Pediatric Rosdahl Prep U

A toddler has otitis media. On which of the following teaching instructions for the caregiver should the nurse place the highest priority? a) How to put ear drops in the toddler's ear b) Instructions on myringotomy and tympanostomy tube insertion c) Removing any environmental allergen triggers d) Making sure the client gets the full antibiotic course

Making sure the client gets the full antibiotic course Explanation: The course of antibiotics should be completed even after symptoms improve to decrease any resistance to the antibiotic. Ear drops would be used only with a tympanostomy insertion. Every client is not a candidate for myringotomy or tympanostomy. Allergens are not the focus of this diagnosis.

A toddler has otitis media. On which of the following teaching instructions for the caregiver should the nurse place the highest priority? a) Making sure the client gets the full antibiotic course b) Removing any environmental allergen triggers c) Instructions on myringotomy and tympanostomy tube insertion d) How to put ear drops in the toddler's ear

Making sure the client gets the full antibiotic course Explanation: The course of antibiotics should be completed even after symptoms improve to decrease any resistance to the antibiotic. Ear drops would be used only with a tympanostomy insertion. Every client is not a candidate for myringotomy or tympanostomy. Allergens are not the focus of this diagnosis.

While obtaining a history from a 15-year-old girl, the girl tells the nurse that she often experiences cramping abdominal pain about the middle of her menstrual cycle. The nurse documents this as which of the following? a) Secondary dysmenorrhea b) Mittelschmerz c) Secondary dysmenorrhea d) Amenorrhea

Mittelschmerz Explanation: Mittelschmerz refers to pain that occurs with ovulation, which takes place at approximately the middle of the menstrual cycle. Primary dysmenorrhea is painful menstruation with no accompanying pelvic disease; secondary dysmenorrhea is painful menstruation accompanied by organic pelvic disease. Amenorrhea refers to the absence of the menstrual cycle.

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. Which of the following would alert the nurse to the possibility of early localized Lyme disease? a) Ring-shaped rash b) Facial palsy c) Chronic fatigue d) Recurrent arthritis pain

Ring-shaped rash Explanation: A ring-shaped rash is an early sign of Lyme disease. Facial palsy and chronic fatigue are two symptoms that can occur weeks after infection if the disease is not treated. Arthritis occurs in the late stage of the disease.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature has been over 102°F. He has this rash on his face and chest that looks like sunburn but feels really rough." Which of the following would the nurse suspect? a) Rubeola b) Varicella c) Scarlet fever d) Rubella

Scarlet fever Explanation: Like some other diseases, scarlet fever is accompanied by fever and rash, but the rash is sandpaper-like in texture.

When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? a) Physical therapy b) Occupational therapy c) Skeletal traction d) Orthotics

Skeletal traction Explanation: Skeletal traction would be the least likely treatment for a child with cerebral palsy. Physical therapy, orthotics and braces, and occupational therapy are all common treatments used for cerebral palsy.

The nurse is caring for a 4-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder? a) "He still seems to have trouble talking intelligibly sometimes." b) "He seems to always be talking non-stop." c) "He can't even sit still for a short story." d) "He seems to be less and less interested in talking to us."

"He seems to be less and less interested in talking to us." Explanation: A significant lack of interest in social interaction and preoccupation with one's self are possible signs of autism spectrum disorders. The child who hasn't yet developed language skills may be showing signs of a specific learning disability. Incessant talking and a short attention span may be signs of attention deficit hyperactivity disorder.

The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions? a) Asperger's syndrome b) Dyslexia c) Attention deficit/hyperactivity disorder d) Depression

Attention deficit/hyperactivity disorder Explanation: Children with Tourette syndrome may also display symptoms of attention deficit hyperactivity disorder and obsessive compulsive disorder.

A nurse is caring for a 2-month-old child who has undergone surgery for pyloric stenosis. Which should the nurse do as part of the postoperative care? a) Start glucose water feeding immediately after surgery. b) Position the baby supine with the head remaining flat. c) Schedule care to provide bath only after feeding. d) Bubble the baby as frequently as possible.

Bubble the baby as frequently as possible. Explanation: During the postoperative care for a baby who has undergone surgery for pyloric stenosis, the nurse should bubble the baby frequently to remove fundic gas. The care should be scheduled such that bathing is done before, not after, the feeding. The baby should be positioned on the right side, with his or her head slightly elevated. Glucose water feeding should be started 2 to 3 hours after surgery, and not immediately after surgery.

The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? a) Calling the doctor if the child gets a sore throat b) Using acetaminophen if the child needs an analgesic c) Keeping a written copy of the treatment plan d) Writing down phone numbers and appointments

Calling the doctor if the child gets a sore throat Explanation: Calling the doctor if the child exhibits any sign of an upper respiratory infection--such as a sore throat--is a priority. Infections can lead to life threatening septicemia.

The nurse is applying a urine bag to a 15-month-old male to collect a urine specimen. Which of the following steps would be done first in the process? a) Apply the bag to the perineal space b) Clean and dry the perineal area c) Offer the child fluids d) Ensure that the foreskin is in its normal position

Clean and dry the perineal area Explanation: After positioning the child, nurse cleans and dries the child's perineal area. The nurse confirms that the foreskin is in its normal position (if the boy is uncircumcised) and applies the bag. The nurse then offers fluids to encourage voiding. (The nurse also offers fluids 30 minutes before applying the bag.)

A child with Down's syndrome is being seen at the pediatrician's office. For which of the following cardiac conditions should the nurse expect the child to also be evaluated? a) Congenital heart defects b) Systemic hypertension c) Cardiomyopathy d) Hyperlipidemia

Congenital heart defects Explanation: Congenital heart defects are often found in approximately 35% of children with Down's syndrome. Cardiomyopathy, hyperlipidemia, and systemic hypertension are not associated with Down's syndrome.

A 4 year old is newly diagnosed with Duchenne muscular dystrophy. The nurse is educating the caregiver. Which of the following progressive complications would the nurse explain? a) Contractures, obesity, and pulmonary infections b) Trembling, frequent loss of consciousness, and slurred speech c) Dry skin, protruding tongue, and mental retardation d) Anorexia, gingival hyperplasia, and dry skin/hair

Contractures, obesity, and pulmonary infections Explanation: Contractures, obesity, and pulmonary infections are signs and symptoms linked to losing muscle function. In muscular dystrophy, the disorder is progressive. Dry skin, protruding tongue, and mental retardation are signs and symptoms of Down's syndrome. Anorexia, gingival hyperplasia, and dry skin/hair are not produced by Duchenne dystrophy. Slurred speech, trembling, and loss of consciousness could be caused by head trauma.

A nurse is preparing a presentation for a local parent group about urinary tract infections in children. Which of the following would the nurse incorporate into the presentation as the most common cause? a) E.coli b) Klebsiella c) Staphylococcus aureus d) Pseudomonas

E.coli Explanation: Urinary tract infections can be caused by a variety of perianal microorganisms, but E. coli is the most common.

A 10-year-old girl is admitted to a same-day surgery center to have a tonsillectomy and adenoidectomy. Which of the following should the nurse do in caring for this client after the surgery? a) Encourage the child to drink orange juice. b) Position the child on her back with the head of the bed down. c) Encourage the child to drink milk. d) Encourage the child to drink water.

Encourage the child to drink water. Explanation: The nurse should encourage fluids after the child is awake and fully responding. Clear, bland fluids are best; milk tends to form a film in the throat. Children usually accept popsicles, nonacidic fruit drinks, gelatins, and sherbet very well. The nurse should also position the child on the side or abdomen with the head o the bed elevated to prevent aspiration.

An 11-year-old client has been diagnosed with diabetes mellitus type 1. How can the nurse best assist this client in managing this condition? a) Explain to the child that only a healthcare professional should test the child's blood glucose level. b) Caution the child to avoid summer camps with other diabetic children. c) Encourage the child to self-administer his injections as soon as possible. d) Discourage the child from exercising.

Encourage the child to self-administer his injections as soon as possible. Explanation: The nurse should encourage the child to self-administer his injections as soon as possible. The nurse should also encourage the child to exercise, to test his own blood glucose level, and to attend summer camps for diabetic children so that he can gain the understanding that other children share his condition.

The nurse is performing the physical examination of a child with bulimia. Which of the following would the nurse identify as supporting this disorder? a) Dry skin b) Eroded dental enamel c) Bradycardia d) Pink moist gums

Eroded dental enamel Explanation: Recurrent vomiting will cause patients with bulimia nervosa to exhibit erosion of enamel on the front teeth, irritation of the throat, and dental caries.

A nurse is caring for a 10-year-old client diagnosed with impetigo contagiosa. Which symptom would the nurse expect to find in the client with impetigo contagiosa? a) Watery blisters over the skin between the toes b) Honey-colored crust on the face and hands c) Distinct ring-shaped rash on the thighs and face d) Pain, soreness, and stiffness of hip joints

Honey-colored crust on the face and hands Explanation: Clients with impetigo contagiosa usually develop reddened vesicles over the face and hands, which break open and leave a sticky, honey-colored crust. Distinct ring-shaped rashes over the client's thighs and face usually develop in clients with Lyme disease. Watery blisters over the skin between the toes are observed in clients with tinea pedis. Pain, soreness, and stiffness of hip joints are seen in clients with Legg-Calvé-Perthes disease.

Which genetic disorder primarily affects children of Ashkenazi Jewish descent and involves the child becoming hypotonic, losing vision, and dying before 4 years of age? a) Neurofibromatosis b) Tay-Sachs disease c) Down syndrome d) Fragile X syndrome

Tay-Sachs disease Explanation: Tay-Sachs disease is an inborn error of metabolism, primarily affecting children of Ashkenazi Jewish descent. Symptoms begin at about 1 year of age. The child becomes hypotonic and loses vision. Death usually occurs before 4 years. Neurofibromatosis, Down syndrome, and fragile X syndrome are all genetic disorders, but none is specific to Ashkenazi Jews.

Choice Multiple question - Select all answer choices that apply. The nurse is teaching child safety at a local community center. During education about ingestion of poisons, the nurse would teach public safety measures that include which of the following? Select all that apply. a) Do not tell the child that medicine is or tastes like candy. b) Post the Poison Control Center number by the phone. c) Switch medicines from original to new containers. d) Place childproof caps on all medicines. e) Paint over lead-based paint with a fresh coat of new paint.

• Place childproof caps on all medicines. • Do not tell the child that medicine is or tastes like candy. • Post the Poison Control Center number by the phone. Explanation: Medicines should remain in original containers with their own labels. Painting over lead paint does not prevent exposure. The other choices are correct.

A 3 year old is being seen in the doctor's office for a routine examination. The caregiver confides in the nurse that the child does not talk and stares for hours at fans in their home. The caregiver has read that these are symptoms of autism. The nurse completes taking an admission history by asking which question of the caregiver? a) "Does your child have weekly speech therapy sessions?" b) "Does your child have siblings?" c) "Do you have trouble keeping child care providers for your child?" d) "Does your child come to you for hugs and kisses?"

"Does your child come to you for hugs and kisses?" Explanation: Autism is a very complicated disorder with deficits in social, behavioral, and intellectual areas. Children that lack or have a deficit in the area of social interaction are often assessed further for autistic traits. They may not like to touch or be held, and may lack verbal skills.

After teaching the parents of a child with ADHD about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state which of the following? a) "We can use a reward system when he behaves appropriately." b) "We need to make sure that he completes one project before we give him another." c) "If he gets distracted, we need to punish him." d) "We'll need to create a quiet space where he can do his homework."

"If he gets distracted, we need to punish him." Explanation: The family of the child with ADHD need to minimize environmental stimuli, set limits, and focus on the child's positive behaviors rather than what they see as shortcomings. They should give the child only one direction at a time so that he does not become overwhelmed trying to simultaneously deal multiple instructions and goals.

A 4 year old is newly diagnosed with Duchenne muscular dystrophy. The nurse is educating the caregiver. Which of the following progressive complications would the nurse explain? a) Contractures, obesity, and pulmonary infections b) Trembling, frequent loss of consciousness, and slurred speech c) Dry skin, protruding tongue, and mental retardation d) Anorexia, gingival hyperplasia, and dry skin/hair

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The nurse is caring for a 10-year-old recently diagnosed with attention deficit/hyperactivity disorder (ADHD). The nurse would expect to provide teaching regarding which of the following medications? a) Dimercaprol b) Pimozide c) Edetate acid d) Methylphenidate

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The nurse is caring for a 6-year-old girl who will be undergoing a surgical procedure that will result in a temporary ileostomy. Which of the following approaches would be most effective in helping prepare the child for surgery? a) Use a doll to role-play the events surrounding the surgical experience and the procedure. b) Show the child a teaching DVD about ileostomy care. c) Draw a picture that explains the procedure. d) Show the child photographs of another girl with her ileostomy.

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The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, writhing movements. Which of the following would the nurse use when documenting these observations? a) Spastic b) Athetoid c) Ataxic d) Mixed

Athetoid Explanation: Athetoid cerebral palsy is characterized by abnormal, involuntary movement. The movements increase in periods of stress and stop during sleep. Spastic cerebral palsy is characterized by spasticity and hypertonicity in one or more limbs. Ataxic is characterized by poor coordination and problems with depth perception and balance.

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify which of the following as the least likely site for childhood cancer? a) Brain b) Blood c) Bladder d) Kidney

Bladder Explanation: The most common sites for childhood cancer include the brain, bones, kidney, adrenal glands, and structures of the central nervous system.

A nurse has to apply a jacket device to a child at the healthcare facility. Which should the nurse do when applying the restraint to the child? a) Cross the straps in the front and tie at the back. b) Check the child's circulation every three hours. c) Tie the straps to the side rails of the bed. d) Apply the device directly over the body.

Cross the straps in the front and tie at the back. Explanation: When applying a jacket restraint to the child, the nurse should cross the straps in the front and tie at the back to prevent the child from getting caught in the straps and choking or strangling. The straps should not be tied to the side rails of the bed so that the rails can be raised or lowered without tightening or loosening restraints. The nurse should check the child's circulation every 1 to 2 hours and not every 3 hours; the child should be allowed to exercise. To reduce skin irritation, the jacket restraint should be applied over clothing or a gown and not directly over the body.

A nurse is caring for a 3-year-old mentally retarded child in a healthcare facility. The child is known to have phenylketonuria, a hereditary metabolic disorder. The nurse knows that which food item can be safely included in the client's diet plan? a) Milk b) Oranges c) Legumes d) Bread

Oranges Explanation: Oranges can be safely included in the client's diet plan. The client can have low-protein natural foods such as fruits, vegetables, and certain cereals. Clients with phenylketonuria should avoid phenylalanine-containing foods such as most breads, eggs, meat, milk, cheese, legumes, nuts, and artificial sweeteners containing phenylalanine. Phenylketonuria is a hereditary metabolic disorder caused by the lack of phenylalanine hydroxylase, which is essential for the conversion of phenylalanine to tyrosine.

When teaching the parents of a child with PKU, the nurse would instruct them to include which of the following foods in the child's diet? a) Milk b) Eggs c) Oranges d) Meat

Oranges Explanation: Foods that contain phenylalanine are to be avoided. These include milk, meat, eggs, legumes, and nuts. Low-protein natural foods such as oranges would be allowed.

The nurse is examining a 7-year-old with suspected appendicitis. Which of the following physical findings would indicate the possibility of appendicitis? a) Pain localized in the right lower quadrant b) Severe diarrhea c) Pain localized in the left lower quadrant d) Diffuse abdominal pain

Pain localized in the right lower quadrant Explanation: Appendicitis is characterized by pain localized in the right lower quadrant of the abdomen. Other symptoms include fever, nausea, and vomiting.

A 6-month-old infant is admitted with suspected bacterial meningitis. Which of the following interventions should the nurse take initially? a) Placing the infant in isolation. b) Monitor the infant's fontanels for fullness. c) Educate the family about bacterial meningitis. d) Provide the infant with additional stimulation.

Placing the infant in isolation. Explanation: Children with bacterial meningitis must be placed in isolation until antibiotics have been administered for 24 hours. Healthcare staff and family members may require prophylactic treatment. Reducing environmental stimulation is critical. Educating the family about the disease is appropriate but should wait until after clinical measures have been taken. Monitoring of the fontanels is a measure of care for patients with hydrocephalus.

A 16 year old told friends of plans to commit suicide. The school nurse was made aware of this, and the nurse's next action is determined by what knowledge? a) If a plan does not really exist, then the teen is probably just being dramatic. b) No intervention is needed because this client has made threats before. c) Most teens will threaten to commit suicide. d) Suicide threats should not be ignored.

Suicide threats should not be ignored. Explanation: One should never ignore any threats of suicide. It is never normal for people to make threats of suicide. Just because there is not a plan, this does not mean that the person is joking.

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which of the following assessments would lead the nurse to suspect cat scratch disease? a) Swollen lymph nodes b) Swollen salivary glands c) Strawberry tongue d) Koplik spots

Swollen lymph nodes Explanation: Cat scratch disease can cause lymphadenopathy (swollen lymph nodes). Strawberry tongue is typical of scarlet fever. Swollen salivary glands are suggestive of mumps, and Koplik spots are a sign of measles.

A 4-year-old boy at the healthcare facility is on intravenous (IV) therapy following diarrhea. Which method should the nurse use to determine the body temperature of this child on IV therapy? a) Tympanic temperature b) Oral temperature c) Axillary temperature d) Rectal temperature

Tympanic temperature Explanation: The nurse should take a tympanic temperature for the child. Rectal temperature should not be taken in a child with diarrhea. Oral temperature is taken for children older than 6 years of age. The axillary method should only be used if no other method is available.

Parents of a newborn have just learned their child has clubfoot. They ask the nurse what the treatment for clubfoot is. Which of the following treatments would the nurse educate the parents about? a) A special shoe device b) Possible surgery on the affected limb c) Weekly casting or splinting d) A harness to keep the hip in full abduction

Weekly casting or splinting Explanation: The first treatment for clubfoot is serial casting in 1- to 2-week intervals or splinting with manipulation. Surgery may be considered if treatment is not successful. An abduction device would be used for hip disorders. Shoes would not apply to this age.

The nurse is caring for a child diagnosed with leukemia. The nurse recognizes that in the body of the child with leukemia there is an uncontrolled reproduction of abnormal __________________. a) red blood cells b) brown fat cells c) hormones d) white blood cells

white blood cells Explanation: Leukemia involves the excessive production of abnormal white blood cells, which are not capable of effectively fighting infection.

The nurse is assessing an 11-year-old female with scoliosis. Which of the following would the nurse expect to find? Select all that apply. a) Complaints of severe back pain b) Diminished motor function c) Even curve at the waistline d) Asymmetrical shoulder elevation e) Pronounced one-sided hump on bending over

• Asymmetrical shoulder elevation • Pronounced one-sided hump on bending over Correct Explanation: Assessment findings associated with scoliosis include asymmetrical shoulder elevation, uneven curve at the waistline, rib hump on one side, and a pronounced hump on one side when bending over.

Choice Multiple question - Select all answer choices that apply. A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention-deficit hyperactivity disorder. When explaining this disorder to the parents, which of the following would the nurse include as being involved? Select all that apply. a) Hyperactivity b) Impulsivity c) Distractibility d) Tics e) Echolalia

• Impulsivity • Distractibility • Hyperactivity Explanation: ADHD is characterized by impulsivity, distractibility (short attention span), and hyperactivity. Tics are associated with Tourette syndrome. Echolalia may be exhibited with Tourette syndrome or autism spectrum disorders.

A nurse is preparing to assess a male toddler who has been brought to the clinic by his mother. Which of the following would support an assessment of otitis media? Select all that apply. a) The child has a low-grade fever. b) The mother indicates that the child has been tugging at his ear. c) The mother indicates that the child has had diarrhea. d) One of the child's tympanic membranes is red and swollen. e) The mother indicates that the child's appetite has increased.

• One of the child's tympanic membranes is red and swollen. • The mother indicates that the child has been tugging at his ear. • The child has a low-grade fever. Correct Explanation: Symptoms of otitis media include fever, red and swollen tympanic membranes, and decreased appetite (possibly with vomiting). Affected children frequently express pain; infants may express pain by scratching or tugging at the affected ear.

Choice Multiple question - Select all answer choices that apply. A nurse is assessing a toddler during a well-child visit. What should the nurse document and assess? Select all that apply. a) Play patterns and activities b) Tone and pitch of cry c) Age of weaning d) Language development e) Response to painful procedures

• Play patterns and activities • Age of weaning • Language development Explanation: During the well-child visit, the nurse should assess and document the play patterns and activities, age of weaning, and the language development of the child. Tone and pitch of cry and response of the child to painful procedures are assessed and documented when assessing an infant.

A 12-year-old girl is brought to the healthcare facility with complaints of joint pain, restricted and painful movements of the limbs, and painful subcutaneous nodules. The client's parents explain that the pain is not relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). On further examination, the client is diagnosed with juvenile rheumatoid arthritis (JRA). Which nursing measure must the nurse employ when caring for this client? a) Ensure that the diet does not contain dairy products. b) Avoid giving hot baths or whirlpool treatment. c) Exercise the client's limbs during the acute stage. d) Encourage the client to perform daily activities on her own.

Exercise the client's limbs during the acute stage. Explanation: During the acute stage of JRA, the nurse should assist in exercising the client's legs to improve the circulation and prevent complications. Nurses are often asked to assist clients with JRA by applying heat in the form of hot baths, packs, or whirlpool treatments. Restriction of dairy products is not necessary for clients with JRA. They have the usual nutritional requirements of normal children. Clients with JRA are often helped with their daily activities and are not encouraged to perform daily activities on their own.

A 2 month old is diagnosed with Down's syndrome. The nurse is assessing the infant and knows to check for a simian line where on the infant? a) Feet b) Head c) Hands d) Abdomen

Hands Explanation: In Down's syndrome, the child has an abnormal crease straight across the palms of the hands. The line is not located on any of the other areas.

A mother of a toddler is attending a Healthy Family Day at the local clinic. She discusses with the public health nurse how they just moved back to their older home that was remodeled to decrease lead. When discussing safety measures, about which of the following responses by the nurse are most appropriate to educate the mother? a) "Now that your home is remodeled, the risk for lead is gone." b) "You should use hot water to prepare all of your child's meals to decrease the risk of lead." c) "You do not have to change your child's diet to decrease lead levels." d) "Make sure to wash and dry your child's hands and face before all meals."

"Make sure to wash and dry your child's hands and face before all meals." Explanation: Lead poisoning is contracted by hand-to-mouth transmission. Therefore, washing and drying the child's hands and face before meals will help to prevent lead poisoning. The risk of lead in the older home is not 100% gone. Use of hot water can cause lead to be absorbed more easily. Nutrition is important. Having a balanced diet including iron, calcium, and little fat will help prevent absorption of lead.

A father believes his 2-year-old son is frightened by seeing an intramuscular (IM) medication injected into his thigh and requests that the child's "butt" be used. What will be the nurse's response? a) "OK, if that's what you'd prefer." b) "The medication will be better absorbed from his thigh." c) "Because he is still in diapers, the thigh is a better choice." d) "The muscle in his butt is not well enough developed to receive this injection."

"The muscle in his butt is not well enough developed to receive this injection." The anterior thigh is the preferred intramuscular injection site for children under 3 years of age, because the other muscles typically have not developed sufficiently.

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? a) "He'll have to live with this his entire life." b) "At least he's not in pain." c) "This condition could gradually go away on its own." d) "The surgeon is going to operate on him immediately."

"This condition could gradually go away on its own." Explanation: Hydrocele is a painful condition in which serous fluid accumulates in the scrotal sac. The fluid may be reabsorbed spontaneously; if not, excision and drainage may be necessary.

A 5 year old is diagnosed with acute lymphocytic leukemia (ALL). After teaching the caregivers about the upcoming diagnostic testing and treatments, the nurse evaluates the caregivers understanding of ALL. Which of the following statements indicates the caregiver has received the appropriate information? a) "This will show us the extent of growth of the tumor and the need to comfort our child only." b) "This will show how bad the cancer is and at what stage." c) "This will help show us if chemotherapy is needed." d) "This will tell us if surgery would be the best treatment."

"This will show how bad the cancer is and at what stage." Explanation: ALL cancer is assigned a stage at diagnosis. Treatment is then decided. The goal of treatment is remission, which can be achieved through chemotherapy. ALL is not a solid mass tumor that can be removed; therefore, surgery is not an option. Further testing may be done to see if organs other than the bone marrow are affected.

A nurse is caring for a 7-year-old client who has come to the pediatrician's office for treatment of a recurrent urinary tract infection. The client's mother states, "My child has starting sucking her thumb and wetting the bed." Based on the information, which of the following should the nurse consider? a) The child is having trouble at school. b) The child may need to be referred for psychological counseling. c) The child may have experienced sexual abuse. d) The child just wants attention.

The child may have experienced sexual abuse. Explanation: When sexual abuse is suspected, the following signs/symptoms may occur: sudden behavioral changes, abdominal pain or headaches, emotional disturbance, avoidance of touching/physical contact, and vaginal/rectal bleeding. The child is 7 years old and should not be sucking a thumb or bedwetting. These are behaviors typically found in a toddler/early preschooler. When a behavior appears that is not typical of the child's developmental age, this is a red flag to investigate further. No evidence of school issues or lack of attention from the parent has been described. Counseling may be needed if abuse has occurred, but the abuse must be identified first.

In Duchenne muscular dystrophy, the nurse knows to assess for Gowers' sign, which is performed how? a) The client bends from the waist and touches his or her toes. b) The client closes his or her eyes and touches his or her nose with alternating index fingers. c) The client hops on one foot and then the other. d) The client rises from a squatting position by using the hands to climb up the legs to be upright.

The client rises from a squatting position by using the hands to climb up the legs to be upright. Explanation: Children with Duchenne will display the Gowers' sign, which is difficulty rising and standing from a squatting position because of a lack of muscle strength and weak hips. When the client touches his or her nose with alternating fingers, which is called the Romberg sign, it is checking for balance. Hopping from one foot to another also tests balance. Bending from the waist to the toes tests for flexibility.

In Duchenne muscular dystrophy, the nurse knows to assess for Gowers' sign, which is performed how? a) The client bends from the waist and touches his or her toes. b) The client hops on one foot and then the other. c) The client rises from a squatting position by using the hands to climb up the legs to be upright. d) The client closes his or her eyes and touches his or her nose with alternating index fingers.

The client rises from a squatting position by using the hands to climb up the legs to be upright. Explanation: Children with Duchenne will display the Gowers' sign, which is difficulty rising and standing from a squatting position because of a lack of muscle strength and weak hips. When the client touches his or her nose with alternating fingers, which is called the Romberg sign, it is checking for balance. Hopping from one foot to another also tests balance. Bending from the waist to the toes tests for flexibility.

A 15 year old has a history of one incident of over-dosing on pain pills and writing suicide notes. The nurse knows that certain risk factors are indicators of a repeat attempt at suicide. Which of the following factors would alert the nurse of this risk? a) The teen's parent died recently. b) The statement "I wish I hadn't over-dosed that day and made that stupid mistake." c) The teen's grades dropped before the first suicide attempt. d) The teen lives with one parent and one stepparent.

The teen's parent died recently. Explanation: Losing a parent is a risk factor associated with suicide. Dropping grades is usually associated with the first attempt of suicide. Nothing indicates a relationship problem with the parent or stepparent. The teen being remorseful for the first attempt at suicide shows positive improvement.

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior? a) The toddler cries inconsolably. b) The toddler is quiet, looks sad, and is uninterested in playing. c) The girl acts extremely agitated. d) The child exhibits signs of anger.

The toddler is quiet, looks sad, and is uninterested in playing. Explanation: The second stage of separation anxiety is despair. In this stage, the child becomes inactive and sad and has little interest in food or play. Agitation, crying, and anger are signs of protest, which is the first stage of separation anxiety.

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior? a) The toddler is quiet, looks sad, and is uninterested in playing. b) The girl acts extremely agitated. c) The toddler cries inconsolably. d) The child exhibits signs of anger.

The toddler is quiet, looks sad, and is uninterested in playing. Explanation: The second stage of separation anxiety is despair. In this stage, the child becomes inactive and sad and has little interest in food or play. Agitation, crying, and anger are signs of protest, which is the first stage of separation anxiety.

The nurse is assessing a 6-year-old with attention deficit hyperactivity disorder (ADHD). The nurse observes the boy making repeated clicking noises and notes he has a slight grimace. The nurse recommends the boy receive further evaluation for which of the following? a) Autism spectrum disorder b) Asperger syndrome c) Anxiety disorder d) Tourette syndrome

Tourette syndrome Explanation: People with Tourette syndrome exhibit frequent physical and vocal tics. The described grimacing and clicking could be examples of those tics. Those with Tourette syndrome may also exhibit symptoms of ADHD and obsessive compulsive disorder.