Pediatric CMS Reviewers.

Nurse is performing a yearly physical on an adolescent. The adolescent's parent asks about the adolescent's developmental needs. Which of the following statements by the parent should the nurse investigate further?

"He spends several hours a day on the internet."

Kawasaki disease?

Inflammation of blood vessels, hence the strawberry tongue causes coronary artery aneurysms. Sudden and recent deprivation of food. Protein.

The nurse is caring for a 15 year old client with myelogenous leukemia whose platelet count is 26,000/mcl. Which nursing interventions would be included in the plan of care? Select all that apply.

Instruct the client not to use razor for shaving. Assess the client for pain in the joints.

Diaper dermatitis treatment?

Keeping the area dry and applying Zinc Oxide and petrolatum.

Nurse is teaching the parents of a newborn who has congenital hypothyroidism about care of their child. Which of the following should the nurse recommend to the parents?

Life long administration of thyroid hormone.

A nurse is contributing to the plan of care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occulusive crisis. Which of the following interventions should the nurse include in the plan?

Maintain bed rest to prevent hypoxemia.

Bucks traction nursing interventions?

Maintain supine position. Assess peripheral pulses every 4 hours. Head Flat.

A pontoon the right side of the abdomen, about two-thirds of the distance between the umbilicus and the anterior bony prominence of the hip?

McBurney's point.

If a child has an allergic to neomycin with an anaphylactic reaction what vaccine should you withhold? Or an allergy to eggs or gelatin?

Measles, mumps, rubella. MMR.

A nurse is planning care for a 2 day old infant who has a myelomeningocele. Which of the following nursing measures should take highest priority in the immediate postoperative period?

Measure the head circumference every shift.

Allergic blood transfusion reactions?

Mild - Itching, hives, flushing. Administer Benadryl. Anaphylactic - Wheezing, dyspnea, chest tightness, cyanosis, hypotension. Maintain airway, admin. 02, IV fluids, antihistamines, corticosteroids, and vasopressors.

A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse recognize as appropriate in the care of this child?

Monitoring blood pressure every 4 hr.

A nurse is caring for a 3 year old child who has persistent otitis media. When taking the history of the child from her parent, which of the following would be the most appropriate for the nurse to ask regarding the child's recurrent otitis media?

"Does anyone smoke around, or in the same house as, the child?"

A nurse is caring for a child who has a diagnosis of iron deficiency anemia. Which of the following instructions would be appropriate for the nurse to give to the parents?

"Give the iron between meals with orange juice."

A 3 year old boy has arrived in the emergency department. The nurse documents the following assessment findings in the client's chart, knowing that they are consistent with which disease process?

Pneumonia.

Do not give in peaked T WAVE?

Potassium Chloride.

Treat severe inflammation, Anti-inflammatory.

Prednisone.

A nurse is caring for a child who is in Buck's traction. Which of the following should the nurse recognize as an appropriate intervention to prevent complications?

Provide small meals with high fiber.

Congenital malformation involving four distinct heart defects, place infant in knee chest position to bring blood back to hear and 100% O2 via face mask.

Tetralogy of Fallot.

A nurse is caring for a 5 year old child who is in the terminal stages of cancer. Which statements about the child's impending death are most likely to be true? Select all that apply.

The child does not fully understand the concept of death. The parents may be at different stages of grief in dealing with the child's impending death. The dying child may become clingy and act like a toddler. The death of a child may have long-term disruptive effects on the family.

A nurse is completing a screening tool on a 4 1/2 year old child. To be consistent with others at this age, what behaviors would the nurse expect the child to demonstrate? Select all that apply.

The child speaks clearly. The child copies a circle that is closed or very nearly closed. The child draws a person with at least three body parts. The child is able to follow one basic instruction through completion.

A nurse is caring for a preschooler who is 90-90 traction. Which of the following is the nurses priority action.

Cleanse and dress the pin sites.

Narrowing of the aorta, should expect to have high blood pressure and weak femoral pulses.

Coarction of the aorta (CoA)

The nurse is caring for a 4 year old recently diagnosed with acute lymphocytic leukemia (ALL). Which statement, made by the parents, indicates the effectiveness of teaching? Select all that apply.

"I am glad that there's a 95% chance of obtaining a first remission with treatment." "I understand that ALL affects all blood-forming organs and systems throughout the body." "I realize that the adverse effects of chemotherapy include sleepiness, loss of hair, and sores in the mouth."

A nurse is educating the parent of a 9 month old infant who has recently been diagnosed with cerebral palsy. Which of the following statements by the parent should indicate to the nurse that teaching has been effective?

"I am hopeful that the early schooling will increase my child's ability for self-care."

A nurse is conducting postoperative teaching for the parent of a 3 month old infant who is recovering from an umbilical hernia repair. Which of the following statements by the parent indicates an understanding of the teaching?

"I will keep my baby's diaper away from the incision."

Nurse is caring for a child who will be receiving PE tubes in the morning. The nurse is teaching the parents how to care for the tubes upon discharge. Which of the following statements should indicate to the nurse that the teaching was understood?

"I will keep water out of my child's ears."

Nurse is caring for a child who is undergoing a bone marrow aspiration. Which response by the child should indicate to the nurse that the teaching has been effective?

"I'll have to lie on my belly while it's done."

A nurse is caring for a child who is admitted with swollen, painful joints and is diagnosed with rheumatic fever. When educating the child's parent about rheumatic fever, which of the following statements by the nurse would be appropriate?

"It is preceded by a streptococcal infection."

The nurse is caring for an adolescent with the following skin disorder. Which client statement indicates a need for further teaching?

"My breakouts are exacerbated by eating fatty foods."

A 10 year old child visits the health care provider's office for an annual sports examination. When a nurse asks how he is doing, he becomes quiet and states that his grandmother died last week. Which statements by the child show that he understands the concept of death? Select all that apply.

"My grandmother is an angel watching over me." "I am mad that she is gone." "My grandmother's death has been hard to understand." "My grandmother died because she was sick and nothing could make her better."

Nurse receives the following laboratory values on a 2 month old child who has cyanotic heart disease. The results are a hemoglobin of 17 g/dL and a hematocrit of 51%. Which of the following statements by the nurse reflects the most appropriate interpretation of this information?

"The infant's body is compensating for tissue hypoxia by increasing RBC production."

The parent of a toddler asks the nurse why the toddler's abdomen protrudes. Which of the following statements would be an appropriate response by the nurse?

"The muscles of the abdomen are weak, and therefore, the abdomen protrudes."

Parent calls a primary care provider's office and says her child has a respiratory infection and a temperature of 39° C (102.2° F). The nurse instruct the parent to give the child 240 mg of acetaminophen (Tylenol). The label on the bottle reads 160 mg/5 mL. The nurse should instruct the parent to administer which of the following doses?

1 1/2 tsp

High serum lead level in children?

> 45 mcg/dL provide chelating agents, but in some cases > 10 mcg/dL, provide high calcium diet to help decrease lead absorption, yearly screenings

Charge nurse is assigning rooms for admissions. An 8 year old child who is admitted with sickle cell anemia and is dehydrated. Which of the following is an appropriate room assignment for this child?

10 year old male; postoperative appendectomy.

Normal pre albumin for child?

15-33 mg/dL.

Normal platelet for child?

150,000 - 400,000

A nurse, on the pediatric unit, received shift handoff on a 15 month old with the following needs. Using Maslow''s hierarchy framework, prioritize the following nursing care activities for the toddler. All options must be used.

1st. Clearing the airway of thick secretions. 2nd. Notifying the health care provider about suspected compartment syndrome. 3rd. Changing a soiled diaper. 4th. Administering antipyretics for an axillary temperature of 103°F (39.4°C). Progressing the diet after surgery.

A 4 year old postoperative child is found unresponsive. Place the following actions in the correct sequence to perform CPR after the child has been assessed for responsiveness and help has been called. All options must be used.

1st. Feel for the carotid pulse. 2nd. Perform 30 compressions. 3rd. Open the airway. 4th. Check for breathing. 5th. Provide 2 rescue breaths.

The nurse is preparing to insert an intravenous catheter into an acutely ill toddler. Place the following steps in the order the nurse would follow. All options must be used.

1st. Inform the parents of the procedure. 2nd. Wash hands and gather supplies. 3rd. Prepare the equipment. 4th. Inform the toddler of the procedure. 5th. Select and prep the appropriate site. 6th. Insert the intravenous catheter and secure it appropriately.

Nurse is caring for a child who has cellulitis and a rectal temperature of 102.2° F (39° C). The child has an order for acetaminophen (Tylenol) 280 mg by mouth. The label on the bottle reads 160 mg/5 mL. Which of the following is the correct dose the nurse should dispense to the child? Round it to the nearest hundredth.

8.8 mL

A child weighing 44 lb (20 kg) is to receive 45 mg/kg/day of penicillin V potassium oral suspension in four divided doses for every 6 hours. The suspension that is available is penicillin V potassium 125 mg/5 ml. How many milliliters would the nurse administer for each dose? Record your answer using a whole number.

9 ml.

While assessing a child experiencing respiratory distress, the nurse notes subcostal retractions. Which graphic highlights in blue the area where subcostal retractions are seen?

2.

A nurse is caring for an infant who weighs 8 kg and is ordered to receive ampicillin 25 mg/kg intravenously every 6 hours. How many milligrams would a nurse administer per dose? Record the answer as a whole number.

200 mg/dose.

Needle size for 4 year old Childs immunizations?

22-25 gauge needle to minimize pain.

A 4½-year-old is ordered to receive 25 ml/hour of intravenous solution. The nurse is using a pediatric microdrip chamber 60 gtts/min to administer the medication. For how many drops per minute would the microdrip chamber be set? Record your answer using a whole number.

25 drops/minute.

Normal HCT for a child?

32-44%.

Normal urine output for an adolescent?

33 to 62.5 mL/hr.

Child milestones?

4 year old: Cuts outline shape using scissors. 5 year old: Draws stick figure with seven body parts. 6 year old: Spread butter with utensils and identifies right from left hand.

A nurse is preparing a dose of amoxicillin for a 3-year-old with acute otitis media. The child weighs 33 lb (15 kg). The dosage prescribed is 50 mg/kg/day in divided doses for every 8 hours. The concentration of the drug is 250 mg/5 ml. How many milliliters would the nurse administer? Record your answer using a whole number.

5 mL.

Normal WBC for child?

5,000 - 10,000 mm3.

A child is brought to the emergency department severely dehydrated after having gastroenteritis for 4 days. The health care provider orders an intravenous infusion to maintain fluid replacement for this child. If the child weighs 18 kg, what is the hourly flow rate in milliliters? Use the standard, 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg of body weight, and 20 ml/kg/day for each kilogram above 20 kg of body weight for daily maintenance.

58 ml.

A nurse is collecting data from a child who has type 1 diabetes mellitus and has slurred speech, is diaphoretic, and has glucose reading of 45 mg/dl. Which of the following should the nurse administer?

6 oz regular soft drink.

A 3 year old is to receive 500 ml of dextrose 5% in normal saline solution D5NSS over 8 hours. At what rate in milliliters per hour would a nurse set the infusion pump? Round your answer to a whole number.

63 ml/hour.

When should a baby begin to make babble noises?

7 months.

A physician orders an intravenous infusion of dextrose 5% in quarter-normal saline solution D5 0.25 NSS to be infused at 7 ml/kg/hour for a 10 month old infant. The infant weighs 22 lb 10 kg. How many milliliters of the ordered solution would the nurse infuse each hour? Record your answer using a whole number.

70 ml/hour.

Normal Hgb for child?

9.5-14 g/dL.

Nurse is admitting a toddler brought to the hospital for circumferential burns. The history given and burn markings do not correlate, therefore, child abuse is suspected. Which of the following should the nurse consider the most important to include in the documentation?

A description of the burns.

A nurse in the well child clinic is collecting data from four clients. Which of the following findings should the nurse report to the provider as a potential indication of child maltreatment.

A four year old child who has a history of frequent urinary tract infections.

A nurse is caring for a 10 year old child who is obese. Which of the following menu choices is the most appropriate for this child?

A glass of skim milk, baked fish sandwich on whole wheat roll with lettuce, and a medium apple.

A nurse is reviewing the medical records of a group of clients. Which of the following findings should the nurse report to the local authorities.

A six month old infant who has a spiral fracture to a lower extremity.

A nurse is caring for an adolescent client who has a fractured right tibia and the cast. Which of the following findings should the nurse report to the provider?

Coolness of the toes.

A nurse is preparing to administer the measles mumps and rubella vaccine to an adolescent. Which of the following should the nurse identify as contraindication to administer the vaccine?

Current pregnancy.

What is an indication of bacterial meningitis?

Increase protein concentration. Increased WBC. Decreased glucose level. Increased cerebrospinal fluid pressure.

Bronchodilator, improves Childs breathing?

Albuterol.

Indication of early septic shock?

Increased heart rate. Normal BP. Fever and chills. Normal urinary output.

A nurse is caring for a child who is receiving chemotherapy with anorexia and nausea. Which of the following interventions should the nurse recognize as the most appropriate for the child experiencing these symptoms?

Allow the client to eat whatever the client wants, at any time.

What should you expect with a child following a perforated appendix repair?

Absence of peristalsis.

Nurse is caring for a child who has been brought to the emergency room after ingesting a bottle of acetaminophen (Tylenol). Which of the following medications should the nurse anticipate administering?

Acetylcysteine (Mucomyst)

Inflamed throat with exudate, strep throat?

Acute Streptococcal Pharyngitis.

A nurse is contributing to the plan of care for a school age child who is being admitted for diabetic ketoacidosis. Which of the following intervention should the nurse recommend?

Administer subcutaneous insulin 30 minutes before meals.

Severe reaction occurring immediately after exposure to a drug; characterized by respiratory distress and vascular collapse?

Anaphylactic reaction.

A nurse is reinforcing teaching about injury prevention with a group of parents who have adolescent children. Which of the following statements by the parent indicates an understanding of the teaching.

Antibiotics will be needed prior to dental work.

Inflammation of the vermiform appendix, treat with morphine?

Appendicitis.

Nurse is caring for a child who has epistaxis. Which of the following actions would be the most appropriate for the nurse to take?

Apply a cold cloth to bridge of nose.

A 7 year old child is admitted to the hospital for a course of intravenous antibiotics. What actions would the nurse take before inserting the peripheral intravenous catheter? Select all that apply.

Apply a topical anesthetic to the I.V. site before the procedure. Ask the child which hand he/she uses for drawing. Tell the child that they can cry but they must hold still during the procedure.

What to do following a lumbar puncture?

Apply topical analgesics 1 hr before. Place client in prone or flat position for up to 12 hours after. Encourage to drink extra fluids.

Nursing interventions for a child scheduled for a wound debridement?

Apply topical ointment following hydrotherapy. Apply gauze after therapy. Administer an analgesic beforehand. And, AVOID prophylactic antibiotic therapy.

Nurse is assessing an adolescent who sustained a broken tibia while playing football. Following the application of a fiberglass cast, the client complains of pain and a tingling feeling in the limb. Which of the following is the most appropriate action for the nurse to take?

Assess for signs of circulatory impairment and swelling.

Nurse is caring for a 10 year old child who is postoperative abdominal surgery and was medicated 6 hr ago. When assessing the child, the nurse finds the child quiet and not interacting with family. Which of the following is an appropriate nursing action?

Assess the child's need for pain medication.

A nurse at an urgent care clinic is caring for a child who hit her head on the playground at school 30 minutes ago. Which of the following findings is the nurses priority?

Asymmetric pupil's.

A type of cerebral palsy that is characterized by poor balance and equilibrium in addition to uncoordinated voluntary movement. But can still walk with a slow gait?

Ataxic Cerebral Palsy.

Osteomyelitis Nursing Interventions?

Avoided bearing weight, antibiotics for several weeks.

A nurse is reviewing the laboratory report of a preschooler during a well child visit. Which of the following laboratory results should the nurse report to the provider?

Calcium 9mg/dL. Sodium 140 mEq/L. Iron 100 mcg/dL. Hemoglobin 8 g/dL.

Childs vital signs?

BP: S:86-118, D:44-74 HR: 80-120 RR:20-25/min

Hemolytic transfusion reaction?

Back pain is an adverse reaction. Hypotension. Tachycardia.

Pinkeye; very contagious, purulent eye drainage?

Bacterial conjunctivitis.

A nurse is caring for a 6 month old infant who has colic and vomiting who will be undergoing testing to rule out intussusception. Which of the following would be the appropriate treatment for intussusception?

Barium enema.

A nurse is caring for an 8 year old postoperative tonsillectomy client. When performing a postoperative assessment, which signs and symptoms of bleeding would be monitored for by the nurse? Select all that apply.

Blood red vomitus. Frequent swallowing. Frequent clearing of the throat.

Nurse is admitting a child who has a possible diagnosis of leukemia. Which of the following tests is the most appropriate for the nurse to consider when confirming a diagnosis of leukemia?

Bone marrow aspiration.

Varicella?

Chickenpox, airborne, keep room cool, avoid aspirin.

Febrile blood transfusion reaction?

Chills. Fever. Headache. Flushing. Tachycardia. Anxiety.

Administer pancreatic enzyme within 30 minutes eating, may need to increase dosage by provider until steatorrhea resolves, encourage fluids, increase fat content to 35-40% of total caloric intake?

Cystic fibrosis nutrition.

A school nurse is caring for a child who has asthma and begins to have difficulty breathing. Which of the following actions should the nurse take?

Encourage the use of flutter mucus clearance device.

A nurse is caring for a child who has urinary tract infection. Which of the following findings should the nurse expect?

Deep cold colored urine. Osmolaity 700 mOsm/L. Specific gravity 1.015. Positive leukocyte esterase.

Kussmaul respirations?

Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body. In keto acidosis.

A nurse is reinforcing teaching about sibling adaption with the parent of a child who has cystic fibrosis. Which of the following instructions to the nurse include in the teaching?

Designate one parent to stay at home with the sibling.

Antidiuretic hormone is not secreted adequately, or the kidney is resistant to its effect. Normal blood glucose, extremely thirsty & dehydrated. Expect higher sodium due to excessive loss of free water.

Diabetes insipidus.

A nurse is collecting data from a school age child who has hypothyroidism. Which of the following findings should the nurse expect?

Diarrhea. Hirsutism. Lethargy. Tachycardia.

Cardiac glycoside, brush teeth after to avoid teeth decay from sweetened liquid, vomiting is a sign of toxicity?

Digoxin.

A nurse is assisting with the care of a preschooler who is postoperative following tetralogy of fellow correction. Which of the following manifestation indicates the child is possibly experience decreased cardiac output and?

Diminished pulses.

Benadryl, decreases allergic reaction?

Diphenhydramine.

A nurse at the immunization clinic is preparing to administer injections to a 5 year old child. Which of the following is the appropriate injection for the nurse to administer?

Diphtheria.

Cerebral palsy that involves continuous involuntary movements associated with hyperbilirubinemia and damage to basal nuclei ganglion; manifestations include drooling and uncontrollable movements of the face and extremities?

Dyskinetic non spastic Cerebral Palsy.

A nurse is caring for a 6 year old child who is receiving chemotherapy. The child has a platelet count of 20,000/mm3. Which of the following should the nurse recognize as the appropriate intervention for a child with this platelet count?

Encourage quiet play.

Nurse is caring for a toddler who has asthma. The parents are concerned about the toddler's reaction to the hospitalization. Which of the following nursing actions should the nurse perform to decrease the stress experienced by the toddler?

Encourage rooming-in.

Given to help breathing during an anaphylactic reaction?

Epinephrine medication.

Treat anaphylaxis?

Epinephrine.

10 month old infant has been hospitalized four times for a total of 42 days. The nurse notices that the infant does not seem upset when the parents leave. Which of the following should the nurse recognize as an appropriate explanation for this behavior?

Experiencing detachment.

A nurse is caring for a 3 year old child who is scheduled for a nephrectomy. When preparing preoperatively, which of the following actions should the nurse recognize as appropriate?

Explain the procedure to the child in simple sentences just before administering the preoperative sedation.

A nurse is caring for a child who has cerebral palsy who is scheduled for orthopedic surgery. Which of the following strategies should the nurse plan to include in the initial plan of care?

Facilitate communication with the child by their usual means.

Tinea pedis?

Fungal infection of the foot. Athlete's foot. Wear sandals as much as possible to allow air to circulate?

Where should O2 be placed for child?

Great toe. Check for pulse frequently and cover with sock.

Nurse is caring for a 7 year old child diagnosed with glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 mm Hg. The child is receiving hydralazine Apresoline. Which of the following lunch choices should the nurse recognize as most appropriate?

Grilled chicken on a roll, pear slices, and 4 oz of apple juice.

A nurse is reinforcing teaching with the parent of a school age child who has a new prescription for albuterol. The nurse should instruct the parents to report which of the following findings as an adverse effect of the medication?

Headache.

Meningitis manifestations?

Headaches. Nuchal rigidity. Positive kerning's sign.

Nurse is caring for a child who has tetralogy of Fallot preoperatively. Which of following laboratory values should the nurse expect to find?

Hematocrit of 58%.

A nurse is caring for a child who has acute glomerulonephritis. Which of the following manifestations should the nurse expect?

Hypokalemia. Dehydration. Hypertension. Muehrcke lines on the nails.

State of deficient pituitary gland activity, stunts growth, use recombinant growth hormone medication?

Hypopituitarism.

A nurse is reinforcing teaching with the pain of a six month old infant about introducing solid foods into the infants diet. Which of the following statements by the parent understanding of the teaching?

I should introduce a new solid food to my baby every 5 to 7 days.

Nurse is caring for a child who has cystic fibrosis. Which of the following assessments should the nurse recognize as a priority to report to the primary care provider?

Inability to clear secretions.

A school nurse is assisting a child who has been stung by a bee. The child's hand is swelling and the nurse notes that the child has allergies to insect stings. Which of the following manifestations should the nurse recognize with anaphylaxis? Select all that apply.

Nausea. A common gastrointestinal response to excessive histamine release is nausea. Urticaria. A common skin manifestation of excessive histamine release is hives URTICARIA. Stridor. A serious, life threatening response to excessive histamine release is airway narrowing, which presents as dyspnea and stridor.

Nursing interventions for a child with an epidural hematoma?

Neuro checks q 15 mins. Avoid suctioning nares. Implement seizure activity. Position infant midline slightly elevated.

Celiac disease?

No barley, wheat, oat, rye. Substitute with soy, rice and corn.

Burns treatment?

No prophylactic antibiotic therapy. Cleanse area with mild soap and water. Apply antimicrobial ointment, for major burn management. Maintain decompression of stomach via NG tube.

Stiffness in cervical neck area?

Nuchal rigidity.

A nurse is providing education to a parent whose child has had a colostomy. Which of the following is an appropriate method to determine understanding of the teaching?

Observe the parents while they perform the procedure.

Who can sing consent?

Over 18 year old. Parent of a minor. Or, if under 18 and married can sign themselves.

A nurse is admitting a child who has an exacerbation of cystic fibrosis. The nurse should expect to find which of the following assessments?

Oxygen saturation of 85%

Used for hip dysplasia in infants. Remove only to take baths, place diapers under the harness straps, do not use products because can cause skin irritation, and do not adjust straps.

Pavlik harness.

A nurse is caring for a child who is a vegetarian and has sustained superficial partial-thickness burns on her legs. Which of the following diet choices would be appropriate for this child?

Peanut butter and jelly sandwich.

How to test for a sickle turbidity test?

Perform a finger stick. If test is positive hemoglobin electrophoresis is required to distinguish b/w children who have the genetic trait and children who have the disease.

Nurse is caring for a child who has superficial partial thickness burns over 50% of his body. In planning for the nutritional needs of the child, which of the following should to nurse recognize as an appropriate intervention?

Perform dressing changes at least 1 hr before or after meals.

Swelling in the limbs, particularly the feet and ankles, due to an accumulation of interstitial fluid. Palpate the dorsal of the child's feet for 5 seconds.

Peripheral edema.

Involuntary waves of muscle involves contractions of the smooth muscle that push the food toward the stomach.

Peristalsis.

Inflammation of the peritoneum: membrane lining the abdominal cavity and surrounding the organs within it. Abdominal distention, chills, irritability, restlessness.

Peritonitis.

Whooping cough; highly contagious bacterial infection of the pharynx, larynx, and trachea caused by Bordetella pertussis?

Pertussis.

A nurse is assisting with the care of an infant who has heart failure. Which of the following action should the nurse take?

Place the infant in a supine position during naps.

A nurse is assisting with the care of a school age child who recently returned to the PACU following pin placement for a Radial head fracture with casting. Which of the following findings should the nurse monitor for when conducting a circulatory check for compartment syndrome.

Pulselessness.

A nurse is providing education on poisoning prevention to a group of parents of toddlers. Which of the following would be an appropriate statement by the nurse?

Put all cleaning supplies in a locked cabinet.

A type of cerebral palsy in which the person has very tight muscles occurring in one or more muscle groups, resulting in stiff, uncoordinated movements. Ankle clonus, exaggerated stretch reflex, contractures?

Pyramidal. Spastic Cerebral Palsy.

Highly contagious infection caused by a member of the paramyxovirus family, kopek spots on buccal mucosa?

Rubella. (Measles)

Nurse is preparing a 7 year old child for a tonsillectomy. Which of the following nursing actions would be appropriate in this preparation?

Schedule the child for a preoperative visit to the hospital.

Should expect to see a unilateral rib hump with hip flexion.

Scoliosis.

Nursing interventions for tunneled central venous access device?

Semipermeable transparent dressing. Use a noncoding angles or straight needle when accessing. Flush with heparin solution daily when not in use. Avoid use of scissors.

Marasmus?

Severe lack of food over a long period of time, resulting from inadequate energy and protein.

A nurse on the pediatric unit is caring for four clients who all have assessments ordered in the morning. Which of the following values should the nurse report to a client's primary care provider immediately?

Sickle cell anemia and a urine specific gravity of 1.030.

Dehydration manifestations?

Skin breakdown. Hypotension. Hyperpyrexia. Tachypnea.

Antidote for hyperkalemia?

Sodium polystyrene sulfonate. Kayexalate.

School nurse is assessing a child who returned to school following a case of mononucleosis. The child has a note from his primary care provider excusing him from gym class. Which of the following should the nurse recognize as the most appropriate reason for this excuse?

Sustaining abdominal trauma.

Caused by the overproduction of the antidiuretic hormone ADH, may have mental confusion and neurological manifestations when severe, over hydration?

Syndrome of Inappropriate Antidiuretic Hormone (SIADH).

What can a child experience with a low HCT?

Tachycardia. Lightheadedness. Fatigue. Dyspnea. Pallor.

Nurse is providing diabetic teaching to a 12 year old child who appears apprehensive during the teaching. Which of the following actions should the nurse recognize as appropriate in this situation?

Teach the child to do her own finger-sticks.

A nurse is caring for a child who has frequent urinary tract infections. When educating the parent on the prevention of urinary tract infections, which of the following instructions should the nurse include in the teaching?

Teach the child to wipe her perineum from front to back after urinating.

Intussusception?

Telescoping of a segment of the intestine within itself, lethargy and vomiting are expected due to episodes of severe pain and obstruction.

A nurse is planning care for a child who is autistic. Which of the following goals is of primary importance in the care of this child?

To be protected from self-injury.

A nurse is caring for four children who have congenital heart disease. Based on the pathophysiology of the disorders, which of the following should the nurse recognize would present with cyanosis?

Transposition of great vessels.

Nursing interventions for a child in a tonic clonic seizure?

Turn to side. No food or drink. Nothing by mouth.

Nurse is caring for a child who has a vesicular rash. The parent asks the nurse what illness can cause the rash. Which of the following is the most appropriate response for the nurse to give?

Varicella.

Nurse is preparing to administer an injection to a 2 month old infant. Which of the following is an appropriate site for the nurse to give the injection

Vastus lateralis.

Nurse should expect to hear a loud harsh murmur due to the left to right shunting of blood?

Ventricular septal defect.

Signs of digoxin toxicity?

Vomiting.

A nurse is contributing to the care plan of an 18 month old child who has pneumonia. Which of the following items should the nurse select for the child's play activities?

Wooden building blocks.

A nurse is reinforcing teaching with the guardian of a school age child who has enuresis. Which of the following statements should the nurse make?

You should limit the amount of fluid your child drinks within two hours before bedtime.

Opisthotonos position?

backward bending, assumed with nervous system complications.

A school nurse is gathering registration data for a child entering first grade. Which immunizations would the school nurse verify that the child has had? Select all that apply.

Varicella vaccine. H. Influenza type b series. Diphtheria-tetanus-pertussis series.

An 11 year old girl comes into the health care provider's office stating dysuria. The nurse suspects a urinary tract infection. Which finding on the laboratory report is consistent with a urinary tract infection?

WBCs: 20 per high-power field.

A parent phones the health care provider's office stating that his 13 month old has had diarrhea for 3 days and he is unsure what fluids to offer. Which suggestions would the nurse provide? Select all that apply.

Water. Pedialyte.

A child with sickle cell anemia is being treated for sickle cell crisis. The physician orders morphine sulfate 2 mg intravenously. The concentration of the vial is 10 mg/1 ml of solution. How many milliliters of solution would the nurse administer? Record your answer using one decimal place.

0.2 ml.

A nurse is preparing to administer intravenous methylprednisolone sodium succinate to a child who weighs 44 lb. The order is for 0.03 mg/kg intravenously daily. How many milligrams would the nurse prepare? Record your answer using one decimal place.

0.6 mg.

A 6 year old who reports fever, malaise, and anorexia is diagnosed with varicella (chickenpox). The nurse explains to the parents how skin lesions will develop. Place the following descriptions in the order that they will occur as the disease progresses. All options must be used.

1st. Itchy red macules on the face, scalp, and trunk progress to papule. 2nd. Papule develop into clear vesicles on an erythematous base. 3rd. Vesicles become cloudy and break easily. 4th. Scabs form. 5th. As initial lesions progress through stages, new lesions form on the trunk and extremities.

A nurse is preparing to check the capillary blood glucose level of a school age child. Which of the following action should the nurse plan to take?

Allow the skin antiseptic to dry prior to puncturing the child's finger.

A nurse is caring for an adolescent who was admitted to the hospital's medical unit after attempting suicide by ingesting acetaminophen. Which interventions would the nurse incorporate into the client's care plan? Select all that apply.

Ask the client's parents if they keep firearms in their home. Inventory all personal items upon arrival to the unit. Inspect the client's mouth after giving oral medications. Ask the client if he/she is currently having suicidal thoughts. Assist the client with bathing and grooming as needed.

A 10-year-old child is admitted to the hospital with a temperature of 104°F (40°C) and is difficult to arouse. The child has a history of varicella 2 weeks ago. Reye's syndrome is suspected. Which objective data are supportive of the diagnosis? Select all that apply.

Coma. Disorientation. An abnormal liver biopsy. Vomiting.

A 15 month old has just received routine immunizations, including DTaP, IPV, and MMR. What information would the nurse give to the parents before they leave the office? Select all that apply.

Discomfort at the immunization site and mild fever are common. Minor symptoms can be treated with acetaminophen. Call the office if the toddler develops a fever above 103°F (39.4°C), seizures, or difficulty breathing.

A nurse is reinforcing teaching with a group of adolescence about safety. Which of the following information should the nurse include in the teaching?

Driving skills can be impaired when friends are present.

A nurse is preparing a child who has suspected bacterial meningitis for a lumbar puncture. Which of the following cerebrospinal fluid finding supports the diagnosis?

Elevated total protein.

Which nursing interventions are important when caring for a hospitalized toddler? Select all that apply.

Encourage use of a security object from home. Maintain the toddler's routine when able. Allow client autonomy by offering select choices. Instruct parent that regression commonly occurs.

A nurse is caring for a child who is brought to the urgent care clinic following exposure to poison ivy one hour ago. Which of the following actions should the nurse take first?

Flash the area with cold running water.

A nurse is reviewing the laboratory results of an adolescent who has diabetes myelitis. Which of the following values should the nurse notify the provider?

Glucose 120 MG/DL.

The nurse is examining an adolescent boy. The nurse classifies his sexual maturity as Tanner stage 3. Which graphic depicts this stage?

Hair growth on the pubic area.

A nurse is reviewing the medical record of an adolescent who has bulimia nervosa. Which of the following information should the nurse report to the provider immediately?

HbAt 10.7%.

A nurse is caring for child who has dehydration. Which of the following findings should the nurse expect?

Hct 45%. Urine Output 35 mL/hr. Capillary refill less than two seconds. Urine specific gravity 1.035.

A healthy 2 month old infant is being seen in the local clinic for a well child checkup and initial immunizations. When analyzing the pediatric record, which immunizations would the nurse anticipate administering at this appointment? Select all that apply.

Hib: Haemophilus influenza vaccine. DTaP: Diphtheria, tetanus, and acellular pertussis. PCV: Pneumococcal vaccine. IPV: Inactivated polio vaccine.

A nurse is assessing a 10 month old infant during a checkup. Which developmental milestones would the nurse expect the infant to display? Select all that apply.

Holding the head erect. Sitting on a firm surface without support. Bearing the majority of weight on legs.

A nurse is reinforcing teaching with a guardian of a preschooler who has varicella and is hospitalized. Which of the following statements by the guardian indicates an understanding of the teaching?

I will wait to bathe for my child once the crust have fallen off the lesions.

An adolescent scored a 20 on the Depression Scale for Children indicating moderate depression. Citalopram 20 mg daily is prescribed. Which nursing instructions are essential? Select all that apply.

Improvement in mood may take up to one month. Discard any MAO inhibitor medications in home. Have the parent be involved in medication management. Monitor the adolescent for signs of self-harm.

A nurse is caring for an adolescent client who is scheduled for surgery. Which of the following actions should the nurse take to prepare the child based on the developmental stage?

Keep equipment out of the clean side. Avoid involving the client in a decision regarding treatment. Emphasize that the procedure is not a punishment. Discuss how the procedure might affect the clients appearance.

A 17 year old client confides in the school nurse that he/she is interested in understanding safe sex practices. In instructing the client on how to correctly use a condom, which information would be stressed? Select all that apply.

Leave a 1/2 inch space at the end of the condom. The condom would be applied on an erect penis. Condoms should be stored in a cool, dry place to prevent damage. Never reuse a condom.

A nurse is reinforcing teaching with a female adolescent who has dysmenorrhea. Which of the following instructions should the nurse include?

Massage the lower back area.

A nurse is teaching a 16 year old female client with inflammatory bowel disease about corticosteroid treatment. Which adverse effects are likely to be concerns for this client? Select all that apply.

Mood swings. Adrenal suppression. Hirsutism. Osteoporosis. Acne.

A nurse in the clinic is speaking with a parent of a one year old toddler who received her schedule immunization one hour ago. Which of the following findings reported by the parent is the nurses priority?

My child cries when I touch the area where she received the shot.

The emergency room nurse documents the following in the note. When completing the documentation, which information would be included? Select all that apply.

Objective findings from a thorough head to toe assessment. Diagram of site of injuries. Description, including color and measurement, of injuries.

A nurse is caring for a 34 month old who is hospitalized for a lengthy illness. Which behaviors would the nurse identify as examples of expected developmental regression for the child's age group? Select all that apply.

One to two word expressions. Encopresis. Enuresis.

The nurse is caring for an 11 year old client experiencing status epilepticus. When providing and delegating immediate nursing care, which nursing actions would be completed? Select all the apply.

Pad side rails with cushions/pillows. Administer oxygen via nasal cannula. Instruct the nursing assistant to obtain the crash cart.

A nurse is caring for a preschooler who is terminally ill. Which of the following reactions to that show the nurse expect?

Perceives death as punishment.

The nurse is caring for a 17 year old male client with Duchenne muscular dystrophy. When assisting the client during a hospitalization for pneumonia, which anticipated nursing interventions would reflect client specific care? Select all that apply.

Providing directions to the client's educational level. Clearing a path to the bathroom for safe and easy access. Assisting the client to a Fowler position for a breathing treatment.

A child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises would the nurse provide to the child and family? Select all that apply.

Report a sore throat to an adult immediately. Drink plenty of fluids. Wash hands before meals and after playing.

A 2 year old is being treated for pneumonia. After reviewing the respiratory section of the client care flow sheet shown below, the nurse concludes that which position is most beneficial to maximize oxygenation?

Right-side lying.

A nurse is reinforcing teaching with a parent of a child who has attention deficient hyperactivity disorder (ADHD). Which of the following statements should the nurse include in the teaching to promote this child's learning.

Schedule a different routine for your child's each day.

A nurse is conducting an infant nutrition class for parents. Which foods would the nurse tell parents that they may introduce during the first year of life? Select all that apply.

Strained vegetables. Oatmeal cereal. Pureed fruits.

The nurse is instructing a parent of a school age client on nutrition. The client is currently receiving vincristine for treatment of acute lymphocytic leukemia. Which instruction is included in the plan of care? Select all that apply.

Suggest nutrient dense supplements if appetite is poor. Have the client select between three acceptable food options. Offer nutrient dense snacks between meals and at bedtime.

A nurse is caring for a 17 year old female client with cystic fibrosis who has been admitted to the hospital for administration of intravenous antibiotics and respiratory treatment for exacerbation of a lung infection. The client states, "I have a number of questions about my future and the consequences of this disease." Which statements about the course of cystic fibrosis are true? Select all that apply.

The client is at risk for developing diabetes. Breast development is commonly delayed. Normal sexual relationships can be expected.

The nurse is caring for an infant who exhibits the following characteristics (Down syndrome toddler that on image). When planning care, which would be the best long term client goal?

The client will reach his/her optimal level of functioning.

The nurse is caring for the following infant after surgery. Which short-term goal is the priority?

The infant will remain infection free in the postoperative period.

The nurse is assessing the primitive reflexes of a 1 month old infant. Of the reflexes shown in the photos, which one would the nurse expect to remain the longest?

Tickling the plantar foot of the infant that on the image.

A nurse is caring for a school age child who has an acute otitis media and a new prescription for clindamycin. Which of the following findings indicate the child is experiencing an allergic reaction to the medication?

Urticaria.

A nurse is reinforcing teaching about controlling allergens that's with a parent of a child who has a new diagnosis of asthma. Which of the following instruction should the nurse include?

Use humidifier in your child's bedroom.

A nurse is reinforcing teaching with a parent of a child who has sprained wrist. Which of the following intervention should the nurse instruct the parent to implement during the firs 24 hours minimize swelling?

Wrapped extremity loosely wit an elastic bandage.

A 5 year old is admitted to the pediatric unit with diagnosis of possible intussusception. Which assessment data supports this diagnosis? Select all that apply.

Abdominal pain. Abdominal distention. Currant jelly stools.

A nurse is assisting with the care of a school age child who has shigella. Which of the following action should the nurse take?

Administer antiviral medication.

A nurse is caring for an 18 month old infant who is 12hr postoperative following a myringotomy. Which of the following pain rating scales should the nurse use?

FLACC Scale.

A nurse is assisting with the plan of care for an adolescent who has rheumatoid arthritis and reports difficulty feeding themselves. Which of the following referrals should the nurse recommend?

Occupational therapy.

A nurse is planning to collect a stool specimen from an infant to check for the presence of ova and parasites. Which of the following actions should the nurse plan to take?

Place a urine collection device on the infant until the specimen is obtained.

A nurse is assisting with a collection of a bone marrow specimen from a preschooler. Which of the following action should the nurse take?

Place the child and proposition to expose the posterior Illlac crest.

A nurse is preparing to administer nasal gastric tube feedings to a 2 month old infant which of the following actions should the nurse plan to take?

Position the infant in a supine position during feedings.

A nurse is reviewing the medical record of a school age child who has admitted for suspected physical maltreatment. Which of the following findings in the child's medical history should the nurse identify as potential risk factor for physical maltreatment?

Prematurity.

The pediatric cardiac nurse is assessing the heart sounds of a 3 year old child with a mitral valve regurgitation. Which graphic shows the area where the nurse would assess the site of the insufficiency?

b) 1

A nurse is reinforcing teaching with the parents of a 10 week old infant who is scheduled for surgical repair of a cleft lip. Which of the following information should the nurse include?

Your baby will be placed in elbow restraints following surgery.

The school nurse is assessing the chest of a first-grade child and notes a pectus excavatum. Which graphic depicts this abnormality?

a) 1

A nurse is caring for a 4 year old child who developed acute renal failure after a traumatic injury with hemorrhaging. Place the following events in the order in which they most likely occurred during progression of the severe renal deterioration. All options must be used.

1st. Oliguria. 2nd. Azotemia. 3rd. Acidosis. 4th. Severe hypocalcemia.

A parent is planning to enroll a 9 month old infant in a day care facility. The parent asks a nurse what to look for as indicators that the facility is adhering to good infection control measures. The nurse identifies which as an indication of meeting proper infection control standards? Select all that apply.

Soiled diapers are discarded in covered receptacles. Facilities for hand hygiene are located in every classroom. Disposable papers are used on the diaper changing surfaces.

A nurse is reinforcing teaching with the parent of a child who has otitis media and a new prescription for amoxicillin oral suspension. Which of the following information should the nurse include?

This medication can cause loose stools.

A nurse is contributing to the plan of care for a school age child who has Crohn's disease. Which of the following food choices should the nurse include in the plan?

Plain Yogurt.

A nurse is reinforcing teaching with a parent of a child who has otitis media and the new prescription for amoxicillin oral suspension. Which of the following information should the nurse include?

This medication can cause loose stools.

A nurse is reviewing the laboratory report of a newly admitted school age child who has a fever. The nurse should identify the which of the following laboratory results is an infection and should be reported to the charge nurse immediately?

WBC 17,500/MM3.

A nurse in a family practice clinic is collecting data from a school age child. Which of the following behavioral findings should the nurse identify as a possible indicator of sexual abuse?

Withdraw.

A nurse is caring for a group of toddlers in a large urban hospital. When considering providing care, which clients require contact precautions? Select all that apply.

A toddler with a multi drug-resistant organism. A toddler with scabies.

A nurse is reinforcing teaching with a guardian of a one year old infant about it ministering a liquid oral medication. Which of the following statements should the nurse make?

You should add the medication to your child's formula prior to feeding.

A nurse is reinforcing teaching about injury prevention with a group of parents who have the adolescent children. Which of the following statements by a parent indicates understanding of the teaching?

My child will drive more safely if they have a few friends in the car.

A nurse is teaching the parents of a 6 month old infant about normal growth and development. Which statements regarding infant development are true? Select all that apply.

A 6 month old infant can usually roll from prone to supine and supine to prone positions. A teething ring is appropriate for a 6 month old infant. Lack of visual coordination usually removes by age 6 months.

A mother brings her child to the health care provider's office for evaluation of chronic stomach pain. The mother states that the pain seems to go away when she keeps the child home from school. The health care provider diagnoses school phobia. Which other behaviors or symptoms may the child exhibit? Select all that apply.

Headaches. Nausea. Dizziness.

A nurse is caring for a 3 year old diagnosed with viral meningitis. Which signs and symptoms would the nurse expect to find during the admission assessment? Select all that apply.

Photophobia. Nuchal rigidity. Irritability. Fever.

The nurse is caring for a 3 year old client being treated for severe status asthmaticus. After comparing clinical manifestations with laboratory results (reported below), a nurse determines evidence that this client has progressed to which condition?

Respiratory acidosis.

A nurse is teaching parents about the developmental milestones of an infant. Place the following developmental activities for an infant in order of occurrence by age from earliest to latest. All options must be used.

1st. Turning self from prone to supine. 2nd. Turning self from supine to prone. 3rd. Sitting alone. 4th. Crawling on hands and knees. 5th. Effectively using pincer grasp.

The nurse is caring for an infant with the following congenital anomaly at birth. Which nursing interventions are helpful in feeding the 3 month old prior to surgical repair usually 3-6 months of age? Select all that apply.

Record daily intake on a chart. When feeding, give water last. Feed in small amounts assessing for tolerance. Dilute solids making them in a softer consistency. Instruct on the normal feeding patterns.