Peds Exam 5

Which of the following is not a manifestation of Wiskott-Aldrich Syndrome? •A. Jaundice •B. Eczema •C. Recurrent infections •D. Increased bleeding

A. Jaundice

The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately? "No blood sampling in lower extremities." "No intramuscular injections." "No milk or milk products allowed." "Do not palpate abdomen."

"Do not palpate abdomen."

A child has been diagnosed with impetigo and the nurse is performing discharge teaching to the parents. Which statements by the parents indicate that additional teaching is necessary? Select all that apply. "Good hygiene is important so we will be sure our child washes their hands frequently." "We will be sure to schedule the oral cephalosporin so it is evenly distributed throughout a 24-hour time period." "Even though the lesions have crusted, the infection is contagious and our child should stay home from school." "We should soak impetiginous lesions with cool compresses to remove crusts before applying topical medication." "Antifungal medications should be administered as ordered by our physician."

"Even though the lesions have crusted, the infection is contagious and our child should stay home from school." "We should soak impetiginous lesions with cool compresses to remove crusts before applying topical medication." "Antifungal medications should be administered as ordered by our physician."

A 13-year-old female adolescent is being evaluated for lupus. Which statement(s) by the adolescent indicates a need for further education regarding this disease? Select all that apply. "I should have not spent so much time in the sun. That may have been what caused me to get lupus." "Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it." "I am at a higher risk than of developing lupus than a man would be." "I just got over a sinus infection last week. This may have been what triggered the disease." "My grandmother was diagnosed with lupus, so that means I am at a higher risk."

"I should have not spent so much time in the sun. That may have been what caused me to get lupus." "Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it."

A child receiving chemotherapy wants to have a large birthday party and invite all the classmates. When the parent asks the nurse about this, what is the nurse's best response? "That will be a good way to cheer your child up!" "What about taking your child to a movie instead?" "It is better to avoid large groups right now." "We can have the party here in the hospital playroom."

"It is better to avoid large groups right now."

What is the best response by the nurse to the parents of a child with leukemia who express guilt because they did not take immediate action when their child seemed to develop one respiratory infection after another? "Keep in mind that the signs of leukemia are often subtle and difficult to recognize." "Don't feel bad. Children get lots of colds." "Young children develop minor illness easily and often. Stop being hard on yourselves." "You need to focus on the present treatment now and not worry about the past."

"Keep in mind that the signs of leukemia are often subtle and difficult to recognize."

A 6-year-old child has been diagnosed with tinea capitis. Which statement(s) by the parents demonstrate the need for further teaching? Select all that apply. "We can use selenium sulfide shampoo to decrease contagiousness." "Our child can return to school 24 hours after taking the antifungal medication." "We should not expect our child to suffer hair loss." "We should have our child take the prescribed antifungal medication until symptoms have resolved." "We should wash sheets and towels in hot water to decrease the spread to other family members."

"Our child can return to school 24 hours after taking the antifungal medication." "We should not expect our child to suffer hair loss." "We should have our child take the prescribed antifungal medication until symptoms have resolved."

A child is diagnosed with varicella. The parent states the child is "just miserable" and wants to know how best to make the child feel more comfortable. Which instruction(s) would the nurse give this parent? Select all that apply. "Place the child in a soothing tepid bath." "Keep only light clothing on your child." "Keep your child's fingernails short so scratching will not disturb vesicles." "You can administer acetaminophen to help with fever and pain." "Administer prescribed topical steroid ointment to reduce inflammation."

"Place the child in a soothing tepid bath." "Keep only light clothing on your child." "Keep your child's fingernails short so scratching will not disturb vesicles." "You can administer acetaminophen to help with fever and pain."

An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE? "SLE is a rheumatic disease that mostly affects my joints." "SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms." "SLE only affects my skin. It seldom causes problems in any other organs." "If my SLE has been found early enough in the disease process, there is a good chance that medication can cure it."

"SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms."

A school-aged child diagnosed with atopic dermatitis is having difficulty in school, and school performance is declining. The parent asks the nurse for interventions that can help improve the situation. How should the nurse respond? Select all that apply. "Have the teacher move the child to a desk on the front row to help with concentration." "Talk with the child's teacher about work the child can do at home until flare-ups resolve." "Obtain an order from the health care provider for the child to rest in the nurse's office if too stressed." "You can help your child sleep better at night by giving the prescribed antihistamines." "The school nurse can apply skin moisturizers during the school day."

"Talk with the child's teacher about work the child can do at home until flare-ups resolve." "Obtain an order from the health care provider for the child to rest in the nurse's office if too stressed." "You can help your child sleep better at night by giving the prescribed antihistamines." "The school nurse can apply skin moisturizers during the school day."

A 10-year-old who is receiving chemotherapy has received ondansetron before this therapy session. About an hour later, the child tells the nurse that his mouth feels really dry. The child has urinated several times and his skin turgor is normal. Which response by the nurse would be most appropriate? "You might be having a severe allergic reaction. Are you itchy?" "Let me increase your intravenous fluids." "The drug you got to help with the nausea can cause dry mouth." "This indicates an infection. We need to start antibiotics."

"The drug you got to help with the nausea can cause dry mouth."

A child is brought to the clinic by the parents because the child had a high fever. Assessment reveals vesicles on the tongue and shallow ulcers on the oral mucosa. The child is diagnosed with hand, foot and mouth disease. When teaching the parents about this infection, which information would the nurse likely include? Select all that apply. "The infection can continue to spread to others for about 2 to 3 weeks." "This condition usually resolves in about 1 week." "You need to make sure to wash your hands frequently." "This infection is spread mostly through contact with urine." "Try offering cold items, like popsicles for fluids."

"This condition usually resolves in about 1 week." "You need to make sure to wash your hands frequently." "Try offering cold items, like popsicles for fluids."

The parent of a child on chemotherapy contacts the health care provider because her child was exposed to chickenpox and wants to know what to do. What is the nurse's best response? "Your child can receive nonlive vaccines which will prevent chickenpox." "Your child can be given zoster immune globulin to prevent chickenpox." "Your child can't receive any live-virus vaccines while on chemotherapy." "Nothing can prevent chickenpox, but give your child diphenhydramine for itching."

"Your child can be given zoster immune globulin to prevent chickenpox."

A parent calls the nurse triage line at the clinic. The parent is concerned and believes the preschool-aged child may have contracted rubeola. Which question(s) should the nurse ask the parent to aid in making this diagnosis? Select all that apply. -"Has your child completed the measles vaccine series?" -"Has your child been around any other children with measles?" -"How long has your child had the cough and runny nose?" -"When you look in your child's mouth can you see any spots or anything unusual?" -"Can you describe what your child's rash looks like?"

-"Has your child been around any other children with measles?" -"How long has your child had the cough and runny nose?" -"When you look in your child's mouth can you see any spots or anything unusual?" -"Can you describe what your child's rash looks like?"

The nurse is teaching an 8-year-old child the steps for using an epinephrine auto-injector. Place the steps for administering the medication with this device in the order the child will perform them. Use all options. a. Hold your leg steady. b.Place the orange tip of the auto-injector in the middle of your thigh. c.Hold the auto-injector at a right angle to your thigh. d.Push the auto-injector firmly until a "click" is heard.

1. Hold your leg steady. 2. Place the orange tip of the auto-injector in the middle of your thigh. 3. Hold the auto-injector at a right angle to your thigh. 4. Push the auto-injector firmly until a "click" is heard.

A 7-year-old client presents to the emergency room (ER) after experiencing an allergic reaction to a bee sting. The client is breathing and able to verbally communicate. The nurse notes the client's pulse 90 beats/minute, respirations are 23 breaths/minute, blood pressure is 100/60 mm Hg, lungs are clear. Which nursing action is priority? Assess the client's oxygen saturation level. Administer epinephrine to the client. Ask if any medications were given before arriving to the ER. Apply ice to the site of the sting.

Ask if any medications were given before arriving to the ER.

The nurse is concerned that a school-aged child has iron-deficiency anemia. What did the nurse assess in this client? Shyness Asking many questions Craving for ice cubes Thumb-sucking

Craving for ice cubes

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. Ensure a consistent and daily intake of adequate fluids to prevent dehydration. B. Suggest the child participate in sports activities without restriction. C. Treat upper respiratory infections with over-the-counter medication. D. Remind parents that the child should avoid immunizations to prevent the introduction of bacteria into the body.

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

A child is diagnosed with sickle cell anemia. Which test will the nurse expect the primary health care provider to prescribe for this client? Hemoglobin level Leukocyte level Thrombocyte level Metabolic screening test

Hemoglobin level

The community nurse receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo. Which information related to impetigo will the nurse provide to the day care center? The facility staff should wear masks until all children and adults are healthy. Impetigo cannot be treated with medication and has to run its course. Impetigo usually develops because of sensitivity to pollens and molds. Impetigo is highly contagious and can spread quickly.

Impetigo is highly contagious and can spread quickly.

A nurse is providing care to a child admitted to the hospital with a diagnosis of severe periorbital cellulitis. Which intervention(s) should the nurse expect to implement? Select all that apply. Institute contact isolation precautions. Administer intravenous antibiotics. Restrict visitors to the child's room. Obtain blood cultures. Maintain the child on NPO status.

Institute contact isolation precautions. Administer intravenous antibiotics. Obtain blood cultures.

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? Means of transmission Reservoir Portal of exit Portal of entry

Portal of entry

A nurse is preparing a class for parents of infants about managing diaper dermatitis. What advice would the nurse include in the presentation? Select all that apply. Refrain from using rubber pants over diapers. Wash the diaper area with an antibacterial soap. Apply topical nystatin to the diaper area. Use a blow dryer on warm to dry the diaper area. Use scented diaper wipes to clean the area.

Refrain from using rubber pants over diapers. Use a blow dryer on warm to dry the diaper area.

A nurse is caring for a 12-year-old girl who is recovering from surgery for removal of a brain tumor. Which intervention should the nurse implement to avoid increasing intracranial pressure? Place a sterile towel under wet dressings Regulate the rate of IV fluid infusions carefully Apply saline eye drops, as prescribed Sponge the client's face

Regulate the rate of IV fluid infusions carefully

Which nursing problems could be associated with a child with primary immunodeficiency? Select all that apply. Risk for infection Altered gastrointestinal function Altered fluid and electrolytes Altered skin integrity Delayed growth and development

Risk for infection Altered skin integrity Delayed growth and development

A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily? The stools will appear black. The reticulocyte count will have decreased. The infant will develop diarrhea. The infant will be more irritable than at the last visit.

The stools will appear black.

A 6-month-old boy has been admitted to the hospital with severe bloody diarrhea. The nurse notes petechiae and eczema with signs of secondary infection. As the nurse documents the boy's history, the parents report easy bruising and prolonged bleeding after circumcision. Based on these findings, the nurse suspects a diagnosis of: beta-thalassemia major. von Willebrand disease. severe combined immunodeficiency. Wiskott-Aldrich syndrome.

Wiskott-Aldrich syndrome.

A 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. b)Increase fluid intake. c)Teach the child how to use an EpiPen. d)Administer oxygen. e)Initiate intravenous access.

a)Administer epinephrine as ordered d)Administer oxygen. e)Initiate intravenous access

The nurse is preparing to administer intravenous immune globulin to child with Wiskott-Aldrich syndrome (WAS). What consideration(s) should the nurse take into account while administering this therapy? Select all that apply. a)Do not mix with other IV medications or fluids. b)Have epinephrine available. c)Prepare for the possibility of administering antipyretics and antihistamines. d)Notify the health care provider of muscle weakness. e)Avoid St. John's wort.

a)Do not mix with other IV medications or fluids. b)Have epinephrine available. c)Prepare for the possibility of administering antipyretics and antihistamines.

The parents of a child ask the nurse, "Why are infants and young children so prone to getting infections?" What is the best response by the nurse? a)The immune system of infants and young children is weaker than that of adults. The system matures as the child ages." b)"It is really unclear why infants and children get infections more than adults." c)"Infants and young children probably get infections more than adults because they aren't aware of how to prevent infection." d)"Phagocytosis in the infant and young child is overactive, allowing infections to occur."

a)The immune system of infants and young children is weaker than that of adults. The system matures as the child ages."

The nurse is caring for a child who has a depressed immune system due to chemotherapy treatments. The child is due for scheduled immunizations according to CDC recommendations. The nurse must ensure that the child does not receive which type of immunization? a)live vaccine b)killed vaccine c)inactivated vaccine d)any vaccine

a)live vaccine

A child allergic to insect stings presents to the school nurse stating, "A bee stung me on the playground." Which action by the nurse is priority? a)Notify the client's caregivers and primary health care provider b)Assess the client's airway and breathing rate c)Administer epinephrine subcutaneously to the client d)Locate the stinger and remove it with tweezers

b)Assess the client's airway and breathing rate

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse? a)The child should not have information about his health provided at this age. b)Children at this age should have full disclosure of their condition. c)When providing health information to a child of this age it should be simplistic and at the child's level of understanding. d)Once a child is apprised of their health concerns they do not normally experience any after-effects.

c)When providing health information to a child of this age it should be simplistic and at the child's level of understanding.

Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis? a)jogging every other day b)using a treadmill c)swimming d)playing basketball

c)swimming

The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect? cellulitis impetigo cat scratch disease staphylococcal scalded skin syndrome (SSSS)

cellulitis

A child is brought to the emergency department with bronchospasm, wheezing, and urticaria. The primary health care provider prescribes the medications listed below. Which medication will the nurse administer first? diphenhydramine IM epinephrine IM albuterol via nebulizer methylprednisolone IV

epinephrine IM

The nurse is obtaining a health history and assessment for a child being admitted who is suspected of having measles. What signs and symptoms does the nurse expect to find during the assessment? Select all that apply. maculopapular rash that began on the face and has spread to the rest of the body upper respiratory infection symptoms fever erythematous flushing clear, fluid-filled vesicles

maculopapular rash that began on the face and has spread to the rest of the body upper respiratory infection symptoms fever

The nurse is caring for a client with terminal cancer who is experiencing dyspnea and increasing levels of pain. What would be the priority for pain management with this child? monitoring the child's vital signs frequently preventing and alleviating pain following the health care provider's rigid guidelines regarding dosages preventing addiction to the opioid medications

preventing and alleviating pain

The nurse is caring for a child with a skin disorder. The child presented with papules that progressed to vesicles with a honey-colored exudate. What treatment would the nurse expect to be ordered to treat this disorder? Select all that apply. regular hygiene measures topical mupirocin ointment warm compresses after washing with soap and water several times a day oral cephalexin cool compresses to assist in removing crusts on vesicles

regular hygiene measures topical mupirocin ointment cool compresses to assist in removing crusts on vesicles

The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply. two or more serious infections such as sepsis two or more new episodes of acute otitis media in 1 year two or more episodes of severe sinusitis in 1 year history of infections requiring IV antibiotics to clear failure to thrive in an infant

two or more serious infections such as sepsis two or more episodes of severe sinusitis in 1 year history of infections requiring IV antibiotics to clear failure to thrive in an infant