Final exam Peds

A child is admitted to the hospital with a diagnosis of possible meningitis. Which information is the most important to ask at the time of admission? "Are there any pets in the household?" "Is anyone else in the household ill?" "Are the immunizations up to date? "Has the child had a recent injury?"

"Are the immunizations up to date?

The pediatric nurse clinician is discussing the pathophysiology related to childhood leukemia with a class of nursing students. Which statement made by a nursing student indicates a lack of understanding of the pathophysiology of this disease? 1. The platelet count is decreased. 2. Red blood cell production is affected. 3. Reed-Sternberg cells are found on biopsy. 4. Normal bone marrow is replaced by blast cells.

3. Reed-Sternberg cells are found on biopsy.

Piaget's sensorimotor stage

Age: 0-2 years old Significant development: Object permanence Nurse adaptations: Play "peek a boo"

Piaget's formal operations stage

Age: 12-18 years old Significant development: Adaptability and flexibility Nurse adaptations: The child can understand consequences to their actions. they can consider others' feelings. They are figuring out other cultures, beliefs and ways of living.

Piaget's preoperational stage

Age: 2-7 years old Significant development: Egocentric, concrete thinkers Nurse adaptations: The child can't understand others' feelings. Choose words very carefully

Piaget's concrete operational stage

Age: 7-11 years old Significant development: conservation of objects; they have height, weight and volume. Understanding of the relationship between things and ideas Nurse adaptations: The child will love to collect objects; cards, shells, dolls, animals, stickers. The child can read, understand time and organize things into catagories

Erikson 1-3 years

Autonomy vs. shame and doubt

Which is the most appropriate recommendation for relief of teething pain? Rub the gums with aspirin to relieve inflammation. Apply hydrogen peroxide to the gums to relieve irritation. Give the child a frozen teething ring to relieve inflammation. Have the child chew on a warm teething ring to encourage tooth eruption.

Give the child a frozen teething ring to relieve inflammation.

Erikson 12-18 years

Identity vs. role confusion

Based on Piaget's theory of cognitive development, what is one basic concept a child is expected to attain during the first year of life? If an object is hidden, that does not mean that it is gone. He or she cannot be fooled by changing shapes. Parents are not perfect. Most procedures can be reversed.

If an object is hidden, that does not mean that it is gone.

Erikson 6-12 years

Industry vs. inferiority

18month milestones

Picky eater anterior fontanel closed *Physiologically able to control sphincter assumes standing position walks up stairs when one hand is held pulls and pushes toys jumps in place with both feet seats self on chair throws ball overhead without falling builds a tower of 3-4 blocks reach and release are developed turns 2-3 pages of a book at a time *Says 10 or more words Forms word combinations *temper tantrums *imitates very well *ownership of objects. "my toy" *May develop dependence on something: security blanket

According to Piaget, at what stage of development do children typically solve problems through trial and error? Sensorimotor stage Preoperational stage Formal operational stage Concrete operational stage

Sensorimotor stage

8 month milestones

Separation anxiety starts Sitting without assistance Trunk control gained Able to bear weight on legs with support, may start pulling self up with furniture. Rings a bell purposefully Reaches for a toy while it's out of reach makes sounds "Dada" but doesn't know the meaning responds to "no" beginning to have pincer grasp

Which infant is at risk for developing vitamin D-deficient rickets? Lacto-ovovegetarians Those who are breastfed exclusively Those using yogurt as a primary source of milk Those exposed to daily sunlight

Those using yogurt as a primary source of milk

A nurse is examining a toddler and is discussing with the mother psychosocial development according to Erikson's theories. Based on the nurse's knowledge of Erikson, the most age-appropriate activity to suggest to the mother at this stage is to feed lunch. allow the toddler to start making choices about what to wear. allow the toddler to pull a talking-duck toy. turn on a TV show with bright colors and loud songs

allow the toddler to start making choices about what to wear.

During their school-age years, children best understand concepts that can be seen or illustrated. The nurse knows this type of thinking is termed as concrete operations. preoperational. school-age rhetoric. formal operations.

concrete operations.

Cephalocaudal

head to toe

During a well-baby visit, the parents of a 12-month-old ask the nurse for advice on age-appropriate toys for their child. Based on the nurse's knowledge of developmental levels, the most appropriate toys to suggest are (Select all that apply) push-pull toys. toys with black-white patterns. pop-up toy such as Jack-in-the-box. soft toys that can be put in the mouth. toys that pop apart and go back together.

push-pull toys. pop-up toy such as Jack-in-the-box. toys that pop apart and go back together.

According to Erikson, infancy is concerned with acquiring a sense of trust. industry. initiative. separation.

trust.

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1. Fine grayish red lines 2. Purple-colored lesions 3. Thick, honey-colored crusts 4. Clusters of fluid-filled vesicles

1. Fine grayish red lines

The nurse instructs the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement, if made by the parent, indicates a need for further instructions? 1. "I will take a rectal temperature daily." 2. "I will inspect the skin daily for redness." 3. "I will inspect the mouth daily for lesions." 4. "I will perform proper hand washing techniques."

1. "I will take a rectal temperature daily."

The nurse is teaching the parents of a child with growth hormone deficiency about preparing and administering synthetic growth hormone to the child. Which statement, if made by the parents, would indicate an understanding of the procedure? 1. "We will rotate injection sites." 2. "We will give the injection weekly on Monday." 3. "We will administer the injection every morning." 4. "We will store the mixed growth hormone in the medicine cabinet."

1. "We will rotate injection sites."

The nurse is performing an assessment on a 10-year-old child suspected to have Hodgkin's disease. The nurse understands that which assessment findings are specifically characteristic of this disease? Select all that apply. 1. Abdominal pain 2. Fever and malaise 3. Anorexia and weight loss 4. Painful, enlarged inguinal lymph nodes 5. Painless, firm, and movable adenopathy in the cervical area

1. Abdominal pain 5. Painless, firm, and movable adenopathy in the cervical area

The nurse has reviewed the health care provider's prescriptions for a child suspected of a diagnosis of neuroblastoma and is preparing to implement diagnostic procedures that will confirm the diagnosis. What should the nurse expect to do next to assist in confirming the diagnosis? 1. Collect a 24-hour urine sample. 2. Perform a neurological assessment. 3. Assist with a bone marrow aspiration. 4. Send to the radiology department for a chest x-ray.

1. Collect a 24-hour urine sample.

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 cells/mm3. On the basis of this laboratory result, which intervention should the nurse include in the plan of care? 1. Initiate bleeding precautions. 2. Monitor closely for signs of infection. 3. Monitor the temperature every 4 hours. 4. Initiate protective isolation precautions.

1. Initiate bleeding precautions.

A 2-year-old child is admitted to a hospital burn unit with partial- and full-thickness burns involving 35% of body surface area. After admission assessment and review of the health care provider's prescriptions, the priority nursing intervention should focus on which action? 1. Inserting a Foley catheter 2. Inserting a nasogastric tube 3. Sedating with morphine sulfate 4. Restricting intravenously administered fluids

1. Inserting a Foley catheter A Foley catheter is inserted into the child's bladder so that urine output can be measured accurately each hour. A nasogastric tube may or may not be required, but this is not the priority intervention. Although pain medication may be required, the child should not be sedated. Intravenously administered fluids are not restricted and are administered at a rate sufficient to keep the child's urine output at 1 mL/kg of body mass per hour, thus reflecting adequate tissue perfusion.

A 14-year-old girl is admitted to the hospital with a diagnosis of acute lymphocytic leukemia. She is receiving a combination chemotherapeutic regimen that includes cyclophosphamide. The nurse plans care understanding that which are associated with this medication? Select all that apply. 1. It is platelet sparing. 2. It causes constipation. 3. It causes hemorrhagic cystitis. 4. It causes bone marrow depression. 5. Increased fluid intake is necessary.

1. It is platelet sparing. 3. It causes hemorrhagic cystitis. 4. It causes bone marrow depression. 5. Increased fluid intake is necessary.

The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment of subjective data, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms' tumor, should avoid which during the physical assessment? 1. Palpating the abdomen for a mass 2. Assessing the urine for the presence of hematuria 3. Monitoring the temperature for the presence of fever 4. Monitoring the blood pressure for the presence of hypertension

1. Palpating the abdomen for a mass

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1. The child is 18 months old. 2. The child is being bottle-fed. 3. A sibling is using lindane for the treatment of scabies. 4. The child has a history of frequent respiratory infections.

1. The child is 18 months old.

The nurse is monitoring a 3-year-old child for signs and symptoms of increased intracranial pressure (ICP) after a craniotomy. The nurse plans to monitor for which early sign or symptom of increased ICP? 1. Vomiting 2. Bulging anterior fontanel 3. Increasing head circumference 4. Complaints of a frontal headache

1. Vomiting

A 9-year-old child with leukemia is in remission and has returned to school. The school nurse calls the mother of the child and tells the mother that a classmate has just been diagnosed with chickenpox. The mother immediately calls the clinic nurse because the leukemic child has never had chickenpox. Which is an appropriate response by the clinic nurse to the mother? 1. "There is no need to be concerned." 2. "Bring the child into the clinic for a vaccine." 3. "Keep the child out of school for a 2-week period." 4. "Monitor the child for an elevated temperature, and call the clinic if this happens."

2. "Bring the child into the clinic for a vaccine." Immunocompromised children are unable to fight varicella adequately. Chickenpox can be deadly to the immunocompromised child. If an immunocompromised child who has not had chickenpox is exposed to someone with varicella, the child should receive varicella-zoster immune globulin within 96 hours of exposure

The pediatric nurse specialist provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for information? 1. "The femur is the most common site of this sarcoma." 2. "The child does not experience pain at the primary tumor site." 3. "Limping, if a weight-bearing limb is affected, is a clinical manifestation." 4. "The symptoms of the disease in the early stage are almost always attributed to normal growing pains."

2. "The child does not experience pain at the primary tumor site.

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 1. Scarring is less severe in a child than in an adult. 2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 4. The lower proportion of body fluid to mass in a child increases the risk of cardiovascular problems. 5. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

The nurse is teaching the parent of a preschool child how to administer the child's insulin injection. The child will be receiving 2 units of Humulin R insulin and 12 units of Humulin N insulin every morning. How should the nurse instruct the parents to prepare the insulin? 1. Draw the insulin into separate syringes. 2. Draw the Humulin R insulin first and then the Humulin N insulin into the same syringe. 3. Draw the Humulin N insulin first and then the Humulin R insulin into the same syringe. 4. Check blood glucose first, and if the result is between 80 and 120 mg/dL, withhold the insulin injection.

2. Draw the Humulin R insulin first and then the Humulin N insulin into the same syringe.

A 6-year-old child with diabetes mellitus and the child's mother come to the health care clinic for a routine examination. The nurse evaluates the data collected during this visit to determine if the child has been euglycemic since the last visit. Which information is the most significant indicator of euglycemia? 1. Daily glucose monitor log 2. Glycosylated hemoglobin (hemoglobin A1c) 3. Dietary history for the previous week 4. Fasting blood glucose performed on the day of the clinic visit

2. Glycosylated hemoglobin (hemoglobin A1c)

A child's fasting blood glucose levels range between 100 and 120 mg/dL daily. The before-dinner blood glucose levels are between 120 and 130 mg/dL, with no reported episodes of hypoglycemia. Mixed insulin is administered before breakfast and before dinner. The nurse should make which interpretation about these findings? 1. Exercise should be increased to reduce blood glucose levels. 2. Insulin doses are appropriate for food ingested and activity level. 3. Dietary needs are being met for adequate growth and development. 4. Dietary intake should be increased to avoid hypoglycemic reactions

2. Insulin doses are appropriate for food ingested and activity level.

A nurse is caring for a 9-year-old child with leukemia who is hospitalized for the administration of chemotherapy. The nurse would monitor the child specifically for central nervous system (CNS) involvement by checking which item? 1. Pupillary reaction 2. Level of consciousness (LOC) 3. The presence of petechiae in the sclera 4. Color, motion, and sensation of the extremities

2. Level of consciousness (LOC)

The nurse is monitoring a child with burns during treatment for burn shock. The nurse understands that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? 1. Skin turgor 2. Neurological assessment 3. Level of edema at burn site 4. Quality of peripheral pulses

2. Neurological assessment

Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? Select all that apply. 1. Maintain the child in a semiprivate room. 2. Reduce exposure to environmental organisms. 3. Use strict aseptic technique for all procedures. 4. Ensure that anyone entering the child's room wears a mask. 5. Apply firm pressure to a needle stick area for at least 10 minutes.

2. Reduce exposure to environmental organisms. 3. Use strict aseptic technique for all procedures. 4. Ensure that anyone entering the child's room wears a mask.

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which intervention? 1. Restrict oral fluids. 2. Use good hand washing technique. 3. Give immunizations appropriate for age. 4. Institute strict isolation with no visitors allowed.

2. Use good hand washing technique.

The nurse is collecting data on a 9-year-old child suspected of having a brain tumor. Which question should the nurse ask to elicit data related to the classic symptoms of a brain tumor? 1. "Do you have trouble seeing?" 2. "Do you feel tired all the time?" 3. "Do you throw up in the morning?" 4. "Do you have headaches late in the day?"

3. "Do you throw up in the morning?"

A home care nurse is teaching an adolescent with type 1 diabetes mellitus about insulin administration and rotation sites. Which statement, if made by the adolescent, would indicate effective teaching? 1. "I should use only my stomach and my thighs for injections." 2. "I need to use a different major site for each insulin injection." 3. "I need to use one major site for 2 to 3 weeks before changing major sites." 4. "I need to use the same major site for 1 month before rotating to another site."

3. "I need to use one major site for 2 to 3 weeks before changing major sites."

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? 1. "It is extremely contagious." 2. "It is most common in humid weather." 3. "Lesions most often are located on the arms and chest." 4. "It might show up in an area of broken skin, such as an insect bite."

3. "Lesions most often are located on the arms and chest."

A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother? 1. "I have a vase in the utility room, and I will get it for you." 2. "I will get the vase and wash it well before you put the flowers in it." 3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time." 4. "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible."

3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time."

The nurse is caring for a 3-year-old boy with a diagnosis of acute lymphocytic leukemia (ALL). The child is crying and complaining that his knees hurt. Which nursing intervention is most appropriate? 1. Involve the child in a diversional activity. 2. Ask the child if he would like a "baby aspirin." 3. Administer acetaminophen (Tylenol) to the child. 4. Apply heat to the child's knees and elevate the knees on a pillow.

3. Administer acetaminophen (Tylenol) to the child.

An adolescent with diabetes receives 30 units of Humulin N insulin at 7:00 am. In accordance with the peak insulin action time, the nurse would monitor for a hypoglycemic episode at what time? 1. At bedtime 2. At midmorning 3. Before supper 4. After breakfast

3. Before supper

A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leukemia is suspected. The nurse understands that which diagnostic study should confirm this diagnosis? 1. Platelet count 2. Lumbar puncture 3. Bone marrow biopsy 4. White blood cell count

3. Bone marrow biopsy

An adolescent with type 1 diabetes mellitus has been chosen for the school's cheerleading squad. The adolescent visits the school nurse to obtain information regarding adjustments needed in the treatment plan for diabetes. What should the school nurse instruct the student to do? 1. Eat half the amount of food normally eaten. 2. Take two times the amount of prescribed insulin on practice and game days. 3. Eat six graham crackers or drink a cup of orange juice prior to practice or game time. 4. Take the prescribed insulin 1 hour prior to practice or game time rather than in the morning.

3. Eat six graham crackers or drink a cup of orange juice prior to practice or game time.

The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquids. 4. Administer an additional dose of regular insulin.

3. Encourage the child to drink liquids.

The nurse should implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL? Select all that apply. 1. Administer regular insulin. 2. Encourage the child to ambulate. 3. Give the child a teaspoon of honey. 4. Provide electrolyte replacement therapy intravenously. 5. Wait 30 minutes and confirm the blood glucose reading. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

3. Give the child a teaspoon of honey. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

An adolescent with type 1 diabetes mellitus is attending a dance in the school gym. The adolescent suddenly becomes flushed and complains of hunger and dizziness. The school nurse, who is present at the dance, takes the child to the nurse's office and performs a blood glucose level test that shows 60 mg/dL. Which is the initial nursing intervention? 1. Call the child's mother. 2. Assist the child with administering regular insulin. 3. Give the child ½ cup of a sugar-sweetened carbonated beverage. 4. Call an ambulance to take the child to the hospital emergency department.

3. Give the child ½ cup of a sugar-sweetened carbonated beverage.

A topical corticosteroid is prescribed by a health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body. 2. Apply a thick layer of cream to affected areas only. 3. Avoid cleansing the area before application of the cream. 4. Apply a thin layer of cream and rub it into the area thoroughly.

4. Apply a thin layer of cream and rub it into the area thoroughly.

Permethrin (Elimite) is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1. Apply the lotion to areas of the rash only. 2. Apply the lotion and leave it on for 6 hours. 3. Avoid putting clothes on the child over the lotion. 4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears. 2. Urine specific gravity is 1.030. 3. Urine output is less than 1 mL/kg/hour. 4. Capillary refill is less than 2 seconds.

4. Capillary refill is less than 2 seconds.

The home care nurse is visiting a child newly diagnosed with diabetes mellitus. The nurse is instructing the child and parents regarding actions to take if hypoglycemic reactions occur. The nurse should tell the child to take which action? 1. Administer glucagon immediately if shakiness is felt. 2. Drink 8 ounces of diet cola at the first sign of weakness. 3. Report to a hospital emergency department if the blood glucose is 60 mg/dL. 4. Carry hard candies whenever leaving home in case a hypoglycemic reaction occurs.

4. Carry hard candies whenever leaving home in case a hypoglycemic reaction occurs.

A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4. Checks the amount of urine output A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription?Rationale: In hypotonic dehydration, electrolyte loss exceeds water loss. The priority assessment before administering potassium chloride intravenously would be to assess the status of the urine output. Potassium chloride should never be administered in the presence of oliguria or anuria.

A school-age child with type 1 diabetes mellitus has soccer practice three afternoons a week. The school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunchtime. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.

A diagnostic workup is being performed on a 1-year-old child with suspected neuroblastoma. The nurse reviews the results of the diagnostic tests and understands that which finding is most specifically related to this type of tumor? 1. Positive Babinski's sign 2. Presence of blast cells in the bone marrow 3. Projectile vomiting, usually in the morning 4. Elevated vanillylmandelic acid (VMA) urinary levels

4. Elevated vanillylmandelic acid (VMA) urinary levels

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

The nurse is asked to prepare for the admission of a child to the pediatric unit with a diagnosis of Wilms' tumor. The nurse is developing a plan of care for the child and should include which intervention in the plan? 1. Monitor the temperature for hypothermia. 2. Monitor the blood pressure for hypotension. 3. Palpate the abdomen for an increase in the size of the tumor. 4. Inspect the urine for the presence of hematuria at each void

4. Inspect the urine for the presence of hematuria at each void Fever (not hypothermia), hematuria, and hypertension (not hypotension) are clinical manifestations associated with Wilms' tumor.

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

The nurse has just administered ibuprofen (Motrin) to a child with a temperature of 38.8° C (102° F). The nurse should also take which action? 1. Withhold oral fluids for 8 hours. 2. Sponge the child with cold water. 3. Plan to administer salicylate (aspirin) in 4 hours. 4. Remove excess clothing and blankets from the child.

4. Remove excess clothing and blankets from the child.

The nurse has been caring for an adolescent newly diagnosed with type 1 diabetes mellitus. The nurse provides instructions to the adolescent regarding the administration of insulin. The nurse should include which instruction? 1. Use only the stomach and thighs for injections. 2. Rotate each insulin injection site on a daily basis. 3. Use the same site for injections for 1 month before rotating to another site. 4. Use one major site for the morning injection and another site for the evening injection for 2 to 3 weeks before changing major sites.

4. Use one major site for the morning injection and another site for the evening injection for 2 to 3 weeks before changing major sites.

The school nurse is conducting pediculosis capitis (head lice) assessments. Which finding indicates a child has a "positive" head check? 1. Maculopapular lesions behind the ears 2. Lesions in the scalp that extend to the hairline or neck 3. White flaky particles throughout the entire scalp region 4. White sacs attached to the hair shafts in the occipital area

4. White sacs attached to the hair shafts in the occipital area

A preschool child watches a nurse pour medication from a tall, thin glass to a short, wide glass. Which statement is appropriate developmentally for this age group? The amount of medicine is less. The amount of medicine did not change, only its appearance. Pouring medicine makes the medicine hot. The glass changed shape to accommodate the medicine.

The amount of medicine is less.

Which statement helps explain the growth and development of children? Development proceeds at a predictable rate. The sequence of developmental milestones is predictable. Rates of growth are consistent among children. At times of rapid growth, there is also acceleration of development.

Development proceeds at a predictable rate.

Erikson 3-6 years

Initiatve vs. guilt

Erikson Birth to 1 year

Trust vs. mistrust