PN108 PrepU Chapter 35

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A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority?

Protecting the child from harm during the seizure

A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis? Select all that apply.

Purulent drainage is a common symptom. It is highly contagious. Warm compresses are used to remove crusts that form on the eyes.

The nurse is assessing a child with a hordeolum. Which finding would the nurse be least likely to observe?

Reddened conjunctiva

A 5-year-old is diagnosed with acute otitis media. Which nursing intervention would be primary?

Relief of pain

The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed?

"We need to raise the volume of our voices significantly so he can hear us."

The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39° C (102.2° F). Which intervention would the nurse expect to implement?

Administering antibiotics as soon as they're available

The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component?

American Sign Language

A boy is seen in the emergency room with tearing and pain in his right eye. To assess for a foreign body under the upper lid, which method would you use?

Avert the upper lid over an applicator stick.

What finding is consistent with increased ICP in the child?

Bulging fontanel

The vision impairment seen in a child in which the child can see objects at close range but not at a distance is known as:

Myopia

The nurse is discussing with a parent the difference between a breath-holding spell and a seizure. The nurse would be correct in telling the parent what information in regard to seizures?

Convulsive activity occurs.

A 5-year-old girl is diagnosed with amblyopia. What treatment options are available for this child? Select all that apply.

Covering the good eye with a patch Use of correcting lenses (glasses) Lasik surgery to the eye with the refractive error Administration of levodopa

The nurse is performing a physical assessment of a 9-month-old child who has been rubbing his eyes. The nurse suspects that the child has glaucoma based on assessment of which of the following?Select all that apply.

Different pupil sizes Photophobia

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed?

Dramatic increase in head circumference

The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5ºC. Which action will be taken?

Instruct the parents to watch for worsening symptoms.

The prevention of cerebral palsy is the most important aspect of care. Which of the following are focus areas for the prevention of cerebral palsy? Select all that apply.

Prenatal care to improve nutrition Postnatal prevention of infection Perinatal monitoring to decrease birth trauma

Put the following events of a generalized epileptic seizure in correct order:

Prodromal period Tonic stage Clonic stage Postictal period

The nurse is preparing an ongoing assessment plan for a child with multiple sensory disorders. Which of the following will contribute most to the detection and intervention of problems?

The nurse is preparing an ongoing assessment plan for a child with multiple sensory disorders. Which of the following will contribute most to the detection and intervention of problems?

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful?

The shorter and wider eustachian tubes of an infant increase the risk.

The most effective approach to prepare a school-aged boy for a myringotomy procedure is to

explain the procedure to the child using puppets.

Any individual taking phenobarbital for a seizure disorder should be taught:

never to discontinue the drug abruptly.

When assisting a child while she is having a tonic-clonic seizure, it would be important to:

protect the child from hitting her arms against furniture.

You care for a 4-year-old with meningitis. A primary nursing goal would be to

reduce the pain related to nuchal rigidity.

The nurse is assessing a 4-year-old child whose mother reports that the child is more irritable lately. Which of the following questions would suggest suspected increased intracranial pressure (ICP)?

"Does she have headaches when she gets out of bed?"

The school nurse is educating the parents of a child with infectious conjunctivitis. Which comment provides the most value for prevention?

"Don't use anything that touches her face."

A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" What is your best response?

"The tubes remain in place for 6 to 12 months until they come out by themselves."

The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?

"Use this information to teach family and friends."

A 9-year-old boy who is blind is admitted to the hospital. When serving him a meal in bed, which statement would be most appropriate to increase his self-esteem?

"You have a sandwich on your plate, a glass of milk to your right, and an apple to your left."

The nurse is caring for a child with hearing loss due to damage from chronic inner ear infections. The nurse knows that the child most likely has which type of hearing loss?

Conductive

A 10-month-old is brought to the emergency department by her parents after they found her face down in the bathtub. The mother said, "I just left the bathroom to answer the phone. When I came back, I found her." Which assessment would be the priority?

Airway, breathing, and circulation

The nurse in the acute care setting is caring for a child with deafness. Which nursing intervention is appropriate for this child?

Allow the child to see the nurse prior to touching or completing any assessments or procedures.

A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition?

Amblyopia

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?

Assess the child's ability to convey information.

The eyes of a 9-year-old who suffered a head injury are crossed. Besides checking ICP, which intervention would be most important for the nurse to perform?

Assess the child's level of consciousness.

A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)?

Cloudy appearance

The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?

Encouraging the child to keep his hands away from his eyes

T/F: Hearing aids can improve hearing for children who have inner ear or nerve deafness.

False

T/F: The nurse caring for a patient with a cranial injury knows that broad spectrum antibiotics are used to reduce cerebral edema.

False

An 8-month-old boy is diagnosed as having cerebral palsy. Which finding would make you suspect that he has this?

He has a strong Moro reflex when startled.

The nurse knows that children have larger heads in relation to the body and a higher center of gravity. When developing a teaching plan for parents, the nurse includes information about an increased risk for which problem?

Head trauma

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?

Head trauma

The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding?

Indications of increased intracranial pressure

The nurse is caring for a 6-year-old child who has a history of febrile seizures and is admitted with a temperature of 102.2° F(39° C). What is the nurse's highest priority?

Institute safety precautions.

When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of what condition?

Intracranial hemorrhage

What is a true statement regarding status epilepticus?

It is a common neurological emergency in children.

The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss?

It is caused by chronic otitis media or another infection.

Absence seizures are marked by what clinical manifestation?

Loss of motor activity accompanied by a blank stare

The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents?

Monitor their child's level of sedation.

A nurse is assessing a child's vision. Which test should the nurse use to test for accommodation?

Moving a penlight toward the client's nose and observing whether his eyes can follow it

A nurse is caring for an 8-month-old diagnosed with cerebral palsy and is teaching the parents about the possible deficits that their child may experience. Which of the following would the nurse most likely address? Select all that apply.

Musculoskeletal disorders Language disorders Neurobehavioral disorders Respiratory infections

The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which clinical manifestation would likely have been noted in this child?

Shaking the head and pulling the ear

A nurse is examining a boy with cerebral palsy. He has hypertonic muscles and abnormal clonus in his legs and walks on his toes. Which of the following is the type of cerebral palsy that this boy is demonstrating?

Spastic

A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause?

Staphylococcus aureus

A 16-year-old boy reports to the school nurse of headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis?

Sunlight is "too bright"

When assessing a neonate for seizures, what would the nurse expect to find? Select all that apply.

Tachycardia Elevated blood pressure Jitteriness Ocular deviation

The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child?

Use his name before touching him.

The mother of a child having myringotomy tubes placed asks, "Will my son lose his hearing while the tubes are in place?" What is the nurse's best answer?

`"The tubes are inserted into a section of eardrum in which the hearing is not affected."

A nursing instructor is working with a student caring for a 18-month-old client. In order to ascertain that the tympanic membrane is optimally visualized, the faculty will assess that the student pulls the pinna of the ear

down and back

A 10-year-old boy develops bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. An important measure you would want to teach him is

to clean the discharge away from the inner to outer canthus.


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