OB/PEDS (Pre-Quiz) 38 & 39

The nurse in the emergency department is caring for a child who has a simple contusion of the right eye following a motor vehicle accident. Upon discharge to home, which response by the parents requires further clarification?

"I will need to apply heat to the eye four times a day."

The nurse is caring for a 3-year-old child who experienced a febrile seizure for the first time. What statements by the parents of the child should the nurse address further? Select all that apply.

"It is so scary to think that our child will likely develop epilepsy now." "I am afraid that our 10-year-old will start having febrile seizures."

The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion?

"It seems like bright lights really bother our child."

The nurse is educating the parents of a 7-year-old child who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed?

"We need to raise the volume of our voices significantly so our child can hear us."

A nurse demonstrates understanding of the various levels of consciousness as they progress from most alert to least alert. Place the levels of consciousness in the order that reflects this progression.

1) Oriented to person, place, and time 2) Disorientation 3) Obtundation 4) Stupor 5) Coma

A child is hospitalized and diagnosed with bacterial meningitis. What can the nurse anticipate will be included in the plan of care and treatment? Select all that apply.

Acetaminophen Administering tepid baths as needed Antibiotic therapy

The nurse is caring for a 20-month-old child with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?

Administering antibiotics as soon as they're available

A nurse is preparing a presentation for a group of parents about vision impairment. When describing the causes, what would the nurse include as a common cause? (Select all that apply.)

Amblyopia Infantile glaucoma Refractive error Retinopathy of prematurity

The nurse is discussing communication options with the parents of a 2-year-old child with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component?

American Sign Language

After teaching a group of students about neural tube disorders, the instructor determines that additional teaching is needed when the students identify this as a neural tube defect.

Arnold-Chiari malformation

A group of nursing students are reviewing cerebral vascular disorders and risk factors in children. The students demonstrate understanding of the material when they identify which as a risk factor for hemorrhagic stroke?

Arteriovenous malformations (AVMs)

A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform?

Assess the level of consciousness (LOC)

The nurse assesses a child and finds that the child's pupils are pinpoint. What does this finding indicate?

Brain stem dysfunction

A nurse is providing care to a child with status epilepticus. Which medications would the nurse identify as appropriate for administration? Select all that apply.

Diazepam Lorazepam Fosphenytoin

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?

Dramatic increase in head circumference

The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as a possible trigger?

Drinking three cans of diet cola

A child is being prepared for discharge after sustaining a simple contusion of the eye. Which advice would the nurse expect to include in the discharge instructions?

Encourage the parents to apply ice to the area for 20 minutes at a time for the first 24 hours.

The nurse is teaching the family of a 6-year-old child with allergic conjunctivitis how to minimize the exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?

Encouraging the child to keep the hands away from the eyes

The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority?

Ensuring the protective eye patch is securely in place

The nurse is caring for a child who was injured in a bike accident. The nurse determines that a child is experiencing late signs of increased intracranial pressure based on which assessment findings? Select all that apply.

Fixed dilated pupils Bradycardia Irregular respirations

The parent of a 4-week-old infant is discussing what babies see with the nurse. What information should be included? (Select all that apply.)

Infants experience blurry vision due to the immaturity of their eye structures. Children will not have 20/20 vision until they are school age. Your baby can see about 8 to 10 in.

A child returns to the clinic after an episode of otitis externa, which has resolved. What would the nurse emphasize as the priority for preventing future episodes?

Keeping ear canals dry

A nurse is assessing a toddler who is brought to the clinic by the parent. The parent states, "My toddler has been so irritable lately and I've noticed the toddler frequently pulling on the right ear." The nurse suspects acute otitis media based on which assessment findings? (Select all that apply.)

Loss of appetite Red bulging tympanic membrane Low-grade fever

A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the common causes? (Select all that apply.)

Staphylococcus aureus Neisseria gonorrhoeae Haemophilus influenzae Chlamydia trachomatis Streptococcus pneumoniae

While obtaining the health history for an 11-year-old child, the nurse suspects the child may have myopia based on what information? (Select all that apply.)

The child tells the nurse that they have to squint to see their teacher write on the white board at the front of the classroom. The parent tells the nurse that the child always wants to set close to the movie screen, but never did in the past. The child tells the nurse that it is difficult to see the ball in the outfield when playing baseball.

A nurse is providing information to the parents of a child diagnosed with absence seizures. What information would the nurse expect to include when describing this type of seizure? Select all that apply.

This type of seizure is usually short, lasting for no more than 30 seconds. You might see a blank facial expression after a sudden stoppage of speech. You might have mistaken this type of seizure for lack of attention. This type of seizure is more common in girls than it is in boys.

The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures?

Understanding the side effects of medications

When developing the plan of care for a child with a visual impairment, what would the nurse include? (Select all that apply.)

Using touch and tone of voice to demonstrate affection Encouraging activities to stimulate development Ensuring that the child's environment is familiar and secure

The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all that apply.

Verbal response Motor response Eye opening

While observing a child, the nurse notes that the child's arms and legs are extended and pronated. During shift hand-off, the nurse reports potential damage to:

the midbrain.

A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate?

Teach the child and his parents to keep a headache diary.

A 12-year-old child expresses embarrassment about having to start wearing glasses. What is the best response by the nurse?

"Let's talk about what it will be like wearing them for the first time."

A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question?

"Did you use any medications like aspirin for the fever?"

The nurse is caring for a 6-year-old child with sensorineural hearing loss. Which would the nurse be least likely to identify as the cause of the child's hearing loss?

Acute otitis media

After conducting vision screening and examination of a preschooler, the nurse suspects amblyopia based on:

asymmetric corneal light reflex.

A child is diagnosed with aseptic meningitis. The child's mother states, "I don't know where she would have picked this up." The nurse prepares to respond to the mother based on the understanding that this disorder is most likely caused by:

enterovirus

Vision screening reveals that a child has myopia. The nurse interprets this as:

light rays being focused in front of the retina.

The nurse is screening a 4-year-old child for vision problems. What problem could result in loss of vision?

Amblyopia

What finding is consistent with increased intracranial pressure (ICP) in an infant?

Bulging fontanel (fontanelle)

The nurse is providing education to the parents of a 2-year-old boy with hydrocephalus who has just had a ventriculoperitoneal shunt placed. Which information is most important for the parents to be taught?

"Watch for changes in his behavior or eating patterns."

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?

Head trauma

The nurse is assessing a child with a hordeolum. Which would the nurse be least likely to observe?

Reddened conjunctiva

A nurse is preparing a presentation for a group of parents who have children with significant visual impairment. What would the nurse be least likely to include as an example of self-stimulatory actions?

Shouting

When assessing a neonate for seizures, what would the nurse expect to find? Select all that apply.

Tachycardia Elevated blood pressure Ocular deviation Jitteriness

The nurse is caring for an 8-year-old girl who was in a car accident. What would lead the nurse to suspect a concussion?

The child is easily distracted and can't concentrate.

A mother has brought her 5-month-old son to the clinic because he has been drowsy and unresponsive. The child has hydrocephalus and had a shunt placed about a month previously. Which symptom indicates that the shunt is infected?

The child is not responding or eating well.

The nurse is caring for an 11-year-old with otalgia and fever. When reviewing the child's medical record, which would the nurse identify as a risk factor for acute otitis media?

The parent has had recurrent otitis media.

The nurse is performing an assessment on a child who is 6 days old. When assessing the eyes, the nurse notes the presence of a bluish tinge to the sclerae. What can the nurse infer about this finding?

This is normal in infants up to several weeks of age.

The nurse is assessing a 13-year-old adolescent with an eye injury. The nurse determines that evaluating pupillary response to light and accommodation is not appropriate based on the suspicion of a:

scleral hemorrhage.