PEDS EAQ Quizzes
The nurse is counseling the parents of a 12-year-old child with Duchenne muscular dystrophy about problems that may develop during adolescence. What body system does the nurse expect will be affected? Neurological Integumentary Gastrointestinal Cardiopulmonary
Cardiopulmonary
A 3-month-old infant has been hospitalized with respiratory syncytial virus (RSV). What is the priority intervention? Administering an antiviral agent Clustering care to conserve energy Offering oral fluids to promote hydration Providing an antitussive agent whenever necessary
Clustering care to conserve energy
An 8-year-old child with cerebral palsy is admitted to the hospital for a tendon-lengthening procedure. After the surgery the parents ask a nurse why their child must wear braces and shoes for at least 12 hours a day, even while in bed. What is the best response by the nurse? "Ambulation should be encouraged as soon as possible." "They maintain body alignment and help prevent foot drop." "They stretch your child's ligaments and strengthen muscle tone." "It helps your child accept the physical constraints of the condition."
"They maintain body alignment and help prevent foot drop."
The nurse is planning care for a preschooler with Kawasaki disease. Which intervention should the nurse plan to implement? Restricting fluids, especially fruit juices Ensuring bright lighting in the room during assessments Administering penicillin G benzathine (Bicillin) as prescribed Administering intravenous immune globulin (IVIG) as prescribed
Administering intravenous immune globulin (IVIG) as prescribed
A nurse is providing teaching to a client who is learning how to self-administer gastrostomy tube feedings. What should the teaching include? Administering water after the feeding is completed Maintaining the supine position during the feeding Heating the feeding to slightly above body temperature Determining tube placement by instilling water before the feeding
Administering water after the feeding is completed
A 4-month-old infant is being treated for talipes equinovarus (clubfoot). The infant has a cast change every 2 to 3 weeks. When the infant is brought to the well-baby clinic for a routine visit, a nurse evaluates the foot in the cast. Which assessments should the nurse include? Select all that apply. Pedal pulses of both feet Range of motion of the foot in the cast Color of the toes of the foot in the cast Movement of the toes of the foot in the cast Knee flexion and extension of the affected leg
Color of the toes of the foot in the cast Movement of the toes of the foot in the cast
Which factors should the nurse consider when administering medications to adolescents? Select all that apply. Explanation of the medication administration procedure by the nurse to the client Interactive communication regarding the procedure of medication administration Implementation of comfort measures like holding Acceptance of aggressive behavior with certain limitations Encouragement of self-expression, individuality, and self-care
Explanation of the medication administration procedure by the nurse to the client Interactive communication regarding the procedure of medication administration Encouragement of self-expression, individuality, and self-care
A parent whose infant is born with talipes equinovarus (clubfoot) tells the nurse, "I am afraid to have more children because they might have the same problem." What is the best response by the nurse? Reassuring the parent that this problem is unlikely to occur again Discussing the probability of the defect occurring in future children Exploring the parent's understanding of the probable causes of this disorder Explaining that there is no way of knowing whether the deformity will occur in a future child
Exploring the parent's understanding of the probable causes of this disorder
An infant born with hydrocephalus will be discharged after insertion of a ventriculoperitoneal shunt. Which common complication should the nurse instruct the parents to report if it occurs at home? Visibility of the sclerae above the irises Violent involuntary muscle contractions Excessive fluid accumulation in the abdomen Fever accompanied by decreased responsiveness
Fever accompanied by decreased responsiveness
A 3-month-old infant with tetralogy of Fallot is admitted for a diagnostic workup in preparation for corrective surgery. The morning after cardiac catheterization the infant suddenly becomes cyanotic and begins breathing rapidly. In what position should the nurse immediately place the infant? Supine Lateral Knee-chest Semi-Fowler
Knee-chest
A nurse is caring for a preschool-aged child with a history of physical and sexual abuse. What type of therapy will be the mostadvantageous for this child? Play Group Family Psychodrama
Play
Children's patterns of play change as they grow from infancy through school age. Rank the order of appearance of each type of play, starting with infant play. Associative Cooperative Parallel Solitary
Solitary parallel associative cooperative The infant plays alone, with others initiating the play activity. Toddlers' play activity is described as parallel; they play beside other children but not with them. Preschoolers' play is associative in loose groups, with activities involving interaction among players. The school-age child is capable of cooperative play, which includes organized play such as sports, board games, and card games.
The nurse instructed a client with asthma about the use of a peak flow meter at home. The client assesses the peak expiratory flow by using the peak flow meter. Which action performed by the client would be appropriate when the reading is in the yellow zone? Perform the peak expiratory flow again immediately Increase the prescribed drug therapy Use a prescribed reliever drug therapy Reassess the asthma plan and change the controller medication
Use a prescribed reliever drug therapy
A nurse is changing the dressing of a sixth-grader with severe burns. What basic principles of surgical asepsis must the nurse consider? Select all that apply. A paper field must remain dry to be considered sterile. Sterile items held below the waist are considered sterile. A 1-inch (2.5 centimeter) border around a sterile field is considered contaminated. Sterile objects in contact with clean objects are considered contaminated. A fenestrated drape is not considered sterile.
A paper field must remain dry to be considered sterile. A 1-inch (2.5 centimeter) border around a sterile field is considered contaminated. Sterile objects in contact with clean objects are considered contaminated.
An 8-year-old child with viral pneumonia is admitted to the pediatric unit. The admitting nurse reviews the instructions from the healthcare provider. Which prescription should the nurse question? Encourage oral fluids Chest physiotherapy twice a day Start IV fluids D5% 0.45% NS at 80 mL/hr Aspirin 325 mg every 4 hours prn for fever higher than 101.4° F (38.6° C)
Aspirin 325 mg every 4 hours prn for fever higher than 101.4° F (38.6° C)
A 3-year-old is placed in a bilateral hip spica cast for the treatment of developmental dysplasia of the hip. The nurse should teach the parents to monitor their child and report to the practitioner the occurrence of what? Warm toes Leg numbness Skin desquamation Generalized discomfort
Leg numbness
A newborn is admitted to the neonatal intensive care unit with a myelomeningocele. What is the priority nursing intervention during the first 24 hours? Using only disposable diapers for perineal care Placing the infant in a prone or side-lying position Washing the infant's genital area with an antiinfective Performing neurologic checks above or at the site of the lesion
Placing the infant in a prone or side-lying position
What physiologic alteration does the nurse expect when assessing a 6-month-old infant with bronchiolitis (respiratory syncytial virus [RSV])? Decreased heart rate Intercostal retractions Increased breath sounds Prolonged expiratory phase
Prolonged expiratory phase:Infectious and mechanical changes narrow the bronchial passages and make it difficult for air to leave the lungs. As a result of increased respiratory effort and decreased oxygen exchange, tachycardia may develop. Intercostal retractions are unlikely because of overinflation of the chest with air and shallow, rapid breathing. Breath sounds may be diminished because of swelling of the bronchiolar mucosa and filling of the lumina with mucus and exudate.
A nurse is preparing a 10-year-old child for a tonsillectomy and adenoidectomy to be performed later in the day. What information should the nurse share with the child? How the surgical procedure will be performed The type of surgical equipment that will be used What the child will experience before and after the procedure The changes in the child's nose and throat during the procedure
What the child will experience before and after the procedure
When will a nurse plan to administer pancrelipase to a child with cystic fibrosis? With meals and snacks In the morning and at bedtime On awakening and every 3 hours while the child is awake After each bowel movement and after postural drainage is performed
With meals and snacks
A nurse is caring for a 5-year-old child who is a victim of physical abuse. Which interventions are appropriate while talking to the child to help reveal the abuse? Select all that apply. Asking about the family's social or legal problems, if any Discussing the body parts using words the child will understand Telling the child that it is not the child's fault and no one is going to blame the child Telling the child that reporting the abuse to the nurse is the right thing to do Allowing the child to talk in the presence of the family members to minimize fear
Discussing the body parts using words the child will understand Telling the child that it is not the child's fault and no one is going to blame the child Telling the child that reporting the abuse to the nurse is the right thing to do
The nurse is inspecting the abdomen of an 18-month-old child. Which methods should the nurse adopt to inspect for inguinal hernia? Select all that apply. Have the child blow up a balloon Palpate the umbilicus for abdominal contents Get the child to laugh so as to raise the intraabdominal pressure Place the index finger of the right hand on the child's right femoral pulse Slide the little finger into the external inguinal ring while having the child cough
Have the child blow up a balloon Get the child to laugh so as to raise the intraabdominal pressure
The mother of an infant who just underwent cleft lip repair tells the nurse, "He seems restless. May I hold him?" What information influences the nurse's response? Holding may meet needs and reduce tension on the suture line. Sedation limits activity and decreases tension on the suture line. Handling may increase irritability, causing tension on the suture line. Arm movements cannot be controlled, placing tension on the suture line.
Holding may meet needs and reduce tension on the suture line
An infant with bronchiolitis caused by respiratory syncytial virus (RSV) is admitted to the pediatric unit. What does the nurse expect the prescribed treatment to include? Humidified cool air and adequate hydration Postural drainage and oxygen by hood Bronchodilators and cough suppressants Corticosteroids and broad-spectrum antibiotics
Humidified cool air and adequate hydration
After a cleft lip repair a nurse places elbow restraints on the infant. The parents ask the nurse, "Why does our child have to have restraints?" How should the nurse respond? "They're used routinely on infants who have had lip surgery." "Legally we're required to put them on infants after lip surgery." "The staff can't be with your baby continuously to prevent touching of the mouth." "Because we're keeping the arms straight, your baby won't be able to touch the mouth."
"Because we're keeping the arms straight, your baby won't be able to touch the mouth."
A newborn with a severe bilateral cleft lip and palate is shown to the father. The father says, "How could this happen to us? What's my wife going to do? It would've been better if she'd never gotten pregnant." How should the nurse respond? "This must be very hard on you. I can go with you when your wife sees the baby." "You have a healthy baby, and the clefts can be closed so they won't be noticeable." "This feeling won't last. Soon you'll love your baby so much that you won't even notice the clefts." "I know this is difficult for you, but you can't think of yourself now, because your wife needs you to be strong."
"This must be very hard on you. I can go with you when your wife sees the baby."
A pediatric client with a past history of chicken pox reports a fever and headache. Which drug should the nurse avoid giving to the client? Aspirin Tetracycline Nalidixic acid Chloramphenicol
Aspirin: Clients with a past history of chicken pox should not be administered aspirin because of the risk of the client developing Reye syndrome. Tetracycline generally causes discoloration of the teeth. Nalidixic acid sometimes causes cartilage erosion. Chloramphenicol is associated with Gray syndrome in children.
During assessment, the nurse asks a client about developmental milestones such as the age at which thelarche and menarche occurred. The nurse determines that the client experienced pubertal delay. Which finding in the client's history supports the nurse's conclusion? Weight increased by 8 to 12 kg. Menarche occurred 2 years after thelarche. Breast development occurred by 15 years of age. Growth in height stopped 2 years after menarche.
Breast development occurred by 15 years of age.: When the development of breasts has not occurred by 13 years of age in girls, it is considered pubertal delay. An increase in weight between 7 and 25 kg is considered normal during the growth spurt period. The occurrence of menarche within 2 years of onset of breast development, or thelarche, is a normal finding. Generally in girls, growth in height stops 2 to 2.5 years after menarche.
A nurse is caring for a 2-year-old child with meningitis. For which clinical manifestations of increasing intracranial pressure should the nurse assess the child? Select all that apply. Seizures Vomiting Bulging fontanels Subnormal temperature Decreased respiratory rate
Seizures Vomiting Decreased respiratory rate
A nurse in the pediatric clinic should be most observant for signs of cerebral palsy in a 6-month-old infant in which instance? Has a 40-year-old mother Was born exhibiting the Moro reflex Was delivered by an elective cesarean birth Was born during the 32nd week of gestation
Was born during the 32nd week of gestation
While performing preoperative teaching a nurse explores a young adolescent's concern about changes in appearance after surgery to correct scoliosis. What is the most appropriate statement by the nurse? "After surgery your back will be much straighter." "You're concerned about how you'll look after surgery." "Many teenagers who have this type of surgery do very well." "Your parents think it's important for you to have this surgery."
"You're concerned about how you'll look after surgery."
An infant with hypertrophic pyloric stenosis is admitted to the pediatric unit. What does the nurse expect to find when palpating the infant's abdomen? A distended colon Marked tenderness around the umbilicus An olive-sized mass in the right upper quadrant Rhythmic peristaltic waves in the lower abdomen
An olive-sized mass in the right upper quadrant: The olive-like mass is caused by the thickened muscle (hypertrophy) of the pyloric sphincter. The obstruction is above the intestinal area; the colon is not involved. There is no significant tenderness in the abdomen. There is little or no peristalsis in the intestines.
The nurse notes that the peak height velocity (PHV) for an 11-year-old female has occurred since the last health maintenance visit. Which assessment question should the nurse ask the adolescent based on this data? "Have you begun to menstruate?" "How tall do you think you will get?" "What do you typically eat in a normal day?" "Are you taller than most of the other girls in your class?"
"Have you begun to menstruate?"
An adolescent who had an inguinal hernia repair is being prepared for discharge home. The nurse provides instructions about resumption of physical activities. Which statement by the adolescent indicates that the client understands the instructions? "I can ride my bike in about a week." "I don't have to go to gym class for 3 months." "I can't perform any weightlifting for at least 6 weeks." "I can never participate in football again."
"I can't perform any weightlifting for at least 6 weeks."
A 3-year-old boy is found to have X-linked Duchenne muscular dystrophy. Neither parent has muscular dystrophy. Which statement indicates that the parents understand how the disorder is transmitted? "Our sons or daughters may have the disease." "Our daughters may be carriers of the disease." "We each contributed a gene that gave our son the disease." "We know that that our other son probably won't get the disease."
"Our daughters may be carriers of the disease."
Menarche is the central event of puberty in females, indicating the new possibility for fertilization. When does menarche occur in young girls? Six months after ovulation 24 months after the beginning of the development of breasts Six months after attaining peak weight velocity 12 months after attaining peak height velocity
24 months after the beginning of the development of breasts Menarche in girls occurs two years after the appearance of breast buds, which indicates the start of breast development. Ovulation does not occur before menarche but occurs six to 14 months after menarche. Menarche occurs after attainment of three months of peak weight velocity and nine months of peak height velocity.
What should the nurse explain to the parents of a newborn with developmental dysplasia of the hip (DDH) will most likely will be part of the infant's treatment? A fitted Pavlik harness Tight swaddling in blankets Periodic strapping to a cradleboard Placement in an infant seat on a set schedule
A fitted Pavlik harness
When planning long-term care for a 2-year-old child with cerebral palsy (CP), what is important for the nurse to consider? CP is not progressively degenerative. The effects of CP are unpredictable. The child probably has some degree of cognitive impairment (CI). The child should have genetic counseling before planning a family.
CP is not progressively degenerative.
A nurse is caring for an infant with Down syndrome. What does the nurse recall as the most common serious anomaly associated with this disorder? Renal disease Hepatic defects Congenital heart disease Endocrine gland malfunction
Congenital heart disease
As part of the physical assessment, a nurse inspects a newborn for the presence of an umbilical hernia. Which infant behavior will assist the nurse in identifying this problem? Crying Inhaling Suckling Sleeping
Crying
A 2-year-old boy born with cryptorchidism is to undergo orchiopexy. What should the nurse tell the parents about the anticipated outcome of this surgery? The urine stream will be directed downward. Damage to the undescended testicle will be prevented. Fluid that has collected in the scrotum will be removed. The fibrous tissue that has caused the penile deformity will be released.
Damage to the undescended testicle will be prevented.
A nurse is caring for a newborn with a diaphragmatic hernia and impaired gas exchange. What does the nurse identify as the cause of the infant's decreased gas exchange? Incarcerated hernia Decreased oxygen intake Increased basal metabolic rate Excessive respiratory secretions
Decreased oxygen intake
A nurse is reviewing previous education with the parents and a 12-year-old child with cystic fibrosis (CF). The disease was diagnosed when the child was 3 years old and has resulted in one hospitalization for a respiratory infection. For which potential complications of CF should the family be alert? Select all that apply. Diabetes Hematuria Nasal polyps Prolapsed rectum Pulmonary infections Urinary tract infections
Diabetes Nasal polyps Prolapsed rectum Pulmonary infections
An 8-year-old child undergoes tonsillectomy. What is the priority action in the immediate postoperative period? Assisting with coughing and deep breathing Encouraging frequent intake of cool liquids Ensuring airway patency by placing the child in a side-lying position Promoting consciousness by encouraging caregivers to interact with the child
Ensuring airway patency by placing the child in a side-lying position
According to the nurse describing Erikson's theory, in which stage does a preschooler start to pretend? Initiative versus guilt stage Integrity versus despair stage Autonomy versus sense of shame and doubt stage Generativity versus self-absorption and stagnation stage
Initiative versus guilt stage
A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made, and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care? Place in a warm, dry environment. Maintain standard and contact precautions. Administer prescribed antibiotic immediately. Allow parents and siblings to room in with the infant.
Maintain standard and contact precautions.
A nurse is caring for a toddler in acute respiratory distress precipitated by laryngotracheobronchitis. The child has a temperature of 103° F (39.4° C). What is the priority nursing intervention? Delivering humidified oxygen Initiating measures to reduce fever Monitoring respiratory status continuously Providing support to diminish apprehension
Monitoring respiratory status continuously
What should the nursing care of an 8-month-old infant with tetralogy of Fallot include? Restriction of fluid intake to conserve energy Provision of iron-fortified formula to prevent anemia Administration of coagulants to control bleeding tendencies Prevention of increased respiratory effort to promote oxygenation
Prevention of increased respiratory effort to promote oxygenation
A 3-month-old infant with chronic constipation has a tentative diagnosis of Hirschsprung disease. What definitive diagnostic test does the nurse expect to prepare the infant for? Sweat test Guthrie test Rectal biopsy Blood glucose level
Rectal biopsy
What should the nurse teach the parents about preventing sudden infant death syndrome (SIDS)? Select all that apply. Refrain from smoking around the infant. Refrain from co-sleeping or bed-sharing. Position the infant on the side while sleeping. Use soft pillows to support the infant while sleeping. Refrain from placing stuffed toys on the infant's bed.
Refrain from smoking around the infant. Refrain from co-sleeping or bed-sharing. Refrain from placing stuffed toys on the infant's bed.
An infant who has undergone surgery for hypertrophic pyloric stenosis (HPS) is being bottle fed by the mother. What should the nurse teach the mother about feedings to decrease the chance of the infant vomiting? Start with small, frequent feedings. Rock for 20 minutes after a feeding. Keep the infant awake for 30 minutes after feeding. Position the infant flat on the right side during feedings.
Start with small, frequent feedings.
A nurse is performing a respiratory assessment of an 8-month-old child with the diagnosis of viral pneumonia. The nurse identifies bronchial breath sounds over areas of consolidation, mild substernal retractions, profuse mucus production, pallor, and a temperature of 102° F (38.9° C). What is the priority nursing action? Suctioning the nasopharynx so a patent airway can be maintained Starting an intravenous infusion to provide necessary fluids and electrolytes Calling the respiratory therapist to start preparations for oxygen administration Notifying the practitioner of the fever so a prescription for an antipyretic can be issued
Suctioning the nasopharynx so a patent airway can be maintained
Which explanation should the nurse consider when formulating a response to a client's inquiry about intussusception of the bowel? Kinking of the bowel onto itself A band of connective tissue compressing the bowel Telescoping of a proximal loop of bowel into a distal loop A protrusion of an organ or part of an organ through the wall that contains it
Telescoping of a proximal loop of bowel into a distal loop
While assessing a client, the nurse suspects that the client has acute osteomyelitis. Which symptoms in the client support the nurse's suspicion? Select all that apply. Foot ulcer Temperature of 102° F Erythema of the affected area Tenderness of the affected area Drainage from the affected area
Temperature of 102° F Erythema of the affected area Tenderness of the affected area
The parents of an infant who just underwent insertion of a ventriculoperitoneal shunt for hydrocephalus are concerned about the prognosis. What information should the nurse give the parents? The prognosis is excellent, and the valve is permanent. The shunt may need to be replaced as the child grows older. If any brain damage has occurred, it is irreversible even after the first year of life. Hydrocephalus usually is self-limiting by 2 years of age, and then the shunt is removed.
The shunt may need to be replaced as the child grows older.
A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. What is the most important equipment for the nurse to have available when the child is admitted to the pediatric unit? Intravenous set Tracheotomy set Nasal cannula for oxygen Crib with padded side rails
Tracheotomy set: A patent airway is the priority. A tracheotomy set should be kept immediately available in case of complete obstruction of the airway. An intravenous setup may be needed later if the child does not respond to treatment. Humidified mist, not oxygen, is the treatment of choice unless the child does not respond to the treatment. Padded side rails are appropriate for seizures, which are not associated with croup.
A nurse is concerned about helping the parents of an infant with cerebral palsy set long-term goals for the family. What is most important to understand when setting long-term goals? Cognitive impairments require special education. Progressive deterioration requires future institutionalization. Unknown extent of the disability requires continual adjustments. Diminished immune responses require protection from infection.
Unknown extent of the disability requires continual adjustments.
A toddler is admitted to the emergency department with a diagnosis of acute spasmodic laryngitis. After the spasms subside, the child is ready to be discharged. What should the nurse teach the parents to do at home to help prevent another croup episode? Perform postural drainage. Discourage before-bedtime snacks. Use a cool mist vaporizer in the child's room. Demonstrate to the child how to expel air after inspiration.
Use a cool mist vaporizer in the child's room.
An infant is found to have cerebral palsy (CP) several months after birth. When the infant is 10 months old the mother comes to the pediatric clinic because the child has begun to exhibit slow writhing movements. The nurse explains that these movements are characteristically associated with what type of CP? Ataxic Spastic Dystonic Athetoid
athetoid: The athetoid type of CP consists of slow, wormlike, writhing movements. The ataxic type of CP is characterized by rapid, repetitive movements. The spastic type of CP is characterized by hypertonicity of muscles. The dystonic type of CP is a combination of the spastic and athetoid types.
3.A 14-year-old girl in whom scoliosis has been diagnosed undergoes spinal fusion. On the first postoperative day her face is red, she is rigid, and she is crying because she is in pain. She has prescriptions for morphine sulfate for severe pain and an acetaminophen-codeine compound for moderate pain. What information should influence the nurse's choice of analgesic? One dose of morphine may be given, but the drug should be restricted thereafter because it is addictive. Adolescents tend to exaggerate their discomfort, particularly when they are immobilized by surgery or injury. Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic. The acetaminophen-codeine compound is preferred because morphine can cause respiratory depression or respiratory arrest.
Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic.
The nurse caring for a 3-year-old child with meningitis should be alert for which signs and symptoms of increased intracranial pressure? Select all that apply. Vomiting Headache Irritability Tachypnea Hypotension
Vomiting Headache Irritability
The nurse is teaching a client undergoing intravenous gentamicin therapy for the treatment of acute osteomyelitis. Which statement by the client indicates effective learning? "I should drink lots of water if I retain urine." "I should use eyeglasses if I have vision problems." "I should stop the medication when the symptoms have subsided." "I should report any hearing loss to the primary healthcare provider."
"I should report any hearing loss to the primary healthcare provider."
A healthcare provider prescribes inhaled corticosteroids for a 6-year-old child with asthma. The nurse concludes that the mother understands the teaching about the side effects of this medication when the mother makes which statement? "I'll watch for frequent urination." "I'll check for white patches in the mouth." "I'll be alert for short episodes of not breathing." "I'll monitor for an increased blood glucose level."
"I'll check for white patches in the mouth."
An infant is admitted to the pediatric intensive care unit (PICU) after open-heart surgery for the repair of a ventricular septal defect. Place these nursing assessments in order of priority. Heart rate Operative site Urinary output Respiratory status Intravenous catheter
Respiratory status Heart rate Intravenous catheter Operative site .Urinary output
An emergency tracheotomy has been performed on a 6-year-old child with acute epiglottitis, and the child is receiving humidified air through a tracheotomy collar. What early clinical manifestations of hypoxia should alert the nurse to suction the tracheotomy? Dyspnea and cyanosis Agitation and diaphoresis Restlessness and increase in pulse Severe substernal retractions and stridor
Restlessness and increase in pulse
A nurse is assessing an 18-month-old toddler with suspected developmental dysplasia of the left hip. In what position should the nurse place the toddler to elicit the Trendelenburg sign? Standing on the affected leg Supine with the back arched Side-lying on the unaffected side Sitting upright with the legs separated
Standing on the affected leg
A toddler is found to have coarctation of the aorta. What does the nurse expect to identify when taking the child's vital signs? Irregular heartbeat Weak femoral pulse Thready radial pulses Increased temperature
Weak femoral pulse
A 9-year-old child with cerebral palsy is to be taught the four-point alternate crutch gait. The parents ask why this gait was chosen. How should the nurse respond? "Your child has more power in the arms than in the legs." "Your child doesn't have power or step ability in the legs." "It provides two points of support on the floor between steps." "It provides for equal but partial weight-bearing on each limb."
"It provides for equal but partial weight-bearing on each limb."
After her baby undergoes corrective surgery for hypertrophic pyloric stenosis, the mother is asked to offer the first feeding. The infant sucks it eagerly and vomits immediately. What is the nurse's explanation to the mother? "This often occurs after the first feeding." "The baby is ridding postoperative mucus." "Your feeding technique may need to be changed." "Feedings will have to be stopped until peristalsis improves."
"This often occurs after the first feeding."
A child with recently diagnosed idiopathic scoliosis has a mild structural curve. The child's mother asks whether the problem can be corrected with exercise. What should the nurse tell the mother concerning an exercise program? Exercise is used in conjunction with a brace. Exercise can be used if the child appears highly motivated. Exercise might exaggerate the curvature if the curve is severe. Exercise is needed to correct the curvature without the need for a brace.
Exercise is used in conjunction with a brace.
What should the plan of care for a newborn with hypospadias include? Preparing the infant for insertion of a cystostomy tube Explaining to the parents the genetic basis for the defect Keeping the infant's penis wrapped with petrolatum gauze Giving the parents reasons why circumcision should not be performed
Giving the parents reasons why circumcision should not be performed
A 1-month-old infant with a ventricular septal defect (VSD) is examined in the cardiology clinic. What sign related to this disorder does the nurse expect to find when assessing this infant? Bradycardia at rest Activity-related cyanosis Bounding peripheral pulses Murmur at the left sternal border
Murmur at the left sternal border
A client is diagnosed with the genetic disorder osteogenesis imperfecta. Which condition can be anticipated in the client at an age of 30? Loss of auditory acuity Loss of visual acuity Loss of smell perception Loss of touch perception
Loss of auditory acuity
A 3-year-old child is scheduled for cardiac catheterization. What is the priority nursing care after this procedure? Encouraging early ambulation Monitoring the site for bleeding Restricting fluids until the blood pressure has stabilized Comparing blood pressure readings in the lower extremities
Monitoring the site for bleeding
What is most important for a nurse to teach the parents of a child with Duchenne muscular dystrophy to do for their school-aged child? Maintain a high-calorie diet Institute seizure precautions Restrict the use of larger muscles Perform range-of-motion exercises
Perform range-of-motion exercises
A school nurse is screening children for scoliosis. In what age group is it usually identified? Adolescence Preadolescence Early school years Middle school years
Preadolescence because of the growth spurt that occurs at this time. Although scoliosis may occur at any age, idiopathic scoliosis, the most common type, tends to become evident during the preadolescent growth spurt.
An 8-year-old child with a history of asthma is brought to the emergency department because of respiratory distress. The nurse immediately places the child in a bed with the head of the bed elevated and administers oxygen by means of a face mask. The healthcare provider performs a physical assessment, writes prescriptions, and admits the child to the pediatric unit. Which instruction should the nurse carry out first? Teach incentive spirometer use. Administer the nebulizer treatment. Obtain a blood specimen for a complete blood count. Notify the respiratory therapist to perform chest physiotherapy.
Administer the nebulizer treatment.
How does a nurse identify possible developmental dysplasia of the hip (DDH) during a newborn assessment? Depressed dance reflex Limited adduction of the leg Asymmetry of the gluteal folds Shortened leg on the unaffected side
Asymmetry of the gluteal folds
A school-aged child with cystic fibrosis has recurrent episodes of bronchitis, and the parents ask the nurse why this happens. What reason should the nurse include in the reply? Associated heart defects cause heart failure and respiratory depression. Neuromuscular irritability causes spasm and constriction of the bronchi. Tenacious secretions that obstruct the respiratory tract provide a favorable medium for growth of bacteria. The increased salt content in saliva irritates the mucous membranes, resulting in inflammation of the nasopharynx.
Tenacious secretions that obstruct the respiratory tract provide a favorable medium for growth of bacteria.
A toddler with a repaired myelomeningocele has urinary incontinence and some flaccidity of the lower extremities. What should the nurse teach the parents? An ileal bladder will be necessary once the child is of school age. An indwelling catheter offers the best hope for bladder management. The child will probably require a program of intermittent straight catheterization. The child will have to wear diapers for many years because bladder training is a slow process.
The child will probably require a program of intermittent straight catheterization.
A child with hip dysplasia has undergone a closed reduction surgery. The nurse assesses the child 2 days after the surgery and feels that the treatment and care provided for the child were not effective. The nurse made this conclusion based on what findings? The child has a staggering gait. The child is unable to walk independently. The child has impaired muscle tone and flexibility. The child's femoral head did not return to the hip socket.
The child's femoral head did not return to the hip socket.
The nurse is caring for a client who sustained a soft tissue injury while playing sports. Following an assessment of the extent of the injury, what should be the order of nursing interventions according to priority? Elevating the involved limb Assessing neurovascular status Obtaining x-rays of the extremity Applying a compression bandage
The client with a soft tissue injury should first assess the extent of the injury and determine the neuromuscular status of the client. Next intervention is elevating the involved limb. Then the nurse should apply compression bandage to the affected limb. Then the client's diagnostic report such as x-ray should be obtained to provide required treatment.
The nurse prepares to discharge a newborn from the hospital. Which placement of the infant by the father indicates an understanding of the nurse's education regarding car seat safety? Back seat, facing forward Front seat, facing forward Front seat, facing backward Back seat, facing backward
Back seat, facing backward
A nurse confers with the nutritionist about the diet of a 4-year-old child with spina bifida who spends many hours in a wheelchair. What should the nurse encourage the mother to increase in her child's diet? Select all that apply. Fat Fiber Protein Calories Carbohydrates
Fiber Protein Extra fiber is needed to combat constipation resulting from immobility. Extra protein is needed for maintaining muscle mass and to help prevent pressure ulcers. Of this child's dietary intake, 25% should consist of fat; this is the lowest recommended daily intake for fat. It should not be increased because more fat calories may lead to obesity in an immobilized child. Calories should be limited because energy needs are less for immobile children than for children who are active. Carbohydrates, especially simple sugars, should be limited to help prevent obesity.
An infant who has been found to have developmental dysplasia of the hip (DDH) is being examined in the pediatric clinic. What clinical finding does the nurse expect to identify during the physical assessment? Limited abduction of the affected hip Downward and inward rotation of the affected hip Inability to flex and extend the hip on the affected side Free abduction of the affected hip when placed in the frog position
Limited abduction of the affected hip
The nurse assessing a newborn suspects Down syndrome. Which characteristics support this conclusion? Select all that apply. Hypotonia High-pitched cry Rocker-bottom feet Epicanthal eye folds Singe transverse palmar crease
Hypotonia Epicanthal eye folds Singe transverse palmar crease
A 5-year-old child undergoes cardiac catheterization. The child is in the post-cardiac catheterization unit for 2 hours when the incoming nurse receives the report from the outgoing nurse. Which part of the child's report should the incoming nurse question? Vital signs every 30 minutes Voided 100 mL since admission Pressure dressing over entry site Bed rest with bathroom privileges
Bed rest with bathroom privileges Children are kept on complete bed rest for 4 to 6 hours after cardiac catheterization to reduce the risk of bleeding or trauma at the insertion site; the report regarding bathroom privileges should be questioned. Frequent assessment of vital signs is part of routine postcatheterization care. Urine output of 100 mL is within acceptable limits for a child of this age; oral fluids are encouraged to promote hydration and urination. A pressure dressing is placed over the insertion site to prevent bleeding. This is routine postcatheterization care.
Which assessment data would cause the nurse to suspect that a toddler-age client is experiencing physical abuse? Abdominal distention Bloody underclothing Recurrent urinary tract infections Bruises in various stages of healing
Bruises in various stages of healing
A nurse is assessing a newborn with a myelomeningocele. What clinical findings prompt the nurse to suspect hydrocephalus? Select all that apply. Bulging fontanels High-pitched crying Apgar score of less than 5 A defect in the lumbosacral area Head circumference 2 cm greater than the chest circumference
Bulging fontanels High-pitched crying A defect in the lumbosacral area
An infant is born with a bilateral cleft palate. Plans are made to begin reconstruction immediately. What nursing intervention should be included to promote parent-infant attachment? Demonstrating positive acceptance of the infant Placing the infant in a nursery away from view of the general public Explaining to the parents that the infant will look normal after the surgery Encouraging the parents to limit contact with the infant until after the surgery
Demonstrating positive acceptance of the infant
A preschool-aged child is admitted to the pediatric unit for urinary diversion surgery. The ureters are transplanted to a section of the colon, with one end attached to the abdominal wall as an ileostomy. The parents ask the nurse for the name of the procedure. What is the nurse's response? Cystostomy Ileal conduit Ureterosigmoidostomy Cutaneous ureterostomy
Ileal conduit;An ileal conduit is the transplantation of the ureters to a section of the colon with one end attached to the abdominal wall. A cystostomy is an opening into the bladder through the abdominal wall that allows urine to flow out. An ureterosigmoidostomy involves transplanting the ureter into the colon so the urine is excreted through the rectum. A cutaneous ureterostomy involves the surgical creation of an opening from the ureter to the skin surface of the abdomen.
A nurse is caring for a 4-year-old child with just-diagnosed cystic fibrosis. The child has been passing loose, bulky, foul-smelling stools and is in the third percentile for weight. What is the best explanation of the growth failure? Impaired digestion and absorption because of the lack of pancreatic enzymes Dyspnea and shortness of breath, which cause anorexia and disinterest in food Increased bowel motility and diarrhea, which lead to inadequate absorption of nutrients Pulmonary obstruction, which causes an oxygen deficit and inadequate tissue nourishment
Impaired digestion and absorption because of the lack of pancreatic enzymes
A 5-year-old child is admitted to the pediatric intensive care unit with a diagnosis of acute asthma. A blood sample is obtained to measure the child's arterial blood gases. What finding does the nurse expect? High oxygen level Increased alkalinity Decreased bicarbonate Increased carbon dioxide level
Increased carbon dioxide level
A 15-year-old adolescent with Down syndrome is scheduled for surgery. The parents inform the nurse that their child has a mental age of 8 years. At what age level should the nurse prepare the child's preoperative teaching plan? Adult, for the parents to understand Specific age, as ordered by the healthcare provider Adolescent, because this is the child's chronologic age School-age, because this is the child's developmental age
School-age, because this is the child's developmental age
The nurse is admitting an 8-month-old infant with suspected bacterial meningitis to the hospital. List in order of priority the nursing actions that should be taken. Insert an intravenous access device Institute respiratory isolation Monitor for signs of increased intracranial pressure (ICP) Assist with a lumbar puncture Administer the prescribed antibiotics
The nurse should first ensure that all who come in contact with the child are appropriately gowned, gloved, and masked. A circulatory access device provides an avenue to administer prescribed fluids and medications; also, it provides a circulatory access in case of an emergency. The next priority is to obtain a sample of cerebrospinal fluid (CSF). This will help determine whether the cause is viral or bacterial, permitting prescription of the appropriate pharmacological therapy by the healthcare provider. An antibiotic is usually not administered until the lumbar puncture is completed and CSF specimen is sent for culture. Complications, such as increased intracranial pressure and seizures, should be monitored for after the infant is admitted, placed on isolation, and antibiotics are started.
All women of childbearing age are advised to include at least 400 mcg of folic acid in the daily diet to decrease the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Select all that apply. Vitamin A Vitamin B6 Vitamin B9 Vitamin B12 Legumes, dark-green leafy vegetables, and citrus fruits Eggs, meat, and poultry
Vitamin B9 Legumes, dark-green leafy vegetables, and citrus
A 4-month-old infant is admitted to the pediatric unit with a diagnosis of congestive heart failure. Which nursing assessment would most accurately demonstrate improvement in the infant's condition? Decreased tremors Increased hours of sleep Weight loss during next 2 days More rapid heart rate within 2 days
Weight loss during next 2 days Weight loss indicates fluid loss. Water retention is a classic sign of congestive heart failure. Tremors are not typical in infants with heart disease. Tremors are related to central nervous system irritability. If the infant's condition improved, energy would increase and sleeping needs would decrease. Tachycardia is a sign of congestive heart failure. The purpose of the cardiotonic is to slow the heart rate.
A newborn is found to have a diaphragmatic hernia. What is the immediate intervention after the neonate is admitted to the neonatal intensive care unit? Hydrating the infant with isotonic enemas Limiting formula feedings to small amounts Placing the infant in the Trendelenburg position Providing gastric decompression via nasogastric tube
Providing gastric decompression via nasogastric tube: When a diaphragmatic hernia is present, intra-abdominal pressure must be minimized; this is accomplished with the use of gastric decompression. Hydrating the infant with isotonic enemas is not beneficial. These infants are not fed orally; intravenous fluids are given with careful measurement of electrolytes and intake and output to guide replacement therapy. The Trendelenburg position is contraindicated; the abdominal organs will increase pressure on the diaphragm.
