FA Davis Ch 34 & 35

The nurse is providing care at a pediatric clinic for a 4-year-old child. The parents report recent episodes of daily incontinence of stool with symptoms of ongoing constipation. The health care provider diagnoses encopresis. Which prescribed care would the nurse expect? (Select all that apply.)

-Initiation of a bowel-retraining program -Set times for the child to sit on the toilet daily -Administration of a commercially prepared enema

The nurse is preparing information for parents about urinary tract infections (UTIs) in children. Which information would the nurse include? (Select all that apply.)

-Male infants are more prone to UTIs than female infants. -After infancy, girls are more prone to UTIs than boys. -Diapered infants and toilet-training toddlers are at greatest risk.

The nurse is preparing information for parents about urinary tract infections (UTIs) in children. Which information would the nurse include? Select all that apply.

-Male infants are more prone to UTIs than female infants. -After infancy, girls are more prone to UTIs than boys. -Diapered infants and toilet-training toddlers are at greatest risk.

The LPN/LVN is reinforcing teaching by the RN to parents of an infant diagnosed with gastroesophageal reflux (GER). Which teaching would the LPN/LVN reinforce? Select all that apply.

-Methods of positioning before, during, and after feedings -Burp frequently to prevent a buildup of swallowed air. -Administer medications as prescribed.

The LPN/LVN is assisting with the care of a 15-year-old male patient. The patient is at the pediatrician's office because of the lack of signs of puberty. If Klinefelter syndrome is diagnosed, which additional manifestations would the LPN/LVN expect to observe in this patient? Select all that apply.

-Physical examination reveals small testes. -Genetic testing identifies the syndrome. -The patient reports being in special classes. -The patient has a medical history of treatment for anxiety.

Two children are seen in the emergency department with moderate gastroenteritis identified as food poisoning. The parent states that the children ate homemade French fries and hand-pattied burgers for lunch. Which parent teaching by the RN would be least likely to be included about preventing food poisoning?

Buying unsafe food from stores and markets

The LPN/LVN is assisting with the care of an infant diagnosed with severe gastrointestinal reflux (GER). The infant has a history of prematurity, GER-associated symptoms since discharge from the neonatal intensive care unit, and inconsolable crying after feeding. Which complication would be the most serious that the LPN/LVN would associate with the infant's condition?

Esophageal erosion

The nurse in a pediatric clinic is observing a female patient who is 13 years of age for symptoms of a urinary tract infection (UTI). The nurse notices labial adhesions that appear related to female genital mutilation (FGM). Which initial action would the nurse perform regarding this finding?

Explain the cause and treatment of the UTI to the accompanying adults.

The LPN/LVN is reviewing dietary planning provided by the RN with the parent of a child diagnosed with celiac disease. The parent is selecting menus that are appropriate for the child. Which the LPN/LVN would suggest the RN provide additional teaching if the parent makes which menu selections?

Fish sandwich on a rye bun, French fries, and a dish of ice cream.

The nurse is assisting with a well-child appointment for a 12-year-old child. Observation reveals hypertension, hyperlipidemia, and proteinuria. Which additional finding would lead the nurse to suspect nephrotic syndrome?

Golden-yellow, foamy urine

The nurse is developing a plan of care for a 4-year-old child who is experiencing nocturnal enuresis. Which intervention would the nurse include in the plan of care?

Limit fluids after dinner.

The nurse receives a medical prescription for an adolescent patient being treated for an exacerbation of Crohn disease. The patient identifies a pain level of 4 on a scale of 0 to 10. Which medication prescription would cause the nurse to consult with the prescribing health care provider?

Opioids

The nurse in a pediatric emergency department is observing an 11-year-old child presenting with lower-right abdominal pain rated as a 9 on a scale of 0 to 10. The child has nausea, vomiting, and chills. Which finding would cause the nurse to contact the health care provider immediately?

Pain level is suddenly rated as a 4 on a scale of 0 to 10.

The nurse is making observations on an infant suspected of having pyloric stenosis. Which objective finding would most strongly support this suspected diagnosis?

Palpation of an olive-shaped mass in the infant's abdomen.

The LPN/LVN is instructed to obtain a urine specimen from a male infant for specific gravity and pH testing. Which action would indicate appropriate procedure?

Placing a collection bag over the penis and testicles

The nurse is planning care for a newborn with a cleft lip and palette defect. Which patient need would be the nurse's priority focus for this newborn?

Prevention of aspiration

The nurse is obtaining a health history from a parent of a 3-year-old child who is experiencing gastrointestinal (GI) issues. Which component of the health history would the nurse include?

Problems with any step of the GI process

A mother delivers a newborn with exstrophy of the bladder, a congenital urinary anomaly. Which nursing intervention would the nurse include in the plan of care related to this anomaly?

Provide the mother with information about the anomaly and treatment.

The pediatric nurse examines a 5-week-old infant who has been observed having projectile, nonbilious vomiting. Upon palpation, the nurse feels an olive-shaped mass in the midepigastrium. Based on these data, which condition does the nurse suspect?

Pyloric stenosis

The nurse is obtaining a health history on a 3-year-old child whose parent is concerned about intermittent periods of constipation. The parent states that the issue has occurred on and off for the past 4 to 5 months. The parent expresses frustration because "the child has been potty-trained since 14 months of age." Which possible cause would the nurse identify?

Rebellion is causing the holding of stools.

Which is the appropriate nursing intervention when providing care to a child diagnosed with nephrotic syndrome who is edematous and on bedrest?

Repositioning every 2 hours

A parent brings a 6-year-old child to the emergency department and reports the discovery of a small toy in the child's vagina. The toy was discovered when the child expressed pain with urination and stated, "I think there is a toy in there." Which factor would be the greatest concern by the pediatric health team?

The possibility of the child having mental illness.

A child is admitted to the emergency department with diabetic ketoacidosis. Which biological process would impact the acid-base imbalance in this child first?

The respiratory system will blow off carbon dioxide.

The nurse is assessing an 18-year-old patient diagnosed with ulcerative colitis. The patient's medical history indicates multiple periods of remissions and exacerbations since the age of 10 years. Which statement by the patient would indicate nonintestinal manifestations?

"I have started to have aching joints and rashes."

The LPN/LVN is providing care to a toddler who is hospitalized with intractable vomiting from an unknown cause. Which actions would the LPN/LVN perform while caring for this toddler? Select all that apply.

-Provide 1 tablespoon of prescribed liquids every 15 minutes. -Ensure toddler is in an upright position. -Maintain accurate input and output (I&O), including liquid stools.

The LPN/LVN is reinforcing teaching by the RN to the parent of a toddler who exhibits signs of dehydration. Which signs of the condition would the LPN/LVN emphasize? Select all that apply.

-Rapid heart rate -Decrease in mental activity -Slow capillary refill time

The RN is preparing teaching information for parents whose newborn has a cleft lip and palette. Which risks for the child would the LPN/LVN expect the RN to explain to the parents if the defects are not repaired? Select all that apply.

-The child is at increased risk for aspirating food into the airway. -The child may experience delayed or abnormal speech. -The child may experience failure-to-thrive syndrome.

The mother of a newborn who is 18 hours old tells the LPN/LVN, "If I am patient, I can get the baby to take 2.5 oz of formula." For which reason would the LPN/LVN inform the RN of a need for patient teaching?

A newborn's stomach capacity is 15 to 20 mL.

The mother of a newborn who is 18 hours old tells the LPN/LVN, "If I am patient, I can get the baby to take 2.5 oz. of formula." For which reason would the LPN/LVN inform the RN of a need for patient teaching?

A newborn's stomach capacity is 15 to 20 mL.

The nurse is providing care for a toddler admitted for treatment of a urinary tract infection (UTI) caused by Escherichia coli. Which prescription would cause the nurse to contact the health care provider regarding medication therapy?

Amoxicillin

The LPN/LVN is reinforcing teaching by the RN to the parents of a 10-month-old infant who has undergone a cleft palate repair. Which teaching would be reinforced by the LPN/LVN to help avoid trauma to the surgical site?

Apply padded arm restraints on the infant.

The nurse is assisting at a pediatric clinic with an infant who is experiencing episodes of diarrhea. The parent states that the infant has cried nonstop for the past several hours. The nurse finds the anal area of the infant to be red, inflamed, and excoriated. Which information would the nurse require to determine which teaching by the RN to reinforce with the parent?

Ask about the method used to clean the diaper area.

Before administering a tube feeding to an infant, the nurse is required to confirm tube placement. Which action would be performed to accomplish this task?

Aspirate for stomach contents.

The nurse in a pediatric emergency department is observing an 8-month-old infant. The accompanying adult states that the infant has refused food and fluids for the past 36 hours. Which findings would indicate that the infant is moderately dehydrated?

Capillary refill time of 4 seconds

The LPN/LVN is directed to obtain a urine specimen for culture and sensitivity from a child diagnosed with a urinary tract infection. Which factor would the LPN/LVN recognize as part of the process?

Contamination of the specimen is avoided.

The LPN/LVN is assisting the RN in preparing an educational program about genitourinary disorders that are associated with kidney damage. Which condition would the LPN/LVN suggest is solely seen in males?

Hypospadias

A child is admitted with vomiting, severe abdominal pain, and bloody diarrhea. Which additional symptom would cause the nurse to suspect a diagnosis of hemolytic uremic syndrome (HUS)?

Small bruises in the mouth

The LPN/LVN is expected to apply knowledge about anatomy and physiology, terminology, and pathophysiology when working in patient care environments. Which difference would the LPN/LVN identify between esophageal atresia (EA) and tracheoesophageal fistula (TEF) using acquired knowledge?

TEF involves an abnormal opening between two structures.

The LPN/LVN is reviewing the results of testing on an adolescent patient with either ulcerative colitis or Crohn's disease. Which information on the report would cause the LPN/LVN to expect the diagnosis to be Crohn disease?

There are healthy bowel sections between lesions.

A child's laboratory results indicate hypokalemia, and the health care provider prescribes potassium replacement therapy. For which reason would the nurse contact the health care provider before initiating the prescribed care?

There is no recent record of urinary output.

The nurse is providing care for an 18-mopnth-old child who was recently diagnosed with intussusception. Which reason would the nurse recognize as the least likely purpose for immediate surgery?

To decrease the child's extreme pain and suffering

The nurse is preparing a presentation for high-school students about urinary tract infections and sexually transmitted infections (STIs) when sexually active. Which information would be correct?

Urinate before and after sexual intercourse.

The nurse is preparing a school-age child for a voiding cystourethrogram (VCUG). The child's parent asks about the reason for the test. Which information would the nurse include in an explanation?

VCUG helps identify an abnormal flow of urine.

The nurse is preparing to administer a prescribed tube feeding of 50 mL to an infant. The nurse aspirates 32 mL of feeding from the infant's stomach. Which action would be appropriate for the nurse to perform?

Wait an hour, and recheck the stomach contents.

The nurse at a pediatric clinic is providing teaching to the parents of a preschool-age child with mild dehydration. The nurse has determined that the child can be safely rehydrated at home. Which comments by the parents would indicate that teaching has been effective? Select all that apply.

-"A commercial electrolyte solution is appropriate." -"It is safe to add a small amount of juice to electrolyte solutions."

When providing care to a child admitted to the hospital in order to rule out appendicitis, which of the following interventions should the nurse consider? (Select all that apply.)

-Assess the child's last oral intake. -Prepare the child and family for a surgical appendectomy. -Maintain NPO status.

Which is the priority nursing intervention when caring for a neonate who is born with bladder exstrophy?

Covering the defect with sterile plastic wrap

The nurse is providing care for a school-age patient admitted with hypotonic dehydration validated by a sodium level of 128 mEq/L. Which condition would the nurse associate with the admitting diagnosis and laboratory results?

Cystic fibrosis

The LPN/LVN is assisting the RN in providing care to a child admitted for suspected appendicitis. Which assessment action would the LPN/LVN expect the RN to avoid while confirming the diagnosis?

Deep palpation

The nurse in the neonatal intensive care unit is providing care for a premature infant expected to develop necrotizing enterocolitis (NEC). The nurse reviews documentation for additional causes of the condition. Which finding related to pregnancy and delivery would be unlikely to be a contributing factor?

Delayed prenatal care

The nurse is providing care for an 8-year-old female patient who is hospitalized for a severe bacterial urinary tract infection (UTI). Which intervention would be a priority for this patient?

Determine the patient's choice of fluids.

The nurse is providing postoperative care for a 10-month-old infant after repair of a cleft lip. Which factor would cause the nurse the greatest concern during the first 24 hours after surgery?

Development of signs of a compromised airway

The nurse is providing care for an early school-age girl recently diagnosed with Turner syndrome. Which unique manifestations would be likely to have alerted medical personnel to the diagnosis?

Distinctive physical characteristics

The nurse is aware that multiple medications are prescribed for the child with nephrotic syndrome. Which medication and indication would the nurse identify as correct?

Diuretics for fluid overload

The nurse is observing an infant during a well-baby visit at a pediatric clinic. The nurse collects a urine sample for specific gravity (SG) testing. Test results indicate an SG of 1.008. Which action would the nurse perform regarding the infant's urine SG?

Document the SG in the health record.

The nurse informs new parents that their newborn cannot be fed because of the diagnosis of esophageal atresia (EA). The parents are concerned about the newborn not receiving nourishment and ask how long feeding will be delayed. Which answer by the nurse would be correct?

"Only until the percutaneous endoscopic gastrostomy (PEG) tube is in place."

The nurse in the pediatric intensive care unit is providing care for a child admitted with hemolytic uremic syndrome (HUS). The nurse is providing support for the child's family members. Which comment by a family member would give the nurse a hint about the cause of the child's diagnosis?

"We buy only organically grown fruits and vegetables."

The nurse is assisting a couple whose baby was born with external genitalia that appear male. The couple learns that the baby was born with XX chromosomes and adrenal hyperplasia. Which comment by the parents would indicate a need for emotional support from the nurse?

"What do we tell people? Everyone thinks she is a boy."

A parent brings a young school-age child to the pediatric clinic and voices concerns about the child's bowel habits. Which information by the parent would indicate that the child is experiencing constipation? Select all that apply.

-"I noticed some streaks of blood on the outer surface of his stool." -"When he does defecate, the stool is large, hard, and dry." -"He complains of not being able to drink water at school."

The nurse is providing care at a pediatric clinic for a 4-year-old child. The parents report recent episodes of daily incontinence of stool with symptoms of ongoing constipation. The health care provider diagnoses encopresis. Which prescribed care would the nurse expect? Select all that apply.

-Administration of a commercially prepared enema -Initiation of a bowel-retraining program -Set times for the child to sit on the toilet daily

The LPN/LVN is assisting in the care of a young toddler hospitalized with severe diarrhea and dehydration. A "BRATTY" diet, as tolerated, has been prescribed. Which foods would the LPN/LVN recognize as being appropriate for this patient? Select all that apply.

-Bananas and applesauce -Rice or rice cereal -Yogurt

A new parent asks the LPN/LVN why his infant became dehydrated after 1 day of diarrhea and vomiting. Which previously taught information by the RN would the LPN/LVN reinforce for the parent? Select all that apply.

-Body water percentage is higher in infants than in adults. -Infants have a larger ratio of body surface area to weight. -Infants have less body fluid in the intracellular space. -The infant cannot conserve a source of body water as well as an adult.

The nurse is observing a young toddler whose weight gain indicates a failure to thrive (FTT). Which diagnostic test would the nurse expect to be ordered by the health care provider? Select all that apply.

-Complete blood cell count (CBC) -72-hour fecal fat collection -Thyroid function -Stool examination

The nurse in a pediatric clinic is observing a school-age child who presents with a headache, sore throat, and rash on the buttocks and legs. Which additional findings would contribute to the nurse's suspicion that the patient has acute glomerulonephritis (AGN)? Select all that apply.

-Dark brown (tea-colored) urine -History of a sore throat 10 days prior -High blood pressure -Reports of fatigue and lethargy -Low overall urine output

Which clinical manifestations assessed when performing a genitourinary assessment for a child diagnosed with hemolytic uremic syndrome could indicate the need for dialysis? (Select all that apply.)

-Edema -Fluid retention -High BP

The LPN/LVN is assisting with the care of a 6-month-old infant with gastrointestinal (GI) issues. The parent feels concern about the sudden problems. Which teachings by the RN would the LPN/LVN reinforce with the parent? Select all that apply.

-GI issues can be traced to fetal development. -Disorders often appear with the introduction of food.

A child is brought to the emergency department exhibiting confusion and seizure activity. Laboratory results indicate hyponatremia, and observation reveals pleural effusion. Which additional information about the child would cause the nurse to suspect water intoxication? Select all that apply.

-The child is identified as having low cognitive functioning. -The child has a history of child abuse involving excessive water intake. -The child has a history of severe mental illness. -The child has a physiological condition causing excessive thirst.

The LPN/LVN on a pediatric unit is assisting with a child admitted with severe diarrhea. The laboratory results identifies Clostridium difficile as the cause. Which prior teaching from the RN would the LPN/LVN reinforce with the family of the child?

The need for and process of effective hand washing

The LPN/LVN is assisting in the care of a child admitted to the hospital for complications related to diarrhea caused by a bowel disorder. For which condition would the LPN/LVN expect the child to be monitored with laboratory testing?

Development of metabolic acidosis

The LPN/LVN is assisting with the care of an infant who is hospitalized with dehydration from diarrhea. The infant is placed in the intensive care unit (ICU) on IVs and cardiac monitoring. Which condition would the LPN/LVN associate with the need for cardiac monitoring?

Electrolyte imbalances

The LPN/LVN in the newborn nursery discusses with the RN the possibility of a newborn having Hirschsprung disease. Which manifestation would the LPN/LVN associate with this condition?

The newborn has a heart defect associated with Down syndrome.

The LPN/LVN is reinforcing teaching by the RN to a school-age female patient who is being treated for vulvitis and vaginitis. Which information about the patient would indicate a cause?

The patient practices for a swim team 5 days a week.

The nurse is reviewing teaching by the RN with the parents of an infant who is postoperative for surgical resolution of Hirschsprung disease. Which information regarding the care of this infant would be appropriate for the LPN/LVN to reinforce?

The care of the infant's colostomy

The LPN/LVN is assisting with the care of a 12-year-old child admitted for dehydration. Admitting observations indicate a fever of 101.2°F (38.4°C), blood pressure of 116/68 mm Hg, and respiration rate of 18 breaths per minute. The child reports "feeling very tired." Which change would the LPN/LVN report immediately to the RN?

The child asks, "Where am I, and why am I here?"

The nurse is obtaining information from a parent whose 4-year-old child has experienced vomiting for the past three mornings. The child's vital signs are within normal limits, and the child denies pain. Which factor would the nurse likely identify as the cause of the child's episodes of vomiting?

The child began attending preschool.

The LPN/LVN is reviewing the medical record of a child who is coming to the clinic for a follow-up visit for a urinary tract infection (UTI). Which information would cause the LPN/LVN to identify a congenital anomaly?

The child's voiding cystourethrogram indicates urinary reflux.