PEDS STUDY SET

The nurse is providing dietary interventions for a 12-year-old child with a shellfish allergy. Which response by the parent most concerns the nurse?

"my child will most likely outgrow this"

A nurse is reviewing with an 8-year-old how to self-administer insulin. Which of the following is the proper injection technique for insulin injections?

Elevate the subcutaneous tissue before the injection.

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? 1)epinephrine 2) albuterol 3) nebulizer 4)diphenhydramine

Epinephrine

A 13-year-old, diagnosed with beta-thalassemia major is seen in the pediatric clinic. The nurse completes an assessment and notes that the client is below the 10th percentile in height for age. What assumption can the nurse make based on this information?

This finding is a common manifestation of the client's diagnosis.

A 6-year-old boy has a moon-face, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child?

Tumor of the adrenal cortex

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?

fluid replacement

The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse conducting an assessment of the child what causes the disease. What is the nurse's best response?

"ITP is primarily an autoimmune disease in which the immune system attacks and destroys the body's own platelets, for an unknown reason."

The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching?

"If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."

A pediatric nurse is discharging a 1-month-old infant. The infant was diagnosed with congenital hypothyroidism on this admission and will be treated with levothyroxine. The nurse knows it is important to teach the parent about medication administration. Which process will the nurse include in the teaching?

Give the crushed medication in a syringe mixed with a small amount of formula

A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor?

infection

A nurse is taking the history of a 4-year-old child who will undergo a cardiac catheterization. Which statement by the parent may necessitate rescheduling of the procedure?

"My child seems listless and slightly warm."

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. Which response by the nurse would be most appropriate?

"The best way is to eliminate the food from the diet and then look for improvement."

the nurse is assessing a child diagnosed with Cushing disease. Which statement by the parents demonstrates a need for further teaching?

"This disorder is most likely due to an infection my child had recently." *** round, full face (moon face), rapid weight gain, excessive hair growth and poor wound healing are all seen in Cushing disease

An infant suspected of having a patent ductus arteriosus is schedule for an echocardiogram. After teaching the parents about this procedure, the nurse determines that the teaching was successful based on which parental statement?

"This test should not cause our baby any pain."

The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder?

"When they get my son's thyroid levels normal, he won't be so tired."

When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which finding in the child's fasting glucose levels?

220 MG/DL

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?

Administer subcutaneous glucagon

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings?

Discuss preparing for a thyroid function test. ***child exhibits signs and symptoms of Graves disease (hyperthyroidism). A thyroid function test would show an elevation in T4 and T3 levels caused by overfunctioning of the thyroid.

A child with sickle cell disease is brought to the emergency department by his parents. He is in excruciating pain. A vaso-occlusive crisis is suspected and analgesia is prescribed. What would the nurse expect as least likely to be ordered?

Meperidine

A child has been diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH) and has been admitted to the hospital. Which nursing intervention is most important for this child?

Monitor sodium levels. ***ADH continues to be released, causing water retention and decreased serum sodium. To correct the problem the child should be placed on fluid restriction and IV sodium chloride should be administered to correct hyponatremia

The nurse is providing care to a child and is to collect a 24-hour urine specimen for catecholamines. The nurse integrates knowledge of this testing as indicative of:

Neuroblastoma

In caring for a child with sickle cell disease, the highest priority goal is:

The child's fluid intake will improve.

A nurse is teaching a school-aged child with iron-deficiency anemia and her parents about dietary measures to increase iron intake. The nurse determines that the teaching was successful when they state which food is high in iron? Select all that apply.

eggs fortified cereal green leafy vegetables

The nurse is assisting with skin testing on a pediatric client with allergies. What will the nurse do first?

ensure the child has not taken diphenhydramine in the past week

The nurse is planning care for a child with idiopathic thrombocytopenic purpura. Which client education should be included?

not to pick or irritate the nose

The nurse is caring for a 12-year-old girl with hypothyroidism. Which information should be part of the nurse's teaching plan for the child and family?

reporting irritability or anxiety

A child is diagnosed with iron-deficiency anemia. Which diagnostic test results would the nurse expect to be altered?

serum ferritin

A nurse in the emergency department is examining a 6-month-old with symmetrical swelling of the hands and feet. The nurse immediately suspects:

sickle cell disease.

When caring for a child with a congenital heart defect, which assessment finding may be a sign the child is experiencing heart failure?

tachycardia

The nurse in the emergency department is examining an 18-month-old child who recently received a first dose of penicillin. The nurse notes lip edema, urticaria, stridor, and tachycardia. Which action will the nurse take next?

admin epinephrine

A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate?

"Because the baby grows rapidly during the first months, he uses up what you gave him.""

A nurse is teaching an adolescent with type 1 diabetes about the disease. Which instruction by the nurse about how to prevent hypoglycemia would be most appropriate for the adolescent?

"Carry crackers or fruit to eat before or during periods of increased activity."

A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl?

"Have you noticed any hair loss or redness on your face?"

The nurse is caring for a child recently diagnosed with growth hormone deficiency. After providing education regarding this disorder, which statement by the parent demonstrates a need for further teaching?

"If growth hormone therapy is used, it will continue for the rest of my child's life." ***Treatment stops when the epiphyseal growth plates fuse; therefore, it will not continue throughout the child's lifetime.

The nurse is teaching the parents of a child with a suspected diagnosis of juvenile idiopathic arthritis about the disease. Which statement by the parents demonstrates the need for further teaching?

"If our child does not have a positive rheumatoid factor, our child does not have the disease."

The nurse is working with a pregnant client who is HIV positive and has been prescribed oral zidovudine. Which statement by the nurse explains the primary rationale for taking this medication?

"It is to help prevent transmission of the disease to your infant.

A nurse is reviewing the blood sugar test results of a child diagnosed with type 1 diabetes: Before meal: 84 mg/dL (4.66 mmol/l) 1 hour after meal: 160 mg/dL (8.88 mmol/l) 2 hours after meal: 180 mg/dL (9.99 mmol/l) Middle of the night: 92 mg/dL (5.11 mmol/l) Which result would lead the nurse to notify the health care provider?

2 hour after meal

The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age?

4-7 weeks

A nurse instructor is teaching pregnant women how HIV can spread from mother to fetus without treatment. For the untreated child who contracts HIV through placental transmission, when will the child test positive for HIV?

6 months of age

The nurse is caring for an 18-month-old client with suspected iron-deficiency anemia. The nurse will expect to prepare the client for which laboratory tests first?

CBC and iron level

A newborn exhibits significant jittery movements, convulsions, and apnea. Hypoparathyroidism is suspected. What would the nurse expect to be administered?

Calcium gluconate ***calcium gluconate is used to treat acute or severe tetany

A 4-year-old child has developed acute lymphoblastic leukemia (ALL). Nursing care for the child with ALL involves taking axillary, rather than rectal, temperatures because the child:

low platelet count

When caring for a child with Kawasaki disease, the nurse would know that:

management includes administration of aspirin and IVIG. ***treatment is directed to reduce the inflammation in the walls of the coronary arteries and prevent thrombosis. Children are given high-dose aspirin therapy four times a day and they receive an infusion of IV immunoglobulins (IVIG) to prevent cardiac complications

The nurse is caring for a child with an elevated erythrocyte sedimentation rate, a hemoglobin level of 9.3 g/dL (93 g/L), and a positive antinuclear antibody. What would the nurse expect to identify when assessing this child? Select all that apply.

swelling noted in the affected joint redness and warmth in the affected join The child reports stiffness in the joints that is worse in the morning. ***S/S OF JIA

The nurse is caring for a child who is beginning to show signs and symptoms of anaphylaxis. Which intervention would be the priority?

Assessing patency of the airway

The nurse is preparing a presentation for a local parent group about nutritional measures to prevent anemia. The group of parents have children between the ages of 4 and 8. The nurse would recommend a daily iron intake of which amount?

10 mg ***daily dietary iron intake for children 1 to 10 years of age is 10 mg. The recommended daily dietary iron intake for children 0 to 6 months of age is 6 mg. The recommended daily dietary iron intake for boys 11 to 18 years of age is 12 mg. The recommended daily dietary iron intake for girls 11 to 18 years of age is 15 mg.

The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply.

The child states that his tongue feels "too big" for his mouth. The child has developed hives on his face and trunk. The child states he feels like he might "throw up". The child states that he feels like he might faint.

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education?

humoral immunity is functional at birth

A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode?

apply heat to the bleeding site

A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which action would be the priority?

checking vital signs ***loss of electrolytes would be reflected in vital sign

When a child is scheduled for a cardiac catheterization, an important health teaching point for parents is that the:

child will return with a pressure dressing over the catheter insertion area.

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during:

horizontal = sexual vertical = from mother to fetus

The nurse is caring for a 6-year-old girl with leukemia who is having an oncologic emergency. Which signs and symptoms would indicate hyperleukocytosis?

tachycardia and respiratory distress

The nurse is assessing an 8-year-old boy who is performing academically at a second-grade level. The mother reports that the boy states feeling weak and tired and has had a weight increase of 6 pounds (13.2 kg) in 3 months. Which additional data would fit with a possible diagnosis of hypothyroidism?

the boy reports that the exam room is cold

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:

femoral pulse weaker than brachial pulse.

The nurse is speaking with the parent of a child who has experienced an allergic reaction to peanuts. Which statement by the parent would indicate a need for further education?

if my child is having GI upset they are not having anaphlaytic shock

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child:

polyarticular JIA ***Pauciarticular JIA is defined by the involvement of four or fewer joints. Systemic JIA presents with fever and rash in addition to join involvement at the time of diagnosis

The nurse is preparing to administer the child's ordered lispro (Humalog) insulin at 0800. When will the child's blood glucose level begin to decline?

0815 ***The onset of rapid acting insulins like lispro (Humalog) is within 15 minutes

A child is brought to the clinic experiencing symptoms of nervousness, tremors, fatigue, increased heart rate and blood pressure. Based on this assessment, the nurse would suspect a diagnosis of which condition?

Graves disease

Which immunoglobin occurs most frequently in plasma and is the major immunoglobulin synthesized during secondary response?

IgG

After teaching an adolescent how to use an epinephrine autoinjector, the nurse observes the adolescent attempting to self-administer the medication. The adolescent indicates the site to be used, pointing to the abdomen just below the umbilicus. Which action should the nurse take next?

Stop the adolescent from continuing and review the appropriate site to use. ***outer aspect of the thigh

The nurse is caring for a school-age child with reports of generalized joint pain and a pharyngitis. During assessment, the nurse notes a cardiac murmur. Which action by the nurse is priority?

Swab throat for culture. ***generalized joint pain, pharyngitis, and murmur is exhibiting signs of rheumatic fever.

A 6-year-old child has been found to have a stage II brain tumor. The parent asks the nurse to explain what "stage II" means. Which information would the nurse provide?

The cancer has spread in the brain itself but the chance of complete surgical removal is good

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? a child reporting coughing, itching, and anxiety a child experiencing rhinitis an HIV positive child experiencing lethargy A child with a vesicular rash with yellow crusts

a child reporting coughing, itching, and anxiety

A school-aged child, who is allergic to bee stings, states, "I think I was stung by a bee outside." Which intervention by the school nurse is most appropriate?

access for anaphylactic shock

During an assessment of an adolescent child, the nurse notes that the child has a protuberant tongue, fatigued appearance, poor muscle tone, and exophthalmos. What medical diagnosis would the nurse expect the child to have?

graves disease

A child with hemophilia A is scheduled for surgery. Which precautions would the nurse institute with this client?

handle the child gently when moving to the stretcher

The young girl has been diagnosed with juvenile idiopathic arthritis (JIA) and has been prescribed methotrexate. Which statements by the child's parent indicates that adequate learning has occurred? Select all that apply.

A warm bath before bed might help her sleep better." "Swimming sounds like a good exercise for her. "We'll need to bring her back in for some lab tests after she starts methotrexate."

A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication?

Decreased cognitive development of the fetus

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant?

has your child had penicillin before?

A nurse is preparing a presentation for a parent group on childhood cancers. As part of the presentation, the nurse plans to discuss rhabdomyosarcoma. What are some common sites where rhabdomyosarcoma occurs? Select all that apply.

head neck extremities