Chronic Condition or Terminal Illness 4

The nurse is working with a school-age child who is hospitalized. Which action by the nurse will promote a sense of industry in this child? 1. Allow the child to assist with her care. 2. Encourage parents to participate in the child's care. 3. Give the child a detailed scientific explanation of the illness. 4. Speak to the child in a high-pitched voice.

1. Allow the child to assist with her care.

At the conclusion of teaching parents about cerebral palsy, the nurse asks, "What is your hope for your toddler with cerebral palsy?" Which reply from a parent best indicates an understanding of a realistic achievement for the child? 1. "I hope my child qualifies for the Winter Olympics like I did." 2. "I hope my child just enjoys life." 3. "I hope my child will attend our neighborhood school." 4. "I hope my child is liked and accepted by other children."

3. "I hope my child will attend our neighborhood school."

The nurse is planning a class for school-age children on prevention of obesity through exercise. It is important to encourage the children to exercise a minimum of how many minutes a day to meet current recommendations? 1. 20 minutes 2. 30 minutes 3. 60 minutes 4. 90 minutes

3. 60 minutes

Which client in the pediatric intensive care unit (PICU) would most benefit from palliative care? 1. A child with end-stage leukemia 2. A child with a broken arm after a motor vehicle accident 3. A child with burn injuries to the legs 4. A child with recurrent asthma

3. A child with burn injuries to the legs

The nurse is working in an adolescent medical clinic. What can the nurse anticipate when comparing adolescents in the clinic with chronic conditions to their peers? 1. A high level self-esteem 2. A concern for their parents 3. An altered body image 4. A decreased concern about their appearance

3. An altered body image

A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect?(Select all that apply.) A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects D. Falling to the floor E. Having a piercing cry

A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects

A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of thefollowing results indicate viral meningitis? (Select all that apply.) A. Negative gram stain B. Normal glucose content C. Cloudy color D. Decreased WBC count E. Normal protein content

A. Negative gram stain B. Normal glucose content E.Normal protein content

A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness.Which of the following actions by the nurse is appropriate? A. Place the client on NPO status. B. Prepare the client for a liver biopsy. C. Position the client dorsal recumbent. D. Put the client in a protective environment.

A. Place the client on NPO status.

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take? A. Position the child in a side-lying position B. Try to determine the seizure trigger C. Reorient the child to the environment D. Note the time of the postictal period

A. Position the child in a side-lying position

A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following should be included in the discussion? (Select all that apply.) A. Vagal nerve stimulator B. Additional antiepileptic medications C. Corpus callosotomy D. Focal resection E. Radiation therapy

A. Vagal nerve stimulator B. Additional antiepileptic medications C. Corpus callosotomy D. Focal resection

How can chronic illness and frequent hospitalizations affect the psychosocial development of a toddler? a. They can create a distortion or differentiation of self from parent. b. They can interfere with the development of autonomy. c. They can interfere with the acquisition of language, fine motor, and self-care skills. d. They can create feelings of inadequacy.

ANS: B Feedback A The infant with a chronic illness may have distortion of differentiation of self from parents. B Chronic illness may interfere in the development of autonomy, which is the major psychosocial task of the toddler. C Chronic illness with frequent hospitalizations can inhibit the acquisition of language, motor, and self-care skills in the preschool-age child. D Feelings of inadequacy and inferiority can occur if independence is compromised by chronic illness in the school-age child.

The nurse must prepare parents to see their adolescent daughter in the pediatric intensive-care unit (PICU). The child arrived by life flight after experiencing multiple traumas in a car accident involving a suspected drunk driver. At this time, which statement by the nurse to the family is the most appropriate? 1. "Don't worry; everything will be okay. We will take excellent care of your child." 2. "You should press charges against the drunk driver." 3. "Your child's leg was crushed and may have to be amputated." 4. "Your child's condition is very critical; her face is swollen, and she may not look like herself."

4. "Your child's condition is very critical; her face is swollen, and she may not look like herself."

The nurse must perform a procedure on a toddler. Which technique is the most appropriate when performing the procedure? 1. Ask the mother to restrain the child during the procedure. 2. Ask the child if it is okay to start the procedure. 3. Perform the procedure in the child's hospital bed. 4. Allow the child to cry or scream.

4. Allow the child to cry or scream.

A young school-age client is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. Which action by the nurse is the most appropriate? 1. Reschedule the treatment for a later time. 2. Show the respiratory therapist to the playroom so the treatment may be performed. 3. Escort the child to his room and ask the child-life specialist to bring toys to the bedside. 4. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

4. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

A school bus carrying children in grades K-12 crashed into a ravine. The critically injured children were transported by ambulance and admitted to the pediatric intensive-care unit (PICU). The nurse is concerned about calming the frightened children. Which nursing intervention is most appropriate to achieve the goal of calming the frightened children? 1. Tell the children that the physicians are competent. 2. Assure the children that the nurses are caring. 3. Explain that the PICU equipment is state of the art. 4. Call the children's parents to come into the PICU.

4. Call the children's parents to come into the PICU.

An infant has been NPO for surgery for 4 hours and does not have an intravenous line. The nurse receives a call from the operating room with the information that the surgery has been postponed due to an emergency. Which action by the nurse is the most appropriate? 1. Feed the infant 4 ounces of formula. 2. Reassure the parents that it will not be much longer before surgery. 3. Allow the parents to feed the infant an ounce of oral rehydration solution. 4. Call the physician to see if the infant needs to have an intravenous line started.

4. Call the physician to see if the infant needs to have an intravenous line started.

The charge nurse is concerned with reducing the stressors of hospitalization. Which nursing intervention is most helpful in decreasing the stressors for the toddler-age client? 1. Assign the same nurse to the toddler as much as possible. 2. Let the child listen to an audiotape of the mother's voice. 3. Place a picture of the family at the bedside. 4. Encourage a parent to stay with the child.

4. Encourage a parent to stay with the child.

Siblings of a client in pediatric intensive care unit (PICU) are preparing to visit their brother, who was hit by a car while riding his bike. Which intervention by the nurse will assist the siblings in preparing for the visit? 1. Spend time developing a relationship with the siblings. 2. Have the parents go with the siblings when they visit. 3. Encourage the siblings to talk to a social worker before seeing their brother. 4. Explain what the siblings will hear and see when they visit.

4. Explain what the siblings will hear and see when they visit.

The parents of a toddler-age child who sustained severe head trauma from falling out a second-story window are arguing in the pediatric intensive-care unit (PICU) and blaming each other for the child's accident. Which nursing diagnosis is most appropriate for this family? 1. Parental Role Conflict Related to Protecting the Child 2. Hopelessness Related to the Child's Deteriorating Condition 3. Anxiety Related to the Critical-Care-Unit Environment 4. Family Coping: Compromised, Related to the Child's Critical Injury

4. Family Coping: Compromised, Related to the Child's Critical Injury

The nurse is providing care to a pediatric client recently diagnosed with celiac disease. Which food choice indicates appropriate understanding of the material presented? 1. Pizza with milk 2. Spaghetti and meat sauce with juice 3. Hot dog on a bun with a shake 4. Fruit plate with Gatorade

4. Fruit plate with Gatorade

A group of children on one hospital unit are all suffering separation anxiety. Which child is experiencing the despair stage of separation anxiety? 1. Does not cry if parents return and leave again 2. Screams and cries when parents leave 3. Appears to be happy and content with staff 4. Lies quietly in bed

4. Lies quietly in bed

An adolescent with cystic fibrosis is intubated with an endotracheal tube. Which nursing diagnosis is most appropriate for this adolescent? 1. Potential for Imbalanced Nutrition, More Than Body Requirements Related to Inactivity 2. Anxiety Related to Leaving Chores Undone at Home 3. Potential for Fear of Future Pain Related to Medical Procedures 4. Powerlessness (Moderate) Related to Inability to Speak to or Communicate with Friends

4. Powerlessness (Moderate) Related to Inability to Speak to or Communicate with Friends

The clinic nurse is working with a child with multiple disabilities. The parents have asked the nurse to help them in meeting with the school board to develop an Individualized Education Plan (IEP) and an Individualized Health Plan (IHP). Which nursing intervention is most appropriate? 1. Providing a written list of the child's medical diagnoses for the IEP meeting. 2. Offering to wait with the child while the parents attend the IEP meeting. 3. Listening to the parents' concerns and complaints about the school district. 4. Presenting verbally the child's cognitive, physical, and social skills to school officials at the IEP meeting.

4. Presenting verbally the child's cognitive, physical, and social skills to school officials at the IEP meeting.

A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG). Which of the following statements, by a guardian indicates teaching was effective? A. "My child should remain quiet and still during this procedure." B. "I cannot wash my child's hair prior to the procedure." C. "I should not give my child anything to eat prior to the procedure." D. "This procedure will be very painful for my child."

A. "My child should remain quiet and still during this procedure."

A nurse is teaching a group of parents about the risk factors for seizures. Which of the following should be included in the teaching? (Select all that apply.) A. Febrile episodes B. Hypoglycemia C. Sodium imbalances D. Low serum lead levels E. Presence of diphtheria

A. Febrile episodes B. Hypoglycemia C. Sodium imbalances

A nurse is teaching a parent about complicated grief. Which of the following statements should the nurse make? A. "Complicated grief occurs when little time is spent thinking about the loss." B. "Personal activities are rarely affected when experiencing complicated grief." C. "Guardians will experience complicated grief together." D. "Counseling can be helpful in resolving complicated grief."

D. "Counseling can be helpful in resolving complicated grief."

A nurse is caring for a child who has a terminal illness and review palliative care with an assertive personnel (AP). Which of the following statements by the AP indicated understanding of this review? A. "I'm sure the family is hopeful that the new medication will stop the illness." B. "I'll miss working with the client now that only nurses will be caring for the client." C. "I will get all of the client's personal objects out of the room." D. "I will listen and respond as the family talks about their child's life."

D. "I will listen and respond as the family talks about their child's life."

A nurse is caring for a 4-month-old infant who has meningitis. Which of the following findings isassociated with this diagnosis? A. Depressed anterior fontanel B. Constipation C. Presence of the rooting reflex D. High-pitched cry

D. High-pitched cry

The parents of a toddler are concerned about their child's finicky eating habits. While counseling the parents, which statements by the nurse are the most appropriate? Select all that apply. 1. "The child is experiencing physiologic anorexia, which is normal for this age group." 2. "A general guideline for food quantity at a meal is one-quarter cup of each food per year of age." 3. "It is more appropriate to assess a toddler's nutritional demands over a 1-week period rather than a 24-hour one." 4. "Nutritious foods should be made available at all times of the day so that she is able to 'graze' whenever she is hungry." 5. "The toddler should drink 16 to 24 ounces of milk daily."

1. The child is experiencing physiologic anorexia, which is normal for this age group. 3. "It is more appropriate to assess a toddler's nutritional demands over a 1-week period rather than a 24-hour one." 5. "The toddler should drink 16 to 24 ounces of milk daily."

Match the behaviors with its stage of separation anxiety the child may exhibit. A. Protest B. Despair C. Denial 1. Withdrawal or compliant behavior 2. Appearance of being happy and content with everyone 3. Clinging to parents 4. Lack of protest when parents leave 5. Screaming and crying 6. Sadness

1/B, 2/C, 3/A, 4/C, 5/A, 6/B

Match the child's concept of death with their behavioral response. A. Infant B. Toddler C. Preschool-age child D. School-age child E. Adolescent 1. Understands difference between temporary separation and death. 2. Senses emotions of caregivers and altered routines. 3. Capable of understanding death, recognizes all people and self will die. 4. No understanding of true concept of death. 5. Believes death is temporary and the person will return.

1/D, 2/A, 3/E, 4/B, 5/C

Match the formalized plan for the child with a chronic condition with its description. A. Individualized family service plan (IFSP) B. Individualized education plan (IEP) C. Individualized health plan (IHP) D. Individualized transition plan (ITP) 1. Helps individuals receive vocational training and move successfully from the home into other community settings. 2. Developed for a child with cognitive, motor, social, and communication impairment who needs special education services. 3. Developed for the early intervention process for infants with special healthcare needs and their families. 4. Developed for the child with medical conditions that need to be managed within the school setting.

1/D, 2/B, 3/A, 4/C

A school-aged child is admitted with pneumococcal meningitis. The child weighs 44 pounds. The physician orders: ceftriaxone (Rocephin) 50 mg/kg/dose IV every 12 hours three times and then every 24 hours. Calculate how many mg/dose of ceftriaxone the child will receive and then calculate mL/hr to infuse via pump. Supply on hand is: a premix of ceftriaxone 1 g/50 mL, administer over 30 minutes.

1000 mg/dose, 100 mL/hr

The nurse is providing nutritional guidance to the parents of a toddler. Which comment by the parent would prompt the nurse to provide additional education? 1. "I should not give my child raw oysters." 2. "It is safe to leave my meat red in the center as long as there are no juices running." 3. "We always wash our hands well before any food preparation." 4. "We use separate utensils for preparing raw meat and preparing fruits, vegetables, and other foods."

2. "It is safe to leave my meat red in the center as long as there are no juices running."

A child is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate? 1. "One of you might take a leave of absence to be here more." 2. "Parents often feel this way; would you be interested in talking with others who have experienced having a child in the NICU?" 3. "Perhaps the grandparents can make the visits for you." 4. "Why can't you visit after work every day?"

2. "Parents often feel this way; would you be interested in talking with others who have experienced having a child in the NICU?"

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that which hospitalized child at highest risk to experience separation anxiety when parents cannot stay? 1. 6-month-old 2. 18-month-old 3. 3-year-old 4. 4-year-old

2. 18-month-old

The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. Which action by the nurse is the most appropriate? 1. Escort the parents to the waiting room and assure them that they can see their child soon. 2. Allow the parents to stay with the child. 3. Ask the physician if the parents can stay with the child. 4. Tell the parents that they do not need to stay with the child.

2. Allow the parents to stay with the child.

The child was just transferred to the postanesthesia unit (PACU) and report given. The nurse has performed baseline vital signs, the child is stable and pain is under control. What should the nurse do next? 1. Document 2. Allow the parents to visit the child 3. Discharge the child 4. Look for signs of infection 5. Offer clear liquids

2. Allow the parents to visit the child

Which intervention is considered supportive care for a family whose infant has died from sudden infant death syndrome (SIDS)? 1. Interviewing parents to determine the cause of the SIDS incident 2. Allowing parents to hold, touch, and rock the infant 3. Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints 4. Advising parents that an autopsy is not necessary

2. Allowing parents to hold, touch, and rock the infant

In working with parents of children with chronic diseases, the nurse is concerned with helping the parents to protect themselves from compassion fatigue. Which activities are appropriate for the nurse to encourage? Select all that apply. 1. Sleeping more than 9 hours per 24-hour period 2. Exercising 3. Fostering social relationships 4. Developing a hobby 5. Moving away

2. Exercising 3. Fostering social relationships 4. Developing a hobby

A family actively participates in school functions. One of the children is paraplegic and requires a wheelchair for mobility. Which process does the nurse determine the family is working on based on these assessment findings? 1. Stagnation 2. Normalization 3. Isolation 4. Interaction

2. Normalization

While teaching a health promotion class to a group of parents of children in a Head Start class, which information should the nurse include to help decrease the risk of dental caries? 1. Delay introducing cow's milk until at least 1 year of age. 2. Offer drinking cups only at meal and snack times. 3. Encourage use of homemade baby food without preservatives. 4. Offer juices diluted 50 percent with water.

2. Offer drinking cups only at meal and snack times.

Which nursing interventions would be best for the nursing diagnosis of Powerlessness Related to Relinquishing Control to the Healthcare Team? Select all that apply. 1. Provide a primary nursing care model. 2. Prepare the child in advance for procedures. 3. Provide optimal pain relief. 4. Explain procedures in developmentally appropriate terms. 5. Incorporate home rituals when possible.

2. Prepare the child in advance for procedures. 4. Explain procedures in developmentally appropriate terms. 5. Incorporate home rituals when possible.

An adolescent client has a stiff neck, a headache, a fever of 103 degrees Fahrenheit, and purpuric lesions noted on the legs. Although the adolescent's physical needs take priority at the present time, the nurse can expect which to be the most significant psychological stressor for this adolescent? 1. Separation from parents and home 2. Separation from friends and permanent changes in appearance 3. Fear of painful procedures and bodily mutilation 4. Fear of getting behind in schoolwork

2. Separation from friends and permanent changes in appearance

Celiac disease presents many challenges for a family. What should the nurse emphasize when educating the parents of a newly diagnosed child? 1. Ice cream is a safe dessert on a gluten-free diet. 2. The child's weight and height should reach normal levels in about 1 year. 3. Processed foods are usually gluten-free. 4. Insurance pays only a small amount of the cost of celiac diets.

2. The child's weight and height should reach normal levels in about 1 year.

A child is on a ventilator in the pediatric intensive care unit (PICU). Which nursing intervention would best meet the psychosocial needs of this child? 1. Allow the parents to remain at the bedside. 2. Touch and talk to the child often. 3. Provide the child with a blanket from home. 4. Provide consistent caregivers.

2. Touch and talk to the child often.

A nurse is talking to the mother of an exclusively breastfed African American 3-month-old infant who was born in late fall. Which supplement will the nurse recommend for this infant? 1. Iron 2. Vitamin D 3. Fluoride 4. Calcium

2. Vitamin D

The nurse has set up a group discussion for several families with chronically ill children. The nurse informs these parents that they may face which ethical issue? 1. Normalization 2. Withholding and refusal of treatment 3. Repeated hospital admissions 4. Lack of proper dietary needs

2. Withholding and refusal of treatment

A young school-age child is in the pediatric intensive-care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway and collided with a car. Which nursing diagnoses may be appropriate for this family? Select all that apply. 1. Guilt Related to Lack of Child Supervision and Safety Precautions 2. Family Coping: Compromised, Related to the Critical Injury of the Child 3. Parental Role Conflict Related to Child's Injuries and PICU Policies 4. Knowledge Deficit Related to Home Care of

1, 2, 3, 5

The nurse is providing care to a preschool-age client who was admitted to the medical-surgical unit after an acute asthma attack. Which interventions foster a family-centered focus to client care? Select all that apply. 1. Discussing rooming in with the parents of the client 2. Allowing the client to "cry it out" after the parents leave for the evening 3. Providing comfort items from home, such as a blanket 4. Maintaining strict visitation for the family 5. Discussing what to expect during the hospital stay

1, 3, 5

Parents of a child in the pediatric intensive care unit (PICU) have been experiencing shock and disbelief regarding their situation. Which statement by the parents indicates they are moving forward into the next stage of coping? 1. "Why not me instead of my child?" 2. "It is hard for me to have others take care of my child." 3. "I feel like life is suspended in time." 4. "I am glad I can help with his care."

1. "Why not me instead of my child?"

It is important that parents of adolescents with special needs transition care of the adolescent so they can learn to make good decisions on their own. Which items are considered transitional needs? Select all that apply. 1. Attending school 2. Discussing sexual matters 3. Letting most friends know of the medical condition 4. Socialization beyond the family 5. To write his or her own individualized healthcare plan

1. Attending school 2. Discussing sexual matters 4. Socialization beyond the family

The nurse is working with a child with a chronic condition. The nurse observes that over time, the parents have experienced a pattern of periodic grieving alternating with denial. What are the parents currently experiencing based on this assessment finding? 1. Chronic sorrow 2. Compassion fatigue 3. Dysfunctional parenting 4. Pathological grieving

1. Chronic sorrow

The nurse is providing care to an adolescent client who is dying. Which assessment findings indicate the client is experiencing a decrease in peripheral circulation? Select all that apply. 1. Cool skin 2. Mottled appearance 3. Cheyne-Stokes respirations 4. Increased agitation 5. Increased urine output

1. Cool skin 2. Mottled appearance

While teaching the parents of a newborn about infant care and feeding, which instruction by the nurse is the most appropriate? 1. Delay supplemental foods until the infant is 4 to 6 months old. 2. Delay supplemental foods until the infant reaches 15 pounds or greater. 3. Begin diluted fruit juice at 2 months of age, but wait 3 to 5 days before trying a new food. 4. Add rice cereal to the nighttime feeding if the infant is having difficulty sleeping after 2 months of age.

1. Delay supplemental foods until the infant is 4 to 6 months old.

The school nurse completes an assessment of a school-age client to determine the services this child will need in the classroom. The client is a newly diagnosed with type I diabetes mellitus. Based on this information, which special healthcare need category is the most appropriate? 1. Dependent on medication or special diet 2. Dependent on medical technology 3. Increase use of healthcare services 4. Functional limitations

1. Dependent on medication or special diet

The nurse is assessing an adolescent and notes signs and symptoms of anorexia nervosa. Which signs and symptoms led the nurse to believe the adolescent has this condition? Select all that apply. 1. Extreme weight loss 2. Depression 3. Irregular menses 4. Sedentary lifestyle 5. Bradycardia

1. Extreme weight loss 2. Depression 3. Irregular menses 5. Bradycardia

Which stressor is common in the hospitalized toddler with a chronic disorder? Select all that apply. 1. Fear of painful procedures 2. Self-concept 3. Interruption of normal routines 4. Unfamiliarity of caregivers 5. Isolation

1. Fear of painful procedures 3. Interruption of normal routines 4. Unfamiliarity of caregivers

The nurse is instructing a parent of a newborn on the foods that are to be started based on age. The nurse instructs the parent that the first food given to a newborn is rice cereal. What statement by the parent suggests appropriate understanding of the next food that can be introduced? 1. "Chicken can be given next." 2. "Eggs can be given next." 3. "Fruits should be given next." 4. "Whole milk should be started."

3. "Fruits should be given next."

The nurse is working with an adolescent client who will be admitted to the hospital in two days. Which nursing approach is most appropriate to prepare this client for hospitalization? 1. Have teens who have had similar experiences talk to the adolescent about hospitalization. 2. Provide an opportunity for the child to talk with an adult who has had a similar experience. 3. Teach parents what to expect so the information can be shared with the adolescent. 4. Provide an opportunity for the teen to try on surgical attire.

1. Have teens who have had similar experiences talk to the adolescent about hospitalization.

The nurse is conducting a nutritional assessment for a toddler client who is diagnosed with failure to thrive (FTT). Which parameters will the nurse include in the assessment process for this toddler and family? Select all that apply. 1. Height 2. Weight 3. Hemoglobin and hematocrit 4. Twenty-four-hour food diary 5. Maternal dietary intake during pregnancy

1. Height 2.Weight 3. Hemoglobin and hematocrit 4.Twenty-four-hour food diary

There are many healthcare needs of children with chronic conditions. What nursing strategy would best help parents with continuity of care? 1. Include the family and older child in decision making. 2. Assist the family in gaining transportation to healthcare appointments. 3. Provide the family with resources such as social services. 4. Recognize and respect the cultural needs of the family.

1. Include the family and older child in decision making.

A 5-year-old sibling of a 9-year-old child with cystic fibrosis tells the nurse, "I wish I had a breathing disease, too." The nurse knows the parents strive to spend quality time with each child and with both children together. What is the sibling currently experiencing? 1. Jealousy 2. Isolation 3. Loneliness 4. Anger

1. Jealousy

A school-age client is admitted to the pediatric intensive care unit (PICU) in critical condition after a motor vehicle accident. Which intervention should be implemented at this time? 1. Maintain consistent caregivers. 2. Turn the lights off at night. 3. Keep alarm levels low. 4. Consult the hospital play therapist.

1. Maintain consistent caregivers.

A toddler-age client is in end-stage renal failure. Which nursing intervention will assist this child most? 1. Maintain the child's normal routines. 2. Explain body changes that will take place. 3. Encourage friends to visit. 4. Allow the child to talk about the illness.

1. Maintain the child's normal routines.

The nurse in the long-term care clinic is reviewing the charts of a group of children with chronic physical, psychological, functional, and social limitations. Which conditions are most likely to lead to chronic limitations? Select all that apply. 1. Near drowning 2. Congenital heart defect 3. Sinusitis 4. Fetal insult when the mother contracted rubella in the first trimester of pregnancy 5. Sepsis contracted as a neonate

1. Near drowning 2. Congenital heart defect 4. Fetal insult when the mother contracted rubella in the first trimester of pregnancy 5. Sepsis contracted as a neonate

The nurse is planning activities for a toddler with a birth injury of a torn brachial plexus that resulted in muscle atrophy and weakness of his right arm. Which nursing intervention is most appropriate for this client? 1. Offering the toddler a choice of clothing 2. Asking the toddler if he would like to take his medicine 3. Dressing the toddler 4. Feeding the toddler

1. Offering the toddler a choice of clothing

The nurse is teaching the parents of a 4-month-old infant about good feeding habits. The nurse emphasizes the importance of holding the baby during feeding and not letting the infant go to sleep with the bottle. Which disorder is associated with propped feedings and going to sleep with the bottle? 1. Otitis media 2. Aspiration 3. Malocclusion problems 4. Sleeping disorders

1. Otitis media

The emergency-room nurse receives a preschool-age child who was hit by a car. Which nursing interventions are a priority for this child? Select all that apply. 1. Performing a rapid head-to-toe assessment 2. Recording the parents' insurance information 3. Assessing airway, breathing, and circulation 4. Asking the parents about organ donation 5. Asking the parents if anyone witnessed the accident

1. Performing a rapid head-to-toe assessment 3. Assessing airway, breathing, and circulation

The nurse is working with a hospitalized preschool-age child. The nurse is planning activities to reduce anxiety in this child. Which action by the nurse is the most appropriate? 1. Provide the child with a doll and safe medical equipment. 2. Read a story to the child. 3. Use an anatomically correct doll to teach the child about the illness. 4. Talk to the child about the hospitalization.

1. Provide the child with a doll and safe medical equipment.

The nurse is planning care for a preschool-age client who has cerebral palsy (CP). Which interventions are appropriate for this client? Select all that apply. 1. Providing health supervision 2. Collaborating with physical therapy 3. Assisting with planning educational services 4. Prescribing medication for spasticity 5. Promoting growth and development

1. Providing health supervision 2. Collaborating with physical therapy 3. Assisting with planning educational services 5. Promoting growth and development

A novice nurse in the newborn intensive care unit (NICU) has just performed postmortem care on a premature infant who passed away. The novice nurse asks to be excused near the end of the shift. Which interventions can be implemented to support this nurse? Select all that apply. 1. Schedule additional education on bereavement care 2. Ask a seasoned nurse to talk with the novice nurse 3. Tell the nurse it is OK to grieve with the family 4. Recommend that the nurse transfer to another unit 5. Assign the nurse to stable clients only

1. Schedule additional education on bereavement care 2. Ask a seasoned nurse to talk with the novice nurse 3. Tell the nurse it is OK to grieve with the family

During a 4-month-old's well-child check, the nurse discusses introduction of solid foods into the infant's diet and concerns for foods commonly associated with food allergies. Due to allergies, which foods will the nurse instruction the parents to avoid until after 1 year of age? 1. Strawberries, eggs, and wheat 2. Peas, tomatoes, and spinach 3. Carrots, beets, and spinach 4. Squash, pork, and tomatoes

1. Strawberries, eggs, and wheat

The nurse is caring for a client in the pediatric intensive-care unit (PICU). The parents have expressed anger over the nursing care their child is receiving. Which nursing intervention is most appropriate based on the situation? 1. Ask the physician to talk with the family. 2. Explain to the parents that their anger is affecting their child so they will not be allowed to visit the child until they calm down. 3. Acknowledge the parents' concerns and collaborate with them regarding the care of their child. 4. Call the chaplain to sit with the family.

3. Acknowledge the parents' concerns and collaborate with them regarding the care of their child.

The nurse is providing care to a school-age client who is admitted to the hospital after a motor vehicle accident. Which interventions are appropriate to prepare this client and family for their hospital stay? Select all that apply. 1. A hospital tour 2. A health fair brochure 3. An orientation to the unit 4. An age-appropriate explanation of procedures 5. A child life program consultation

3. An orientation to the unit 4. An age-appropriate explanation of procedures 5. A child life program consultation

A school-age client, recently diagnosed with asthma, also has a peanut allergy. The nurse instructs the family to not only avoid peanuts but also to carefully check food label ingredients for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. Based on the client's history, the nurse knows that this client is at an increased risk for which complication? 1. Urticaria 2. Diarrhea 3. Anaphylaxis 4. Headache

3. Anaphylaxis

A school-age child with congenital heart block codes in the emergency department (ED). The parents witness this and stare at the resuscitation scene unfolding before them. Which nursing intervention is most appropriate in this situation? 1. Ask the parents to leave until the child has stabilized. 2. Ask the parents to call the family to come into watch the resuscitation. 3. Ask the parents to sit near the child's face and hold her hand. 4. Ask the parents to stand at the foot of the cart to watch.

3. Ask the parents to sit near the child's face and hold her hand.

During a well-child physical, an adolescent female has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 50th to 75th percentile for her age. Which disorder is the nurse concerned about based on the assessment findings? 1. Anorexia nervosa 2. Kwashiorkor 3. Bulimia nervosa 4. Marasmus.

3. Bulimia nervosa

A nurse is assessing a child who has a concussion. Which of the following are clinical manifestations of a minor head injury? (Select all that apply.) A. Amnesia B. Systemic hypertension C. Bradycardia D. Respiratory depression E. Confusion

A. Amnesia E. Confusion

Parents of a child who will begin enteral feedings ask the nurse what advantage this type of feeding has over other methods. Which responses by the nurse are the most appropriate? Select all that apply. 1. "Enteral feeding is the closest to natural feeding methods." 2. "The child must be able to absorb nutrients." 3. "Enteral feeding is complex to administer." 4. "Enteral feeding requires a central venous catheter." 5. "Enteral feeding has a high success rate."

1. "Enteral feeding is the closest to natural feeding methods." 2. "The child must be able to absorb nutrients." 5. "Enteral feeding has a high success rate."

The mother of a toddler is concerned because her child does not seem interested in eating. The child is drinking 5 to 6 cups of whole milk per day and one cup of fruit juice. When the weight-to-height percentile is calculated, the child is in the 90th to 95th percentile. What is the best advice the nurse can provide to the mother? 1. Eliminate the fruit juice from the child's diet. 2. Offer healthy snacks, presented in a creative manner, and let the child choose what he wants to eat without pressure from the parents. 3. Change from whole milk to 2 percent milk and decrease milk consumption to three to four cups per day and the fruit juice to a half cup per day, offering water if the child is still thirsty in between. 4. Make sure that the child is getting adequate opportunities for exercise, as this will increase his appetite and help lower the child's weight-to-height percentile.

3. Change from whole milk to 2 percent milk and decrease milk consumption to three to four cups per day and the fruit juice to a half cup per day, offering water if the child is still thirsty in between.

The nurse needs to administer a medication to a preschool-age child. The medication is only available in tablet form. Which action by the nurse is the most appropriate? 1. Place the tablet on the child's tongue and give the child a drink of water. 2. Break the tablet in small pieces and ask the child to swallow the pieces one by one. 3. Crush the tablet and mix it in a teaspoon of applesauce. 4. Crush the table and mix it in a cup of juice.

3. Crush the tablet and mix it in a teaspoon of applesauce.

A toddler recently diagnosed with a seizure disorder will be discharged home on an anticonvulsant. Which action by the mother best demonstrates understanding of how to give the medication? 1. Verbalizing how to give the medication 2. Acknowledging understanding of written instructions 3. Drawing up the medication correctly in an oral syringe and administering it to the child 4. Observing the nurse draw up the medication and administering it to the child.

3. Drawing up the medication correctly in an oral syringe and administering it to the child

The nurse is assessing a 14-year-old and notes signs and symptoms of bulimia nervosa. Which assessments led the nurse to this conclusion? Select all that apply. 1. Pale skin 2. Dry, splitting hair 3. Erosion of tooth enamel 4. Calluses on back of hand 5. Gum recession

3. Erosion of tooth enamel 4. Calluses on back of hand 5. Gum recession

A child is being discharged from the hospital after a 3-week stay following a motor vehicle accident. The mother expresses concern about caring for the child's wounds at home. She has demonstrated appropriate technique with medication administration and wound care. Which nursing diagnosis is the priority in this situation? 1. Knowledge Deficit of Home Care 2. Altered Family Processes Related to Hospitalization 3. Parental Anxiety Related to Care of the Child at Home 4. Risk for Infection Related to Presence of Healing Wounds

3. Parental Anxiety Related to Care of the Child at Home

The nurse can instruct parents to expect children in which age group to begin to assume more independent responsibility for their own management of a chronic condition, such as blood-glucose monitoring, insulin administration, intermittent self-catheterization, and appropriate inhaler use? 1. Toddlers 2. Preschool-age 3. School-age 4. Adolescents

3. School-age

A preschool-age client is seen in the clinic for a sore throat. In this child's mind, what is the most likely causative agent for the sore throat? 1. Was exposed to someone else with a sore throat. 2. Did not eat the right foods. 3. Yelled at his brother. 4. Did not take his vitamins.

3. Yelled at his brother.

The mother of an infant born prematurely at 32 weeks expresses the desire to breastfeed her child. The nurse correctly responds with which statement when the mother asks how long she should breastfeed her baby? 1. "Until the child begins solid foods." 2. "Many breastfeed for 2 years." 3. "It is recommended that mothers of preterm infants breastfeed at least a month." 4. "Breast milk should be the only food for the first 6 months."

4. "Breast milk should be the only food for the first 6 months."

The nurse is working with a group of parents who have children with chronic conditions. Which statement by a parent would indicate a risk for a caregiver burden that could become overwhelming? 1. "My mother moved in and helped us take our quadruplets home." 2. "Our health insurance sent us a rejection letter for my child's brand-name medication, and we must fill out forms to get the generic." 3. "I chose to quit my job to be home with my child, and my husband helps in the evening when he can." 4. "I have to care for my child day and night, which leaves little time for me."

4. "I have to care for my child day and night, which leaves little time for me."

A nurse often cares for children who are dying. Which of the following are appropriate actions for the nurse to maintain professional effectiveness? (Select all that apply) A. Remain in contact with the family after their loss. B. Develop a professional support system C. Take time off of work D. Suggest that a hospital representative attend the funeral E. Demonstrate feelings of sympathy towards the family

A. Remain in contact with the family after their loss. B. Develop a professional support system C. Take time off of work

A nurse is caring for an adolescent who has sustained a closed head injury. Which of the following are clinical manifestations of increased intracranial pressure (ICP)? (Select all that apply.) A. Report of headache B. Alteration in pupillary response C. Increased motor response D. Increased sleeping E. Increased sensory response

A. Report of headache B. Alteration in pupillary response D. Increased sleeping

A nurse is caring for a child who was admitted to the emergency department after a motor-vehicle crash.The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following is the priority nursing action at this time? A. Stabilize the child's neck B. Clean the child's laceration with soap and water C. Implement seizure precautions for the child D. Initiate IV access for the child

A. Stabilize the child's neck

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. This is often characterized by which response? a. Denial b. Guilt and anger c. Social reintegration d. Acceptance of child's limitations

ANS: B Feedback A The initial diagnosis of a chronic illness or disability often is often met with intense emotion and characterized by shock and denial. B For most families, the adjustment phase is accompanied by several responses that are normally part of the adjustment process. Guilt, self-accusation, bitterness, and anger are common reactions. C Social reintegration and acceptance of the child's limitations is the culmination of the adjustment process. D Social reintegration and acceptance of the child's limitations is the culmination of the adjustment process.

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 the child's care d. Primary care physician and key health professionals involved in the child's care

ANS: C Feedback A The nursing staff can address the nursing care needs of the child with the family, but other involved disciplines must be included. B The family must be included in the discharge conferences, which allow them to determine what education they will require and the resources needed at home. C A multidisciplinary conference is necessary for coordination of care for children with complex health needs. The family is involved as well as key health professionals who are involved in the child's care. D A member of the nursing staff must be included to review the nursing needs of the child.

A nurse is caring for a child who has increased intracranial pressure. Which of the following are appropriate actions by the nurse? (Select all that apply.) A. Suction the endotracheal tube every 2 hr. B. Maintain a quiet environment. C. Use two pillows to elevate the head. D. Administer a stool softener. E. Maintain body alignment

B. Maintain a quiet environment. D. Administer a stool softener. E. Maintain body alignment

A nurse is developing an educational program about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? (Select all that apply.) A. Inactivated polio vaccine (IPV) B. Pneumococcal conjugate vaccine (PCV) C. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) D. Haemophilus influenzae type B (Hib) vaccine E. Trivalent inactivated influenza vaccine (TIV)

B. Pneumococcal conjugate vaccine (PCV) D. Haemophilus influenzae type B (Hib) vaccine

A nurse is teaching a parent of a preschool child about factors that affect the child's preconception of death. Which of the following factors should the nurse include in the teaching? A. Preschool children have no concept of death B. Preschool children perceive death as temporary C. Preschool children often regress to a previous stage of behavior D. Preschool children experience fear related to the disease process

B. Preschool children perceive death as temporary

A nurse is caring for a child who is taking mannitol for cerebral edema. Which of the findings should the nurse monitor for as an adverse effect of mannitol? A. Bradycardia B. Weight loss C. Confusion D. Constipation

C. Confusion

A nurse is caring for a child who is dying. Which of the following are finding of impending death? (Select all that apply) A. Heightened sense of hearing B. Tachycardia C. Difficulty Swallowing D. Sensation of being cold E. Cheyne-Stoke respirations

C. Difficulty Swallowing E. Cheyne-Stoke respirations

A nurse is caring for a school-age client who possibly has Reye syndrome. Which of the following is arisk factor for developing Reye syndrome? A. Recent history of infectious cystitis caused by Candida B. Recent history of bacterial otitis media C. Recent episode of gastroenteritis D. Recent episode of Haemophilus influenzae meningitis

C. Recent episode of gastroenteritis