Peds exam 3 tb
The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" Which response by the nurse would be most appropriate?
A. "Sometimes it's hard to tell if a product contains aspirin."
An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?
A. "Tell me what makes you think the medication is not working"
A child is diagnosed with short bowel syndrome. What would the nurse expect to be included in the child's plan of care? Select all that apply.
A. Antibiotics B. Vitamin supplements C. Total parenteral nutrition
Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone?
A. Antidiuretic hormone
During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply.
A. Child reports abdominal pain. B. Child has a change in school performance. C. Child demonstrates anxiety or trouble sleeping. D. Child does not want to be left alone with a certain adult.
The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply.
A. Cuts and bruises on the hands B. Burns on the dorsal surface of the hand C. A curved laceration on the back D. Linear lesions across the chest and abdomen
While observing the parents of a neonate with pyloric stenosis feeding the baby, the nurse notes that the parents are becoming frustrated. The nurse identifies a nursing diagnosis of risk for impaired parenting related to frustration and difficulty feeding neonate. Which would be appropriate for the nurse to include in the plan of care? Select all that apply.
A. Encouraging rooming in with the neonate C. Assisting the parents in holding and feeding their neonate D. Pointing out positive aspects about their neonate
A young child is brought to the emergency department and requires advanced life support. The nurse is preparing to administer medication to maintain the child blood pressure and systemic perfusion. Which of the following might the nurse administer?
A. Epinephrine B. Dopamine C. Dobutamine
The nurse is caring for a child with a gastrointestinal disorder and measuring intake and output. The nurse observes that the child is demonstrating symptoms of adequate hydration when she/he has which of the following? Select all that apply.
A. Fontanelles with normal tension B. Adequate skin turgor D. Pink and moist mucous membranes
Which type of diet should be included in the plan of care for a child diagnosed with Addison disease?
A. High-protein, low-carbohydrate, high-sodium diet
A child has been admitted to the acute care facility for the management of dehydration. The nurse is preparing to administer intravenous fluid replacement to the child. Which fluids are suitable for use? Select all that apply.
A. Lactated Ringer B. Normal saline
The nurse is caring for a newborn with a cleft palate. Which findings in the maternal medical record are considered to be contributing factors? Select all that apply.
A. Maternal tobacco use. D. Anticonvulsant therapy used to manage a seizure disorder.
A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information when the students identify which system of most consistently affected by metabolic disorders?
A. Nervous system
The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which finding would the nurse identify as contributing to this current complaint?
A. Overproduction of cerumen
The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information?
A. Process that requires the individual to view a situation from a different perspective
A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication if she becomes pregnant. The nurse integrates understanding of which of the following when responding to the client?
A. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy
An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder?
A. The child should maintain an active lifestyle.
The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply.
A. The child's mother has a history of substance use disorder. C. The child was born prematurely. D. The child has cerebral palsy.
A child aged 3 months has been spitting up regularly since birth and is somewhat underweight. The nurse suggests which interventions to the parents? Select all that apply.
A. Thicken feedings with rice cereal. B. Feed smaller amounts more frequently. D. Burp well when feeding.
The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?
A. This medication must be given by injection.
During the assessment of a preschooler, the nurse notes that the child has abnormal dryness and thickening of the conjunctiva and dry and scaly skin. Which vitamin deficiency does the nurse suspect this child is experiencing?
A. Vitamin A
A child is exhibiting symptomatic bradycardia that has been unresponsive to ventilation and oxygenation. Which of the following would the nurse expect to be administered?
Atropine
A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?
B. Avoid unattended baths for the toddler.
The nurse is reviewing the history of an adolescent with peptic ulcer disease. Which client activity would the nurse identify as an associated contributing factor? Select all that apply.
B. Ingestion of diet colas C. High coffee intake D. Cigarette smoking
A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe?
B. Loss of motor activity accompanied by a blank stare
A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent?
B. Most of these conditions will spontaneously resolve.
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply.
B. Orthostatic hypotension C. Weak pulse E. Hypothermia
A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time?
B. Preparation for an emergency endoscopy to remove the batteries
The nurse is caring for a pediatric client newly diagnosed with Crohn's disease. When reviewing the client's subjective and objective data, which is consistent with the diagnostic criteria? Select all that apply.
B. Significant weight loss C. Perianal lesions D. Lesions limited to the colon and rectum
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?
C. "I always keep phenobarbital with me in case of a fever."
A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child?
C. "Is there anything that you do over and over again and can't resist doing?"
The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate?
C. Document the bruises and any statements made by the child relating to them.
What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy?
C. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.
When educating parents of preschoolers what is most important to include in your presentation?
C. Keep chemicals in a locked cabinet.
The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply.
D. "In infancy a lack of loving behaviors such as cuddling is concerning." E. "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be?
D. Assess the child's airway and manage airway patency
An unconscious client is brought to the emergency department after ingesting too much prescribed medication. What is the highest priority nursing intervention?
D. Establish a patent airway.
A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client?
D. Excess fluid volume
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone?
D. Growth hormone
A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority?
A. Administering 100% oxygen by mask
A 9-year-old girl has just been diagnosed with Grave's disease. Which symptom should the nurse expect in this child? Select all that apply.
A. Exophthalmos (protruding eyes) B. Moist skin C. Nervousness D. Increased basal metabolic rate
A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client?
A. Severe erosion of teeth
The nurse is caring for a teenager recently diagnosed with Addison disease. Which findings can be anticipated by the nurse? Select all that apply.
A. Sodium level 128 mEq/L B. Potassium level 5.6 mEq/L C. Muscular weakness
After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply.
A. The parents recently divorced B. The father is unemployed and mother is infrequently home D. The child is expected to care for younger siblings while mother sleeps E. There is history of multiple injuries obtained from a motor vehicle crash
The school nurse is educating the parents of a child with infectious conjunctivitis. Which of the following statements by the nurse would be most helpful for the parents related to prevention?
B. "Don't use anything that touches her face."
A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan?
B. Provide some time to talk to her several times a day.
A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room?
C. A private room near the nurses' station
The nurse is examining a child with hypoparathyroidism. The nurse would expect to assess which signs and symptoms? Select all that apply.
C. Chvostek E. Trousseau
An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient?
C. Increased temperature and decreased respiratory rate
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms?
A. Syndrome of inappropriate antidiuretic hormone
A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement?
A. Take glucometer readings as ordered
The nurse is educating parents of a male infant with Chiari type II malformation about the condition. Which of the following would be most important for the nurse to include?
A. Taking time to feed the infant
The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?
A. The child constantly opens and closes the hands.
The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder?
D. "My child does not say more than one or two words and grunts to indicate needs."
The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching?
A. "Encourage a bland diet."
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis?
A. "He recently helped clean the basement.
The nurse is performing discharge teaching for a 16-year-old diagnosed with peptic ulcer disease. Which statements by the parents and client demonstrate learning has occurred?
A. "I will need to make sure to take all of the antibiotic prescribed." B. "It's important to take my histamine agonist medication at the appropriate time." D. "The prednisone that I take for my rheumatoid arthritis may be a cause of my peptic ulcer disease."
The young child has been diagnosed with hepatitis B. Which of the following statements by the child's mother indicates that further education is required?
A. "We went swimming in a local lake 2 months ago and I just knew she drank some of the lake water." D. "The only way you can get this virus is from intravenous drug use."
The nurse is called into a toddler's room. The child's mother says "he's having trouble breathing." What should the nurse do first?
A. Assess patency of the child's airway.
A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?
A. Blood glucose level
A nurse is caring for a 3-year-old girl with microcephaly. Which of the following actions is appropriate for the nurse to take?
A. Playfully ask the child to touch her nose
A 10-year-old boy has just arrived by ambulance at the emergency room following a motor vehicle accident, and a nurse is assessing him. Which three body systems should the nurse evaluate fist?
A. Respiratory, cardiovascular, and neurologic
The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis?
A. The bone scan would show bone age would be two or more deviations below normal.
The nurse is caring for a 3-year-old girl who has just undergone a ventriculostomy. Which of the following would the nurse include in this child's plan of care to manage increased intracranial pressure (ICP)?
A. Use pillows to support the child when lying on her side
An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?
Acetylcysteine
A nurse is developing a teaching plan for an adolescent diagnosed with gastroesophageal reflux disease. Which would the nurse include? Select all that apply.
B. "You need to avoid acidic foods like oranges and grapefruits." C. "Eating smaller portions might be helpful." E. "Try sleeping with your upper body elevated on a foam wedge."
A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make?
B. "Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye."
The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply.
B. Normal saline C. Lactated Ringer's
A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care for an omphalocele?
B. Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities.
The nurse is conducting a physical examination of a child with suspected Crohn disease. Which finding would be the most suspicious of Crohn disease?
B. Perianal skin tags or fissures
The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best?
D. "I am here to answer your questions and be with you during this difficult time."
A child is brought into the emergency department. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next?
D. Assess level of consciousness.
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder?
D. The child constantly stares at a rotating wheel on the crib mobile.
The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion?
D. The disorder is caused by a difference in brain architecture.
When describing the negative feedback system that controls endocrine function, the nurse explains that a decreased secretion of which correlates with a decrease in blood glucose levels?
Insulin
A child has been prescribed Stimate (esmopressin) acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse?
Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that will slow down your urine output
The nurse is providing education to the parents of a female with hydrocephalus who has just had a shunt inserted. When discussing the child's condition with the parents, which of the following would be most appropriate?
A. "Tell me your concerns about your child's shunt."
A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result?
A. 8.5%
The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate?
C. "Small increments in dosage lead to sharp increases in plasma drug levels."
For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder?
C. An 8-year-old who will not stay overnight at a friend's house
The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required?
C. The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe.
A nurse suspects that a child is experiencing isotonic dehydration based on which assessment findings? Select all that apply.
B. Cool skin temperature C. Irritability D. Normal serum sodium level
A 12-year-old boy has broken his arm and is showing signs and symptoms of shock. Which of the following would the nurse do first?
B. Establish a suitable IV site.
A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply.
B. Hypersensitivity to touch C. Lack of facial expression
A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be most appropriate?
C. "As endocrine functions become more stable throughout childhood, alterations become more apparent."
An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa?
C. "I feel chubby no matter what I wear."
A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back, which of the following would be most appropriate to do?
C. Logroll the child to the side.
The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching?
A. "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."
The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statements by the teen indicates that adequate learning has occurred? Select all that apply.
A. "This famotidine may make me tired." B. "The omeprazole could give me a headache." C. "It sounds like the physician is reluctant to give me a prokinetic because of the side effects."
A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply.
A. "We need to set clear limits for our child's behavior." B. "A reward system would be useful to give our child positive feedback." C. "We need to limit the number of choices our child has."
The nurse caring for a neonate experiencing seizures asks the charge nurse: "How can I tell if a baby is having a seizure or is just crying for attention?" Which response would be most appropriate? Select all that apply.
A. "You will not be able to stop a seizure with gentle restraint." B. "The baby experiencing a seizure will be tachycardic." C. "Stimulating the baby by singing to him will not stop a seizure."
A 7-year-old child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? Select all that apply.
A. Administer epinephrine as ordered. D. Administer oxygen. E. Initiate intravenous access.
The nurse is caring for a 24-month-old child with a fever of 101°F. The child also exhibits a toxic appearance. Which of the following would the nurse expect to implement?
A. Administering antibiotics as ordered
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication?
A. Anorexia
A panicked mother calls the health care provider's office and reports that her 5-year-old has a high fever and just had a seizure. The mother asks the nurse what she should do. Which is the nurse's best response?
A. Report to the emergency room for medical evaluation
The nurse caring for a young adolescent with Crohn's disease. After teaching the adolescent and her family about this condition, the nurse determines that the teaching was successful when they identify which of the following as a possible complication? Select all that apply.
A. Stricture B. Fistula C. Intra-abdominal abscess formation
The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond?
B. "Breastfeeding is likely to be possible, but check with the surgeon."
The nurse is performing CPR on a child who is a victim of a near-drowning experience. How should the nurse open the child's airway to provide breaths?
B. Jaw-thrust maneuver
A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning?
C. Keep cleaning solutions locked up.
The nurse is caring for a child recovering from surgery to correct strabismus. Which interventions should the nurse include when planning this child's care? Select all that apply.
C. Support for nausea and vomiting. D. Provide pain medication as prescribed. E. Apply antibiotic ointment as prescribed.