Review
A group of nurses is reviewing the cardiovascular system and its function. Which statement by one of the nurses demonstrates an understanding of a child's cardiovascular system?
"At birth, the infant's right and left ventricle are about the same size."
A nursing student tells the staff nurse on the pediatric orthopedic unit that she has heard of a musculoskeletal disorder in which there is an infection of the bone. Which disorder does this statement describe?
osteomyelitis
The nurse is caring for a child with a diagnosis of rotavirus. What is the highest priority at this time?
Improving hydration
The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education?
"Because our child is being treated by using braces, the braces will have to be worn almost all the time."
The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever?
"Children who have this diagnosis may have had strep throat."
The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first?
"Has the child ever eaten shellfish before now?"
The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure?
"He was just staring into space and was totally unaware."
The nurse is preparing a child for discharge following a sickle cell crisis. Which statement by the mother indicates a need for further teaching?
"She has been down, but playing in soccer camp will cheer her up."
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system?
"The largest organ of the body helps regulate body temperature."
A nurse is reinforcing teaching with a parent of a 1-month-old infant who is to undergo the initial surgery to treat Hirschsprung's disease. Which of the following statements should indicate to the parent understand the goal of therapy?
'm glad the ostomy is only temporary"
The nurse caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply.
-Time the seizure started -Incontinence of urine or stool -Eye position and movement -Factors present before seizure started
The health care provider orders amoxicillin 35 mg/kg/day in three divided doses for a child with otitis media. The child weighs 44 lb and the medication is available in a suspension of 50 mg/ml. What is the total daily dosage in ml for this child?
14.0
The musculoskeletal system is made up of various types of bones. Most bone growth is completed by which age?
20 years old
The nurse is bottle feeding an infant diagnosed with pneumonia. An important action for the nurse to take is clearing the infant's nose, and then the nurse should feed the infant using which of the following?
A nipple that is small enough so that the baby doesn't choke, but not so small that he or she has to work too hard to eat
A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following findings should the nurse identify as indicating viral meningitis? Select all that apply.
A. Negative Gram stain B. Normal glucose content E. Normal protein content
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?
Blood pressure 136/84
The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take?
Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. Isotretinoin is a pregnancy category X drug: It must not be used at all during pregnancy because of serious risk of fetal abnormalities. To rule out pregnancy, a urine test is done before beginning treatment. For the sexually active adolescent girl, an effective form of contraception must be used for a month before beginning and during isotretinoin therapy. The risk to the fetus, should pregnancy occur, should be discussed with the girl whether she is sexually active or not.
The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?
Administer subcutaneous glucagon
The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which issues should be reported if they occur or are seen related to this child? Select all that apply.
Any area on the cast that is warm to the touch A foul odor under the cast Drainage from under the cast Looseness of the cast on the extremity
The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child?
Apply ice to the affected area
What information is most correct regarding the nervous system of the child?
As the child grows, the gross and fine motor skills increase.
A pediatric nurse explains discharge instructions to the parents of a child who is postoperative from a tonsillectomy. Which instruction does the nurse stress?
Avoid highly seasoned and "sharp" foods.
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:
obtaining a clean catch voided urine.
The caregiver of a 6-month-old boy calls the nurse concerned about her child. The child has been irritable, fussy, and is sneezing. The child's temperature is 100F (37.8C). The nurse suspects that the cause of the symptoms is:
Common cold
The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which clinical manifestations would the nurse most likely note in this child?
Drowziness and fruity odor to breath Explanation: Diabetic ketoacidosis is characterized by drowsiness, decreased skin turgor, acetone breath with a fruity smell, and Kussmaul breathing (abnormal increase in the depth and rate of the respiratory movements). Nausea and vomiting may occur. If untreated, the child lapses into coma and exhibits dehydration, electrolyte imbalance, rapid pulse, and subnormal temperature and blood pressure.
In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure?
During this procedure, small tubes are inserted into the typmpanic membrane.
The nurse is teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family?
Encourage everyone in the family to use good hand-washing techniques.
When caring for a child with acute bronchiolitis, which nursing interventions should be included in the plan of care? Select all that apply.
Encourage fluids Administer oxygen Place child in mist tent Follow contact precautions The child is treated with high humidity by mist tent, rest, and increased fluids. Oxygen may be administered. Antibiotics are not prescribed because the causative organism is a virus. IV fluids often are administered to ensure an adequate intake and to permit the infant to rest. The hospitalized child is placed on contact transmission precautions to prevent the spread of infection.
The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and the tongue out. The nurse recognizes these symptoms as those seen with which disorder?
Epiglottitis
Which of the following is not a chest physiotherapy technique?
Extracting oropharyngeal secretions
Doctor orders Cefazolin 350 mg IV every 4 hours. The child weighs 31 lbs. The safe dose range for this medication is 25-75 mg/kg/day. Is this dose safe for this patient?
False
The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child
Feels increasing severe pain
The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?
Handling the cast with open palms when moving the arm.
The nurse is collecting data on an 18-month-old admitted with a diagnosis of possible seizures. When interviewing the caregivers, which questions would be most important for the nurse to ask
Have you checked your child temperature
Which nursing actions are essential for safety when providing care to a pediatric patient at risk for respiratory compromise? Select all that apply.
Identifying distress Supporting a compromised airway Choosing the appropriate method of oxygen
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?
In this disorder the sphincter that leads into the stomach is relaxed.
The caregivers of a child just diagnosed with diabetes express concern that they won't remember the different signs and symptoms of hyperglycemia and hypoglycemia. As a result, they are afraid they won't handle an emergency correctly. What is the best initial response by the nurse to help ensure the child's safety?
Instruct them to treat the reaction as if it's hypoglycemia, which is more likely.
A 4-year-old child is brought to the emergency department with a high fever, swollen eyes, and a bright colored tongue. The parents state, "The fever has lasted 6 days and is not responding to Tylenol or Ibuprofen." Which condition does the nurse suspect?
Kawasaki Disease
What statement is the most accurate regarding the structure and function of the newborn's respiratory system?
Most infants are nasal breathers rather than mouth breathers.
The nurse caring for a deaf child is preparing to give the child an intramuscular injection in the child's upper arm. The child's attention is focused on the caregiver on the opposite side of the bed. Before administering the injection, it would be most important for the nurse to do which of the following?
Move around the bed and make eye contact, then show the child the syringe and indicate that the shot is going to be given.
A symptom often seen in the child diagnosed with Haemophilus influenza meningitis occurs when the child has a stiff neck. This symptoms is referred to as which of the following?
Nuchal rigidity
The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis. Which medication would most likely be prescribed for the child?
Nystatin
In developing a plan of care for the child diagnosed with rheumatic fever, the nursing intervention that takes highest priority for this child is to:
Promote rest periods and bed rest
Which teaching point should the nurse include in the discharge instructions for a pediatric patient recovering from subacute bacterial endocarditis?
Prophylactic antibiotics are required for any dental, oral, or upper respiratory tract prodecures
The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which vital sign might indicate the possibility of an infection?
Pulse rate 135 bpm
Which data collected during the pediatric respiratory assessment require further action by the nurse? Select all that apply.
Stridor Nasal flaring Substernal retractions
The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. What would be the best action for the caregiver to follow in removing the tick?
The caregiver should use tweezers and remove carefully
What statement made by the nurse accurately describes the difference between the respiratory systems of a child and an adult?
The epiglottis in the younger child is longer and flaccid, making it more susceptible to swelling that may lead to airway occlusion.
A breastfeeding mother asks a nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concern?
The first food offered to the infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive iron and vitamin D.
The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority?
The nurse follows contact precautions.
When caring for a child who has a urinary tract infection, which nursing interventions would be most appropriate? Select all that apply.
The nurse observes for signs of pain or burning on urination The nurse administers antipyretics as needed. The nurse monitors intake and output.
The nurse is caring for a child with congestive heart failure and is administering the drug digoxin. At the beginning of this drug therapy, the process of digitalization is done for which reason?
To build the blood levels to a therapeutic level
Which of these age groups has the highest actual rate of death from drowning?
Toddlers Toddlers and older adolescents have the highest actual rate of death from drowning.
A nurse is assessing a 6 month old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question as to what the infant should be learning at this point in life?
Trust
The nurse assess an infant with suspected congenital heart disease. The nurse notes which findings are specific to patent ductus arteriosus (PDA)? Select all that apply.
Wide pulse pressure Fluctuating blood pressure
The parent of a child diagnosed with intussusception asks the nurse why the child's stool looks so strange. How should the nurse reply?
Your child's stool is mixed with blood and mucus, so it looks very different.
The nurse notices that a child's lips are bluish in color and the child's skin appears pale. What is the nurse's priority action?
administer oxygen
A child presents with a barking cough and, when auscultating the lungs, the nurse notes stridor upon inspiration. The nurse suspects that the child has which respiratory infection?
croup
The nurse is educating a group of caregivers about fractures seen in children. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in the:
epiphyseal plate
A nurse admits an infant with a possible diagnosis of congestive heart failure. Which signs or symptoms would the infant most likely be exhibiting?
feeding problems
The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other clients, the nurse should:
follow standard precautions
A nurse is collecting data from a 4-month-old infant who has meningitis. Which of the following manifestations should the nurse expect?
high pitched cry
A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, which parts of the body (besides the lungs) are most affected by this disease?
pancreas and liver
The nurse is doing neurovascular checks on a child who has had a cast applied to treat a fracture. The nurse observes for diminished or absent sensation and numbness or tingling. In doing this the nurse is monitoring for which symptom?
paresthesia
The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?
projectile vomiting
The nurse is caring for a 3-year-old diagnosed with diabetes mellitus. The child's eating patterns are unpredictable. One day the child will eat almost nothing, the next day the child eats everything on her tray. The nurse recognizes that this type of insulin would most likely be used in treating this child?
rapid acting insulin
The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?
spica cast
The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?
tea colored urine
