PEDS exam 2 part 3

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."

A. "I can't believe it. We're not unclean, poor people."

Which statement by the parent of a 12-month-old child diagnosed with Down syndrome shows the need for further education? A. "I will need to delay any further immunizations." B. "Thyroid testing is needed every year." C. "In a couple of years, my child will need an x-ray of the neck." D. "I will watch closely for development of respiratory infection."

A. "I will need to delay any further immunizations."

A nurse is teaching parents of a child with a nursing diagnosis of pain related to pruritus from skin lesions. Which of the following would the nurse include in the instructions? Select all that apply. A. "Keep the child's fingernails short." B. "Wrap your child up snugly with blankets." C. "Bathe the child in lukewarm water and baking soda." D. "Have the child press on the itching area instead of scratching it." E. "Avoid having your child wear cotton clothing."

A. "Keep the child's fingernails short." C. "Bathe the child in lukewarm water and baking soda." D. "Have the child press on the itching area instead of scratching it."

The mother of Mary Jo, a 10-year-old who had a febrile reaction following a transfusion, asks the nurse: "Why did this happen to my child?" Which response by the nurse would be most appropriate? A. "Mary Jo's blood has developed antibodies to the white blood cells, platelets or plasma protein antigens in the donor blood." B. "Mary Jo's blood was not compatible with the blood product, causing the red blood cells to destruct." C. "The donor blood contained plasma proteins or other antigens to which Mary Joe was hypersensitive." D. "Too much of the blood product was transfused at too rapid a rate."

A. "Mary Jo's blood has developed antibodies to the white blood cells, platelets or plasma protein antigens in the donor blood.

The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following? A. "We will make sure to remind him not to scratch the lesions." B. "We can give him aspirin for fever." C. "We should put him in a warm bath if he is itchy." D. "We can use salt solutions to help heal his oral lesions."

A. "We will make sure to remind him not to scratch the lesions."

The nurse is assessing an 8-week-old infant in the clinic. The parent states the infant was feeding well and gaining weight until a few weeks ago and now is noted to have lost weight and "isn't doing well" per the parent. What action would the nurse take next? A. Assess the infant further for an inborn error of metabolism B. Advise the parent to decrease the feedings daily to every 6 hours C. Suggest the child be fed in a supine position, using a car seat or carrier D. Refer the parents to a dietitian for education on increasing the child's appetite

A. Assess the infant further for an inborn error of metabolism

After teaching the parents of a child diagnosed with sickle cell disease, the nurse determines that the teaching was successful when the parents state that they will contact the primary health care provider if the child develops which signs or symptoms? Select all that apply. A. Chest pain B. Severe dizziness C. Sudden change in vision D. Constipation E. Irritability

A. Chest pain B. Severe dizziness C. Sudden change in vision

The nurse is reviewing information about hemophilia with an adolescent client. The client demonstrates understanding of the information when identifying hemophilia B as a deficiency of which factor? Select all that apply. A. Christmas factor B. Factor IX C. Stuart's factor D. Antihemophilic factor E. Factor VIII

A. Christmas factor B. Factor IX

A nurse is providing care to a child with hemophilia who is experiencing muscle and joint involvement related to the bleeding. Which would the nurse include as an adjunctive measure to control bleeding? A. Compression B. Heat C. Exercise D. Lowering extremities

A. Compression

A nurse is administering a blood transfusion to a child. About 35 minutes after beginning the transfusion, the child develops pruritus and urticaria. Some wheezing is noted. Which action would the nurse take first? A. Discontinue the transfusion. B. Obtain a blood culture. C. Give an iron-chelating agent. D. Ask the health care provide for a prescription for a diuretic.

A. Discontinue the transfusion.

The nurse is caring for a 1-year-old boy with Down syndrome. Which intervention would the nurse be least likely to include in the child's plan of care? A. Educating parents about how to deal with seizures B. Explaining developmental milestones to parents C. Promoting annual vision and hearing tests D. Describing the importance of a high-fiber diet

A. Educating parents about how to deal with seizures

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? A. Encourage rest and relaxation. B. Antibiotic therapy may be initiated. C. Antiviral medications can be prescribed. D. Range of motion to prevent contractures.

A. Encourage rest and relaxation.

A nurse performs a focused physical assessment for a child diagnosed with aplastic anemia. Which of the following would the nurse most likely document as a typical characteristic? Select all that apply. A. Epicanthal folds B. Small jaw C. Café-au-lait spots D. Narrow nasal base E. Large eyes

A. Epicanthal folds B. Small jaw C. Café-au-lait spots

A child is receiving antithymocyte globulin for treatment of acquired aplastic anemia. After administering the drug, assessment of which of the following would the nurse identify as a possible adverse reaction? Select all that apply. A. Fever B. Urticaria C. Dyspnea D. Constipation E. Diarrhea

A. Fever B. Urticaria C. Dyspnea

After teaching a class of students about genetics and inheritance, the instructor determines that the teaching was successful when the students identify this as the basic unit of heredity. A. Gene B. Chromosome C. Allele D. Autosome

A. Gene

The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs? A. Gloves B. Gown C. N95 respirator D. Face mask E. Eye wear

A. Gloves B. Gown C. N95 respirator

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation? A. Head lice are becoming very resistant to treatment. B. Send your child to school even if you suspect head lice, but have the school nurse check the child. C. Discourage the children from going to sleepovers. D. Wash the bed linens in hot water to kill the lice.

A. Head lice are becoming very resistant to treatment.

The nurse preparing a child for diagnostic testing to diagnose disseminated intravascular coagulation (DIC). Which results would the nurse identify as indicating this condition? A. Increased D-Dimer assay B. Increased antithrombin III C. Decreased fibrogen/fibrin degradation products D. Decreased fibrinopeptide A level

A. Increased D-Dimer assay

A newborn was screened for hereditary metabolic disorder at 8 hours old. Which action by the nurse is most appropriate? A. Instruct the parent to have another screening in 1 to 2 weeks B. No further intervention is needed C. Repeat screening in 8 hours D. If the infant is premature, screening needs to be done every 8 hours for 48 hours

A. Instruct the parent to have another screening in 1 to 2 weeks

A child with sickle cell anemia comes to the emergency department for evaluation. The nurse suspects that the child is experiencing a vaso-occlusive crisis based on assessment of which signs and symptoms? Select all that apply. A. Low back pain B. Fever C. Distended abdomen D. Splenic enlargement E. Increased reticulocyte count

A. Low back pain B. Fever C. Distended abdomen

The nurse is assessing the eyes of a 6-month-old and notices that she has wide-spaced eyes and bilateral epicanthal folds. Which condition associated with these findings should also be assessed for in this child? A. Low-set, malformed ears B. Amblyopia C. Strabismus D. Ptosis

A. Low-set, malformed ears

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe.The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition? A. Mumps B. Infectious mononucleosis C. Poliomyelitis D. Herpes zoster

A. Mumps

A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which medications are potentially ordered with instructions placed on the discharge summary? Select all that apply. A. Penicillin B. Erythromycin C. Mupirocin D. Tetracycline E. Lindane

A. Penicillin B. Erythromycin C. Mupirocin

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

A. Redness of the skin produced by congestion of the capillaries

The nurse is educating an 18-year-old female client with Turner syndrome. What information will the nurse include in the teaching plan? A. Resources regarding infertility and family planning B. Requirements for post secondary educational needs C. The need to eliminate amino acids from the diet D. The options for a cure as the client enters adulthood

A. Resources regarding infertility and family planning

The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis? A. Slightly yellow sclera B. Enlarged mandibular growth C. Increased growth of long bones D. Depigmented areas on the abdomen

A. Slightly yellow sclera

While receiving a transfusion of packed red blood cells, a school-aged child begins to experience itchy skin, hives, and wheezes. What should the nurse do first for this child? A. Stop the transfusion. B. Obtain a blood culture. C. Slow the transfusion rate. D. Provide a diuretic as prescribed

A. Stop the transfusion

A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A. That the infant's skin has greater permeability than that of an adult B. That there is less body surface area to be concerned about. C. That there is decreased absorption rates of topical drugs in infants. D. That there is a lower concentration of water in an infant's body compared with an adult.

A. That the infant's skin has greater permeability than that of an adult

The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern? A. The child is immune to further attacks of the disease. B. It does not matter because mumps in adulthood is not serious. C. The child should receive active immunization against mumps. D. There is nothing that can be done to prevent another attack of mumps in the future.

A. The child is immune to further attacks of the disease.

When teaching about Turner's syndrome, what should the nurse include? A. Timing and use of growth hormone B. Use of hormone therapy to prevent infertility C. Long-term effects of decreased intellectual ability D. Treatment for gynecomastia

A. Timing and use of growth hormone

A client with severe chronic anemia is receiving ongoing transfusion therapy. The nurse frequently assesses the client for what major complication of this therapy? A. Toxic iron overload B. Fibrin clots C. Chronic idiopathic thrombocytic purpura D. Vaso-occlusive crisis

A. Toxic iron overload

A 9-year-old child is diagnosed with von Willebrand's Disease (vWD) with the following characteristics: decreased quantities of all sizes of von Willebrand's factor multimers and decreased activity of von Willebrand's factor. The nurse identifies this as which type of vWD as being involved? A. Type I B. Type II C. Type III D. Type IIIB

A. Type I

A child is receiving a blood transfusion. Which of the following would alert the nurse that the child is experiencing a hemolytic reaction? Select all that apply. A. Urticaria B. Respiratory distress C. Diaphoresis D. Lower back pain E. Chills

A. Urticaria D. Lower back pain E. Chills

A nurse is describing the underlying cause of trisomy 21 to a group of parents, integrating knowledge that the disorder is due to: A. nondisjunction. B. deletion. C. duplication. D. translocation

A. nondisjunction.

A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 ug/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding: A. removal or covering of flaking paint on the walls of the home B. putting child safety locks on kitchen cabinets C. putting medicine away where children cannot reach it D. placing house plants out of reach of children

A. removal or covering of flaking paint on the walls of the home

A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur? A. 1 copy of the chromosome 8 has occurred instead of 2 copies. B. 3 copies of trisomy 21 has occurred instead of 2 copies. C. 3 copies of trisomy 18 has occurred instead of 2 copies. D. 3 copies of trisomy 13 has occurred instead of 2 copies.

B. 3 copies of trisomy 21 has occurred instead of 2 copies.

A child develops treatment-related thrombocytopenia. When preparing the plan of care for the child, which would the nurse include? Select all that apply. A. Allowing frequent blood-drawing procedures for laboratory testing B. Applying pressure to a puncture site for a full 5 minutes C. Limiting the use of adhesive tape on the child's skin D. Administering medications orally or intravenously E. Obtaining extra amounts of blood just in case when drawing blood

B. Applying pressure to a puncture site for a full 5 minutes C. Limiting the use of adhesive tape on the child's skin D. Administering medications orally or intravenously

The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective? A. Mother applies hot compresses to itchy skin areas every few hours B. Child drinks a glass of water every 1 to 2 hours throughout the day C. Child showers in hot water and uses soap on the rash every morning D. Child wearing long denim pants and a long-sleeve shirt while playing outside

B. Child drinks a glass of water every 1 to 2 hours throughout the day

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome? A. Instances of Down syndrome in the family greatly increases the risk for the baby also having Down syndrome. B. Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg. C. Down syndrome occurs only in females, and there is no risk as the baby is male. D. Children with Down syndrome are usually born to older mothers.

B. Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

The nurse is caring for a newborn diagnosed with an inborn error of metabolism with several referrals ordered. What referral would the nurse place as the priority for the infant? A. Spiritual advisor B. Dietitian C. Community support group D. Genetic counseling

B. Dietitian

The nurse is assessing a child who is experiencing acute splenic sequestration secondary to sickle cell disease. The nurse would identify which of the following as the priority? A. Pain relief B. Emergent transfusion C. Antibiotic administration D. Oxygen administration

B. Emergent transfusion

When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, what would be the priority? A. Assisting with scheduling follow-up visits B. Establishing a trusting relationship C. Teaching the family what to expect D. Using measures to promote growth and development

B. Establishing a trusting relationship

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? A. Measles B. Mumps C. Whooping cough D. Scabies

B. Mumps

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed? A. "Our child is contagious for 1 week after the rash appeared." B. "Acetaminophen or ibuprofen can be given to help with pain." C. "Antibiotics are needed to help our child recover from rubella." D. "Family members should wear a mask when coming to visit us."

C. "Antibiotics are needed to help our child recover from rubella."

Which of the following women has the greatest risk of having a child with Down syndrome? A. 25-year-old B. 30-year-old C. 42-year-old D. 35-year-old

C. 42-year-old

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

C. Discolored skin spot not elevated at the surface

The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching? A. Suggest the child participate in sports activities without restriction. B. Treat upper respiratory infections with over-the-counter medication. C. Ensure a consistent and daily intake of adequate fluids to prevent dehydration. D. Remind to avoid immunizations to prevent the introduction of bacteria into the body.

C. Ensure a consistent and daily intake of adequate fluids to prevent dehydration

The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely? A. Interrupted family process related to the child's diagnosis B. Deficient knowledge deficit related to the genetic disorder C. Grieving related to the child's poor prognosis D. Ineffective coping related to stress of providing care

C. Grieving related to the child's poor prognosis

A child with sickle cell disease is brought to the emergency department by his parents. He is in excruciating pain. A vaso-occlusive crisis is suspected and analgesia is prescribed. Which of the following would the nurse least likely expect to be ordered? A. Morphine B. Nalbuphine C. Meperidine D. Hydromorphone

C. Meperidine

A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them. A. Intense red rash on the face B. Rash on the flexor surfaces of extremities and trunk C. Rash on extremity extensor surfaces D. Fever and headache E. Lace-like lesion appearance

D, A, C, B, E

The nurse is educating a parent after the birth of a newborn who is diagnosed with phenylketonuria (PKU). Which parent statement indicates teaching has been effective? A. "I will supplement my breast milk with prescribed formula." B. "Once the baby is on solid foods, the dietary restriction will be gone." C. "The concern is the baby has an excess of a liver enzyme." D. "I will not breast feed the baby since breast milk contains phenylalanine."

D. "I will not breast feed the baby since breast milk contains phenylalanine."

The parent of an infant born with trisomy 18 says to the nurse, "I am so lost...I can't even think about my baby not being healthy." How should the nurse respond? A. "I understand...we occasionally see clients with trisomy 18 and it is very sad." B. "This is a difficult time, but let's talk about the ways your baby will outgrow this." C. "I would encourage you to talk with the doctor about ways to cure this disorder." D. "This is a sad time for you. I will sit with you quietly in case you want to talk."

D. "This is a sad time for you. I will sit with you quietly in case you want to talk."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? A. "We should apply alcohol to the lesions every four hours." B. "If he has a fever, we can give him some aspirin." C. "The lesions should eventually form soft crusts that drain." D. "We need to make sure that he washes his hands frequently."

D. "We need to make sure that he washes his hands frequently."

The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse? A. "I am sure it must be frustrating. Where did you have the immunizations performed?" B. "I am wondering if your physician followed the immunization schedule correctly?" C. "Are you sure your child received an immunization for mumps?" D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

The nurse is planning care for a school-aged child recovering from being hit by a motor vehicle while riding a bicycle. For what will the nurse assess to determine the onset of disseminated intravascular coagulation in this child? A. Blurred vision B. Nausea and vomiting C. Sudden onset of knee pain D. Bleeding from intravenous sites

D. Bleeding from intravenous sites

The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to incorporate into the plan of care when working with this family? A. Gathering information from at least three generations B. Informing the family of the need for a wide range of information C. Maintaining the confidentiality of the information D. Presenting the information in a nondirective manner

D. Presenting the information in a nondirective manner

The nurse is comforting a family who were just informed by the health care provider that their baby will likely be born with a significant genetic abnormality. What actions by the nurse would be therapeutic? Select all that apply. A. Advise the parents to discuss their fears with only each other B. Discuss the nurse's personal beliefs regarding genetic abnormalities C. Encourage the family to ask questions after they have researched the disorder D. Refer the family to appropriate parent group or local family with similar needs E. Allow the family to discuss their emotions in an authentic and trusting environment

D. Refer the family to appropriate parent group or local family with similar needs E. Allow the family to discuss their emotions in an authentic and trusting environment

The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection? A. Dark red color B. Noticeable crusts but no pruritus C. Dark red, macular, very pruritic lesions D. Various stages of lesions present at the same time

D. Various stages of lesions present at the same time

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: A. not until all lesions have completely faded. B. as soon as the temperature is normal. C. 10 days after the initial lesions appear. D. as soon as all lesions are crusted.

D. as soon as all lesions are crusted.

The parents of a 1-year-old child with Down syndrome are at a follow-up clinic visit for their child. What information would the nurse review with the parents at this time? Select all that apply. A. Plan to have the child's vision and hearing tested at the age of 18 months B. The child should be consuming added calories now that he is growing more C. Dental visits should be scheduled yearly from this age to adolescence D. Cervical x-rays need to be scheduled for the next visit in 3 months E. Monitor for symptoms of respiratory infections and ear infections F. A thyroid test will be scheduled for this visit to monitor for high or low thyroid concerns

E. Monitor for symptoms of respiratory infections and ear infections F. A thyroid test will be scheduled for this visit to monitor for high or low thyroid concerns