Nurs 307 Wk2
The nurse is caring for a 14 month old boy with cystic fibrosis. Which sign of ineffective family coping requires urgent intervenion? A. Compliance with therapy is diminished B. The family becomes over vigilant C. The child feels fearful and isolated D. Siblings are jealous and worried
A - Family must adjust to demands of disease, they can become overwhelmed and exhausted, resulting in worsening of symptoms.
The nurse is developing a teaching plan for the parents of a 10-year old boy with CF. The plan should include teaching about a: A. Flutter valve device B. Metered dose inhaler C. Nebulizer D. peak flow meter
A - Flutter valve used to assist w mobilization of secretions metered dose inhalers, nebulizers and Peak flow meter used for asthma
The young child has been diagnosed with group A streptococcal pharyngitis. The physician orders amoxicillin 45mg/kg in 3 equally divided doses. The child weighs 23lb. Calculate how many mg the child will receive with each dose of amoxicillin. Round to whole number
157
The nurse is caring for a 10-year old with allergic rhinitis. Which intervention helps prevent secondary bacterial infection? A. Using normal saline nasal drips B. Teaching parents how to avoid allergens C. Discussing anti-inflammatory nasal sprays D. Educating parents about oral antihistamines
A - Using nasal washes to improve air flow will help prevent secondary bacterial infection by preventing mucus from becoming thing & immobile Teach parents to avoid allergens like tobacco smoke, dust mites, and mold to prevent recurrence Anti inflammatory and oral antihistamines are treatment
The child has been diagnosed with asthma and the child's physician is using a stepwise approach. Rank the following in the order the nurse should administer these medications as the child's condition worsens. A. Albuterol as needed B. Low-dose inhaled corticosteroid C. Medium-dose inhaled corticosteroid D. Medium-dose inhaled corticosteroid and salmeterol
A,b,c,d Asthma attack --> SABA, second is low dose inhaled corticosteroid, then medium dose, then corticosteroid and long acting (salmeterol)
Allergic rhinitis is associated with __________ dermatitis and asthma
Atopic
The nurse is auscultating the lungs of a lethargic, irritable 6 year old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma? A. I'm going to have the respiratory therapist get some mucus from our lungs B. I'm going to have this hospital worker take a picture of your lungs C. We're going to take a look at your lungs to see if there are any sores on them D. I'm going to hold your hand while the phlebotomist gets blood from your arm
B - X ray is ordered for assessment of asthma to check for hyperventilation. Sputum culture for pneumonia, CF, TB Sweat chloride is for CF
The nurse is caring for a 3-year old girl who is cyanotic and breathing rapidly. Which intervention is best to relieve these symptoms? A. Suction B. Oxygen administration C. Saline lavage D. Saline gargles
B -Oxygen admin is indicated for treatment of hypoxemia.
The Nurse is taking a health history for a 3 year old suspected of having pneumonia who presents with a fever, chest pain, and cough. Which information places the child at risk for pneumonia? A. The child is a triplet B. The child was a post maturity date infant C. The child has diabetes D. The child attends day care
D - Attending daycare is RF for pneumonia Triplet is RF for bronchiolits Prematurity rather than post maturity RF for pneumonia Diabetes is RF for pneumonia
The child has been admitted to the hospital with a possible diagnosis of pneumonia. Which findings are consistent with this diagnosis? SATA A. Temperature is 98.4F (36.9F) B. Childs chest x-ray indicated the presence of periphilar infiltrates C. The child's white blood cell count is elevated D. The child's respiratory rate is rapid E. The child is producing yellow purulent sputum
B,C,D,E not A - pneumonia typically has fever
A nurse is caring for a 18 month old infant who has chronic otitis media. The nurse should recognize that chronic otitis media will affect which of the following? A. Olfaction B. Visual acuity C. Speech patterns D. hand-eye coordination
C
The nurse is assessing several children. Which child is most at risk for dysphagia A. 7 month old with erythematous rash B. 8 year old with fever and fatigue C. 5 year old with epiglottitis D. 2 month old with toxic appearance
C - The child with epiglottitis has a sore, swollen throat, placing child at risk for dysphagia.
The nurse is discussing the differences between children's and adults respiratory systems. Which statements by the nurse are accurate? SATA A. Children are less likely to develop problems associated with swelling of the airways B. Children's tongues are proportionally smaller C. The only time that newborns can breathe through their mouths is when they cry D. A newborns respiratory tract is drier because the newborn doesn't make very much mucus E. Children under the age of 6 are more prone to developing sinus infections
C,D - Until 4 weeks, newborns are nose breathers. Newborns respiratory tract makes very little mucus. Children have increased risk of developing problems associated with airway edema Childrens tongues proportionally larger than adult Children under 6 reduced risk of developing sinus infections
A nurse is preparing to feed an infant who has a cleft lip and palate. Which of the following actions should the nurse plan to take? A. Burp the infant atleast 2to 3 times during feeding B. Remove nipple from infants mouth if swallowing becomes audible C. Stop feeding appears in nasal cavity of infant D. Discourage parents from participating in feeding prior to surgical repair
Correct A; Infants who have CP/CL will swallow an increased amount of air during feeding due to lack of separation between oral and nasal cavities. Infants should be burped after every ounce. Incorrect: B,C,D B: typically noisy feeders due to inc. amount of air swallowed. watch for signs of distress ie. wrinkled brow, elevated brows, watering eyes. If noted remove nipple and allow infant to swallow C: Formula expected to appear due to lack of separation between oral and nasal cavities D. Parents should be encouraged to begin feeding ASAP. enables caregiver to gain experience and confidence prior to discharge
A nurse is providing anticipatory guidance about the accidental ingestion of a toxic substance to the parents of a toddler. Nurse should instruct the parents to take which of the following actions first if the child ingests a hazardous substance A. Give toddler milk B. Go to emergency department C. Call the poison control center D. Induce vomiting
Correct C: Poison control center will identify what actions parents should take Incorrect: A: depends on substance taken B: depends on poison and amount ingested D: depends on substance, corrosives, inducing vomiting can cause additional harm by prompting burns
A nurse is caring for a 4 month old child who has acute otitis media and has a fever of 38.1 (101F). Which of the following medications should the nurse administer A. Diphenhydramine B. Furosemide C. Amoxicillin D. Ibuprofen
Correct C: acute otitis media should be given antibiotic to alleviate infection Incorrect A: antihistamine used for allergic reactions B: furosemide used to reduce edema C: Less than 6 mo should not take ibuprofen. Acetaminophen is preferred choice for children of this age
A nurse is teaching a group of parents and guardians about otitis media. Which of the following should the nurse identify as a risk factor for this illness? A. Summer months B. Breastfeeding C. Ages 7-10 years D. Passive smoking
Correct D: Exposure to secondhand smoke promotes attachment of pathogens to middle ear Incorrect A: winter and spring months (oct-mar) are RF for otitis media. Respiratory infections are common & otitis media occurs after this type of infection B: bottle feeding is RF otitis media, slanted position of infant increases RF formula to enter eustachian tube C: 6 and younger are RF for otitis media, most common 2-3 and 4-6
A nurse is caring for a toddler who is postoperative following a cleft palate repair. Which of the following actions should the nurse take? A. Restrain toddlers arms at the elbows B. Feed toddler with spoon C. Monitor toddler's oral temperature D. weigh toddler every 48 hours
Correct: A Apply elbow restrains to prevent toddler from rubbing or disrupting sutured area incorrect B: avoid using hard utensils due to risk of injury to repair C: Avoid placing rigid objects in mouth such as thermometer due to RF injury to repair D. Nurse should weigh infant same time each day using same scale to check status
A nurse is planning care for a 10-month-old infant who has suspected FTT. Which of the following interventions should the nurse include in plan of care? (SATA) A. Observe parents actions when feeding the child B. Maintain detailed record of food and fluid intake C. Follow child's cues to time food and fluids D. Sit beside childs high chair E. Play music videos during scheduled meal times
Correct: A & B Incorrect: C: Structured routine used to promote weight gain. Child with FTT may not offer feeding cues D: Sit directly in front of child to encourage feeding E: Provide quiet, stimulation free environment to focus on food intake
A nurse is preparing a school-age child for a tonsillectomy. Which of the following actions should the nurse take? A. Schedule the child for a preoperative visit to the facility B. Inform the child he will be put to sleep for the procedure C. Read the child a story about a cartoon character have a similar operation D. Tell the child the appointment is to have his throat checked.
Correct: A - Education helps child ease prior to surgical procedure Incorrect: B: after 9 child understands concept of death. Put to sleep can be connected with death C:: cartoon book developmentally appropriate for preschool-aged child or toddler D: needs factual information and explanations
A nurse is providing teaching to the guardians of an infant who is FTT. Which of the following pieces of information should the nurse include in the teaching? A. Add fortified rice cereal to infant's formula B. Alternate feedings between several family members C. Offer the infant juice between feedings D. Provide feedings on demand rather than on a schedule
Correct: A adding fortified cereal promotes weight gain Incorrect B: caregiver consistency is recommended when providing feedings C: Restrict infants intake of juice until adequate weight is gained D: maintain a schedule to promote weight gain and behavior modification
A nurse is caring for a child who is in the emergency department after ingesting a bottle of acetaminophen. Which of the medications should the nurse plan to adminster? A. Digoxin immune fab B. Acetylcysteine C. Naloxone D. Vitamin K
Correct: B Incorrect A: given for digoxin toxicity C: antidote for opioid D: or aspirin (salicylate) poisoning or OD
A nurse in the ED is caring for a 2 year old child who was found by his parents crying and holding container of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action by the nurse? A. Remove child's contaminated clothing B. Check respiratory status C. Administer antidote to child D. Establish IV access for child
Correct: B ABC, assess patient first
A nurse is providing immediate postoperative care for a preschooler who had a tonsillectomy. Which of the following actions should the nurse take? A. Offer ice cream or pudding when the child is fully awake B. Eliminate the use of a straw when offering fluids C. Apply a heating pad to the neck area D. Instruct child to blow his nose to clear bloody secretions
Correct: B - Straws can accidently injury surgical site and cause bleeding Incorrect: A: dairy can induce coughing C: ice collar to provide nonpharm relief D: Pressure from nose blowing can increase bleeding from surgical site
The nurse is caring for a 5 year old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder for the child to: A. Report ear pain B . Experience nuchal rigidity C. Have unilateral breath sounds upon auscultation D. Be at risk for respiratory distress
D - Airway can become completely occluded due to epiglottis, respiratory distress may lead to respiratory arrest & death.
A nurse is providing discharge teaching to a guardian of an adolescent who is postoperative following a tonsillectomy. Which of the following manifestations should the guardian report to provider? A. nasal secretions containing dark brown blood B. Constant clearing of throat C. Unpleasant odor from oral cavity D. temp of 99.8 37.7 at 48hr postop
Correct: B constant clearing of blood that is draining in back of throat. Incorrect A: some secretions can contain old blood. Old blood is dark brown color, fresh blood is bright red. C: unpleasant odor from nasal cavity is expected manifestation D: low grade fever is expected manifestation
A nurse is assessing a 6 year old child who is immediately postoperative following a tonsillectomy. Which of the following findings should the nurse report to provider? A. Child has a small amount of dark brown blood between the teeth B. Child is swallowing frequently C. Child has HR of 118/ min D. Child refuses application of an ice collar
Correct: B- manifestation of hemorrhage. Incorrect: A; small amount of dark brown blood between teeth is expected finding following tonsillectomy C: Hr of 118/min is expected reference range for 6yr old D: refusing ice collar is expected responses from child who is postop
A nurse is providing dietary teaching to the parent of a toddler who has phenlketonuria. Which of the following foods should the nurse recommend? A. Whole milk B. Ground Beef C. Cooked Carrots D. Eggs
Correct: C - foods low in protein such as cooked carrots and fruits Incorrect A,B,D avoid foods high in protein like milk, eggs, beef
A nurse is caring for a child who is postoperative following a tonsillectomy. Which of the following findings is a nurse's priority? A. Nausea B. Hoarse Voice C. Frequent swallowing D. Sore Throat
Correct: C - indication of bleeding Incorrect A: adverse effect of anesthesia B: Hoarse voice expected finding D: sore throat is expected finding
A nurse is providing teaching about home care to parents of infant who has diaper dermatitis. Which of the following instructions should the nurse include? A. Dry affected area with hair dryer on low setting twice per day B. use cloth diapers washed in a low-residue detergent C. Wash genital area vigorously with each diaper change D. Leave zinc oxide ointment intact and reapply as necessary during diaper changes
Correct: D Incorrect A: Can leave exposed to air to maximize drying but head can cause burns B: Superabsorbent disposable diapers should be used to reduce wetness C: Overwashing skin can increase risk for developing dermatitis.
A nurse is caring for an infant who has a cleft palate. The parents ask the nurse how long they should wait before the child can have corrective surgery. The nurse should explain that the parents should wait no longer than 6 to 12 months for surgery to prevent which of the following outcomes? A. Repeated ear infections B. Nutritional deficits C. Immune system deficits D. Difficulty with language acquisition
Correct: D - difficulty acquiring language because they need to use palate for vocalizing sound. A: Ear infections can persist even after repair B. Increased RF poor nutrition, but strategies to promote nutrition to help infant create seal and generate suction to feed C: Does not affect immune system
A nurse in a pediatric clinic is caring for a 3 year old child who has a blood lead level of 3mcg/dL. When teaching the toddler's parent about the correct nutrition with lead poisoning, which of the following pieces of information is appropriate for the nurse to include? A. Decrease child's vitamin C intake until the blood lead level decreases to zero B. Administer a folic acid supplement to the child each day C. Give pancreatic enzymes to child with meals and snacks. D. Ensure childs dietary intake of calcium and iron is adequate.
Correct: D - with elevated blood lead levels should have adequate intake of calcium and iron to reduce absorption of and effects from lead. Milk is good source of calcium incorrect A: Vit C does not influence absorption or excretion of lead B: 3 year old doesnt need folic acid supplement C: Pancreatic enzymes given to patients with cystic fibrosis
A nurse is caring for a 12 month old infant following the surgical repair of a cleft palate. The nurse should plan to feed the infant using which of the following instruments? A. Spoon B. Straw C. Firm Nipple D. Cup
Correct: D. Cup Infant should be fed clear liquids using a cup for 7-10 days following CP repair to prevent trauma and injury to suture line Incorrect A,B,C C: Feeding using firm nipple is contraindicated follow CP repair because placing object in mouth could rub or disturb suture line
A nurse is caring for an infant following surgical repair of CL and CP. Which of the following actions should the nurse take? A. keep infants mouth open using tongue blade for 4 hr following surgery B. Suction infant gently with bulb syringe PRN C. Place infant in prone position D. Clean infant incision with chlorhexidine
Correct: Gently suction infants mouth with bulb syringe to maintain patent airway Incorrect A: Avoid placing objects in patients mouth C: place patient upright to facilitate drainage of secretions. Prone can lead to aspiration D. clean operative incision with sterile saline or sterile water after feeding as needed
Cough and _____________ are symptoms of influenza for both children and adults
Coryza
Nasal Cannula
Must have patent nasal passages
Pseudoephedrine is an example of a _______ used for the treatment of runny or stuffy nose associated with the common cold
Decongestant
Pulse oximetry is an __________ measurement of oxygen saturation in arterial blood
Indirect
Tuberculin skin testing is also known as __________ test
Mantoux
Simple Face Mask
Minimum flow rate of 6L/min
Venturi Mask
Mixes room air and oxygen
Nonrebreather Mask
One way valve
Partial rebreather Mask
Oxygen reservoir bag
A _________ is a surgical construction of a respiratory opening in the trachea
Tracheostomy
Auscultation of the lungs might reveal ________ or rales in the younger child with pneumonia
Wheezes
