Peds exam 2 questions
The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take?
notify the primary health care provider
The parent of a child with a terminal illness starts to give away the child's toys and eventually stops visiting the child regularly in the hospital. Upon assessing the parent's actions, the nurse begins instruction on:
anticipatory grief that has led to the acceptance stage of grief
A mother brings her 15-year-old girl to the gynecologist's office for a physical examination. The mother pulls the nurse to the side and says that she is concerned that her daughter may have an eating disorder. Which finding would tend to confirm a diagnosis of anorexia nervosa?
the girl repeatedly describes herself as fat even though she appears to be severely underweight
A 6-month-old infant develops roseola. When obtaining information from the parent, what would the nurse expect the parent to report?
the infant's temperature fell when the rash appeared
The developmental task of the school-aged period, according to Erikson, is gaining a sense of:
industry vs inferiority
An adolescent comes to the clinic reporting a sore throat and chills. The nurse suspects that the adolescent has infectious mononucleosis. Which instruction(s) will the nurse provide to this adolescent? Select all that apply.
-take acetaminophen for fever and pain -rest and sleep when possible -eat some, nonirritating foods
In which situation would the nurse expect parents to experience the stages of anticipatory grief?
9 year old with terminal bone cancer
Based on Erikson's developmental theory, what is the major developmental task of the adolescent?
finding an identity
The nurse caring for children with fungal infections most often administers which medication?
griseofulvin
A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?
red, strawberry tongue
The nurse is administering 8 p.m. medications when a 9-year-old child expresses concern about dying sometime during the night. Which action by the nurse is most appropriate?
stay with the child and encourage further discussion
When working with the family who has just learned that their child is dying, which of the following nursing interventions would be the highest priority for the nurse to do for this family?
the nurse encourages the family to express their feelings and anxieties
A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease?
playing in the woods about a week ago
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?
I can't believe it. We're not unclean, poor people
An extremely thin preadolescent is being assessed by the nurse. Which client statement will cause the nurse to suspect the client is experiencing anorexia nervosa?
I feel chubby no matter what I wear
A toddler is being treated for pinworms. What advice should the nurse give to the mother to prevent reinfection?
everyone in the family will need to. be treated
A 12-year-old girl with terminal leukemia has chosen to die in a local hospice facility. The nurse understands that which of the following is an advantage of a hospice facility over a hospital and the home in terms of an environment for death?
a homelike setting combined with access to skilled professional health care
After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?
after the lesions have crusted
Which nursing action will best assist a 15-year-old client accomplish the developmental task according to Erikson?
allow the client's friends to visit while the client is hospitalized
A school-age child with a rash over the abdomen now has a bright red tongue. The health care provider is going to begin treatment for scarlet fever. On which medication should the nurse instruct the mother for the child's care?
antibiotics
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?
antibiotics are needed to help our child recover from rubella
The mother of a 7-year-old girl with terminal leukemia has made elaborate plans for the funeral service and burial of her daughter. She has created a beautiful scrapbook of her daughter's life to remember her by and recorded many happy memories of her in a journal. Which of the following would best characterize this mother's coping mechanism?
anticipatory grief
What is the priority nursing intervention for the sibling of a child who has died?
assess the child's feelings about the sibling's death
The nurse is educating a parent support group for adolescents with anorexia nervosa. The parents express concern for their adolescents and appear anxious about doing the "right thing" as parents. For beginning instruction, which content is essential for the parents to understand?
avoid making comments about the adolescents appearance
The mother of a 5-year-old girl with terminal brain cancer tells the nurse, "I'm not ready to throw in the towel yet. I just made a big donation to the American Cancer Society (ACS) and told God that I would support that organization for the rest of my life if my girl will just pull through." Which stage of grief does the nurse suspect this mother to be in?
bargaining
The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation?
boys grow at a slower, steadier rate than do girls
The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?
bull's-eye rash around the bite
During a well-child visit for a 12-year-old female client, the parent states, "I have noticed a lot of physical and emotional changes in my child. How will I know when my child has reached puberty?" Which is the best response by the nurse?
by age 14, many girls have the physical appearance of a young woman
The father of a 4-year-old boy with leukemia tells the nurse that he believes his son was misdiagnosed by his two previous oncologists and that the lab results were in error. Thus, he has switched doctors in hopes of "finding someone who can diagnose his son accurately." Which stage of grief does the nurse suspect this father to be in?
denial
An adolescent has been diagnosed with bulimia, and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent?
develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals
A 14-year-old is admitted to the hospital for the second time for treatment of anorexia nervosa. Her responses to your questions on admission are either yes, no, or no response. Initially, your primary nursing goal in caring for this adolescent would be to:
develop rapport for a trusting relationship
The nurse is caring for a 12-year-old client diagnosed with a respiratory infection and on antibiotics for the second time in a 30-day period. When assessing information from the first infection, which question is most important for the nurse to ask?
did you finish all of the antibiotics prescribed after the last respiratory infection
A nurse is teaching a class to new parents on how to prevent the spread of infection in their children. What is the best suggestion the nurse could offer to these parents?
encourage frequent hand hygiene
The nurse is providing discharge instructions to a child diagnosed with encopresis. Which of the following instructions would the nurse question?
encourage positive reinforcement for the child's toilet habits
The nurse is caring for an infant brought to the clinic for a rash. The nurse notes a blanchable, rose-pink macular rash on the trunk. The nurse obtains the following vital signs: temperature 99.0°F (37°C), pulse 100 bpm, respiratory rate 22 breaths/minute, and oxygen saturation 100% on room air. Which question by the nurse will be most helpful when planning interventions?
has your child had a recent fever
To be an effective nurse with a female child who is dying, it is first necessary to:
identify your own reactions and feelings about death
According to Erikson, the adolescent develops their own sense of being an independent person with individual thoughts and goals. This stage is referred to as:
identity vs. role confusion
Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period?
incubation period
A nurse is instructing the parents of a child who is suspected of having pinworms on how to check their child. Which instruction is appropriate?
inspect the child's anus with a flashlight 2-3 hours after the child is asleep
An adolescent asks the nurse what the term "puberty" means. What is the nurse's best response?
it is at the age which one first becomes capable of sexual reproduction
A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings?
koplik spots
The appearance of which hallmark clinical manifestation occurs in measles?
koplik spots
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 mostlikely has which condition?
mumps
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?
mumps
A child is newly diagnosed with tinea capitis. Which parent statement helps the nurse identify the likely source of the condition?
my child was in a play where they shared a variety of clothes and hats
According to the American Psychiatric Association (DSM-5, 2013), a client with anorexia nervosa has a body image disturbance in which one's body weight or shape is not experienced realistically. Which statement by a client would best validate this criterion?
my stomach really sticks out and looks fat
The nurse is discussing an adolescent's development with the client's parents. Which statement by the parents indicate an understanding of the nurse's teaching?
our adolescent is working toward achieving a sense of personal identity
What is the priority nursing action for a dying child who is restless, moaning, and vomiting?
pain assessment and control
A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child?
penicillin V
While assessing a child, the nurse notes a runny nose, temperature 100.4°F (38°C), and a whoop sound when the child coughs. On which diagnosis will the nurse anticipate providing education for this family?
pertussis
A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter?
portal of entry
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema?
redness of the skin produced by congestion of the capillaries
The nurse is working with a child diagnosed with encopresis. After a complete medical workup has been done, no organic cause has been found for the disorder. What follow-up will the nurse expect?
referred for counseling
What information should be included in the teaching plan for a child with varicella?
remind the child not to scratch the lesions
The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?
ring-like rash on lower leg
A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?
scarlet fever
A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:
scarlet fever
A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?
severe erosion of teeth
The parents of a child with a brain tumor are shouting that their health care provider must be incompetent or else their child would be healed. How will the nurse address the parents' anger?
sit down and discuss the parents feelings
The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?
the adolescent telling the nurse purging occurs after each meal
The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructor determines the class is successful after the students correctly choose which milestone as the beginning of adolescence?
the beginning of puberty
The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?
the child will have a complete physical exam
The nurse is caring for the family of a child with a terminal illness. Which action on the part of the parents indicates to the nurse that the parents are beginning to accept the diagnosis?
the parents acknowledge feelings of sadness
An 11-year-old girl arrives at the doctor's office with fever, a sore throat, chills, and malaise. A throat culture indicates scarlet fever. Which other symptom should the nurse notice in this client that clearly indicates scarlet fever?
the tongue has a white or red "strawberry" appearance
The father of a 10-year-old who has recently been diagnosed with a terminal illness tells the nurse that his family had been working together for the previous year trying to get the 10-year-old and his 6-year-old sister to play better together and to share with each other. Which statement would be most appropriate for the nurse to tell the father regarding children and the diagnosis of an illness?
the younger child might believe that her anger at her brother caused his illness; she will need reassurance that she does not have that power
During an examination, an adolescent client tells the nurse about being anxious and frustrated because of the facial acne. Which nursing response is appropriate?
this is one of the most common physical changes during adolescence
An adolescent is concerned that although he has pubic hair, he has no facial hair yet. He wishes facial hair would grow to cover acne lesions. The nurse would advise him that facial hair:
usually follows pubic hair growth
The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate?
vaccinations are very effective at preventing serious disease and infection
A group of grade-school children is going camping. As a school nurse, you would offer them which advice to prevent Lyme disease?
wear jeans tucked inside your socks when in the woods
A hospice nurse is caring for a child who is dying. Which assessment finding needs to be documented to officially determine that death has occurred? Select all that apply.
-absence of respirations -flat electroencephalogram -lack of reflex response
A 15-month-old child with honey-crusted skin lesions around the mouth is diagnosed with impetigo. Which nursing instruction(s) will need to be placed on the discharge summary? Select all that apply.
-admin amoxicillin 250 mg by mouth daily -wash the crusted areas with soap and warm water and pat dry -use mupirocin ointment directly to the skin lesions - prevent further impetigo transmission by washing your hands
A nurse is assessing an 8-year-old child with a terminal illness. The nurse determines that the child is near death based on which findings? Select all that apply.
-mottled hands and feet -diaphoresis
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group?
you have a lot of hormone changes going on right now
The nurse is instructing a 12½-year-old boy who says, "I am too short! Girls are taller than I am. Guess I won't be playing basketball." What instructions are best included in the plan of care? Select all that apply.
-girls begin to grow rapidly at a younger age than boys do. boys start later and grow longer -there are a lot of size differences in your age group now b/c everyone enters puberty and grows at slightly different times -you could add as much as 12 inches to your height before you stop growing
The parents of a child diagnosed with a terminal illness tell the nurse, "This isn't fair!" What is the most therapeutic nursing response?
this must be very difficult for your child and family
Assessment of a child reveals black burrows of about 1-inch long between the fingers and toes and in the axilla. A diagnosis of scabies is made. When planning this child's care, the nurse anticipates which medication being prescribed?
topical permethrin
During a routine assessment, the nurse determines that a school-age child has head lice. What did the nurse assess in this child?
white flakes on hair shafts
The parents of a 5-year-old child who is very near death are at the bedside.The parents ask, "Can our child hear what we are saying?" Which response by the nurse is appropriate?
yes, your child can hear what you are saying even though your child may not respond
During a health visit, an adolescent client tells the nurse, "Why am I having all this acne?" Which response by the nurse would be appropriate?
your body is producing hormones called androgens that are responsible for your acne
