ped : neuro/gastro

The nurse is caring for a child with a diagnosis of intussusception. Which manifestation should the nurse expect to note in this child?

Blood and mucus in the stools

A client has been prescribed valproic acid (Depakene) for the treatment of generalized seizures, and the nurse reinforces instructions to the child about the potential side effects of the medication. Which statement by the client would indicate a need for further teaching?

"I am so glad that I won't lose any of my hair. I was worried what my friends would think."

Which finding would indicate that a child had a tonic-clonic seizure during the night?

Blood on the pillow

The nurse reviews the record of an infant who is seen in the clinic. The nurse notes that a diagnosis of esophageal atresia with tracheoesophageal fistula (TEF) is suspected. The nurse expects to note which most likely manifestation of this condition in the medical record?

Choking with feedings

The nurse is assigned to care for a child who is scheduled for an appendectomy. Which prescriptions does the nurse anticipate to be prescribed? Select all that apply.

Initiate an intravenous line. Maintain nothing-by-mouth status. Administer intravenous antibiotics. Administer preoperative medications.

The nurse is reviewing the laboratory results of an infant suspected of having hypertrophic pyloric stenosis. Which acid-base disorder would the nurse expect to note in the infant?

Metabolic alkalosis

The nurse assists in developing a plan of care for the child with meningitis. Which should be the priority client problem for a child with a meningitis diagnosis?

Neurological dysfunction

The nurse reviews the plan of care for a child with Reye's syndrome. The nurse prioritizes the nursing interventions included in the plan and prepares to monitor for which complication?

Signs of increased intracranial pressure

The nurse provides feeding instructions to a mother of an infant diagnosed with gastroesophageal reflux (GER). To assist in reducing the episodes of emesis, which instruction should the nurse provide the mother?

Thicken the feedings by adding rice cereal to the formula.

The nurse is caring for a child recently diagnosed with cerebral palsy. The parents of the child ask the nurse about the disorder. The nurse bases the response to the parents on the understanding that cerebral palsy is best described by which statement?

Cerebral palsy is a chronic disability characterized by a difficulty in controlling the muscles.

The nurse is caring for a child who sustained a head injury in an automobile accident and is monitoring the child for signs of increased intracranial pressure (ICP). The nurse plans to monitor for an early sign of increased ICP by checking for which sign?

Changes in level of consciousness

The nurse is caring for a newborn with a diagnosis of spina bifida (myelomeningocele). Which should the nurse perform to monitor for a major symptom of this condition?

Check for responses to painful stimuli from the torso downward.

A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse reviews the record, expecting to note which sign as evidence of this disorder?

Evidence of soiled clothing

To ensure a safe environment for a child admitted to the hospital for a craniotomy to remove a brain tumor, the nurse should include which in the plan of care?

Initiating seizure precautions

The nurse is caring for a child following surgical removal of a brain tumor. The nurse is monitoring the child and notes that the pulse rate has increased and the blood pressure has dropped significantly. Bloody drainage also is noted on the posterior dressing. Which is the best nursing action?

Notify the registered nurse (RN)

A licensed practical nurse (LPN) is bathing a neonate and notices small dark tufts of fine hair on the neonate's lower back. The LPN should take which best action

Notify the registered nurse of the finding.

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP) and notes that the anterior fontanel bulges when the infant is sleeping. Based on this finding, which is the priority nursing action?

Notify the registered nurse.

An infant returns to the nursing unit after the surgical repair of a cleft lip located on the right side of the lip. The best position to place this infant at this time is which?

On his or her left side

The nurse is reviewing the health record of a child with a diagnosis of celiac disease. Which clinical manifestation should the nurse expect to note documented in the health record?

Profuse watery diarrhea and vomiting

A licensed practical nurse is providing care for a child with hydrocephalus who has had a ventriculoperitoneal shunt revision. Which data collection finding should be reported to the registered nurse immediately?

Temperature 100.9° F

When checking a child's glossopharyngeal nerve function, the nurse should perform which data collection technique?

Test sense of sour or bitter taste on the posterior segment of the tongue.

A school nurse is preparing a physical education plan for a child with Down syndrome. Before preparing the plan, the nurse obtains which copy of an x-ray report?

The child's cervical spine

A 2-year-old child is diagnosed with constipation due to encopresis. Which description is a characteristic of this disorder?

The infrequent and difficult passage of dry stools

The nurse should implement which in the care of a child who is having a seizure? Select all that apply.

Time the seizure. Stay with the child. Loosen clothing around the child's neck.

A child with a diagnosis of a hernia has been scheduled for a surgical repair in 2 weeks. The nurse reinforces instructions to the parents about the signs of possible hernial strangulation. The nurse tells the parents that which manifestation requires health care provider (HCP) notification by the parents?

Vomiting

The nurse is preparing to care for a child with a head injury. On review of the records, the nurse notes that the health care provider has documented decorticate posturing. The nurse plans care, knowing that this type of posturing indicates which finding?

Dysfunction in the cerebral hemisphere

The nurse is admitting a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to note?

Frothy stools

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. The nurse understands that which is unassociated with this disorder

The passage of currant jelly-like stools

The nurse is assigned to assist in caring for a newborn with a colostomy that was created during surgical intervention for imperforate anus. When the newborn returns from surgery, the nurse checks the stoma and notes that it is red and edematous. Which is the appropriate nursing intervention?

Document the findings

A child with a brain tumor returns from the recovery room following "debulking" of the tumor. The nurse assigned to care for the child monitors the child for brainstem involvement. Which sign would indicate that brainstem involvement occurred during the surgical procedure?

Elevated temperature

A child is diagnosed with lactose intolerance. The child's mother asks the nurse about the disease. Which statement is the appropriate nursing response?

"It is the inability to tolerate sugar found in dairy products.

The nurse is checking the status of jaundice in a child with hepatitis. Which should the nurse check to ascertain if the child is jaundiced?

The mucous membranes

A nursing student is caring for a child with increased intracranial pressure. On review of the chart, the student nurse notes that a transtentorial herniation has occurred. A nursing instructor asks the student about this type of herniation. Which statement by the student indicates a need for further research about this condition?

"It involves only the anterior portions of the client's brain

The nurse is assisting in collecting data on a child with seizures. The nurse is interviewing the child's parents to establish their adjustment to caring for their child with a chronic illness. Which statement by the parents indicates a need for further teaching?

"Our child sleeps in our bedroom at night."

The nurse is reinforcing instructions to the parents of a child with a hernia regarding measures that will promote reducing the hernia. The nurse determines that the parents understand these measures if they make which statement?

"We will provide comfort measures to reduce any crying periods by our child."

The nurse is reinforcing information to parents regarding the signs of meningitis. The nurse informs the parents that which are the primary signs/symptoms of meningitis?

Severe headache and neck stiffness

The nurse is reviewing the health record of an infant with a diagnosis of gastroesophageal reflux. Which signs/symptoms of this disorder should the nurse expect to note documented in the record?

Hiccupping and spitting up after a meal

The nurse is caring for a newborn with spina bifida (myelomeningocele type) who is scheduled for the removal of the gibbus (sac on the back filled with cerebrospinal fluid, meninges, and some of the spinal cord). Which is the priority nursing action in the preoperative period?

Maintain moisture of the normal saline dressing on the gibbus area

The nurse reinforces home-care instructions to the parents of a child with celiac disease. Which food item should the nurse advise the parents to include in the child's diet?

Rice

The nurse is assisting a health care provider with an assessment of a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the health care provider palpates the child at McBurney's point. The nurse understands that McBurney's point is located midway between which body landmarks?

Right anterior superior iliac crest and the umbilicus

The nurse is assisting in admitting to the hospital a 4-month-old infant with a diagnosis of vomiting and dehydration. The nurse assists in developing a plan of care for the infant and suggests which position for the infant?

Side-lying position

The nurse should anticipate that which medication is the most likely to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder?

Sulfisoxazole

The nurse is caring for a newborn diagnosed with Down syndrome. The parents are asking questions about the disorder. The nurse should provide which information when discussing Down syndrome?

The condition is congenital and results in moderate to severe retardation and has been linked to an extra chromosome 21 (group G).

The nurse reinforces home care instructions to the mother of a child recovering from Reye's syndrome. Which statement by the mother indicates a need for further teaching?

"I need to give frequent, small, nutritious meals if my child starts to vomit."

The nurse reinforces home-care instructions to the parents of a child with hepatitis regarding the care of the child and the prevention of the transmission of the virus. Which statement by a parent indicates a need for further teaching?

"I need to provide a well-balanced, high-fat diet to my child."

The nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement by the mother indicates a need for further teaching?

"I need to use a nipple with a small hole to prevent choking."

The nurse reinforces home care instructions to the parents of an infant following surgical intervention for imperforate anus and tells the parents about the procedure for anal dilation. Which statement by the parents indicates the need for further teaching?

"I will insert a glycerin suppository before the dilation."

The nurse is evaluating the parent's understanding of discharge care regarding the functioning of the infant's ventricular peritoneal shunt. Which statement by a parent indicates an understanding of the shunt complications?

"If my baby has a high-pitched cry, I should call the health care provider."

The nurse in a newborn nursery is told that a newborn with spina bifida (myelomeningocele type) will be transported from the delivery room. The nurse is asked to prepare for the arrival of the newborn. The nurse places which priority item at the newborn's bedside?

A bottle of sterile normal saline

The nurse assists in monitoring for early signs of meningitis in a child and assists with attempting to elicit Kernig's sign. Which is the appropriate procedure to elicit a Kernig's sign?

Extend the leg and knee and check for pain

A child is diagnosed with intussusception. The nurse collects data on the child, knowing that which is a characteristic of this disorder?

Invagination of a section of the intestine into the distal bowel

Which represents a primary characteristic of an autism spectrum disorder?

Lack of social interaction and awareness

The nurse is monitoring a 7-year-old child who sustained a head injury in a motor vehicle crash for signs of increased intracranial pressure (ICP). The nurse assesses the child frequently for which early sign of increased ICP?

Nausea

The nurse is collecting data about a child who has been admitted to the hospital with a diagnosis of seizures. Which action would best assist in determining the causes of the seizure?

Obtaining a history regarding factors that may occur before the seizure activity

The nurse reviews the record of a 1-year-old child seen in the clinic and notes that the health care provider has documented a diagnosis of celiac crisis. Which symptom should the nurse expect to note in this condition?

Profuse, watery diarrhea

The nurse is reviewing the record of a child with a diagnosis of pyloric stenosis. Which data should the nurse expect to note as having been documented in the child's record?

Projectile vomiting

The nurse is monitoring for signs of dehydration in a 1-year-old child who has been hospitalized for diarrhea and prepares to take the child's temperature. Which method of temperature measurement should be avoided?

Rectal

A child has a basilar skull fracture. Which health care provider's prescription should the nurse question?

Suction via the nasotracheal route as needed.

Which statement should the nurse include when providing safety instructions to the parents of an infant with a diagnosis of hydrocephalus?

"When picking up your infant, support the infant's neck and head with the open palm of your hand."

The nurse is caring for a 3-year-old child with suspected bacterial meningitis. Which signs and symptoms should the nurse expect to find during the initial data collection? Select all that apply.

Fever Irritability Nuchal rigidity

The nurse is assisting with data collection from an infant who has been diagnosed with hydrocephalus. If the infant's level of consciousness diminishes, which is a priority intervention?

Palpating the anterior fontanel

The nurse is caring for an infant with a diagnosis of Hirschsprung's disease. The nurse should check for which clinical findings that are consistent with Hirschsprung's disease? Select all that apply

Fever Constipation Failure to thrive Abdominal distention Explosive, watery diarrhea

A child is admitted to the hospital, and a diagnosis of bacterial meningitis is suspected. A lumbar puncture is performed, and the results reveal cloudy cerebrospinal fluid (CSF) with high protein and low glucose levels. The nurse determines that these results are indicative of which finding?

Confirmation of the diagnosis

The nurse is caring for a hospitalized infant and is monitoring for increased intracranial pressure (ICP). The nurse notes that the anterior fontanel bulges when the infant cries. Based on this finding, which action should the nurse take?

Document the findings.

The nurse is reinforcing dietary instructions to the mother of a child with celiac disease. Which statement by the mother indicates a need for further teaching

"I am so pleased that I won't have to eliminate oatmeal from my child's diet."

The nurse reinforces instructions to the mother about dietary measures for a 5-year-old child with lactose intolerance. The nurse should tell the mother that which supplement will be required as a result of the need to avoid lactose in the diet?

Calcium

A 1-year-old child is diagnosed with intussusception. The mother of the child asks the nurse to describe the disorder. The nurse should base the response on which description of this disorder?

A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel

A 4-year-old child is hospitalized for severe gastroenteritis. The child is crying and clinging to the mother. The mother becomes very upset and is afraid to leave the child. Which nursing intervention would be most appropriate to alleviate the child's fears and the mother's anxiety?

Ask the mother if she would like to stay overnight with the child.

The nurse has reinforced dietary instructions to the mother of a child with celiac disease. The nurse determines that further teaching is needed if the mother states that she will include which item in the child's nutritional plan?

Oatmeal

A nursing student is preparing to conduct a clinical conference, and the topic is hepatitis in children. The nursing instructor advises the student to further research the topic if the student plans to include which information in the discussion?

Enteric precautions are necessary for hepatitis B (HBV) but not for hepatitis A (HAV).

A mother brings her 5-month-old daughter into the pediatrician's office with complaints that the child has been vomiting during feedings. The mother also states that the child is sometimes very fussy. Which should be the nurse's initial action?

Obtain a complete history of the child's feeding habits.

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On data collection of the child, the nurse expects to note which characteristic of this type of posturing?

Rigid extension and pronation of the arms and legs

The nurse is developing a plan of care for a child with autism. The nurse should identify which priority problem for this child?

Risk for injury

The nurse is reinforcing instructions to the parents of an infant with a ventriculoperitoneal shunt. The nurse plans to include which instruction?

"Call the health care provider if the infant has a high-pitched cry."

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most specifically elicit information regarding this disorder?

"Does your infant have foul-smelling, ribbon-like stools?"

The nurse is caring for an 18-month-old child who has been vomiting. The appropriate position to place the child during naps and sleep time is which?

A side-lying position

The nurse is initiating seizure precautions for a child being admitted to the nursing unit. Which items are essential for the nurse to place at the bedside?

A suction apparatus and oxygen

The nurse working in the day care center is told that a child with autism will be attending the center. The nurse collaborates with the staff of the day care center and assists in planning activities that will meet the child's needs. The nurse understands that the priority consideration in planning activities for the child is to ensure which need is met?

Safety with activities

The nurse is assisting to develop a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

Time the seizure. Stay with the child. Move furniture away from the child.

The nurse is caring for a child who is scheduled for an appendectomy. When the nurse reviews the health care provider's preoperative prescriptions, which should be questioned?

Administer a Fleet enema.

The nurse provides instructions to the parents of an infant with gastroesophageal reflux (GER) regarding proper positioning to manage reflux. The nurse should tell the parents that the infant should be maintained in which position?

An upright angle 24 hours a day

The nurse prepares to administer a pancreatic enzyme powder to the child with cystic fibrosis (CF). Which food item should the nurse mix with the medication?

Applesauce

A 1-year-old child is admitted to the hospital for control of tonic-clonic seizures. The nurse should perform which actions in order to protect the child from injury? Select all that apply.

Turn the client to the side during a seizure. Keep side rails and other hard objects padded

The nurse is preparing to feed a 1-year-old hospitalized child. The nurse prepares the amount of formula to be given to this child, knowing that generally a 1-year-old consumes approximately which amount?

175 mL per feeding

mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. The nurse plans to base the response on which information?

It is a congenital aganglionosis or megacolon.

The nurse is monitoring a child with a head injury. On data collection, the nurse notes an abnormal flexion of the upper extremities and an extension of the lower extremities. The nurse documents that the child is experiencing which?

Decorticate posturing

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurse bases the response on the understanding that cerebral palsy is which type of condition?

A chronic disability characterized by impaired muscle movement and posture

The nurse is told that a child with rheumatic fever (RF) will be arriving to the nursing unit for admission. Which question should the nurse ask the family to elicit information specific to the development of RF?

"Did the child have a sore throat or a fever within the past 2 months?"

The nurse is monitoring for fluid volume deficit in an infant who is vomiting and having diarrhea. The nurse weighs the infant's diaper after each voiding and stool and carefully calculates fluid volume based on which knowledge?

Each gram of diaper weight is equivalent to 1 mL of urine.

The nurse reviews the record of a 3-week-old infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse understands that which manifestation led the mother to seek health care for the infant?

Foul-smelling, ribbon-like stools

A mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. The nurse plans to base the response on which information?

It is a congenital aganglionosis or megacolon.

Which is the primary goal that should be included in the plan of care for a child who has cerebral palsy?

Maximize the child's assets and minimize the limitations.

A licensed practical nurse (LPN) is bathing a neonate and notices small dark tufts of fine hair on the neonate's lower back. The LPN should take which best action?

Notify the registered nurse of the finding.

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. The nurse understands that which is unassociated with this disorder?

The passage of currant jelly-like stools

An infant returns to the nursing unit following surgery for an esophageal atresia with tracheoesophageal fistula (TEF). The infant is receiving intravenous (IV) fluids, and a gastrostomy tube is in place. The nurse assisting in caring for the infant should ensure that which action is done to the gastrostomy tube?

Elevated

The nurse assists with preparing a nursing care plan for a child who has Reye's syndrome. Which is the priority nursing intervention?

Providing a quiet atmosphere with dimmed lights

A diagnostic workup is performed on a 1-year-old child suspected of a diagnosis of neuroblastoma. Which finding specifically associated with this type of tumor would the nurse expect to find documented in the child's record?

Elevated vanillylmandelic acid (VMA) levels in the urine

The nurse is assigned to care for a child with hypertrophic pyloric stenosis scheduled for a pyloromyotomy. In which position should the nurse place the child during the preoperative period?

Prone with the head of the bed elevated

Which interventions should the nurse include when preparing a plan of care for a child with hepatitis? Select all that apply.

Providing a low-fat, well-balanced diet Teaching the child effective hand-washing techniques Instructing the parents about the risks associated with taking medications

A child is diagnosed with Reye's syndrome. The nurse assists to develop a nursing care plan for the child and should include which intervention in the plan?

Providing a quiet atmosphere with dimmed lighting

When checking a child's trochlear nerve function, the nurse should perform which data collection technique?

Have the child look down and in.

A newborn infant is diagnosed with gastroesophageal reflux (GER). The mother of the infant asks the nurse to explain the diagnosis. The nurse plans to base the response on which description of this disorder?.

Gastric contents regurgitate back into the esophagus.

The nurse is caring for a 1-year-old child following a cleft palate repair. Which solution should the nurse use after feedings to cleanse the child's mouth?

Water (Sterile)

The nurse is reviewing a chart of a child with a head injury. The nurse notices that the level of consciousness has been documented as obtunded. Which observation should the nurse expect to make during data collection of the child?

The child sleeps unless aroused and, once aroused, interacts poorly with the environment.

The nurse is assisting in preparing a plan of care for a child who is being admitted to the pediatric unit with a diagnosis of seizures. Which components should be included in the plan of care? Select all that apply.

Maintain the bed in a low position. Pad the side rails of the bed with blankets. Place the child in a side-lying lateral position if a seizure occurs. Protect the child's head, body, and extremities if a seizure occurs.