Passpoint School age child

A child has been prescribed a 3-day course of treatment with gentamicin sulfate while recovering from surgery. Which assessment of the child causes the nurse to be the most concerned?

decreased urine output

The nurse cares for a child who has been receiving long-term steroid therapy. The nurse should assess the child for which complication?

development of truncal obesity

Which goal is most important when developing a long-term care plan for a child with hemophilia?

Prevent injury during each stage of development.

An school-age client is brought to the health clinic for a routine checkup. To assess the client's vision, what question should the nurse ask?

"How are you doing in school?"

Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following?

Decreased red blood cell production.

A child who is of preschool age is diagnosed as having severe autism. The most effective therapy involves which intervention?

one-on-one play therapy

A nurse manager plans care for an 8-year-old child who requires around-the-clock care by unlicensed assistive personnel. How does the nurse best ensure safe care for the client?

Provide written instructions, education, and ongoing supervision.

Which of the following should the nurse expect to include in the plan of care for a child who is diagnosed with rheumatic fever and carditis and admitted to the hospital?

Providing the child with periods of rest.

Which food would be the best to offer first to a child who has had a tonsillectomy?

blue ice pop

The nurse is caring for a child with leukemia. Which beverage should the nurse plan to give the child to relieve nausea?

carbonated soda

A healthcare provider prescribes an antibiotic for a 6-year-old client with an upper respiratory tract infection. For what prescribed antibiotic will the nurse seek clarification from the healthcare provider?

tetracycline

The nurse teaches the child with scoliosis being treated with a Boston brace about exercises. The nurse explains that the exercises are performed primarily for what reason?

to strengthen the back and abdominal muscles

A 12-year-old child is sent home for pediculosis after being at camp for 1 week. The parent thinks others at camp have it. The parent asks the nurse how their child could have gotten pediculosis. How should the nurse reply?

"Children who sleep close to someone who has it get it more easily."

Which question should the nurse ask first when obtaining a history from the parent of a school-age child with a fever, malaise, and swelling around the eyes?

"Does the child urinate as much as usual?"

The parent of a school-age child with autism asks the nurse how they should tell their child that they have autism. Which response by the nurse is most therapeutic?

"Explain the definition of autism and emphasize your child's strengths as well as their areas of challenge."

A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger cookies to help control the nausea. What should the nurse tell the parents?

"You can try them and see how they do."

A child has a seizure while a nurse is performing a bed bath. Which of the following are priority actions for the nurse to implement? Select all that apply.

-Time the length of the seizure. -Observe the stages of the seizure. -Turn the child to a side-lying position.

To help promote independence in the area of feeding for a school-age child in skeletal traction, the nurse should help the child choose which meal?

chicken nuggets with sauce, carrot sticks, apple slices, an ice cream sandwich, and milk in a carton

The nurse is educating parents of first graders about child sexual abuse. What is the most critical information the nurse should convey to the parents?

An adult who sexually abuses a child is usually known to the child.

At the beginning of a shift, the nurse is assigned to care for four school-age children admitted that day due to an acute asthma exacerbation. Which children should the nurse assess first?

child with oxygen saturation of 93% and no wheezing on auscultation

The nurse caring for a 7-year-old child who has undergone a cardiac catheterization 2 hours ago finds the dressing and bed saturated with blood. What should the nurse do first?

Apply pressure just above the catheter insertion site.

A nurse assesses an 8-year-old child and obtains a heart rate of 80 beats/minute. Which of the following is the appropriate action by the nurse?

Continue with the assessment; this is a normal finding.

The nurse develops the teaching plan for the parents of a child needing a Pavlik harness. What should be the nurse's initial step?

Determine the parents' knowledge about the device.

The parents of a child on sulfamethoxazole and trimethoprim for a urinary tract infection report that the child has a red, blistery rash. What instruction should the nurse give the parents?

Discontinue the medicine and come for immediate further evaluation.

Which intervention should the nurse perform for a child who is receiving chemotherapy and allopurinol?

Encourage a high fluid intake.

The nurse creates a plan of care to meet the developmental needs of an 8-year-old child who is confined to home with osteomyelitis. What goal should the nurse include in the care plan?

Encourage the child to communicate with schoolmates.

The nurse teaches the parent of a child with sickle cell anemia about managing the disease and preventing complications. What statement by the parent indicates the need for further education about sickle cell anemia?

I know they don't have as much pain as they act like they have."

A school nurse at an elementary school has been asked to conduct scoliosis screening for students. What will the nurse consider with the scoliosis screening request?

The request is appropriate and the nurse can arrange to screen these students.

A nurse is planning care for a hospitalized school-age child and is delegating care to a pediatric care assistant. When a nurse delegates a task to an unlicensed assistive personnel (UAP), which factor is most important?

The task is appropriate for that individual's preparation.

The nurse discusses the eating habits of school-age children with their parents. The nurse should explain that eating habits are most influenced by which factor?

examples provided by parents at mealtimes

The nurse should explain that the most common cause for the unhappiness some children experience when first entering school is due to which factor?

feelings of insecurity

The nurse is conducting health assessments for school-age children. Which play preferences would the nurse anticipate finding in a 7-year-old girl?

likes to play only with other girls

A parent tells the nurse that their 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of which factor?

mastery of language ambiguities

After a car accident, a 10-year-old child is treated in the emergency department for a fractured clavicle and evaluated for a possible head injury. What is the priority nursing measure?

orientation assessment

A parent says that their family will soon be traveling abroad and asks why the drinking water in many regions must be boiled. The nurse should explain that, in addition to various types of dysentery, contaminated drinking water is most commonly responsible for the transmission of which disease?

typhoid fever

A nurse is teaching the proper use of crutches to a school-age child with a femur fracture with no weight bearing. What will the nurse include with teaching about walking with crutches?

"After advancing both crutches the length of one step, move your 'good' leg forward."

The nurse admits an 8-year-old child who is unconscious secondary to ketoacidosis. During the admission history, which parental statement is most consistent with the diagnosis of insulin-dependent diabetes?

"They started to wet the bed at night for the first time in 3 years."

When making rounds, the nurse should assess which client first?

10-year-old child who has just been admitted in sickle cell crisis

The nurse observes as a child with Duchenne muscular dystrophy attempts to rise from a sitting position on the floor. After attaining a kneeling position, the child "walks" their hands up to their legs to stand. The nurse documents this as which sign?

Gower sign

The nurse asks a school-age child with Guillain-Barré syndrome to cough and also assesses the child's speech for decreased volume and clarity. The underlying rationale for these assessments is to determine which finding?

involvement of facial and cranial nerves

A school-age child is being discharged with a diagnosis of rheumatic fever. Which instructions should be included in the teaching plan for the family?

The child should stay on penicillin and return for a follow-up appointment.

The nurse discusses home care with the parent of a school-age child who has had a craniotomy for a brain tumor. Which statement made by the parent would warrant further exploration by the nurse?

"After this, I will never let them out of my sight again."

The nurse is caring for an 8-year-old girl with frequent urinary tract infections who is withdrawn and quiet. The nurse learns the child is left with a male caregiver while the mother is at work. The child states, "It hurts down there." What is the best response to the child?

"Are there other times you have hurt down there?"

Caregivers of a 9-year-old client in the terminal phase of a fatal illness ask the nurse for guidance in discussing death with the client. Which response is appropriate?

"At this developmental stage, most children have an adult concept of death and should be encouraged to discuss it."

A school-age child with a severe head injury is unconscious and has coarse breath sounds, a temperature of 39°C (102.2°F), a heart rate of 70 bpm, a blood pressure of 130/60 mm Hg, and an intracranial pressure (ICP) of 36 mm Hg. Which action should the nurse perform first?

Administer prescribed intravenous (IV) mannitol.

An 8-year-old child, immobilized with a hip spica cast, says to the nurse, "I am so bored! Do you have any video games I can play?" What is the best nursing action?

Give child access to the unit's portable video game console and age-appropriate games.

The nurse assesses a child with fever, sensitivity to light, and a red rash on the back. How will the nurse assess for Kernig's sign?

Have the child lie supine with flexed knees, then ask the child to extend the knees.

A school-age child is admitted to the hospital with the diagnosis of probable infratentorial brain tumor. During the child's admission to the pediatric unit, which action should the nurse anticipate taking first?

Prepare the child and parents for diagnostic procedures.

A nurse is caring for a 9-year-old child who is shy and fearful. The nurse asks the child a question, but the child does not answer immediately. What is the best approach by the nurse to develop a therapeutic relationship with the child?

Remain silent after asking a question.

A child is brought to the clinic by a grandparent who states that someone may have sexually abused the child. The grandparent noticed blood and a discharge on the child's underpants. After the child is assessed and treated for injuries, what is the priority intervention by the nurse?

Report the suspicion to the appropriate authorities.

An 11-year-old child is sent to the school nurse reporting difficulty reading the blackboard in the classroom. The nurse assesses that the child does not have difficulty reading a laptop screen or reading books. What is the best action by the nurse?

Request that the child be screened for myopia.

The nurse cares for a child receiving a blood transfusion. The child becomes flushed and is wheezing. What should the nurse do first?

Switch the transfusion to normal saline solution.

A 10-year-old client has arrived to sleepover summer camp. The child's parent states that the client has just been diagnosed with insulin-dependent diabetes mellitus but does not perform self-injections. The child is nervous, cries, and jerks away when the nurse initially attempts to give insulin. Which is the best nursing action?

Teach the child to self-administer the insulin injections.

A 10-year-old child is hospitalized for treatment of acute osteomyelitis. After assessing swelling and tenderness of the left tibia, the nurse initiates antibiotic therapy as prescribed. The child's left leg is immobilized in a splint. What is an appropriate goal at this time for this child?

The child will change position every 2 hours while awake.

During an admission history, the parents of a pediatric client explain that the family is Jewish and follows a kosher diet. Which food items would most likely be appropriate for the client?

chicken, a cup of fruit, and a glass of water

A parent is concerned about their 9-year-old child's compulsion for collecting things. The nurse's explanation is based on the understanding that this behavior is related to the cognitive ability to perform which functions?

concrete operations

The nurse is assisting a healthcare provider with suturing an arm laceration on a school-age client. What relaxation strategy will the nurse instruct the client to use during this painful procedure?

"Take a deep breath, and blow out until I say to stop."

Parents of a school-age child with asthma express concern about letting the child participate in sports. What will the nurse instruct the parents about the relationship between exercise and asthma?

"Taking prophylactic medication before the activity can prevent asthma attacks, making exercise safer."

Which statement by the parents of a child with asthma who are being taught the reasons for using a peak expiratory flow meter indicates the need for additional teaching?

"If there is no increase in flow after he gets his bronchodilator, we should give another treatment."

The nurse teaches a child's parent about sickle cell disease. Which statement by the parent would indicate the need for additional teaching?

"My child is going to be playing on a soccer team when they're feeling better."

A 6-year-old child with a history of varicella and aspirin intake is brought to the emergency department. The nurse suspects Reye's syndrome. Which assessment findings are consistent with this syndrome?

fever, decreased level of consciousness (LOC), and impaired liver function

A client with iron deficiency anemia was prescribed ferrous sulfate. Which statement by the caregiver would indicate a need for further instruction on proper administration?

"I mix the medication in milk to make it taste better."

The nurse teaches the family of a child with leukemia about preventing infections. How should the nurse explain to the parents why their child is at risk for infections?

"Immature white blood cells are incapable of handling an infectious process."

The parents of a 12-year-old girl ask why their child, who is not sexually active, should receive the human papillomavirus (HPV) vaccine. What should the nurse tell the parents?

"The vaccine is most effective against cervical cancer if given before becoming sexually active."

The nurse providing health promotion education to the parents of a 6-year-old child should include which statements about 6-year-old children in the education?

"They are very sensitive to criticism."

When teaching parents about fifth disease (erythema infectiosum) and its transmission, the nurse should provide which information?

Fifth disease is transmitted by respiratory secretions.

The parents of a 6-year-old child tell the nurse that they are concerned about the child's tonsils. On inspection, the nurse notes that the tonsils are large but not reddened or inflamed. How does the nurse interpret this finding?

a normal increase in lymphoid tissue

A parent states that a health care provider described their child as having 20/60 vision, and the parent asks the nurse what this means. The nurse responds based on the interpretation that the child is experiencing which condition?

ability to see at 20 feet what they should see at 60 feet

When teaching a parent of a school-age child about signs and symptoms of fever that require immediate notification of the physician, which description should the nurse include?

complaints of a stiff neck

A 10-year-old child is taking high doses of aspirin. Which finding indicates the child is experiencing early salicylate toxicity?

dizziness

The nurse is instructing the mother of a child with asthma about noting food triggers for asthma attacks. Which foods would most likely be responsible for causing an allergic reaction?

fish

A mother tells a nurse that her child has been exposed to roseola. After the nurse teaches the mother about the illness, which finding, if stated by the mother as the most characteristic sign of roseola, indicates successful teaching?

high fever followed by a drop and then a rash

The nurse is caring for a child with cystic fibrosis. What behavior exhibited by the parents of a child with a chronic illness may indicate feelings of guilt about the child's illness?

overindulgence

A nurse is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity is most appropriate for the nurse to schedule in the care plan?

reading books

A nurse is interviewing the parent of a 7-year-old child. Which symptom reported by the parent leads the nurse to suspect that the child has type 1 diabetes?

recent bed-wetting

A nurse is teaching parents how to reduce the spread of impetigo. The nurse should encourage parents to:

teach children the importance of proper hand washing.

The nurse teaches a family about the correct use of a Boston brace to treat scoliosis. The nurse determines teaching has been effective when the child and family state they will remove the brace at which times?

when bathing, for about 1 hour per day

A 6-year-old child is being discharged from the emergency department after being diagnosed with varicella (chickenpox). The nurse knows the parents need more medication teaching when they state they will give the child which over-the-counter medication?

aspirin

A nurse is teaching the parents of a 7-year-old child about the use of protective restraints in the car to help avoid spinal cord injuries in car accidents. The child weighs 20 kg (44 lb). Which of the following information should the nurse emphasize in the teaching?

using a booster seat

The nurse reviews the laboratory report of a 7-year-old child with leukemia (see exhibit). What does the nurse determine is the priority problem for this client?

risk for bleeding

A parent asks the nurse about their 9-year-old child's apparent need for between-meal snacks, especially after school. What information should the nurse include in the teaching plan?

should help with preparing their own snacks.

The nurse conducts the discharge teaching with a family of a child recovering from sickle cell crisis. Which condition does the nurse tell the family to report immediately to the health care provider?

sore throat and fever

A school-age child is admitted to the hospital with acute rheumatic fever. What intervention should the nurse teach the parents is necessary in the child's long-term care plan?

antibiotic therapy

An 8-year-old child is receiving moderate sedation for a medical procedure. The nurse is assessing the child's level of sedation. The child's gag reflex is intact. The child is breathing comfortably unassisted and opens eyes on verbal request. The nurse recognizes that the child is:

appropriately sedated.

A school-age child is admitted to the hospital with acute rheumatic fever with chorea-like movements. Which eating utensil should the nurse remove from the meal tray?

fork

After staying several hours with their 9-year-old child who is admitted to the hospital with an asthma attack, the parent leaves to attend to their other children. The child exhibits continued signs and symptoms of respiratory distress. Which finding should lead the nurse to believe the child is experiencing anxiety?

frequent requests for someone to stay in the room

A parent asks the nurse if the lesions around their child's mouth could be impetigo. What manifestations would verify the parent's suspicion?

honey-colored crusts, vesicles, and reddish maculae on the skin

According to Erikson's theory of development, chronic illness can interfere with which stage of development in an 11-year-old child?

industry versus inferiority

A 10-year-old child proudly tells the nurse that brushing and flossing their teeth is their responsibility. How does the nurse interpret the statement? The child:

is most likely capable of this responsibility.

A 7-year-old child is hospitalized with cystic fibrosis. To help the child manage secretions and avoid respiratory distress, the nurse should:

perform chest physiotherapy every 4 hours.

A 7-year-old child is admitted to the hospital with acute rheumatic fever. During the acute phase of the illness, which diversional activity would the nurse most discourage?

playing video games with a roommate

When teaching a caregiver of a school-age client about signs and symptoms accompanying fever that require immediate notification of the physician, which description should the nurse include?

reports of a stiff neck

Which action by the nursing assistant would require immediate intervention by the nurse?

restraining a school-age child at risk for self-harm because the nursing assistant had to leave the room

In a family with a 7-year-old child with a chronic illness, which family members feel jealousy, resentment, embarrassment, shame, fear of becoming ill, and guilt at causing the illness?

siblings

A 9-year-old child is placed on a liquid preparation of ferrous sulfate for the treatment of iron deficiency anemia. The nurse is teaching the parents about the side effects of ferrous sulfate. Which of the following statements is the most appropriate information for the nurse to convey to the parents?

"Have the child take the medicine through a straw."

A school-age child was recently hospitalized at a child psychiatric unit for inattention and acting out behavior at school and home. The health care provider (HCP) prescribed the methylphenidate patch to control their attention deficit hyperactivity disorder (ADHD) symptoms, and inpatient unit staff worked with them on behavioral control measures. During the first office visit after their discharge from the hospital, the office nurse discovers that the client has been taking off the patch during the day, which is causing problems at school and at home. In which order of priority from first to last should the nurse take the actions? All options must be used.

-Explore the child's reasons for removing the patch during the day rather than at the end of the day. -Explore the parents' attitudes about medication administration in general and their child's medication in particular. -Explain to the family, in terms the child can understand, the benefits of this medication in dealing with school and home problems they are experiencing. -Have the HCP discuss with the child and parents a trial of a different medication.

On a crisis shelter hotline, the nurse talks to two 11-year-old children who think a friend abuses inhalants. They say their friend's breath sometimes smells like glue and they act drunk. They say they are afraid to tell their parents about the friend. When the nurse is formulating a reply, what is the most important factor for the nurse to consider?

The callers probably fear punishment.

What test should the nurse review to best assess the effectiveness of treatment for a child with insulin-dependent diabetes?

glycosylated hemoglobin

The nurse takes a diet history from the parent of a 7-year-old child with phenylketonuria. A report of an intake of which food should cause the nurse to gather additional information?

diet cola

A 10-year-old child is admitted with a brain tumor. Which assessment made by the nurse is most critical to report to the child's health care provider (HCP)?

difficulty in recalling the day of the week