Peds Midterm

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The infant of the cocaine-addicted mother has an "O-positive" blood type. The infant's mother has an "A-positive" blood type. What action should the nurse take? A. Place the blood typing report on the chart. B. Notify the health care provider of the results. C. Watch for an ABO incompatibility in the infant. D. Watch for an ABO incompatibility in the mother.

A. Place the blood typing report on the chart.

What pain scale would be most appropriate for the nurse to use for the child in question 1? A. The FLACC Pain Assessment Tool B. The comfort scale C. The Wong-Baker FACES Pain Scale D. The Oucher Pain Scale

A. The FLACC Pain Assessment Tool

The mother asks what things she can check to ensure that her infant is doing well. What outcomes for the infant should the nurse discuss with the parents? Select all that apply. A. The baby's airway will remain open. B. The baby's temperature will remain within a normal range. C. The parents should dress the infant with the same amount of clothing they are wearing. D. The infant will breastfeed effectively. E. The parents will place the infant on his back for sleeping. F. The infant will have several soft stools every day.

A. The baby's airway will remain open. B. The baby's temperature will remain within a normal range. D. The infant will breastfeed effectively. F. The infant will have several soft stools every day.

Several diagnostic tests are ordered. Appropriate nursing interventions in this preoperative period include which of the following? A. Apply moist heat to the abdomen to relieve pain. B. Administer an enema to ensure total bowel evacuation preoperatively. C. Perform deep abdominal palpation to assess the level of pain. D. Ensure that diagnostic tests are administered as soon as possible to prevent delay in treatment.

D. Ensure that diagnostic tests are administered as soon as possible to prevent delay in treatment.

Over the past hour, the infant with the cocaine addiction has begun having a high-pitched cry and a periodically exaggerated Moro reflex. What priority action should the nurse take? A. Gently rock the infant. B. Reposition the infant. C. Auscultate the infant's lungs. D. Notify the health care provider.

D. Notify the health care provider.

Which of the following clinical manifestations should lead the nurse to suspect that Maria's appendix has ruptured? A. Fever B. Localized pain C. Increasing anorexia D. Sudden relief from pain

D. Sudden relief from pain

A 6-month-old girl is suspected to have a urinary tract infection. The nurse expects which of the following lab results? A.Pyuria B.Hypoglycemia C.Hypercalcemia D.Hypokalemia

A.Pyuria

The parents ask what the leading cause of accidental death in infants is. What should the nurse answer? A. Drowning B. Motor vehicle accidents C. Suffocation D. Falls

C. Suffocation

The nurse educator is reviewing assessment of the tympanic membrane. Which statements made by the nurse educator need correcting? Select all that apply. A. The normal tympanic membrane is a translucent, light pearly pink or gray. B. Ashen gray areas of the tympanic membrane indicate allergy. C. If one ear is painful, the nonpainful ear should be examined first. D. A black area in the tympanic membrane indicates infection. E. An infant's pinna should be held down and back during insertion of the speculum.

B. Ashen gray areas of the tympanic membrane indicate allergy. D. A black area in the tympanic membrane indicates infection.

The parents ask whether or not the twins should get their immunizations if they have a cold or are sneezing. What is the appropriate response by the nurse? A. "A cold or sneezing would not cause us to postpone the scheduled immunizations." B. "As long as the temperature is not over 101°F (axillary), we can give the immunizations." C. "Immunizations can cause a cold to become more severe." D. "What is your concern?"

A. "A cold or sneezing would not cause us to postpone the scheduled immunizations."

Which topics should the nurse discuss with the parents of a young child to promote health in their child? Select all that apply. A. Getting the child immunized at the appropriate ages B. Obtaining a dental checkup after the baby teeth erupt C. Helping the child maintain a normal body weight D. Placing the child in an appropriate car seat or restraint system E. Allowing the child to be in a small child's swimming pool without supervision F. Supervising infants when they begin to become mobile

A. Getting the child immunized at the appropriate ages B. Obtaining a dental checkup after the baby teeth erupt C. Helping the child maintain a normal body weight D. Placing the child in an appropriate car seat or restraint system F. Supervising infants when they begin to become mobile

The mother mentions that her son has difficulty deciding what to eat and often gets frustrated. Which suggestion by the nurse would provide the best guidance? A. Give your son only two options from which to choose. B. When your son gets hungry enough, he will eat what is fixed. C. Use yes and no questions when asking him what he wants to eat. D. Fix your son whatever he wants to eat until the baby arrives.

A. Give your son only two options from which to choose.

The mother is asking about the car safety seat the parents just purchased from some friends. What questions should the nurse ask? Select all that apply. A. Has the car safety seat ever been in a car crash? B. Was the car seat purchased by their friends more than a year ago? C. Do you have the instructions regarding the use of the car seat? D. Does it have a certification label stating that it complies with federal motor vehicle safety standards? E. What color is the car safety seat?

A. Has the car safety seat ever been in a car crash? C. Do you have the instructions regarding the use of the car seat? D. Does it have a certification label stating that it complies with federal motor vehicle safety standards?

To prepare the infant for surgery, the nurse has a number of activities to perform, including repeated saline enemas and intravenous antibiotics. What can the nurse instruct the mother to encourage while her infant is receiving nothing by mouth (NPO) preoperatively? A. Have the infant use a pacifier to maintain his sucking ability. B. Lubricate his lips with water to maintain their hydration. C. Continually hold the infant so he feels loved and secure. D. Maintain the infant in a 45-degree position for easier breathing.

A. Have the infant use a pacifier to maintain his sucking ability.

The child has patient-controlled analgesia (PCA) of morphine with an 8-minute lockout. Teaching by the nurse has been effective if what behavior is seen in this child? A. He pushes the button on the PCA whenever he wants. B. He waits 8 minutes until pushing the button again. C. The nurse pushes the PCA button whenever she is turning him. D. The mother pushes the PCA button whenever the child moans or makes a strange face.

A. He pushes the button on the PCA whenever he wants

The mother mentions that her son has been hitting his sister more recently. What questions would be best for the nurse to ask to obtain an appropriate approach? Select all that apply. A. Is this behavior also happening at school? B. Is there any hitting going on at home, either with your husband or daughter? C. What situations at home have changed recently that might cause your son frustration? D. Are you ignoring your son unless he's acting out or hitting his sister? E. Why do you think this is happening?

A. Is this behavior also happening at school? B. Is there any hitting going on at home, either with your husband or daughter? C. What situations at home have changed recently that might cause your son frustration? D. Are you ignoring your son unless he's acting out or hitting his sister?

The mother mentions that her daughters have been visiting a friend's home and that the friend's mother breeds dogs and has several litters of puppies. What anticipatory information would be most useful based on what the mother has mentioned? A. Make sure your daughters wash their hands well with soap and water before and after playing with the puppies. B. Do not let your children touch the puppies because the puppies could have rabies. C. Make sure your children have their tetanus shots up to date in case of a puppy bite. D. I would suggest not letting your children play with the puppies until you have talked with the mother.

A. Make sure your daughters wash their hands well with soap and water before and after playing with the puppies.

The mother mentions her son's breath-holding tantrums and how they frighten her. What explanation by the nurse is best? A. Physical harm is rare because the breathing mechanism in the body will be triggered. B. Make sure that you do not let your son faint from a low level of oxygen in his body. C. Consistency is important during a tantrum, so both parents should react in the same way. D. Pick your son up and let him have his tantrum on a soft surface like the bed.

A. Physical harm is rare because the breathing mechanism in the body will be triggered.

The nurse educator is talking about assessment of the heart. What information should the nurse include during the presentation? A. The S1 is louder at the apex of the heart in the pulmonic and aortic areas. B. The S2 is louder near the base of the heart in the mitral and tricuspid areas. C. Listen to the heart with the child in at least two positions: sitting and reclining. D. Atrial sounds such as S4 are heard best with the person in a sitting position.

C. Listen to the heart with the child in at least two positions: sitting and reclining.

The mother asks about the care of her son's penis with the Plastibell. What information provided by the nurse is best? A. "Apply the petrolatum gauze dressings I give you loosely on his penis." B. "There's no special dressing or care; just keep the area clean." C. "Apply the diaper tightly to apply pressure to prevent bleeding." D. "Keep the diaper off as much as you can while he is awake."

B. "There's no special dressing or care; just keep the area clean."

Teen girls are seen often wearing earphones attached to their personal music devices, which are playing at a very loud level. What statement by the nurse is true? A. "You need to limit listening to music." B. "Using earphones with your personal music player playing loudly can lead to hearing loss." C. "Make certain that you do not listen longer than an hour at a time." D. "You can listen as much as you want as long as the sound is very low."

B. "Using earphones with your personal music player playing loudly can lead to hearing loss."

The teens begin to open up to the nurse about some topics they do not want to talk about with their parents. One of the girls mentions that her boyfriend wants her to go out in the woods and shoot a handgun belonging to his father. What should the nurse say to give the best guidance? A. "You need to make sure your boyfriend knows how to use the gun correctly." B. "What did the father say, in your presence, about shooting the gun?" C. "What does your family think about this activity?" D. "When is this event supposed to happen?"

B. "What did the father say, in your presence, about shooting the gun?"

The nurse is obtaining a history of the infant's early months. What question is most critical for the nurse to ask to aid in the diagnosis of HD? A. "Did your son urinate immediately after delivery?" B. "When did your son have his first bowel movement?" C. "Did you breastfeed or bottle feed your son?" D. "Did your son experience any colic?"

B. "When did your son have his first bowel movement?"

The infant is scheduled for surgery in a few hours to remove the malfunctioning part of the bowel. What teaching from the nurse would best prepare the mother to know what to expect when she first sees her infant after surgery? A. "Your son will have a colostomy with a bag on his abdomen and an IV." B. "Your son will have an IV line, an oxygen source, a dressing, and perhaps a colostomy bag." C. "He will have a colostomy with a bag, a feeding tube, and an oxygen mask." D. "He will be wearing a diaper and will have an abdominal dressing and soft restraints."

B. "Your son will have an IV line, an oxygen source, a dressing, and perhaps a colostomy bag."

The child's pain management is of great concern to his mother. What information about this child should the nurse take into account when providing medication for pain? A. Children with autism do not perceive pain as do regular children. B. Children with neurologic disorders, such as autism, are at greater risk than other children for undertreatment of pain. C. EMLA cream is contraindicated for use before restarting the child's intravenous line. D. Distraction and guided imagery can be used to help make this child comfortable.

B. Children with neurologic disorders, such as autism, are at greater risk than other children for undertreatment of pain.

The topic of appropriate toys for parents to bring to the hospital is being discussed. What points should the educator make to cover a broad range of patient ages? Select all that apply. A. New toys that the child has been wanting are the best ones for the parents to bring. B. Comfort toys such as stuffed animals and blankets work well. C. The toys should be washable if the child is coughing and sneezing because of safety and infection concerns. D. Having more toys provides the child with a variety from which to choose.

B. Comfort toys such as stuffed animals and blankets work well. C. The toys should be washable if the child is coughing and sneezing because of safety and infection concerns.

Three hours after birth, the infant who needed suctioning has an oxygen saturation of 94% and a respiratory rate of 56 breaths/min, even with the oxyhood. What priority actions should the nurse take? Select all that apply. A. Place the infant in a prone position. B. Reposition the head. C. Gently suction the nasopharynx. D. Auscultate the lungs. E. Increase the oxygen flow to 2 L/min.

B. Reposition the head. C. Gently suction the nasopharynx. D. Auscultate the lungs.

During the health history at the pediatric dermatology clinic, the nurse determines that the teenager is not using the prescribed skin cleansing regimen and that the acne has not decreased in intensity. Which phrase should the nurse use for the most therapeutic communication? A. "It looks like you're not using the prescribed skin cleansing plan." B. "You could be a little more cooperative about cleaning your skin." C. "I was hoping that your skin would be a little better by this visit." D. "Do you want me to show you how to use the skin care products again?'

C. "I was hoping that your skin would be a little better by this visit."

Several parents disclose that their children argue about having to sit in the back of the car and not being allowed to sit up front. What response by the nurse would best emphasize the need for the children to continue sitting in the rear passenger seats? A. "School-age children do not understand the danger of riding in cars." B. "Children at this age have not developed the ability to understand causes and effects of their actions." C. "The most common cause of severe injury and death in school-age children is motor vehicle accidents." D. "Children want to act more adult than they really are."

C. "The most common cause of severe injury and death in school-age children is motor vehicle accidents."

An enema is to be given to a 6-year-old child to prepare her for an examination of the lower bowel. What type and amount of enema solution would the nurse anticipate administering? A. 200 mL of a prepackaged Fleet enema B. 300 mL of tap water C. 400 mL of normal saline D. 500 mL of mineral oil

C. 400 mL of normal saline

When assigning nursing staff to this infant, which concept should be followed? A. Assign nurses who look most like his mother. B. Assign a different nurse each day to assess the infant. C. Assign the same nurse as much as possible. D. Assign a nurse who is much older than his mother.

C. Assign the same nurse as much as possible.

The nurse makes sure that a toddler has a teddy bear and that a nightlight is on in the hospital room at bedtime. What concept would these nursing actions demonstrate? A. Nonmaleficence B. Justice C. Atraumatic care D. Advocacy

C. Atraumatic care

Other than her yearly influenza vaccines, Imani last received immunizations at 18 months old, and at that time, she was up to date with her vaccinations. Imani has a history of some localized redness and swelling with previous DTaP injections; otherwise she has had no reactions and she has no allergies. Which of the following immunizations should the nurse plan to administer? Select all that apply. A. Hepatitis B (Hep B) B. Rotavirus (RV) C. Tetanus, dDiphtheria, acellular Ppertussis (Tdap) D. Haemophilus influenzae tType b (Hib) E. Pneumococcal-13 (PCV) F. Inactivated poliovirus (IPV) G. Influenza H. Measles, Mmumps, rRubella (MMR) I. Varicella (VAR) J. Hepatitis A (Hep A) K. Meningococcal L. Human Ppapillomavirus (HPV)

F. Inactivated poliovirus (IPV) H. Measles, Mmumps, rRubella (MMR) J. Hepatitis A (Hep A)

The nurse is instructing the staff on measuring head circumference. Teaching by the nurse has been effective if the staff make which statements? Select all that apply. A. The head circumference should be measured up to 24 months of age in children with an appropriate head size. B. The head circumference should be measured 1 inch below the eyebrows and at the pinnae of the ears. C. Measuring tapes should be made of paper or metal. D. For greatest accuracy, use devices marked with tenths of a centimeter because the percentile charts have only 0.5-cm increments. E. The shape of the child's head can affect the accuracy of the measurement.

C. Measuring tapes should be made of paper or metal. D. For greatest accuracy, use devices marked with tenths of a centimeter because the percentile charts have only 0.5-cm increments. E. The shape of the child's head can affect the accuracy of the measurement.

What is the leading cause of death in children older than the age of 1 year? A. Drowning B. Burns C. Motor vehicle accidents D. Cancer

C. Motor vehicle accidents

The boy's mother mentions that her son stutters at times and that she tries to finish his sentences to diminish his frustration. What information from the nurse is most helpful? A. The son's attempt to master sensorimotor integrations results in stuttering or stammering as he is trying to say the word about which he is already thinking. B. Stuttering affects boys more frequently than girls, has been shown to have a genetic link, and usually resolves during childhood. C. Parents of children who stutter need to speak slowly, be relaxed, and not complete the child's sentences. D. The son should read to his pet dog.

C. Parents of children who stutter need to speak slowly, be relaxed, and not complete the child's sentences.

A young child is being treated for giardiasis. Which of the following should the nurse recommend to the child's parent? A.The parasite is difficult to transmit, so no special precautions are indicated. B.The child can swim in a pool if wearing diapers. C.Diapers must be changed as soon as soiled and disposed of in a closed receptacle. D.Cloth diapers should be rinsed in the toilet before washing.

C.Diapers must be changed as soon as soiled and disposed of in a closed receptacle.

An infant arrives at the clinic with a persistent cough. Mother reports the infant has not been feeding well for the past day. What nursing interventions would be appropriate? A.Provide oxygen to the infant via cannula B.Undress the infant to do a complete assessment C.Suction the infant's nose with a bulb syringe D.Start an IV

C.Suction the infant's nose with a bulb syringe

A child is being admitted with the diagnosis of dehydration. What is the nurse's first responsibility? A.Orient the family to the unit B.Get vital signs C.Weigh the patient D.Start an IV

C.Weigh the patient

The mother states that she is very nervous about taking care of the baby's umbilical cord and does not want to hurt him. What information should be reinforced by the nurse? A. "Place your baby in an infant tub as long as the water is below the navel." B. "Use a little alcohol on the cord to help it shrivel and separate faster." C. "Place a dab of bacitracin on the cord with each diaper change." D. "Fold the diaper below the cord to avoid irritation and wetness on the cord."

D. "Fold the diaper below the cord to avoid irritation and wetness on the cord."

The infant's mother asks about the testing her little son needs to undergo. She is very worried because she does not understand what testing is involved even after the pediatrician has explained it. What response from the nurse would be most appropriate? A. "What are your concerns?" B. "It's too soon for us to be discussing the tests." C. "Every mother is scared when her baby is ill." D. "There are several tests, including x-rays and a rectal biopsy, but we will keep your son comfortable."

D. "There are several tests, including x-rays and a rectal biopsy, but we will keep your son comfortable."

The nurse is preparing to administer penicillin G (Bicillin) to a school-age child. What action should the nurse take to determine that the bevel of the needle is in the correct place? A. Check the bottom of the syringe for blood after aspirating. B. Evaluate the ease with which the needle was inserted. C. Ensure that the needle was inserted at a 90-degree angle. D. Check the top of the syringe for blood while aspirating.

D. Check the top of the syringe for blood while aspirating.

The mother tells the nurse that the daycare provider has called about her son not listening as well as he used to, although the mother has not noticed it at home. Which response by the nurse would be most accurate? A. He is secretly having bad thoughts about the new baby. B. He needs to have time-outs used whenever he does not listen. C. Just ignore this behavior and it will eventually disappear. D. He is experiencing stress but does not know how to express it.

D. He is experiencing stress but does not know how to express it.

A 4-year-old child is brought to the ED by ambulance after being hit by a car. The child is unresponsive; pulse 150; respirations 30; cool, mottled extremities; capillary refill 4 seconds; and weak pulses. The paramedics have immobilized her and started 100% oxygen but have been unable to establish intravenous (IV) access en route to the hospital. Which of the following actions would be most likely? A. Prepare equipment for insertion of a peripherally inserted central catheter (PICC). B. Prepare equipment to start a peripheral IV. C. Prepare equipment for insertion of a long-term central venous access device (Broviac, Hickman, Groshong, Mediport). D. Prepare equipment to start an intraosseous infusion.

D. Prepare equipment to start an intraosseous infusion.

After talking about the variety of stressors that children can experience during hospitalization, the nurse educator explains in detail the greatest stress imposed by hospitalization during early childhood. Teaching by the educator has been effective if the attendees choose which stressor? A. Pain or comfort issues B. Different toileting arrangements C. Wearing unusual clothing D. Separation anxiety

D. Separation anxiety

Imani's parent states that recently there have been several cases of pinworms at daycare and that Imani seems to be "scratching her bottom at night a lot lately." Which of the following diagnostic tests is/ or are most likely to be ordered? Select all that apply. A. Lower gastrointestinal endoscopy. B. Two stool specimens for culture C. Test stool for occult blood D. Tape test early in the morning

D. Tape test early in the morning

A preschooler's abdominal incision is healing well after removal of a large benign tumor. Which approach by the nurse will best convey to the child that he or she is getting better? A. Tell the child that the incision looks clean and is healing well. B. Put on a smaller dressing than the previous one. C. Have the child look at the incision so the child knows the nurse is telling the truth. D. Ask the child how he or she thinks the tummy is healing.

B. Put on a smaller dressing than the previous one.

One of the attendees asks whether therapeutic play and play therapy are the same because they have almost the same words. Which explanation by the nurse educator provides the most accurate differentiation? A.Play therapy is nondirective play that allows children freedom of expression and can be tremendously therapeutic. B. Therapeutic play is a psychologic technique reserved for use by trained and qualified therapists as an interpretative method with emotionally disturbed children. C. Tension release can be facilitated by the use of play therapy. Activities such as tossing beanbags at a target or using a pounding board can be helpful for young patients. D. Therapeutic play is nondirective play that allows children freedom of expression. Painting a picture and hitting a punching bag because of being angry about being sick are two activities that can be used.

D. Therapeutic play is nondirective play that allows children freedom of expression. Painting a picture and hitting a punching bag because of being angry about being sick are two activities that can be used.

What question would be most appropriate for the nurse to ask about his hesitancy to go to bed? A. How long has this been going on? B. Does he bathe before bedtime? C. Does his sister have the same problem? D. What does he watch on television?

D. What does he watch on television?

Maria has an appendectomy. Because Maria had a ruptured appendix with signs of peritonitis, the nurse anticipates that she will remain on low intermittent gastric decompression until A. pain decreases B. nausea subsides C. infection resolves D. bowel motility returns.

D. bowel motility returns.

A toddler has a small-bore tube for tube feeding and requires a medication in suspension form. Which action by the nurse is the most important preventive action to maintain patency of the tube? A. Flushing after the medication with an adequate amount of fluid B. Dissolving all tablets completely in warm water before giving them C. Checking for placement by aspiration of the small-bore tube D. Elevating the head of the toddler's bed at least 45 degrees

A. Flushing after the medication with an adequate amount of fluid

The mother mentions to the nurse that one of her daughter's friends has had noticeable bruises on her legs. When the mother asks what happened to her legs, the child shrugs her shoulders and says, "I don't know." The mother is not sure what to do but thinks something might be going on in the home that could put the child in danger. What is the best suggestion that the nurse can give the mother? A. "I'll give you the phone number of the local child protection services so you can call and give them the specific information." B. "Let the child's parents know that you are going to call child protection services if you see their daughter bruised again." C. "Check with the parents to determine if there is any chance that the child has an underlying medical problem that could be causing the bruising." D. "Watch how she plays with your daughter when she comes over to determine if there really is a problem."

A. "I'll give you the phone number of the local child protection services so you can call and give them the specific information."

The child's mother asks about her son's dependence on large doses of pain medication and whether it will cause addiction later in life. What response by the nurse is most appropriate? A. "The risk for addiction is extremely low. The child would not want to take this medication if there was no pain." B. "As long as he uses the pain medication for less than 2 weeks, there shouldn't be any problem." C. "It will be easier for him to become dependent on this medication if he needs it later in life." D. "This is something you really need to address with his surgeon because she ordered the pain medication dosage."

A. "The risk for addiction is extremely low. The child would not want to take this medication if there was no pain."

A parent states that he believes his daughter can begin riding her bike to school and wants to know about helmets and clothing when cycling. Which responses from the nurse are correct? Select all that apply. A. "Your daughter can use a helmet from an older child who outgrew it as long as it has not been damaged." B. "Helmets should be replaced every 5 years or sooner if the manufacturer recommends it." C. "Helmets should be approved by the American Academy of Pediatrics (AAP)." D. "The helmet should be loose to allow for head growth." E. Your child can wear sandals or flip-flops while bike riding." F. "Your child should wear light-colored clothing or clothing with reflective or fluorescent material if riding when it is beginning to get dark."

A. "Your daughter can use a helmet from an older child who outgrew it as long as it has not been damaged." B. "Helmets should be replaced every 5 years or sooner if the manufacturer recommends it." F. "Your child should wear light-colored clothing or clothing with reflective or fluorescent material if riding when it is beginning to get dark."

What information should the nurse remember in order to effectively work with parents of an infant with failure to thrive (FTT)? A. A trust relationship needs to be established for the best success when working with the parents. B. The parents need to be watched constantly when they are interacting with the infant. C. Teaching the parents how to play with the infant is essential before successful feeding can occur. D. Only the parents should know about the techniques of successful feeding and infant care.

A. A trust relationship needs to be established for the best success when working with the parents.

The last question the mother asks is about plants she could have around her daughters without worrying about the children being poisoned. What suggestions by the nurse would be correct? A. African violet, begonia, and gardenia B. Dieffenbachia, elephant ear, and philodendron C. Ivy, mistletoe, and Christmas cactus D. Holly, English ivy, and asparagus fern

A. African violet, begonia, and gardenia

The nurse is trying to get a preschooler to eat after having nothing by mouth (NPO) for several days postoperatively. The child has been experiencing nausea. What approaches should the nurse try? Select all that apply. A. Allow the parents to feed the child. B. Encourage the child to eat the same amount of food as he or she did preoperatively. C. Serve food that the child chooses. D. Cover the plate with a variety of food. E. Cut sandwiches into small shapes. F. Avoid giving cookies or sweet drinks.

A. Allow the parents to feed the child. C. Serve food that the child chooses. E. Cut sandwiches into small shapes.

The mother expresses concern about her son's fear of monsters in his room at night. What suggestion by the nurse would provide the best guidance? A. Check the room with the child before going to bed to show him there are no monsters in his room. B. Have the child draw a big picture of the monster and then tear it up. C. Keep a night-light on in the bathroom down the hall. D. Ask the child why he thinks there are monsters in his room.

A. Check the room with the child before going to bed to show him there are no monsters in his room.

The new morbidity and pediatric social illness are terms used to denote certain types of health problems common to certain groups of children. Which groups of children would the nurse include in a discussion of these problems? Select all that apply. A. Children who live in poverty B. Children from a large family C. Children who are homeless D. Children of immigrant families E. Children with chronic psychiatric illness F. Children attending day care centers

A. Children who live in poverty C. Children who are homeless D. Children of immigrant families E. Children with chronic psychiatric illness F. Children attending day care centers

All of the following children have been brought to the ED with dehydration. You are receiving a report from the previous nurse. Which of the following patients would be the priority for the nurse to assess? A. Abbott, a 12 year old boy, is brought in after playing in an all-day soccer tournament in 90-degree weather. Abbott is described as thirsty and somewhat irritable with his parent, but he is otherwise reported as being tired and cooperative. B. Bethany, a 6 year old girl who weighs 25 lb, was somewhat lethargic when she first arrived at the ED. She has just finished receiving her second 500-ml NS bolus and is reported as alert and interactive. C. Caleb, a 2 year old boy with a canker sore for the past 2 days, is reported by his parent to be reluctant to eat or drink. Caleb is irritable and resistant to being examined. Caleb had a large void and his specific gravity was 1.022. D. Daphne, a 4-month-old infant, has had moderate to severe diarrhea for the past week but no fever. Her parent states Daphne has been less interested in her bottle and has been sleeping contently most of the day.

A. Daphne, a 4-month-old infant, has had moderate to severe diarrhea for the past week but no fever. Her parent states Daphne has been less interested in her bottle and has been sleeping contently most of the day.

The mother asks about pacifier use and thumb sucking. Which statements by the mother indicate teaching by the nurse has been effective? Select all that apply. A. Sucking provides the infants comfort as well as pleasure, whether it is by thumb sucking or using a pacifier. B. Pacifier use has been associated with an increased risk of otitis media. C. Sucking is a natural tendency that can be active before birth. D. Pacifiers need to be discontinued by the time a toddler is 2 years old. E. Pacifiers have been found to increase the incidence of sudden infant death syndrome (SIDS). F. Thumb sucking is harmful to the teeth if it lasts past 4 years of age.

A. Sucking provides the infants comfort as well as pleasure, whether it is by thumb sucking or using a pacifier. B. Pacifier use has been associated with an increased risk of otitis media. C. Sucking is a natural tendency that can be active before birth.

A parent mentions that his son has become very moody, has headaches almost daily, and has begun wetting the bed several nights a week. What suggestion should the nurse make while continuing to address the group? A. Take your son to his pediatrician. B. Just watch him for a few more weeks before doing anything. C. Ignore these signs because they are just part of a phase that many school-age children experience. D. Ask your son what is going on at school.

A. Take your son to his pediatrician.

When talking with the girls, what approaches by the nurse would promote the most open and honest answers? Select all that apply. A. Tell the girls that she wants to maintain their privacy but also wants to keep them safe. B. Use as many closed-ended questions as possible so the teens do not need to elaborate on answers if they do not want to. C. Allow the teens to do most of the talking, including expression of their feelings. D. Tell the teens what she would do in the same situation. E. Begin with the most sensitive topics to get them out of the way.

A. Tell the girls that she wants to maintain their privacy but also wants to keep them safe. C. Allow the teens to do most of the talking, including expression of their feelings.

The mother mentions that her son has been more resistant to using his potty chair as her belly has been expanding. Which explanation by the nurse is best? A. This behavior indicates your child may be a little stressed by the unknown events. B. Most children go through periods of regression at some time in their lives. C. You need to keep insisting that he continue using his potty chair. D. Tell him he needs to be a big boy because he will soon become a big brother.

A. This behavior indicates your child may be a little stressed by the unknown events.

The child is started on hemodialysis and is given a transfusion of packed red blood cells. What monitoring by the nurse is critical to evaluate the effectiveness of treatment? A. Vital signs, lung sounds, and level of consciousness B. Abdominal circumference, pupil checks, and capillary refill C. Bowel sounds, skin turgor, and mucous membrane moisture D. Pallor, lethargy, and heart rate

A. Vital signs, lung sounds, and level of consciousness

The parents keep wondering how their otherwise healthy daughter could have gotten this illness. What question by the nurse would help uncover the source of the contamination? A. What did she eat or drink at the fair? B. Has she gone swimming in the family pool? C. Does she have a pet at home? D. Do you pack her lunch?

A. What did she eat or drink at the fair?

An 8-year-old girl was diagnosed and treated for strep throat last week. The parent reports that the child has demonstrated malaise and lethargy for the past 24 hr. The parent states that "her eyes appear puffy." What action should the nurse take first? A.Assess for periorbital edema B.Assess the child's upper respiratory tract C.Obtain a sputum specimen D.Restrict intake of oral fluids

A.Assess for periorbital edema

Which of the following best describes the incidence of pyloric stenosis? A.Females are affected more often than males. B.African American infants are affected more often than Caucasian infants. C.Preterm infants are affected more often than full-term infants. D.Firstborn infants are affected more often than later born infants.

A.Females are affected more often than males.

Which children are most at risk for fluid and electrolyte imbalances? A.Infants B.Preschoolers C.School-aged children D.Adolescents

A.Infants

A 7-year-old child with acute diarrhea has been rehydrated with ORS. What should the nurse recommend for the child's diet? A.Regular diet B.Clear liquids C.High-carbohydrate diet D.BRAT diet (bananas, rice, apples, and toastor tea)

A.Regular diet

What is the difference between culture and ethnicity? A. Ethnicity characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another. Culture is the affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. B. Culture characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another. Ethnicity is the affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. C. Culture is a term with roots in anthropology, distinguishing variety in humans by physical traits. Ethnicity is the affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. D. Ethnicity is a complex social construction that usually incorporates levels of education in the family, occupation, income, and access to resources. Culture characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another.

B. Culture characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another. Ethnicity is the affiliation of a set of persons who share a unique cultural, social, and linguistic heritage.

Which approach by the nurse would best teach appropriate feeding techniques to the parents? A. Provide lengthy explanations to the parents about effective feeding techniques. B. Demonstrate the feeding techniques, including the cues the infant is sending. C. Begin the feeding, and then give the infant to the parents to finish the feeding. D. Praise the parents about anything positive they do for the infant.

B. Demonstrate the feeding techniques, including the cues the infant is sending.

Parents from Japan have brought their family to the United States for a vacation in Florida. Their daughter becomes ill and requires hospitalization. The parents do not ask questions of the nurses or physicians. What approaches by the nurse would be most effective in promoting clear and effective communication? Select all that apply. A. Obtain an interpreter for the family and child as soon as the child arrives. B. Determine the family's level of English language comprehension upon admission. C. Tell the family what is happening at frequent intervals. D. Let the family know that questions are expected and welcomed by the staff.

B. Determine the family's level of English language comprehension upon admission. C. Tell the family what is happening at frequent intervals. D. Let the family know that questions are expected and welcomed by the staff.

The mother mentions that her younger daughter has been having some sleep disturbances and telling her mother that she has an "itchy butt." What question would be best for the nurse to ask to obtain more information about the daughter? A. Do you check that your daughter's anal area is wiped well after bowel movements? B. Does she play in the dirt at day care or at home? C. Does your daughter shower or take a tub bath? D. How long has this been going on?

B. Does she play in the dirt at day care or at home?

What anticipatory information about child safety seats would be appropriate for the nurse to share with the parents? A. The twins should be kept facing the same way even if one twin is larger and can go into a front-facing car seat. B. Dressing the infants in an outfit with sleeves and legs allows the harness to hold the infants securely in their safety car seat. C. It is now recommended that all infants and toddlers ride in rear-facing car safety seats until they reach the age of 3 years or the height recommended by the car seat manufacturer. D. Holding the infant on the lap is permissible for rides less than 5 minutes or 5 miles from home.

B. Dressing the infants in an outfit with sleeves and legs allows the harness to hold the infants securely in their safety car seat.

During the clinic visit, Imani and her older sister are noticed to be scratching their heads. Closer inspection reveals head lice (pediculosis capitis). Both are prescribed permethrin 1% cream rinse. Which of the following would also be included as part of teaching? Select all that apply. A. Cut hair shorter. B. Give directions to clean the environment. C. Remove all nits with a fine -toothed comb, tweezers, or by hand. D. Supplement treatment with home remedies such as application of mayonnaise or vinegar

B. Give directions to clean the environment. C. Remove all nits with a fine -toothed comb, tweezers, or by hand.

The girls ask about having their navels pierced. What information should be shared by the nurse? Select all that apply. A. Make sure a piercing gun is used for the navel piercing. B. Make sure the piercing is not done by friends or yourself. C. The person doing the piercing should wear gloves to protect the person having the piercing done. D. Sterile technique should be used whenever and wherever a piercing is done. E. Infection, keloid formation, and allergy to the metal object in the area pierced are possible complications.

B. Make sure the piercing is not done by friends or yourself. D. Sterile technique should be used whenever and wherever a piercing is done. E. Infection, keloid formation, and allergy to the metal object in the area pierced are possible complications.

How should the nurse position and wrap the cocaine-addicted infant in his bassinet? A. On his left side, propped front and back with blanket rolls, with the head of the bassinet slightly elevated B. On his back, swaddled C. Loosely wrapped and positioned on his back D. On his right side, wrapped with two blankets

B. On his back, swaddled

One of the mothers mentions that she is afraid of her son being hit in the mouth and losing a tooth during sports activities, although he wears a light mouth guard. What should the nurse include in explaining first aid for a child who has had a permanent tooth knocked out on the playing field or in the gymnasium? A. After washing the tooth with soap and water, hold the tooth by the root. B. Place the cleaned tooth in milk for transport to the dentist. C. Scrub the tooth with a toothbrush before placing it back in the mouth. D. Place the tooth in clear diet soda to bubble away any debris.

B. Place the cleaned tooth in milk for transport to the dentist.

A 15-month-old child with a high fever and barking cough is admitted to the pediatric unit. The toddler has blue and white string bracelets on each hand. What is the initial action the nurse should take? Select all that apply. A. Remove the bracelets so the identification band can be placed. B. Place the identification band on the toddler's leg. C. Obtain a complete health history from the parent. D. Ask the purpose of the blue and white string bracelets.

B. Place the identification band on the toddler's leg. C. Obtain a complete health history from the parent. D. Ask the purpose of the blue and white string bracelets.


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