Peds Final

The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (SATA)

"Advertising of unhealthy food can increase snacking." "Increased screen time may be related to unhealthy sleep." "There is a link between the amount of screen time and obesity."

The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?

"During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation."

The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching?

"I will use precautions when administering oral medication to a school-age child."

An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

"Keep buttons, beads, and other small objects out of his reach."

Parents of a preschool child ask the nurse, "Should we set rules for our child as part of a discipline plan?" Which is an accurate response by the nurse?

"Set clear and reasonable rules and expect the same behavior regardless of the circumstances."

An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restrains can be removed. What nurse's response is best?

"That is fins as long as your are with him."

The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect?

1 hour until maximum effect

The nurse understands that which guideline should be followed to determine serving sizes for toddlers?

1 tbsp of solid food per year of age

By which age should the nurse expect that an infant will be able to pull to a standing position?

11 to 12 months

The nurse is teaching parents about avoiding accidental burns with their toddler. What water heater setting should the nurse recommend to the parents?

120*F

Pertussis vaccination should begin at which age?

2 months

What is the earliest age at which a satisfactory radial pulse can be taken in children?

2 years

The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than 2500g. The newborn's weight is 5lb 4 oz. What is the newborn's weight in grams?

2386

At a well-child checkup, the nurse notes that an infant with a previous diagnosis of failure to thrive is not steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?

4oz/day

At which age do most infants begin to hear strangers?

6 months

The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

95th percentile

A nurse is observing children playing in the playroom. What describes parallel play?

A child playing with blocks next to a child playing with trucks

During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?

A normal finding

Which statement best describes colic?

A paroxysmal abdominal pain or cramping manifested by episodes of loud crying

What do the psychosocial developmental tasks of toddlerhood include?

Ability to delay gratification.

What factors can negatively affect parents' reactions to their child's illness? (SATA)

Additional stresses Lack of support systems Seriousness of the threat to the child

The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first?

Administer naloxone (Narcan)

When the nurse interviews an adolescent, which is especially important?

Allow an opportunity to express feelings.

A 4-year-old girl is admitted to outpatient surgery for removal of a cyst on her back. Her mother puts the hospital gown on her, but the child is crying because she wants to leave on her underpants. What is the most appropriate nursing action at this time?

Allow her to wear her underpants.

The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

Allow the child to choose the type of juice to drink with the administration of oral medications.

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?

Assign her to same nurse as much as possible.

Which is a complication that can occur after abdominal surgery if pain is not managed?

Atelectasis

An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?

Autonomy

The nurse needs to assess a 15-month-old child who is sitting quietly on his father's lap. What initial action by the nurse would be most appropriate?

Begin the assessment while the child is in his father's lap.

Which type of family should the nurse recognize when a mother, her children, and a stepfather live together?

Blended

Where do eczematous lesions most commonly occur in an infant?

Cheeks and extensor surfaces of the arms and legs

Which is the single most important factor to consider when communicating with children?

Child's developmental level

The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?

Childhood obesity is the most common nutritional problem among children.

The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?

Clear set of family values, rules, and beliefs.

Evidence based practice (EBP), a decision-making model, is best described as which?

Combining knowledge with clinical experience and intuition

Which is the leading cause of death in infants younger than 1 year in the United States?

Congenital anomalies

The nurse is preparing to admin a 1-year-old child with pertussis (whooping cough). Which clinical manifestation of pertussis should the nurse expect to observe? (SATA)

Coryza Low-grade fever Dry hacking cough

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization?

Create a calendar with special events such as a visit from a friend to maintain a routine.

The nurse is discussing with a parent group the importance of fluoride for healthy teeth. What should the nurse recommend?

Determine whether the water supply is fluoridated.

The nurse is administering an oral antihistamine at bedtime to a child with atopic dermatitis (eczema). Which antihistamine should the nurse expect to be prescribed at bedtime?

Diphenhydramine (benadryl)

The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse?

Discuss with him how his body is always in the process of making blood.

The nurse gives an injection in a patient's room. How should the nurse dispose of the needle?

Dispose of the syringe and needle in a rigid, puncture-resistant container in the patient's room.

The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast mild in the microwave. What should the nurse recommend?

Do not thaw or heat breast milk in a microwave oven.

During an otoscopic examination on an infant, in which direction is the pinna pulled?

Down and back

Which situation denotes a non therapeutic nurse-patient-family relationship?

During shift report, the nurse is criticizing parents for not visiting their child.

An infant, age 6 months, has six teeth. The nurse should recognize that this is what?

Earlier that expected tooth eruption

The nurse is aware that if patients' different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?

Ethnocentrism

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital?

Explain hospital schedules to her, such as mealtimes.

The nurse is planning to counsel family members as a group to assess the family's group dynamics. Which theoretic family model is the nurse using as a framework?

Family systems theory

Parents of a hospitalized toddler ask the nurse, "What is meant by family-centered care?" The nurse should respond with which statement?

Family-centered care recognizes that the family is the constant in the child's life.

The mother of a 3-month-old infant asks about giving her baby water because it is summer and very warm. What should the nurse tell her?

Fluids in addition to breast milk are not needed.

Which should the nurse teach to parents regarding oral health of children? (SATA)

Fluoridated water should be used. Early childhood caries is a preventable disease. Dental hygiene should begin with the first tooth eruption.

A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children?

Foster children tend to have a higher that normal incidence of acute and chronic health problems.

What is an appropriate action when an infant becomes apenic?

Gently stimulate the trunk by patting or rubbing

Which intervention is the most appropriate recommendation for relief of teething pain?

Give the infant a frozen teething ring to relieve inflammation.

The nurse is assessing a 20-month-old toddler during a well-child visit and notices tooth decay. The nurse should understand that early childhood caries are caused by what?

Giving the child a bottle of juice or milk at nap time.

Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?

Have the child "help" with palpation by placing his or her hand over the palpating hand.

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

Help the family develop a written list of specific questions to ask the practitioner.

A 2-year-old child has to receive Rocephin IM injections every 12 hours. What nursing intervention should be implemented for the child?

Hold the child while rocking in a chair after each injection.

A bone marrow biopsy will be performed on a 7-year-old girl. She wants he r mother to hold her during the procedure. How should the nurse respond?

Holding may help your child relax.

An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of inadequate caloric intake. The nurse understands that the reason for the FTT is most likely related to what?

Incorrect formula preparation

What is the leading cause of death during the toddler period?

Injuries

Examination of the abdomen is performed correctly by the nurse in which order?

Inspection, auscultation, percussion, palpation

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose?

Lets the child express thoughts and feelings through pictures rather than words

A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to control anxiety?

Lorazepam (ativan)

A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer?

Metronidazole (flagyl)

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child?

Negotiate a daily schedule that incorporates hospital routine, therapy, and free time.

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize this finding as which?

Normal because the lower back and leg muscles are not yet well developed.

Where is the best place to observe for the presence of petechiae in dark-skinned individuals?

Oral mucosa

Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?

Oral sucrose and nonnutritive sucking

The nurse is using the CRIES pain assessment tool on a preterm infant in the neonatal intensive care unit. Which are the components of this tool? (SATA)

Oxygen saturation Sleeplessness Facial Expression

When discussing discipline with the mother of a 4-year-old child, which should the nurse include?

Parental control should be consistent.

The nurse is reviewing the importance of role learning for children. The nurse understands that children's roles are primarily shaped by which members?

Parents

The parents tells nurse, "Our child is having some short-term negative outcomes since the hospitalization." The nurse recognizes that what can negatively affect short-term negative outcomes? (SATA)

Parents' anxiety Length of hospitalization Multiple invasive procedures

A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?

Plan a preventive schedule of pain medication around the clock.

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do?

Prepare the child for conscious sedation being used for the procedure.

Which responsibilities are included in the pediatric nurse's promotion of the health and well-being of children? (SATA)

Promoting disease prevention. Providing support and counseling. Establishing a therapeutic relationship. Participating in ethical decision making.

The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route?

Provides most rapid onset of effect, usually in about 5 minutes.

The parent of an 8.2-kg (18-kb) 9-month-old infant is borrowing a federally approved care seat from the clinic. The nurse should explain that the safest way to put in the car seat is what?

Rear facing in back seat

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what?

Regression

After the family, which has the greatest influence on providing continuity between generations?

School

The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

Select an area that is safe and non stimulating, such as a hallway.

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse related to the students?

Separation anxiety

The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering IV antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

Start the IV line and then allow for expression of feelings.

What often causes cellulitis?

Streptococci or staphylococci

The school reviewed the pediculosis capitis police and removed the "no nit" requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?

The child can remain in school with treatment done at home.

The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine? (SATA)

The hepatitis B vaccination series should be begun at birth. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart.

What do mortality statistics describe?

The number of individuals who have died over a specific period.

The nurse is teaching parents about toilet training. What should the nurse include in the teaching session?

The physiologic ability to control the sphincters occurs between 18 and 24 months.

A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. Would should your explanation to the parents include?

The pump can deliver baseline and bolus dosages.

What describes nonpharmacologic techniques for pain management?

They may reduce pain perception.

At which are should a nurse keep teaching time short (5 minutes)?

Toddler

What is the major cause of death for children older than 1 year in the United States?

Unintentional injuries

The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which?

Use the large cuff.

The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have?

Varicella

Which is described as an elevated, circumscribed skin lesion that is less than 1cm in diameter and filled with serous fluid?

Vesicle

The nurse is assessing breath sounds on a child. Which are expected auscultated breath sounds? (SATA)

Vesicular Bronchial Bronchovesicular

Which vitamin supplementation has been found to reduce both morbidity and mortality in measles?

Vitamin A

How is family systems theory best described?

When the family system is disrupted, change can occur at any point in the system.

Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?

Yogurt