Peds: Unit 2
For which of the following children would nonopioid analgesics be recommended? A) A child with juvenile arthritis B) A child with end-stage cancer C) A child with a broken arm D) A child with severe postoperative pain
A
Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug causing most of the adverse effects? A) Central nervous system B) Peripheral nervous system C) Digestive system D) Musculoskeletal system
A
The nurse is preparing to administer a topical anesthetic for a 10-year-old girl with a chin laceration. The nurse would expect to apply which of the following as ordered in preparation for sutures? A) TAC (tetracaine, epinephrine, cocaine B) Iontophoretic lidocaine C) EMLA D) Vapocoolant spray
A
The nurse is providing teaching to the parents of a newborn prior to a heelstick. The nurse is describing the procedure and recommending various methods for the parents to help comfort their baby. Which of the following statements by the parents indicates a need for further teaching? A) "It's better if we are not in the room for this." B) "We can use kangaroo care before and after." C) "We hope you are using a very tiny needle." D) "We can offer him nonnutritive sucking to calm him."
A
The nurse is caring for medically fragile children in a hospital setting. What nursing role has the greatest impact on the child and family when caring for this population? A) Teacher B) Advocate C) Coordinator D) Caregiver
A. While the infant or child is still in the hospital, nurses can help parents build on their strengths, empowering them to care for their medically fragile infant or special needs child. Education is paramount and should begin as early in the hospitalization as possible. - The advocate, coordinator, and caregiver roles are also important for the nurse caring for this population; however, empowering the parents to care for their children through education is the most important role
The nurse is caring for a child who is complaining of chronic pain. Which of the following is the priority nursing assessment? A) How the pain impacts the child's and family's stress level B) The pain's history, onset, intensity, duration, and location C) The child's and parents' feeling of anxiety and depression D) The child's cognitive level and emotional response
B
The nurse is explaining the effects of heat application for pain relief. Which of the following would the nurse be likely to include as an effect? A) Increased blood flow to the area B) Increased pressure on nociceptive fibers C) Possible release of endogenous opioids D) Altered capillary permeability
B
The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using? A) Relaxation B) Distraction C) Imagery D) Thought stopping
B
The student nurse is learning about the effects of heat and cold when used in a pain management plan. Which of the following accurately describes one of these effects? A) Cold results in vasodilation. B) Cold alters capillary permeability. C) Heat results in vasoconstriction. D) Heat decreases blood flow to the area.
B
The nurse is administering pain medication for a child with continuous pain from internal injuries. Which of the following methods would be ordered to dispense the medication? A) Administer the medication PRN (as needed). B) Administer the mediation when pain has peaked. C) Administer the medication around the clock at timed intervals. D) Administer the medication when the child complains of pain.
C
The nurse is preparing a child for a lumbar puncture. How far ahead of the procedure should the nurse apply the EMLA cream? A) 30 minutes B) 1 hour C) 3 hours D) 4 hours
C
The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which of the following parent statements signifies successful child teaching? A) "I will avoid using descriptive words like pinching, pulling, or heat." B) "I will not use positive reinforcement until the technique is perfected." C) "I will begin using the technique before he experiences pain." D) "I will be honest and tell him that the procedure will hurt a lot."
C
Pentazocine is prescribed for a child with moderate pain. The nurse identifies this drug as an example of which type? A) Nonsteroidal anti-inflammatory drug (NSAID B) Prostaglandin inhibitor C) Opioid D) Mixed opioid agonist-antagonist
D
The nurse is conducting a pain assessment of a 10-year-old boy who has been taking acetaminophen for chronic knee pain. The assessment indicates that the recommended dose is no longer providing adequate relief. What is the appropriate nursing action? A) Increase the dosage of the acetaminophen. B) Tell the child he is experiencing the ceiling effect. C) Use guided imagery to help his pain. D) Obtain an order for a different medication.
D
The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which of the following adverse effects of the medication? A) Epidural hematoma B) Arachnoiditis C) Spinal headache D) Respiratory depression
D
The nurse is providing instructions to a mother on how to use thought stopping to help her child deal with anxiety and fear associated with frequent painful injections. Which of the following statements indicates the mother understands the technique? A) "We will imagine that we are on the beach in Florida." B) "We can talk about our favorite funny movie and laugh." C) "She can let her body parts go limp, working from head to toe." D) "We'll repeat 'quick stick, feel better, go home soon' several times."
D
The nurse is transporting a 6-month-old with a suspected blood disorder to the nursery. What is the most appropriate method of transporting the child by the nurse? A) A wagon with rails B) Cradle hold C) Football hold D) Over the shoulder
Over the shoulder A 4-month-old should be carried in the "over-the-shoulder" method. A wagon with rails is for an older child. A cradle hold is for infants until 3 months of age. A football hold is for infants until 2 months of age.
The nurse is assessing heart rate for children on the pediatric ward. Which of the following is a normal finding based on developmental age? A)An infant's rate is 90 bpm. B)A toddler's rate is 150 bpm. C)A preschooler's rate is 130 bpm. D)A school-age child's rate is 50 bpm.
A
The nurse is caring for a child who is recovering from an appendectomy. Which of the following is the appropriate term for the pain this child is experiencing? A) Nociceptive pain B) Neuropathic pain C) Chronic pain D) Superficial somatic pain
A
A mother brings her 31/2-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature, which method would be least appropriate? A)Oral B)Tympanic C)Rectal D)Axillary
C
The nurse is assessing the heart rate of a healthy 13-month-old child. The nurse knows to auscultate which of the following sites to obtain an accurate assessment? A)Radial pulse B)Brachial pulse C)Apical pulse at the third or fourth intercostal space D)Apical pulse at the fourth or fifth intercostal space at the midclavicular line
C
The nurse is conducting a routine health assessment of a 3-month-old boy and notices a flat occiput. The nurse provides teaching and emphasizes the importance of tummy time. Which of the following responses by the mother indicates a need for further teaching? A)"He must be positioned on his tummy as much as possible." B)"I need to watch him during his tummy time." C)"I need to change his head position while he is in an upright chair." D)"His head has flattened due to the pressure of his head position."
A
When the nurse is assessing a child's pain, which of the following is most important? A) Obtaining a pain rating from the child with each assessment B) Using the same tool to assess the child's pain each time C) Documenting the child's pain assessment D) Asking the parents about the child's pain tolerance
B
The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which of the following behaviors of the child would alert the nurse that he is in the second stage of separation anxiety? A) He ignores his parents when they return to his room. B) He cries uncontrollably whenever they leave. C) He forms superficial relationships with his caregivers. D) He sits quietly and is uninterested in playing and eating.
He sits quietly and is uninterested in playing and eating. Separation anxiety consists of three stages—protest, despair, and detachment. In the protest stage, the child reacts aggressively to separation and exhibits great distress by crying, expressing agitation, and rejecting others who attempt to offer comfort. In the despair phase the child displays hopelessness by withdrawing from others, becoming quiet without crying, and exhibiting apathy, depression, lack of interest in play and food, and overall feelings of sadness. In the detachment stage the child shows interest in the environment, starts to play again, and forms superficial relationships with the nurses and other children. If the parents return, the child ignores them. A child in this phase of separation anxiety exhibits resignation, not contentment.
The nurse working in community nursing uses epidemiology as a tool. What information can be obtained using this process? A) Health needs of a population B) Cultural needs of a population C) Income levels of a population D) Mortality rates of a population
Health needs of a population Epidemiology can help determine the health and health needs of a population and assist in planning health services. Community health nurses perform epidemiologic investigations in order to help analyze and develop health policy and community health initiatives. The nurse provides culturally competent care but does not use epidemiology to determine culture, income levels, or mortality rates of children.
The nurse is caring for a 5-year-old boy who is terminally ill. Which intervention would best meet the needs of this dying child? A) Offer the child decision-making opportunities. B) Provide the child with specific details. C) Assure the child that he did nothing wrong. D) Act as a confidant for the child's concerns.
Ans: C Feedback: The magical thinking of preschool-age children may cause him to think that dying is punishment for doing something wrong. Assuring him that he did nothing wrong is very important. School-age children would benefit from receiving specific details and being given decision-making opportunities. They may also use nurses as their confidants.
The nurse is caring for terminally ill children in a hospital setting. With which of the following children would the nurse consult regarding the continuation or withdrawal of treatment? A) A 4-year-old with an inoperable brain tumor B) A 5-year-old with kidney failure C) A 6-year-old with life-threatening injuries D) A 7-year-old with end-stage leukemia
Ans: D Feedback:
The nurse is measuring the blood pressure of a 12-year-old boy with an oscillometric device. The boy's reading is greater than the 90th percentile for gender and height. What is the appropriate nursing action? A)Repeat the reading with the oscillometric device. B)Repeat the blood pressure reading using auscultation. C)Measure the blood pressure in all four extremities. D)Measure the blood pressure with a Doppler.
B
The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs? A) Developing body image B) Developing peer relationships C) Developing language and motor skills D) Learning through sensorimotor exploration
c. In special needs children, developmental delays may occur in all stages. In particular, motor and language skill development may be delayed if the toddler is not given adequate opportunities to test his or her limits and abilities.
The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question? A)Endocrine B)Genitourinary C)Hematologic D)Neurologic
A
The nurse is assessing the neck of an 8-year-old child with Down syndrome. Which of the following findings would the nurse expect during the examination? A)Webbing B)Excessive neck skin C)Lax neck skin D)Shortened neck
C
The nurse is conducting an assessment of a high school track athlete. He tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain? A) Cutaneous B) Neuropathic C) Visceral D) Deep somatic
D
The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which of the following statements from the nurse accurately reflects the pain experience in children? A) "You can expect that your child will tell you when he is experiencing pain." B) "Your child will learn to adapt to the pain he is experiencing." C) "Your child will experience more adverse effects to narcotics than adults." D) "It is very rare that children become addicted to narcotics."
D
The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which of the following questions would be most likely to elicit valuable information? A)"Do you like your new school?" B)"Are you happy with your teacher?" C)"Do you enjoy reading a book?" D)"What are your new classmates like?"
D
After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify which of the following as a characteristic? A) Focus on coping B) Use of a highly structured format C) Dramatization of emotions D) Expression of feelings
Use of a highly structured format Therapeutic play is nondirected play, focused on helping the child cope with feelings and fears. Real-life stressors and emotions can be acted out or dramatized, allowing the child to express his or her feelings.
The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which of the following responses from the mother indicates a need for further teaching? A) "I really need to carefully check for skin breakdown." B) "I must really scrub her teeth and gums well." C) "I must use a soft toothbrush." D) "I can use a soft gauze sponge to care for her gums."
"I must really scrub her teeth and gums well." The nurse should caution the mother that overly vigorous brushing should be avoided as it can injure or irritate the gums. The other statements are recommended guidelines for care.
The mother of a hospitalized child reports that her daughter, who is having some difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the child's intake flow sheet as which of the following? A) 2 ounces B) 4 ounces C) 6 ounces D) 8 ounces
2 ounces Ice chips are included as fluid intake, and the amount is approximately equivalent to half the same amount of water. Therefore, the nurse would document this fluid intake as 2 ounces.
The nurse is inspecting the genitals of a prepubescent girl. Which of the following are normal signs of the onset of puberty? A)Appearance of pubic hair around 11 to 13 years old B)Swelling or redness of the labia minora C)Presence of a small amount of downy pubic hair D)Lesions on the external genitalia
A
The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which of the following topics might the nurse include? Select all answers that apply. A)The child's toileting habits B)Use of car seats and other safety measures C)Problems with growth and development D)Prenatal and perinatal history E)The child's race and ethnicity F)Use of supplements and vitamins Ans:
ABF
The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order? A)Inspection, palpation, percussion, auscultation B)Inspection, percussion, palpation, auscultation C)Palpation, percussion, inspection, auscultation D)Inspection, auscultation, palpation, percussion
A
Which of the following would be least effective in gaining the cooperation of a toddler during a physical examination? A)Tell the child that another child the same age wasn't afraid. B)Allow the child to touch and hold the equipment when possible. C)Permit the child to sit on the parent's lap during the examination. D)Offer immediate praise for holding still or doing what was asked.
A
A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate? A)Increased intracranial pressure B) Over hydration C)Dehydration D)These are normal findings.
D
The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in which of the following ranges? A)80 to 150 bpm B)70 to 120 bpm C)65 to 110 bpm D)60 to 100 bpm
D
Assessment reveals that a child weighs 73 lb and is 4 ft 1 in. tall. The nurse calculates this child's body mass index as: A)19.1 B)20.7 C)21.4 D)24.5
C
The nurse is performing a physical examination on a sleeping newborn. Which of the following body systems should the nurse examine last? A)Heart B)Abdomen C)Lungs D)Throat
D
The nurse is researching behavioral-cognitive pain relief strategies to use on a 5-year- old child with unrelieved pain. Which of the following methods might the nurse choose? Select all answers that apply. A) Relaxation B) Distraction C) Biofeedback D) Thought stopping E) Massage F) Sucking
A, B, C, D
The nurse is caring for infants having the condition failure to thrive (FTT). Which infants would be at risk for this condition? Select all that apply. A) A newborn baby with tetralogy of Fallot B) An infant with a cleft palate C) An infant born to a diabetic mother D) An infant born to an impoverished mother E) An infant with bronchopulmonary dysplasia F) An infant born to a teenage mother
A, B, D, E Infants and children with cardiac or metabolic disease, chronic lung disease (bronchopulmonary dysplasia), cleft palate, or gastroesophageal reflux disease are at particular risk for FTT. Also, poverty is the single greatest contributing risk factor (Block et al., 2005). An infant born to a diabetic mother or an infant born to a teenage mother does not have increased risk for FTT.
The nurse is managing children who have chronic diseases in a neighborhood clinic. Which of the following are examples of chronic conditions? Select all answers that apply. A) Diabetes mellitus B) Myocardial infarction C) Rheumatoid arthritis D) Compound fracture E) Acute asthma F) Bronchopneumonia
A, C, E
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? Select all answers that apply. A) Pretend to perform the procedure on her doll. B) Explain the procedure to her in medical terms. C) Do not allow her to see or touch the equipment. D) Teach her the steps of the procedure. E) Tell her not to pay attention to any sounds she might hear. F) Introduce her to the health care personnel.
A, D, F Useful techniques for reducing stress in children include the following: perform nursing care on stuffed animals or dolls and allow the child to do the same, teach the child the steps of the procedure or inform him or her exactly what will happen during the hospital stay, introduce the child to the health care personnel with whom he or she will come in contact, avoid the use of medical terms, allow the child to handle some equipment, show the child the room where he or she will be staying, explain the sounds the child may hear, and let the child sample the food that will be served.
The nurse is teaching the student nurse the physiology involved in pain transmission. Which of the following statements accurately describes a physiologic event in the nervous system related to pain transmission? Select all answers that apply. A) Thermal stimulation may involve the release of mediators, such as histamine, prostaglandins, leukotrienes, or bradykinin. B) When nociceptors are activated by noxious stimuli, the stimuli are converted to electrical impulses that are relayed to the spinal cord and brain. C) Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid rates; unmyelinated small C fibers transmit the impulse slowly. D) Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus. E) The point at which the person first feels the highest intensity of the painful stimulus is termed the pain threshold. F) Peripheral sensitization allows the nerve fibers to react to a stimulus that is of lower intensity than would be needed to cause pain.
B, C, D, F
The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which of the following examples are behavioral indicators? Select all answers that apply. A) The infant grimaces. B) The infant's heart rate is elevated. C) The infant flails his arms and legs. D) The infant's respiratory rate is elevated. E) The infant is crying uncontrollably. F) The infant's oxygen saturation is low.
A, C, E
The nurse is caring for a special needs infant. Which intervention will be most important in helping the child reach her maximum developmental potential? A) Directing her parents to an early intervention program B) Monitoring her progress in elementary school C) Serving on an individualized education program committee D) Preparing a plan for her to transition to college
A. Early intervention is critical to maximizing the child's developmental potential by laying the foundation for health and development. While important, intervention in elementary or secondary school does not have the impact of early intervention. When the time arrives, it is important to have a written plan for transition to college, if this is a possibility for the grown child.
The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on this child? A) Taking her on an adventure down the hall B) Helping her do a simple craft project C) Introducing her to children in the playroom D) Limiting the staff providing care for her
A. Preschool-age children need to develop a sense of initiative, and helping the child to explore her area of the hospital would help accomplish this developmental need.
A 7-year-old boy has reentered the hospital for the second time in a month. Which intervention is particularly important at this time? A) Assessing his parents' coping abilities B) Seeking his parents' input about their child's needs C) Educating his family about the procedure D) Notifying the care team about his hospitalization
A. Transition times, such as when the child reenters the hospital, create additional stress on the parents and child. Assessing the parents' coping abilities is particularly important at this time.
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which of the following measures might the nurse consider when caring for this child? Select all answers that apply. A) Use the en face position when holding the toddler. B) Use a bed for toddlers who have an adult present. C) Avoid leaving small objects that can be swallowed in the bed. D) Explain activities in concrete, simple terms. E) Allow the child to select meals and activities. F) Encourage parents to stay to prevent separation anxiety.
C, F For a toddler, the nurse would avoid leaving small objects that can be swallowed in the bed and encourage parents to stay to prevent separation anxiety. The nurse would use the en face position when holding an infant and use a bed only for the older toddler who has an adult present in the room at all times. The nurse would explain activities in concrete, simple terms for a preschooler and allow a school-age child to select meals and activities.
For which of the following children would the nurse conduct an immediate comprehensive health history? A)A child who is brought to the emergency room with lacerations B)A child who is a new client in a pediatric office C)A child who is a routine client and presents with signs of a sinus infection D)A child whose condition is improving
B
The nurse is coordinating home care for a 3-year-old girl with special care needs. Which approach provides the greatest benefit to the family of this child? A) Asking the father for his observations on his daughter's progress B) The nurse adjusting her office schedule to be available C) Urging parents to arrange respite care whenever possible D) Monitoring the mother for depression
B
The nurse is inspecting the fingernails of an 18-month-old girl. Which of the following findings indicates chronic hypoxemia? A)Nails that curve inward B)Clubbing of the nails C)Nails that curve outward D)Dry, brittle nails
B
The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In order to get an accurate reading, what does the nurse need to do? A)Pull the earlobe back and down B)Direct the infrared sensor at the tympanic membrane C)Pull the earlobe down and forward D)Remove any visible cerumen from inside the ear canal
B
The nurse is examining the posture of a male toddler and notes the condition "lordosis." What would be the appropriate reaction of the nurse to this finding? A)Explain that the child will need a back brace. B)Refer the toddler to a physical therapist. C)Do nothing; this is a normal condition for toddlers. D)Notify the primary care physician about the condition.
C
The parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond? A)"Your daughter has acrocyanosis; this is causing her blue hands and feet." B)"Let's watch her carefully to make sure she does not have a circulatory problem." C)"This is normal; her circulatory system will take a few days to adjust." D)"This is a vasomotor response caused by cooling or warming."
C
The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? A) "Let's work together to plan your day along with your treatments." B) "The sooner you cooperate, the sooner you are going to leave." C) "If you are more cooperative, perhaps we can arrange a visit from friends." D) "Please don't make me call your parents about this."
"Let's work together to plan your day along with your treatments." Collaborating with the adolescent will provide the teen with increased control. The nurse should work with the teen to provide a mutually agreeable schedule that allows for the teen's preferences while incorporating the required nursing care. Threatening to call the parents will most likely promote further resistance. The nurse should try to immediately engage the girl, rather than making the nurse's cooperation conditional upon the girl's cooperation. Telling the girl that the sooner she cooperates, the sooner she will leave is inappropriate. The nurse is incorrectly implying that her behavior, rather than her medical needs, is going to determine when she will be discharged from the hospital.
The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which of the following statements would best help prepare the girl for the test and decrease anxiety? A) "You won't hear a sound if you wear your headphones." B) "The machine makes a very loud rattle; however, headphones will help." C) "There are a variety of loud sounds you will hear." D) "The MRI scanner sounds like a machine gun."
"The machine makes a very loud rattle; however, headphones will help." The nurse should acknowledge that an MRI is loud and briefly describe the noises the machine makes. Then, the nurse should immediately offer a solution: headphones. Telling the girl she won't hear a sound is untrue. Telling her that there are loud sounds isn't enough and could increase anxiety. Comparing the MRI scanner to the sound of a machine gun is not appropriate imagery for a child.
The nurse is enlisting the parents' assistance for therapeutic hugging prior to an otoscopic examination. What should the nurse emphasize to the parents? A) "You will need to keep his hands down and his head still." B) "If this does not work, we will have to apply restraints." C) "If you are not capable of this, let me know so I can get some assistance." D) "I may need you to leave the room if your son will not remain still."
"You will need to keep his hands down and his head still." The nurse needs to provide a specific explanation of the parents' role and what body parts to hold still in a safe manner. Implying that the parents may not be capable or may have to leave the room is inappropriate. Telling the parents that restraints may be required is not helpful, does not teach, and may be perceived as a threat.
The nurse referring a child to home care discusses the advantages and disadvantages with the child's family. Which of the following are disadvantages of this method of health care? Select all answers that apply. A) The nurse is performing care of the child in the family's home. B) The home care nurse is not always equipped to perform technical care. C) The out-of-pocket cost of home care is more expensive. D) The technical procedures may be overwhelming for the family. E) The financial burden may cause more stress for the family. F) The child does not receive continuity of care provided in the hospital setting.
A, C, D, E There are some disadvantages to home care. The presence of health care professionals in the home can be an intrusion on family privacy. Financial issues can become a large burden: families may have higher out-of-pocket costs if their insurance does not reimburse for home care. Having one parent at home full time and not earning an income can contribute to increased financial strain, not to mention social isolation of that parent. All of these can lead to increased stress on family members. Also, caring for children with complex medical needs can be overwhelming for some families. The home care nurse should arrange for continuity of care for the child.
The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which of the following are examples of interventions that nurses perform in the "building a trusting relationship" stage? Select all answers that apply. A) Gathering information about the child using the child's own toys B) Preparing the child for a procedure by playing games C) Explaining in simple terms what will happen during surgery D) Allowing the child to devise an exercise plan following surgery E) Praising the child for how well he is doing following instructions F) Giving the child a favorite toy to cuddle following a painful procedure
B, C The introduction phase involves the initial contact with children and their families and it establishes the foundation for a trusting relationship. A trusting relationship can be built by using appropriate language, games, and play such as singing a song during a procedure, preparing the child adequately for procedures, and providing explanations and encouragement. In the decision-making phase, the nurse gives some control over to the child by allowing him to participate in making certain decisions, such as devising an exercise. Finally, the comfort and reassurance phase uses techniques such as praising the child and providing opportunities to cuddle with a favorite toy.
The nurse is caring for families with vulnerable child syndrome. Which situation would be most likely to predispose the family to this condition? A) Having a postterm infant B) Having an infant who is reluctant to feed properly C) Having a child diagnosed with impetigo at age 10 D) Having a child with juvenile diabetes
B. "Vulnerable child syndrome" is a clinical state in which the parents' reactions to a serious illness or event in the child's past continue to have long-term psychologically harmful effects on the child and parents for many years. Risk factors for the development of vulnerable child syndrome include preterm birth, congenital anomaly, newborn jaundice, handicapping condition, an accident or illness that the child was not expected to recover from, or crying or feeding problems in the first 5 years of life.
A nurse is providing teaching to the mother of an adolescent girl about how to manage menstrual pain nonpharmacologically. Which of the following statements by the mother indicates a need for further teaching? A) "I need to help her learn techniques to distract her, card games, for example." B) "I need to be able to identify the subtle ways she shows pain." C) "I need to follow these instructions exactly for them to work properly." D) "I need to encourage her to practice and utilize these techniques."
C
The nurse is caring for a child who is experiencing pain related to chemotherapy treatment. Which of the following is a behavioral factor that might affect the child's pain experience? A) Knowledge of the therapy B) Fear about the outcome of therapy C) Participation in normal routine activities D) Ability to identify pain triggers
C
The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination? A)The child B)The parents C)Chief complaint D)Developmental age
C
Which would be least appropriate to include in the discharge plan for a medically fragile child? A) Assisting with referrals for financial support B) Arranging for necessary care equipment and supplies C) Assessing the family's home environment D) Encouraging passive caregiving
D. As part of the discharge plan for a medically fragile child, the nurse would encourage active caregiving by the parents to help them increase their self-confidence in the child's care. Assisting with referrals, arranging for equipment and supplies, and determining the adequacy of the home environment are important aspects of the discharge plan.
The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? A) Regression B) Suppression C) Repression D) Denial
Regression Sucking the thumb and changing the speech pattern (such as to baby talk) are signs of regression, a defense mechanism used by children to deal with unpleasant experiences by returning to a previous stage that may be more comfortable to the child. Suppression is a conscious inhibition of an idea or desire. Repression is an unconscious inhibition of an idea or desire. Denial would be exhibited by expressions of resignation instead of true contentment, not thumb sucking or baby talk.
The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted? A) Mental health problems B) Injuries C) Respiratory disorders D) Gastrointestinal disorders
Respiratory disorders According to Child Health USA 2008-2009, diseases of the respiratory system account for the majority of hospitalizations in children younger than 5 years of age, while diseases of the respiratory system, mental health problems, injuries, and gastrointestinal disorders lead to more hospitalizations in older children.
When speaking to a group of parents at a local elementary school, the nurse describes school nursing as a specialized practice of nursing based on the fact that a healthy child has a better chance to succeed in school. Which of the following best describes the strategy school nurses use to achieve student success? A) They coordinate all school health programs. B) They link community health services. C) They work to minimize health-related barriers to learning. D) They promote student health and safety.
They work to minimize health-related barriers to learning. School nurses work to remove or minimize health barriers to learning to give students the best opportunity for academic success. Coordinating school health programs, linking community health programs, and promoting health and safety are individual components within the ultimate goal of removing or minimizing health barriers.
The nurse is providing palliative care for a 9-year-old boy in hospice. Which is unique to hospice care for children? A) Encouraging visits from friends and family B) Educating parents about terminal dehydration C) Prolonging treatment that might possibly help D) Treating constipation to relieve abdominal pain
Ans: C Feedback: Hospice for children allows for continuation of hopeful treatment so long as certain criteria are met. This is different from adult hospice. Encouraging visits from friends and family, educating parents about terminal dehydration, and treating constipation are common to family-centered care.
The nurse is performing an admission of a 10-year-old boy. Which of the following actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all answers that apply. A) The nurse should not minimize the child's fears by smiling. B) The nurse should initiate introductions. C) The nurse should not use formal titles at the introduction. D) The nurse should maintain eye contact at the appropriate level. E) The nurse should start communication with the child first and then move on to the family. F) The nurse should use age-appropriate communication with the child.
B, D, F Regardless of the site of care, nursing care must begin by establishing a trusting, caring relationship with the child and family. The nurse should smile, start introductions, give his or her title, and let the child and family know what will happen and what is expected of them. The nurse should also maintain eye contact at the appropriate level, communicate with children at age-appropriate levels, and, with a younger child, start with the family first so the child can see that the family trusts you.
The nurse has applied EMLA cream as ordered. How does the nurse assess that the cream has achieved its purpose? A) Assess the skin for redness. B) Note any blanching of skin. C) Lightly tap the area where the cream is. D) Gently poke the child with a needle.
C
The nurse is reviewing the Adolescent Health Transition Project's recommended schedule for transition planning. According to the schedule, at what age should the nurse explore health care financing for young adults? A) 12 years old B) 14 years old C) 17 years old D) 19 years old
C. -By age 14, the nurse should ensure that a transition plan is initiated and that the individualized education plan (IEP) reflects post-high school plans. -By age 17, the nurse should explore health care financing for young adults. - The nurse should check the teen's eligibility for Supplemental Security Income (SSI) the month the child turns 18. - By age 21, the nurse should ensure that the young adult has registered with the Division of Developmental Disabilities for adult services if applicable.
The nurse working with children in a hospital setting notes that they are being discharged earlier and earlier. Which of the following is a primary reason for this trend? A) Nursing shortages B) Increased funding for home care C) National health care initiatives D) Cost containment
Cost containment Over the past century changes in health care, such as strained health care funding, shorter hospital stays, and cost containment, have led to a shift in responsibilities of care for children from the hospital to homes and communities. Nursing shortages influence the delivery of health care. National health care initiatives may or may not affect earlier discharge to home health care.
An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate? A) Discussing the events with the adolescent and his mother upon arrival the morning of the procedure B) Providing detailed explanations of the procedure at least a week in advance of the procedure C) Encouraging the parent to stay with the adolescent as much as possible before the procedure D) Answering the adolescent's questions with simple answers, encouraging him to ask the surgeon
Providing detailed explanations of the procedure at least a week in advance of the procedure The adolescent needs a detailed explanation about the procedure at least 7 to 10 days beforehand. Waiting until the morning of the procedure would be inappropriate. However, information could be clarified and additional questions could be answered at this time. Having the parent stay with the adolescent is something that the adolescent would need to decide; he may or may not want a parent present. Referring the adolescent to the surgeon for his questions is inappropriate and ignores the adolescent's desire for control and information.
The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse? A) Riley Infant Pain Scale B) Pain Observation Scale for Young Children C) CRIES Scale for Neonatal Postoperative Pain Assessment D) FLACC Behavioral Scale for Postoperative Pain in Young Children
A
The nurse is preparing to assess the pulse of an 18-month-old child. Which pulse would be most difficult for the nurse to palpate? A)Radial B)Brachial C)Pedal D)Femoral
A
When providing care to a dying child and his family, which would be most important? A) Focusing on the family as the unit of care B) Teaching the family appropriate care measures C) Offering the child support and encouragement D) Assisting the parents in decision making
Ans: A Feedback: When caring for a dying child and his family, the most important aspect of care is focusing on the family as the unit of care. Teaching, offering support, and assisting in decision making are important, but these actions must be implemented while focusing on the family as the unit of care.
The nurse is conducting a health history for a 9-year-old child with stomach pains. Which of the following is a recommended guideline when approaching the child for information? A)Wear a white examination coat when conducting the interview. B)Allow the child to control the pace and order of the health history. C)Use quick deliberate gestures to get your point across. D)Do not make physical contact with the child during the interview.
Ans: B
When describing organ donation to the family of a dying child, what would the nurse include in the discussion? A) Telling them that further harm may occur to the child through the process B) Tell them that their cultural and religious beliefs will be considered C) Including this topic in the discussion of impending death D) Informing the family that organ donation will delay the funeral
Ans: B Feedback: During organ donation, the family's cultural and religious beliefs must be considered, and the team discussing organ donation with the family must do so in a sensitive and ethical manner. The donating child will not suffer further because of organ donation. The topic of organ donation should be separated from the discussion of impending death or brain death notification. Organs are harvested in a timely fashion after the declaration of death so the family need not worry about delay of the wake or funeral.
The nurse is providing home care for the family of an 8-year-old boy who is dying of leukemia. Which action will be most supportive to the parents of the child? A) Encouraging organ and tissue donation B) Being patient with parental indecision C) Getting prior authorization for treatments D) Explaining how anorexia is a natural process
Ans: B Feedback: It is critical to be patient with parents who may vacillate when making decisions. Give them the information and time they need to make decisions and avoid being judgmental. Explaining about anorexia and encouraging organ donation may be discussed when the parents indicate they are concerned. Getting prior authorization facilitates care delivery and is not a supportive intervention.
The parents of an 11-year-old boy who is dying from cancer are concerned that he is not eating. Which intervention would serve both the parents' and child's needs? A) Urging the child to eat one good meal per day B) Serving small meals of things the child likes C) Straightening up around the child before meals D) Administering antiemetics as ordered for nausea
Ans: B Feedback: The child is more likely to eat small amounts of foods of his choosing. This accommodates the child's reduced appetite, reassures his parents that he is not starving, and gives the child a sense of control. Straightening up the child's area before meals provides a more pleasant eating environment. The use of antiemetics controls nausea but may not increase appetite. Urging the child to eat a substantial meal is unnecessary and creates stress.
The nurse is caring for a child involved in an automobile accident whose family has been informed that the child is brain dead. What teaching might the nurse provide the family regarding organ donation? A) The nurse should ask about organ donation when the family is informed of their child's condition. B) The nurse should explain that written consent is necessary for the organ donation. C) The nurse should make sure the parents know that procurement of organs may mar their child's appearance. D) The nurse should make sure the parents know that they will be responsible for expenses related to organ procurement.
Ans: B Feedback: Written consent is necessary for organ donation, so the family must be appropriately informed and educated. The discussion of organ donation should be separate from the discussion of impending death or brain death notification. Families need to know that procurement of the organs does not mar the child's appearance, so that an open casket at the child's funeral is still possible if the family desires. All expenses for organ procurement are borne by the recipient's family, not the donor's.
The nurse is caring for a preschool child who is receiving palliative care for end-stage cancer. What would be the focus of age-appropriate interventions for this child? A) Providing unconditional love and trust B) Providing a familiar and consistent routine C) Teaching the child that death is not punishment D) Providing specific, honest details of death
Ans: C Feedback: Spirituality in the preschool years focuses on the concept of right versus wrong. The 3- to 5-year-old may see death as punishment for wrongdoing, and the nurse must correct this misunderstanding. For the infant, unconditional love and trust are of utmost importance. The toddler, 1 to 3 years old, thrives on familiarity and routine; the nurse should maximize the toddler's time with parents, be consistent, provide favorite toys, and ensure physical comfort. The school-age child has a concrete understanding of death. Children who are 5 to 10 years old need specific, honest details (as desired).
Which of the following would the nurse include in the plan of care for a dying child with pain? A) Administering analgesics as needed B) Using measures the nurse finds comforting C) Playing the television or radio so the child can hear it D) Changing the child's position frequently but gently
Ans: D Feedback: Pain management includes changing the child's position frequently but gently to minimize discomfort. Analgesics are given around the clock rather than as needed. The nurse would use measures that the child finds comforting to provide additional relief. A calm environment with minimal noise and light is helpful.
The nurse is assessing the temperature of a diaphoretic toddler who is crying and being uncooperative. What would be the best method to assess temperature in this child? A)Oral thermometer B)Axillary method C)Temporal scanning D)Rectal route
B
The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which of the following statements accurately describes a recommended guideline for setting the tone of the examination for a school-age child? A)Keep up a running dialogue with the caregiver, explaining each step as you do it. B)Include the child in all parts of the examination; speak to the caregiver before and after the examination. C)Speak to the child using mature language and appeal to his or her desire for self-care. D)Address the child by name; speak to the caregiver and do the most invasive parts last.
B
While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft and quiet and heard each time the heart is auscultated. The nurse documents this finding as which of the following? A)Grade 1 B)Grade 2 C)Grade 3 D)Grade 4
B
The nurse is helping a 20-year-old woman transition to adult care. Which would be the most important role of the nurse following a successful transition? A) Teacher B) Consultant C) Care provider D) Advocate
B. Transition planning involves multidisciplinary care coordination; acknowledgment of the changing roles among the youth, family, and health care professionals; and fostering of the youth's self-determination skills. - Prior to transition, educating the client is the most important role of the nurse. - After the transition, the nurse serves as a consultant to the adult office in relation to the teen's needs. The nurse consults with a transition services coordinator or other service agency as available in the local community.
The nurse is caring for a 14-year-old girl with special health needs. What is the priority intervention for this child? A) Encouraging the parents to promote the child's self-care B) Assessing the child for signs of depression C) Discussing how her care will change as she grows D) Monitoring for compliance with treatment
C) Discussing how her care will change as she grows
The nurse is looking into the Individuals with Disabilities Education Improvement Act of 2004 to help provide resources for a client with multiple chronic diseases. What are mandates of this legislation? Select all that apply. A) The law mandates government-funded care coordination and special education for children up to 8 years of age. B) This early intervention program is a state-funded program run at the federal level. C) This federal law allows each state to define "developmental disability" differently. D) An evaluation of the child's physical, language, emotional, and social capabilities is performed to determine eligibility. E) The primary care nurse manages the developmental services and special education that the child requires. F) The goal is to maintain a natural environment, so most services occur in the home or day care center.
C, D, F The Individuals with Disabilities Education Improvement Act of 2004 mandates government-funded care coordination and special education for children up to 3 years of age. Federal law allows each state to define "developmental disability" differently, but in general an evaluation of the child's physical, language, emotional, and social capabilities is performed by qualified personnel to determine eligibility. The goal of the program is that the child receives services in a "natural environment," so most services occur in the home or day care center. This early intervention program is administered through each state. Children who qualify for services receive care coordination, and the service coordinator manages the developmental services and special education that the child requires.
The nurse is teaching the student nurse about abnormal findings when assessing the breasts of children. Which of the following may be associated with renal disorders? A)Swollen nipples upon inspection of a newborn's breasts B)Tender nodule palpated under the nipple of a 10-year-old C)Observation of enlarged breast tissue in a male adolescent D)Observation of a supernumerary nipple along the mammary ridge
D
The nurse is using pulse oximetry to measure oxygen saturation in a 3-year-old girl. The nurse understands that falsely high readings may be associated with which situation or condition? A)A nonsecure connection B)Cold extremities C)Hypovolemia D)Anemia
D
The nurse is using the acronym QUESTT to assess the pain of a child. Which of the following is an accurate descriptor of this process? A) Question the child's parents. B) Understand the child's pain level. C) Establish a caring relationship with the child. D) Take the cause of pain into account when intervening.
D
The nurse uses the FLACC behavioral scale to assess a 6-year-old's level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing: A) Little to no pain B) Mild pain C) Moderate pain D) Severe pain
D
Which tool would be the least appropriate scale for the nurse to use when assessing a 4- year-old child's pain? A) FACES pain rating scale B) Oucher pain rating scale C) Poker chip tool D) Numeric pain intensity scale
D
The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which of the following criteria must occur to ensure proper use of these restraints? Select all answers that apply. A) The nurse must check the restraints every 15 minutes while they are in place. B) Secure the restraints with ties to the side rails, not the bed or crib frame. C) Assess the temperature of the affected extremities, pulses, and capillary refill every 15 minutes after placement. D) Use a clove-hitch type of knot to secure the restraints with ties. E) Remove the restraint every 2 hours to allow for range of motion and repositioning. F) Encourage parent participation, providing continuous explanations about the reasons and time frame for restraints.
D, E, F The nurse should use a clove-hitch type of knot to secure the restraints with ties, remove the restraint every 2 hours to allow for range of motion and repositioning, and encourage parent participation, providing continuous explanations about the reasons and time frame for the restraints. The nurse must check restraints 15 minutes following initial placement and then every hour for proper placement and secure the restraints with ties to the bed or crib frame, not the side rails. The nurse should also assess the temperature of the affected extremities, pulses, and capillary refill, initially after 15 minutes and then every hour after placement.
The nurse caring for young children in a hospice setting is aware of the following statistics related to the occurrence of death in children. Which statement accurately reflects one of these statistics? A) Each year, about 50,000 children die in the United States; of those, about 15,000 are infants. B) It is unusual for a child's chronic illness to progress to the point of becoming a terminal illness. C) Despite strides made, diabetes remains the leading cause of death from disease in all children older than the age of 1 year. D) Congenital defects and traumatic injuries are the most common causes of diseases leading to death.
D. Diseases can lead to terminal illness in children, with congenital defects and traumatic injuries being the more common causes. Each year, about 45,000 children die in the United States; of those, about 24,500 are infants (Heron et al., 2013). In many cases, a child's chronic illness may progress to the point of becoming a terminal illness. Cancer remains the leading cause of death from disease in all children older than the age of 1 year (Heron et al., 2013).
The nurse is providing home care for a 1-year-old girl who is technologically dependent. Which intervention will best support the family process? A) Finding an integrated health program for the family B) Teaching modifications of the medical regimen for vacation C) Assessing family expectations for the special needs child D) Creating schedules for therapies and interventions
D. Coordinating care with the schedules and capabilities of the parents provides the greatest support for the family. It gives them a sense of order and control. Integrated health care programs may not be available in the family's area. Teaching therapy modifications for travel and assessing family expectations are not supportive interventions.
The nurse is weighing an underweight infant diagnosed with failure to thrive (FTT) and notes that the baby does not make eye contact and is less active than the other infants. What would be a probable cause for the FTT related to the infant's body language? A) Congenital heart defect B) Cleft palate C) Gastroesophageal reflux disease D) Maternal abuse
D. Infants with FTT related to maternal neglect may avoid eye contact and be less interactive than other infants. Inorganic causes of FTT include neglect, abuse, behavioral problems, lack of appropriate maternal interaction, poor feeding techniques, lack of parental knowledge, or parental mental illness.
The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. Which of the following would be the best intervention? A) Offer the child reading materials. B) Enlist the aid of a child life specialist. C) Encourage the child to complete his homework. D) Ask for the parents' assistance.
Enlist the aid of a child life specialist. The nurse should enlist the aid of a child life specialist to provide suggestions for appropriate activities. Offering the child reading materials or encouraging him to complete his homework would most likely be met with resistance as he has already verbalized his boredom and disinterest in play, reading, and schoolwork. The parents could offer the child life specialist ideas about the boy's likes and dislikes; however, the child life specialist could offer expertise in assisting hospitalized children.
Community-based nursing provides opportunities that are quite different from acute care nursing. Which of the following job characteristics is unique to home care nursing? A) Experiencing a greater amount of independence B) Building a close relationship with the family C) Coordinating therapy services and reimbursements D) Focusing teaching on child independence
Experiencing a greater amount of independence The nurse in the home care setting experiences a greater amount of independence due to the lack of co-workers, supervisors, or doctors. Building a close relationship with the family, coordinating services and reimbursement, and teaching self-care to the child are not unique to the home care setting.
The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control? A) Ask the child to identify her areas of concern. B) Encourage participation of parents in care activities. C) Offer the girl as many choices as possible. D) Enlist the family's assistance in creating a time schedule.
Offer the girl as many choices as possible. The nurse needs to offer the girl as many choices as possible, such as options for food and drink (as her diet allows), hygiene, activities, or clothing options to promote feelings of individuality and control. Two of the other options engage the parents in the process. A 13-year-old girl is capable of making her own choices regarding activities, schedules, and routine, but she may not be able to identify her areas of concern.
The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which of the following would be a priority intervention to help satisfy this preschool child's basic needs? A) Encourage friends to visit as often as possible. B) Suggest that a family member be present with her 24 hours a day. C) Explain necessary procedures in simple language that she will understand. D) Allow her to make choices about her meals and activities as much as permitted.
Explain necessary procedures in simple language that she will understand. Preschoolers fear mutilation and are afraid of intrusive procedures since they do not understand the body's integrity. They interpret words literally and have an active imagination; therefore, procedures should be demonstrated and/or explained in simple terms. Adolescents typically do not experience separation anxiety from being away from their parents; instead, their anxiety comes from being separated from friends, and therefore encouraging friends to visit is a priority intervention. Toddlers are especially susceptible to separation anxiety and would benefit from a family member being present as much as possible. School-age children are accustomed to controlling self-care and typically are highly social; they would benefit from being involved in choices about meals and activities.
When preparing to apply a restraint to a child, which of the following would be most important for the nurse to do? A) Expect to keep the restraint on for at least 8 hours. B) Explain that safety, not punishment, is the reason for the restraint. C) Plan to use a square knot to secure the restraint to the side rails. D) Use a limb restraint rather than a jacket restraint for most issues.
Explain that safety, not punishment, is the reason for the restraint. Before applying a restraint, the nurse needs to explain the reason for the restraint to the child, emphasizing that the restraint is for safety, not to punish the child. The least restrictive type of restraint should be used, and it should be applied for the shortest time necessary. A clove-hitch knot is used to secure the restraint with ties to the bed or crib frame, not the side rails.
The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention? A) Enlist the assistance of a child life specialist. B) Explain to the boy that he must keep his leg very still. C) Apply a clove-hitch restraint to the boy's left leg. D) Explain that a restraint will be applied if he cannot hold still.
Explain to the boy that he must keep his leg very still. An explanation about the desired goal is necessary and appropriate for a 7-year-old child to understand what is required. In many cases, this will be all that is needed. Explaining that a restraint will be applied if the boy cannot hold still will likely be perceived as a threat or punishment. All alternative measures need to be tried before the use of restraints. Enlisting the assistance of the child life specialist is not a priority.
The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. Which of the following would be the best teaching method for this child and his family? A) Demonstrate the care and ask for a return demonstration. B) Provide and review educational booklets and materials. C) Provide a written schedule for the child's care. D) Provide a trial period of home care.
Provide a trial period of home care. Parents of children with multiple medical needs may benefit from a trial period of home care. This occurs while the child is still in the hospital, but the parents or caregivers provide all of the care that the child requires. The other options are also important teaching methods, but a trial period is the best solution for a child with multiple medical conditions.
The nurse is caring for a 10-year-old girl who is in an isolation room. Which of the following interventions would be a priority intervention for this child? A) Reduce noise as much as possible. B) Provide age-appropriate toys and games. C) Discourage visits from family members. D) Put on mask prior to entering the room.
Provide age-appropriate toys and games. Children in this setting may experience sensory deprivation due to the limited contact with others and the use of personal protective equipment such as gloves, masks, and gowns. The nurse should stimulate the child by playing with her with age-appropriate toys/games. Reducing noise would be appropriate for sensory overload. The nurse should encourage the family to visit often, introduce him- or herself before entering the room, and allow the child to view his or her face before applying a mask.
The nurse is working as a community health care nurse. What would be the nurse's focus when providing care of the child? A) Providing care to the individual and family in acute care settings B) Providing care to the indigent in family care settings C) Providing care in geographically and culturally diverse settings D) Providing care for particular age groups or particular diagnoses
Providing care in geographically and culturally diverse settings Community health nurses work in geographically and culturally diverse settings. They address current and potential health needs of the population or community. Community-based nursing focuses more on providing care to the individual or family (which, of course, impacts the community) in settings outside of acute care. They promote and preserve the health of a population and are not limited to particular age groups, income levels, or diagnoses.
The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors? A) Puppets and dolls B) Drawing paper and crayons C) Wooden hammer and pegs D) Sewing puppets with needles
Sewing puppets with needles The nurse understands that the child may benefit from supervised needle play to assist the child undergoing frequent blood work, injections, or intravenous procedures. The child life specialist can determine what form of therapeutic play is best, but the nurse can recommend interventions based on his or her knowledge of the specific child.
The nurse is teaching a group of parents with premature infants about the various medical and developmental problems that may occur. The nurse determines that additional teaching is needed when the group identifies what as a problem? A) Sudden infant death syndrome B) Hydrocephalus C) Peptic ulcer D) Bronchopulmonary dysplasia
c. Gastroesophageal reflux disease, not peptic ulcer, is a medical problem that commonly affects premature infants. - infant death syndrome, hydrocephalus, bronchopulmonary dysplasia, cardiac changes, growth retardation, nutrient deficiencies, bradycardia, rickets, inguinal or umbilical hernias, visual problems, hearing deficits, delayed dentition, and growth delays.