Peds Final Prep Exam

Evidence-based research shows that which is the most successful strategy for preventing smoking in teenagers? Large-scale public information campaigns Emphasis on long-term effects of smoking Emphasis on immediate effects of smoking Threatening the social norms of groups most likely to smoke

Emphasis on immediate effects of smoking Emphasis on the immediate effects of smoking, such as the tobacco smell and other aesthetic issues, has proved one of the most effective strategies for preventing smoking. Public campaigns can be effective when they are focused on the immediate effects of smoking, but they are often focused on the longer-term effects of smoking. Because this age-group is neither future nor consequence oriented, emphasis on the long-term effects of smoking does not work as well as focusing on the immediate effects. Threatening social norms in adolescents is not an effective strategy for the prevention of smoking.

Which intervention is the emergency room nurse's priority when caring for an unconscious toddler after an accidental poisoning? Administer a chelating agent. Establish a patent airway. Initiate intravenous (IV) access. Treat for concurrent trauma.

Establish a patent airway.

Which is the most common clinical manifestation of Down syndrome? Select all that apply. One, some, or all responses may be correct. Flat nasal bridge Early-onset dementia Hyperplastic mandible Separated sagittal suture High, arched, narrow palate

Flat nasal bridge Separated sagittal suture High, arched, narrow palate The most common clinical manifestations of Down syndrome include a separated sagittal suture; small nose; high, arched, narrow palate; wide space between the big and second toes; plantar crease between the big and second toes; hyperflexibility and muscle weakness; neck skin excess and laxity; depressed nasal bridge; and oblique palpebral fissures. Early-onset dementia occurs in one-third of those with Down syndrome. Hypoplastic mandible, rather than hyperplastic mandible, is a clinical manifestation of Down syndrome.

Which response would the nurse provide when the parent of a 3-month-old breastfed infant asks about giving the baby water because it is summer and very warm? Fluids in addition to breast milk are not needed. Water should be given if the infant seems to nurse longer than usual. Clear juice is better than water for promoting adequate fluid intake. Water once or twice a day will make up for losses caused by environmental temperature.

Fluids in addition to breast milk are not needed.

Which failure to thrive (FTT) classification would the nurse use for a 1-month-old infant with FTT secondary to congenital heart disease? Increased metabolism Inadequate caloric intake Inadequate absorption Defective utilization

Increased metabolism New classifications for FTT expands on organic and inorganic FTT to now reflect the pathophysiology of the FTT. A child with congenital heart disease would be classified as having FTT caused by increased metabolism. FTT caused by inadequate caloric intake may be the result of neglect, breastfeeding problems, or restriction of caloric intake. FTT caused by inadequate absorption may be the result of cystic fibrosis, celiac disease, or cow's milk allergy. FTT caused by defective utilization may be the result of trisomy 21 or 18, congenital infection, or metabolic shortage diseases.

After administering an intramuscular injection to a newborn, which physiologic response related to acute pain might the nurse observe? Select all that apply. One, some, or all responses may be correct. Crying Decreased heart rate Limb withdrawal Increased muscle tone Rapid, shallow respirations Changes in the sleep-wake cycle

Increased muscle tone Rapid, shallow respirations After administering an intramuscular injection to a newborn, the physiologic responses that may be present related to acute pain are increased muscle tone and rapid, shallow respirations. Crying is a behavioral, not physiologic, response to pain in the neonate. In the neonate, heart rate increases, not decreases, with pain. Like crying, limb withdrawal and changes in sleep-wake cycle are behavioral, not physiologic, responses to pain in the neonate.

Which term describes any significant lag in a child's physical, cognitive, behavioral, emotional, or social development compared with developmental norms? Behavioral delay Dysmorphic features Cognitive impairment Developmental delay

Developmental delay

Which recommendation would the nurse provide the mother of 8-month-old infant who wishes to discontinue breastfeeding? Offer whole cow's milk. Feed organic skim milk. Avoid commercial canned formulas. Feed commercial iron-fortified formula.

Feed commercial iron-fortified formula.

Which information is included as the priority side effect of huffing when teaching a class on the dangers of huffing? Cardiac arrest Loss of vision Delay of growth Loss of consciousness

Loss of consciousness

Which blood oxygenation test is the photometric measurement of oxygen? Oximetry Capnography Arterial puncture Transcutaneous oxygen and carbon dioxide monitoring

Oximetry

Which condition would the nurse suspect when a 6-month-old infant demonstrates increased drooling, finger sucking, and biting on objects? Illness Cavities Teething Viral illness

Teething

The nurse is caring for an 8-year-old child with lymphoma undergoing extensive radiotherapy. The parent tells the nurse that the child has been falling asleep at the dinner table. Which would be the best response to the parent's concerns? "Your child may need to be home schooled." "Fatigue is a common side effect of irradiation." "Most kids don't get tired as a result of radiotherapy." "Your child needs to be reevaluated so that we can determine whether more treatments are necessary."

"Fatigue is a common side effect of irradiation."

The nurse is educating a group of pregnant women about the importance of folic acid supplementation in the diet. Which suggestion given by the nurse is appropriate? "Foods rich in folic acid prevent the onset of cerebral palsy in infants." "Foods rich in folic acid prevent the development of neural tube defects." "Foods rich in folic acid prevent Guillain-Barré syndrome in infants." "Foods rich in folic acid prevent Werdnig-Hoffmann disease in infants."

"Foods rich in folic acid prevent the development of neural tube defects."

Which statement made by the child indicates the need for further education about how to manage newly diagnosed type 1 diabetes mellitus (DM)? "I should check my blood glucose levels before meals and at bedtime." "It is important to rotate the injection sites to prevent tissue damage." "I should check my blood glucose and ketones every 3 hours when I am sick." "I can eat cake and candy as long as I give myself extra insulin to compensate."

"I can eat cake and candy as long as I give myself extra insulin to compensate."

Which response would the nurse provide a 9-year-old child's parents who are concerned that the child appears more thin recently? "Don't worry; many children are underweight during this age, and this problem corrects itself as they become better eaters." "Because your child is thin, you need to provide more fatty foods in the child's diet." "Encourage your child to play indoor games to avoid excessive exercise that may lead to additional weight loss." "Many children this age look thinner because of the reduction and redistribution of fat. This is normal."

"Many children this age look thinner because of the reduction and redistribution of fat. This is normal."

A patient with chronic diabetes has been on insulin injections for the past 3 months. The patient's blood reports show the hemoglobin A1c is 6%. When discussing the lab results with the parents, which statement by the nurse would be correct? "The patient's diabetes is cured; therefore you need not take insulin henceforth." "The patient has high blood glucose, so you need to visit the endocrinologist." "The patient has anemia because of an iron deficiency, so the patient needs iron-rich food." "The patient's diabetes is under control; please continue the same regimen of treatment."

"The patient's diabetes is under control; please continue the same regimen of treatment."

Which advice would the nurse provide to the parents of a child with lactose intolerance to help control symptoms? Select all that apply. One, some, or all responses may be correct. "Use enzyme tablets for digestion." "Substitute dairy with soy-based formula." "Do not include yogurt in the diet." "Replace milk with hard cheese." "Include sodium supplements in the diet."

"Use enzyme tablets for digestion." "Substitute dairy with soy-based formula." "Replace milk with hard cheese." Lactose intolerance is characterized by a deficiency of the enzymes to digest lactose. The patient may develop symptoms of indigestion on consumption of milk or milk products. Therefore these patients should take enzyme tablets to replace the deficient enzymes and metabolize the lactose of milk. Substitution of soy-based formula for cow's milk-based formula helps prevent indigestion. Eating hard cheese, cottage cheese, or yogurt instead of drinking milk helps avoid lactose intolerance. In meals, a probiotic-like yogurt may be included to facilitate ingestion of Lactobacillus or Bifidobacterium organisms. Calcium supplements, not sodium supplements, are required for patients who do not consume any dairy products to prevent deficiency of calcium.

When caring for children, which child would the nurse recognize as having an increased risk for poor coping strategies? A child who is visited frequently by the family A child undergoing multiple invasive procedures A sick school-age child who loves board games A teenager who is given information about physical status

A child undergoing multiple invasive procedures

The nurse would explain to parents that their child is receiving furosemide for severe congestive heart failure because of which effect? A diuretic A β-blocker An angiotensin-converting enzyme (ACE) inhibitor A form of digitalis

A diuretic

Which symptom would the nurse observe in a child with Down syndrome? Prominent nose Hyperthyroidism High birth weight A high, arched, narrow palate

A high, arched, narrow palate

Which would the nurse know about substance abuse? Most teenagers begin smoking because their parents smoke. A person can be physically dependent on a drug without being addicted. Most teenagers abuse substances because of what they see in the media. "Just say no" programs have proved most successful in drug prevention for teens.

A person can be physically dependent on a drug without being addicted.

Urinalysis of a patient with type 1 diabetes mellitus shows ketones, glucose, and high concentrations of H + ions. On examination, the nurse finds that the patient's skin is dry, radial artery pulse is weak, and level of consciousness is decreased. Which measure would be taken by the nurse for diabetic ketoacidosis (DKA) management? Select all that apply. One, some, or all responses may be correct. Administer potassium supplements. Administer amitriptyline. Administer insulin. Administer intravenous fluids. Administer furosemide.

Administer potassium supplements. Administer insulin. Administer intravenous fluids.

The family of a child hospitalized for care during a sickle cell crisis calls the nurse into the room because the child is struggling to breathe. On assessment, the nurse notes a respiratory rate of 30 and that the child is clutching the abdomen and crying. Which does the nurse determine the child may be experiencing? Deficient fluid volume Acute chest syndrome Cerebrovascular accident Increasing splenomegaly

Acute chest syndrome

Which is the priority nursing intervention when caring for an infant who experiences anaphylaxis after a meal? Determine what the infant has eaten. Assess the infant's airway. Administer intramuscular epinephrine. Activate emergency medical services.

Administer intramuscular epinephrine.

Which nursing intervention would the nurse perform when caring for an infant with hypoxemia? Select all that apply. One, some, or all responses may be correct. Administer morphine subcutaneously. Place the infant in a knee-chest position. Provide potassium supplements. Monitor the infant for signs of hypertension. Perform good hand washing during care.

Administer morphine subcutaneously. Place the infant in a knee-chest position. Perform good hand washing during care.

Which ethnic group has the highest incidence of sickle cell disease? Whites Hispanics Native Americans African Americans

African Americans

For which condition is an EpiPen indicated? Anaphylaxis Septic shock Status epilepticus Status asthmaticus

Anaphylaxis

What is the recommended age for a child to begin primary immunizations? At birth 2 months 4 months 1 year

At birth

Which congenital heart defect is described as the incomplete fusion of the endocardial cushions? Atrial septal defect Ventricular septal defect Patent ductus arteriosus Atrioventricular canal defect

Atrioventricular canal defect

The nurse is assessing a newborn's reflexes. Which is the reflex assessed by stroking the outer sole of the foot? Perez Glabellar Babinski Dance or step

Babinski

Which laboratory test shows the extent of deviation from the normal buffer base concentration? pH PCO 2 Anion gap Base excess

Base excess Base excess (whole blood) is the laboratory test that is used to express the extent of deviation from normal buffer base concentration. A partial pressure of hydrogen, or pH, test is used to express the concentration of hydrogen. A partial pressure of carbon dioxide, or PCO 2, test is a measure of carbon dioxide tension. It reflects plasma concentrations of carbonic acid. An anion gap reflects the difference between measured cations (sodium) and anions of chloride and bicarbonate.

A nurse is teaching a mother of a 2-month-old infant about nutrition of the baby. Which food is the best for the child at this age? Breast milk Rice cereal Chicken soup Pureed meat

Breast milk

Which discharge education would the nurse provide the parent of an infant who will have home monitoring after an apparent life-threatening event (ALTE)? Cardiopulmonary resuscitation (CPR) Administration of intravenous fluids Foreign airway obstruction removal with the Heimlich maneuver Advise that the infant not be left with caregivers other than the parents

Cardiopulmonary resuscitation (CPR) Education on CPR is essential for all parents and caregivers, especially when an infant has a history of an ALTE and will be monitored at home. Intravenous fluids are not a standard component of discharge care after an ALTE. The Heimlich maneuver is used to intervene when a child or an adult is experiencing a choking episode; it is not indicated for infants, and choking is not a concern for this infant. (Back slaps and chest thrusts are used on the responsive infant who is choking.) There is no reason that the infant cannot be left with capable and trained caregivers. Anyone caring for the infant will need to be taught to use the necessary equipment and how to perform CPR.

Which diet alternative would the nurse recommend to a 3-month-old infant who is allergic to cow's milk? Goat's milk Soy-based formula Skim milk diluted with water Casein hydrolysate milk formula

Casein hydrolysate milk formula The milk protein is broken down in casein hydrolysate milk formulas, making them a safe alternative for the infant who is allergic to cow's milk. The milk protein in goat's milk cross-reacts with cow's milk protein, making goat's milk an unsafe alternative. Soy-based formulas are avoided because of the cross-reaction with cow's milk protein; they are not a safe alternative. Cow's milk protein is contained in skim milk, making it an unsafe alternative.

The parents of a 4-year-old child call the hospital to ask how to prepare the child for the upcoming hospitalization and surgical procedure in a week. The nurse's reply would be based on which knowledge? Preparation at this age will only increase the child's stress. Children who are prepared experience less fear and stress during hospitalization. Preparation needs to be at least 2 to 3 weeks before hospitalization to be effective. Children who are prepared experience overwhelming fear by the time hospitalization occurs.

Children who are prepared experience less fear and stress during hospitalization.

Which is the major cause of death in the first year of life besides preterm birth?Asthma Cystic fibrosis Congestive heart failure Congenital heart defect

Congenital heart defect

Which is the primary goal in the nutritional management of infants with failure to thrive? Select all that apply. One, some, or all responses may be correct. Don't allow catch-up growth. Correct nutritional deficiencies. Achieve excess weight for height. Restore optimal body composition. Educate the parent on the infant's nutritional requirements. Explain to the parent that the infant will require tube feedings first.

Correct nutritional deficiencies. Restore optimal body composition. Educate the parent on the infant's nutritional requirements.

A father brings his 5-year-old son to the clinic because he has recently lost a lot of weight. He reports to the nurse that the boy is always hungry, thirsty, and complaining that he has to use the bathroom. Which disorder is best described by these symptoms? Diabetes mellitus Addison disease Cushing syndrome Pheochromocytoma

Diabetes mellitus

A child is admitted to the hospital for whooping cough. The plan of care indicates that the nurse would assess the patient for signs of airway obstruction. For which sign will the nurse assess the child? Select all that apply. One, some, or all responses may be correct. Cyanosis Skin pallor Apprehension in the child Increased temperature Increased restlessness

Cyanosis Apprehension in the child Increased restlessness Whooping cough is a respiratory infection caused by Bordetella pertussis. Airway obstruction can occur as a result of the infection. Therefore nurses are instructed to assess for signs of airway obstruction, including cyanosis, apprehension, and increased restlessness. The nurse would immediately report any of these signs. Pallor is seen in cases of shock, and an increased temperature indicates infection, not airway obstruction.

Which is a sign of mucus partially occluding the airway of an infant with a tracheostomy? Select all that apply. One, some, or all responses may be correct. Cyanosis Drop in SaO 2 Decrease in heart rate Decrease in respiratory effort Increase in positive inspiratory pressure on ventilator

Cyanosis Drop in SaO 2 Increase in positive inspiratory pressure on ventilator Signs of mucus partially occluding the airway include cyanosis, a drop in oxygen saturation (SaO 2), and increased positive inspiratory pressure on ventilation. An increase, rather than a decrease, in heart rate or respiratory effort is a sign that mucus is partially occluding the airway.

Which physiologic factor contributes to neonates being highly susceptible to infection? Increased humoral immunity An overwhelming antiinflammatory response Diminished nonspecific and specific immunity Excessive levels of immunoglobulin A and immunoglobulin M

Diminished nonspecific and specific immunity

A school-age child recently diagnosed with type 1 diabetes mellitus asks the nurse if playing soccer, playing baseball, and swimming are still possible. The nurse's response would be based on which knowledge? Exercise is contraindicated in the child with type 1 diabetes. The level of activity depends on the type of insulin required. Soccer and baseball are too strenuous, but swimming is acceptable. Exercise is not restricted unless indicated by other health conditions.

Exercise is not restricted unless indicated by other health conditions. Exercise is encouraged for children with type 1 diabetes because it lowers blood glucose levels. Insulin and meal requirements require careful monitoring to ensure the child has sufficient energy for exercise. Exercise is highly encouraged. The decrease in blood glucose can be accommodated by having snacks available. Sports are encouraged, with insulin and food adjusted for the exercise. The child needs to be cautioned to monitor responses to the exercise. The level of activity does not depend on the type of insulin used. Long-acting and short-acting insulin may both be used to provide coverage for the training and sporting events.

Which is the priority of care for chest physical therapy (CPT) when explaining to the parents of a child with cystic fibrosis how CPT helps their child? Helps clear the airway Helps expand the chest Decreases intracranial pressure Helps comfort the child in the same way as massage

Helps clear the airway

Which is a common complication among infants of diabetic mothers that occurs shortly after birth? Hypoglycemia Hyperglycemia Meconium stools Congenital hyperinsulinism

Hypoglycemia

Which would be the current treatment option for children with type 1 diabetes? Diet only Oral agents Insulin and diet Diet and oral agents

Insulin and diet

When caring for an infant with protein-energy malnutrition, which nutritional supplement would the nurse withhold until the infant is able to tolerate a steady food source? Zinc Iron Copper Vitamin A

Iron Iron supplementation in a protein-energy malnourished child should be withheld until the child is able to tolerate a steady food source. Zinc, copper, and vitamin A are recommended nutritional supplements for a child with protein-energy malnutrition, even when the child is unable to tolerate a steady food source.

Which clinical manifestation would the nurse anticipate when caring for the newborn of a diabetic mother? Select all that apply. One, some, or all responses may be correct. Small for gestational age Large for gestational age Listlessness Hypoglycemia Hyperglycemia Jitteriness

Large for gestational age Hypoglycemia

Which heavy metal is appropriate when considering a commonly ingested toxic substance? Iron Lead Silver Mercury

Lead Lead is a heavy metal that is a commonly ingested toxic substance. Mercury toxicity is a rare form of heavy metal poisoning. Iron and silver are not among the commonly ingested toxins.

Which clinical finding would the nurse recognize as suggestive of marasmus? Select all that apply. One, some, or all responses may be correct. Zinc deficiency Loose, wrinkled skin Depigmentation of skin Prominent abdomen with ascites Generalized wasting of body tissues

Loose, wrinkled skin Generalized wasting of body tissues The clinical findings that are suggestive of marasmus are loose, wrinkled skin and generalized wasting of body tissues. Zinc deficiency, depigmentation of skin, and prominent abdomen with ascites are findings in kwashiorkor.

For which reason is low-fat milk not recommended for an infant less than 6 months old? Select all that apply. One, some, or all responses may be correct. Low-fat milk is high in sodium. Low-fat milk contains inadequate proteins. Low-fat milk has a high propensity to cause colic. Low-fat milk has a propensity to cause diarrhea. Low-fat milk contains inadequate essential fatty acids.

Low-fat milk is high in sodium. Low-fat milk contains inadequate essential fatty acids. Infants less than 6 months old should not receive low-fat milk because fats are necessary for optimal growth and development. Low-fat milk is also high in electrolytes such as sodium. The essential fatty acids in low-fat milk are inadequate. Low-fat milk has a high protein concentration. Low-fat milk does not cause colic. Low-fat milk does not cause diarrhea.

Which drug is not recommended for treating pain during sickle cell disease episodes? Morphine Ketorolac Ibuprofen Meperidine

Meperidine Meperidine is not recommended because a metabolite of meperidine (normeperidine) can produce anxiety, tremors, myoclonus, and seizures when it accumulates with repetitive doses. Morphine is used for severe pain. Ketorolac is used to enhance pain management effects. Ibuprofen is useful with the mild pain associated with painful episodes.

The parents report that their child has excessive urination, thirst, hunger, irritability, fatigue, flushed skin, headache, blurred vision, and dry skin. The child is diagnosed with type 1 diabetes mellitus. Based on this diagnosis, which would the nurse include in the plan of care? Assess the feet for open sores. Obtain a urine dipstick for bacteria. Administer corticosteroids to decrease inflammation. Monitor capillary blood glucose levels before meals and at bedtime.

Monitor capillary blood glucose levels before meals and at bedtime. Type 1 diabetes mellitus is a carbohydrate-metabolism disorder characterized by polyuria, polydipsia, overeating, weight loss, fatigue, and irritability. The patient with type 1 diabetes mellitus may have hyperglycemia because of an inability of the pancreas to secrete insulin. Therefore the nurse should monitor the capillary blood glucose levels before meals and at bedtime. It is important to assess the feet of patients with diabetes for open sores, but this is a long-term complication of uncontrolled diabetes mellitus. Obtaining a urine dipstick for bacteria will help diagnose a urinary tract infection and is not related to diabetes management. Corticosteroids will increase blood glucose levels and should not be administered unless absolutely necessary.

A patient with diabetes is on twice-daily dosing of rapid-acting and intermediate-acting insulin. The child is admitted for dose adjustment of intermediate-acting insulin, which is required to be administered in the evening. Which blood sugar level readings of the patient are taken into consideration? Postprandial blood sugar level after lunch Random blood sugar levels of the same day Random blood sugar levels of the previous day Morning fasting blood sugar levels of the same day

Morning fasting blood sugar levels of the same day

Which is an essential part of dietary counseling in a weight-reduction program for overweight adolescents?Dietary restriction Nutritional quality of the diet Eating convenient packaged foods Fad diets that result in immediate weight loss

Nutritional quality of the diet

Which action would the nurse take while caring for an infant after administering exogenous surfactant for bronchopulmonary dysplasia? Select all that apply. One, some, or all responses may be correct. Provide gentle tactile stimulation. Observe for signs of caffeine toxicity. Observe for signs of fluid overload. Provide feedings with increased caloric density. Assess skin for breakdown and irritation at the nasal septum.

Observe for signs of fluid overload. Provide feedings with increased caloric density. The nurse would observe for signs of fluid overload or pulmonary edema and provide increased caloric density (feedings) with human milk fortifier or protein supplements. The nurse would provide gentle tactile stimulation, observe for signs of caffeine toxicity, and assess skin for breakdown and irritation at the nasal septum when caring for an infant with apnea of maturity.

A nurse understands that a number of factors influence food preferences and may differ from one age-group to another. Which factor is instrumental in determining food preferences in adolescents? Peer acceptability Parental influence Culture Health education

Peer acceptability

Which complete blood count (CBC) test value would the nurse consider outside normal range? Red blood cell (RBC) count 5.0 million/mm 3 White blood cell (WBC) count 12.8 x 10 3 cells/mm 3 Platelet count 70 x 10 3/mm 3 Eosinophils 2.5% of differential WBC count

Platelet count 70 x 10 3/mm 3

Which manifestation helps the nurse to identify hyperglycemia in a child with diabetes mellitus (DM)? Chart/Exhibit 1 Presence of paleness or pallor Shallow normal respirations Presence of acetone breath Excessive sweating

Presence of acetone breath

An infant has a low-grade fever, is sneezing, has tearing eyes, and exhibits a short and rapid cough that occurs mainly at night and is followed by a crowing sound. Which nursing action is appropriate for this patient? Select all that apply. One, some, or all responses may be correct. Provide humidified oxygenation and suction. Place the child on the bed in a supine position. Restrict oral fluids because these can aggravate the cough. Place the patient on droplet precautions. Administer mild sedatives to the child as necessary.

Provide humidified oxygenation and suction. Place the patient on droplet precautions. The child's symptoms are indicative of pertussis (whooping cough). Therefore the nurse should provide humidified oxygen to the child and suction the child as needed. The nurse should also use droplet precautions for the child because pertussis can be transmitted through droplets. The child is at risk for aspiration during coughing fits. Therefore the child should be placed on the side rather than in the supine position in the bed. The child needs oral fluids for adequate hydration. Mild sedatives are given to children with poliomyelitis because they help relieve anxiety and promote rest; they are not used when children have pertussis.

Which is the most appropriate nursing intervention for a 16-year-old girl who tells the school nurse that she has not started to menstruate? Explaining that this is not unusual Referring the adolescent for an evaluation Assuming that the adolescent has become pregnant Suggesting that the adolescent stop exercising until menarche occurs

Referring the adolescent for an evaluation

Which condition would the nurse suspect when caring for a 35-week premature infant that develops tachypnea, dyspnea, nasal flaring, and retractions? Acrocyanosis Polycythemia Hyperbilirubinemia Respiratory distress syndrome (RDS)

Respiratory distress syndrome (RDS)

Which is the major stressor of hospitalization for children from middle infancy throughout the preschool years? Fear of pain Loss of control Separation anxiety Fear of bodily injury

Separation anxiety Separation anxiety is a major stressor for children from infancy through the preschool years. Fear of pain, fear of loss of control, and fear of bodily injury are all stressors associated with hospitalization, but none is the primary stressor in this age-group.

The nurse is caring for a child who has a loss of respiratory muscle strength and who is unable to cough. Which nursing intervention does the nurse perform to help the child clear the airway? Ask the child to suppress the cough. Restrict fluid intake for the child. Splint the chest while the child is coughing. Administer antibiotic drugs to the child.

Splint the chest while the child is coughing. In the case of respiratory muscle weakness, there is difficulty in coughing. The nurse should support the child's chest by splinting with a pillow so that it is easier to cough. Coughing is a defense mechanism of the body that removes foreign irritants from the respiratory tract. Thus the nurse should encourage the child to cough. The child should be provided adequate fluids to prevent thickening of chest secretions. Antibiotic drugs should be administered only if the child shows signs and symptoms of infection.

The nurse is administering a blood transfusion to a child for treatment of hemophilia. On assessment, the nurse notes that the child is cyanotic, has difficulty breathing, and has rales upon inspiration throughout the lung fields. Which is the nurse's best response to these findings? Reassess the patient again in 5 minutes. Stop the transfusion immediately. Administer epinephrine immediately. Insert a urinary catheter and monitor hourly outputs.

Stop the transfusion immediately.

A newborn is displaying behavioral clues indicating pain. Which is a nonpharmacologic pain-management technique? Select all that apply. One, some, or all responses may be correct. Swaddling Nonnutritive sucking Acetaminophen Sucrose via nipple or syringe Skin-to-skin contact with the mother

Swaddling Nonnutritive sucking Sucrose via nipple or syringe Skin-to-skin contact with the mother

The nurse is educating an adolescent female about proper hygiene and necessary care to prevent urinary tract infections (UTIs). Which would the nurse include in the teaching plan? The importance of urinating two times a day The importance of limiting water intake to 5 ounces a day The importance of wearing nylon underwear instead of cotton The importance of wiping the perineum from the front to the back

The importance of wiping the perineum from the front to the back

The nurse is caring for a neonate. The neonate's stool has a thick consistency and offensive odor. Which is the possible reason for this? The neonate is nourished with oral sucrose. The neonate is nourished with human milk. The neonate is nourished with whole milk formula. The neonate is nourished with vitamin K supplements.

The neonate is nourished with whole milk formula.

Which would the nurse teach the child and family about the distinctive features of ambulatory or outpatient care settings? There is no preadmission preparation. There is minimized separation from family. There is a minimum of one night's hospital stay. The cost of treatment increases.

There is minimized separation from family.

For which reason would the nurse advise a family to avoid giving honey to their baby until the child is 1 year old? To reduce the risk for tetanus in the child To reduce the risk for diarrhea in the child To reduce the risk for botulism in the child To reduce the risk for allergy in the child

To reduce the risk for botulism in the child The use of honey should be discouraged for the initial 12 months to reduce the risk for botulism. The use of honey does not increase the risk for tetanus. Honey does not cause diarrhea. It is a honeybee sting that causes allergic manifestations, not honey.

In the early neonatal period, crying or straining can result in increased pressure that shunts unoxygenated blood from the right side of the heart across the ductal opening. Which is this condition called? Jaundice Hypotension Transient cyanosis Nonpathologic cyanosis

Transient cyanosis

Erikson theorized that the acquisition of which characteristic is the primary focus in infancy? Trust Industry Initiative Separation

Trust

Which action would the nurse take next when caring for an infant with a tracheostomy after accidental decannulation occurs and the nurse is unable to reinsert the tube? Notify the surgeon. Perform oral intubation. Try to insert a larger tracheostomy tube. Try to insert a smaller tracheostomy tube.

Try to insert a smaller tracheostomy tube. A smaller tracheostomy tube would be available at the bedside at all times. Insertion of the smaller tube will keep the stoma open until further action can be taken. The surgeon would be notified after the emergency situation is handled. Oral intubation is done if a tracheostomy tube cannot be inserted. A larger tracheostomy tube would cause trauma to the trachea and therefore is not used.

Which physiologic alteration is characterized by destruction of pancreatic beta-cells that produce insulin? Type 1 diabetes Type 2 diabetes Gestational diabetes Impaired glucose tolerance

Type 1 diabetes

For which complication would the nurse monitor an 11-month-old infant fed a vegetarian diet? Calcium deficiency Vitamin C deficiency Vitamin B 12 deficiency Hypervitaminosis of vitamin A

Vitamin B 12 deficiency Infants fed a vegetarian diet are at risk for vitamin B 12 deficiency, particularly those on vegan diets. Calcium deficiency may result in neonatal tetany, but it is not associated with vegetarian diet. Vitamin C deficiency, which may result in scurvy, is not associated with vegetarian diet. Hypervitaminosis of vitamin A, which may cause thrombocytopenia, is not associated with vegetarian diet.

At which age can the infant distinguish the mother's voice from that of another woman? 3 days 7 days 2 weeks Prenatally

3 days Infants at 3 days of age have been found to be able to distinguish the mother's voice from those of other women. Infants at 2 weeks and 7 days are already able to discriminate the mother's voice from that of another woman. Infants have not been found to be able to distinguish their mother's voice from that of other women before birth.

Which would be the expected peak of rapid-acting insulin (i.e., NovoLog)? 2 hours after injection 5 hours after injection 15 to 30 minutes after injection 30 to 90 minutes after injection

30 to 90 minutes after injection Rapid-acting insulin peaks 30 to 90 minutes after injection, not 2 hours, 5 hours, or 15 to 30 minutes after injection.

For which reason would the nurse emphasize proper diet when discussing health promotion with an adolescent girl? Adolescent girls usually have a high body mass index. Adolescent girls tend to eat less because of fear of becoming overweight. Adolescent girls tend to eat more to gain size and strength. Adolescent girls are highly predisposed to have cardiovascular diseases.

Adolescent girls tend to eat less because of fear of becoming overweight.

Which intervention would the emergency room nurse prioritize when caring for a toddler with carbon monoxide inhalation? Administer oxygen. Assess airway patency. Evaluate vital signs. Determine source of carbon monoxide.

Assess airway patency.

The nurse is caring for four infants diagnosed with various respiratory conditions. Which infant would the nurse anticipate will be treated with bevacizumab? Chart/Exhibit 1 Infant 1: pneumothorax Infant 2: apnea of prematurity Infant 3: retinopathy of prematurity Infant 4: meconium aspiration syndrome Infant 1 Infant 2 Infant 3 Infant 4

Infant 3

Type 1 diabetes mellitus has just been diagnosed in a teenage boy who is actively involved in sports. Which important instruction would the nurse include in the teaching plan? Because exercise can lower the blood glucose level, blood glucose needs to be closely monitored. Because exercise can increase the blood glucose level, blood glucose needs to be closely monitored. Because exercise can increase the blood glucose level, additional insulin should be taken before physical activity. Because exercise can lower the blood glucose level, additional insulin should be taken before physical activity.

Because exercise can lower the blood glucose level, blood glucose needs to be closely monitored.

Which condition does research suggest overweight children and adolescents are at risk for throughout life? Low blood pressure and type 2 diabetes mellitus Being overweight throughout life along with health and social consequences No social consequences or health problems Health problems without social consequences

Being overweight throughout life along with health and social consequences

Which test is appropriate for the child who is urinating frequently and in large amounts and whose urinalysis reveals a high specific gravity and osmolality? Chest x-ray results Blood glucose levels Serum potassium level Liver function tests

Blood glucose levels

Which procedure is appropriate when identifying the means of eliminating excess iron in a child with thalassemia major? Antiemetics Splenectomy Chelation therapy Blood transfusions

Chelation therapy

Which light meal dietary item would the nurse offer an adolescent who is prescribed 6 hours of fasting before surgery? Fruit pulp Clear tea French fries Boiled egg

Clear tea A light meal typically consists of toast and clear liquids. Clear liquids include clear tea, fruit juices without pulp, water, carbonated beverages, and black coffee. Meals that include fried and fatty foods or eggs prolong the gastric emptying time and are therefore not included in the meal.

For which condition would the nurse monitor long term in a newborn with phenylketonuria (PKU)? Obesity Diabetes insipidus Respiratory distress Cognitive impairment

Cognitive impairment

Which condition would the nurse suspect in an infant who cries loudly, draws the legs to the abdomen, and takes a prolonged period to soothe? Select all that apply Colic Torticollis Dyssomnia Plagiocephaly

Colic Colic manifests as prolonged crying, loud crying, and drawing the legs to the abdomen. Torticollis manifests as a tightened sternocleidomastoid muscle, causing the head to be tilted preferentially toward the tightened muscle. Dyssomnia manifests as difficulty falling or staying asleep or difficulty staying awake. Plagiocephaly manifests as a flattening of the skull.

Which is the most appropriate recommendation by the nurse when asked by an adolescent about prevention of sexually transmitted diseases? Condoms Prophylactic antibiotics Any type of contraception method Withdrawal method of contraception

Condoms

Which injection site is contraindicated for an infant? Deltoid muscle Dorsogluteal muscle Ventrogluteal muscle Anterolateral thigh muscle

Dorsogluteal muscle The dorsogluteal muscle is present in the leg and is very close to the sciatic nerve. Injecting medication into the dorsogluteal muscle may damage the sciatic nerve; therefore it is contraindicated. The deltoid muscle is a triangular muscle in the shoulder, which is easily accessible and does not cause any harm. The ventrogluteal muscle is present on the leg and does not cause any harm to the infant. The anterolateral thigh muscle is the safest and most easily accessible muscle for administration of intramuscular injection.

Which term is used to describe an infant born between the beginning of the 38th week and the completion of the 42nd week of gestation, regardless of birth weight? Preterm infant Full-term infant Postterm infant Late-preterm infant

Full-term infant

Which are the most common clinical feature(s) of sickle cell anemia in children? Select all that apply. One, some, or all responses may be correct. Gallstones Hematuria Osteomyelitis Hepatomegaly Chronic ulcers

Gallstones Hematuria Osteomyelitis Hepatomegaly Common clinical features of sickle cell anemia found in children include gallstones, hematuria, osteomyelitis, hepatomegaly, cerebrovascular accident, paralysis, retinopathy, blindness, hemorrhage, avascular necrosis, splenomegaly, splenic sequestration, hyposthenuria, abdominal pain, dactylitis, priapism, and pain. Chronic ulcers are not a common finding in children with sickle cell anemia.

The nurse would recognize that when a child develops diabetic ketoacidosis (DKA), treatment will be instituted as described in which of the following statements? DKA is best treated at home. DKA is best treated at a practitioner's office or clinic. Immediate treatment is required because DKA is a life-threatening situation. No treatment is required because DKA is an expected outcome of type 1 diabetes mellitus.

Immediate treatment is required because DKA is a life-threatening situation.

Which finding is most often observed with destruction of the pancreatic beta cells? Increased insulin secretion in the body Decreased growth hormone in the body Increased serum thyroxin levels in the body Increased blood glucose levels in the body

Increased blood glucose levels in the body

During the summer, many children are more physically active. Which change in the management of the child with type 1 diabetes mellitus would be expected as a result of more exercise? Increased food intake Decreased food intake Decreased risk for insulin shock Increased risk for hyperglycemia

Increased food intake

Which is the name for defects in which blood exiting the heart meets an area of anatomic narrowing? Mixed Cyanotic Acyanotic Obstructive

Obstructive

A child has pain and sacral dimpling in the lumbosacral region, a left thoracic curve, and bladder incontinence. Which would the nurse expect as the follow-up plan of care? Provide reassurance because the child will normally outgrow the issue. Refer the patient and parents to a urologist for the management of incontinence. Conduct a magnetic resonance imaging (MRI) of the abdomen to identify the cause of urinary incontinence and pain. Take an MRI of the spine for further evaluation of the severity of the issue.

Take an MRI of the spine for further evaluation of the severity of the issue.

Which statement is an accurate representation of the Apgar scoring system? The Apgar scoring system is predictive of infant morbidity. The Apgar scoring system is an evaluation of newborn well-being. The Apgar scoring system determines the diagnosis of cerebral palsy. The Apgar scoring system determines the predictive growth pattern in the first month of life.

The Apgar scoring system is an evaluation of newborn well-being.

Which is a clinical manifestation of failure to thrive? Select all that apply. One, some, or all responses may be correct. Smiling Undernutrition Fear of strangers Developmental delays Avoidance of eye contact

Undernutrition Developmental delays Avoidance of eye contact Clinical manifestations of failure to thrive include undernutrition and growth failure, developmental delays, apathy, withdrawn behavior, feeding or eating disorders, and avoidance of eye contact. Smiling and fear of strangers are not clinical manifestations of failure to thrive.

The nurse is giving discharge instructions to the parent of an 8-month-old infant who is receiving a liquid medication. How would the nurse teach the parent to measure liquid medicine to achieve the most accurate measurement? Use a teaspoon measuring device intended for cooking. Use a household measuring spoon to portion out the dose. Use a regular silverware teaspoon to measure the dose. Use a plastic syringe (without the needle) calibrated in teaspoons/milliliters.

Use a plastic syringe (without the needle) calibrated in teaspoons/milliliters.

Which is an example of dramatic play?Using puppets to decrease anxiety Decorating the hospital room to decrease anxiety Using crayons and paper to express anxiety Using paint and imagination to reduce anxiety

Using puppets to decrease anxiety Dramatic play is a technique for emotional release of the child during hospitalization. A puppet show includes dramatic play. Asking the child to decorate the room will help divert the child through creative expression. Providing crayons and paper for the child are diversion activities. Painting is also a type of creative expression.

During assessment, the nurse finds that a toddler has an upper respiratory tract infection, serous drainage, inflamed conjunctiva, and swollen eyelids. Which condition does this patient likely have? Viral conjunctivitis Allergic conjunctivitis Bacterial conjunctivitis Conjunctivitis caused by a foreign body

Viral conjunctivitis Conjunctivitis is inflammation of the conjunctiva. Upper respiratory tract infection, serous drainage, inflamed conjunctiva, and swollen eyelids are symptoms suggestive of viral conjunctivitis. Itching in the eye, stringy discharge, inflamed conjunctiva, and swollen eyelids are symptoms of allergic conjunctivitis. Purulent drainage, crusting of eyelids (especially on awakening), inflamed conjunctiva, and swollen eyelids are symptoms of bacterial conjunctivitis. Tearing, pain, and inflamed conjunctiva are symptoms of conjunctivitis caused by a foreign body. In foreign body conjunctivitis, usually only one eye is affected.