exam 1 Peds 205

When teaching an adolescent mother about risk factors for neonatal death, the most important factor is: A. low birth weight. B. injuries to the mother during pregnancy. C. newborn obesity. D. chronic illness of the mother.

A. low birth weight.

A 6-year-old is hospitalized with a fractured femur. Based on the nurse's knowledge of opioid side effects, the nurse should include which actions in the patient's plan of care to prevent constipation? (Select all that apply.) Instruct the child to remain supine while in bed. Administer docusate sodium (Colace). Encourage fluid intake. Encourage the child to eat fruit. Administer diphenhydramine (Benadryl).

Administer docusate sodium (Colace). Encourage fluid intake. Encourage the child to eat fruit.

The parent of a 12-month-old infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself; he makes too much of a mess." The nurse's BEST response is: "It's important not to give in to this kind of temper tantrum at this age. Simply ignore the behavior and the mess." "You need to try different types of utensils, bowls, and plates. Some are specifically designed for young children." "It's important to let him make a mess. Just try not to worry about it so much." "Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

"Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

The nurse is interviewing the mother of Adam, 9 years old. As the nurse begins to assess Adam's school performance, the MOST appropriate question to ask is: "Did Adam go to preschool?" "Does Adam have problems at school?" "How is Adam doing in school?" "How well does Adam seem to be doing in school?"

"How is Adam doing in school?"

It is time to give a 3-year-old boy his medication. Which approach is MOST likely to receive a positive response? "It's time for your medication now. Would you like water or apple juice afterward?" "Wouldn't you like to take your medicine?" "You must take your medicine, because the doctor says it will make you better." "See how nicely this boy took his medicine? Now take yours."

"It's time for your medication now. Would you like water or apple juice afterward?"

A parent has a 2-year-old in the clinic for a well-child checkup. Which statement by the parent would indicate to the nurse that the parent needs more instruction regarding accident prevention? "We locked all the medicines in the bathroom cabinet." "We turned the thermostat down on our hot water heater." "We placed gates at the top and bottom of the basement steps." "We stopped using the car seat now that my child is older."

"We stopped using the car seat now that my child is older."

What explains the importance of detecting strabismus in young children? Color vision deficit may result. Amblyopia, a type of blindness, may result. Epicanthal folds may develop in affected eye. Ptosis may develop secondarily.

Amblyopia, a type of blindness, may result.

A diagnosis of rheumatic fever is being ruled out for a child. Which lab test(s) is/are the most reliable? (Select all that apply.) Throat culture C-reactive protein (CRP) Antistreptolysin-O titer (ASO) titer Elevated white blood cell count (WBC) Erythrocyte sedimentation rate (ESR)

Antistreptolysin-O titer (ASO) titer

What should the nurse recognize as an early clinical sign of compensated shock in a child? Confusion Sleepiness Hypotension Apprehension

Apprehension

Which method should the nurse use to view the tonsils and oropharynx of a cooperative 6-year-old child? Ask child to open mouth wide and say "aah." Ask child to open mouth wide and then place the tongue blade in the center back area of the tongue. Examine the mouth when the child is crying to avoid use of tongue blade. Pinch nostrils closed until the child opens his or her mouth and then insert the tongue blade.

Ask child to open mouth wide and say "aah."

The nurse is ready to begin a physical examination on an 8-month-old infant. The child is sitting contentedly on his mother's lap, chewing on a toy. What should the nurse do FIRST? Elicit reflexes Auscultate heart and lungs Examine eyes, ears, and mouth Examine head, systematically moving toward feet

Auscultate heart and lungs

At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning? 4 months 6 months 10 months 14 months

10 months

The nurse would expect that most children would be using sentences of six to eight words by age: 18 months. 24 months. 3 years. 5 years.

5 years.

The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. Which of the following should be included? Flossing is not recommended at this age. The child is old enough to brush teeth effectively. Brush teeth with plain water if child does not like toothpaste. Toothbrush should be small and have hard, rounded, nylon bristles.

Brush teeth with plain water if child does not like toothpaste.

Nurses play an important role in current issues and trends in health care. Which is a current trend in pediatric nursing and health care today? A. The patient is the unit of care for the health care provider. B. Discharge planning begins when the physician writes the order. C. Health promotion resources enable children to achieve their full potential. D. The focus of pediatric health care is trending toward acute hospital care.

C. Health promotion resources enable children to achieve their full potential

The signs and symptoms in a nursing diagnosis describe: A. projected changes in an individual's health status, clinical conditions, or behavior. B. an individual's response to health pattern deficits in the child, family, or community. C. a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems. D. physiologic, situational, and maturational factors that cause the problem or influence its development.

C. a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems.

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan? Cardiopulmonary resuscitation (CPR) Administration of intravenous (IV) fluids Reassurance that the infant cannot be electrocuted during monitoring Advice that the infant not be left with other caretakers such as baby-sitters

Cardiopulmonary resuscitation (CPR)

A camp nurse is assessing a group of children attending summer camp. Based on the nurse's knowledge of special parenting situations, which group of children is at risk for a sense of belonging? Children adopted as infants Children recently placed in foster care Children whose parents recently divorced Children who recently gained a stepparent

Children recently placed in foster care

Which behavior would most likely be manifested in a young child experiencing the protest phase of separation anxiety? Inactivity Clings to parent Depressed, sad Regression to earlier behavior

Clings to parent

The nurse is caring for a Vietnamese child and observes various marks on the child's body. When completing a thorough assessment, the nurse should keep which applicable cultural practices in mind? (Select all that apply.) Coining Cupping Forced kneeling Topical garlic application Burning

Coining Cupping Burning

Evidence-based practice, a current health care trend, is best described as: A. gathering evidence of mortality and morbidity in children. B. meeting physical and psychosocial needs of the child and family in all areas of practice. C. using a professional code of ethics as a means for professional self-regulation. D. questioning why something is effective and whether there is a better approach.

D. questioning why something is effective and whether there is a better approach.

The role of the pediatric nurse is influenced by trends in health care. The greatest trend in health care is: A. primary focus on treatment of disease or disability. B. national health care planning on a distributive or episodic basis. C. accountability to professional codes and international standards. D. shift of focus to prevention of illness and maintenance of health.

D. shift of focus to prevention of illness and maintenance of health.

During an otoscopic examination on an infant, in which direction is the pinna pulled? Down and back Down and forward Up and forward Up and back

Down and back

Which health promotion teaching points should a nurse include in a dental teaching plan to help prevent dental caries? (Select all that apply.) Drink fluoridated water. Begin dental hygiene after eruption of both front teeth. Schedule regular dental appointments after age 2. Dates and locations of free dental clinics. Dental caries are preventable.

Drink fluoridated water. Dates and locations of free dental clinics. Dental caries are preventable.

The nurse should instruct a child to remain completely still during which procedure in which high frequency sound waves are translated into images by a transducer? Echocardiography Electrocardiography Cardiac catheterization Electrophysiology

Echocardiography

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy in the toddler? Helping the toddler complete tasks Providing opportunities for the toddler to play with other children Helping the toddler learn the difference between right and wrong Encourage the toddler to do things for self when capable of doing them

Encourage the toddler to do things for self when capable of doing them

A 10-year-old female child requires daily medications for a chronic illness. Her mother tells the nurse that she is always nagging her to take her medicine before school. What is the MOST appropriate nursing action to promote the child's compliance? Establishing a contract with her, including rewards Suggesting time-outs when she forgets her medicine Discussing with her mother the damaging effects of nagging Asking the child to bring her medicine containers to each appointment so they can be counted

Establishing a contract with her, including rewards

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age group? (Select all that apply.) Falls Drowning Poisoning Sports injuries Tricycle and bicycle accidents

Falls Drowning Poisoning Tricycle and bicycle accidents

What is appropriate advice for parents who are preparing to tell their children about their decision to divorce? Avoid crying in front of children. Avoid discussing the reason for the divorce. Give reassurance that the divorce is not the children's fault. Give reassurance that the divorce will not affect most aspects of the children's lives.

Give reassurance that the divorce is not the children's fault.

What should the nurse recommend to help a toddler cope with the birth of a new sibling? Give the toddler a doll on which he or she can imitate parenting. Discourage the toddler from helping with care of new sibling. Prepare the toddler for upcoming changes about 1 to 2 weeks before birth of the sibling. Explain to the toddler that a new playmate will soon come home.

Give the toddler a doll on which he or she can imitate parenting.

Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is MOST likely to minimize this sensation and promote relaxation? Palpating another area simultaneously Asking the child not to laugh or move if it tickles Beginning with deeper palpation and gradually progressing to superficial palpation Having the child "help" with palpation by placing his or her hand over the palpating hand

Having the child "help" with palpation by placing his or her hand over the palpating hand

The nurse observes erythema, pain, and edema at a child's intravenous (IV) site with streaking along the vein. What should the nurse do FIRST? Immediately stop the infusion. Check for a good blood return. Ask another nurse to check the IV site. Increase the IV drip for 1 minute and recheck.

Immediately stop the infusion.

The nurse notices that a toddler is more cooperative when taking medicine from a small cup rather than from a large cup. This is an example of which characteristic of preoperational thought? Egocentrism Irreversibility Inability to conserve Transductive reasoning

Inability to conserve

When assessing for hypertension in an infant, the nurse will expect the infant to exhibit which signs? (Select all that apply.) Dizziness Changes in vision Irritability Head rubbing Waking up screaming in the night

Irritability Head rubbing Waking up screaming in the night

A 4-year-old female child is afraid of dogs. What should the nurse recommend to her parents to help her with this fear? Keep her away from dogs Buy her a stuffed dog toy Force her to touch a dog briefly Let her watch other children play with a dog

Let her watch other children play with a dog

A 9-month-old infant is seen in the emergency department after developing a urticaric rash with cough and wheezing. When collecting the history of events before the sudden onset of the rash with cough and wheezing, the mother states they were "feeding the baby new foods." Which food is the possible cause of this type of reaction in the infant? Potatoes Green beans Spinach Peanut butter

Peanut butter

The nurse needs to take the blood pressure of a preschool boy for the first time. Which action would be BEST in gaining his cooperation? Taking his blood pressure when a parent is there to comfort him. Telling him that this procedure will help him get well faster. Explaining to him how the blood flows through the arm and why the blood pressure is important. Permitting him to handle equipment and see the dial move before putting the cuff in place.

Permitting him to handle equipment and see the dial move before putting the cuff in place.

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching? (Select all that apply.) Administer iron with meals. Place iron toward the back side of the mouth with a dropper. Mix iron with milk for greater absorption. Report black, tarry stools to health care provider. Apply barrier ointment if needed to buttocks.

Place iron toward the back side of the mouth with a dropper. Apply barrier ointment if needed to buttocks.

Which statement explains why it can be difficult to assess a child's dietary intake? No systematic assessment tool has been developed for this purpose. Biochemical analysis for assessing nutrition is expensive. Families usually do not understand much about nutrition. Recall of children's food consumption is frequently unreliable.

Recall of children's food consumption is frequently unreliable.

When changing a dressing on the leg of a 16-year-old patient who suffered second degree burn injuries, the nurse expects to observe which characteristics of pain expression? (Select all that apply.) Stomping feet on the ground and screaming, "No" Attempting to move leg out of reach of the nurse. Repeatedly stating, "You're hurting me." Clinching fists and tensing arms in anticipation. Scooting away and asking parents to stop the nurse.

Repeatedly stating, "You're hurting me." Clinching fists and tensing arms in anticipation.

The nurse is caring for a 12-year-old child who sustained major burns when putting charcoal lighter on a campfire. The nurse observes that the child is "very brave" and appears to accept pain with little or no response. What is the most appropriate nursing action? Request a psychological consultation. Ask why the child does not have pain. Praise the child for the ability to withstand pain. Encourage continued bravery as a coping strategy.

Request a psychological consultation.

When admitting a child to the inpatient pediatric unit, the nurse should assess for which risk factors that can increase the child's stress level associated with hospitalization? (Select all the apply.) Mild temperament Lack of fit between parent and child Below-average intelligence Age Gender

Risk factors for increased stress level of a child to illness or hospitalization: • "Difficult" temperament • Lack of fit between child and parent • Age (especially between 6 months and 5 years old) • Male gender • Below-average intelligence • Multiple and continuing stresses (e.g., frequent hospitalizations)

The parents of a toddler ask the nurse for suggestions about discipline. When discussing the use of timeouts, which of the following suggestions should the nurse include? Send the child to his or her room. If the child cries, refuses, or is more disruptive, try another approach. Select an area that is safe and nonstimulating, such as a hallway. The general rule for length of time is 1 hour per year of age.

Select an area that is safe and nonstimulating, such as a hallway.

A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected? Dark brown and small hard pebbles Loose with green mucus streaks Formed and with white mucus Semiformed, seedy, yellow

Semiformed, seedy, yellow

The parents of a toddler ask the nurse how to handle their child's increasing number of temper tantrums. The nurse should include which positive reinforcement methods of reducing the number of tantrums? (Select all that apply.) Suggest that parents provide the child an "all or none" position. Suggest that parents ignore the behavior as long as child is not harming self. Encourage the parents to provide comfort once the child has calmed down. Ask parents to praise the child for positive behavior when not having a tantrum. Tell parents not to give in to the original request that started the temper tantrum.

Suggest that parents ignore the behavior as long as child is not harming self. Encourage the parents to provide comfort once the child has calmed down. Ask parents to praise the child for positive behavior when not having a tantrum. Tell parents not to give in to the original request that started the temper tantrum.

A hospitalized toddler clings to a worn, tattered blanket. She screams when anyone tries to take it away. What is the nurse's BEST explanation to the parents for the child's attachment to the blanket? The blanket encourages immature behavior. The blanket is an important transitional object. She has not mastered the developmental task of individuation-separation. She has not bonded adequately with her mother.

The blanket is an important transitional object.

The nurse is assessing skin turgor in a child. The nurse grasps the skin on the abdomen between the thumb and index finger, pulls it taut, and quickly releases it. The tissue remains suspended, or tented, for a few seconds, then slowly falls back on the abdomen. Which evaluation can the nurse correctly assume? The tissue shows normal elasticity. The child is properly hydrated. The assessment is done incorrectly. The child has poor skin turgor.

The child has poor skin turgor.

A child is brought to the emergency department after falling down the basement stairs. On assessment, what findings may cause the nurse to suspect child maltreatment? (Select all that apply.) The child's bruises are located only on the right arm and leg. The child is brought to the emergency department by an unrelated adult. The child has a history of a broken arm last year from falling off a swing. The child's caregiver is anxious that the child get immediate medical attention. The child has red, green, and yellow bruises on more than one plane of the body.

The child is brought to the emergency department by an unrelated adult. The child has red, green, and yellow bruises on more than one plane of the body.

Place the following steps of the nursing process in the proper order of completion when the nurse is caring for a child with pneumonia. (Place the answer options in the correct order. ) Determine whether antibiotic therapy has been effective by reviewing white blood cell count. Administer antibiotics as ordered. Listen to the child's breath sounds and monitor vital signs. Identify the problem of impaired gas exchange. Establish therapeutic goals and prioritize health care provider orders.

The correct steps in the nursing process are: Assessment: listening to breath sounds Diagnosis: identifying patient problems Planning: establish goals and prioritize Implementation: administer antibiotics Evaluate: determine effectiveness of interventions

When completing a health history on a hospitalized child, the nurse should assess for which factors that can commonly affect the parents' reaction to the child's illness? (Select all that apply.) Previous experience with illness or hospitalization Available support systems Medical procedures involved with treatment Previous coping abilities Cultural and religious beliefs

The following are all factors affecting parents' responses to their child's illness or hospitalization: • Seriousness of the threat to the child • Previous experience with illness or hospitalization • Medical procedures involved in diagnosis and treatment • Available support systems • Personal ego strengths • Previous coping abilities • Additional stresses on the family system • Cultural and religious beliefs • Communicationpatterns among family members

The nurse preparing a nutritional teaching plan for the parents of a preschool child should include which information? The quality of the food consumed is more important than the quantity. Nutrition requirements for preschoolers are very different from requirements for toddlers. Requirement for calories per unit of body weight increases slightly during the preschool period. Average daily intake of preschoolers should be about 3000 calories.

The quality of the food consumed is more important than the quantity.

The nurse is teaching the parents of a 24-month-old about motor skill development. The nurse should include which statement in the teaching? The toddler walks alone but falls easily. The toddler's activities begin to produce purposeful results. The toddler is able to grasp small objects but cannot release them at will. The toddler's motor skills are fully developed but occur in isolation from the environment.

The toddler's activities begin to produce purposeful results.

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's BEST reply? A pacifier should be substituted for the thumb. Thumb-sucking should be discouraged by age 12 months. Thumb-sucking should be discouraged when the teeth begin to erupt. There is no need to restrain nonnutritive sucking during infancy.

There is no need to restrain nonnutritive sucking during infancy.

The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What should be the NEXT action by the nurse? Notifying the surgeon Performing oral intubation Trying to insert a larger-size tube Trying to insert smaller-size tube

Trying to insert smaller-size tube

The parents of a toddler state their child is having trouble sleeping. What is the nurse's BEST suggestion to improve sleep habits? Using a transitional object. Varying the bedtime ritual. Restricting stimulating activities during the day. Explaining away fears.

Using a transitional object.

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant? Vitamin B Vitamin D Vitamin C Vitamin K

Vitamin D

Informed consent is valid when: (Select all that apply.) universal consent is used. it is completed only for major surgery. a person is over the age of majority and competent. information is provided to make an intelligent decision. the choice exercised is free of force, fraud, duress, or coercion.

a person is over the age of majority and competent. information is provided to make an intelligent decision. the choice exercised is free of force, fraud, duress, or coercion.

The psychosexual conflicts of preschool children make them extremely vulnerable to: separation anxiety. loss of control. bodily injury and pain. loss of identity.

bodily injury and pain.

One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child's readiness for toilet training, it is important for the nurse to emphasize that: nighttime bladder control develops first, so parents should focus on that in the initial teaching with their toddler. bowel control is accomplished before bladder control, so the parent should focus on bowel training first. the toddler must have the gross motor skill to climb up to the adult toilet before training is begun. the universal age for toilet training to begin is 2 years, and the universal age for completion is 4 years.

bowel control is accomplished before bladder control, so the parent should focus on bowel training first.

One of the goals for children with asthma is to prevent respiratory infection. This is because respiratory infection: lessens effectiveness of medications. encourages exercise-induced asthma. increases sensitivity to allergens. can trigger an episode or aggravate an asthmatic state.

can trigger an episode or aggravate an asthmatic state.

A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BEST option for a substitute is: goat's milk. soy-based formula. skim milk diluted with water. casein hydrolysate milk formula.

casein hydrolysate milk formula.

The nurse is starting an intravenous (IV) line on a school-age child with cancer. The child says, "I have had a million IVs. They hurt." The nurse's response should be based on the knowledge that: children tolerate pain better than adults. children become accustomed to painful procedures. children often lie about experiencing pain. children often demonstrate increased behavioral signs of discomfort with repeated painful procedures.

children often demonstrate increased behavioral signs of discomfort with repeated painful procedures.

The nurse is assessing a preschool age child who is stuttering when answering the nurse's questions. The nurse should offer alternate methods of responding to the stuttering when observing the parent: completing the child's sentences. listening attentively. encouraging the child to speak slowly. helping the child relax.

completing the child's sentences.

Myelination of the spinal cord is almost complete by 2 years of age. As a result of this, the toddler can gradually achieve: throwing a ball without falling. slowing of gastrointestinal transit time. visual acuity of 20/20. control of anal and urethral sphincters.

control of anal and urethral sphincters.

Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the: importance of reducing caloric intake to decrease cardiac demands. importance of relaxing discipline and limit-setting to prevent crying. need to be extremely concerned about cyanotic spells. desirability of promoting normalcy within the limits of the child's condition.

desirability of promoting normalcy within the limits of the child's condition.

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy? help the toddler complete tasks. provide opportunities for the toddler to play with other children. help the toddler learn the difference between right and wrong. encourage the toddler to do things for himself or herself when he or she is capable of doing them.

encourage the toddler to do things for himself or herself when he or she is capable of doing them.

When completing the health assessment for a 2-year-old child, the nurse should expect the child to: engage in parallel play. fully dress self with supervision. have a vocabulary of at least 500 words. be one third of the adult height.

engage in parallel play.

A 2-year-old child has recently started having temper tantrums during which she holds her breath and sometimes faints. The nurse should: refer the child for respiratory evaluation. refer the child for psychologic evaluation. explain to the parent that this is not harmful. explain to the parent that the child is spoiled.

explain to the parent that this is not harmful.

The nurse needs to give an injection in the deltoid to a 4-year-old child. The BEST approach to use is to: smile while giving the injection to help child relax. tell the child that you will be so quick that the injection will not even hurt. explain that the child will experience a little stick in the arm. explain with concrete terms, such as putting medicine under the skin.

explain with concrete terms, such as putting medicine under the skin.

Guidelines for a nurse using an interpreter in developing a care plan for an 8-year-old admitted to rule out epilepsy include: explaining to the interpreter what information is necessary to obtain from the patient and family. encouraging the interpreter to ask several questions at a time to make the best use of time. not giving the interpreter too much information so the interview evolves. discouraging the interpreter and client from discussing topics that are deemed irrelevant to the original intent of the interview.

explaining to the interpreter what information is necessary to obtain from the patient and family.

The most consistent indicator of pain in infants is: increased respirations. increased heart rate. clenching the teeth and lips. facial expression of discomfort.

facial expression of discomfort.

The most consistent indicator of pain in infants is: increased respirations. increased heart rate. squirming and jerking. facial expression of discomfort.

facial expression of discomfort.

The causative agent for erythema infectiosum (fifth disease) is: paramyxovirus. human herpes virus type 6. human herpes virus types 1 and 2. group A β-hemolytic streptococci.

human herpes virus type 6.

The nurse is giving anticipatory guidance to the parent of a 5-year-old. In this guidance, it is MOST important to: prepare the parent for increased aggression. encourage the parent to offer the child choices. inform the parent to expect a more tranquil period at this age. advise parents that this is the age when stuttering may develop.

inform the parent to expect a more tranquil period at this age.

The nurse's BEST approach for effective communication with a preschool age child is through: speech. play. drawing. actions.

play.

The nurse is doing preoperative teaching with a child and his parents. The parents say that he is "dreading the shot" for premedication. The nurse's response should be based on the knowledge that: preanesthetic medication can only be given intramuscularly. in children the intramuscular route is safer than the intravenous (IV) route. the child will have no memory of the injection because of amnesia. preanesthetic medication should be "atraumatic," using oral, existing intravenous, or rectal routes.

preanesthetic medication should be "atraumatic," using oral, existing intravenous, or rectal routes.

Characteristics of physical development of a 30-month-old child are the: (Select all that apply.) anterior fontanel is open. birth weight has doubled. genital fondling is noted. sphincter control is achieved. primary dentition is complete.

sphincter control is achieved. primary dentition is complete.

The primary therapy for secondary hypertension in children is: weight reduction. low-salt diet. increased exercise and fitness. treatment of underlying cause.

treatment of underlying cause.

The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of: trust. industry. initiative. separation.

trust.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C. The nurse suspects croup and should recommend: controlling fever with acetaminophen and calling if the cough gets worse during the night. trying a cool-mist vaporizer at night and watching for signs of difficulty breathing. trying over-the-counter cough medicine and coming to the clinic in the morning if there is no improvement. admitting to the hospital and observing for impending epiglottitis.

trying a cool-mist vaporizer at night and watching for signs of difficulty breathing.

When caring for a child with an intravenous (IV) infusion, the most appropriate nursing interventions are to (Select all that apply.) use an infusion pump with a microdropper to ensure the prescribed infusion rate. check IV fluids and infusion rate with another licensed professional. avoid restraining the child to prevent undue emotional stress. observe the insertion site frequently for signs of infiltration. change the insertion site every 24 hours.

use an infusion pump with a microdropper to ensure the prescribed infusion rate. check IV fluids and infusion rate with another licensed professional. observe the insertion site frequently for signs of infiltration.

When caring for a child after a tonsillectomy, the nurse should: watch for continuous swallowing. encourage gargling to reduce discomfort. position the child on the back for sleeping. apply warm compresses to the throat.

watch for continuous swallowing.

The parents of a toddler express frustration to the nurse because their child is a "fussy eater." The nurse's BEST response is: "You should provide larger servings of different foods. "Provide more bland food varieties as toddlers have few food preferences." "Table manners will improve if you provide finger foods." "Becoming a fussy eater is expected during the toddler years."

"Becoming a fussy eater is expected during the toddler years."

The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8-week-old make which statement? (Select all that apply.) "I only smoke in the kitchen." "I put my baby to sleep on her back." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

"I only smoke in the kitchen." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

A mother tells the nurse that she will visit her 2-year-old son tomorrow about noon. During the child's bath, he asks for mommy. The nurse's BEST reply is: "Mommy will be here after lunch." "Mommy always comes back to see you." "Your mommy told me yesterday that she would be here today about noon." "Mommy had to go home for a while, but she will be here today."

"Mommy will be here after lunch."

A Mexican American adolescent states to the nurse, "I have cancer because it is God's will. It will make me stronger." The MOST appropriate response by the nurse is: "You're too young to think that way. You still have many years to live." "Tell me how you feel about the treatment plan." "I'll move your family into the waiting area to give you some quiet time." "I'll contact the hospital chaplain for you."

"Tell me how you feel about the treatment plan."

A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? "Never shake baby powder directly on your infant because it can be aspirated into his lungs." "Do not permit your child to chew paint from window ledges because he might absorb too much lead." "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." "Keep doors of appliances closed at all times."

"When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall."

Because the absorption of fat-soluble vitamins is decreased in children with cystic fibrosis, supplementation of which vitamins is necessary? C, D A, E, K A, D, E, K C, folic acid

A, D, E, K

What has had the greatest impact on reducing infant mortality in the United States? A. Access to high-quality prenatal care B. Decreased incidence of congenital abnormalities C. Better maternal nutrition D. Improved funding for health care

A. Access to high-quality prenatal care

The MOST appropriate recommendation for relief of teething pain is to instruct the parents to: rub gums with aspirin to relieve inflammation. apply hydrogen peroxide to gums to relieve irritation. give child a frozen teething ring to relieve inflammation. have child chew on a warm teething ring to encourage tooth eruption.

give child a frozen teething ring to relieve inflammation.

The nurse expects which characteristic of fine motor skills in a 5-month-old infant? Strong grasp reflex Neat pincer grasp Able to build a tower of two cubes Able to grasp object voluntarily

Able to grasp object voluntarily

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of: identity. intimacy. initiative. industry.

initiative.

Which statement is true concerning the increased use of telephone triage by nurses? Telephone triage has led to an increase in health care costs. Emergency department visits are not recommended by nurses and thus are not a Perry component of telephone triage. Access to high-quality health care services has increased through telephone triage. Home care is often recommended when it is not appropriate.

Access to high-quality health care services has increased through telephone triage.

The nurse should expect to possibly incorporate which religious and cultural practices into the plan of care when caring for a 35-year-old Jewish mother who just gave birth to a healthy baby boy? (Select all that apply.) Circumcision in hospital Ordering house diet lunch tray of roasted pork with mashed potatoes Allowing family, friends, and rabbi to visit patient often Ask males to remove shawl and yarmulke while visiting Ordering house diet with the exception of shellfish

Allowing family, friends, and rabbi to visit patient often Ordering house diet with the exception of shellfish

The nurse teaching parents of an adolescent about nutrition will include what important information? A. Adolescents are usually mature enough to make healthy food choices. B. Resources to assist lower income families about obtaining enough protein. C. Behavior problems in this age group are not related to nutritional deficiencies. D. Parental influence has the greatest impact on food choices at this age.

B. Resources to assist lower income families about obtaining enough protein.

When is bronchial (postural) drainage generally performed? Immediately before all aerosol therapy Before meals and at bedtime Immediately on arising and at bedtime Thirty minutes after meals and at bedtime

Before meals and at bedtime

The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? Putting her in parents' bed to cuddle Beginning to put her to bed while still awake Letting her cry herself back to sleep Giving her a bottle of formula instead of breastfeeding her so often at night

Beginning to put her to bed while still awake

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake? Using developmental stimulation by a specialist during feedings Avoiding solids until after the bottle is well accepted Being persistent through 10 to 15 minutes of food refusal Varying schedule of routine activities on a daily basis

Being persistent through 10 to 15 minutes of food refusal

What is the most appropriate teaching point to include in a health promotion teaching plan for parents of children age 5 to 14? A. Causes of mechanical suffocation B. Keeping all medications out of childrens' reach C. Storing firearms in locked cabinets. D. Warning signs of violent crimes.

C. Storing firearms in locked cabinets.

Which statement about early childhood caries (ECC) is correct? The syndrome is distinguished by protruding upper front teeth, resulting from sucking on a hard nipple. Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. The syndrome can be prevented by breastfeeding. Giving the child juice in the bottle instead of milk at bedtime prevents this syndrome.

Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome.

Children are taught the values of their culture through observation and feedback on their own behavior. A nurse teaching a class on cultural awareness-competence should be aware of which factor(s) that may be culturally determined? (Select all that apply.) Social roles Racial variation Degree of competition Determination of status Geographic

Social roles Degree of competition Determination of status

Which statement is true concerning folk remedies? They may be used to reinforce the treatment plan. They are incompatible with modern medical regimens. They are a leading cause of death in some cultural groups. They are not a part of the culture in large, developed countries.

They may be used to reinforce the treatment plan.

Which statement is correct about young children who report sexual abuse? They may exhibit various behavioral manifestations. In most cases the child has fabricated the story. Their stories are not believed unless other evidence is apparent. They should be able to retell the story the same way to another person.

They may exhibit various behavioral manifestations.

The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets? Lacto-ovo vegetarians Those who are breastfed exclusively Those using yogurt as primary source of milk Those exposed to daily sunlight

Those using yogurt as primary source of milk

Parents of a 10-year-old child are concerned that their child has recently been showing signs of loneliness and abandonment. What should the nurse consider when discussing this issue with the parents? Changing self-esteem is difficult after about age 5. Self-esteem is the objective judgment of one's worthiness. Transitory periods of loneliness and abandonment are expected developmentally. High self-esteem develops when parents show adequate love for the child.

Transitory periods of loneliness and abandonment are expected developmentally.

Which is considered a mixed cardiac defect? Pulmonic stenosis Atrial septal defect Patent ductus arteriosus Transposition of the great arteries

Transposition of the great arteries

A 5-year-old child is brought to the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions? (Select all that apply.) Vital signs Throat culture Medical history Assessment of breath sounds Emergency airway equipment readily available

Vital signs Medical history Assessment of breath sounds Emergency airway equipment readily available

The nurse is discharging a young child from the hospital. The nurse should instruct the parents to look for which posthospital child behaviors? (Select all the apply.) Tendency to cling to parents Jealousy toward others Demands for parents' attention Anger toward parents New fears such as nightmares

Young children's posthospital behaviors include: • They show initial aloofness toward parents; this may last from a few minutes (most common) to a few days. This is frequently followed by dependency behaviors: • Tendency to cling to parents • Demands for parents' attention • Vigorous opposition to any separation (e.g., staying at preschool or with a babysitter) Other negative behaviors include: • New fears (e.g., nightmares) • Resistance to going to bed, night waking • Withdrawal and shyness • Hyperactivity • Temper tantrums • Food peculiarities • Attachment to blanket or toy • Regression in newly learned skills (e.g., self-toileting) Posthospital behaviors for older children include: Negative behaviors: • Emotional coldness followed by intense, demanding dependence on parents • Anger toward parents • Jealousy toward others (e.g., siblings

The nurse is preparing a plan to teach a mother how to administer 1½ teaspoons of medicine to her 6-month-old child. The nurse should recommend using: a household measuring spoon. a regular silverware teaspoon. a paper cup measure in 5-ml increments. a plastic syringe (without needle) calibrated in milliliters.

a plastic syringe (without needle) calibrated in milliliters.

It is important that a child with Group A ß-hemolytic streptococci (GABHS) infection be treated with antibiotics to prevent: otitis media. diabetes insipidus. nephrotic syndrome. acute rheumatic fever.

acute rheumatic fever.

The nurse is planning care for a patient with cultural background different from that of the nurse. An appropriate goal is to: strive to keep cultural background from influencing health needs. encourage continuation of cultural practices in the hospital setting. attempt in a nonjudgmental way to change cultural beliefs. adapt as necessary cultural practices to health needs.

adapt as necessary cultural practices to health needs.

Transdermal fentanyl (Duragesic) is being used for an adolescent with cancer who is in hospice care. The adolescent has been comfortable for several hours but now complains of severe pain. The most appropriate nursing action is to: administer meperidine (Demerol) intramuscularly (IM). administer morphine sulfate immediate release (MSIR) intravenously (IV). use a nonpharmacologic strategy. place another fentanyl patch on the adolescent.

administer morphine sulfate immediate release (MSIR) intravenously (IV).

The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.) allow for catch-up growth. correct nutritional deficiencies. achieve ideal weight for height. restore optimum body composition. educate the parents or primary caregivers on child's nutritional requirements. educate the parents or primary caregivers that the child will need tube feedings first.

allow for catch-up growth. correct nutritional deficiencies. achieve ideal weight for height. restore optimum body composition. educate the parents or primary caregivers on child's nutritional requirements.

Before transporting a 16-year-old American Indian female for a magnetic resonance imaging (MRI) scan, the nurse notices the girl is wearing a decorated amulet necklace. The nurse's next BEST action is to: remove the necklace and place it at the nurse's station. explain the risks of wearing the necklace during the MRI. ask the patient if there is a special reason for wearing the necklace. place tape around the neck covering the necklace.

ask the patient if there is a special reason for wearing the necklace.

A child with asthma is having pulmonary function tests. The purpose of the peak expiratory flow rate (PEFR) is to: confirm the diagnosis of asthma. determine the cause of asthma. identify "triggers" of asthma. assess the severity of asthma.

assess the severity of asthma.

Several types of long-term central venous access devices are used. A benefit of using an implanted port (e.g., Port-a-cath) is that it: is easy to use for self-administered infusions. does not need to pierce the skin for access. does not need to limit regular physical activity, including swimming. cannot dislodge from the port, even if child plays with port site.

does not need to limit regular physical activity, including swimming.

An important nursing responsibility when a dysrhythmia is suspected is to: order an immediate electrocardiogram. count the radial rate at 1-minute intervals 5 times in a row. count the apical rate for 1 full minute and compare it with the radial rate. have someone else take the radial rate while the nurse simultaneously checks the apical rate.

count the apical rate for 1 full minute and compare it with the radial rate.

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is: unsafe play that should be discouraged. creative play that should be encouraged. suggestive of limited family resources. suggestive of limited adult supervision.

creative play that should be encouraged.

A 4-year-old child will be having cardiac surgery next week. The child's parents call the hospital, asking about how to prepare her for this. The nurse's BEST response is to inform the parents that: preparation at this age will only increase the child's stress. preparation needs to be at least 2 to 3 weeks before hospitalization. children who are prepared experience less fear and stress during hospitalization. children who are prepared experience overwhelming fear by the time hospitalization occurs.

children who are prepared experience less fear and stress during hospitalization.

The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that: this assessment is normal. the child is probably cognitively impaired. developmental/neurologic evaluation is needed. the parent needs to work with the infant to stop head lag.

developmental/neurologic evaluation is needed.

The nurse should explain to the parents that their child is receiving Lasix for severe congestive heart failure because it is a/an: diuretic. â-blocker. form of digitalis. ACE inhibitor.

diuretic.

The nurse working in an outpatient surgery center for children should understand that: children's anxiety is minimal in such a center. waiting is not stressful for parents in such a center. accurate and complete discharge teaching is the responsibility of the surgeon. families need to be prepared for what to expect after discharge.

families need to be prepared for what to expect after discharge.

When caring for a preschool age child, the nurse should incorporate knowledge that body image has developed to include: a well-defined body boundary. knowledge about his or her internal anatomy. fear of intrusive procedures. anxiety and fear of separation.

fear of intrusive procedures.

The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer and very warm. The nurse should recommend that: fluids in addition to breast milk are not needed. water should be given if the infant seems to nurse longer than usual. water once or twice a day will make up for losses caused by environmental temperature. clear juices would be better than water to promote adequate fluid intake.

fluids in addition to breast milk are not needed.

An appropriate intervention to provide comfort for the child with itching associated with chickenpox is to: encourage frequent warm baths. give aspirin or acetaminophen. give an antipruritic medication such as Benadryl. apply thick coat of Caladryl lotion over open lesions.

give an antipruritic medication such as Benadryl.

Standard Precautions for infection control include that: gloves are worn any time a patient is touched. needles are capped immediately after use and disposed of in a special container. gloves are worn to change diapers when there are loose or explosive stools. masks are needed only when caring for patients with airborne infections.

gloves are worn to change diapers when there are loose or explosive stools.

A child who has been receiving morphine intravenously will now start receiving it orally. The nurse should anticipate that, to achieve equianalgesia (equal analgesic effect), the oral dose will be: the same as the intravenous (IV) dose. greater than the IV dose. one half of the IV dose. one fourth of the IV dose.

greater than the IV dose.

The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. FIRST the nurse should: determine what the child has eaten. administer diphenhydramine (Benadryl). move the child to the nurse's office or hallway. have someone call for an ambulance/paramedic rescue squad.

have someone call for an ambulance/paramedic rescue squad.

The parents of a 4-year-old girl are worried because she has an imaginary playmate. The nurse's BEST response is to tell the parents: a psychosocial evaluation is indicated. an evaluation of possible parent-child conflict is indicated. having imaginary playmates is normal and useful at this age. having imaginary playmates is abnormal after about age 2 years.

having imaginary playmates is normal and useful at this age.

The doctor suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent: pulmonary infection. right-to-left shunt of blood. decreased workload on left side of heart. increased pulmonary vascular congestion.

increased pulmonary vascular congestion.

When preparing to administer Hepatitis B vaccine to a newborn, the nurse should: (Select all that apply.) initiate an immunization record. confirm the hepatitis B status of the newborn's mother. obtain a syringe with a 25-gauge, 5/8-inch needle. assess the dorsogluteal muscle as the preferred site for injection. confirm that the newborn's mother has signed the informed consent.

initiate an immunization record. confirm the hepatitis B status of the newborn's mother. obtain a syringe with a 25-gauge, 5/8-inch needle. confirm that the newborn's mother has signed the informed consent.

The practice of cultural humility is continual and an important concept in the nursing process. Nurses can facilitate this process by: (Select all that apply.) integrating cultural knowledge. recognizing cultural differences. acting in a culturally appropriate manner. being aware of their own beliefs and practices. helping the family adapt to the health care practices.

integrating cultural knowledge. recognizing cultural differences. acting in a culturally appropriate manner. being aware of their own beliefs and practices.

The best explanation for why pulse oximetry is used on young children is that it: is noninvasive. is better than capnography. is more accurate than arterial blood gases. provides intermittent measurements of O2.

is noninvasive.

An immediate intervention when an infant chokes on a piece of food would be to: have infant lie quietly while a call is placed for emergency help. position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades. administer mouth-to-mouth resuscitation. give water by cup to relieve the obstruction.

position the infant in a head-down, face-down position and administer five quick blows between the shoulder blades.

An infant with a congenital heart defect is receiving palivizumab (Synagis). The purpose of this is to: prevent respiratory syncytial virus (RSV) infection. make isolation of infant with RSV unnecessary. prevent secondary bacterial infection. decrease toxicity of antiviral agents.

prevent respiratory syncytial virus (RSV) infection.

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. The nurse is aware that children in this country are at increased risk for: rickets. marasmus. kwashiorkor. pellagra.

kwashiorkor.

The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.) large blocks alphabet flash cards 100-piece puzzles dolls hand puppets

large blocks alphabet flash cards dolls hand puppets

A child who is terminally ill with bone cancer is in severe pain. Nursing interventions should be based on knowledge that: children tend to be overmedicated for pain. giving large doses of opioids causes euthanasia. narcotic addiction is common in terminally ill children. large doses of opioids are justified when there are no other treatment options.

large doses of opioids are justified when there are no other treatment options.

A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after the child receives his gastrostomy feeding, there is often a backup of formula feeding into the tube. As a result, the nurse should: position the child in a supine position after feedings. position the child on his or her left side after feedings. leave the gastrostomy tube open and suspended after feedings. leave the gastrostomy tube clamped after feedings.

leave the gastrostomy tube open and suspended after feedings.

The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large, and one is too small. The BEST nursing action is to: use the small cuff. use the large cuff. use either cuff, using palpation method. locate the proper size cuff before taking the blood pressure.

locate the proper size cuff before taking the blood pressure.

Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. The nurse should recognize that in clinical practice this system is: helpful because it explains the hemodynamics involved. helpful because children with cyanotic defects are easily identified. problematic because cyanosis is rarely present in children. problematic because children with acyanotic heart defects may develop cyanosis.

problematic because children with acyanotic heart defects may develop cyanosis.

A child is being seen in the emergency department with multiple facial abrasions and lacerations. The combination agent lidocaine, adrenaline, and tetracaine (LAT) is applied topically to the wounds. The purpose of this combination therapy is to: cleanse the wound. promote scab formation. prevent infection of the wound. provide anesthesia to the wound.

provide anesthesia to the wound.

Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include: (Select all that apply.) lung function. associated allergies. frequency of symptoms. frequency and severity of exacerbations.

lung function. frequency of symptoms. frequency and severity of exacerbations.

Nonpharmacologic strategies for pain management: may reduce pain perception. make pharmacologic strategies unnecessary. usually take too long to implement. trick children into believing that they do not have pain.

may reduce pain perception.

Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: atrophic changes in the mucosal wall of intestines. hypoactivity of the autonomic nervous system. hyperactivity of the sweat glands. mechanical obstruction caused by increased viscosity of mucous gland secretions.

mechanical obstruction caused by increased viscosity of mucous gland secretions.

When assessing a preschooler's chest, the nurse would expect: respiratory movements to be chiefly thoracic. anteroposterior diameter to be equal to the transverse diameter. intercostal retractions on respiratory movement. movement of the chest wall to be symmetric bilaterally and coordinated with breathing.

movement of the chest wall to be symmetric bilaterally and coordinated with breathing.

The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by: suffocation. child abuse. infantile apnea. sudden infant death syndrome (SIDS).

sudden infant death syndrome (SIDS).

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs/practices. The nurse should recognize that this is: normal in spiritual development. abnormal in spiritual development. related to illness and occurs only at times of crisis. related to the inability of parents to explain adequately their beliefs/practices.

normal in spiritual development.

The nurse is preparing to give digoxin to a 9-month-old infant. He or she checks the dose and draws up 4 ml of the drug. The MOST appropriate nursing action is to: not give the dose; suspect dosage error. mix the dose with juice to disguise its taste. check heart rate; administer the dose by placing it to the back and side of the mouth. check heart rate; administer the dose by letting the infant suck it through a nipple.

not give the dose; suspect dosage error.

A 4-year-old girl is brought to the emergency room. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should: examine her oral pharynx and report to the physician. make her lie down and rest quietly. auscultate her lungs and make preparations for placement in a mist tent. notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

The charge nurse is observing a student nurse obtain a temperature on a pediatric patient. The nurse should intervene when observing the student: (Select all that apply.) obtain a rectal thermometer probe for a child with diarrhea. attempt to take an oral temperature on a child who is receiving oxygen. take an oral temperature on a 12-year-old child who ate ice cream 2 hours ago. documenting an axillary temperature for a 3-year-old child. taking an axillary temperature on a 3-week-old infant.

obtain a rectal thermometer probe for a child with diarrhea. attempt to take an oral temperature on a child who is receiving oxygen. documenting an axillary temperature for a 3-year-old child.

The parent of a hospitalized child tells the nurse, "We do not eat meat. We are practicing Buddhists and strict vegetarians." The most appropriate intervention by the nurse is to: order the child a meatless tray. tell the parent to take any meat off the child's meal tray. ask the parent if they would like to have a Buddhist priest visit. explain to the parent that meat provides protein needed to heal their child.

order the child a meatless tray.

Nursing care of the infant or child with congestive heart failure would include: forcing fluids appropriate to age. monitoring respirations during active periods. organizing activities to allow for uninterrupted sleep. giving larger feedings less often to conserve energy.

organizing activities to allow for uninterrupted sleep.

When preparing parents to teach their preschool child about human sexuality, the nurse should emphasize that: a parent's words may have a greater influence on the child's understanding than the parent's actions. parents should determine exactly what the child wants to know before answering a question about sex. parents should avoid using correct anatomic terms because they are confusing to the preschooler. parents should allow children to satisfy their sexual curiosity by playing "doctor."

parents should determine exactly what the child wants to know before answering a question about sex.

During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. His birthday is close to the cutoff date, and he has not attended preschool. The nurse's BEST recommendation is to: start kindergarten. perform developmental screening. observe a kindergarten class. postpone kindergarten and go to preschool.

perform developmental screening.

When explaining the proper restraint of toddlers in motor vehicles to a group of parents, the nurse should include: wearing safety belts snugly over the toddler's abdomen. placing the car seat in the front passenger seat if there is an airbag. using lap and shoulder belts when the child is over 3 years of age. placing the car seat in the back seat of the car facing forward.

placing the car seat in the back seat of the car facing forward.

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other trauma resulting from a motor vehicle injury. The child is experiencing severe pain. An important consideration in managing the child's pain is to: give only an opioid analgesic at this time. increase the dosage of analgesic until the child is adequately sedated. plan a preventive schedule of pain medication around the clock. give the child a clock and explain when he or she can have pain medications.

plan a preventive schedule of pain medication around the clock.

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these symptoms are suggestive of: pneumothorax. bronchodilation. carbon dioxide retention. increased viscosity of sputum.

pneumothorax.

After a patient returns from cardiac catheterization, the nurse assesses that the pulse distal to the catheter insertion site is weaker. The nurse should: elevate the affected extremity. record the data on the nurse's notes. notify the physician of the observation. apply warm compresses to the insertion site.

record the data on the nurse's notes.

The most accurate method of determining the length of a child less than 12 months of age is: standing height. estimation of length to the nearest centimeter or ½ inch. recumbent length measured in the prone position. recumbent length measured in the supine position.

recumbent length measured in the supine position.

A 4-year-old boy has been having increasingly more frequent angry outbursts in preschool. He is very aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. The MOST appropriate intervention is to: explain that this is normal in preschoolers, especially boys. refer the child for professional help. talk to the preschool teacher to obtain validation for the behavior the parent reports. encourage the parent to try more consistent and firm discipline.

refer the child for professional help.

A 7-year-old female child has a fever associated with a viral illness. She is being cared for at home. The nurse should recognize that the principal reason for treating fever in this child is: relief of discomfort. reassurance that illness is temporary. prevention of secondary bacterial infection. prevention of life-threatening complications.

relief of discomfort.

The nurse is caring for a comatose child with multiple injuries. The nurse should recognize that pain: cannot occur if a child is comatose. may occur if a child regains consciousness. requires astute nursing assessment and management. is best assessed by family members who are familiar with the child.

requires astute nursing assessment and management.

An early sign of congestive heart failure that the nurse should recognize is: tachypnea. bradycardia. inability to sweat. increased urine output.

tachypnea.

The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. The nurse's initial action is to: advise the mother to follow a milk-free diet for 3 to 5 days. take a thorough, detailed history of usual daily events. administer simethicone drops to provide relief from gas pains. explain that the parents need to stay calm so the infant will remain calm.

take a thorough, detailed history of usual daily events.

An important consideration when using the FACES pain rating scale with children is: that children color the face with the color they choose to best describe their pain. the scale can be used with most children, including those as young as 3 years old. the scale is not appropriate for use with adolescents. the scale is useful in pain assessment but is not as accurate when assessing physiologic responses.

the scale can be used with most children, including those as young as 3 years old.

A nurse is conducting a health history on an adolescent. Components of the health history include: (Select all that apply.) sexual history. review of systems. physical assessment. growth measurements. family medical history.

sexual history. review of systems. family medical history.

A 4-year-old female child sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This is MOST likely described as: a nightmare. sleep terror. seizure activity. sleep apnea.

sleep terror.

The most overwhelming adverse influence on health is: race. customs. socioeconomic status. genetic constitution.

socioeconomic status.

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates: liquefying secretions. improving oxygenation. promoting ventilation. soothing inflamed mucous membrane.

soothing inflamed mucous membrane.

A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a: spacer. nebulizer. peak expiratory flow meter. trial of chest physiotherapy.

spacer.

A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is: low Fowler's. prone. supine. squatting.

squatting.

The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, O.K.?" The nurse should: start the IV line because allowing the child to manipulate the nurse is bad. start the IV line because unlimited procrastination results in heightened anxiety. postpone starting the IV line until the child is ready so that the child experiences a sense of control. postpone starting the IV line until the child is ready so the child's anxiety is reduced.

start the IV line because unlimited procrastination results in heightened anxiety.

Poisoning in toddlers can best be prevented by: consistently using safety caps. storing poisonous substances in a locked cabinet. keeping ipecac syrup in the home. storing poisonous substances out of reach.

storing poisonous substances in a locked cabinet.

The nurse is caring for a dying boy whose religion is Islam (Muslim/Moslem). An important nursing consideration related to his impending death and religion is that: there are no special rites. there are specific practices to be followed. the family is expected to "wait" away from the dying person. baptism should be performed if it has not been done previously.

there are specific practices to be followed.

A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that: the infant is most likely spoiled. this is a normal reaction for this age. this is an abnormal reaction for this age. grandparents are not responsive to that infant.

this is a normal reaction for this age.

The nurses caring for a child are concerned about the child's frequent requests for pain medication. During a team conference, a nurse suggests that they consider administering a placebo instead of the usual pain medication. This decision should be based on knowledge that: this practice is unjustified and unethical. this practice is effective in determining whether a child's pain is real. the absence of a response to a placebo means the child's pain has an organic basis. a positive response to a placebo will not occur if the child's pain has an organic basis.

this practice is unjustified and unethical.

Infants most at risk for sudden infant death syndrome (SIDS) are those: (Select all that apply.) who sleep supine who sleep prone who were premature with prenatal drug exposure with a cousin that died of SIDS

who sleep prone who were premature with prenatal drug exposure