Peds 2
An 18-month-old toddler is to receive an intravenous infusion of 1000 mL 5% dextrose and 0.45% sodium chloride over 24 hours. At what rate should the nurse set the volume-control device? Record your answer using a whole number. __________ mL/hr
42
A 1-year-old child is found to have nutritional iron-deficiency anemia. What nursing interventions are most important in the care of an infant with iron-deficiency anemia? (Select all that apply.) 1 Conserving the infant's energy 2 Protecting the infant from infection 3 Teaching the parents about nutrition 4 Telling the parents to offer small, frequent feedings 5 Instructing the parents to increase the amount of milk offered
1 conserving the infants energy, 2 protecting the infant from infection, 3 teaching the parents about nutrition
A toddler is admitted to the pediatric unit with diarrhea and severe dehydration. After several days of treatment the child is evaluated. What clinical findings indicate that the child is rehydrated? (Select all that apply.) 1 Decreased hematocrit 2 Increase in daily weight 3 Negative blood cultures 4 Increased sedimentation rate 5 Decreased blood urea nitrogen level
1 decreased hematocrit, 2 increased daily weight, 5 decreased blood urea nitrogen level
A nurse is obtaining a health history from the parents of a toddler who has recently been diagnosed with acute lymphocytic leukemia. Which early physiological changes does the nurse expect the parents to report? (Select all that apply.) 1 Pale skin 2 Loss of hair 3 Eating less food 4 Sores in the mouth 5 Purplish spots on the skin
1 pale skin, 3 eating less food, 5 purplish spots on the skin
The health care provider is assessing a 2-year-old child for the presence of celiac disease. For what specific signs and symptoms should the nurse be alert? (Select all that apply.) 1 Steatorrhea 2 Thin, drawn facies 3 Hyperalbuminemia 4 Distended abdomen 5 Iron-deficiency anemia
1 steatorrhea, 4 distended abdomen, 5 iron deficiency anemia
A nurse is evaluating a toddler and the family dynamics of the child's family, in which abuse is suspected. What behavior is expected? (Select all that apply.) 1 The child cringes when approached. 2 The child has unexplained healed injuries. 3 The parents are overly affectionate toward the child. 4 The child lies still while surveying the environment. 5 The parents give detailed accounts of the child's injuries.
1 the child cringes when approached, 2 the child has unexplained healed injuries, 4 the child lies still while surveying the environment
Which of the following signs are indications of hydration status during a sickle cell crisis? (Select all that apply.) 1 Turgor of tissue 2 Edema of the ankles 3 Specific gravity of urine 4 Amount of urinary output 5 Texture of mucous membranes
1 turgor of tissue, 5 texture of mucous membranes
A nurse is performing health screenings of toddlers in a culturally diverse neighborhood. Which child should the nurse consider at risk for β-thalassemia (Cooley anemia)? 1 2-year-old child of Greek descent with a large abdomen 2 18-month-old child of Irish descent with very pale skin color 3 3-year-old child of Spanish descent with increased hematocrit 4 20-month-old child of Asian descent with edematous knee joints
1-2 year old child of Greek descent with a large abdomen
A 13-month-old child is admitted with a tentative diagnosis of bacterial meningitis, and the practitioner schedules a lumbar puncture. What is the most important action the nurse should take in preparation for the lumbar puncture? 1 Asking the parents what they were told about the test 2 Using a doll to demonstrate the procedure to the child 3 Obtaining a pacifier for the child to suck on during the procedure 4 Telling the parents that they may stay with their child during the test
1-asking the parents what they were told about the test
A toddler with lead poisoning is started on chelation therapy. Succimer (Chemet) is ordered. What information should the nurse give the parents concerning the administration of this medication? 1 The contents of the capsules may be sprinkled on food. 2 The medication will be administered daily for 3 months. 3 The child will be helped to endure the painful injections. 4 Fluid intake should be limited during the course of treatment.
1- the contents of the capsules may be sprinkled on food.
During a routine visit to the child health clinic the parent of a 3-year-old girl reports, "My daughter is still sucking her thumb." What is the nurse's best response? 1 "She'll stop when she's ready." 2 "You can buy a bitter liquid for her thumb." 3 "Is she being teased by her friends in nursery school?" 4 "Do you want me to recommend a child psychologist?"
1-"she'll stop when she's ready"
What behavior does a nurse expect from a toddler subjected to prolonged hospitalization with limited parental visits? 1 Cheerful interactions with staff members 2 Indications of sadness throughout the day 3 Excessive crying when parents are not present 4 Limited emotional response to the environment
1-cheerful interactions with staff members
An 18-month-old toddler who stepped on a rusty nail 4 days ago shows signs of generalized tetanus, including neck and jaw stiffness and facial muscle spasms. The toddler is receiving intravenous diazepam (Valium) as a muscle relaxant every 4 hours. What response to the medication does the nurse anticipate? 1 Control of hypertonicity and prevention of seizures 2 Control of laryngospasms and neck and jaw rigidity 3 Prevention of excess oxygen and caloric expenditure 4 Prevention of restlessness and resistance to assisted ventilation
1-control of hypertonicity and prevention of seizures
A 2-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia major (Cooley anemia). The parents are told that there is no cure but the anemia can be treated with frequent blood transfusions. The father tells the nurse he is glad that there is a treatment that "fixes" his child's problem. Before responding, the nurse should recall that blood transfusions: 1 Correct the anemia but may cause other problems 2 Reverse the anemia but also present a risk of hepatitis 3 Are a supportive treatment; fewer will be needed as the child grows older 4 Are a replacement for defective red blood cells; they are like giving insulin to a person with diabetes
1-correct the anemia but may cause other problems
The mother of a 3-year-old child with rubeola states that she once heard that it was called by another name. The nurse tells the mother that rubeola commonly is known as: 1 Measles 2 Chickenpox 3 German measles 4 Whooping cough
1-measles
When providing nursing care to children the nurse remembers that in the child, as in the adult, respiratory patterns are controlled by the: 1 Medulla 2 Cerebellum 3 Hypothalamus 4 Cerebral cortex
1-medulla
A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse tell the parents is the most important factor in the process of toilet training? 1 Parents' attitude about it 2 Child's desire to remain dry 3 Child's ability to sit still on the toilet 4 Parents' willingness to work at the toilet training
1-parents' attitude about it
A parent tells the nurse in the emergency department, "My 3-year-old has had a fever for several days and has been vomiting." After prescribed measures to reduce the fever have been instituted, what nursing action is most important? 1 Preventing shivering 2 Restricting oral fluids 3 Measuring output hourly 4 Taking vital signs hourly
1-preventing shivering
A nurse anticipates that surgery will be needed for an 18-month-old child with undescended testes because: 1 Psychological damage is limited 2 Maturation of testes starts at age 7 3 Future malignancy may be prevented 4 The puboscrotal ring is more elastic at age 2
1-psychological damage is limited
When is the best time to prepare a toddler for impending surgery? 1 Shortly before the procedure 2 On the day before the procedure 3 In response to the toddler's questions 4 When the parents give their consent for the surgery
1-shortly before the procedure.
A toddler who has undergone cleft palate repair is now able to tolerate fluids. What should the nurse use to offer the toddler fluids? 1 Small cup 2 Soft nipple 3 Bulb syringe 4 Teflon-coated spoon
1-small cup
During the second week of hospitalization for intravenous antibiotic therapy, a 2-year-old toddler whose family is unable to visit often smiles easily, goes to all the nurses happily, and does not express interest in the parent when the parent does visit. The parent tells the nurse, "I'm so happy he's adjusting, but should I be worried about his reaction to seeing me?" What is the best response by the nurse? 1 The child is repressing feelings for the parent. 2 Routines have been established and the child feels safe. 3 The child has given up fighting and accepts the separation. 4 Behavior has improved because the child feels better physically.
1-the child is repressing feelings for the parent
A 3-year-old boy has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking his mother. The nurse takes time when interviewing the mother to ask about television habits because: 1 Viewing violent programs is positively correlated with the development of aggression 2 The nurse is interested in how much time the mother spends in interactions with the child. 3 Watching Sesame Street and other children's shows results in slow cognitive development. 4 There is a direct connection between the number of hours of television viewed and toddler aggression
1-viewing violent programs is positively correlated with the development of aggression
A nurse in the child life center is evaluating a 15-month-old toddler's ability to perform physical tasks. What behavior indicates to the nurse that the child's development is age appropriate? (Select all that apply.) 1 Sharing toys 2 Drinking from a cup 3 Building a tower of six blocks 4 Walking with a wide-based gait 5 Throwing toys around the room
2 drinking from a cup, 4 walking with a wide based gait, 5 throwing toys around the room
A toddler has just had a cast applied for a fractured wrist. The wrist and elbow are immobilized. What information should the nurse include in the home care instructions before discharge? (Select all that apply.) 1 Resume usual activities. 2 Report swelling of fingers. 3 Keep the affected shoulder immobilized. 4 Elevate casted arm when the child is standing. 5 Lower the casted arm when the child is lying down.
2 report swelling of fingers, 4 elevate casted arm when the child is standing
A nurse in the pediatric clinic is advising the mother of a toddler who has a pinworm infestation. What should the nurse teach the mother about caring for her child during and after treatment? (Select all that apply.) 1 How to identify pinworm eggs 2 Strategies to prevent reinfestation 3 The need for medication for the entire family 4 The importance of handwashing before eating 5 The reason for obtaining stool specimens from the child
2 strategies to prevent reinfestation, 3 the need for medication for the entire family, 4 the importance of hand washing before eating
A toddler with hemophilia A is receiving factor VIII. The mother asks the nurse, "If my son hurts himself, I'll give him 2 children's Advil. Is that right?" How should the nurse respond? 1 "That's right. Advil will ease the pain." 2 'Give him Tylenol—Advil may cause bleeding." 3 "No. I'll explain why he isn't allowed pain medications." 4 "You seem concerned about giving medications to your child."
2- 'Give him Tylenol—Advil may cause bleeding."
A toddler with cystic fibrosis has been hospitalized with bacterial pneumonia. The nurse determines that the child has no known allergies. What does the nurse conclude is the reason that the health care provider selected a specific antibiotic? 1 Tolerance of the child 2 Sensitivity of the bacteria 3 Selectivity of the bacteria 4 Preference of the health care provider
2- Sensitivity of the bacteria
A nurse is teaching a group of assistants in a daycare center about toddlers' developmental milestones. What behavior should indicate to the assistants that one of the milestones has been achieved? 1 Trusting others 2 Accepting external limits 3 Initiating superego control 4 Distinguishing roles in society
2- accepting external limits
A 2-year-old child with developmental dysplasia of the hip has a spica cast applied. The mother asks the nurse how to keep the cast clean. How should the nurse respond? 1 "Tuck a folded diaper above the perineal opening." 2 "Place plastic wrap or duct tape around the perineal edges of the cast." 3 "Wipe the cast with a wet cloth and sprinkle it with baby powder." 4 "Do the best you can, because it will get soiled no matter what you do."
2-"place plastic wrap or duct tape around the perineal edges of the cast."
A toddler with a history of enlarged lymph nodes, prolonged fever that is unresponsive to antibiotics, erythema of the extremities, and a rash is admitted to the pediatric unit with a diagnosis of Kawasaki disease. What does the nurse suspect was essential in confirming this diagnosis? 1 An increased ASO titer 2 A combination of signs 3 A low-grade temperature 4 An increased sedimentation rate
2-a combination of signs
The parents of a 2-year-old child who is being admitted to the hospital tell the nurse that their child is accustomed to sleeping with a favorite blanket. What should the nurse do, knowing that the blanket is worn and dirty? 1 Refuse to allow the parents to leave it 2 Allow the parents to give it to the child 3 Offer to wash the blanket later when the child is asleep 4 Suggest that the parents take this one home when they bring in another blanket
2-allow the parents to give it to the child.
The mother of a 2½ -year-old child is concerned about how to handle temper tantrums. The nurse replies that tantrums: 1 Will require counseling by a behavioral child psychologist 2 Can be reduced with the provision of a less stressful environment 3 Should be ignored because they are an expected occurrence in toddlers 4 Subside quickly if the mother holds the child during the tantrum
2-can be reduced with the provision of a less stressful environment
A nurse is caring for a 2½-year-old child who is expressing pain. What is the most reliable indicator of this child's pain? 1 Crying and sobbing 2 Changes in behavior 3 Verbal exclamations of pain 4 Changes in pulse and respiratory rate
2-changes in behavior
A nurse in the pediatric clinic is teaching the parents of a toddler how to prevent accidental poisoning. What should the nurse emphasize? 1 Importance of setting limits 2 Child's need for exploration 3 Child's need for parental approval 4 Importance of labeling medications
2-child's need for exploration
A 2-year-old boy born with cryptorchidism is to undergo orchiopexy. What should the nurse tell the parents about the anticipated outcome of this surgery? 1 The urine stream will be directed downward. 2 Damage to the undescended testicle will be prevented. 3 Fluid that has collected in the scrotum will be removed. 4 The fibrous tissue that has caused the penile deformity will be released.
2-damage to the undescended testicle will be prevented.
A nurse is caring for a 3-year-old child with acute laryngotracheobronchitis. The child has severe dyspnea and a temperature of 104.0º F (40.0° C) and is receiving cool mist by way of a facemask. The mother asks why her child is not receiving warm mist. The nurse explains that cool mist: 1 Helps dry mucosal secretions faster 2 Facilitates reduction of mucosal edema 3 Provides a more comfortable environment 4 Assists in absorption of fluid by the mucosa
2-facilitates reduction of mucosal edema
After many episodes of otitis media a 3-year-old child is to undergo myringotomy and have tubes implanted surgically. What should the nurse include in the discharge preparation for this family? 1 Keep the child at home for 1 week. 2 Insert earplugs during the child's bath. 3 Apply an ointment to the ear canal daily. 4 Use cotton swabs to clean the inner ears.
2-insert ear plugs during the child's bath
A 2½-year-old child is receiving intravenous fluid. A 500 mL bag of D5 in ½NS is hung at 1 am and is to infuse at 45 mL/hr. At 6 am the nurse notes that there is 125 mL left in the bag. The nurse correctly concludes that the fluid that has infused: 1 Should be recalculated in an hour 2 Is more than the child should have received 3 Is less than the amount prescribed for the child 4 Remained at the prescribed rate through the night
2-is more than the child should have received
A nurse is teaching the parents of a toddler with a recent diagnosis of hemophilia about the disease. What area of the body should the nurse include as the most common site for bleeding? 1 Brain 2 Joints 3 Kidneys 4 Abdomen
2-joints
A nurse teaches the mother of a 2-year-old child who has celiac disease which foods to avoid. Which foods identified by the mother indicate that she understands the teaching? 1 Bacon and eggs 2 Macaroni and cheese 3 Tuna salad and rice cakes 4 Chicken leg and corn on the cob
2-macaroni and cheese
A 2-year-old toddler has hearing loss caused by recurrent otitis media. What treatment does the nurse anticipate that the practitioner will recommend? 1 Ear drops 2 Myringotomy 3 Mastoidectomy 4 Steroid therapy
2-myringotomy
A toddler who was admitted in acute respiratory distress is now resting quietly. The parents tell the nurse that they must leave. What should the nurse suggest that the parents do? 1 Try to room in to decrease the child's anxiety 2 Plan to visit the child as frequently as possible 3 Tell the child that they are leaving but will be back tomorrow 4 Leave while the child is distracted to reduce the upset it may cause
2-plan to visit the child as frequently as possible
What action should the nurse suggest to help parents promote the effectiveness of their toddler's myringotomy procedure? 1 Counting how frequently the child swallows 2 Positioning the child with the affected ear down 3 Administering pain medication when the child awakens in the morning 4 Observing the child for bleeding from the ear on which surgery was performed
2-positioning the child with the affected ear down
A toddler undergoes cardiac catheterization as part of a diagnostic workup for pulmonic stenosis. In which part of the cardiovascular system should the nurse expect an increase in pressure? 1 Left atrium 2 Right ventricle 3 Pulmonary vein 4 Pulmonary artery
2-right ventricle
What should the nurse teach a mother that will best help her 2½ -year-old son learn to control his behavior? 1 Reward good behavior. 2 Set limits and be consistent. 3 Punish the child for misbehavior. 4 Help the child learn through trial and error.
2-set limits and be consistent.
The parent of a 14-month-old toddler asks the nurse how to proceed with bowel training. What is the best response by the nurse? 1 Place the child on the toilet every 2 hours 2 Start by having the child sit on a potty chair 3 Avoid bowel training until the child is 2 years old 4 Begin before the child's diet consists mainly of solid foods
2-start by having the child sit on a potty chair
What is a characteristic of play among toddlers? 1 Toddlers play with each other. 2 Toddlers play beside each other. 3 Toddlers play in organized groups. 4 Toddlers play by themselves.
2-toddlers play beside each other.
A nurse is observing the growth and development skills of several 2-year-olds in the clinic playroom. The nurse determines that the child requiring further evaluation is the one who: 1 Cannot stand on one foot 2 Uses echolalia when speaking 3 Builds a tower of seven blocks 4 Colors outside the lines of a picture
2-uses echolalia when speaking
What clinical findings should lead a nurse to suspect that a toddler with a rash has rubella? (Select all that apply.) 1 Conjunctivitis 2 Nuchal rigidity 3 Low-grade fever 4 Lymphadenopathy 5 Koplik spots in the mouth
3 low grade fever, 4 lymphadenopathy
A toddler who swallowed drain cleaner is hospitalized for observation because of the risk for vomiting and aspiration. Over the next 24 hours the child does not exhibit any respiratory distress and does not vomit. At discharge the nurse emphasizes that the parents should monitor their child for the onset of: 1 Tonic-clonic seizures 2 Yellow-tinged sclera 3 Gagging and vomiting 4 Abdominal pain and diarrhea
3-gagging and vomiting
The mother of an 18-month-old boy with a cleft palate asks the nurse why the pediatrician has recommended that closure of the palate be performed before the child is 2 years old. How should the nurse respond? 1 "As he gets older, the palate gets wider and more difficult to repair." 2 "Eruption of the 2-year molars often complicates the surgical procedure." 3 "You need to have the surgery performed before he starts to use faulty speech patterns." 4 "After a child is 2 years old, surgery is frightening, so you need to avoid it if at all possible."
3-"you need to have the surgery performed before he starts to use faulty speech patterns."
A nurse is observing hospitalized toddlers in the playroom. What does the nurse identify as their most important need? 1 Stimulating play 2 Therapeutic play 3 Contact with their parents 4 Gentle discipline from the nurse
3-contact with their parents
A 16-month-old toddler has had large, frothy, foul-smelling stools since the introduction of table foods and is irritable and apathetic. The child is diagnosed with celiac disease and a gluten-free diet is prescribed. What response does the nurse anticipate in the child after 2 days on the diet? 1 Return of appetite 2 Increase in weight 3 Improved behavior 4 Cessation of diarrhea
3-improved behavior
A toddler may not be able to confirm that two glasses of water contain the same amount of liquid if one glass of water is poured into a taller, thinner vessel. What is this behavior characteristic called? 1 Centration 2 Egocentrism 3 Inability to conserve 4 Transductive reasoning
3-inability to conserve
An 18-month-old child has received all required immunizations. What immunization should the nurse explain to a parent will be one of the vaccines required between 4 and 6 years of age? 1 Rotavirus 2 Hepatitis B 3 Inactivated poliovirus 4 Haemophilus influenzae type b
3-inactivated poliovirus
A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the nurse expect? 1 Proteinuria 2 Peripheral edema 3 Increased hematocrit 4 Absence of pedal pulses
3-increased hematocrit
A 3-year-old child has a tentative diagnosis of pinworm infestation. What should the nurse teach the parents about obtaining a specimen to confirm the diagnosis? 1 Save the returns from a tapwater enema. 2 Tape a gauze pad over the child's anus before bedtime. 3 Make an anal impression on cellophane tape when the child awakens. 4 Collect the stool specimen by inserting a cotton-tipped swab into the anus.
3-make an anal impression on cellophane tape when the child awakens
A nurse is caring for a toddler in acute respiratory distress precipitated by laryngotracheobronchitis. The child has a temperature of 103° F (39.4° C). What is the priority nursing intervention? 1 Delivering humidified oxygen 2 Initiating measures to reduce fever 3 Monitoring respiratory status continuously 4 Providing support to diminish apprehension
3-monitoring respiratory status continuously
After oral surgery the dentist writes a prescription for pain medication for an 18-month-old child. Which medication should the nurse question? 1 Acetaminophen (Tylenol) 2 Codeine 3 Oxycodone/aspirin (Percodan) 4 Morphine
3-oxycodone/aspirin (Percodan)
A 2-year-old toddler is admitted to the pediatric unit with a diagnosis of bacterial meningitis. What is the most important safety measure for the nurse to institute immediately after the child has a seizure? 1 Monitoring the child's vital signs 2 Padding the side rails of the toddler's crib 3 Placing the child in the side-lying position 4 Bringing suction equipment to the bedside
3-placing the child in side-lying position
A 2-year-old boy who has fallen from a tree tells his parents and the nurse, "Bad, bad tree." The nurse concludes that the child is within the cognitive developmental norm of Piaget's: 1 Concrete operations 2 Concept of reversibility 3 Preconceptual operations 4 Sensorimotor development
3-preconceptual operations
A nurse is teaching a mother how to care for her toddler who is in a spica cast. In what position should the nurse suggest that the mother place the toddler during a feeding? 1 Upright while on the mother's lap 2 Recumbent with a pillow under the head 3 Semi-Fowler on a padded, adjustable tilt board 4 Side-lying in the football hold, facing the mother
3-semi-Fowler on a passed, adjustable tilt board
At 1 am a 28-month-old toddler is admitted to the pediatric unit with suspected meningitis. At 3 am, after the child is settled in, the mother tells the nurse, "I have to leave now, but whenever I try to go my child gets upset and then I start to cry." What is the best action by the nurse? 1 Walking the mother to the elevator 2 Encouraging the mother to spend the night 3 Staying with the child while the mother leaves 4 Telling the mother to wait until the child falls asleep
3-staying with the child while the mother leaves
A nursing student is selecting liquids for an 18-month-old toddler after oral surgery. Which choice by the student should cause the nurse to intervene? 1 Ice chips 2 Lime sherbet 3 Lemon ice pops 4 Strawberry gelatin
4 strawberry gelatin
To evaluate kidney function, the nurse must accurately measure the hourly urine output of a 1½-year-old toddler weighing 22 lb who has been admitted with extensive burns. What is the minimum safe output per hour for a child this age? 1 61 to 80 mL 2 41 to 60 mL 3 21 to 40 mL 4 10 to 20 mL
4- 10 to 20 mL
As the working mother of a toddler is preparing to take her child home after a prolonged hospitalization during which she was not able to visit often, she asks the nurse what type of behavior she should expect. What is the most appropriate description by the nurse of her child's probable behavior? 1 Excessively demanding behavior 2 Hostile attitude toward the mother 3 Cheerful, with shallow attachment behaviors 4 Withdrawn, without emotional ties to the mother
4- withdrawn, without emotional ties to the mother
A pregnant mother asks about the best time to begin weaning her 2-year-old son from the bottle. What is the best reply by the nurse? 1 "You can start anytime you like." 2 "As soon as possible; it's already a little late." 3 "Just after the baby is born; it'll motivate him to act grown up." 4 "Anytime, as long as there aren't other changes going on in his life."
4-"anytime, as long as there aren't other changes going on in his life."
A mother brings her 16-month-old daughter to the well-child clinic for a checkup. She is upset and reports, "My child refuses to eat at mealtimes. It's a battle between us." What is the best response by the nurse? 1 "How often do you offer her food?" 2 "What's her daily eating schedule?" 3 "Does the doctor know that she refuses food?" 4 "It may be helpful to keep a daily diary of the food she eats."
4-"it may be helpful to keep a daily diary of the food she eats."
A mother asks why her 2-year-old toddler's cleft palate was not repaired at the same time that the cleft lip was repaired. What is the best response by the nurse? 1 "Waiting leaves time for other birth defects to be detected and corrected." 2 "The cleft lip was so disfiguring that surgery was done as quickly as possible." 3 "Your surgeon prefers to separate the operations to minimize the potential for complications." 4 "The palate usually is repaired before a child starts to speak. Some surgeons prefer to wait up to 2 years."
4-"the palate usually is repaired before a child starts to speak. Some surgeons prefer to wait up to 2 years."
A nurse notes that a child is exhibiting signs of cerebral palsy. At what age are these signs usually first noticeable? 1 2 years 2 3 years 3 3 months 4 12 months
4-12 months
While reviewing the admission assessment the nurse finds that a 2-year-old child has not received immunization for measles, mumps, and rubella (MMR). At what age should the child have received this vaccine? 1 2 months 2 4 months 3 6 months 4 12 months
4-12 months
A nurse is teaching a group of parents about the developmental needs of young toddlers. What is the priority topic that the nurse should include? 1 Toilet training 2 Temper tantrums 3 Adequate nutrition 4 Accident prevention
4-accident prevention
A 3-year-old child with chronic lead poisoning who has not responded to succimer (Chemet) therapy must be given multiple injections of edetate calcium disodium (calcium EDTA). How should the nurse prepare the child psychologically for this treatment? 1 Explain the reasons for the injections so that the child does not feel punished for the disease 2 Tell the child that the treatment will not hurt because a special medicine will be used to limit the pain 3 Role-play with puppets dressed as physicians and nurses to minimize the child's fear of unfamiliar adults 4 Allow the child to play with a syringe, using a doll, before treatment is initiated and after each injection is administered
4-allow the child to play with a syringe, using a doll, before treatment is initiated and after each injection is administered.
A 30-month-old boy with cystic fibrosis is admitted to the pediatric unit with a severe upper respiratory infection. The toddler is small for his age. What pathological process does the nurse know is the cause of his small stature? 1 Increased salt retention 2 An atrioventricular defect 3 Retention of carbon dioxide 4 An absence of pancreatic enzymes
4-an absence of pancreatic enzymes
A nurse who is teaching a growth and development class to a group of parents at the daycare center explains that the toddler strives for a sense of: 1 Trust 2 Industry 3 Initiative 4 Autonomy
4-autonomy
The mother of a toddler complains that the toddler has not been acting quite right lately. She has had a fever for a couple of days and now presents with decreasing oral intake and a rash over her hands and feet. Which condition does the nurse suspect? 1 Teething 2 Food aversion 3 Streptococcus infection 4 Coxsackievirus infection
4-coxsackievirus infection
What clinical signs should lead a nurse to suspect that a 1-year-old child has rubella (German measles)? 1 Bulging fontanel and nuchal rigidity 2 Conjunctivitis and sensitivity to light 3 Koplik spots on the soft palate and buccal mucosa 4 Enlarged posterior cervical and postauricular nodes
4-enlarged posterior cervical and postauricular nodes
An 18-month-old toddler with celiac disease is to be started on a gluten-free diet. The nurse teaches the parents to identify foods that should be avoided. Which food named by the parents as one to be avoided indicates to the nurse that the teaching has been successful? 1 Steamed rice 2 Mashed corn 3 Fresh applesauce 4 Grilled frankfurter
4-grilled frankfurter
A 2½-year-old toddler is admitted with a fever of 103º F (39.4° C), stiffness of the neck, and general malaise. The diagnosis is acute bacterial meningitis. What is the priority nursing intervention for this child? 1 Increasing fluids 2 Administering oxygen 3 Giving a tepid sponge bath 4 Instituting droplet precautions
4-instituting droplet precautions
The parents of a 3-year-old tell the nurse that their child is afraid to sleep alone because of monsters under the bed. They ask for suggestions. What should the nurse recommend? 1 Tell the child that monsters do not exist. 2 Allow the child to sleep with the parents temporarily. 3 Look under the bed and say, "I don't see any monsters." 4 Leave a small light on at night and state, "Monsters aren't allowed in the house."
4-leave a small light on at night and state, "monsters aren't allowed in the house."
An 18-month-old toddler who stepped on a rusty nail is brought to the emergency department a week later. The nurse determines that the family lives in a rural area and that the toddler has never received health care. The child shows signs of generalized tetanus, including neck and jaw stiffness and facial muscle spasms. What does the nurse conclude is the cause of these clinical findings? 1 Bacterial infection of the upper respiratory tissues progressing to sepsis and death 2 Neuropathy caused by an allergic reaction to the presence of the invading organism 3 Localized edema of the upper trunk and neck tissues resulting in obstruction of the airway 4 Painful muscle rigidity caused by exposure of the nervous system to the exotoxin of the causative organism
4-painful muscle rigidity caused by exposure of the nervous system to the exotoxin of the causative organism
A nurse takes a 1-year-old child to the hospital playroom. What toy should the nurse select for this child? 1 Rocking horse 2 Stuffed animal 3 Four-piece puzzle 4 Squeaky plastic duck
4-squeaky plastic duck
What chelating agent does the nurse anticipate will be prescribed for a toddler with lead poisoning? 1 Protamine sulfate 2 Calcium gluconate 3 Cisplatin (Platinol) 4 Succimer (Chemet)
4-succimer (chemet)
Why is it essential for the nurse to obtain the height and weight of a severely dehydrated toddler? 1 The extent of dehydration is based on these measurements. 2 These measurements are used as the baseline for future growth. 3 The management of dietary needs is based on height and weight. 4 The values are used to calculate fluid replacement and medication dosages.
4-the values are used to calculate fluid replacement and medication dosages.
A nurse must administer a medication by means of injection to a 2-year-old whose parent is not present. What is the most therapeutic approach for the nurse to use? 1 Avoiding telling the child beforehand, giving the injection, and then cuddling the child 2 Demonstrating how an injection is given, telling the child why it is needed, and then gathering the equipment 3 Giving a doll the injection, encouraging the child to give the doll an injection, and then giving the injection 4 Warning the child about the injection just before administering it, saying that it is OK to cry, and then comforting the child
4-warning the child about the injection just before administering it, saying that it is OK to cry, and then comforting the child
A 2-year-old toddler is admitted to the pediatric unit with tachycardia, tachypnea, and shortness of breath. The nurse auscultates the toddler's lungs. What term should the nurse use in the medical record to document the following sound heard during auscultation of the lungs? Listen to the audio. 1 Stridor 2 Rhonchi 3 Crackles 4 Wheezes
4-wheezes
Which is the most appropriate toy for a nurse to offer a 2½-year-old child? 1 Plastic mirror 2 Set of nesting blocks 3 Colorful hanging mobile 4 Wooden puzzle with large pieces
4-wooden puzzle with large pieces.
What are the best ways to remove plaque from a toddler's teeth? Select all that apply. A Brushing B Flossing C Using mouthwash D Swishing and swallowing E Topical fluoride treatment
A brushing, B flossing
What is included in a toddler's diet if the family follows a lactovegetarian diet? Select all that apply. A Eggs B Milk C Fruit D Meat E Vegetables
B Milk, C Fruit, E Vegetables
