NURS 371 Quiz Review

Otitis media (ear infection) is one of the most common infections during early childhood. Which of the following are pre-disposing factors for OM? Select all that apply. Down syndrome Breastfeeding Older age Cleft palate Attendance at day care

Down syndrome Cleft palate Attendance at day care

Children who began primary immunization at the recommended age but failed to receive all doses must begin the series over again. True False

False

Infants and young children in respiratory distress do not deteriorate as rapidly as adults in respiratory distress because they are young and resilient. True False

False

The nurse is reviewing a patient's immunization record. The child is 9 years old, and behind on tetanus, diphtheria and a cellular pertussis vaccination. In order to attend school they need another dose of Dtap. True False

False

Categorize the defects based on their likely hemodynamic flow pattern Categories: Increased pulmonary flow Obstructed flow from ventricles Decreased pulmonary flow Mixed blood flow pattern Defects: Arterial septal defect (ASD) Transposition of the great arteries Coarctation of aorta Pulmonic stenosis Patent ductus arteriosus Tetralogy of Fallot Aortic stenosis Ventricular septal defect (VSD) Hypoplastic left heart syndrome (HLHS)

Increased pulmonary flow: Atrial septal defect (ASD) Ventricle septal defect (VSD) Patent ductus arteriosus Decreased pulmonary blood flow: Tetralogy of Fallot Obstructed blood flow from ventricles: Coarctation of aorta Pulmonic stenosis Aortic stenosis Mixed blood flow pattern: Hypoplastic left heart syndrome (HLHS) Transposition of the great arteries

Which of the following statements is incorrect regarding differences in the respiratory anatomy and physiology of a two month old compared to older children and adults? The infant's eustachian tubes and airway are shorter placing them at risk for ear and respiratory infections The infant is an obligate nose breather until about four months of age Infants and young children have smaller and less developed lower airways Infants have lower metabolic rates and less oxygen consumption compared to older children and adults

Infants have lower metabolic rates and less oxygen consumption compared to older children and adults

Which of the following statements is correct when considering whether to administer MMR vaccination? Correct answer: MMR vaccines may be administered to a child whose Mother is pregnant. MMR is administered orally. MMR should be administered to children no later than 6 months of age. MMR vaccines should not be administered to a child whose Mother is pregnant

MMR vaccines may be administered to a child whose Mother is pregnant.

Match the correct information with the corresponding vaccine. vaccines: MMR, HiB, Varicella, Flu vaccine info: Protects against haemophilus influenzae which can lead to meningitis, epiglottitis, and other serious conditions during infancy Because this is Elsa's first dose and she is under age 8, she will receive another in 4 weeks Protects against chickenpox; sometimes can see fever/rash following administration Protects against measles, mumps, and rubella; LIVE vaccine

MMR: Protects against measles, mumps, and rubella; LIVE vaccine HiB: Protects against haemophilus influenzae which can lead to meningitis, epiglottitis, and other serious conditions during infancy Varicella: Protects against chickenpox; sometimes can see fever/rash following administration Flu vaccine: Because this is Elsa's first dose and she is under age 8, she will receive another in 4 weeks

You are caring for Fern. She is here for her six month old well child visit. Upon assessment, you note that Fern's anterior fontanel is open. Which of the following is your MOST appropriate action? Perform an intensive developmental examination. Perform an intensive neurological examination. Notify the physician immediately because there is a problem. Do nothing because this is a normal finding for this age.

Do nothing because this is a normal finding for this age.

Listed below are many of the medications used to manage symptoms of asthma. Correctly categorize each medication. Categories: Rescue medication (relieves acute bronchospasm) Leukotriene or immunoglobulin E inhibitor (maintenance) Maintenance medication (manage airway inflammation) Medications: Fluticasone propriatate + salmeterol (advair) Albuterol Fluticasone (Flovent) Montelukast sodium (singulair) Epinephrine Monoclonal antibodies

Rescue medication (relieves acute bronchospasm): Albuterol Epinephrine Maintenance medication (manage airway inflammation): Fluticasone (Flovent) fluticasone propriatate + salmeterol (Advair) Leukotriene or immunoglobulin E inhibitor (Maintenance): Montelukast sodium (singulair) Monoclonal antibodies (Fasenra, Dupixent)

Categorize the below options to indicate which are characteristic of a successful child maltreatment prevention program and which are not. Connecting families to community resources Caregiver education Threatening teen parents with taking away their children Building strong social connections Shaming caregivers Taking away resources as punishment Close nurse-family partnerships

Successful programs: Connecting families to community resources Caregiver education Building strong social connections Close nurse-family partnerships

Match each of the following respiratory infections to the vaccine that can help prevent the disease. Respiratory infections: Epiglottitis Pertussis Laryngotracheobronchitis (croup) Pneumococcal pneumonia Group A Beta Hemolytic Streptococcus Vaccines: No preventive vaccination Diphtheria, tetanus, acellular pertusis (DTaP) administered during infancy Haemophilus influenza type B (Hib) - administered during infancy No preventive vaccination Pneumococcal vaccination

Epiglottitis > Haemophilus influenza type B (Hib) - administered during infancy Pertussis > Diphtheria, tetanus, acellular pertusis (DTaP) administered during infancy Laryngotracheobronchitis (croup) > No preventive vaccination Pneumococcal pneumonia > Pneumococcal vaccination Group A Beta Hemolytic Streptococcus > No preventive vaccination

Kawasaki disease should be suspected in a young child who presents with which of the following symptoms? Select all that apply. Loud heart murmur Tender, swollen abdomen Hypothermia Erythema of lips/oral cavity with cracked lips (strawberry tongue) Persistent high fever (>100 degrees F [37.8 C]) unresponsive to antipyretics Irritability Edema and erythema of the palms of hands or soles of feet Enlarged cervical lymph nodes

Erythema of lips/oral cavity with cracked lips (strawberry tongue) Persistent high fever (>100 degrees F [37.8 C]) unresponsive to antipyretics Irritability Edema and erythema of the palms of hands or soles of feet Enlarged cervical lymph nodes

An eight-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing response is which of the following? Correct answer: Explain in simple terms how it works Determine why she is so anxious Ask her why she wants to know Tell her she will see how it works as it is used

Explain in simple terms how it works

Administering supplemental oxygen will prevent respiratory deterioration and failure in the child with croup, epiglottitis and other respiratory infections. True False

False

Assessing the child's family or household situation is only marginally important when providing care to the hospitalized child. True False

False

The father of a 11 year old male and female twins - Maizy and Blu - tells the nurse he is not interested in the HPV shot for Blu, but is okay with Maizy getting it. How should the nurse respond? "That's okay, HPV if really only important for girls." "Are you sure? If you don't start the series by age 12, you can't give it at all." "The American Academy of Pediatrics recommends HPV vaccination for both boys and girls, since in addition to preventing cervical cancer, it can help prevent many cancers including head, neck, and mouth cancer." "It won't give Blu or Maizy 'permission to have sex' if that's what you're worried about!"

"The American Academy of Pediatrics recommends HPV vaccination for both boys and girls, since in addition to preventing cervical cancer, it can help prevent many cancers including head, neck, and mouth cancer."

The mother of an eighteen-month old mentions that she is concerned about her child's round abdomen. Which of the following statements indicates an understanding of the physical growth of an eighteen month old? "This is a normal finding for this age due to immaturity of the abdominal muscles." "She should be placed on a diet because of the size of her belly." "Have you traveled outside the United States?" "I am very concerned and will call the doctor right away."

"This is a normal finding for this age due to immaturity of the abdominal muscles."

Since her asthma diagnosis last year, Kara has been admitted to the emergency department three times with wheezing and shortness of breath. Her medication regimen includes: Advair (salmeterol/fluticasone) 2 puffs twice daily Ventolin (short-acting beta-2 agonist) 2 puffs every 6 hours as needed. Kara is stabilized in the emergency room and ready for discharge. She will continue on her current regimen and is to follow-up with her primary care provider. Which of the following statements by Kara's parents indicate a need for further education regarding Kara's condition and treatment plan? "We'll make sure that Kara avoids all exercise to prevent further attacks." "Kara should use her bronchodilator before her advair until her symptoms are well-managed." "We should make sure that Kara uses her advair every day as ordered." "We will keep a log of activities and exposures that trigger Kara's wheezing."

"We'll make sure that Kara avoids all exercise to prevent further attacks."

Signs of respiratory distress in this child (with croup) might include: Nasal flaring, intercostal and substernal retractions A respiratory rate of 36 breaths per minute Pursed lip breathing Oxygen saturation of 97% with a respiratory rate of 30 Clubbing of the finger nails

Nasal flaring, intercostal and substernal retractions

Which of the following statements reflect the key principles of pediatric nursing care? Correct answer: A, C, & D are all key principles of pediatric nursing. B. Family dependence on and conformity with the health care system is promoted D. Pediatric nursing focuses on promotion of health and prevention of illness and injury. A. The child and family are both central to our care. C. Providing care to the child should be done in a manner that minimizes harm to the child (ie., should be atraumatic)

A, C, & D are all key principles of pediatric nursing.

Supplemental oxygen can increase pulmonary blood flow at the expense of systemic and cardiac perfusion which is detrimental for some children with complex congenital heart disease. True False

True

9 month old Natalie was diagnosed with a Ventricular Septal Defect at birth who was growing and doing well at home until recently. She is now admitted for surgical correction of her defect due to congestive heart failure. Which of the following classifications and blood flow patterns best describes this defect? Acyanotic with increased pulmonary blood flow Acyanotic with obstruction to blood flow from the ventricles Cyanotic with increased pulmonary blood flow Acyanotic with mixed blood flow

Acyanotic with increased pulmonary blood flow

Categories the following congenital heart defects with their correct classification Categories: Acyanotic defect Cyanosis defect Heart defects: Ventricular septal defect Tetralogy of Fallot Coarctation of the aorta Atrial septal defect Hypoplastic left heart syndrome Aortic Stenosis Transposition of the great arteries

Acyanotic Defect: Ventricular septal defect Coarctation of the aorta Atrial septal defect Aortic Stenosis Cyanotic Defect: Transposition of the great arteries Hypoplastic left heart syndrome Tetralogy of Fallot

A mother who brings her five month old infant to the clinic for a regular check-up is concerned that her infant is not developing appropriately. When assessing the infant, which of the following would the nurse expect to find? Absence of head lag when pulled upright Ability to feed themselves Ability to say mama or dada Fine motor finger-to-thumb pincer grasp

Absence of head lag when pulled upright

A 2 year old child presents to the emergency room with her parents who report sudden onset of fever, severe sore throat, and worsening ability to swallow. On admission, you note clear breath sounds, respiratory rate of 36, Temp 39C (102.2 F). The child is listless, inattentive and drooling. Which of the following diagnoses do you suspect? Acute epiglottitis Acute tracheitis Acute laryngotracheo-bronchitis Acute spasmodic laryngitis (common croup) Group-A Beta-Hemolytic Streptococcus

Acute epiglottitis

It is important that a child with acute streptococcal (Strep B) pharyngitis be treated with a complete course of antibiotics in order to prevent: Acute rheumatic fever Otitis media Nephrotic syndrome Pneumonia Drug resistant strains of viruses

Acute rheumatic fever

Which of the following instructions are important when discharging a 5 year old child following tonsillectomy for obstructive sleep apnea? Select all that apply. Administer non-opioid analgesics (acetaminophen) routinely to minimize pain Observe the child for restlessness or difficulty breathing Administer the prescribed opioid around the clock, even if the child is really sleepy Watch for frequent swallowing behavior which might indicate bleeding in throat Encourage frequent sips of cool liquids Avoid over-the-counter analgesics in young children Administer codeine as needed for throat pain

Administer non-opioid analgesics (acetaminophen) routinely to minimize pain Observe the child for restlessness or difficulty breathing Watch for frequent swallowing behavior which might indicate bleeding in throat Encourage frequent sips of cool liquids

The mother of a 1 month old infant states that she is curious as to whether her infant is developing normally. Which of the following developmental milestones would the nurse expect the infant to perform? Rolling from back to side Turning the head from side to side Grabbing a toy that is placed in front of them Placing objects in their mouth

Turning the head from side to side

Inflammatory conditions of the heart can result from viral or bacterial infections in the blood stream. Children with congenital heart defects may be at higher risk for bacterial endocarditis. Which of the following signs and symptoms suggest bacterial endocarditis in the child with CHD? Select all that apply. Anorexia Weight gain Petechia on oral mucous membranes Splinter hemorrhages under nails Afebrile Painful nodes on fingers

Anorexia Petechia on oral mucous membranes Splinter hemorrhages under nails Painful nodes on fingers

In order to obtain the most accurate heart rate prior to administering digoxin, the child's heart rate should be assessed in the following manner: Radial pulse x 30 seconds and multiply x 2 Apical pulse for 1 minute Brachial pulse for 15 seconds and then multiply x 4 Use the heart rate value from the pulse oximeter

Apical pulse for 1 minute

Which of the following strategies is your first priority when a parent tells you that they are uncertain about vaccinating their young infant. Educate the parent about why vaccinations are important during infancy. Ask the parent to tell you why they are uncertain about vaccination. Tell the parent that vaccinations are not linked to autism. Inform the parent about research that refutes the dangers of vaccination during infancy.

Ask the parent to tell you why they are uncertain about vaccination.

Which of the following actions are critical prior to administering digoxin? Select all that apply. Assess apical heart rate for 1 minute Assess for presence of edema Double or triple check the dose against the order and the child to avoid accidental overdose Mix the digoxin with breastmilk or formula to ensure the infant swallows it

Assess apical heart rate for 1 minute Double or triple check the dose against the order and the child to avoid accidental overdose

Kara is an 8-year-old girl being seen in the pulmonary clinic for new diagnosis of bronchial asthma. As the nurse educator in the clinic you are providing the patient education for Kara and her parents. When teaching Kara about her asthma, which of the following statements may best help Kara and her parents to understand her condition? Asthma is a chronic condition that causes narrowing in the airways - making it hard to breathe. Asthma can be readily cured with good management and adhering to the asthma plan. The single cause of asthma is an allergic hypersensitivity. Asthma is, in part, managed by abstaining from vigorous sport activities.

Asthma is a chronic condition that causes narrowing in the airways - making it hard to breathe.

Based on your suspicion, which type of infection is the cause? suspicion: acute epiglottitis Fungal Bacterial Protozoac

Bacterial

Choose the therapies that are most likely to be used to manage Natalie's CHF. Not all therapies are applicable. Categories: Decrease cardiac demand Decrease preload Improve cardiac function Therapies: Maintain normothermia Administer digoxin as ordered Restrict fluids and salt Use naso-gastric tube to feed infant to maintain nutritional status Administer furosemide (Lasix) Promote rest by shortening feedings

Decrease cardiac demand: Maintain normothermia Use naso-gastric tube to feed infant to maintain nutritional status Promote rest by shortening feedings Improve cardiac function: Administer digoxin as ordered Decrease preload: Administer furosemide (Lasix)

Which of the following factors are critical in order to mitigate or lessen the effects of cumulative stress on the child (and family)? Correct answer: Both B & C are critical to help mitigate the effects of stress. A. Having a household where two parents (mom and dad) are present. B. Having a strong social support network. D. Having the ability to deny or ignore problems. C. Having access to the resources (financial, household, community) needed by the child and family.

Both B & C are critical to help mitigate the effects of stress.

Parents of an infant diagnosed with cystic fibrosis ask the nurse about the genetic implications of CF to better understand the disorder in order and to plan for future pregnancies. Which statement, made by the nurse accurately describes the genetic implications? Both parents are carriers of this defective gene since the infant has cystic fibrosis Cystic fibrosis is inherited as an autosomal dominant trait - with one parent carrying the gene. Cystic fibrosis is inherited from parents and found primarily in non-White infants There is a 50% chance that siblings of an affected child will also inherit the condition

Both parents are carriers of this defective gene since the infant has cystic fibrosis

Please select all findings from the history and physical exam that suggest the possibility of child maltreatment. Mom's boyfriend did not come to the emergency department with them Bruising in a 4 month old Injuries in various stages of healing Injuries inconsistent with developmental age Mom has wrapped Alex in a blanket and is holding him close

Bruising in a 4 month old Injuries in various stages of healing Injuries inconsistent with developmental age

Providing for rest and comfort for infants and children addresses which of these goals when treating congestive heart failure? Decrease cardiac demands Remove accumulated fluid and sodium (decrease preload) Improve tissue oxygenation and decrease oxygen consumption. Improve cardiac function (increase contractility and decrease afterload)

Decrease cardiac demands

Caring for the child after right femoral cardiac catheterization includes which of the following activities? Select all that apply. Ambulate the child early to increase blood flow to the right leg Check femoral dressing and catheterization site for bleeding and hematoma Allow the parent to hold the child immediately after the procedure to decrease the child's distress Give IV antibiotics to prevent sepsis Keep the child in bed with the right leg straight for 6-8 hours Frequent assessment of bilateral pedal pulses

Check femoral dressing and catheterization site for bleeding and hematoma Keep the child in bed with the right leg straight for 6-8 hours Frequent assessment of bilateral pedal pulses

Match the following terms to the correct definitions. Terms: Cyanosis Clubbing Tachypnea Apnea Definitions: Absent respirations Rapid respiratory rate Blue gray tint to skin, mucosa or nail bed Enlargement of fingertips and downward sloping of nails; due to chronic hypoxemia

Cyanosis: Blue gray tint to skin, mucosa or nail bed Clubbing: Enlargement of fingertips and downward sloping of nails; due to chronic hypoxemia Tachypnea: Rapid respiratory rate Apnea: Absent respirations

Which of the following are signs of heart failure during infancy? Select all that apply. Difficulty feeding Jugular venous distension Blood pressure higher in upper extremities compared to lower extremities Warm extremeties Weight loss Tachycardia Cool extremeties Tachypnea

Difficulty feeding Tachycardia Cool extremeties Tachypnea

Elsa is a 4 month old female with a history of prematurity (ex 34 weeker) who is exclusively breastfed. What is correct about Elsa's nutritional needs? Select all that apply. Elsa should be receiving vitamin D supplements Elsa is at increased risk for iron deficiency anemia, and should start iron fortified cereals by 4-6 months Elsa will need less calories as a premature baby Elsa requires extra fluids like water to avoid dehydration

Elsa should be receiving vitamin D supplements Elsa is at increased risk for iron deficiency anemia, and should start iron fortified cereals by 4-6 months

The goals of Kara's asthma management are to maintain near normal lung function and normal activity as well as to prevent exacerbation of symptoms. When educating Kara and her family you will include the following strategies with the exception of which? Teach Kara how to use a peak flow meter to measure forced expiratory volume Ensure that Kara and her parents understand the importance of maintaining daily use of inhaled albuterol (SABA). Have Kara and her family assess for potential asthma triggers in her environment. Ensure that Kara and her parents understand the importance of adhering to daily use of her inhaled corticosteroid (Flovent) as ordered.

Ensure that Kara and her parents understand the importance of maintaining daily use of inhaled albuterol (SABA).

Dylan, a 15 year old trans female, presents to the pediatric clinic asking to be tested for STIs. She is accompanied by an older male who will not leave her side and answers all the nurse's questions for Dylan. What action should be the nurse's priority? Check to make sure Dylan is up to date on her HPV vaccine Find an opportunity to get Dylan alone and ask her if she's safe Collect a urine sample for both a urinalysis and culture Recommend that Dylan is also test for HIV

Find an opportunity to get Dylan alone and ask her if she's safe

You are assigned to triage a 3 year old boy who presents to the emergency room with mild fever and a barking-like cough. You suspect the child has laryngotracheobronchitis (croup) and prioritize your assessment appropriately. Drag the following items to reflect the most appropriate order for your assessment. First assessment Assess the child's vital signs and oxygen saturation Assess the parents' ability to adhere to discharge instructions Auscultate the child's breath sounds Assess the child's general appearance and responsiveness Last assessment

First assessment Assess the child's general appearance and responsiveness Assess the child's vital signs and oxygen saturation Auscultate the child's breath sounds Assess the parents' ability to adhere to discharge instructions Last assessment

Congestive heart failure (CHF) in children occurs most commonly in those with congenital defects that limit or prevent blood from pumping to the systemic circulation; this results in congestion of fluid in the heart, lungs, liver and periphery. The following interventions and assessments are imperative when caring for the child with CHF with the exception of: Daily weights and accurate intake and output assessments Promotion of rest to decrease cardiac demands Ensuring adequate caloric intake Forcing fluids to improve circulation

Forcing fluids to improve circulation

Acute rheumatic fever can permanently damage the heart valves and can result from incomplete antibiotic treatment of which of the following infections: Staphylococcus aurius Hepatitis B Haemophilis influenzae Group A Beta Hemolytic Streptococcus Adenovirus

Group A Beta Hemolytic Streptococcus

You are caring for a 12 year old boy in urgent care who presents with sore throat. In addition to a positive throat swab, which of the following signs and symptoms are consistent with group A beta-hemolytic streptococcus (GABHS) (i.e., strep throat)? Select all that apply. Headache Fever Throat pain on swallowing Right lower abdominal pain Constipation for past 3 days Tonsils are inflamed and covered in exudate

Headache Fever Throat pain on swallowing Tonsils are inflamed and covered in exudate

Which of these symptoms will lead you to withhold the infant's dose of digoxin: A drop in blood pressure and fussiness Heart rate < 90 - 110 Heart rate > 140 with cyanosis

Heart rate < 90 - 110

A 3 month old infant on the cardiac unit is receiving Furosemide (Lasix). Which of the following side effects may occur in children taking furosemide, mandating close monitoring? Hypernatremia, hypokalemia, weight loss, weakness Hypokalemia, hyponatremia, hypocalcemia, postural hypotension Hypotension, cough, renal dysfunction Bradycardia, extreme weakness, pallor

Hypokalemia, hyponatremia, hypocalcemia, postural hypotension

During a discharge education session, which of the following actions or statements by the parents indicate a need for more teaching? If the baby vomits, I should give a second dose of digoxin right away. If I miss a dose, I shouldn't give an extra dose but give the next dose on time as ordered. If I miss more than 2 doses, I should call the doctor. The parent gives the dose by slowly directing the syringe to side and back of the infant's mouth.

If the baby vomits, I should give a second dose of digoxin right away.

Which of these treatment goals is addressed by administering digitalis? Decrease cardiac demands Improve cardiac function (increase contractility and decrease afterload) Remove accumulated fluid and sodium (decrease preload) Improve tissue oxygenation and decrease oxygen consumption.

Improve cardiac function (increase contractility and decrease afterload)

Which of these treatment goals is addressed by administering digitalis? Improve cardiac function (increase contractility and decrease afterload) Remove accumulated fluid and sodium (decrease preload) Decrease cardiac demands Improve tissue oxygenation and decrease oxygen consumption.

Improve cardiac function (increase contractility and decrease afterload)

Administration of supplemental oxygen addresses which of the following goals when treating children with congestive heart failure? Remove accumulated fluid and sodium (decrease preload) Improve cardiac function (increase contractility and decrease afterload) Decrease cardiac demands Improve tissue oxygenation by increasing available oxygen during inspiration

Improve tissue oxygenation by increasing available oxygen during inspiration

All of the following are physical differences found in infants and toddlers when compared with adults except: Urethra is shorter Larynx/trachea are rigid Eustachian tubes are shorter Kidneys are unable to concentrate urine

Larynx/trachea are rigid

Jessica is a 10 month-old infant who has been assigned to you. Answer the following question regarding Jessica's nursing care. Jessica has an appointment in the clinic for a preoperative history and physical exam. When you enter the room to perform her physical exam, Jessica is sitting contentedly on her Mother's lap, sucking a pacifier. Which of the following techniques will help you to successfully complete your examination and assessments? Measure the blood pressure first to make sure this important task gets done. Leave the baby on the mother's lap for most assessments and perform traumatic procedures last. Remove the child's clothes first and place them on the examination table for all assessments Check to see if she has a wet diaper first Remove the pacifier from the infant's mouth to begin your examination.

Leave the baby on the mother's lap for most assessments and perform traumatic procedures last.

A 4-year-old child is scheduled to have two different medications at 9am. As the nurse caring for this child, which of the following approaches is the most appropriate? If the child is resistant to taking her medications, find another nurse to help restrain her while giving her medications. Wait until the child's mother is in the room before giving the medication. Let the child decide which medication to take first. Ask the child if she would like to take her medications.

Let the child decide which medication to take first.

Tetralogy of Fallot (TOF) is a congenital heart defect that includes four defects: ventricular septal defect, overriding aorta, pulmonic stenosis, and right ventricular hypertrophy. Common symptoms that you will see in the child with this combination of defects include the following except: Chronic hypoxemia with cyanosis Failure to thrive Lower blood pressure in the lower extremities compared to arms Polycythemia Shortness of breath with activity

Lower blood pressure in the lower extremities compared to arms

Effective communication with families and children involves all of the following actions except: Build trust by listening, answering questions and addressing the family's concerns Practice the use of open, friendly and non-judgmental body language behavior. Respect the family's cultural norms Minimize the family's concerns in order to reduce their stress level Ask open-ended questions

Minimize the family's concerns in order to reduce their stress level

Since the nurse suspects child maltreatment, a CPS report must be completed. Which of the following is NOT necessary to include in the report? Alex's full name and DOB Mom's full name and address Size, shape, and location of Alex's bruising Mom switched from breast milk to formula without telling pediatrician

Mom switched from breast milk to formula without telling pediatrician

The child's responsiveness can help you detect respiratory distress and failure. Put the following signs in order from unlikely respiratory distress to worsening distress and arrest. No respiratory distress Irritable, restless, appears uncomfortable Awake, alert and interactive Unresponsive Lethargic, difficult to arouse, unaware of surroundings Inconsolable, agitated, confused, may be combative Seems focused on breathing, but aware of surroundings Failure

No respiratory distress Awake, alert and interactive Seems focused on breathing, but aware of surroundings Irritable, restless, appears uncomfortable Inconsolable, agitated, confused, may be combative Lethargic, difficult to arouse, unaware of surroundings Unresponsive Failure

Toddlers should transition from breast milk or formula to Vitamin D whole milk at what age? Two years of age Nine months of age One year of age Eighteen months of age

One year of age

At 7 months of age, you would expect an infant to display all of the following skills except: Ability to sit up with support Roll over Pick-up objects with a palmer grasp Pick up a cheerio with a fine pincer grasp

Pick up a cheerio with a fine pincer grasp

Which physiological changes occur as a result of chronic hypoxemia in children with congenital cyanotic heart disease? Polycythemia and clubbing Increased white blood cells and low platelets Elevated erythrocyte sedimentation rate and peripheral edema Anemia and barrel chest

Polycythemia and clubbing

You are in charge of planning a pre-hospitalization program for preschoolers that are coming in for elective surgery. To best address the needs of this age group include the following content in your plan except: Let the child play with some of the objects they will see during the hospital stay (stethoscope, thermometer) Give the children a tour of the surgery unit followed by a snack and chance to play Identify comfort objects or toys that the child can bring with them to the hospital Provide a detailed explanation to the child of what will take place during surgery and hospital admission

Provide a detailed explanation to the child of what will take place during surgery and hospital admission

Match these commonly used monitoring equipment or assessment techniques with their intended purpose Equipment/techniques: Pulse oximeter Electrocardiograph Capnography Arterial blood gas Apnea monitor Stethoscope Purpose: Assesses heart rate and rhythm Measures the levels of oxygen and carbon dioxide in the blood as well as acids and bases Measures oxygen saturation in the blood Assesses respiratory rate and rhythm Assesses end-tidal carbon dioxide which reflects adequate ventilation Assess depth of breathing and breath sounds

Pulse oximeter: Measures oxygen saturation in the blood Electrocardiograph: Assesses heart rate and rhythm Capnography: Assesses end-tidal carbon dioxide which reflects adequate ventilation Arterial blood gas: Measures the levels of oxygen and carbon dioxide in the blood as well as acids and bases Apnea monitor: Assesses respiratory rate and rhythm Stethoscope: Assess depth of breathing and breath sounds

The 3 year old is diagnosed with severe croup and admitted to your inpatient unit. The orders include administration of oral dexamethasone for which of the following indications: Reduce airway inflammation Provide mild sedation Relieve discomfort in the chest and throat Prevent bacterial infection

Reduce airway inflammation

Which of the following goals of treating congestive heart failure is addressed by administering a diuretic (Lasix or furosemide)? Decrease cardiac demands Remove excess fluid (decrease preload) Improve tissue oxygenation and decrease oxygen consumption. Improve cardiac function (increase contractility and decrease afterload)

Remove excess fluid (decrease preload)

Categorize the following signs and symptoms appropriately (not all are applicable) Categories: respiratory distress (early signs) and respiratory failure Pale capillary beds Tachypnea Abnormal or obstructed breath sounds Unresponsive Tachycardia Agitation Restlessness Strong, loud cry Clubbing of fingers Cyanotic capillary beds Bradycardia Increased respiratory effort Pale capillary beds Little or no respiratory effort Slow breathing

Respiratory distress (early signs): Increased respiratory effort Pale capillary beds Tachycardia Agitation Restlessness Tachypnea Respiratory failure: Abnormal or obstructed breath sounds Unresponsive Cyanotic capillary beds Bradycardia Little or no respiratory effort Slow breathing

Which of the following actions is appropriate when caring for a hospitalized infant with congestive heart failure? Schedule care to provide for rest periods between feedings Restrict fluids and sodium intake Educate parents that fever and cyanosis are normal symptoms of heart failure Awaken and stimu.ate the infant frequently to ensure responsiveness.

Schedule care to provide for rest periods between feedings

Based on the NP exam finding, which diagnosis is most likely? Findings: difficult to arouse, retinal hemorrhages, lethargy, several chest bruises Shaken baby syndrome (abusive head trauma) - retinal hemorrhages suggest a contra coup brain injury Meningitis - Alex is too young to be vaccinated Dehydration - Alex hasn't eaten in almost 12 bourse Anemia - Alex shouldn't bruise so easily

Shaken baby syndrome (abusive head trauma) - retinal hemorrhages suggest a contra coup brain injury

Jessica is a 10 month-old infant who has been assigned to you. Answer the following question regarding Jessica's nursing care. On the day of discharge you observe Jessica's parents playing with her. Which behavior indicates that Jessica has developed object permanence? She bangs two cubes in her hands and throws them to the floor. She looks for the toy that her parents hid under the blanket. She recognizes that a ball of clay is the same object even when it's flattened out. She returns the play blocks to the same spot on the table.

She looks for the toy that her parents hid under the blanket.

A 2 year old child with Tetralogy of Fallot presents to the ED with dehydration. After the nurse inserts an intravenous (IV) catheter, the child becomes acutely cyanotic, hyperpneic, and has an abrupt decrease in arterial oxygen saturation (SpO2). All of the following are appropriate nursing interventions except: Place the child in knee/chest position Provide comfort measures to decrease distress Start a low dose epinephrine infusion through the existing IV line Administer supplemental "blow by" oxygen

Start a low dose epinephrine infusion through the existing IV line

Which of the following signs and symptoms would indicate congestive heart failure in Natalie? Tachycardia, retractions, poor weight gain, fussiness, difficulty feeding, pallor, grunting, pale, cool extremities Tachycardia, jugular venous distention, exercise fatigue Bradycardia, hypotension, fussiness, pallor, nasal flaring

Tachycardia, retractions, poor weight gain, fussiness, difficulty feeding, pallor, grunting, pale, cool extremities

Which of the following instructions are important for most children with cystic fibrosis. Select all that apply. Take pancreatic enzymes 10 to 20 minutes prior to meals or snacks, Avoid vaccinations if the child is underweight Avoid antibiotics to prevent drug resistant strains of bacteria Take fat soluble vitamins (A D E K) on a daily basis Adhere to a low fat low protein diet Take water soluble vitamins (B6 B12 and C) every day Maintain a high calorie diet Use pulmozyme to thin respiratory secretions Adhere to daily chest physiotherapy schedule Crush pancreatic enzymes and take immediately after every meal or snack

Take pancreatic enzymes 10 to 20 minutes prior to meals or snacks Take fat soluble vitamins (A D E K) on a daily basis Maintain a high calorie diet Use pulmozyme to thin respiratory secretions Adhere to daily chest physiotherapy schedule

A 3 year old is hospitalized following tonsillectomy to relieve obstructive sleep apnea. The child has received an opioid analgesic and acetaminophen to promote comfort, and is receiving humidified air by blow-by device. The child has been sleeping all evening, and the nurse has received several paging notifications for oxygen desaturation events (SpO2 < 90%). The first thing the nurse should assess when entering the child's room is: The blow-by device for proper functioning. The pulse oximeter for potential artifact. The child's respiratory effort and breath sounds. The child's IV line for proper functioning.

The child's respiratory effort and breath sounds.

Based on your suspicion, you know that the following actions are contraindicated (select all that apply): suspicion: acute epiglottitis Use of a tongue depressor to assess appearance of the throat Assessing the child's temperature with a tympanic thermometer Swabbing the throat for culture Use of a pulse oximeter to assess the child's oxygen saturation

Use of a tongue depressor to assess appearance of the throat Swabbing the throat for culture

Cardiopulmonary arrest in children is most often due to respiratory obstruction or failure compared to adults where the cause is most often due to a cardiac reason. True False

True

An infant with congestive heart failure is receiving diuretic therapy. The nurse is closely monitoring the intake and output. Which is the most appropriate method to assess the urine output for an infant? Measure the amount of water added to formula Weigh the diapers Weigh the baby before and after each diaper change Insert a foley catheter after every feeding

Weigh the diapers

A 6 month old baby is in your clinic for a well child/preventative health visit. The following assessments are your priority for this healthy visit: Abdominal girth Weight, length, and head circumference Blood pressure, temperature and oxygen saturation Oxygen saturation and respiratory rate

Weight, length, and head circumference

Marco is a 15 year old male track athlete. At his well visit, his mother asks about healthy nutrition. The nurse replies that as an active adolescent, it is important that Marco receives adequate ________________ and _______________

iron, protein