HR II EXAM 1: ch 33

The nurse is providing care for a hospitalized child who is scheduled to receive morning medications. Place the statements in order that the nurse will state them, beginning with what the nurse will say first during the medication administration. Use all options.

"Hello, I am going to be your nurse for today." "It is time for you to take your morning medications." "Would you like your medicine before or after your mom helps you take a bath?" "You are doing great today. Would you like to play a game now?"

The nurse has finished an educational program for parents of children who are scheduled to undergo a surgical procedure. Which statement by a parent would indicate a need for further education?

"I will not bring my daughter's favorite stuffed animal to the hospital with us. I don't want it to get lost."

A mother in the outpatient setting is explaining how she plans to prepare her 5-year-old for hospital admission. What remark indicates the parent requires additional teaching?

"We told him to use his manners and behave like a big, brave boy."

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?

Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.

The nurse is caring for a 6-year-old client who is prescribed to cough and deep breathe following surgery. Which nursing action is best for this client?

Blow a pinwheel and bubbles with the child.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?

Determine how much the child knows and is capable of understanding.

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child?

Observe him for physical signs which might indicate pain.

The nurse is reviewing a job description of a school nurse. Which activity would the nurse question?

Provide immunizations to students.

The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use?

Remove one restraint at a time on a regular basis to check for skin irritation.

A 5-year-old is admitted to the pediatric unit for treatment of dehydration caused by a gastrointestinal illness. The nurse notes from the assessment that the child is anxious and fearful. What nursing interventions can help the child to feel less anxious and fearful? Select all that apply.

The nurse briefly explains procedures to the child before performing them. The nurse asks the child if he would like to play a game with the nurse. The nurse allows the parents to stay with the child overnight. The nurse asks the child, "Can you tell me what is making you scared?"

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior?

The toddler is quiet, looks sad, and is disinterested in playing.

A mother is scheduled for rooming-in with her infant prior to discharge from the hospital. The nurse realizes that rooming-in is done for what purpose?

allow the caregiver to practice treatments and procedures that will be necessary once the infant is home

The pediatric nurse would use standard precautions in caring for which client on her floor?

an adolescent who has a broken arm

The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.

boxes to put toys in and/or take out toys stacking blocks or small boxes nursery rhymes or sing-along songs on tape

The nurse is caring for an 18-month-old boy hospitalized with a gastrointestinal disorder. The nurse knows that the child is at risk for separation anxiety. The nurse watches for behaviors that indicate the first phase of separation anxiety. For which behavior should the nurse watch?

crying and acting out

A nurse is caring for a young child who has been hospitalized in a facility that is located several hours from the child's home. The child has not seen his parents in three weeks. When they arrive to visit, the child ignores them. The nurse is aware that this is common in which stage of separation anxiety?

third stage

A nurse caring for a 5-year-old who had abdominal surgery yesterday is trying to teach the child how to take deep breaths. The best way that the nurse can accomplish this is by:

using a pinwheel.

The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which statement would best help prepare the girl for the test and decrease anxiety?

"The machine makes a very loud rattle; however, headphones will help."

The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan?

Place the infant in a room close to the nurses' station.

A preschool teacher calls the hospital and wants to introduce the concept of a hospital to her preschool class in case they ever get sick and need to be admitted. What resources could the child life specialist provide for this group to aid in their learning? Select all that apply.

Provide a room for the class with hospital gowns, masks and equipment used on children. Tour the hospital, including the playrooms on the pediatric floors. Let the children lie in the beds, use the call lights and practice being a patient.

The nurse is caring for a school-age child on the rehabilitation pediatric unit. The nurse hears the mother tell the child not to worry about doing schoolwork and just focus on getting better. What action should the nurse take?

Speak with the mother privately to let her know that keeping the normal routine, including schoolwork, is good for normal growth and development of her child.

A nurse realizes that a child's hospitalization is stressful for the family for which reasons? Select all that apply.

guilt about the illness past experiences of illness and hospitalizations cause of the illness the illness's treatment disruption in family life

On the first postoperative day, a 4-year-old child who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?

protest

A nurse is using a doll to explain what will be done when starting an intravenous (IV) line on a 4-year-old child. What type of play is this?

therapeutic play

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best?

"Why don't you sit on your mom's lap?"

A nurse is caring for a 6-year-old boy hospitalized due to an infection requiring intravenous antibiotic therapy. The child's motor activity is restricted and he is acting out, yelling, kicking, and screaming. How should the nurse respond to help promote positive coping?

"Would you like to read or play video games?"

The home health nurse is caring for a child requiring ongoing home health care for a chronic disease. The family shares with the nurse, "We don't think we can financially afford to keep our child at home. We have explored all options, but we know we are going to have to find a long-term care facility for our child. We feel so guilty but we have to provide for our other children too." What is the best response from the nurse?

"It must be a very difficult decision for you. Why don't I give the case manager a call to give you some assistance with finding a facility."

The hospital nurse is providing discharge instructions to the caregivers of a 10-year-old child with a new prosthetic limb. Which finding will cause the nurse to contact the primary health care provider?

The child is being discharged home with the caregiver.

The nurse is caring for a 7-year-old boy in a body cast. He is shy and seems fearful of the numerous personnel moving in and out of his room. How can the nurse help reduce his fear?

Write the name of his nurse on a board and identify all staff on each shift, every day.

The charge nurse is planning staffing on a pediatric unit. Which client will the charge nurse assign to the registered nurse?

the 1-year-old client with a respiratory disorder prescribed oxygen therapy

The nurse is educating the parents of a 7-year-old boy scheduled for surgery to help prepare the child for hospitalization. Which statement by the parents indicates a need for further teaching?

"It is best to wait and let him bring up the surgery or any questions he has."

A nurse with no pediatric experience has been transferred to a pediatric unit to work for the day. Which comment by the nurse indicate knowledge of developmental considerations when providing hygiene needs to a 3-month-old infant?

"I plan on using a sponge bath to bathe the infant." A 3-month-old would require a sponge bath or tub bath to bathe because he or she cannot sit unaided. Talcum powder is not suggested for infants. A bathtub can be used for toddlers or older. No child should ever be left alone during bathing for any length of time.

The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?

"We are going to take our child to an open house at the hospital so she can see the pediatric unit."

A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure?

in a treatment room All treatments are performed in a treatment room so the child's room remains a "safe zone" for the child. By maintaining the client's room as a safe place, the child is reassured that nothing bad will happen when he or she is in the room. Procedures are never performed in public places such as a playroom to maintain the child's privacy. Distractions are provided in the treatment room.