Peds

6. Which children must be secured in the back seat in a rear-facing safety seat? a. Children weighing up to 20 lb b. Children weighing between 20 and 30 lb c. Children weighing between 30 and 40 lb d. Children weighing more than 40 lb

ANS: A. Children weighing up to 20 lb

12. What is the third leading cause of accidental death in children 1 to 4 years of age? a. Falls b. Asphyxiation c. Poisons d. Burns

ANS: D. Burns

What age-group is most likely to be diagnosed with scoliosis? a. Adolescents b. Children c. Adults d. Infants

a. Adolescents

An LPN/LVN hears a 1-year-old Vietnamese patient crying shortly after the parents enter the room. The LPN/LVN enters and observes an object in the mother's hand and bright red welts on the toddler's skin. What is the appropriate nursing intervention? a. Ask the parent to explain what is occurring. b. Immediately notify the RN and report the observations. c. Immediately notify social services for the possibility of child abuse. d. Quickly approach the parents and ask them to leave the room.

a. Ask the parent to explain what is occurring.

In which part of the pregnancy is organ development most important? a. First trimester b. Second trimester c. Third trimester d. The birth

a. First trimester

What can affect a child's growth and development? Select all that apply. a. Heredity b. Nutrition c. Social environments d .Enuresis

a. Heredity b. Nutrition c. Social environments

The nurse is assessing a child with learning disabilities. What signs and symptoms might this nurse expect to find? (Select all that apply.) Select all that apply. a. Slowed academic progress b. Speech problems c. Behavior problems d. Seizures e. Excellent social relationships

a. Slowed academic progress b. Speech problems c. Behavior problems

What medication might be prescribed for an 8-year-old experiencing enuresis? a. Azithromycin b. Fexofenadine c. Loratadine d. Imipramine

d. Imipramine

An autistic 8-year-old child is a new admission to the pediatric floor. What special needs for autism does the nurse implement? a. Monitoring for loose liquid stools, typical with autistic children, and encourages fluids at each interaction b. Arranging for extra time to spend with the child to explain thoroughly procedures and treatments c. Use of communication techniques that maintain eye contact and physical contact d. Provision of a private room to decrease stimulation from noises and movement

d. Provision of a private room to decrease stimulation from noises and movement

The community health nurse is developing a program on obesity in children and adolescents. What does the nurse list as the most common factor contributing to overweight children? a. Decreased physical activity b. Fast-food consumption c. Poverty d. Working mothers

A. Decreased physical activity

The nurse addresses the local PTA about accident prevention for adolescents. What is most important for the nurse to highlight during the session? a. Education and review of basic first aid; setting consequences for substance abuse; and discussing the dangers of swimming alone b. Wearing seat belts; teaching fire safety; and the need to inform parents of whereabouts c. Teaching proper use of protective gear in sports; review acceptable behavior in a moving car; and practicing fire drills d. Teaching of traffic dangers; keeping sharp objects out of reach; and avoiding use of pillows

A. Education and review of basic first aid; setting consequences for substance abuse; and discussing the dangers of swimming alone

The parents of a 1-year-old child are concerned because he places "everything" in his mouth. The nurse informs the parents that aspiration of foreign bodies can lead to asphyxiation. Which statements are true? (Select all that apply.) Select all that apply. a. Monitor nipples on bottles and pacifiers. Replace if the nipples become worn or detached. b. Common foods that can be dangerous are round, such as grapes, hard candy, nuts, popcorn, and hot dogs. c. All toys should be checked for loose objects before use to prevent choking. d. Children older than age 3 are at greatest risk for aspiration of foreign bodies, because hand to mouth activities are common at this age. e. Objects that can be aspirated are coins, beads, buttons, balloons, small toys, or toy parts.

A. Monitor nipples on bottles and pacifiers. Replace if the nipples become worn or detached. B. Common foods that can be dangerous are round, such as grapes, hard candy, nuts, popcorn, and hot dogs. E. Objects that can be aspirated are coins, beads, buttons, balloons, small toys, or toy parts.

A mother brings her 2 year old to the medical clinic with burns to his arms. Based on the risk factors, which statements are correct? (Select all that apply.) Select all that apply. a. The burns are from scalding. b. The burns are a result of chemicals. c. Toddlers are more vulnerable to accidental burns. d. The burns are a result of a flame. e. The burns occurred at his home.

A. The burns are from scalding. B. The burns are a result of chemicals. C. Toddlers are more vulnerable to accidental burns. E. The burns occurred at his home.

An 18-month-old child is having difficulty maintaining his respiratory status. The child's health care provider orders oxygen therapy per nasal cannula. Which statements are true regarding oxygen therapy for children? (Select all that apply.) Select all that apply. a. To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and PRN. b. Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. c. Maintaining cannula placement may be difficult as the child is able to remove it from the nares. d. A nasal cannula is an effective oxygen delivery device even if the child breathes through the mouth. e. Encourage the child to cry because crying ensures the child has adequate oxygen supply.

A. To assess adequate oxygenation, the nurse checks cannula placement and oxygen saturation using a pulse oximeter every 2 hours and PRN. B. Oxygen flow by nasal cannula allows constant oxygen delivery even while eating and talking, because the mouth remains unobstructed. C. Maintaining cannula placement may be difficult as the child is able to remove it from the nares.

18. The school nurse collaborates with the physical education instructor to increase the amount of physical activity during the school day. What are major benefits of physical activity? (Select all that apply.) a. Reduced death rates as adults b. Reduced risk of cardiovascular disease c. Reduced risk of hypertension d. Reduced risk of diabetes e. Reduced self-esteem

ANS: A, B, C, D

17. What are reasons that a pediatric nurse should stress that health promotion activities must be ongoing? (Select all that apply.) a. To identify health risks b. To encourage healthy behavior c. To strengthen family bonds d. To improve nutrition e. To prevent accidents

ANS: A, B, D, E

19. Which are physical risks associated with excess weight? (Select all that apply.) a. Poor eyesight b. Heart disease c. Arthritis d. Stroke e. Appendicitis

ANS: B, C, D

20. Which of the following interventions should be included when teaching a healthy behaviors class for parents of adolescents? (Select all that apply.) a. Always monitor the child's telephone conversations b. Insist on seatbelt use at all times c. Encourage tanning bed use versus exposure to the sun d. Maintain recommended immunization schedule e. Encourage good dental care

ANS: B, D, E

13. The school nurse recognizes that lack of physical activity and increased consumption of fast food by children are causative factors contributing to which of the following problems? a. Nutritional disorders b. Weight gain c. Type I diabetes d. Dental caries

ANS: B. Weight gain

15. What age group is experiencing the largest increase in drug use? a. 7- to 9-year-olds b. 10- to 12-year-olds c. 12- to 13-year-olds d. 15- to 17-year-olds

ANS: C. 12- to 13-year-olds

9. What practice should be used by a pediatric nurse to remind parents of their responsibility in reducing the number of accidents involving children? a. Child awareness b. Good manners c. Anticipatory guidance d. Strict discipline

ANS: C. Anticipatory guidance

11. What is the leading cause of fatal injury in children younger than 1 year old? a. Burns b. Poisons c. Asphyxiation d. Motor vehicle accidents

ANS: C. Asphyxiation

2. What is the single most preventable cause of death and disease in the United States today? a. Drug use b. Alcohol addiction c. Cigarette smoking d. Malnutrition

ANS: C. Cigarette smoking

3. Smoking contributes to an increased risk of heart and lung disease in children by which methods? a. Air pollution b. Allergens in the environment c. Environmental smoke d. Lack of oxygen in the air

ANS: C. Environmental smoke

10. To prevent accidental poisoning of a child, where should medications be placed in the home? a. In a dresser drawer b. In the medicine cabinet c. In a locked cupboard d. On a high shelf

ANS: C. In a locked cupboard

1. The nurse stresses that regular physical activity has been identified as a leading health indicator. Regular physical activity has which positive effect on children? a. Improves social skills b. Reduces fluid retention c. Increases bone and muscle strength d. Increases attention span

ANS: C. Increases bone and muscle strength

4. Which factor is mostly associated with problems such as domestic violence, sexually transmitted infections (STIs), school failure, and motor vehicle accidents (MVAs)? a. Lack of supervision b. Psychological problems c. Substance abuse d. Physiological problems

ANS: C. Substance abuse

7. The pediatric nurse reminds the parents of a 2-year-old that by this age the child should be protected against how many vaccine-preventable childhood diseases? a. 4 b. 6 c. 8 d. 10

ANS: D. 10

5. Approximately half of all new HIV cases are among people under what age? a. 50 years b. 40 years c. 30 years d. 25 years

ANS: D. 25 years

16. Because the water in the infant's residential area is not fluoridated, when should the nurse suggest that the infant receive supplemental fluoride? a. 2 months old b. 4 months old c. 5 months old d. 6 months old

ANS: D. 6 months old

14. The nurse sets up a sample physical activities schedule to fit the FDA's Dietary Guidelines for Americans that recommends that children get at least how many minutes of physical activity per day? a. 15 b. 30 c. 45 d. 60

ANS: D. 60

8. A major dental problem among very young children is bottle mouth caries. What is a preventative measure the nurse should suggest? a. Juice at bedtime b. Milk at bedtime c. A sugar-coated pacifier d. Water at bedtime

ANS: D. Water at bedtime

The nurse uses many communication strategies when talking with children. Which strategies would be appropriate for the pediatric nurse? (Select all that apply.) Select all that apply. a. Always offer children a choice to allow the child control of his or her situation. b. As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. c. Address all communication to the parent and ask the parent to give the information to the child. d. Avoid phrases that may be misinterpreted or provide more information than the child can understand. e. Using a calm, unhurried voice in a positive way to give directions or information.

B. As a general guide, use sentences whose sum of words is equal to the child's age in years plus one. D. Avoid phrases that may be misinterpreted or provide more information than the child can understand. E. Using a calm, unhurried voice in a positive way to give directions or information.

The hospital environment can be frightening and traumatic for children. How can the pediatric nurse help alleviate these stressors? a. Keep nurse time with the child at a minimum by performing tasks and procedures as quickly as possible. b. During preadmission, offer the parents and child a tour of the pediatric unit and inviting the parents to room-in with the child during hospitalization. c. Adhere to strict visiting hours as parents visit, because the child feeds off of parental anxieties leading to more crying. d. Keep the television on at all times while the child is in the hospital to distract the child and muffle unfamiliar noises.

B. During preadmission, offer the parents and child a tour of the pediatric unit and inviting the parents to room-in with the child during hospitalization.

A nurse is employed in an impoverished area. Nursing responsibilities include teaching proper oral care for infants. What information would the nurse provide regarding prevention of caries? a. Use water in the bedtime bottle and brush the infant's teeth with a soft bristle toothbrush with fluorinated toothpaste. b. Giving the last bottle before bedtime and wiping off the teeth and gums with a damp washcloth before bed. c. Breast-fed infants do not need oral care as breast milk does not promote dental caries because of low lactose content. d. No oral care is necessary, because the infant may have only a few teeth and these teeth are not permanent.

B. Giving the last bottle before bedtime and wiping off the teeth and gums with a damp washcloth before bed.

A newborn male infant is being assessed by the pediatrician in the nursery. The infant is showing signs of heart failure and an audible machine-like murmur is heard at the upper left sternal border. Further assessment finds a widened pulse pressure and bounding pulses. Which type of congenital heart disease does this assessment data identify? a. Ventricle septal defect b. Patent ductus arteriosus c. Arterial septal defect d. Tetralogy of Fallot

B. Patent ductus arteriosus

Which statement is true in regards to nutrition in children? a. Fat restriction is an appropriate intervention for overweight toddlers. b. The most important role a nurse can play related to overweight and obese children is education. c. Environmental tobacco smoke does not result in increased risk of heart and lung disease among children. d. Cigarette smoking is prevalent among 55% of senior high school students.

B. The most important role a nurse can play related to overweight and obese children is education.

A 3 month old at the clinic is to receive an intramuscular injection. What is the most appropriate site for this injection? a. Dorsogluteal muscle b. Vastus lateralis muscle c. Deltoid muscle d. Rectus femoral muscle

B. Vastus lateralis muscle

A 12 year old tearfully informs the school nurse that she does not fit in. What is the most appropriate intervention? a. Immediately make a referral to a mental health professional as the girl is depressed and suicidal. b. Use effective listening techniques to gain further information so the nurse can report to the parents. c. Be aware that these feelings are common in adolescents and place the girl at risk for substance abuse, depression, and eating disorders. d. Offer suggestions on how to fit in with her peers.

C. Be aware that these feelings are common in adolescents and place the girl at risk for substance abuse, depression, and eating disorders.

The nurse must know how to compute medication doses correctly for children. Which is correct regarding the dosage calculation for children? a. A child dose is half the adult dose. b. The BSA of an adult divided by the BSA of a child multiplied by the adult dose equals the child's dose. c. The proportional amount of BSA to body weight is calculated. d. Unit doses are used in pediatrics and are based on a child's weight.

C. The proportional amount of BSA to body weight is calculated.

Because pain is often underestimated in children, how will the nurse best assess a child's pain? a. Observe the child's facial expressions. b. Monitor vital signs for elevated pulse or blood pressure. c. Use accepted pain assessment tools. d. Observe the child's activity.

C. Use accepted pain assessment tools.

A 4-year-old child has a respiratory infection. The health care provider has ordered Rocephin IM for treatment. Which statement by the LPN/LVN will best prepare the child for the injection? a. "The health care provider says you need a shot of medicine to get better since you keep spitting out the other medicine." b. "I am going to give you a shot. It will feel like a mosquito bite and will burn for a short time afterward." c. "This shot will hurt but you are a big girl, so don't cry." d. "Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?"

D. "Other kids tell me different things about how this feels. Some say it feels like a cat scratch. Will you tell me how it felt to you after we are done?"

A patient and her newborn son are getting ready to go home. The nurse is doing discharge teaching regarding the use of an infant car seat. Which statement by the patient would be correct? a. "There are no laws governing the use of infant car seats. It is just standard practice." b. "Short trips from home do not require the infant to be placed in the car seat as long as the parents hold him." c. "The car seat should be secured in the front seat between the parents." d. "The car seat should be secured in the back seat, rear facing until the infant reaches 20 lb."

D. "The car seat should be secured in the back seat, rear facing until the infant reaches 20 lb."

An LPN/LVN is assisting at a community health fair at the immunization booth and needs to be prepared to answer parents' questions regarding immunizations. Which statement is accurate? a. Immunizations have eradicated 10 childhood diseases and may not even be necessary in the future because of advances in medical research. b. If a child falls behind in the immunization schedule, the child must restart the immunizations. c. Immunization is effective and no booster dose is needed to prevent the spread of infectious diseases. d. Following the recommended immunization schedule will protect children against 10 childhood diseases by age 2.

D. Following the recommended immunization schedule will protect children against 10 childhood diseases by age 2.

What is an appropriate patient problem for the adolescent who is experimenting with tobacco? a. Potential for infection related to tobacco use b. Potential for injury related to accidental poisoning c. Imbalanced nutrition: less than body requirements related to decreased appetite from cigarette smoking d. Ineffective health maintenance related to smoking tobacco

D. Ineffective health maintenance related to smoking tobacco

An off-duty LPN/LVN is buying groceries and observes a child sitting in the cart ahead. The child raises her shirt and picks at some scabs on her abdomen. The LPN/LVN recognizes that the wounds look like the result of cigarette burns. What is the best response as a health care professional? a. Hand the mother a brochure on managing stress. b. Assess for signs and symptoms of infection, and refer the child's mother to a health care provider. c. Ignore the observations as the LPN is off duty as a nurse and there is nothing that can be done. d. Notify the appropriate agency that there is reason to believe a child has been abused.

D. Notify the appropriate agency that there is reason to believe a child has been abused.

The nurse is educating a parent group regarding accidental poisoning. What will the nurse be sure to include as a measure of prevention? a. Keep syrup of ipecac on hand for all types of suspected poisonings. b. Place medications in a medicine cabinet. c. Tighten caps on cleaning supplies under the sink. d. Remind grandparents to keep their medications out of reach when children visit.

D. Remind grandparents to keep their medications out of reach when children visit.

A child newly diagnosed with juvenile idiopathic arthritis (JIA) has come to the clinic for a checkup. While there, the parents ask about activities at school. What is the nurse's most appropriate response? a. "Talk with the school nurse to arrange for medications and rest periods." b. "Provide pain medications only during school activities." c. "Do not allow your child to participate in school activities." d. "Walk your child to all his classes to make sure other kids do not pick on him."

a. "Talk with the school nurse to arrange for medications and rest periods."

The school-age child diagnosed with attention deficit hyperactivity disorder (ADHD) has multifactorial nursing considerations. What are appropriate nursing interventions? (Select all that apply.) Select all that apply. a. Scheduling routine follow-up appointments for medication management and review b. Explaining medications and possible side effects to the parents, the child, and educators c. Instruction on the benefits of megavitamins and herbal therapies d. Educating the parents on discipline, rewarding, accident prevention, and safety needs e. Encouraging the parents to enroll the child in multiple after-school activities

a. Scheduling routine follow-up appointments for medication management and review b. Explaining medications and possible side effects to the parents, the child, and educators d. Educating the parents on discipline, rewarding, accident prevention, and safety needs

A young mother is at the clinic with her 5-year-old daughter. She has just been diagnosed with iron deficiency anemia. The physician has ordered iron supplements. As the nurse, what instructions would you give the mother? a. "Give the iron supplement when your daughter is showing increased signs of fatigue." b. "Give the iron supplement with citrus fruit juice on an empty stomach." c. "Give the iron supplement with meals." d. "Give the iron supplement at night before bed."

b. "Give the iron supplement with citrus fruit juice on an empty stomach."

A nurse is collecting information from a patient's mother while in the clinic. It is suspected that the patient has scarlet fever and the nurse will assess the child for what signs or symptoms of scarlet fever? (Select all that apply.) a. Peeling skin on palms b. Sandpaper-like red rash c. Koplik spots d. Pharyngitis e. White strawberry tongue

b. Sandpaper-like red rash d. Pharyngitis e. White strawberry tongue

The nurse is doing discharge teaching with a new mother regarding the recommended position to lay her infant down for sleep; the nurse and will recommend which position? a. Head elevated b. Supine c. Prone d. Side-lying

b. Supine

Children are not able to tolerate adult doses of drugs. What are the best ways to determining medication doses for children? Select all that apply. a. The child's age b. The child's weight c. The child's body surface area d. The child's height

b. The child's weight c. The child's body surface area

Which rule is used in calculating the dose for a 10-month-old child? a. Young's rule b. Clark's rule c. Fried's rule d. Cramer's rule

c. Fried's rule

The nurse considers which patient problem the highest priority for an infant born with a cleft lip? a. Ineffective coping b. Impaired skin integrity c. Imbalanced nutrition: less than body requirements d. Risk for aspiration

c. Imbalanced nutrition: less than body requirements

A young child with cerebral palsy has been assigned to the care of an LPN/LVN. What is the primary goal for a patient with cerebral palsy? a. Eliminate any cause of the disease. b. Improve muscle coordination and control of extremities. c. Reinforce the child's abilities and minimize any limitations caused by the disease. d. Prevent the onset of any emotional disturbances.

c. Reinforce the child's abilities and minimize any limitations caused by the disease.

A young child is brought to the clinic to have tests run regarding an endocrine disorder. What is the most common endocrine disorder in children? a. Diabetes mellitus type 2 b. Hypothyroidism c. Hyperthyroidism d. Diabetes mellitus type 1

d. Diabetes mellitus type 1

A nurse is caring for a 4-year-old child with abdominal pain related to an intestinal obstruction. What is the most common cause of intestinal obstruction in a child at this age? a. Hernias b. Hypertrophic pyloric stenosis c. Hirschsprung disease d. Intussusception

d. Intussusception

A distraught mother brings her 7-year-old child into the clinic for testing. The child has missed school because of headaches and abdominal pain. She explains that the pain is worse in the morning but is gone by mid-afternoon. The nurse recognizes these symptoms could be associated with: a, malnutrition. b. child abuse. c. hypoglycemia. d. school avoidance.

d. school avoidance.