Evolve: School-Aged Children
A nurse is observing the activities of 5-year-old children in the playroom. What typical play behavior does the nurse expect?
cooperative
The parent of a child with hemophilia asks the nurse, "If my son hurts himself, is it all right if I give him 2 baby aspirins?" What is the best response by the nurse?
"Aspirin may cause more bleeding. Give him acetaminophen instead."
Allopurinol (Zyloprim) is prescribed for a 6-year-old child undergoing chemotherapy regimen for cancer of the bone. When given the medication, the child asks, "Why do I have to take this pill?" What is the best response by the nurse?
"Because with the other medicines it helps you get rid of the things that are making you sick."
After treatment for Lyme disease, a child expresses fear of going camping again because of the ticks. What is the best response by the nurse?
"Checking yourself frequently for ticks will help prevent another infection."
The parents of a 6-year-old child tell a nurse at the pediatric clinic that their child is weak and lethargic, has headaches, has no appetite, and has dark, cloudy urine. The nurse suspects acute poststreptococcal glomerulonephritis (APSGN). What should the nurse ask the mother?
"Did your child have a sore throat during the past 3 weeks?"
The parents of a school-aged child with cystic fibrosis tell the nurse that they have changed to generic pancreatic enzymes because of money issues. An appropriate response by the nurse is:
"Generic enzymes are not as effective as the brand-name one. This is something you need to discuss with your healthcare provider."
The parents of a 6-year-old boy tell the nurse in the pediatric clinic that their son has recently started to wet the bed at night. What is the most helpful response by the nurse?
"Have there been any changes in his life recently?"
A Girl Scout leader arrives at the hospital's emergency department with a 7-year-old child who may have a broken ankle. The history reveals that the child fell about 1 mile from the camp while on a hike with the scout leader and four other 7-year-olds. The nurse asks whether all of the other children are safely back in camp. Assuming that the scout leader acted appropriately, the nurse expects the scout leader to respond:
"I carried the injured girl and led the rest of the girls back to camp."
A mother with newly diagnosed ovarian cancer knows that she must tell her 8-year-old child about the diagnosis and how her upcoming treatment will affect their family life. She asks the nurse how she should answer if her child asks, "Are you going to die?" What should the nurse advise the mother to answer?
"I don't know, but I'm going to try very hard to stay alive."
A 10-year-old child with recently diagnosed asthma is receiving information about the use of a peak expiratory flow meter (PEFM). The nurse knows that the child understands how to use the PEFM when she states:
"I have to blow out as fast and hard into the machine as I can."
A nurse is teaching a class of school-age children about bicycle safety. The nurse determines that a child needs further teaching when the child states:
"I will always wear a helmet and ride with traffic facing me."
A nurse teaches the mother of a child with a pinworm infestation how pinworms are transmitted. Which statement indicates that the teaching has been effective?
"I'll have to reinforce her handwashing habits, especially before she handles food."
A nurse is teaching a 12-year-old child about a bone marrow aspiration. What statement indicates that the preadolescent needs further explanation of the procedure?
"I'll have to rest after the procedure."
The nurse is providing instruction to a parent of a child with influenza. Which statement by the parent indicates the need for further instruction?
"I'll manage the fever with baby aspirin."
What statement by the nursing student indicates understanding of the precautions needed in the provision of care to a 7-year-old child who is HIV positive?
"I'll put on gloves if I'm going to be in contact with body fluids."
A parent who has been physically abusing a 7-year-old son is undergoing treatment for anger management. What statement by the client indicates the development of some insight into the abusive behavior?
"If I feel upset at my son, I'm going to go into the bedroom and punch a pillow."
An 8-year-old boy is found to have a mild concussion and is to be discharged home. The mother was instructed to check her child for responsiveness every 2 hours and to wake him up for this assessment after he goes to sleep. She telephones the nurse and says that she is afraid to allow him to go to sleep. How should the nurse respond? (Select all that apply.)
"If your son becomes difficult to awaken, bring him to the hospital." "Awakening your son throughout the night should alert you to any change."
A 6-year-old child who has undergone abdominal surgery complains of incisional pain. The nurse administers the prescribed acetaminophen (Tylenol). The mother asks the nurse why her child isn't being given ibuprofen (Advil). The nurse considers the pharmacokinetics of ibuprofen before responding that:
"It could prolong bleeding time."
A 7-year-old boy with a diagnosis of attention deficit hyperactivity disorder (ADHD) is receiving methylphenidate (Concerta). His mother asks about its action and side effects. What is the nurse's initial response?
"It is a stimulant that has a calming effect on children with your son's disorder."
A 7-year-old child who is taking medication to prevent seizures has been seizure free for 2 years. The child's parents ask a nurse, "How much longer will my child need to take the medication?" What is the best response by the nurse?
"It is important that the medications be gradually decreased."
A 13-year-old boy tells the nurse, "I'm so much shorter than the other kids in my class, and I don't get picked for sports teams." What should the nurse's initial response be?
"It must be difficult being shorter than the other kids."
A 5-year-old girl is undergoing a course of chemotherapy. One day the nurse sees the child crying. The child tells the nurse, "All my hair is gone and everyone stares at me." What is the best response by the nurse?
"Let's ask your mother to bring in a hat for you to wear until your hair grows back."
The parents of a school-aged child with leukemia ask the nurse why irradiation of the spine and skull is necessary. What is the most accurate response by the nurse?
"Leukemic cells may invade the nervous system, but the usual drugs are ineffective in the brain."
An 8-year-old child has experienced the death of a sister. The child begins to ask many questions about what happens to the body after death. The parents wonder whether this is abnormal or morbid behavior picked up from playing video games. What is the best response by the nurse?
"School-aged children are inquisitive and ask a lot of questions about death."
After surgery for a ruptured appendix, a 12-year-old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. A bolus of morphine can be delivered every 6 minutes. A parent will be staying with the child during the immediate postoperative period. What statement indicates to the nurse that the instructions about the PCA pump have been understood?
"She needs to push the PCA button whenever she needs pain medication."
The parents of a school-aged child with recently diagnosed leukemia ask the nurse why they were told that their child has too many white blood cells. How should the nurse respond?
"The bone marrow is not controlling your child's white blood cell production as it should."
When a 12-year-old boy who sustained several tick bites on a camping trip becomes ill, he is told that he may have Lyme disease. He asks the nurse, "What is Lyme disease?" What is the best response by the nurse?
"The tick bites gave you an infection. There is medication that will treat it."
An 8-year-old child with cerebral palsy is admitted to the hospital for a tendon-lengthening procedure. After the surgery the parents ask a nurse why their child must wear braces and shoes for at least 12 hours a day, even while in bed. What is the best response by the nurse?
"They maintain body alignment and help prevent foot drop."
A 5-year-old-child is undergoing chemotherapy. The mother tells the nurse that the child is not up to date on the required immunizations for school. What is the best response by the nurse?
"This isn't the best time to finish the immunizations, because your child's immune system is suppressed."
A nurse teaches the parents of a 5-year-old boy with type 1 diabetes about blood glucose monitoring at home. What statement by the parents indicates that the teaching has been effective?
"We'll notify the clinic if the blood sugar is higher than 200."
What should a nurse say to promote a sense of control in a 6-year-old child who is about to receive an injection?
"Which arm should I use to give you the medicine?"
A 7-year-old child is expressing fear concerning an uncomfortable sterile dressing change. What should the nurse say to be most therapeutic?
"Will you help hold the package of bandages for me?"
A mother tells the clinic nurse that her 6-year-old child has been wetting the bed for the past 3 weeks. Previously there had been no problems. How should the nurse respond?
"You did the right thing to bring your child in to be examined."
A 10-year-old boy who is about to begin chemotherapy for acute myelogenous leukemia (AML) tells the nurse that he is old enough to refuse treatment. What is the nurse's most appropriate response?
"You seem frightened. Let's talk about it."
A 9-year-old child with a tentative diagnosis of leukemia is to undergo bone marrow aspiration. What information should the nurse give the child before the procedure?
"You'll be given medication to relax you before the test, and you'll remember nothing afterward."
Parents are considering a bone marrow transplant for their child who has recurrent leukemia. The parents ask the nurse for clarification about the procedure. What is the best response by the nurse?
"Your child's immune system must be destroyed before the transplantation can take place."
A nurse is reinforcing previous learning about cystic fibrosis and its treatment with a 9-year-old child. What is the most suitable information to present to this child?
"Your mucus is thick because cystic fibrosis interferes with how your mucous glands work."
The father of a child who is dying of cancer asks the nurse whether he should tell his 7-year-old son that his sister is dying. What is the most appropriate response by the nurse?
"Your son probably doesn't understand death as we do but fears it just the same. He should be told the truth to let him prepare for his sister's possible death."
A 12-year-old child with type 2 diabetes is scheduled for abdominal surgery. Which factors are most important for the nurse to consider during the postoperative period? (Select all that apply.)
-The blood glucose level will increase because of the stress of surgery. -Diabetic control is usually maintained with insulin after surgery.
A nurse is changing the dressing of a sixth-grader with severe burns. What basic principles of surgical asepsis must the nurse consider? (Select all that apply.)
1 A paper field must remain dry to be considered sterile. 3 A 1-inch border around a sterile field is considered contaminated. 4 Sterile objects in contact with clean objects are considered contaminated.
A practitioner prescribes an initial loading dose of 75 mcg of oral digoxin (Lanoxin) for a school-aged child. The medication is supplied as an elixir, 50 mcg/mL. How many milliliters of solution should the nurse administer? Record your answer rounding to one decimal place. __________ mL
1.5 mL
A 5-year-old child is admitted with burns covering the face and anterior arms and hands. Using the total body surface area (TBSA) percentages shown in the diagram, determine what percentage of the child's body has been burned. Record your answer using a whole number. __________%
15
A 10-year-old child has sustained partial-thickness burns of the anterior surfaces of both arms and hands and the upper half of the chest. Using the grading system of the American Burn Association, the nurse estimates the total body surface area (TBSA) involved. What is the approximate TBSA affected? Record your answer using a whole number. _________ %
17%
The nurse is reviewing discharge instructions for a mother whose school-aged child was recently found to have celiac disease. Which statements by the mother demonstrate understanding of the child's nutritional needs? (Select all that apply.)
2 "I'll try to provide meals that are lower in fats and higher in carbohydrates." 4 "She loves raw carrots for snacking, so I'll have to avoid those when the disease is worse." 5 "I'll be sure to look at the labels more closely from now on—we need to avoid hydrolyzed vegetable protein."
A 7-year-old child with cystic fibrosis is receiving an intravenous antibiotic. The medication is supplied in a 125-mL bag of 0.45% sodium chloride. It is to be infused over 30 minutes. At what rate should the infusion pump be set to deliver the medication in the prescribed time? Record your answer using a whole number. __________ mL/hr
250 mL/hr
Which intelligence quotient (IQ) in a school-age child indicates special learning needs?
60
A school-aged child with acute glomerulonephritis has fluid intake restricted to the previous day's output plus 40 mL. The child's output over the past 24 hours was 140 mL. From 3 pm to 11 pm the child is to receive one third of the total daily fluid permitted. How much fluid should the nurse provide for the evening intake?
60 mL
A 9-year-old child who has had type 1 diabetes for several years is brought to the emergency department of a community hospital. The child is exhibiting deep, rapid respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst. What blood pH and glucose level does the nurse expect the laboratory tests to reveal?
7.20 and 460 mg/dL
A 6-year-old child is experiencing tonic-clonic seizures, and carbamazepine (Tegretol) 15 mg/kg/day divided into two doses is prescribed. The child weighs 44 lb. The medication available is carbamazepine suspension 100 mg/5 mL. How many milliliters should the nurse administer in one dose? Record your answer rounding to one decimal place. __________ mL
7.5 mL
Basing the decision on developmental norms for a 5-year-old child, a nurse decides to withhold a scheduled dose of digoxin (Lanoxin) elixir and notify the health care provider. Below what apical pulse did the nurse withhold the medication?
70 beats/min
Acetaminophen (Tylenol) 15 mg/kg is prescribed for a preschooler who weighs 44 lb. Each 5 mL of solution contains 160 mg. How many milliliters of acetaminophen should the nurse administer? Record your answer rounding to one decimal place. __________ mL
9.4
A nurse is caring for an 8-year-old child who has been admitted to the pediatric unit with a tentative diagnosis of acute poststreptococcal glomerulonephritis (APSGN). Diagnostic tests are ordered. Which tests will help confirm the diagnosis? (Select all that apply.)
ASO titer Urinalysis Blood chemistry
A nurse in the pediatric clinic determines that the pancreatic enzyme replacement being taken by a child with cystic fibrosis is inadequate. What clinical finding supports this conclusion?
Abdominal cramping
A nurse is caring for a hospitalized school-age child. What development-related activity is most important for the nurse to encourage?
Academic studies
A 6-year-old child begins sucking her thumb after surgery. The child did not engage in this behavior before the surgery. What is the best action for the nurse to take?
Accepting the thumb-sucking
A nurse explains to the parents of a 4-year-old child with chickenpox that immunity by antibody formation during the course of the illness provides:
Active natural immunity
A 5-year-old child is admitted to the pediatric unit complaining of colicky abdominal pain with guarding, nausea, anorexia, and a low-grade fever. Palpation of the right lower quadrant of the abdomen elicits pain. What is the most likely diagnosis the nurse should expect when planning care for this child?
Acute appendicitis
An 8-year-old child with a history of asthma is brought to the emergency department because of respiratory distress. The nurse immediately places the child in a bed with the head of the bed elevated and administers oxygen by means of a facemask. The health care provider performs a physical assessment, writes prescriptions, and admits the child to the pediatric unit. Which instruction should the nurse carry out first?
Administer the nebulizer treatment.
An 8-year-old child who is experiencing a sickle cell pain episode is admitted to the child health unit. What is the most appropriate nursing care during this acute period?
Administering prescribed analgesics
A 7-year-old child contracts a urinary tract infection. A sulfonamide preparation is prescribed. What is the priority nursing responsibility when the nurse is administering this drug?
Administering the drug at the prescribed times
The day after undergoing an abdominal appendectomy, a school-aged child is prepared for ambulation. Which nursing action would be most effective before the start of ambulation?
Administering the prescribed pain medication
Methylphenidate (Ritalin SR) is ordered for a 6-year-old boy with the diagnosis of attention deficit-hyperactivity disorder (ADHD). The nurse teaches the father about the safe administration of the medication and concludes that the instructions have been understood when the father says that he should administer it:
After breakfast
What does the nurse identify as an early sign of chronic lead poisoning (plumbism) in school-aged children?
Anemia
A nurse is teaching a group of parents about age-related issues in 5-year-old children. What should the nurse include as a major concern of children of this age?
Anxiety about body integrity
A 7-year-old child with juvenile idiopathic arthritis (JIA) complains of knee pain. What does the nurse expect to be prescribed to help relieve this discomfort?
Application of moist heat
A hospitalized 10-year-old child is apathetic about eating. What is the best nursing intervention to support the child's nutrition?
Asking the parents to visit at mealtimes
An 8-year-old child with viral pneumonia is admitted to the pediatric unit. The nurse reviews the instructions from the health care provider. Which prescription should the nurse question?
Aspirin 325 mg every 4 hours prn for fever higher than 101.4° F.
What should the nurse encourage the parents of a child with plumbism (lead poisoning) to do?
Assess the family's home environment for lead sources and have them removed
A nurse is teaching parents about growth and development in preadolescent girls, and a mother asks at what age her daughter will have her first period. What is the most accurate response by the nurse?
At the end of the growth spurt
A nurse is planning to administer albuterol (Proventil) to a 4-year-old child. The nurse should evaluate the effectiveness of this medication by:
Auscultating breath sounds
The urinary output of a 9-year-old child with acute glomerulonephritis decreases to 250 mL/24 hr. A diet low in sodium and potassium is prescribed. What should the nurse encourage the child to have for lunch?
Baked chicken, green beans, and lemonade
A child with celiac disease is prescribed a gluten-restricted diet. Which lunch selection for the child indicates that the parent understands the dietary instruction provided by the nurse?
Beef taco, corn, canned peaches, chocolate milk
A nurse is reviewing the health care provider's prescriptions for a school-aged child with diarrhea caused by a Salmonella infection. Which prescription should the nurse question?
Bismuth subsalicylate (Kaopectate), 2 teaspoons after each stool
An 11-year-old child with juvenile idiopathic arthritis will be receiving continued nonsteroidal anti-inflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs must be included in the nurse's discharge instructions to the child and family?
Blood in the urine
A nurse is explaining the genetic pattern of inheritance to the parents of a 6-year-old child with newly diagnosed cystic fibrosis. The parents should be taught that the disorder follows an autosomal recessive pattern of inheritance and occurs when:
Both parents are carriers of cystic fibrosis
A 10-year-old child who was rescued from a house fire is brought to the emergency department with burns of the extremities. What finding is of most concern to the nurse?
Burns around the mouth
How should a nurse turn a 10-year-old child in a spica cast?
By log-rolling the body as one unit
Severe hypertension develops in a child with acute glomerulonephritis. What medication does the nurse anticipate that the practitioner will prescribe?
Captopril (Capoten)
The nurse is counseling the parents of a 12-year-old child with Duchenne muscular dystrophy about problems that may develop during adolescence. What body system does the nurse expect will be affected?
Cardiopulmonary
The day after brain surgery a 9-year-old child with type 1 diabetes has a temperature of 103.0° F (39.4° C). What does the nurse suspect as the probable cause of the fever?
Cerebral edema after brain surgery exerts pressure on the hypothalamus.
A 9-year-old child who has cerebral palsy and scoliosis also is mentally challenged and blind. The child is incontinent, has contractures of the elbows and wrists, and sits in a customized wheelchair most of the day. One goal of nursing care is for the child's skin integrity to remain intact. Which nursing action will best achieve this goal?
Changing disposable diapers every 2 to 3 hours
A 6-year-old child is hospitalized with nephrotic syndrome. The mother asks the nurse what she may bring for her child to play with during the hospitalization. In light of the child's age, what should the nurse suggest? (Select all that apply.)
Checkers Paper and crayons Simple card games
A nurse is caring for a 7-year-old child with severe burns who has extensive eschar formation on the arms. What is the priority nursing intervention?
Checking radial pulses
A nurse is obtaining the health history from the mother of a preschooler with Reye syndrome. The nurse should ask the mother if the child has recently had:
Chickenpox
A child with leukemia is to continue taking prednisone (Meticorten) at home. The nurse discovers that the child's sibling is home from school with chickenpox. What is the nurse's priority concern?
Chickenpox can be fatal to individuals with leukemia.
A 7-year-old child sustains a fractured femur in a bicycle accident. The admission x-ray films reveal evidence of fractures of other long bones in various stages of healing. What does the nurse suspect as the cause of the fracture?
Child abuse
A nurse is obtaining the health history of a 5-year-old child who has been admitted to the child health unit with acute glomerulonephritis. The nurse expects the child's mother to report that the:
Child had a sore throat a few weeks ago
A 10-year-old child is admitted to the pediatric unit in vaso-occlusive sickle cell crisis. The nurse is planning to assign a room. Which child is the best roommate option for this client?
Child with thalassemia
After a preschooler undergoes craniotomy for the removal of a brain tumor, the nurse identifies an area of serosanguineous drainage about the size of a quarter on the child's dressing. What is the immediate response by the nurse?
Circling the area with nonabsorbable ink
A 10-year-old child is undergoing radiation therapy for a brain tumor. What should the nurse include in the skin care for this child?
Cleansing the head with water
The gross motor skills of a 5-year-old child are being evaluated. According to the principles of developmental direction, in which order do these skills develop? Begin with the skill that is accomplished first.
Climbing up and down stairs Riding a tricycle Skipping and hopping on one foot Walking backward
A 9-year-old child with chronic kidney disease is undergoing peritoneal dialysis. For which associated complication should the nurse monitor the child?
Cloudy return dialysate
How should the nurse expect the urine of a child with acute glomerulonephritis with hematuria to appear?
Cola-colored
What is the most appropriate toy for the nurse to give a 6-year-old child on complete bedrest?
Coloring book and crayons
A woman and her children, who have not received immunizations for childhood diseases, immigrate to the United States. Before being immunized, one of the school-aged children contracts varicella (chickenpox). The nurse teaches the mother that varicella is:
Communicable until all vesicles are dry
What is the cognitive developmental stage of school-age children?
Concrete operations
A 12-year-old child is to be bedridden at home for several weeks after orthopedic surgery. What activity should the nurse encourage the parents to plan?
Continuing schoolwork
A child becomes cyanotic during a generalized tonic-clonic seizure. What is the most appropriate action by the nurse?
Continuing to observe the seizure
A nurse is caring for a 9-year-old child with juvenile idiopathic arthritis (JIA). What is most important for the nurse to attempt to prevent?
Contracture deformities
A 5-year-old child is brought to the child health clinic for a routine visit, and the nurse observes the child interacting with other children. What type of play does the nurse expect of the child?
Cooperative
A 10-year-old child with acute glomerulonephritis (AGN) is selecting foods for dinner from a menu. Which foods should the nurse encourage?
Corn on the cob, baked chicken, rice, apple, and milk
A 9-year-old child who has successfully completed the emergency (resuscitative) phase of treatment for a severe burn injury is started on a high protein, high calorie diet. Which snacks should the nurse encourage between meals? (Select all that apply.)
Crackers and cheese Banana pudding and whipped cream Frozen yogurt and chocolate sprinkles
A 5-year-old child who is newly arrived from Latin America attends a nursery school where everyone speaks English. The child's mother tells the nurse that her child is no longer outgoing and has become very passive in the classroom. What is the probable reason for the child's behavior?
Culture shock
The parent of a child who has received all of the primary immunizations asks the nurse which ones the child should receive before starting kindergarten. The nurse tells the parent that her child should receive:
DTaP, IPV, MMR
While playing on a jungle gym in the school playground, a school-age child falls and sustains head trauma. The nurse suspects dysfunction of the brainstem at a low level when the child assumes the posturing depicted in the illustration. How should the nurse document this posturing in the child's hospital record?
Decerebrate
A school-aged child with celiac disease has been eating a gluten-free diet for 2 days. What criterion should the nurse and parent use to determine the effectiveness of the diet?
Decreased irritability
A nurse is planning to teach the importance of handwashing to children in first grade. What is the most effective approach for this age group?
Demonstrating handwashing and asking for return demonstrations
A nurse is asked to screen children in a third-grade class for head lice. In light of an 8-year-old's developmental level, how should the nurse first address the class?
Describe what head lice are and how they look
A nurse in the pediatric clinic is evaluating a 6-year-old child with sickle cell anemia whose spleen autoinfarcted by age 4. What is the priority nursing care at this time?
Determining parental knowledge about infection
The regulation of type 1 diabetes in an 8-year-old child is best attained with a combination of therapeutic modalities in addition to the administration of insulin. Which modalities should be included in the teaching plan? (Select all that apply.)
Dietary control Regular exercise Blood glucose monitoring
A nurse is planning play activities for a 6-year-old child whose energy level has improved after an acute episode of gastroenteritis. What activity should the nurse encourage?
Drawing and writing with a pencil or marker
A nurse is caring for a school-aged child with type 1 diabetes and determines that the child is experiencing an episode of hyperglycemia. What symptoms led the nurse to this conclusion? (Select all that apply.)
Dry skin -Increased thirst -Deep, rapid breathing
One principle to be followed for children with type 1 diabetes is to provide for the variability of the child's activity. What should the nurse teach the child about how to compensate for increased physical activity?
Eat more food when planning to exercise more than usual.
An 8-year-old child is being discharged after recovery from a sickle cell vasoocclusive (painful crisis) episode. The nurse teaches the parents the do's and don'ts of the child's care. The nurse is satisfied that the parents understand the principles of care when they state that they are planning to:
Encourage the child to engage in low-intensity activities
A nurse is caring for a 6-year-old child with sickle cell anemia. What is the priority nursing intervention to prevent thrombus formation?
Encouraging fluids
What intervention should be included in the nursing plan of care to help a 10-year-old girl live with Crohn disease?
Encouraging her to express feelings while focusing on the ways she is like her friends
The parents of an 11-year-old child with a terminal illness appear overwhelmed and anxious. What is the best response by the nurse?
Encouraging the parents to express their feelings
A 10-year-old child undergoes open heart surgery to repair a cardiac defect. The health care provider informs the parents that antibiotics are required before any dental work is performed. Later the parents ask the nurse why this is necessary. When responding, the nurse explains that this is done to prevent:
Endocarditis
A nurse is determining whether a 5-year-old child is displaying appropriate behaviors for this age. What developmental findings does the nurse expect? (Select all that apply.)
Enjoys imitative play Makes up rules for a new game
The nurse is caring for a child with a very low platelet count related to chemotherapy. The nurse should monitor this child's urine for the presence of:
Erythrocytes
A nurse is planning care for a school-aged child after the application of a spica cast. What should the nurse include in the plan of care for the child?
Evaluating neurovascular status of the legs
After surgery a 5-year-old child experiences intense pain and an analgesic is prescribed. What should the nurse consider when administering the analgesic?
Even though children do not like medicines, analgesics will make them more comfortable.
After abdominal surgery, a 5-year-old child is experiencing pain, and an opioid analgesic is prescribed. What should the nurse consider about children in pain and their response to opioid analgesics when an opioid analgesic is prescribed?
Even though children do not like taking medicines, analgesics will make them more comfortable.
A 7-year-old child with cerebral palsy who wears leg braces has a slight sensory loss in the lower extremities. What is the most essential information for the nurse to teach the child and parents?
Examine the skin for evidence of pressure points.
What should the nurse teach parents is the most important influence on the eating habits of early school-age children?
Example of parents and siblings at mealtimes
A child with recently diagnosed idiopathic scoliosis has a mild structural curve. The child's mother asks whether the problem can be corrected with exercise. What should the nurse tell the mother concerning an exercise program?
Exercise is used in conjunction with a brace.
An 11-year-old child has gained weight. The mother tells the nurse that she is concerned that her child, who loves sports, may become obese. What is the most appropriate response by the nurse?
Explaining that this is expected during preadolescence
An 11-year-old child is found to have acute lymphocytic leukemia (ALL), and the health care provider discusses the diagnosis and treatment with the child and family. What age-appropriate behavior does the nurse expect from the child regarding the life-threatening diagnosis?
Expressing anger by being insolent
The nurse is caring for a school-aged child with cystic fibrosis. Which pathophysiological factor has the greatest impact on the child's health status and is of priority in the care plan?
Extremely thick mucus causes obstructed airways.
The nurse in the pediatric clinic is reviewing the health history of a 10-year-old girl with a diagnosis of juvenile idiopathic arthritis (JIA). Currently the child is experiencing recurrent pain and swelling of the joints, particularly her knees and ankles. What organ is commonly affected in children with this disorder?
Eyes
A 12-year-old child with cystic fibrosis is to receive four pancrelipase (Pancrease) capsules five times a day. The nurse explains that the medication should be taken with meals and snacks because this will:
Facilitate nutrient utilization
Obesity in children is an ever-increasing problem. What should a nurse consider before confronting the problem with individual children?
Familial and cultural influences are deciding factors in eating habits.
Which of the following clinical findings should the nurse expect to find during the care of a child with acute glomerulonephritis (AGN)? (Select all that apply.)
Flank pain Periorbital edema
A nurse is discussing dietary guidelines with the parents of a school-aged child with irritable bowel disease (IBD) who is anorexic. What should the nurse instruct them to offer their child to ensure sufficient intake of calories?
Frequent snacks of high protein, high calorie foods
A 4-year-old child is brought to the pediatric clinic for a well-child visit. While entering the examination room the child bumps into the door jamb and then tilts his head to one side. The nurse suspects that the child has strabismus. What additional clinical finding supports this conclusion?
Frequent squinting
Children with special needs have the same needs as other children, although their means of satisfying these needs may be limited. What effect should the nurse expect that these limitations will frequently cause?
Frustration
The mother of 10-year-old twin boys tells the nurse in the pediatric clinic that she is concerned because the boys want to spend all their time with their father. What is the best response regarding this behavior?
Gender identification is natural at this age.
A nurse is planning to screen a school-age child for impaired hearing because the child is receiving an antibiotic that affects hearing. Which medication does the nurse suspect may have caused hearing impairment?
Gentamicin (Garamycin)
A nurse is caring for a school-age child with type 1 diabetes. There have been problems maintaining euglycemia. What laboratory test does the nurse expect to be prescribed that will reveal the effectiveness of the diabetic regimen over time?
Glycosylated hemoglobin
A practitioner prescribes supplemental oral iron therapy for a child with iron-deficiency anemia. What side effect should the nurse tell the parents to anticipate?
Greenish-black stool
A school-age child with a fracture of the femur near the epiphyseal plate is admitted to the hospital. The parents ask if there will be any aftereffects when the bone heals. Before responding, what should the nurse consider?
Growth of that leg may be affected.
What is the most appropriate lunch for the nurse to offer a child who is on a restricted-sodium diet?
Hamburger on a bun, grapes, lemonade
A nurse provides nutrition instruction to the parents of a school-aged child with celiac disease, including foods that their child may safely eat. What foods selected by the parents indicate that the teaching has been successful?
Hamburgers and fries
An 8-year-old child is found to have Legg-Calvé-Perthe disease. The health care provider orders an abduction brace 23 hours a day and non-weight-bearing activity. What should the nurse teach the parents to do?
Have the child transfer to a wheelchair, using the unaffected leg
What activity beyond the capabilities of a toddler does the nurse conducting an evaluation expect of a 4-year-old child?
Having a vocabulary of about 1500 words
A nurse initiates preparations for an infratentorial craniotomy in a 9-year-old child. What should the nurse include in the plan?
Having the child draw a picture of a brain and briefly clarifying misconceptions
A child visits the pediatric clinic for a 6-week checkup after an adenoidectomy. The nurse should evaluate the child's ability to:
Hear
What is the priority of care for a 7-year-old child with recently diagnosed celiac disease?
Helping the parents and child adjust to the long-term dietary restrictions
A 9-year-old child is admitted to the pediatric unit with a diagnosis of acute glomerulonephritis. What does the nurse expect the admission urinalysis to reveal?
Hematuria
A 5-year-old child who is HIV positive is taken to the health department for immunizations before the start of school. The CD4 count shows severe immunosuppression. What immunizations can the child be given safely at this time? (Select all that apply.)
Hepatitis A Polio vaccine (IPV) Diptheria, tetanus, pertussis (DTaP)
A parent of a 7-year-old child asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent differentiates rubeola from rubella?
High fever and Koplik spots
A nurse in the pediatric unit is caring for an 8-year-old child with asthma after an exacerbation at home. The child is short of breath. In what position should the child be placed to facilitate breathing and to promote respiratory drainage?
High-Fowler
A 6-year-old child with sickle cell disease is admitted with a vaso-occlusive crisis (painful episode). What are the priority nursing concerns? (Select all that apply.)
Hydration Pain management
A nurse is planning care for a school-aged child experiencing respiratory acidosis. What is the sequence of events that occurs in the child's respiratory response to acidosis? Place the physiological responses in the order in which they occur.
Hyperventilation Increased CO2 elimination Decreased blood H+ ions Increased pH
A nurse anticipates that dialysis will be necessary for a 12-year-old child with chronic kidney disease when the child begins to exhibit:
Hypervolemia
Chelation therapy with calcium disodium edetate (EDTA) has effects besides the desired effect of removing lead from the blood. What side effect should the nurse anticipate?
Hypocalcemia
A 6-year-old child with Reye syndrome is receiving an intravenous solution of 10% glucose and mannitol (Osmitrol) to reduce cerebral edema. For which complication of this therapy should the nurse monitor the child?
Hypovolemic shock
A 7-year-old child survives a near-drowning episode in a cold pond. What factor does the nurse identify that will have the greatest effect on the child's prognosis?
Hypoxia
A nurse in the pediatric clinic plans to administer a booster immunization for polio to a child. Which vaccine should the nurse administer?
IPV
A 5-year-old child with a ventricular septal defect (VSD) is scheduled for cardiac catheterization. The parents ask the nurse why this test is being done. In formulating a reply, the nurse recalls that it:
Identifies the specific location of the defect
A preschool-aged child is admitted to the pediatric unit for urinary diversion surgery. The ureters are transplanted to a section of the colon, with one end attached to the abdominal wall as an ileostomy. The parents ask the nurse for the name of the procedure. What is the nurse's response?
Ileal conduit
A nurse is caring for a 10-year-old boy who sustained a fractured cervical vertebra while playing football. When he is placed in cervical traction, the nurse teaches him that the traction will:
Immobilize the area to minimize injury to the spinal cord
A nurse in the emergency department is caring for a 9-year-old child with a suspected spinal cord injury sustained while falling off a bicycle. What is the initial nursing action?
Immobilizing the child's spine to limit additional injury
A nurse is screening children in an elementary school for head lice (pediculosis capitis). What common secondary infection from head lice is of most concern to the nurse?
Impetigo
What is the best room assignment for a 5-year-old child admitted with injuries that may be related to abuse?
In a room near the nurses' desk
A 13-year-old-child with type 1 diabetes is receiving 15 units of Novolin R insulin and 20 units of Novolin N insulin at 7 am each day. At what time should the nurse anticipate a hypoglycemic reaction from the Novolin N to occur?
In the afternoon
A preschool-aged child admitted with Reye syndrome will most likely be placed:
In the intensive care unit
A 13-year-old child is hospitalized with an exacerbation of chronic bronchitis. What action should a nurse take to decrease retained secretions?
Increase fluid intake to at least 2000 mL/day
Temperature: 98.2 °F Pulse: 96 bpm Respirations: 26 breaths/min Blood pressure: 150/90 mmHg A 7-year-old child is admitted for a diagnostic workup and is transferred from the emergency department to the pediatric unit. The nurse reviews the admission note and physical assessment. The nurse obtains the child's vital signs and talks with the parents. The parents ask the nurse why their child has severe headaches. What explanation should the nurse give for the cause of the headaches?
Increased blood pressure
A 10-year-old child is receiving oxygen 2 L/min by way of nasal cannula. The health care provider asks that pulse oximetry be started. What is the appropriate placement for the oximetry probe in a child of this age?
Index finger
A 10-year-old child has been working on earning all of the scouting badges. Which of Erickson's stages of psychosocial development is this child achieving?
Industry
An adolescent with a history of type 1 diabetes is admitted in ketoacidosis. What does the nurse suspect as a precipitating cause of this episode of ketoacidosis?
Infection
A nurse is preparing a 5-year-old girl who has undergone a myringotomy for discharge. What should the parents be taught about their child's care at home?
Insert ear plugs whenever a bath is given.
Before discharging a 9-year-old child who is being treated for acute poststreptococcal glomerulonephritis (APSGN), what information should the nurse plan to give the parents?
Instructions about which high-sodium foods to avoid
A 9-year-old child who has iron-deficiency anemia tells the nurse, "I get dizzy in gym class." What is the most likely explanation for this symptom?
Insufficient cerebral oxygenation
A nurse knows that when routine oxygen therapy is being administered to a 7-year-old child, the oxygen:
Is closely monitored for the correct concentration
When planning nursing care for a 5-year-old child with acute poststreptococcal glomerulonephritis, what should the nurse emphasize that the child and family must maintain?
Isolation from children with infections
A child with a diagnosis of tuberculosis is admitted to the pediatric unit. Which location should the nurse select as the best placement for the child?
Isolation room
A nurse is planning to teach the four-point alternate crutch gait to a 9-year-old child with cerebral palsy. The nurse teaches the parents that this gait was chosen because:
It provides for equal but partial weight bearing on each limb
A nurse is teaching a class for staff members working in a group home about the cognitive development of children with cognitive impairments. What concept can these children probably learn the fastest?
Large versus small
A 6-year-old child comes to the well-child clinic for a routine examination. The nurse identifies black lines on the teeth at the gum line. What does the nurse suspect as the cause of this finding?
Lead poisoning
The nurse is teaching crutch-walking to a 12-year-old child. What does the child do that indicates the need for more teaching?
Looks down when placing the crutches
The nurse anticipates that the family of a child with cerebral palsy is at risk for difficult parenting issues. What does the nurse conclude is the probable basis for this difficulty?
Loss of the expected healthy child
The parents of a school-aged child with fever, headache, and a stiff neck ask that the child be tested for meningitis. Which test should the nurse tell the parents is used to confirm the diagnosis of meningitis?
Lumbar puncture
Which of the following clinical manifestations does the nurse associate with rubeola?
Macular rash
A 9-year-old child has been found to have Legg-Calvé-Perthes disease and is on bedrest. The nurse encourages the parents to look for something creative for the child to do or a hobby for the child to begin with the purpose of:
Meeting the developmental task of initiative
A critically ill 5-year-old child exhibits Kussmaul respirations. The nurse suspects an increasing acid-base imbalance related to:
Metabolic acidosis cause by a concentration of cations in body fluids
A school-aged child scores between 55 and 68 on a standardized intelligent quotient (IQ) assessment test. What degree of intellectual impairment should the nurse consider this to represent?
Mild
A nurse in the pediatric clinic is counseling the parents of a school-aged child with celiac disease. The child has extensive mucosal damage and as a result the digestion of disaccharides is impaired. What substance should the nurse teach the parents to temporarily eliminate from their child's diet?
Milk
The nurse is rendering preoperative care to a child with a Wilms tumor. What is the most important aspect of this care?
Monitoring blood pressure
A school-aged child with a seizure disorder has been taking carbamazepine (Tegretol) for 3 years. What nursing intervention is most important at this time?
Monitoring the child's complete blood cell counts
A nurse notes the weights attached to a 7-year-old child in traction are touching the floor. What action should the nurse take?
Moving the child toward the head of the bed
While in the playroom a 7-year-old child exhibits twitching of the right arm and leg that progresses to a generalized tonic-clonic seizure. What is the nurse's initial action?
Moving toys and furniture away from the child
A 4-year-old child is undergoing a diagnostic workup for pulmonic stenosis. The mother asks the nurse about the diagnosis. The nurse bases the response on the fact that pulmonic stenosis is:
Narrowing of the valve between the right ventricle and the pulmonary artery
The mother of a preschooler with acute glomerulonephritis (AGN) asks the nurse whether her child will have to stay in bed. The nurse responds that bedrest is:
No longer a necessary part of the treatment plan
A nurse is planning an evening snack for a child receiving Novolin N insulin. What is the reason for this nursing action?
Nourishment helps counteract late insulin activity.
A nurse teaches the parents of a school-aged child with celiac disease about the foods that should be eliminated from the diet. Which foods do the parents name that indicate to the nurse that the teaching has been understood? (Select all that apply.)
Oatmeal Whole-wheat bread
A nurse is caring for several school-aged children on the pediatric unit who are on prolonged bedrest and eating regular diets. Which breakfast should the nurse recommend to the children?
Oatmeal with raisins and milk
A 9-year-old child with type 1 diabetes is hospitalized for insulin dosage regulation. A nurse observes the child sneaking food and trying to talk family members into bringing candy. What action should the nurse take when the child complains of feeling hypoglycemic?
Obtain a blood glucose level
A 9-year-old child with type 1 diabetes has a history of erratic blood glucose readings. During a visit to the clinic the child is seen sneaking food and trying to talk the mother into providing sweets. The child complains of feeling hypoglycemic. What is the priority nursing action?
Obtaining a blood glucose level
A nurse is caring for an 11-year-old child with type 1 diabetes. Two hours after breakfast the child becomes pale, diaphoretic, and shaky. What action should the nurse take?
Obtaining a current blood glucose level
An 8-year-old child is being given insulin glargine (Lantus) before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack?
Offer a snack to prevent hypoglycemia during the night.
A 6-year-old child has a fractured arm and multiple old injuries. Child maltreatment is suspected. What parental characteristic supports this suspicion?
Offering inconsistent stories about the injuries
A 5-year-old child is receiving dactinomycin (Cosmegen) and doxorubicin therapy after nephrectomy for Wilms tumor. What intervention should the nurse include when planning care?
Offering warm saline mouthwash
A nurse is administering high concentrations of oxygen to a 7-year-old child. What is the nurse's most important consideration concerning the oxygen?
Oxygen must be humidified before administration.
The alkylating agent cyclophosphamide (Cytoxan) is prescribed for a school-aged child with cancer. What is the most important sign or symptom for the nurse to be alert for while the child is receiving this medication?
Pain with urination
The parents of a 12-year-old boy with cystic fibrosis (CF) ask the nurse why he needs a glucose tolerance test. What information should the nurse consider before replying?
Pancreatic scarring predisposes the child to diabetes.
A school-aged child who has just arrived from Africa has been exposed to diphtheria, and a nurse in the pediatric clinic is to administer the antitoxin. Which type of immunity does the antitoxin confer?
Passive artificial
The mother of a 5-year-old child recovering from varicella (chickenpox) calls the nurse in the pediatric clinic, asking how the child's itching can be relieved. What is the best response by the nurse?
Pat the lesions while applying the prescribed calamine lotion.
A nurse manager is providing a class on cystic fibrosis for the pediatric staff nurses. Physiological adaptations to cystic fibrosis are a result of:
Pathology of mucus-secreting glands
The nurse is planning care for a school-aged child with autism spectrum disorder (ASD) who has been hospitalized for some tests. Which intervention should the nurse plan to implement?
Placing the child in a private room
When providing care to a 6-year-old child with leukemia, a nurse notes blood on the pillowcase and several bloody tissues. What blood component value on the child's laboratory results should the nurse verify?
Platelets
A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's urine output decreases to less than100 mL/24 hr, the creatinine clearance is 60 mL/min, and there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn for testing. Which serum level requires immediate intervention?
Potassium 6.1 mEq/L
In addition to standard precautions, what protective equipment or precautions should the nurse use when caring for a 4-year-old child admitted with pertussis?
Private room
What should the plan of care include to minimize the potential for a sickling episode in a child with sickle cell anemia?
Promoting adequate oxygenation
What is the nurse's priority responsibility when abuse of an 8-year-old child is suspected?
Protecting the child from future abuse
What nursing care to prevent a crisis is the same for school-aged children with sickle cell anemia and celiac disease?
Protecting the child from infection
A nurse is caring for an anemic, malnourished 11-year-old child who has celiac disease. The health team develops a plan to help the parents correct their child's nutritional problems. What should the parents be encouraged to do?
Provide foods high in folic acid, iron, and vitamin B12 to correct the anemia
A 7-year-old child with juvenile idiopathic arthritis has difficulty getting ready for school in the morning because of joint pain and stiffness. Which recommendation should the nurse make to the family?
Provide warm, moist heat to the affected joints before arising.
During chemotherapy, altered nutrition is a common side effect. Knowing that compromised nutrition can contribute to an increased risk of infection and other problems, the nurse:
Provides oral supplements
A 10-year-old child is admitted to the hospital for surgery. The parents state that the child is mentally challenged and functions on the level of a 3-year-old. What should be included in the child's preoperative teaching plan?
Providing explanations at a preschooler's level of understanding
A school-aged child is undergoing chemotherapy. How can the nurse best manage a common side effect of chemotherapy?
Providing meticulous oral hygiene
A 9-year-old boy is told that he must stay in the hospital for at least 2 weeks. The nurse finds him crying and unwilling to talk. What is the priority nursing care at this time?
Providing privacy to allow him to express his feelings
An 11-year-old child with type 1 diabetes who also has a learning disability has difficulty measuring the required insulin dose. The child frequently draws up 42 units of insulin instead of the prescribed 24 units. What is the most appropriate intervention to ensure dosage safety?
Providing the child with a preset syringe that was developed for the visually impaired
What nursing intervention will be most effective in helping relieve the anxiety of a young school-age child during the postoperative period?
Providing the child with sterile dressing equipment and a doll
The nurse is caring for a child with spasmodic croup. The nurse knows that immediate nursing intervention is required for:
Rapid respiration
A 7-year-old child who has sustained frostbite of the toes after skiing in below-freezing weather is brought to the emergency department. What is the nurse's initial intervention?
Rapidly rewarming the toes by placing the feet in warm water
What nursing intervention is most effective in alleviating the fretfulness of a hospitalized 5-year-old child?
Reading a story to the child
An 8-year-old child is admitted to the emergency department with signs and symptoms of Reye syndrome. What information from the child's history is most important for the nurse to obtain in light of the child's tentative diagnosis?
Recent viral infection
An 8-year-old child admitted to the hospital 2 days ago tells the nurse, "I'm too sick to feed myself." The nurse recognizes that this statement is most likely indicative of:
Regression
A 12-year-old child with sickle cell anemia is admitted during a vaso-occlusive crisis. What is the priority of care for this child?
Relieving pain
What action should the nurse take if abuse of a 10-year-old child is suspected?
Report the suspicion to local authorities
A school-aged child with cystic fibrosis has been admitted with a respiratory infection. The child has been very disruptive and angry with staff and parents. The nurse suspects that the child is:
Resentful of the restriction of the hospitalizations
A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?
Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid
An emergency tracheotomy has been performed on a 6-year-old child with acute epiglottitis, and the child is receiving humidified air through a tracheotomy collar. What early clinical manifestations of hypoxia should alert the nurse to suction the tracheotomy?
Restlessness and increase in pulse
A nurse is teaching the parents of a child with juvenile idiopathic arthritis how to prevent loss of joint function. Which activities should be encouraged? (Select all that apply.)
Riding a bicycle Walking to school Swimming in the community pool
Methylphenidate (Ritalin) has been prescribed for a 7-year-old child with attention deficit-hyperactivity disorder (ADHD) and is to be taken with meals. What rationale should the nurse provide for the parents about the timing of medication administration?
Ritalin depresses the appetite.
An 8-year-old child who is cognitively impaired and blind does not speak or respond to the nurse. What should the nurse do when entering the child's room?
Say the child's name and touch the child's arm before starting care
A 10-year-old child who is developmentally delayed and blind must be fed all meals. The child has problems swallowing and frequently chokes and coughs during the feeding. What technique should the nurse use when feeding this child?
Seating the child in a wheelchair, giving small bites of food with metal tableware, and encouraging participation
What is the first activity of daily living (ADL) that the nurse should help teach a developmentally disabled 8-year-old child?
Self-feeding
A nurse has just finished feeding a 4-year-old child through a nasogastric tube. In what position should the child be placed to help ensure retention of the feeding and prevent aspiration?
Semi-Fowler
The parents of a boy with hypospadias with chordee ask a nurse why their child should undergo corrective surgery. What problem that may develop eventually should the nurse discuss with the parents?
Sexual difficulties
A school-aged child is receiving a blood transfusion. What should the nurse do first if an allergic reaction to the blood occurs?
Shut off the infusion
A 7-year-old child has a moderate cognitive disability. What should the nurse suggest that the parents provide for the child?
Simple, repetitive tasks
A nurse is caring for a school-aged child who has had a tonic-clonic seizure. How should the nurse describe the clonic phase?
Spasmodic body jerking
A school-aged child is brought to the emergency department with partial- and full-thickness burns of the lower extremities. The practitioner writes multiple prescriptions. What is the nurse's priority intervention?
Starting an intravenous line with a large-bore catheter
A 6-year-old child is admitted with an acute infection and dehydration. There is a prescription for an IV antibiotic to be piggybacked to a continuous hydration solution. During the administration of the antibiotic the child becomes restless, flushes, and begins to wheeze. Place the nursing actions in order of their priority.
Stopping the antibiotic infusion Assessing the respiratory status Maintaining the hydration infusion Notifying the practitioner
A 6-year-old child with acute spasmodic bronchitis who is receiving humidified air removes the mask, and while bathing the child the nurse notes increasing respiratory distress. What is the most appropriate nursing intervention?
Stopping the bath and replacing the mask
A 9-year-old child is found to have acute glomerulonephritis after a recent infection. What microorganism should the nurse suspect as the cause of the child's current health problem?
Streptococcus
An 11-year-old preadolescent has just been found to have type 1 diabetes. The child, who likes sweets, asks about sugar and sugar substitutes in the diet. What information should the nurse and the dietitian give the child?
Sugar substitutes such as saccharin, aspartame, or sucralose can be used.
A nurse is caring for a first-grader receiving prednisone (Meticorten). What outcome does the nurse expect with adrenocorticosteroid therapy?
Suppressed inflammatory process
A nurse is counseling the family of a child with AIDS. What is the most important concern that the nurse should discuss with the parents?
Susceptibility to infection
A nurse questions the parents of a child with chickenpox about relatives or friends who are undergoing specific prolonged medication therapy. What type of medication will put a person at risk if he or she is exposed to the varicella virus?
Systemic corticosteroid
A nurse administers albuterol to a child with asthma. For what common side effect should the nurse monitor the child?
Tachycardia
A school-aged child with a seizure disorder is to start taking divalproex (Depakote). What should the nurse teach the parents about caring for their child in regard to this medication?
Take the child for regularly scheduled blood tests
After multiple upper respiratory infections, a school-aged child undergoes a tonsillectomy and adenoidectomy. Two weeks after surgery the nurse evaluates the child's condition. On what should the nurse focus? (Select all that apply.)
Taste Smell Hearing Breathing
A 4-year-old girl decided to surprise her mother by making hot chocolate and spills hot water on her legs, resulting in partial-thickness burns. Because of the child's age, the nurse's discharge instructions to the parents should emphasize the importance of:
Teaching their child basic safety rules
An 11-year-old boy who has stepped on a rusty nail is given tetanus immune globulin in the emergency department. The nurse knows that the immune globulin injection will confer:
Temporary passive acquired immunity
A school-aged child with cystic fibrosis has recurrent episodes of bronchitis, and the parents ask the nurse why this happens. What reason should the nurse include in the reply?
Tenacious secretions that obstruct the respiratory tract provide a favorable medium for growth of bacteria.
What safety instruction should a nurse teach a 10-year-old child with diminished sensation in the legs because of cerebral palsy?
Test the temperature of the water before a bath.
An infant needs emergency surgery. A nurse is aware that the child's mother is 13 years old and the father is 16 years old. The father and the paternal grandmother, who both take care of the infant, are the only family members at the bedside. From whom should the nurse obtain the informed consent?
The 16-year-old father
Range-of-motion exercises are prescribed for a child with juvenile idiopathic arthritis. What criterion should the nurse use to evaluate the effectiveness of the exercises?
The affected joints can flex and extend.
A school-aged child is being observed overnight for responses to a closed head injury sustained when the child fell off a piece of playground equipment. The nurse knows to call the health care provider immediately if:
The child begins vomiting
Permethrin 1% lotion (Nix) is prescribed for a 5-year-old child with pediculosis capitis (head lice). What instruction should the nurse include while teaching the parents about treating the head lice?
The child's hair must be combed with a fine-toothed comb to remove nits.
The practitioner prescribes no weight bearing on a leg that has been casted because of a fracture of the femur. How should the nurse determine the appropriate length of the crutches for this child? (Select all that apply.)
The crutches should reach 2 inches below the axillae. The crutches' tips should rest 6 inches outside the feet.
A nurse is helping a 7-year-old child with juvenile idiopathic arthritis (JIA) perform range-of-motion exercises. What outcome indicates that the exercises have been effective?
The knees are more mobile.
A 10-year-old child is found to have hemophilia. The nurse is explaining how hemophilia is inherited. What is the best explanation of the genetic factor that is involved?
The mother is a carrier of the disorder but is not affected by it.
The parents of a critically ill 7-year-old child constantly blame each other for their child's illness. What parental response suggests that the nurse's intervention has been successful?
The parents make an appointment with a family counselor.
A nurse is teaching a school-aged child how to use an insulin pump. What is most important for the child to understand?
The pump is an attempt to mimic the way a healthy pancreas works.
A 6-year-old child with a leg fracture of suspicious origin is brought into the emergency department by the mother and the mother's boyfriend. It is the child's first visit to this hospital. After assessing the child, a nurse anticipates that the health care provider will order a skeletal survey. Why is a skeletal survey the preferred diagnostic tool?
The skeletal history of the current fracture and any previous healing or healed fractures are identified.
A preadolescent brings home a note from the school nurse informing the parents that the child should be evaluated for scoliosis. The mother calls the clinic nurse to ask for a description of scoliosis. Before responding, the nurse recalls that in scoliosis:
There is a rotary deformity of the lateral curvature of the spine
A nurse is caring for several school-aged children with cystic fibrosis. Why does the nurse anticipate that these children will probably be small and underdeveloped for their age?
These children digest little food because pancreatic enzymes are blocked.
A nurse places a school-aged child with bacterial meningitis in isolation with droplet precautions. What is the purpose of these precautions?
They keep the child away from uninfected people.
The parents of a gifted 4-year-old notice that their child has been showing signs of rebellion and acting out. One important thing to teach the parents about gifted children is:
They need boundaries like any other child
The parents of a 6-year-old child with celiac disease tell the nurse that their child becomes dejected because she is not able to eat snack foods like the rest of her class and friends. What snack can the nurse recommend that is safe for the child to eat?
Tortilla chips
The mother of a school-age child asks the school nurse how her child got head lice. What should the nurse explain to the mother?
Transmission occurs through contact with contaminated children and objects.
A nurse in the pediatric clinic is evaluating the fine motor skills of a 5-year-old child. According to the principles of developmental direction, in which order does a child develop these skills? Begin with the skill that is accomplished first.
Turns a doorknob Places objects into a narrow-necked bottle Uses scissors Copies a square on a piece of paper
What strategy should the nurse employ to be effective when using play therapy with a 6-year-old child with autism?
Use mechanical and inanimate objects for play
A nurse is caring for a 9-year-old child who is undergoing chemotherapy to treat leukemia. What is the priority nursing action?
Using techniques to minimize risk of infection
A 6-year-old child is in the acute phase of nephrotic syndrome. The mother asks the nurse about play activities for her child. What should the nurse suggest? (Select all that apply.)
Video games Children's books
After being bitten by a rabid dog a 4-year-old child is to receive a series of antirabies inoculations. The nurse who is to administer the injections should recall that rabies is a:
Viral infection characterized by seizures and difficulty swallowing
A nurse is monitoring a 6-year-old child for toxicity precipitated by digoxin (Lanoxin). For what sign, the most common, of digoxin toxicity should the nurse assess the child?
Vomiting
The nurse is caring for a 6-year-old child admitted from the emergency department after an acute asthma attack. The child has a new order for fluticasone (Flovent). What instructions must the family be given about this drug before the child's discharge?
Watch for white patches in the mouth and report them to the primary care provider.
An 8-year-old child with a supracondylar fracture of the right humerus is being prepared for surgery. What clinical finding related to the fracture should the nurse report immediately?
Weak radial pulse in the right wrist
A preschooler is admitted with a diagnosis of acute glomerulonephritis. The child's history reveals a 5-lb weight gain in 1 week and periorbital edema. How can the nurse obtain the most accurate information on the status of the child's edema?
Weighing daily
A nurse is preparing a 10-year-old child for a tonsillectomy and adenoidectomy to be performed later in the day. What information should the nurse share with the child?
What the child will experience before and after the procedure
A new nurse has been assigned to a school-aged child who is in contact isolation for methicillin-resistant Staphylococcus aureus (MRSA). The primary nurse observes the new nurse during morning care. Which behavior should the primary nurse address to improve isolation technique?
While changing the bed the nurse wears gloves but no gown.
The mother of a kindergartener tells the nurse that her daughter is constantly scratching behind her ears. The nurse suspects pediculosis capitis (head lice). What does the nurse expect to find during inspection?
White spots attached to the bases of hair shafts
A 7-year-old child must remain quietly in bed while undergoing peritoneal dialysis. What activity is most appropriate for the nurse to plan for this child?
Working multiple-piece puzzles with another child
A nurse is reinforcing previous learning about cystic fibrosis and its treatment with a 9-year-old child. What is the most suitable information for a child of this age?
Your mucus is thick because of the way your mucous glands work."
