PEDS FINAL REVIEW

A child who had bacterial meningitis is scheduled to have his hearing tested before discharge. The parents asks the nurse why this test is necessary. Which response by the nurse is appropriate?

"Some children with bacterial meningitis suffer damage to the nerve responsible for hearing; this test screens for hearing loss."

The nurse is assisting with orientation of a new employee. What safety measures should the nurse include that all healthcare workers must practice when using and storing hazardous substances? SATA

*Have the phone number for the healthcare agency's Poison Control Center readily available *Read labels carefully noting all emergency information *Be aware of proper spill cleanup procedures *Always wear protective equipment when working with such liquids

The nurse is taking a telephone order from the provider. Nurse was not clear about the order received. What are the nurse's responsibilities? SATA

*Read back the order to clarify *Not give medications until order is clarified

An infant's birthweight is 7 pounds, 8 ounces. The nurse can project the weight at 6 months to be

15 pounds (double @ 6 months triples by 1 year of age)

The mother of a newborn asked the nurse, "When will my baby get the hepatitis B vaccine?" The nurse bases a response on the knowledge that the first dose of Comvax should be given to infants born to a hepatitis B-positive mother within _____ after birth.

A: 12 hours

Which guideline ensures safety when applying a restraint on a child?

A: A physician's order is usually required for a restraint.

The nurse is working with a child who is in a sickle cell crisis. Treatment and nursing care for this child includes which of the following? SATA

A: Administering oxygen B: Administering analgesics D: Transfusion of red blood cells

The nurse is reinforcing teaching related to treatment of pediculosis with the parent of a toddler. What should the nurse include in the teaching? Select all that apply.

A: All household members should be treated. B: A second application of the pediculicide is usually recommended. D: Items used by the toddler, such as combs, should not be shared.

The nurse is providing patient teaching for an adolescent diagnosed with mononucleosis. Which of the following teaching points should the nurse include?

A: Avoid playing contact sports during the acute phase of the illness.

The nurse is obtaining the history of an adolescent female who is suspected of having anorexia nervosa. Which of the following would the nurse expect to find? Select all that apply

A: Constipation B: Amenorrhea C: Desire for perfectionism

The nurse is providing education to the mother of a toddler who is brought to the pediatrician for a well visit. What would be a focal point for client education based on the child's developmental level?

A: Discipline and limit setting

A nurse suspects that a 5 year old child brought to the clinic has epiglottitis. Which of the following signs support that assessment? Select all that apply.

A: Drooling B: Respiratory distress D: Absence of cough

he parent of a child with iron-deficiency anemia asks what foods would be good for the child to eat. What foods should the nurse identify for the parent? (Select all that apply.)

A: Egg yolks C: Raisins D: Peanut butter F: Oatmeal

A 6-year-old child with a history of varicella and aspirin intake is brought to the emergency department. The nurse suspects Reye's syndrome. Which data collection findings are consistent with this syndrome?

A: Fever, decreased level of consciousness (LOC), and impaired liver function

As nursing evolves, which trends in health are expected to continue into the 21st century? Select all that apply.

A: Higher acuity of clients in hospital settings B: A shift toward in-hospital-based care C: An increased use of technology D: Nurses assuming more autonomy E: A greater life expectancy among clients

An 8-year-old client is diagnosed with infectious mononucleosis. Which nursing considerations should the nurse employ when caring for the client? Select all that apply.

A: Instruct the client to avoid strenuous exercise and contact sports. C: Administer analgesics and encourage the client to rest. D: Administer measured doses of systemic steroids to the client.

Which questions about the effects of air pollution should be asked during the client interview? Select all that apply

A: Is smog a problem where you currently live? B: When was the last time you were diagnosed with sinusitis? D: Does anyone living in your home smoke tobacco in any form? E: Have you ever been diagnosed with any type of bronchitis?

A 7-year-old child is diagnosed with chickenpox. Which eruption is the first to be seen in chickenpox?

A: Papules

The nurse planning a seminar on safety for the preschooler will focus on what aspect(s)? Select all that apply.

A: Poisonings B: Burns C: Falls D: Abductions E: Vehicles and pedestrian

The nurse is caring for a 6 year old boy diagnosed with the mumps. Which teaching point would be appropriate for the parents of this child?

A: Protect your other children from close contact with your son.

Which nursing interventions demonstrate an understanding of the nurse's responsibility regarding an advanced directive? SATA

A: Providing a client with a brochure that explains the purpose of an advance directive? B: Notifying the healthcare provider that the client has initiated an advance directive. C: Informing clients that they have the right to refuse treatment or can refuse life-prolonging measures but can still receive palliative care and pain control. D: Documenting actions appropriately in the nursing records. E: Knowing that specific advance directives may apply to certain areas(e.g. mental health units).

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. Which of the following would alert the nurse to the possibility of early localized Lyme disease?

A: Ring-shaped rash

A nurse is teaching new parents about the causes of sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS) and interventions to help prevent these deaths. Which information about SUID and SIDS is accurate? SATA

A: SUID can be caused by metabolic disorders C: SIDS has been linked to sleeping in a prone position D: One theory links SIDS to malfunctioning brain stem causing faulty respirations

The nurse is caring for a 10-year-old boy diagnosed with chronic ulcerative colitis. Which of the following is a prominent symptom of this disorder?

A: Severe diarrhea that may be bloody

The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? Select all that apply.

A: Toxoplasmosis C: Cytomegalovirus D: Rubella E: Herpes simplex

The nurse is teaching a new mother about the advantages/disadvantages of breastfeeding versus formula feeding. Which statements accurately describe the process? SATA

A: breast milk is readily available and convenient B: breast milk is always the right temperature D: breasts milk contains antibodies

The nurse is caring for a 10 year old girl with burns covering two-thirds of her body caused by a home fire. Which are chief nursing concerns in threatening this client? SATA

A: combating shock C: alleviating pain F: restoration of fluid and electrolyte balance

A 12 year old girl with sickle cell anemia has severe pain in her abdomen and legs. The girl asks the nurse why the doctor has ordered oxygen when she is breathing just fine. The nurse will give the correct response by explaining the benefit of oxygen as which of the following?

A: oxygen prevents further sickling of your cells

The nurse planning a seminar on safety for the preschooler will focus on what aspect(s)? SATA

A: poisonings B: burns C: falls D: abductions E: vehicles and pedestrians

A child with Reye syndrome is exhibiting signs of increased intracranial pressure (ICP). Which nursing intervention would be most appropriate for this child?

A: position the child with the head elevated and the neck in a neutral position

A 6 year old is in the emergency room with suspected Legg-Calve-Perthes (LCP) disease. For which of the following symptoms would the nurse assess the child? SATA

A: stiffness in the morning or after rest B: referred knee pain E: insidious limp after activity

The nurse is caring for an older woman in the nursing facility. She is unable to perform complex activities of daily living. Which of the following are considered complex instrumental activities of daily living (IADLs)? Select all that apply.

A: using a cell phone D:managing money E: using a computer F: taking care of household maintenance

A nurse is reinforcing education on preventing injuries with the parents of a toddler. Which instructions are appropriate for the nurse to give the parents? SATA

B: "Place locks on cabinets containing toxic substances" C: "Never allow a toddler to be near water at any time without adult supervision"

A 5-year-old arrives in the clinic for a physical to enter school. Which potential child abuse findings should be brought to the health care provider's attention? Select all that apply

B: A patterned bruise is noted on the back C: Parental description of accident does not match injury. E: Injuries in various stages of healing are documented

A nurse is caring for a 3-year-old with viral meningitis. Which signs and symptoms does the nurse anticipate finding when gathering data? SATA

B: Fever C: Nuchal rigidity D: Irritability E: Photophobia

A 10-year-old client visits the healthcare clinic with complaints of watery blisters over the skin between the toes. What client teaching should the nurse provide for this client? Select all that apply

B: Frequently change the shoes C: Wear flip-flops at swimming pools

A nurse is measuring the head and chest circumference of a child. Which guideline is recommended for these procedures?

B: Measure the occipital frontal circumference of the head for children up to 3 years of age

A 16-month-old with a history of hydrocephalus is admitted with an infected ventriculoperitoneal shunt. Which assessment takes priority in this toddler?

B: Monitor for signs of increased intracranial pressure.

The nurse giving iron dextran intramuscularly (IM) will use the Z-track method because this method: (Select all that apply.)

B: Prevents staining of the skin when performed properly.

The nurse is taking a telephone order from the provider. Nurse was not clear about the order received. What are the nurses responsibilities? SATA

B: Read back the order to clarify. C: Not give medication until order is clarified.

The nurse has been performing cardiopulmonary resuscitation (CPR) on an infant. Which method does the nurse use to determine its effectiveness?

B: Stops chest compressions to feel for a pulse

Which head-to-chest ratio is normal for children?

B: The chest and head are about equal for ages 1 to 2 years.

When gathering data on a preschool-age child, the nurse finds multiple contusions over the body. Which statement indicates the findings that should be documented?

B: all lesions, including location, shape, and color, should be documented

The nurse is assessing an 11 year old female with scoliosis. Which of the following would the nurse expect to find? SATA

B: asymmetrical shoulder elevation D: pronounced one-sided hump on bending over

A nurse is caring for a 3-year-old diagnosed with viral meningitis. Which signs and symptoms does the nurse anticipate finding when gathering data? Select all that apply

B: fever C: nuchal rigidity D: irritability E: photophobia

The mother of a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons and that recently she had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to which of the following?

B: latex

The nurse is discussing behavior patterns with the parents of a toddler. Which issues should the nurse include in the discussion? SATA

B: separation anxiety D: negativism E: temper tantrums

The nurse is teaching an adolescent about medications to treat his acne. Which of the following is a nursing consideration for the use of topical and systemic agents?

B: topical agents may cause bleaching of hair or clothing D: retinoic acid, a topical agent, is available in many over-the-counter topical agents

An infant is hospitalized for RSV bronchiolitis. Which type of precautions would the nurse use when caring for the infant?

C: Contact precautions

A 25 year old client has been diagnosed with a tubal pregnancy. Which factor predisposes a woman to this type of pregnancy? SATA

C: IUD use D: Pelvic infections E: Endocrine imbalances

A client with diabetes asks the nurse, "If I can't do heavy exercise, what's the point in exercising?" What response by the nurse can encourage the client to perform moderate exercise? Select all that apply.

C: It will enhance energy levels D: It will reduce stress E: It will provide relaxation

A 16 year old client has been diagnosed with anorexia nervosa. The client appears very thin. The client does not have proper dietary intake and is obsessed with losing weight. Which of the following is true for a client with anorexia nervosa?

C: extreme and persistent hunger is an important sign

The nurse caring for a child diagnosed with hemolytic uremic syndrome explains to the parents that a combination of three conditions occurs in this illness. Which of the following is one of these conditions?

C: renal failure

A nurse is preparing to perform phenylketonuria (PKU) testing. Which baby is ready for the nurse to test?

a 2-day-old baby who has been breast-fed

A 1-year-old infant is hospitalized with a diagnosis of eczema. Which signs and symptoms does the nurse expect to observe?

exudative , crusty, papulovesicular, erythematous lesions on the cheeks, scalp, forehead, and arms.

A 5 year old is diagnosed with acute lymphatic leukemia (ALL). After teaching the caregivers about the upcoming diagnostic testing and treatments, the nurse evaluates the caregivers understanding of ALL. Which of the following statements indicates the caregiver has received the appropriate information?

" This will show how bad the cancer is and at what stage"

The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which of the following would the nurse include? SATA

*Blurred vision in the second trimester *Sudden leakage of fluid during the second trimester *Vaginal spotting in the first trimester

A client is diagnosed with juvenile glaucoma. Which of the following accurately describes this disorder?

: Abnormally high intraocular pressure

A nurse is explaining to parents the expected stool that their child, diagnosed with Meckel's diverticulum, may experience. What kind of stool will the nurse describe to the parents?

: Bloody or tarry stool

The mother of an infant asls you when to begin brushing her son's teeth. Your best response would be:

: as soon as the first tooth erupts

One reason that infants are more vulnerable to fluid and electrolyte imbalances than adults is that:

A greater percentage of body weight in infants is extracellular

The nurse is counseling a couple who are concerned that their children might inherit sickle cell anemia. Which of the following responses from the couple indicates a need for further teaching?

A: " the father cannot pass the disease on to his son or the mother to her daughter"

A 15-month-old has just received routine immunizations, including DTaP, IPV, and MMR. What information should the nurse give to the parents before they leave the office? Select all that apply.

A: "Minor symptoms can be treated with acetaminophen." C: "Call the office if the toddler develops a fever above 103°F (39.4°C), seizures, or difficulty breathing." D: "Soreness at the immunization site and mild fever are common."

Which food items selected by a child with celiac disease would cause the nurse to intervene? SATA

A: corn flakes cereal, skim milk, and a banana B: a bologna, lettuce, and tomato sandwich C: slice of cheese, sausage, and vegetable pizza

The nurse is caring for a dying client. What is the priority nursing action during the care of this client?

A: maintain a patent airway

A 15 month old has just received routine immunizations, including DTap, IPV, and MMR. What information should the nurse give to the parents before they leave the office? SATA

A: minor symptoms can be treated with acetaminophen? C: call the office if the toddler develops a fever above 103F (39.4C), seizures, or difficulty breathing. D: soreness at the immunization site and mild fever are common

Which diagnostic finding supports a diagnosis of rheumatic fever?

B: Elevated erythrocyte sedimentation rate (ESR)

The nurse is caring for a 5-year-old who is upset that the nurse is leaving at the end of a shift. Which statement by the nurse will most help the child understand why the nurse is leaving?

C: "I have a 4-year-old son and I need to go play with him"

The nurse clarifies to the parents of a 4-year-old child recovering from rheumatic fever that the child will need to receive monthly injections of penicillin G for a minimum of ___ year(s).

C: 5

Which promotes the clotting of blood?

C: Prothrombin

A parent is concerned because her son was exposed to varicella at preschool. The nurse would tell this parent that the incubation period for varicella is ________ days?

D: 14-21 days

It is appropriate to take an oral temperature for a child experiencing which condition?

D: Diarrhea

Which intervention should the nurse implement when using an arm board for the child with an IV?

D: Pad the board with a towel and fasten it with tape

A nurse would base a response to a parent about how his child got hepatitis A on the information that the child:

D: ate shrimp while they were in Mexico

An adolescent is diagnosed with narcolepsy. Which of the following is a characteristic of this disorder?

D: it is accompanied by an early appearance of REM sleep

Age consideration is needed when educating the caregivers of a newly diagnosed toddler with diabetes mellitus. Which of the following instructions should the nurse include in the diabetic teaching with consideration of the child's age? SATA

D: let the toddler help clean the finger off with alcohol before the glucose test E: let the toddler pick his or her meals from specific foods

It has been determined that a client with hepatitis has contracted the infection from contaminated food. What type of hepatitis is this client most likely experiencing?

Hepatitis A

A 16-month-old with a history of hydrocephalus is admitted with an infected ventriculoperitoneal shunt. Which assessment takes priority in this toddler?

Monitor for signs of increased intracranial pressure.

The nurse cautions parents to place their infants in the __________position to reduce the risk of sudden infant death syndrome (SIDS)

Supine

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful?

This condition could gradually go away on it's own

A nurse is collecting data on a neonatal born 3 hours ago. Which finding would lead the nurse to suspect that the neonate may have developmental dysplasia of the hip?

Unequal gluteal folds