. Place the following events in the order in which they most likely occurred.
1. oliguria 2. azotemia 3. acidosis 4. severe hypocalcemia
a nurse is caring for a 5 year old child who is in the terminal stages of cancer. Which statements about the child's impending death are most likely to be true?
1. the parents may be at different stages of grief in dealing with the child's impending death 3. the dying child may become clingy and act like a toddler 5. the death of a child may have long-term disruptive effects on the family 6. the child does not fully understand the concept of death
a nurse is teaching parents about the developmental milestones of an infant. Place the following developmental activities in order from earliest to latest?
1. turning self from prone to supine 2.. turning self from supine to prone 3. sitting alone 4. crawling on hands and knees 5. effectively using pincer grasp
the nurse is caring for a 4 year old recently diagnosed with acute lymphocytic leukemia. Which statement, made by the parents indicates the effectiveness of teaching?
2. "I understand that ALL affects all blood-forming organs and systems throughout the body" 4. "I realize that the adverse effects of chemotherapy include sleepiness, loss of hair and sores in the mouth." 5. "I am glad that there's a 95% chance of obtaining a first remission with treatment."
a school nurse is gathering registration data for a child entering first grade. Which immunizations would the school nurse verify that the child has had?
2. DTaP 3. H. influenza b 4. varicella vaccine
a nurse is teaching the parents of a 6-month old infant about normal growth and development. Which statements regarding infant development are true?
2. a 6-month old infant can usually roll from prone to supine and supine to prone positions 3. a teething ring is appropriate for a 6-month-old infant 6. lack of visual coordination usually resolves by age 6 months
a 10 year old child is admitted to the hospital with a temperature of 104 and is difficult to arouse. The child has a history of varicella 2 weeks ago. Reyes syndrome is suspected, which objective data are supportive of the diagnosis?
2. an abnormal liver biopsy 3. vomiting 5. coma 6. disorientation
a 7 year old child is admitted to the hospital for a course of intravenous antibiotics. What actions would the nurse take before inserting the catheter?
2. apply a topical anesthetic to the IV site before the procedure 3. ask the child which hand he or she uses for drawing 6. tell the child that they can cry but they must hold still
a child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises would the nurse provide to the child and family?
2. drink plenty of fluids 4. report a sore throat to an adult immediately 6. wash hands before meals and after playing
a nurse is caring for a 3-year-old diagnosed with viral meningitis. Which signs and symptoms would the nurse expect to ind during the admission assessment?
2. fever 3. nuchal rigidity 5. irritability 6. photophobia
Which nursing interventions are important when caring for a hospitalized toddler?
2. instruct parents that regression commonly occurs 3. encourage use of a security object from home 4. allow client autonomy by offering select choices 5. maintain the toddler's routine when able
a nurse is conducting an infant nutrition class for parents. Which foods would the nurse tell parents that they may introduce during the first year of life?
2. pureed fruits 4. oatmeal cereal 5. strained vegetables
a 2-year old is being treated for pneumonia. after reviewing the respiratory section of the client flow sheet, the nurse concludes that which position is most beneficial to maximize optimal oxygenation
2. right side lying
a parent is planning to enroll a 9-month old infant in a day care facility. the parent asks a nurse what to look for as indicators that the facility is adhering to good infection control measures. The nurse identifies which as an indication of meeting proper infection control standards?
2. soiled diapers are discarded in covered receptacles 4. disposable papers are used on the diaper changing surfaces 5. facilities for hand hygiene are located in every classroom
a nurse is completing a screening tool on a 4.5 year old child, to be consistent with others at this age, what behaviors would the nurse expect the child to demonstrate?
2. the child copies a circle that is closed or nearly closed 3. the child speaks clearly 4. the child draws a person with at least 3 body parts 5. the child is able to follow one basic instruction through completion
the nurse is instructing a parent of a school age client on nutrition. The client is currently receiving vincristine for treatment of acute lymphocytic leukemia. Which instruction is included in the plan of care?
3. offer nutrient dense snacks between meals and at bedtime 5. have the client select between three acceptable food options 6. suggest nutrient dense supplements if appetite is poor
a parent phones the health care provider's office stating that his 13-month old has had diarrhea for 3 days and is unsure of what fluids to offer, what should the nurse suggest?
5. electrolyte replacement solutions 6. water