NUR404 Exam 4 Pedi

A child being treated for leukemia is diagnosed with neutropenia. What nursing instructions directly prevent client infections? Select all that apply. A. Avoid large crowds. B. Inspect the skin daily for scratches or scrapes. C. Increase the intake of fresh fruits and vegetables. D. Remove house plants, flowers, and goldfish from the home environment. E. Stay away from people who have obvious colds, rashes, or other infections.

A. Avoid large crowds. B. Inspect the skin daily for scratches or scrapes. D. Remove house plants, flowers, and goldfish from the home environment. E. Stay away from people who have obvious colds, rashes, or other infections.

The nurse is caring for a 16-year-old client. The client confides in the nurse that they use of marijuana daily. Which action by the nurse is appropriate? A. Discuss adverse side effects with the client. B. Notify local law enforcement. C. Ask the client where the marijuana is obtained. D. Determine how long the client has used marijuana.

A. Discuss adverse side effects with the client.

A parent of a child diagnosed with seizures states, "I've heard about a special diet that may control seizures, I think it's called ketogenic. What can you tell me about it?" Which are appropriate responses by the nurse? Select all that apply. A. "About 40% to 50% of children who follow the diet have really good results." B. "The diet consists of high fat foods." C. "Children are encouraged to eat a lot of breads and pasta on this diet." D. "Most families find this diet is easy to incorporate into their life." E. "Protein is limited in this diet."

A. "About 40% to 50% of children who follow the diet have really good results." B. "The diet consists of high fat foods." E. "Protein is limited in this diet."

An adolescent asks the nurse what the term "puberty" means. What is the nurse's best response? A. "It is the age at which one first becomes capable of sexual reproduction." B. "It denotes the beginning of secondary sex characteristics." C. "It is the time span between 12 and 18 years." D. "It is the time span that denotes the onset of maturity."

A. "It is the age at which one first becomes capable of sexual reproduction."

During shift handoff, the nurse provides report on a 14-year-old client who has a cervical neck injury after a fall at gymnastics practice. The nurse verbalizes the assessment of the cranial nerves including a deficit in cranial nerve III. Upon baseline assessment, which assessment technique will the nurse use? A. Assess hand grasps. B. Assess pupil reactivity. C. Have the client smile. D. Whisper in the client's ear.

B. Assess pupil reactivity.

The nurse is preparing the parents for the death of their child. Which signs will the nurse include in the teaching session? Select all that apply. A. Diarrhea may occur and the abdomen may be distended. B. The skin may feel cool and appear mottled or cyanotic. C. Respirations slow and lungs may have more secretions. D. The child may lose gag reflex and be unable to swallow. E. Hearing is absent when the child appears to be in a coma. F. Dehydration occurs with mouth and eyelid dryness.

B. The skin may feel cool and appear mottled or cyanotic. C. Respirations slow and lungs may have more secretions. D. The child may lose gag reflex and be unable to swallow. F. Dehydration occurs with mouth and eyelid dryness.

An adolescent comes into the emergency department with a foot wound. Upon assessment, the nurse learns that the client is a runaway and has been living on the streets. Which is the most appropriate care for the nurse to provide to the client at this time? A. Recommend returning to live with parents. B. Treat the wound and provide wound care supplies. C. Discuss the importance of a diet high in protein and vitamin C. D. Explain how the wound needs to be flushed with water every 4 hours.

B. Treat the wound and provide wound care supplies.

Chapter 33 A 15-year-old adolescent is seen at a health care facility for facial acne. When counseling the teen, the nurse would teach that the basic cause of acne is: A. lack of showering adequately after gym class. B. activation of androgen hormones. C. vitamin deficiency from an inadequate diet. D. thyroid-gland secretions increasing with adolescence.

B. activation of androgen hormones.

A child who knows about her terminal disease tells the nurse of plans to recover and become a doctor to cure everyone in the whole world. What is the child demonstrating to the nurse? A. anxiety about the illness B. bargaining stage of grief C. immature magical thinking D. poor opinion of the care received

B. bargaining stage of grief

The nurse has gotten a report on four hospitalized children. Which child needs to be seen first? A. child with leukemia getting ready to start chemotherapy B. child with cystic fibrosis with an oxygen saturation of 91% C. child in the final stages of dying with family at bedside D. child with diabetes who has a fasting blood sugar of 110 mg/dl (6.11 mmol/l)

B. child with cystic fibrosis with an oxygen saturation of 91%

Chapter 54 A 14-year-old is admitted to the hospital for the second time for treatment of anorexia nervosa. Her responses to your questions on admission are either yes, no, or no response. Initially, your primary nursing goal in caring for this adolescent would be to: A. encourage her to eat a nutritious diet. B. develop rapport for a trusting relationship. C. decrease her anxiety. D. relieve her anger.

B. develop rapport for a trusting relationship.

Any individual taking phenobarbital for a seizure disorder should be taught: A. to brush his or her teeth four times a day. B. never to discontinue the drug abruptly. C. never to go swimming. D. to avoid foods containing caffeine.

B. never to discontinue the drug abruptly.

The nurse is concerned that a child receiving vincristine is developing an adverse reaction to the medication. What did the nurse most likely assess in the client? A. tooth pain B. numb fingertips C. reduced hearing D. bright red cheeks

B. numb fingertips

The school nurse is planning a presentation to be given during the next parent/teacher conference to include the 2020 National Health Goals to prevent unintentional injuries in children. What should the nurse include in this presentation? Select all that apply. A. legal aspects of child abuse B. recognize signs of self-injury C. provide information on home safety D. ways to determine intentional injuries E. emphasize safety with sports activities

B. recognize signs of self-injury C. provide information on home safety D. ways to determine intentional injuries E. emphasize safety with sports activities

The parent of a high school soccer player diagnosed with osteosarcoma of the femur tells the nurse, "I never wanted my child to play soccer in the first place." Which response by the nurse is appropriate? A. "Your child's tumor is linked to a lack of milk intake to grow strong bones." B. "Your concerns were warranted about sports injuries and osteosarcoma." C. "The recent trauma did not cause the tumor to develop; it just called attention to the problem." D. "You know how adolescents are, they like to do what they want."

C. "The recent trauma did not cause the tumor to develop; it just called attention to the problem."

During a health visit, an adolescent client tells the nurse, "Why am I having all this acne?" Which response by the nurse would be appropriate? A. "Your thyroid gland is secreting more hormones as you grow." B. "Your acne is most likely from not keeping your skin clean enough." C. "Your body is producing hormones called androgens that are responsible for your acne." D. "You must have a vitamin deficiency because you're not eating healthy."

C. "Your body is producing hormones called androgens that are responsible for your acne."

When assisting parents in a home care plan for a child with Legg-Calvé-Perthes disease (LCPD), the nurse would teach the parents that which is anticipated? A. Surgery with supporting rods B. Passive range-of-motion exercises 3x per day C. A non-weight-bearing period initially occurs. D. Exercise to increase muscle strength of the knee joint

C. A non-weight-bearing period initially occurs.

Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson? A. Permit the client to make decision regarding one's care B. Praise the client for correctly performing self-care C. Allow the client's friends to visit while the client is hospitalized D. Provide the client with crafts and puzzles to complete independently

C. Allow the client's friends to visit while the client is hospitalized

The community nurse is visiting the home of a family with a child with mild intellectual disability. Which observation indicates that the family is adjusting to this child's learning capacity? A. Older sibling teases the child and uses the term "dummy." B. Father tells the child to play with a toy while the adults talk. C. Parents support and engage the child in family conversation. D. Mother tells the child to stop making a mess on the kitchen table.

C. Parents support and engage the child in family conversation.

Which action would provide an indication that an adolescent's parents understand their child's need for increased independence? A. Verbalizing, "We try to do everything we can to make things easier for her." B. Reporting they understand that their child's chief need is for increased privacy C. Stating they are encouraging their child in the search for an after-school job D. Saying, "We will always be here for her whenever our child needs us."

C. Stating they are encouraging their child in the search for an after-school job

What activity would best foster the developmental task of an adolescent who uses a wheelchair to ambulate? A. Allowing the adolescent to decide when to bathe B. Watching television on the set in the adolescent's room C. Talking to another adolescent who has a similar situation D. Having a teacher bring school work to the adolescent

C. Talking to another adolescent who has a similar situation

The nurse is planning care for a child recovering from neck surgery for rhabdomyosarcoma. Which outcome suggests the best long-term prognosis for this client? A. The child tolerates chemotherapy to treat the tumor and on the neck and lungs. B. The child tolerates radiation for neck tumor and tumor found in the colon and liver. C. The child tolerates chemotherapy provided after complete removal of the neck tumor. D. The child tolerates chemotherapy every 4 weeks for 24 months to eradicate the inoperable tumor.

C. The child tolerates chemotherapy provided after complete removal of the neck tumor.

The nurse is identifying outcomes for an adolescent client who has been avoiding bread products and grains in order to lose weight. Which outcome should the nurse identify as appropriate for this client's nutritional needs? A. The client will ingest bread and grain products during breakfast. B. The client will have no further signs of calcium, iron, and zinc deficiency. C. The client will have no further signs of thiamine and riboflavin deficiency. D. The client will ingest bread and grain products when eating out with high school friends.

C. The client will have no further signs of thiamine and riboflavin deficiency.

An adolescent is prescribed retinoic acid cream as therapy for his acne. About which of the following would you caution him? A. not putting the medication on just prior to bedtime B. applying the cream while his face is wet C. avoiding staying in the sun for extended periods of time D. not applying the cream directly on lesions

C. avoiding staying in the sun for extended periods of time

An adolescent girl has spinal instrumentation surgery at 16 years of age. Immediately after this procedure, the nurse would teach her to: A. sit up, although this may hurt. B. always sleep prone. C. wait to be log-rolled before turning from one side to the other. D. plan on 6 months of hospitalization.

C. wait to be log-rolled before turning from one side to the other.

The nurse is preparing the medication leucovorin to provide to a child who is currently receiving methotrexate for a brain tumor. What should the nurse explain to the child and parents regarding the purpose of this medication? A. It will encourage bone marrow to build new cells after methotrexate therapy. B. It helps methotrexate enter leukemia cells the same as insulin helps glucose enter cells. C. It is an experimental drug to ensure resistance to infection during methotrexate therapy. D. It prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

D. It prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

When auscultating bowel sounds, which of the following frequencies would the nurse identify as normal? A. One to two per minute B. Five to 10 per minute C. Thirty to 40 per minute D. Sixty per minute

B. Five to 10 per minute

An adolescent is concerned that he is going to be unusually short. The nurse would advise him that the epiphyseal lines of long bones in boys that govern growth usually close between ages: A. 13 and 14 years. B. 14 and 15 years. C. 17 and 18 years. D. 20 and 22 years.

C. 17 and 18 years.

The most important assessment of neurovascular status to make after spinal surgical instrumentation is: A. check the nailbeds of the fingers for capillary refill. B. determine the presence of brachial pulses. C. assess the legs for warmth. D. ask if the child has pain.

C. assess the legs for warmth.

On the third week of hospitalization following a spinal cord injury, an adolescent reports that his face is bright red, and he is sweating profusely. Which nursing action is completed first? A. Obtain a stat electrocardiogram. B. Lower his head to increase cerebral circulation. C. Massage his lower extremities to cause vasodilation. D. Assess if his retention catheter is blocked.

D. Assess if his retention catheter is blocked.

The school nurse is teaching a group of adolescents about cancer prevention. What information will the nurse include when teaching these adolescents? Select all that apply. A. "Human papillomavirus (HPV) vaccines are needed for all genders to prevent cancer." B. "Do not give in to peer pressure to start smoking." C. "Use sunscreen any time you are out in the sun." D. "It is important to have a family doctor who knows your health history." E. "Decrease the use of fried foods in your diet."

A. "Human papillomavirus (HPV) vaccines are needed for all genders to prevent cancer." B. "Do not give in to peer pressure to start smoking." C. "Use sunscreen any time you are out in the sun." E. "Decrease the use of fried foods in your diet."

An adolescent is prescribed tretinoin (Retin-A cream) as therapy for acne. After teachig the adolescent about this medication, the nurse determines that the teaching was successful based on which client statement? A. "I need to make sure I protect myself when I'm outside." B. "I should apply the cream while my face is wet." C. "I should avoid using the medication prior to bedtime." D. "The cream should not be applied directly to the acne lesions."

A. "I need to make sure I protect myself when I'm outside."

The mother of a terminally ill child stays with the child day and night. Which statement indicates that the mother is in the chronic sorrow of depression stage? A. "I will never accept that my child is dying." B. "I know that there is nothing that can be done for my child." C. "There must be another doctor somewhere that can help my child." D. "I will go to church every week if this will keep my child from dying."

A. "I will never accept that my child is dying."

The nurse is teaching a group of novice nurses how to assess bowel sounds. Which statement will the nurse include in the education? A. "You should auscultate all four quadrants for a full minute each." B. "Hypoactive bowel sounds are expected in a client with diarrhea." C. "Bowel sounds should be present within the first few days of life." D. "Bowel sounds will be audible by the naked ear unless distention is present."

A. "You should auscultate all four quadrants for a full minute each."

Which statement best explains the principle behind a Rinne test for determining hearing loss? A. Air conduction of sound is normally better than bone conduction of sound. B. Conduction of sound is intensified in the middle of the forehead. C. A tuning-fork vibration will not be heard as sound in a child under 2 years of age. D. Bone conduction of sound is normally better than air conduction of sound.

A. Air conduction of sound is normally better than bone conduction of sound.

During a routine health checkup, an adolescent expresses concern about pregnancy and sexually transmitted infections. The adolescent states being sexually active. What information can the nurse provide the adolescent? Select all that apply. A. Do not be influenced by friends to have sex. B. If you have intercourse, there is no 100% method to prevent pregnancy. C. Learn about and practice safe sexual techniques. D. Sexual activity does not harm routine physical activity. E. Adolescence is the time when all sexual activity begins.

A. Do not be influenced by friends to have sex. B. If you have intercourse, there is no 100% method to prevent pregnancy. C. Learn about and practice safe sexual techniques. D. Sexual activity does not harm routine physical activity.

A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy? A. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy B. Risk for impaired mobility related to depressant effects of methotrexate C. Excess fluid volume related to effect of methotrexate on aldosterone secretion D. Risk for self-directed violence related to effect of methotrexate on central nervous system

A. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy

The nurse is caring for a 17-year-old client recovering from a failed suicide attempt. Which factor should the nurse recognize as potentially causing the client to reattempt suicide? A. The client states feeling sad. B. The client has three other siblings. C. The client performs in the school band. D. The client is on the honor roll at school.

A. The client states feeling sad.

The hospice nurse is planning a community program that emphasizes the 2030 National Health Goals to reduce long-term illness and early death in children. Which information should the nurse include in this program? Select all that apply. A. strategies to prevent unintentional injury B. seeking early prenatal care when pregnant C. following recommended immunization schedules D. supporting childhood physical activity expectations E. following recommended dietary intake requirements

A. strategies to prevent unintentional injury B. seeking early prenatal care when pregnant C. following recommended immunization schedules

A parent asks the nurse what the philosophy or purpose of a hospice program is. What is the nurse's best response? A. "A hospice is a facility that provides long-term care." B. "A hospice provides care with the belief that death is an extension of life." C. "A hospice allows for open visiting and homelike care." D. "A hospice is a facility for the terminally ill."

B. "A hospice provides care with the belief that death is an extension of life."

The nurse is providing education on adolescent safety to a group of caregivers. Which statement by a caregiver indicates additional teaching is needed? A. "Teenagers should not cook on the stove when home alone." B. "Taking a course on driving safety is sufficient to teach safe driving skills." C. "Firearms should be kept in locked boxes, closets, or cabinets." D. "Setting limits is beneficial when rearing teenagers."

B. "Taking a course on driving safety is sufficient to teach safe driving skills."

Chapter 56 The intravenous infusion line infiltrates on a child who is terminally ill, and the child's mother tells the nurse that the nursing care in this hospital is the worst she has ever seen. What is the nurse's best response to her? A. "Tell me with what you are comparing the care here." B. "You seem angrier today than before. Is something going on?" C. "I think you should talk to a nursing supervisor." D. "You're right, but we're trying to improve."

B. "You seem angrier today than before. Is something going on?"

The parents of a terminally ill child do not want the child dying in the hospital. What can the nurse suggest to help the parents' needs? A. Admit to a long-term care facility. B. Have hospice provided through home care. C. Discharge the child to home right before death. D. Have family stay with the child around-the-clock in the hospital.

B. Have hospice provided through home care.

Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again? A. Assessing financial situation B. Helping to learn better problem solving C. Teaching the parents to keep medicine in a locked cabinet D. Helping to locate a close friend at school

B. Helping to learn better problem solving

While caring for a child recovering from viral pneumonia, the nurse examines the child's lungs for evidence of exudate and fluid. Which finding would suggest cause for concern? A. a respiratory rate of 20 heard on auscultation B. dullness of his lower lobes heard on percussion C. a longer inspiratory than expiratory rate noticed by inspection D. fine rhonchi heard in the upper lobe on auscultation

B. dullness of his lower lobes heard on percussion

Chapter 53 Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for: A. platelets. B. leukemic cells. C. early meningitis. D. early development of septicemia.

B. leukemic cells.

A 16-year-old girl who has been confined to a wheelchair since early childhood has been acting rebellious and rude. Her parents ask the nurse, "Are all adolescents like this?" What is the nurse's best response? A. "Yes. Although your daughter's behaviors are more like those of an adolescent boy." B. "No. Your daughter must need some help in dealing with her feelings." C. "Your daughter's behavior seems to be typical adolescent behavior. Let's talk more about it." D. "Your daughter's behavior results from feelings about her disability; ignore them."

C. "Your daughter's behavior seems to be typical adolescent behavior. Let's talk more about it."

A high school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told their son not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and his parents? A. Osteosarcoma often follows trauma, such as a football injury. B. You can expect some discoloration of the leg following chemotherapy. C. Football injuries do not contribute to the development of a tumor. D. Tumor growth is related to your dislike of milk.

C. Football injuries do not contribute to the development of a tumor.

Chapter 49 A 16-year-old has suffered a thoracic-level spinal injury from a diving accident. To initiate CPR at the poolside, which measure would be most important? A. Hyperextend the neck to clear the airway prior to mouth-to-mouth resuscitation. B. Administer cardiopulmonary resuscitation in a prone position. C. Do not administer CPR after a head injury. D. Elevate the mandible to assess airway with the head in a neutral position.

D. Elevate the mandible to assess airway with the head in a neutral position.

The nurse is caring for a chronically ill adolescent client. When developing the plan of care for this client, which area would the nurse focus on to maintain stimulation and support the client's sense of identity while hospitalized? A. Plan interventions to fall around scheduled rest periods. B. Teach the client about food choices appropriate to the prescribed diet. C. Instruct on the name and indications for use of all medications. D. Encourage keeping in contact with friends through social media.

D. Encourage keeping in contact with friends through social media.

The nurse is planning educational materials to help the parents care for an intellectually disabled child at home. What should the nurse include in this teaching? Select all that apply. A. Provide generous praise. B. Reduce environmental stimulation. C. Scold for not learning abstract concepts. D. Break a large task down into smaller steps. E. Demonstrate the skill that the child is to perform.

A. Provide generous praise. B. Reduce environmental stimulation. D. Break a large task down into smaller steps. E. Demonstrate the skill that the child is to perform.

The nurse is planning outcomes for an adolescent male diagnosed with Hodgkin lymphoma. Which outcome should the nurse use to address feelings of powerlessness with the disease? A. The client attends recommended appointments. B. The client reduces the frequency of extracurricular activities. C. The client cuts back the number of hours worked after school. D. The client spends time with elderly grandparents and other family members.

A. The client attends recommended appointments.

Chapter 51 A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note? A. The posterior spine when bending forward B. The angle of the iliac crest when bending forward C. The posterior spine when bending sideways D. The angle of the lower chest when sitting down

A. The posterior spine when bending forward

The school nurse is preparing an educational session for adolescents to address the 2030 National Health Goals for healthy habits. What should the nurse include in this presentation? Select all that apply. A. abstaining from alcohol B. avoidance of tobacco products C. providing support in times of crisis D. attending college preparation programs E. refusing to participate in substance abuse

A. abstaining from alcohol B. avoidance of tobacco products C. providing support in times of crisis E. refusing to participate in substance abuse

The nurse is preparing an educational session for adolescents to best ensure a lifelong healthy musculoskeletal system. Which teaching will be beneficial to the most attendees? A. importance of daily exercise B. need for early diagnosis of painful joints C. need for at least 8 hours of sleep each night D. adequate intake of calcium in dietary or supplement form

A. importance of daily exercise

A child with acute lymphoblastic leukemia (ALL) is starting treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing? A. induction stage B. sanctuary stage C. consolidation stage D. delayed intensive-therapy stage

A. induction stage

When planning the care for a child with leukemia who is receiving methotrexate, the nurse would assess the child closely for which possible effect? A. mucositis B. cushingoid facial appearance C. weight gain D. paresthesias of the fingers

A. mucositis

The nurse instructs the parents of a child with Guillain-Barré syndrome on care that will be needed once the child is discharged home. Which statement made by the parents indicates that teaching has been effective? A. "We need to be sure to change our child's body position at least twice a day." B. "Our child might experience weakness even after recovering from the illness." C. "It will take about 10 days for our child to be back normal and return to school." D. "This disease affects the heart and lungs, so our child will have limited ability going forward."

B. "Our child might experience weakness even after recovering from the illness."

The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? A. Analgesic B. Antiemetic C. Antipyretic D. Antineoplastic

B. Antiemetic

An adolescent admits to using marijuana on a daily basis. What should the nurse explain to the client to help improve performance in school? A. The effect of marijuana fades fastest if eating occurs after use. B. Marijuana causes memory gaps that interfere with learning. C. Marijuana leads to muscle laxness, so it should not be used close to gym class. D. Marijuana increases blood pressure; running should not be done after smoking it.

B. Marijuana causes memory gaps that interfere with learning.

The nurse meets a child with a slipped capital femoral epiphysis. In what type of child does this usually occur? A. Tall, thin girls B. Obese adolescent boys C. Preadolescent girls D. Active school-age children

B. Obese adolescent boys

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse? A. The adolescent stating "You're the best nurse on the unit." B. The adolescent telling the nurse purging occurs after each meal. C. The adolescent stating the desire to eat again. D. Saying which nurse's orders the adolescent will follow.

B. The adolescent telling the nurse purging occurs after each meal.

Which symptom would lead the nurse to suspect that a child is developing a common side effect of vincristine? A. The cheeks are turning bright red. B. The child says the fingertips feel numb. C. The child says the teeth "ache." D. The child's hearing seems to be altered.

B. The child says the fingertips feel numb.

The nurse instructs an adolescent on the hazards of body piercings and tattoos. Which outcome indicates that teaching has been effective? A. The client gets a small tattoo on the inner ankle. B. The client describes the signs and symptoms to report to the provider. C. The client observes a tattoo being done and decides to get one with an older brother. D. The client limits body piercings and tattoos to areas on the trunk.

B. The client describes the signs and symptoms to report to the provider.

The nurse is caring for a dying child. Which respiratory assessment findings indicate that the child is approaching death? Select all that apply. A. Kussmaul respirations B. dyspnea C. excess secretions D. tachypnea E. adventitious breath sounds F. Cheyne Stokes breathing

B. dyspnea C. excess secretions E. adventitious breath sounds F. Cheyne Stokes breathing

A child with cancer is receiving vincristine. It is most important to observe this child for which of the following side effects? A. constipation B. diarrhea C. flatulence D. rectal bleeding

A. constipation

The community health nurse is working with the school district to provide an educational program on the 2030 National Health Goals to address cognitive and mental health disorders in children. Which topics should the nurse emphasize in this program? Select all that apply. A. stress-reduction techniques B. manifestations of stress in children C. recognizing depression in children D. strategies for oppositional behavior E. nutrition and adequate weight gain

A. stress-reduction techniques B. manifestations of stress in children C. recognizing depression in children E. nutrition and adequate weight gain

An adolescent wears a body brace for scoliosis. Which client education should the nurse provide? A. to continue with age-appropriate activities B. to stand absolutely still when not wearing the brace C. to wear the brace a maximum of 20 hours each day D. that secondary sex changes will stop until the brace is removed

A. to continue with age-appropriate activities

After several weeks of caring for a child who is dying, a nurse finds herself hoping that the child will die on the weekend she is scheduled to be off work. This behavior is consistent with which stage of grief? A. acceptance B. bargaining C. anger D. depression

B. bargaining

The nurse caring for children on a pediatric oncology floor delays entering some of the children's rooms unless providing medication or performing a procedure. Which stage of the grieving process is influencing this nurse's ability to provide client care? A. anger B. denial C. bargaining D. depression

B. denial

The nurse is caring for a child diagnosed with scoliosis. What actions by the child would indicate a need for intervention by the nurse? Select all that apply. A. placement of the brace over a t-shirt B. removal of the brace at bedtime C. Reports of, "I feel taller with the brace on." D. Loosening of the straps on the brace prior to bedtime. E. removal of the brace while playing a soccer game

B. removal of the brace at bedtime D. Loosening of the straps on the brace prior to bedtime.

The nurse is planning a program for a community that focuses on the 2030 National Health Goals for neurologic health. Which topics should the nurse include in this presentation? Select all that apply. A. ensuring a diet adequate in vitamins and protein B. use of helmets for bicycle and motorcycle safety C. learning the signs and symptoms of inflammatory disorders D. practicing good handwashing technique and infection control E. importance of proper emergency care to protect the head and neck

B. use of helmets for bicycle and motorcycle safety D. practicing good handwashing technique and infection control E. importance of proper emergency care to protect the head and neck

An adolescent shares with you that she wishes her breasts would grow larger. Which initial nursing response is best? A. "It is unlikely that your breasts will grow any more. I wouldn't spend time thinking about it." B. "You look fine to me. Why would you want larger breasts?" C. "Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?" D. "Let's talk about your concern. You know that breast size has nothing to do with ability to reproduce."

C. "Breast growth usually stops by the age of 16 years. What is the reason you were hoping yours would grow more?"

Which nursing response best supports the therapeutic relationship between an adolescent with a terminal illness and the nurse? A. "You are special. Angels are around you." B. "How do you want to have your breakfast served in the morning?" C. "I know you are tired. I will sit with you until you fall asleep." D. "It was nice that your friends came to see you. You must miss them."

C. "I know you are tired. I will sit with you until you fall asleep."

Chapter 34 Which finding would the nurse interpret as least significant when assessing a child's lungs? A. stridor B. crackles C. rhonchi D. wheezing

C. rhonchi

While in a pediatric client's room, the nurse notes that the client is beginning to have a tonic-clonic seizure. Which nursing action is priority? A. Administer lorazepam rectally to the client. B. Refer the client to a neurologist. C. Discuss dietary therapy with the client's caregivers. D. Protect the child from hitting the arms against the bed.

D. Protect the child from hitting the arms against the bed.

During a physical assessment, a 15-year-old male expresses concern about being short in height. When responding to the client, the nurse would incorporate an understanding of which information about growth? A. Most male adolescents stop growing by age 17 years. B. Maximum height is typically achieved by age 14 years. C. The epiphyseal lines of long bones close when signs of puberty occur. D. The epiphyseal lines of long bones close at about 18 to 20 years of age in males.

D. The epiphyseal lines of long bones close at about 18 to 20 years of age in males.

The nurse notes that a chronically ill child has not been seeing the health care provider for several months, although monthly checkups and blood work are needed to help maintain the illness. What should the nurse suspect as a reason for the child missing appointments? A. The parents have been too busy to bring the child. B. The family does not have the money to pay for multiple visits. C. The child is afraid of having the blood drawn, so the parents do not bring him. D. The parents are having a difficult time grieving with the idea of the child's illness.

D. The parents are having a difficult time grieving with the idea of the child's illness.

To be an effective nurse with a female child who is dying, it is first necessary to: A. explain the stages of grief to her parents. B. assess at which stage of grief the parents are. C. help the child understand the grieving process. D. identify your own reactions and feelings about death.

D. identify your own reactions and feelings about death.

The nurse is preparing to discuss the most frequent causes of death in adolescents with a group of high school students. On which area should the nurse focus during this discussion? A. water safety B. home safety C. firearm safety D. motor vehicle safety

D. motor vehicle safety

The nurse receives a report from the admission department that a child with a slipped capital femoral epiphysis is in route to the care area. The nurse would likely have received which description of the child to plan care? A. tall, thin female B. preadolescent female C. active school-age male D. obese preadolescent male

D. obese preadolescent male

The nurse is caring for a 16-year-old adolescent who was arrested for driving while intoxicated. Which teaching method is most effective in changing the adolescent's behavior? A. scolding the client for such irresponsible behavior B. reviewing the long-term effects of alcohol on the liver C. teaching that alcohol eventually will lead to other drug abuse D. stressing that the driver's license can be lost if drinking continues

D. stressing that the driver's license can be lost if drinking continues

The nurse is planning an education session for adolescent males on health promotion activities. Which topic should the nurse include as being the most applicable for this population? A. reproductive cycle B. immunization schedule C. importance of socialization D. testicular self-examination

D. testicular self-examination

The community nurse is caring for a family who has a child with a long-term illness. At which point in life should the nurse anticipate the parents having the least difficult time accepting the child's condition? A. on the child's first birthday B. the day the child starts kindergarten C. the day the child is toilet trained D. the day the child would have graduated college

D. the day the child would have graduated college

An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. The nurse would advise him that facial hair: A. usually grows before pubic hair. B. is rarely present before 20 years of age. C. is delayed in boys with acne. D. usually follows pubic hair growth.

D. usually follows pubic hair growth.