Passpoint - School-age Child

A school-age child has a fever, joint inflammation, and a nonpruritic rash. Knowing that these are signs of rheumatic fever, the nurse should ask the parents:

"Has your child had strep throat recently?"

A 10-year-old child monitors and adjusts insulin dosage independently. Which response reflects an understanding of appropriate adjustment of insulin dosage when the child has the flu?

"I'll do a fingerstick test first, then figure out how much insulin to take."

During chemotherapy, a boy, age 10, loses his appetite. When teaching the parents about his food intake, the nurse should include which instruction?

"Let your child eat any food he wants."

The parents of a child with cystic fibrosis ask the nurse why their child must receive supplemental pancreatic enzymes. Which response by the nurse would be most appropriate?

"Pancreatic enzymes promote absorption of nutrients and fat."

An 11-year-old child with a head injury has been in the hospital 2 weeks while receiving therapy. The child sometimes makes inappropriate statements, and occasionally has combative and violent outbursts. When questioned about this behavior, what is the best response by the nurse?

"This is a stage of healing for your child."

A school-age child needs an I.V. catheter inserted for administration of I.V. fluids. Which explanation by the nurse empowers the client to deal effectively with the procedure?

"You can help by keeping your arm as still as a tree."

The physician prescribes meperidine, 30 mg I.M., as preoperative medication for a school-age child who weighs 66 lb (30 kg). The meperidine is supplied as 50 mg/ml. How much meperidine should the nurse administer?

0.6 ml

A nurse in a well-child clinic is collecting data on children for scoliosis screening. Which child is at greatest risk for scoliosis?

10-year-old girl

A 10-year-old child with a concussion is admitted to the pediatric unit. The nurse would place this child in a room with which roommate?

A 12-year-old child with a fractured femur

An 8-year-old child is suspected of having meningitis. Signs of meningitis include:

Kernig's sign.

A school-age client reports pain. After rating the pain on an age-appropriate pain scale, the nurse determines that the client's pain is minor. Which of the following drugs should the nurse administer?

Acetaminophen

The nurse is reinforcing education regarding insulin injections with an 11-year old child with diabetes Type I. Which guideline is appropriate to follow?

At age 11, the child should be old enough to give injections independantly.

The nurse is caring for a 10-year-old child with cystic fibrosis. The child's parents tell the nurse that they're having difficulty coping with their child's disease. Which action would be most appropriate for the nurse to take?

Consulting with the social worker to help the family find appropriate resources

The school nurse is examining a student at an elementary school who presents with vesicular lesions that ooze, forming crusts on the face and extremities. What is the nurse's most appropriate action?

Contact the parents; the child requires medical treatment and cannot attend school.

A nurse is caring for a school age child with systemic lupus erythematosus (SLE). Which of the following prescribed medication should the nurse administer to combat inflammation?

Corticosteroids

Which action is most appropriate for the nurse caring for a school-age child and his parents?

Encouraging the parents to remain with the child as much as possible while considering the parents' needs

The health care team in the intensive care unit assesses a school-age child and believes his prognosis is grave. The team feels that life support should be withdrawn. After the team discusses withdrawing life support with the parents, the parents agree. How should the nurse intervene during this difficult time?

Explain to the family what will happen when life support is withdrawn.

An 8-year-old client has tested positive for West Nile virus infection. The nurse suspects the client has the severe form of the disease when she recognizes which signs and symptoms?

Fever, muscle weakness, and change in mental status

According to Erikson's psychosocial theory of development, an 8-year-old child would be in which stage of development?

Industry versus inferiority

The mother of a school-age child reports that her child is having some problems in school. Which of the following would be the priority action?

Obtain more information from the mother and the child.

The nurse is caring for a 10-year-old client with cardiac failure who is on bed rest. The client is crying because of boredom. Based on the client's developmental growth, which appropriate action would the nurse implement to eliminate this client's boredom?

Play a game of checkers with the client.

A nurse is caring for a school-age child who is at risk for harming himself or herself when left alone. What is the nurse's most appropriate intervention?

Provide one-on-one observation.

In providing psychosocial care to a 6-year-old child who has had abdominal surgery for Wilms tumor, which activity initiated by the nurse would be most appropriate?

Provide the child with supplies and ask the child to draw how he or she feels.

Which health care team members are necessary to ensure a pediatric approach that combines physical, emotional, social, and spiritual issues?

Social worker, chaplain, nurses, nursing assistants, child life specialist, and physicians

One day after an appendectomy, a 9-year-old client rates his pain at 4 out of 5 on the pain scale but is playing video games and laughing with his friend. Which of the following would the nurse document on the child's chart?

The child rates pain at 4 out of 5. Pain medication administered as prescribed.

A child who was hospitalized for sickle cell crisis is being discharged. Which client outcome demonstrates effective teaching regarding prevention of future crises?

The client verbalizes the need to stay away from anyone with a known or suspected infection.

The nurse is reinforcing the correct use of crutches to a client in the emergency. Which should the nurse include?

The crutches should end 2 in (5 cm) below the axilla.

A child is receiving total parenteral nutrition (TPN). During TPN therapy, the most important nursing action is:

monitoring the blood glucose level closely.

A nurse is caring for 10-year-old child with sickle cell anemia admitted for vaso-occlusive crisis. Which would be the most appropriate activity for the nurse to provide for the child?

reading

The nurse is teaching parents how to reduce the spread of impetigo. The nurse should encourage parents to:

teach children the importance of proper hand washing.

A school-age child experiences symptoms of excessive polyphagia, polyuria, and weight loss. The physician diagnoses type I diabetes mellitus and admits the child to the facility for insulin regulation. The physician prescribes an insulin regimen of insulin (Humulin R) and isophane insulin (Humulin N) administered subcutaneously. How soon after administration can the nurse expect the regular insulin to begin to act?

½ to 1 hour

The parents of a 9-year-old child in the terminal phase of a fatal illness ask the nurse for guidance in discussing death with their child. Which response is appropriate?

"At this developmental stage, most children have an adult concept of death and should be encouraged to discuss it."

The nurse views the laboratory results for a 9-year-old child hospitalized with severe vomiting and diarrhea. Which serum potassium level would the nurse expect to observe in this child?

2.5 to 3.4 mmol/L

The nurse is taking a history from the parents of an 11-year-old girl admitted with Reye's syndrome. Which illness would the nurse expect the parents to report their child having the previous week?

Chickenpox

The nurse is caring for a terminally ill school-age child. Which resource might be most helpful in caring for this child?

Child life specialist

The nurse is caring for an 8-year old child with acute asthma. Which data collection finding should the nurse immediately report to the charge nurse?

During auscultation, breath sounds are diminished bilaterally and no wheezing is audible.

A nurse is caring for a disabled school-age child whose parents are overprotective. What is the most appropriate action of the nurse?

Encourage the parents to arrange a play date for their child with other children.

A nurse is teaching newborn care to expectant parents. Which information about sleep should the nurse include in the teaching plan?

Infants should not sleep in a bed with another person.

A 9-year-old child is being discharged from the hospital after severe urticaria caused by an allergy to nuts. Which instructions would be included in discharge education for the child's parents?

Instruct parents and child on how to use an epinephrine administration kit.

After a series of tests, a 6-year-old client weighing 50 lb (22.7 kg) is diagnosed with complex partial seizures. The physician prescribes phenytoin, 125 mg by mouth twice per day. After the nurse administers phenytoin, where is the drug metabolized?

Liver

A child is admitted with a tentative diagnosis of clinical depression. Which data collection finding is most significant in confirming this diagnosis?

Sadness

The parents of a school-age child with asthma express concern about letting the child participate in sports. What should the nurse tell the parents about the relationship between exercise and asthma?

Taking prophylactic drugs before the activity can prevent asthma attacks and enable the child to engage in most sports.

A pediatric nurse is providing discharge instructions for the family of a school-age child with idiopathic thrombocytopenia. Which activity should be restricted until further notice?

bicycle riding

A nurse is participating in a health class for preteen girls about puberty. The nurse recognizes the teaching has been successful when the students are able to correctly identify which sign as the first sign of sexual maturation in females?

breast bud development

A 10-year-old child has been experiencing insatiable thirst and urinating excessively and the serum glucose is normal. Which condition is the child most likely experiencing?

diabetes insipidus

A nurse is performing a scoliosis screening at a local elementary school. What will the nurse inspect for? Select all that apply.

different shoulder heights head not centered directly over the pelvis uneven rib cage

Which immunization should the nurse in the health care provider's office verify the child has had upon entering school? Select all that apply.

hepatitis B series fiphtheria-tetanus-acelluar pertussis (DTaP) seris Haemophilus influenzae type b series varicella vaccine Inactivated polio series

A nurse working as part of a multidisciplinary team is caring for a school-age child who has cerebral palsy. The child has difficulty eating using regular utensils and requires extensive assistance. The nurse advocating for the child would seek out which team member to assist in promoting the child's independence?

occupational therapist

The mother of several young children calls the nurse when her school-age child comes down with chickenpox. The nurse provides instruction on communicability and home management of this disease. Which response by the mother indicates effective teaching?

"I should have my child soak in oatmeal baths twice daily."

Which advice should a nurse give over the phone to the parent of a 7-year-old child with right lower abdominal pain, fever, and vomiting?

"Seek immediate emergency medical care."

An 8-year-old child is brought to the clinic with watery eyes and clear nasal drainage that has lasted more than 10 days, without fever. The nurse observes that the child has dark circles under the eyes and a crease above the tip of the nose. Which intervention should be the nurse's priority?

Collect data about potential environmental allergy triggers.

A school-age child with terminal leukemia is admitted to the pediatric unit. The nurse must discuss advance directives with the child's parents. The nurse should include which information?

Comfort care options

Which of the following would be an effective relaxation strategy for a school- age child to use during a painful procedure?

Having the child take a deep breath and blow it out until told to stop

The nurse is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity would be most appropriate for the nurse to schedule in the care plan?

Reading books

A 12-year-old with diabetes mellitus uses a glucometer to test their glucose level before lunch. The child receives a reading of 245 mg/dL (13.6 mmol/L) and notifies the nurse. What should the nurse do next? Select all that apply.

Tell the client to administer their regular insulin according to the child's sliding scale. Give the client their lunch tray.

A 6-year-old child's indwelling urinary catheter was removed at 6 a.m. At noon, the child still has not voided, appears uncomfortable, and the nurse palpates slight bladder distention. Which action should the nurse take first?

Turn on the water faucet and provide privacy.

Parents of a 6-year-old child tell a physician that the child has been having periods of unawareness with short periods of staring. Based on his history, the child is probably having which type of seizure?

Typical absence

When collecting data on a girl, age 10, the nurse keeps in mind that the first sign of sexual maturity in girls is:

breast bud development.

A nurse is reinforcing education with the parents of a 5-year-old on how to respond in case of accidental poisoning. If poisoning occurs and the child is alert and in no distress, what should the parents' first response be?

call the poison control center

A child with asthma is receiving theophylline. The nurse knows that theophylline is administered primarily to:

dilate the bronchioles.

An 8-year-old child arrives at the emergency department with chemical burns to both legs. Which nursing action should the nurse perform first?

dilute the burns

A 10-year-old child being treated for common warts asks about the cause. The nurse would reveal which virus as the cause?

human papillomavirus (HPV)

A 10-year-old child falls, injures the left shoulder, and is taken to the emergency department. While the child waits to be seen by the primary health care provider, what is the priority nursing action?

Apply ice to the injured shoulder.

A 6-year-old child with cystic fibrosis is being seen in the health clinic. The parent states that the child, "snores like a bear even while awake. Why?" Which response, if given by the nurse, indicates the understanding of the clinical manifestations that may occur with cystic fibrosis?

"You child snores due to the development of mucus plugs."

A child is receiving chemotherapy for treatment of acute lymphoblastic leukemia. During discharge preparation, which topic is most important for the nurse to discuss with the child and parents?

Ways to prevent infection

A 10-year-old client with asthma is prescribed 2 mg of albuterol syrup four times per day. The syrup comes in a dosage strength of 2 mg/5 ml. How many milliliters of syrup should the nurse administer? Record your answer using a whole number.

5

A nurse is caring for a school-age child who's dying of brain cancer. The parents have requested information about a do-not-resuscitate (DNR) order. Which of the following is the nurse's most appropriate response?

A DNR order does not mean withholding treatment while the child is alive. It involves not initiating treatment after the child has died.

A child with diabetes insipidus receives desmopressin acetate (DDAVP). When evaluating for therapeutic effectiveness, the nurse would interpret which finding as a positive response to this drug?

Decreased urine output

A nurse is preparing to teach a group of school-age children about injury prevention. Which intervention is most appropriate?

Play group games involving sports safety equipment.

A school-age child is admitted to the facility with a diagnosis of acute lymphoblastic leukemia (ALL). The nurse recognizes a nursing diagnosis of Risk for infection. What is the most effective way for the nurse to reduce the child's risk of infection?

Practicing thorough hand washing

A school-age child's family asks the nurse to describe palliative care. Which statement best describes palliative care?

Total care given when disease doesn't respond to curative treatment

The nurse is caring for an 11-year-old child with cerebral palsy who has a pressure ulcer on the sacrum. When reinforcing education for the parent about dietary intake, which foods should the nurse plan to emphasize?

lean meats and low-fat milk

The nurse is caring for a child with history of strep throat reporting abdominal pain and joint achiness. Which laboratory data does the nurse communicate with the health care provider immediately?

leukocytosis

After collecting data on a newly admitted 5-year-old child, the nurse determines that the parents may need additional help adjusting when the when which finding is observed?

parents' not having any support systems in place

A child who had bacterial meningitis is scheduled to have his hearing tested before discharge. The parent asks the nurse why this test is necessary. Which response by the nurse is appropriate?

"Some children with bacterial meningitis suffer damage to the nerve responsible for hearing; this test screens for hearing loss."

A 6-year-old child is observed to have a papulovesicular eruption on the left anterior lateral chest, with reports of pain and tenderness of the lesion. What condition does the nurse suspect the child is experiencing?

herpes zoster

Several children in a kindergarten class have been treated for pinworm. To prevent the spread of pinworm, the school nurse meets with the parents and explains that they should:

tell the children not to bite their fingernails.

A pediatric client with iron deficiency anemia is prescribed ferrous sulfate, an oral iron supplement. When teaching the child and parent how to administer this preparation, the nurse should provide which instruction?

"Administer ferrous sulfate with fruit juice to promote absorption."

A 10-year-old girl visits a clinic for a checkup before entering school. The child's parent questions the nurse about what to expect at this stage of the daughter's growth and development. Which responses from the nurse would be most appropriate? Select all that apply.

"She may begin to develop secondary sex characteristics, such as breast buds." "Friends will be very important to her, and she'll develop an interest in the opposite sex."

A parent reports that their 6-year-old daughter recently started wetting the bed and running a low-grade fever. A urinalysis is positive for bacteria and protein. A diagnosis of a urinary tract infection (UTI) is made, and the child is prescribed antibiotics. Which interventions are appropriate? Select all that apply.

Assess the parent's understanding of UTI and its causes. Instruct the parent to administer the antibiotic as prescribed—even if the symptoms diminish. Discourage taking bubble baths.

The nurse is giving instructions to parents of a school-age child diagnosed with sickle cell disease. The instructions should include which of the following?

Avoid areas of low oxygen concentration such as high altitudes.

A child is sent to the school nurse because, according to the teacher, the child is constantly scratching their head. When the nurse evaluates the hair and scalp, there is evidence of lice. What strategies should the nurse recommend to the teacher and parents to minimize the spread of lice to other students? Select all that apply.

Do not allow children to share combs, brushes, or towels. Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere. Do not allow children to share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes. All household members and other close contacts should be checked; those persons with evidence of an active infestation should be treated.

A 10-year-old boy falls, injures his left shoulder, and is taken to the emergency department. While the client waits to be seen by the physician, what intervention should the nurse perform first?

Keep him in a comfortable position and apply ice to the injured shoulder.

The nurse is caring for a 7-year-old child hospitalized with cystic fibrosis. To help the child manage secretions and avoid respiratory distress, which nursing intervention would be a priority?

Perform chest physiotherapy every 4 hours.

A 10-year-old child is in the hospital for the first time. The nurse has provided support and teaching to help the family and child adjust and to reduce their anxiety related to the child's hospitalization. Which of the following would the nurse view as unexpected?

The parents choose to leave to let the child build a relationship with the staff.

The nurse is caring for an 8-year-old child admitted with pneumonia. Based on the child's age, which type of pneumonia does the nurse suspect?

mycoplasma pneumonia

A parent brings a child to the health care provider's office for evaluation of chronic stomach pain stating, "The pain seems to go away when I keeps the child home from school." The health care provider diagnoses school phobia. Which other behaviors or symptoms may the child exhibit? Select all that apply.

nausea headaches dizziness

A nurse is examining the progress record of a client with femur fractures who has had bilateral leg skeletal traction applied. The nurse reinforces education of the child on performing Kegel exercises. What is the most important purpose of these exercises?

to maintain good perineal muscle tone by tightening the pubococcygeus muscle

The mother of a child with chickenpox (varicella) asks the nurse when her child may return to school. The nurse responds correctly by telling the mother that the child can return:

when all of the lesions are crusted over.

When collecting data from a 6-year-old child who has a 20% deep partial-thickness (second-degree) burn of the arms and trunk, the nurse determines that the child has damage to what layer(s) of skin?

epidermis and part of the dermis