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The condition is likely to self-resolve, which will avoid unnecessary antibiotic use.

A father asks why his preschool-age child was not prescribed an antibiotic for pain in his right ear that was described as a "possible ear infection." The nurse's explanation would include which rationale?

dental erosions and caries

A mother is suspicious that her adolescent has bulimia because the child seems to be dependent upon laxatives and vomits frequently after eating a meal. What physical finding would be most suggestive of this diagnosis?

schedule an immediate history and physical examination.

A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who is experiencing headaches. Her grades have dropped, and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to:

amblyopia

A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? Eye patching is used for amblyopia or any condition that results in one eye being weaker than the other. Corrective lenses would be appropriate for astigmatism, hyperopia, and myopia

statements of hopelessness changes in behavior from feeling dejected to euphoric displaying poor judgment violence and truancy

A nurse is conducting a class for parents of adolescents on the topic of suicide prevention. What are the warning signs for suicide that the nurse will provide for this group? Select all that apply.

Why does that red train keep crashing into all of the other trains?

A nurse is conducting a mental status examination with a 5-year-old boy who is playing with trains and blocks of different colors. He repeats the same actions with the trains over and over again throughout the examination. Which of the following questions would be most appropriate?

"Do you know how she is planning to kill herself?"

The nurse is interviewing a 13-year-old girl with depression. During the course of the interview, the girl reveals that her best friend is thinking about committing suicide. Which response by the nurse would be most appropriate?

Stroke the bottom of the foot to determine if there's fanning and dorsiflexion of the big toe.

The nurse is obtaining data from a 1-month-old infant during a routine examination at a family health center. Which method does the nurse use to test for Babinski sign?

Evidence of bleeding will be reabsorbed within 1 to 3 weeks.

The nurse is planning care for a school-age child with a black eye. Which outcome would be the most appropriate for this client?

Allow the child to see the nurse prior to touching or completing any assessments or procedures.

The nurse in the acute care setting is caring for a child with deafness. Which nursing intervention is appropriate for this child?

Assess the client's respiratory rate.

A 10-month-old infant is brought to the emergency department by the parents after they found the infant face down in the bathtub. The parent states, "I just left the bathroom to answer the phone. When I came back, I found my infant." Which nursing action is priority?

"The tubes remain in place for 6 to 12 months until they come out by themselves."

A child having tympanostomy tubes placed asks, "How and when will the tubes be removed?" What is the nurse's best response?

Wake him every 2 hours to check his movement and responses."

A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions?

cloudy appearance

A child is diagnosed with bacterial meningitis. The nurse would suspect which abnormality of cerebrospinal fluid (CSF)?

"Individuals with bulimia have a normal weight or are slightly overweight."

A nurse is explaining the difference between anorexia nervosa and bulimia nervosa. The nurse knows the teaching was effective when the parents make which statement?

Ensure proper oxygen followed by administer intravenous (IV) or intramuscular (IM) benzodiazepine

A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. Complete the following sentence(s) by choosing from the lists of options. The nurse should first

"The child will have the tubes for about 1 year, until the tubes fall out on their own,"

A parent of a child child having tympanostomy tubes placed asks, "How long will my child have to have the tubes?" How should the nurse respond to this parent?

Decrease environmental stimulation

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan?

offering vision screening to all students in kindergarten

A school nurse knows that most of the students in the community's elementary school have not received routine vision screening because the families live below the federal poverty threshold. What is the most effective method to promote vision screening for this client population?

appetite suppression

A school-age boy is on methylphenidate for ADHD. What negative side effect should the mother be advised to monitor for in the child?

loss of interest

A school-age child diagnosed with depression is receiving antidepressant therapy. What behavior would the nurse instruct the parents to watch for (and notify the physician immediately) if demonstrated by the child?

use of the affected eye promotes vision development.

The nurse will help parents of a child with amblyopia understand that occluding vision in the unaffected eye is therapeutic because:

Signs of increased intracranial pressure (ICP)

Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis?

"My stomach really sticks out and looks fat."

According to the American Psychiatric Association (DSM-5, 2013), a client with anorexia nervosa has a body image disturbance in which one's body weight or shape is not experienced realistically. Which statement by a client would best validate this criterion?

The shorter and wider eustachian tubes of an infant increase the risk.

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful?

The child should maintain an active lifestyle.

An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? As a rule, children with seizures should attend regular school and participate in physical education classes and active sports.

"The most important thing for your child to understand is that he or she is not to blame for the bullying."

During a wellness health check, a 10-year-old child reports not liking school because the child is getting picked on by other children. The child's parents state a desire to know what the child did to cause the bullying. Which statement by the nurse is most therapeutic?

automobile accidents

During adolescence, alcohol is connected to what problem frequently seen in this age group?

The child may have a fear of being separated from the parent.

In collecting data on a 7-year-old child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which would most likely be a cause of the child having school phobia?

easily distracted failure to complete tasks before going on to another one impulsiveness

Parents are reluctant to accept that their preschooler has attention deficit hyperactivity disorder (ADHD), so the nurse is explaining the commonly seen characteristics of this syndrome. Which characteristics would the nurse include in the explanation? Select all that apply.

Behavioral Theory

Parents of a school-age child have begun a program of therapy that includes giving the child a token each time the child follows directions. Which theoretical framework provides the background for such a program?

"What happened just before the seizures?"

The emergency room nurse is taking a history of a 1-year-old child whose parent said that she had a "fit" at home. Which inquiry would be best to start with?

Assess the child's level of consciousness

The eyes of a 9-year-old who suffered a head injury are crossed. Besides checking ICP, which intervention would be most important for the nurse to perform?

Indifferent attachment to a parent

The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which finding will the nurse expect to assess?

Wipe the drainage away from the inner to the outer canthus of the eye.

The nurse is caring for a 10-year-old child with bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. What should the nurse teach the parents about the care of the eye?

high-pitched cry and nuchal rigidity

The nurse is caring for a 12-month-old infant diagnosed with Haemophilus influenzae meningitis. Which clinical manifestation would likely have been noted in this child?

Promoting eye safety

The nurse is caring for a 3-year-old with amblyopia. Which intervention would be most appropriate to include in the child's plan of care?

Record intake and weight.

The nurse is caring for a child prescribed methylphenidate. Which teaching will the nurse reinforce for this client and caregiver?

It is caused by chronic otitis media or another infection.

The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss?

"I hate to think that I will need to be worried about my child having seizures for the rest of his life."

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education?

Attempt to turn the child on their side to prevent aspiration.

The nurse is caring for a child who is having a seizure. What is the appropriate action by the nurse?

relieving pain

The nurse is caring for a toddler diagnosed with acute otitis media. Which should be the nurse's concern?

"She has been irritable for the last hour....seems like she is just upset for some reason."

The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status?

American Sign Language

The nurse is discussing communication options with the parents of a 2-year-old girl with congenital hearing loss. The nurse integrates knowledge of what form of communication as having no verbal component?

"Use this information to teach family and friends."

The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?

After the implant surgery our child will have normal hearing.

The nurse is educating the parents of an 18-month-old child being prepared to receive cochlear implants. Which statement by the parents requires further teaching?

clonic

The nurse is in the room when a child with a seizure disorder is having a seizure. The child is having generalized jerking muscle movement, and the nurse notes the bed appears to be wet with urine. The child is in which stage of the generalized seizure?

Irritability, fever, and vomiting

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Assess the child's ability to convey information.

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?

"A brief hearing loss after the infection is an abnormal development."

The nurse is providing teaching to the parent of a 4-year-old child being treated for otitis media. When discussing the condition, the parent indicates an understanding of the information provided when making which statement?

"We are worried about what you eat because not eating can cause significant health issues including death." "We are worried because you are not eating enough food to keep your body functioning like it should." "I can see you are frustrated with your mom and you feel like she is controlling you. What does she do that makes you feel that way?"

The nurse is speaking with an adolescent diagnosed with anorexia. The client states, "I do not get why everyone is so worried about what I eat. I just want to be skinny and my mom wants to control me." What response(s) by the nurse is appropriate? Select all that apply.

encouraging the child to keep his hands away from his eyes

The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?

- Motor response• -Eye opening• -Verbal response

The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all answers that apply.

head trauma

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?

normal conversation and above.

The nurse screens a school-aged boy for hearing and discovers he has a hearing loss of 60 dB. This means he would have difficulty hearing:

"Sometimes it is hard to tell if a product contains aspirin."

The parent of a 12-year-old child with Reye syndrome approaches the nurse wanting to know how this happened to their child, saying, "I never give my kids aspirin!" Which response by the nurse is appropriate?

"The tubes are inserted into a section of eardrum in which the hearing is not affected."

The parent of a child having tympanoplasty tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer?

Does it happen all of the time, or just occasionally?

The parents of a 4-week-old infant phone the nursing help line to report that the child has "crossed eyes." What follow-up question should the nurse ask about this strabismus?

absent

The school nurse is observing a child in the classroom. The child is speaking and then suddenly stops and stares for about 5 seconds and then continues speaking. The nurse charts this as what type of seizure?

- Initiate droplet isolation -identify close contacts of the child who will require post-exposure prophylactic medication - Administer antibiotics as ordered• -Initiate seizure precautions

The young child has been diagnosed with bacterial meningitis. Which nursing interventions are appropriate? Select all that apply.

Protect the child from hitting the arms against the bed.

While in a pediatric client's room, the nurse notes that the client is beginning to have a tonic-clonic seizure. Which nursing action is priority?

"Tell me exactly how you would hurt yourself."

While interviewing a depressed adolescent, it is revealed that the client has considered hurting oneself. What question is the nurse's priority?

The adolescent telling the nurse purging occurs after each meal.

The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?

Minimize stimuli that exacerbate the child's undesired behaviors

The nurse identifies a nursing diagnosis of Impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior. Why?

"What you are describing may be what is called myopia."

The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate? Myopia (nearsightedness) occurs when light rays focus anterior to the retina, causing objects that are far away to be unfocused. Typically, this develops around age 8 years and then progresses. These children can read a book or a computer screen immediately in front of them but are unable to read the blackboard clearly from a distance.

the student

A 15-year-old student has been referred by the homeroom teacher to the school nurse for evaluation. The teacher is concerned that the student may be suffering from major depression. Who should be the primary source of information to investigate the concerns about the student?

-depression -lanugo over the back and arms -disposes of food in the trash or toilet

In reviewing the assessment findings of a young hospitalized adolescent female, the nurse would realize that which finding would be indicative of the diagnosis of anorexia nervosa? Select all that apply.

arranging for an evaluation of the child's hearing.

Parents request help from the nurse in managing their young child's "poor behavior." They describe "loud talk and play, not coming when called, seldom following directions, 'blasting' the volume on the TV set, and difficulty understanding spoken words." The appropriate nursing action is:

"There is a decreased perception of danger from drug use by adolescents."

Statistics indicate that adolescents' use of heroin has increased over the last few years, although the numbers remain low. Which statement by a parent of an adolescent indicates that they understand presented education on why adolescents are at a higher risk than in years past?

Insensitivity to pain

Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe?

Not punishing the child for encopresis

When teaching parents of a child with encopresis, what would the nurse stress?

"Have you made a plan to commit suicide?"

An adolescent comes to the school nurse and after being quiet for several minutes states, "I think the world will be better when I am gone." Which statement should be the nurse's first response to this adolescent?

"I always keep phenobarbital with me in case of a fever."(Phenobarbital is used for prolonged seizures or neurologic abnormalities

An otherwise healthy 18-month-old child with a history of febrile seizures is in the wellchild clinic. Which statement by the father would indicate to the nurse that additional teaching should be done?

Prodromal period Tonic stage Clonic stage Postictal period

Put the following events of a generalized epileptic seizure in the correct order: 1 Prodromal period2 Tonic stage3 Postictal period4 Clonic stage

False

The nurse caring for a client with a cranial injury knows that broad spectrum antibiotics are used to reduce cerebral edema.

Bradycardia Fixed dilated pupils Irregular respirations

The nurse determines that a child is experiencing late signs of increased intracranial pressure based on which assessment findings? Select all that apply.

While assessing the child's pupils, there is no change in diameter in response to a light.

The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)?

Use a repetitive series of movements.

To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take?

evaluation of intraocular pressure (IOP) and adherence to the occlusive patch regimen

Which measures should receive priority when planning care for the child who is having surgery to remove a cataract?

School-age and adolescent children view the threats to their health as far in the future, and the child feels that he or she can stop at any time.

With all the warnings on cigarette packages and media coverage of the side effects of tobacco use, why do school-age children and adolescents continue to smoke or chew tobacco?


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