sherpath for test 3 pediatrics

The nurse receives an intershift report on four assigned patients with iron deficiency anemia (IDA). After a review of each patient's history, combined with the shift report information, which patient should the nurse see first?

A 3-month-old with an intestinal malformation and slight pallor

The clinic nurse wants to develop a teaching program for parents of patients at risk for developing iron deficiency anemia (IDA). Which patient does the nurse correctly identify as being at greatest risk for developing IDA?

A 5-year-old child who lives in a home built in 1942

A parent of a breastfed infant with iron deficiency anemia (IDA) questions the need for iron supplementation. Which response by the nurse is most appropriate?

"Because the infant is growing so rapidly, his body needs extra iron."

The nurse is educating a parent of a child newly diagnosed with sickle cell anemia. Which statements, made by the parent, indicate teaching was effective?

"I keep bottles of water with me whenever we go out." "I made an appointment for the year 4 immunizations." "I will call our health care provider as soon as I notice any cough or fever." "We only play in the snow for about 20 minutes at a time."

Which instructions by the nurse would be appropriate for the school-age child who is active in sports?

"Rest often and drink plenty of water."

The nurse cares for a patient receiving carbamazepine for seizures. Which statement by the child's parents requires immediate follow-up?

"The practitioner at the clinic put him on an antibiotic for bronchitis."

Which is the best response to a parent's concern that his 6-year-old frequently lies to get out of trouble?

"This is normal and you can set an example for what is right."

The nurse is completing discharge teaching of a patient who originally presented with symptoms of aplastic anemia. Which statement, made by the parents, indicates teaching was effective?

"We bought a new soft-bristle toothbrush yesterday."

A 2-year-old patient diagnosed with beta-thalassemia requires chelation therapy. The child's parents state, "So we bring her here for the needle to be placed for each treatment." Which response by the nurse is most appropriate?

"You will be taught how to prepare medications for chelation therapy."

A 9-month-old infant has a "whooping" cough after having a runny nose, low-grade fever, and mild cough. Which action should the nurse consider doing next?

Administer antibiotics as prescribed.

A 6-year-old child presents with anxiety, stridor, and becomes agitated when asked questions. The parents report the child had a high fever. Which action by the nurse is a priority?

Administer humidified oxygen.

A 3-year-old child with a history of status epilepticus is brought to the emergency department and the parent's state this seizure began 14 minutes ago. Intravenous access cannot be obtained. What should the nurse do?

Administer rectal diazepam gel. Ensure that intubation equipment is at the bedside. Place a heart rate and oximetry monitor on the child.

The mother of a 6-month-old infant who was recently admitted for a "whooping" cough, rhinorrhea, and fever, reports that she has two other children age 3 and 5 at home. Which action should do the nurse take?

Advise to consult these children with a health care provider.

A 3-year-old female presents with a persistent cough, rhonchi and poor oral intake. The nurse reviews the health care provider's prescription. Which prescription would the nurse question?

Antibiotics

A 3-year-old male presents with drooling, retractions, and oxygen saturation of 88% on room air. The parents report the child became sick over the past few hours and cries quietly when disturbed. Which action by the nurse is priority?

Anticipate emergency support.

The nurse is caring for a child recently admitted to the hospital with upper respiratory infection and "whooping" cough. Which prescription would the nurse question?

Ambulate in hall daily

A 2-year-old female presents with stridor, restlessness, and a hoarse cry. The nurse reviews the health care provider's prescription. Which medication would the nurse question?

Ampicillin intravenous

A 6-year-old child is brought to the hospital due to chills, fever, chest pain, and breathing difficulties. The nurse obtains the following vital signs: temperature 101.8o F, HR 110, RR 30, and oxygen saturation 90% on room air. Order the nursing interventions based on priority, with the highest priority being placed first.

Apply oxygen Provide oral fluids Administer antibiotics Reassess oxygen saturation

The nurse is caring for a child with beta-thalassemia, who had a splenectomy 3 weeks ago. The patient reports malaise and has a runny nose and a cough. The nurse notes a temperature of 101.2° F, heart rate of 116, blood pressure of 106/88, and respiratory rate of 26. In which order should the nurse implement interventions?

Assess lung sounds Obtain complete blood count Administer an antibiotic Administer antipyretic

A 14-year-old child who was admitted due to fever, night sweats, mild cough, and weight loss, with a positive Mantoux test, is being prepared for discharge. Which actions should the nurse consider doing next?

Assess the family's financial status. Coordinate care with health department.

Which pedestrian safety recommendations are common to enforce in children who ride bikes, inline skates, and skateboards?

Do not listen to music Do not ride when sunlight is dim Wear appropriate head protection

The parents of an overweight nine-year-old are concerned about their child's eating habits. Which recommendations can the nurse make for family-wide changes that may impact their child's food choices?

Avoid giving food for reward Increase the number of home-cooked meals

Which developmental milestones are normal for a 10-year-old child?

Back-talking to parents Interest in the opposite sex Interest in getting a cell phone Being upset when artwork does not look like others

What is the process of physical growth in boys and girls from early school-age to age 12?

By age 12 girls are taller and heavier than boys.

The mother of a 10-month-old reports that the child has been pale, tires quickly, and sometimes has difficulty breathing. Which orders would the nurse anticipate for this patient?

Collect blood for complete blood count (CBC). Prepare the patient for insertion of in intravenous line. Obtain vital signs, including pulse oximetry, and notify the provider of any concerning results.

A patient with sickle cell anemia presents with pallor, lethargy, headache, and a history of fainting spells. Which provider order would the nurse anticipate?

Collect blood for type and cross-matching.

Match the student's behavioral problem with the relevant manifestation.

Complaint of feeling sick while at school: school refusal Pushing another child to assert authority: peer victimization Drinking alcohol while home alone after school: problems associated with self-care

The caregivers of an 11-year-old child report that the child is worried about upcoming tests and is not sleeping well. The nurse tells the parents to watch for which signs of stress?

Screaming during the night

A 5-year-old child who was admitted for chills, fever, breathing difficulties, and chest pain, begins coughing and is restless. Which action by the nurse is a priority?

Elevate the head of bed

The neonatal patient exhibits odd behavior such as tongue thrusting. Which additional findings cause the nurse concern?

Eye deviation horizontally Apnea episode greater than 20 seconds Drooling saliva continuously

A 9-month-old infant is brought to the hospital by the parents because the infant is "breathing fast." Assessment reveals retractions, wheezing, rhinorrhea, and oxygen saturation is 89%. Which question would help the nurse determine the next intervention?

How many wet diapers has the infant had today?

Which fire safety recommendation is a priority for school-aged children, as it takes advantage of their developing cognitive abilities?

How to use appliances safely

A child is experiencing status epilepticus. The nurse can expect to monitor which possible metabolic changes?

Hypoxia Increased lactic acid levels Decreased blood glucose levels

The nurse in a pediatric hematology unit admits a patient with sickle cell anemia, transferred from the emergency department. Which finding warrants immediate additional assessment by the nurse?

Shortness of breath and a white blood cell (WBC) count of 16,000

A 10-year-old patient presents to the pediatric clinic with maxillary hyperplasia, malocclusion, hypochromic anemia, and elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Which additional assessments should the nurse perform?

Measure oxygen saturation. Perform a complete abdominal assessment. Evaluate peripheral pulses in all extremities. Evaluate parent's understanding of treatment.

Which activity shows the school-age child has normal gross motor skill development?

Skipping on sidewalk

Decreased eating at mealtime, poor test scores, and refusal to talk about school may be signs that a child is experiencing which school-age problem?

Peer victimization

A 10-year-old patient with aplastic anemia presents with the following vital signs: blood pressure of 118/70, heart rate of 112, respiratory rate of 28, temperature of 102.3° F. The nurse can anticipate which orders from the provider?

Obtain a blood culture. Administer antibiotics. Administer an antipyretic. Obtain a complete blood count (CBC).

A 2-year-old child is brought to the hospital for persistent coughing, weight loss, and appearing malnourished. While gathering history, the mother reports the child has a positive Mantoux test "a few months ago." Which action should the nurse take?

Obtain a medication history.

On assessment of a patient with aplastic anemia, the nurse notes peripheral pulses 1+, cool extremities, and capillary refill of 4 seconds. Which actions should the nurse take?

Obtain vital signs. Notify the health care provider. Complete a neurologic examination.

A 2-year-old child presents to ER due to chills, fever, chest pain on left side, productive cough, and difficulty breathing. The health care provider prescribes therapies for the child. Which prescription should the nurse question?

Oral antihistamines

A 1-year-old female presents with restlessness, rhinorrhea, retractions, and poor feeding. The nurse reviews the health care provider's prescription. Which treatment would the nurse question?

Palivizumab IM

The parent of a 10-year-old child is distressed by the child's recent tendency to post embarrassing photos of other children on social media sites. Which common behavioral problem do these actions exemplify?

Peer victimization

The nurse is caring for a 3-year-old child who presents with persistent cough, weight loss, fever, and night sweats. Organize the nursing actions by priority, with the highest priority being placed first.

Perform Mantoux skin test Obtain history and physical exam Coordinate care with local health department Administer prescribed anti-tuberculosis medication

The nurse notes the vital signs of a patient with sickle cell anemia (SCA) after splenectomy to be as follows: heart rate, 122; respiratory rate, 24; blood pressure, 80/48; and temperature of 100.3° F. The patient appears drowsy but is easy to arouse. Based on this assessment, which initial action should the nurse take?

Prepare the patient for insertion of an intravenous (IV) line.

The parent of an eight-year-old reports that the child has trouble getting to sleep at night. Which practices should the nurse recommend to promote sleep?

Reading before bed Keeping the room dark and quiet Limiting media exposure prior to bedtime

Match the safety recommendation with the activity for which it is most important.

Ride on the right side of the road with traffic: bicycle walk across intersections: scooter limit to areas with no traffic: skateboard do not ride on gravel roads: inline skates

The nurse is caring for a child who presents with tachypnea, cyanosis, and periods of apnea. ABG results show pH 7.32, CO2 35, HCO3 18, paO2 78. The nurse also notes diminished breath sounds bilaterally. Labs are obtained. Which action should the nurse take?

Start oxygen inhalation.

Which instructions could the nurse provide to parents to encourage self-esteem of the school-age child?

Tell her "I love you" and give her a hug before leaving. Give her a chore chart with things she can do each day. Allow her to solve problems and make responsible choices.

The school nurse is evaluating a 6-year-old child for behavior problems noticed in the classroom. Which findings cause the nurse to be concerned that the child is having seizures?

The child is noted to periodically bob his head while sitting. The child looks away for a few seconds then returns to activity. The child exhibits a blank facial expression in the middle of a conversation.