Exam 3 Quiz

A 10 year old male is 24 hours post appendectomy. He is awake, alert, and oriented. He tells the nurse that he is experiencing pain. He has a prescription for morphine 1 to 2 mg PRN for pain what is the priority nursing action in managing the child's pain? Change the child's position in bed Obtain vital signs with a pain score Administer 1 mg morphine as prescribed Perform a head-to-toe assessment

Obtain vital signs with a pain score Change the child's position in bed Administer 1 mg morphine as prescribed

A child is admitted with constipation and a diagnosis of possible appendicitis. The child is in acute pain. Which nursing interventions would be appropriate prior to surgery to decrease pain? Select all that apply. offer an ice pack Apply a heating pad Assume a position of comfort Limit the child's activity Request a prescription for a cathartic

Offer an ice pack Assume a position of comfort Limit the child's activity

Which connection would the nurse judge to be a healthy coping behavior for a male adolescent after an appendectomy? insisted on wearing a t-shirt and gym shorts rather than pajamas avoiding interactions with other adolescents on the nursing unit refusing to fill out the menu and allowing the nurse to do so not taking telephone calls from friends so he can rest

insisting wearing a t-shirt and gym shorts rather than pajamas

Which statement obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure? the child has had a low-grade fever for several weeks the family history is negative for convulsions the seizure resulted in respiratory arrest the seizure occurred when a child has respiratory infection

the seizure occurred when a child has respiratory infection

The parent brings a child to the clinic after discharge from the hospital for Guillain Barre Syndrome. Which statement by the parent indicates that the discharge plan is being followed? she and her sister argue all day I have to bribe her to get her to do her exercises I take her to the pool where she can exercise with other children she has missed a few of her therapy sessions because she had often sleeps

I take her to the pool where she can exercise with other children

A father of a child with a urinary tract infection cause the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We do not want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best? I sympathize with your difficulties but just ignore the behavior for now. I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible. I understand that things are difficult for you right now, but your child is ill and deserves special treatment. I understand your concern, but this type of behavior happens all the time; your child will get over it when feeling better

I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible

The nurse is teaching the parent of a child with celiac disease about dietary management. Which statement by the parent indicates successful teaching? I will feed my child foods that contain wheat products. I'll be sure to give my child lots of milk. I will plan to feed my child foods that contain rice. I'll be sure my child gets oatmeal everyday.

I will plan to feed my child foods that contain rice.

The health care provider has prescribed a sterile urine specimen for a three year old boy with a history of recurrent urinary tract infections. The family is upset because the last time the child was catheterized, the procedure was very painful and traumatic. What is the nurses best response? I'll request a prescription for a sedative to help him relax I can't do anything to reduce the pain, but you can hold him during the procedure I'll get a prescription for numbing lubricant to make the procedure more comfortable I can apply a topical anesthetic 20 minutes before placing the catheter

I'll get a prescription for numbing lubricant to make the procedure more comfortable

What would the nurse expect as a normal response from an adolescent who has just returned to her room after an open appendectomy? I will need plastic surgery for this scar. I am worried about the size of my scar. I do not want to have any pain. What will my boyfriend say about the scar.

I'm worried about the size of my scar.

An adolescent is being seen in the clinic for abdominal pain with a fever. In what order should the nurse assess the abdomen?Auscultate, Inspect, Palpate, Percuss

Inspect, Auscultate, Percuss, Palpate

Which assessment would be most important for the nurse to make initially in a school-age child being seen in the clinic who has a sore throat, muscle tenderness, arms feeling weak, and generally is not feeling well? difficulty swallowing diet intake for the last 24 hours exposure to illnesses has difficulty urinating

difficulty swallowing

What should be the priority assessment for an adolescent on return to the nursing unit after an appendectomy? the dressings on the surgical site intravenous fluid infusion site NG tube function amount of pain

the dressing on the surgical site.

A seven-year-old has an appendectomy on November 12th. He has had pain for the last 24 hours. There is a prescription to administer acetaminophen with codeine every 3 to 4 hours as needed. The nurse is beginning the shift, and the child is requesting pain medication. The nurse reviews the chart for pain history. Based on the information in the medical record, what should the nurse do next? Administer the acetaminophen with codeine Distract the child by giving him breakfast Instruct the child to take deep breaths and blow explain away Assess the child again in 1 hour

Administer the acetaminophen with codeine

An adolescent client scheduled for an emergency appendectomy is to be transferred directly from the emergency department to the operating room. Which statement by the client should the nurse interpret as most significant? All of a sudden, it does not hurt at all. The pain is centered around my navel. I feel like I'm going to throw up. It hurts when you press on my stomach.

All of a sudden, it does not hurt at all.

When developing the post-operative plan of care for an adolescent who has undergone an appendectomy for a ruptured appendix, in which position should the nurse expect to place the client during the early post-operative period. Semi Fowler's position Supine Lithotomy position Prone

Semi Fowler's position

A child is to receive IV antibiotics for osteomyelitis. Before the initial dose of antibiotics can be given, the nurse confirms that a blood sample for which test has been drawn? creatinine culture hemoglobin white blood count

culture

A typically developing preschool child is experiencing pain after an appendectomy. Which data collection tool is the most appropriate for the nurse to use to assess pain? visual analog scale FLACC scale numerical Pain Scale faces pain rating scale

The nurse should use the faces pain rating scale for children Age 3 or older, the visual analog and numerical scales are used with adults for older children who count well. The faces, legs, activity, cry, controllability (FLACC) scale is a behavioral scale that is appropriate for very small children or non-verbal children.

When the nurse is obtaining the initial health history from a 10 year old child with abdominal pain and suspected appendicitis, which question would be most helpful in eliciting data to help support the diagnosis? Where did the pain start? What did you do for the pain? How often do you have a bowel movement? Is the pain continuous or does it let up?

Where did the pain start?

A recent history of which problems should alert the nurse to gather additional information about the possibility of a urinary tract infection in a toddler who is exhibiting fever and fussiness? abdominal pain swollen lymph glands skin rash back pain

abdominal pain

When developing the plan of care for a school-age child with a suspected diagnosis of appendicitis who has severe abdominal pain, the nurse would expect to include which measure in the child's plan of care? application of a heating pad insertion of a rectal tube application of an ice bag administration of an intravenous narcotic

application of an ice bag

Which assessment finding should alert the nurse to suspect appendicitis in a male adolescent with severe abdominal pain? the abdomen appears slightly rounded bowel sounds are heard twice in two minutes all four abdominal quadrants reveal tympany the client demonstrates a cremasteric reflex

bowel sounds are heard twice in 2 minutes

The nurse is teaching the parent of a preschool-age child with celiac disease about a gluten-free diet. The nurse determines that teaching has been successful when the parents tells the nurse she will prepare which breakfast for the child? eggs and orange juice wheat toast and grape jelly oatmeal and skim milk rye toast and peanut butter

eggs and orange juice

To meet the developmental needs of an 8 year old child who is confined to home with osteomyelitis, what goals should the nurse include in the care plan? encourage the child to communicate with schoolmates encourage the parents to stay with the child allow siblings to visit freely throughout the day talk to the child with about his interest twice-daily

encourage the child to communicate with schoolmates

Which action should be the priority when caring for a school-age child admitted to the Pediatric unit with the diagnosis of Guillain Barre Syndrome? assess the child's ability to follow simple commands evaluate the child's bilateral muscle strength make a game of the range of motion exercises provide the child with a diversional activity

evaluate the child's bilateral muscle strength

The parent of a child with celiac disease ask, "How long must he stay on this diet?" Which response by the nurse is best? until the jejunal biopsy is normal until his stools appear normal for the next 6 months for the rest of his life

for the rest of his life

The nurse prepares to teach an adolescent scheduled for an appendectomy about what to expect. The adolescent says "I'd rather look this up on the Internet." What should the nurse do? explain that completing the teaching checklist is required by the hospital help the client find information on the internet provide the client with written information instead explain that the information found on the internet cannot be trusted

help the client find information on the internet

The nurse is conducting a health history on a school-age child. Which parent statement would suggest to the nurse that a child may have celiac disease? his urine is so dark in color his stools are large and smelly his belly is so small he is so short

his stools are large and smelly

A teenage girl has been diagnosed with a urinary tract infection. The nurse recognizes the need for teaching when the client makes which statement? I will not take bubble baths I will drink plenty of water I can drink coffee I can drink cranberry juice

i can drink coffee

During the initial assessment of a child admitted to the Pediatric unit with osteomyelitis of the left tibia, when assessing the area over the tibia, which is an expected finding? diffuse tenderness decreased pain increased warmth localized edema

increased warmth

Assessment of a school-age child with Guillain Barre Syndrome reveals absent gag and cough reflexes. Which problem should receive the highest priority during the acute phase? impaired physical mobility related to paralysis ineffective breathing pattern related to neuromuscular impairment impaired swallowing related to neuromuscular impairment fluid volume deficit related to total urinary incontinence

ineffective breathing pattern related to neuromuscular impairment

After insertion of bilateral tympanostomy tubes in a toddler, which instruction should the nurse include in the child's discharge plan for the parents? insert ear plugs into the canals when the child bathes gently clean the ear canal with cotton swabs administer antibiotics daily while the tubes are in place disregard any drainage from the ear after 1 week

insert ear plugs into the canals when the child bathes

An adolescent who has had an appendectomy and developed peritonitis has nausea. Which intervention should be should the nurse do first? administer an antiemetic irrigate the NG tube notify the surgeon take the blood pressure

irrigate the NG Tube

A nurse is teaching the parents of a child diagnosed with a urinary tract infection secondary to vesicoureteral reflux. How should the nurse explain how the reflux contributes to the infection? it prevents complete emptying of the bladder it causes urine backflow into the kidney it results in painful bladder spasms it causes painful urination

it prevents complete emptying of the bladder

When teaching an adolescent with a seizure disorder who is receiving valproic acid, the nurse should instruct the client to immediately report which sign or symptom to the health care provider? diarrhea loss of appetite jaundice sore throat

jaundice

A child is being treated with Vancomycin 40 mg/kg/day IV divided into three doses for osteomyelitis the health care provider has prescribed drug protocol management by Pharmacy and a trough Vancomycin level 30 minutes before the third dose scheduled for 0900 hours the laboratory report returns prior to the 3rd dose what action should the nurse take? administer the 0900 dose notify the healthcare provider notify the pharmacist draw a peak drug level

notify the pharmacist

During assessment of a child with celiac disease, the nurse would most likely note which physical finding? enlarged liver protuberant abdomen tender inguinal lymph nodes periorbital edema

protuberant abdomen

After the nurse instructs a group of school teachers about seizures, the teachers role play a scenario involving a child experiencing a generalized tonic-clonic seizure. Which action, when performed first, indicates that the nurse's teaching has been successful? Ask the other children what happened before the seizure move the child to the nurse's office for privacy remove any nearby objects that could harm the child place a padded tongue blade between the child's teeth

remove any nearby objects that could harm the child

Which foods would be appropriate for a 12 month old child with celiac disease? oatmeal pancakes rice cereal waffles

rice cereal

The parents of a child with occasional generalized seizures wants to send the child to summer camp. The parents contact the nurse for advice on planning for the camping experience. Which type of activity should the nurse and family decide the child should most avoid? rock climbing hiking swimming tennis

rock climbing

A toddler is scheduled to have tympanostomy tubes inserted. When approaching the toddler for the first time, which should the nurse do? talk to the mother first so that the toddler can get used to the new person hold the toddler so that the toddler becomes more comfortable walk over and pick the toddler up right away so the mother can relax pick up the toddler and take the child to the play area so that the mother can rest

talk to the mother first so that the child can get used to the new person

A nurse is developing a plan of care with the parents of a school-age client diagnosed with a seizure disorder. What instructions should the nurse give the parents to promote the client's growth and development? the child will need activity limitation and will be unable to perform as well as her peers there is potential for a learning disability and a child might need tutoring to reach high grade level the child will likely have normal intelligence and be able to attend regular school there will be problems associated with social stigma, and parents should consider home-schooling

the child will likely have normal intelligence and be able to attend regular school

A nine-year-old child with Guillian Barre Syndrome requires mechanical ventilation. Which action should the nurse take? maintain the child in a Supine position to prevent unnecessary nerve stimulation transfer the child to a bed side chair three times a day to prevent postural hypotension engage the child in vigorous passive range of motion exercises to prevent loss of muscule function turn the child slowly and gently from side-to-side to prevent respiratory complications

turn the child slowly and gently from side to side to prevent respiratory complications

The nurse is caring for a child with osteomyelitis who will be receiving high-dose intravenous antibiotic therapy for 3 to 4 weeks. What should the nurse plan to monitor? blood glucose level thrombin times urine glucose level urine specific gravity

urine specific gravity

After the nurse teaches the parents of a child with febrile seizures about methods to lower temperature other than using medication, which statement by the parents indicates successful teaching? we will add extra blankets when he says he is cold we will wrap him in a blanket if he starts shivering we will make the bath water cold enough to make him shiver we will use a solution of half alcohol and half water when sponging him

we will wrap him in a blanket if he starts shivering

An adolescent girl with a seizure disorder controlled with phenytoin and carbamazepine asks the nurse about getting married and having children. Which response by the nurse would be most appropriate? you probably should not consider having children until your seizures are cured your children will not necessarily have an increased risk of seizure disorder when you decide to have children, talk to the healthcare provider about changing your medication women who have seizure disorders don't commonly have a difficult time conceiving

when you decide to have children talk to the healthcare provider about changing your medication

A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger cookies to help control the nausea. What should the nurse tell the parents? You can try them and see how he does I would need to get a prescription your child needs medication for the vomiting we discourage the use of home remedies in children

you can try them and see how he does