Developmental Concepts - Peds Module 2
A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement? "Benzocaine drops should be placed in your eye to numb it and reduce pain." "Benzocaine is an antibiotic for your eye infection." "Benzocaine drops should be placed in your ear to numb it and reduce pain." "Benzocaine is an antibiotic for your ear infection."
"Benzocaine drops should be placed in your ear to numb it and reduce pain."
Is the following statement True or False? The nurse accurately explains to parents of a child with a fever that antipyretics will help change the course of the infection.
False Reduce the fever
The nurse has just finished administering the DTaP vaccine to a 2-month-old and is educating the parent about immunization. Which statement is accurate? A) "Bring her back for the second dose when she is 4 months old." B) "You need to renew this immunization every 10 years." C) "The 'T' stands for tuberculosis." D) "There are no side effects from this vaccine."
A) "Bring her back for the second dose when she is 4 months old."
The nurse has just taken the blood pressure of a 13-year-old, and the percentile rank is 88%. Why would the nurse categorize the child as prehypertensive? A) The teenager's blood pressure was 122/83. B) The teenager was born at 33 weeks' gestation. C) The teen gets no regular exercise. D) The teenager eats a high-fat diet.
A) The teenager's blood pressure was 122/83. A blood pressure greater than 120/80 is categorized as prehypertensive regardless of the percentile.
The rash in roseola is pruritic. Which measure would you teach the parent to provide comfort? A) Dress the child warmly to bring out the rash so that it fades quickly. B) Apply cool compresses to the skin to stop local itching. C) Discuss with the child the importance of not scratching lesions. D) Administer infant aspirin every 4 hours as necessary for comfort.
B) Apply cool compresses to the skin to stop local itching.
A nurse teaches new parents that the best way to help prevent infections in the newborn is which method? A) Keep them inside for the first month of life. B) Breastfeed. C) Limit visitors. D) Keep them warm at all times.
B) Breastfeed.
When teaching about primary and secondary humoral responses, what should the nurse identify as the immunoglobin that is first to appear in the serum? A) IgG B) IgM C) IgD D) IgE
B) IgM
The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? A) "We should apply alcohol to the lesions every four hours." B) "If he has a fever, we can give him some aspirin." C) "The lesions should eventually form soft crusts that drain." D) "We need to make sure that he washes his hands frequently."
D) "We need to make sure that he washes his hands frequently."
The nurse is caring for an 8-year-old boy with otitis media with effusion. Which situation may have caused this disorder? A) He frequently goes swimming. B) He has good attendance at school. C) He had recent bacterial conjunctivitis. D) He is experiencing recurrent nasal congestion.
D) He is experiencing recurrent nasal congestion.
The nurse is caring for a 2-year-old girl with persistent otitis media with effusion. Which intervention is most important to the developmental health of the child? A) Informing the parents to avoid nonprescription drugs B) Telling parents not to smoke in the house C) Educating the parents about proper antibiotic use D) Reassessing for language acquisition
D) Reassessing for language acquisition
The nurse is providing teaching to a new mother who is breastfeeding. The mother demonstrates understanding of teaching when she identifies which characteristics as being true of the stool of breastfed newborns? Select all that apply. A) formed in consistency B) completely odorless C) firm in shape D) yellowish gold color E) stringy to pasty consistency
D) yellowish gold color E) stringy to pasty consistency
A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? A) Chalazion B) Stye C) Blepharitis marginalis D) Conjunctivitis
D)Conjunctivitis
A 5-year-old is diagnosed with acute otitis media. Which nursing intervention would be primary? A) Cautioning the child not to pull on the ear B) Administration of a mydriatic C) Cautioning the child not to blow the nose D) Relief of pain
D)Relief of pain
The nurse is preparing to administer the diphtheria, tetanus, and pertussis (TDaP) vaccine to an infant. Which route will the nurse utilize? A) Subcutaneous B) Intramuscular C) Oral D) Intrathecal
B) Intramuscular
The nurse is administering a chicken pox vaccination to a 12-month-old girl. Which concern is unique to varicella? A) This disease can reactivate years later and cause shingles. B) Vitamin A is indicated for children younger than 2 years. C) Dehydration is caused by mouth lesions. D) Children with this disease need to avoid pregnant women.
A) This disease can reactivate years later and cause shingles. Varicella zoster results in a lifelong latent infection and can reactivate later in life resulting in shingles.
A 3-year-old girl was in the hospital for a week following open heart surgery. By the end of the week, she had contracted an infection. The nurse recognizes this type of infection as a: A) health care-associated infection (HAI). B) viral infection. C) bacterial infection. D) fungal infection.
A) health care-associated infection (HAI).
The nurse is conducting an assessment on a newborn and witnesses a startled response with the extension of the arms and legs. The nurse should document this as which response? A) Fencing B) Moro C) Tonic neck D) Rooting
B) Moro
A nurse is giving instructions to the parents of a girl with otitis media with effusion who has just undergone placement of myringotomy tubes in her ears. Which of the following should she mention to the parents? A) Encourage the child to swim for exercise B) Notify the school nurse of the child's condition C) Have the child shower rather than bathe D) Use cotton-tipped applicators to clean around the tubes
B) Notify the school nurse of the child's condition
The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? A) "Breastfeeding my baby will pass on a type of active immunity." B) "Breastfeeding my baby will pass on passive immunity." C) "Breastfeeding my baby will provide lifelong immunity against certain diseases." D) "Breastfeeding my baby will help to stimulate my baby's immune system to activate."
B) "Breastfeeding my baby will pass on passive immunity."
The school nurse is educating the parents of a child with infectious conjunctivitis. Which comment provides the most value for prevention? A) "This could have started with a head cold." B) "Don't use anything that touches her face." C) "Place the ointment inside the lower eyelid." D) "Use all the medication as directed."
B) "Don't use anything that touches her face."
A 3-hour old newborn is assessed and is tachypneic with a respiratory rate of 44. Heart rate is 168, temperature is 97.3°F (36.3°C) and blood glucose is 90. What is the first action the nurse should take? A) Feed the newborn to provide more glucose. B) Place the newborn away from drafts and under a blanket. C) Begin the newborn on oxygen with BNC at 2L. D) Place a pillow under the newborn to raise the head of the bed.
B) Place the newborn away from drafts and under a blanket. When a newborn becomes cold stressed, they often develop respiratory distress. The newborn's temperature is low, so the first nursing action is to place the newborn in a warmer environment and cover with a blanket to warm the newborn up.
The nurse is discussing Varicella immunization with a mother of a 13-month-old. The mother is reluctant to vaccinate because she feels it is "not necessary." Which comment by the nurse will be most persuasive for immunization? A) "Mild reactions occur in 5% to 10% of children." B) "Varicella is a highly contagious herpes virus." C) "Children not immunized are at risk if exposed to the disease." D) "Risk of Varicella is greater than the risk of vaccine."
C) "Children not immunized are at risk if exposed to the disease."
A pregnant woman reports she is interested in breastfeeding to promote improved health for her child. Which statement by the nurse is most appropriate? A) "Breastfeeding will improve your child's health." B) "Breastfeeding provides what is called active immunity." C) "Passive immunity can be transmitted to your child providing him with some temporary immunity against illness." D) "Lifelong immunity is provided against some bacterial illnesses from breasting."
C) "Passive immunity can be transmitted to your child providing him with some temporary immunity against illness."
The mother of a 4-month-old refuses for her baby to be "stuck" when immunized. What immunization will the nurse administer under these restrictions? A) Polio B) Hepatitis A C) Haemophilus influenzae D) Rotavirus
D) Rotavirus
A 12-hour-old infant is receiving IV fluids for polycythemia. For which complication should a nurse monitor this client? A) tachycardia B) hypotension C) decreased level of consciousness D) fluid overload
D) fluid overload
At what point should the nurse expect a healthy newborn to pass meconium? A) before birth B) within 1 to 2 hours of birth C) by 12 to 18 hours of life D) within 24 hours after birth
D) within 24 hours after birth
A nurse is assessing a toddler who is brought to the clinic by his mother. The mother states, "He's been so irritable lately and I've noticed him frequently pulling on his right ear." The nurse suspects acute otitis media based on which assessment findings? Select all that apply. A) Loss of appetite B) Upper respiratory infection 3 months ago C) Red bulging tympanic membrane D) Low-grade fever E) Mobile eardrum
A) Loss of appetite C) Red bulging tympanic membrane D) Low-grade fever
A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? A) Neck B) Arms C) Legs D) Stomach
A) Neck
A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority? A) Relieving the child's pain B) Administering a mydriatic C) Cautioning the child not to pull on the ear D) Cautioning the child not to blow the nose
A) Relieving the child's pain
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause? A) Staphylococcus aureus B) Haemophilus influenzae C) Chlamydia trachomatis D) Streptococcus pneumoniae
A) Staphylococcus aureus
A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause? A) Staphylococcus aureus B) Streptococcus pneumoniae C) Haemophilus influenzae D) Chlamydia trachomatis
A) Staphylococcus aureus
Which question by the nurse is the best one to elicit complete information about a young boy's immunization status? A) "When and where did your child receive his last immunization?" B) "Tell me which immunizations your child needs today." C) "Do you have any questions about the immunizations children need at various ages?" D) "Are your son's immunizations up-to-date?"
A) "When and where did your child receive his last immunization?"
Which situation would cause the nurse to become concerned about possible hearing loss? A) A 12-month-old who babbles incessantly, making no sense. B) An 8-month-old who says only "da". C) A 3-month-old who startles easily to sound. D) A 3-year-old who drops the letter "s".
B) An 8-month-old who says only "da".
The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder? A) Properly applying the prescribed antibiotic B) Washing hands frequently C) Keeping hands away from eyes D) Staying home from school
B) Washing hands frequently
The school nurse is assessing a student complaining of left eye pain. Upon visual inspection, the nurse notes left conjunctivae redness and thick, colored discharge. The nurse understands that these signs and symptoms are consistent with which diagnosis? Bacterial conjunctivitis Allergic conjunctivitis Viral conjunctivitis Chalazion
Bacterial conjunctivitis
During a physical assessment of a 6-year-old child, the nurse observes the child has lost a tooth. The nurse uses the opportunity to promote oral health care with the child and parents. Which comment should the nurse include in this discussion? A) "Oral health can affect general health." B) "Fluoridated water has significantly reduced cavities." C) "Try to keep the child's hands out of the mouth." D) "Limit the amount of soft drinks in the child's diet."
A) "Oral health can affect general health."
The nurse manager is orienting a new nurse. Which statement by the new nurse would indicate that the nurse manager should intervene? A) "I will document the date and time the vaccine was given in the child's permanent record." B) "I do not need to document the vaccine manufacturer's name in the child's permanent record." C) "If a child receives a vaccine at another facility, we will need to document it in the child's permanent record." D) "If a child has a fever after a vaccine, I do not have to report it to the Vaccine Adverse Event Reporting System."
B) "I do not need to document the vaccine manufacturer's name in the child's permanent record."
The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? A) "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection." B) "The pathophysiology of sepsis is complex." C) "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys." D) "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are responsible for the clinically observable effects of the sepsis."
C) "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."
The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed? A) "We need to make sure we are speaking clearly." B) "We need to face our son when we are speaking." C) "We need to raise the volume of our voices significantly so he can hear us." D) "Using hand gestures as visual cues should help our child understand a little better."
C) "We need to raise the volume of our voices significantly so he can hear us."
The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39° C (102.2° F). Which intervention would the nurse expect to implement? A) Obtaining a culture of fluid from the middle ear B) Administering antivirals to ensure broad coverage of all organisms C) Administering antibiotics as soon as they're available D) Determining if the girl's balance is shaky when walking
C) Administering antibiotics as soon as they're available
The nurse is teaching parents of a 6-year-old child about otitis media (OM). What predisposes the child to OM infections? A) The use of cotton swabs, which can damage the eardrum B) Eustachian tubes that are long and narrow in children C) Bacteria entering through the eustachian tube D) Swimming and other water activities
C) Bacteria entering through the eustachian tube
The pediatric office nurse notes that several of the young children that are waiting to see the physician may have conjunctivitis. Which findings are consistent with bacterial conjunctivitis? Select all that apply. A) There is clear, watery drainage from both eyes. B) The drainage is white. C) Only the right eye is involved. D) The child suffers from seasonal allergies. E) The drainage is yellow and thick.
C) Only the right eye is involved. E) The drainage is yellow and thick
The new mother is holding her infant, speaking softly and gently stroking the baby's face. She giggles and asks the nurse why the baby turns toward her finger when she strokes the cheeks. The nurse should explain that this is which common newborn reflex? A) Moro B) Tonic neck C) Rooting D) Sucking
C) Rooting
The nurse is caring for a 6-year-old boy with sensorineural hearing loss. Which is the least likely cause of the child's hearing loss? A) Acute otitis media B) Ototoxic medication use C) Excess noise exposure D) Intrauterine exposure to rubella
A) Acute otitis media
The nurse is preparing to administer a diphtheria, tetanus and pertussis vaccine to a 3-year-old child. Which version of the formulation of the vaccine should be administered? A) DTaP B) DPT C) TdaP D) DT
A) DTaP
The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statements by the nurse will be most helpful to the mother in accepting the vaccine? A) "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need." B) "It is one of the most commonly used childhood vaccines." C) "This vaccine is approved by the American Academy of Pediatrics." D) "This vaccine is recommended by the Centers for Disease Control and Prevention."
A) "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."
In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? A) During this procedure, small tubes are inserted into the typmpanic membrane. B) The purpose of this procedure is to decrease or stop the drainage. C) This procedure is performed as soon as otitis media is diagnosed. D) A small incision is made in the earlobe during this procedure.
A) During this procedure, small tubes are inserted into the typmpanic membrane.
Which physical findings would the nurse observe in a newborn that would indicate that the newborn is full-term? Select all that apply. A) Fingernails are present and extend to the end of the fingers. B) Pinnae are flexible with rapid recoil. C) Labia minora are prominent upon observation. D) The newborn has a relaxed posture. E) Creases on the feet cover 2/3 of the bottom of the feet.
A) Fingernails are present and extend to the end of the fingers. B) Pinnae are flexible with rapid recoil. E) Creases on the feet cover 2/3 of the bottom of the feet.
A child diagnosed with conjunctivitis is being seen in the pediatric clinic. Which statements are correct regarding conjunctivitis? Select all that apply. A) It is highly contagious. B) Treatment is symptomatic. C) Warm compresses are used to remove crusts that form on the eyes. D) It is most often caused by a virus. E) Purulent drainage is a common symptom.
A) It is highly contagious. C) Warm compresses are used to remove crusts that form on the eyes. E) Purulent drainage is a common symptom.
The nurse is caring for a child who has a depressed immune system due to chemotherapy treatments. The child is due for scheduled immunizations according to CDC recommendations. The nurse must ensure that the child does not receive which type of immunization? A) Live vaccine B) Killed vaccine C) Inactivated vaccine D) Any vaccine
A) Live vaccine
A mother asks you if there is any way to prevent acute otitis media. What would the nurse state to the mother? A) The frequency of otitis media is reduced in breastfed infants. B) Prophylactic acetic acid instillations may be helpful. C) Prophylactic myringotomy tubes can be inserted at birth. D) Beginning immunizations at birth rather than age 2 months might help.
A) The frequency of otitis media is reduced in breastfed infants.
A nurse is teaching a new mother about what to expect for bowel elimination in her newborn. Because the mother is breastfeeding, what should the nurse tell her about the newborn's stools? A) Stools should be yellow-green and loose. B) Stools should be yellow-gold, loose, and stringy to pasty. C) Stools should be greenish and formed in consistency. D) Stools should be brown and loose.
B) Stools should be yellow-gold, loose, and stringy to pasty.
The nurse has finished teaching the parents of a 10-month-old male ways to prevent another acute otitis media infection. Which statement by the mother indicates she has the correct understanding of the information provided? A) "I should continue to smoke in the house." B) "I should continue to breastfeed my son because it lowers the incidence of acute otitis media." C) "Immunizations will not help prevent another otitis media infection." D) "Because the infection is in my son's ear, hand washing is not important."
B) "I should continue to breastfeed my son because it lowers the incidence of acute otitis media."
The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement? A) Making sure the child showers and shampoos before bedtime B) Encouraging the child to keep his hands away from his eyes C) Rinsing the child's eyelids with a clean washcloth and cool water D) Washing the child's hands and face when returning from outdoors
B) Encouraging the child to keep his hands away from his eyes
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis? A) Exposure to infective agents B) Recently helped clean the basement C) Recent upper respiratory infection D) Family history of conjunctivitis
B) Recently helped clean the basement
The nurse is assisting with lab testing to measure the type of protein produced in the liver that is present during episodes of acute inflammation. Which test is the nurse performing? A) complete blood count B) erythrocyte sedimentation rate C) C-reactive protein D) blood culture and sensitivity
C) C-reactive protein
The nurse is preparing to administer acetaminophen to a 4-year-old girl to provide comfort to the child. Which precaution is specific to antipyretics? A) Check for medicine allergies B) Take entire course of medication C) Ensure proper dose and interval D) Warn of possible drowsiness
C) Ensure proper dose and interval
The community nurse is preparing an educational session on how to provide anticipatory guidance to clients for other nurses. Which example will the nurse include in the teaching? A) The nurse takes an 8-year-old child's vital signs. B) The nurse provides a vaccination to a 2-year-old. C) The nurse teaches hand washing at an elementary school. D) The nurse orders food for a post-op surgery client.
C) The nurse teaches hand washing at an elementary school.
The mother of a child with conjunctivitis asks you if her son will develop amblyopia later in childhood because of the infection. You would teach her that amblyopia results from a condition such as: A) conjunctivitis. B) prematurity. C) ptosis. D) eye strain.
C)ptosis
When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voiding per day as a good indicator of adequate fluids? A) 6 to 8 B) 4 to 6 C) 8 to 10 D) 2 to 4
A) 6 to 8
The nurse caring for a 4-year-old child documents headache, spasms, clamping of the jaw, difficulty swallowing, and stiff neck. Which of the following infections should the nurse suspect? A) tetanus B) pertussis C) diphtheria D) scarlet fever
A) tetanus
The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which clinical manifestation would likely have been noted in this child? A) Body stiffening and loss of consciousness B) Shaking the head and pulling the ear C) Severe vomiting and confusion D) High-pitched cry and nuchal rigidity
B) Shaking the head and pulling the ear
A child has been diagnosed with bacterial conjunctivitis. Which statements by the child's parent indicate the need for further education? Select all that apply. A) "All of us at home need to wash our hands really well." B) "He can go back to school in 4 hours after that thick yellow drainage is gone." C) "We should not use a towel that he has used." D) "I'll continue to use eye drops to help with the redness." E) "This is really contagious."
B) "He can go back to school in 4 hours after that thick yellow drainage is gone." D) "I'll continue to use eye drops to help with the redness."
The nurse works in a pediatrician office. Which children, who have been diagnosed with acute otitis media, does the nurse expect the physician to treat with antibiotics? Select all that apply. A) 12-year-old child who reports he has some mild ear pain with a temperature of 101.4° F (38.6° C) B) 2-month-old child who is having difficulty sleeping and has a fever of 102.6° F (39.2°C) C) 22-month-old child who is irritable with the presence of purulent drainage from her right ear D) 5-month-old child who is fussy and pulling at her ears E) 8-year-old child who is crying due to ear pain and has a temperature of 103° F (39.4°C)
B) 2-month-old child who is having difficulty sleeping and has a fever of 102.6° F (39.2°C) C) 22-month-old child who is irritable with the presence of purulent drainage from her right ear D) 5-month-old child who is fussy and pulling at her ears E) 8-year-old child who is crying due to ear pain and has a temperature of 103° F (39.4°C)