Pediatrics Prep U exam 1
When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that:
imagination in a 3-year-old is at its peak.
The nurse is documenting the relationship between a postpartum mother and her infant. Which observation would demonstrate attachment?
"The mom is talking to the infant while breast-feeding the infant."
The nurse is caring for a preschool-aged child who needs a CT scan. Which action would the nurse use to best prepare the child for this diagnostic test?
Help the child to pretend that the CT scan machine is a camera.
The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development?
Her vocabulary is between 10 and 15 words.
A client who just learned she is pregnant says, "I can no longer eat strawberries, even though they are my favorite." What best explains this statement?
It is related to culture.
n working with the toddler, which statement would be most appropriate to say to the toddler to decrease the behavior known as negativism? pg.118
It is time for lunch. I am going to put your bib on."
The parents of a 3-year-old boy have asked the nurse for advice about a preschool for their child. Which suggestion is most important for the nurse to make?
"The staff should be trained in early childhood development."
The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?
A sense of competence, mastery, and worth
Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent?
Telephone consent with two witnesses listening simultaneously
The public health nurse is aware suicide in teens is a significant health issue. Which child is most at risk?
The 17-year-old Native American/First Nations male adolescent
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent?
The adolescent's need for privacy should be respected.
The nurse is talking with an adopted child and the family. Which statement represents "positive" adoption language?
The birth mother was how old when your child was born?
The nurse is taking a respiratory history of a newly admitted child. While documenting the symptoms the child has, what other item is important to document when taking a history on an altered respiratory status?
The triggers in the environment
What is the best awake state for infant interaction?
Eyes wide and bright
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?
The development of a 3-month-old
How is wheezing in children best heard?
as the child exhales
The caregiver of a 6-year-old expresses concern that the child cannot yet print the first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?
"By the age of 6, most children can print some letters and maybe their first name."
A parent wants to wait outside the room while a procedure is completed on his young child, saying, "I don't think I can stand to see you do this!" The nurse's best response is:
"Certainly. I will stay with your child during the procedure."
The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?
"At this age it is helpful to remind children to go to the bathroom."
A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best?
"Be sure to clean the navel several times a day."
The mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important?
"Be sure to get the proper size bike."
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse?
"Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses."
The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?
"Children this age sometimes can't distinguish between fantasy and reality."
A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed?
"Drinking sodas is not related to my blood pressure."
The nurse is discussing the impact of smoking with the mother of a toddler. Which statement by the mother indicates an adequate understanding of the impact of her smoking?
"Even the clothing I wear when smoking can pose a danger to my son."
A 14-year-old child shares with the nurse that she is adopted. She reports she was born in another country and now wishes she had more information about her ethnic and cultural background. She states her parents are not comfortable with this. What response by the nurse is most appropriate?
"Finding out about your culture may be enlightening for you."
The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem?
"He doesn't respond if I wave to him."
The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching?
"Her goal is to be a size smaller by our vacation in two weeks."
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education? pg.137
"I am so glad I can get rid of all of those bath toys because they take up so much room."
The nurse is assessing for violence in the home. Which statement by a parent would warrant further investigation?
"I don't think my children have seen my husband hit me."
A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply.
"I only tan before going on spring break to get a base tan so I won't burn." "My favorite time of day to be outside is the middle of the day, around noon." "The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."
The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates understanding of the instructions regarding the medication?
"I should give the enzymes before each meal or snack."
A nurse is preparing a hospitalized child for a lumbar puncture. The physician states that he will perform the procedure in the child's hospital room. What should the nurse inform the physician to advocate for the child?
"I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure."
The nurse is taking a health history for a 12-year-old boy who is seriously overweight. Which general question would the nurse direct to the child's parents?
"Is there a family history of hypertension, heart disease, or diabetes?"
Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie?
"It is a personal decision, let me give you a pamphlet from the AAP."
A 10-year-old child tells the school nurse that she is embarrassed that she is afraid of the dark. Which is the best response by the nurse?
"It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?"
A mother is concerned because her 14-month-old son, who had a big appetite when breast-feeding a few months ago, seems uninterested in eating solid food. She still breast-feeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother?
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate.
The nurse is reviewing sleep and rest activities of a 16-month-old child with the parents. The father states, "I have told my wife it is unhealthy for our child to sleep with us. It's time for him to sleep in his own bed. What do you think?" What is the nurse's best initial response?
"It must be difficult for the two of you to both feel strongly about what is best for you and your child."
The father of a child with mononucleosis is concerned with his child's fever and cough. The father asks when antibiotic therapy will begin. What is the best response by the nurse?
"Mononucleosis is a viral infection so an antibiotic isn't used. We address the symptoms with appropriate therapy."
The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?
"My child sleeps between 11 and 12 hours a night."
The nurse is working with the 5-day-old baby boy of a young Jewish couple. What comment is not culturally sensitive?
"Oh, I see you have chosen not to have your baby circumcised.
An adolescent's parent states not knowing what to do with the adolescent. The parent reports the adolescent is taking two or three showers a day when not that long ago the parent could barely get the adolescent to take a shower at all. What should the nurse's reply be to the parent?
"Reinforce the family rules but also allow the adolescent to develop one's own routine."
The parents of an 8-year-old girl with a slow-to-warm temperament are concerned about their daughter's reaction when she visits the dentist for the first time after having a cavity filled at the last visit. How should the nurse respond?
"Remind her in simple terms what will happen in the dentist's office."
The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?
"She screams and thrashes when we try to touch her."
The nurse is caring for a child. The nurse is trying to ensure that the family's cultural practices are supported. Which statement by the nurse indicates a lack of understanding regarding cultural competence?
"Since your child is only 8, I doubt that your child has any cultural practices we need to be aware of."
A student nurse shares an interest in pediatric nursing. When discussing her thoughts about pediatric nursing, which statements are consistent with the philosophies of pediatric nursing care? Select all that apply.
"The child should be included as much as possible in the plan of care." "I believe the family should be included in all aspects of the plan of care and treatment." "Since health care can be scary for a child, it's important to make them feel secure."
The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?
"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."
A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes?
"This is common for this age group and it will get better with time."
The nurse is preparing a 5-year-old for a radiograph. What would be the best communication to prepare the child for the procedure?
"We are going to use a big camera to take pictures inside your body."
The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed? pg.139
"We just got him a new bike he can grow into."
The nurse is caring for a 12-year-old child with a depressive disorder. When providing teaching about the disorder and the importance of treatment to the child's parents, the nurse accurately includes which teaching points? Select all that apply.
"We need to monitor your child's academic performance since this is often affected." "It's important to be aware that having a depressive disorder as a child increases the chance of mental health issues as an adult." "Substance use disorder is common during the adolescent years if mental health issues are present during childhood."
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group?
"You have lots of hormone changes going on right now."
The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?
"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth."
A nurse is providing care to a child and family recently admitted to the hospital. The nurse would anticipate the need to obtain specialized informed consent in which situation? Select all that apply.
-Before a bone marrow aspiration -Prior to radiation therapy -Before photographing the child
Which child needs to be seen immediately in the physician's office?
10-month-old with a fever and petechiae who is grunting
The nurse working at the child community clinic must administer the influenza vaccine to the high-risk kids first. Which child would she choose?
23-month-old Ava who had heart surgery as an infant for a defect
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit? pg.64
24 pounds (10.8 kg) and 30 inches (75 cm)
The mother of a 12-year-old boy is concerned about the dangers of the Internet. Which suggestion by the nurse best targets safety related to this?
Never share personal information online.
A parent is disciplining the 5-year-old daughter by putting her in time-out. How long should the child be in time-out?
5 minutes
The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?
Newborn
The parents of a 30-month-old toddler have brought the toddler into the emergency department because of a seizure. During the health history, the nurse suspects the toddler had a breath-holding spell. Which parental report suggests breath-holding?
A tantrum preceded the event.
The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is:
Acyclovir
The nurse is caring for a 16-year-old female who has been brought to the clinic by her mother seeking information about contraceptives. What action by the nurse will best promote the client's autonomy?
After a review of suitable contraceptive options, ask the client which is of the greatest interest.
When teaching an adolescent about home care after hospitalization, what is most important for the nurse to do?
Allow opportunity for the adolescent to express feelings.
A nurse is preparing to administer medication to a preschooler. What can the nurse do to ensure communication with the child is effective?
Allow the child to choose between juice, water, or soda to take the medication.
A 4-year-old child has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. The parents are extremely distraught over the child's condition and the fact that the child has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of the parents?
Allow the parents to remain with the child as much as possible.
A teen is being cared for on the inpatient unit. When planning care using atraumatic care principles, what is of the highest priority for the nurse?
Allow the teen to participate in the planning of care.
Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?
Allowing the preschooler to fall asleep wherever and whenever the child is tired enough
What is the correct amount of wet diapers a mature infant should produce each day?
An infant should have 6 to 8 wet diapers/day.
An 8-year-old girl presents with drooling and a complaint of painful swallowing. She has a high fever and is lethargic. On examination the nurse sees that her palatine tonsils are bright red and swollen. The girl's mother says that she has never had these symptoms before. A throat culture indicates a streptococcus infection. What is the course of treatment that the nurse would expect in this situation?
Antipyretic, analgesic, and antibiotic
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
The nurse is caring for a child whose family recently immigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate?
Ask parents which immunizations have been given.
The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful?
Ask the child questions as you read.
A nurse is attempting to reduce pain that a child is experiencing after an emergency appendectomy. What intervention can the nurse provide to meet this goal?
Assess the child frequently and use pharmacologic and nonpharmacologic methods of pain relief as needed.
The nurse is caring for a child who appears fearful and is reluctant to talk. The nurse uses therapeutic communication skills to interact with the child. What initial goal does the nurse accomplish when using these skills to communicate with the child?
Assess the perception of the problem.
While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action?
Assess the situation with the help of the school staff and parents.
What should be the first step in developing a teaching plan for a 9-year-old who needs education about a gluten-free diet for the treatment of celiac disease?
Assessing the child's current level of understandin
The nurse in a free clinic is caring for a 1-year-old girl and her single mother. Which nursing intervention would most likely be needed initially?
Assessing the child's nutritional status
The nurse is providing care to a 6-year-old child following surgery. The nurse asks the child to rate the pain using the Faces of Pain scale. Which phase of the nursing process is the nurse demonstrating?
Assessment
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson?
Autonomy versus shame and doubt
A 7-year-old with sickle-cell disease who comes to the hospital frequently appears withdrawn and depressed. He refuses to talk to anyone or even admit that he is sad. What would be the best thing for the nurse to do that might help the child deal with his feelings?
Get him to draw a picture.
A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:
Bacteria
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn?
Bathing is a time for bonding with the parents.
The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?
Bull's-eye rash around the bite
The appearance of which hallmark clinical manifestation occurs in measles?
Koplik spots
A nurse is reviewing the medical record of a 3-year-old child who is brought to the clinic for an evaluation. The nurse notes that the child is participating in a community Early Head Start program. The nurse understands that this program focuses on which aspect?
Child development
A 6-year-old reports pain in the stomach upon eating. The nurse replies, "Let me see if I have this right. Every time you eat anything, you get a pain in your tummy?" The nurse is using which technique of therapeutic communication?
Clarifying
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions?
Clients who are showing pubertal changes
What information would the nurse include when teaching the parents of an infant about colic?
Colic symptoms will probably fade at 3 months of age.
A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?
Contact Precautions
A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client?
Delayed growth and development related to frequent illness
The nurse is caring for a Native American child. Which approach would be most consistent with the culture?
Discussing treatment as reestablishing harmony
A nurse is discussing a 9-year-old girl's obesity with her parents. Which nursing instructions are helpful? Select all that apply.
Decrease intake of approximately 1,200 calories a day Limit time spent on sedentary activity Participate in a formal weight-control program Encourage fun exercise classes
The parent of a 2-year-old toddler tells the nurse needing to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training
A bilingual family tells the nurse their desire for their child to learn Spanish as well as English. English is the predominant language spoken in the home. The parents ask the nurse when is the best time to teach the child a second language. What time period would the nurse respond?
During the preschool years
The nurse is teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family?
Encourage everyone in the family to use good hand-washing techniques.
The nurse is preparing to administer acetaminophen to a 4-year-old girl to provide comfort to the child. Which precaution is specific to antipyretics?
Ensure proper dose and interval
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?
Ensure that the child brushes his teeth after each meal and snacks.
The nurse is providing information to the parents of a 6-year-old boy who has been caught lying at home and at school. Which information would the nurse share with the parents? Select all that apply.
Explain that children this age typically lie to avoid punishment. Suggest reading a story with the child about the consequences of lying.
A client family recently moved to the United States. They live with their relatives, who were already residing in the United States. This is an example of which family form?
Extended
What is a symptom of bacterial pharyngitis?
FEVER
The nurse is assessing a 3-year-old child. Which assessment finding would the nurse identify as abnormal? pg.141
Falls when bending over to touch toes.
What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child?
Fish, spinach salad and a glass of milk
A toddler's mother reports that her child will only eat peanut butter and jelly sandwiches for several days in a row. The child will then refuse to eat them for several weeks. Which term would the nurse use to document this behavior?
Food jag
The parents report that their son does not exhibit gender behavior typical of their other sons. The parents voice concern with the child's behavior. What is the appropriate response by the nurse?
Have you voiced your concerns to your primary physician?
A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse?
Having wet dreams indicates that your body is going through a process of maturing."
The school nurse asks a group of school-age children about pedestrian safety. Which comments by the children should the nurse address with either the child or parents of the child? Select all that apply.
I am 6 years old and I walk my younger brother to the park that is 5 blocks from our house." My friends and I like to walk on the side of the road because our sidewalk is very uneven." "I think it is funny to hide behind my dad's car before he leaves for work and scare him."
The nurse is teaching a 15-year-old boy with diabetes mellitus and his parents how to monitor glucose levels. Which communication technique is least effective?
Ignoring the adolescent's tirade about his therapy
A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group? pg.128
Imagination
A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?
In two months you can try bananas if you think she is ready."
An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step?
Industry
Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?
Iron deficiency
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance?
Is there a gun in your home?
The family who are vegetarian voice concern that their child is not growing well. The nurse should suggest which food to increase the calcium intake for adequate bone growth?
Kale
The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?
Learning the mother is not the custodial parent
An infant is breastfed. When assessing the stools, which findings would be typical?
Less constipation than bottle-fed infants
The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent?
Let them choose their hairstyle, even though it may not look the best for them.
The nurse is obtaining a health history and assessment for a child being admitted who is suspected of having measles. What signs and symptoms does the nurse expect to find during the assessment? Select all that apply.
Maculopapular rash that began on the face and has spread to the rest of the body Fever Upper respiratory infection symptoms
A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior?
Make time each day to spend with the child individually.
The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?
Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.
The parents of a 16-year-old are fearful that their child may be using illegal drugs. They report to the nurse that they have noticed recently that their child seems much more focused when doing homework or chores, is losing weight, displays a high level of energy, and becomes agitated easily. The nurse is aware that the teen is displaying symptoms of which type of drug use?
Methamphetamine
What statement is the most accurate regarding the structure and function of the newborn's respiratory system?
Most infants are nasal breathers rather than mouth breathers.
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability?
Most infants do not sit steadily until 8 months; this infant is normal.
The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation?
Motor vehicle safety
A 17-year-old has been diagnosed with HIV. When developing the plan of care, which initial action should be included?
Notify the local health department of the individual's HIV status.
A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you consider?
Organizing nursing care at times other than visiting hours
A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, which parts of the body (besides the lungs) are most affected by this disease?
Pancreas and liver
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:
Parellel play
A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family?
Parental anxiety related to lack of understanding of childhood development
A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care?
Parents
A nurse is caring for a hospitalized 10-year-old. What would be an appropriate activity for this child to meet the developmental tasks of this age group?
Participating in a craft project
The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is:
Penicillin
The nurse is supervising a play group of children on the unit. The nurse expect the toddlers will most likely be involved in which activity? pg.98
Playing with the plastic vacuum cleaner and pushing it around the room
The mother of a school-aged child is discussing parenting behaviors with the nurse. She questions the nurse about the best way to provide feedback to her child. What suggestion by the nurse is most appropriate?
Positive reinforcement is more valuable than negative feedback.
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget?
Preoperational thought
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?
Pretending to be mommies and daddies in the playhouse
A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?
Red, strawberry tongue
In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason?
Relief of acute symptoms
The mother of a child who has been termed to have a "difficult" temperament voices frustration in managing his care. What would be the best initial course of action by the nurse for this parent?
Review strategies that are beneficial in the care of a child with a difficult temperament.
The school nurse is caring for a 12-year-old boy with a bloody nose. Which action would be most appropriate for the nurse to do?
Seat the child leaning forward and pinch the anterior portion of the nose closed
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
Sitting independently
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule?
Small elevation of epidermis filled with a viscous fluid
The nurse is reinforcing teaching about medications with the parents of a 2-year-old who has cystic fibrosis. The nurse suggests that pancreatic enzymes may be given by which method?
Sprinkled onto the food
The school nurse is preparing a presentation for a group of teachers about teen suicide. When discussing risk factors for this occurrence which should be included? Select all that apply.
Substance use disorder History of mental illness Homosexuality
The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child?
Sweat sodium choloride test
A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client?
Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail.
An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate?
Take the child to a private room and interview her regarding her sexual history and partners.
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans?
Teens are busy developing their own personal identity.
The nurse suggests to the parent of a preschooler who had unexpected surgery that the child be given a doctor/nurse kit to play with at home. Select all reasons that this would be an effective strategy.
The child can use the kit with dolls or stuffed animals to work through feelings about the healthcare experience. The parent can observe the child's play to identify any misperceptions about the unprepared-for experience and correct them. Role-play is an age-appropriate, common form of play for preschoolers through which experimentation and learning occur. The preschooler can pretend to be a physician or nurse practitioner who has the power to control events that the child lacked as a recipient of care.
The nurse is observing a 5-year-old in the play room of the medical unit of the hospital. The child uses the toy medical equipment and proceeds to change the bandage on a doll, pretends to give the doll medication, and talks elaborately to the doll. How does the nurse accurately interpret this play?
The child is expressing anxiety about the hospitalization through play
A nurse is talking with a 10-year-old and her parent about the current treatment plan for the child's asthma. The child stands behind the parent and does not ask questions or look at the nurse. What should the nurse consider the child's behavior could indicate?
The child may be shy and have some reluctance about communicating.
The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?
The importance of crossing streets safely
The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.
The infant does not pay attention to noises behind him. The infant seems disinterested in the surrounding environment. The infant has frequent episodes of crossed eyes.
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
The infant's gumline will be tender.
The NICU nurse is caring for a preterm neonate with respiratory distress syndrome on mechanical ventilation. Which assessment data would alert the nurse that a pneumothorax might have developed? Select all that apply.
The neonate's respiratory rate is 68. Neonate is exhibiting nasal flaring and grunting. The neonate's chest is asymmetrical. with decreased breath sounds on one side.
The nurse is working in a pediatric facility whose mission statement strongly emphasizes providing family-centered care. What nursing intervention best exemplifies this facility's belief?
The nurse plans a meeting with the parents, child, and case worker to discuss care alternatives for the child
A nurse, who is also a mother of a 2-year-old child, attends a party at a friend's house and notes some safety concerns that she would like to share with the other mother privately. Which observations during the party would be considered a safety concern that should be addressed privately when appropriate? Select all that apply.
The nurse/mother notes that the toddler's car seat is located in the passenger front seat. The parent is busy entertaining guests and did not notice the toddler running out in the neighborhood street to get a toy. The parents allow the toddler to climb up on the counter and watch as food is stirred on the stove.
The nurse is assessing the teaching needs of the parents of an 8-year-old boy with leukemia. Which assessment should the nurse explore as a potential issue with the parent's health literacy?
The parents missed the last scheduled appointment.
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?
The respirations of a 1-month-old infant are normally irregular and periodically pause.
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler?
The toddler should speak in two-word sentences ("Me go").
The nurse providing care to the fifth-grade child and his family reviews the nursing care plan, noting that teaching about pubertal changes is one of the individualized interventions. The nurse chooses not to address this. How should the nurse's action be evaluated?
This nurse has not met the standard of care that constitutes adequate nursing practice identified in Pediatric Nursing: Scope of Standards and Practice.
What was the primary goal for the establishment of the Children's Bureau?
To improve the standards of health care
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life?
Trust
The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?
Undressing himself
A nurse is preparing a presentation for a local parent group. The group consists of parents with children younger than 4 years of age. As part of the presentation, the nurse plans to include teaching about preventing deaths in this age group. The nurse would most likely focus on prevention activities primarily related to which area?
Unintentional injuries
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 approach would be most effective in helping prepare the child for surgery?
Use a doll to role-play the events surrounding the surgical experience and the procedure.
Over coffee following a worship service, parents ask the parish nurse for guidance in disciplining their children ages 4 years, 9 years, and 14 years. What concepts will guide the nurse's response? Select all that apply.
Use parental attention as positive reinforcement for desired behaviors. Maintain consistency in expectations at all ages. Role model appropriate behavior in word and deed.
The nurse at a camp for children with asthma is teaching these children about the medications they are taking and how to properly take them. The nurse recognizes that many medications used on a daily basis for the treatment of asthma are given by which method?
Using a nebulizer
When assessing a child for the probable cause of acute bronchiolitis, the nurse focuses on which factor?
Viral infections
The client is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program would you recommend to the child's young mother?
WIC
The nurse provides soy milk and fresh vegetables to a pregnant woman who is single, and the mother of a toddler. Which federal program is the nurse implementing?
WIC Food Package Revised
Which nursing activity requires the pediatric nurse to implement the ethical principle of nonmaleficence?
Weighing the potential harm caused by a child's chemotherapy with its potential benefits
The student nurse views a boy from a large extended family as poor because his father is unemployed. Considering his family structure, in what way might he view the student nurse as "poor"?
You are unmarried and live alone.
A nurse is assessing a child with a tick-borne disease. What finding would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted fever?
absence of rash
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)?
an 18-month-old child receiving chemotherapy over 5 days
When caring for hospitalized teens, nurses should choose their words and actions carefully since adolescents typically are concerned about:
appearing out of control of the situation and/or themselves.
When a woman is admitted to the labor-and-delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to
ask him if he knows that he can stay with his wife during labor.
While caring for a hospitalized child, the nurse notes the father does not take into consideration the wishes or opinions of the child. During a period of discussion the father explains to the nurse that he feels his child is best served having clearly outlined rules and expectations. This is most consistent with which style of parenting?
authoritarian
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?
be able to turn over onto the back
The most important safety precaution for parents to teach preschoolers is: pg.138
not to ride in a car with strangers.
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
object permanence.
During a well-child care visit, the mother of a 4-year-old child reports her son is extremely active at home and cries easily if frustrated. This is consistent with which level of the classic temperament theory?
difficult temperament
When caring for a woman in her sixth month of pregnancy, the client reports her plans to nurse her baby for at least 2 to 3 years like the rest of the women in her family. Based upon the nurse's knowledge, the nurse should:
document her report but do nothing as this is a cultural belief that should be respected.
A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as:
fifth disease
According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as:
identity vs. role confusion.
Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:
increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive.
The developmental task of the school-aged period, according to Erikson, is gaining a sense of:
industry versus inferiority.
The school-age child with a new colostomy will require teaching by the nurse to learn to care for the ostomy. In order for the nurse to teach the child effectively, what is most important for the nurse to know about the child?
learning style
A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:
make her child attend school every day.
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that:
preoccupation with death and dying is common in the school-aged child.
A preschooler's mother asks the nurse an appropriate time to tell her son that she is pregnant. The nurse's best answer would be:
probably at the point she begins to look pregnant.
A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:
scarlet fever
A 2-year-old toddler holds the breath until passing out when the toddler wants something the parent does not want the toddler to have. The nurse would base evaluation of whether these temper tantrums are a form of seizure on the basis that:
seizures are not provoked; temper tantrums are.
After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma?
shellfish
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to:
testing and identification of group role.
Glycogen loading is practiced regularly by the local high school football team. What is most important for the nurse to monitor in these students?
the amount of carbohydrates the student is eating
Suicide is so common in adolescents it ranks as the third leading cause of death in the 10- to 24-year-old age group.
true
The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?
urine output of 10 ml over 3 hours
Which is most likely to encourage parents to talk about their feelings related to the poor prognosis their child has been given?
using open-ended questions
If there is a foreign body in the larynx, how will the client present?
with stridor