PEDI EXAM 4 PREPU

The nurse is caring for a 6-year-old boy with Russell traction applied to his left leg. Which intervention would be most appropriate to prevent complications?

Assess the popliteal region carefully for skin breakdown

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant?

Baclofen

The nurse is conducting a physical examination of a newborn with suspected osteogenesis imperfecta. Which finding is common?

Blue sclera

A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client?

Bracing

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

Color Sensation Pulse Capillary refill

The parents of an infant born with an abnormality on the back are told by the neonatologist that their child has a myelomeningocele. They ask the nurse what exactly that means. Which would be the nurse's best reply?

"It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved."

A 13-year-old adolescent with hyperthyroidism who takes antithyroid medication has a sore throat and a fever. The parent calls the nurse and asks what to do. Which is the best response from the nurse?

"Please take your child straight to the emergency department."

A child has been diagnosed with impetigo and the nurse is performing discharge teaching to the parents. Which statements by the parents indicate that additional teaching is necessary? Select all that apply.

"Even though the lesions have crusted, the infection is contagious and our child should stay home from school. Not contagious after crusts "Antifungal medications should be administered as ordered by our physician." Its bacterial - ABX "We should soak impetiginous lesions with cool compresses to remove crusts before applying topical medication." Warm? I'm confused by dis bc it is cool

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement?

"I should be certain to use fabric softener in the care of the infant's clothes."

The nurse is providing education to a teenaged boy diagnosed with impetigo. Which statement by the boy indicates the need for further education?

"I will need to cover my son's skin lesions with bandages until it has healed."

Which statement by the parent of a 12-month-old child diagnosed with Down syndrome shows the need for further education?

"I will need to delay any further immunizations."

The nurse is developing a care plan for a 15-year-old female client with Turner syndrome with the assessment notes shown above. Which expected outcome should take priority

Maintaining appointments with cardiologist

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?

Metformin

The nurse is educating a parent of a toddler with Down syndrome. Which statement by the parent indicates teaching was effective?.

"I hope my child does well with the various therapies we have arranged.

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education?

"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis?

"I always tell my daughter to use her own hairbrush."

A nurse is providing discharge education to the parents of an infant diagnosed with Turner syndrome. Which statement made by the parents is most accurate concerning this condition?

"Our child will need estrogen therapy."

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child feels increasing severe pain.

Ominous sign: paresthesia

A nurse is caring for a 10-year-old who is in skeletal traction following injuries sustained in a car accident. Which statement accurately describes a recommended nursing measure for this type of traction?

Perform pin-site care on a daily or weekly basis after the first 48 to 72 hours

The nurse is caring for an infant with a myelomeningocele who has paralysis of the lower extremities. Which actions would be most appropriate to help reduce friction resulting from this paralysis? Select all that apply.

Place a folded diaper in between the legs. Place the child on a special care mattress. Place synthetic sheepskin under the infant's chest.

A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?

Provide instruction on how to care for a diaper rash.

The nurse is educating an 18-year-old female client with Turner syndrome. What information will the nurse include in the teaching plan?

Resources regarding infertility and family planning

An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants?

Staphylococcus aureus

The nurse is assessing an 8-year-old boy who is performing academically at a second-grade level. The mother reports that the boy states feeling weak and tired and has had a weight increase of 6 pounds (13.2 kg) in 3 months. Which additional data would fit with a possible diagnosis of hypothyroidism?

The child states that the room is cold

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing intervention is the highest priority for this child?

The nurse follows contact precautions

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note?

The posterior spine when bending forward

A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin?

do not mix this insulin with other insulin

After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question?

"So, hypothyroidism can be treated by exposing our baby to a special light, right?"

A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown and there are many environmental factors that may contribute to it."

A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching?

"We should bathe our child in hot water, twice a day."

The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder?

"When they get my son's thyroid levels normal, he won't be so tired."

For a diagnosis of Klinefelter syndrome, what would be the chromosome pattern to identify this disorder?

47 XXY

The nurse measures the client's blood glucose level prior to breakfast. The measurement obtained is 130 mg/dL. The orders read to administer 2 units of Humalog insulin for a blood glucose of 100 to 150mg/dL. How soon should the nurse ensure that the client eats their breakfast after receiving their insulin?

15-30 mins

The nurse is caring for a group of children in the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.

The nurse is caring for several pregnant women. Which woman would the nurse identify as being at highest risk for having a child born with Down syndrome?

A woman at 28 weeks who will be 37 years old at time of delivery

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

Administration of levothyroxine indefinitely

The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. What would the nurse expect to administer if ordered?

Diazepam

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings?

Discuss preparing for a thyroid function test

A child is brought to the clinic experiencing symptoms of nervousness, tremors, fatigue, increased heart rate and blood pressure. Based on this assessment, the nurse would suspect a diagnosis of which condition?

Grave's

During an assessment of an adolescent child, the nurse notes that the child has a protuberant tongue, fatigued appearance, poor muscle tone and exophthalmos. What medical diagnosis would the nurse expect the child to have?

Grave's

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone?

Growth Hormone

The nurse is educating parents of a toddler with Down syndrome. What would the nurse include in the teaching plan?

Have the child's thyroid function tested regularly

A simple blood test to diagnose hypothyroidism is required in most states

High TSH decreased T3

A 3-month-old infant is seen in the pediatric clinic. The infant's parent expresses concern that the child has developed cerebral palsy. The nurse assesses the infant. Which assessment finding indicates to the nurse that the parent's concern is valid?

Hypertonia in upper extremities

An 18-year-old male is diagnosed with Klinefelter syndrome. What signs and symptoms are consistent with this diagnosis?

Hypogonadism and gynecomastia

An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug?

I have to make sure that I do not become pregnant while taking this drug."

A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true?

Kids can normally be managed with an oral agent, meal planning and exercise

A 9-year-old child with Graves disease is seen at the pediatrician's office reporting sore throat and fever. The nurse notes in the history that the child is taking propylthiouracil. Which of the following would concern the nurse?

Leukopenia

The nurse is performing an assessment of a 6-year-old girl with Turner syndrome. What finding would the nurse most likely assess?

Short stature slow growth

A nurse is conducting a physical examination on an 11-year-old boy with Legg-Calvé-Perthes disease. Which assessment finding would be expected?

Trendelenberg gait

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply.

polyphagia polydispia polyuria

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome?

Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply.

If I am sexually active I need to let my doctor know." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." "It's important I get my CBC blood test when my doctor orders it."

The nurse is caring for a pediatric client diagnosed with Turner syndrome. Which assessment finding(s) will the nurse expect? Select all that apply.

Webbed neck Swollen hands Narrow fingernails Short stature

The nurse is taking a history on a 10-year-old child who has a diagnosis of hypopituitarism. Which question is important for the nurse to ask the parents?

What time each day does your child take his growth hormone? (should be around bedtime)

A nurse is reviewing information about the various types of insulin that are used to treat type 1 diabetes mellitus. Integrating knowledge about the duration of action, place these types in the order from shortest to longest duration.

aspart regular NPH glargine

A 9-year-old male is coming into the office to be seen for possible precocious puberty. The nurse would expect that the lab will perform which test?

hCG

The nurse is educating a female client about genetic disorders. Which statement by the client best describes the major risk factor for trisomy 21?

increasing maternal age

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has:

polyphagia

The nurse is creating a care plan for a child with a leg cast. What interventions would be appropriate for the nursing diagnosis of Risk for ineffective peripheral tissue perfusion related to pressure from cast? Select all that apply.

Assess foot and toes every 4 hours for color, warmth, and presence of pedal pulses. Keep the leg elevated by a pillow at all times. Assess capillary refill of toes every 4 hours.