Prep you Pediatric test 3

The mother of a 10-year-old boy phones the school nurse. The child has attention deficit/hyperactivity disorder (ADHD) and must go to the office to take medication at lunchtime. The child informed the mother that kids have been making fun that he no longer wants to take the medication. Which is the nurse's best response?

"You can speak with your doctor about extended-release medications for treatment of ADHD."

The nurse is explaining the procedure of bone marrow aspiration to a 6-year-old child with leukemia. What explanation would be best to give to the child?

"You may feel pressure on your hip during the procedure."

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?

A classroom with a plan of study that is followed each day

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

Apply heat to the site of bleeding.

The nurse is providing preoperative care for a 7-year-old boy with a brain tumor and his parents. Which intervention is priority?

Assessing the child's level of consciousness

A parent brings a preschooler to the behavioral clinic for evaluation. Upon entering the room the child appears not to notice the nurse's presence. The child screams upon the nurse's touch. What condition should the nurse suspect?

Autism

What is one advantage of an implanted port (central venous access device) that the nurse will explain to an adolescent?

Body appearance changes very little.

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

Handle the child gently when transferring to a stretcher.

Which diagnosis would be most appropriate for an infant with a large retinoblastoma after surgery?

Disturbed sensory perception related to enucleation

The nurse is talking with the parents of a child who has been identified as having a learning disability. The parents state that there child performs well on oral examinations but struggles otherwise on exams. The nurse is aware that the parents are describing which disorder?

Dyslexia

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Encourage rest and relaxation.

A 12-year-old child is admitted to the hospital with a diagnosis of sickle cell crisis. The nurse has completed an assessment and is creating a plan of care. What aspect of the plan of care is most important to the client's outcome?

Increasing the daily fluid intake

A 9-year-old boy was in a car accident. The child is suffering from posttraumatic stress disorder. Which would be the best approach for treatment?

Individual psychotherapy sessions

Which nursing diagnosis would be most appropriate for a child with idiopathic thrombocytopenic purpura?

Ineffective tissue perfusion related to poor platelet formation

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

Infection

Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe?

Insensitivity to pain

The health care provider has recently informed parents that their child has an intellectual disability. The parents express the need for information and help with the important decisions they need to make concerning care of their child. What is an appropriate nursing diagnosis for this situation?

Parental knowledge deficit related to health care needs for a child with an intellectual disability

A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl played then with. In this case what is the portal of exit in the chain of infection?

Upper respiratory excretion

A 5-year-old child has frequent visits to the school nurse's office. Which assessment data should alert the nurse that this child may be a victim of physical neglect?

malnourished with frequent absences from school

A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child?

"Is there anything that you do over and over again and can't resist doing?"

A nurse is assessing a child with a tick-borne disease. What finding would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted fever?

Absence of rash

When reviewing information about the incidence of the various types of childhood cancer, nursing students demonstrate understanding of the information when they identify which type as having the highest incidence?

Acute lymphocytic (lymphoblastic) leukemia

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is:

Acyclovir

The nurse is assessing a child who presents with a history of fever malaise fatigue and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take?

Notify the primary health care provider

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?

Obtain blood cultures

The nurse is completing the health history of a 6-month-old infant with retinoblastoma with the child's parents. Which symptom should the nurse expect that the parents have observed?

One pupil appears white.

A child is receiving chemotherapy and develops stomatitis. The nurse identifies a nursing diagnosis of impaired oral mucous membranes related to the effects of chemotherapy. What instructions would the nurse include in the child's plan of care? Select all that apply.

Provide various soft and bland foods to minimize further irritation., Have the child rinse the mouth with lukewarm water three times a day. Apply a lip balm or petroleum jelly to prevent cracking.

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?

Red, strawberry tongue

With all the warnings on cigarette packages and media coverage of the side effects of tobacco use why do school-age children and adolescents continue to smoke or chew tobacco?

School-age and adolescent children view the threats to their health as far in the future and the child feels that he or she can stop at any time.

The nurse is assessing an adolescent with suspected osteosarcoma. What would the nurse be least likely to assess?

Severe bone pain

The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis?

Slightly yellow sclera

A nurse is assessing a little boy who has been diagnosed with Tourette syndrome. Which finding would the nurse expect to see?

Speaks sudden, fast phrases out of context

The nurse is assessing a 4-year-old girl whose mother reports that she is not eating well, is losing weight, and has started vomiting after eating. Which risk factor from the health history suggests the child may have a Wilms tumor?

The child has Beckwith-Wiedemann syndrome.

A child has been prescribed methylphenidate to take daily. Which nursing instructions are important to provide to the family?

Stress the need for adequate nutrition.

The nurse is administering a chicken pox vaccination to a 12-month-old girl. Which concern is unique to varicella?

This disease can reactivate years later and cause shingles.

The nurse is assessing a 6-year-old with attention deficit/hyperactivity disorder (ADHD). The nurse observes the boy making repeated clicking noises and notes he has a slight grimace. The nurse recommends the boy receive further evaluation for:

Tourette syndrome.

A nurse is in the family clinic with a 7-year-old child. The parent states that the child has been having frequent eye blinking and facial grimacing. The parent also adds that the child has started to repeat words and says an occasional "bad word." Which disorder does the nurse suspect

Tourette's syndrome

A nurse is providing care for a child with disseminated intravascular coagulation (DIC). What would alert the nurse to possible neurologic compromise?

Widely fluctuating blood pressure

The nurse is discussing teenage substance use with a group of caregivers of adolescent children. Which statement made by the caregivers is most accurate regarding substance use disorders in teens?

"The most common drug used by teenagers is alcohol."

A nurse is reviewing the medical records of several children who have undergone lead screening. The nurse would identify the child with which lead level as requiring no further action?

8 mcg/dL

The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority?

Calling the doctor if the child gets a sore throat

The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate?

Document the bruises and any statements made by the child relating to them.

A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor?

Headache, vision changes, and vomiting

A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy?

Keeping the child's lips moist with petroleum jelly to prohibit cracking

The nurse is examining a child with fetal alcohol syndrome (FAS). Which assessment finding should the nurse expect?

Low nasal bridge with short upturned nose

A 15-year-old boy has been diagnosed with an osteogenic sarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area?

Lungs

A school nurse is giving a presentation to teenagers about preventing sexual assault. Which statement will be helpful?

"Avoid or limit alcohol or drug intake." "Make sure your date understands 'no means no'." "Do not let anyone in your house when alone." "Have keys in your hand walking to your car." "Do not tell others when your parents are away."

The nurse is meeting with a family that has learned that their 11-year-old child has some cognitive impairments. They tell the nurse that the child is having trouble coping with different situations at school. What is the best response by the nurse?

"Coping and adaptation are often affected by cognitive impairments."

A nurse in a residential foster home is caring for a 17-year-old client with oppositional defiant disorder. The client is using profanity and refusing to complete assigned chores. The nurse reminds the client that there are only 5 minutes in which to finish the chores. The client throws a dirty plate at the wall. How should the nurse respond?

"I am sorry you are feeling so angry tonight but you must still complete your chores."

The nurse is interviewing a 13-year-old girl with depression. During the course of the interview the girl reveals that her best friend is thinking about committing suicide. Which response by the nurse would be most appropriate?

, "Do you know how she is planning to kill herself?"

A nurse is providing care to a child who is to receive a blood transfusion. The health care provider has prescribed the infusion to run at a rate of 5 mL/kg/hour. The child weighs 55 lb The nu(25 kg). At what rate should the nurse set the infusion pump?

125

A nurse is working at a facility that provides care to children with developmental disabilities. Which role would be the nurse's most important?

Advocate

The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure?

Antiemetic

The nurse is caring for a child whose family recently immigrated from a developing country. While completing the admission history the parents report all the child's immunizations are up to date. Which nursing action is most appropriate?

Ask parents which immunizations have been given.

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:

Bacteria

Parents of a school-age child have begun a program of therapy that includes giving the child a token each time the child follows directions. Which theoretical framework provides the background for such a program?

Behavioral theory

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer?

Bladder

The nurse is planning care for a school-aged child recovering from being hit by a motor vehicle while riding a bicycle. For what will the nurse assess to determine the onset of disseminated intravascular coagulation in this child?

Bleeding from intravenous sites

The nurse is admitting to an examination room a child with the diagnosis of "probable acute lymphoblastic leukemia." What will confirm this diagnosis?

Bone marrow aspiration

The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects?

Brush his or her teeth

The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which complications that signal refeeding syndrome?

Cardiac arrhythmias, confusion, seizures

A 17-year-old child has been admitted with complications of anorexia nervosa. What diagnostic tests can be anticipated in the plan of care/treatment? Select all that apply.

Complete blood cell count. Metabolic panel

A 16-year-old client is highly disruptive in class and has been in trouble at home. The parent recently found the adolescent torturing a cat. When questioned the adolescent laughed. What condition might the client be suffering from?

Conduct disorder

An 11-year-old client has come to the school nurse more than 15 times for somatic complaints during the first quarter of school and has subsequently left school after each visit. What should the school nurse do?

Contact the child's parents to discuss the situation.

An adolescent has been diagnosed with bulimia and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent?

Develop a contract with the adolescent, setting goals of behavior and her diet as well as privileges gained by meeting the contracted goals.

A nurse caring for an 8-year-old with a bleeding disorder documents the following nursing diagnosis: ineffective tissue perfusion related to intravascular thrombosis and hemorrhage. This diagnosis is most appropriate for a client with:

Disseminated intravascular coagulation

An infant diagnosed with nonorganic failure to thrive (NFTT) is being treated in the hospital. Which intervention would the nurse implement for this child to provide increased nutritional intake?

Document all feedings and the infant's response to the feeding.

The nurse is caring for a 13-year-old girl with a nursing diagnosis of Ineffective coping related to inability to deal with life stressors as evidenced by few or no meaningful friendships and low self-esteem. Which intervention would be the priority to promote coping skills?

Encourage her to discuss her thoughts and feelings.

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor?

Factor VIII

Which observation would demonstrate that the adolesecent client suffers from attention deficit hyperactivity disorder (ADHD)?

Forgets to turn in homework does not follow directions cannot stay in the assigned seat in class and is always talking excessively and inappropriately

The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs?

Gloves Gown N95 respirator

A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply.

Hypersensitivity to touch Lack of facial expression

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare?

Iliac crest

Which site is most frequently used to perform a bone marrow aspiration?

Iliac crest

A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia and is experiencing a pain crisis. Using the FACES scale, the nurse assesses the child's pain to be a 10 on a scale of 1 to 10. The child is receiving intravenous fluids and oxygen at 2 L/min via nasal cannula. The parent is at the bedside holding the child's hand and has a concerned look. What is the nurse's priority in caring for the child?

Implement strategies to address the child's pain.

A child with acute lymphoblastic leukemia (ALL) is beginning treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing?

Induction stage

The child with thalassemia may be given which classification of medication to prevent one of the complications frequently seen with the treatment of this disorder?

Iron-chelating drugs

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child?

Menstrual problems

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority?

Monitor the site dressing and vital signs.

When teaching parents of a child with encopresis what would the nurse stress?,

Not punishing the child for encopresis

A child is diagnosed with scarlet fever. History reveals that the child has no known drug allergies. When preparing the child's plan of carethe nurse would anticipate administering which agent as the drug of choice?,

Penicillin V

A mother is telling the school nurse about her concerns regarding her 13-year-old daughter who reports headaches. The child's grades have dropped and the child is sleeping late and going to bed early every night. Which would the nurse identify as the priority?,

Scheduling an immediate history and physical examination

The nurse is caring for a 17-year-old girl in the terminal phase of osteosarcoma. Which action demonstrates integration of the recommendations of the American Academy of Pediatrics (AAP) Committee on Bioethics?

Telling the child exactly what to expect of further treatments

The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately?

Temperature of 101° F (38.3° C) or greater

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?

The adolescent telling the nurse purging occurs after each meal.

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first?

a child with erythema infectiosum experiencing fatigue and confusion

A school nurse is developing a plan of care for a child with suspected violence between the child's parents. The nurse monitors for which behaviors in the child?

aggressive behavior in school

During adolescence

alcohol is connected to what problem frequently seen in this age group?,automobile accidents

Which child will the nurse identify as at greatest risk for developing a urinary tract

an 8-month-old bottle-fed female with HIV

A mother is suspicious that her adolescent has bulimia because the child seems to be dependent upon laxatives and vomits frequently after eating a meal. What physical finding would be most suggestive of this diagnosis?

dental erosions and caries

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

urine output of 10 ml over 3 hours

A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement?

"A definitive cause can be found for every developmental disorder."

The parent of a child with Down syndrome calls the nurse and reports 3 weeks of a lack of energy, limping, and weight loss in the young child. What is the most appropriate response by the nurse?

"Bring your child to the primary health care provider to be examined."

The nurse is interviewing a depressed 13-year-old adolescent. During the course of the interview the adolescent reveals that the best friend is thinking about committing suicide. How should the nurse respond?,

"Do you know how your friend is planning to commit suicide?"

Parents of a 36-month-old child confide in the clinic nurse that their child does not speak and spends hours staring at their ceiling fan. They are worried that their child may have autism spectrum disorder. Which question would be important for the nurse to ask the parents?

"Does your child come and hug you or seek comfort from you?"

A nurse is discussing concerns about possible child abuse with the nursing supervisor. Which statement by the nurse requires correction by the supervisor?

"HIPAA prevents nurses from disclosing confidential information from parents."

A 6-year-old child is brought to the clinic by his parents. The parents state

"He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?, Scarlet fever

The parents of an adolescent are concerned about his mental health and have brought the adolescent into the physician's office for an evaluation. Which statements by the parents indicate that the child may have a mental health disorder? Select all that apply.

"He has started sleeping for only 3 hours each night." "He has lost 10 pounds over the last 4 months." "He used to be a straight-A student and now he's bringing home Cs and Ds."

The father of a child with mononucleosis is concerned with his child's fever and cough. The father asks when antibiotic therapy will begin. What is the best response by the nurse?

"Mononucleosis is a viral infection so an antibiotic isn't used. We address the symptoms with appropriate therapy."

The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder?

"My child does not say more than one or two words and grunts to indicate needs."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate?

"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

An adolescent is recovering from surgery, radiation, and chemotherapy following a diagnosis of Ewing sarcoma. Which statement by the family indicates that reteaching is needed?

"Our child is looking forward to playing football again."

The nurse is caring for a child with aplastic anemia. The nurse is reviewing the child's blood work and notes the granulocyte count is about 500, platelet count is over 20,000, and the reticulocyte count is over 1%. The parents ask if these values have any significance. Which response by the nurse is appropriate?

"These values will help us monitor the disease."

The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate?

"Vaccinations are very effective at preventing serious disease and infection."

An adolescent tells the school nurse when questioned about a recent respiratory tract infection that the adolescent "vapes" sometimes with friends. The adolescent tells the nurse that there is nothing wrong with vaping since there is no tobacco involved. What would be the nurse's response?

"Vaping can be as addictive as cigarette smoking with the gradual nicotine dependence of e-cigarettes."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

"We need to make sure that he washes his hands frequently."

A parent brings a child to the pediatric clinic stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptom does the nurse anticipate finding with this child?

, inattention, impulsive, and hyperactivity

When can autistic behaviors first be noticed?

1 year of age

The nurse is reviewing the results of a clotting study for a healthy 6-year-old. What would the nurse document as a normal prothrombin finding

11.0 to 13.0 seconds

Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications?

Administer the antiemetic before starting chemotherapy

The nurse is caring for a 6-year-old boy with an abdominal neuroblastoma prior to having a magnetic resonance imaging (MRI) scan without contrast done. Which intervention would the nurse expect to perform?

Administering a sedative as ordered to keep the child still

The nurse is working with a child who is in sickle cell crisis. Treatment and nursing care for this child include which actions? Select all that apply.

Administering oxygen, Administering analgesics,Maintaining fluid intake

An 8-month-old girl appears pale, irritable, and anorexic. On blood testing, the red blood cells are hypochromic and microcytic. The hemoglobin level is less than 5 g/100 mL, and the serum iron level is high. Which symptom should the nurse most expect as a result of excessive iron deposits?

An enlarged spleen Explanation:The child with thalassemia major may have both an enlarged spleen and liver due to excessive iron deposits and fibrotic scarring in the liver and the spleen's increased attempts to destroy defective RBCs.

A family includes a 9-year-old child. The nurse suspects that the family has Munchausen syndrome by proxy. Which nursing intervention is best when assessing the child and family in the pediatrician's office?

Ask to speak to the child separate from the family

How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old?

Call it a tumor of muscle tissue

The father of an 8-year-old boy who is receiving radiation therapy is upset that his son has to go through 6 weeks of treatments. He doesn't understand why it takes so long. In explaining the need for radiation over such a long time, what should the nurse mention?

Cells are only susceptible to treatment by radiation during certain phases of the cell cycle Explanation:Radiation is not effective on cells that have a low oxygen content (a proportion of cells in every tumor), nor is it effective at the time of cell division (mitosis). Therefore, radiation schedules are designed so that therapy occurs over a period of 1 to 6 weeks and includes time intervals when cells will be in a susceptible stage.

The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system?

Child reports of facial palsy and vision problems

The pediatric nurse knows that there are a number of anatomic and physiologic differences between children and adults. Which statement about the immune systems of infants and young children is true?

Children have an immature immune response.

A young school-age child who is being treated for cancer has constipation and loss of appetite. What nursing interventions should the nurse suggest to the family?

Choose all that apply. Add high-fiber snacks such as popcorn and apples to the diet. Increase gross motor activities such as family walks. Provide adequate private time in the bathroom.

The nurse is concerned that a school-aged child has iron-deficiency anemia. What did the nurse assess in this client?

Craving for ice cubes

The nurse is preparing a care plan for the child diagnosed with Tourette syndrome. Which nursing interventions should the nurse include? Select all that apply.

Educate the child and family that tics may worsen during times of stress.Encourage the parents to arrange for testing at school to take place in a different room than the classroom. Support the family in pursuing different therapy options.Suggest the family makes note if tics are less prominent during focused activity.

The nurse cares for adolescents with cancer. Which recommended psychosocial interventions will the nurse use to help the adolescents cope with their disease? Select all that apply.

Encourage adolescents to engage in their usual activities. Encourage the adolescents to make plans for the future. Control the amount of information given out about the adolescents' conditions.

A 10-year-old girl has been referred for evaluation due to difficulties integrating with her peers at her new school. The counselor believes she is at risk for situational low self-esteem due to problematic relationships with both family members and peers. What is the best approach?

Engage the girl in dialogue regarding feelings about self/personal appearance.

The nurse is preparing to administer acetaminophen to a 4-year-old girl to provide comfort to the child. Which precaution is specific to antipyretics?

Ensure proper dose and interval

A child receiving chemotherapy is experiencing significant reduction in red blood cells secondary to myelosuppression. Which agent would the nurse most likely expect to be ordered?

Epoetin alfa

The pediatric nurse examines the radiographs of a client that show that there are lesions on the bone. This finding is indicative of:

Ewing sarcoma.

A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client?

Expect menstrual bleeding to be heavy.

The nurse is preparing a plan to educate the parents of a 10-year-old boy with a learning disorder. What will be part of this plan?

Explain the child's strengths and weaknesses.

Parents have just been informed that their child has a malignancy. The mother breaks down in tears, while the father appears to be in shock. What is an appropriate nursing diagnosis for this family?

Fear related to diagnosis of cancer

The nurse prepares to collect a 24-hour urine specimen for catecholamines from the child admitted with which likely childhood cancer diagnosis?

Neuroblastoma

Which sign is consistent with autism spectrum disorder (ASD) in a 2-year-old boy?

Performs repetitive activity with toys

The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for:

seizures.

A 16-year-old is seen in the emergency department with symptoms including a high fever chills headache nausea and vomiting and painful joints. During the nursing history the teenager reports recently returning from a trip to a rain forest in South America. What infectious disease does the nurse suspect the client has contracted?

Malaria

A young client in the clinic has a rash cough, and fever that the parent says spiked on day 5 of the rash. The client also had conjunctivitis. What illness would the nurse expect the health care provider to diagnose?,

Measles

The nurse is caring for a 7-year-old girl with conduct disorder. The child is very aggressive and at risk for self-harm. To promote the child's adaptive and social skills the nurse refers the family to a therapist who specializes in which type of therapy?

Milieu therapy

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child the nurse would be alert to which muscle groups being affected next?

Neck

The nurse is conducting a community educational program for parents of school-aged children. What would the nurse include in education plan in regards to the potential for drug and alcohol consumption in the school-age population?

Parental modeling of drug and alcohol avoidance is

The nurse is caring for a 10-year-old girl with an anxiety disorder. During a physical examination which physical finding would the nurse expect?

Patches of hair loss

The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is:

Penicillin

What would be the priority goal for the nurse caring for an infant diagnosed with nonorganic failure to thrive?

Provide adequate nutrition for growth.

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used?

Puncturing a vein on the dorsal side of the hand

A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease?

Reed Sternberg cells

A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding:

Removal or covering of flaking paint on the walls of the home

A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child?

Risk for imbalanced nutrition, less than body requirements, related to inflammation

The nurse is conducting an examination of a boy with Tourette syndrome. Which finding should the nurse expect to observe?

Sudden, rapid stereotypical sounds

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate?

Take the child to a private room and interview her regarding her sexual history and partners.

What is an example of impaired adaptive functioning in an 8-year-old girl with a developmental disorder?

The child cannot properly dress herself.

The nurse is conducting an assessment of a 5-year-old client. During the assessment the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?,

The child constantly opens and closes the hands.

Which sign or symptom suggests that a 5-year-old child who does not maintain eye contact or speak may have autism spectrum disorder (ASD)?

The child constantly pats his or her legs The child constantly opens and closes his hands.

What finding would suggest that a 5-year-old boy might have a developmental disorder?

The child is not able to follow directions.

A 15-year-old student has been referred by the homeroom teacher to the school nurse for evaluation. The teacher is concerned that the student may be suffering from major depression. Who should be the primary source of information to investigate the concerns about the student?

The student

To feed lunch to a child with autism spectrum disorder (ASD)which action would be most important for the nurse to take?,

Use a repetitive series of movements.

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first?

a child with hemophilia reporting knee pain and edema

The nurse is telephone triaging multiple pediatric calls. Which telephone call will the nurse return first?

a parent whose infant was diagnosed with hand-foot-mouth disease and is now lethargic

A nurse in a residential foster home is caring for a 17-year-old girl with conduct disorder. The adolescent is using profanity and refusing to complete the assigned chores. The nurse reminds the adolescent that there are only five minutes in which to finish. The adolescent throws a dirty plate at the wall. Which response would be most appropriate? "You appear to be feeling very angry tonight

but you must still complete your chores."

A child is sent to pediatric intensive care following surgery for a brain tumor. Which prescription would the nurse question?

elevate head of bed 90 degrees

The football coach notices that one of the players has been more energetic and overly happy lately during practice. The player also got in fight with a teammate last week. The coach contacts the health care provider concerned that the student is using anabolic steroids. What physical sign would the nurse advise the coach to be on the lookout for that would further validate the illicit drug use?

gynecomastia

An adolescent is being seen in the local clinic for obesity problems. The nurse realizes that which factor would not play a role in this eating disorder?

having positive self-esteem

A parent suspects that their child has taken cocaine. What physical and psychological effects would the nurse tell the parents to monitor for in the child if this were true? Select all that apply.

increased heart rate and respirations euphoria increased body temperature

A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphocytic leukemia?

lethargy, bruises, and lymphadenopathy

Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:

leukemic cells.

The nurse is performing a physical assessment of 16-year-old girl who is intellectually disabled. This client attended her local public elementary school through fifth grade and has since been enrolled at a special education school where she has received social and vocational training. She plans on getting a job in the coming month and on living independently in a few years. The nurse recognizes this client's level of intellectual disability as:

mild.

Which approach to drug education would be most effective for a group of school-age children?

providing the children with strategies of how to refuse offers of drugs

A mother is telling the school nurse about her concerns regarding her 13-year-old daughter who is experiencing headaches. Her grades have dropped and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to:

schedule an immediate history and physical examination.

When providing care for a child with herpes zoster (shingles)the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?,

"Herpes zoster is a reactivation of a previous varicella zoster infection."

The father of a 14-year-old daughter reports she has been rebelling at home. The use of a contract for behaviors has been discussed. Which response from the father indicates the need for further discussion?

"I can relax rules at home if she has had a bad day."

A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement?

"I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already."

The nurse is providing teaching about medication management of attention deficit hyperactivity disorder (ADHD). Which response indicates a need for further teaching?

"If he takes this medicine he will no longer have ADHD."

A nurse is explaining the difference between anorexia nervosa and bulimia nervosa. The nurse knows the teaching was effective when the parents make which statement?

"Individuals with bulimia have a normal weight or are slightly overweight."

In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia?

"Milk is a perfect food, and babies should be able to have all the milk they want."

The nurse is discussing health concerns and issues with a group of caregivers of adolescents. Which statement made by a caregiver would indicate a need for follow-up by the nurse?

"Our daughter has never had any health problems and now she has developed so many cavities."

The nurse is caring for a child with attention deficit hyperactivity disorder who is experiencing insomnia related to the prescribed psychostimulant. The parents are considering stopping the medication and want to know if there are other options. Which response by the nurse would be most appropriate?

"Speak to the doctor about atomoxetine."

A 6-year-old boy is suspected of having late-stage Lyme disease. Which assessment should the nurse use to produce findings supporting this concern?

Asking the child if his knees hurt

The nurse is caring for a child with leukemia. Which nursing intervention would be the highest priority for this child?

Following guidelines for protective isolation

What is the leading cause of neonatal sepsis and death?

Group B streptococcus

The nurse is admitting a 15-year-old female with severe weight loss from anorexia nervosa. She also has a fluid and electrolyte imbalance. The nurse is preparing the care plan. Which nursing diagnosis will be the highest priority?

Imbalanced nutrition, less than body requirements

The mother of an 8-year-old boy is concerned that her son has attention-deficit/hyperactivity disorder. She describes the symptoms he demonstrates. Which behavior should the nurse recognize as an example of impulsiveness?

Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission

The appearance of which hallmark clinical manifestation occurs in measles?

Koplik spots

What is a well-defined risk management technique that the nurse can teach children and parents to prevent cancer?

Limit sun exposure throughout childhood and adolescence

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply.

Lyme disease Rocky Mountain spotted fever

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning?

"I mix ferrous sulfate with milk in a bottle."

A nurse is providing teaching to the parents of a child diagnosed with sickle cell anemia. The discussion is focused on precipitating factors for sickle cell crisis. Which statement by the parents requires the nurse to reinforce the teaching?

"Our family is taking a fun hiking trip up in the mountains next week."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate?

"Preterm infants are at risk for iron-deficiency anemia."

A nurse is providing dietary interventions for a 5-year-old with an iron deficiency. Which response indicates a need for further teaching?

"Red meat is a good option; he loves the hamburgers from the drive-thru."

A nurse is caring for a 10-year-old intellectually challenged girl hospitalized for a scheduled cholecystectomy. The girl expresses fear related to her hospitalization and unfamiliar surroundings. How should the nurse respond?

"Tell me about a typical day at home."

While interviewing an adolescent client with depression the client reveals to the nurse that he has considered hurting himself. Which response by the nurse would be most appropriate?,

"Tell me exactly how you would hurt yourself."

The nurse is caring for a 2-year-old with sickle cell anemia and instructing the parents on the manifestions of the disease. Which statement by the mother indicates a need for further teaching?

"The acute manifestations, like splenic sequestration, are most often life-threatening."

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state"Could you please explain it to us?" What is the best response by the nurse?

"The infection your child has causes the release of toxins into the system which can lead to impaired function in the lungs liver and kidneys."

During a wellness health check a 10-year-old child reports not liking school because the child is getting picked on. The child's parents state wishing they knew what the child did to cause these children to bully the child. Which statement by the nurse is most therapeutic?,

"The most important thing for your child to understand is that he or she is not to blame for the bullying."

A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective?

"The sickle shape of red blood cells decreases oxygen to tissues."

The nurse is caring for a child in sickle cell crisis. To best promote hemodilution, the nurse would expect to administer how much fluid per day intravenously or orally?

150 mL/kg of fluids

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38 Celsius. The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 mL." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38 C? Record your answer using one decimal place.

7.5

The nurse is caring for a 2-year-old girl who is receiving chemotherapy using antitumor antibiotics. Which intervention would the nurse question?

Assessing the mouth for redness, lesions, or ulcers

A mother has presented with her 2 year old child. She states that the child was talking in earlier months but recently has "kind of withdrawn." The child does not interact with other children or adults much but does enjoy throwing a ball retrieving it and throwing it again. The nurse realizes that the child needs further assessment for which disorder?

Autism

The nurse identifies the nursing diagnosis of risk for infection related to chemotherapy-induced immunosuppression. What would the nurse include in the teaching plan for the child and parents about reducing the child's risk? Select all that apply.

Having the child sleep in a single bed and room. Encouraging frequent, thorough handwashing

A young parent brings the school-aged child to the office for a sports physical examination. During the appointment the parent informs the nurse about being worried because the child does not like school and does not seem to be reading, writing, or spelling as well as others in the class. The parent adds that the child struggles to get organized and to manage time. What condition does the nurse suspect?,

Learning disorder

The adolescent client has become bored with the video game system which had been the positive reward for cleaning one's room. Which intervention would be most effective intervention at this time?,

Let the adolescent choose another reward that would be more fun.

The nurse is evaluating the complete blood count of a 7-year-old child with a suspected hematological disorder. Which finding is associated with an elevated mean corpuscular volume (MCV)?

Macrocytic red blood cells (RBCs)

When the health care provider looks in a child's mouth during a sick-visit examination the parent exclaims: "The tongue is bright red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis?

Penicillin to prevent acute glomerulonephritis

A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important?

Placing a "no abdominal palpation" sign above the child's bed

A child is suspected of having bipolar disorder. What would the nurse identify if the child was experiencing a manic episode? Select all that apply.

Pressured speech Decreased sleep Flamboyant behavior

The nurse is caring for a client with terminal cancer who is experiencing dyspnea and increasing levels of pain. What would be the priority for pain management with this child?

Preventing and alleviating pain

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child?

Preventing spread of infection

What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)?

Protect the abdomen from manipulation.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder?

The child has had 8 ounces of formula in the past 24 hours.

The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?

The child will have a complete physical exam.

A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily?

The stools will appear black.

The nurse is caring for a child admitted to the hospital for an open fracture of the femur following a motor vehicle accident. The nurse notes the following lab values: white blood cells 10,000mm3, hemoglobin 7.9 g/dL (79 g/L), hematocrit 28%, platelets 151,000 mm3. Which nursing action is priority?

Transfuse 1 unit of packed red blood cells.

A chief danger of scarlet fever is that children may develop:

acute glomerulonephritis.

What potential side effect of smoking crack should the nurse teach adolescents about to ensure their understanding of the drug's possible impact?

cardiac arrest

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response?

"I will report this to the pediatrician."

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?

Administering the measles, mumps, rubella (MMR) vaccine

A 15-year-old Vietnamese-American boy has been referred by his homeroom teacher to the school nurse for evaluation. The teacher is concerned that the adolescent may be suffering from major depression. When investigating these concerns at the family's primary care office the nurse would use which person as the primary source of information?

The client

The nurse is collecting data from the caregiver of an 8-year-old child who recently started soiling his underwear each day rather than using the toilet to defecate. How would the nurse document this in the medical record?

The client has regressed to encopresis.

A 6-year-old client has been diagnosed with an autism spectrum disorder. Which symptoms would the nurse expect the client to display?

The client spends time alone and shows little interest in making friends.

A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client?

The dog was unprovoked when he bit the girl

A 14-year-old girl who is a vegetarian has recently developed anemia. Blood smear results show large, fragile, immature erythrocytes. She claims to take an iron supplement regularly and is surprised to learn that she is anemic, as she is otherwise healthy. The nurse recognizes that this is the likely cause of this type of anemia:

Vitamin B12 deficiency

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply.

Wearing protective clothing when playing in wooded areas. Inspecting the skin closely for ticks after the child plays in wooded areas. Contacting the health care provider if there is any area of inflammation that might be a bite.

The nurse is concerned that the child is developing septic shock. Which findings are consistent with this condition? Select all that apply.

White blood cell count is elevated. The child is pale and lethargic. The child's respiratory rate is elevated. The child's blood pressure is reduced.

An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate?

angry outbursts directed at authority figures

The nurse will select which meal as the best choice for a child with iron-deficiency anemia?

cheeseburger, broccoli, and fresh strawberries

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

d. Baseball Explanation:Children with hemophilia should stay active. Good physical activities would be swimming, baseball, basketball, and bicycling (with a helmet). He would still need to be careful about falls and sliding into base. Intense contact sports like football, wrestling, and soccer should be avoided

To prevent further sickle cell crisis, you would advise the parents of a child with sickle cell anemia to

d. notify a health care provider if the child develops an upper respiratory infection. Explanation:Reduction of oxygen and dehydration lead to increased sickling of cells. Early prevention of these with respiratory illness is important