PrepU peds exam 4

An infant was born with a genetic condition. The nurse is obtaining a neonatal health history from the parents. Which question(s) will the nurse ask the parents? Select all that apply.

"Did your infant require staying under the warmer or in an incubator to stay warm?" "Have you had problems feeding your infant?" "Has your infant ever experienced a seizure?" "Do you ever feel like your infant's muscle tone is not good?"

A female child with Down syndrome is preadolescent. The parent is asking the nurse how to best explain the bodily changes to the child. How will the nurse reply?

"Discuss the changes honestly and on her cognitive level."

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond?

"Has your child ever been tested for a peanut allergy?"

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

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

A family has been given the news that their expected child has a serious genetic condition. Which therapeutic communication technique(s) will be beneficial for the nurse to use when helping this family? Select all that apply.

"I know you have been given a large amount of information. I am interested in what you think." "I know this news has been hard. I am going to just sit with you and not talk while you begin to process your thoughts." "The health care provider suggested you seek genetic testing. Does this make you more upset?"

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent?

"Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily."

The nurse is reviewing the developmental milestones of an 18-month-old child with Down syndrome with the child's parents. Which statement by the parents requires further follow up by the nurse?

"Our child struggles to eat while using just the hands."

The nurse is caring for a child diagnosed with juvenile idiopathic arthritis. Which statement(s) by the parents demonstrates an understanding of how to care for their child with this disease? Select all that apply.

"We may note our child has a fever above 103°F (39.5°C) for a couple weeks and should monitor our child's temperature." "We need to administer medication to decrease inflammation and pain in our child." "We should encourage swimming as an activity for our child."

A parent calls the pediatric clinic and tells the nurse that the child has developed a large rash. Which question is most important for the nurse to ask the parent?

"What more can you tell me about the rash?"

A client is being admitted to the medical unit for exacerbation of symptoms of systemic lupus erythematosus (SLE). When assessing the client, the nurse notices a butterfly-shaped rash across the client's cheeks and bridge of the nose. Which action by the nurse is most appropriate?

Document the finding in the client's medical record.

Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000/mm3, and 10% eosinophils?

Obtain a careful health history.

The nurse is teaching a school-age child and the parents about an insulin pump. Which instruction is appropriate? Select all that apply.

The needle is inserted at a 45-degree angle. Carefully monitor the child's response to medication. Tape the small catheter in place before turning on the pump. Remove the pump but leave the catheter in while showering.

Which treatments are common to both systemic lupus erythematosus and juvenile idiopathic arthritis? Select all that apply.

corticosteroids nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone?

growth hormone

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

has polyarticular JIA.

The nurse is teaching the parents of a 13-year-old child with folliculitis about potential causes of the condition. What will the nurse include in the teaching? Select all that apply.

hygiene exposure to contaminated water shaving

The nurse prepares to assess the circulation status of a toddler in the emergency room following a near-drowning. What would the nurse specifically assess? Select all that apply.

level of consciousness apical and femoral pulse skin color and temperature

The nurse is educating an immunocompromised child about the organs that assist in the immune process. The nurse recognizes teaching was effective when the child identifies which organs? Select all that apply.

liver spleen thymus bone marrow

An 8-year-old child is brought to the emergency department after being lost in the woods for the past 10 hours. It has been snowing and the temperatures have been between 20°F and 25°F (-6.7°C to -3.9°C), with the windchill 0°F (-17.8°C). The nurse assesses the child and suspects fourth-degree frostbite of the hands and feet. Which finding(s) would support the nurse's suspicion? Select all that apply.

sloughing of skin on the soles of both feet and hands gangrene of the right index finger and left great toe

The nurse is caring for a child presenting with plaques around the nose and mouth that have a honey-crusted appearance. What treatment does the nurse anticipate for the child?

topical mupirocin for 10 to 14 days

The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply.

two or more episodes of severe sinusitis in 1 year failure to thrive in an infant two or more serious infections such as sepsis history of infections requiring IV antibiotics to clear

A 5-year-old child is exhibiting manifestations of hypotension. What is the first-line treatment for poor perfusion and hypotension?

volume replacement

A toddler is brought to the emergency department after ingesting a corrosive substance. Which intervention will the nurse implement as part of the treatment regimen?

Perform a respiratory assessment.

A child is brought to the emergency department after being submerged for an undetermined amount of time in the family pool. Resuscitative efforts have resulted in a normal heart rate, but the child remains intubated on respiratory support and has not regained consciousness. Which potential complication will have the greatest effect on the child's outcome?

atelectasis

An infant is diagnosed with phenylketonuria (PKU). After teaching the parent about diet for the infant, the nurse determines that teaching was successful when the parent states that the infant should avoid which food(s)? Select all that apply.

ice cream eggs nuts

The nurse is educating a female client about genetic disorders. Which statement by the client best describes the major risk factor for trisomy 21?

increasing maternal age

Cardiopulmonary resuscitation (CPR) is in progress on an 8-year-old boy who is in shock. Which nursing intervention is priority?

inserting an intraosseous needle via the femoral route

The nurse is assessing a 2-week-old boy who was born at home and has not had metabolic screening. Which sign or symptom indicates phenylketonuria?

musty or mousy odor to the urine

The nursing instructor is speaking with a group of nursing students about rapid cardiopulmonary assessment. Which statement by a student would indicate a need for further education?

"I will place the child on a cardiac monitor. I will use this to assess the child's heart rate."

The nurse is teaching the parents of a 4-year-old client with a peanut allergy about dietary restrictions. Which response by the parents indicates a need for further teaching?

"We cannot go wrong with barbeque and french fries."

The nurse is providing education on prenatal testing for a 39-year-old client with Fragile X syndrome who is at 16 weeks' gestation. Which statement by the nurse accurately describes the appropriate testing option for this client?

"Amniocentesis uses an ultrasound to guide a needle to draw fluid that is tested."

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed?

"Antibiotics are needed to help our child recover from rubella."

The nurse is educating the parent of a preschooler with trisomy 21 regarding oral health. What statement by the parent indicates the nurse's teaching was effective?

"I encourage him to brush his teeth and offer praises when he participates in brushing."

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse?

"I had our plumber lower our water heater temperature to 130°F (53°C).

The nurse is educating a parent of a toddler with Down syndrome. Which statement by the parent indicates teaching was effective?

"I hope my child does well with the various therapies we have arranged."

The nurse is educating the parent of a male child born with trisomy 21. Which statement by the parent indicates teaching has been effective?

"I plan to make time for my child's multiple therapy appointments."

The nurse is teaching the parents of a female child with Turner syndrome about the child's condition. The mother is currently pregnant, and the fetus was found to be male. The nurse is reviewing information related to how the condition occurs, its prevalence, and the implications for growth and development. While confirming their understanding of the presented information, which statement by the parents requires further follow up by the nurse?

"This condition affects males more than females."

The parents of a child with physical and developmental special needs state, "We wish our child could get some kind of educational experience." How should the nurse respond?

"This must be difficult for you. Let's talk with the social worker to see what programs are available for your child."

The nurse is providing education to the parents of a child with trisomy 21. The parents ask the nurse about the purpose of early intervention therapy. Which response by the nurse best explains early intervention therapy?

"To help you meet your child's specific needs and to encourage development."

A nurse is providing care to a 10-year-old child hospitalized after a near-drowning incident. The child is awake and alert, and vital signs are within normal parameters. The child has a mild, productive cough and has been placed on supplemental oxygen via nasal cannula. The child's parent asks the nurse "Why does my child need to be hospitalized? My child seems ok." Which is the nurse's best response?

"Your child's heart and lungs should be monitored for changes for 6 to 8 hours."

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

"Humoral immunity is generally functional at birth."

The nurse is performing the intake assessment on a child about to undergo allergy skin testing. Which statements by the parent would demonstrate to the nurse that the parent understands the procedure? Select all that apply.

"I am a little nervous because I know my child could have a severe reaction during testing." "We will be here in the exam room for quite a while I'm guessing." "If my child is allergic to any of the substances there will be a raised red area at the reaction site."

A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the best way for the nurse respond?

Explain that children who have had a serious injury sometimes exhibit regressive behavior.

The nurse is caring for an adolescent client with a genetic disorder with the following assessment data: large head, long face, prominent ears, flat feet, flexible joints, and a short attention span. Which facts are true for the suspected genetic disorder? Select all that apply.

Focus of care is on developmental therapies. It has an X-linked dominant inheritance pattern.

The nurse is assessing a 12-year-old male adolescent in the pediatric unit. The adolescent's parent reports a new onset of behavioral problems. For which genetic disorder would the nurse further asses the client?

Fragile X syndrome

After hospital discharge, the parent of a child newly diagnosed with type 1 diabetes mellitus telephones the nurse because the child is acting confused and very sleepy. Which emergency measure would the nurse suggest the parent carry out before bringing the child to see the health care provider?

Give the child a glass of orange juice.

A newborn was screened for a possible hereditary metabolic disorder at 8 hours old. Which action by the nurse is most appropriate?

Instruct the parent to have another screening in 1 to 2 weeks.

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess?

It is difficult to keep the child awake.

A toddler is brought to the emergency department after sustaining a life-threatening injury. During an assessment, the nurse utilizes the Glasgow Coma Scale. The toddler's score is 7. Based on this score, what inference can the nurse make about the child?

It will be necessary to intubate the child.

When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation?

Koplik spots

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?

Regular insulin

What information should be included in the teaching plan for a child with varicella?

Remind the child not to scratch the lesions.

The nurse is caring for a preschool-age child who has been seen in the emergency department for an allergic reaction to stinging insects twice in the past month. What teaching should the nurse provide the parents to help reduce the child's exposure to insects?

Remove flowering plants from the patio deck.

The nurse is assessing a child with a varicella infection. The nurse would be alert for which possible complication(s)? Select all that apply.

Secondary bacterial infection Pneumonia Scarring Encephalitis

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about?

The child is allergic to shellfish

A child will receive IV immunoglobulin (IVIG). The nurse assesses the child every 15 minutes for the first hour of infusion for symptoms of anaphylaxis. Which symptom(s) would indicate to the nurse that anaphylaxis is occurring? Select all that apply.

The child's face is flushed. The child's temperature begins to elevate. The child appears increasingly anxious. Inspiratory wheezes are heard on auscultation.

A nurse is evaluating the plan of care for a 30-month-old child with Down syndrome. Which outcome requires follow up by the nurse?

The parent has rescheduled three clinic visits.

A child is hospitalized in intensive care for a life-threatening heart condition. The child's treatment regimen includes epinephrine. What will the nurse consider when administering this medication?

The risk for extravasation requires access via a central line.

The nurse is administering a chickenpox 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 caring for a pediatric client diagnosed with Turner syndrome. Which assessment finding(s) will the nurse expect? Select all that apply.

Webbed neck Swollen hands Narrow fingernails Short stature

Which treatment is the antidote for acetaminophen toxicity?

acetylcysteine

The nurse is providing teaching for the parents of a child with a latex allergy. The nurse tells the client to avoid which food?

bananas

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

checking vital signs

A child with growth hormone deficiency is prescribed growth hormone (GH) by subcutaneous injection. When teaching the child's parents about this drug, the nurse would instruct the parents to administer the drug at which frequency?

daily, 6 to 7 days a week

The nurse is assisting a couple wishing to conceive who just received the results from genetic testing. Which intervention takes priority?

psychosocial support

A 2-year-old child has been diagnosed with fragile X syndrome. In creating a nursing plan of care, which client goal will the nurse prioritize?

receives developmental support

A female adolescent comes to the clinic with symptoms of delayed puberty. The nurse discusses sexual development with the adolescent, the beginning of menstruation, and how to take the low-dose estrogen product. What additional topic is most important for the nurse to discuss with the adolescent?

risk for infertility

The most common complication of varicella is:

secondary bacterial infections.

A nurse working as a member of a genetic counseling team carefully assesses which body areas in a newborn to gain important indications for structural genetic disorders?

space between the eyes, the shape of the ears, and the numbers of fingers and toes

Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?

swimming

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

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

A child's parent calls the clinic nurse and states, "My child just drank an unknown amount of a cleaning solution. What should I do?" Which statement by the nurse is best?

"You need to hang up with me and call the poison control center now."

A nurse is reinforcing the diagnosis of constitutional delay by the health provider to a 13-year-old male adolescent. Which is the best approach for this teen?

"You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you."

A child and parents are being seen in the office after discharge from the hospital. The child was newly diagnosed with type 2 diabetes. When talking with the child and parents, which statement by the nurse would be most appropriate?

"Young people can usually be managed with an oral agent, meal planning, and exercise."

The nurse is collecting a brief health history from the parents of a 3-year-old child brought to the emergency department experiencing a cardiac emergency. What questions are appropriate for inclusion? Select all that apply.

"Has your child had any recent illnesses?" "What foods or drugs is your child allergic to?" "Tell me about any coughing or wheezing you may have noticed when your child has been playing lately."

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."

A 10-year-old child has been diagnosed with precocious puberty. When talking with the child, what statements are appropriate? Select all that apply.

"How are you doing in school?" "Developing is normal but your development is happening early." "Would talking with someone about your feelings help?" "Tell me about your feelings about what is happening to your body."

A 9-year-old has suffered a severe anaphylactic reaction and dies. The nurse is providing support for the grieving parents. Which comment would best help them cope?

"How can I help you get through this?"

The nurse is providing a class for a group of child care providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction?

"If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it.

The mother of a 5-year-old child with allergies to a variety of foods including eggs, milk, peanuts, and shellfish asks if her child will "always have these problems." What response by the nurse is most accurate?

"In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear."

The nurse is caring for a pregnant client who received prenatal testing. The results showed phenylketonuria (PKU). The client is concerned and asks the nurse about PKU. Which statement made by the nurse is most accurate?

"It can lead to brain damage without treatment."

The parent of a child diagnosed with nonbullous impetigo brings the child back to the clinic. The parent states, "I am doing what I am supposed to for my child, but the lesions have not gone away yet." The child began treatment with a topical antibiotic ointment 7 days ago. Which response by the nurse is most appropriate?

"It takes 10 to 14 days for the lesions to decrease."

The nurse is evaluating the plan of care for an infant with trisomy 13. Which outcome(s) indicate that the plan of care has been effective for the infant's condition? Select all that apply.

-The caregivers receive genetic counseling. -The infant receives comfort care. -Symptomatic care is provided as needed.

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.

The nurse is preparing to administer intravenous immune globulin (IVIG) to a pediatric client. The nurse reviews the primary health care provider's prescription which states: Give 400 mg/kg IVIG subcutaneously. Which action will the nurse take next?

Contact the primary health care provider.

A child is undergoing diagnostic testing for an endocrine dysfunction. The results indicate excessive levels of circulating cortisol. The nurse interprets this finding as indicating which of the following?

Cushing syndrome

An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?

acetylcysteine

A child is hospitalized with a diagnosis of anaphylactic shock secondary to an allergic reaction to an insect bite. In providing care to the child, what should the nurse prioritize?

administration of intravenous fluids

When discussing care of an infant with congenital hypothyroidism, you would stress that the infant will need:

administration of levothyroxine for a lifetime.

A nurse is providing care to a child hospitalized with sepsis. The nurse suspects the child's condition has progressed to septic shock, and the child is showing signs of decompensation. Which assessment finding supports the nurse's suspicion?

altered neurologic status

A client presents to the clinic for allergy testing. The nurse is reviewing current medications taken within the past 5 to 7 days. Which classification of medication, if taken by the client, will cause the nurse to reschedule the allergy testing appointment?

antihistamine

In the newborn nursery, the nurse assesses a newborn and sees the ears are low-set. What action will the nurse take first?

assess for additional anomalies

A nurse is preparing discharge instructions for the family of a child diagnosed with fragile X syndrome. Then nurse will include referral to which health professional in the discharge instructions?

behavioral therapist

A 10-year-old child is brought to the clinic by the parents for evaluation of swelling of the foot. The child tells the nurse, "I wore new soccer shoes and got a blister. The blister broke and is red." Further inspection reveals an edematous third toe on the right foot. The area is reddened and warm and tender to the touch. A diagnosis of cellulitis is made and medication is prescribed for the child. The nurse would most likely educate the child and parents about which medication?

cephalexin

A nurse is talking to parents whose children have immune disorders. What does the nurse identify as causing dysfunction of the immune system? Select all that apply.

congenital problems secondary complication from a viral invasion exposure to a toxic substance

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom?

constipation

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern?

elevated blood pressure

The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism?

enlarged tongue

A child is scheduled to have allergy skin testing in the office. What does the nurse need to ensure is available during the testing? Select all that apply.

epinephrine oxygen suction equipment

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated?

erythrocyte sedimentation rate (ESR)

A nurse is providing care to a child diagnosed with septic shock. The nurse believes the child's condition is progressing to decompensated shock. What significance does the nurse's belief have on the child's condition?

Additional measures are necessary to meet the child's metabolic requirements.

A nurse has assessed a newborn diagnosed with trisomy 13. The parents are at the bedside and have just been informed of the diagnosis. Which is the nurse's most appropriate action?

Allow time for the parents to ask questions and express their concerns.

A toddler is brought to the emergency department after swallowing some of the parent's prescription opioid medication. The toddler is unresponsive with shallow respirations. The nurse has administered naloxone to the toddler. Which intervention will the nurse expect to implement?

Administer additional doses as needed.

A child with a known allergy to bees is stung while on the playground at school. The school nurse is the first to arrive and notes the child is wheezing and begins vomiting. What will the nurse do first?

Administer epinephrine.

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

Administer subcutaneous glucagon.

The nurse is preparing to perform a dressing change for a 9-year-old child with a severe burn injury. What nonpharmacologic intervention(s) will the nurse perform to decrease pain and discomfort for the child? Select all that apply.

Allow the child to choose means of distraction. Provide positive feedback. Allow the child to choose where on the body to start procedure.

The nurse is caring for a 5-year-old child recently diagnosed with type 1 diabetes. When discussing the care and management of the disorder with the child's parents, which statement(s) indicates understanding? Select all that apply.

"Regular exercise will help in the regulation of my child's blood sugar levels." "The insulin dosages will be directly associated to my child's carbohydrate ingestion." "We need to rotate insulin injection sites to prevent complications."

A 13-year-old female adolescent is being evaluated for lupus. Which statement(s) by the adolescent indicates a need for further education regarding this disease? Select all that apply.

"Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it." "I should have not spent so much time in the sun. That may have been what caused me to get lupus."

The nurse is conducting a presentation for a group of parents at the local pediatric community health center. The nurse is describing the importance of immunizations to prevent common viral infections such as rubeola and rubella. As part of the presentation, the nurse describes the development of rubeola and explains the progression of signs and symptoms. Place the signs and symptoms listed below in the order that the nurse would describe them. Use all options.

fever rash Koplik spots desquamation

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

fluid replacement

A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as a possible substitution(s) for milk? Select all that apply.

fruit juice rice milk soy milk

The nurse is providing care to a 2-day-old newborn. The nurse suspects that the newborn may have trisomy 21 based on which assessment finding(s)? Select all that apply.

loose joints poor muscle tone

The parents of a child with a developmental disability express feeling guilty because they sometimes find themselves wondering how their child would be without the disability. Which response by the nurse best shows empathy and encourages the parents to vent their feelings?

"I can only imagine how hard it is for you. You should know that it is common for parents to have these feelings when having a child with special needs."

A 15-year-old girl has had type 1 diabetes since she was 2 years old. She recently began dialysis and is also struggling with exhaustion. She has been hospitalized with an infection and confides to the nurse that she feels hopeless due to her failing health. How should the nurse respond?

"What do you think would help you feel better or improve your situation?"

The nurse just received laboratory results for a 2-day-old infant that show an increased phenylalanine level. Which action should take priority?

Draw blood for additional testing.

The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which clinical manifestations would the nurse most likely note in this child?

Drowsiness and fruity odor to breath

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply.

Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh Oral candidiasis (thrush), persistent over the past 6 to 7 months

A nurse is preparing a presentation for a group of parents with children diagnosed with type 1 diabetes. The children are all adolescents. What issues would the nurse address related to their developmental level? Select all that apply.

Deficient decision-making skills Body image conflicts Struggle for independence

The school nurse is teaching a child with stinging-insect allergies how to avoid insects while on the class trip. Which instruction will the nurse provide?

Do not sit by the garbage can.

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has:

Polyphagia

A child is in shock and requires IV fluids but establishing an IV site has been difficult. Peripheral sites have been unsuccessful to establish the IV. Which location would be the most appropriate site for the nurse to establish IV access?

intraosseous

The nurse is speaking to a local parent group about poisoning in children. Which of the following would the nurse include as one of the most common causes of poisoning death in children?

iron

Which of the following would the nurse most likely identify as important in diagnosing an infection or inflammatory process in children?

erythrocyte sedimentation rate (ESR)

When caring for a child experiencing anaphylactic shock, the most important nursing action would be to:

facilitate breathing.

A pediatric nurse practitioner (PNP) is conducting an in-service education program on the topic of shock for a group of pediatric nurses. The PNP is describing the different categories of shock and the events that occur with each. The PNP determines that the teaching was successful when the group identifies the events of distributive shock. Place the events below in the order from first to last that would demonstrate successful teaching. Use all options.

massive vasodilation decreased peripheral vascular resistance relative hypovolemia decreased venous return decreased stroke volume and cardiac output insufficient organ perfusion

The nurse is creating a plan of care for an infant with trisomy 13. What will the nurse focus on in the child's plan of care?

treating symptoms

The nurse is teaching a 12-year-old girl with type 2 diabetes mellitus and her parents about dietary measures to control her glucose levels. Which comment by the child indicates a need for additional teaching?

"I can eat two small cookies with each meal."

The nurse is caring for an 8-year-old child with salicylate toxicity. What will the nurse include in the child's plan of care? Select all that apply.

-Administer activated charcoal. -Replace electrolytes. -Administer sodium bicarbonate. -Monitor for bleeding.

The nurse is teaching the parents of an infant newly diagnosed with congenital hypothyroidism about the etiology of the disease. Which information would the nurse likely include? Select all that apply.

Due to an absent or nonfunctioning thyroid gland Role of environmental factors More common in infant girls

The nurse is providing education on bone and joint health to the parents of a 2-year-old client with trisomy 21. Which statements made by the parents demonstrate an understanding of this teaching? Select all that apply.

-"We will need to get a cervical X-ray in a year." -"An X-ray will be needed before engaging in strenuous activity." -"It is important to avoid overextending or over flexing the neck."

The nurse is caring for a 3-year-old child who ingested a dangerous amount of amitriptyline, a tricyclic agent. What will the nurse include in the child's plan of care? Select all that apply.

-Administer sodium bicarbonate as prescribed. -Monitor for lethargy. -Perform continuous EKG monitoring.

A community health nurse is planning a class on water safety for families. What information is important for the nurse to include in the class? Select all that apply.

-It is important for adult supervision at poolside at all times. -The family needs to maintain fencing around pools to deter unsupervised swimming. -Personal floatation devices are recommended for children riding in boats.

A child is diagnosed with diabetes insipidus (DI) and will start on the medication desmopressin. Which instruction(s) would the nurse include in teaching the parent about administering this drug? Select all that apply.

Keep the drug refrigerated. Clear the nostrils before administering the drug. If the child sneezes, repeat the dose administration. Monitor the urine specific gravity while the child is taking the drug.

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

Elevate the subcutaneous tissue before the injection.

A nurse is providing care to a child who was involved in a severe car accident. The child sustained significant internal injuries and blood loss. The child has developed refractory shock. Which action is most important for the nurse take?

Make arrangements for the parents to meet with the health care team.

The nurse is caring for a 4-year-old boy during a growth hormone stimulation test. Which task is priority in the care of this child?

Monitoring blood glucose levels.

A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be the priority?

Monitoring oxygen saturation levels

A nurse is providing anticipatory guidance to the parents of a newborn with Down syndrome. To prevent associated complications, what will the nurse tell the parents? Select all that apply.

-See an ophthalmologist by 6 months of age. -Stay on track with your newborn's immunizations. -Have the newborn evaluated by a cardiologist.

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

220 mg/dl

The nurse is evaluating the plan of care of a child with measles. Which outcome(s) indicates the plan of care has been effective for the child? Select all that apply.

Oxygen saturation remains at 95% or above. Fever resolved at day 7. The child's comfort is maintained. The child maintains adequate hydration.

The nurse is caring for a 7-year-old child who exhibits symptoms of anaphylactic shock after being stung by a bee. The nurse notes that the child's lips are swelling. The nurse hears audible wheezing with dyspnea. Which intervention will the nurse perform first?

Place an endotracheal tube insertion tray at bedside.

The nurse is educating a family of an infant newly diagnosed with a genetic disorder. What strategies will benefit the family? Select all that apply.

Allow the parents time to adjust to the new diagnosis. Assess the family's willingness to learn before beginning the teaching session.

The nurse on the postpartum unit is educating the parents of an newborn diagnosed with an genetic disease. What statement by the parent would indicate to the nurse that family is receptive to additional teaching?

"I am so glad we have this time of quiet to learn what we need to learn before we go home."

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care?

Airway remains patent.

A parent is observing a nurse provide care for the parent's 2-year-old toddler who was burned in a house fire. When the nurse is finished, the parent tells the nurse "I cannot believe this has happened. I should have been able to prevent this from happening." What is the best action for the nurse to take?

Encourage the parent to talk more about feelings.

A nurse has provided teaching on water safety to the parents of a child hospitalized after a near drowning. What action will the nurse take to evaluate the parents' learning?

Have the parents verbalize ways they can reduce the child's risk of drowning.

The nurse is preparing educational materials for a group of new parents about allergic reactions. Which specific immunoglobulin should the nurse emphasize as being responsible for these types of reactions?

IgE

A 14-month-old trauma victim has arrived in the emergency department. What client priority will the nurse need to address first?

Inadequate systemic perfusion

A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?

Ineffective protection related to impaired humoral defenses

A 3-year-old child has sustained injuries from a fall. Once the airway is secured, which of the following interventions would be done next?

Stabilizing the cervical spine.

A nurse is creating a plan of care for a child hospitalized after accidentally ingesting the parent's prescription opioid. Which outcome is the best indicator that the plan of care was successful?

The child maintains effective gas exchange.

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

The child states that the exam room is cold.

The student nurse is studying the genetics of clients who are seeking assistance from a genetic counseling center. The student nurse notes monogenic disorders have which characteristic?

The disorders are considered single-gene.

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action?

They can mask signs of infection.

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

Type 1 diabetes mellitus

A couple who are pregnant with their first child have made an appointment with a clinical geneticist to discuss prenatal screening. The man states that they, "just want to make sure that there is nothing wrong with our baby." How could the clinician best respond to this statement?

"Testing the umbilical blood and performing amniocentesis can give us some information, but not a guarantee."

A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate?

"The best thing to do is keep any infant under the age of 6 months out of the sun."

A nurse is teaching about autosomal dominant and recessive genetics. Which statement by the nurse is accurate?

"Two abnormal genes, one from each parent, are required to produce the phenotype in an autosomal recessive disorder."

The nurse is preparing to open the airway of an unconscious child with a suspected cervical spine injury. What action will the nurse take?

Use the jaw-thrust maneuver.

The nurse is reviewing the health records for several children at a health clinic. Which child would the nurse expect to be newly diagnosed with an inborn error of metabolism?

a newborn female

A nurse is providing care to a 13-year-old client hospitalized with deep partial- and full-thickness (deep second-degree and third-degree) burns on the neck, torso and arms. The nurse attempts to begin a treatment, but the client refuses and angrily tells the nurse "What is the point in all this? I will never be the same again!" What action should the nurse take?

Acknowledge that the client is upset and offer to talk about feelings.

The nurse is educating parents of an toddler with Down syndrome. What would the nurse include in the teaching plan?

Have the child's thyroid function tested regularly.

A nurse is reviewing a plan of care for a 5-year-old child hospitalized with severe burns. Due to systemic changes that occur secondary to the burn injuries, what intervention(s) related to nutrition should the nurse expect to implement? Select all that apply.

Insert a nasogastric tube. Administer a proton pump inhibitor. Offer the child's favorite foods. Initiate total parenteral nutrition.

A 6-year-old girl in shock is receiving dobutamine. What would the nurse most likely do?

Monitor for ventricular arrhythmias.

The health care team is performing cardiopulmonary resuscitation on a child following a suspected poisoning. Which action by the nurse would indicate that CPR is warranted?

The nurse assesses the child's heart rate at 45 and begins chest compressions The child with a pulse of less than 60 beats per minute should receive chest compressions to maintain adequate perfusion and circulation