Lip/Saunders Peds/GI
the parent of a 9 month old expressed concern that the baby is developing slowly. the nurse is concerned about a developmental delay when finding the baby is unable to accomplish which skill? 1. vocalizing single syllables 2. standing alone 3. building a tower of two cubes 4. drinking from a cup with little spilling
1. vocalizing single syllables
a 2 year old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. what should the nurse try first? 1. ask another nurse to assist 2. allow a parent to assist 3. wait until the child calms down 4. restrain the child's arms
2. allow a parent to assist
a child has just ingested about 10 adult strength acetaminophen tablets an hour ago. the mother brings the child to the ED. what should the nurse do? Put in order from first to last 1. administer activated charcoal 2. assess the airway 3. check serum acetaminophen levels 4. administer acetylcysteine
2. assess the airway 1. administer activated charcoal 3. check serum acetaminophen levels 4. administer acetylcysteine
when teaching the parents of an infant how to perform back slaps to dislodge a foreign body, what should the nurse tell the parents to use to deliver the blows? 1. palm of the hand 2. heel of the hand 3. fingertips 4. entire hand
2. heel of the hand
the parent tells the nurse that an 8 year old child is continually telling jokes and riddles to the point of driving the other members of the family crazy. the nurse should explain this behavior is a sign of which factor? 1. inadequate parental attention 2. mastery of language ambiguities 3. inappropriate peer influence 4. excessive TV watching
2. mastery of language ambiguities
when assessing pain in a toddler, which method would be the most appropriate? 1. ask the child about the pain 2. observe the child for restlessness 3. use a numeric rating pain scale 4. assess for changes in vital signs
2. observe the child for restlessness
a 13 month old has a febrile seizure 3 weeks after the administration of the chicken pox vaccine. what is the best action for the nurse to take? 1. recognize that the events are unrelated 2. report the event through an immunization surveillance system 3. explain to the parents that this a rare but acceptable risk 4. refer the child to a neurologist
2. report the event through an immunization surveillance system
which intervention should the nurse employ to reduce trauma caused by vaccine administration to an infant? 1. use a 5/8 inch needle 2. simultaneously administer vaccines at separate sites with a second nurse 3. aspirate to verify needle placement 4. breastfeed right before administering the vaccines
2. simultaneously administer vaccines at separate sites with a second nurse
when performing the nursing history, which information would be most important for the nurse to obtain from the mother of an infant with suspected colic? 1. the type of formula the infant is taking 2. the infant's crying pattern 3. the infant's sleeping position 4. the position of the infant during burping
2. the infant's crying pattern
the nurse is teaching the parent of a child with celiac disease about dietary management. which statement by the parent indicates successful teaching? 1. I will feed my child foods that contain wheat products. 2. I will be sure to give my child lots of milk 3. I will plan to feed my child foods that contain rice 4. I will be sure my child gets oatmeal every day
3. I will plan to feed my child foods that contain rice
when developing the teaching plan about illness for the parent of a preschooler, which information should the nurse include about how a preschooler perceives illness? 1. a necessary part of life 2. a test of self worth 3. a punishment for wrongdoing 4. the will of god
3. a punishment for wrongdoing
the nurse begins CPR on a 5 year old unresponsive client. when the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 with cyanotic legs. what should the team do next? 1. continue administering breaths with a bag mask device without compressions 2. suspend CPR briefly to apply defibrillation patches 3. begin 2 person CPR at a ratio of 2 breaths to 15 compressions 4. begin 2 person CPR at a ratio of 2 breaths to 30 compressions
3. begin 2 person CPR at a ratio of 2 breaths to 15 compressions
when performing CPR, which finding indicates that external chest compressions are effective? 1. mottling of the skin 2. pupillary dilation 3. palpable pulse 4. cool, dry skin
3. palpable pulse
a 17 year old high school senior calls the clinic because she thinks that she might have gonorrhea. she wants to be seen but she wants assurances that no one will know. which is the most appropriate response by the nurse? 1. because you are underage, we will need your parent's consent to treat you 2. we can treat you without your parents' consent, but they have a right to review your medical record 3. we can see you without your parents' consent but have to report any positive results to the public health department 4. we can see you, treat any infections, and will not share your results with anyone
3. we can see you without your parents' consent but have to report any positive results to the public health department
parents bring their infant to the ED because the child has stopped breathing. a nurse obtains a brief history of events occurring before and after the parents found the infant not breathing. which question should the nurse ask the parents first? 1. was the infant sleeping while wrapped in a blanket? 2. was the infant lying on his stomach? 3. what did the infant look like when you found him? 4. when had you last checked in the infant?
3. what did the infant look like when you found him?
the nurse is invited to attend a meeting with several parents who express frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. what does the nurse explain that this behavior indicates? 1. an abnormal narcissism 2. a method of procrastination 3. a way of testing the parents limit setting 4. a result of developing self concept
4. a result of developing self concept
which child is at most risk for SIDS? 1. infant who is 3 months old 2. 2 year old who has apnea lasting up to 5 seconds 3. firstborn child whose parents are in their early 40s 4. 6 month old who has had two bouts of pneumonia
1. infant who is 3 months old
a child with a nut allergy presents with a severe reaction for the third time in 3 months. the parent says "I am having trouble with the food labels" what should the nurse do first? 1. assess the parent's ability to read 2. refer the client to the dietician 3. notify the HCP 4. obtain a social service consult
1. assess the parent's ability to read
the nurse is teaching the parent of a preschool age child with celiac disease about a gluten free diet. the nurse determines that teaching has been successful when the parent tells the nurse she will prepare which breakfast for the child? 1. eggs and orange juice 2. wheat toast and grape jelly 3. oatmeal and skim milk 4. rye toast and peanut butter
1. eggs and orange juice
the breastfeeding mother of a 1 month old diagnosed with cow's milk sensitivity asks the nurse what she should do about feeding her infant. which recommendation would be most appropriate? 1. continue to breastfeed, but eliminate all milk products from your own diet 2. discontinue breastfeeding, and start using a predigested formula 3. limit breastfeeding to once per day and begin feeding an iron fortified formula 4. change to a soy based formula exclusively and begin solid foods
1. continue to breastfeed, but eliminate all milk products from your own diet
which breathing rates should the nurse use when performing rescue breathing during CPR for a 5 year old? 1. 10 breaths/min 2. 12 breaths/min 3. 15 breaths/min 4. 20 breaths/min
1. 10 breaths/min
when explaining parents how to reduce the risk of SIDS, the nurse should teach about which measures? sata 1. maintain a smoke free environment 2. use a wedge for side lying positions 3. breastfeed the baby 4. place the baby on their back to sleep 5. use bumper pads over the bed rails 6. have the baby sleep in the parent's bed
1. maintain a smoke free environment 3. breastfeed the baby 4. place the baby on their back to sleep
which foods would be appropriate for a 12 month old child with celiac disease? 1. oatmeal 2. pancakes 3. rice cereal 4. waffles
3. rice cereal
the nurse is teaching the parents of an 8 month old about what the child should eat. the nurse should include which information points in the teaching plan? 1. vegetables should be introduced before fruits when the infant is 6 months old 2. solid foods should not be introduced until the infant is 10 months old 3. iron fortified cereals should not be introduced until the infant is 8 months old 4. formula can be changed to whole milk when the infant is 12 months old
4. formula can be changed to whole milk when the infant is 12 months old
while the nurse is delivering abdominal thrusts to a 6 year old who is choking on a foreign body, the child begins to cry. what should the nurse do next? 1. tap or gently shake the shoulders 2. deliver back slaps 3. perform a blind finger sweep of the mouth 4. observe the child closely
4. observe the child closely
on finding a child who is not breathing, the nurse has someone activate the emergency medical system and then does what first? 1. clear the airway 2. begin mouth to mouth resuscitation 3. initiate oxygen therapy 4. start chest compressions
4. start chest compressions
The nurse instructs a primaparous client about bottle-feeding her neonate. which action demonstrates that the mother has understood the nurse's instructions? 1. placing the neonate on his back after the feeding 2. bubbling the baby after 1 oz of formula 3. putting three quarters of the bottle nipple into the baby's mouth 4. pointing the nipple toward the neonate's palate
1. placing the neonate on his back after the feeding
the nurse discusses the eating habits of school age children with their parents, explaining that these habits are most influenced by which factor? 1. food preferences of their peers 2. smell and appearance of foods offered 3. examples provided by parents at mealtimes 4. parental encouragement to eat nutritious foods
3. examples provided by parents at mealtimes
when providing intermittent nasogastric feedings to an infant with failure to thrive, which method is preferred to confirm tube placement before each feeding? 1. obtaining a bedside chest x ray 2. verifying that the gastric pH is <5.5 3. auscultating the stomach while instilling an air bolus 4. comparing the tube insertion length to a standardized chart
2. verifying that the gastric pH is <5.5
After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent: 1. did you know that vaccinations are required by law for school entry? 2. what concerns do you have about vaccinations? 3. would you prefer that fewer vaccines are given at a time? 4. can you please sign this vaccine waiver form?
2. what concerns do you have about vaccinations?
a child is hospitalized because of persistent vomiting. the nurse should monitor the child closely for which problem? 1. diarrhea 2. metabolic acidosis 3. metabolic alkalosis 4. hyperactive bowel sounds
3. metabolic alkalosis
the health care team determines that the family of an infant with failure to thrive who is to be discharged will need follow up care. which approach would be the most effective method of follow up? 1. daily phone calls from the hospital nurse 2. enrollment in community parenting classes 3. twice weekly clinic appointments 4. weekly visits by a community health nurse
4. weekly visits by a community health nurse
after teaching the mother of a 2 year old child with lactose intolerance about which dairy products to include in the child's diet, the nurse understands that teaching has been effective if the mother states she will include which food? 1. ice cream 2. creamed soups 3. pudding 4. yogurt
4. yogurt
a nurse walks into a room just as a 10 month old infant places an object in his mouth and starts to choke. after opening the infant's mouth, which should the nurse do next to clear the airway? 1. use blind finger sweeps 2. deliver back slaps and chest thrusts 3. apply 4 subdiaphragmatic abdominal thrusts 4. attempt to visualize the object
2. deliver back slaps and chest thrusts
the nurse judges that the mother has understood the teaching about care of an infant with colic when the nurse observes the mother doing which action? 1. holding the infant prone while feeding 2. holding the infant in her lap to burp 3. placing the infant prone after the feeding 4. burping the infant during and after the feeding
4. burping the infant during and after the feeding
the parent of a child with celiac disease asks "how long must he stay on this diet?" which response by the nurse is best? 1. until the jejunal biopsy is normal 2. until his stools appear normal 3. for the next 6 months 4. for the rest of his life
4. for the rest of his life
the parents of a preschooler ask the nurse how to handle their child's temper tantrums. which technique should the nurse include in the teaching plan? sata 1. putting the child in time out 2. ignoring the child 3. putting the child to bed 4. spanking the child 5. trying to reason with the child
1. putting the child in time out 2. ignoring the child
assessment of a term neonate at 2 hours after birth reveals a heart rate of <100 bpm, periods of apnea approximately 25 to 30 seconds in length, and mild cyanosis around the mouth. the nurse notifies the HCP based on the interpretation that these findings may lead to which condition? 1. respiratory arrest 2. bronchial pneumonia 3. intraventricular hemorrhage 4. epiglottitis
1. respiratory arrest
the nurse provides home care instructions to the parents of a child with celiac disease. the nurse should teach the parents to include which food item in the child's diet? 1. rice 2. oatmeal 3. rye toast 4. wheat bread
1. rice
which amount of daily milk intake should the nurse include in the plan of care for a 15 month old? 1. 1/2 cup to 1 cup 2. 2 to 3 cups 3. 3 to 4 cups 4. 4 to 5 cups
2. 2 to 3 cups
the nurse teaches the parents of a preschool child diagnosed with lactose intolerance how to incorporate dairy products into their child's diet. which statement by the parent reflects the need for more teaching? 1. my child should limit milk consumption to one small glass at a time 2. it is best to drink milk alone, not with meals 3. eating hard cheese, cottage cheese, or yogurt may cause fewer symptoms than drinking milk 4. using lactase enzymes or milk products containing lactase may help decrease gas
2. it is best to drink milk alone, not with meals
during assessment of a child with celiac disease, the nurse would most likely note which physical finding? 1. enlarged liver 2. protuberant abdomen 3. tender inguinal lymph nodes 4. periorbital edema
2. protuberant abdomen
the parents of a child with colic are asked to describe the infant's bowel movements. which description should the nurse expect? 1. soft, yellow stools 2. frequent watery stools 3. ribbon like stools 4. foul smelling stools
1. soft, yellow stools
after teaching the parents of a child with lactose intolerance about the disorder, the nurse determines that the teaching was effective when the mother uses which statement to describe the condition? 1. the lack of an enzyme to break down lactose 2. an allergy to lactose found in milk 3. inability to digest proteins completely 4. inability to digest fats completely
1. the lack of an enzyme to break down lactose
the parent of a 4 year old expresses concern that the child may be hyperactive. the parent describes the child as always in motion, constantly dropping and spilling things. which action would be appropriate at this time? 1. determine whether there have been any changes at home 2. explain that this is not unusual behavior 3. explore the possibility that the child is being abused 4. suggest that the child be seen by a pediatric neurologist
2. explain that this is not unusual behavior
the nurse is conducting a health history on a school age child. which parent statement would suggest to the nurse that a child may have celiac disease? 1. his urine is so dark in color 2. his stools are large and smelly 3. his belly is so small 4. he is so short
2. his stools are large and smelly
a young child has had a cardiac arrest and the rapid response team has been activated. the nurse arrives in the clients room and observes a LPN administering CPR to an infant. what should the nurse do to assist the LPN? 1. take over rescue breaths with a rate of 1 breath per 5 compressions using a bag mask device while the LPN continues compressions 2. take over compressions using one hand while the LPN uses a mask device to administer rescue breaths 3. take over rescue breaths using a rate of 2 breaths per 15 compressions using a bag mask device wile the LPN delivers compressions 4. take over compressions at 80 compressions a min while the LPN use a bag mask device to administer rescue breaths
3. take over rescue breaths using a rate of 2 breaths per 15 compressions using a bag mask device wile the LPN delivers compressions
a child who is 18 months of age is brought to the ED by her babysitter. the babysitter states "she fell from the sofa an hour ago and hasn't been herself since" on questioning, the babysitter appears to be unsure of time and other facts about the incident. which question below would be most effective in obtaining more information about the child's injuries? 1. why did you leave the child alone on the couch? 2. have you taken a course in safe babysitting? 3. tell me what was happening before she fell 4. where are her parents? do they know what happened?
3. tell me what was happening before she fell
when planning a visit to the parents of an infant who died of SIDS at home, the nurse should visit the parents at which time? 1. a few days after the funeral 2. 2 weeks after the funeral 3. as soon as the parents are ready to talk 4. as soon after the infants death as possible
4. as soon after the infants death as possible
the nurse is preparing care for a child with a diagnosis of intussusception. the nurse reviews the child's record and expects to note which sign of this disorder documented? 1. watery diarrhea 2. ribbon like stools 3. profuse projectile vomiting 4. bright red blood and mucus in the stools
4. bright red blood and mucus in the stools
a 16 year old client who has been confined to a wheelchair since early childhood has lately been acting rebellious and rude. her parents ask the nurse "are all adolescents like this?" the nurse should respond with which statement? 1. yes, although your daughter's behaviors are more like those of an adolescent boy 2. no. your daughter must need some help in dealing with her feelings 3. your daughter's behavior seems to be typical adolescent behavior. let us talk more about it 4. your daughter's behavior results from feelings about her disability. ignore it
3. your daughter's behavior seems to be typical adolescent behavior. let us talk more about it
during a school party, a child with a known food allergy has an itchy throat, is wheezing, and not feeling "quite right". the nurse should do what in order from first to last? 1. administer the child's epinephrine 2. assess vital signs 3. position to facilitate breathing 4. send someone to activate the EMS 5. notify the parents
4. send someone to activate the EMS 1. administer the child's epinephrine 3. position to facilitate breathing 2. assess vital signs 5. notify the parents
A nurse compares a child's height and weight with standard growth charts and finds the child to be in the 50th percentile for height and in the 25th percentile for weight. The nurse interprets these findings as indicating that the child is: 1. typical height and weight. 2. overweight for height. 3. underweight for height. 4. abnormal in height.
1. typical height and weight.
the mother tells the nurse that the diagnosis of colic upsets her because she knows her infant will continue to have colicky pain. which response by the nurse would be most appropriate? 1. I know that your baby's crying upsets you, but she needs your undivided attention for the next few months 2. it can be difficult to listen to your baby cry so loud and so long, so try to make sure that you get some free time 3. it must be distressing to see your baby in pain, but at least she does not have an intestinal obstruction 4. the next 3 months will be difficult time for you, but your baby will outgrow the colic by this time
2. it can be difficult to listen to your baby cry so loud and so long, so try to make sure that you get some free time
a parent brings a 5 year old to a weekend vaccination clinic to prepare for school entry. the nurse notes that the child has not has any since 4 months of age. what is the best way for the nurse to determine how to catch up the child's vaccinations? 1. contact the HCP during office hours 2. review nationally published immunization guidelines 3. read each vaccine's manufacturers insert 4. visit a local pharmacist on duty
2. review nationally published immunization guidelines
as part of a health education program, the nurse teaches a group of parents CPR. the nurse determines that the teaching had been effective when a parent makes which statement about providing CPR to a child? 1. If I am by myself, I should call for help before starting CPR. 2. I should compress a child's chest using 2 to 3 fingers 3. I should deliver chest compression at a rate of 100 per minute 4. If I cannot get the breaths to make the chest rise, I should administer abdominal thrusts
3. I should deliver chest compression at a rate of 100 per minute
during an admission history, the parents of a pediatric client explain that the family is Jewish and follows a kosher diet. which food items would be appropriate for the client? 1. sausage and pepperoni pizza and a glass of milk 2. bacon and eggs and a glass of orange juice 3. chicken, a cup of fruit, and a glass of water 4. turkey sandwich and a glass of milk
3. chicken, a cup of fruit, and a glass of water
a parent of a toilet trained 3 year old expresses concern over her child's bed wetting while hospitalized. what should the nurse tell the parent? 1. your child was too immature to be toilet trained. in a few months your child should be old enough 2. children are afraid in the hospital and frequently wet the bed 3. it is very common for children to regress when they are in the hospital 4. this is normal. your child probably received too much fluid the night before
3. it is very common for children to regress when they are in the hospital
the nurse formulates a plan of care to address negative feeding patterns for a 5 month old infant diagnosed with failure to thrive. to meet the short term outcomes of the infant's plan of care, the nurse should expect to implement which intervention? 1. instruct the parents in proper feeding techniques 2. give the infant high calorie formula 3. provide consistent staff to care for the infant 4. allow the infant to sit in a high chair during feedings
3. provide consistent staff to care for the infant
the nurse should refer the parents of an 8 month old child to a HCP if the child is unable to demonstrate which gross motor ability? 1. stand momentarily without holding onto furniture 2. stand unsupported well for long periods of time 3. stoop to recover an object on the ground 4. sit without support for long periods of time
4. sit without support for long periods of time
the nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? 1. provide less frequent, larger feedings 2. burp the infant less frequently during feedings 3. thin the feedings by adding water to the formula 4. thicken the feedings by adding rice cereal to the formula
4. thicken the feedings by adding rice cereal to the formula
the parent of a 9 month old infant is concerned that the infants front soft spot is still open. what should the nurse tell the parent? 1. I will measure your baby's head to see if it is a normal size 2. your infant will need to be referred for more testing 3. you should contact your HCP immediately 4. this is normal because this soft spot usually closes between 12 and 18 months
4. this is normal because this soft spot usually closes between 12 and 18 months
