Week 4 & 5 Wong

Nonpharmacologic strategies for pain management:

may reduce pain perception.

Physiologic measurements in children's pain assessment are:

of limited value as sole indicator of pain.

Which is an appropriate nursing intervention when caring for a child in traction?

Assess for tightness, weakness, or contractures in uninvolved joints and muscles

The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which is a priority in the care for this child?

Assessing respiratory efforts

Which should cause a nurse to suspect that an infection has developed under a cast?

"Hot spots" felt on cast surface

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

"We're glad there is a cure for this disorder."

olescent with juvenile idiopathic arthritis (JIA) is prescribed abatacept (Orencia). Which should the nurse teach the adolescent regarding this medication? (Select all that apply.)

-Avoid receiving live immunizations while taking the medication. -Before beginning this medication, a tuberculin screening test will be done

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which interventions? (Select all that apply.)

-Cluster care to conserve energy -Administration of antibiotics

Which should the nurse expect to find in the cerebral spinal fluid (CSF) results of a child with Guillain-Barré syndrome (GBS)? (Select all that apply.)

-Normal glucose -Fewer than 10 WBSs

The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? (Select all that apply.)

-Positive Ortolani click -Unequal gluteal folds

How much folic acid is recommended for women of childbearing age?

0.4 mg

A nurse is admitting an infant with asthma. What usually triggers asthma in infants?

A viral infection

When is it generally recommended that a child with acute streptococcal pharyngitis may return to school?

After taking antibiotics for 24 hours

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which action?

Avoid using for more than 3 days

The nurse is caring for a preschool child immobilized by a spica cast. Which effect on metabolism should the nurse monitor on this child related to the immobilized status?

Decreased metabolic rate

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

Diet should be high in carbohydrates and protein

B-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. Which describes their action?

Dilate the bronchioles

The nurse is conducting a staff in-service on casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

Dries rapidly

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?

Dyspnea

Which type of croup is always considered a medical emergency?

Epiglottitis

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?

FLACC tool (face, legs, activity, cry, consolability)

A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?

Frequent, serial casting is tried first.

Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?

Give small amounts of favorite fluids frequently to prevent dehydration

A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is HIV positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test?

Greater than or equal to 5 mm

Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement?

Growth can be affected by this type of fracture.

The parents of a child with cerebral palsy ask the nurse whether any drugs can decrease their child's spasticity. The nurse's response should be based on which statement?

Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on which symptom?

Inability to speak

Which clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease)?

Lying in the frog position

An adolescent with a fractured femur is in Russell's traction. Surgical intervention to correct the fracture is scheduled for the morning. Nursing actions should include which action?

Maintaining continuous traction and checking position of traction frequently

The nurse is teaching a group of nursing students about newborns born with the congenital defect of myelomeningocele. Which common problem is associated with this defect?

Neurogenic bladder

A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis?

Nonproductive cough, wheezing

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

Nonsteroidal antiinflammatory drugs (NSAIDs)

Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first?

Notify the practitioner of the changes noted.

A child is diagnosed with influenza. Management includes which recommendation?

Oseltamivie (Tamiflu)

Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included?

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

Which frequency is recommended for childhood skin testing for tuberculosis (TB) using the Mantoux test?

Periodically for children who reside in high-prevalence regions

Which consideration is the most important in managing tuberculosis (TB) in children?

Pharmacotherapy

A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable?

Preadolescent growth spurt

. The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1. Which signs and symptoms are associated with this disease?

Progressive weakness and wasting of skeletal muscle

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. Which describes the most appropriate way to position and feed this neonate?

Prone, head turned to side, and nipple-fed

Nitrous oxide is being administered to a child with extensive burn injuries. Which is the purpose of this medication

Provide anesthesia

The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the nurse that she does not have pain, but a few minutes later she tells her parents that she does. Which should the nurse consider when interpreting this?

Children may be experiencing pain even though they deny it to the nurse

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

Complete obstruction

A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child's pulse oximetry status?

Continuous

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?

There is heightened airway reactivity

Which explains why cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of childhood respiratory tract infections?

They are safer

The nurse should monitor for which effect on the cardiovascular system when a child is immobilized?

Venous stasis

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?

Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

Before chest physiotherapy (CPT)

A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which diagnosis?

Bronchitis

Which is a type of skin traction with the legs in an extended position?

Buck extension

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which disease or assessment findings may develop?

Slowed growth

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Sweat chloride test

A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?

Sweat chloride test, stool for fat, chest radiograph films

Parents of two school-age children with asthma ask the nurse, "What sports can our children participate in?" The nurse should recommend which sport?

Swimming

The nurse is caring for a school-age child diagnosed with juvenile idiopathic arthritis (JIA). Which intervention should be a priority?

Teach the child and family correct administration of medications

A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?

Teaching the family the care and management of the corrective appliance

A child with cystic fibrosis (CF) is receiving recombinant human deoxyribonuclease (DNase). Which is an adverse effect of this medication?

Voice alters

The nurse is planning a staff in-service on childhood spastic cerebral palsy. What characterizes spastic cerebral palsy?

Hypertonicity and poor control of posture, balance, and coordinated motion

Parents of a child with cystic fibrosis ask the nurse about genetic implications of the disorder. Which statement, made by the nurse, expresses accurately the genetic implications?

If it is present in a child, both parents are carriers of this defective gene.

The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition?

Increased convex angulation in the curve of the thoracic spine

A nurse is teaching nursing students about clinical manifestations of cystic fibrosis (CF). Which is/are the earliest recognizable clinical manifestation(s) of CF?

Meconium ileus

The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which is essential in this child's care?

Monitor arterial blood gases

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. What is the priority nursing intervention?

Monitoring pulse oximetry

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

Morphine

The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction should be included in the teaching?

Elevate casted arm when resting and when sitting up

The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy?

Extensor reflex at 7 months of age

The nurse is completing a pain assessment on a 4-year-old child. Which of the depicted pain scale tools should the nurse use with a child this age?

FACES tool

A nurse is caring for a school-age child with left unilateral pneumonia and pleural effusion. A chest tube has been inserted to promote continuous closed chest drainage. Which interventions should the nurse implement when caring for this child? (Select all that apply.)

-Assessing the chest tube and drainage device for correct settings -Administering prescribed doses of analgesia -Monitoring for need of supplemental oxygen

Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration?

-Bran cereal -Prune juice -Vegetables

. A nurse recognizes which physiologic responses as a manifestation of pain in a neonate?

-Diaphoresis -Decreased SaO2 -Increased heart rate

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention should be included in the child's care? (Select all that apply.)

-Encourage the child to drink 8 ounces of formula every 4 hours. -Cluster care to encourage adequate rest. -Place on noninvasive oxygen monitoring

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child? (Select all that apply.)

-Instructions to avoid exposure to sunlight -Teaching about body changes associated with SLE

Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply.)

-Lordosis -Gower sign (walk their hands up their thighs to stand up) -Waddling gait

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Nursing care for this child includes which action(s)? (Select all that apply.)

-Monitoring and maintaining systemic blood pressure -Administering corticosteroids

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which action should the nurse include in the child's postoperative care plan? (Select all that apply.)

-Notify the surgeon if the child swallows frequently. -Place the child on the abdomen until fully wake. -Encourage the child to cough frequently

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)

-Severe pain not relieved by analgesics -Tingling of extremity -Inability to move extremity

The Heimlich maneuver is recommended for airway obstruction in children older than _____ year(s).

1

A 4-year-old child has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. The management plan should include which action?

Recommend genetic counseling.

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain?

Recurrent

The nurse is teaching nursing students about normal physiologic changes in the respiratory system of toddlers. Which best describes why toddlers have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included?

Return to clinic every 1 to 2 weeks.

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

Russell

Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

Short-acting B2 agonists

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant displays which clinical manifestation?

Signs of an earache

Which term is used to describe a type of fracture that does not produce a break in the skin?

Simple fracture

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. The nurse's rationale for this action is described primarily in which statement?

The mother's presence will reduce anxiety and ease the child's respiratory efforts

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status?

Venous stasis leading to thrombi or emboli formation

A nurse is caring for a child in acute respiratory failure. Which blood gas analysis indicates the child is still in respiratory acidosis?

pH 7.32, CO2 50