Peds test 2 prac questions prac *

The mother of a 10-year-old questions the nurse regarding the method of chemotherapy administration and is concerned the child will require frequent IV insertions. With which statement should the nurse respond? "The injections will not hurt." "The peripheral IV will remain in place for up to 3 months." "Eventually, the child will get accustomed to the frequent injections." "A central venous catheter (CVC) may be implanted for long-term chemotherapy administration."

"A central venous catheter (CVC) may be implanted for long-term chemotherapy administration." A CVC will likely be placed for long-term chemotherapy administration and to prevent the possibility of infection related to frequent needle sticks.

A parent reports concern that her preschool child is not as coordinated at sports as other children. Which statement by the nurse is most appropriate to address this concern? "All children should be at the same level by 4 years old." "Children develop differently and practicing will help." "This sounds like a balance problem that needs follow-up." "Your child should be able to throw and catch a ball by now."

"Children develop differently and practicing will help." This is the most appropriate statement to address the parent's concern because as long as the child has met critical motor milestones, other motor skill ability varies widely among children and practice may improve skills.

The nurse is preparing a 3-year-old patient for a positron emission tomography (PET) scan to diagnose a neck mass. The child's caregiver asks what will be done to prevent potential discomfort and restlessness of the child during the procedure. What should the nurse respond? "Your child will be sedated prior to the procedure." "We will administer opioid analgesia 2 hours prior to the procedure." "You will be allowed to remain in the room at all times with your child." "Soft wrist restraints during the procedure will help the procedure go faster."

"Your child will be sedated prior to the procedure." Young children may need to be sedated prior to a PET scan because they will need to remain still during the procedure.

The nurse is caring for a four-year-old child with leukemia who is receiving chemotherapy. The parent reports that the child has abdominal pain, nausea, and vomiting. Upon exam, the nurse notes poor skin turgor, pallor, dry mucus membranes, and poor appetite. Which action should the nurse take first? Administer pain medicine Assess hourly urine output Administer oral antiemetic Administer normal saline IV bolus

Administer normal saline IV bolus A child with leukemia is at risk for dehydration and fluid and nutrition imbalance. Thus, administering IV bolus of normal saline is a priority nursing intervention to treat signs of dehydration.

A child diagnosed with leukemia reports nausea, vomiting, and anorexia related to chemotherapy treatment. The nurse notes a hemoglobin count of 10, WBC count of 8, platelet count of 103,000, and an albumin level of 2.1. Which prescription would the nurse anticipate? Decrease dietary protein Administer PO allopurinol Administer platelet transfusion Administer total parenteral nutrition

Administer total parenteral nutrition An albumin level of 2.1 indicates malnutrition. The nurse would administer total parenteral nutrition via a central line to improve the child's nutritional status.

The mother of a 5-year-old patient reports unexplained weight loss in the child over the past month, frequent epistaxis, and persistent diarrhea. Which other findings support a possible diagnosis of cancer? Select all that apply. Anemia Frequent sneezing Poor concentration Ulcers of the mouth Mass in the child's neck

Anemia Anemia is a sign of malignancy and would support a diagnosis of cancer in a child with epistaxis, weight loss, and diarrhea. Mass in the child's neck Lymphadenopathy, or swollen lymph nodes, may manifest as a mass in the child's neck and is a sign of malignancy. This would support a diagnosis of cancer in a child with epistaxis, weight loss, and diarrhea.

A two-year-old child diagnosed with Hodgkin Lymphoma presents with enlarged neck lymph nodes, and an x-ray reveals widening of the mediastinum. Which action should the nurse take first? Prepare for surgical excision Auscultate for bowel sounds Assess the child's airway for patency Educate parents or caregiver on chemotherapy

Assess the child's airway for patency The nurse should assess the airway patency of a child with cervical lymphadenopathy and mediastinal disease from Hodgkin lymphoma, because swelling of cervical lymph nodes and mediastinal disease can cause airway obstruction.

The nurse is educating the parents of a child with leukemia about necessary homecare. During the teaching session, the mother states, "We plan to let him return to baseball practice next week." Which information is most important for the nurse to include in the response? Avoid physically exhausting activities. Apply ample amounts of sunscreen on child's skin while outside. Assess the child's mucus membranes for signs of dehydration frequently while playing. Notify the health care provider immediately if the child has shortness of breath while playing.

Avoid physically exhausting activities. Providing information about activities to be avoided, such as baseball, is the most important teaching that the nurse should provide the mother because patients with leukemia are often thrombocytopenic and neutropenic, and engaging in physically exhausting activities can trigger bleeding, injury, and infection.

What physiological changes are augmented by strenuous exercise and high altitudes in the patient with pulmonary arterial hypertension (PAH)? Select all that apply. Cyanosis Peripheral edema Pulmonary edema Right-sided heart hypertrophy Increased pulmonary venous pressure

Cyanosis Patients with PAH can develop cyanosis with strenuous exercise and high altitudes as pulmonary blood flow rate may not be adequate. Peripheral edema Peripheral edema is possible as the right side of the heart is volume- and pressure- overloaded. Right-sided heart hypertrophy The right side of the heart can develop hypertrophy due to increased pressure within pulmonary arteries.

In doing the respiratory assessment in a patient with heart failure (HF), which assessment findings should the nurse expect to see? Select all that apply. Distinctive cough Abnormal lung sounds Deep breaths with activity Distinctive odor on the breath Increased number of respirations

Distinctive cough Patients suffering from heart failure may have an accumulation of fluid in the lungs, and a distinctive cough may be heard in doing a respiratory assessment in these patients. Abnormal lung sounds If there is congestion in the lungs, this may be heard by the nurse while performing the respiratory assessment on the child. Deep breaths with activity A child with heart failure will often need to take deep breaths with any sort of exertion, and this would be an expected finding in the respiratory assessment.

Which situation identifies an environment in which a child may be at increased risk of developing cancer? Residing in low-income housing Making frequent trips to a foreign country Visiting at private school near a clothing factory Exposure to radiation from repeated computed tomography (CT) scans

Exposure to radiation from repeated computed tomography (CT) scans Exposure to radiation can increase a child's risk of developing cancer.

A mother is concerned that her child suffering from heart failure (HF) has started to experience abdominal pain. What explanation by the nurse can be provided to the mother to help her understand this coexisting condition? Heart failure causes ischemia leading to abdominal pain. Fluid overload causing congestion can lead to abdominal pain. H. pylori infections often occur in heart failure patients causing abdominal pain. Heart failure can lead to increased secretion of abdominal acids therefore causing stomach pain in the child.

Fluid overload causing congestion can lead to abdominal pain. Since many children with heart defects experience right-sided heart failure, they can experience congestion in the abdomen due to inadequate delivery of blood back to the heart.

The nurse is evaluating a child who was admitted for persistent cough, dyspnea, swelling, and discomfort in the neck and axilla. Lymph node biopsy confirmed that the child has Non-Hodgkin Lymphoma. Which question would best determine the effectiveness of nursing care to this patient? Is the child's core body temperature stable? Is the child's urine output sufficient for age? Has the child's respiratory status remained stable? Are the parents knowledgeable about the disease process?

Has the child's respiratory status remained stable? Evaluating the child's respiratory status for rate, rhythm, and breath sounds, and ensuring that they are stable indicates that the nursing care rendered to the child is effective.

Pulmonary arterial hypertension (PAH) management is designed to treat the symptoms of heart failure (HF). How does treating HF symptoms facilitate the management of PAH? Select all that apply. Improving right-sided heart function and fluid management will decrease the symptoms of PAH. Increasing afterload will force the heart to increase contractility and therefore decrease PAH. Improving left-side heart functions will increase cardiac output to systemic circulation, therefore decreasing pulmonary arterial hypertension. Increasing preload will increase ventricular stretch and improve contractility (Frank-Starling Mechanism) which will overcome the afterload of the PAH.

Improving right-sided heart function and fluid management will decrease the symptoms of PAH. The right side of the heart cannot match the afterload of the PAH and begins to undergo fibrosis and chamber dilation. Increasing contractility will help match afterload and decrease EDV. Decreasing blood volume will also improve right-side function. Increasing afterload will force the heart to increase contractility and therefore decrease PAH. PAH is the cause of increased afterload. Drugs targeting pulmonary circulation to decrease afterload can be useful.

The parent of a patient with aortic stenosis would like more information about a new diagnosis of pulmonary venous hypertension. What information should the nurse provide regarding treatment and outcomes? Select all that apply. Keep regular follow-up appointments for observation. Increase water consumption to increase blood volume. Use of vasodilators will improve both the aortic stenosis and the pulmonary venous hypertension. Interventional correction of the stenotic valve will improve cardiac output and decrease the pulmonary hypertension. Pay close attention to symptoms such as exercise intolerance, chest pain, dizziness, syncope, and changes in breathing patterns.

Keep regular follow-up appointments for observation. Keep regular appointments for observation of the aortic stenosis and progression of PAH. Changes in symptoms may require medical intervention. Athletes, depending on the severity of the stenosis and PAH, may need to limit or abstain from competitive sports. Interventional correction of the stenotic valve will improve cardiac output and decrease the pulmonary hypertension. Surgical valvuloplasty decreases the stenosis and improves cardiac output.

A six-year-old child with leukemia presents with altered level of consciousness (LOC) and sluggish pupils but no cardiac compromise after falling from a bike. The nurse notes a platelet count of 10,000, WBC of four, and hemoglobin of seven. After the patient's airway is stabilized, which priority order should the nurse anticipate? Obtain a head CT Assess serum glucose Administer IV fluid bolus Administer pain medication

Obtain a head CT The nurse should first obtain a head CT on a patient with thrombocytopenia and altered LOC after a head injury to evaluate for cerebral hemorrhage.

The nurse is caring for a 16-year-old child diagnosed with Hodgkin Lymphoma who reports shortness of breath, and chest pain. The nurse notes hoarseness of patient's voice when speaking. Which prescription would the nurse take first? Obtain sputum culture Administer pain medication Administer albuterol nebulizer Obtain an emergency chest radiograph

Obtain an emergency chest radiograph Respiratory symptoms and hoarseness suggest mediastinal involvement. Because this can lead to airway obstruction, this must be evaluated immediately. The nurse would obtain a STAT chest x-ray to determine whether a mediastinal tumor is present.

The nurse is caring for a 17-year-old with single-node Hodgkin lymphoma who reports right upper quadrant pain, nausea and vomiting. The nurse notes icteric skin and sclera, and abdominal distention. Which prescription would the nurse anticipate? Administer IV pain medicine Assess serum potassium level Obtain serum AST and ALT levels Administer oral antiemetic medication

Obtain serum AST and ALT levels The patient's symptoms indicate potential hepatomegaly and liver involvement related to Hodgkin lymphoma. The nurse would obtain liver function tests to determine the extent of liver damage.

child is admitted to the hospital with Non-Hodgkin lymphoma, and reports having lower abdominal pain of 6/10. The nurse notes a temperature of 102.3° F, heart rate 107 and respiratory rate 14. Which actions are most important for the nurse to take? Select all that apply. Assess lung sounds Obtain urine culture Obtain blood culture Obtain uric acid level Administer pain medication

Obtain urine culture A temperature of 102.3 indicates a fever and possible infection. The nurse should obtain a urine culture to identify the cause of infection. Obtain blood culture A temperature of 102.3 indicates a fever and possible infection. The nurse should obtain a blood culture to identify the cause of infection.

The nurse is caring for a child receiving chemotherapy and notes bruising on the arms and legs. Which test will help identify the cause for bruising? Biopsy Albumin level Platelet levels Head computed tomography (CT)

Platelet levels Chemotherapy causes damage to rapidly growing cells, including platelets, which can lead to bruising and bleeding. A platelet level will help identify the severity of the patient's thrombocytopenia.

The nurse conducts an assessment on a child who presents with swelling and discomfort in the axilla, persistent cough, and dyspnea. Which assessment is a priority? Temperature Lung sounds Tracheal position Breathing pattern

Tracheal position The nurse would check the position of the trachea. Cough and respiratory distress indicate signs of mediastinal disease, which may also cause tracheal deviation.

When preparing a child to receive chemotherapy, the nurse can expect to see which values in the patient's electronic health record? ABG levels WBC levels Serum glucose level Resting metabolic rate

WBC levels WBC levels should be obtained prior to chemotherapy. This provides a baseline for comparison once treatment has begun.

The nurse is caring for a child with circumferential burns to the abdomen. On assessment, the nurse notes tachycardia, tachypnea, and diminished bowel sounds. Which additional questions should the nurse ask? Select all that apply. "Have you expelled any gas?" "How did you get this burn?" "Are you experiencing any pain?" "Will your family come visit today?" "When was your last bowel movement?"

"Have you expelled any gas?" Circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea indicate abdominal compartment syndrome. The nurse should ask the patient about other GI activity such as expulsion of gas. "Are you experiencing any pain?" The nurse would conduct a thorough pain assessment on a patient with circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea. "When was your last bowel movement?" Circumferential burns to the abdomen and diminished bowel sounds, tachycardia, and tachypnea indicate abdominal compartment syndrome. The nurse should ask the patient about other GI activity such as bowel elimination patterns.

Which report by a parent would indicate normal social development of the 2-year-old patient? "He doesn't care at all when I leave him." "He only talks to himself, and not to me." "I never really know what he is saying to me." "He will play next to another child and watch the child, but won't interact with the child."

"He will play next to another child and watch the child, but won't interact with the child." Playing beside other children, or parallel play, indicates normal social development of the toddler.

The nurse is ordered to administer a stat IV medication to a 3-month-old patient. The parent asks, "Why can't you just give this medication by mouth; it'll take some time to start working anyway?" What is the best response by the nurse? "IV medications will begin to take effect immediately." "Oral medications are not absorbed as well as IV medications." "The healthcare provider ordered the medication IV, so I have to give it that way." "I can request the health care provider change the medication to be given orally."

"IV medications will begin to take effect immediately." IV medications have a rapid onset of action, and this is a stat medication. This would be the preferred method, and the most accurate and best response by the nurse to the parent's query.

A mother requests the use of a numbing agent on the infant's skin before starting an IV. Which response from the nurse best explains the concerns with using a topical numbing agent? "Infants are prone to skin irritation and contact dermatitis." "Numbing agents can change the blood flow and affect the IV medication." "The use of a numbing agent will not be effective when applied to the skin of an infant." "Infants and young children have a higher body surface area-to-weight ratio and thinner skin than adults."

"Infants and young children have a higher body surface area-to-weight ratio and thinner skin than adults." The large body surface area-to-weight ratio of infants coupled with thinner outer skin layer results in a higher absorption of topical medications. Therefore, the nurse must be careful in the use of a numbing agent and ensure the agent is approved for use in infants

The parent of a four-year old child is concerned because the child has lost several teeth. What response by the nurse is most appropriate? "Only provide milk at bedtime, not juice." "Your child should be checked for malnutrition." "It is normal at this age for your child to begin losing deciduous teeth." "You should focus on flossing your child's teeth more so they will not fall out."

"It is normal at this age for your child to begin losing deciduous teeth." Children may begin to lose deciduous teeth around four to five years of age. This is a normal occurrence, and the deciduous teeth should be replaced by permanent teeth.

A nurse is teaching caregivers appropriate safety guidelines for their four-year-old child regarding firearm safety, burn safety, and personal safety. Which teaching from the nurse is appropriate for all safety situations? Select all that apply. "Make the child aware of the danger." "Demonstrate, rather than explain, to the child." "The child should go to a trusted adult if there is a safety concern." "Communicate your safety rules in a clear and precise manner." "Educate the child to immediately leave the house when in danger."

"Make the child aware of the danger." For any dangerous situation, it is important to communicate with the child so that they are informed and prepared if put in that situation. "The child should go to a trusted adult if there is a safety concern." In every situation involving child safety, the child should understand that a trusted adult should be alerted. "Communicate your safety rules in a clear and precise manner." When reviewing safety measures, communication is key. Clear and precise instructions can help a child understand the appropriate action.

The nurse is educating parents of a child with sunburn on the upper back and shoulders. Which statement, made by the parents, indicates the need for further teaching? "I can expect itching as the area starts to heal." "Cool compresses are effective for pain relief." "My child needs to be on bedrest for 3-4 days." "I will apply lotion when the skin begins to peel."

"My child needs to be on bedrest for 3-4 days." When educating a parent about sunburn, the nurse knows further teaching is necessary if the parents say they will keep the child with minor burns on bed rest for 3-4 days.

The nurse is educating new parents on environmental safety concerns to make in the home. A new mother states that she uses the microwave to heat the infant's bottles because it is convenient and quick. Which response by the nurse is most appropriate? "Place ice cubes in the bottle to decrease the temperature." "It is alright to give the baby a bottle right out of the refrigerator." "Breastfeeding is the best method of feeding and has no risk for injury." "The microwave heats unevenly and can cause scalding injuries to the mouth and throat."

"The microwave heats unevenly and can cause scalding injuries to the mouth and throat." The nurse should inform the patient that the microwave can lead to scalding injury.

An 8-year-old child is prescribed a medication that must be delivered by injection. Which statements should the nurse make to prepare the child for administration of this medication? Select all that apply. "This may sting a bit but should not last very long." "This medication is necessary to help your body function properly." "This medication is going to help you and you did not do anything wrong." "I am going to ask your parents to leave briefly while I administer your medication." "You may feel a warm sensation at the injection site, but it is normal and will only last a few minutes."

"This may sting a bit but should not last very long." Preparing the child for what to expect will help him process the situation and encourage his involvement in the process. "This medication is necessary to help your body function properly." The nurse should explain the reason for the injection and help the child understand that the medication will help with her illness. This will help the child remain calm if she understands that it is for her benefit. "This medication is going to help you and you did not do anything wrong." Helping the child to understand that the injection will help her feel better is an important aspect of increasing the child's confidence in the procedure. The nurse should help the child understand that the injection in NOT a punishment. "You may feel a warm sensation at the injection site, but it is normal and will only last a few minutes." The nurse should explain the length of time sensations associated with the injection should last when preparing the child for an injection. If the child knows what to expect then he or she is more likely to be cooperative.

The nurse is evaluating the teaching provided to parents about fall prevention for toddlers. Which statement(s) by the parents indicate that the teaching was effective? Select all that apply. "We need to install screen guards in our windows." "We should let our child freely explore and learn from experience." "We should remove any furniture that can be easily moved or tilted." "We should make sure our child doesn't climb on any breakable furniture." "We should check on our children periodically, so they learn how to maintain safety independently."

"We need to install screen guards in our windows." This is an important safety precaution. Toddlers can easily fall from windows, and screen guards are an important way to prevent these accidents. "We should remove any furniture that can be easily moved or tilted." This is necessary to protect toddlers, especially as they grow more curious and begin to meet their motor development milestones. Toddlers often pull on furniture to stand, and furniture may topple and fall on them.

The parent of a 7-year-old with deep partial thickness burns on the legs from a camping accident asks the nurse about the healing time for the child's injury. Which response by the nurse is most appropriate? "With proper care, the wound should heal in the next 1-3 weeks." "The wound will not heal without skin grafting and other surgeries." "You can expect the wound to heal in the next 3-7 days without treatment." "You can expect it to take 30 days to several months for complete healing."

"You can expect it to take 30 days to several months for complete healing." A deep partial thickness burn will heal in 30 days as long as it does not become infected.

A child weighs 26.4 lbs and is 90 cm tall. The child requires a medication with a dose of 15 mg/m2 and the drug comes in a 10 mg/mL concentration. The required dose is mL. BSA (m2) = √weight (kg) x height (cm) 3600

0.49 mL The nurse will convert the weight to kilograms (26.4 lbs/2.2 = 12 kg). The next step is to calculate the BSA. BSA (m2) = √weight (kg) x height (cm) 3600 BSA (m2) = √(12 x 90) = √1080 = √0.3 3600 3600 BSA (m2) = √0.3 = 0.55 m2 The nurse will then determine the approximate dose (0.55 m2/1.7) *15 mg/m2 = 4.9 mg. In the final step, the nurse will determine the number of milliliters required for administration. 4.9 mg / 10 mg/mL = 0.485 mL The nurse should administer 0.485 mL of the medication.

Match the activity with the age at which it is first exhibited. 15mo 18mo 24mo 36mo Stacking multiple blocks to build towers Walking independently Turning the pages as they are read to Dressing themselves

15 months Walking independently 18 months Turning the pages as they are read to 24 months Dressing themselves 36 months Stacking multiple blocks to build towers

Which head circumference measurement would be expected for a two-year-old whose head circumference was 18 inches at the 12-month checkup? 18in 17in 19.5in 21.5in

19.5 inches Head circumference increases approximately 1.5 inches from 12 months to 24 months.

The nurse has an order to administer 250mg cephalexin p.o. every 12 hours to a pediatric patient who weighs 25 lbs. The pediatric dose limit is 45 mg/kg/day BID. The patient can receive ______ mg/dose.

256.5 mg/dose The nurse will have to convert the weight to kilograms (25 lbs/2.2= 11.4 kg). The next step is the multiplication of the weight times the dose (11.4 kg*45 mg/kg/day = 513 mg/day). The final step in calculation is the determination of the amount per dose. The order reads that the patient should receive two doses p.o. per day—513 mg/day /2 = 256.5 mg/dose. The ordered 250 mg/dose is a safe dose to administer.

What is the extent of injury for a 1-year-old with burns to the posterior trunk, buttocks, and bilateral thighs? 9% 13% 29% 42%

29% The extent of injury for a 1-year-old with burns to the posterior trunk, buttocks, and bilateral thighs is 29% according to the Lund and Browder chart.

A toddler who weighs 22 lbs at 1 year of age would be expected to weigh approximately_____ lbs by the third birthday.

32 The average weight gain is 5 lbs (2.26 kg) per year. Therefore, a toddler weighing 22 pounds at 1 year of age would be expected to weigh approximately 32 pounds (22 + 5 + 5) by the third birthday.

A toddler who was 33 inches in height on his or her second birthday would be expected to measure approximately ________ inches in height on his or her third birthday.

36 The average toddler grows approximately 3 in. (7.62 cm) each year. The toddler would therefore be expected to be 36 inches (33 + 3) on his or her third birthday.

The nurse has an order to administer 250 mg cephalexin p.o. every 12 hours to a pediatric patient who weighs 25 lbs. The pediatric dose limit is 45 mg/kg/day BID. The patient can receive ______ mg/day.

513 mg/day The nurse will have to convert the weight to kilograms (25 lbs/2.2 = 11.4 kg). The next step is the multiplication of the weight times the dose (11.4 kg*45 mg/kg/day = 513 mg/day). The patient can receive up to 513 mg of cephalexin p.o. each day.

Which would be the expected adult height for a toddler who is 34 inches tall at the 30-month checkup? __

68 Children attain half their adult height between ages 2 and 3 years. A child who was 34 inches tall at the 30-month checkup would be expected to be approximately 68 inches tall as an adult.

The parents of a young child report that the child is not eating well during mealtime. What information should the nurse ascertain to appropriately assess the eating concern? Select all that apply. Accessibility to food How the child snacks Which foods are provided What size dish the child uses Adequate time given to complete the meal

Accessibility to food Knowing if the child has easy access to food will help the nurse appropriately assess the eating concern. Limited access to food may lead to a problem with the child's nutrition. The nurse could assist the family in accessing resources. How the child snacks Knowing how the child snacks will help the nurse appropriately assess the eating concern. Many children can fill up on snacks, then not want to eat their food at mealtime. Which foods are provided Knowing what foods are provided will help the nurse appropriately assess the eating concern. There should be a variety of foods offered.

A 5-year-old with severe burns weighs 25 kg. The child has a urine output 30 mL in the last two hours, serum sodium of 122, and serum potassium of 5.1. Which action is most important for the nurse to take? Administer IV fluids as ordered Assess serum glucose as ordered Administer Kayexalate PO as ordered Assess serum calcium level as ordered

Administer IV fluids as ordered The child with 30 mL of urine output in two hours, hyponatremia, and hyperkalemia has a fluid and electrolyte imbalance that should be treated with IV fluids.

Upon entering the room of a child with minor burns on the back and anterior trunk after a trip to the beach, the child complains of itching to the area. Which actions should the nurse take? Select all that apply. Begin wound debridement Apply warm compress to the area Administer PO Benadryl as ordered Encourage parents to apply lotion to the area Explain that itching is a sign of normal healing

Administer PO Benadryl as ordered The nurse should administer an antihistamine to a child with itching over a minor burn. Correct Encourage parents to apply lotion to the area The nurse should encourage parents to apply lotion to the area of a minor burn that itches. Correct Explain that itching is a sign of normal healing The nurse should teach parents that itching is a normal sign of healing for patients with minor burns.

A 9-year-old child with severe burns on the face, trunk, and abdomen is lethargic and pale 24 hours after the initial burn. The nurse notes edema in the extremities, heart rate 135, urine output 60 mL over the past four hours. Which actions should the nurse take? Select all that apply. Obtain chest x-ray as ordered Administer colloids as ordered Apply silvadene cream as ordered Administer pain medication as ordered Increase the rate of IV fluids as ordered

Administer colloids as ordered Pallor, tachycardia, decreased urine output and edema indicate poor organ perfusion and third spacing of fluid into the interstitial space. Colloids should be administered to help decrease cell permeability and force fluids back into the cell. Increase the rate of IV fluids as ordered Pallor, tachycardia, decreased urine output and edema indicate poor organ perfusion and third spacing of fluid into the interstitial space. The IV fluid rate should be increased to help improve renal perfusion.

Which action by the nurse would be most appropriate when preparing the preschool child for a medical procedure? Telling the child he or she will get a sticker if he or she does not cry at all Explaining the entire sequence of the procedure to the child Avoiding giving the medical procedure equipment silly names Allow the child to practice the procedure on a stuffed bear

Allow the child to practice the procedure on a stuffed bear Allowing the child to practice the procedure on a stuffed bear can be therapeutic for the child and is the most appropriate action.

The nurse is preparing to administer an ophthalmic solution to an 8-year-old patient who is refusing to open his eyes. How should the nurse respond to facilitate administration of the medication by the parents? Select all that apply. Demonstrate the administration for the parents. Allow the parents to practice prior to administration. Explain to the parents the necessity of the medication. Withhold the medication until the parents are available to assist. Encourage the parents to use a reward after administering the medication

Allow the parents to practice prior to administration. The parents should be allowed to practice administering the medication prior to actual administration to ensure confidence in both the parents and the child. Demonstrate the administration for the parents. The nurse should teach the parents how to deliver the medication so that they are confident in their approach. Encourage the parents to use a reward after administering the medication The nurse should encourage the parents to use positive reinforcement to build trust and help reduce the fear that the child is feeling.

What anticipatory guidance can the nurse give parents of a toddler to support the toddler's need for increasing autonomy? Take the food away if the toddler spills it. Continue feeding the toddler during mealtime. Give the toddler finger foods to decrease messes. Allow the toddler to practice feeding with a spoon.

Allow the toddler to practice feeding with a spoon. Allowing the toddler to practice feeding with a spoon will help increase autonomy at mealtimes.

Which action by the nurse when caring for the preschool child is appropriate, given preschoolers' level of independence? Allowing the child to brush teeth alone Hand-feeding the child during mealtimes and snacks Explaining the entire procedure for ear tube surgery Allowing the child to put on the exam gown by him- or herself

Allowing the child to put on the exam gown by him- or herself The nurse should allow the child to undress him-/herself to put on the exam gown. Preschool children want to assert independence and undressing without assistance is appropriate given preschooler's level of independence.

The nurse is administering an injection to a 4-year-old patient who is fearful of the procedure. What can the nurse do to facilitate cooperation of the patient? Select all that apply. Ask the child to hold a toy. Explain in detail how the medication works. Tell the child they get a fun bandage after the injection. Tell the child how well she did after administering the injection. Tell the child she will receive a sticker of her choice after the procedure.

Ask the child to hold a toy. Providing a distraction, such as a favorite toy, helps the child accept the injection in a more favorable light. Tell the child they get a fun bandage after the injection. Adhesive bandages following an injection help the child feel better about receiving the medication because children of this age tend to think "magically." Therefore, the bandage will "make it all better." Tell the child how well she did after administering the injection. Praising the child will help her feel good about herself and facilitate the child being less afraid of future injections. Tell the child she will receive a sticker of her choice after the procedure. Rewarding good behavior will help the child focus on something positive and not what she is afraid of.

Based on the developmental level of a 7-year-old child, what should the nurse do before administering an IM medication to enhance cooperation? Demonstrate the injection using puppets. The nurse should give a sticker or lollipop as a reward. Ask the child which arm he or she would prefer for the injection. Provide a detailed explanation about the mode of action of the medication.

Ask the child which arm he or she would prefer for the injection. A school-aged child, such as a 7-year-old child, should be offered as many choices as possible to help feel in control.

Question 17 of 18 A child with electrical burns from touching an active power line reports numbness in the fingers. The nurse notes the hands and arms are edematous. Which actions should the nurse take? Select all that apply. Assess capillary refill Assess the peripheral pulses Perform neurovascular checks Assess the toes and lower extremity Administer pain medication as ordered

Assess capillary refill When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should assess the capillary refill. Assess the peripheral pulses When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should assess the peripheral pulses. Perform neurovascular checks When a child with electrical burns to the arm complains of numbness in the fingers, the nurse should perform neurovascular checks.

A 17-year-old girl has burns to the face and neck after a kitchen accident. The parents tell the nurse that the girl does not interact with friends or family, spends most of her time in her room, and avoids going to school. Which actions should the nurse take? Select all that apply. Assess for suicidal ideation. Consult with a child life specialist. Recommend home schooling through graduation. Encourage the patient to verbalize feelings about her appearance. Discuss ways to use cosmetics to minimize the perceived disfigurement.

Assess for suicidal ideation. If a 17-year-old is self-isolating after a burn injury, the nurse would assess for suicidal ideation. Incidence of suicide is high in adolescents. Correct Consult with a child life specialist. If a 17-year-old is self-isolating after a burn injury, the nurse would consult a child life specialist to help the child explore their feelings. Encourage the patient to verbalize feelings about her appearance. If a 17-year-old is self-isolating after a burn injury, the nurse would encourage the patient to verbalize feelings about her appearance. Correct Discuss ways to use cosmetics to minimize the perceived disfigurement. If a 17-year-old is self-isolating after a burn injury, the nurse would discuss ways to use cosmetics to minimize the perceived disfigurement.

A 12-year-old child has burns to the face, hands, legs, and palms after a house fire. Which action by the nurse is most important? Determine the TBSA Assess the airway for patency Begin IV fluid bolus as ordered Administer pain medication as ordered

Assess the airway for patency The priority nursing action is to assess the airway for all patients with facial burns.

Identify the gross motor capability of the toddler. Select all that apply. Riding a bicycle Ascending the stairs Jumping over objects Hop on one foot Throwing a ball overhand

CORRECT: Ascending the stairs Learning to climb is a gross motor milestone of the toddler. Throwing a ball overhand Throwing a ball overhand is a gross motor skill capability of the toddler. INCORRECT: Riding a bicycle Riding a bicycle is not a gross motor milestone of the toddler, but of the school-age child. Jumping over objects Jumping in place, not over objects, is a gross motor capability of the toddler. Hop on one foot Hopping on one foot is not a gross motor capability of the toddler, but of the preschool child.

Identify fine motor capabilities for the toddler. Select all that apply. Drawing a circle Stacking blocks or toys Drinking from a sippy cup Using a spoon without difficulty Drawing a person with several body parts

CORRECT: Drawing a circle Drawing loops and lines (scribbling) is a fine motor skill capability of the toddler. Stacking blocks or toys Building a tower of blocks is a fine motor skill capability of the toddler. Drinking from a sippy cup By 12-18 months, the toddler should have mastered the use of a sippy cup and can use an adult cup without much spilling. INCORRECT: Using a spoon without difficulty Although most toddlers can use a spoon, they have not yet perfected this fine motor skill and will spill most of the food. Drawing a person with several body parts Drawing a person with several body parts is a fine motor skill of the preschool child, not the toddler.

Which characteristics are typical of the toddler's physical appearance? Select all that apply. Leaner Knees curved inward Flattened plantar arch Inward curve of the spine Mature abdominal muscles

CORRECT: Leaner Loss of adipose (fat) tissue as the toddler becomes more active is typical of a toddler's appearance. Flattened plantar arch Toddler's feet seem flat because of a plantar fat pad that disappears around 2 years of age. This is typical of a toddler's appearance. Inward curve of the spine An exaggerated lumbar curve is typical of a toddler's appearance. INCORRECT: Knees curved inward The toddler's legs are short and bowed outward. Knees curved inward are not typical of a toddler's appearance. Mature abdominal muscles Toddlers have immature abdominal muscles that are typical of a toddlers "potbellied" appearance.

When preparing a suspension or elixir that specifies dosage in milligrams (mg), what should the nurse do to ensure the patient receives the correct amount of the medication? Use a tablespoon to administer the oral medication. Weigh the bottle of liquid on a scale and then weigh the dose. Draw an amount of liquid equal to the number of milligrams prescribed. Calculate the dose based on the number of mg/mL in the suspension.

Calculate the dose based on the number of mg/mL in the suspension. Prescriptions will often state the dosage in mg—and not mL—for liquids; care must be given to calculate the correct liquid dose.

A patient who sustained an electrical injury from a toaster complains of pain 9/10 to the right arm. Lab results show pH of 7.2, HCO3 of 17, and PCO2 of 40. Normal saline is running at 125 mL/hr, IV pain medications are ordered for every four hours. Which action should the nurse take first? Administer oxygen via nasal cannula Administer IV pain medication as ordered Increase IV fluid rate to 250ml/hr as ordered Change IV fluids to Ringer's Lactate as ordered

Change IV fluids to Ringer's Lactate as ordered The patient's lab results indicate metabolic acidosis. The nurse should change the fluids to ringer's lactate because it has a higher concentration of electrolytes and will help correct the problem.

An 8-year-old pediatric patient was prescribed a topical medication. What steps should the nurse take to prepare for the application of the medication? Select all that apply. Cleanse the skin allow it to dry. Examine the skin for abnormalities. Teach the child to not touch treated areas. Assist the child in applying the medication. Use tie-down restraints to restrain the child.

Cleanse the skin allow it to dry. In preparing the skin for the application of a topical medication the skin should be cleansed to remove exudates, scales, and other residue. This preparation will allow proper penetration of the topical medication. Examine the skin for abnormalities. The presence of bruises, abrasion, and irritation would affect the absorption of topical medications and, therefore, should not be present at the site of application. Teach the child to not touch treated areas. The child should avoid manipulating the treated area once the topical medication has been applied. Manipulation of the treated area could alter the perfusion of the area, which would change the absorption characteristics of the medication. Assist the child in applying the medication. Children should be involved in their own care as much as is appropriate for the child's development.

The parent of a five-year-old child is frustrated by the child's tendency to hit and pull hair when angry. The nurse assures the parent that this lack of impulse control can be normal for children and to address the problem in which ways? Select all that apply. Clearly define rules Enforce rules consistently Explain truthfully why the rule is set Spank the child when they engage in prohibited behavior Vary the type of discipline until you find one that works best

Clearly define rules Clearly defining rules and setting boundaries for the child can help the child learn self-confidence, self-control, and family expectations. Enforce rules consistently The child must be consistently disciplined for acts that are destructive, socially unacceptable, or morally wrong. To prevent confusion and anxiety, the consequences of misbehavior should be articulated in advance and carried out immediately after misbehavior occurs. When the child is disciplined for misbehavior, a simple, truthful explanation of why the behavior was unacceptable should be given. Explain truthfully why the rule is set When the child is disciplined for misbehavior, a simple, truthful explanation of why the behavior was unacceptable should be given. This will help the child understand the rules better.

Closure of the ductus arteriosus occurs shortly after birth. Children born with right-to left shunts begin to experience an increase in cyanosis with this closure. Which explanation describes the pathophysiology of this clinical manifestation? Closure of the patent ductus arteriosus (PDA) decreases the right-to-left shunting. Closure of the ductus arteriosus causes the development of pulmonary hypertension. Closure of ductus arteriosus decreases the volume of blood going to the lungs for oxygenation. Closure of the ductus arteriosus increases the volume of blood going to the lungs. Increased blood flow causes decreased oxygenation.

Closure of ductus arteriosus decreases the volume of blood going to the lungs for oxygenation. In a right-to-left shunt, deoxygenated blood mixes with the oxygenated blood on the left side of the heart. This can decrease blood flow through the pulmonary trunk. When there is a PDA, mixed blood from the left side can go to the lungs for oxygenation. When the ductus arteriosus closes, this alternate pathway for oxygenation is lost.

Which activity for play therapy would be most appropriate for the nurse to suggest for the hospitalized preschool child? Reading riddles and jokes Playing complex a card game Holding onto a push-pull toy Coloring with colored pencils

Coloring with colored pencils Coloring with colored pencils is the most appropriate activity for the hospitalized preschool child.

A child has been diagnosed with hypoplastic left heart syndrome. Which action by the nurse will be a priority for providing long term management of this child? Contact provider as surgical consult is needed Ensure adequate weight gain through proper feeding Administer diuretics as ordered to help control fluid overload Administer digoxin as ordered and prepare to administer on long term basis

Contact provider as surgical consult is needed This child will need a surgical consult in order to be assessed for a 3 step surgical procedure called "staged palliation". This procedure is for long-term management and is meant to correct the blood flow pattern in and out of the heart and help to improve the child's blood oxygenation.

The nurse is caring for a child who is experiencing an acute asthma attack. What approach should the nurse use to administer a bronchodilator? Encourage the child to continue to breathe rapidly. Supply the medication using a metered-dose inhaler. Use a spacer to aid the child in inhalation of the dose. Deliver the nebulized medication with supplemental oxygen.

Deliver the nebulized medication with supplemental oxygen. Using oxygen with the nebulizer allows both the medication and oxygen to be delivered to the lungs. The delivery of oxygen is independent of the nebulized medication because oxygen transfer occurs in the alveoli and nebulized medication will not travel into the alveoli.

A nurse has been asked to administer an intramuscular injection to a 1-year-old child. How does the nurse choose the appropriate needle to use? Select all that apply. The nurse may contact a colleague to obtain information about the correct needle to use. Determine the shortest length needle according to the selected muscle. Choose the needle length by taking into account the amount of body fat on the child. Determine the appropriate gauge needle for the type of medication to be administered. Look up the last intramuscular injection that was given to see what size was used before.

Determine the shortest length needle according to the selected muscle. The nurse should choose the shortest-length needle for the administering of an IM injection based upon the selected muscle for administration. This will help prevent the injection from penetrating too deeply. Correct Choose the needle length by taking into account the amount of body fat on the child. The amount of body fat on the child would influence the correct needle choice by requiring a longer needle when the child is carrying a higher amount of body fat. Correct Determine the appropriate gauge needle for the type of medication to be administered. The nurse should choose the smallest-gauge needle, based on the site and viscosity of the medication, when administering an IM injection. Using the smallest-gauge needle will help reduce the pain associated with intramuscular injection and increase the child's cooperation during the procedure.

What are some of the clinical manifestations associated with left-sided obstructive lesions? Select all that apply. Peripheral edema Exercise intolerance Right ventricle atresia Pulmonary hypertension Left ventricular hypertrophy

Exercise intolerance The left side of the heart supplies blood to systemic circulation. A left-side obstruction would decrease blood delivery and decrease exercise tolerance. Pulmonary hypertension Increased pressure in left ventricle due to left-side heart obstruction can cause backflow into lungs and hypertension. Left ventricular hypertrophy Increased pressure in left ventricle causes hypertrophy.

A three-year-old girl is brought to the emergency department with a third-degree burn on her hand. The mother is extremely distressed and says to the nurse: "My daughter is so active and curious—it is hard to predict her behavior." Why is it important for the nurse to discuss developmental milestones when advising this parent about safety measures? Select all that apply. Developmental milestones do not need to be discussed, since they are not related to this child's third-degree burn. Discuss the importance of keeping the child close at all times and preventing exploration and wandering to prevent injury. Discussing developmental milestones will help the mother prepare for the type of behavior the child will exhibit now and in the future. Discussing motor milestones, including increased motor capacity, explains why the child will be reaching and moving quickly, making the child more prone to accidents. Discussing cognitive milestones, including increased curiosity and the desire to explore without understanding the consequences of actions, will help the parent understand the need for child-proofing the home and close supervision of the child at this age.

Discussing developmental milestones will help the mother prepare for the type of behavior the child will exhibit now and in the future. Preparing for the future by providing anticipatory (ie, anticipatory guidance) is an important reason for the nurse to discuss developmental milestones when advising this mom. This can help to prevent injury in the future anticipate behavior associated with. Discussing motor milestones, including increased motor capacity, explains why the child will be reaching and moving quickly, making the child more prone to accidents. Motor milestones are important for the nurse to discuss when advising this mother about safety measures. This will help the mother consider ways to make the child's environment safe (eg, keeping poisonous substances out of reach, restricting access to climbing hazards). Discussing cognitive milestones, including increased curiosity and the desire to explore without understanding the consequences of actions, will help the parent understand the need for child-proofing the home and close supervision of the child at this age. Cognitive milestones are important for the nurse to discuss when advising a parent about safety measures. At this age, children do not have the capacity to anticipate consequences so they should be watched closely, and appropriate measures should be taken to make her environment as safe as possible.

A 7-year-old child is admitted to the hospital to receive an intravenous antibiotic. The child's parent is concerned about injury to the child's arm because this is the child's first IV infusion. How does the nurse ensure patient safety while placing the IV catheter? Select all that apply. Do not allow the parents to hold the child. Reduce pain using topical pharmacological agents. Have the parent leave the room during the IV insertion. Obtain help from a colleague to hold the child and the extremity. Tell the child to imagine his or her favorite activity while guiding the catheter.

Do not allow the parents to hold the child. The parents should be allowed to therapeutically hold the child during the IV insertion if they are comfortable with the position and the procedure. Reduce pain using topical pharmacological agents. The use of EMLA cream will reduce the pain associated with the insertion of an IV catheter and encourage more cooperation from the child helping to prevent injury. Obtain help from a colleague to hold the child and the extremity. Therapeutic holding of a child may be a necessary step for the insertion of an IV catheter. Insertion of an IV catheter can be a traumatic event for a child. Restraint of the child will reduce the length of time the child is in the stressful situation. Tell the child to imagine his or her favorite activity while guiding the catheter. The nurse should help the child imagine positive images when preparing them for the insertion of an IV catheter. This imagery will help the child feel in control of the situation and improve cooperation.

Which cognitive advancements are expected between 19 and 24 months? Domestic mimicry Ability to relate to time of day Abstract thinking to solve problems Imitating an action only while another person is performing it

Domestic mimicry Domestic mimicry (imitating a parent of the same sex) and deferred imitation (imitating an action hours after the toddler watched the original action) are expected cognitive advancements of the toddler.

The nurse is caring for a pediatric patient and is implementing orders to infuse an IV medication at a rate of 50 mL/hr. The nurse returns to the room 15 minutes after initiating the IV medication and finds the pump set to 75 ml/hr. What action should the nurse take? Select all that apply. Double check the prescribed rate. Check the infusion site for edema. Disconnect the infusion and flush the site. Verify the medication that is to be infused. Stop the infusion and contact the health care provider.

Double check the prescribed rate. The nurse should verify the ordered rate of the IV medication. If it was administered incorrectly, stop the infusion and notify the health care provider. Check the infusion site for edema. The nurse should check the IV site for signs of edema, infection, and infiltration, a medication instilled at an incorrect higher rate may cause edema or infiltration at the IV site. Disconnect the infusion and flush the site. The nurse should stop the infusion and flush the site if the rate prescribed is not the same as the rate that is set on the infusion pump. This will prevent a continuing medication error. Stop the infusion and contact the health care provider. After stopping the infusion, the nurse contacts the health care provider to inform him or her of the increased rate of medication administration and to receive further orders.

Summary

During the toddler years, children change rapidly. Changes occur in physical growth, motor-skill development, and cognitive/social development. The rapid changes in motor skills and the toddler's inability to make judgements about the safety of actions place the toddler at risk for unintentional injury. The importance of safety regarding the most common injuries of the toddler period, including aspiration, burns, drowning, and falls, should be communicated to parents of toddlers. The toddler years are characterized by a struggle for autonomy as the child develops a sense of self separate from the parent. Nurses should help parents understand that toddler behaviors, which include negativism, ritualism, temper tantrums, and separation anxiety, are normal processes of toddler development. Parents should be given information to help cope with these behaviors appropriately. During the well-child checkup, the nurse's role is to be a child advocate by providing parents of toddlers with anticipatory guidance related to growth, safety, and common age-related concerns. Nurses should also listen to any concerns that parents have about the development of their toddler because parental concerns provide a reliable indicator of possible developmental delay.

Which one of the following developmental characteristics explains why a toddler frequently uses the words me, I, and mine? Animism Ritualism Negativism Egocentrism

Egocentrism Egocentrism is when a toddler views everything in relation to self and is unable to consider another's point of view, and it explains why the predominant words in the toddler's language are me, I, and mine.

A parent reports concern that his or her preschool child has difficulty following directions. The nurse should recommend which actions by the parent to help the child with this task? Giving the child specific direction Telling the child he or she could do it better next time Explaining the directions in more detail next time Reminding the child that good children always listen

Giving the child specific direction The nurse should recommend the parent give specific direction because preschool children are often unable to follow directions unless they are given one step at a time.

A child who sustained an electrical burn reports shortness of breath and chest heaviness. The nurse notes diaphoresis, and pallor. Which additional assessment(s) are a priority for the nurse to obtain? Select all that apply. Heart rate Serum glucose Serum sodium level Abdominal ultrasound Obtain an order for an ECG

Heart rate When a child with electrical burns complains of shortness of breath and chest heaviness, the heart rate should be assessed along with a full cardiac assessment. Obtain an order for an ECG When a child with electrical burns complains of shortness of breath and chest heaviness, an ECG is a priority because the electricity can disrupt the electrical activity of the heart.

When educating a caregiver about personal safety for a preschooler, which information would the nurse indicate as most important for the child to learn? The ability to run How to verbalize dissent Identification of a dangerous person Alerting other children to the danger

Identification of a dangerous person Distinguishing a stranger from a well-intentioned person is challenging and often difficult for the preschooler. Strangers are often portrayed as evil, and may not appear as such in a real-life situation. Therefore, it is appropriate to teach "stranger danger."

What is the relationship between right-sided heart failure and pulmonary artery stenosis? Decreased pressures on the right side of the heart cause backflow, peripheral edema and failure. Increased blood flow to the pulmonary circulation can lead to right-sided heart failure due to increased workload. Increased pressure developed in the right ventricle can cause hypertrophy and eventual failure of the right side of the heart. Decreased venous return limits the preload on the right side of the heart. This leads to the development of pulmonary artery stenosis.

Increased pressure developed in the right ventricle can cause hypertrophy and eventual failure of the right side of the heart. Development of hypertrophy and the increased workload of the right ventricle are caused by the stenotic PA. The RV has to increase its contraction efforts to overcome the resistance from the PA, and this can lead to right sided heart failure.

The nurse is caring for an 8-year-old patient with second degree burns over 15% of the total body surface area (TBSA). On assessment, the nurse notes the following vital signs: HR 134, RR28, BP 82/48, Temp 97.4. Which action should the nurse take first? Give IV antibiotics as ordered Administer IV dopamine as ordered Initiate IV fluid resuscitation as ordered Administer IV pain medication as ordered

Initiate IV fluid resuscitation as ordered A child with second degree burns and tachycardia should have IV fluid resuscitation.

The health care facility supplies the nurse with which tools to prevent medication errors in the pediatric population? Select all that apply. Limiting variations in drug preparation by using standardized doses. Universal procedures for drug administration facilitates proper usage. Use of kilograms for weight in all dose calculations and medical records. Dose-range software programs to provide alerts for potentially incorrect doses. Eliminating use of bar-coding technology for medications that require a nurse perform a second check.

Limiting variations in drug preparation by using standardized doses. The standardization of pediatric medications will reduce medication errors by limiting the variations in drug preparation. Universal procedures for drug administration facilitates proper usage. The establishment of universal procedures for drug administration facilitates proper usage and reduces the risk of medication errors by providing a standard mechanism that is followed by all health care providers. Use of kilograms for weight in all dose calculations and medical records. The use of kilogram weight in children for prescriptions, dose calculations, medical records, and staff communication will standardize communication procedures and reduce the risk of medication errors. Dose-range software programs to provide alerts for potentially incorrect doses. The use of software programs to alert about incorrect doses is a protocol that will help catch medication errors.

Atrial septal defects are conservatively treated as many spontaneously close. What assumptions can be made regarding the possible outcomes if the defect does not close? Select all that apply. Right-sided pressures will increase. There will be increased systemic pressures. Right side of heart will be volume overloaded. There will be increased pulmonary blood flow. There will be increased oxygen saturation on right side of the heart.

Right-sided pressures will increase. Volume from the high pressure, left side of the heart will create increased pressures on right side of the heart. Right side of heart will be volume overloaded. Volume from the high pressure, left side of the heart will create a volume overload of right side of the heart. There will be increased pulmonary blood flow. Volume from the high pressure, left side of the heart will cause an increase in pulmonary blood flow. There will be increased oxygen saturation on right side of the heart. Volume from highly saturated, left side of the heart will mix with deoxygenated blood on the right side. This will increase oxygen saturation on right side of the heart.

A newborn infant has pulmonary atresia with intact ventricular septum. The parents want to know why the health care provider said it was important to keep fetal structures open. How can the nurse explain the rationale for maintaining fetal structures in the newborn infant? Maintaining open fetal structures will allow blood to bypass lungs. This will allow for use of mechanical ventilation. Maintaining open fetal structures will allow blood to make its way to the lungs. This will allow for oxygenation of the blood for the baby. Maintaining open fetal structures will shift pressure in the ventricles. High pressure generated on right side of the heart will force pulmonary blood flow. Maintaining open fetal structures will allow for reversal of blood flow in the heart and body. This will allow for oxygenation of blood from left side of the heart and right side of the heart will pump blood to body.

Maintaining open fetal structures will allow blood to make its way to the lungs. This will allow for oxygenation of the blood for the baby. In the fetus, blood bypasses nonfunctioning lungs using ductus arteriosus and foramen ovale. Foramen ovale will continue to let deoxygenated blood move to left side of the heart. Ductus arteriosus will now have reversed flow; blood will move from aorta into ductus arteriosus and to pulmonary circulation for oxygenation of blood. Then, mixed blood can be pumped to body.

What important parental guidance advisory needs should caregivers be reminded of when discussing motor development in the toddler? Encourage the toddler to walk because he or she will fall down when running. Keep the toddler in a crib until 3 years of age, even if he or she tries to climb out. As motor development increases, allow the toddler to use a toothbrush unsupervised. Motor development in this age group is far ahead of development of judgment and perception.

Motor development in this age group is far ahead of development of judgment and perception. This difference in timing of the development of different skills increases the risk for injury.

A child recovering from major burns four weeks ago complains of nausea, vomiting, and epigastric pain that worsen with eating. The nurse notes tenderness on palpation and a positive gastric aspirate positive for blood. Which provider orders should the nurse anticipate? Select all that apply. NPO Endoscopy Hemoccult IV protonix Administer PO acetaminophen

NPO If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate making the patient NPO to prevent pain. Correct Endoscopy If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate sending the patient for an endoscopy to determine if a stress ulcer is present. IV protonix If a child with burn injury complains of epigastric pain that worsens with eating, the nurse would anticipate giving IV protonix to decrease the risk for worsening stress ulcer.

A pediatric patient cannot swallow pills. The medication order is for an enteric-coated medication. How should the nurse proceed? Notify the health care provider. Crush tablet for administration. Ask the child to chew the tablet. Administer the medication as a liquid.

Notify the health care provider. The nurse should notify the ordering provider and request the medication be changed to a different form. Medication that is enteric-coated cannot be crushed or chewed without hindering the effectiveness of the medication.

The parents of a toddler are worried that the child is not eating at meal times. Which suggestions should the nurse make to promote healthy eating for the child? Offer three meals and two snacks per day. Offer the child a routine menu of nutritious food each day. Offer a treat, such as a cupcake, with meals to encourage a healthy appetite. Serve a large breakfast with a high protein content to increase the child's metabolism.

Offer three meals and two snacks per day. This will help the child build a regular appetite. Setting meal times will train the toddler to eat at regular times, and limited snacks will help ensure an appetite at those times.

A parent of a four-year-old child is frustrated at the child's new habit of acting out and hitting other children. The nurse should recommend which actions to address this behavior? Select all that apply. Taking away something the child loves as punishment Offering hugs and physical encouragement when positive behavior is experienced Explaining that if the child hits other children, he/she will be punished with a spanking Explaining to the child that he/she will not be able to play with other children when the behavior occurs

Offering hugs and physical encouragement when positive behavior is experienced A time-in is often effective at enforcing positive behavior. Frequent, brief, nonverbal, physical contact should be provided when the child is acting appropriately.

How can a nurse distinguish between a patient with hypoplastic left heart syndrome and truncus arteriosus? Oxygenated blood flows to left ventricle in hypoplastic left heart syndrome, whereas deoxygenated blood flows into left heart in truncus arteriosus. Oxygenated blood flows to right atrium in hypoplastic left heart syndrome, whereas deoxygenated blood flows into left heart in truncus arteriosus. Deoxygenated blood flows to the left atrium in hypoplastic left heart syndrome, whereas deoxygenated blood flows into the left heart in truncus arteriosus. Oxygenated blood flows to left atrium in hypoplastic left heart syndrome, whereas oxygenated blood flows into left ventricle where blood mixing occurs in truncus arteriosus.

Oxygenated blood flows to left atrium in hypoplastic left heart syndrome, whereas oxygenated blood flows into left ventricle where blood mixing occurs in truncus arteriosus. These findings will help a nurse distinguish patient with hypoplastic left heart syndrome from one with truncus arteriosus. In hypoplastic heart syndrome, most of oxygenated blood cannot leave aorta and is instead shunted to right side back in to pulmonary circulation.

The nurse is discussing sleeping habits with the parents of a five-year-old child. Which assessment findings would be concerning to the nurse? Select all that apply. The child takes a nap more than once during the day. Parents allow the child to stay up until tired. The parents use a bedtime routine to help the child relax. Parents offer the child snacks while in bed to encourage going to bed. Parents withhold playtime until the child agrees to go to bed at a certain time.

Parents allow the child to stay up until tired. Children need a core routine during the day and night, and a regular bedtime should be set and followed every night. Parents offer the child snacks while in bed to encourage going to bed. Offering the child snacks while in bed may interfere with the bedtime routine. Moreover, if the snacks are sugary in nature, they may be detrimental to the deciduous teeth. Parents withhold playtime until the child agrees to go to bed at a certain time. Although it is important that the child have a nightly routine, it is more important that the parents interact and bond with the child. Parent-child playtime is an important act that should not be used as a reward or punishment.

What is the relationship between the fetal cardiac anatomical features and the survivability of complex cardiac lesions in the early neonatal stage? Fetal structures can prevent the formation of pressure gradients and reduce shunting. Patent fetal structures can be removed during surgery and used during the surgical repair. Fetal structures close quickly to prevent aberrant flow. This prevents the mixing of oxygenated and deoxygenated blood. Patent fetal structures maintain pathways for the movement of blood and allow for mixing of oxygenated and deoxygenated blood.

Patent fetal structures maintain pathways for the movement of blood and allow for mixing of oxygenated and deoxygenated blood. Fetal structures (foramen ovale and ductus arteriosus) that can be maintained after birth can improve survivability of patients with heart defects. Theses maintained pathways allow for the movement of blood around possible obstructions or due to pressure gradients. They also allow for the mixing of oxygenated and deoxygenated blood which can reduce hypoxia and therefore improve survivability in children with heart defects.

What conclusions can be drawn regarding clinical manifestations for a patient with a left-to-right ventricular shunt and decreased pulmonary blood flow? Select all that apply. Patient may have polycythemia. Patient may be hypoxemic, resulting in cyanosis. Patient may have increased pulmonary pressures. Patient may have increased oxygen saturation on left side of heart. Patient may have increased cardiac workload and ventricular strain.

Patient may have polycythemia. Polycythemia results from decreased systemic oxygenation. The kidney responds by increased RBC production. Patient may be hypoxemic, resulting in cyanosis. Decreased pulmonary blood flow and mixing of blood in the ventricles can result in hypoxemia and cyanosis. Patient may have increased cardiac workload and ventricular strain. Cardiac workload and ventricular strain would increase due to shunting blood and lesion or malformation that limits pulmonary blood flow.

Which motor skills should be developed in the preschool child? Playing hopscotch Cutting paper using safety Drawing a picture of his or her home and pets Balancing on each foot for one second Riding a bicycle without training wheels

Playing hopscotch The preschool child can hop on one foot and jump forward, two skills used in hopscotch. Drawing a picture of his or her home and pets Drawing objects that resemble familiar objects is a motor skill that should be developed in the preschool child. Balancing on each foot for one second Balancing on each foot for one second is a motor skill that should be developed in the preschool child.

The nurse is preparing a community program to decrease the incidence of water-related accidents and deaths. The nurse should plan to implement teaching about water-safety issues in which ways? Select all that apply. Prepare handouts with parent education about home water safety precautions. Promote education about life jacket use on boats among summer camp populations. Organize community outreach sessions and material on swimming classes for children and water safety programs. Perform inspections at community pools and condo associations to check for pool safety issues. Provide pamphlets with information on preventing drowning deaths to community pool locations.

Prepare handouts with parent education about home water safety precautions. Handouts are a good way to provide water safety recommendations. The nurse can inform parents of simple in-home water safety precautions, including guidelines such as installing toilet lid locks and never allowing a child to bathe unattended. Promote education about life jacket use on boats among summer camp populations. The nurse can target certain populations, such as summer camps and other communities where children are at a higher risk for water-related accidents, to provide educational materials to address this risk. Organize community outreach sessions and material on swimming classes for children and water safety programs. The nurse can plan outreach education about swimming and water safety classes. The nurse can recommend certain organizations, such as the American Red Cross and the YMCA, for assistance. Provide pamphlets with information on preventing drowning deaths to community pool locations. Providing education to those using community pools will work to decrease the rates water-related injury.

Which physical changes are normally seen as an infant transitions into a toddler? Cherub appearance Protruding abdomen Increased adipose tissue Excessive curve of the back

Protruding abdomen A potbellied abdomen due to immature abdominal muscles is a normal physical change as an infant transitions into a toddler. Excessive curve of the back An exaggerated lumbar curve is a normal physical change as an infant transitions into a toddler. Wide gap between knees when standing erect A gap between the knees is the result of short, bowed legs, which are a normal physical change as an infant transitions into a toddler.

A child recovering from a moderate burn to the anterior trunk and abdomen has Hgb 12, Na 140, K 4.7, and serum albumin 2.8. Which action is most important for the nurse to take? Transfuse 1 unit PRBCs as ordered Give albumin intravenously as ordered Provide high-calorie, high-protein foods Administer 1 gram of Potassium chloride as ordered

Provide high-calorie, high-protein foods A serum albumin of 2.8 indicated malnutrition. Protein is necessary for wound healing. The nurse should offer a high-calorie, high-protein diet to promote healing.

A patient with burns on the face and neck has an order to apply moist sterile gauze and silver sulfadiazine to all burns. Which action should the nurse take first? Question the order for Silvadene. Change the order to moist gauze. Apply bacitracin ointment to face as ordered. Apply Silvadene as ordered, but avoid the eyes.

Question the order for Silvadene. Silvadene cream is not typically used on facial burns. The nurse should question the order.

The nurse has to give the 6-year-old patient with diabetes a dose of insulin. Which statement(s) describes what the nurse should do before administering the medication? Select all that apply. Record the time. Verify the dosage calculation and the order. Ask another nurse to double-check the medication. Administer the insulin as soon as the dose is prepared. Confirm the six rights of medication administration after receiving the medication order.

Record the time. As part of the six rights of medication administration, the nurse must ensure the patient is receiving medication at the appropriate time. The nurse must document this Verify the dosage calculation and the order. The dosage calculation of the drug should be performed before administering any medication. The nurse should discuss any discrepancies in calculations with the prescribing health care provider and pharmacist. Ask another nurse to double-check the medication. Insulin is a drug that requires a second nurse to check before administration, as defined by the Institute for Safe Medication Practices.

A child is brought to the allergist's office for frequent congestion and watery eyes. The health care provider orders a series of allergens to be administered subcutaneously to determine the child's allergies. When the nurse administers these subcutaneous injections, which steps should be taken? Select all that apply. Massage the site of injection. Release the tissue and inject the medication. Gently pinch the subcutaneous tissue from the muscle. Insert the needle at a 45-degree angle with the bevel up using a dart motion. Apply gentle pressure to the site using dry gauze after removing the needle.

Release the tissue and inject the medication. Releasing the tissue before injecting the medication will remove pressure from the tissue allowing the medication to be safely injected. Correct Gently pinch the subcutaneous tissue from the muscle. The nurse should pinch the child's skin to raise the subcutaneous tissue from the muscle underneath. This will help prevent the needle from being inserted too deeply into the patient. Apply gentle pressure to the site using dry gauze after removing the needle. Applying gentle pressure will help stimulate clotting and prevent the medication from leaking out of the needle site.

When caring for a toddler in the hospital, which nursing intervention is most developmentally appropriate? Not allowing the child to have a pacifier while in the hospital. Allowing the child to decide if the nurse can perform a procedure. Asking the parents to leave the room when performing an assessment. Scheduling evening medications to follow the toddler's bedtime routine.

Scheduling evening medications to follow the toddler's bedtime routine The toddler may experience distress when a routine is not followed. The nurse can provide care in the hospital that helps support routines, if possible.

The nurse makes which recommendation(s) to the parents of a three-year-old who throws a tantrum every night at bedtime? Select all that apply. Set appropriate limits. Establish a regular bedtime routine. Set a behavior expectation plan. Allow the tantrums as a sign of autonomy. Identify the triggers for the tantrums.

Set appropriate limits. Appropriate limit-setting will help the toddler better understand the boundaries with regard to his or her behavior. Establish a regular bedtime routine. A regular bedtime routine will be predictable and thereby make the transition from waking to sleeping time smoother. Set a behavior expectation plan. Having a behavior expectation plan in place will help the parents respond in a consistent manner to the tantrums. It shows what behaviors the parents will not tolerate and the expected consequences. Identify the triggers for the tantrums. It is important for the parents to identify specific triggers for the toddler's tantrums (eg., sleepiness) so that they can be addressed. Prevention is the best intervention.

Which toy is appropriate to encourage cognitive development in the toddler? Card game Board game Stacking cups One-hundred-piece puzzle

Stacking cups Stacking cups would encourage cognitive development. Cups are also safe and durable. This would be an appropriate toy.

Parents of a 6-year-old comment that their son enjoys playing outside most of the day during summer break. They apply SPF 10 sunscreen in the morning, and provide beverages to maintain the child's hydration. Which information is important to include in teaching for these parents? Select all that apply. Sunscreen should be reapplied frequently. Avoid sun exposure between 1000 and 1500. Encourage the child to wear multiple layers of clothing. Juice and cola are acceptable for maintaining hydration. Sunscreen should be SPF 15 or higher and have UVA and UVB protection.

Sunscreen should be reapplied frequently. Parents should be told to reapply sunscreen frequently when their child is outside for an extended time. Avoid sun exposure between 1000 and 1500. The nurse should teach parents to keep children out of the sun between 1000 and 1500 during the summer months. Sunscreen should be SPF 15 or higher and have UVA and UVB protection. Parents should be encouraged to use sunscreen with SPF of at least 15 with UVA and UVB protection.

In response to the pathophysiology of heart failure (HF), there is activation of the sympathetic nervous system and the release of hormones in an effort to maintain cardiac output (CO). How do these two systems synergistically increase cardiac output? Select all that apply. Sympathetic nervous system activity increases heart rate. Sympathetic nervous system activity increases stroke volume. Sympathetic nervous system activity initiates vasodilation in most of the peripheral vasculature. Endocrine function of hormones from the heart, such as atrial naturietic peptide, work to increase blood volume. Endocrine function of the hormones of renin-angiotensin-aldosterone-system (RAAS) leads to increased intravascular volume.

Sympathetic nervous system activity increases heart rate. Sympathetic outflow increases heart rate which increases CO. Sympathetic nervous system activity increases stroke volume. Sympathetic outflow increases stroke volume which increases CO. Endocrine function of the hormones of renin-angiotensin-aldosterone-system (RAAS) leads to increased intravascular volume. In response to low blood volume and low blood pressure, the RAAS system works to increase sodium and water reabsorption in the kidney to increase blood volume and increase CO.

The nurse is teaching the mother of a toddler about safety precautions necessary to prevent accidents and injuries. The nurse determines that the teaching has been effective when the mother identifies which situation(s) as requiring close supervision? Select all that apply. Taking a nap Taking a bath Taking medicine Climbing a tree Helping to cook in the kitchen

Taking a bath Infants, toddlers, and young children should be watched closely throughout their baths to prevent drowning. It takes only seconds to drown in only one inch of water. Taking medicine Taking medicine is a situation that warrants close supervision. Children should be given medicine by a parent or another responsible adult. In addition, parents should be sure all medications and poisonous items are kept securely in a locked medicine box or cabinet. Climbing a tree Toddlers should be watched closely when they are climbing. Toddlers are curious and as their gross motor skills increase, they are often eager to climb, making them prone to falls. Providing effective supervision is an excellent way to let children grow and explore yet keep them safe. Helping to cook in the kitchen Helping prepare food is a situation that warrants close supervision. Toddlers and small children should not be left alone in the kitchen or around hot water to prevent thermal injuries such as scalds and burns.

Which role does the nurse play in toilet training? Select all that apply. Explaining Piaget's and Freud's stages of development Teaching parents the importance of physical readiness Providing the parents with one-on-one toilet training coaching Making home visits to ensure the child is reaching appropriate milestones Teaching the parents about developmental signs of toilet training readiness

Teaching parents the importance of physical readiness There are physical and psychological signs of readiness that the nurse can explain to the parents, such as voluntary control of the bladder and bowel and recognition of the need to void. This will help the parents determine when their child is ready and will decrease frustration. Teaching the parents about developmental signs of toilet training readiness The nurse can inform the parents of physical and psychological signs of readiness, such as the child showing interest in the toilet or the child disliking a wet or soiled diaper.

The parent of a two-and-a-half-year-old with 19 teeth reports that they do not have fluoridated city water at home and do not have access to a dentist for preventative care. Which actions should the nurse take? Select all that apply. Tell the parents to apply a topical fluoride varnish daily. Tell the parents to apply a topical fluoride varnish every six months. Recommend that the parents give the child an oral supplement of 0.5 mg of fluoride daily. Recommend that the parents give the child an oral supplement of 0.25 mg of fluoride daily. Recommend that the parents give the child and oral supplement of 0.5 mg of fluoride every six months.

Tell the parents to apply a topical fluoride varnish every six months. The application of fluoride varnish should be every three to six months during early childhood if the child does not have access to a dentist. Recommend that the parents give the child an oral supplement of 0.25 mg of fluoride daily. A supplement containing 0.25 mg of fluoride is recommended for children without access to fluoridated water.

The parent of a toddler reports that the two-year-old sometimes screams and hits himself in the head with a toy when it is close to bedtime. How would the nurse describe this behavior? Acting out Temper tantrum Tourette's syndrome Developmental disability

Temper tantrum This child is having a temper tantrum, which is a common behavior pattern seen in toddlers. Children of this age lack the verbal ability to express themselves well or to reason with parents and often resort to tantrums and aggressive outbursts.

How does the ability for a 24-month-old to build a two-block tower demonstrate a toddler's fine motor development? The ability to stack one block on top of another demonstrates an improvement in the toddler's balance. The ability to stack one block on top of another demonstrates an improvement in the toddler's autonomy. The ability to stack one block on top of another demonstrates an improvement in the toddler's visual acuity. The ability to stack one block on top of another demonstrates an improvement in a toddler's hand-eye coordination.

The ability to stack one block on top of another demonstrates an improvement in a toddler's hand-eye coordination. An improvement in a toddler's hand-eye coordination is typical at this stage and stacking blocks demonstrates development of fine motor skills.

The pediatric nurse is teaching a new nurse how to recognize signs that a toddler is ready for toilet training. The nurse includes which indicators as signs of readiness for toilet training? Select all that apply. The child shows an interest in toilets and putty chairs. The child is able to pull up and remove his or her pants. The child is eager to please the parents with a dry diaper. The child notices his or her own wet diaper and may try to remove it. When placed on the toilet, the child will sit for a short time.

The child shows an interest in toilets and putty chairs. It is a sign of readiness when the toddler shows an interest in the toilet and how it works. This shows that the child may be ready to learn about the process and practice of using the toilet or potty chair. The child is able to pull up and remove his or her pants. This demonstrates physical maturation and is one sign of readiness for toilet training. The child is eager to please the parents with a dry diaper. This scenario reflects readiness for toilet training, since the child is showing signs of psychological maturation as well as the physical ability to hold their urine for a while. The child notices his or her own wet diaper and may try to remove it. This reflects readiness for toilet training because the child understands the difference between being wet and dry and shows a preference for being clean and dry.

A mother calls the clinic and states that upon giving her 18-month-old child a prescribed medication, the child has become hyperactive. Her older child takes the same medication and it makes her sleepy. Which physiological mechanism(s) describes the differences in the children's responses to the medicine? Select all that apply. The liver's metabolism of drugs can differ by age. The medication is able to access the brain of the older child faster. Plasma proteins are higher in concentration in a young child because of the smaller blood volume. The body fluid of older children is a larger percentage of body weight resulting in drug dilution. The development of the nervous system is not complete, resulting in different reactions in children of different ages.

The liver's metabolism of drugs can differ by age. The metabolic enzyme systems in the liver are immature in young children, which can lead to differences in the metabolism of the medication. In a young child, all of the drug may not be metabolized resulting in a higher concentration of the drug in the blood. The development of the nervous system is not complete, resulting in different reactions in children of different ages. The immaturity of the infants' and toddlers' nervous system can lead to paradoxical effects in infants and toddlers compared to the same drug's effects in older children.

A young child explains to the nurse that her uncle often hits her on the bottom when she misbehaves. Which information is the most important for the nurse obtain from the child before action is taken? The age of the uncle How well the child knows the uncle The timing and frequency of physical contact The nature and circumstances of the physical contact

The nature and circumstances of the physical contact Preventing sexual abuse begins with teaching children the normal, healthy boundaries of their bodies and what constitutes inappropriate behavior. A spanking, while not encouraged, should be distinguished from sexual contact.

The nurse is administering medications to a group of pediatric patients. The nurse recognizes that which child is at the highest risk for experiencing an adverse medication reaction? The 6-month-old infant being treated with topical cortisone. The 2-month-old infant receiving a dose of oral acetaminophen. The premature newborn receiving a dose of intravenous amoxicillin. The 18-month-old child being injected with a newly developed vaccine.

The premature newborn receiving a dose of intravenous amoxicillin. Smaller, younger babies do not metabolize drugs in the same manner as older infants, children, or adults due to differences in physiology. These differences are most striking in the premature newborn.

The nurse notes that QP/QS ratio (pulmonary-to-systemic ratio) is normal, however the right side of the heart has increased saturation. What conclusion can be drawn from this data? There is a right-to-left shunt. There is a left-to-right shunt. There is increased blood flow out of the right ventricle. There is decreased pulmonary blood flow leading to pulmonary hypotension.

There is a right-to-left shunt. When pulmonary-to-systemic ratio is norma, equal amounts of blood are being pumped by both sides of the heart. A right-to- left shunt would decrease oxygen saturation on the left side of the heart.

Which behaviors are expected in the toddler? Select all that apply. Throwing tantrums Crying when the toddler's parent leaves for work Developing a sense that bad behavior is punished Insisting on same book being read every morning Feeling guilty when they steal a toy from another child

Throwing tantrums Negativism, or saying "no" to requests, is an expected behavior in toddlers and is a way that they can test their independence and boundaries. In extreme cases, it can lead to screaming, kicking, hitting, biting, or breath-holding. Crying when the toddler's parent leaves for work Crying when a parent leaves, or separation anxiety, is an expected behavior in the toddler. Developing a sense that bad behavior is punished Controlling behavior to avoid punishment is an expected behavior in the toddler. Insisting on same book being read every morning Reading the same book, or ritualism, is an expected behavior in the toddler.

In patients with coarctation of the aorta, infusion of prostaglandin E1 may be used to keep the ductus arteriosus open. What is the rationale for facilitating patent ductus arteriosus (PDA) when the patient has coarctation of the aorta? To increase oxygenation of blood entering descending aorta To increase pressures in left ventricle and force perfusion of aorta To decrease blood flow distal to lesion and increase blood flow to pulmonary circulation. PDA maintains flow from aorta to lungs To increase blood flow to descending aorta by allowing deoxygenated blood from pulmonary trunk to mix with blood distal to lesion

To increase blood flow to descending aorta by allowing deoxygenated blood from pulmonary trunk to mix with blood distal to lesion Coarctation of the aorta is an obstructive lesion that decreases blood supply to abdominal organs and lower periphery. Maintaining PDA will increase blood flow in the descending aorta.

What is the rationale for administering potent vasoconstriction agents to a child experiencing a hypercyanotic episode? Select all that apply. To decrease the afterload To increase stroke volume To increase systemic vascular resistance To decrease the degree of right-to-left shunting To increase blood flow into the pulmonary circulation

To increase systemic vascular resistance Vasoconstriction will increase systemic vascular resistance and help maintain BP. This increase in pressure will help limit shunting of blood, thereby helping to improve movement of blood out of right ventricle into pulmonary artery and to lungs for oxygenation. To decrease the degree of right-to-left shunting Vasoconstriction can help to limit amount of blood that enters left ventricle through ventricular septal defects. This will help to limit amount of deoxygenated blood entering left ventricle and the aorta into systemic circulation. To increase blood flow into the pulmonary circulation Potent vasoconstrictors can help to limit amount of deoxygenated blood that enters aorta and help to increase amount of blood entering pulmonary artery and lungs for proper oxygenation.

The parents of a four-year-old patient are concerned about their child's stuttering. The nurse should advise the parents to take which actions to address this problem? Talk for the child Encourage the child not to speak Correct the stutter whenever it occurs Try to focus on the child's ideas, not the stutter

Try to focus on the child's ideas, not the stutter The nurse should advise the parents to try to focus on the child's ideas, not the stutter. This helps to minimize the stress.

An infant is prescribed nasal drops by the primary health care provider. Which actions should the nurse take to ensure proper delivery of the medication? Select all that apply. Hold the infant in a semi-upright position. Use a calm voice to help the infant relax. Obtain assistance in restraining the child. Remove any excess mucus with a bulb syringe. Hold the infant's nose after administration to ensure adequate delivery.

Use a calm voice to help the infant relax. Using a calm voice helps the baby know how to react to a disturbing event and can increase the likelihood that the infant remains still during administration. Obtain assistance in restraining the child. The restraining of a child is not always necessary, but may be necessary if efforts getting the child to cooperate fail. Remove any excess mucus with a bulb syringe. The removal of excess mucus from the nares is essential for preparing an infant to receive nasal medication because it will allow the medication access to the mucus membranes.

When caring for a child with a right-to-left shunt, what precaution is essential when obtaining IV access? Carefully inspect tubing to ensure adequate pressure in the vein. Use meticulous attention to avoid introducing air bubbles in tubing of IV line. Use careful attention to the access site; placement in the forearm will limit accidental removal. Ensure that the patient will be able to walk to limit deep vein thrombosis. Placement of the IV into a vein of the upper extremity is preferred.

Use meticulous attention to avoid introducing air bubbles in tubing of IV line. There is an increased risk of air embol in patients with right-to-left shunts, which can cause stroke or heart attack.

A nurse is ordered to administer oral pain medication to a 5-year-old patient who is newly admitted after a vehicle accident. Which action is least likely to help the nurse prevent medication errors? Use the medication calculations provided by the pharmacy. Describe in detail the medication procedure to the child's caregivers. Ask the patient's caregivers which medications the child typically takes at home. Administer high-risk medications after verifying the prescribed dose with another nurse.

Use the medication calculations provided by the pharmacy. The nurse should always perform an independent double-check of the medication calculations to ensure accuracy and should not rely on calculations provided by the pharmacy. The nurse should discuss any discrepancies with the healthcare provider or pharmacist.

The nurse is preparing to administer prescribed oral medication to a 3-month-old patient. How should the nurse administer this medication? Place the infant on his or her back prior to administering medication. Hold the infant with the dominant hand to ensure the child does not move. Using a nipple, wait for the infant to begin sucking before adding the medication. Using a teaspoon, place the medication into the mouth along the side of the cheek.

Using a nipple, wait for the infant to begin sucking before adding the medication. The infant should be encouraged to begin sucking the empty nipple and only afterward should the medication be added. By waiting until the infant is sucking the nurse can ensure that the infant is able to feed.