PED's Ch. 23-27 +42
Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital?
"I will be back after you eat your dinner and SpongeBob goes off."
The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy, and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother?
"This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit?
24 pounds (10.8 kg) and 30 inches (75 cm)
The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply.
A. cheese and crackers C. whole grain granola with yogurt E. turkey sandwich
The nurse is admitting a 10-year-old for surgery. What action should the nurse prioritize when caring for this child?
Answer questions regarding pain
The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler?
Button clothes
Stress to the client that she is in control of the outcome of her care
Contract agreements are often recommended for clients with eating disorders. Informing a contract with a hospitalized adolescent diagnosed with anorexia nervosa, the nurse should make a point to:
encopresis
During a routine well-child check the caregiver of a 10-year-old tells the nurse that her child has recently starting passing stool into his underwear. This behavior indicates a symptom of which disorder?
The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?
Hop on one foot
The nurse is conducting a class at the local health department office for new mothers of infants who are in the various stages of weaning. Which alternative foodshould the nurse prioritize when questioned by a mother whose infant is refusingto drink milk from a cup to ensure the infant is consuming enough calcium?
cottage cheese
68 in (172.72 cm)
The nurse is measuring the height of a 13-year-old girl who was 56 in (142.24 cm) tall at age 9. The nurse predicts the girl will be approximately how tall if following the normal pattern of growth?
Compulsive overeating
The nurse recognizes in working with children that the child who has polyphagia will likely exhibit which of the following?
A first-time parent asks the nurse what toys would be appropriate for her son's second birthday next month. What recommendations would be nurse make?
play lawn mower
Talk therapy with the nurse
An advance practice mental health nurse is preparing for an individual therapy session with a 14-year-old boy who has normal cognitive abilities but is suffering from depression. Which of the following approaches is most likely to engage the boy and establish a therapeutic alliance?
"Tell me what makes you think the medication is not working"
An 11-year-old boy has recently been prescribed methylphenidate (Ritalin). The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?
"Set a good example. Wear your own seat belt every time you drive."
Boys grow at a slower, steadier rate than do girls.
The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation?
Teens are busy developing their own personal identity.
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans?
referred for counseling.
The nurse is working with a child diagnosed with encopresis. After a complete medical workup has been done, no organic cause has been found for the disorder. The nurse will anticipate the child will next be:
referred for counseling
The nurse is working with a child diagnosed with encopresis. After a complete medical workup has been done, no organic cause has been found for the disorder. What follow-up will the nurse expect?
Dairy products, meat, poultry, fish, and eggs
The school nurse is presenting information to a group of high school students who are asking about vegetarian diets? Which foods will the nurse point out are not eaten when following the vegan diet?
"I am feeling so fat. I think I need to exercise a few extra hours today."
The school nurse is teaching a health class on nutrition with some adolescents. Which comment by a student should the nurse prioritize and provide more teaching?
counseling to improve feelings of control over her body.
The therapy you would expect to see prescribed for an adolescent with anorexia nervosa would be:
The school nurse is discussing obesity with a group of caregivers of school-aged children. Which statement by the caregivers best illustrates that they are prepared to help their child prevent obesity?
"I always cook foods that are low in fat."
The pediatric nurse is meeting with a group of preschoolers' family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants?
"I feel better knowing that her curiosity is normal."
The nurse is conducting a class for new parents of infants. The nurse determines the session is successful when the parents correctly choose which instruction concerning bathing their infant?
"When I bathe my baby, I shampoo his hair each time as well."
"Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen."
A 15-year-old client tells the nurse he has been having wet dreams and is ashamed and afraid he will get into trouble because he believes his parents think he is too young to understand or know about sex. To which statement would be the most appropriate for the nurse to respond?
Red meat, poultry, and fish
A group of nursing students are preparing sample menus for the lacto-ovo-vegetarian diet. The instructor determines the presentation is successful after noting the students avoided the use of which foods in planning the menus?
Every time a toddler's mother asks her a question, the response is "No!" regardless of what the mother asks the child. What would the nurse recommend to the mother to help alleviate this behavior?
Allow the child choices when asking questions, such as "Do you want to wear the red or the blue top?"
The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?
Allow the child to touch and play with the nebulizer for a few minutes before the treatment.
Contact the child's parents to discuss the situation.
An 11-year-old boy has come to the school nurse more than 15 times for somatic complaints during the first quarter of school and has subsequently left school after each visit. What should the school nurse do?
"Have you made a plan to commit suicide?"
An adolescent comes to the office of the school nurse and after being quiet for several minutes states, "I think the world will be better when I am gone." Which statement should be the nurse's first response to this adolescent?
Forgets to turn in her homework, does not follow directions, cannot stay in her assigned seat in class and is always talking excessively and inappropriately.
An adolescent is being observed for ADHD. Which of the following would demonstrate that she suffers from that disorder?
A 7-year-old seen in the clinic for a routine well-child visit is noted on assessment to have gained 5 lb (2.26 kg) and grown 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters?
Weight is within expected range and height is above expected range.
Calluses on back of knuckles
What would lead the nurse to suspect that an adolescent has bulimia?
Not punishing the child for encopresis
When teaching parents of a child with encopresis, what would you stress?
The nurse is preparing to teach a class to a group of young parents with infants the basics of introducing solid foods into the diet. Which factor about the food should the nurse point out the infants respond to best when introducing solid foods into the diet?
bland
The nurse is assessing a 9-year-old girl during her well-child checkup and notes the child weighs 86 lb (39 kg). After noting she weighed 9.5 lb (4.30 kg) at birth and her growth has been within normal patterns, the nurse determines this girl is within which category?
slightly overweight
A 6-year-old male has come to the clinic for a routine well-child visit. The nurse, after noting in the medical record that this child has followed basic growth and development standards, anticipates documenting which common assessment finding?
swayed back
The pediatric nurse is discussing the daily activities of a 4-year-old with the caregiver to assess growth and development status. The nurse would documentthat the child has reached the initiative stage of development if the caregiver indicates the child participates in which activity?
tries to sweep up spilled cereal but cries when can't do well
The nursing students working with a group of 8-year-olds have determined they will illustrate the concept of conservation of weight. Which activity would best help these children grasp this concept?
weighing a pound of oranges and a pound of bricks and counting how many of each make a pound
The nurse is preparing an in-service training session on Erikson's theories for the pediatric nurses. Which task should the nurse prioritize as an example for the school-aged child?
will work on a picture until it is finished
During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family?
"Children of this age may stutter while they search for just the right word."
A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother?
"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
The father of a 4-year-old is concerned his child is not telling the truth and blaming others for things that have happened. Which response should the nurse prioritize after the father shares that the child is blaming someone named "Andrew" for a broken tool, and they have no idea who this is?
"Your son may have a friend named Andrew, but it could be an imaginary friend."
A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply.
-Crib and playpen bars should be no more than 2 3/8 inches apart. -Car seats should be placed in back seats. -A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).
Encourage the client and the client's family to participate in family therapy.
. The nurse is caring for an adolescent with anorexia nervosa. What intervention should the nurse include in the care of this client?
The nurse is addressing a caregiver's concerns regarding adequate sleep for an 11-year-old child who gets up at 6:30 a.m. each morning. The nurse should point out which time as the most appropriate bedtime for this child?
9:00 p.m.
"Let's set up an appointment as soon as possible."
A 10-year-old girl with ADHD has been on Ritalin (methylphenidate) for 6 months. The girl's mother calls and tells the nurse that the medication is ineffective and requests an immediate increase in the child's dosage. What should the nurse say?
Anorexia
A child with ADHD is placed on methylphenidate (Ritalin) therapy. What symptom may children on Ritalin develop?
"Having wet dreams indicates that your body is going through a process of maturing."
A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse?
The nurse is preparing a presentation for a community health fair on the topic of helping school-aged children develop the self-confidence they will need to mature into responsible adults. Which suggestion should the nurse prioritize to caregivers to enable them to help their children in this area?
Caregivers should maintain consistent rules and expectations
A toddler is hospitalized and the nurse wants to make the transition from home to hospital as easy as possible for him. Which action by the nurse would be most beneficial to assist the toddler in adapting to the hospital?
Follow the child's home routines as much as possible while in the hospital
The child may have a fear of being separated from her mother.
In collecting data on a 7-year-old-child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which of the following would most likely be a cause of the child having school phobia?
The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?
Iron
The pediatric nurse is meeting with a group of young mothers of newborn infants who are questioning the "soft spot" on the head and when it will close. Which fact should the nurse point out to the mothers?
It may increase slightly in size the first few months of life
A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers?
Learning to act on one's own
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child?
Needs 10 to 12 hours of sleep per night
The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play?
Playing in an organized group with each other
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?
Playing independently and are side by side
The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity?
Playing with the plastic vacuum cleaner and pushing it around the room
"You have lots of hormone changes going on right now."
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, 'I just feel like my whole body is changing and I don't know why' what should the nurse point out to this group?
A first-time mother calls the pediatrician's office to ask the nurse about her baby's tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby's dentition?
Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption.
A first-time father calls the pediatric nurse stating he is concerned that his 4- year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate?
"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?
"Children this age sometimes can't distinguish between fantasy and reality."
An 8-month-old child is diagnosed with a second ear infection and the father is concerned the infections are being caused by something he is doing or by something in the child's development. Which question should the nurse prioritize to collect more information to answer this father's questions?
"Does the baby go to bed with a bottle of formula each night?"
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information?
"Food is so expensive, we always make our children eat everything on their plates."
The caregiver of a 6-year-old is concerned the child is not getting proper nutrition because on some days, the child will only eat one type of food. Which response should the nurse prioritize for this caregiver?
"Food jags are common in this age. This probably won't last long."
The parent of a 4-year-old is expressing concern that this child is not talking as much—or as well—as her other children did at that age. Which question should the nurse prioritize when assessing this preschooler for this concern?
"Has your child had their hearing tested?"
Parents are beginning to potty train their 2-year-old child and seek advice from the nurse on how to be successful in this endeavor. Which statement by the parents indicates that further teaching is needed?
"He wants to accompany me to the bathroom but I prefer to go alone."
The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her infant son crying. Which is the best response from the nurse to help this mother?
"If he cannot see you, he thinks you are gone and that is frightening."
The nurse is meeting with a group of new mothers of infants and is leading the discussion related to weaning. Which suggestion should the nurse prioritize to this group of mothers concerning weaning their infant?
"It is important to let the infant set the pace for weaning, no matter what age they are."
A nurse is reviewing important concepts related to bathing and tub baths with a parent of a toddler. Which statement by the parent indicates the need for additional teaching?
"It's okay to let my toddler take bubble baths and play in the bubbles."
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern?
"Remain calm, pick the child up, and move to a quiet and neutral place until the child gains self-control; don't give in to the child's demands."
A mother calls the pediatrician's office upset because her 2-year-old son has begun acting out now that the new baby is home. He wants to have a bottle like the newborn and has begun to have accidents in his pants. Which statement by the nurse would best address this problem?
"Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."
The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents?
"This is normal for this age group. It's referred to as solitary independent play."
The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son?
"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained."
4 stages of substance abuse
1. experimental- learning the mood swing 2. more regular use with noticeable changes in schoolwork, friendships, and dress. Seeking the mood swing. 3. Preoccupation with the mood swing, dramatic behavior changes, truancy, lost job. 4. Using to feel normal. Dependency with deterioration in health
The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lbs (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements?
32 lbs (14.54 kg) and 27 in (68.58 cm) tall
CRAFFT
6-item screen for alcohol or drugs in adolescents, 14-18 (C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
"Have you explored with your child if something is causing her to be afraid to go to school?"
A 10 year-old girl has a pattern of school success, solid peer relationships, and a healthy family life. The girl's caregiver reports for the past 3 weeks the child has reported abdominal pain with vomiting and diarrhea, and tells the caregiver lets her stay home, she is fine by mid-morning. She is also fine on weekends. which question should the nurse prioritize to this caregiver?
Engage the girl in dialogue regarding feelings about self/personal appearance.
A 10-year-old girl has been referred for evaluation due to difficulties integrating with her peers at her new school. The counselor believes she is at risk for situational low self-esteem due to problematic relationships with both family members and peers. What is the best approach?
Keep a log of the child's visits and contact the parents if the visits continue
A 10-year-old girl has been visiting the school nurse three to four times a week with somatic complaints of a stomachache. She spends a few minutes in the nurse's office and then returns to class. This has been an ongoing complaint for almost two weeks. Which action by the nurse would be most appropriate?
develop rapport for a trusting relationship.
A 14-year-old is admitted to the hospital for the second time for treatment of anorexia nervosa. Her responses to your questions on admission are either yes, no, or no response. Initially, your primary nursing goal in caring for this adolescent would be to:
"Let's sit down and talk about your concerns."
A 15-year-old girl has been evaluated and diagnosed with major depression. The advance practice mental health nurse has prescribed paroxetine (Paxil), a selective serotonin reuptake inhibitor. The mother of the girl refuses to let her take the medicine because she has read about several suicides of teenagers who have been on this medicine. What should the nurse say to address the mother's concerns?
A sense of trust and identity
A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship?
Nonorganic failure to thrive
A 6-month-old infant presents at the pediatric clinic with his/her mother. The child is very thin, less than 5% on the growth chart, irritable, listless, unresponsive to the nurse, and has poor muscle control. The child has no history of serious illness. When the infant begins to cry, the mother is very slow to respond and the child is not comforted by the mother. The nurse is concerned about the infant, because these are signs of:
A review of the boy's typical day
A 6-year-old is seen in a mental health clinic for possible hyperactivity. His mother reports that he is just "all boy." He has always been active and does not like to sit still for more than a minute. Which data would be most important to assess to help evaluate his behavior?
"I am almost 15 now, so that means I could possibly get this disease."
A male nurse is meeting with a group of high school boys to discuss various health topics. After the session on testicular self-exam, the nurse determines the session is successful when one of the students responds with which comment?
schedule an immediate history and physical examination.
A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who is experiencing headaches. Her grades have dropped, and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to:
Being a member of a family that has had another member who uses drugs Being a member of an abusive family Having behavioral problems Being a slow learner
A nurse is assessing a child with suspected drug use. Which characteristics are related to an increased risk of substance use? Select all that apply.
Entangled relationships with family members Poor communication with parents Perfectionist personality Satisfaction with appearance Intake of regular meals
A nurse is assessing an adolescent female who is suspected of having an eating disorder. When obtaining the history from the adolescent, which of the following would the nurse identify as a possible risk factor? Select all that apply.
Why does that red train keep crashing into all of the other trains?
A nurse is conducting a mental status examination with a 5-year-old boy who is playing with trains and blocks of different colors. He repeats the same actions with the trains over and over again throughout the examination. Which of the following questions would be most appropriate?
Impulsivity Inattention Distractibility Hyperactivity
A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, what would the nurse include as being involved? Select all that apply.
0.5 to 1 lb (0.27 to 0.45 kg)
A nurse is providing care to an adolescent being treated for anorexia as an outpatient. The nurse is evaluating the adolescent's weight gain over the past week. The nurse determines that the adolescent is achieving the expected outcome when the adolescent shows a gain of how much for the week?
"Does your child interact with you when playing?"
A parent expresses concern that the child has an autism spectrum disorder. The nurse obtains a health history of the symptoms to understand the parent's concern. Which question would the nurse ask first?
Loss of interest
A school-age child diagnosed with depression is receiving antidepressant therapy. What behavior would the nurse instruct the parents to watch for and to notify the physician immediately if the child demonstrates it?
A nurse is preparing a presentation for a health fair discussing various aspects of preschoolers. Which example should the nurse use to best illustrate dramatic play?
Acting out a troubling or stressful situation
Anabolic Steroids
Adolescent athletes sometimes take megadoses of which of the following substances because they believe it will increase their athletic abilities?
"If he misbehaves, we need to punish him instead of reward him."
After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state:
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply.
B. Consistency in the rules is important so the child understands what is expected. C. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. D. Even at this young age, children need boundaries.
A 15-month-old toddler is brought to the pediatrician's office for a well-child checkup and the nurse is reviewing health promotion with the family. What recommendation(s) would the nurse make to the family to help ensure the child's health? Select all that apply.
C. Keep all medications locked up and out of reach for the child. D. Turn the hot water heater temperature down to 120°F (48.9°F). E. Never allow the child to ride in the car unless secured in a car seat.
While the nurse is taking a blood pressure on a 4-year-old, the child states that the blood-pressure cuff is too tight and angrily says, "That hurt, you big poo-poo head." What is the most appropriate response by the nurse?
Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names.
Is planning to commit suicide
Candace, age 16, is being seen for a long overdue checkup. Her caregiver has come with her. Candace is calm, pleasant, and in good spirits. The caregiver reports to the nurse that she is relieved because for the past 6 months Candace has been lethargic, angry, and sad. The mother reports that since she got her driver's license two days earlier, her child's mood has changed dramatically. Rather than resist this appointment, Candace has simply smiled and said " It won't matter much, but okay, I'll be ready in a minute." The nurse recognizes that the child's seeming well-being and drastic change in behavior should be further investigated to determine if the child:
True
Depressive disorder-findings must be present for 1 year to diagnose in children and adolescents
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight?
Encourage activities that will increase his physical activity.
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother?
Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?
Ensure that the child brushes his teeth after each meal and snacks.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
Failure to Thrive (FTT)
Inadequate growth resulting from inability to obtain or use calories required for growth. •Infant or child who falls below the fifth percentile for weight (and possibly height) or persistent weight loss •Inadequate caloric intake •Inadequate absorption •Increased metabolism •Defective utilization RISK FACTORS: •premature birth •low birth weight •IUGR •Neglect •Lack of parental knowledge •Disturbed maternal-child attachment •Poverty •Family Stress •Feeding resistance Clinical manifestations and diagnosis: •less than fifth percentile on growth chart for weight •malnourished appearance •poor muscle tone •no fear of strangers •minimal smiling •decreased activity level •developmental delay •withdrawal behavior
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since the child's last visit a year ago. How should the nurse respond to this mother's concerns?
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about
The caregivers of a 2-year-old are concerned the child is not learning how to share and play well with other children. While acknowledging their concern and devotion, the nurse should point out which activity would be best for this child's developmental level?
Mowing the lawn with a toy lawnmower
A 2-year-old child is reported to be a "picky eater" by his father. What pointers could the nurse provide the parent to help minimize stress related to mealtime? Select all that apply.
Offer small portions of 1 to 2 teaspoons to the child. Mealtime for a toddler should not exceed 20 minutes. Do not use sweets as a reward for cleaning their plate.
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics?
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
The caregivers of an infant state that their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and develop a sense of security when the child's primary caregiver is out of sight?
Play peek-a-boo with the child when happy
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?
Pretending to be mommies and daddies in the playhouse
A mother tells the nurse that her toddler does not want to go to bed at night and keeps getting back up when she is put to bed. What recommendations would the nurse make to this mother to foster sleep in the toddler?
Read the child a book in bed and take time to calm the child down before turning out the lights.
The nurse is working with a group of 8-year-olds who are learning about the concept of conservation of numbers. Which activity will help teach this concept to these school-aged children?
Rearranging a group of coins first into a circle, then a triangle and then a square
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply.
Remain calm and ignore the tantrum Stay nearby to ensure the child's safety without giving in to the child's desires
rechewing undigested food.
Rumination disorder is a poorly understood condition of young children. This refers to:
Anxiety disorders
SX include: sleep disturbances, restlessness, fatigue, irratibility, muscle tension, difficulty concentrating
He spends time alone and shows little interest in making friends.
Samuel is a 6-year-old boy who has been diagnosed with autism. Which of the following symptoms would you expect Samuel to display?
The 6-year-old at a well-child office visit tells the nurse, "I can't play on teams because I am not as good at doing things as my big sister is." What suggestion should the nurse point out to the caregiver that will help increase the child's feelings of self-confidence?
Set up some playdates that include projects or activities in which the child can be successful.
The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant?
Smiles at significant others
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers?
Snacks throughout the day help the child meet nutritional requirements
Steve
Steve, a 15-year-old Vietnamese boy, has been referred by his homeroom teacher to the school nurse for evaluation. The teacher is concerned that Steve may be suffering from major depression. Who should be the primary source of information to investigate the concerns about Steve?
Behavioral theory
Susan's parents have begun a program of therapy that includes giving Susan a token each time she follows directions. The following theoretical framework provides the background for such a program:
The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur?
Takes in new information at a rapid rate and asks "why" and "how"
Tolerance
The ability of body tissues to endure and adapt to continued or increased use of substance, so that the drug user requires larger doses of the drug to produce the desired effect is called:
The parents of 5-year-old boy are concerned about the how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child's behavior is likely related to which factor?
The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along.
Inability to relate to others Inability to communicate with others Obviously limited activities and interests.
The characteristics of the child with autism fall into three categories. What are these three categories?
The nurse is meeting with a group of young parents to discuss nutrition and theirreschooler. Which response should the nurse prioritize when asked if using desserts as a reward for good behavior is an appropriate idea?
The child can use food to manipulate others' behavior
Repetitive actions
The child diagnosed with autism spectrum disorder (ASD) will likely display which behavior?
Alcohol
The drug most commonly abused by children and adolescents is:
Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.
The father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent?
A breastfeeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns?
The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive vitamin D and iron.
The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?
The first tooth usually erupts by 6 months
gynecomastia
The football coach notices that one of the players has been more energetic and overly happy lately during practice. The player also got in fight with a teammate last week. The coach contacts the health care provider, concerned that the student is using anabolic steroids. What physical sign would the nurse advise the coach to be on the lookout for that would further validate the illicit drug use?
The mother has presented to the pediatric clinic with her 1-year-old infant for the next round of immunizations. The nurse would question administering the immunizations if which situation is noted on assessment?
The infant is being treated for a case of eczema
The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care.The group will be helping the parents with infant care. Which instruction should the nurse prioritize with this group?
The infant sleeps 10 to 12 hours at night and can take two to three naps during the day.
Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes.
The mother of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this mother?
102 pounds
The nurse does a weight measurement on an adolescent girl who should weigh 120 pounds according to the expected weight for her age and height. The adolescent is found to weigh exactly the weight that would indicate to the nurse that this adolescent fits the criteria for anorexia nervosa. Which of the following amounts does the girl weigh?
162 pounds
The nurse does a weight measurement on an adolescent girl whose ideal weigh is 135 pounds according to the expected weight for her age and height. The adolescent is found to weigh exactly the lowest weight that would indicate to the nurse that this adolescent fits the criteria for obesity. Which of the following amounts does the girl weigh?
A 14-month old whose reaction to his caregiver leaving him is to calmly repeat the statement, "Bye bye, Will. Bye bye, Will.
The nurse has gathered the following data on four different children. Which child will likely be further assessed and tested for autism?
Complete a rape kit to rule out possible sexual abuse while the client was blacked out.
The nurse in an emergency department is assessing an 18-year-old who is reporting a gap in memory for the previous night. The client reports feeling dizzy and disoriented after drinking only one drink. The client woke up in a friend's bed but has no recollection of getting there. What action should the nurse prioritize for this client?
Attention deficit hyperactive disorder (ADHD)
The nurse in the well-child clinic observes a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, " Oh yeah." and happily climbs back up. The nurse suspects that the child has:
"You're following expected patterns of growth."
The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize?
Even slight malocclusions make chewing and jaw function less efficient.
The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation?
"Do you have oral, anal, or vaginal sex?"
The nurse is assessing an adolescent in the clinic at a routine well-visit. Which question should the nurse prioritize to encourage the adolescent to share detailed information?
Methylphenidate
The nurse is caring for a 10-year-old recently diagnosed with attention deficit/hyperactivity disorder (ADHD). The nurse would expect to provide teaching regarding which medication?
He stares at a rotating wheel on his crib mobile.
The nurse is caring for a 12-month-old with autism spectrum disorder (ASD). What description would you expect to elicit from his mother on history-taking?
Encourage her to discuss her thoughts and feelings.
The nurse is caring for a 13-year-old girl with a nursing diagnosis of Ineffective coping related to inability to deal with life stressors as evidenced by few or no meaningful friendships and low self-esteem. Which intervention would be the priority to promote coping skills?
The child plays and sleeps quietly for long periods of time without fussing.
The nurse is caring for a 6-month-old infant diagnosed with nonorganic failure to thrive. Which of the following would the nurse most likely have noted with this child?
Correct fluid and electrolyte imbalances
The nurse is caring for a child with an eating disorder. Which is the priority treatment for the disorder?
"Speak to the doctor about atomoxetine."
The nurse is caring for a child with attention deficit/hyperactivity disorder who is experiencing insomnia related to the prescribed psychostimulant. The parents are considering stopping the medication and want to know if there are other options. Which response by the nurse would be most appropriate?
Food refusal
The nurse is caring for an adolescent girl with anorexia nervosa. What findings would indicate to the nurse that the girl requires hospitalization?
Rumination
The nurse is collecting data for a child diagnosed with nonorganic failure to thrive, and notes that the child voluntarily vomits after eating. This is referred to as:
The child is of normal weight for her height according to the growth charts.
The nurse is collecting data on a 16-year-old girl with the diagnosis of bulimia. What would the nurse most likely note in this child?
The child does not make eye contact.
The nurse is collecting data on an 18-month-old child with a diagnosis of autism spectrum disorder (ASD). What clinical manifestations would likely have been noted in the child with this diagnosis?
Ecstasy
The nurse is collecting data on an adolescent who is brought to the emergency center by her caregivers, who suspect that she has been using substances. The adolescent states that she has not had anything to eat nor any sleep in several days, but that she is nauseated. The nurse observes that she is diaphoretic, clenching her teeth and complaining of blurred vision. Which substance would this adolescent most likely have been using?
The nurse should teach and support the caregiver
The nurse is developing a plan of care for the child hospitalized with nonorganic failure to thrive. The following nursing interventions would be included in this plan. Which nursing intervention would be the highest priority for this child
" Our daughter has never had any health problems, and now she has developed so many cavities."
The nurse is discussing health concerns and issues with a group of caregivers of adolescents. Which statement made by a caregiver would indicate a need for follow-up by the nurse?
"I may drink too much on the weekends but I don't drink during the week."
The nurse is discussing substance abuse with an adolescent. Which of the following statements made by the adolescent should the nurse follow-up on first?
"The most common drug used by teenagers is alcohol."
The nurse is discussing teenage substance abuse with a group of caregivers of adolescent children. If the caregivers make the following statements, which statement is the most accurate regarding substance abuse in teens?
A classroom with a plan of study that is followed each day.
The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?
0.08%
The nurse is discussing the use of alcohol with a group of adolescents. One of the teens says that she heard your fine motor control could be affected at low levels of alcohol. Another teen was correct in saying that most states consider a person under the influence of alcohol if the blood alcohol level is which of the following?
Hypokalemia
The nurse is doing a presentation on the diagnosis of bulimia to a group of pediatric nurses. Which clinical manifestation would the nurse teach this group to observe for in the adolescent with bulimia?
Withdrawal Symptoms
The nurse is doing an in-service training with nurses who will be working with children who have concerns with drugs and alcohol. In discussing this topic, one of the nurses says she has heard that there may be physical and psychological signs that occur when a drug is no long being used. Which term best describes what the nurse is referring to?
Dependance
The nurse is doing an in-service training with nurses who will be working with children who have concerns with drugs and alcohol. In discussing this topic, one of the nurses says that sometimes a person has a compulsive need to use a substance for its satisfying or pleasurable effects. Which term best describes what the nurse is referring to?
inability to properly synthesize glucose.
The nurse is educating parents of a child recently diagnosed with autism. A description of the characteristics of autism are explained within categories. The nurse becomes concerned when the mother states that the categories of autism are associated with:
"Do you know how she is planning to kill herself?"
The nurse is interviewing 13-year-old girl with depression. During the course of the interview, the girl reveals that her best friend is thinking about committing suicide. Which response by the nurse would be most appropriate?
A heterosexual relationship
The nurse is leading a discussion in a health class at the high school on adolescent relationships. The nurse determines the session is successful when the students correctly choose which type of relationship as involving a member of the opposite sex?
-Dried fruits -Peanuts -Hard boiled eggs
The nurse is meeting with a group of adolescent athletes to discuss their nutritional needs. The nurse should encourage the adolescents to include which foods in their diet to increase iron intake?
Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality.
The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers?
Let them choose their hairstyle, even though it may not look the best for them.
The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent?
While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack.
The nurse is observing a group of 2- and 3- year olds in a play group. Which behavior noted in one of the children indicates to the nurse that the child may have autism spectrum disorder (ASD)?
Syncope Secondary amenorrhea Desire for perfectionism
The nurse is obtaining the history of an adolescent female who is suspected of having anorexia nervosa. What findings would the nurse expect? Select all that apply.
Split fingernails Eroded dental enamel
The nurse is performing the physical examination of a child with bulimia. What findings would the nurse identify as supporting this disorder? Select all that apply.
Promotion of normal development Learning Social interaction Specific language development
The nurse is talking with the parents of a child diagnosed with autism. Together, they set specific goals of care for the child. Which goals may be included? Select all that apply.
Soybean curd
The nurse is teaching a nutritional class to a group of Asian adolescents who are lactose-intolerant. Which food should the nurse point out will help these adolescents consume the calcium they need for proper nutrition?
"Just because his friends are experimenting does not mean that he will."
The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching?
Stress to the client that he or she is in control of the outcome of the care.
The nurse is working on forming a contract with a hospitalized adolescent diagnosed with anorexia nervosa. Which information should the nurse prioritize with the client when making the contract?
"When she watches TV and hears a commercial, she repeats one word from the commercial but doesn't seem to understand what she is saying."
The nurse is working with a group caregivers of children who are diagnosed with autism. Which statement made by the parents shows an example of echolalia
Marijuana
The nurse is working with a group of caregiver's of adolescents who have abused substances. One of the caregivers states, " My son used to do great in school. However, since he started using drugs he has no motivation, he is never on time, and he makes the worst decisions, especially when is is driving." These behaviors indicate that this adolescent was likely using which substance?
Cocaine
The nurse is working with a group of caregivers of adolescents who have abused substances. one of the caregivers states, " i have heard that some drugs have the effect of causing an excited feeling and it makes the person more social." Which drug would most likely have the effect this caregiver is describing?
"The medications your child is on may cause a decreased appetite."
The nurse is working with a group of caregivers of school-aged children diagnosed with attention deficit hyperactivity disorder (ADHD). Which statement would be most appropriate for the nurse to make to this group of caregivers
The child will have a complete physical exam.
The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?
A 12-year-old girl whose parents have just gotten a divorce
The nurse recognizes that which client has the greatest risk for suicidal behavior?
The beginning of puberty
The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructors determines the class is successful after the students correctly choose which milestone as the beginning of adolescence?
Uses to get high Takes pride in the amount of the substance consumed Uses to relieve feelings Denies that they have a problem
The nursing instructor is teaching a group of pediatric nursing students about the stages of substance abuse in children. Which of the following behaviors is associated with Stage 2 - Seeking the mood swing?
Promises to quit or attempts to quit
The nursing instructor is teaching a group of pediatric nursing students about the stages of substance abuse in children. Which of the following behaviors is associated with Stage 3 - Preoccupation with the mood swing?
"The diet excludes red meat and possibly poultry."
The nutritionist is presenting information about vegetarian diets with a group of nursing students. The nutritionist determines the session is successful when the students correctly choose which factor concerning the semi-vegetarian diet?
He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.
The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?
Tends to be a perfectionist May demonstrate signs of depression Adheres to a rigorous exercise program Has rigid study habits
The school health nurse is educating a group of teachers regarding anorexia nervosa. The discussion includes which of the following as possible indicators of the illness? Select all that apply.
"Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."
The school nurse is conducting a health class with a group of high school students on the topic of sex and sexuality issues. The nurse determines the session is successful when the students correctly choose which aspect as most important?
The individual's sex no longer decides which career options are available.
The school nurse is preparing for a career fair at the local high school. Which factor should the nurse point out when presenting various medical career options to the students?
The nurse is observing 4-year-old twins during their well-child appointment. Which observation by the nurse would indicate the children are demonstrating cooperative play?
They are building a house for their dolls with blocks in the room.
Use a repetitive series of movements.
To feed lunch to a child with autism spectrum disorder (ASD), which action would it be most important for the nurse to take?
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life?
Trust
The nursing instructor is conducting a class discussion exploring the normal dentition progression of the school-aged child. The instructor determines the session is successful when the students correctly choose which factor as most likely occurring in 10-year-olds?
Two of the cuspid teeth have erupted
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?
Use the crib for sleeping only, not for play activities
When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?
Weight is above an expected range and height is within an expected range
126 pounds
When weighing and measuring an adolescent whose ideal body weight is 105 pounds, the nurse would identify the child as obese if the child weighs which of the following?
A lack of concentration
Which behavior demonstrated by a boy with ADHD is most indicative of the syndrome?
Insensitivity to pain
Which behavior typical of children with autism spectrum disorder (ASD) requires you to maintain special care to keep them safe?
The child has rigid study skills and ritualistic behaviors
Which characteristic is commonly noted in the child with anorexia nervosa
Diabetes Mellitus
Which disorder is a concern in adulthood as well as in childhood for the person who is overweight or obese during childhood?
"I feel chubby no matter what I wear."
Which statement by an adolescent with anorexia nervosa would be most typical of an adolescent with this disorder?
"Tell me exactly how you would hurt yourself."
While interviewing a depressed adolescent boy, he reveals to the nurse that he has considered hurting himself. What should the nurse ask him?
Her telling you that she is still inducing vomiting after each meal
You have been working with an adolescent with an eating disorder for several days. What is an indication that she is developing trust in you?
The nurse is conducting an assessment on a 1-year-old healthy child and commends the parents for maintaining routine visits. When questioned by the parents as to the recommended schedule for future visits, which schedule should the nurse recommend?
at 15 months and at least annually thereafter
A 6-month-old arrives for a well-baby visit with a case of diaper rash that the parent believes is normal for infants. The parent reports changing the baby's diaper when he wakes up and before naps or bedtime. Which frequency should the nurse point out will better help heal and prevent future incidences of diaper rash?
every 2 to 4 hours
The 11-year-old arrives in the emergency department presenting with the following: nosebleed with no apparent trauma, disoriented, confused, difficulty walking, nausea, and coughing. The nurse should question the child concerning which potential activity?
experimenting with an inhalant
The nurse is assessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check?
eye coordination
The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year- old will be best suited to work on which activity?
form vases from blocks of clay
The school nurse is assessing a 6-year-old child's dentition. Which assessment should the nurse prioritize for this child?
has first permanent molars
The nurse notes a school-aged child in the pediatric unit playroom is busy sorting through the Legos and putting them in certain groupings. The nurse determines this child is illustrating which developmental concept?
hierarchical arrangement
The nurse is preparing a care plan for a school-age child to address the child's hospitalization. Which factor should the nurse incorporate into this plan?
increased attention span and interest in an activity for a long length of time
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital?
insists on doing a new skill and then asking for help
The nurse is assessing the motor skills of an infant who is 9 months old. Which motor skills should the nurse prepare to assess in an infant achieving normal growth and development milestones?
is eating cereal using the thumb and index finger
The nurse is conducting a training session for families who are to receive assistance from the Women, Infants, and Children (WIC) supplemental food program. The nurse determines the session is successful after the participants correctly choose which food items they will be able to receive through the program?
milk dry beans juice bread eggs
The nursing instructor is illustrating the various types of play. The instructor determines the class is successful when the students correctly choose which example as best representing onlooker play?
observing without participating
The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity?
painting pictures in the art corner of the room
Refeeding syndrome
potentially fatal complication that can occur with aggressive nutritional rehabilitation and weight gain in severe malnutrition. Monitor calorie intake and weight gain and electrolytes.
The nurse is monitoring children playing in the unit's playroom. The nurse notes that some children are involved in associative play by which actions?
pushing toy cars around on a large rug with roads
The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution?
safely store all chemical substances
The school nurse is preparing to conduct routine health screenings of the elementary school students. Which screening will the nurse prioritize for students ages 6 to 8?
vision and hearing
