Peds Ch 47 PrepU

A nurse is providing education to pregnant women diagnosed with HIV. Which statement indicates the need for further teaching? 1. My health care provider may want me to have a cesarean birth. 2. Antiretroviral treatment is effective in reducing maternal-fetal transmission. 3. It is not safe to breastfeed my baby, so I will use formula. 4. Pregnancy will accelerate the progression of the disease.

4

The nurse is caring for a school-age child recently diagnosed with an allergy to peanuts. Which nursing action is a priority? 1. Advise parents the child may benefit from skin testing. 2. Remind parents to report the allergy to the child's school teacher. 3. Offer the parents information about a community support group. 4. Include the child when discussing foods that contain peanuts.

4

The nurse is providing teaching for the parents of a child with a latex allergy. The nurse tells the client to avoid which food? 1. pumpkins 2. blueberries 3. pomegranates 4. bananas

4

The nurse is preparing to administer IVIG to a child who has not received the medication before. What medication should the nurse expect to administer prior to the infusion? 1. prednisone 2. diphenhydramine 3. aspirin 4. ibuprofen

2

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated? 1. radioallergosorbent test 2. immunoglobulin electrophoresis 3. erythrocyte sedimentation rate (ESR) 4. lymphocyte immunophenotyping T-cell quantification

3

The nurse is providing discharge teaching to the client with myasthenia gravis. Which statements by the parents of the client demonstrate knowledge of proper care? Select all that apply. 1. "I picked up our child's medical alert bracelet today." 2. "If my child shows signs of an upper respiratory infection I will contact our physician right away." 3. "We will give our child his anticholinergic medication just after eating." 4. "If our child starts to have difficulty swallowing we will increase their dosage of their anticholinergic medication." 4. "We love to take family vacations to Florida, but we will have to find a new vacation spot."

1, 2, 4

A pregnant client who is HIV positive asks the nurse if she will be able to breastfeed the newborn. Which response by the nurse is most appropriate? 1. "Breastfeeding passes protective immunity along to your newborn." 2. "Breastfeeding will increase your newborn's risk of contracting HIV." 3. "Since your newborn will have HIV it is okay for you to breastfeed." 4. "You should speak to your primary health care provider about breastfeeding."

2

The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for a pediatric client with an immune disorder receiving a stem cell transplant. Which action by the UAP will cause the RN to intervene? 1. The UAP assists the client to ambulate in the room. 2. The UAP takes a rectal temperature on the client. 3. The UAP wears a mask when entering the client's room. 4. The UAP places a lunch tray in the client's room.

2

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin? 1. IgA 2. IgE 3. IgG 4. IgM

2

The nurse in the emergency department is examining an 18-month-old child who recently received a first dose of penicillin. The nurse notes lip edema, urticaria, stridor, and tachycardia. Which action will the nurse take next? 1. Gather tracheal intubation equipment. 2. Begin cardiopulmonary resuscitation (CPR). 3. Administer epinephrine. 4. Obtain intravenous (IV) access.

3

The nurse is caring for a child who is receiving an intravenous immunoglobulin treatment. The client calls the nurse and reports she vomited. What action should be completed first? 1. Contact the physician. 2. Take the client's vital signs. 3. Discontinue the infusion. 4. Check the physician's orders for an antiemetic.

3

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during: 1. the birthing process. 2. feeding with breast milk. 3. sexual contact. 4. pregnancy.

3

The nurse is preparing a care plan for a 4-year-old client newly diagnosed with severe combined immune deficiency. What is the priority goal for this client? 1. The client will perform hygiene care with assistance. 2. The client will demonstrate basic knowledge of the disorder. 3. The client will return to normal activities after discharge. 4. The client will remain free from infection.

4

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching? 1. "I must not feed my child eggs in any form." 2. "1.5 Tbsp each of water and oil, plus 1 tsp baking powder, equals one egg in a recipe." 3. "1 tsp yeast and ¼ cup warm water is a substitute in baked goods." 4. "I can use the egg white when baking, but not the yolk."

4

The nurse is teaching the parents of a 4-year-old client with a peanut allergy about dietary restrictions. Which response by the parents indicates a need for further teaching? 1. "We must be careful with Asian food." 2. "Baked goods often contain hidden peanut ingredients." 3. "Some hot chocolate mixes have peanuts." 4. "We cannot go wrong with barbeque and french fries."

4

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education? 1. "Cellular immunity is cell-mediated immunity controlled by T cells." 2. "Humoral immunity is immunity mediated by antibodies secreted by B cells." 3. "Phagocytosis is the process in which phagocytes swallow up and break down microorganisms." 4. "Humoral immunity is generally functional at birth."

4

The nurse is helping the parents of a toddler identify foods that are causing allergic symptoms in the child. Which strategy should the nurse encourage the parents to use? 1. Elimination diet 2. Corticosteroid challenge testing 3. Complete dietary protein restriction 4. Hyposensitivity testing

1

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent? 1. "Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily." 2. "I recommend you consult a genetic counselor to reveal other susceptible family members." 3. "Your child should join a peer support group to help relieve anxiety about this problem." 4. "Arrange for your child to receive allergy testing for foods with ingredients similar to those in insect venom."

1

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate? 1. Encourage parents to avoid feeding the infant peanuts. 2. Instruct the parents to soak the lesions in mineral oil. 3. Advise the parents to change the infant's formula. 4. Contact the health care provider to request treatment.

4

The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? 1. 1900/mm3 2. 1700/mm3 3. 1300/mm3 4. 1500/mm3

3

An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE? 1. "SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms." 2. "If my SLE has been found early enough in the disease process, there is a good chance that medication can cure it." 3. "SLE is a rheumatic disease that mostly affects my joints." 4. "SLE only affects my skin. It seldom causes problems in any other organs."

1

The nurse is caring for a child who is receiving a skin test to determine the presence of allergies. A positive skin test for one particular allergen shows the mediation of which type of immune globulin? 1. IgE 2. IgM 3. IgA 4. IgG

1

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom? 1. constipation 2. nausea 3. itchy mouth 4. anxiety

1

The parents of an adolescent tell the nurse, "Our child seems to have allergy symptoms every time we visit our favorite cafe. I don't understand since the only allergy indicated in the testing was to eggs?" How should the nurse respond? 1. "Does your child get a whipped cream or foam topping on their favorite drink?" 2. "That doesn't really make any sense if your child is only allergic to eggs." 3. "Maybe the allergy testing didn't evaluate everything your child is allergic to." 4. "Maybe coffee drinks just don't agree with your child's system."

1

The nurse is teaching the parents of a child with a suspected diagnosis of juvenile idiopathic arthritis about the disease. Which statement by the parents demonstrates the need for further teaching? 1. "If our child does not have a positive rheumatoid factor, our child does not have the disease." 2. "A warm bath at bedtime and warm compresses can increase our child's comfort." 3. "Swimming is a good activity that will help our child maintain joint mobility." 4. "It is important to control our child's inflammation and pain."

1

A client is being seen for symptoms indicating a secondary immunodeficiency. To obtain the information needed for this diagnosis, the nurse would ask which question(s)? Select all that apply. 1. "Do you take steroids regularly?" 2. "Were you born prematurely?" 3. "Have you ever had cancer?" 4. "Do you have any chronic illnesses?" 5. "Have you had sinusitis more than once this year?"

1, 2, 3, 4

The nurse is observing a child demonstrate the use of an EpiPen. The nurse determines that the child has performed the procedure correctly. Place the steps in the proper sequence that was demonstrated by the child. 1 Grasps EpiPen with black tip pointing downward 2 Holds EpiPen in place for 10 seconds 3 Massages site for 10 seconds after removing EpiPen 4 Pulls off the gray safety release 5 Forms a fist around the EpiPen 6 Jabs the EpiPen firmly into the outer thigh at a 90-degree angle

1, 5, 4, 6, 2, 3

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant? 1. "What do you give her to alleviate itching?" 2. "Has she ever had penicillin before?" 3. "Do you have a telephone to call us immediately if she develops trouble breathing?" 4. "Is there any family history of allergy to penicillin?"

2

The nurse is caring for a child diagnosed with juvenile idiopathic arthritis. Which statement(s) by the parents demonstrates an understanding of how to care for their child with this disease? Select all that apply. 1. "Our child may report photosensitivity, so we should always carry sunglasses for our child." 2. "We need to administer medication to decrease inflammation and pain in our child." 3. "We may notice our child has alopecia and should prepare our child for this." 4. "We should encourage swimming as an activity for our child." 5. "We may note our child has a fever above 103°F (39.5°C) for a couple weeks and should monitor our child's temperature."

2, 4, 5

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond? 1. "That is odd. Does anyone else in your family react that way?" 2. "Is your child allergic to milk?" 3. "Maybe it is an allergy to something else and you just notice after eating there by coincidence." 4. "Has your child ever been tested for a peanut allergy?"

4

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority? 1. Educate the parents about possible side effects of penicillin in children. 2. Question the child about the amount of penicillin that was taken. 3. Advise the parents to have their child evaluated for atopic diseases. 4. Encourage the child to wear a medical alert bracelet for penicillin.

4

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which foods would the nurse most likely include? Select all that apply. 1. Carrots 2. Bananas 3. Shrimp 4. Potatoes 5. Eggs 6. Peanuts

3, 5, 6