pediatrics (med surg)
The nurse is teaching parents of a child with cataracts about the upcoming treatment. The nurse should give the parents what information about the treatment of cataracts?
"Cataracts require surgery to remove the cloudy lens and replace it."
The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching?
"I should gently massage the skin under the straps once a day to stimulate circulation.
The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching?
"I should place a pillow under my child's head during a seizure."
The nurse is teaching the parent of a 4-year-old child with a cast on the arm about care at home. What statement by the parent indicates a correct understanding of the teaching?
"I will use an ice pack to relieve the itching."
The nurse is teaching infant care to parents with an infant who has been diagnosed with osteogenesis imperfecta (OI). What should the nurse include in the teaching session?
"Lift the infant by the buttocks, not the ankles, when changing diapers."
Parents are considering treatment options for their 5-year-old child with Legg-Calvé-Perthes disease. Both surgical and conservative therapies are appropriate. They are able to verbalize the differences between the therapies when they make what statement?
"Surgical correction requires a 3- to 4-month recovery period."
The nurse is teaching parents about caring for their infant with seborrheic dermatitis (cradle cap). Which statement by the parents indicates understanding of the teaching?
"We will use a fine-tooth comb to help remove the loosened crusts from the strands of hair."
The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what?
"We're happy this is the only cast our baby will need."
The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, "My child has a low platelet count, and we are being discharged this afternoon. What do I need to do at home?" What statement is most appropriate for the nurse to make?
"Your child should avoid contact sports or activities that could cause bleeding."
A child has had contact with some poison ivy. The school nurse understands that the full-blown reaction should be evident after how many days?
2 days
The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time?
30 minutes before breakfast
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
90 beats/min
A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. How should the nurse respond?
A step-wise approach will be used to reduce the dosage gradually.
What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
Adequate dosage will turn the stools a tarry green color
The nurse is preparing to administer a topical application of 1 ml of nystatin (Mycostatin) to an infant with oral thrush. Which actions should the nurse plan to implement? (Select all that apply.)
Administer after a feeding Use a sponge applicator to swab the oral mucosa and tongue. Deposit the remainder of the dose in the mouth with a syringe so the infant swallows a small amount.
The nurse is preparing to administer a unit of packed red blood cells to a hospitalized child. What is an appropriate action that applies to administering blood?
Administer the first 50 mL of blood slowly and stay with the child
What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule?
Alkylating agents
What condition is defined as reduced visual acuity in one eye despite appropriate optical correction?
Amblyopia
The test that provides the most reliable evidence of recent streptococcal infection is which?
Antistreptolysin O test
What cardiovascular defect results in obstruction to blood flow?
Aortic stenosis
What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)?
Applying ice to the face Administration of adenosine (Adenocor) Having the child perform a Valsalva maneuver
Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?
Applying of the medication occurs at least 20 to 30 minutes after washing.
Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant's status, which finding is indicative of achieving this goal?
Appropriate weight gain for age
What is an appropriate nursing intervention when caring for a child in traction?
Assessing for tightness, weakness, or contractures in uninvolved joints and muscles
A 23-month-old child is admitted to the hospital with a diagnosis of meningitis. She is lethargic and very irritable with a temperature of 102° F. What should the nurse's care plan include?
Assessing the level of consciousness (LOC) and vital signs every 2 hours
What should the nurse plan for an immobilized child in cervical traction to prevent deep vein thrombosis (DVT)?
Assist the child to dorsiflex the feet and rotate the ankles
What is most descriptive of atopic dermatitis (AD) (eczema) in an infant?
Associated with hereditary allergies
The nurse should teach the family that which residual disabilities can occur for a child being treated for a brain tumor?
Ataxia Dysphagia Sensory deficits Cranial nerve palsies
What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?
Avoid activities that cause pain or crying
The nurse is planning care for an infant with eczema. Which interventions should the nurse include in the care plan? (Select all that apply.)
Avoid giving the infant a bubble bath Avoid overdressing the infant
The nurse is caring for a child with increased intracranial pressure (ICP). What interventions should the nurse plan for this child?
Avoid jarring the bed Administer prescribed stool softeners Administer a prescribed antiemetic for nausea
A toddler is diagnosed with chronic benign neutropenia. The parents are being taught about caring for their child. What information is important to include?
Avoid large indoor crowds and people who are ill
What intervention should be beneficial in reducing the risk of Reye syndrome?
Avoidance of aspirin for children with varicella or those suspected of having influenza
The nurse is preparing a community outreach program about the prevention of iron-deficiency anemia in infants. What statement should the nurse include in the program?
Breast milk or iron-fortified formula should be used for the first 12 months.
What clinical manifestations suggest hydrocephalus in an infant?
Bulging fontanel and dilated scalp veins
The nurse is preparing to admit a 10-year-old child with Duchenne muscular dystrophy. What clinical features of Duchenne muscular dystrophy should the nurse recognize
Calf muscle hypertrophy Progressive muscular weakness, wasting, and contractures Loss of independent ambulation by 9 to 12 years of age Slowly progressive, generalized weakness during adolescence
The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause?
Candida albicans infection
A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?
Careful bathing and handling
The nurse should know what about Lyme disease?
Caused by a spirochete that enters the skin through a tick bite
The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Cervical lymphadenopathy Strawberry tongue Erythematous palms
A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal antiinflammatory drug (NSAID). What nursing consideration should be included?
Check for abdominal pain and bloody stools
In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?
Check for moist mucous membranes
The clinic nurse is evaluating causes for iron deficiency due to impaired iron absorption. What should the nurse recognize as causes for iron deficiency due to impaired iron absorption? (Select all that apply.)
Chronic diarrhea Lactose intolerance Inflammatory bowel disease
What clinical manifestation should be the most suggestive of acute appendicitis?
Colicky, cramping, abdominal pain around the umbilicus
What statement best identifies the cause of heart failure (HF)?
Consequence of an underlying cardiac defect
What is a major goal for the therapeutic management of juvenile idiopathic arthritis (JIA)?
Control pain and preserve joint function
What primary nursing intervention should be implemented to prevent bacterial endocarditis?
Counsel parents of high-risk children
An infant is born with a gastroschisis. Care preoperatively should include which priority intervention?
Covering the defect with a sterile bowel bag
The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?
Covering the intact bowel with a nonadherent dressing to prevent injury
What explanation provides the rationale for why iron-deficiency anemia is common during infancy?
Cow's milk is a poor source of iron
The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe?
Dark tufts of hair Skin depression or dimple Por-wine angiomatous nevi Soft, subcutaneous lipomas
What finding is a clinical manifestation of increased intracranial pressure (ICP) in children?
Diplopia, blurred vision
When does idiopathic scoliosis become most noticeable?
During the preadolescent growth spurt
A child is recovering from Kawasaki disease (KD). The child should be monitored for which?
Electrocardiograph (ECG) changes
A child has a seizure disorder. What test should be done to gather the most specific information about the type of seizure the child is having?
Electroencephalogram (EEG)
A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?`
Elevate casted arm when both upright and resting
The nurse is caring for a 10-year-old child who has an acute head injury, has a pediatric Glasgow Coma Scale score of 9, and is unconscious. What intervention should the nurse include in the child's care plan?
Elevate the head of the bed 15 to 30 degrees with the head maintained in midline.
The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)
Encourage fluids Monitor urinary output Monitor serum peak and trough levels
What is an important priority in dealing with the child suspected of having Wilms tumor?
Ensuring the abdomen is protected from palpation
The nurse is caring for a child with erythema multiforme (Stevens-Johnson syndrome). What local manifestations does the nurse expect to assess in this child? (Select all that apply.)
Erythematous papular rash Lesions absent in the scalp Lesions enlarge by peripheral expansion
The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula?
Excessive frothy saliva
The nurse is preparing to admit an adolescent with bacterial meningitis. What clinical manifestations should the nurse expect to observe?
Fever Chills Headache Drowsiness
The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?
Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.
The nurse is caring for a child with psoriasis. What local manifestations does the nurse expect to assess in this child? (Select all that apply.)
First lesions appear in the scalp Round, thick, dry reddish patches Patches are covered with coarse, silvery scales
The nurse is preparing to admit a 6-year-old child with irritable bowel syndrome (IBS). What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Flatulence Constipation Feeling of incomplete evacuation of the bowel
What therapeutic intervention is most appropriate for a child with β-thalassemia major?
Frequent blood transfusions
A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain?
Frequent, serial casting is tried first
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
Give an antiemetic before chemotherapy begins.
A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt?
Growth of the child since the initial shunting
The clinic nurse is assessing an infant. What are early signs of cognitive impairment the nurse should discuss with the health care provider? (Select all that apply.)
Head lag at 11 months of age Unable to speak two to three words at 24 months of age Unresponsiveness to the environment at 12 months of age
A child with sickle cell disease is in a vasoocclusive crisis. What nonpharmacologic pain intervention should the nurse plan?
Heat to the affected area
The nurse is preparing to admit a 6-month-old infant with increased intracranial pressure (ICP). What clinical manifestations should the nurse expect to observe in this infant?
High-pitched cry Poor feeding Setting-sun sign Distended scalp veins
A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?
Hirschsprung disease
The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include? (Select all that apply.)
Hold the infant in the prone position after a feeding. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.
After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
Hydration
A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The child's care should include which therapeutic interventions?
Hydration and pain management
What is the primary method of treating osteomyelitis?
IV antibiotic therapy
Bacterial infective endocarditis (IE) should be treated with which protocol?
IV antibiotics (penicillin type) for 2 to 8 weeks
An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method?
IV infusion
A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38° C (100.4° F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother?
Immediately bring the child to the clinic for evaluation
For children who do not have a matched sibling bone marrow donor, the therapeutic management of aplastic anemia includes what intervention?
Immunosuppressive therapy
What nutritional component should be altered in the infant with heart failure (HF)?
Increase in calories
A lumbar puncture (LP) is being done on an infant with suspected meningitis. The nurse expects which results for the cerebrospinal fluid that can confirm the diagnosis of meningitis?
Increased WBC Decreased glucose
What blood flow pattern occurs in a ventricular septal defect?
Increased pulmonary blood flow
What term describes invagination of one segment of bowel within another?
Intussusception
A pregnant woman asks about prenatal diagnosis of hydrocephalus. The nurse's response should be based on which knowledge?
It can be diagnosed with fetal ultrasonography.
What statement is true concerning osteogenesis imperfecta (OI)?
It is an inherited disorder
What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)?
It is characterized by presence of Gower sign, a waddling gait, and lordosis.
The nurse is preparing to admit a neonate with bacterial meningitis. What clinical manifestations should the nurse expect to observe?
Jaundice Cyanosis Poor tone Poor sucking ability
The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included?
Keep environmental stimuli to a minimum
The nurse is discussing the management of atopic dermatitis (eczema) with a parent. What should be included?
Keep the infant's fingernails and toenails cut short and clean.
The nurse is teaching parents the signs of a hearing impairment in infants. What should the nurse include as signs? (Select all that apply.)
Lack of a startle reflex to a loud sound Failure to localize a sound by 6 months of age Response to loud noise as opposed to the voice
After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience?
Lethargy and confusion
The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching? (Select all that apply.)
Lima beans Baked beans Raisin bran cereal
A child has been admitted with status epilepticus. An emergency medication has been ordered. What medication should the nurse expect to be prescribed?
Lorazepam (ativan)
What immunization should not be given to a child receiving chemotherapy for cancer?
MMR
The nurse is preparing to admit an adolescent with encephalitis. What clinical manifestations should the nurse expect to observe?
Malaise Apathy Hypoactivity
The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a child's BP?
Measure BP with the child in the sitting position on three separate occasions
Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care?
Measuring all fluid intake and output
The nurse is preparing to admit a 7-year-old child with complex partial seizures. What clinical features of complex partial seizures should the nurse recognize?
Mental disorientation is common There is frequently a postictal state There is usually an impaired consciousness
Neuropathic bladder disorders are common among children with which disorder?
Myelomeningocele
What refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column?
Myelomeningocele
The nurse is performing a physical assessment on a 3-year-old child. The parents state that the child excessively rubs the eyes and often tilts the head to one side. What visual impairment should the nurse suspect?
Myopia, or nearsightedness
An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse's response should be based on what?
NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect?
Neonatal herpes
What is a common clinical manifestation of Hodgkin disease?
Non-tender enlargement of lymph nodes
A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?
Notify the practitioner because chest syndrome is suspected
A woman who is 6 weeks pregnant tells the nurse that she is worried that, even though she is taking folic acid supplements, the baby might have spina bifida because of a family history. The nurse's response should be based on what?
Open neural tube defects (NTDs) result in elevated concentrations of α-fetoprotein in amniotic fluid.
A 5-year-old child has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. What nursing intervention is most important at this time?
Orient him to his immediate surroundings
A child with hemophilia A will have which abnormal laboratory result?
PTT
The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)`
Pain is common Weight loss is severe Diarrhea is moderate to severe`
What are signs and symptoms of anemia? (Select all that apply.)
Pallor Fatigue Muscle weakness
The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge?
Parents need to learn specific, important guidelines for administration of digoxin.
The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign?
Paresthesia
The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Passage of red, currant jelly-like stools Tender, distended abdomen Sudden acute abdominal pain
The nurse is conducting preoperative teaching to parents and their child about an external fixation device. What should the nurse include in the teaching session?
Pin care Crutch walking Modifications in activity Observing pin sites for infection
The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which?
Place the infant on the side to decrease pressure on the spinal sac.
What sign/symptom is a major clinical manifestation of rheumatic fever (RF)?
Polyarthritis
The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron. What should the nurse recognize as causes for iron deficiency caused by an inadequate iron supply? (Select all that apply.)
Prematurity Excessive milk intake Severe iron deficiency in the mother
The nurse understands that which gestational disorders can cause a cognitive impairment in the newborn? (Select all that apply.)
Prematurity Postmaturity Low birth weight
A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do?
Prepare the child for conscious sedation being used for the procedure.
A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube
Prevent abdominal distention
What rationale explains why prolonged use of oxygen should be discouraged in a child with anemia?
Prolonged use of oxygen can decrease erythropoiesis
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate?
Prone with the head turned to the side
What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis?
Protein count is normal Gram stain findings are negative WBC count is slightly elevated
A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention?
Provide a latex-free environment
The nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. What should the nurse tell the family to do to minimize joint injury?
Provide intravenous (IV) infusion of factor VIII concentrates.
What statement related to clinical trials developed for pediatric cancers is most accurate?
Provide the best available therapy compared with an expected improvement
The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication?
Pulmonary hypertension
The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?
Pulmonary vascular congestion
What action by the school nurse is important in the prevention of rheumatic fever (RF)?
Refer children with sore throats for throat cultures
A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
Refer the adolescent for an evaluation.
The mother of an infant tells the nurse that sometimes there is a whitish "glow" in the pupil of his eye. The nurse should suspect which condition?
Retinoblastoma
The school nurse is seeing a child who collected some poison ivy leaves during recess. He says only his hands touched it. What is the most appropriate nursing action?
Rinse his hands in cold running water
The nurse is caring for a child with meningitis. What acute complications of meningitis should the nurse continuously assess the child for?
Seizures Cerebral edema Cognitive impairments
The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt. What issues should be addressed?
Shunt malfunction or infection requires immediate treatment.
What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?
Sickle cell anemia
The nurse is caring for a 14-year-old child with juvenile idiopathic arthritis (JIA). What clinical manifestations should the nurse expect to observe?
Soft tissue contractors Swelling in multiple joints Morning stiffness of the joints Loss of motion in the affected joints
What most accurately describes bowel function in children born with a myelomeningocele?
Some degree of fecal continence can usually be achieved.
The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Spitting up Failure to thrive Excessive crying Respiratory problems
A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. What is the most appropriate initial action by the school nurse?
Stay with child and have someone else call emergency medical services (EMS).
A 2-year-old child starts to have a tonic-clonic seizure. The child's jaws are clamped. What is the most important nursing action at this time?
Stay with the child and observe his respiratory status
The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Steatorrhea Malnutrition Foul-smelling stools
The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate?
Stop the drug infusion immediately
The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic. What cardinal signs of cancer in children should the nurse make the new nurse aware of?
Sudden tendency to bruise easily Frequent headaches Unexplained loss of energy
What side effect commonly occurs with corticosteroid (prednisone) therapy?
Susceptibility to infection
What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA)?
Teach the child and family correct administration of medications.
Nursing care of the child with Kawasaki disease is challenging because of which occurrence?
The child's irritability
What statement best describes Hirschsprung disease?
The colon has an aganglionic segment.
The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
The object may be lodged in the esophagus
When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?
Therapeutic management includes administration of gamma globulin and salicylates.
The nurse is preparing to admit a 10-year-old child with absence seizures. What clinical features of absence seizures should the nurse recognize?
There is no aura There is a brief loss of consciousness There is an occasional clonic movement
A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
Thicken feedings and enlarge the nipple hole.
Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
Use good hand-washing technique
A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information?
Usually the postoperative dressing covers the entire scalp.
The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information?
Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.
An infant had a gastrostomy tube placed for feedings after a Nissen fundoplication and bolus feedings are initiated. Between feedings while the tube is clamped, the infant becomes irritable, and there is evidence of cramping. What action should the nurse implement?
Vent the gastrostomy tube
A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what?
Ventricular septal defect
The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Weight loss Projectile vomiting The infant is hungry after vomiting
Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what?
Wheezing
A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that antibiotic therapy will begin when?
When the medication is received from the pharmacy
A child, age 10 years, has a neuroblastoma and is in the hospital for additional chemotherapy treatments. What laboratory values are most likely this child's?
White blood cell count, 3,000/mm3; hemoglobin, 11.5 g/dl
A new parent asks the nurse, "How can diaper rash be prevented?" What should the nurse recommend?
Wipe stool from the skin using water and a mild cleanser.
What statement is descriptive of most cases of hemophilia?
X-linked recessive inherited disorder in which a blood clotting factor is deficient
A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary
alteration in level of consciousness
In which condition are all the formed elements of the blood simultaneously depressed?
aplastic anemia
A young girl has just injured her ankle at school. In addition to notifying the child's parents, what is the most appropriate, immediate action by the school nurse?
apply ice
If an intramuscular (IM) injection is administered to a child who has Reye syndrome, the nurse should monitor for what?
bleeding
A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
bowel cleansing
A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions?
contact
The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?
current-like jelly
What pain medication is contraindicated in children with sickle cell disease (SCD)?
demerol
What intervention is contraindicated in a suspected case of appendicitis?
enemas
When taking the history of a child hospitalized with Reye syndrome, the nurse should not be surprised if a week ago the child had recovered from what?
flu
A child is on phenytoin (Dilantin). What should the nurse encourage?
good dental hygiene
What is the usual presenting symptom for testicular cancer?
hard, painless mass
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?
heart failure
Nutritional management of the child with Crohn disease includes a diet that has which component?
increased protein
A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?
metabolic alkalosis
Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?
milk
A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on what?
most likely part of normal pubertal development
What are the most common clinical manifestations of brain tumors in children?
nausea and vomitting
A 5-year-old child is admitted to the hospital in a sickle cell crisis. The child has been alert and oriented but in severe pain. The nurse notes that the child is complaining of a headache and is having unilateral hemiplegia. What action should the nurse implement?
notify HCP
The nurse is caring for an adolescent male with gynecomastia. What groups of drugs can induce gynecomastia in male adolescents? (Select all that apply.)
oral ketoconazoles calcium channel blockers histamine 2 receptor blockers cancer chemotherapeutic agents
The nurse is caring for a child with hemophilia A. The child's activity is as tolerated. What activity is contraindicated for this child?
passive ROM exercises
A 17-year-old patient is returning to the surgical unit after Luque instrumentation for scoliosis repair. In addition to the usual postoperative care, what additional intervention will be needed?`
position changes are made by log rolling.
A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which?
potassium
One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?
rectal bleeding
A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?
refer him for immediate medical attention
A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock?
restlessness
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material?
soak in a bathtub
A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he "heard a pop," that the pain is "pretty bad," and that the ankle feels "as if it is coming apart." Based on this description, the nurse suspects what injury?
sprain
An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
stress management may be helpful
Rickets is caused by a deficiency in what?
vitamin D and calcium
What clinical manifestation is a common sign of digoxin toxicity?
vomiting
