Pediatric final

The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond?

"Let's work together to plan your day along with your treatments.

A child has been prescribed growth hormone. When collecting data from this patient, which report is of the greatest concern?

"My hips often hurt."

The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the moth

"The cereal should be a fairly thin consistency at first."

The nurse is performing developmental surveillance for children at a medical home. Which infants are most at risk for developmental delays? Select all that apply.

-A child whose parent has a mental illness -A child raised by a single parent -A child with a lead level above 10 mg/dL -A child with hypertonia or hypotonia

The nurse is assessing the developmental milestones of an infant. The infant was born 8 weeks ago and was 4 weeks premature. The nurse anticipates that the infant will be meeting milestones for what age of child? Record your answer in weeks.

4

At which age would the nurse expect to find the beginning of object permanence?

6 months

The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in what ranges?

60 to 100 bpm

The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up the child weighed 80 pounds. According to average growth for this age group, what would be his expected current weight?

87 pounds

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate?

Advising how to create a toddler-safe home

The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching?

Advising them to use praise, not scolding

The nurse is assessing heart rate for children on the pediatric ward. What is a normal finding based on developmental age?

An infant's rate is 90 bpm. -The normal heart rate for an infant is 80 to 150 bpm, for a toddler is 70 to 120 bpm, for a preschooler is 65 to 110 bpm, and for a school-age child is 60 to 100 bpm.

The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations?

"You need to adhere to various routines."

When providing anticipatory guidance to parents about their preschool son who was caught in a lie, what would the nurse emphasize?

"You need to determine the reason for lying before punishing the child."

What activity would the nurse expect to find in an 18-month-old?

Climbing stairs with assistance

When performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess?

Decreased tactile fremitus

The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs?

Developing language and motor skills

The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan?

Developing management and decision-making skills

The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance?

Discouraging the addition of fruit juice to the diet

A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which instruction would the nurse include when teaching the parents about caring for their child?

Discouraging the child from stretching or bending forward for 4 weeks

A 6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. What is the priority nursing intervention?

Discussing the child's feeding patterns

The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned?

Draws a person with three body parts

The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's 'negativism.' Based on Erickson's theory of development, what would be an appropriate intervention for this child?

Encourage the child to pick out his own clothes.

The nurse is educating a first-time mother who has a 1-week-old boy. Which is the most accurate anticipatory guidance?

Explaining that the stomach holds less than 1 ounce

Infant vital signs (Birth-12months)

HR: 80-150 RR: 25-55 -1st count respirations -2nd count apical heart rate -3rd BP -4th Temperature

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy?

Height increase of 4 inches

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type?

Hemoglobin A

The nurse is implementing interventions to prevent physical stressors for a 9-year-old child receiving chemotherapy in the hospital. What is an example of using atraumatic care for this child?

Insert a saline lock if the child will require multiple doses of parenteral medications.

The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order

Inspection, palpation, percussion, auscultation

The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents?

Monitor their child's level of sedation.

The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is priority to promote adequate growth?

Monitoring the child's weight and height

Which tool would be the least appropriate scale for the nurse to use when assessing a 4-year-old child's pain?

Numeric pain intensity scale

The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control?

Offer the girl as many choices as possible.

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally?

Pancreatic enzymes

The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan?

Place the baby on his or her back when sleeping.

The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which nursing intervention should be questioned?

Provide alcohol baths as needed.

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia?

Pulse oximetry

The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area?

The child does not point to named body parts.

The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem?

The child does not vocally respond to voices.

The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development?

The child is unable to push a toy lawnmower.

The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder?

The parents report that their son "can't drink enough water."

The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last?

Throat

After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify what as a characteristic of therapeutic play?

Use of a highly structured format

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select?

Vastus lateralis

Anticipatory guidance

educating parents and caregivers about what to expect in the next phase of development

Developmental milestones 8 months

sits unsupported

The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?

Initiate pain assessment with a standardized pain scale.

A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route?

Intramuscular injection

The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a b2-adrenergic agonist for treatment of bronchospasm?

Ipratropium

When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note?

Parallel play -Parallel play is associated with toddlers. Cooperative, dramatic, and fantasy play are commonly used by preschoolers.

The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors?

Sewing puppets with needles

The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. What information would the nurse include?

Soaking the catheter in a vinegar and water solution to steriliz

The pediatric nurse is planning quiet activities for hospitalized 18-month-old. What would be an appropriate activity for this age group?

Stacking blocks

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?

Strawberry tongue

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

Sunken fontanels

The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which best examplifies a school-ager working toward accomplishing this developmental task?

The child signs up for after-school activities.

Developmental milestones 9 months

crawls, abdomen off the floor

Fine motor skills

develop proximodistal (from center to the periphery)

The nurse uses the FLACC behavioral scale to assess a 6-year-old's level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing:

severe pain.

Developmental milestones 12 months

sits from standing position, walks independently

Developmental milestones 6 months

tripod sits

The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply.

-Abdominal pain -Hypertension -Crackles

The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply.

-Around 2 months the infant exhibits a first real smile. -Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. -Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue -Separation anxiety may also start in the last few months of infancy.

The nurse is assessing an 11-year-old girl with scoliosis. What would the nurse expect to find? Select all answers that apply.

-Asymmetric shoulder elevation -Pronounced one-sided hump on bending over

The nurse is providing atraumatic care to children in a hospital setting. What are principles of this philosophy of care? Select all that apply.

-Avoid or reduce painful procedures -Avoid or reduce physical distress -Use core primary nursing

The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? Select all that apply.

-Counting 10 or more objects -Correctly naming at least four colors -Understanding the concept of time -Knowing everyday objects

The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply.

-Extending breastfeeding into toddlerhood is believed to be beneficial to the child. -Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. -The toddler requires an average intake of 500 mg calcium per day.

A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? Select all that apply.

-Intravenous immunoglobulin -Acetaminophen -Aspirin

Infant growth rate

-Newborns lose 10% of their body weight to first week of life -Double their birth weight by 4 months of age -Triple their birth weight by 1 year of age

The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.

-Plans activities and makes up games -Initiates activities with others -Acts out roles of other people

The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which examples are behavioral indicators? Select all that apply.

-The infant grimaces. -The infant flails his arms and legs. -The infant is crying uncontrollably.

The nurse is preparing to perform a dressing change on a 13-year-old client who is being treated for burns he received two weeks ago. The client prefers not to take pain medication before the dressing change because it causes drowsiness. What nursing interventions would provide atraumatic care? Select all that apply.

-The nurse asks the client if he would like the television on during the dressing change. -The nurse encourages the client to wear headphones to listen to music during the dressing change.

Toys for 7 months

-fabric or board games -Different types of music -East to hold toys - Floating bath toys -Soft dolls or animals

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day?

1,600 mL

The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply.

1. At 1 month the infant lifts and turns the head to the side in the prone position. 2. At 7 months the infant sits alone with some use of hands for support. 3. At 9 months the infant crawls with the abdomen off the floor. 4. At 12 months the infant walks independently.

After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?

After the lesions have crusted

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

Albuterol

The nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level?

Allow the child extra time to complete thoughts.

The nurse is inspecting the fingernails of an 18-month-old girl. What finding indicates chronic hypoxemia?

Clubbing of the nails

The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?

Teaching the parents how to administer the desmopressin acetate

The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance?

Telling how and when to introduce rice cereal

The nurse is inspecting the genitals of a prepubescent girl. Which is a normal sign of the onset of puberty?

Appearance of pubic hair around 11 to 13 years old

When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend?

Approximately 16 to 24 ounces of milk per day

The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations?

Athetoid

After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow?

Atrial septal defect

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find?

BUN levels -With nephrotic syndrome, proteinuria, hyperlipidemia, decreased serum protein levels (hypoproteinemia), and decreased serum albumin levels (hypoalbuminemia) are present. BUN typically becomes elevated.

The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse would expect this insulin to begin acting at which time?

Between 9 and 11 a.m.

The nurse is performing an annual check-up for an 8-year-old child. Compared to the previous assessment of this child, which characteristic would most likely be observed?

Breathing is diaphragmatic.

The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a

By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth.

The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative?

Reward the child for initiative in order to build self-esteem.

The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse?

Riley Infant Pain Scale

When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

Skeletal traction

Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?

Step

The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse?

The toddler's anterior fontanel is not fully closed.

What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele?

Covering the sac with saline-soaked nonadhesive gauze

Based on Erikson's developmental theory, what is the major developmental task of the adolescent?

Finding an identity

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next?

Give 10 to 15 grams of a simple carbohydrate.

A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information?

This is a primitive reflex known as the palmar grasp.'

The nurse is watching toddlers at play. Which normal behavior would the nurse observe?

Toddlers engage in parallel play

After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time?

When the child is 4 to 6 years of age