RQ 7

After undergoing eye surgery, the client reports being nauseated. Which intervention should the postanesthesia care unit (PACU) recovery room nurse implement?

1. Administer an IV antiemetic medication. prevent vomiting because it increases IOP

The client diagnosed with glaucoma is prescribed oral acetazolamide. Which information should the client discuss with the client?

1. Administer the medication in the morning. The oral medication acetazolamide (Diamox), a carbonic anhydrase inhibitor, has a diuretic effect; therefore, it should be taken in the morning to prevent sleep deprivation because of the need to get up to urinate during the night.

7. The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding?

1. Frequent swallowing

The nurse is teaching parents how to instill antibiotic otic drops in their 6-year-old child diagnosed with otitis media. Which instruction should the nurse discuss with the parents? Select all that apply.

1. Insert the otic medication in the affected ear after pulling the earlobe upward and back. 2. After instilling medication, gently massage the area immediately anterior to the ear. 4. Allow the child to lie quietly on the side after instilling ear drops into the affected ear.

The parent of a 23-month-old child diagnosed with acute otitis media calls the clinic and tells the nurse their child is crying and pulling at her ears. Which action should the nurse implement?

1. Instruct the parent to give acetaminophen elixir as prescribed on the bottle.

The client diagnosed with Meniere's disease, also known as endolymphatic hydrops, is prescribed meclizine. Which statement best describes the scientific rationale for this medication?

1. It will help decrease the whirling sensation experienced in Meniere's disease. antivertigo medication, helps prevent dizziness and the whirling sensation characteristic of Meniere's disease.

1. The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which action would the nurse perform immediately?

1. Notify the surgeon. Colorless drainage on the dressing in a child after craniotomy indicates the presence of cerebrospinal fluid

2. A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock. Which is the most appropriate nursing action?

1. Notify the surgeon. In the event of shock, the surgeon is notified immediately.

3. The parent of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the parent tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms' tumor, would plan to avoid which during the physical assessment?

1. Palpating the abdomen for a mass Wilms' tumor is the most common intra-abdominal and kidney tumor of childhood. If Wilms' tumor is suspected, the tumor mass would not be palpated by the nurse. Excessive manipulation can cause seeding of the tumor and spread of the cancerous cells.

10. A child has been diagnosed with acute otitis media of the right ear. Which interventions would the nurse include in the plan of care? Select all that apply.

1. Provide a soft diet. 5. Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6. Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

9. The nurse is reviewing a pediatrician's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record would the nurse question? Select all that apply.

1. Restrict fluid intake. 6. Give meperidine, 25 mg intravenously, every 4 hours for pain.

8. The nurse provides home care instructions to the parents of a child with celiac disease. The nurse would teach the parents to include which food item in the child's diet?

1. Rice The important factor to remember is that all wheat, rye, barley, and oats need to be eliminated from the diet and replaced with corn, rice, or millet.

5. The clinic nurse is reviewing the pediatrician's prescription for a child who has been diagnosed with lice. Lindane shampoo has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record?

1. The child is 18 months old. It is contraindicated for children younger than 2 years because they have more permeable skin, and high systemic absorption may occur, placing the children at risk for central nervous system toxicity and seizures.

The 3-year-old child diagnosed with an eye infection has an ophthalmic ointment and ophthalmic drops prescribed. Which action by the primary nurse warrants intervention by the charge nurse?

1. The primary nurse applies ophthalmic ointment first.

1. After a tonsillectomy, a child begins to vomit bright red blood. The nurse would take which initial action?

1. Turn the child to the side. prevent aspiration

6. The nurse is monitoring a 3-year-old child for signs and symptoms of increased intracranial pressure (ICP) after a craniotomy. The nurse would plan to monitor for which early sign or symptom of increased ICP?

1. Vomiting Vomiting, an early sign of increased ICP, can become excessive as pressure builds up and stimulates the medulla in the brainstem, which houses the vomiting center.

10. The nurse is conducting staff in-service training on von Willebrand's disease. Which would the nurse include as characteristics of von Willebrand's disease? Select all that apply.

1.Easy bruising occurs. 2.Gum bleeding occurs. 3.It is a hereditary bleeding disorder. 4.Treatment and care are similar to that for hemophilia. 6.The disorder causes platelets to adhere to damaged endothelium.

10. Which interventions would the nurse include when creating a care plan for a child with hepatitis? Select all that apply.

1.Providing a low-fat, well-balanced diet 2.Teaching the child effective handwashing techniques 5. Instructing the parents to avoid administering medications unless prescribed

Which statement indicates that the parent understands the procedure for administering otic drops to the child diagnosed with otitis media?

2. "I will warm the drops to room temperature before instilling them." Cold otic drops cause pain when they contact the tympanic membrane; therefore, otic solutions should be allowed to warm to room temperature before being administered.

The 3-year-old female child is diagnosed with acute otitis media. Which statement by the parent indicates to the nurse that the parent needs more teaching?

2. "My son started pulling at his ears, so I gave him some of my daughter's antibiotics."

4. The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for further instruction?

2. "The child does not experience pain at the primary tumor site." Osteosarcoma is manifested clinically by progressive, insidious, and intermittent pain at the tumor site. By the time these children receive medical attention, they may be in considerable pain from the tumor.

3. The nursing student is presenting a clinical conference and discusses the cause of β-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these?

2. A child of Mediterranean descent

8. The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply.

2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 6. Infants and young children are at increased risk for protein and calorie deficiency, because they have smaller muscle mass and less body fat than adults.

The mother of a 13-year-old child diagnosed with external otitis tells the nurse her child spends a lot of time swimming. Which information is most important for the nurse to discuss with the mother?

2. Administer a drying agent in the ear canal after swimming. This is the most important information for the nurse to teach because, although suggesting ways to prevent water from entering is helpful, the client must dry the canal to prevent further external otitis episodes.

The client diagnosed with Meniere's disease is admitted with an acute attack and prescribed IV diazepam. Which intervention should the nurse implement when administering this medication?

2. Administer the diazepam undiluted via a saline lock. Diazepam (Valium), a sedative-hypnotic, cannot be diluted because it is oil based and will not dissolve with normal saline.

7. The nurse is preparing to instruct the parents of a child with iron-deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction would the nurse give the parents?

2. Administer the iron through a straw. iron stains the teeth.

The client reports having dry and irritated eyes to the clinic nurse. Which intervention should the nurse implement first?

2. Assess the eyes for any redness or discharge. determine infection.

7. A 4-year-old child is admitted to the hospital for abdominal pain. The parents report that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory result confirms the diagnosis?

2. Bone marrow biopsy showing blast cells

2. The parent of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation?

2. Possible sexual abuse A diagnosis of chlamydial conjunctivitis in a child who is not sexually active would signal the health care provider to assess the child for possible sexual abuse. Trauma, allergy, and infection can cause conjunctivitis, but the causative organism is not likely to be Chlamydia.

7. The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the parent about the child's symptoms?

2. Projectile vomiting In pyloric stenosis, hypertrophy of the circular muscles of the pylorus causes narrowing of the pyloric canal between the stomach and the duodenum.

4. The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review?

2. Prothrombin time . The prothrombin time results would identify a potential for bleeding.

10. Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? Select all that apply.

2. Reduce exposure to environmental organisms. 3. Use strict aseptic technique for all procedures. 4. Ensure that anyone entering the child's room wears a mask

5. The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position?

2. Side-lying to be placed in a prone or side-lying position after the surgical procedure to facilitate drainage.

6. After a tonsillectomy, the nurse reviews the surgeon's postoperative prescriptions. Which prescription would the nurse question?

2. Suction every 2 hours. suction equipment needs to be available, but suctioning is not performed unless there is an airway obstruction because of the risk of trauma to the surgical site.

The client diagnosed with nasal congestion is prescribed a nasal solution. Which information should be included in the medication teaching?

2. Tell the client to blow the nose before instilling the solution. clear nasal passages.

9. The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation made by the nurse indicates the presence of this condition?

2. The child consistently tilts the head to see. Strabismus is a condition in which the eyes are not aligned because of lack of coordination of the extraocular muscles. The nurse may suspect strabismus in a child when the child complains of frequent headaches, squints, or tilts the head to see.

To which client should the HCP recommend an OTC ceruminolytic?

2. The client diagnosed with impacted earwax helps remove ear wax.

The primary nurse is administering antibiotic otic drops to a 2-year-old child. Which action by the primary nurse warrants intervention by the charge nurse?

2. The primary nurse dons nonsterile gloves before inserting the otic drops.

The 4-year-old child diagnosed with otitis media with effusion is not prescribed systemic antibiotics. The parent asks the nurse, "Why didn't the doctor order antibiotics for my child?" Which statement is the nurse's best response?

3. "Because your child did not have a fever, the doctor did not order antibiotics."

3. The nurse prepares a teaching plan for the parent of a child diagnosed with bacterial conjunctivitis. Which, if stated by the parent, indicates a need for further teaching?

3. "It is okay to share towels and washcloths." Conjunctivitis is an inflammation of the conjunctiva. Bacterial conjunctivitis is highly contagious, and the nurse would teach infection control measures. These include good handwashing and not sharing towels and washcloths.

4. The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction?

3. "Lesions most often are located on the arms and chest."

8. A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandparent of the child visits and brings a fresh bouquet of flowers picked from the garden and asks the nurse for a vase for the flowers. Which response would the nurse provide to the grandparent?

3. "The flowers from your garden are beautiful, but cannot be placed in the child's room at this time." neutropenic child, flowers or plants would not be kept in the room, because standing water and damp soil harbor Aspergillus and Pseudomonas aeruginosa, to which the child is susceptible.

1. The nurse is monitoring a child with burns during treatment. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation?

3. Adequacy of capillary filling

The nurse is preparing to administer ophthalmic medication to the client. To which area should the nurse administer the medication?

3. C Middle lower eye.

8. A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted?

3. Capillary refill is less than 2 seconds.

The pediatric nurse is administering nasal medication to the 13-month-old child. Which intervention should the nurse implement?

3. Turn the child's head slightly from side to side and back to midline. disperse medication to the maxillary and frontal sinuses.

The nurse is instructing the adult client diagnosed with external otitis how to instill otic drops. How should the nurse teach the interventions? Rank in order of performance.

3. Warm the medication by holding the container in hand for 5 minutes. 4. Tilt the head toward the unaffected side when in the sitting position. 2. Demonstrate pulling the pinna of the ear up and back when inserting drops. 5. Administer the prescribed number of drops into the ear canal. 1. Loosely place a small piece of cotton in the auditory meatus.

The client is diagnosed with allergies and rhinitis. The HCP prescribed OTC fluticasone nasal spray. How should the nurse teach the client to position themselves to administer the nasal spray?

3. bend at the waist head down

4. A child with β-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication would the nurse anticipate being prescribed?

4. Deferoxamine To prevent organ damage from too much iron, chelation therapy with either deferasirox or deferoxamine may be prescribed. Deferoxamine is classified as an antidote for acute iron toxicity

4. The nurse provides feeding instructions to the parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction would the nurse give to the parent to assist in reducing the episodes of emesis?

4. Thicken the feedings by adding rice cereal to the formula. Small, more frequent feedings with frequent burping often are prescribed in the treatment of gastroesophageal reflux. Feedings thickened with rice cereal may reduce episodes of emesis. If thickened formula is used, cross-cutting of the nipple may be required.

5. The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 mm3 (19.5 × 109/L). On the basis of this laboratory result, which intervention would the nurse include in the plan of care?

1. Initiate bleeding precautions. low platelet count

2. An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse would place the infant in which best position at this time?

3. Left lateral position nurse avoids positioning an infant on the side of the repair or in the prone position, because these positions can cause rubbing of the surgical site on the mattress

5. A child is hospitalized because of persistent vomiting. The nurse would monitor the child closely for which problem?

3. Metabolic alkalosis Vomiting causes the loss of hydrochloric acid and subsequent metabolic alkalosis.

The client diagnosed with bilateral conjunctivitis is prescribed antibiotic ophthalmic ointment. Which interventions should the nurse implement when discussing the medication with the client? Select all that apply.

1. Apply a thin line of ointment evenly along the inner edge of the lower lid margin. 2. Press the nasolacrimal duct after applying the antibiotic ointment. 5. Instruct the client to sit with the head slightly tilted back or lie supine.

The nurse is discussing how to instill artificial tears into the client's eyes. Which information should the nurse discuss with the client? Select all that apply.

1. Do not allow the artificial tear dropper to touch the eye. 2. Keep the eyes closed 1 to 2 minutes after instilling drops. 4. Wash the hands before instilling the artificial tears into the eyes.

2. The parent of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin?

1. Fine grayish red lines. Scabies appears as burrows or fine, grayish red, threadlike lines.

The client diagnosed with glaucoma is prescribed epinephrine ophthalmic drops. Which statement indicates the client understands the teaching?

1 "I will call my HCP if I start experiencing any eye pain." indicates attack of angle closure glaucoma

The client diagnosed with glaucoma is prescribed latanoprostene bunod ophthalmic medication. Which information should the nurse discuss with the client? Select all that apply.

1 Place the ophthalmic medication in the lower conjunctival sac. 3. Remove contact lenses for medication administration. 5. Store the unopened ophthalmic medication in the refrigerator. 6. Notify the HCP if you notice a brownish color of the iris of the eye or eyelid.

8. Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided?

1. "Administer the antibiotics until they are gone."

The nurse is administering ophthalmic medication to the client. To which area should the nurse instruct the client to apply pressure for 1 to 2 minutes after instilling the medication?

1. A. inner eye increase local effect and decrease systemic absorption.

5. The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction?

4. Fluid overload The parents of a child with sickle cell disease would encourage fluid intake of 1.5 to 2 times the daily requirement to prevent dehydration.

1. The clinic nurse reviews the record of an infant and notes that the primary health care provider (PHCP) has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the parent to seek health care for the infant?

4. Foul-smelling ribbon-like stools

4. An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings would the nurse expect to note?

4. Fruity breath odor and decreasing level of consciousness Signs of hyperglycemia

6. A child with type 1 diabetes mellitus is brought to the emergency department by the parents, who state that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?

4. Normal saline infusion Rehydration is the initial step in resolving diabetic ketoacidosis. Normal saline is the initial IV rehydration fluid.

1. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child?

4. Partial thromboplastin time

The 2-year-old child is diagnosed with acute otitis media. Which intervention will help increase the parent's compliance with the medical regimen?

4. Provide written and oral instructions about antibiotic therapy.

8. Laboratory studies are performed for a child suspected to have iron-deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?

4. Red blood cells that are microcytic and hypochromic

The client diagnosed with multiple mouth ulcers is prescribed nystatin oral suspension. Which interventions should the nurse implement when administering this medication? Select all that apply.

2. Encourage the client to swish medication in the mouth for at least 2 minutes. 5. Teach the client to avoid eating for 5 to 10 minutes after using the medication.

Which statement best describes the scientific rationale for administering mydriatic ophthalmic medication to a client diagnosed with glaucoma?

2. It dilates the pupil to reduce aqueous humor production. Mydriatic medications dilate the pupil, reduce aqueous humor production, and increase absorption effectiveness of aqueous humor, reducing intraocular pressure in open-angle glaucoma.

5. A parent brings a 2-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation?

2. It is negative. It is characterized by blood phenylalanine levels greater than 20 mg/dL (1210 mcmol/L); normal level is 0 to 2 mg/dL (0 to 121 mcmol/L).

3. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record?

3. Choking with feedings any child who exhibits the "3 Cs"—coughing and choking with feedings and unexplained cyanosis— would be suspected to have tracheoesophageal fistula.

The client diagnosed with seasonal allergies is reporting ocular itching. The HCP orders cetirizine ophthalmic solution. Which information should the nurse include when teaching about this medication?

3. Contact lenses may be reinserted 10 minutes after medication administration. remove the contact lenses before administration.

2. The parents of a 6-year-old child who has type 1 diabetes mellitus call a clinic nurse and tell the nurse that the child has been sick. The parents report that the child's urine is positive for ketones. The nurse would instruct the parents to take which action?

3. Encourage the child to drink liquids. liquids are essential to aid in clearing the ketones.

The client diagnosed with a fungal infection of the eye is prescribed natamycin ophthalmic drops. Which medication teaching should the nurse discuss with the client? Select all that apply.

3. Explain that the medication may cause temporary blurred vision. 5. Teach the client to shake the medication well before using.

The nurse is administering otic drops to a 5-year-old child diagnosed with acute otitis media. How should the nurse implement the interventions? Rank in order of performance.

3. Explain the procedure to the child in developmentally appropriate terms. 1. Brace the administering hand against the child's head above the ear. 4. Gently pull the top of the child's ear up and back. 2. Insert the required number of drops and gently massage the tragus. 5. Keep the child on the unaffected side for several minutes.

6. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

3. Failure to pass meconium stool in the first 24 hours after birth Imperforate anus is the incomplete development or absence of the anus in its normal position in the perineum. During the newborn assessment, this defect would be identified easily on sight. However, a rectal thermometer or tube may be necessary to determine patency if meconium is not passed in the first 24 hours after birth.

9. The nurse would implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply.

3. Give the child a teaspoon of honey. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

The client calls the clinic and tells the nurse that a live insect is in the client's right ear. Which intervention should the clinic nurse implement?

3. Have the client put mineral oil into the ear canal. immobilize or kill insects.

6. A 10-year-old child with hemophilia A has slipped on the ice and bumped the knee. The nurse would prepare to administer which prescription?

3. Intravenous infusion of factor VIII replace the missing clotting factor and minimize the bleeding

The nurse is instructing the client on how to instill nasal drops. How should the nurse teach the interventions? Rank in order of performance.

3. Open and breathe through the mouth. 5. Hold the dropper tip just above the nostril without touching the nose. 4. Instill the solution laterally toward the nasal septum. 2. Remain in position for 5 minutes. 1. Discard any remaining solution in the dropper.

2. The nurse is preparing home care instructions for the parents of a 10-year-old child with hemophilia. Which sport activity would the nurse suggest for this child?

3. Swimming Children with hemophilia need to avoid contact sports

The client diagnosed with glaucoma is prescribed betaxolol ophthalmic drops. Which information should the nurse discuss with the client?

3. Teach the client how to prevent orthostatic hypotension. beta blocker that may cause bradycardia and hypotension if absorbed systemically. The nurse should discuss ways to prevent orthostatic hypotension.

The client diagnosed with open-angle glaucoma is prescribed ophthalmic drops. The client is demonstrating instilling the medication. Which action by the client warrants intervention?

3. The client keeps the eyes open immediately after administering the medication. The client should close the eyes for 1 to 2 minutes after instilling ophthalmic eye drops to distribute the medication and enhance medication effectiveness (Hoffman & Sullivan, 2018). This action warrants the nurse correcting the behavior.

The client is undergoing eye surgery and the nurse is administering cycloplegic ophthalmic medication. Which intervention should the nurse implement?

4 Explain that the eyes will be paralyzed for 24 to 48 hours. Cycloplegic medication paralyzes the eye for 1 to 2 days. The client should be aware of this information because most ophthalmic surgery is performed as day surgery. Because the client will be at home, they need to be knowledgeable about the medication.

The client diagnosed with glaucoma is prescribed pilocarpine eye drops. Which statement indicates the client needs more teaching concerning the medication?

4. "I will take the eye drops every time I have eye pain." everyday to reduce IOP. Glaucoma is painless, pain needs to be reported.

The parent of a 5-year-old child diagnosed with five ear infections in the past 6 months asks the nurse, "What can be done because my child keeps having ear infections?" Which response by the nurse is most appropriate?

4. "Your child may need tubes inserted into both ears."

6. A topical corticosteroid is prescribed by the pediatrician for a child with contact dermatitis (eczema). Which instruction would the nurse give the parent about applying the cream?

4. Apply a thin layer of cream and rub it into the area thoroughly.

3. Permethrin is prescribed for a child with a diagnosis of scabies. The nurse would give which instruction to the parents regarding the use of this treatment?

4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

9. The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented?

4. Bright red blood and mucus in the stools Bright red blood and mucus are passed through the rectum and commonly are described as currant jelly-like stools.

3. A pediatrician prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription?

4. Checks the amount of urine output. priority assessment before administering potassium chloride intravenously would be to assess the status of the urine output. Potassium chloride would never be administered in the presence of oliguria or anuria.

The client called the emergency department (ED) and told the nurse that bleach had splashed into both eyes. Which action should the nurse tell the client to perform first?

4. Cleanse the eye continuously with tap water.

1. A school-age child with type 1 diabetes mellitus has soccer practice, and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which would the school nurse tell the child to do?

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice. An extra snack of 15 to 30 g of carbohydrates eaten before activities such as soccer practice would prevent hypoglycemia.

The client diagnosed with otitis media is prescribed clarithromycin 500 mg by mouth every 12 hours for 10 days. Which medication teaching should the nurse discuss with the client?

4. Encourage the client to eat yogurt or buttermilk daily. help maintain GI flora.

7. The nurse has just administered ibuprofen to a child with a temperature of 102° F (38.8° C). The nurse would also take which action?

4. Remove excess clothing and blankets.

To which client should the nurse question administering betaxolol ophthalmic drops?

4. The client diagnosed with chronic obstructive pulmonary disease (COPD)

9. A diagnosis of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease?

4. The presence of Reed-Sternberg cells in the lymph nodes The presence of giant, multinucleated cells (Reed-Sternberg cells) is the classic characteristic of this disease.

7. The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check for lice?

4. White sacs attached to the hair shafts in the occipital area