Term 2 Unit 2
The nursing students are learning how to perform a health assessment on a pediatric client. The nursing instructor identifies a need for further teaching when a student states:
"I should take blood pressure on a child beginning at age 2 years."
The nurse is teaching parents of a 2-year-old toddler with cellulitis about temperature measurement. Which statement by the parents demonstrates the need for further teaching?
"We should verify any fever using a rectal thermometer for accuracy."
The nurse is teaching a group of novice nurses how to assess bowel sounds. Which statement will the nurse include in the education?
"You should auscultate all four quadrants for a full minute each."
Blood pressure monitoring becomes part of the routine health assessment at what age and older
3 years
Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?
Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.
The nurse is collecting data on a 9-year-old child being admitted to the pediatric unit. What is the most appropriate way to gather information from the child's caregiver?
Ask the caregiver questions and document the answers.
The nurse wants to find out how much time a preschooler spends in various activities throughout the day. What should the nurse do to learn this information?
Ask the parents to complete a day history.
A hospitalized child has a pulse oximeter attached to his finger. What interventions would the nurse implement in caring for this client?
Check the skin under the probe every 2 hours for tissue perfusion.
The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?
Determine how much the child knows and is capable of understanding.
When assessing heart sounds on a high school athlete, the nurse hears a "lub d-dub" sound which is associated with inspiration. What action will the nurse take?
Document the findings as normal.
When auscultating bowel sounds, which of the following frequencies would the nurse identify as normal?
Five to 10 per minute
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure? Select all that apply.
Pretend to perform the procedure on her doll. Teach her the steps of the procedure. Introduce her to the health care personnel.
A child is scheduled for surgery and will have a preoperative visit. What action(s) can the nurse take to help reduce the child's anxiety? Select all that apply.
Provide a tour of the unit. Enlist the help of the Child Life Services department. Allow the child to put on gowns and masks. Answer questions on an age-appropriate level.
A parent has brought the child into the clinic for a routine health assessment. The parent asks when routine screening for back symmetry will begin. Which response by the nurse is most accurate?
School Age
To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?
Take the apical pulse.
The pediatric nurse would use standard precautions in caring for which client on her floor?
an adolescent who has a broken arm
The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.
boxes to put toys in and/or take out toys stacking blocks or small boxes nursery rhymes or sing-along songs on tape
A child is hospitalized with pneumonia. What assessment(s) will the nurse complete for this child's chest and lungs? Select all that apply.
Auscultate lung sounds in all lung fields, Observe chest movement with breathing, Auscultate the lungs for adventitious breath sounds.