Pediatrics Practicum

A child with sickle cell anemia is being treated for sickle cell crisis. The health care provider orders morphine sulfate 2 mg intravenously. The concentration of the vial is 10 mg/1 ml of solution. How many milliliters of solution would the nurse administer?

0.2 ml

A nurse is preparing to administer intravenous methylprednisolone sodium succinate to a child who weighs 44 lb. The order is for 0.03 mg/kg intravenously daily. How many milligrams would the nurse prepare?

0.6 mg

A nurse is caring for an 8 year old postoperative tonsillectomy client. When performing a postoperative assessment, which signs and symptoms of bleeding would be monitored by the nurse? 1. frequent clearing of the throat 2. breathing through the mouth 3. frequent swallowing 4. throat pain 5. pulse rate of 98 beats/minutes 6. blood red vomitus

1,3,6

A nurse is caring for a 34 month old who is hospitalized for a lengthy illness. Which behaviors would the nurse identify as examples of expected developmental regress for the child's age group? 1. enuresis 2. encopresis 3. one- to two-word expressions 4. altered gait 5. loss of fine motor skills

1,2,3

A 10 year old child visits the health care provider's office for an annual sports examination. When a nurse asks how he is doing, he becomes quiet and states that his grandmother died last week. Which statements by the child show that he understands the concept of death? 1. "I am mad that she is gone" 2. "My grandmother is an angel watching over me" 3. "My grandmother's death has been hard to understand" 4. "My grandmother died because she was sick and nothing could make her better" 5. "My grandmother is dead, but she'll come back" 6. "My grandmother died because someone in the family did something bad"

1,2,3,4

A nurse is caring for an adolescent who was admitted to the hospital's medical unit after attempting suicide by ingesting acetaminophen. Which interventions would the nurse incorporate into the client's plan of care? 1. Inventory all personal items upon arrival to the unit 2. Ask the client's parents if they keep fire arms in their home 3. Ask the client if he/she is currently having suicidal thoughts 4. Assist the client with bathing and grooming as needed 5. Inspect the mouth after giving oral medications 6. Assure the client that anything said will be held in strict confidence

1,2,3,4,5

A nurse is teaching a 16 year old female client with inflammatory bowel disease about corticosteroid treatment. Which adverse effects are likely to be concerns for this client? 1. acne 2. hirsutism 3. mood swings 4. osteoporosis 5. growth spurts 6. adrenal suppression

1,2,3,4,6

A mother brings her child to the health care provider's office for evaluation of chronic stomach pain. The mother states that the pain seems to go away when she keeps the child home from school. The health care provider diagnoses school phobia. Which other behaviors may the child exhibit? 1. nausea 2. headaches 3. weight loss 4. dizziness 5. specific areas of pain

1,2,4

A nurse is caring for a 17 year old female client with cystic fibrosis who has been admitted to the hospital for administration of intravenous antibiotics and respiratory treatment for exacerbation of a lung infection. The client states "I have a number of questions about my future and the consequences of this disease". which statements about the course of cystic fibrosis is true? 1. Breast development is commonly delayed 2. The client is at risk for developing diabetes 3. Pregnancy and childbearing are not affected. 4. Normal sexual relationships can be expected 5. Only males carry the gene for the disease 6. By age 20 the client is able to decrease the frequency in respiratory treatments

1,2,4

The nurse is caring for an 11 year old client experiencing status epilepticus. When providing and delegating immediate nursing care, which nursing actions would be completed? 1. Administer oxygen via nasal cannula 2. Pad side rails with cushions/pillows 3. Instruct the nursing assistant to obtain the crash cart 4. Place the bed in the lowest position and restrain all extremities 5. Instruct the LPN to obtain vital signs 6. Open clenched mouth to place an oral airway

1,2,5

A 15-month-old has just received routine immunizations including DTaP, IPV, and MMR. What information would the nurse give to the parents before they leave the office? 1. Minor symptoms can be treated with acetaminophen. 2. Analgesics for discomfort are suggested following arrival home. 3. Call the office if the toddler develops a fever above 103, seizures, or difficulty breathing. 4. Discomfort at the immunization site and mild fever are common. 5. The immunizations prevent the toddle from contracting their associated diseases. 6. The parents would restrict the toddler activity for the remainder of the day.

1,3,4

The nurse is caring for a 17 year old male client with Duchenne muscular dystrophy. When assisting the client during a hospitalization for pneumonia, which anticipated nursing interventions would reflect client-specific care? 1. assisting the client to a Fowler position for a breathing treatment 2. feeding the client a high calorie breakfast 3. clearing a path to the bathroom for safe and easy access 4. providing directions to the client's educational level 5. completing a bed bath to conserve energy 6. crushing pills for morning medication administration

1,3,4

A 5 year old is admitted to the pediatric unit with diagnosis of possible intussusception. Which assessment data supports this diagnosis? Select all that apply. 1. currant jelly stools 2. diarrhea 3. abdominal pain 4. tarry, black stools 5. abdominal distention

1,3,5

A nurse is caring for a 5 year-old child who is in the terminal stages of cancer. Which statements about the childs impending death are most likely to be true? 1. The parents may be at different stages of grief in dealing with the child's impending death. 2. The child is thinking about the future and knows he/she may not be able to participate. 3. The dying child may become clingy and act like a toddler. 4. Avoid the topic of death unless brought up by the child. 5. The death of a child ay have long term disruptive effects on the family. 6. The child does not fully understand the concept of death.

1,3,5,6

A healthy 2-month-old infant is being seen in the local clinic for a well-child checkup and initial immunizations. The nurse should anticipate administering which immunizations? 1. DTaP (diphtheria, tetanus, and acellular pertussis) 2. MMR (measles, mumps, and rubella) 3. IPV (inactivated polio vaccine) 4. Varicella (chickenpox) vaccine 5. Hib (Haemophilus influenzae vaccine) 6. PCV (pneumococcal vaccine)

1,3,5,6

The nurse is caring for a 15 year old client with myelogenous leukemia whose platelet count is 26,000 mcl. Which nursing interventions would be included in the plan of care? 1. Instruct the client to not use a razor for shaving 2. Plan to infuse red blood cells 3. Encourage the client to eat foods high in iron 4. Assess the client for pain in the joints 5. Encourage jogging to increase endurance

1,4

A nurse is assessing a 10-month-old infant during a checkup. Which developmental milestones would the nurse expect the infant to display? Select all that apply. 1. holding the head erect 2. self-feeding with a spoon 3. demonstrating good bowel and bladder control 4. sitting on a firm surface without support 5. bearing the majority of weight on legs 6. walking alone

1,4,5

A nurse is caring for a group of toddlers in a large urban hospital. When considering providing care, which clients require contact precautions? 1. a toddler with scabies 2. a toddler with mumps 3. a toddler with streptococcal pharyngitis 4. a toddler with pulmonary tuberculosis 5. a toddler with a multidrug-resistant organism

1,5

A school nurse is gathering registration data for a child entering first grade. Which immunizations would the school nurse verify that the child has had? 1. influenza vaccine 2. dipertheria-tetanus-pertussis series 3. Haemophilus influenzae type b series 4. varicella vaccine 5. pneumonia vaccine 6. oral polio series

2,3,4

A nurse is completing a screening tool on a 4 and a half year old child. To be consistent with others at this age, what behaviors would the nurse expect the child to demonstrate? 1. The child balances on each foot at least 6 seconds. 2. The child copies a circle that is closed or very nearly closed. 3. The child speaks clearly. 4. The child draws a person with at least three body parts. 5. The child is able to follow one basic instruction through completion.

2,3,4,5

An adolescent scored a 20 on the Depression Scale for Children indicating moderate depression. Citalopram 20 mg daily is prescribe. Which nursing instructions are essential? 1. Eliminate aged cheese, yogurt, and chocolate from the diet 2. Improvement in mood may take up to 1 month 3. Monitor for the adolescent for signs of self-harm 4. Have the parent be involved in medication management 5. Discard any MAO inhibitor medications in home 6. Stop medication immediately if side effects of nausea develop

2,3,4,5

Which nursing interventions are important when caring for a hospitalized toddler? 1. Provide thorough explanation to the toddler prior to a procedure. 2. Instruct parents that regression commonly occurs. 3. Encourage the use of a security object from home. 4. Allow client autonomy by offering select choices. 5. Maintain the toddler's routine when able. 6. Discourage the parents' participation in client care.

2,3,4,5

A parent is planning to enroll a 9-month-old infant in a day-care facility. The parent asks a nurse what to look for as indicators that the facility is adhering to good infection control measures. The nurse identifies which as an indication of meeting proper infection control standards? Select all that apply. 1. The facility keeps boxes of gloves in the director's office. 2. Soiled diapers are discarded in covered receptacles. 3. Toys are kept on the floor for the children to share. 4. Disposable papers are used on the diaper changing surfaces. 5. Facilities for hand hygiene are located in every classroom. 6. Soiled clothing and diapers are sent home in labeled paper bags.

2,4,5

A 10 year old child is admitted to the hospital with a temperature of 104 degrees and is difficult to arouse. The child has a history of varicella 2 weeks ago. Reye's syndrome is suspected. Which objective data are supportive of the diagnosis? 1. dysuria 2. an abnormal liver biopsy 3. vomiting 4. client states, "I have a headache" 5. coma 6. disorientation

2,3,5,6

A nurse is caring for a 3-year old diagnosed with viral meningitis. Which signs and symptoms would the nurse expect to find during the admission assessment? 1. bulging anterior fontanelle 2. fever 3. nuchal rigidity 4. petechiae 5. irritability 6. photophobia

2,3,5,6

A 7 year old child is admitted to the hospital for a course of intravenous antibiotics. What actions would the nurse take before inserting the peripheral intravenous catheter? 1. Explain the procedure to the child immediately before the procedure. 2. Apply a topical anesthetic to the IV site before the procedure 3. Ask the child which hand he/she uses for drawing. 4. Explain the procedure to the child using abstract terms 5. Do not let the child see the equipment to be use in the procedure 6. Tell the child that they can cry but they must hold still during the procedure

2,3,6

A nurse is teaching the parents of a 6-month-old infant about normal growth and development. Which statements regarding infant development are true? Select all that apply. 1. A 6-month-old infant has difficulty holding objects. 2. A 6-month-old infant can usually roll from prone to supine and supine to prone positions. 3. A teething ring is appropriate for a 6-month-old infant. 4. Stranger anxiety usually peaks at age 12 to 18 months. 5. Head lag is commonly noted in infants at age 6 months. 6. Lack of visual coordination usually revolves by age 6 months.

2,3,6

A 4 year old postoperative child is found unresponsive. Place the following actions in the correct sequence to perform CPR after the child has been assessed for responsiveness and help has been called. 1. Open the airway 2. Feel for the carotid pulse 3. Check for breathing 4. Perform 30 compressions 5. Provide 2 rescue breaths

2,4,1,3,5

A nurse is conducting an infant nutrition class for parents. Which foods would the nurse tell parents that they may introduce during the first year of life? Select all that apply. 1. bread with honey 2. pureed fruits 3. whole grapes 4. oatmeal cereal 5. strained vegetables 6. fruit drink

2,4,5

The nurse is caring for a 4-year-old recently diagnosed with acute lymphocytic leukemia (ALL). Which statement, made by the parents, indicates the effectiveness of teaching? 1. "I read that ALL is a rare form of childhood leukemia." 2. "I understand that ALL affects all blood-forming organs and systems throughout the body" 3. "Because of the increased risk of bleeding, I will eliminate evening teeth brushing" 4. "I realize that the adverse effects of chemotherapy include sleepiness, loss of hair, and sores in the mouth" 5. "I am glad that there's a 95% chance of obtaining a first remission with treatment" 6. "I will not discipline my child during this difficult time"

2,4,5

A 17 year old client confides in the school nurse that he/she is interested in understanding safe sex practices. In instructing the client on how to correctly use a condom, which information would be stressed? 1. The condom only needs to be placed on the penis immediately before ejaculation. 2. Condoms should be stored in a cool, dry place to prevent damage. 3. A condom would be applied to the penis when sexual contact anticipated. 4. Leave a 1/2 inch space at the end of the condom. 5. Never reuse a condom. 6. The condom would be applied on an erect penis.

2,4,5,6

A child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises would the nurse provide to the child and family? Select all that apply. 1. Avoid foods high in folic acid 2. Drink plenty of fluids 3. Use cold packs to relive joint pain 4. Report a sore throat to an adult immediately 5. Restrict activity to quiet board games 6. Wash hands before meals and after playing

2,4,6

A nurse on the pediatric unit, received shift handoff on a 15-month-old with the following needs. Using Maslow's hierarchy framework, prioritize the following nursing care activities for the toddler. 1. progressing the diet after surgery 2. clearing the airway of thick secretions 3. changing a soiled diaper 4. administering antipyretics for an axillary temperature of 103 5. notifying the health care provider about suspected compartment syndrome

2,5,3,4,1

A nurse is caring for an infant who weighs 8 kg and is ordered to receive ampicillin 25 mg/kg intravenously every 6 hours. How many milligrams would a nurse administer per dose? Record the answer as a whole number.

200 mg/dose

A 4 1/2 year old is ordered to receive 25 ml/ hour of intravenous solution. The nurse is using a pediatric microdrip chamber (60 gtts/min) to administer the medication. For how many drops per minute would the microdrip chamber to be set?

25 drops/minute

A 6 year old child who reports fever, malaise, and anorexia is diagnosed with varicella (chickenpox). The nurse explains to the parents how skin lesions will develop. Place the following descriptions in order that they will occur as the disease progresses. 1. As initial lesions progress through stages, new lesions form on the trunk and extremities. 2. Papules develop into clear vesicles on an erythematous base. 3. Itchy red macules on the face, scalp, and trunk progress to papules. 4. Vesicles become cloudy and break easily. 5. Scabs form.

3,2,4,5,1

The nurse is instructing a parent of a school-age client on nutrition. The client is currently receiving vincristine for treatment of acute lymphocytic leukemia. Which instruction is included in the plan of care? 1. Provide a diet high in protein and saturated fats to maintain weight 2. Encourage raw organic vegetables with a complementary dip 3. Offer nutrient-dense snacks between meals and at bedtime 4. Encourage a farm fresh unpasteurized milk with meals 5. Have the client select between three acceptable food options 6. Suggest nutrient-dense supplements if appetite is poor

3,5,6

A nurse is teaching parents about the developmental milestones of an infant. Place the following developmental activities for an infant in order of occurrence by age from earliest to latest. All options must be used. 1. crawling on hands and knees 2. sitting alone 3. turning from supine to prone 4. turning from prone to supine 5. effectively using pincer grasp

4,3,2,1,5

The nurse is preparing to insert an intravenous catheter into an acutely ill toddler. Place the following steps in the order the nurse would follow. 1. Wash hands and gather supplies 2. Prepare the equipment 3. Inform the toddler of the procedure 4. Inform the parents of the procedure 5. Select and prep appropriate site 6. Insert the intravenous catheter and secure it appropriately

4,1,2,3,5,6

A nurse is caring for a 4 year old child who developed acute renal failure after a traumatic injury with hemorrhaging. Place the following events in the order in which they most likely occurred during progression of the severe renal deterioration. 1. acidosis 2. severe hypocalcemia 3. azotemia 4. oliguria

4,3,1,2

A nurse is preparing a dose of amoxicillin for a 3-year-old with acute otitis media. The child weighs 33 lbs (15 kg). The dosage prescribed 50 mg/kg/day in divided doses for every 8 hours. The concentration of the drug is 250 mg/5ml. How many milliliters would the nurse administer?

5 ml

A parent phones the health care provider's office stating that his 13-month-old has had diarrhea for 3 days and he is unsure what fluids to offer. Which suggestions would the nurse provide? 1. apple juice 2. whole milk 3. ginger ale 4. cola 5. electrolyte replacement solutions 6. water

5,6

A child is brought to the emergency department severely dehydrated after having gastroenteritis for 4 days. The health care provider orders an intravenous infusion to maintain fluid replacement for this child. If the child weighs 18 kg what is the hourly flow rate in milliliters?

58 ml

A 3 year old is to receive 500 ml of dextrose 5% in normal saline solution over 8 hours. At what rate in ml/hr would a nurse set the infusion pump?

63 ml/hour

A health care provider orders an intravenous infusion of dextrose 5% in quarter-normal saline solution (D5 0.25 NSS) to be infused at 7 ml/kg/hour for a 10 month old infant. The infant weighs 22 lbs (10 kg). How many milliliters of the ordered solution would the nurse infuse each hour? Record your answer using a whole number.

70 ml/hour

A child weighing 44 lb (20 kg) is to receive 45 mg/kg/day of penicillin V potassium oral suspension in four divided doses for every 6 hours. The suspension that is available is penicillin V potassium 125 mg/ 5 ml. How many milliliters would the nurse administer for each dose?

9 ml