PassPoint - Infant, child & preschool
The parent of a 6-month-old reports starting the child on 2% milk. What should the nurse ask the parent first?
"Can you tell me more about the reason you switched your baby to 2% milk?"
At a 6-month well-child check an infant has a high fever and cold symptoms and is diagnosed with otitis media. The child is scheduled to receive their 6-month immunizations. The parent asks the nurse if the child will receive them. What is the nurse's best response?
"Make an appointment to come back to get your child's immunizations when they've finished the antibiotics."
pursue obtaining orders for alternative treatments to a blood transfusion.
"We will check the color and temperature of the toes of the casted leg frequently."
A child who tests positive for the human immunodeficiency virus (HIV) is placed in foster care. The foster parents ask the nurse how to prevent HIV transmission to other family members. How should the nurse respond?
"Wear gloves when you're likely to come into contact with the child's blood or body fluids."
The parent of an 11-month-old infant reports to the nurse that the infant sleeps much less than other children. The parent asks the nurse whether the infant is getting sufficient sleep. What should be the nurse's initial response?
Ask the parent for more information about the infant's sleep patterns.
The nurse admits a toddler with croup to the unit. What should the nurse do first?
Assess respiratory status.
The nurse assesses an 8-month-old infant for a possible head injury after a fall of about 3 feet. The child is awake, alert, and crying. Vital signs are within normal limits. What action should the nurse take next?
Assess the infant's pupillary responses.
The parent of a preschooler reports that the child creates a scene every night at bedtime. What is the best course of action?
Establish a set bedtime, and follow a routine.
The nurse is inspecting a child's throat (see figure). How should the nurse proceed with the throat examination?
Guide the tongue blade while the child is holding it to depress the tongue to visualize the throat.
The nurse is inserting a nasogastric tube in an infant to administer feedings. In the figure below, indicate the location for the correct placement of the distal end of the tube.
Middle of stomach area
A child is being discharged after being diagnosed with an asthma attack. What information regarding the rescue inhaler is most important for the nurse to include in discharge teaching?
Monitor heart rate.
What should a nurse do to ensure a safe hospital environment for a toddler?
Move the equipment out of reach.
A nurse is caring for an infant being treated for an upper respiratory infection. The physician would like to order a series of X-rays for the infant, who has been in a foster home for 4 months. How should the nurse obtain consent?
Obtain consent from the foster parents.
For a child with hemophilia, what is the most important nursing goal?
Preventing bleeding episodes
A toddler has been admitted to the pediatric unit with pneumonia. While assessing a toddler the nurse finds bruise marks consistent with a belt buckle on the buttocks. The nurse suspects the toddler is being abused. What action should the nurse take?
Report the case to local authorities.
A parent calls the nurse to report that their toddler has just been burned on the arm. What should the nurse advise the parent to do first?
Run cool water over the burned area, and then wrap it in a clean cloth.
The parents of a child with diarrhea report to the nurse that they have treated the child with home remedies, including herbal medicine. What is the most important information for the nurse to communicate to the parents regarding the use of home remedies?
Share home remedy information with healthcare professionals.
The nurse develops a teaching plan for the parent of a toddler diagnosed with scabies. What information should the nurse expect to include?
Treat the entire family.
A toddler diagnosed with nephrotic syndrome has a fluid volume excess related to fluid accumulation in the tissues. Which measure should the nurse anticipate including in the child's plan of care?
Weigh the child before breakfast.
The parent of a 2-week-old infant brings the child to the clinic for a checkup. The parent expresses concern about the baby's breathing because the infant breathes quickly for a while and then breathes slowly. The nurse interprets this finding as an indication of what factor?
a normal pattern in infants of this age
An infant is admitted to the hospital with dehydration secondary to viral gastroenteritis. Which room assignment is the most appropriate for this infant?
a private room
A child is diagnosed with Wilms' tumor. During assessment, the nurse expects to detect
an abdominal mass.
A preschool child presents with a history of vomiting and diarrhea for 2 days. Which assessment finding indicates that the child is in the late stages of shock?
bradycardia
The nurse assesses an infant with an undescended testis. The nurse should be alert for which symptom?
bulging in the inguinal area
The nurse is caring for a child whose mother is deaf and untrusting of staff. She frequently cries at the bedside, but refuses intervention from the social worker or the chaplain. Which issue is most important for the nurse to address with the mother to promote a trusting relationship?
communication barriers between the mother and staff
The nurse develops the discharge plan for the parents of an infant who has undergone a myelomeningocele repair. What information is most important for the nurse to include?
daily care required by the infant
A client is admitted to the pediatric unit with fever, seizures, and vomiting. The client is awake and alert. As the nurse is putting a gown on the client, the nurse notices petechiae across the client's chest, abdomen, and back. The nurse should
evaluate the client's neurologic status.
A toddler receiving chemotherapy after surgery for a Wilms tumor has developed neutropenia. The parent is trying to encourage the child to eat by bringing extra foods to the room. Which food would the nurse discourage for this child?
fresh strawberries
The nurse is caring for a child in the early stages of burn recovery. Which nursing diagnosis does the nurse prioritize?
impaired skin integrity
The nurse performs a well-child checkup on a 2-year-old at the clinic. Which skill should the nurse expect the child to be able to perform?
kicking a ball forward
When developing a care plan for a hospitalized client, the nurse knows that children in which age-group are most likely to view illness as a punishment for misdeeds?
preschool age
The parents of a preschooler are refusing a blood transfusion to treat severe hypovolemia because they are Jehovah's Witnesses. The parents are aware of the potential consequences of refusing the treatment. The priority intervention for the nurse at this point is to:
pursue obtaining orders for alternative treatments to a blood transfusion.
When discussing an infant's motor skill development with the parent, the nurse should explain that by age 7 months, an infant most likely will be able to perform which skill?
sitting alone using the hands for support
In which parts of the body should the nurse administer an intramuscular injection to a 6-month-old infant?
the lateral middle third of the thigh between the greater trochanter and the knee
A 4-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. The nurse should suspect that the child's I.V. fluid intake is excessive if assessment reveals
worsening dyspnea.
An initial bolus of crystalloid fluid replacement for a child in shock is 20 ml/kg. The nurse is preparing to administer how many milliliters of fluid for a child weighing 30 kg?
600 mL
After receiving a report, the nurse is making out assignments. Which client would be appropriate to assign to unlicensed assistive personnel?
8-month-old with pneumonia who will be discharged today
A nurse is assessing a child who recently received an antibiotic for an ear infection. The parent states that the child seems to have a harder time hearing than before and that the child reported ringing in the ears. The nurse suspects the child is taking an antibiotic from which class?
aminoglycosides
For an infant who's about to undergo a lumbar puncture, the nurse should place the infant in:
an arched, side-lying position, avoiding flexion of the neck onto the chest.
