Pediatric Adaptive HW
An adolescent who has just been found to have type 1 diabetes asks a nurse about exercise. What is the best response by the nurse?
"Extra snacks are needed before exercise." Exercise lowers the blood glucose level; an extra snack can prevent hypoglycemia.
A 14-year-old teenager with type 1 diabetes wants to go out to eat with friends after a volleyball game. The teenager asks the school nurse whether this is permissible on the insulin/diet/exercise regimen that has prescribed. How should the nurse respond?
"I'll teach you how to determine the amount of carbohydrates in different fast foods." A fast food exchange list allows the diabetic teenager to participate in postgame activities without feeling different from peers; this is important to the adolescent.
The clinic nurse is teaching the parents of a 3½-year-old child who is up to date on all vaccinations when it will be necessary to return to the clinic for the next set of vaccinations. Which statement indicates that the parents understand the teaching?
"We need to come back to the clinic in 1 year for more vaccinations." The child who is up to date on vaccinations at 3½ years of age will need to return to the clinic for an annual influenza vaccination.
A 6-year-old child is admitted with an acute infection and dehydration. There is a prescription for an IV antibiotic to be piggybacked to a continuous hydration solution. During the administration of the antibiotic the child becomes restless, flushes, and begins to wheeze. Place the nursing actions in order of their priority.
1. Stopping the antibiotic infusion Correct 2. Assessing the respiratory status 3. Maintaining the hydration infusion 4. Notifying the practitioner The child is experiencing an allergic reaction. First the antibiotic should be stopped to prevent anaphylactic shock. Maintaining respiratory function is a priority; therefore it should be checked immediately and assessed routinely. The continuation of hydration is important to dilute the effect of the allergen and to keep the vein open if emergency medication is required. After the immediate needs of the child have been met, the practitioner should be notified.
How many words should the nurse expect the 3-year-old child to acquire each day?
5 to 6 The nurse would expect the 3-year-old toddler-age child to acquire 5 to 6 new words each day.
According to current studies, what percentage of adolescents has used alcohol by the end of high school? Record your answer using a whole number. _____%
85
The nurse is preparing to assess several clients at a pediatric clinic. Which client would require a developmental screening versus developmental surveillance during a scheduled health maintenance visit?
A 9-month-old infant The nurse would conduct a developmental screening for the 9-month-old infant during a scheduled health maintenance visit.
A nurse is caring for an infant whose vomiting is intractable. Which complication is most likely to occur?
Alkalosis Excessive vomiting causes an increased loss of hydrogen ions (HCl), leading to metabolic alkalosis, an excess of base bicarbonate
A 2½-year-old boy who has undergone surgery to revise a ventriculoperitoneal shunt is to be discharged. The nurse advises the parents to call the clinic if the child does what?
Appears drowsy after a nap and becomes irritable Drowsiness and irritability are characteristic signs of increasing intracranial pressure;
Which type of play should the nurse encourage when providing age-appropriate care to a preschool-age child who is hospitalized?
Associative The nurse should encourage the hospitalized preschool-age client to participate in associative play.
What changes are observed in a preschool-aged child? Select all that apply.
Balanced and coordinated body Decreased abdominal protrusion By the third year of life, the child's body becomes slimmer, taller, and better balanced. In addition, abdominal protrusion decreases.
What transformations occur during the mid-puberty stage of a normally developing adolescent female?
Breast enlargement and the growth of pubic hair During mid-puberty, the breast enlarges from a small bud of breast tissue, while pubic hair develops and covering the mons pubis and labia majora.
A nurse is performing a neurologic assessment of an adolescent with a seizure disorder. How should the nurse test cranial nerve XI?
By telling the adolescent to shrug the shoulders The accessory nerve (cranial nerve XI) innervates the sternocleidomastoid and trapezius muscles; the nurse evaluates this nerve by asking the client to shrug the shoulders.
According to the Piaget's theory, which behavior does a nine-year-old child show?
Concrete thinking
Which pain scale should a nurse use to measure the intensity of pain in toddlers?
FACES scale The nurse should use a FACES scale to measure the intensity of pain in children.
A nurse in the pediatric unit is admitting an 8-year-old child with asthma after an exacerbation at home. The child is short of breath. In what position should the child be placed to facilitate breathing and to promote respiratory drainage?
High-Fowler The high-Fowler position gives the lungs more room to expand, thereby promoting respiration and affording more comfort.
A client is undergoing highly active antiretroviral therapy (HAART). From what viral disease could the client possibly be suffering?
Human immunodeficiency virus (HIV) Highly active antiretroviral therapy (HAART) is a combination of antiretroviral drugs used to treat human immunodeficiency virus (HIV).
What does a nurse identify as the priority short-term goal for a toddler with dehydration caused by diarrhea?
Improvement of fluid balance Rehydration and correction of electrolyte imbalances are the priorities; diarrhea causes loss of fluid and electrolytes that can be life threatening.
A 3-year-old is placed in a bilateral hip spica cast for the treatment of developmental dysplasia of the hip. The nurse should teach the parents to monitor their child and report to the practitioner the occurrence of what?
Leg numbness Numbness is a neurologic symptom that should be reported immediately because it indicates pressure on the nerves and blood vessels.
Which plant, if ingested by a toddler-age client, would necessitate further action by the nurse?
Lily If a toddler-age client eats a lily, the nurse should tell the parents that the plant is poisonous and to proceed to the emergency department for further care
A nurse is caring for an infant with heart failure. What treatment does the nurse most likely anticipate in the care of this infant?
Medications that are prescribed for both children and adults Because the mechanism of heart failure is the same in children and adults, the same medications (e.g., cardiac glycosides, angiotensin-converting enzyme [ACE] inhibitors, and diuretics) are used, although the dosage will be adjusted for the infant and for the child.v
A school-aged child is admitted to the hospital with severe burns on the arms. Therapeutic escharotomy is planned. What is the priority nursing action at this time?
Monitoring radial pulses Eschar is rigid and may restrict circulation and lead to loss of limb perfusion.
An 18-month-old toddler who stepped on a rusty nail is brought to the emergency department a week later. The nurse determines that the family lives in a rural area and that the toddler has never received health care. The child shows signs of generalized tetanus, including neck and jaw stiffness and facial muscle spasms. What does the nurse conclude is the cause of these clinical findings?
Painful muscle rigidity caused by exposure of the nervous system to the exotoxin of the causative organism Tetanus is characterized by trismus (difficulty opening the mouth), stiffness of the facial and neck muscles progressing to laryngospasm, generalized rigidity, opisthotonos, and respiratory arrest.
A 5-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal glomerulonephritis. What assessment data lead the nurse to conclude that the child has a fluid volume excess?
Periorbital edema, smoky urine, headaches Periorbital edema indicates fluid retention, and headaches are a symptom of hypertension.
What is the nurse's priority intervention when preparing for admission of a child with acute laryngotracheobronchitis?
Placing a tracheostomy unit by the bedside The priority is a patent airway; the equipment needed to ensure a patent airway must be immediately available.
What findings should a nurse expect when examining the laboratory report of a preschooler with rheumatic fever?
Positive antistreptolysin titer A positive antistreptolysin titer is present with rheumatic fever because of the previous infection with streptococci.
A 7-month-old infant is brought to the pediatric clinic for a well-child visit. The nurse assesses several of the infant's behaviors. What behavior is most unusual for an infant of this age?
Putting clothespins in a plastic bottle Putting objects in a container is expected of 9- to 12-month-old infants; this behavior is most unusual at 7 months of age.
Which test is used to diagnose trichomoniasis?
Saline wet smear test A saline wet smear test is used to diagnose trichomoniasis.
The parents of a 4-year-old child call the health center and report that their child has a fever of 102.6° F (39.2° C), is complaining of a sore throat, and will not lie down, preferring to sit up and lean forward. The child is drooling and looks ill and agitated. In light of this information, what guidance should the nurse provide the family?
The child needs to be seen immediately by a healthcare provider. This child is presenting with signs and symptoms of epiglottitis, which is a medical emergency.
A nurse provides clapping, percussion, and postural drainage every 4 hours for a 3-month-old infant with cystic fibrosis. When is the best time for the nurse to schedule chest physiotherapy?
Two hours after feedings Chest physiotherapy is done midway between feedings (about 2 hours before or after a feeding). This will decrease the likelihood of vomiting and increase drainage of respiratory secretions.
Which statement is true regarding varicoceles?
Varicoceles cause an elongation of the veins of the spermatic cord. Varicocele is characterized by a dilation and elongation of the veins of the spermatic cord that is presently superior to a testicle.
A preschooler is admitted with a diagnosis of acute glomerulonephritis. The child's history reveals a 5-lb (2.3 kg) weight gain in 1 week and periorbital edema. How can the nurse obtain the most accurate information on the status of the child's edema?
Weighing daily Weight monitoring is the most useful means of assessing fluid balance and changes in the edematous state; 1 L of fluid weighs about 2.2 lb (1 kg).
