Peds Midterm

A 2-day-old infant way just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? a. gallop and rales b. blood pressure discrepancies in the extremities c. right ventricular hypertrophy on ECG d. heart murmur

d. heart murmur

Which of the following are reasons that stealing occurs in school-age children? (select all that apply) a. To escape punishment b. High self-esteem c. Low expectations of family/peers d. lack of sense of property e. Strong desire to own something

A. To escape punishment d. Lack of sense of property e. Strong desire to own something

When giving parents guidance for the adolescent years, the nurse would advise the parents to (select all that apply) a. Accept the adolescent as a unique individual b. provide strict, inflexible rules c. listen and try to be open to the adolescent's views e. respect the adolescent's privacy f. provide unconditional love

A. accept the adolescent as a unique individual C. Listen and try to be open to the adolescent's views E. respect the adolescent's privacy F. provide unconditional love

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: a. Learning from repeating tasks b. developing a sense of worth and competence c. using fantasy and magical thinking to cope with problems d. developing a sense of trust

B. Developing a sense of worth and competence

The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother? a. Having the boys on the same team will make it more convenient for the mother b. Levels of coordination and concentration differ, so the boys need to be on different teams c. Put the boys on the same team because they are both school-age children d. It is best to avoid putting the boys on the same team to prevent sibling rivalry.

B. Levels of coordination and concentration differ, so the boys need to be on different teams.

Which activities will promote weight loss in an obese school-age child? (select all that apply) a. Unlimited computer/TV time b. Role modeling by family c. Becoming active in sports d. Eating unstructured meals e. involving child in meal planning/grocery shopping f. drinking three glasses of water/ day

B. Role modeling by family C. Becoming active in sports E. Involving child in meal planning/ grocery shopping

Samantha, a 10-year-old girl, is brought into your clinic for a well-child exam. Her mother states "Samantha's friend group seems to be so much more important to her these days." As the nurse caring for her, how would you explain the role of peers in the school-age child? a. This allows her the opportunity to learn conflict management b. Helps her to shape her concept of self and provides security as she gains independence from her parents c. This will encourage her to remain dependent on her teachers and family d. This will help her to work through her fears of body safety.

B. This helps her to shape her concept of self and provide security as she gains independence form her parents

A 5-year-old who had a renal transplant 9 months ago and has no history of chickenpox presents to the pediatric clinic for his vaccinations. which is the most appropriate set to give? a. DTap, IPV b. DTap, IPV, MMR, varicella c. DTap, IPV, varicella d. IPV only

a. DTaP, IPV

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? a. Hesitancy and dysfluency are normal during this period of development. b. Reading to the child will help model appropriate speech. c. Expressive language concerns warrant a developmental evaluation. d. the mother should ask her child's physician for a speech therapy evaluation.

a. Hesitancy and dysfluency are normal during this period of development

When compared with adults, why are infants and children at an increased risk of head trauma? a. The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed. b. The development of the nervous system is complete at birth but remains immature c. The spine is very immobile in infants and young children d. The skull is more flexible due to the presence of sutures and fontanels.

a. The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed

The parents of a child with a developmental disability ask the nurse for advice about disciplining their child. What is the best response by the nurse? a. You should choose methods that are most congruent with your values about discipline b. children like this really can't follow directions, so they may be very hard to discipline c. punish your child only for socially unacceptable or offending behviors d. spanking works well for this type of child, as they really don't like pain.

a. You should choose methods that are most congruent with your values about discipline

A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, french fries, and ice cream. What is the best action? a. Ask that the child's desired foods be sent up from the kitchen b. Negotiate with the child to eat at least part of the food on the tray c. Remove a privilege d. Offer the child cereal and milk from stock on the nursing unit

a. ask that the child's desired foods be sent up from the kitchen

The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess? a. obesity from overeating b. clubbing of the nail beds c. squatting during play activities d. exercise intolerance

a. obesity from overeating

A 3-month-old infant presents with a history of vomiting after feeding. the plan for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention? a. poor weight gain b. small "spits" after feeding c. sleeps through the night d. difficult to burp

a. poor weight gain

Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem? a. previous streptococcal throat infection b. history of open-heart surgery at 5 years of age c. playing too much soccer and not getting enough rest d. exposure to a sibling with pneumonia

a. previous streptococcal throat infection

In developing a weight-loss plan for an adolescent, which would the nurse include? (select all that apply) a. Have parents make all of the meal plans b. Eat slowly and place the fork down between each bite. c. Have the family exercise together d. Refer to an adolescent weight-loss program e. Keep a food and exercise diary

b. Eat slowly and place the fork down between each bite. c. Have the family exercise together d. Refer to an adolescent weight-loss program e. Keep a food and exercise diary

A 6-month-old infant is admitted to the hospital with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. The priority nursing intervention would be a. educate the family on ways to prevent bacterial meningitis b. initiate appropriate isolation precautions and begin intravenous antibiotics c. assess the infant's fontanels d. encourage the mother to hold the infant and feed her.

b. Initiate appropriate isolation precautions and begin intravenous antibiotics

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother?

b. Place the child in time-out for 4 minutes

The nurse is caring for a 3-year -old with a gastrostomy tube and tracheostomy who is on supplemental oxygen and multiple medications. The mother is rooming in during this hospitalization. What is the priority nursing action? a. Incorporate the mother's assistance in care when convenient b. Recognize the mother as the expert on her child's needs and care c. Recommend that the mother go home to get some rest. d. Provide family-centered care since the mother is there.

b. Recognize the mother as the expert on her child's needs and care

Which is associated with early adolescence? (select all that apply). a. Uses scientific reasoning to solve problems b. Still at times wants to be depended upon parents c. incorporates own set of morals and values d. is influenced by peers and values memberships in cliques

b. Still at times wants to be dependent upon parents d. is influenced by peers and values memberships in cliques

A mother brings her 6-month-old infant to the clinic. The child has been vomiting since early morning and has had diarrhea since the day before. His temperature is 38 degrees C, pulse 140, and respiratory rate 38. He has lost 6 oz since his well-child visit 4 days ago. He cries before passing a bowel movement. he will not breastfeed today. What is the priority nursing analysis? a. altered thermoregulation b. pain (abdominal) related to diarrhea c. hypovolemia related to excessive losses and inadequate intake d. alteration in nutritional status related to decreased oral intake

c. hypovolemia related to excessive losses and inadequate intake

Which facility fulfills the characteristics of a medical home? a. An urgent care center b. A primary care pediatric practice c. A mobile outreach immunization program d. A dermatology practice

b. a primary care pediatric practice

An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his examination. You review all his birth records and find no documentation that a newborn hearing screening was performed. What is the best action by the nurse? a. Do nothing; responding to the bell proves the infant does not have a hearing deficit b. schedule the infant immediately for newborn hearing screening. c. Ask the mother to observe for signs that the infant is not hearing well d. Screen again with the bell at the infant's 2-month health supervision visit.

b. b. Schedule the infant immediately for newborn hearing screening.

What has the most influence in deterring an adolescent from beginning to drink alcohol? a. Drinking habits of parents b. Drinking habits of peers c. Drinking philosophy of adolescent's culture d. Drinking philosophy of adolescent's religion

b. drinking habits of peers

A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? a. Tie the restraint loosely to prevent skin breakdown b. Leave the baby unrestrained when directly observed c. Position the restrained infant prone to prevent aspiration d. place infant in a room near the nurses' station

b. leave the baby unrestrained when directly observed

A child presents with a 2-day history of fever, abdominal pain, occasional vomiting, and decreased oral intake. Which finding would the nurse prioritize for immediate reporting to the physician? a. Temperature 101.9F b. Rebound tenderness and abdominal guarding c. Parents will be leaving the child alone in the hospital d. Child can tolerate only sips of fluid without nausea.

b. rebound tenderness and abdominal guarding

A 4-year-old girl presents with recurrent urinary tract infection. A prior workup did not reveal any urinary tract abnormalities. What is the priority nursing action? a. obtain a sterile urine sample after completion of antibiotics b. teach appropriate hygiene c. prepare the child for surgery to reimplant the ureters. d. administer antibiotics intramuscularly

b. teach appropriate toileting hygiene

When the nurse is caring for a child with hemolytic uremic syndrome or acute glomerulonephritis and the child is not yet toilet trained, which action by the nurse would best determine fluid retention? a. test urine for specific gravity b. weight child daily c. weight the wet diapers d. measure abdominal girth daily

b. weight child daily

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child's visual acuity? a. Snellen b. Ishihara c. Allen figures d. CVTME

c. Allen figures

The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment? a. determine the child's weight b. ask if the family has traveled outside of the country c. assess circulation and perfusion d. send a stool specimen to the lab

c. Assess circulation and perfusion

The nurse is caring for a child after a cardiac catheterization. What is the nursing priority? a. Allow early ambulation to encourage activity participation b. check pulses above the catheter insertion site for strength and quality c. assess extremity distal to the insertion site for temperature and color d. change the dressing to evaluate the site for infection.

c. Assess extremity distal to the insertion site for temperature and color

The nurse is caring for a child who has received all possible medical care for cancer yet continues to experience relapse and metastasis. It is time to make the transition from curative care attempts to palliative care. What is the most important nursing consideration at this time? a. The health care professionals should make the decision about the child's care b. The family may lose a sense of hope, so cancer treatments should continue c. Involve the family in the decision-making process about the shift to palliative care d. Palliative care can take place only at home, so the child should be discharged

c. Involve the family in the decision-making process about the shift to palliative care

A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location? a. increased risk for infection b. increased health care costs c. need to be transferred if overnight stay is required d. increased disruption of family functioning

c. need to be transferred if overnight stay is required

The parents of a 5-year-old with special health care needs talk to the parents of a 10-year-old with a similar condition for quite a while each day. What is the nurse's interpretation of this behavior? a. The nurse has not provided enough emotional support for the parents. b. This relationship between the children's parents is potentially unhealthy. c. Support between parents of special children is extremely valuable. d. Confidentiality is a pressing issue in this particular situation.

c. Support between parents of special children is extremely valuable

During the health interview, the mother of a 4-month-old says, "I'm not sure my baby is doing what he should be. " What is the nurse's best response? a. I'll be able to tell you more after I do his physical b. Fill out this developmental screening questionnaire and then I can let you know c. Tell me more about your concerns d. All mothers worry about their babies. I'm sure he's doing well.

c. Tell me more about your concerns

The nurse providing home care to a 2-year-old listens to the child's parents talk about how the child and family are adjusting to the child's current illness. Which of the following roles in the nurse participating in? a. Case management b. Child and family advocacy c. direct nursing care d. child and family education

c. direct nursing care

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment of intervention done to herself. The nurse identifies this preschooler's behavior as: a. problematic; the child is old enough to begin to have a basis in reality. b. normal, because the child is hospitalized and out of her routine. c. normal for this stage of growth and development d. problematic, as it interferes with needed nursing care.

c. normal for this stage of growth and development

At a well-child visit, hydrocephalus may be suspected in an infant if upon assessment the nurse finds a. narrow sutures b. sunken fontanels c. rapid increase in head circumference d. increase in weight since last visit

c. rapid increase in head circumference

A 3-day-old infant presenting with physiologic jaundice is hospitalized and placed under phototherapy. Which response indicates to the nurse that the parents need more teaching? a. "my infant is at risk for dehydration." b. "My infant needs to stay under the lights, except during feeding time." c. "My infant can continue to breastfeed during this time." d. "My infant has a serious liver disease."d.

d. "My infant has a serious liver disease."

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration?

d. A less discriminating sense of taste

The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action?

d. Allow the boy to keep his underwear on

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. what is the priority action by the nurse? a. Allow the child unlimited access to the sippy cup to ensure adequate hydration b. Encourage sweets for the extra caloric content. c. Teach the mother about nutritional needs of the preschooler. d. Assess the child's usual intake pattern at home.

d. Assess the child's usual intake pattern at home.

A 15-month-old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child's immunization record but believes she is fully immunized: "She had immunizations 3 months ago at the local health department." Which would be the best action by the nurse? a. Ask the mother to bring the records to the 18-month health supervision visit b. Start the "catch-up" schedule because there are no immunization records c. Keep the child at the facility while the mother returns home for the records d. Call the local health department and verify the child's immunization status.

d. Call the local health department and verify the child's immunization status

While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action? a. Provide supplemental oxygen by face mask b. Administer a dose of IV morphine sulfate c. Begin cardiopulmonary resuscitation d. Place the infant in a knee-to-chest position

d. Place the infant in a knee-to-chest position

A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would the priority nursing intervention? a. Prevention of injury by removing the child from his bed b. Prevention of injury by placing a tongue blade in child's mouth c. Prevention of injury by restraining the child d. Prevention of injury by placing the child on his side and opening his airway

d. Prevention of injury by placing the child on his side and opening his airway.

The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn't want the child to go to school. What is the best response by the nurse? a. Do you need some time alone to collect youself b. you've known for a while this time would come c. can I call you husband or a friend for you d. it is normal to feel stressed or sad at this time

d. it is normal to feel stressed or sad at this time

The nurse is performing education for the parents of an infant with bladder exstrophy. Which statement by the parents would indicate an understanding of the child's future care? a. Care will be no different than that of any other infant b. my infant will only need this on surgery c. my child will wear diapers all his life d. we will need to care for the urinary diversion.

d. we will need to care for the urinary diversion