N411

After teaching the parents of an 8 year old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma? a. Shellfish b. Indoor molds c. Dust mites d. Pet dander

A

The nurse is assessing the behavioral indicators of a 9-month-old to determine the child's pain level. Which description would be commonly associated with a pain response? a. The child has an angry facial expression with the eyes open b. The baby's eyebrows are drawn together with the eyes closed c. The child's body may be stiff but does not thrash around d. The infant responds minimally when a painful area is stimulated

A

Assessment of a 12-year-old who crashed his bicycle without a helmet reveals the following: temperature 99.2°F, pulse 100 bpm, respiratory rate 24 breaths per minute with easy work of breathing, and BP 102/70 mm Hg. What is the priority action by the nurse? A.) Assess neurologic status while observing for obvious injuries. B.) Administer IV fluid bolus of normal saline at 20 mL/kg. C.) Remove the cervical collar if he complains that it bothers him. D.) Listen for bowel sounds while assessing for pain.

A Rationale: After assessing airway, breathing, and circulation, move on to "D" (disability), which involves assessing the child's neurologic status. After that, "E" (exposure) involves examining the child for any other obvious injuries. (Refer to text book and Benjamin Woodhouse's Presentation)

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by: a. Supporting the parent in his/her presence and caregiving b. Keeping the infant warm and dry c. Holding and rocking the infant d. Providing opportunity for nonnutritive sucking

A Rationale: All of the actions by the nurse would be helpful in reducing stress. However, the 6-month-old, who prefers his parents to other caregivers, will be stressed the least by having that person available to provide basic care and give comfort.

Which of these factors contributes to infants' and children's increased risk for upper airway obstruction as compared with adults? A.) Underdeveloped cricoid cartilage and narrow nasal passages. B.) Small tonsils and narrow nasal passages. C.) Cylinder-shaped larynx and underdeveloped sinuses. D.) Underdeveloped cricoid cartilage and smaller tongue.

A Rationale: Infants and children have smaller nasal passages than adults, thus making obstruction with mucus more common. The funnel shape of the larynx due to underdevelopment of the cricoid cartilage places children less than 10 years of age at increased risk of airway obstruction in the event of edema or mucus production.

A toddler has moderate respiratory distress, is mildly cyanotic, and has increased work of breathing, with a respiratory rate of 40. What is the priority nursing intervention? A.) Airway maintenance and 100% oxygen by mask B.) 100% oxygen and pulse oximetry monitoring C.) Airway maintenance and continued reassessment D.) 100% oxygen and provision of comfort

A Rationale: Priorities of care for the child with respiratory distress are to clear the airway and provide oxygen supplementation.

An 18-month-old child is brought to the emergency department via ambulance after an accidental ingestion. What is the priority nursing action? A.) Take the child's vital signs B.) Give oral syrup of ipecac C.) Insert a nasogastric tube D.) Start an IV line

A Rationale: The first step of the nursing process is assessment. Since the child has just arrived, the nurse must first assess the child before providing any interventions.

A nurse is caring for a child who sustained a fracture. Which of the following actions should the nurse take? (Select all that apply.) A.) Place a heat pack on the site of the injury. B.) Elevate the affected limb. C.) Assess neurovascular status frequently. D.) Encourage ROM of the affected limb. E.) Stabilize the injury.

A, C, & E Rationale: Elevating the affected limb can decrease swelling at the site of injury. Assessing neurovascular status assists the nurse in determining if the affected limb has adequate blood supply. Stabilizing the injury will prevent further injury and damage. The nurse should apply a cold pack on the site of injury to decrease swelling. The nurse should encourage ROM of the non-affected limbs.

A nurse is discussing risk factors for asthma with a group of newly licensed nurses. Which of the following conditions should the nurse include in the teaching? (select all that apply.) A.) Family history of asthma B.) Family history of allergies C.) Exposure to smoke D.) Low birth weight E.) Being underweight

A,B,C, & D

a nurse is caring for a child who has a fracture. Which of the following are manifestations of a fracture? (select all that apply.) A.) crepitus B.) edema C.) Pain D.) Fever E.) ecchymosis

A,B,C, & E Rationale: crepitus can be hear if fragments of bone make a grating sound

A nurse is teaching a group of parents about influenza. Which of the following information should the nurse include in the teaching? A.) "Amantadine will prevent the illness." B.) "Rimantadine is administered intramuscularly." C.) "Zanamivir can be given to children 1 year and older." C.) "oseltamivir should be given within 48 hours of onset of symptoms."

A.) Amantadine can shorten the length of the illness. B.) Rimantadine is administered orally two times per day for 7 days. C.) Zanamivir is approved for children over the age of 5 years. D.) CORRECT: oseltamivir decrease flu manifestations in clients who have findings for less than 48 hr

A nurse is caring for a child in the postoperative period following a tonsillectomy. Which of the actions should the nurse take? A.)encourage the child to blow her nose gently. B.)Administer analgesics on a schedule. C.) offer orange juice. D.) position the child supine

A.) Blowing the nose causes pressure and could increase the risk of bleeding. B.) CORRECT:Analgesics should be administered on a scheduled basis to provide pain relief. C.) citrus juices such as orange juice can cause discomfort and should be avoided postoperatively. D.) the client should be positioned on the abdomen or side‑lying following a tonsillectomy

a nurse is caring for a child who has cerebral palsy. Which of the following medications should the nurse expect to administer to treat painful muscle spasms? (select all that apply.) C.) Baclofen B.) Diazepam C.) oxybutynin D.) methotrexate E.) Prednisone

A.) CORRECT: Baclofen is a centrally acting skeletal muscle relaxant that decreases muscle spasm and severe spasticity. B.) CORRECT: Diazepam is a skeletal muscle relaxant that decreases muscle spasms and severe spasticity. C.) oxybutynin is an antispasmodic, anticholinergic medication that decreases bladder spasms. D.) methotrexate is a cytotoxic disease‑modifying antirheumatic drug that slows joint degeneration and progression of rheumatoid arthritis. it is used for children who have juvenile idiopathic arthritis E.) prednisone is a corticosteroid that increases muscle strength for children who have muscular dystrophy. It decreases inflammation in children who have JIA .

a nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (select all that apply.) A.) Weak femoral pulses B.) Cool skin of lower extremities C.) severe cyanosis D.) Clubbing of the fingers E.) Heart failure

A.) CORRECT: Narrowing of the lumen of the aorta results in obstruction of blood flow from the ventricle, resulting in weak or absent femoral pulses. B.) CORRECT: Narrowing of the lumen of the aorta results in obstruction of blood flow from the ventricle, resulting in cool skin of the lower extremities. C.) a client who has coarctation of the aorta exhibits adequate oxygenation of blood. severe cyanosis is not present. D.) Clubbing of the fingers is a manifestation of chronic hypoxemia and will not be observed in an infant who has coarctation of the aorta. E.) CORRECT: Heart failure occurs when the heart is unable to meet the body's demands, and is a manifestation of coarctation of the aorta.

a nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (select all that apply.) A.) arythema marginatum (rash) B.) Continuous joint pain of the digits C.) Tender, subcutaneous nodules D.) decreased erythrocyte sedimentation rate E.) elevated C‑reactive protein

A.) Correct: rheumatic fever is caused by Group a beta‑hemolytic streptococcus. An erythema marginatum (rash) is a manifestation. B.) client who has rheumatic fever exhibits migratory joint pain of the large joints. C.) client who has rheumatic fever exhibits nontender subcutaneous nodules of bony prominences. D.) rheumatic fever is caused by Group a beta‑hemolytic streptococcus, which results in an elevated erythrocyte sedimentation rate. E.) CORRECT: rheumatic fever is caused by Group A beta‑hemolytic streptococcus. an increase in C‑reactive protein is a manifestation

A nurse is caring for a child who is in the postoperative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding? A.) Hgb 11.6 and Hct 37% B.) Inflamed and reddened throat C.) frequent swallowing and clearing of the throat D.) Blood‑tinged mucus

A.) Hgb 11.6 and Hct 37% ar e within the expected reference range. B.) Inflamed and reddened throat is an expected finding following a tonsillectomy. C.) CORRECT:frequent swallowing and clearing of the throat indicates that there is an increased amount of fluid in the back of the throat, which is a clinical finding in the client who is experiencing postoperative bleeding. D.) Blood‑tinged mucus is an expected finding following a tonsillectomy .

a nurse caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first? A.) Increase the oxygen flow rate. B.) encourage the child to take deep breaths. C.)ensure proper placement of the sensor probe. D.) place the child in the Fowler's position

A.) Increasing the oxygen flow rate for a child who has an oxygen saturation of 89% is important, but there is another action the nurse should take first. B.)encouraging the child to take deep breaths to increase oxygenation is important, but there is another action the nurse should take first. C.) CORRECT:the first action the nurse should take using the nursing process approach is to assess. ensuring the sensor probe is properly placed is the nurse's priority action. D.)placing the child in Fowler's position to increase oxygenation is important, but there is another action the nurse should take first.

a nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? (select all that apply.) A.) Purposeless, involuntary, abnormal movements B.) spinal defect and saclike protrusion C.) muscular weakness in lower extremities D.) unsteady, wide‑based or waddling gait E.) upward slant to the eyes

A.) a child who has cerebral palsy exhibits purposeless, involuntary, abnormal movements. B.) an infant who has the spinal defect myelomeningocele will exhibit a saclike protrusion. C.) CORRECT: A child who has MD will exhibit muscular weakness in the lower extremities as one of the first manifestations. D.) CORRECT: a child who has MD will exhibit an unsteady, wide‑based, or waddling gait due to the progressive muscle weakness. E.) a child who has Down syndrome can exhibit an upward slant to the eyes.

a nurse is caring for a child who is suspected of having legg‑calve‑Perthes disease. the nurse should prepare the child for which of the following diagnostic procedures? A.) Bone biopsy B.) genetic testing C.) MRI D.) radiographs

A.) bone biopsy is used to diagnose cancer, infection, and other bone disorders. it is not indicated to diagnose legg‑calve‑Perthes. B.) legg‑calve‑Perthes is necrosis of the femoral head and is not genetic. genetic testing is not indicated to diagnose. C.) an MRI is used to visualize structures inside the body. D._ CORRECT: a child who has legg‑calve‑Perthes exhibits necrosis of the femoral head and can be diagnosed by radiographs of the hip and pelvis.

a nurse is completing preoperative teaching with an adolescent client who is scheduled to receive spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching? A.) "You will go home the same day of surgery." B.) "You will have minimal pain." C.) "You will need to receive blood." D.) "You will not be able to eat until the day after surgery."

A.) clients who have spinal instrumentation for scoliosis are hospitalized for approximately 1 week. B.) clients who have spinal instrumentation for scoliosis experience intense pain that requires a PCA pump. C.) CORRECT: clients who have spinal instrumentation for scoliosis have a lengthy surgery with blood loss and require blood replacements. D.) clients who have spinal instrumentation for scoliosis are allowed to advance the diet as tolerated

A nurse is caring for a child who has bronchiolitis. Which of the following actions should the nurse take? (select all that apply.) A.) Administer oral prednisone. B.) Initiate chest percussion and postural drainage. C.) Administer humidified oxygen. D.) suction the nasopharynx as needed. E.) Administer oral penicillin

A.) corticosteroids are not indicated for a client who has bronchiolitis. B.) chest percussion and postural drainage are not indicated for a client who has bronchiolitis. C.) CORRECT: Humidified oxygen provides moisture to the airway and is an appropriate action for the nurse to take. D.) CORRECT:suctioning the nasopharynx will assist the client to clear secretions and is an appropriate action for the nurse to take. E.) Antibiotics are not indicated for a client who has bronchiolitis

a nurse is providing teaching to the mother of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A.) "do not offer your baby fluids after giving the medication." B.) "digoxin increases your baby's heart rate." C.) "Give the correct dose of medication at regularly scheduled times." D.) "if your baby vomits a dose, you should repeat the dose to ensure that he gets the correct amount."

C Rationale: digoxin slows the heart rate and does not require fluid restrictions. digoxin should not be given again if child vomits because of its potential for toxicity.

Parents are concerned because their 18-month-old will eat only when they feed him. They report he was independent with feeding at home but is unwilling in the hospital. The nurse considers this behavior: a. Negativism b. Ritualism c. Egocentrism d. Regression

D

The nurse is assessing a child for clubbing. What would the nurse identify as the initial sign? a. Shininess of the nail beds b. Rounding of the fingers c. Thickening of the nail ends d. Softening of the nail beds

D

A 2-DAY-OLD INFANT WAS JUST DIAGNOSED WITH AORTIC STENOSIS. WHAT IS THE MOST LIKELY NURSING ASSESSMENT FINDING? A.) GALLOP AND RALES B.) BLOOD PRESSURE DISCREPANCIES IN THE EXTREMITIES C.) RIGHT VENTRICULAR HYPERTROPHY ON ECG D.) HEART MURMUR

D RATIONALE: Typically, children with aortic stenosis have a murmur that is best heard along the left sternal border. They do not commonly exhibit a gallop, rales, or right ventricular hypertrophy. Blood pressure and pulse discrepancies between the upper and lower extremities occur with coarctation of the aorta, not aortic stenosis.

A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses should the nurse make? A.) "The Pavlik harness is used for children with scoliosis, not hip dysplasia." B.) "The Pavlik harness is used for school-age children." C.) "The Pavlik harness cannot be used for your child because her condition is too severe." D.) "The Pavlik harness is used for infants less than 6 months of age."

D Rationale: The Pavlik harness is a soft brace designed for infants less than 6 months of age. A toddler is too large to fit into the brace.

The nurse is caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes? A.) "I will stop the enzymes if my child is receiving antibiotics." B.) "I will decrease the dose by half if my child is having frequent, bulky stools." C.) "Between meals is the best time for me to give the enzymes." D.) "The enzymes should be given at the beginning of each meal and snack."

D Rationale: The enzymes are necessary for appropriate digestion and absorption of food and nutrients. They must be given each time the child eats, usually in smaller doses for snacks than for meals.

A nurse is caring for a child who is in a plaster spica cast. Which of the following actions should the nurse take? A.) Use a heat lamp to facilitate drying. B.) Avoid turning the child until the cast is dry. C.) Assist the patient with crutch walking after the cast is dry. D.) Apply moleskin to the edges of the cast.

D Rationale: The nurse should apply moleskin to the edges of the cast to prevent the cast from rubbing on the patient's skin. A cool fan can be used to facilitate drying of a plaster cast. The child should be turned every 2 hours to expose all areas of the cast to facilitate drying. A patient who has a spica cast is non-weight bearing until the cast is removed.

a nurse is caring for an infant who has a myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care? A.) assist the mother with cuddling the infant. B.) assess the infant's temperature rectally. C.) Place the infant in a supine position. D.) apply a sterile, moist dressing on the sac.

D Rationale: cuddling can cause rupture to the sac as well as placing the child in supine. Temp. should not be tested rectally during post-op due to anal prolapse

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant? a. Baclofen b. Botulin toxin c. Lorazepam d. Prednisone

A

The nurse is caring for a 14 year old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed? a. Digoxin b. Furosemide c. Alprostadil d. Indomethacin

A

The nurse is caring for a 2 year old boy with cerebral palsy. The medical record indicates "hypertonicity and permanent contractors affecting both extremities on one side". Based on these findings, the nurse identifies this type of CP as: a. Spastic b. Mixed c. Ataxic d. Athetoid or dyskinetic

A

The nurse is providing family education for the administration of ibuprofen. Which response indicates a need for further teaching? a. This can be taken with other medications we have at home that don't require a prescription b. This medication is to be taken by mouth c. This should be given with food to avoid upsetting the stomach d. I should monitor for signs of easy bruising and bleeding gums

A

HEART ANOMALY CAUSING CHRONIC CYANOSIS. WHEN PERFORMING THE HISTORY AND PHYSICAL EXAMINATION, WHAT IS THE NURSE LEAST LIKELY TO ASSESS? A.) OBESITY FROM OVEREATING B.) CLUBBING OF THE NAIL BEDS C.) SQUATTING DURING PLAY ACTIVITIES D.) EXERCISE INTOLERANCE

A RATIONALE: Children with CHD causing chronic cyanosis are likely to demonstrate failure to thrive, not obesity. They frequently develop clubbing of the nail beds and exercise intolerance, and those with tetralogy of Fallot or pulmonary stenosis may display hypercyanotic spells (squatting).

a nurse is caring for a school‑age child who has juvenile idiopathic arthritis. Which of the following home care instructions should the nurse include in the teaching? (select all that apply.) A.) provide extra time for completion of ADLs B.) use cold compresses for joint pain. C.) take ibuprofen on an empty stomach. D.) remain home during periods of exacerbation E.) Perform range‑of‑motion exercises

A & E

a nurse is caring for a child who is in skeletal traction. Which of the following actions should the nurse take? (select all that apply.) A.) remove the weights to reposition the client. B.) assess the child's position frequently. C.) assess pin sites every 4 hr. D.) ensure the weights are hanging freely. E.) ensure the rope's knot is in contact with the pulley.

A.) the weights should only be removed by the provider or in an emergency situation. B.) CORRECT: the nurse should assess the child's position frequently to ensure proper alignment is present. this avoids putting stress on the pinned areas and other areas of the body causing pain. C.) CORRECT: Pin sites should be assessed frequently to monitor for the development of infection or loosening of the pins. Pin site care should be administered per facility policy. D.) CORRECT: the nurse should ensure that the weights are hanging freely to allow for prescribed traction. E.) the knot in the rope should not touch the pulley as this will alter the weight of the traction

a nurse is caring for a 2‑year‑old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A.) Place on NPO status for 12 hr prior to the procedure. B.)Check for iodine or shellfish allergies prior to the procedure. C.) elevate the affected extremity following the procedure. D.) limit fluid intake following the procedure

B Rationale: child should be NPO 4-6 hours before procedure, affected extremity should remain straight after procedure, fluids should be encouraged after procedure so patient can eliminate the dye use.

A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (select all that apply.) A.)Oxygen saturation 95% B.) Wheezing C.) Retraction of sternal muscles D.) Warm extremities E.) Nasal flaring

B,C & E

The nurse who wishes to be as supportive as possible to the hospitalized preschooler makes great effort to avoid threatening the 4-year-old's: a. Creativity b. Food preferences c. Body integrity d. Verbal skills

C Rationale: Preschoolers are very concerned about physically intrusive procedures. They lack understanding of the way in which the body works and feel extremely threatened by all that could possible cause bodily harm.

A preschooler presents to the emergency department with a history of vomiting, diarrhea, and fever over the past few days. She is receiving 100% oxygen via nonrebreather mask. Vital signs are temperature 104.5°F, pulse 144 bpm, respiratory rate 22 breaths per minute, and BP 70/50 mm Hg. She is listless and difficult to arouse and has weak peripheral pulses and prolonged capillary refill. What nursing intervention takes priority? A.) Administering acetaminophen rectally for the high fever B.) Administering IV antibiotics for the infection C.) Preparing the child for tracheal intubation D.) Giving an IV bolus of normal saline 20 mL/kg

D Rationale: Airway and breathing have been addressed. The priority at this point is restoring perfusion through IV fluid resuscitation.

A child who is experiencing an exacerbation of his asthma is brought to the emergency department by his parents. When reviewing the child's laboratory and diagnostic test results, which would the nurse expect to find? a. Hyperinflation on chest radiograph b. Low arterial blood CO2 level c. Increased peak expiratory flow rates d. Decreased pulmonary function tests

A

The nurse is providing care to a 2 year old who is experiencing hypoxemia related to a respiratory infection. The nurse understands that which anatomic characteristic accounts for the higher risk of hypoxemia in children? a. Smaller number of alveoli b. Compliant chest walls c. Diaphragmatic breathing d. Narrow trachea and bronchi

A

A nurse is admitting a child who has cystic fibrosis. Which of the following medications should the nurse anticipate including in the plan of care? (select all that apply.) A.)Tobramycin B.)Loperamide C.) Fat‑soluble vitamins D.)Albuterol E.)Dornase alfa

A.) CORRECT: Children who have cystic fibrosis have pulmonary infections. Administering antibiotics is an expected part of the plan of care. B.) Children who have cystic fibrosis have constipation and are expected to have a laxative or stool softener as part of the plan of care. Loperamide is an antidiarrheal medication. C.)CORRECT: Children who have cystic fibrosis have difficulty absorbing fat. supplementation of the fat‑soluble vitamins is an expected part of the plan of care. D.) CORRECT:Children who have cystic fibrosis have mucus plugs. Administering a bronchodilator is an expected part of the plan of care. E.) CORRECT: Children who have cystic fibrosis have mucus plugs. Administering dornase alfa, which decreases the viscosity of the mucus, is an expected part of the plan of care

a nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following actions should the nurse take? (Select all that apply.) A.) Instruct the child that the treatment will last 30 min. B.) Obtain vital signs prior to the procedure. C.) tell the child to take slow deep breaths. D.) determine if the child should use a mask. E.) attach the device to an air source

A.)nebulized medications take approximately 10 to 15 min to deliver. B.) CORRECT: Baseline vital signs should be obtain prior to a nebulized medication for purposes of comparison with how the client tolerates the medication. C.) CORRECT: the client should take slow, deep breaths to inhale the medication deeply into the respiratory tract. D.) CORRECT: nebulized medications can be delivered by mask, mouthpiece, or blow‑by. the nurse should determine the best method of delivery. E.) CORRECT: nebulized medications need to have an air source to break the medication into small particles for inhalation

a nurse in the emergency department is assessing a newly‑admitted infant. Which of the following findings is an early indication of hypoxemia? A.) nonproductive cough B.) hypoventilation C.) Cyanosis D.) nasal stuffiness

A.) nonproductive cough is a manifestation of a respiratory infection. B.) hypoventilation is a manifestation of oxygen toxicity. C.) CORRECT: Cyanosis is an early indication of hypoxemia in an infant. D.) nasal stuffiness is a manifestation of a respiratory infection.

A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise? A.) Fluticasone/salmeterol B.) montelukast C.) Prednisone D.) Albuterol

A.) the nurse should instruct the adolescent that fluticasone/salmeterol is a combination of LABA and corticosteroid medications, and to use it for maintenance control of asthma. B.) the nurse should instruct the adolescent that montelukast is affects the immune response to prevent medication, and to use it for maintenance control of asthma. C.)the nurse should instruct the adolescent that prednisone is an anti- inflammatory medication used short-term for exacerbations of asthma. D.) CORRECT:Albuterol is a beta2-agonist used for bronchodilation. the nurse should instruct the adolescent the medicine is quick-acting, should be administered prior to exercise, and is used to provide immediate relief of bronchoconstriction.

A 5 year old girl is breathing spontaneously but is unable to maintain an airway. What would be the priority action? a. Placing a towel under her shoulders b. Inserting an oropharyngeal airway c. Assisting with tracheal tube insertion d. Positioning her using head/tilt/chin lift

B

A nurse is taking the history if a 4 year old boy who will undergo a cardiac catheterization. Which statement by his mother may necessitate rescheduling of the procedure? a. He is allergic to iodine and shellfish b. He seems listless and slightly warm c. He is very scared and nervous about the procedure d. He is not taking any medication

B

The 10-year-old girl hospitalized for bladder surgery will be most stressed when nurses provide what care? a. Change of the hospital gown b. Perineal and indwelling catheter care c. Auscultation of breath and bowel sounds d. Abdominal dressing change

B

The nurse is preparing a female toddler for the repair if an eyebrow laceration. The girl is most likely to demonstrate which response in anticipation of the procedure? a. Attempt to postpone the procedure by asking to "go potty" b. Scream and cling tightly to her parent. c. Stare out the window while clenching her hands d. Remain outwardly calm and ask numerous question.

B

a nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include? A.) structure interventions according to the toddler's chronological age. B.) evaluate the toddler's need for an evaluation of hearing ability. C.) monitor the toddler's pain level routinely using a numeric rating scale. D.) provide total care for daily hygiene activities

B

a nurse is teaching a group of parent about fractures. Which of the following information should the nurse include in the teaching? A.) "children need a longer time to heal from a fracture than an adult." B.) "epiphyseal plate injuries can result in altered bone growth." C.) " a greenstick fracture is a complete break in the bone." D.) "Bones are unable to bend, so they break.

B

A nurse is assessing a preschool-age child for developmental dysplasia of the hip. Which of the following assessments should the nurse include? A.) Barlow test B.) Galeazzi sign C.) Manipulation of foot and ankle D.) Ortolani test

B Galeazzi sign, uneven knee heights while lying down, is used to detect DDH. Performing the Ortolani and Barlow maneuvers is beyond the nurse's scope of practice. Manipulation of the foot and ankle is a test that assesses for clubfoot.

a nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (select all that apply.) A.) Bradycardia B.) Cool extremities C.) Peripheral edema D.) increased urinary output E.) Nasal flaring

B,C, & E

a nurse is caring for a child who sustained a fracture. Which of the following actions should the nurse take? (select all that apply.) A.) Place a heat pack on the site of injury B.) elevate the affected limb. C.) assess neurovascular status frequently. D) encourage ROM of the affected limb. E.) stabilize the injury.

B,C, & E

A nurse is assessing a child who has legg‑calve‑Perthes disease. Which of the following findings should the nurse expect? (select all that apply.) A.) longer affected leg B.) Hip stiffness C.) intense pain D.) limited ROM E.) limp with walking

B,D, & E Rationale: this disease causes a shorter affect leg. this disease in painless

A 15-year old boy asks numerous questions about recovery from anesthesia and typical behaviors of someone awakening from sedation. The nurse interprets the concern of this teen to be: a. About a change in his body image b. Anxiety related to the surgical procedure itself c. About his ability to control his own behavior d. Adequacy of post surgical pain control

C

The nurse is taking the health history of a 6 week old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure? a. He does not seem short of breath b. He does not seem sick c. He gets sweaty when he eats d. He seems to have a normal appetite

C

When administering parenteral or epidural opioids, the nurse should always have ready access to which medication? a. Antihistamines b. Anticonvulsants c. Naloxone d. Prostaglandin synthesis inhibitors e. Benzodiazepines

C

THE NURSE IS CARING FOR A CHILD AFTER A CARDIAC CATHERIZATION. WHAT IS THE NURSING PRIORITY? A.) ALLOW EARLY AMBULATION TO ENCOURAGE ACTIVITY PARTICIPATION B.) CHECK PULSES ABOVE THE CATHETER INSERTION SITE FOR STRENGTH AND QUALITY C.) ASSESS EXTREMITY DISTAL TO THE INSERTION SITE FOR TEMPERATURE AND COLOR D.) CHANGE THE DRESSING TO EVALUATE THE SITE FOR INFECTION

C RATIONALE: Vessel spasm or hematoma may occur after the catheterization, occluding circulation. The extremity may become pale, feel cool to the touch, and have diminished pulses distal to the insertion site.

A nurse is caring for a boy preparing to undergo a dressing change. Which statement by the father lets the nurse know that the child's pain experience is at risk of being intensified? a. Let's think about something you really like b. You can hold my hand if you want to c. I will be here for you the whole time d. I hope that you will be a brave boy and not cry

D

A nurse is conducting a physical examination of a 5 year old boy with spinal muscular atrophy type 2. What assessment findings would the nurse expect to find? a. Pseudohypertrophy of the calves b. Loss of strength in ankle dorsiflexion c. Loss of strength in hip extension d. Pectus excavatum

D

Developmental dysplasia of the hip refers to abnormalities of the developing hip that include dislocation, dysplasia, and _______ of the hip joint. A.) Hypertrophy B.) Underdevelopment C.) Weakness D.) Subluxation

D

WHILE ASSESSING A 4-MONTH-OLD INFANT, THE NURSE NOTES THAT THE BABY EXPERIENCES A HYPERCYANOTIC SPELL. WHAT IS THE PRIORITY NURSING ACTION? A.) PROVIDE SUPPLEMENTAL OXYGEN BY FACE MASK B.) ADMINISTER A DOSE OF IV MORPHINE SULFATE C.) BEGIN CARDIOPULMONARY RESUSCITATION D.) PLACE THE INFANT IN A KNEE-TO-CHEST POSITION

D RATIONALE: Hypercyanotic spells are a dangerous event. Placing the infant in a knee-to-chest position increases systemic vascular resistance, thereby improving pulmonary blood flow. It is the first action the nurse should take.

True or False Developmental dysplasia of the hip is more common in males.

False

True or False Tachypnea is a late-stage sign of respiratory distress in children

False

True or False The normal heart rate is lower in infancy than in adulthood.

False

True or False Congenital cardiac anomaly is an enlargement of the heart caused by hypertrophy or thickening of the walls of the heart.

False This is an aquired defect

True or False Clubbing is the enlargement of the terminal phalanx of the fingers resulting from chronic hypoxemia.

True

True or False Depending on age, the structure and function of the infant's and child's cardiovascular system differ from those of adults.

True

True or False Rales are crackling sounds, heard during auscultation, that are the result of alveoli becoming filled with fluid.

True

a nurse is caring for a child who is receiving oxygen. Which of the following findings indicates oxygen toxicity? A.) Increased blood pressure B.) hyperventilation C.)decreased paCO2 D.) Unconsciousness

A.)Increased blood pressure is not a manifestation of oxygen toxicity. B.)hypoventilation is a manifestation of oxygen toxicity. C.) an increased paCO2 is a manifestation of oxygen toxicity. D.) CORRECT: Children who exhibit oxygen toxicity progress into an unconscious state rapidly.

A 5-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate initial nursing intervention? A.) Attempt to calm the infant by placing him in his mother's lap and offering him a bottle. B.) Alert the physician or nurse practitioner to the situation and ask for an order for a stat chest radiograph. C.) Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure. D.) Bring the emergency equipment to the room and begin bag-valve-mask ventilation.

C Rationale: Priorities of care for the child with respiratory distress are to clear the airway and provide oxygen supplementation. Children who experience respiratory distress often deteriorate very quickly, and the nurse must be prepared in the event of respiratory failure or arrest.

The nurse is caring for a 7 year old who just had a tonsillectomy. Which intervention is least appropriate? a. Placing the child on his side b. Discouraging the child from coughing c. Applying an ice collar d. Providing fluids by straw

D

The nurse is caring for an 11-year-old boy with pneumonia who is exhibiting an increased work of breathing. Which would the nurse identify as the priority action for this child? a. Administering IV fluids as ordered b. Administering analgesics as ordered c. Administering supplemental O2 as ordered d. Positioning the child in a comfortable position

D

The nurse is caring for an infant with a myelomeningocele who has paralysis of the lower extremities. Which action would be most appropriate to help reduce friction resulting from this paralysis? a. Place synthetic sheepskin under the infant's chest b. Place a pad beneath the diaper area and change frequently c. Place the child on a special care mattress d. Place a folded diaper in between the legs

D

The nurse is caring for a 10 year old with a suspected heart arrhythmia. The nurse would expect to prepare the child for which test to identify and quantitate the arrhythmia? a. Ambulatory electrocardiogram monitoring b. Chest radiograph c. Echocardiogram d. Arteriogram

A

SAM, AGE 11, HAS A DIAGNOSIS OF REHUMATIC FEVER AND HAS MISSED SCHOOL FOR A WEEK. WHAT IS THE MOST LIKELY CAUSE OF THIS PROBLEM? A.) PREVIOUS STREPTOCOCCAL THROAT INFECTION B.) HISTORY OF OPEN HEART SURGERY AT 5 YEARS OF AGE C.) PLAYING TOO MUCH SOCCER AND NOT GETTING ENOUGH REST D.) EXPOSURE TO A SIBLING WITH PNEUMONIA

A RATIONALE: Rheumatic fever occurs as a sequela to group A streptococcal infection.

A mother of a neonate with clubfoot feels guilty because she believes she did something to cause the condition and asks the nurse how this happened to her baby. The nurse should explain that the cause of clubfoot is: A.) Unknown B.) Hereditary C.) Due to restricted movement in utero D.) An anomalous embryonic development

A Rationale: The definitive cause of clubfoot is unknown.

A nurse is reviewing the diagnostic findings for a preschool age child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of cystic fibrosis? A.) sweat chloride content 85 mEq/L B.)increased serum levels of fat‑soluble vitamins C.) 72 hr stool analysis sample indicating hard, packed stools D.)Chest x‑ray negative for atelectasis

A.) CORRECT:Children who have cystic fibrosis excrete an excessive amount of sodium and chloride in their sweat. A sweat chloride content of 85 mEq/L is above the expected reference range and is an indication of cystic fibrosis. B.) Children who have cystic fibrosis are expected to have decreased serum levels of fat‑soluble vitamins. C.) Children who have cystic fibrosis are expected to have large, bulky, frothy, greasy, foul‑smelling stools (steatorrhea). D.)Children who have cystic fibrosis are expected to have obstructive emphysema and atelectasis on chest x‑ray.

A nurse is providing discharge teaching for a child who has cystic fibrosis. Which of the following instructions should the nurse include? A.)Provide a low‑calorie, low‑protein diet. B.) Administer pancreatic enzymes with meals and snacks. C.)Implement a fluid restriction during times of infection. D.) restrict physical activity.

A.) Children who have cystic fibrosis should eat a high‑calorie, high‑protein diet to allow for proper growth. B.) CORRECT: Children who have cystic fibrosis have pancreatic insufficiency. the nurse should provide instruction about administering pancreatic enzymes within 30 min of a meal or snack. C.) Children who have cystic fibrosis should increase fluids to assist in thinning thick mucus. D.) Children who have cystic fibrosis should engage in daily aerobic activity to assist with lung expansion and to stimulate mucus expectoration

The nurse is listing physiological indicators of pain in children while teaching a pain management class for peers. Which of the indicators will be included? Select all that apply. a. Change in blood pressure b. Facial expression c. Body movements d. Oxygen saturation level e. Palmar sweating

A, D, E

A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? (select all that apply.) A.)Hoarseness and difficulty speaking B.) difficulty swallowing c.) low‑grade fever D.) drooling E.) dry, barking cough F.) stridor

A,B,D, & F

A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? (select all that apply.) A.)Wheezing B.) Clubbing of fingers and toes C.) barrel‑shaped chest D.)Thin, watery mucus E.)rapid growth spurts

A,B, & C

A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? (select all that apply.) A.)Perform chest percussion. B.)Place the child in an upright position. C.) monitor oxygen saturation. D.) Administer bronchodilators. E) Administer dornase alfa daily

A.) the nurse should use chest percussion to promote movement of mucus plugs for a child who has cystic fibrosis. B.)CORRECT:Children who are experiencing an asthma exacerbation have decreased oxygenation. the nurse should place the child an upright position to promote ventilation. C.) CORRECT: Children who are experiencing an asthma exacerbation have decreased oxygenation. the nurse should monitoring oxygen saturation to detect changes in the child's condition. D.) CORRECT:Children who are experiencing an asthma exacerbation experience bronchoconstriction. the nurse should administer bronchodilators to promote ventilation. E.) the nurse should administer dornase alfa to a child who has cystic fibrosis to help with removal of respiratory secretions.

a nurse is assessing a preschool‑age child for developmental dysplasia of the hip. Which of the following assessments should the nurse include? A.) Barlow test B.) tendelenburg sign C.) Manipulation of foot and ankle D.) ortolani test

A.) use a Barlow test to assess developmental dysplasia of the hip for infants. B.) CORRECT: The trendelenburg sign assesses for developmental dysplasia of the hip. the preschooler bears weight on the affected leg while holding on to something for balance. the examiner observes from behind for abnormal downward tilting of the pelvis on the unaffected side. C.) Manipulation of the foot and ankle is a test that assesses for clubfoot. D.) the ortolani test assesses developmental dysplasia of the hip for infants

A nurse is teaching a child who has asthma how to use a peak flow meter. Which of the following information should the nurse include in the teaching? (select all that apply.) A.) Zero the meter before each use. B.) Record the average of the attempts. C.) Perform three attempts. D.) Deliver a long, slow breath into the meter. E.)sit in a chair with feet on the floor

A.)CORRECT: the nurse should instruct the child to zero the monitor before each use to achieve accurate results. B.) the nurse should instruct the child to record the highest number reading. C.) CORRECT: The child should perform three attempts to achieve accurate results. D.)The nurse should instruct the child to breathe hard and fast when using the peak flow meter to measure airflow. E.) the nurse should instruct the child to stand upright when using a peak flow meter.

An unresponsive toddler is brought to the emergency department. Assessment reveals mottled skin color, respiratory rate of 10 breaths per minute, and a brachial pulse of 52 bpm. What is the priority nursing action? A.) Prepare the defibrillator and draw up code medications. B.) Provide 100% oxygen with a bag-valve-mask and start chest compressions. C.) Start chest compressions and provide 100% oxygen via nonrebreather mask. D.) Begin an IV fluid infusion and administer epinephrine IV.

B Rationale: The child's own respiratory effort is insufficient, heart rate is too low, and perfusion is poor. This child requires immediate cardiopulmonary resuscitation.

A 6-month-old infant who was born premature is being seen for a follow-up examination. The child is to receive an IM injection monthly through the winter and spring season. Which drug would the nurse expect to be ordered? a. Nedocromil b. Palivizumad c. Amantadine d. Zanamivir

B * Synagis; Used to prevent RSV

A nurse is teaching an adolescent to administer a corticosteroid medication using a metered-dose inhaler. Which of the follow instructions should the nurse include? A.) Shake the device prior to use B.) Rinse and expectorate after administration C.) Inhale slowly with medication administration D.) Exhale quickly after medication administration E.) Wait 30 seconds between puffs

B & C Rationale: corticosteroids can cause oral fungal infection so rinsing mouth after is important. Client should breathe slowly to administer the medication into the lungs