Exam 1 prep

A child who is of preschool age is diagnosed as having severe autism. The most effective therapy involves which intervention?

one-on-one play therapy

Which chromosomal genetic disorders present with cognitive impairment? Select all that apply: - Patau - Turner - Klinefelter - Angelman - Prader-Willi

- Patau - Angelman - Prader-Willi

A 10-month-old child with recurrent otitis media is brought to the clinic for evaluation. What is most important for the nurse to ask the family about the baby's symptoms?

"Do you give the baby a bottle to take to bed?"

Airborne isolation

- Measles (Rubella) - Tuberculosis - Varicella virus (chicken pox, shingles) - covid

Anterior fontanel closes...

12-18 months

autosomal dominant

50% chance of presentation

Failure to thrive

<5%

Infant mortality rates for which ethnicities have decreased dramatically over the past two decades?

Hispanic, AAPI

What is the primary goal of atraumatic care?

Do no harm

What role should nurses play in ensuring that spiritual health care practices do not negatively affect the therapeutic relationship between patient and nurse?

Maintain open communication between the family and health care team

A first-time mother is concerned that her 6-month-old infant is not gaining enough weight. What should the nurse tell the mother?

"Birth weight doubles by 6 months of age."

The parent of a 6-month-old reports starting 2% milk. What should the nurse ask the parent first?

"Can you tell me more about the reason you switched your baby to 2% milk?"

A parent is concerned about spoiling a 2-month-old child by picking up the child each time the child cries. Which suggestion should the nurse offer?

"Continue to pick up the crying baby because young infants need cuddling and holding to meet their needs."

The mother of a toilet-trained toddler who was admitted to the hospital for severe gastroenteritis and subsequent dehydration and is now at home asks the nurse why the child still wets the bed. What would be the nurse's best response?

"Hospitalization is a traumatic experience for children. Regression is common, and it takes time for them to return to their former behavior."

On observing a parent propping a bottle for a 2-month-old child in the waiting room, the nurse explains the dangers to the parent. Which statement indicates that the parent has understood the nurse's teaching?

"I can see how it might cause choking and cause tooth decay."

After teaching a community class to new parents, the nurse evaluates client understanding of strategies to prevent sudden infant death syndrome (SIDS). Which statements indicates appropriate understanding?

"I will place my baby in a supine position for sleep during the first year."

Which nursing actions are most appropriate when building a therapeutic relationship with a hospitalized child and family? Select all that apply: - learning about the religious beliefs of the child/family - assessing the family's feelings of anxiety or fear - focusing on the technical aspects of providing care - working overtime to care for the child/family - encouraging family involvement in the caring process

- learning about the religious beliefs of the child/family - assessing the family's feelings of anxiety or fear - encouraging family involvement in the caring process

How is galactosemia diagnosed in an infant? Select all that apply: - physical examination - increased galactosuria - increased glucose levels - hx of E. Coli sepsis - hx of vomiting and weight gain

- physical examination - increased galactosuria - hx of E. Coli sepsis (Glucose levels are not increased, hx of V/D/weight loss common)

A parent brings an 8-month-old to the pediatrician's office. When the nurse approaches to measure the child's vital signs, the child clings to the parent tightly and starts to cry. The parent says, "The baby used to smile at everyone. I don't know why the baby is acting this way." The nurse begins teaching the parent about growth and development by stating:

"Your baby's behavior indicates stranger anxiety, which is common at his age."

Proximodistal

"inside-to-outside rule"; motor skills emerge in a sequence of center moving outward; trunk --> extremities

Parents of a 10-year-old child ask the nurse if they should tell their child about their decision to get divorced. Which response by the nurse would be appropriate? Select all that apply: - discuss your decision with your child - refrain from crying in front of your child - give reassurance that you love your child - allow your child to freely express feelings - refrain from telling your child because it will depress the child

- discuss your decision with your child - give reassurance that you love your child - allow your child to freely express feelings

Interventions for FTT

- first intervention would be for a nurse to do a home visit to assess the feeding - higher calorie formula (at least 24 kcal per oz) - have a feeding schedule - in severe cases IV or tube feeding

Which genetic disorders require diet modification to prevent severe impairments or death? Select all that apply: - Tay-Sachs - galactosemia - sickle-cell anemia - PKU - malignant hyperthermia

- galactosemia - PKU

What therapies are used to manage genetic diseases? Select all that apply: - exercise - gene transfer - transplantation - diet modification - metabolic manipulation

- gene transfer - transplantation - diet modification - metabolic manipulation

Which conditions occur when untreated 1-phosphate metabolites of galactose accumulate in the blood? Select all that apply: - jaundice - cataracts - hypertelorism - splenomegaly - cirrhosis of the liver

- jaundice - cataracts - splenomegaly - cirrhosis of the liver

Posterior fontanel closes...

2-3 months

When is PKU testing most accurate in a healthy term infant?

24-48 hr of life

autosomal recessive

25% chance of presentation, 50% of being a carrier

The nurse is discussing the pattern of inheritance with the family. Which statement about the autosomal dominant inheritance pattern is correct? A. Only males are affected B. 50% chance of inheriting if parent affected C. Requires several mutant allele to express D. Reduced chance with each pregnancy

50% chance of inheriting if parent affected

Obesity

>90%

A couple with a 7-year-old child get divorced. Which factor is considered when determining who gets custody of the child? - financial resources - preference of the child - ability to best provide for the child's welfare - familiarity with the existing care of the child

Ability to best provide for the child's welfare

Which of the following parental factors has the greatest effect on the transition to parenthood? A. Age of the parent, resources, and coping skills B. IQ of the parent, IQ of the child, and age of the parent C. IQ of the child, health care needs of the child, and age of the parent D. Resources, coping skills, and health care needs of the child

Age of the parent, resources, and coping skills

When explaining to parents how to reduce the risk of sudden infant death syndrome (SIDS) the nurse should teach about which measures? Select all that apply. Maintain a smoke-free environment. Use a wedge for side-lying positions. Breastfeed the baby. Place the baby on his back to sleep. Use bumper pads over the bedrails. Have the baby sleep in the parents' bed.

Maintain a smoke-free environment. Breastfeed the baby. Place the baby on his back to sleep.

Which condition is a major cause of infant mortality? - respiratory distress - congenital anomalies - unintentional injuries - SIDS

Congenital anomalies

Child presents with small head, moon-shaped face, wide-spaced eyes, and a cry that sounds like a cat

Cri du chat syndrome

The discovery of the genetic basis of Down syndrome is based on which study? - cytogenetics - pharmacogenetics - molecular genetics - biochemical genetics

Cytogenetics

What's the most common dental condition in children?

Dental caries

An 18-month-old child is admitted to the pediatric unit. Which of the following can the nurse do to reduce the stress on the client during this hospitalization?

Encourage the client's caregivers to be with the client as much as possible

T or F Death rates for children >1y are higher than infants d/t increased mobility

F

Describe permissive parenting

Few limits/boundaries are placed on children; parents are reluctant to enforce rules; characterized as being warm and indulgent but they don't like to say no to or disappoint their children; parents do not control children's actions

What advancement uses DNA probes to attach to specific areas of chromosomes?

Fluorescent in situ hybridization

What vitamin is needed prenatal to prevent neural tube defects?

Folic acid (B9)

The nurse is caring for an infant with a congenital anomaly. What strategy can the nurse use to promote parental bonding and adjustment? A. Nurse can perform all infant care B. Identify the parents' weaknesses C. Guide parents in recognizing infants cues D. Help parents recognize this is a lifetime burden

Guide parents in recognizing infants cues

Define extended family

Includes at least one parent, 1+ children, 1+ members other than a parent or sibling (may be grandparent, aunt, cousin, etc)

Define blended family

Includes at least stepparents, step sibling, or half-sibling

What is the most common cause of death and disability in US children?

Injuries

What are some reasons there is a sharp rise in death rate in later adolescence (>15y)?

Injuries, homicide, suicide, hormonal influences, depression

Which nursing interventions are important when caring for a hospitalized toddler? Select all that apply. Provide thorough explanation to toddler prior to a procedure. Instruct parent that regression commonly occurs. Encourage use of a security object from home. Allow client autonomy by offering select choices. Maintain the toddler's routine when able. Discourage parents' participation in client care.

Instruct parent that regression commonly occurs. Encourage use of a security object from home. Allow client autonomy by offering select choices. Maintain the toddler's routine when able.

Characteristics of invisible poverty

Lack of health care facilities, limited employment opportunities

What a atomic characteristic predisposes young children to cranial injuries?

Large head

Which disorder has disruption of the metabolic feedback mechanism causing accumulation of the end product of uric acid? - thalassemias - PKU - Tay-Sachs disease - Lesch-Nyhan syndrome

Lesch-Nyhan syndrome

Folic acid supplementation in people of childbearing age reduces ______ defects

Neural tube

Which type of family is this?: hospitalized child, foster parents, foster brother - nuclear - blended - extended - binuclear

Nuclear

Name an example of an inherited disease that is known as an inborn error of metabolism?

PKU

Describe authoritative/democratic parenting

Parents impose control, but not as much as seen in authoritarian; parents involve child in decision-making; punishments tend to be expected/natural consequences

Which parenting style would the nurse document in a family where the parents have little to no control over the children? - permissive - democratic - authoritarian - authoritative

Permissive

Characteristics of visible poverty

Poor nutrition, poor sanitation, insufficient clothing

The assessment process of nursing is: A. Purposeful collection B. Establishing priorities C. Interventions D. Determining outcome

Purposeful collection

The nurse asks a child of Jewish ancestry about a blister on the wrist. The child tells the nurse, "my grandmother rubbed garlic there." Which condition is the grandmother treating? - poor eyesight - skin infection - digestive problems - respiratory illness

Skin infection

A recognized pattern of congenital anomalies resulting from a single specific cause is a ______

Syndrome

T or F Children aged 5-14 have the lowest death rate

T

What is the primary ethical concern regarding gene carrier testing?

That tested people will misunderstand or misuse the information

The nurse is caring for an infant who exhibits the above characteristics (Down syndrome). When planning care, which would be the best long term client goal?

The client will reach his/her optimal level of functioning.

The nurse is assigned to care for a chronically ill child who is hospitalized. The child is 14 months old, and is the youngest of 9 children ranging in age from 2 months to 17 years. Which nursing action is the best example of enhancing family-centered care? A. The nurse answers the call light promptly. B. The nurse asks the mother to describe the child's feeding history. C. The nurse offers to feed the child and allow mom to take a nap. D. The nurse allows all of the siblings to remain in the room as much as they wish.

The nurse allows all of the siblings to remain in the room as much as they wish.

Child reactions to hospitalization by age Toddler: Preschooler: Adolescent:

Toddler: separation anxiety Preschooler: feels punished Adolescent: withdrawn

Which mendelian-inherited genetic disorder has a major finding of acute sun sensitivity (severe sunburns and blistering with minimal exposure) and over 1000-fold increased risk for cutaneous and ocular neoplasms? - PKU - xeroderma pigmentosum - neurofibromatosis type 1 - oculocutaneous albinism type 1

Xeroderma pigmentosum

Define binuclear family

a post-divorce family structure comprised of two nuclear families, one headed by the ex-wife and the other by the ex-husband

The nurse is evaluating an infant for auditory ability. What is the expected response in an infant with normal hearing?

blinking and stopping body movements when sound is introduced

A mother brings a 15-month-old child to the well-baby clinic. She states the child has been taking approximately 18 to 20 oz (540 to 600 mL) of whole milk per day from a bottle with meals and at bedtime. The nurse should suggest that she begin weaning the child from the bottle to avoid risking:

dental caries

Growth and development: weight

double birth weight at 6m triple birth weight at 12m

A 3-month-old infant is admitted to the hospital to rule out nonaccidental trauma. X-ray findings indicate a fractured right humerus, fractured ribs, and a fractured left scapula. In this situation, a nurse is responsible for:

ensuring that the suspected child abuse is reported to local authorities.

Cephalocaudal

head to toe; head control develops before limb control

The most common nutritional problem in American children is: A. Lack of breastfeeding B. Obesity C. Access to healthy food D. Vitamins

obesity

The court grants joint physical custody of a child to a divorced couple (married 8 years). Which disposition of the child reflects this decision? - staying with the father for most of the time - staying with the mother for most of the time - staying with both parents for a shared amount of time - staying with the mother, but the father is also a legal guardian

staying with both parents for a shared amount of time

Describe authoritarian parenting

parents control the child's attitude and behavior; rigid and strict rules; impose severe (may be corporal) punishment quickly; unquestioned parental mandates

The nurse assesses an 8-month-old's language development. Which finding would the nurse consider to be typical language development?

saying "dada" and "mama" nonspecifically

A 4-year-old child is admitted to the hospital for surgery. The nurse applies interventions to address what major stressor for a child of this age?

separation from family

A nurse is assessing an 8-month-old infant during a wellness checkup. Which action is a normal developmental task for an infant this age?

sitting without support

SIDS risk factors

sleeping on stomach, smoking in household, prematurity, age 1-12m, co-sleeping, soft bedding, overheating

Which infant most needs a developmental referral for a gross motor delay?

the 9-month-old who does not stand holding on

Which empowerment strategy would the nurse discuss with the family of a chronically ill child? - expressing sorrow verbally - incorporating use of telemedicine - encouraging Facebook participation - using family-to-family support networks

using family-to-family support networks

Name a key factor in the higher neonatal mortality rate in the US compared with rates of other developed countries

Low birth weight (the lower the birth weight, the higher the mortality)

Which nursing intervention is most effective in providing atraumatic care to a 3-year-old boy preparing for major surgery? A. Explain to the child that he will be away from his parents for only a short time. B. Allow a parent to accompany the child to the preoperative holding area. C. Give the child a teddy bear from the hospital's toy closet. D. Hold the child's hand as you accompany the child to the preoperative holding area.

Allow a parent to accompany the child to the preoperative holding area.

Principles of atraumatic care

•Promote family-centered care, treating the family as the patient •Prevent or minimize separation from the family •Promote sense of control •Prevent or minimize bodily injury and pain