Test #4

Which statement from the parents of a school-aged child diagnosed with ADHD indicates the need for further education by the nurse? a. "I will develop a reward system for desired behaviors." b. "I will stick to the same routine each day after school." c. "I will let him do his homework while he is watching his favorite television show." d. "I will take my child to the physician every 3 months for a weight and height check"

c. "I will let him do his homework while he is watching his favorite television show."

The mother of a toddler-aged patient states, "My daughter seems to be at an increased risk for complications associated with respiratory infections." Which response by the nurse is accurate? a. "You are incorrect in your assessment." b. "Younger children do not breathe as deeply as do older children." c. "The younger child's airway is smaller and more easily occluded." d. "Air passages are more likely to become blocked with mucus because younger children

c. "The younger child's airway is smaller and more easily occluded."

Rales

Also known as crackles, adventitious breath sounds associated with fluid collection in the base of the lungs.

Hypoxemia

An abnormally low level of oxygen in the blood resulting from respiratory compromise that prevents the lungs from adequately performing gas exchange.

1. A toddler is prescribed digoxin (Lanoxin) for cardiac failure. Which should the nurse instruct the toddler's parents to monitor for as a manifestation associated with digoxin toxicity? a. Ataxia b. Tinnitus c. Bradycardia d. Hypotension

bradycardia bradycardia is a sign of digoxin toxicity. Take pulse before giving, ALWAYS

Compartment Syndrome

A situation in which a traumatic injury causes pressure to build up in a confined space, such as in the rigid fascia surrounding the muscles

Stridor

A high-pitched harsh sound that occurs during inspiration (other heard without the aid of a stethoscope),which denotes the presence of an obstruction in the upper airway.

Scoliosis

A lateral or S-shaped curvature of the spine that often presents with two curves.

Rhonchi

A low-pitched adventitious breath sound when a mucous plug is within a large airway structure: a rattling sound that moves with coughing.

Adventitious Breath Sounds

Abnormal, acquired or accidental breath sounds

Epiphyseal plates

The center of ossification at the extremity of each of the long bones. Considered the "growth plate" of long bones, were new bone growth occurs.

Intussusception

The invagination or folding, of one section of the bowel into the other, which causes acute bowel obstruction, inflammation and necrosis if not rapidly treated by low-pressure contrast or water enema.

Which parental statements indicate correct understanding of the care that is needed for a pediatric patient after the insertion of tympanostomy tubes? Select all that apply. a. "It is important for my child to drink plenty of fluids after the procedure." b. "I should restrict my child to quiet activities after surgery." c. "I will remind my child to use ear plugs prior to showering and swimming." d. "It is important to limit my child's diet after surgery and allow only soft, bland foods." e. "I should plan to administer a decongestant to my child for 1 to 2 weeks following surgery."

a. "It is important for my child to drink plenty of fluids after the procedure." b. "I should restrict my child to quiet activities after surgery." c. "I will remind my child to use ear plugs prior to showering and swimming."

A 1 year old has received her MMR and Varivax vaccines at the clinic today. The nurse explains the chance for rash and gives visual aids to the mother to take home. The nurse knows that the mother understands the normal reaction to Varivax when she points out which of the following? a. A varicella-type rash. b. A maculopapular rash. c. A pin point rash. d. A strawberry-patterned rash on her tongue.

a. . A varicella-type rash.

Which should the nurse monitor when assisting with the rapid assessment of body systems to assess a child's cardiovascular system? a. Presence of petechiae b. Retinal hemorrhage c. Paradoxical breathing a. Abnormal Heart sounds

a. Abnormal Heart sounds

Which nursing actions are appropriate when providing care to an infant diagnosed with tetralogy of Fallot who is having a "tet" spell? Select all that apply. a. Administering oxygen b. Drawing blood for a serum hemoglobin c. Placing the child in knee-chest position d. Administering diphenhydramine (Benadryl) as ordered e. Administering IV morphine per prescriber's order

a. Administering oxygen c. Placing the child in knee-chest position e. Administering IV morphine per prescriber's order *Morphine (calms, decreased tachypnea, and also decreases PVR- Pulmonary Vascular Resistance-the arteries that supply oxygen to the lungs)

Which is a responsibility of the nurse when implementing safety precautions for pediatric patients each shift? a. Checking that the bedside equipment is functional and the right size b. Verifying a dose of insulin with another nurse prior to administration c. Using the 10 rights of medication administration with each drug given d. Verifying the patient prior to administering a prescribed treatment

a. Checking that the bedside equipment is functional and the right size

The nurse is caring for a 2 year old child who has experienced a febrile seizure for the first time. Which of the following would the nurse include in the education for the caregivers? Select all that apply. a. Febrile seizures usually occur as the result of a rapid rise in core body temperature. b. The child will never have another febrile seizure if the caregiver gives acetaminophen as instructed. c. Children who experience febrile seizures usually outgrow them by age 6 years. d. Febrile seizures are considered harmless for most children. e. The child will have to take anti-seizure medication for the remainder of their life.

a. Febrile seizures usually occur as the result of a rapid rise in core body temperature. c. Children who experience febrile seizures usually outgrow them by age 6 years. d. Febrile seizures are considered harmless for most children.

Which should the nurse include when assessing the central nervous system (CNS) of a child who is acutely ill? Select all that apply. a. Irritability b. Lethargy c. Hypoventilation d. Vomiting e. Seizures

a. Irritability b. Lethargy e. Seizures

Which defects of the heart should the nurse include in the educational session for parents of a newborn diagnosed with tetralogy of Fallot? Select all that apply. a. Overriding aorta b. Ventricular septal defect c. Hypertrophic right ventricle d. Pulmonary stenosis or atresia e.Transposition of the great vessels

a. Overriding aorta b. Ventricular septal defect c. Hypertrophic right ventricle d. Pulmonary stenosis or atresia

Which should the nurse monitor when assisting with the rapid assessment of body systems to assess a child's integumentary system? a. Presence of petechiae b. Retinal hemorrhage c. Paradoxical breathing a. Abnormal Heart sounds

a. Presence of petechiae

In the neural tube defect spina bifida, which of the following problems can the nurse expect the child to exhibit? Select all that apply a. Problems walking/control b. Difficulty with speech c. Partial or complete paralysis of the legs d. Blindness e. Problems with bowel or bladder

a. Problems walking/control c. Partial or complete paralysis of the legs e. Problems with bowel or bladder ?

The nurse is providing care to a child diagnosed with impetigo. The child's parents ask what caused this to occur. Which organism does the nurse include when educating the parents about impetigo? a. Staphylococcus aureus b. Human papillomavirus (HPV) c. Pseudomonas aeruginosa d. Escherichia coli

a. Staphylococcus aureus *Impetigo may be caused by S aureus or Streptococcus pyogenes (S pyogenes) or both. On rare occasions, another bacterium may be responsible for the skin infection.

Which data collected during the pediatric respiratory assessment require further action by the nurse? Select all that apply. a. Stridor b. Strong Cry c. Nasal Flaring d. Substernal retractions e. Lung sounds clear to auscultation

a. Stridor c. Nasal Flaring d. Substernal retractions

1. In which position should the nurse place a child who is experiencing a medical emergency in order to use color-coded resuscitative response tape? a. Supine b. Prone c. Side-lying d. Trendelenburg

a. Supine

Which information should the nurse include in the handoff communication with the receiving unit when a child is transferred to a higher level of care? Select all that apply. a. The child's full name, date of birth and admitting diagnosis b. Short history of the hospital stay up to this time c. Reason for the transfer to higher level of care d. Any pertinent results of laboratory or radiological studies e. Which family members are present and their emotional condition

a. The child's full name, date of birth and admitting diagnosis b. Short history of the hospital stay up to this time c. Reason for the transfer to higher level of care d. Any pertinent results of laboratory or radiological studies e. Which family members are present and their emotional condition

The nurse in the ER is caring for a 6-year-old who fell off his bike and fractured his arm. The xrays revealed a greenstick fracture of the left radius. Which of the following will the nurse tell the parents when explaining this type of fracture? a. "This fracture consists of a raised portion of the bone." b. "This fracture is considered incomplete and extends partially through the bone." c. "This is a fracture where the bone is splintered into pieces." d. "This is a fracture where the bone protrudes through to the skin's surface."

b. "This fracture is considered incomplete and extends partially through the bone." ?

A pediatric patient arrives by life flight to the hospital after experiencing multiple traumas in a motor vehicle crash involving a suspected drunk driver. Which statement is most important for the nurse to make to the parents before they see their child? a. "You should press charges against the drunk driver." b. "Your child's condition is very critical; her face is swollen, and she might not look like herself." c. "Your child's leg was crushed and might have to be amputated." d. "Don't worry; everything will be okay. We will take excellent care of your child."

b. "Your child's condition is very critical; her face is swollen, and she might not look like herself." *The priority is to prepare the parents for the child's changed appearance.

1. In a child with a diagnosis of acute glomerulonephritis symptoms usually appear 1 to 3 weeks after the onset of what? a. A staph infection b. A strep infection c. Ingestion of a toxin d. Grossly bloody urine

b. A strep infection ?

1. The licensed practical nurse (LPN) notes circular ecchymosis on a school-aged child's back. The LPN is not sure if this is due to abuse or a cultural practice. Which is the priority action by the LPN? a. Contacting child protective services b. Asking the registered nurse to assist with the assessment c. Instructing the parent to proceed to the waiting room for the remainder of the examination d. Initiating a child life specialist consult for a more in-depth assessment of the current situation

b. Asking the registered nurse to assist with the assessment

A pediatric nurse explains discharge instructions to the parents of a child who is postoperative from a tonsillectomy. Which instruction does the nurse stress? a. Recommend vigorous toothbrushing. b. Avoid highly seasoned and "sharp" foods. c. Encourage coughing and clearing the throat. Avoid popsicles the first day postoperative because of aspiration risk.

b. Avoid highly seasoned and "sharp" foods.

Which nursing actions are appropriate when responding to a pediatric patient's family member who threatens harm or violence? Select all that apply a. Attempting to talk the family member down b. Engaging the assistance of a security guard c. Knowing institutional codes d. Notifying local law enforcement e. Blocking the exit

b. Engaging the assistance of a security guard c. Knowing institutional codes d. Notifying local law enforcement

In a child with a diagnosis of congestive heart failure, what would chest radiographs show? a. Pigeon chest b. Enlarged heart c. Lung infiltrates d. Flail chest

b. Enlarged heart chest radiographs reveal an enlarged heart.

1. Which immunization should the nurse plan to give prior to newborn discharge from the hospital? a. Rotavirus b. Hepatitis B c. Inactivated poliovirus d. Measles, Mumps, and rubella

b. Hepatitis B

The pediatric nurse examines a 5-week-old infant who has been observed having projectile, non-bilious vomiting. Upon palpation, the nurse feels an olive-shaped mass in the mid-epigastrium. On the basis of these data, which condition does the nurse suspect? a. Rectal atresia b. Hypertrophic pyloric stenosis c. Intussusception d. Malrotation of the intestine

b. Hypertrophic pyloric stenosis

1. A child comes into the clinic presenting with the following symptoms: A swollen abdomen, edema, and GI changes; the hair is thin and dry with patchy alopecia. The child is apathetic and irritable. When weighed and measured, the nurse finds the child has retarded growth. What does the nurse suspect is the diagnosis? a. Marasmus b. Kwashiorkor c. Mineral insufficiencies d. Niacin insufficiency

b. Kwashiorkor

The nurse is teaching parents how to prevent the spread of infectious disease. Which priority health promotion strategy should the nurse recommend for all age groups of children? a. Decreasing environmental exposure to pathogens b. Performing hand hygiene c. Ensuring all toys are clean and free from germs d. Keeping children away from sick adults

b. Performing hand hygiene

1. A nurse is assessing a 1-month old child with RSV. The nurse identifies the following: HR-140; RR 32; O2 sat 90% on room air; inspiratory and expiratory wheezes; temperature of 100.5 (38.1C); Large amounts of thin secretions Which of the following is the priority of the nurse at the time? a. Providing a quiet environment b. Providing oxygen for the low saturation c. Suctioning the nares and oropharynx to remove the secretions d. Administering acetaminophen to reduce the fever

b. Providing oxygen for the low saturation

Which instructions should be provided to the parents of a 4-year-old girl who has experienced chronic UTIs in the last 2 years? Select all that apply. a. Wear only nylon underwear for better airflow. b. Teach the child to wipe from front to back. c. Encourage the child to take long baths by allowing the child bubbles and toys in the tub. d. Encourage the child to drink additional fluids throughout the day. e. Plan potty breaks every 2 hours throughout the day.

b. Teach the child to wipe from front to back. d. Encourage the child to drink additional fluids throughout the day. e. Plan potty breaks every 2 hours throughout the day.

A young mother calls the pediatric triage nurse because she is worried about her 4-month-old daughter. Her daughter had immunizations administered yesterday. The infant is not eating and is more irritable than usual. The nurse verifies that the infant had a DTaP immunization. The nurse knows which of the following about these signs and symptoms? a. This is a medical emergency. The mother should bring the infant to an emergency room to make sure that the child is not having an allergic reaction. b. This is a normal reaction and will subside in a day or two. c. This is abnormal, and the mother should follow up with the doctor in two days. d. This is only occurring because the child has not been given Tylenol for the pain at the injection site.

b. This is a normal reaction and will subside in a day or two.

The pediatric nurse is providing a preschool-aged child's mother with information regarding impetigo. The mother is concerned about the possibility of passing the infection on to her other toddler-aged child. Which response by the nurse is most appropriate in this situation? a. "I know that you are concerned about the health of both of your children. Your child has been prescribed 7 days of antibiotic therapy. After 24 hours of antibiotic therapy, you will not need to worry about any transmission of bacteria to your other child." b. "Caring for both of your children right now will take more time than usual. Do you have anyone who can come and help you with their care?" c. "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well." d. "You need to concern yourself only with the child who has impetigo. It is important to ensure that all of the medication is taken and that all toys and linens are washed in the next 24 hours."

c. "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well."

An adolescent who is brought to the emergency department (ED) by his parents has the following symptoms: periumbilical pain that peaks at 4-hour intervals followed by right lower quadrant pain, which is followed by vomiting. On the basis of these data, which condition does the nurse suspect? a. Meckel's diverticulum b. Omphalitis c. Appendicitis d. Ulcerative colitis

c. Appendicitis

Which action should the nurse implement in order to apply the principles of family-centered care in the hospital environment? a. Implementing strict visitation policy for siblings b. Allowing a child to "cry it out" when parents leave the bedside c. Encouraging parents to continue bedtime routines, such as reading a story d. Discouraging cultural foods because they cannot be provided by the dietary department

c. Encouraging parents to continue bedtime routines, such as reading a story

1. A 4-year-old boy, current on his immunizations, presents to the clinic with his dad for his well-check. Which immunization booster does the nurse provide parental education during the health maintenance visit for a 4-year-old patient? a. Hepatitis B b. Haemophilus influenzae type B (HIB) c. Inactivated poliovirus (IPV) d. Human papillomavirus (HPV)

c. Inactivated poliovirus (IPV)

When care is provided to an infant, which clinical manifestation supports the diagnosis of meningitis? a. Hypothermia b. Soft, flat fontanel c. Poor feeding habits d. Cries that are consoled with holding

c. Poor feeding habits

Which clinical data noted by the nurse during the shift assessment indicate the pediatric client may be experiencing compartment syndrome? Select all that apply a. Pink, warm extremity b. Dorsalis pedis pulse present d. Pain not relieved by pain medication e. Paresthesia of the leg

c. Prolonged capillary refill time d. Pain not relieved by pain medication e. Paresthesia of the leg

Which nursing action exemplifies the therapeutic communication required when a child is moved to a higher level of care in an acute care facility? a. Asking the provider on call to communicate why the child was transferred to intensive care b. Calling the hospital social worker to communicate with the parents during the transfer process c. Talking to the family in a calm, matter-of-fact manner, explaining each step of the transfer process d. Instructing the family to go to the waiting room until a provider is available to update them on their child

c. Talking to the family in a calm, matter-of-fact manner, explaining each step of the transfer process

1. Which factors associated with Munchausen syndrome by proxy should the nurse include in an educational session regarding this topic? Select all that apply. a. The child is usually under the age of 10 years. b. The child often displays symptoms during the hospitalization. c. The child has had multiple hospitalizations in the medical history. d. The perpetrator is usually the mother with some knowledge of health care. e. The claimed history is not supported by evidence found by health-care providers.

c. The child has had multiple hospitalizations in the medical history. d. The perpetrator is usually the mother with some knowledge of health care. e. The claimed history is not supported by evidence found by health-care providers.

Which are clinical manifestations of sexual abuse that the nurse should include when assisting with the assessment process? Select all that apply a. Enuresis b. Poor hygiene c. Vaginal discharge d. Positive Chlamydia e. Ecchymosis located on the inner thighs

c. Vaginal discharge d. Positive Chlamydia e. Ecchymosis located on the inner thighs

1. A 6-year-old boy with Varicella-zoster (chickenpox) and a visible rash is being admitted to the hospital for treatment of dehydration. Which of the following isolation precautions needs to be taken? a. Contact b. Airborne c. Contact and droplet d. Contact and airborne

d. Contact and airborne

Which nursing action is appropriate when assisting with the rapid assessment of a patient diagnosed with a neurological condition? a. Assessing apical pulse b. Monitoring blood pressure c. Obtaining an oral temperature d. Determining level of consciousness

d. Determining level of consciousness

You are the emergency department nurse admitting a 6-year-old male client who has come in by ambulance from his school. The paramedics inform you that the child has been having repeated seizures for approximately 35 minutes. What drug would you expect the health care provider to order? a. IV Dilantin b. IV Solumedrol c. IV Morphine d. IV Diazepam

d. IV Diazepam

1. What is one symptom of premenstrual syndrome? a. Intense itching b. Severe abdominal pain c. Weight loss d. Increased anxiety

d. Increased anxiety

The clinic nurse is obtaining a history on the child who is presenting with abdominal pain. The parent reports that the child has had no previous GI symptoms prior to developing acute abdominal pain and tenderness along with passing red, blood-tinged stool. a. Rectal atresia b. Hypertrophic pyloric stenosis c. Intussusception d. Malrotation of the intestine

d. Malrotation of the intestine