School-age Child

The parent of a school-age child with autism asks the nurse how she should tell her son that he has autism. Which response by the nurse is most therapeutic?

"Explain the definition of autism and emphasize your child's strengths as well as his areas of challenge." SUBMIT ANSWER

A school-age client with rheumatic fever is on long-term aspirin therapy. Which client statement most indicates that the client is experiencing a serious adverse reaction to aspirin?

"I hear ringing in my ears."

Which statement by the parent of a child with polycystic kidney disease and stage 2 renal disease indicates the need for more teaching?

"My child will outgrow this disease."

A staffing agency is assigning a licensed practical/vocational nurse (LPN/VN) to cover a shift on a pediatric unit. Because the unit manager is unfamiliar with the nurse's skill level, what assignment is best for the LPN/VN?

9-year-old child receiving subcutaneous insulin for diabetes mellitus

When developing the teaching plan for the mother and a child with insulin-dependent diabetes about sick-day management, which of the following instructions should the nurse include?

Adjust insulin based on more frequent testing of blood glucose levels. SUBMIT ANSWER

To meet the developmental needs of an 8-year-old child who is confined to home with osteomyelitis, what goal should the nurse include in the care plan?

Encourage the child to communicate with schoolmates.

An 8-year-old child, immobilized with a hip spica cast, says to the nurse, "I am so bored! Do you have any video games I can play?" What is the best nursing action?

Give child access to the unit's portable video game console and age-appropriate games.

Which intervention should the nurse implement to help minimize joint pain in a child with rheumatic fever?

Limit movement of the affected joints.

A 10-year-old child proudly tells the nurse that brushing and flossing her teeth is her responsibility. How does the nurse interpret the statement?

She is most likely capable of this responsibility.

The nurse cares for a child receiving a blood transfusion. The child becomes flushed and is wheezing. What should the nurse do first?

Switch the transfusion to normal saline solution.

-Which situation indicates that more teaching is needed when a 10-year-old is hospitalized for the first time?

The parents choose to leave to let the child build a relationship with the staff.

A child has a seizure while a nurse is performing a bed bath. Which of the following are priority actions for the nurse to implement? Select all that apply.

Time the length of the seizure. Observe the stages of the seizure. Turn the child to a side-lying position.

Which beverage should the nurse plan to give a child with leukemia to relieve nausea?

a carbonated beverage SUBMIT ANSWER

A mother states that a health care provider (HCP) described her daughter as having 20/60 vision, and she asks the nurse what this means. The nurse responds based on the interpretation that the child is experiencing which condition?

ability to see at 20 feet what she should see at 60 feet

According to Erikson's psychosocial theory of development, an 8-year-old child would be in which stage?

industry versus inferiority

The parent tells the nurse that an 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of which factor?

mastery of language ambiguities

A child is receiving total parenteral nutrition (TPN). During TPN therapy, the most important nursing action is:

monitoring the blood glucose level closely. SUBMIT ANSWER

A 7-year-old child is hospitalized with cystic fibrosis. To help the child manage secretions and avoid respiratory distress, the nurse should:

perform chest physiotherapy every 4 hours.

The school nurse is assessing a client for "pinkeye." Which findings would cause the nurse to send the client home?

purulent discharge noted from the eyes

A healthcare provider prescribes an antibiotic for a 6-year-old client with an upper respiratory tract infection. For what prescribed antibiotic will the nurse seek clarification from the healthcare provider?

tetracycline

The nurse teaches the family of child with leukemia about preventing infections. How should the nurse explain to the parents why their child is at risk for infections?

"Immature white blood cells are incapable of handling an infectious process."

The nurse is caring for a child who sustained a spinal cord injury in a motor vehicle collision. The child's body temperature fluctuates markedly, and the parents question why this is occurring. How should the nurse respond?

"The child's sympathetic nervous system was damaged in the accident."

Which statement indicates that the parents understand the need for their child to receive long-term antibiotic therapy after an episode of rheumatic fever?

"It will prevent further streptococcal infections."

The nurse assesses a child with fever, sensitivity to light, and a red rash on the back. How will the nurse assess for Kernig's sign?

Have the child lie supine with flexed knees, then ask the child to extend the knees.

A school nurse assesses that an 8-year-old child is preoccupied with sexual comments and activities. The nurse is concerned that the child may have been sexually abused at home. What is the nurse's best response to this situation?

Notify the local Child Protective Services.

Parents of a child with cystic fibrosis demonstrate knowledge of the effects of hot weather on their child when they state that hot weather is hazardous because the child has which problem?

abnormally high salt loss through perspiration

A nurse is giving instructions to parents of a school-age child diagnosed with sickle cell anemia. The instructions should include:

avoiding areas of low oxygen availability such as high altitudes.

The nurse is caring for an 8-year-old girl with frequent urinary tract infections who is withdrawn and quiet. The nurse learns the child is left with a male caregiver while the mother is at work. The child states, "It hurts down there." What is the best response to the child?

"Are there other times you have hurt down there?"

A client with iron deficiency anemia was prescribed ferrous sulfate. Which statement by the caregiver would indicate a need for further instruction on proper administration?

"I mix the medication in milk to make it taste better."

The mother of a 10-year-old girl with diabetes asks the nurse's advice about whether or not her child, who has always been compliant with treatment, should be allowed to go trick-or-treating on Halloween with several friends. The nurse should tell the mother:

"Yes, she needs to be with friends and do the things other children do."

A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger cookies to help control the nausea. What should the nurse tell the parents?

"You can try them and see how he does." SUBMIT ANSWER

The nurse is caring for an 8-year-old with a life-threatening illness. The parents do not speak the native language and want the child discharged so they can pursue alternative therapies that they believe will be less expensive. What is the most important action taken by the nurse to help the family and the child?

Arrange to have a translator present when talking with the parents.

When developing the teaching plan for parents using the Pavlik harness with their child, what should be the nurse's initial step?

Determine the parents' knowledge about the device.

A child with sickle cell crisis is being discharged. As part of discharge teaching to prevent further crisis, what should the nurse advise the parent to do?

Encourage the child to drink lots of liquids.

The nurse is administering insulin to a 9-year-old child and has completed the medication rights and hand hygiene. Place the actions in the order the nurse will take to administer this injection. All options must be used.

Select an appropriate injection site with the child. Clean the site with an alcohol pad; loosen the needle cover. Pinch the skin around the injection site. Uncover the needle; insert at a 45- to 90-degree angle. Release the skin, and give the injection. Cover the site with an alcohol pad.

An adolescent client is having surgery to repair a fractured left femur. As a part of the preoperative safety checklist, what should the nurse do?

Verify that the site, side, and level are marked.

A client is admitted to the emergency department with abdominal pain. The client's caregiver states the pain began about 12 hours ago. The nurse notes the client has a temperature of 100.8° F (38.2° C) and nausea. The client vomited once. Which abdominal area would be most appropriate for the nurse to assess?

right lower abdominal quadrant

In a family with a 7-year-old child with a chronic illness, which family members feel jealousy, resentment, embarrassment, shame, fear of becoming ill, and guilt at causing the illness?

siblings

The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which activity should the nurse suggest as ideal?

swimming

The nurse teaches the mother of a child newly diagnosed with insulin dependent diabetes about the principles of a healthy eating plan. Which statement by the mother indicates effective teaching?

"Snacks are used to keep blood glucose at acceptable levels during times when the insulin level peaks."

A nurse assessing the heart rate and rhythm of an 8-year-old child hears a murmur that's barely audible even in a quiet room. The child's heart rate is 80 beats/minute. The nurse should document her assessment findings as:

"heart rate regular, grade I murmur auscultated."

A school-age child hospitalized with acute poststreptococcal glomerulonephritis during the acute stage has elevated blood pressure and low urine output for 14 hours. What should the nurse do next?

Assess the child's neurologic status.

A school nurse is evaluating a 7-year-old child who is having an asthma attack. The child is cyanotic and unable to speak, with decreased breath sounds and shallow respirations. What is the nurse's next action?

Prepare to ventilate the child.

A child is brought to the clinic by a grandparent who states that someone may have sexually abused the child. The grandparent noticed blood and a discharge on the child's underpants. After the child is assessed and treated for injuries, what is the priority intervention by the nurse?

Report the suspicion to the appropriate authorities.

A 10-year-old child presents to the emergency department with dehydration. A physician orders 1 L of normal saline solution be administered at a rate of 60 ml/hour. While preparing the infusion, a nurse notices that the I.V. pump's safety inspection sticker has expired. Which action should the nurse take next?

Take the pump out of commission and locate a pump with a valid inspection sticker.

A 10-year-old client has arrived to sleepover summer camp. The child's parent states that the client has just been diagnosed with insulin-dependent diabetes mellitus but does not perform self-injections. The child is nervous, cries, and jerks away when the nurse initially attempts to give insulin. Which is the best nursing action?

Teach the child to self-administer the insulin injections.

The nurse is assisting another member of the health care team who is placing a peripherally inserted central catheter in a 10-year-old with peritonitis from a ruptured appendix. The family is present in the treatment room to support the child. The nurse observes that the other team member has contaminated a sterile glove. What should the nurse do next?

Tell the team member the glove is contaminated.

Which child most needs a screening for scoliosis?

a preadolescent client at the beginning of a growth spurt

A client is diagnosed with cystic fibrosis. Which intervention would be performed to prevent nutrition complications?

administration of pancreatic enzymes

When developing the plan of care for a school-age child with a suspected diagnosis of appendicitis who has severe abdominal pain, the nurse should expect to include which measure in the child's plan of care?

application of an ice bag SUBMIT ANSWER

The health care provider (HCP) has prescribed intravenous mannitol for a child with a head injury. The best indicator that the drug has been effective is which assessment finding?

decreased intracranial pressure.

After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child?

drooling of bright red secretions

An emergency room nurse concerned about the emotional health of a child who has been in a motor vehicle accident should collaborate with which disciplines?

social services

A school-age child experiences symptoms of excessive polyphagia, polyuria, and weight loss. The physician diagnoses type 1 diabetes and admits the child to the facility for insulin regulation. The physician orders an insulin regimen of insulin and isophane insulin administered subcutaneously. How soon after administration can the nurse expect the regular insulin to begin to act?

½ to 1 hour

On a crisis shelter hotline, the nurse talks to two 11-year-old boys who think a friend abuses inhalants. They say his breath sometimes smells like glue and he acts drunk. They say they are afraid to tell their parents about the friend. When formulating a reply, what is the mostimportant factor for the nurse to consider?

The boys probably fear punishment.

The nurse should explain that the most common cause for the unhappiness some children experience when first entering school is due to which factor?

feelings of insecurity

After staying several hours with her 9-year-old daughter who is admitted to the hospital with an asthma attack, the mother leaves to attend to her other children. The child exhibits continued signs and symptoms of respiratory distress. Which finding should lead the nurse to believe the child is experiencing anxiety?

frequent requests for someone to stay in the room SUBMIT ANSWER

A parent asks, "Can I get head lice too?" The nurse indicates that adults can also be infested with head lice but that pediculosis is more common among school children, primarily for what reason?

Pediculosis usually is spread by close contact with infested children.

Which nursing action is appropriate to include in the plan of care for a dying child to meet the child's emotional needs during the last days of life?

Answer the child's questions about illness and death honestly.