Childs Health Test 2
The nurse is preparing a room for a child being transferred out of the intensive care unit. The child has a tracheostomy. What item(s) are essential for the nurse to have available at the bedside in case of emergency? Select all that apply.
A new tracheostomy tube of the same size B. A new tracheostomy tube of a smaller size C bag valve mask
The nurse is assessing a child with aplastic anemia. What would the nurse expect to assess? Select all that apply.
A) Ecchymoses B) Tachycardia C) Guaiac-positive stool D) Epistaxis
The nurse is reviewing the medical record of a child with infective endocarditis. What would the nurse expect to find? Select all that apply.
A) Microscopic hematuria with urinalysis B) Electrocardiogram with prolonged PR interval C) Petechiae on palpebral conjunctiva
During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We're so focused on the baby that it seems like our 3-year-old is lost in the shuffle." Which nursing diagnosis would the nurse identify as most appropriate?
Interrupted family processes related to demands of caring for the ill child
A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the healthcare provider to prescribe? Select all that apply.
Intravenous immunoglobin aspirin
The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a β2-adrenergic agonist for treatment of bronchospasm?
Ipratropium
A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur?
Loud without a thrill
The nurse is caring for a child who has undergone stem cell transplantation for severe combined immune deficiency. What finding would the nurse interpret as indicative of graft-versus-host disease?
Maculopapular rash
The nurse is caring for a 7-year-old girl who is undergoing a stem cell transplant. What information would the nurse include in the child's postoperative plan of care?
Monitoring for severe diarrhea and maculopapular rash
Which tool would be the least appropriate scale for the nurse to use when assessing a 4-year-old child's pain?
Numeric pain intensity scale
The nurse is conducting a pain assessment of a 10-year-old boy who has been taking acetaminophen for chronic knee pain. The assessment indicates that the recommended dose is no longer providing adequate relief. What is the appropriate nursing action?
Obtain an order for a different medication
The nurse is developing a plan of care for a child with thalassemia. What information would the nurse expect to include? Select all that apply.
Packed RBC transfusions Deferoxamine therapy
A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally
Pancreatic Enzymes
A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia
Pernicious Anemia
What would be most appropriate to include in the plan of care for a child who has undergone surgery for removal of an astrocytoma?
Positioning the child on his unaffected
The nurse is examining a 5-year-old. Which sign or symptom is a reliable first indication of respiratory illness in children?
Rapid, shallow breathing.
The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster immunization. Which is the priority nursing diagnosis?
Risk for infection related to neutropenia and immunosuppression
The nurse is caring for a child who reports chronic pain. What is the priority nursing assessment?
The pain's 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 this child has a neuroblastoma?
The parents report that their son is vomiting and not eating well. (Along with the swollen abdomen on one side, the parents reporting that the child is vomiting and anorexic points to the possibility of a neuroblastoma.)
A child with suspected dyslipidemia undergoes laboratory testing. The nurse is reviewing the results. Which finding would the nurse interpret as supporting the diagnosis? Select all that apply.
Total cholesterol level of 220 mg/dL (5.70 mmol/L LDL level of 140 mg/dL (3.63 mmol/L)
Pentazocine is prescribed for a child with moderate pain. The nurse identifies this drug as an example of which type?
mixed opiod agonist-antagonist
The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?
positive fibrin split products
A hospitalized child suddenly begins reporting "my chest hurts," is tachypneic, and has tachycardia. The nurse auscultates the lung sounds and finds absent breath sounds on one side. After notifying the health care provide what action would the nurse take first?
prepare for chest tube insertion
The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which statement by the mother would warrant further investigation?
"The baby seems more comfortable over my shoulder."
The nurse is managing children who have chronic diseases in a neighborhood clinic. What are some examples of chronic conditions? Select all that apply.
1. Diabetes Mellitus 2. Rheumatoid Arthritis 3. Acute Asthma
The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which examples are behavioral indicators? Select all that apply.
1. The infrant grimaces 2. The infant flails his arms and legs 3. The infant cries uncrontrollably
The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the healthcare provider if the infant's apical pulse rate was:
80 BPM (hold of its less than 90 BPM)
The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child?
A 7-year-old with halitosis and thick, yellow nasal discharge
For which child would nonopioid analgesics be recommended?
A child with juvenile arthritis
The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure? Select all that apply.
A) The nurse assesses the dorsalis pedis pulse in the left foot. B) The nurse assesses the puncture site frequently. C) The nurse tells the parents that the healthcare provider will discuss the results of the procedure with them
The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply.
A) Tuna B) Salmon C) Tofu D) Dried fruits
A child is in the emergency department with an asthma exaccerbation. Upon asucultation the nurse is unable to hear air movement in the lungs. What action should the nurse take first?
Administer a beta-2 adrenergic agonist
The student nurse is learning about the effects of heat and cold when used in a pain management plan. What accurately describes one of these effects?
Cold alters capillary permeability
The nurse is caring for a child who is recovering from an appendectomy. What is the appropriate term for the pain this child is experiencing?
Nociceptive pain
The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which finding would the nurse most likely expect to assess if the child had transposition of the great vessels?
significant cyanosis without presense of a murmur
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?
strawberry tongue
Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized?
tachypnea with retractions
The nurse is teaching the parent of a child with cystic fibrosis about nutrition requirements for the child. What should be included in this teaching?
"Give your child high-calorie foods and snacks." "Feed your child foods that are high in protein." "Give panreatic enzymes with meals."
The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which statement from the nurse accurately reflects the pain experience in children?
"It is very rare that children become addicted to narcotics."
The mother of a 4-week-old infant is tearful. She reports the healthcare provider has told her that her son has a small atrial septal defect. She reports she is worried and asks the nurse more about the condition. Which statement by the parents best indicates an understanding of the nurse's teaching?
"Most of the time this condition spontaneously resolves
The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next?
Administer the next dose ordered in 12 hours
The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?
Initiate pain assessment with a standardized pain scale
The nurse is discussing discharge instructions with the parents of a 6-year-old who had a tonsillectomy.
Inspect the throat for bleeding.
The nurse is teaching the student nurse the physiology involved in pain transmission. Which statements accurately describe a physiologic event in the nervous system related to pain transmission? Select all that apply.
A) When nociceptors are activated by noxious stimuli, the stimuli are converted to electrical impulses that are relayed to the spinal cord and brain. B) Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid rates; unmyelinated small C fibers transmit the impulse slowly. C) Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus. D)Peripheral sensitization allows the nerve fibers to react to a stimulus that is of lower intensity than would be needed to cause pain.
An infant with a high respiratory rate is NPO and is receiving IV fluids. What assessment(s) will the nurse make to assure this infant is hydrated? Select all that apply.
A. Measure skin turgor B. Palpate anterior fontanel C. Determine urine output
A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?
Hasten air reaborption
A jaundiced neonate must have heel sticks to assess bilirubin levels. Which assessment findings would indicate that the neonate is in pain? Select all that apply.
C. Heart rate is 180 beats per minutes. D. Oxygen saturation level is 88%. E. The infant has facial grimacing and quivering chin.
18. A 14-year-old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes, the nurse would expect to find which nodes as most commonly enlarged? Select all that apply.
Cervical Supraclavicular
The parents bring their 4-year-old son to the emergency department. The child is receiving chemotherapy for acute lymphoblastic leukemia. The parents report that the child has become lethargic and has had significant episodes of vomiting and diarrhea. What findings would lead the nurse to suspect the child may be experiencing tumor lysis syndrome? Select all that apply.
Hyperkalemia Hypercalemia Hyperuricemia
5. The nurse is caring for a 5-year-old boy undergoing radiation treatment for a neuroblastoma. Which nursing diagnosis would be most applicable for this child?
Impaired skin integrity related to desquamation from cellular destruction
The nurse is explaining the effects of heat application for pain relief. Which effect would the nurse be likely to include?
Increased pressure on nociceptive fibers
A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the healthcare provider will most likely order which medication?
Indomethacin
Which test result would the nurse least likely expect to find in a child diagnosed with Wilms tumor?
Elevated homovanillic acid (HVA) with 24-hour urine collection
The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned?
Eosinophils 10% ( normal is 0 to 3)
Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse documents this as which grade?
Grade IV