OB/PEDS (Pre-Quiz) 43 & 48
A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin?
"Do not mix this insulin with other insulins."
A 15-year-old adolescent is scheduled for a pelvic ultrasound to evaluate for a possible ovarian cyst. Which instruction by the nurse would be most appropriate?
"Drink plenty of fluids because you need to have a full bladder."
The healthcare provider has ordered routine hemoglobin A1C levels for an adolescent with diabetes. Following teaching about the test by the nurse, the adolescent and family demonstrate the need for further instruction with which statements? (Select all that apply.)
"I can check this level myself using a blood glucose monitor." "We will need to make sure our adolescent gets this laboratory test at least every 6 months to ensure the diabetes is under control." "I will be sure to not eat or drink anything the night before I get my blood drawn for the test."
The nurse is teaching a 12-year-old child with type 2 diabetes mellitus and parents about dietary measures to control the child's glucose levels. Which comment by the child indicates a need for additional teaching?
"I can eat two small cookies with each meal."
The nurse is teaching the parents of a 3-year-old child with diabetes insipidus how to administer desmopressin acetate. Which comment indicates further need for teaching?
"If our child sneezes the medicine out of the nose, I wait until the next dose."
The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents?
"Let's meet with the dietitian and plan some meals."
A nurse is reviewing information about the various types of insulin that are used to treat type 1 diabetes mellitus. Integrating knowledge about the duration of action, place these types in the order from shortest to longest duration.
1) Aspart 2) Regular 3) NPH 4) Glargine
The nurse is teaching a 9-year-old child with type 1 diabetes mellitus and the parents about blood glucose monitoring. Which comment indicates a need for additional teaching?
"The normal level is 70 to 110 mg/dL (3.9--6.1 mmol/L) before meals."
The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse respond?
"There are several things we can do to help you achieve this goal."
The nurse is caring for an infant with grade II vesicoureteral reflux (VUR). The parent is very fearful that the infant will have progressive renal damage. Which response by the nurse would be appropriate?
"This condition usually resolves spontaneously with no symptoms."
The nurse is providing client teaching regarding the administration of desmopressin acetate for the client diagnosed with diabetes insipidus. Which statements by the client or parents indicate understanding of the teaching? (Select all that apply.)
"We will want to inspect the nares of our child to be sure the medication is not irritating the tissue." "I am going to have to carry a cooler with me if I am going to be gone all day or if I go on a long hike." "We will need to adjust the dose based on how much our child is urinating."
The nurse is performing double diapering for a male infant with hypospadias who has undergone a surgical repair. The nurse performs the following steps. Place the steps in the order in which the nurse performs them.
1) Cuts a hole in the front of the smaller diaper 2) Unfolds both diapers, placing smaller diaper inside larger diaper 3) Places both diapers under the infant 4) Brings the penis and catheter/stent through the hole in the smaller diaper 5) Closes the smaller diaper 6) Closes the larger diaper
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?
Regular insulin
When reviewing the HbA1C results of a 3-year-old child with type 1 diabetes mellitus findings greater than what value, indicate the need for further action?
7.50%
The nurse is caring for a 14-year-old adolescent with hyperpituitarism. What would be the priority treatment?
Administering octreotide acetate as ordered
A group of students are reviewing information about delayed puberty in preparation for a class discussion. The students demonstrate understanding of this condition when they describe which as occurring in female adolescents?
Breast development has not occurred by age 13.
A newborn exhibits significant jittery movements, convulsions, and apnea. Hypoparathyroidism is suspected. What would the nurse expect to be administered?
Calcium gluconate
A child needs to collect urine for 24 hours. The nurse explains to the parents and child that this test assesses glomerular filtration rate and how the kidneys are functioning. What results would be expected in this type of test?
Creatinine clearance
The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?
Grilled chicken, half of a banana, and flavored water
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess?
Heat intolerance
The nurse is reviewing the health history of a client suspected of having vesicoureteral reflux. What findings in the health history are consistent with this disorder? Select all that apply.
Hematuria Flank pain History or repeated urinary tract infections Urinary frequency
When assessing a child with hydronephrosis, what would the nurse expect to find? Select all that apply.
Intermittent hematuria Abdominal mass
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?
Risk for infection
The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered?
Sodium bicarbonate tablets
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?
Sudden onset of severe scrotal pain with significant hemorrhagic swelling
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?
Testis cannot be "milked" down inguinal canal
The nurse is assessing a 5-year-old child whose parent says the child has been vomiting lately and has no appetite. What sign or symptom would the nurse identify as unique to type 1 diabetes mellitus?
The child has lost weight recently.
The nurse is assessing an 8-year-old child who is performing at the second-grade level, reports feeling tired and weak, and is only 45 in (114 cm) tall. Which finding would be specific to hypothyroidism?
The child reports that the exam room is cold.
The nurse is reviewing the blood urea nitrogen (BUN) results of an assigned client. The test is elevated. What factors may be associated with this result? Select all that apply.
The child's diet contains high levels of protein. There may be an infectious process in the child. The child may be dehydrated.
The nurse is assessing a hospitalized child diagnosed with nephrotic syndrome. What assessment(s) is most important for the nurse to complete to help identify hypoalbuminemia in this child?
The heart rate and blood pressure
The home care nurse is conducting an in-home visit for a child who had corrective surgery for hypospadias 3 days prior. What would alert the home care nurse to provide additional teaching?
The parent indicates the child is fussy, but calms down when held on the parent's hip.
While assessing a child with end-stage kidney disease, the nurse notes that the child has fallen into a coma. The nurse interprets this finding as resulting from which complication?
Uremia
The nurse is caring for a child diagnosed with acute post-streptococcal glomerulonephritis. When assessing the child, what findings does the nurse anticipate? Select all that apply.
Weight gain Generalized edema Headache
The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding?
White cottage cheese-like discharge
A group of students are reviewing information about oral diabetes agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?
Metformin
The nurse is caring for a 13-year-old adolescent with delayed puberty. When developing the plan of care for this adolescent, what would be the priority?
Monitoring for therapeutic and side effects of medication
The nurse is caring for an infant boy with grade IV vesicoureteral reflux. Which finding would lead the nurse to suspect that hydronephrosis is present?
Abdominal mass
The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved?
Antidiuretic hormone
A group of nursing students are reviewing the variations in the genitourinary system in children as compared with adults. The students demonstrate understanding of this information when they state:
Bladder capacity reaches adult capacity by age 1 year.
A child with a primary growth hormone deficiency is to receive biosynthetic growth hormone. The nurse would explain to the child and parents that this hormone would be given at which frequency?
Daily
A 15-year-old adolescent is brought to the clinic by the parent because the adolescent has been experiencing irregular and sporadic menstrual periods and excessive body hair growth. Polycystic ovary syndrome is suspected. Which additional assessment finding would help to support this suspicion?
Darkened pigmentation around the neck area
A child with a history of diabetes insipidus has been taking vasopressin. The parents bring the child to the clinic for an evaluation. During the visit, the parents mention that it seems like their child is hardly urinating. The nurse suspects syndrome of inappropriate antidiuretic hormone. What findings would the nurse expect to find to help confirm this condition? (Select all that apply.)
Decreased serum sodium level Serum osmolality 260 mOsm/kg Urine specific gravity 1.033
The parents of an 8-year-old child with nocturnal enuresis bring the child to the clinic for a follow-up. History reveals that the parents have tried numerous behavioral and motivational therapies without success. The nurse anticipates medication therapy. Which agents would the nurse identify as being used? Select all that apply.
Desmopressin Oxybutynin Imipramine
The nurse is assessing a 5-year-old child who has had several convulsions. The nurse continues to assess the child and suspects that the child may have hypoparathyroidism. What evidence would support this suspicion?
Observation reveals tetany.
The nurse is triaging clients as they come in to an express care facility. Which assessment finding is clinically significant for early nephrotic syndrome?
Periorbital edema
The nurse is educating the parents of a child requiring renal replacement. The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?
Peritoneal dialysis
The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia?
Pulse rate and rhythm
The nurse is educating the parents of an infant after a circumcision. The parents demonstrate understanding when they state that they need to report what to the physician?
The infant does not urinate within 6 to 8 hours
The nurse is caring for 1-month-old infant with thyrotoxicosis. What finding would the nurse expect to assess?
The infant has a strong appetite but fails to thrive.
The nurse is providing education to a 10-year-old child and parents about the computed tomography (CT) scan that has been ordered for the following day. What information should be included in the teaching provided? (Select all that apply.)
You will need to lie very still during the test. This test will let us look inside at your tissues and organs.