Peds chapter & prep u review

The nurse is assisting with a physical examination on a child who has been admitted with a diagnosis of possible child abuse. Which finding might alert the nurse to the possibility that the child has been abused? A fractured bone Bruises on the knees and elbows Hyperactive and angry behavior A burn that has not been treated

A burn that has not been treated

A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially

Institute droplet precautions in addition to standard precautions.

A 5-year-old child who has recently been diagnosed with leukemia is never disciplined. The child's mother will feed the child although he is capable of feeding himself. She will not let him do anything for himself. This is an example of:

overprotection

A nurse admits a 10-year-old with spina bifida who is confined to a wheelchair. When asking the parent and child questions, the parent appears disinterested and distant, allowing the child to answer all questions. What typical caregiver response is this parent displaying?

rejection

Caregivers who distance themselves emotionally from the chronically ill child are responding with ____________ toward the child.

rejection

__________ fractures of the long bones of a young child are not common and may indicate possible abuse.

spiral

The nurse is working with a group of 4- and 5-year-old children who are talking about death and dying. One child in the group recently experienced the death of the family pet. Which statement would the nurse expect a 5-year-old child to say about the death of the pet? "I think he was sad to leave us." "He's only a little dead." "A monster came and took him during the night." "I will be real good so I won't die."

"He's only a little dead."

The nurse is interviewing the family caregiver of a 5-year-old child who has been admitted with bruises on the abdomen and thighs as well as additional bruises in various stages of healing. Which statement made by the family caregiver might alert the healthcare team to the possibility of child abuse? "His brother just plays too rough with him." "My child goes to the day care after school." "He just learned to ride his bicycle." "When he is in trouble, I make him go to his room."

"His brother just plays too rough with him"

When caring for a child with a chronic illness, a high priority goal that the nurse should establish for the client is which of the following?

Accomplish growth and development milestones.

A 12-year-old sibling of a child with Down syndrome is overheard telling a friend from school on the telephone, "I don't have any brothers or sisters. I am an only child." What does this child feel about the sibling with Down syndrome?

By having a sibling with Down syndrome, a stigma is attached to him or her.

___________________ is chronic involuntary fecal soiling beyond the age when control is expected (about 3 years of age)

Encopresis

A 3-month-old is brought to the emergency department by a parent who reports that the child won't stop screaming since falling off of a bed 2 hours ago. Physical examination and radiography confirm that the child has a spiral fracture of the femur. What should the nurse suspect has occurred with this infant?

Spiral fractures of long bones in young children are uncommon and can be seen in child abuse (child maltreatment).

A nurse admits an adolescent girl with a diagnosis of possible anorexia nervosa. Of the following characteristics, which would most likely be seen in the adolescent with anorexia? The adolescent gets low grades in school. The adolescent has a sedentary lifestyle. The adolescent freely expresses emotions. The adolescent follows a strict routine.

The adolescent follows a strict routine.

In planning care for an adolescent with an eating disorder, which goal would be most important for the adolescent? The adolescent will verbally express positive attitudes and feelings. The adolescent will plan and participate in age-appropriate activities. The adolescent will maintain a fluid and electrolyte balance. The adolescent will have normal bowel and bladder patterns.

The adolescent will verbally express positive attitudes and feelings.

A teenage client has been undergoing individual psychotherapy following a sexual assault a few days ago. The nurse would determine that the early stage of therapy is successful when the client meets which outcome?

The client is able to describe what happened and express feelings.

The nurse has admitted a 6-year-old child who has received a diagnosis of a seizure disorder and has frequent tonic-clonic seizures. Which are characteristics of tonic-clonic seizures? Select all that apply. The seizure activity might be preceded by a sight, sound, taste, or smell. The seizure activity is usually limited to one side of the body. The seizure activity involves a phase in which the muscles are rigid. The seizure activity causes memory loss and staring. The seizure activity involves a phase in which there are jerking muscle movements. The seizure activity often is followed by a loss of control of bowel and bladder.

The seizure activity involves a phase in which the muscles are rigid. The seizure activity involves a phase in which there are jerking muscle movements.

When documenting a chronic condition, which groups of illness would be considered? Select all that apply. degenerative disorders accidents resulting in spinal injury viral Infections congenital anomalies communicable diseases

degenerative disorders accidents resulting in spinal injury congenital anomalies

The eardrum of the infant and young child is best visualized by utilizing an otoscope and pulling the pinna of the ear __________ and ____________

down and back

The dying child may have a decreased level of consciousness, although the sense of ____________ often remains intact.

hearing

The health care provider is prescribing a pain medication for a pediatric client at the end stage of life. Which route would the nurse suggest?

intravenous

Child __________ is failure to provide adequate hygiene, healthcare, nutrition, love, nurturing, or supervision needed for growth and development.

neglect

When working with the family of a child who is terminally ill, the child's sibling makes the following statement to the nurse. Which statement is an example of the stage of grief referred to as denial? "I will share my toys if he can just come to my birthday party next month." "It makes me mad that they said my brother is going to die." "I think he will get well now that he has a new medicine." "When he dies, at least he won't have any more pain."

"I think he will get well now that he has a new medicine."

While the nurse is working with the family of a child who is terminally ill, the child's sibling makes the following statement to the nurse. Which statement is an example of the stage of grief referred to as bargaining? "I will share my toys if he can just come to my birthday party next month." "It makes me mad that they said my brother is going to die." "I think he will get well now that he has a new medicine." "When he dies, at least he won't have any more pain."

"I will share my toys if he can just come to my birthday party next month."

The nurse is discussing the subject of death and dying with a group of adolescents. Which statement would be expected considering the adolescent stage of growth and development? "I always hold my breath and run past the cemetery to protect myself." "It would be sad to die because my girlfriend would really miss me." "Others die in car wrecks, but even if I had a wreck, I wouldn't be killed." "It makes me nervous to go to sleep. I am afraid I won't wake up."

"Others die in car wrecks, but even if I had a wreck, I wouldn't be killed."

The nurse is with a family whose terminally ill child has just died. Which statement made by the nurse would be the most therapeutic statement? "It will not hurt as much as time passes." "My sister died when I was a teenager. I know how you feel." "I will leave the call light here. Call me if you need me." "This is a really sad and difficult time."

"This is a really sad and difficult time."

Characteristics seen in the child with _______________ include impulsive behavior, ease in being distracted, fidgeting or squirming, and difficulty sitting still.

ADHD

Siblings of a child who has a chronic illness may feel ___________, which is the feeling of embarrassment or shame, especially if the ill child has a physical disfigurement or cognitive deficit.

stigma

Administration of __________________ during a viral illness has been implicated as a contributing factor to the development of Reye syndrome in children.

Aspirin

Children with _________________ do not develop a smiling response to others or an interest in being touched or cuddled.

Autism spectrum disorder

A 9-year-old child is brought to the urgent care center by the parent. Based on assessment findings, the nurse suspects external otitis (acute otitis externa or swimmer's ear). Which finding on otoscopic examination supports this suspicion?

swollen, inflamed ear canal

The nurse is assisting with a physical examination on an adolescent with bulimia nervosa. Of the following signs and symptoms, which would most likely be seen in the adolescent with bulimia? Dry skin Dental caries Low body weight Amenorrhea

Dental caries

_____________________ is involuntary urination beyond the age when control of urination commonly is acquired.

Enuresis

The family of a child with a terminal illness might go through a process known as anticipatory grief. Which of the following might occur for the family during this process? Select all that apply. Having an opportunity to complete unfinished business Preparing for the eventual death of the child Having no feelings of guilt or remorse Beginning the process of preparing for the funeral Helping the child's siblings deal with the coming death

Preparing for the eventual death of the child Beginning the process of preparing for the funeral Helping the child's siblings deal with the coming death

If a child has a febrile seizure, what is the highest priority for the nurse? Document the child's behavior during the seizure. Instruct the caregivers about fever reduction methods. Protect the child during the seizure activity. Reassure the caregivers that seizures are common.

Protect the child during the seizure activity.

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful?

The shorter and wider eustachian tubes of an infant increase the risk.

Caregivers who respond with gradual ___________ take a common-sense approach to the child's chronic condition.

acceptance

The most commonly used drug among children and adolescents is ___________________

alcohol