Peds Final
The pediatric nurse is developing interventions for a school-aged child based on the nursing diagnosis of imbalanced nutrition related to a body mass index (BMI) of 37 and poor food choices as evidenced by patient's mother's food diary for the family and child's statements of food preferences. Which of the following would be an appropriate nursing intervention? A.Provide the child and family with information from https://www.MyPlate.gov for healthy food options. B.Increase the child's activity by incorporating the child's friends into a plan of healthy exercise options C.Provide information on the increased risk for potential disease processes such as diabetes and hypertension D.Explain the importance of balancing diet and exercise to prevent obesity to the child and family.
A. Provide the child and family with information from https://www.MyPlate.gov for healthy food options.
The emergency department nurse is providing care to a 5-year-old child with a repeated exacerbation of otitis media. When it becomes apparent that the parents smoke and refuse to prevent the child's exposure to secondhand smoke, the nurse voices frustration to the family that they are causing the child's otitis media. Which of the provisions of the ANA Code of Ethics for Nurses has the nurse failed to follow? A.The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient B.The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems. C.The patient's right to self-determination must be upheld, justified only when justified by law. D.The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient
B.The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems.
The nurse is asking a parent of a toddler at age 18 months if there are any particular parenting challenges at this time. Which advice will the nurse offer if the parent shares issues with separation anxiety? A.The toddler is to be left only with family members until the fear subsides. B.The parent needs to keep reassuring the toddler that the parent will return C.The parent needs to plan leaving times to coincide with the toddler's naps. D.The parent needs to just leave quickly and ignore the toddler's protests
B.The parent needs to keep reassuring the toddler that the parent will return
A nurse is providing care to a child in the home-care setting. The nurse often provides the mother with advice that varies from how to perform the child's medical care to marital advice. The nurse has stated that this is their favorite patient and has made this child's home the last stop of their shift to use her free time for visits. What is the relationship status between the nurse and family? A.This is not a therapeutic relationship, as the nurse has not included the whole family in the care B.This is a therapeutic relationship based on family-centered care, with a focus on empathy C.This is not a therapeutic relationship, as the nurse has become enmeshed within the family. D.This is a therapeutic relationship, with the nurse focusing on the well-being of the whole family
C.This is not a therapeutic relationship, as the nurse has become enmeshed within the family.
The nurse is evaluating the motor development of a preschooler at age 5 years. Which assessment finding is essential for the child to be considered ready for kindergarten? A.Uses the toilet without assistance B.Dresses independently C.Throws overhand and catches a bounced ball D.Draws stick figures with two or more body parts
A.Uses the toilet without assistance
A school-age patient with rubella is placed in droplet precautions. Which action should the nurse take when implementing these precautions? A.Wear a mask when providing care. B.Instruct to cough into the hands C.Use a mask with a high-efficiency particulate air (HEPA) filter. D.Assign to a negative air pressure room
A.Wear a mask when providing care.
A parent brings their school-age child to the clinic for a rash that developed over the face, trunk, and extremities. Which question should the nurse ask the parent when assessing the patient? A."Was the child exposed to anyone with a respiratory infection?" B."Has the child eaten any food that was not properly cooked?" C."How often is the child given acetaminophen, or Tylenol?" D."Has the child been nauseated or has the child vomited?"
A."Was the child exposed to anyone with a respiratory infection?"
A parent tells the nurse a toddler is exhibiting signs of being ready to potty train. Which action by the parent will draw the nurse's approval? Select all that apply. A."We are using treats, stickers, and new underwear as incentives." B."We are still using diapers to avoid messes." C."He has to sit on the potty 10 minutes each hour." D."Accidents result in the loss of a favorite toy for the day." E."I am initially teaching my son to urinate sitting down."
A."We are using treats, stickers, and new underwear as incentives." E."I am initially teaching my son to urinate sitting down."
The nurse is visiting the home of a new mother and a 2-month-old infant. The nurse notices the infant vigorously sucking on the fist and whining but not crying. The mother validates that the behavior is common. Which information does the nurse need to obtain from the mother? A.What type of feeding schedule is followed B.If the infant draws up the legs when crying C.If the mother is breast or bottle feeding D.How long the infant sleeps at night
A.What type of feeding schedule is followed
During a well-baby checkup, the father of an infant states, "Even if he is occupied with a toy, he cries as soon as he notices I have left the room." Which explanation by the nurse is best? A."Your baby does not know you exist if he cannot see you." B."Babies learn very quickly how to get an adult's attention." C."You should move the baby with you if you leave the room." D."Just ignore him; he will soon learn that you are still present."
A."Your baby does not know you exist if he cannot see you."
The emergency department nurse is providing care to a 3-year-old child who has suffered a major accident. The parents ask the nurse, "Is our child going to be okay?" What is the most effective communication response at this time? A."Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?" B."Your child has suffered a major injury. Please wait here while we finish assessing the injuries." C."Your child is being assessed at this time. I am confident the physician will resolve the problem." D."Your child has suffered a severe laceration to the spinal cord and may have terminal paralysis."
A."Your child has suffered a major injury; let me give you some privacy. May I call the chaplain just to be with you?"
The nurse is interviewing a parent of a 9-month-old infant during a well-baby visit. Which statement by the parent causes the nurse concern about infant safety? A."He loves to get his toys out of a big plastic storage bag on the doorknob." B."It really disturbed me to see my neighbor's infant with a pacifier on a cord around the neck." C."When we eat cooked vegetables, I cut a few into bite size pieces so he can try them." D."He thinks the TV remote is a toy, so it is kept on a shelf too high for him to reach."
A."He loves to get his toys out of a big plastic storage bag on the doorknob."
The pediatric home-care nurse is visiting a toddler born with a genetically related illness. Which comment by the parent is the greatest cause for the nurse to assess for additional information? A."I am having more difficulty keeping her confined." B."Hospitalization would cause some severe stress." C.A chronically ill child affects the entire family." D."The other children seem so accepting of the illness."
A."I am having more difficulty keeping her confined."
The pediatric nurse is providing care to a 5-year-old patient for speech impediments that were caused by repeated incidences of otitis media. Which of the following is an example of current issues regarding this type of medical problem? Select all that apply. A. Increased admissions based on knowledge deficits due to language barriers B. Increased admissions based on environmental risk factors, such as smoking C. Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen D. Increased awareness of childhood health issues from social media and Internet E.Shift in the focus of medical care from disease treatment to disease prevention
A. Increased admissions based on knowledge deficits due to language barriers B. Increased admissions based on environmental risk factors, such as smoking C. Deficient knowledge that has negatively impacted the adherence to the antibiotic regimen
A neonate is delivered 3 weeks before the due date. The nurse performs assessment of gestational age by using the Ballard maturational scoring tool. Which assessment result indicates a premature infant? A.A rating of the lowest scores based on weight, length, and head circumference B.A rating of the highest scores based on weight, length, and head circumference C.A rating of the highest scores for physical maturity and neuromuscular activity D.A rating of the lowest scores for physical maturity and neuromuscular activity
A.A rating of the lowest scores based on weight, length, and head circumference
The neonatal nurse is assessing a term neonate in the delivery room. Which respiratory assessment finding at 15 minutes after birth causes concern to the nurse? A.A single episode of apnea occurs for 18 seconds in a 1-minute period B.Acrocyanosis is pronounced in all four extremities C.Respiratory rate fluctuates between 30 and 60 breaths per minute D.Respirations are irregular, sporadic, shallow, and diaphragmatic
A.A single episode of apnea occurs for 18 seconds in a 1-minute period
During admission of an adolescent to the hospital for an acute illness, the nurse asks about the use of complementary and alternative medicine (CAM). In which manner does the nurse approach the topic to obtain an accurate answer? A.Asks the adolescent what kind of CAM is used in the home and among friends B.Informs the adolescent that CAM must be completely avoided when hospitalized C.Tells the adolescent that unreported CAM is a major cause of complications D.States that CAM is actually a primitive type of modern medication therapy
A.Asks the adolescent what kind of CAM is used in the home and among friends
The nurse in a pediatric office is preparing to remove stitches from an 8-year-old child's arm. Which approach by the nurse before the procedure is most effective? A.Bring the instruments to the room and announce, "Let's get those stitches out." B.Have a coworker in the room to assist if the patient becomes uncooperative. C.Tell the patient, "I will be back in 15 minutes to take out your stitches." D.Provide information in advance of how the procedure is performed.
A.Bring the instruments to the room and announce, "Let's get those stitches out."
The nurse is providing counseling to the caregivers of a 4-year-old child who was born with a genetic condition that interferes with physical and psychosocial development. The child has had multiple hospitalizations for illnesses and infections related to the genetic condition. For which reasons will the nurse suggest the caregivers consider placement in a pediatric medical home? Select all that apply. A.Care is coordinated by an interdisciplinary team that includes the caregivers B.The caregivers will be relieved of care needed for 24 hours every day C.The child's medical history indicates health risks related to family care D.The home is set up to provide pediatric care from birth to adulthood E.The model is designed to reflect care standards suggested by pediatricians
A.Care is coordinated by an interdisciplinary team that includes the caregivers D.The home is set up to provide pediatric care from birth to adulthood E.The model is designed to reflect care standards suggested by pediatricians
Erickson's psychosocial development theory proposes that the school-aged child between ages 6 and 12 years is in the stage of industry vs. inferiority. Based on this theory, how will the pediatric nurse design activities as part of a diversional program for children who are in a long-term medical facility? Select all that apply. A.Designate methods of recognition for completed tasks. B.Set guidelines and policies that are clear and enforceable. C.Identify adequate activities suited for solitary play. D.Provide activities that involve more than one person. E.Allow participation in simple tasks on the unit of care.
A.Designate methods of recognition for completed tasks. B.Set guidelines and policies that are clear and enforceable. D.Provide activities that involve more than one person. E.Allow participation in simple tasks on the unit of care.
The school nurse is presenting information on the importance of exercise to children in the fifth and sixth grades of school. Which reason does the nurse cite as being the best reason for being physically active? A.Early exercise will carry over as good habits for adults. B.Normal childhood activities make exercise fun. C.Physical activity needs to replace technology hours D.Sports provide an opportunity to bond with peers
A.Early exercise will carry over as good habits for adults.
The nurse is providing care to a hospitalized 1-year-old patient. The nurse locks the exits per protocol to prevent the removal of the child from the unit. The grandparents become angry about this, because they want to take the infant outside for "some fresh air." What is the appropriate measure that the staff takes to promote patient safety at this time? A.Explain to the grandparents that this is a measure to prevent abduction of the patient. B.Permit the grandparents to take the child after they sign a waiver for any possible injuries incurred off the unit C.Explain that the child is not to leave the floor without express permission from the parents. D.Permit the grandparents a limited amount of time off the unit, due to treatment schedules
A.Explain to the grandparents that this is a measure to prevent abduction of the patient.
The nurse is preparing to teach a class of adolescents about the increasing numbers of young people being sexually assaulted. Which advice by the nurse will promote adolescent safety from sex crimes? Select all that apply. A.Go out with groups of friends B.Avoid alcohol and substance use C.Remain in public places D.Bring a friend along on a date E.Research a date's background
A.Go out with groups of friends B.Avoid alcohol and substance use C.Remain in public places
The nurses in a local health department are scheduled to perform screenings at a public elementary school. Which printed information will the nurses most likely send home with the students after the screening? A.Methods of treating and avoiding lice infestation B.Procedure for handwashing to prevent illnesses C.Proper way to cover up when coughing or sneezing D.Importance of keeping immunizations up to date
A.Methods of treating and avoiding lice infestation
The nurse works in a neighborhood pediatric clinic that serves a multicultural population. The nurse uses the Giger and Davidhizar Transcultural Assessment Model. Which of the six aspects is most helpful when performing pediatric assessments? A.Personal space between the individuals who are communicating B. Treatment or remedies may be called "old wives tales" C.Treatments should be accepted if they will not harm the patient D.Client and family perception of current health status
A.Personal space between the individuals who are communicating
The school nurse attends a workshop focusing on the identification and prevention of bullying among school-age children. The nurse will be better able to identify both bullies and victims due to knowledge of which factors? Select all that apply. A.Poor academic achievement B.Jealousy over sexual attention C.Leader or follower personality types D.Lower education level of caregivers E.Poor health status or increased health needs
A.Poor academic achievement D.Lower education level of caregivers E.Poor health status or increased health needs
The nurse is visiting the home of a family who is providing care for a school-age child with profound disabilities. The nurse notes that the primary caregiver looks tired and thin. The caregiver admits to feeling overwhelmed and then guilty about negative feelings. Which intervention by the nurse is most helpful? A.Recommend the caregiver to a support group where feelings can be shared. B.Suggest a means of child management so the parents can plan a short getaway C.Provide literature about extended-care facilities where the child can be cared for D.Arrange for a counselor to meet with the family and assess for well-being.
A.Recommend the caregiver to a support group where feelings can be shared.
The nurse works in the pediatric unit of a hospital and is currently providing care for a 1-year-old patient. Which action by the nurse is most important for maintaining the safety of this patient? A.Regularly check equipment in the crib environment for potential safety hazards B.Question about the presence of smoke and carbon monoxide detectors in the home. C.Check the temperatures of water, food, and drinks to prevent burns D.Provide caregiver education on basic home, outdoor play, and car safety measures.
A.Regularly check equipment in the crib environment for potential safety hazards
The parent of a toddler at age 2 years and a preschooler at age 4 years is sharing a concern about sibling rivalry. The parent states, "It is so upsetting to see them fighting with each other. I am afraid one of them will hurt the other." Which interventions will the parent and nurse design together in a plan for management? Select all that apply A.Set rules defining acceptable behavior. B.Recognize the toddler has increased risk for injury C.Teach children to be kind to each other D.Separate them to opposite sides of the room. E.Assist with appropriate expression of feelings
A.Set rules defining acceptable behavior. C.Teach children to be kind to each other E.Assist with appropriate expression of feelings
The school nurse in a high school setting expresses concern to school administration regarding the increase in student complaints about bullying, physical violence, and rejection. Which concern related to psychosocial development does the nurse share as being most important? A.Students may be unable to provide a meaningful definition of self B.Students who are bullied will develop issues related to sexual orientation C.Students who are aggressive will develop a strong sense of guilt as adults D.Students are preoccupied with how they are seen in the eyes of others.
A.Students may be unable to provide a meaningful definition of self
The nurse is involved in a clinic screening for the kindergarten readiness of preschoolers. Primarily the children being screened are between the ages of 4 and 5 years. Which child does the nurse recognize as being ready to attend school? A.The 4-year-old who counts to 10, recalls part of a story, and asks questions about the screening B.The 4-year-old who points correctly to three different colors and voices reluctance to start school C.The 5-year-old who is unhappy about being told there is a 5-minute wait and then refuses to count D.The 5-year-old who insists a parent stay with him, counts to 10, knows five colors, and recalls a story
A.The 4-year-old who counts to 10, recalls part of a story, and asks questions about the screening
Which of the following behaviors serves as an example of the nurse directly upholding the American Nurses Association's (ANA's) Code of Ethics for Nurses? A.The nursing union develops a safe patient-to-nurse ratio. B.The nurse develops a plan of care for a community-wide illness. C.The nurse maintains sterile technique during procedures D.The nurse joins a professional specialty organization
A.The nursing union develops a safe patient-to-nurse ratio.
The nurse is admitting a 15-year-old, who recently immigrated to this country with their family, for abdominal pain lasting 3 days. The accompanying parent reports that the patient is exhibiting intense pain, vomiting, and diarrhea. The nurse notes that the patient places their pain level at 3 on a scale of 0 to 10. Which conclusion does the nurse draw regarding the discrepancy in the level of pain? A.The patient's response may be related to cultural expectations B.The patient is angry that the parent insisted on seeking medical treatment C.The parent wants to make sure the child gets immediate medical care D.The parent's fear of serious illness is causing an exaggeration of symptoms
A.The patient's response may be related to cultural expectations
The nurse is gathering assessment data on a child who is 8 years of age and newly diagnosed with type 1 diabetes mellitus. The caregiver shares a reluctance to allow the child to return to school because the child's glucose levels need to be checked several times daily. Which information is most important for the nurse to share? A.The school nurse can care for the special needs of children in school B.The child's medical condition is manageable in school and other places C.The caregiver may consider personally attending school with the child. D.The school nurse can care for the special needs of children in school
A.The school nurse can care for the special needs of children in school
The nurse in a community pediatric clinic screens for conditions that cause concern for possible infant abuse or neglect. Which situation will prompt the nurse to recommend parenting education? A.The teenage couple with a newborn who live apart, but the father babysits during the day so the mother can attend school B.The stay-at-home mother of four children (ages 4 to 16 years) who is bringing home a newborn C.The newly relocated couple with a young infant who are now 12 hours away from family and friends D.The parents of an infant who live apart because the father of the infant is married and has a family with his spouse
A.The teenage couple with a newborn who live apart, but the father babysits during the day so the mother can attend school
A parent has brought a toddler to a new pediatric clinic for a routine visit. The nurse will obtain a health history from the parent. Which information is most important for the nurse to gather? A.Toddler medical history B.Family medical history C.Chief complaint D.Social history
A.Toddler medical history
The school nurse is developing a teaching session for the population of children in a middle school. The nurse has determined that the greatest need for the overall health of the children is promotion of healthy foods. Which of the following interventions is most likely to be effective? A.Remove all unhealthy snacks from the vending machines B.Engage the students in healthy choices with cooking lessons. C.Survey the student population during lunch breaks. D.Have a poster contest on healthy eating options
B.Engage the students in healthy choices with cooking lessons.
The pediatric nurse is providing care to an 8-year-old client who has Down's syndrome and wants to ensure they are providing evidence-based care. Which of the following resources would best offer evidence-based practice guidelines related to the care of this patient? A.National Database of Nursing Quality Indicators B. Journal of Specialists in Pediatric Nursing C.Journal of Child and Adolescent Psychiatric Nursing D.American Journal of Maternal/Child Nursing
B. Journal of Specialists in Pediatric Nursing
A medical-surgical float nurse is assigned to the pediatric unit for the first time and states that the skills are "the same as general nursing since children are little adults with smaller bodies." What component of pediatric nursing contraindicates this statement? A. Pediatric nursing in based on prevention of infectious diseases. B. Pediatric nursing involves care based on the developmental level of the patient. C. Pediatric nursing involves cultural sensitivity in patient care. D. Pediatric nursing involves the patient's family in the plan of care.
B. Pediatric nursing involves care based on the developmental level of the patient.
A 13-year-old patient is being seen for an annual exam. During the exam, the nurse screens for depression and suicidal ideation. Which response by the client is of greatest concern? A."I have been staying home a lot. I started a new school this year and don't really know anyone." B."A lot of the time, I think everyone would be better off if I'd never been born." C."Sometimes I feel sad or down, especially when I'm stressed out." D."Some nights I have trouble falling asleep, but once asleep, I stay asleep."
B."A lot of the time, I think everyone would be better off if I'd never been born."
A parent with a school-age child with mumps asks for information about the illness and treatment. Which information should the nurse provide? Select all that apply. A."There are no laboratory tests to detect the mumps virus." B."Mumps are seen by observation of swelling around the ears and jaw." C."There is no need to isolate the child." D."Sometimes the complications of mumps involve the testicles and ovaries." E."Provide food and drink that is nonirritating to the mouth and surrounding glands."
B."Mumps are seen by observation of swelling around the ears and jaw." D."Sometimes the complications of mumps involve the testicles and ovaries." E."Provide food and drink that is nonirritating to the mouth and surrounding glands."
The school nurse is asked to assess a student in the third grade who is failing to demonstrate academic success. Which statement(s) made by the child indicate an unmet need according to Maslow's hierarchy? Select all that apply. A."I taught my little brother to ride a bike in just one day." B."My grandma says I'm stupid just like my mother." C."Game and movie nights are always fun at my house." D."I worry because my parents fight all the time." E."I have to go to bed at 10:00 every night."
B."My grandma says I'm stupid just like my mother." D."I worry because my parents fight all the time." E."I have to go to bed at 10:00 every night."
A 17-year-old patient with influenza tells the nurse, "I can't believe I got sick. I've been taking vitamin C, vitamin D, echinacea, and some other herbal remedies to boost my immune system." Which should the nurse say in response to this patient? Select all that apply. A."The vitamins you were taking may have reduced the effectiveness of the herbs." B."The safe use of supplements and herbs has not been determined." C."The effectiveness of supplements and herbs against influenza has not been determined." D."Those supplements help with focus and attention, not disease prevention." E."You probably weren't taking enough of the supplements."
B."The safe use of supplements and herbs has not been determined." fC."The effectiveness of supplements and herbs against influenza has not been determined."
The culturally sensitive pediatric nurse is aware of the racial makeup of the U.S. population. Which of the following reflects the demographics of the U.S. pediatric population in 2018, based on U.S. Census Bureau data? A.The population of Asian children decreased from 2015 to 2018. B.About half of the children fall in the category of something other than White non-Hispanic C.There was no change in the population of Non-Hispanic children who represent two or more races between 2015 and 2018. D.The American Indian and Alaska Native population represent one-fifth of the pediatric population
B.About half of the children fall in the category of something other than White non-Hispanic
The nurse is providing care to a hospitalized pediatric patient, and the patient is refusing all pain medication despite signs of obvious distress. The patient tells the nurse, "All you nurses lied, and the shots hurt." What is the most appropriate nursing measure at this time? A.Provide the medication in a cup of juice B.Admit to the patient that the shots hurt but explain they help C.Have the parents administer the medication D.Explain not all medications are shots
B.Admit to the patient that the shots hurt but explain they help
The new nurse on the pediatric unit asks not to be assigned a child whose family is from the Middle East. Which personal questions does the nurse manager suggest the nurse contemplate as a method to develop self-awareness related to cultural differences? Select all that apply A.Why do I feel so guilty and ashamed for not accepting a different culture? B.Are there conflicting values between the patient/family and myself? C.Is my unacceptance related to political differences between countries? D.Am I attempting to not reject the culture of my family and my upbringing? E.What have been my experiences with those of different cultures?
B.Are there conflicting values between the patient/family and myself? E.What have been my experiences with those of different cultures?
The nurse is assessing an infant during a well-baby visit in the family practice clinic. During this assessment, the nurse asks the mother several routine questions regarding the infant's progress and notes that the mother nods her head but is looking at her cell phone. Which response by the nurse is most appropriate in this situation? A.Contact the facility's social worker for a referral to child protective services for an in-home visit. B.Ask the mother if she could please put the phone down and discuss her infant's progress. C.Continue the assessment and note the mother's disinterest in the infant's chart D.Continue to ask the questions repeatedly until an acceptable answer is provided
B.Ask the mother if she could please put the phone down and discuss her infant's progress.
The nurse is providing care to an 11-month-old child who is hospitalized with pneumonia. Which nursing interventions are appropriate for this child? Select all that apply A.Allow the child to tour the facility before treatments B.Communicate primarily with parents regarding treatment C.Use simple terminology when talking to the child D.Use a singsong wide-eyed approach to interact E.Promote a sense of security with use of gentle touch
B.Communicate primarily with parents regarding treatment D.Use a singsong wide-eyed approach to interact E.Promote a sense of security with use of gentle touch
The nurse is performing a functional family assessment of a chronically ill pediatric patient. In what way can the nurse enhance communication with the family? A.Educate the family on resources in the community to help with care B.Complete a family APGAR questionnaire and share the results C.Assess for abuse and report suspected abuse to the authorities D.Identify the leader of the family and provide options for respite care
B.Complete a family APGAR questionnaire and share the results
The nurse is providing care for a pediatric patient whose family is from another culture. Which action is best when the nurse notices the patient is eating poorly at meals and rejecting snacks? A.Offer the patient a variety of healthy and nutritious foods every 2 hours B.Encourage the family to prepare and bring favorite foods to the patient C.Ask the family members to share the types of foods preferred by the patient D.Contact the health-care provider and ask that dietary supplements be ordered
B.Encourage the family to prepare and bring favorite foods to the patient
The nurse works in an elementary school with students ranging from 6 to 11 years of age. The nurse uses knowledge related to Freud's psychosocial theory to identify which behavior in this pediatric population? A.Curiosity about anatomical differences B.Energy focused on socialization C.Mild struggles with sexuality D.Oedipal or Electra conflicts
B.Energy focused on socialization
The parents of three children aged 4, 6, and 9 years are preparing to travel abroad as missionaries. The children are in good health and up to date for immunizations; however, the parents are concerned about the high level of tuberculosis (TB) in the area to which they are assigned. Which recommendation does the nurse make for the protection of the children? A.Start the children on preventive medication B.Have the children receive the bacillus Calmette-Guerin (BCG) vaccine C.Protect the children with good nutrition D.Arrange for monthly TB testing for the family
B.Have the children receive the bacillus Calmette-Guerin (BCG) vaccine
The nurse is interviewing an adolescent patient 17 years of age who was diagnosed with cystic fibrosis (CF) as an infant. The patient shares feelings of frustration about needing to always live with parents. Which information provided by the nurse is likely to be most important to the patient? A.A list of social organizations available for young persons who have special needs B.How chest physiotherapy (CPT) can be performed independently C.Organizations that will provide transportation for persons with chronic illness D.The availability of home meal delivery to those needing a therapeutic diet
B.How chest physiotherapy (CPT) can be performed independently
The school nurse is attending a meeting with the teachers, school counselors, and parents of a student who has recently refused to attend school. The parents share that the student is either pretending to be ill or being untruthful about going to classes. Which initial intervention by the nurse is best? A.Suggest homeschooling until the problem is resolved B.Inquire about the student's feelings regarding school C.Explain the impact of missing school to the student. D.Ask the parents if they have noticed physical injuries.
B.Inquire about the student's feelings regarding school
The registered nurse (RN) in a pediatric office is preparing to administer oral medication to an infant. Before the actual administration of the medication, which initial action does the nurse take? A.Acquire a calibrated syringe for administration B.Obtain an accurate weight of the infant. C.Provide the caretaker with written information D.Assist the caretaker in holding the infant supine.
B.Obtain an accurate weight of the infant.
The nurse is preparing to provide care to a child from a culture that is unfamiliar to the nurse. Which action by the nurse is most effective in providing culturally competent care? A.Researching the culture on the Internet B.Recognizing that each person and family is unique C.Determining which family member is the decision maker D.Seeking advice from a coworker from the same culture
B.Recognizing that each person and family is unique
The nurse is evaluating the language skills of a 2-year-old patient. Which assessment finding causes the nurse to suspect a developmental delay? A.Points to objects named by the nurse B.Repeats sounds but not words said by the nurse C.States, "Want mommy!" D.Converses using two short sentences
B.Repeats sounds but not words said by the nurse
The nurse in a pediatric clinic is performing well-baby checks. The nurse is checking an infant who is 7 months old for developmental milestones. Which finding is of greatest concern to the nurse? A.The infant exhibits a lack of startle reflex to sound. B.The infant is unable to raise the head when in a prone position C.The infant exhibits a Babinski reflex. D.The infant opens and closes her hands to grasp objects
B.The infant is unable to raise the head when in a prone position
The nurse understands that the nursing profession has standards of care that promote the covenant between patient and nurse. Which of the following is an example of this covenant? A.The nurse adheres to strict guidelines regarding medication administration and procedures. B.The nurse develops a care plan with mutually developed goals and interventions with the patient. C.The nurse attends continuing education courses to maintain competency in skills. D.The nurse considers each patient's cultural practices without bias or judgment
B.The nurse develops a care plan with mutually developed goals and interventions with the patient.
Which of the following nursing actions is an example of a function of the Code of Ethics for Nurses directly relating to the health-care environment? Select all that apply A.The nurse includes the extended family in discharge instructions B.The nurse joins the safety and infection control committees C.The nurse cowrote a policy on nurse:patient ratio for the unit D.The nurse joined a local professional organization that shapes community policy E.The nurse enrolled in a basic American Sign Language course
B.The nurse joins the safety and infection control committees C.The nurse cowrote a policy on nurse:patient ratio for the unit D.The nurse joined a local professional organization that shapes community policy
The nurse assesses a toddler with an apparent ear infection in the emergency department and finds that the child is not up to date on immunizations or well-baby checkups. On further investigation, the nurse discovers that the family is uninsured and undocumented immigrants. What are the most likely barriers to effective communication at this time? A.The insurance status affects many health-care practices such as immunizations B.The possible language issue may affect the family's comprehension of instructions C.The family may have barriers to transportation, employment, or knowledge D.The family may not have a primary care provider and relies on emergency care
B.The possible language issue may affect the family's comprehension of instructions
A new nurse on a pediatric unit is learning to use eutectic mixture of lidocaine and prilocaine (EMLA) cream in preparation for painful procedures. A school-age patient is scheduled to receive intramuscular (IM) medication. Which behavior by the nurse indicates an understanding about the use of EMLA? A.The cream is covered with a thin layer of gauze B.Cream remaining on the skin is gently rubbed in C.Medication is applied at least 45 minutes before the IM injection D.A thin layer of medication is applied to the area.
C.Medication is applied at least 45 minutes before the IM injection
The nurse is providing care to a 17-year-old patient in the family practice clinic. The patient reports concern for the parents, as she is the last one of the four children to leave the home. She is concerned that her parents may "fall apart" when she leaves for college in the fall. What is the best response from the nurse based on the family systems theory? A."Although the family is growing apart, this is a time for your parents to refocus on extended family relationships." B."Each member of the family has to differentiate themselves, whether good or bad, to influence family relationships." C."Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic." D."Although this may put a strain on their relationship, a healthy family recognizes the need love and growth."
C."Although changes that occur in one family member's life affects the entire family, keep in mind that your family is dynamic."
The nurse finishes a series of parenting classes on the topic of tantrums and discipline. Which comment by an attending parent causes the nurse concern? A."She is learning that a tantrum means a time-out alone." B."We have learned to ignore her and she stops." C."He plays and then suddenly screams for no reason." D."I will give a snack and a nap if he is that grumpy."
C."He plays and then suddenly screams for no reason."
The nurse is assessing an adolescent patient in the emergency department with a suspected intentional overdose. After given treatment, the patient refuses to give her parent's contact information and states, "It is none of their business." What is the nurse's best response? A."Although most of your health care is confidential, we are obligated to notify them." B."I think you should tell them, but we will honor your confidentiality and not disclose the reason for your visit." C."I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses." D."Now that you are safe, let me help you develop a plan to prevent a recurrence."
C."I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses."
With endorsement from the family, the health-care provider initiates hospice care for an adolescent patient who is terminally ill. For which statement by the family members about hospice care will the nurse provide additional information? A."Compassionate care will be focused on our child's comfort." B."Our child will have a graceful, natural death."C."Our child will die in the hospital." D."Our family can be involved in care as much as desired."
C."Our child will die in the hospital."
The nurse in the newborn unit of a pediatric hospital is providing care for a neonate born at 34 weeks' gestation. The nurse is aware that the immediate risk to the neonate is which condition? A.Inability to maintain body temperature B.A decrease in renal function C.A lack of a phospholipid in the alveoli D.Delay in closure of cardiac foramen
C.A lack of a phospholipid in the alveoli
A 4-year-old patient is on a regular regimen of oral medications for a chronic condition. The parent expresses frustration because of the difficulty in administering the liquid medications. Which advice will the nurse provide to the parent for managing the process? A.Put the medication in juice or milk as preferred by the child B.Inquire if the child prefers the medication at a certain time C.Ask if the child wants a different flavor of medicine. D.Make sure the medicine is sweet and refer to it as candy.
C.Ask if the child wants a different flavor of medicine.
The nurse is providing care for a pediatric patient and family during the time when death of the patient seems imminent. The family is of Native American culture and has summoned tribal members to come and chant and pray at the bedside. Which behavior by the nurse is culturally correct? A.Call the nursing supervisor and ask for assistance in managing the situation B.Ask the family to respect other patients by keeping the volume of chanting low. C.Ask if the family has any additional needs, close the door, and provide privacy D.Move the patient, family, and tribal members to an isolated location
C.Ask if the family has any additional needs, close the door, and provide privacy
A nurse is caring for an infant from a different culture than their own. The mother allows the infant to continue to cry without assessing for a cause of the distress. The nurse is disturbed about this parenting. Which is the best action for the nurse to take initially? A.Consult with the child-life specialist about the appropriateness of mother's behavior. B.Teach the mother that infants cry for a reason that needs to be identified C.Ask the mother to share what she believes about infant crying D.Become a role model by demonstrating proper care of the infant to the mother
C.Ask the mother to share what she believes about infant crying
The nurse in a pediatric clinic is frequently required to administer medications to infants. Which approach will the nurse take when administering an immunization injection? A.Use a 1-inch needle with a maximum of 1.5 mL of fluid. B.Immediately comfort the infant with cuddling and patting C.Keep the infant on the caregiver's lap and use distraction D.Explain the medication and the purpose in simple terms to the infant.
C.Keep the infant on the caregiver's lap and use distraction
Which of the following interventions are examples of a family-focused strategy? Select all that apply. A.Coordinating care with other departments to lessen sleep disruptions B.Stipulating unilateral visiting rules for all patients and their families C.Providing storage and prep of meals from home for family members D.Involving the parents in nursing change of shift reports and care plans E.Providing dedicated family space with basic needs for rooming in parents
C.Providing storage and prep of meals from home for family members D.Involving the parents in nursing change of shift reports and care plans E.Providing dedicated family space with basic needs for rooming in parents
A nurse is caring for a school-age child who has inflammation of the right eye. Which finding, if present, would indicate to the nurse that the child has bacterial conjunctivitis rather than viral conjunctivitis? A.Eye swelling B.Watery discharge C.Purulent drainage D.Red conjunctiva
C.Purulent drainage
The nurse is aware that the prefrontal cortex of the adolescent brain is still developing. The processes of critical thinking and decision making are in a stage of development. Which example best identifies these changes? A.Capable of identifying and setting short-term goals B.Disinterested in politics and social issues C.Some awareness of personal limitations D.Exhibits confidence by not comparing self to peers
C.Some awareness of personal limitations
The nurse is providing care for a neonate who is identified as being at risk for neonatal abstinence syndrome. Which assessment finding causes the nurse to expect pharmacological interventions for this neonate? A.There is evidence of opioids in the neonate's meconium. B.Symptoms are not alleviated with swaddling, comforting, and feeding C.The Finnegan neonatal abstinence score is 10 at 3 hours after birth. D.Central and autonomic nervous system irritability and dysfunction are present
C.The Finnegan neonatal abstinence score is 10 at 3 hours after birth.
The nurse is performing a physical examination on a male who is 15 years of age. The nurse notices the presence of gynecomastia. The patient states, "I hate my chest," pointing to his breasts. "It's embarrassing. I can't even take my shirt off in front of my friends." Which information does the nurse provide for this patient? A.It indicates the patient is overweight B.The male hormone testosterone is deficient C.The condition is self-limiting D.Surgical removal is recommended
C.The condition is self-limiting
The nurse is providing discharge teaching to the family of a hospitalized 9-year-old patient recently diagnosed with asthma. The family states that they feel overwhelmed with the treatment plans and cannot perform the necessary nebulizer treatments. Which nursing intervention best reflects the professional performance aspect of pediatric nursing standards? A.The nurse contacts the health-care provider to delay the patient's discharge from the hospital until the family is able to perform treatments B.The nurse evaluates progress toward the attainment of outcomes by having the family perform return demonstrations C.The nurse arranges for a home-care respiratory therapy consultation to teach the family proper techniques in the home setting. D.The nurse collects comprehensive data pertinent to the patient's situation by reviewing the home situation
C.The nurse arranges for a home-care respiratory therapy consultation to teach the family proper techniques in the home setting.
The nurse is providing care for a pediatric patient who is 11 years of age. The patient is diagnosed with an aggressive form of cancer and is scheduled to begin chemotherapy. The patient tells the nurse, "I think I am going to die, but I also think I will get much sicker first." Which communication by the nurse is most appropriate for this patient? A.Encourage the patient to ask the doctor to explain what is going to happen B.Explain to the patient the importance of maintaining a hopeful outlook. C.Use basic terms to explain the disease progression and side effects of treatment D.Provide information about the different options that can be considered for the patient.
C.Use basic terms to explain the disease progression and side effects of treatment
The nurse has provided a presentation to middle school children about nursing as a career. One of the children stated that he wanted to be a pediatric nurse, because he wants to take care of babies and little "kids." What would be an appropriate response to this middle school-aged child? A."What you are describing is actually a neonatal nurse. Neonatal nurses work with newborn babies, toddlers, and preschool-age children." B."Nursing is a general practice; all nurses must know how to take care of all ages of patients." C."Being a pediatric nurse requires a master's degree, so be sure to work hard in school!" D. "As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years."
D. "As a pediatric nurse, you would get to care for babies and little kids as well as children through their teenage years."
The nurse learns that a 16-year-old patient has not received the human papillomavirus vaccine (HPV-Gardasil). Which should the nurse explain to the patient at this time about the vaccination? A."You can wait a few years before needing the vaccination." B."A dose can be given today with the final dose in 6 months." C."The complete vaccine can be given today." D."A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."
D."A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."
The nurse is teaching a parenting class being held in a community clinic. The nurse is focusing on behaviors that will assist in increasing the number of children who score well in kindergarten readiness screening. Which comment by a parent indicates the need for additional information? A."I am not athletic, but the kids would love an outdoor play area." B."I like the suggestion to label basic items for word recognition." C.Practicing counting with the kids while traveling is a good idea." D."In our family we watch TV; books are a waste of money."
D."In our family we watch TV; books are a waste of money."
The pediatric hospice nurse is presenting information to a group of nursing students regarding organ donation. Which statement made by the nursing student indicates a need for further education? A."The donor's organs must be undamaged by trauma, disease, or medications." B."Organ procurement is done at the donor's facility." C.The family will be approached by an organ donation team." D."Pediatric organs can only be transplanted into pediatric recipients."
D."Pediatric organs can only be transplanted into pediatric recipients."
A nurse is presenting information to pregnant couples about the "safe to sleep" campaign to prevent sudden infant death syndrome (SIDS). One attendee states, "Babies sleep best on their bellies. What difference does position make?" Which answer by the nurse is best? A."The most dangerous time is 2 to 4 months of age." B.Sleeping face down increases the risk of aspiration." C."Of greater importance is not using blankets." D."Positioning on the back opens the airway fully."
D."Positioning on the back opens the airway fully."
The nurse is assessing an infant at 1 month of age. At birth the infant weighed 7 pounds 10 ounces. Which is the minimum weight the nurse will expect during this assessment? A.8 pounds 2 ounces B.9 pounds 6 ounces C.8 pounds 10 ounces D.8 pounds 14 ounces
D.8 pounds 14 ounces
The nurse in a pediatric clinic is gathering physical assessment information during a yearly visit on a 6-year-old child. Which finding does the nurse expect during the assessment? A.A pulse rate of 102 beats/min B.A blood pressure of 88/50 mm Hg C.A height increase of 5 inches D.A weight gain of 6-1/2 pounds
D.A weight gain of 6-1/2 pounds
A 16-year-old patient is approaching the terminal stage of a brain tumor. The nurse notices the patient is calling friends and making plans for a social gathering several months away. When friends are present the patient assures them of a full recovery because of a new doctor. The nurse recognizes the patient is experiencing which stage of grief? A.Denial B.Bargaining C.Anger D.Acceptance
D.Acceptance ??? (Dr. Katz says it's Acceptance even though it is actually Denial ...)
A nurse is caring for a 4-month-old child diagnosed with influenza. Which order should the nurse expect to read in the electronic health record? A.Administer Motrin for malaise B.Limit oral hydration C.Have the patient wear a mask all of the time. D.Administer Tylenol for fever E.Initiate airborne precautions
D.Administer Tylenol for fever
The nurse is assessing a newborn who has been brought to the family clinic for her first well-child visit. The nurse accidentally drops a metal pan on the floor near the child. The child is startled, but the mother does not react. What is the most appropriate intervention at this time? A.Read the infant's chart to verify how to communicate B.Speak loudly and clearly to mother to enhance comprehension C.Continue with the assessment and document the findings D.Ask the mother if she needs an interpreter to communicate
D.Ask the mother if she needs an interpreter to communicate
A new parent contacts the health-care provider's office to ask for guidance regarding a change in the infant's health. For which reason should the nurse direct the parent to seek immediate medical attention? A.Breastfeeding every 3 hours B.Sleeping for several hours in the afternoon C.Wetting six diapers a day D.Difficult to arouse
D.Difficult to arouse
The nurse is preparing to administer medications to school-aged patients. The nurse is aware the pediatric patient doses are different than medication doses for adults. Which factor does the nurse apply to administering pediatric medications? A.Children's bodies are smaller and need half of the adult dose B.The metabolic rate of a child is slower and can cause overdosing C.The first dosage consideration is based on the age of the child D.Doses of medications are ordered according to the child's weight
D.Doses of medications are ordered according to the child's weight
A parent brings a 2-month-old baby in for a routine wellness examination. Which vaccination should the nurse prepare to administer to this patient? A.Inactivated poliovirus (IPV) B.Hepatitis A C.Measles, mumps, rubella D.Hepatitis B
D.Hepatitis B
A child who is 10 years of age is brought to the clinic with symptoms of a serious lower respiratory infection. The attending adult self-identifies as a grandparent. The child states the grandparent is the only family of the patient. Which is the most important information for the nurse to acquire prior to treatment? A.How to reach one of the patient's parents B.What caused the grandparent to seek medical care C.Which other family members live with the patient D.If the grandparent has legal custody of the patient
D.If the grandparent has legal custody of the patient
The nurse in a pediatric clinic is preparing to assess an infant at the age of 9 months. The nurse is aware that this well-baby checkup will involve assessment for developmental delays or disabilities. Which finding causes the nurse to suspect a developmental delay? A.Waves or shakes the head in response to verbal cues "bye-bye" and "no" B.Displays sucking reflex when presented with bottle or pacifier C.Cries and reaches for the parent when placed on the examination table D.Loses interest in a toy that is dropped out of sight by the nurse
D.Loses interest in a toy that is dropped out of sight by the nurse
The nurse in a pediatric clinic is counseling a parent who expresses concern about a toddler who plays alone at day care and does not interact with the other children who are present. Which information does the nurse provide to alleviate the parent's concern? A.The toddler is likely to grow into a shy, introverted adult. B.It is important for the child to learn to be alone at this age C.The toddler is exhibiting the normal behavior of solitary play. D.Parallel play is being exhibited and is normal at this age.
D.Parallel play is being exhibited and is normal at this age.
The nurse is providing care to the mechanically ventilated 4-year-old patient who is believed to be the victim of abuse from the parents. The parents refuse to permit removal of the ventilator. The nurse believes this is because the parents are afraid that they will be charged with murder if the child dies. What is the recourse for the health-care team in this ethical dilemma? A.Provide the parents with their financial burden of this care. B.Provide the treatment even in the face of undue burden of resources C.Provide support to the parents even if the team would choose differently D.Provide information to the courts for legal involvement
D.Provide information to the courts for legal involvement
A school-age child is brought to the clinic to be evaluated for a headache and stomachache. For which reason should the nurse prepare the patient to have a rapid strep test? A.Jaundiced conjunctiva B.Productive cough C.Coryza D.Strawberry tongue
D.Strawberry tongue
The nurse in an acute care pediatric facility is preparing to assume care of multiple patients at the change of shift. Which patient will the nurse plan to assess first? A.The infant who can sleep only with the head of the bed elevated B.The preschooler with pneumonia who has poor skin turgor C.The toddler who exhibits clubbing of the fingertips D.The infant who prefers a tripod position instead of lying down
D.The infant who prefers a tripod position instead of lying down
Which of the following statements serves as an example of the nurse directly upholding the ANA Pediatric Nursing: Scope and Standards of Practice? A.The nursing union develops a safe patient-to-nurse ratio B.The nurse develops a plan of care for a community-wide illness C.The nurse uses disengagement to remain in difficult situations with the patient D.The nurse maintains therapeutic relationships with the family and patient
D.The nurse maintains therapeutic relationships with the family and patient
The nurse is completing the admission process for a pediatric patient by obtaining information related to the patient's culture. Which area of assessment is most important if the patient is an infant? A.The family's perception of the current health status B.The patient's food preferences C.The religious beliefs of the patient's family D.The typical daily schedule followed by family and patient
D.The typical daily schedule followed by family and patient
During orientation, the new nurse on a pediatric unit is informed that Leininger's Cultural Care Theory is implemented because of a large multicultural population at the facility. Which aspect of Leininger's theory best defines the theory's impact on nursing care? A.Leininger's theory has been able to capture and articulate how culture affects health in developed nations B.The theory considers the complexity and interrelatedness of an individual within an environment and the community to which they belong to be unimportant in providing culturally competent nursing care. C.The theory helps explain how practices handed down from generations can improve an individual's health today D.Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided
D.Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided