Children exam 3

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily

The nurse is speaking to the mother of an adolescent recently diagnosed with type 1 diabetes. The mother asks the nurse how her son's basketball training will affect his blood sugar. Which is the best response by the nurse?

"When exercising, your son should add an extra snack containing 15 to 30 g of carbohydrates for each 45 to 60 minutes of exercise."

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test?

Checking with the parents for any allergies

The pediatric nurse knows that there are a number of anatomic and physiologic differences between children and adults. Which statement about the immune systems of infants and young children is true?

Children have an immature immune response.

The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which clinical manifestations would the nurse most likely note in this child?

Drowsiness and fruity odor to breath

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child?

Effortless vomiting just after the child has eaten

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?

Encourage the child to take all the antibiotics if diagnosed with strep throat.

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse?

Encourage the mother to provide care for her infant.

Which interventions will the nurse include when caring for a child with an infectious disorder? Select all that apply.

Ensure immunization status is current. Use appropriate personal protective equipment. Provide information about disease transmission. Educate the child and family about infection control.

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect?

Gastroenteritis

The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate?

Handwashing is an effective way to prevent infection."

A parent contacts the oncology clinic nurse with concerns about mucositis following chemotherapy. Which are appropriate interventions for the nurse to include? Select all that apply.

Serve soft foods rather than hard or crunchy foods. Encourage rinsing the mouth with lukewarm water. Have the child drink fluids as often as possible to remain hydrated. Use a soft toothbrush and swish with an antibiotic mouthwash.

A client has just completed a renal biopsy. Which manifestation should be given priority attention?

The child is not voiding.

The parents of a 10-year-old with HIV have never told their child that he has the virus. The child asks the nurse why he is "on so many medications." What action should the nurse take?

The nurse should encourage the child to talk with his parents about his medications.

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate?

Vaccinations are very effective at preventing serious disease and infection."

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:

bacteria

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism?

early identification

The nurse is caring for a neonate who is suspected of having sepsis. Which assessment findings would the nurse interpret as most indicative of sepsis?

hypothermia

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease

mumps

A child with a sarcoma is receiving external beam radiation. Which possible side effect will the nurse need to explain to parents?

nausea and erythema

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

sunken fontantels (fontanelles)

A child has been prescribed growth hormone. When collecting data from this client, which report is of the greatest concern?

"My hips often hurt."

The nurse is caring for a 6-year-old child who was injured in a bicycle accident. Which question would be most important for the nurse to ask during the health history?

"Tell me how the bicycle accident happened."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?

"The treatment for the disorder will be a surgical procedure."

The nurse is caring for the client with the assessment note above. Which intervention by the nurse should take priority?

Educate the client and family about dietary requirements.

What is the leading cause of neonatal sepsis and death?

Group B streptococcus

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care?

Maintaining the intravenous (IV) fluid rate as ordered

ch.37. What information should be included in the teaching plan for a child with varicella?

Remind the child not to scratch the lesions.

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?

Teach her to wipe her perineum front to back after voiding.

Urinary tract infections are usually successfully treated by what means?

Administering antibiotics

ch.46 The nurse is providing preoperative care for a 7-year-old boy with a brain tumor, as well as his parents. Which intervention is a priority?

Assessing the child's level of consciousness.

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?

Currant jelly-like

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?

Improving hydration

A 14-month-old trauma victim has arrived in the emergency department. What client priority will the nurse need to address first?

Inadequate systemic perfusion

A nurse in the school office is seeing a 7-year-old child with type 1 diabetes after gym class. The child is jittery and appears sweaty. Which intervention would the nurse advise the child to do?

You will need to drink this 6-ounce bottle of orange juice."

A nurse is caring for a child being assessed for a possible abdominal injury and who reports abdominal pain. The mother asks why her child cannot have anything for pain. What is the best response by the nurse?

"Pain medication can mask increasing pain that could indicate a change in condition. We need to continue to assess your child's condition."

The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated?

"The signs of disease will be noted in 1 to 3 weeks."

The nurse is caring for a child admitted with congenital aganglionic megacolon. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Persistent constipation

The nurse is examining a 7-year-old with suspected appendicitis. Which physical findings would indicate the possibility of appendicitis?

Persistent, right lower quadrant pain with rebound tenderness

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention?

Prepare the infant for surgery.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Projectile vomiting

A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?

The child does not have intravenous access.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

Scarlet fever

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first?

a child with erythema infectiosum experiencing fatigue and confusion

The nurse is developing a plan of care for a child newly diagnosed with phenylketonuria (PKU). Which expected outcome takes priority?

adhering to a diet low in phenylalanine

A 10-year-old child is brought to the emergency department following a near-drowning incident. The nurse completes an assessment with the above findings. What inference can the nurse make about the child's plan of care?

admission for observation overnight

An adolescent is found wandering around. The client is confused, sweaty, and pale. Which test will the nurse prepare to perform first?

blood glucose level

The nurse is providing care to a child with leukemia. When assessing the child, which signs and symptoms would the nurse likely find? Select all that apply

bruising anorexia sore throat lymphadenopathy

When planning the care for a child with leukemia who is receiving methotrexate, the nurse would assess the child closely for which possible effect?

mucositis

The nurse is discussing nutritional requirements to the parents of a child diagnosed with phenylketonuria (PKU). Which food item would be appropriate to recommend?

orange slices

A 14-month-old child who has experienced multiple trauma has arrived in the emergency department. Which challenge will the nurse need to address first?

possible tissue damage from hypoxia

A nurse is conducting an in-service education program for a group of pediatric nurses working on the pediatric unit of a local facility. The nurse is comparing the adult chain of survival with the pediatric chain of survival. The nurse determines that the teaching was successful when the group identifies which activity as the first step in the pediatric chain?

prevention of cardiac arrest and injuries

The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia?

pulse rate and rhythm

A child is brought to the emergency department with suspected poisoning. What treatment would the nurse least likely expect to be used?

syrup of ipecac

The nurse working with the child diagnosed with type 2 diabetes recognizes the disorder can be managed by:

taking oral hypoglycemic agents.

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

urine output of 10 ml over 3 hours

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?

weight, daily

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

Risk for infection

A pregnant client who is HIV positive asks the nurse if she will be able to breastfeed the newborn. Which response by the nurse is most appropriate?

"Breastfeeding will increase your newborn's risk of contracting HIV."

The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation?

"Can you blow this cotton ball across the tray?"

A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be most important for the nurse to include in the child's preoperative plan of care?

Avoiding further abdominal palpation

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate?

"Let's put you in touch with some other girls who are also having the same body changes."

The father of a child with mononucleosis is concerned with his child's fever and cough. The father asks when antibiotic therapy will begin. What is the best response by the nurse?

"Mononucleosis is a viral infection so an antibiotic isn't used. We address the symptoms with appropriate therapy."

A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse?

"You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep."

A toddler has a fever. The parent calls the clinic wanting to know the appropriate dosage of acetaminophen to give the child. The parents say the child weighs 26 lb (11.8 kg). What is the lowest dose the nurse would instruct the parent to administer to the child?

118 mg

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38°C (100.4°F)? Record your answer using one decimal place.

7.5

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?

Acute glomerulonephritis

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?

Administer subcutaneous glucagon.

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?

Administering the measles, mumps, rubella (MMR) vaccine

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

Administration of levothyroxine indefinitely

After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?

After the lesions have crusted

The health care provider has prescribed a thyroid scan to confirm a diagnosis. What intervention should the nurse perform before the examination?

Assess the client for allergies.

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next?

Give 10 to 15 grams of a simple carbohydrate.

The nurse is preparing to administer acetaminophen to a 4-year-old child to provide comfort. Which precaution is specific to antipyretics?

Ensure proper dose and interval.

A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply.

Exposure to blood and body fluids through sexual contact Sharing contaminated needles Transfusion of contaminated blood Perinatally from mother to fetus Through breastfeeding

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply.

IV fluid administration monitor of intake and output daily weight assessment

A nurse is preparing a teaching program for a parenting group about preventing foreign body aspiration. What information would the nurse include?

If an object fits through a standard toilet paper roll, the child can aspirate it.

The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would you anticipate will be prescribed for the child?

Injections of GH

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case?

Intussusception

The nurse is caring for a pregnant client who received prenatal testing. The results showed phenylketonuria (PKU). The client is concerned and asks the nurse about PKU. Which statement made by the nurse is most accurate?

It can lead to brain damage without treatment."

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first?

Obtain blood cultures.

The nurse is caring for a 9-month-old with cryptorchidism noted on the medical record. In which manner will the nurse assess this condition?

Palpate the scrotum for the testes

ch.42 When examining the abdomen of a child, which technique would the nurse use last?

Palpation

The nurse is caring for a 2-year-old that has been rushed to the urgent care clinic immediately after swallowing an unknown number of acetaminophen tablets. Which of the following would the nurse expect to implement first?

Perform a gastric lavage.

A parent is angry about the adolescent's diagnosis of osteosarcoma. The parent is telling the adolescent that if he hadn't played football last year and broken his leg, this would not have happened. What is the nurse's best response to the parent's statement?

Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though."

The nurse is caring for a 5-year-old child recently diagnosed with type 1 diabetes. When discussing the care and management of the disorder with the child's parents, which statement(s) indicates understanding? Select all that apply.

Regular exercise will help in the regulation of my child's blood sugar levels." "The insulin dosages will be directly associated to my child's carbohydrate ingestion." "We need to rotate insulin injection sites to prevent complications."

The nurse is caring for a school-aged child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2030 National Health Goals to reduce the long-term complications from this disease process?

Schedule the child and parents to attend diabetes education classes.

ch.43 A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting?

The child has been sexually abused, maybe on the fishing trip.

A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?

The foreskin is needed for repair.

The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply.

The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing."

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?

This medication must be given by injection.

A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education?

This occurs when there is backflow of urine into the bladder and sometimes the kidneys.

A 5-year-old client is cyanotic, dusky, and has no respiratory effort upon arrival to the emergency department. The client's heart rate is 88 beats/minute. Which action will the nurse complete first?

Ventilate the client with a bag-valve mask.

The nurse is caring for a newborn in the newborn intensive care unit. The nurse notes the newborn's cardiac monitor alarms, showing a heart rate of 244. What would be the nurse's next action?

Verify the pulse rate via the femoral pulse.

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse?

When providing health information to a child of this age it should be simplistic and at the child's level of understanding.

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply.

Wipe from front to back. Encourage fluids throughout the day. Finish all antibiotics prescribed.

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). In educating the parents, the nurse would recommend that the child avoid:

caffeine

A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely?

cognitive impairment

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as:

fifth disease.

The nurse is caring for a 2-year-old child with a gastrointestinal infection resulting in 4 to 5 liquid stools per day over the past 3 days. Based on this information, which important concern(s) will the nurse address in the child's care? Select all that apply.

fluid deficiency risk: dehydration diarrhea and loss of electrolytes the risk for skin maceration in the perineum

The nurse is caring for a child on a pediatric unit who has hemodialysis three times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?

grilled chicken, apple slices, and flavored water

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy?

height increase of 4 inches

The nurse is performing an assessment on a child. Which finding indicates to the nurse the child is at risk for a urinary tract infection (UTI)?

holding urine while at school

A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition?

testicular torsion

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess?

It is difficult to keep the child awake.

An infant with bladder exstrophy is awaiting surgical repair. What is the priority nursing intervention for the nurse to complete in the care for this infant?

Keep the bladder moist and covered with a sterile bag.

A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy?

Keeping the child's lips moist with petroleum jelly to prohibit cracking

A 15-year-old boy has been diagnosed with an osteosarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area?

Lungs

A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child?

infection symptoms