Child Health - Archer Review (3/3) - Growth & Development, Infectious Disease, Endocrine, Urinary/Renal/ Fluid and Electrolytes, Visual/Auditory

Choice C is correct. Finger paints are an example of an appropriate resource to offer for use to the toddler (and the toddler's parent(s)/caregiver(s)) to assist in developing the toddler's fine motor skills. The most educational toys foster the interaction of an adult with a pediatric client in supportive, unconditional play.

The nurse is caring for a hospitalized 18-month-old toddler client. Which is the most appropriate play activity for the nurse to offer the toddler client? A. 36-piece puzzles B. Miniature cars C. Finger paints D. Comic books

Choice D is correct. According to the American Academy of Pediatrics (AAP), an exclusive breastfeeding diet for a minimum of six months with the introduction of appropriate solid foods occurring around six months of age while breastfeeding continues. Beyond one year, breastfeeding should ideally continue for as long as both the infant and mother desire, although after one year, breastfeeding should complement a complete diet of solid foods and fluids. Therefore, the nurse should reply that the recommended time solid foods should be introduced to their child is six months of age.

During the initial assessment at a well-baby clinic, parents of a newborn ask the nurse when to begin introducing solid foods to their infant. The nurse replies that the recommended time solid foods should be introduced is: A. One year B. Two months C. Three months D. Six months

Choice B is correct. Sitting without support is a development milestone reached at nine months of age.

A 10-month-old infant was admitted for dehydration after days of severe diarrhea. During the hospitalization, the infant's parents voiced concern regarding the child's development. Which developmental milestone should the infant have attained by this age? A. Able to say three words other than "mama" and "dada" B. Can sit without support C. Able to build a tower of two cubes D. Can walk well

Choice B is correct. Initiative vs. Guilt is the typical stage of development for preschool children, who are 3 to 5-year-olds, so this is correct for your 4-year-old patient. In Initiative vs. Guilt, children start to assert control and power over their environment. Success leads to initiative when they feel a sense of purpose, but children who try to exert too much power and experience disapproval end up feeling guilty.

Among Erickson's Stages of Development, which of the following stages of development would the nurse expect a 4-year-old patient to be in? A. Trust vs. Mistrust B. Initiative vs. Guilt C. Identity vs. Role confusion D. Industry vs. Inferiority

Choice A is correct. At 1-year-old, children should be beginning to walk. Hospitalization during this age could delay this stage of development.

Hospitalization may affect or delay the progression of which physical development of a 1-yr-old patient? A. Walking B. Running C. Sitting D. Crawling

Choice D is correct. A healthy child is expected to quadruple their weight by age 2.

If a female client weighed 7 lbs at birth, the nurse would expect her weight at her 2-year-old well-child visit to be: A. 35 lbs B. 40 lbs C. 21 lbs D. 28 lbs

Sensorimotor Preoperational Concrete operational Formal operational

Place the following stages of Piaget's Stages of Cognitive Development into the appropriate order: Press and hold an option to rearrange Formal operational Concrete operational Sensorimotor Preoperational

Choice C is correct. According to current recommendations, toddlers should have 11 to 14 hours of sleep (including naps) over an average 24-hour period.

Select the developmental age group that is accurately paired with the correct number of recommended hours of sleep per 24-hour period (including naps). A. Neonates: 14 to 16 hours of sleep per 24-hour period B. Infants: 12 to 14 hours of sleep per 24-hour period C. Toddlers: 11 to 14 hours of sleep per 24-hour period D. Preschoolers: 12 to 14 hours of sleep per 24-hour period

Choice C is correct. Hepatitis A is typically an infection that is self-limiting if the child receives the appropriate supportive care. The disease is usually transmitted by drinking water and food that is contaminated with fecal matter. Removing the source of the infection and providing a healthy diet will often help resolve the infection. A hepatitis A vaccine is available that should be given to all children and high-risk adults. This vaccine should be given in two doses.

The 6-year-old immigrant child has been diagnosed with Hepatitis A. He was brought from Mexico by his grandparents a few days ago. You would expect that treatment for this child will include: A. Acyclovir B. Interferon C. Supportive care D. Ribavirin

mononucleosis

The client is demonstrating signs and symptoms of ____

pyrexia; decrease symptoms of pruritus

The nurse understands that the acetaminophen is prescribed to treat the client's ____ Additionally, the diphenhydramine has been prescribed to ____

Choice C is correct. Fever after a DTaP injection is low-grade and is expected within 24-48 hours of the vaccination.

The parents of a 2-month-old infant brought their child to the clinic due to fever, telling the nurse that the child had a Diphtheria, Tetanus, and Pertussis (DTaP) vaccination injection one week prior. The parents ask the nurse if the fever is related to the DTaP vaccination. What would be the nurse's most appropriate response? A. "The fever after a DTaP injection usually occurs within the first 2 hours of immunization." B. "Fever is rare in a child after a DTaP immunization." C. "Fever after the DTaP injection is usually low-grade and appears within the first two days." D. "The child's fever should be treated."

Choice D is correct. It is essential to understand the normal growth and development of children. In this scenario, the 3-month-old was born at term, and the nurse should expect that his development will follow the normal pattern. A normal 3-month old should be reaching for objects.

You are caring for a 3-month old child. He was born at term in an uncomplicated delivery. If the child is developing normally, you would expect him to be able to: A. Sit without support. B. Creep on hands and knees. C. Follow simple commands. D. Reach for objects.

Choice D is correct. Children with ADHD exhibit short attention spans due to a variety of factors. Inattention tends to appear when a child is involved in tasks that require vigilance, rapid reaction time, visual and perceptual search, and systematic and sustained listening.

A 5-year-old child suspected of having attention-deficit/hyperactivity disorder (ADHD) is brought to the pediatric clinic for an evaluation. Which behavior, if observed by the clinic nurse, would support the suspicion of ADHD? A. Lethargy B. Preoccupation with body parts C. Poor verbal skills D. Short attention span

Choice A is correct. "Trust vs. Mistrust" is the first of eight stages of Erikson's Stages of Psychosocial Development. During this stage, the child's psychosocial development is facilitated when the caregiver provides a secure environment with regular access to affection and food.

A client tells the nurse that they know their baby is in the "Trust vs. Mistrust" stage and want to learn more about it. An accurate explanation from the nurse would be: A. "Trust vs. Mistrust" is the first stage of development in Erikson's theory that describes the eight developmental tasks everyone must face. B. It is a theory based on how an individual derives pleasure from different parts of the body. C. It is a theory that outlines the development of logical thinking. D. It is parallel to Selye's adaptation theory.

Choice B is correct. Toddlers experience a sense of shame when they are not allowed to develop autonomy. Autonomy versus shame and doubt is the second stage of Erikson's psychosocial development and occurs during the toddler age. It is essential to allow the toddler to develop a sense of autonomy.

A nurse is speaking to parents about their toddler. The parents express concern that the child is becoming independent, stating they want to always tend to the toddler. The most appropriate response for the nurse would be: A. "Your child will develop mistrust." B. "Your child will develop shame." C. "Your child will feel guilt." D. "Your child will feel inferior."

- Your child may return to school once all the lesions have crusted. - Warm baths with baking soda or oats may help with the itching. - Contact the school to report your child's infection. - Watch for signs of skin infection including swelling, drainage, and pain.

Click to specify the information the nurse should include in the discharge teaching? Select all that apply - Your child may return to school once all the lesions have crusted. - Warm baths with baking soda or oats may help with the itching. - Contact the school to report your child's infection. - Watch for signs of skin infection including swelling, drainage, and pain. - To treat the fever, you may alternate between acetaminophen and aspirin.

Choices C, D, and E are correct. The stages of development, according to Eric Erickson, that are accurately paired with their developmental task are: Adolescent: Identity versus Role Confusion (Choice C), Elder years: Integrity versus Despair (Choice D), and Preschool Child: Initiative versus Guilt (Choice E). The other developmental tasks, according to Erik Erikson, are: Infant: Trust versus Mistrust Toddler: Autonomy versus Shame and Doubt School-Aged Child: Industry versus Inferiority Young Adult: Intimacy versus Isolation Middle Years: Generativity versus Stagnation

Select the stage of development, according to Eric Erickson that is accurately paired with its developmental task. Select all that apply. Infant: Egocentricity versus Integration. Toddler: Autonomy versus Mistrust. Adolescent: Identity versus Role Confusion. Elder years: Integrity versus Despair. Preschool Child: Initiative versus Guilt.

Choice D is correct. The anterior fontanel typically closes anywhere between 12 to 18 months of age. Therefore, an assessment finding demonstrating the anterior fontanel remaining slightly open is considered normal, which would necessitate no further action for this client. The nurse should reassure the infant's parents.

The clinic nurse assesses a 12-month-old infant and notes that the anterior fontanel remains slightly open. The infant's parent asks about the finding. What is the most appropriate response by the nurse? A. "I will contact the health care provider (HCP) immediately." B. "I need to examine your child further." C. "We will need to obtain an MRI on your child." D. "This is a normal finding on a child of this age."

Choice B is correct. The nurse must always explain the procedure to the child in words that he/she can understand.

The clinic nurse is preparing to administer vaccinations intramuscularly to a 3-year-old toddler. What is the nurse's first intervention? A. Instruct the mother to immobilize the child's leg. B. Talk to the child about the procedure. C. Swab the area with alcohol. D. Inject the medication in the thigh.

Choice A is correct. Group A beta-hemolytic streptococcus is the most common cause of bacterial pharyngitis.

The emergency department (ED) nurse is educating a new nurse about the causes of bacterial pharyngitis in children. Which of the following is the most common cause of bacterial pharyngitis? A. Group A beta hemolytic streptococcus B. Candida glabrata C. Group B Streptococcus D. Neisseria meningitidis

Choice A is correct. The first stage of Piaget's Stages of Cognitive Development is the sensorimotor stage. This stage occurs between 0 and 2 years old. During this stage, the child learns to coordinate their senses with motor responses. They are curious about the world and use their minds to explore. They start to form language and use it for demands. They also develop object permanence.

Which stage of cognitive development does the nurse expect her 6-month-old patient to be in? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

Choices A and C are correct. At this age, most communication is still nonverbal. Infants use crying as a means for discussion and therefore you should take their crying seriously (Choice A). Infants are very responsive to touch. Patting, rocking, stroking, cuddling, and rubbing them are effective ways to calm them down. Therapeutic communication with an infant will be less focused on the actual words you say and more focused on how you interact with them to create a therapeutic environment (Choice C).

A nurse is caring for a 9-month-old infant who is showing signs of irritability. The nurse needs to employ therapeutic communication techniques to soothe the infant. Which of the following strategies should the nurse utilize? Select all that apply. - They use crying as a means for communication and you should take their crying seriously. - They are able to comprehend 5-10 words at this age. - They respond to touch and therefore patting and rubbing are effective calming methods. - They respond better to a low-pitched voice.

Choices B, C, and E are correct. B is correct. According to Piaget's theory of cognitive development, 2-7-year-olds are in the preoperational stage. During this stage, children use symbolic thinking. Their imagination and intuition are developing, but they cannot think abstractly yet. Children create a concept of time, space, and quantity in the operational stage, between 7 and 11 years of age. This information will give the mother reason for why her six-year-old daughter is unable to understand her request and help her communicate more efficiently. C is correct. According to Piaget's theory of cognitive development, 2-7-year-olds are in the preoperational stage. During this stage, children cannot communicate abstractly; they are concrete thinkers. Making this suggestion will help the mother communicate with her daughter. E is correct. Erikson's theory of psychosocial development suggests that a child of this age would be in the stage of "Initiative vs. Guilt" (3-6 years). According to Erikson, children may feel guilty during this stage when they believe they've done something wrong.

A nurse is educating a mother regarding the cognitive development of her 6-year-old child. The mother expresses frustration, stating, "She never listens to me when I tell her she can play for 15 minutes before dinner." What is the most appropriate response from the nurse? Select all that apply. "Don't be so mad. All kids are bad at listening." "Your daughter is still in the preoperational stage. She does not have a concept of time yet." "6-year-olds are not able to think abstractly yet. Try using a more concrete way to communicate with her." "That is frustrating, my 6-year-old always listens." "6-year-olds may develop a sense of guilt when they believe they have done something wrong.'

Choices B and D are correct. The car seat straps should be placed snugly over the infant's shoulders. Rolled blankets and towels may be needed between the groin and legs to prevent slouching and can be placed along the sides to minimize lateral movements.

The nurse is teaching a parenting class on car seat safety. Which statements should the nurse include? Select all that apply. "Place the car seat rear-facing in the back seat and at 90 degrees." "The car seat straps should fit snugly over the shoulders." "Infants should ride in a car seat, rear-facing, in the back seat, until six months." "Rolled blankets may be needed between the crotch and legs to prevent slouching." "You may add padding underneath the infant to increase their comfort."

Choices A, D, and E are correct. According to Freud, the child is in the phallic stage. According to Fowler, the child imitates the religious behavior of others. According to Kohlberg, the child defines satisfying acts as right. Human growth and development have been studied since the beginning of the 20th century and many theories have been developed to explain human responses usually occurring at certain ages during life. Although a psychological approach is familiar to most developmental theories, each method has a different focus. Different opinions examine cognitive, social, and instinctual influences on human growth and development.

Which of the following statements best describe the stage of development that should be expected of preschoolers based on developmental theories? Select all that apply. According to Freud, the child is in the phallic stage. According to Erikson, the child is in the trust vs. mistrust stage. According to Havighurst, the child is learning to get along with others. According to Fowler, the child imitates the religious behavior of others. According to Kohlberg, the child defines satisfying acts as right. According to Havighurst, the child is achieving gender-specific roles.

Choice C is correct. During the preschool years, children perceive rules as definite and require no reason or explanation. School-age children possess more developed cognitive levels, enabling a more thorough understanding of rules and a basis of why the need to adhere to rules is important. Therefore, school-age possess the ability to understand dangers when explained to them.

A nurse is a guest speaker lecturing on accident prevention in school-age children. Which statement by the attendees indicates an understanding of the topic? A. "School-age children become settled and less adventurous compared to preschoolers." B. "School-age children are the safest when at home." C. "School-age children understand dangers when explained to them." D. "School-age children have less self-control compared to preschoolers."

Choice A is correct. Fontanels facilitate the bony plates of the baby's skull to flex and allow the baby's head through the birth canal. Typically, the posterior fontanel closes by two months of age, while the anterior fontanel fuses between 12 and 18 months.

A parent in a pediatric clinic asks the nurse when the soft spots on their baby's head will harden. The most appropriate response by the nurse would be: A. "These soft spots are called fontanels. Typically, the one towards the front of the head closes between 12 and 18 months, and the one on the back of the head closes by two months old." B. "These soft spots are called fontanels. The one towards the front of the head closes at two months, and the one on the back closes at 12 to 18 months old." C. "These soft spots are called fontanels. The one on the front of the head closes between 12 and 18 months, and the one on the back closes around six months old." D. "These soft spots are called fontanels. The one on the front of the head closes at nine months old, and the one on the back closes at two months old."

Choice D is correct. Talking to the child with a counselor will allow the school-aged child to verbalize their feelings and may help determine the cause(s) of the phobia. Additionally, discussing potential solutions as a family with the counselor may allow the family unit to identify the ultimate solution with which to move forward.

A school-aged child has developed a school phobia. The nurse is talking to the child's parents regarding ways to help with the child's phobia. Which statement by the parents is accurate? A. "We will just wait until their fears wear off; until then, we will just keep them home." B. "Teachers and counselors at school cannot possibly help them." C. "We'll try not to talk to them about it too much." D. "We will discuss some solutions with them together with a counselor."

Choice B is correct. Desmopressin is indicated for the treatment of diabetes insipidus and nocturnal enuresis. This medication is a synthetic form of antidiuretic hormone. It is theorized that this medication will cause the client to reabsorb water, thereby decreasing nocturnal enuresis.

The nurse is caring for a child with nocturnal enuresis that was not responsive to non-pharmacological modifications. The nurse anticipates the primary healthcare provider (PHCP) to provide which medication? A. urecholine B. desmopressin C. prazosin D. finasteride

Choices A, C, D, and E are correct. These assessment findings are expected. The posterior fontanel closes between 2-3 months. The Moro (startle) reflex should be absent by 6 months. The Babinski (plantar) reflex should still be present until 12 months. The spinal column continues to straighten, and an infant sitting without support at 9 months is expected.

The nurse is assessing a 9-month-old infant. Which of the following assessment findings would be expected? Select all that apply. Posterior fontanel has closed. Anterior fontanel is closed. Negative Moro reflex. Positive Babinski reflex. Sitting without support.

Choice C is correct. The most appropriate action for school-age children is Simon Says, as it promotes cooperation with some competition, refines communication skills (the children receive both inhibition and activation commands), and is a group activity.

Which activity would best promote a school-age child's development? A. Pull toys B. Pat-a-cake C. Simon Says D. Shopping

Choices B, C and E are correct. Cloudy, foul-smelling urine could indicate an infection and needs to be reported to the healthcare provider. If the stent placed in the urethral meatus appears clogged, no urine will be able to exit the bladder. This needs to be corrected surgically, and the provider needs to be notified. A heart rate of 180 bpm in an 18-month old child is considered tachycardia. The child may be in pain or could be developing an infection, which needs to be reported to the healthcare provider.

You are monitoring an 18-month old child who has just had surgical correction of an epispadias completed. Which of the following assessment findings would the nurse need to report to the healthcare provider? Select all that apply. - Urine output of 2.2 mL/Kg/hr. - Cloudy, foul smelling urine. - Stent in the meatus appears clogged. - Temperature of 37.4 degrees Celsius. - Resting heart rate of 180 bpm

Choice A is correct. Industry vs. Inferiority is the typical stage of development for school-age children, who are 6 to 11-year-olds. In this stage, children need to cope with new social and academic demands. When they are successful with this, they feel competent and achieve the industry. When they are not successful, they handle failure, and it results in inferiority.

You are taking care of a 7-year-old female in the pediatric bone marrow transplant unit. She has been in the hospital for about a year and is working on her school work with the hospital teacher. You note that she is growing increasingly frustrated with her math homework. You know that her successful completion of academic demands is vital to her psychosocial development, as she is in which stage of psychosocial development? A. Industry vs. Inferiority B. Autonomy vs. Shame and Doubt C. Trust vs. Mistrust D. Initiative vs. Guilt

Choice C is correct. Babbling is an expected finding at six months. The babbling resembles one-syllable utterances—ma, mu, da, di, hi.

The nurse is assessing a client who is six months old. Which of the following would be an expected age-related finding? A. Repeats words overheard in a conversation B. Understands simple verbal commands C. Babbling D. Recognizes objects by name

Choice C is correct. IM is a condition caused by the Epstein-Barr virus (EBV) and causes a client to experience fatigue, rash, fever, headache, cervical lymph node enlargement and tenderness, and splenomegaly. The symptoms may persist for weeks. IM is primarily spread by saliva (hence, this condition was also known as the kissing disease).

The nurse is assessing a client with suspected infectious mononucleosis (IM). Which of the following assessment findings would support a diagnosis of mononucleosis? A. systolic heart murmur B. abdominal pain C. cervical lymph node enlargement and tenderness D. conjunctival injection

Choice C is correct. Reye's syndrome is a potentially fatal illness that can lead to liver failure and encephalopathy. Virus-infected children who are given aspirin to manage pain, fever, and inflammation are at an increased risk of developing Reye's syndrome.

Which of the following over-the-counter (OTC) medications is Reye's syndrome associated with? A. Acetaminophen B. Ibuprofen C. Aspirin D. Brompheniramine/pseudoephedrine

Choice B is correct. Upon assessment of the child's medical history, the nurse should anticipate a finding of a viral infection, specifically influenza (A or B) or varicella,within the preceding two-week period.

A toddler has just been diagnosed with Reye syndrome. Upon assessment of the child's medical history, which condition should the nurse expect? A. Cellulitis B. Influenza C. Meningitis D. Mumps

Choice B is correct. Varicella-zoster (chickenpox) virus (VZV) is a condition that causes the individual to experience low-grade fever, malaise, and anorexia. Characteristically, the client with VZV develops a papule type of rash that transitions into vesicles filled with clear fluid. Once these vesicles rupture, it causes shallow erosions that start to heal. These vesicles are commonly painful and cause the client intense itching.

The nurse is assessing a child admitted with varicella zoster (chickenpox). Which of the following assessment findings would be expected? A. linear cracks in the epidermis that extend into the dermis B. painful blisters filled with clear fluid C. nodules filled with either liquid or semisolid material D. elevated, plateau-like patches

Choice C is correct. A complication of glomerulonephritis is encephalopathy caused by severe hypertension associated with the disease process. A client's report of a headache should clue the nurse into checking the client's blood pressure. The client should be monitored for this potential complication, which can be avoided by closely monitoring the client's blood pressure.

The nurse is assessing a child with glomerulonephritis. Which assessment finding requires follow-up by the nurse? A. Periorbital edema B. Decreased urine output C. Headache D. Hematuria

Choice A is correct. This client is demonstrating classic manifestations of conjunctivitis. Conjunctivitis is characterized by Itching, burning, or scratchy eyelids. Additionally, the client has drainage to the affected eye(s), a common conjunctivitis finding.

The nurse is assessing a child with reports of right eye irritation, drainage, and itchiness. This client is at highest risk for developing A. conjunctivitis. B. amblyopia. C. nystagmus. D. ocular herpes.

Cellulitis

The nurse determines that if the client's itching is not controlled, which complication may develop? Cellulitis Pneumonia Encephalitis Desquamation

Choice C is correct. Infants whose needs are consistently unmet or who regularly experience significant delays in meeting their needs are at an increased risk of developing a sense of uncertainty, leading to mistrust of caregivers and the environment. Infants develop mistrust during this stage when their needs are not consistently gratified. Here, the infant's mother's status as a chronic substance abuser, coupled with the fact that by infancy, this client is already experiencing a hospital admission for dehydration and failure to thrive, would lead the nurse to anticipate this infant is likely to develop mistrust.

While caring for an infant hospitalized for dehydration and failure to thrive, the nurse notes that the infant's mother is a chronic substance abuser. With this knowledge, the nurse would anticipate this infant to develop: A. Autonomy B. Trust C. Mistrust D. Shame and doubt

Choice B is correct. The Varicella vaccine contains a live chicken-pox virus. Artificial active immunity refers to the immunization of the specific antigen known to cause illness. This includes live and attenuated vaccines.

The nurse is explaining immunizations to the parent of a pediatric patient. What type of acquired specific immunity would the Varicella vaccine fall under? A. Natural active immunity B. Artificial active immunity C. Passive natural immunity D. Passive artificial immunity

Choice D is correct. When there are symptoms of epiglottitis, a tongue blade should not be used to assess the throat visually. The use of a tongue blade on the infected tissue might result in further swelling and inflammation, potentially closing off the child's airway completely. The symptoms of epiglottitis may resemble the signs of upper airway infection. These may include sudden onset of a severe sore throat, fever, loud voice, and a cough. Worsening symptoms may also involve drooling and leaning forward in a sitting position. Choices A, B, and C are incorrect. The nursing assessment should include listening to the lungs, assessing vital signs, and obtaining a weight.

A 3-year old presents to the emergency department with signs of respiratory distress. The child has epiglottitis associated with a high fever; he is apprehensive and drooling. The nurse must avoid which of the following? A. Listening to the child's lungs B. Assessing the child's vital signs C. Weighing the child D. Inspecting the child's mouth and throat with a tongue blade

Choice A is correct. It is usual for toddlers to play by themselves and not interact with each other. This is called "parallel play."

The mother of a 2-year-old boy states to the nurse during their check-up: "I just don't get it. He just sits there and plays on his own while all his other cousins play with each other. Is there anything wrong with him?" Which response by the nurse is most appropriate? A. "Your child is a toddler. It's normal for his age to just play all by himself while other children play too." B. "Did you encourage him to play with the other children? Maybe you don't encourage him that's why he doesn't play with them." C. "Let's mention that to the doctor when he comes in to see him." D. "I really recommend your child be checked by a child psychologist."

Choice B is correct. A preschool-age client has many fears at this stage. One concern at this age is the fear of pain or, more specifically, mutilation. For children who possess this specific fear, it is essential that the nurse repeatedly stress the reason for a procedure and evaluate the pediatric client's understanding. For example, explaining cast removal to a preschooler client may seem simple enough, but the child's comprehension of the details may vary considerably from the explanation.

The new registered nurse (RN) is caring for a preschool-aged pediatric client in the pediatric ward under the supervision of a nurse educator. Which statement by the new RN indicates to the nurse educator that the new RN understands how to provide age-appropriate care to the preschooler? A. "We can convince the preschooler to cooperate with us by providing a thorough explanation of the procedure." B. "We need to ensure that the preschooler doesn't feel threatened about being hurt during nursing care by explaining what we are doing and assessing understanding." C. "We can make the preschooler more cooperative by involving them in competitive games." D. "The preschooler should not wait to have their needs met."

Choices A, B, C, and E are correct. A is correct. This is an excessive amount of urine output for 1 hour and is concerning for diabetes insipidus, given the procedure the client recently underwent. Any urine output greater than 300 mL is alarming, and the healthcare provider should be notified immediately. Diabetes insipidus is a severe complication from neurosurgery that occurs around the pituitary. This amount of urinary output can lead to shock if not treated promptly. B is correct. Given the assessment, requesting an order for IV fluids is an appropriate nursing action. The nurse should be concerned about the possibility of DI considering the excessive urine output, and no fluid replacement is currently ordered for this client. This is concerning for shock, and IVF should be initiated to rehydrate and adequately replace losses from the urinary output. C is correct. These findings should be accurately documented to ensure proper follow-up and orders for this client. E is correct. The client's neurological status should be monitored, as mental status and behavior changes can indicate electrolyte imbalances, such as hyponatremia.

The nurse cares for a 12-year-old client one hour post-operative following transsphenoidal hypophysectomy. After reviewing the assessment findings, the nurse should take which action? Select all that apply. See the exhibit. View Exhibit - notify the health care provider of the urine output. - request an order for intravenous (IV) fluids - document the findings - administer supplemental oxygen - continue to monitor neurological status

Choice D is correct. Infants have more horizontal, shorter, and narrower eustachian tubes, which makes them more prone to otitis media. The eustachian machine is a conduit from the middle ear to the nasopharynx. An inflammatory swelling in the eustachian tube can cause it to be blocked, trapping the fluid in the middle ear and eventually leading to infection. Several factors, such as allergies, common cold, viral flu, sinus infection, enlarged adenoids, and drinking while lying down (in infants), may predispose to swelling/ blockage of the eustachian tube. In an adult, the eustachian tube typically measures 36 mm and is angled at 45 degrees. In infants, it is shorter (18 mm) and has a more horizontal (angle at 10 degrees). Such a shorter tube predisposes to infection via reflux of bacteria from the nasopharynx

The nurse encounters an infant with irritability from acute otitis media while working in the pediatric clinic. The nurse should know that the infant is at much higher risk than an adult for otitis media due to which of the following? A. Immature cardiac sphincter B. Feeding in a semi-Fowler position C. Introduction of solid foods D. Narrower, shorter, and more horizontal Eustachian tubes

Choice C is correct. Hib (Haemophilus influenzae type B) is the most common cause of the bacterial infection that causes epiglottitis. Incidence has been significantly decreased by the Hib vaccination. That is why the nurse should ask the mother about this vaccination during the admission questions.

The nurse is admitting a child diagnosed with epiglottitis. Which vaccination would be most important for the nurse to ask the mother about? A. Tdap B. Influenza C. Hib D. MMR

Choices A, C, D, and F are correct. A is correct. The Rooting reflex typically disappears by 3-4 months of age. It occurs when the infants turn their face toward stimulation (such as stroking their cheek) and make sucking (rooting) motions with the mouth. This reflex helps to ensure successful feeding. C is correct. The Moro reflex should disappear by about 6 months of age. This reflex is a response to a sudden loss of support. When support is removed, the infant spreads out the arms and cries. D is correct. The Palmar reflex should disappear by 3-4 months of age. When an object is placed in an infant's hand, and the palm is stroked, the fingers will close reflexively. F is correct. The tonic neck reflex disappears around 4 months of age. This reflex is elicited by turning the infant's head to one side and is considered positive if the infant extends the extremities on the side that the head is turned toward, and flexes the extremities on the opposite side.

The nurse is assessing a 7-month-old infant. At this age, which of the following reflexes would the nurse expect to no longer be present? Select all that apply. Rooting. Plantar. Moro. Palmar. Sucking. Tonic neck.

Choices A, D, and E are correct. A is correct. This finding requires follow-up. At 7 months old, the infant should be able to sit up without any support. This milestone is a gross motor skill that should be achieved around 6 to 8 months. So at 9 months old, if the infant still requires help from mom to sit up, this needs to be further evaluated. D is correct. This finding requires follow-up. At 4 months of age, the infants should have developed the fine motor skill of bringing objects to their mouths. This is an important way that infants explore the world around them, and it is not normal for a 9-month-old infant to not be able to bring toys up to their mouth. The nurse should follow up on this finding, as it is abnormal. E is correct. This finding requires follow-up. By 5-6 months, the infant should weigh approximately double their weight at birth. If the infant's weight has only doubled by 9 months, it would require further evaluation.

The nurse is assessing a 9-month-old infant in the clinic. Which of the following findings requires follow up? Select all that apply. Infant sits up with the help of mom. Infant is rolling over from front to back. Infant holds a cube and closes fingers around it. Infant cannot bring toys to their mouth. Infant's weight has doubled since birth. Infant cries when handed to the nurse.

Choices A and B are correct. Sitting without support is a gross motor skill that should be developed by 8 to 9 months. Indeed, a 9-month-old infant should already be able to sit up without support. If they have not yet met this milestone by 9 months of age, follow-up is warranted to evaluate the infant further. They may miss other milestones and need help, such as physical therapy. Rolling over is a milestone that should be developed in a 9-month-old infant. Rolling completely over should be accomplished by the time the infant is six months old. If they have not met this milestone by nine months of age, follow-up is warranted to evaluate the infant further. They may miss other milestones and need help, such as physical therapy.

The nurse is assessing an infant who is 9 months old. Which of the following would be an expected age-related finding? Select all that apply. Sitting without support Rolling over Standing without support Taking their first steps Walks unsupported

Choice A is correct. Autonomy vs. Shame and Doubt is the typical stage of development for early childhood, which lasts from ages 2 to 3 years, so this is what the nurse would expect for a 2-year-old client. In Autonomy vs. Shame and Doubt, children seek to develop a sense of personal control over physical skills and knowledge of independence. When they are successful, for example, with a task like toilet training, they feel independent, and it leads to a sense of autonomy. When they are not successful, they think they are a failure which then results in shame and self-doubt.

The nurse is caring for a 2-year-old client. Among Erickson's Stages of Development, which of the following stages of development would the nurse expect this client to be in? A. Autonomy vs. Shame and Doubt B. Industry vs. Inferiority C. Trust vs. Mistrust D. Initiative vs. Guilt

Choices B and C are correct. An adrenal crisis is a medical emergency for both an adult and a child. Remember, you need to add the treatment in an adrenal crisis (Addisonian crisis). The immediate treatment for a client in an adrenal crisis is replacing the corticosteroid via intravenous (IV) hydrocortisone. The treatment goal of administering IV hydrocortisone is to increase the low glucose levels and retain some of the fluid and sodium. The second essential treatment is administering IV fluids of 5% dextrose with 0.9% saline. The 5% dextrose with 0.9% saline will raise the glucose (D5) and circulating volume (0.9% saline). Giving D5W alone would be detrimental as the water will lower serum sodium levels.

The nurse is caring for a child experiencing an adrenal crisis. The nurse has established a peripheral vascular access device and should be prepared to administer intravenous Select all that apply. potassium chloride. 5% dextrose with 0.9% saline. hydrocortisone. levothyroxine. desmopressin. propranolol.

Choice C is correct. The client is lethargic and hypoglycemic. This is quite concerning and calls for the nurse to immediately administer a parenteral treatment (either glucagon SubQ/IM) or Dextrose 50% via intravenous push (IVP). While this blood glucose may respond to by mouth (PO) foods and fluids, the client is lethargic and should not be fed because of the risk of aspiration.

The nurse is caring for a child who is lethargic and with a capillary blood glucose of 46 mg/dL(70-110 mg/dL). Which essential action should the nurse take? A. Obtain another capillary blood glucose B. Encourage the consumption of 120 mL of fruit juice C. Administer prescribed glucagon SubQ D. Perform a Glasgow Coma Scale (GCS) assessment

Choice C is correct. Most eye injuries require a visual acuity exam which assesses a client's ability to read and identify distant objects. This is a standard assessment for any eye injury.

The nurse is caring for a child who reportedly got a wood chip in their right eye. The nurse should take which appropriate action? A. Rub the eye until the object dislodges B. Irrigate the affected eye with hydrogen peroxide C. Perform a visual acuity exam D. Place a cold compress on the affected eye

Choice B is correct. Autonomy vs. Shame and Doubt is the typical stage of development for early childhood, which lasts from ages 2 to 3 years, so this is what the nurse would expect for her 2-year-old patient. In Autonomy vs. Shame and Doubt, children seek to develop a sense of personal control over physical skills and knowledge of independence. When they are successful, for example, with a task like toilet training, they feel independent, leading to a sense of autonomy. When they are not successful, they think they are a failure, resulting in shame and self-doubt.

The nurse is caring for a client who is two years old. The nurse should plan care knowing that this client is in which stage of Erikson's stages of psychosocial development? A. Initiative vs. Guilt B. Autonomy vs. Shame and Doubt C. Industry vs. Inferiority D. Trust vs. Mistrust

Choice A is correct. Initiative vs. Guilt is the typical stage of development for preschool children, who are 3 to 5-year-olds, so this is correct for your four-year-old client. In Initiative vs. Guilt, children assert control and power over their environment. Success leads to initiative when they feel a sense of purpose, but children who try to exert too much power and experience disapproval and may feel a sense of guilt.

The nurse is caring for a four-year-old child. While developing a plan of care, the nurse recognizes the child is in which stage of Erikson's stages of psychosocial development? A. Initiative vs. Guilt B. Autonomy vs. Shame and Doubt C. Industry vs. Inferiority D. Trust vs. Mistrust

Choice C is correct. Regular insulin should be drawn up first. For a mixed dose of two types of insulin, rapid or short-acting insulin should always be drawn up before the intermediate or long-acting insulin. Regular or Novolin insulin is short-acting insulin with an onset within 30-60 minutes and a duration of 5-8 hours. Short-acting insulin covers the needs for meals the individual eats within 60 minutes. NPH insulin is an intermediate-acting insulin with an onset within 1-2 hours and a duration of 18-24 hours. NPH insulin covers the needs for approximately half the day and is often combined with shorter-acting insulin. The concern when mixing insulin is the contamination of the short-acting insulin with longer-acting insulin if some of the NPH is accidentally introduced into the vial of regular insulin. This could cause severe hypoglycemia with subsequent injections from the vial of regular insulin. These two types of insulin can safely be mixed as long as the correct order of drawing them into the syringe is followed.

The nurse is caring for a teenager who has just been diagnosed with diabetes. The nurse is teaching him about administering his insulin. His standing normal morning dose of insulin includes 8 units of NPH and 8 units of regular insulin. The nurse knows that the teenager understands the instructions when he says: A. "It doesn't make any difference which insulin I draw up first." B. "I cannot mix these two kinds of insulin, so I will have to give myself two shots." C. "I should draw up the regular insulin first." D. "I should draw up the NPH insulin first."

Choice A is correct. The client's temperature of 101°F (38.3°C) is a clinical fever and requires follow-up by the nurse. A fever is a temperature of 38° C (100.4° F) or greater. The nurse should address this vital sign because a fever may cause the client to develop dehydration.

The nurse is conducting a health assessment of a 2-year-old child. Which of the following vital signs requires follow-up? A. Temperature (T) 101°F (38.3°C) B. Respiratory rate (RR) 24/minute C. Pulse (P) 110/minute D. Blood pressure (BP) 90/48 mm Hg

Choice A is correct. Establishing a voiding diary/log for the client is an effective strategy as it may track the nights of the enuresis. The amount of enuresis and any precipitating factors should be noted.

The nurse is counseling parents concerned about their child experiencing frequent nocturnal enuresis. The nurse should educate the parents to do which of the following? A. Establish and maintain a voiding diary for the child. B. Discipline the child after each bedwetting episode. C. Apply diapers or pull-ups routinely at night. D. Have the child go to bed with a full bladder.

Choice B is correct. Autism often involves a strong preference for routines and predictability. Disruptions in routines, especially bedtime routines, can cause distress and anxiety in children with autism. Obtaining information about the bedtime routine allows the healthcare team to create a more comfortable and supportive hospital environment. Hospitalization may be a challenging experience for a toddler, and adding autism to the clinical picture requires home routines and rituals to be continued during hospitalization. Another strategy for a hospitalized individual is to provide a low-stimulus environment with consistent caregivers.

The nurse is developing a care plan for a hospitalized toddler who has autism. What information regarding the child is most important to obtain from the parents? A. Height and weight B. Bedtime routine C. Vaccine history D. Developmental stage

Choices A, B, C, and D are correct. A is correct. Intellectual disabilities are characteristic features of FASDs. Prenatal alcohol exposure can cause neurodevelopmental issues, leading to intellectual disabilities and cognitive impairments in children. B is correct. Another characteristic feature of FASDs is facial abnormalities. Children affected by prenatal alcohol exposure may have distinctive facial features, including a smooth philtrum (the area between the upper lip and nose), a thin upper lip, and small eye openings. C is correct. Growth delays are often seen in individuals with FASDs. Prenatal alcohol exposure can affect overall growth, leading to below-average height and weight in affected individuals. D is correct. Motor impairments, such as poor coordination and balance difficulties, can occur in individuals with FASDs. These difficulties may affect fine motor skills and gross motor functions.

The nurse is educating a group of nursing students about fetal alcohol spectrum disorders (FASDs). Which of the following features are characteristic of FASDs? Select all that apply. Intellectual disabilities Facial abnormalities Growth delays Motor impairments Anxiety

Choice C is correct. The MMR vaccine is safe to administer to a client who is breastfeeding. No evidence exists of this vaccine being weakened by breastfeeding. Further, breastfeeding does not interfere with the response to the MMR vaccine.

The nurse is educating a group of students on the measles, mumps, and rubella (MMR) vaccine. Which statement, if made by the student, would indicate effective teaching? A. "Egg allergy is a contraindication to giving this vaccine." B. "This is a three-series vaccine that should be started at birth." C. "It is safe for breastfeeding women to receive the MMR vaccine." D. "This vaccine is safe if the client is pregnant."

Choices A and D are correct. Impetigo is a skin condition caused by group A Streptococcus (GAS; Streptococcus pyogenes) or Staphylococcus aureus. The condition is highly contagious and spreads by contact with the vesicles. The vesicles should remain clean and dry, and swimming is prohibited because it allows for further disease transmission. Children can return to school 24 hours after beginning antimicrobial therapy if the affected area remains covered. Draining lesions should be kept covered. Linens are an effective way to transmit the bacteria, and they should not be shared and laundered daily to prevent reinfection.

The nurse is educating the parents of a child diagnosed with impetigo. Which of the following statements, if made by the parent, would indicate effective understanding? Select all that apply. - "I should keep my child home from swim practice until the blisters heal." - "The virus causing this condition may cause skin outbreaks from time to time." - "My child should wear a mask in public to prevent others from getting sick." - "I should not share my child's linens with anyone else in the house." - "I should keep the draining blisters uncovered."

Choice B is correct. In the early stages of pregnancy, adolescent clients often deny or conceal their pregnancy. Following confirmation of a positive pregnancy test, common reactions include ambivalence, shock, fear, or apparent apathy. The nurse must emphasize the significance of early prenatal care to prevent complications in the adolescent's pregnancy. Although some clients may want to take some time before notifying their parent(s)/caregiver(s), prolonged denial or concealment of the pregnancy will lead to delayed prenatal care and related complications. The nurse should be aware that nonjudgmental nursing support is critical throughout this sensitive time for the safety of the teen and her pregnancy.

The nurse is formulating a lesson plan for a presentation on teenage pregnancy for a local high school. To most effectively determine which topics to cover, the nurse must understand that: A. There is a low risk of complications in teen pregnancies B. Teenage pregnancies are commonly denied and concealed in the early stages C. Teens are using contraceptives at a decreased rate D. Teenage pregnancies are planned by teenagers as a form of rebellion

Choice C is correct. An untreated streptococcal infection, specifically Group A streptococcus, may lead to rheumatic fever, a severe condition with cardiac implications.

The nurse is interviewing the parents of a child diagnosed with rheumatic fever. Which previous infection is linked to the development of this condition? A. Cystitis B. Influenza C. Streptococcal infection D. Whooping cough

Choices A and B are correct. Erythema infectiosum (Fifth disease) characteristically causes a child to develop erythema on the face (slapped face appearance). It also causes the appearance of maculopapular red spots distributed on the upper and lower extremities. Finally, the client will have mild flu-like symptoms such as a fever, headache, and malaise.

The nurse is performing a physical assessment on a child admitted with erythema infectiosum (Fifth disease). Which of the following would be an expected finding? Select all that apply. Erythema on face Headache Nuchal rigidity Hepatosplenomegaly Photophobia

Choice C is correct. Trust vs. Mistrust is the typical stage of development for infancy, which lasts from birth to 18 months. This is the stage the nurse would expect for a 2-month-old client. In this stage, children develop a sense of trust when caregivers provide reliability, care, and affection. When infants do not have that, they will build Mistrust.

The nurse is performing a psychosocial assessment on a 2-month-old infant. Which of the following psychosocial stages would be expected from this client? A. Initiative vs. Guilt B. Autonomy vs. Shame and Self Doubt C. Trust vs. Mistrust D. Industry vs. Inferiority

Choice B is correct. This image shows an injection given in the vastus lateralis. This is the preferred injection site for IM injections in infants less than 12 months of age. The injection should be administered into the bulkiest part of the vastus lateralis muscle.

The nurse is preparing to administer a vaccine to an infant. Which location should the nurse select for administration? See the images in the options below.

Choice A is correct. Diabetes mellitus is a common co-morbidity associated with cystic fibrosis (CF). The damage that CF may cause to the pancreas may induce diabetes. Thus, random blood glucose levels and quarterly hemoglobin A1C levels are commonly ordered throughout the course of the illness. A random blood glucose level greater than 200 mg/dL may suggest the presence of diabetes.

The nurse is preparing to assess a child with cystic fibrosis at the outpatient clinic. The nurse anticipates that the primary healthcare provider (PHCP) will order which routine laboratory test? A. Blood glucose B. Total cholesterol C. 24-hour urine D. Blood cultures

Choice C is correct. According to Freud's developmental stages, toilet training usually occurs during the anal phase. This development theory believes that children in this stage derive pleasure from eliminating body waste.

The nurse is reviewing Freud's Psychosexual Stages of Development with a student. It would be correct for the student to state that the milestone within the anal stage is A. seeing itsself as separate from the caregiver. B. the onset of puberty. C. toilet training. D. developing emotional relationships.

Choice D is correct. Studies have long held that the failure of adolescents to develop identity results in role confusion. According to Erik Erikson, the main and most important developmental tasks for adolescents are to solve the identity versus role confusion crisis, construct their own unique sense of identity, and find the social environment where they can belong to and create meaningful relationships with other people.

The nurse is speaking to the parents of an adolescent client who report that their child is having difficulty finding their identity. The nurse responds that the failure of the adolescent to develop their identity would result in which of the following? A. Shame B. Guilt C. Inferiority D. Role confusion

Choice C is correct. Soy-based yogurt is permitted as it does not contain added sugars and will not cause intestinal complications, unlike cow's milk products.

The nurse is teaching a parent of a 7-month-old client about food choices that may be introduced into the diet. The nurse should recommend which dietary item? A. cows milk B. apple juice C. soy-based yogurt D. flavored sports drinks

Choice A is correct. Vaccinations, such as the pneumococcal conjugate vaccine (PCV) and influenza vaccine, can help reduce the risk of ear infections in children. They are appropriate interventions for a child at risk for recurrent otitis media. Choice B is correct. Good hand hygiene practices, such as washing hands regularly, and teaching proper respiratory etiquette, like covering the mouth and nose when coughing or sneezing, can help prevent the spread of infections, including those that can cause ear infections.

The nurse is teaching a parent of a child with recurrent otitis media. Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply. - "Keeping my child current on their vaccine schedule will be important." - "My child should wash their hands with soap and water or hand sanitizer frequently." - "My child should not wear headphones." - "I will make sure my child receives annual hearing examinations." - "I will have my child wear a cap while swimming in a pool."

Choices B and C are correct. Parents should stay with their children while trying to use the toilet. Toilet training may be scary for some toddlers; it is a new and unfamiliar activity when they learn about their bodies and how to control something they have not previously controlled. It is essential to their psychosocial development that the toddler feels safe and supported; therefore, providing education to stay with the child while using the toilet is a good tip. Parents should limit sitting on the toilet to 5-8 minutes. Toilet training can be frustrating for toddlers, and it is important to foster their autonomy instead of increasing their frustration. If they have not been able to use the toilet after 5-8 minutes, it is unlikely that they will be able to do so. They may not have full bladder and should not be forced to keep sitting on the toilet if it is unsuccessful. Limiting the time on the toilet to 5-8 minutes will limit frustrations for the toddler and foster autonomy and success in toilet training.

The nurse is teaching a parenting class regarding toilet training for toddlers. Which of the following statements would be correct for the nurse to make? Select all that apply. "Most children are ready to begin toilet training between 12 and 18 months old." "Stay with the child while they are trying to use the toilet." "Limit sitting on the toilet to 5-8 minutes at a time." "A child should be able to stay dry throughout the night before you begin toilet training." "A diet low in fiber helps supports the development and maintenance of bowel movements."

Choices A, C, D, and E are correct. Varicella is a highly contagious virus that may be spread by aerosolized droplets, contact with lesions, and contaminated surfaces. A child may return to school once all the lesions have crusted over. Fever is a common manifestation associated with varicella, and acetaminophen may be taken as prescribed to decrease the fever. Symptomatic care for a child with varicella includes cool baths with products such as baking soda or uncooked oatmeal added to relieve itching. Calamine lotion may also be applied to soothe the skin. Ibuprofen and aspirin should not be taken during the course of the illness because they may cause life-threatening skin infections.

The nurse is teaching parents of a child diagnosed with varicella. Which of the following information should the nurse include? Select all that apply. - Your child may return to school once the lesions have crusted. - Your child should take the entire course of antibiotics. - Acetaminophen may be used for fever. - Baths with baking soda may help with the itching. - Do not use any aspirin or ibuprofen during the illness.

Choice B is correct. Urinalysis shows red blood cells (hematuria) and protein (proteinuria) in a client with AGN. In addition to hematuria, one of the characteristic findings of AGN is the presence of red blood cell casts.

The nurse reviews the assessment data for a child with acute glomerulonephritis (AGN). Which of the following would be an expected finding? A. Urine specific gravity of 1.004 [1.005-1.030] B. Proteinuria C. Urinary incontinence D. Hypotension

emperature Papules and vesicles Reports of burning and itching Location of the lesions

The nurse reviews the history and physical and vital signs Which findings are most significant? Select all that apply Temperature Papules and vesicles Reports of burning and itching Blood pressure Location of the lesions

Choice C is correct. The finding of a blood pressure that is 126/90 mmHg is high for a one-year-old infant. The normal blood pressure of an infant this age is about 90/56 mmHg.

The pediatric nurse is taking vital signs on a one-year-old patient. Which of the following vital signs are abnormal? A. A respiratory rate of 30 breaths per minute B. An axillary temperature of 99.0 degrees Fahrenheit C. Blood pressure of 126/90 mmHg D. Heart rate of 120 beats per minute

Choices A, D, & E are correct. A is correct. Thin nasal secretions are an expected symptom of RSV. This is an acute viral infection that affects the bronchioles. Children experience significant upper respiratory congestion when dealing with RSV and may need frequent suctioning to keep the airway clear and lessen the work of breathing. D is correct. Nasal flaring is an expected sign of RSV. This is a typical signal of respiratory distress in an infant or young child. The nares flare outward with inspiration due to the use of accessory muscles and increased effort to breathe. E is correct. Crackles in the lungs are an expected finding with RSV. This sound occurs due to inflammation or fluid accumulation in the alveoli which results in decreased gas exchange. Wheezing may also occur due to the thick mucus in the bronchioles that restricts airflow

The pediatric nurse is treating an 18-month-old who has tested positive for Respiratory Syncytial Virus (RSV). Which of the following signs and symptoms would the nurse expect to find? Select all that apply. Thin nasal secretions. Productive cough. Bradypnea. Nasal flaring. Crackles in lungs. Drooling.

aerosolized droplets; immunization

The primary healthcare provider diagnoses the client with varicella. The nurse understands that this virus is primarily spread through ____ To primarily prevent the transmission of varicella, the nurse should advocate for ____

Choices A, C, D, and E are correct. Good education regarding the prevention and treatment of pediculosis capitis (head lice) is essential. Lice do not fly or jump and are primarily spread by hats, scarves, combs, brushes, and other items used near the hair. White eggs (nits) are firmly attached to the hair shafts, and lice are small and grayish-tan, have no wings, and are visible to the naked eye. Treatment is through the application of permethrin 1% cream. This treatment must be repeated seven to ten days from the first treatment to ensure a cure. Central to the therapeutic management of this parasite is thoroughly vacuuming carpets, upholstered furniture, and laundering bed linens.

The school nurse is educating parents of children exposed to pediculosis capitis. Which of the following statements by the nurse would be appropriate to make? Select all that apply. - Avoid sharing hats, caps, or scarves - Dogs and cats need to be treated - Nits are observable on the hair shaft - You will need to repeat the treatment after seven to ten days - Thoroughly vacuum carpets and upholstered furniture

Choice C is correct. Asymmetrical pin-point lights on the pupils are a sign of strabismus. If the nurse suspects that the child has strabismus and conducts a corneal light reflex test, this may confirm her suspicions. This child should have a full eye exam performed to confirm the diagnosis and receive proper treatment.

The school nurse is performing the corneal light reflex test on a child suspected of having strabismus. Which finding does the nurse identify as a sign of this condition? A. Symmetrical pin-point light on each pupil B. Red reflex in both eyes C. Asymmetrical pin-point lights on the pupils D. Sun setting sign

Choices A, D and E are correct. To prevent the spread of bacterial conjunctivitis, it is essential not to share towels or washcloths with anyone while infected (Choice A). This is appropriate advice for preventing reinfection of bacterial conjunctivitis. If a client wears the same contact lenses, they will likely spread the disease for a second time and become infected again. They should also be instructed to discard their eye makeup to prevent reinfection (Choice D). Remind adolescent about how to perform proper hand hygiene and to perform prior to touching face or eyes to prevent spread of bacteria (Choice E.)

When educating an adolescent diagnosed with bacterial conjunctivitis about how to prevent the spread of their infection, which of the following points should you include? Select all that apply. - Do not share towels or washcloths with family members. - Stay home from school until they have taken antibiotics for 48 hours. - Apply a warm compress to lessen any irritation. - Throw out the contact lenses and get new ones. - Perform hand hygiene, especially prior to touching face or eyes

Choice C is correct. The cephalocaudal principle (also known as cephalocaudal development) refers to a general pattern of growth and development followed from infancy into toddlerhood and even early childhood whereby development follows a head-to-toe progression.

Which of the following correctly describes the physical growth pattern from infancy into early childhood? A. Growth occurs from the distal to the proximal parts of the body B. Growth occurs from the proximal to the distal parts of the body C. Growth occurs in a head-to-toe progression D. Growth initially occurs most rapidly in the extremities

Choice C is correct. An expected outcome for a pediatric client who is transitioning from being a toddler to a pre-school child is that the child will develop new coping strategies to adapt to a maturational crisis. Maturational crises occur predictably along the life span with expected challenges and tasks that require the person to develop new coping strategies since previously learned coping strategies/mechanisms are no longer useful.

Which of the following is an expected outcome for a pediatric client who is transitioning from being a toddler to a pre-school child? A. The parents will teach the child ways to perform concrete operations. B. The parents will teach the child ways to apply abstract thinking. C. The child will develop new coping strategies to adapt to a maturational crisis. D. The child will develop industry and a sense of achievement.

Choice C is correct. The parenting style described is authoritarian. This parent is often described as the 'rigid disciplinarian'. They are highly controlling; they expect always to be obeyed and are still inflexible with the rules. Though these parents may have their child's best interests at heart, they do not support their growing autonomy. Instead, they expect to be obeyed without reason.

Which of the following parenting styles is described as highly controlling, expecting to always be obeyed, and inflexible with the rules? A. Authentic B. Permissive C. Authoritarian D. Indifferent

Choice D is correct. For nystatin to be effective, the medication should come into contact with the infected area. Nystatin drops are dispensed with a calibrated dropper to allow easier administration in young children. Administering half of the dose into each side of the mouth increases the likelihood the infected area has come into contact with the medication. Specifically, when administering this medication, use the calibrated dropper to place one-half of the dose (i.e., 1 mL (100,000 units)) in each side of the infant's mouth. Additionally, avoid providing oral intake to the infant for a minimum of 5 to 10 minutes following the administration of nystatin.

While on day seven of antibiotic therapy, a 7-month-old infant develops oral thrush. Nystatin drops, 2 mL (200,000 units) four times daily, is prescribed by the infant's health care provider (HCP) for the thrush. Which nursing consideration should be implemented when administering this medication? A. Administer the medication with water B. Administer this medication through a nipple C. Give the medication with food D. Place 1 mL of the medication in each side of the infant's mouth

Choices A, C and E are correct. When discharging a pediatric patient who is newly diagnosed with hypothyroidism, it is essential to educate the parents about how to administer thyroid medication. Taking thyroid medication in the evening can cause insomnia. It should be taken at the same time each day, on an empty stomach, 30 minutes before breakfast. Constipation is common in hypothyroidism, so it is important to educate on the importance of increasing fluids and fibrous foods.

While preparing to discharge a 2-year-old newly diagnosed with hypothyroidism, you include which of the following educational points in your discharge teaching? Select all that apply. - Take the thyroid medication at the same time each day. - Take the thyroid medication 30 minutes after breakfast. - Avoid taking the thyroid medication in the evening. - No follow-up labs are necessary. - Encourage increased fluids and fibrous foods

Choice C is correct. The nurse expects that a throat culture will be ordered to confirm a diagnosis of bacterial tonsillitis. A throat culture will assess for the presence of bacteria on the pharynx and guide the team in making decisions about treatment/antibiotics for this patient. If the suspected diagnosis of bacterial tonsillitis is not confirmed, other tests may be necessary.

While working in the emergency department, the nurse is assigned a 5-year-old client with a chief complaint of sore throat. The father states that the client has been complaining of throat pain for 2 days and when he looks in the child's throat it appears red with white patches. The nurse confirms the red throat with white patches during the throat assessment. Based on these findings, the nurse expects which of the following diagnostic tests to be ordered? A. Basic metabolic panel B. Extended respiratory virus panel C. Throat culture D. Complete blood count