Exam 1

Your patient is 6-months-old. According to Erickson's Stage of Development, this patient is in what stage?* A. Autonomy vs. Shame & Doubt B. Trust vs. Mistrust C. Initiative vs. Guilt D. Identity vs. Role Confusion

B. Trust vs. Mistrust

Cystic fibrosis (CF) is a genetic disorder that causes the endocrine glands to work incorrectly. True or false

False

True or False: A child who is 11 months old and weighs 39.5 kg can ride in a forward facing upright position safety seat. True or False

False

When potty training a child, it is important to remember that bladder control occurs before bowel control. True or False

False

Food and babies

-can start solids at 6 months -iron fortified rice cereal first (even before whole milk) -fruits & veggies -meat & eggs -finger foods (ripe bananas, toast strips, graham crackers, cheese cubes, noodles, firmly cooked veggies, raw fruit)

Burkholderia cepacia

-cystic fibrosis patients are at an increased risk -contact precautions

5 year milestones

-jump rope -walk backwards -throw and catch with ease

Teeth and babies

6-8 teeth in 1st year, clean with cool washcloth, ibuprofen can be given for teething pain to babies >6months

You're assessing a 4 year old with epiglottitis who just arrived to the pediatric clinic. The child is drooling and has a respiratory rate of 45 breaths per minute. In addition, the child is becoming increasingly apprehensive. Which findings below exhibited by the patient represents an acute upper airway obstruction that requires IMMEDIATE treatment? Select all that apply:* A. Stridor B. Cyanosis C. Chest retractions D. Nasal flaring

A, B, C, D

A 4-year-old is hospitalized for the treatment of a brain tumor. As the nurse you know that a preschooler would struggle with which of the following issues during the hospitalization? A. Separation anxiety B. Loss of control C. Loss of relationship with peers D. Negativism

B. Loss of control

You observe toddlers playing. The children are playing with toys, but they are not playing together. This type of play is known as? A. Solitary play B. Parallel play C. Associate play D. Co-operative

B. Parallel play

A 3-year-old is hospitalized. The parent verbalizes to you that at home the child was potty trained but now the child is refusing to use the toilet and is voiding on themselves. The parent expresses concern. As the nurse you should tell the parent? A. Try potty training again while the child is hospitalized. B. Reassure the parent that this is temporary and is most likely occurring because the child is hospitalized. C. Advise the parent to set limits and implement discipline strategies for toilet accidents. D. Recommend the parent avoids ritualistic routines until the child is not hospitalized.

B. Reassure the parent that this is temporary and is most likely occurring because the child is hospitalized.

Your patient is 5-months-old. Which developmental milestone, if not performed by the infant, should be further investigated?* A. Crawling B. Rolling over from back to tummy C. Using the pincer grasp D. Sitting without support

B. Rolling over from back to tummy

According to Piaget's Theory of Development, what stage would a 14-month-old be in? A. Formal operational B. Sensorimotor C. Preoperational D. Concrete operational

B. Sensorimotor

A 14 month old boy is hospitalized with dehydration. He is unconsolable, screaming, and rejecting your physical contact. What best describes the infants response to you? A. Fear of injury and pain B. Separation anxiety-PROTEST PHRASE C. Separation anxiety-DESPAIR D. Loss of Control

B. Separation anxiety-PROTEST PHRASE

According to Piaget's Theory of Development, your patient is in the Preoperational Stage based on their age. The patient demonstrates they are in this stage by which finding below? A. The child understands time and quantity. B. The child likes to play pretend. C. This concept of object permanence is not developed yet. D. The child possesses abstract thinking rather than concrete thinking.

B. The child likes to play pretend.

You note a 10-month-old is using the pincer grasp. Which option below best describes this milestone?* A. The infant is able to grasp large objects with the palm and forefingers. B. The infant is able to grasp small objects with the index finger and thumb. C. The infant is able to grasp small and large objects with the middle finger and thumb. D. The infant is able to grasp large objects with the palm and thumb.

B. The infant is able to grasp small objects with the index finger and thumb.

A 3-week-old infant is exclusively breast fed. What will you include in the patient education to the mother during this clinic visit?* A. Introduce solid foods around 3-4 months of age along with breast feeding. B. The infant needs to be supplemented with Vitamin D (400 IU) daily. C. Cow's milk may be substituted for breast milk around 6 months. D. Breast feeding is only recommended for the first 4 months of life.

B. The infant needs to be supplemented with Vitamin D (400 IU) daily.

A 2 year-old is scheduled to have a tonsilectomy. How would you educate the patient? A. Provide a video and explain in clear terms. B. Use picture books & puppets and repeat explanations. C. Describe the procedure as it is about to be performed. D. Engage in conversations about the procedure and encourage the child to express his or her thoughts.

B. Use picture books & puppets and repeat explanations.

You're educating the parents of an 8-month-old, who was recently diagnosed with cystic fibrosis, about the disease. You explain to the parents that the child has a gene mutation on the ____________. The gene that is specifically mutated is called?* A. endocrine glands; Hbg S gene B. exocrine glands; CFTR gene C. endocrine glands; Chromosome 21 D. exocrine glands; HTT gene

B. exocrine glands; CFTR gene

A parent asks about the pathophysiology of cystic fibrosis. You provide teaching by telling the parent...

Children with cystic fibrosis have an increased sodium and chloride content of their sweat.

Flu teaching to parents

Oseltamivir within 48 hours of symptom onset

Manifestations of down syndrome

-protruding abdomen -broad, short feet and hands -hypotonia -small features (small ears and short pinna) -upward slant to the eyes

4 year milestones

-skip/hop on 1 foot -throw a ball overhead -catch a ball

36 month (3 year) milestones

-stands on 1 foot -tiptoe -draw circles -ride tricycle

Tobramycin monitoring

-weight -I's & O's (r/t oliguria) -auditory function (r/t neurotoxicity) -give over 20-60 mins

You're developing a plan of care for a 3-year-old that includes play activities. What type of play does a child participate in at this age? A. Parallel B. Cooperative C. Associative D. Solidary

A. Parallel

A preschooler is in what stage of development according to Piaget's Theory? A. Preoperational B. Concrete operational C. Formal operational D. Sensorimotor

A. Preoperational

A first-time mother asks you what type of toy would be best for her 2 1/2 year old. Your response is? A. Push-pull toys, large balls, and wooden puzzles B. Video games, CDs, remote control truck C. Movies, computer games, and board games D. Marbles, dress-up clothes, and card games

A. Push-pull toys, large balls, and wooden puzzles

A patient is scheduled to take Pancreatin. When will you administer this medication to the patient?* A. Right before all meals and snacks B. Right before meals only C. Immediately after meals and snacks D. Immediately after meals only

A. Right before all meals and snacks

What is an example of animism in a 3-year-old child? Select the most appropriate option below: A. The child leaves the T.V. on while she plays outside so her doll won't become bored. B. The child dresses up in a doctor outfit. C. The child uses a stick as a sword to slay dragons. D. The child copies her mother by putting on jewelry and high heels.

A. The child leaves the T.V. on while she plays outside so her doll won't become bored.

Piaget: Sensorimotor Stage

0-2 years- first stage, reflexive -> repetitive -> imitate, separation anxiety (4-8 months), object permanence, recognize and use symbols "mental representation, familiar vs unfamiliar people (6-8 months)

You are observing a 5 month old for developmental skills. Which of the following skills would concern you if the infant was not demonstrating? A. Grasps objects B. Sitting with support C. Follows objects with eyes D. Crawling

C. Follows objects with eyes

Dietary needs of kids with cystic fibrosis

"Child should eat 150% of the recommended daily food requirement for age and size" -well balanced, high protein, high calorie -Reuptake of fat soluble vitamins (A, D, E, K) are decreased so water soluble forms can be given -When eating more fat, add more enzymes -Growth failure despite adequate nutritional support may indicate deterioration of pulmonary status

Parallel play

(toddlers) 1-3 yrs plays alongside, not with another characteristic of toddlers

Measles, Mumps, Rubella (MMR) & Varicella vaccines

-don't delay for mild illness without fever -subcutaneous -contraindicated with gelatin allergy

Pancreaze

-enternal feeding -give 30 mins before administering pancrealypase

Airway Clearance therapies (ACTs) / Chest Physiotherapy (CPT) for children with cystic fibrosis

-Percussion, vibration, & postural drainage -Normally done 2x/day; should be done up to 4x/day with pulmonary exacerbations -Never do if pt. has untreated tension pneumothorax

18 month milestones

-able to walk backwards -can throw a ball overhand -jumps with 2 feet -push/pull toys -build tower of 3-4 blocks -turn pages 2 or 3 at a time

2 year milestones

-able to walk up and down stairs one step at a time -can kick a ball -stacks 5-7 blocks -can turn pages 1 at a time

Select all the signs and symptoms that can present with epiglottitis?* A. Slow onset B. Difficulty swallowing C. Drooling D. High Fever E. Barking cough F. Stridor G. Exudate on Tonsils H. Crackles

B, C, D, F

Rotavirus vaccine route

oral / PO

Associative play with others

preschoolers

Providing 4 month old atraumatic care during immunizations

put sucrose on pacifier

Corticosteroid administration

shake 3-4 seconds, rinse and expectorate after, inhale slowly

Nocturnal sleep pattern

3-4 months

Speech by 1 yr

3-5 word vocab understands "no" by 9-10 months

Newborn head circumference

33-35 cm head and chest are equal diameter by 1-2 yrsTodd

Discharge teaching for cystic fibrosis patient

Administer pancreatic enzymes with meals and snacks, high protein/high cal diet, increase fluids, encourage aerobic activity

Explore ways to attract the opposite sex and using personal friendships to confirm identity

Adolescence

A 2-year-old weighed 7 lbs. at birth. How much should the child weigh now? A. 14 lbs. B. 28 lbs. C. 21 lbs. D. 36 lbs.

B. 28 lbs

You're providing caring to a 2-year-old and have noted negativism. Which statement by the nurse to the toddler will help decrease negativism when administering medications to the toddler? A. "Are you ready for your medicine?" B. "Can you take your medicine in a cup?" C. "Do you want to take your medicine now?" D. "You can take your medicine in the blue or green cup."

D. "You can take your medicine in the blue or green cup."

Bronchiolitis

Inflammation of the bronchioles that usually occurs in children younger than 2 years, often caused by the respiratory syncytial virus (RSV), give humidified O2, suction as needed

At 8-9 months of age, what milestone should an infant be able to successfully perform?* A. Begin walking B. Say several words like mama or dada C. Sit without support D. Follow basic commands

C. Sit without support

You're assessing a 2-month-old infant. Which finding below is a normal milestone that should be reached by this infant at this age?* A. The infant can sit up with support. B. The infant holds a rattle. C. The infant smiles at its parent. D. The infant is afraid of strangers.

C. The infant smiles at its parent.

A patient completed a sweat test yesterday. The results are back and are 45 mmol/L. As the nurse you know this means:* A. The patient tested positive for cystic fibrosis. B. The patient tested negative for cystic fibrosis. C. The patient needs further testing because results are not conclusive

C. The patient needs further testing because results are not conclusive

During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain _________ can help prevent most cases of this condition?* A. respiratory syncytial virus, palivizumab B. influenza virus, annual flu shot C. haemophilus influenzae type b, Hib vaccine D. rotavirus, RV vaccine

C. haemophilus influenzae type b, Hib vaccine

You're assisting a patient with performing chest physiotherapy. It is very important you have the patient ___________ during the therapy sessions.* A. bear down B. use the incentive spirometer C. huff cough D. use a peak flow meter

C. huff cough

A 2 year-old patient with cystic fibrosis is scheduled to take Pancrelipase. How will you administer this medication?* A. orally with yogurt B. orally with pudding C. orally with applesauce D. orally with ice cream

C. orally with applesauce

7 month developmental milestone

bangs cubes on the table

10 month developmental milestone

can go from prone to sitting, can balance while sitting

Newborns anterior plate

closes 12-18 months

Trust vs. Mistrust

delayed gratification, caregiver/infant relationship

Diagnostic findings for cystic fibrosis

sweat chloride 85, decreased fat soluble vitamins, large bulky greasy steatorrhea, obstructive emphysema and atelectasis on chest xray

Early finding of hypoxemia in infants

tachypnea

Bronchodilators with nebulizer aerosol therapy

take vitals before, take slow deep breaths, determine need of mask, attach to air source

boys sexual development stages

testicular enlargement, pubic hair, vocal changes, facial hair

meds for cystic fibrosis

tobramycin, mucolytics (dornase alfa), bronchodilators (albuterol), steroids, expectorants

Manifestation of oxygen toxicity

unconsciousness (rapid onset)

Plan of care for asthma

upright position, monitor O2 sat, administer bronchodilators

15 month developmental milestones

walk, go up the stairs, can hold cup, build tower of 2

Cystic fibrosis manifestations

wheezing, clubbing, barrel chest, thick mucus, delayed growth

S&S of Deteriorating Respiratory Status

wheezing, retraction of sternal muscles, nasal flaring

Asthma peak-flow meter teaching

zero meter, record highest reading, perform 3x, blow hard and fast, stand upright

Family teaching about Pancrelipase (Creon)

"You can open the capsule and sprinkle the contents over applesauce" -combo of 3 pancreatic enzymes that cystic fibrosis patients are normally low on due to pancreatic insufficiency -Normally 1-5 capsules are taken 10-30 mins before eating snacks or meals -can be swallowed whole or taken apart and sprinkled on applesauce -Rinse mouth after taking to avoid breakdown of oral mucosa

You need to start an IV on a 4-year-old. Select the appropriate interventions to perform before starting the IV to help the preschooler cope with this procedure. Select-all-that-apply:* A. Let the child know that at 9:00 am you will be starting the IV. B. Be honest with the child about what to expect with starting the IV. C. Have a doll available that the child can start an IV on. D. Give the child privacy and direct the parents to the waiting room while the IV is started. E. Encourage and answer all the child's questions before starting the IV.

B, C, E

You're providing care to a 1-month-old infant who is hospitalized. The parents are unable to be at the bedside. The infant is crying. Select appropriate nursing interventions for this infant:* A. Let the infant play with crib mobiles B. Swaddle the infant C. Attempt to play peek-a-boo with the infant D. Rock the infant E. Distract the infant with a toy

B, D

Your patient is 4-years-old. According to Erickson's Stages of Psychosocial Development the child should develop ____________ by the end of their developmental stage. A. trust B. purpose C. autonomy D. competence

purpose

School Age children physical development

rapid change in height and weight, boys and girls growth difference becomes evident

6 month developmental milestones

rolls back to front & holds bottle

5 month developmental milestone

rolls front to back

The mother of a 2-year-old verbalizes concern about how her child has suddenly developed temper tantrums. She asks about preventive measures. What are some preventive measures you can educate the mother about? Select-all-that-apply: A. Avoid giving the child choices B. Distract the child C. Give in to the child's request D. Prepare the child for a change in activity or an event a few minutes before it occurs E. Avoid new activities when the child is hungry or tired

B, D, E

Which statement below is TRUE regarding a 5-year-old's cognitive development based on Piaget's Theory? A. "The goal of this stage is to achieve the understanding of object permanence. "B. "This child now has the ability to think logically about events." C. "This child's thinking is still egocentric and they can't understand the point of views of others." D. "This child has the ability to create hypothetical arguments."

C. "This child's thinking is still egocentric and they can't understand the point of views of others."

The physician orders chest physiotherapy on your patient with cystic fibrosis. This is best performed:* A. immediately after a meal B. right before a meal C. 1-2 hours after a meal D. only at bedtime

C. 1-2 hours after a meal

An infant weighed 8 lbs. at birth. How many lbs. should the infant weigh at 6 months? A. 24 lbs B. 10 lbs C. 16 lbs D. 32 lbs

C. 16 lbs Birth weight should DOUBLE at 6 months and triple by 1 year

You're developing a plan of care for an infant and you include activities for play. The play activities include hiding a toy and letting the infant look for it along with playing peek-a-boo. Which infant below would best benefit from this type of play?* A. 6-month-old B. 2-month-old C. 9-month-old D. 4-month-old

C. 9-month-old

Which statement is correct regarding the role of the epiglottis? A. This structure prevents food from entering the nasopharynx. B. The epiglottis helps with vocal cord vibration. C. After swallowing this structure moves downward to prevent swallowed contents from entering the trachea. D. The epiglottis is found in between the vocal folds.

C. After swallowing this structure moves downward to prevent swallowed contents from entering the trachea.

A 20-month-old is in what stage of development according to Erickson's Stages of Development? A. Industry vs. Inferiority B. Initiative vs. Guilt C. Autonomy vs. Shame and Guilt D. Trust vs. Mistrust

C. Autonomy vs. Shame and Guilt

A 3-year-old is hospitalized and the parent has to leave to care for other children but will be back to visit. What observation found in this preschooler would demonstrate the child is experiencing the protest phase of separation anxiety? A. Loud crying that is inconsolable B. Withdrawn and sullen C. Crying quietly and acting out D. Happy and content

C. Crying quietly and acting out

A toddler is hospitalized and the parent had to temporarily leave the child. The child was inconsolable when the parent left, but now is quite and withdrawn. This is known as what stage of separation anxiety? A. Detachment B. Denial C. Despair D. Protest

C. Despair

Newborn length

45-55 cm doubles by 5 months triples by 12 months

The mother of a toddler verbalizes her child has become a picky eater. What are some strategies the mother can implement to help her child? Select-all-that-apply: A. Have small easy to grab nutritious snacks available rather than 3 large meals a day B. Give the child new foods to try C. Use the same plate and cup for meals D. Offer food items that are mixed

A, C

You're helping develop a meal plan for a 10-month-old. Which foods will you select to be part of the meal plan? Select all that apply:* A. Mashed potatoes B. Grapes C. Soup D. Toast with honey

A, C

Select the systems below that are affected by cystic fibrosis:* A. Reproductive B. Lymphatic C. Respiratory D. Gastrointestinal E. Neuro F. Integumentary

A, C, D, F

You're providing care to an 18-year-old male who has cystic fibrosis. Select all the possible complications this patient can experience due to cystic fibrosis:* A. Blood glucose 255 mg/dL B. Hearing disturbances C. Hemoptysis D. Greasy, foul smelling stools E. Weight gain F. Meconium ileus G. Excessive mucus production H. Dyspnea I. Coughing J. Hyperoxemia K. Infertility

A, C, D, G, H, I, K

A patient with cystic fibrosis is diagnosed with pancreatic insufficiency. As the nurse you know that the patient will be lacking:* A. Amylase B. Pepsin C. Protease D. Maltase E. Lipase

A, C, E

Your patient, who is 2 years old, is having a temper tantrum. What actions below are not appropriate for dealing with this situation? Select-all-that-apply: A. Attempt to stop the tantrum B. Protect the child from hurting themselves C. Ignore the behavior D. Reason with the child E. Leave the child alone until the tantrum stops F. Be consistent with your approach

A, D, E

A mother brings her 8 month old child in for a well visit. Which statement by the mother would raise concern for the infants safety and the mother would need to be re-educated? A. "I love using the hot steam vaporizer when he has a cold." B. "He is still riding in a rear-facing car seat." C. "Yesterday I threw away all of our house plants." D. "We have a gate at the stairs."

A. "I love using the hot steam vaporizer when he has a cold."

You're teaching a new mom of a 1-week-old infant on how to prevent SIDS (Sudden Infant Death Syndrome). Which statement by the parent requires you to re-educate the parent on this topic?* A. "The best sleeping position for the baby is on their side or tummy". B. "It's okay to share the same room with the baby." C. "I will stop swaddling the baby once he can roll over onto his tummy". D. "I will be sure to remove extra blankets and toys from the baby's bed."

A. "The best sleeping position for the baby is on their side or tummy".

A parent verbalizes concern about her 3-year-old stammering while pronouncing words and asks for suggestions. Which statement by the nurse to the parent is NOT an appropriate intervention regarding the child's stammering? A. "When the child stammers help the child finish the word." B. "Encourage the child to take their time as they speak." C. "It is normal for a child to stammer during this time and should subside." D. "Be patient and listen attentively to the child as she speaks."

A. "When the child stammers help the child finish the word."

A 3 year old arrives to the ER. The child has a temperature of 102.4 'F, respiratory rate of 45, and is agitated. The child is diagnosed with epiglottitis. You note the child is sitting up, positioned forward with chin in the air and the tongue is protruding with the mouth open. Which nursing intervention below is NOT appropriate for this patient?* A. Assist the patient in a supine position. B. Keep the child on the parent's lap during treatments. C. Keep the child nothing by mouth. D. Avoid taking a temperature on the patient orally.

A. Assist the patient in a supine position.

During an assessment of a 10-month-old infant, you note on the infant's gum line two teeth that have erupted. These are the only teeth present in the infant's mouth. These teeth are known as the?* A. Lower central incisors B. Upper central incisors C. Lateral incisors D. Canine

A. Lower central incisors

The nurse is educating the parents of a 13-month-old on how to avoid dental caries. Which statements should the nurse include in the education about this topic to the parents? Select-all-that-apply: A. "If a bottle is given at night, be sure to water down the juice before giving it to the child". B. "When your child's first teeth erupt, it is time to go to the dentist." C. "If your water at home does not contain fluoride, fluoride supplementation may be needed". D. "To help promote autonomy in your child, he should brush his teeth by himself without assistance".

B, C

You're discussing nutrition with your patient who has cystic fibrosis. You explain that it is very important the patient regularly takes fat-soluble vitamins. This includes:* A. Vitamin B B. Vitamin D C. Vitamin C D. Vitamin K E. Vitamin E F. Vitamin A

B, D, E, F

You're assessing the development of a 5-year-old. Which of the following are FINE motor skills a child should be able to perform at this age? Select-all-that-apply: A. Ride a tricycle B. Use blunt tip scissors C. Hop D. Skip E. Copy triangles and circles F. Print their first name

B, E, F

You're teaching a group of new moms about how to assess toilet training readiness in their toddler. Which statement by a participant demonstrates they did NOT understand the education provided:* A. "I should start potty training once my child has had a dry diaper for 2 hours or more." B. "It is best to start night-time potty training before day-time potty training." C. "Having regular bowel movements is a sign of potty training readiness." D. "My child can sit on the toilet for at least 10 minutes without fussy, so I think I will trying potty training soon."

B. "It is best to start night-time potty training before day-time potty training."

Which statement by the mother demonstrates her child is ready for toilet training? A. "She fusses when I sit her on the potty. What can I do?" B. "She is waking up dry from a nap for about a couple of weeks now." C. None of the options are correct. D. "I'm still changing a wet diaper every 2 hours."

B. "She is waking up dry from a nap for about a couple of weeks now."

Regarding question 2, what is the recommended preventive administration schedule for this medication in preventing epiglottitis?* A. 4, 6, 12-15 months and 4-6 years B. 2, 4, 6, 12-15 months C. 4, 6 months and 4-6 years D. 2 and 6 months

B. 2, 4, 6, 12-15 months

An infant was 21 inches at birth. How many inches should the infant be at 6 months?* A. 30-36 inches B. 24-27 inches C. 23-25 inches D. 22-24 inches

B. 24-27 inches At 6 months the infant should grow about half an inch to an inch to 1 inch per month

At what age would you educate the parents of an infant to stop swaddling the infant because the infant will be able to roll over onto its tummy?* A. 2 months B. 4 months C. 6 months D. 10 months

B. 4 months

You're assessing the height of a 24-month-old. The child is 34 inches. Based on this measurement, what is an estimated adult height for this child? A. 6 feet 2 inches B. 5 feet 8 inches C. 5 feet 2 inches D. 6 feet

B. 5 feet 8 inches At two years of age, a child is about HALF of their adult height.

You're providing car seat safety education to a mother of an 18-month-old. Which statement by the mother requires you to re-educate her about this topic? A. The safest place for the child is in the back seat. B. A child is switched to a forward-facing car seat at 12 months. C. A child less than 24 months of age should be in a rear-facing care seat. D. My son sits in a rear-facing car seat in the back of the car.

B. A child is switched to a forward-facing car seat at 12 months.

What nursing intervention would you NOT include in the plan of care with a two-year old experiecning loss of control? A. Allow the two-year old to select if they want orange juice or milk for breakfast. B. Distract the toddler from looking at pictures of parents placed at bedside. C. Provide routines and rituals the 2-year old is familiar with. D. Anticipate temper tantrums

B. Distract the toddler from looking at pictures of parents placed at bedside.

You're assessing a 10-month-old infant. You note on examination the anterior fontanelle is open. The nurse will: A. Document this as an abnormal finding because this fontanelle should close at 2 months B. Document this as a normal finding because this fontanelle closes at about 18 months C. Document this as a normal finding because this fontanelle closes at about 12 months D. Document this as an abnormal finding because this fontanelle should close at 6 months

B. Document this as a normal finding because this fontanelle closes at about 18 months

Respiratory medications for children with cystic fibrosis

Bronchodilators: administer first, can increase blood sugar. Ex. Levalbuterol (xopenex) Dornase alfa (pulmozyme): mucolytic, decrease viscosity of mucus, no "major" adverse affects (can cause minor voice changes and laryngitis)

A 12-month-old arrives to the health clinic for a well visit. You're assessing the infant's developmental milestones. Select below all the milestones the child should be able to perform?* A. Rides a tricycle B. Draws a triangle C. Pulls to a standing position and can take a few steps D. Follows simple commands like "wave bye-bye" E. Puts objects in a container F. Hits two small wooden blocks together G. Says 2-3 word sentences

C, D, E, F

The parents of a 3 year old bring their child to the ER. The parents report the child suddenly developed a fever overnight and has had issues swallowing, which has led to excessive drooling. In addition, the parents explain that the child complains of sore throat, and it is hard to understand the child's speech because her voice is muffled. Based on this information, your next nursing actions will be? Select all that apply:* A. Assess the child's temperature orally B. Obtain a throat culture C. Count the patient's respirations D. Assess the child's throat for tonsillar exudate E. Keep the child NPO

C, E

Which statement by a mother regarding her 15 month old requires further evaluation? A. "I add honey to his oatmeal in the morning." B. "I avoid giving him seeds, popcorn, and raisins." C. "He loves drinking juice from a bottle at night...it helps him sleep." D. "I only buy whole milk, not skim or low fat."

C. "He loves drinking juice from a bottle at night...it helps him sleep."

About one hour after eating a meal, your patient, who has cystic fibrosis, starts to experience abdominal pain and bloating. Then two hours later the patient has a bowel movement. The patient's stool appears to be greasy and have a foul odor. Which medication below that is being taken by the patient is not providing a desirable outcome for this patient and needs to be re-addressed by the physician?* A. Guaifenesin B. Triamcinolone C. Pancrelipase D. Polyethylene Glycol

C. Pancrelipase

Fill-in-the-blank: The anal and urethral sphincter can be voluntarily controlled around _______________. A. 12-18 months B. 24-36 months C. 6-12 months D. 18-24 months

D. 18-24 months

A 5 year-old patient is admitted with a broken left arm. His arm is immobilized. What nursing intervention is age apporiate for this child regarding his hospitalization? A. Discourage school friends from visiting the patient due to embarrassing the child because of his immobilized arm. B. Assess the 5 year old for questions about his appearance and the effects of how his injury will affect the future. C. Explain procedures in simplistic terms without diagrams. D. Allow the child to help with bathing, feeding, and changing bandages

D. Allow the child to help with bathing, feeding, and changing bandages

Cystic fibrosis is an autosomal recessive genetic disorder. Which option below best describes what most likely happens for a child to develop this condition?* A. One parent, who is a carrier of the mutated gene, has to pass it to the child B. One of the parents has to have cystic fibrosis in order to pass it to their offspring C. Both of the parents must have cystic fibrosis in order for the child to develop it D. Both parents, who are carriers of the mutated gene, each pass one mutated gene to the child

D. Both parents, who are carriers of the mutated gene, each pass one mutated gene to the child

A 5 year old with acute epiglottitis is intubated for airway management. As the nurse you know that all of the following can be prescribed as treatment for this condition EXCEPT?* A. Intravenous fluids B. Antipyretics C. Corticosteroids D. Cough suppressants

D. Cough suppressants A cough is usually absent in this condition.

The physician gives an order for a patient with cystic fibrosis to use a positive expiratory pressure (PEP) device to help with airway clearance. As the nurse you will order which device from supply:* A. Incentive spirometer B. Bipap C. Peak flow meter D. Flutter valve

D. Flutter valve

You're creating a plan of care for a 24-month-old and developing interventions to help with the development of the child. According to Erickson's Stages of Development, what intervention below would help promote development in this patient? A. Thoroughly communicate the rules to the child. B. Encourage the child to ask questions about care. C. Take time to swaddle and rock the child when crying. D. Give the child opportunities to make food and drink selections.

D. Give the child opportunities to make food and drink selections.

A 6.5-month-old is hospitalized. What nursing intervention will you include in their plan of care?* A. Separate the infant and parent during procedures B. Maintain the infant's daily rituals and routines C. Allow the infant to examine equipment before usage D. Maintain the same nursing staff during each shift

D. Maintain the same nursing staff during each shift

When considering Erickson's Stages of Psychosocial Development for a 3-year-old which action below would potentially hinder a child's development? A. Giving the child freedom to try new things B. Offering options of play that are imaginary C. Accepting reasonable choices made by the child D. Making choices and decisions for the child

D. Making choices and decisions for the child

You're educating a group of parents about car seat safety. A participant asks about the best position of a car seat for a 6-month-old. Your response is:* A. Forward-facing and back seat B. Forward-facing and front seat C. Rear-facing and front seat D. Rear-facing and back seat

D. Rear-facing and back seat

Asthma med that is given right before exercise

albuterol

12 month developmental milestones

can go from sit to stand, walks with one hand held, can build 2 block tower (but fails), can turn pages in a book

Newborns posterior plate

closes 2-3 months

Parent teaching for children with downs

cool mist humidity

Varicella immunization contraindicated in adolescents

corticosteroid usage

11 month developmental milestone

cruises, walks with both hands held, masters neat pincer grasp

Risk factors for asthma

family history of asthma/allergies, exposure to smoke, low birth weight

postop tonsillectomy bleeding signs

frequent swallowing and clearing throat

postop tonsillectomy action

give analgesics on schedule

Manifestations of myopia

headaches, reading difficulties, poor school performance

Epiglottis findings

hoarseness/difficulty speaking, difficulty swallowing, high grade fever, drooling, stridor

Egocentrism

in Piaget's theory, the preoperational child's difficulty taking another's point of view

Cooperating and displaying the element of order among groups and respecting parental control

industry (6-12)

Newborns and weight

lose 10% of birth weight by 3-4 days regain it 10th-14th day 4x birth weight by 30 months

Signs of hearing loss in toddlers

monotone speech, speak loudly, appear shy

9 month developmental milestones

pulls up, creeps on hands and feet, grasps smaller items