Peds Review 1

The nurse is teaching a class on nutrition to a group of parents of 10- and 11-year-old children. What statement by one of the parents indicates a correct understanding of the teaching?

"I will serve foods that are low in saturated fat and cholesterol."

The school nurse is teaching an adolescent about social networking and texting on phones. What statement by the adolescent indicates a need for further teaching?

"My text messaging during class time in school will not cause any disruption."

The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?

"We know that roundworm can be transmitted from person to person."

At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant's crib. What is the most appropriate response for the nurse to make?

"You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake."

At which age should the nurse expect most infants to begin to say "mama" and "dada" with meaning?

10 months

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 recommended to the parents?

120 degrees F

The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal vaginal pH is in which range?

4.0 to 5.0

After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen?

6 to 8 weeks

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

An 8-year-old girl tells the nurse that she has cancer because God is punishing her for "being bad." What should the nurse interpret this as?

A common belief at this age

The development of sexual orientation during adolescence is what?

A developmental process

A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?

A topical anesthetic can be applied before injections are given.

What do the psychosocial developmental tasks of toddlerhood include?

Ability to delay gratification

Which is characteristic of X-linked recessive inheritance?

Affected individuals are principally males

Which explains the importance of detecting strabismus in young children?

Amblyopia, a type of blindness, may result.

A child with cyanide poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed for the child?

Amyl nitrate

An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific plan. How should asking about a specific plan be viewed?

An appropriate part of the assessment

Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?

Applying of the medication occurs at least 20-30 minutes after washing.

The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?

Ask the adolescent, "Why did you come here today?"

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 the same nurse as much as possible

Which is the most consistent and commonly used data for assessment of pain in infants?

Behavioral

What aspects of cognition develop during adolescence?

Capability of using a future time perspective

The nurse should know what about Lyme disease?

Caused by a spirochete that enters the skin through a tick bite

The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate?

Check to be sure the Tylenol does not exceed 15 mg/kg

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

What is true concerning the development of autonomy during adolescence?

Conformity to both parents and peers gradually declines toward the end of adolescence

In terms of fine motor development, what should the 3-year-old child be expected to do?

Copy (draw) a circle.

The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?

Cultural practice to rid the body of disease

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.

Which muscle is contraindicated for the administration of immunizations in infants and young children?

Dorsogluteal

Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?

Each child of a heterozygous affected parent has a 50% chance of being affected.

The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?

Edema of the lips, tongue, and pharynx

The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?

Empty the mouth of pills, plants, or other material

A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen?

Establish a contract with her, including rewards

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

Ethnocentrism

The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?

Family characteristics

Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

Focus communication on the child.

A 9-year-old child has just been diagnosed with recurrent abdominal pain (RAP). In preparing for discharge, the nurse should include what in the home care instructions to the parents?

Following a high-fiber diet

What is an advantage of the ventrogluteal muscle as an injection site in young children?

Free of significant nerves and vascular structures

What is an important consideration for the school nurse who is planning a class on bicycle safety?

Head injuries are the major causes of bicycle-related fatalities.

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.

According to Erikson, the psychosocial task of adolescence is developing what?

Identity

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety?

Inconsolable and crying

A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which?

Increased risk for Down syndrome

A child has been admitted to the hospital with a blood lead level of 72 mcg/dL. What treatment should the nurse anticipate?

Initiation of chelation therapy

What should the nurse explain about ringworm?

It is spread by both direct and indirect contact.

The nurse is checking reflexes on a 7-month-old infant. When the infant is suspended in a horizontal prone position, the head is raised and the legs and spine are extended. Which reflex is this?

Landau

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

What is the primary treatment for warts?

Local destruction

When checking the intravenous (IV) site on a child, the nurse should take which action?

Look at the site while palpating the area.

The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome?

Low-set ears

An occlusive dressing is applied to a large abrasion. This is advantageous because the dressing will accomplish what?

Maintain a moist environment for healing.

The nurse is admitting a child with frostbite. What health care prescription should the nurse question and verify?

Massage the injured tissue.

Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?

Milk

When assessing a preschooler's chest, what should the nurse expect?

Movement of the chest wall to be symmetric bilaterally and coordinated with breathing

What is marasmus?

Not confined to geographic areas where food supplies are inadequate

Treatment for herpes simplex virus (type 1 or 2) includes which?

Oral antiviral agent

Which non-pharmacologic intervention appears to be effective in decreasing neonatal procedural pain?

Oral sucrose and nonnutritive sucking

The nurse is assessing a child's capillary refill time. This can be accomplished by doing what?

Palpate the nail bed with pressure to produce a slight blanching.

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

Parental control should be consistent

During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boy's birthday is close to the cut-off date, and he has not attended preschool. What is the nurse's best recommendation?

Perform a developmental screening.

The nurse has just given a subcutaneous injection to a preschool child, and the child asks for a Band-Aid over the site. Which action should the nurse implement?

Place a Band-Aid over the site

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

Herpes zoster is caused by the varicella virus and has an affinity for which?

Posterior root ganglia and posterior horn of the spinal cord.

A 6-year-old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide?

Prescribed pain medication before discharge

What is a priority goal in the postpartum care of an adolescent mother?

Prevention of subsequent pregnancies

Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol?

Provides a defense against depression

The nurse's role in facilitating successful childrearing in unmarried teenage mothers includes what?

Providing information and feedback about positive parenting skills.

What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?

Pure tone audiometry

The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

Purposeful and goal directed

The parent of an 8.2-kg (18-lb) 9-month-old infant is borrowing a federally approved car 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

A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?

Reassure the mother that this is normal at this age.

A 5-year-old child returns from the pediatric intensive care unit after abdominal surgery. The orders state to monitor vital signs every 2 hours. On assessment, the nurse observes that the child's heart rate is 20 beats/min less than it was preoperatively. What should be the nurse's next action?

Recheck the pulse and blood pressure in 15 minutes

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

Regression

A child, age 7 years, has a fever associated with a viral illness. She is being cared for at home. What is the principal reason for treating fever in this child?

Relief of discomfort

A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is what?

Ritualism, an expected behavior at this age

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 relate to the students?

Separation anxiety

The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize?

Sexuality is presented as a normal part of growth and development.

What do inflicted immersion burns often appear as?

Sharply demarcated, symmetrical burns

A child age 4 1/2 years sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened, yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This is most likely what?

Sleep terror

During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise?

Slow down eating meals

What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?

Social isolation

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

Start the IV line because unlimited procrastination results in heightened anxiety

Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?

Status

During the preschool period, the emphasis of injury prevention should be placed on what?

Teaching about safety and potential hazards

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation?

The adolescents may be enjoying themselves but have lower energy levels than healthy children.

A couple expecting their first child has a positive family history for several congenital defects and disorders. The couple tells the nurse that they are opposed to abortion for religious reasons. Which should the nurse consider when counseling the couple?

The couple should be encouraged to have recommended diagnostic testing.

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. What should your explanation to the parents include?

The pump can deliver baseline and bolus dosages.

Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is this because of?

They are dealing with issues that are stressful and emotionally laden

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on remembering what?

This is acceptable to encourage head control and turning over.

According to Piaget, magical thinking is the belief of which?

Thoughts are all powerful.

The school reviewed the pediculosis capitis (head lice) policy 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?

Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits are eliminated.

An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child?

Varicella-zoster immune globulin

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

Vesicle

Rickets is caused by a deficiency in what?

Vitamin D and calcium

The nurse is explaining about the developmental sequence in children's capacity to conserve matter to a group of parents. What type of matter is last in the sequence for a child to develop?

Volume

74. Which statement is correct about toilet training?

Wanting to please the parent helps motivate the child to use the toilet.