PEDS E2

A nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

0.9 percent Normal Saline (NS)

A nurse is preparing a 4-year-old boy for surgery. Which nursing action is appropriate for preoperative teaching based on Erikson's developmental stages? 1. Allowing the child to make a project related to the surgery 2. Having the child put a surgical mask on a doll 3. Asking the child how he feels about surgery 4. Allowing the child to listen to music without further instructions

2. Having the child put a surgical mask on a doll

A nurse is teaching a client who has gastroesophageal reflux disease about managing his illness. Which of the following recommendations should the nurse include in the teaching?

Avoid eating within 3 hr of bedtime.

A nurse is assessing a school-age child who has type 1 diabetes mellitus.. The nurse notes that the child is diaphoretic. Which of the following actions should the nurse take?

Obtain a blood glucose level

A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluids?

Oral Rehydration Solution

A nurse is caring for a 6 month old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which of the following fluids should the nurse select for the infant?

Oral electrolyte solution

A nurse is caring for a 4-year-old child who has moderate dehydration. Which of the following findings should the nurse expect?

Orthostatic hypotension

A nurse is caring for a client who has a traumatic brain injury. Which of the following findings should the nurse identify as an indication of increased intracranial pressure (ICP)?

Restlesness

A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following? A. Graham crackers B. 1 tsp sugar C. 4 oz diet soda D. 4 oz skim milk

Graham crackers

A nurse is caring for a child who has acute appendicitis. Which of the following results should the nurse anticipate when reviewing the lab values?

WBC 17,000

A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions following feedings?

Place the infant in an infant seat

A nurse is caring for a child with a suspected diagnosis of bacterial meningitis. Which of the following is the priority action by the nurse?Administer antibiotics when available. Reduce environmental stimuli. Document intake and output. Maintain seizure precautions.

Administer antibiotics when available

A nurse is caring for an infant after surgical repair of a cleft lip. The nurse should comfort the infant by:

rocking her with a favorite blanket.

A nurse is collecting data from an 11-month-old infant. Which of the following clinical manifestations is suggestive of a central nervous system infection?

Bulging fontanel

A nurse enters a client's room and finds the client on the floor having a seizure. Which of the following actions should the nurse take?

Place the client on his side.

A nurse is providing care to a child with a possible intussusception. The parents of the child ask the nurse how the diagnosis is made. Based on an understanding of the diagnostic evaluation for intussusception, which of the following statements should the nurse use?

"A barium enema will be given to visualize the obstruction."

Nurse provides discharge teaching to parents of 6 month old infant postop following hypospadias repair with stent placement. Which instructions should the nurse include in teaching? "You may bathe your infant in an infant bathtub when you go home." "Apply hydrocortisone cream to your infant's penis daily." "You should clamp your infant's stent twice daily." "Allow the stent to drain directly into your infant's diaper."

"Allow the stent to drain directly into your infant's diaper."

A school nurse is screening an 11-year-old client for idiopathic scoliosis. Which of the following instructions should the nurse give the client for this examination?

"Bend forward from the waist with your head and arms downward."

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented?

"Currant jelly" stools.

A nurse is caring for a child with a Milwaukee brace for scoliosis. After educating the adolescent, the nurse evaluates the client understands the proper application and use of the brace. Which of the following statements should indicate to the nurse that the adolescent understands the use of the brace?

"I can take my brace off for about an hour to shower daily."

A nurse is reinforcing teaching to the mother of a 2-month-old infant who had a Pavlik harness applied one week earlier for the treatment of developmental hip dysplasia. Which of the following statements made by the mother indicates an understanding of the teaching?

"I put a shirt under the straps of the harness."

A nurse is providing dietary teaching to a parent of a 10-month-old infant who has phenylketonuria. Which of the following responses by the parent indicates an understanding of the teaching?

"I will steam carrots and cut them into small pieces of her"

A nurse is reinforcing teaching to a parent and a school-age child following application of a fiberglass cast for a radius fracture. Which of the following statements by the parent or child indicates the need for further teaching?

"I will try not to move my fingers very much while I have the cast on."

A nurse is caring for a child who has had a spinal fusion. Which of the following statements by the nurse indicates an understanding of the care of this client?

"I'll log roll the client every 2 hr."

A nurse is caring for a child with acute glomerulonephritis and an ASO titer is ordered. The child's parent asks the nurse, "Why does the child need this titer?" Which of the following would be an appropriate response by the nurse?

"It will tell us if the child had a recent strep infection."

A school-age child is brought to the emergency department with a 2-day history of nausea, vomiting, and report of severe right lower quadrant pain. The child's WBC is 17,000/mm3 so appendicitis is suspected. Which of the following statements made by the child is most concerning to the nurse? "I am scared and I want to go home." "I am hungry and thirsty." "I'm tired and want to take a nap." "My belly doesn't hurt anymore."

"My belly doesn't hurt anymore."

A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

"The quality of food I provide is more important than the quantity"

A nurse is caring for a child who has ICP. Which of the following actions should the nurse take? (select all that apply)

- Maintain a quiet environment - Administer a stool softener - Maintain body alignment

A nurse is caring for an adolescent who has a closed head injury. Which of the following findings are indications of increased intracranial pressure (ICP)? (select all that apply)

- Report of headache - Alteration of pupillary response - Increased sleeping (also decreased motor and sensory response)

Various children are being seen in the clinic for various well-baby checks. By what age should a nurse expect a child to begin to use simple words to communicate needs? 1. Age 10-12 months 2. Age 1-2 years 3. Age 6-9 months 4. Age 2-3 years

1. Age 10-12 months

The maternity nurse is providing instructions to a new mother regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse instructs the mother to take which measure? 1. Allow the newborn infant to signal a need 2. Anticipate all the needs of the newborn infant 3. Attend to the newborn infant immediately when crying 4. Avoid the newborn infant during the first 10 minutes of crying

1. Allow the newborn infant to signal a need

A 4 year old child is diagnosed with leukemia and is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should be implemented to alleviate the child's fears? 1. Encourage the child's parents to stay with the child 2. Encourage play with other children of the same age 3. Advise the family to visit only during the scheduled visiting hours 4. Provide a private room, allowing the child to bring favorite toys from home

1. Encourage the child's parents to stay with the child

An experienced nurse is orienting a new nurse to the care of children in a clinic. Which immunizations should the experienced nurse inform the new nurse to plan to administer to normally healthy children between ages 1 and 5 years? Select all that apply.

1. Inactivated poliovirus 2. Diphtheria, tetanus, pertussis (DTaP) 3. Measles, mumps, rubella (MMR) 4. Hepatitis B (HepB)

A parent of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using Erikson's psychosocial development theory, which instruction(s) should the nurse provide to the parent? Select all that apply. 1. Set limits on the child's behavior 2. Ignore the child when this behavior occurs 3. Allow the behavior, because this is normal at this age period 4. Provide a simple explanation of why the behavior is unacceptable 5. Punish the child every time the child says "no" to change this behavior

1. Set limits on the child's behavior 4. Provide a simple explanation of why the behavior is unacceptable

The nursing instructor asks a nursing student to present a clinical conference to peers regarding Freud's psychosexual stages of development, specifically the anal stage. The student plans the conference, knowing that which characteristic relates to this stage of development? 1. This stage is associated with toilet training 2. This stage is characterized by the gratification of self 3. This stage is characterized by a tapering off of conscious biological and sexual urges 4. This stage is associated with pleasurable and conflicting feelings about the genital organs

1. This stage is associated with toilet training

A 7-year-old child lived in foster homes when he was an infant. He was adopted at the age of 1 year to an intact family who provided him with love and security. Which developmental task was this child most likely unable to complete as an infant? 1. Trust versus mistrust 2. Industry versus inferiority 3. Autonomy versus shame and doubt 4. Initiative versus guilt

1. Trust versus mistrust

A nurse is caring for a child with a history of diarrhea for 24 hr. The primary care provider orders a urine specific gravity. Which of the following values should the nurse expect to see?

1.030

The mother of an 8-year-old child tells the clinic nurse that she is concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial developmental theory, the nurse should make which response? 1. "You need to be concerned" 2. "You need to monitor the child's behavior closely" 3. "At this age, the child is developing his own personality" 4. "You need to provide more praise to the child to stop this behavior"

3. "At this age, the child is developing his own personality"

A nurse is assessing the nutritional needs of a 1-year-old client. According to recommendations for introducing milk products, which type of milk should a 1-year-old child be drinking? 1. 2% milk beginning at the age of 1 2. 1% milk 3. Whole milk until the age of 2 years 4. Skim milk

3. Whole milk until the age of 2 years

A nurse is assessing language development in all the infants presenting at the doctor's office for well child visits. At which age range will the nurse expect a child to verbalize the words "dada" and "mama"?

9-12 months

A nurse is caring for an 18-month-old toddler who has been admitted following surgical repair of a cleft palate. Postoperatively, the child complains of thirst. The nurse should provide fluids using which of the following?

A cup

A nurse is helping a school-age child who has celiac disease select menu items for the next day's meals and snacks. Which of the following foods should the nurse encourage the client to choose?

A nurse is helping a school-age child who has celiac disease select menu items for the next day's meals and snacks. Which of the following foods should the nurse encourage the client to choose? A cheese omelet with orange juice.

A charge nurse is teaching a group of nurses about identifying child abuse. Which of the following findings should the nurse identify as a potential indicator of child abuse?

A toddler repeatedly refuses to let a nurse auscultate his lungs.

A nurse is providing teaching to the parent of an infant who has GERD. Which of the following indicates understanding of the teaching? A. " I will keep my baby in an upright position after feedings" b. "My baby formula can be thickened with oatmeal" c. "I will have to feed my baby formula rather than breast milk" d. I should position my baby side-lying during sleep"

A. " I will keep my baby in an upright position after feedings"

A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is projectile vomiting immediately after eating. Which of the following responses should the nurse make? A. "Bring your baby in to the clinic today." B. "Burp your baby more frequently during feedings." C. "Give your infant an oral rehydration solution." D. "Try switching to a different formula."

A. "Bring your baby in to the clinic today."

A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for further teaching? A. "I only need to catheterize myself twice every day." B. "I carry a water bottle with me because I drink a lot of water." C. "I use a suppository every night to have a bowel movement." D. "I do wheelchair exercises while watching TV."

A. "I only need to catheterize myself twice every day."

A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching? A. "I'm glad that my child's ostomy is only temporary." B. "I'm glad my child will have normal bowel movements now." C. "I want to learn how to use my child's feeding tube as soon as possible." D. "I want to learn how to empty my child's urinary catheter bag."

A. "I'm glad that my child's ostomy is only temporary."

A nurse is caring for a 6 year old child who is newly diagnosed with diabetes mellitus. The nurse is educating the child on how to do finger sticks for blood glucose checks. The nurse knows the most effective method to teach this skill will be to do which of the following?

Allow the child to practice the skill on themselves or others.

The nurse is teaching the parent of type 1 diabetic preschool aged client about management of the disease. Which teaching point is appropriate for the nurse to include in the session?

Allowing the client to choose which finger to stick for glucose testing

A nurse in an emergency department is caring for a child who experienced a submersion injury. Which of the following is the priority action for the nurse to take?

Assist with intubation

A nurse is admitting a 6-month-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance? A. 0.5 mL/kg/hr B. 2 mL/kg/hr C. 7.5 mL/kg/hr D. 15 mL/kg/hr

B. 2 mL/kg/hr

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? A. Identity crisis B. Body image changes C. Feelings of displacement D. Loss of privacy

B. Body image changes

A nurse is collecting data from a child. Which of the following is a clinical manifestation of nephrotic syndrome? A. Polyuria B. Facial edema C. Smokey brown urine D. Hypertension

B. Facial edema

A public health nurse is visiting an older adult client who lives with a family member. The nurse assesses the client and identifies several bruises in various stages of healing. The client explains that the bruises are a result of "clumsiness," and the client's family member agrees. However, based on the location and distribution of the bruises, the nurse suspects the client may be abused. Which of the following actions should the nurse should take first?

B. Follow the agency's guidelines for reporting suspected abuse.

A nurse is assessing an infant following a motor vehicle crash. Which of the following findings should the nurse monitor to identify increased intracranial pressure? A. Brisk pupillary reaction to light B. Increased sleeping C. Tachycardia D. Depressed fontanels

B. Increased sleeping

A nurse is caring for a toddler whose parent states while bathing the child she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

B. Instruct the parent to avoid pressing on the abdominal area.

A nurse is caring for a 17 year old client who is experiencing a relapse of leukemia and is refusing treatment. The client's mother insists that the client receive treatment. Which of the following actions should the nurse take? A. Initiative the IV per the patient's request B. Notify the provider of the situation C. Administer a sedative to calm the client D. Offer the client an antiemetic

B. Notify the provider of the situation

A nurse is assessing a child and notes several bruises. Which of the following actions should the nurse take? A. Report the suspected abuse to the authorities. B. Obtain a detailed history. C. Ask a psychiatrist to talk with the parents. D. Separate the child from the parents.

B. Obtain a detailed history.

You are speaking with a school-age child and his mother during a well-visit. Which of the following statements accurately describes the cognitive development that occurs during this period of childhood? A. School-age children have developed the ability to reason abstractly B. School-age children are able to classify, to group and sort., and to hold a concept in their minds while making decisions based on that concept C. School-age children are capable of applying scientific reasoning and formal logic to new situations D. During the school-age years, children progress from making judgments based on what they reason to making judgments based on what they see

B. School-age children are able to classify, to group and sort., and to hold a concept in their minds while making decisions based on that concept

A nurse is providing anticipatory guidance to the mother of an 8-year-old girl. The mother asks the nurse when her daughter will begin puberty. Which of the following statements is the nurse's best response? A. "She has some time yet, she is only 8 years old" B. "Once she has her growth spurt, she will likely start her period in a few months" C. "Breast development is usually the first sign of puberty in girls" D. "Pubic hair growth is usually the first sign of puberty in girls"

C. "Breast development is usually the first sign of puberty in girls"

A clinic nurse is giving instructions to a mother on the proper technique of applying ophthalmic ointment to her preschool-age child who has conjunctivitis. Which of the following should the nurse include in the instructions? A. Warm the ointment by placing the tube in glass of hot tap water B. Cleanse the eye with a wet cotton ball in a direction towards the inner canthus before applying the ointment C. Discard the first bead of ointment before each application D. Instruct your child to squeeze his eyes shut following application

C. Discard the first bead of ointment before each application

A nurse on an oncology unit is assessing a child who has a brain tumor. Which of the following findings should the nurse expect? A. Negative Babinski reflex B. Increased appetite C. Hyporeflexia D. Tachycardia

C. Hyporeflexia

A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care? A. Place the client in a semi-Fowler's position. B. Admit the client to a private room. C. Measure head circumference every shift. D. Implement seizure precautions.

C. Measure head circumference every shift.

A nurse is assessing a 1-year-old toddler notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect? A. Pyloric stenosis B. Nephritic syndrome C. Wilms' tumor D. Intussusception

C. Wilms' tumor

A nurse is caring for a child who is having a seizure. Which of the following is an appropriate action by the nurse? (Select all that apply.)

Check the client's airway for patency. Place the bed in a low position.

the mother of a child with an umbilical hernia call the clinic and reports that the child has been vomiting and is complaining of pain in the abdominal area. The nurse would instruct the mother to take what action?

Contact the health care provider.

A nurse is caring for a child who has suspected appendicitis. Which of the following provider prescriptions should the nurse clarify? A. Maintain NPO status. B. Monitor oral temperature every 4 hr. C. Medicate the client for pain every 4 hr as needed. D. Administer sodium biphosphate/sodium phosphate.

D. Administer sodium biphosphate/sodium phosphate.

A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development? A. The colorful latex balloons to the side of the crib B. Provide a small electronic toy C. Change the infant's diaper as as soiling occurs D. Allow the infant to stand in the crib

D. Allow the infant to stand in the crib

A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. Which of the following disorders does the infant have? A. Encopresis B. Enterocolitis C. Pyloric stenosis D. Hirschsprung disease

D. Hirschsprung disease

A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid? A. Broth B. Water C. Diluted apple juice D. Oral rehydration solution

D. Oral rehydration solution

A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following restraints for this infant?

Elbow

A nurse is caring for an 8-year-old child who has acute glomerulonephritis. Which of the following should the nurse expect to find with this client?

Elevated red blood cells

The charge nurse is concerned with reducing the stressors of hospitalization. Which nursing intervention is most helpful in decreasing stressors for the toddler aged client? 1. Assign the same nurse to the toddler as much as possible. 2. Let the child listen to an audiotape of the mother's voice. 3. Place a picture of the family at the bedside. 4. Encourage a parent to stay with the child.

Encourage a parent to stay with the child.

A one month old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

Fontanels depressed, capillary refill greater than three seconds.

A nurse is assessing a 24-month-old toddler. Which of the following findings should the nurse report to the provider?

Has a vocabulary of 30 words (increases to about 300)

A nurse is caring for a 4-year-old child with leukemia. The child has undergone chemotherapy and now has a fever, pallor, fatigue, and petechiae. Based on this information, which of the following should the nurse expect to find?

Hemoglobin 6 g/dL

A nurse is caring for an adolescent with diabetes mellitus who has been admitted twice this year to the hospital with diabetic ketoacidosis. Which of the following tests should the nurse recognize as the best information to evaluate the client's compliance?

Hemoglobin A1C

A nurse is caring for a newborn with a myelomeningocele. In planning care for the newborn, the nurse should be aware that postoperatively, the child is most prone to developing which of the following?

Hydrocephalus

A nurse in an emergency department is caring for a preschool-age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

Hyperpyrexia

A nurse is providing care to a toddler age child. Which assessment finding is indicative of abuse?

Inconsistency of stories between caregivers.

The nurse is providing education to a pediatric client diagnosed with diabetes. The client will be playing soccer over the summer. Which changes in the client's management will the nurse explore during the education session?

Increased food intake

A nurse is collecting data from a toddler who weighs 20 kg (44 lb) and has a full-thickness burn to 10% of this body. Which of the following findings should the nurse report to the provider?

Increased restlessness

A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first?

Initiate contact precautions

A nurse is planning care for a child who has osteomyelitis. Which of the following interventions should the nurse include in the plan of care?

Maintain a patent intravenous catheter

A nurse is caring for a child receiving chemotherapy. The white blood cell count is 1,200/mm^3. In planning the child's care, the nurse should prepare to do which of the following?

Maintain protective isolation and monitor for fever.

A nurse is preparing to perform a venipuncture to collect a blood sample from an infant. Which of the following restraints should the nurse plan to use for this procedure?

Mummy (aka swaddling)

a nurse is providing teaching about lice to the parents of a school-age child at well-child visit. which of the following information should the nurse include in the teaching?

Not to share hats with other children

A nurse is caring for a child following an open reduction and internal fixation of a fractured femur and application of a cast. The cast has a window cut in it for viewing of the incision. Which of the following actions should the nurse take first?

Perform neurovascular checks of the affected extremity.

A nurse is caring for an infant with spinal bifida. Which of the following is an appropriate action for the nurse to take?

Place in prone position

A nurse is caring for an adolescent with a fiberglass cast. When providing education for the adolescent, which of the following should the nurse explain?

Place plastic over the cast while bathing.

A nurse is caring for a 2 year old child with vomiting and dehydration. Which of the following assessments should prompt the nurse to contact the primary care provider?

Potassium 2.5 mEq/L

A nurse is caring for a 6-week-old infant admitted to the pediatric unit for evaluation of a suspected pyloric stenosis. Which of the following findings should the nurse expect?

Projectile vomiting

A nurse is collecting data from an infant who has hypertrophic pyloric stenosis. Which of the following findings should the nurse expect?

Projectile vomiting

A nurse is collecting data from an infant. Which of the following is a clinical manifestation of pyloric stenosis?

Projectile vomiting after feedings

A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate actions for the nurse to take to deliver atraumatic care?

Provide a pacifier coated with an oral sucrose solution prior to the injections.

A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

Regular insulin

An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority of this infant?

Risk for Aspiration Related to Regurgitation

A nurse is caring for a toddler who has a fractured right femur and is in Bryant's traction. When monitoring to determine if the traction is appropriately assembled, the nurse expects to observe which of the following? Skin straps maintaining the leg in an extended position. Weights attached to a pin that is inserted in the femur. A padded sling under the knee of the affected leg. The buttocks elevated slightly off of the bed.

The buttocks elevated slightly off of the bed.

A nurse is caring for a child who is 2 days postoperative following an appendectomy due to rupture of the appendix. The child's NG tube is set to low intermittent suction. Which of the following findings indicates that the child's gastrointestinal function has returned?

The nurse auscultates bowel sounds

The nurse caring for a 9-year-old notices some swelling in the child's ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure and notices a markedly slow disappearance of the indentation. Due to these physical findings, the nurse would be most concerned with assessing

Urine output.

A nurse is caring for a 3-year old child admitted with acute diarrhea and dehydration. What client finding indicates that oral re hydration therapy has been effective?

Urine specific gravity 1.015

A nurse is caring for a child diagnosed with nephrotic syndrome who is receiving Predisone (Deltasone). Which of the following should the nurse recognize as a therapeutic response of the medication?

Weight drops 500 g

a nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?a. "I will be sure my child aspirates before injecting the insulin." b. 'the insulin can be injected anywhere there is adipose tissue." c. "I will be sure my child rotates sites after 5 injections in one area." d. "The insulin should be injected at a 90 degree angle."

a. "I will be sure my child aspirates before injecting the insulin."

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurse's approach should include which of the following? a. Answer questions with straightforward honesty. b. Avoid discussing the seriousness of the condition. c. Explain that although the amputation is difficult, it will cure the cancer. d. Assist adolescent in accepting the amputation as better than a long course of chemotherapy.

a. Answer questions with straightforward honesty.

A nurse is reviewing the laboratory results of an adolescent who has chronic glomerulonephritis. Which of the following findings should the nurse expect? a. BUN 50 mg/dl b. Serum K 3.8 mEq/l c. Absence of proteinuria d. Serum phosphorus 4.0 mg/dl

a. BUN 50 mg/dl

a nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings should the nurse expect? a. Closed posterior fontanel b. Uses thumb and index fingers in a pincer grasp c. Lateral incisors d. Sitting steadily without support.

a. Closed posterior fontanel

A nurse is caring for an infant following a cleft life and palate repair. Which of the following actions should the nurse take? a. Suction the infant gently with a bulb syringe PRN. b. Keep the infant's mouth open by using a tongue blade for 4 hr following surgery. c. Place the infant in prone position. d. Clean the infant's incision with chlorhexidine.

a. Suction the infant gently with a bulb syringe PRN.

Which of the following is most descriptive of the therapeutic management of osteosarcoma? a. Treatment usually consists of surgery and chemotherapy. b. Amputation of affected extremity is rarely necessary. c. Intensive irradiation is the primary treatment. d. Bone marrow transplantation offers the best chance of long-term survival.

a. Treatment usually consists of surgery and chemotherapy.

A nurse is providing teaching to a school age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teachng? a. "My morning blood glucose should be between 90 to 130." b. "I should eat a snack half an hour before playing soccer." c. "I should not take my regular insulin when I am sick." d. "I can store unopened bottles of insulin in the freezer."

b. "I should eat a snack half an hour before playing soccer."

A nurse is caring for a client who is dying. The client says, "My mother died in the hospital, but I did not get there before she died." Which of the following statements should the nurse make? a. "We will call your family in time for them to get here." b. "I wonder if you are fearful of dying alone." c. "I will make sure a staff member is in your room at all times." d. " I will tell your family of your concern so that they can be here."

b. "I wonder if you are fearful of dying alone."

A nurse is planning the care for a 10-month-old infant who is 8 hr postoperative following cleft palate repair. Which of the following interventions should the nurse include in the plan of care? a. Feed the infant with a spoon for 48 hr. b. Apply and release elbow restraints every hour. c. Keep the infant supine. d. Suction the mouth with an oral suction tube

b. Apply and release elbow restraints every hour.

a nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority? a. Place the child on a no-salt-added diet b. Check the child's daily weight c. Educate the parents about potential complications d. Maintain a saline-lock.

b. Check the child's daily weight

A nurse is caring for a toddler who is 24 hours postoperative following a cleft palate repair. which of the following actions should the nurse: a. ​Providing feedings with a rubber-tipped syringe. b. ​Suctioning the nasopharynx frequently. c. Administering opioids for pain. d. Changing the oral packing every 6 hr.

c. Administer opioids for pain

Which of the following is the primary method of treating osteomyelitis? a. Joint replacement b. Bracing and casting c. Intravenous antibiotic therapy d. Long-term corticosteroid therapy

c. Intravenous antibiotic therapy

A nurse is assessing the psychosocial development of a toddler. The nurse should recognize that this stage is characterized by which of the following? a. Imaginary playmates b. Erikson's stage of initiative vs. guilt c. Demonstrations of sexual curiosity d. Negative behaviors characterized by the need for autonomy

d. Negative behaviors characterized by the need for autonomy

A nurse is reinforcing teaching a parent of a child who has a fracture of the epiphyseal plate. Which of the following is an appropriate statement by the nurse?

"Normal bone growth can be affected."

Select the best room assignment for a newly admitted child with bacterial meningitis: 1. semiprivate with a roommate who also has bacterial meningitis 2. semiprivate room with a roommate who has bacterial meningitis but has received antibiotics for more than 24 hours 3. private room that is dark and quiet with minimal stimulation 4. private room that is bright and colorful and has developmentally appropriate activities available

3. private room that is dark and quiet with minimal stimulation

A nurse case manager is meeting with the parents of an 8-year-old client. The 8-year-old is scheduled for surgery to repair a cleft palate. The parents ask the case manager when they should discuss and explain the surgery to their child. Based on the child's developmental age, which is the best response by the nurse? 1. Explain the surgery immediately before it is carried out. 2. Explain the surgery 1 to 2 hours before it is carried out. 3. Explain the surgery up to 1 week before it is carried out. 4. Explain the surgery several days before it is carried out.

4. Explain the surgery several days before it is carried out.

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment supports this newborn's diagnosis? 1. Altered electrolytes; projectile vomiting 2. Currant jelly stools; pain 3. Acute diarrhea; dehydration 4. Failure to pass meconium; abdominal distention

4. Failure to pass meconium; abdominal distention

A 10-month-old child reaches the 9-12 month developmental stage. Which nursing action is most appropriate for providing tactile stimulation for this child? 1. Caress the child while diaper changing 2. Give the child a soft squeeze toy 3. Swaddle the child at nap time 4. Let the child squash and mash food while sitting in a high chair

4. Let the child squash and mash food while sitting in a high chair

A nurse is caring for a 3-month-old infant. Based on the developmental age of the child, which motor skill should the nurse expect to see during an assessment? 1. Bangs objects held in hand 2. Begins to grab objects using a pincer grasp 3. Grabs objects using a palmar grasp 4. Looks and plays with his own fingers

4. Looks and plays with his own fingers

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic 2. Release the skin traction 3. Apply ice to the extremity 4. Notify the HCP

4. Notify the HCP

A pediatric nurse is to perform a head-to-toe assessment on a toddler who is admitted to the hospital for nausea and vomiting. Which is most important for the nurse to consider before beginning the examination? 1. Making sure the parents are present. 2. Using a firm tone to settle the child down for the examination 3. Waiting until the child is ready to cooperate 4. Preparing for a physical examination based on the child's developmental age

4. Preparing for a physical examination based on the child's developmental age

The clinic nurse is preparing to explain the concepts of Kohlberg's theory of moral development with a parent. The nurse should tell the parent that which factor motivates good and bad actions for the child at the pre-conventional level? 1. Peer pressure 2. Social pressure 3. Parent's behavior 4. Punishment and reward

4. Punishment and reward

An 8-month-old baby girl, who is developing appropriately, is admitted to a pediatric unit for respiratory syncytial virus (RSV). The baby is crying and being held by her mother. A nurse wants to provide appropriate care based on Erikson's developmental stages. In which stage is this baby, according to Erikson's theory? 1. Punishment versus obedience orientation 2. Oral stage 3. Initiative versus guilt 4. Trust versus mistrust

4. Trust versus mistrust

Which clinical assessment of a neonate with bacterial meningitis would warrant immediate intervention? 1. irritability 2. rectal temp of 100.6 3. quieter than usual 4. resp. rate of 24/minutes

4. resp. rate of 24/minutes

A child is being admitted with a diagnosis of bacterial meningitis. select the procedure the nurse should do first? 1. administer IV antibiotics 2. admin maintenance IV fluids 3. placement of a foley 4. send the spinal fluid and blood levels to the lab

4. send the spinal fluid and blood levels to the lab

A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? A. A child who has nephrotic syndrome B. A child recovering from a ruptured appendix C. A child who has rheumatic fever D. A child who has cystic fibrosis

A. A child who has nephrotic syndrome

A nurse is caring for a 4-year-old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection? A. A needleless syringe and a doll B. A video game C. A story book about a child who has diabetes D. A period of play in the playroom

A. A needleless syringe and a doll

A child is admitted with a suspected diagnosis of Wilms' tumor. The nurse should place a sign with which of the following warnings over the child's bed?

A. Do not palpate abdomen.

A nurse is caring for a 2-month-old infant who is postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take? A. Encourage the parents to rock the infant. B. Offer the infant a pacifier. C. Administer ibuprofen as needed for pain. D. Position the infant on her abdomen.

A. Encourage the parents to rock the infant.

A nurse is caring for a newborn who has myelomeningocele. Which of the following nursing goals has the priority in the care of this infant? A. Maintain the integrity of the sac B. Promote maternal-infant bonding C. Educate the parents about the defect D. Provide age-appropriate stimulation

A. Maintain the integrity of the sac

A nurse is caring for a 6-month-old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which of the following fluids should the nurse select for the infant? A. Oral electrolyte solution B. Half-strength infant formula C. Half-strength orange juice D. Sterile water

A. Oral electrolyte solution

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is a priority action for the nurse to take? A. Perform a neurovascular assessment B. Explain the discharge instructions to the client and parents C. Provide reassurance to the client and parents D. Apply an ice pack to the casted leg

A. Perform a neurovascular assessment

A nurse is caring for a child who has Legg-Calve-Perthes disease and is in Buck extension traction. Which of the following actions should the nurse take? A. Reposition the child every 2 hr B. Remove the traction boot during baths C. Apply antiobiotic ointment to pin sites daily D. Reduce fluid intake

A. Reposition the child every 2 hr

A nurse is assisting with a routine examination of an adolescent. The provider observes a lateral curvature of the spine. The nurse should expect the provider to document which of the following disorders? A. Scoliosis B. Kyphosis C. Lordosis E. Torticollis

A. Scoliosis

A nurse is caring for a 2-year-old child who has seizure and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? A. Shake the container vigorously B. Be sure the child has not eaten within the hour C. Perform mouth care D. Check the child's blood pressure

A. Shake the container vigorously

A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child's appendix is perforated? A. Sudden decrease in abdominal pain B. Absent Rovsing's sign C. Flaccid abdomen D. Low-grade fever

A. Sudden decrease in abdominal pain

A nurse is caring for a child who has Addison's Dx. Which action should the nurse take? A. Teach the parents about cortisol replacement therapy B. Place the child on a low Na+ diet C. Monitor the child for fluid volume excess D. Discuss the manifestation of hypoglycemia with the parents

A. Teach the parents about cortisol replacement therapy

A nurse is caring for a child who has a fracture of the forearm. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. Which of the following statements should the nurse make? A. The bone is broken on one side and bent on the other side. B. Fragments of bone have splintered into the surrounding tissue. C. The bone ends have been forced toward each other. D. The sharp edge of the bone has broken through the skin.

A. The bone is broken on one side and bent on the other side.

A nurse is caring for an infant who has GERD. The nurse should recognize that which of the following findings are associated with this condition? Select all. A. Vomiting B. Weight loss C. Rigid abdomen D. Wheezing E. Fever

A. Vomiting B. Weight loss D. Wheezing

A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has current blood glucose level of 250mg/dL. Which of the following actions should the nurse take?

Administer D5NS by continuous IV infusion

A nurse is assessing an 8-month-old infant for cerebral palsy. Which of the following findings is a manifestation of the condition? A. Tracks an object with eyes B. Sits with pillow props C. Smiles when a parent appears D. Uses a pincer grasp to pick up a toy

B. Sits with pillow props

A nurse is caring for a 7 year old child who has an upper respiratory infection and type 1 DM. Which statement by the mother indicates a need for further instruction? A. " I will encourage her to drink half a cup of water or sugar-free fluids every 30 min" B. " I will report a change in her breathing or any signs of confusion" C. "I will notify the doctor if her temp is not controlled with acetaminophen" D. "I will continue to check his blood sugar two times every day"

D. "I will continue to check his blood sugar two times every day"

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?A. Encourage the child to take a 45 min nap daily B. Allow the child to stay at home on days when her joints are painful C. Apply cool compresses for 20 min every hour D. Administer prednisone on an alternate-day schedule

D. Administer prednisone on an alternate-day schedule

A nurse is planning care for a 5-month-old infant who is scheduled for a lumbar puncture to rule out meningitis. Which of the following actions should the nurse include in the plan of care? A. Keep the infant NPO for 6 hr prior the procedure. B. Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure. C. Place the infant in an infant seat for 2 hr following the procedure. D. Hold the infant's chin to his chest and knees to his abdomen during the procedure.

D. Hold the infant's chin to his chest and knees to his abdomen during the procedure.

A nursing is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care? A. Keep the head of the bed at a 30° angle. B. Reposition the client by log rolling every 4 hr. C. Place the client in protective isolation. D. Initiate the use of a PCA pump for pain control.

D. Initiate the use of a PCA pump for pain control.

A nurse is caring for a male infant who has a palpable mass in the upper right quadrant and stools mixed with blood and mucus. The nurse should recognize that which of the following diagnoses is associated with these findings? A. Tracheoesophageal fistula B. Inguinal hernia C. Hypertrophic pyloric stenosis D. Intussusception

D. Intussusception

A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority? A. Prepare the child for a lumbar puncture. B. Administer an intravenous antibiotic. C. Obtain blood cultures. D. Place the child in isolation.

D. Place the child in isolation.

A nurse is caring for a child who is experiencing a seizure. Which of the following actions should the nurse take? A. Attempt to stop the seizure. B. Restrain the child's arms. C. Use a padded tongue blade.

D. Position the child laterally.

A nurse suspects that a client admitted for treatment of bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse supports this suspicion? A. Photophobia B. Nuchal rigidity C. Positive Kernig's sign D. Restlessness

D. Restlessness

A nurse is caring for a client who has meningitis, a temperature of 39.7° C (103.5° F), and is prescribed a hypothermia blanket. While using this therapy, the nurse should know that the client must carefully be observed for which of the following complications? A. Dehydration B. Seizures C. Burns D. Shivering

D. Shivering

A nurse is caring for a 3-year-old child who is in need of a hypospadias repair. Which of the following should the nurse recognize as a concern to this age group?

Damage to body integrity

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching?

Decompress the stomach.

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? A. Dehydration B. Polyphagia C. Hyperglycemia D. Bradycardia

Dehydration

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites? a. Femur b. Humerus c. Pelvis d. Tibia

a. Femur

A nurse is caring for a 3-year-old child whose parents report that she has an intense fear of painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? (Select all that apply.) a. Have a parent stay with the child during procedure b. Cluster invasive procedures whenever possible c. Perform the procedure as quickly as possible d. Allow the child to keep a toy from home with her. e. use mummy restrains during painful procedures.

a. Have a parent stay with the child during procedure c. Perform the procedure as quickly as possible d. Allow the child to keep a toy from home with her.

A nurse is providing health promotion teaching to the parents of a toddler. Which of the following information should the nurse include in the teaching? (Select all that apply.) a. Management of tantrums b. How to establish trust c. How to encourage cooperative play d. Dental care e. Need for increased caloric intake

a. Management of tantrums d. Dental care

A nurse is providing teaching to an adolescent who has type 1 DM. Which should the nurse include in the teaching? A. Admin glucagon for hyperglycemia b. Obtain an influenza vaccine annually c. Inject insulin in the deltoid muscle d. Take glyburide with breakfast

b. Obtain an influenza vaccine annually

A nurse is assessing a preschooler. Which of the following findings should indicate to the nurse a need for speech therapy? (Select all that apply) a. The preschooler stutters when speaking b. The preschooler mispronounces words. c. The preschooler speaks in three-word sentences. d. The preschooler talks to himself when reading. e. The preschooler speaks in a nasal tone

b. The preschooler mispronounces words. e. The preschooler speaks in a nasal tone