Peds Ch 33

The nurse is teaching the parents of a 15-year-old child hospitalized for the management of severe anorexia nervosa. Which statement by the parents requires further follow up by the nurse? • "Our child should gain about a pound (half kilogram) per week in the hospital." • "We will meet with a behavioral health specialist tomorrow." • "A nasogastric tube may need to be placed." • "Our child's cardiovascular status will be monitored."

"Our child should gain about a pound (half kilogram) per week in the hospital."

The nurse is caring for four clients on the pediatric unit. Which client scenario provides the highest concern of suspected abuse? • a 5-year-old whose father has guns in the home • A 3-year-old whose parents smoke two packs of cigarettes a day • A 7-month-old with multiple bruises on the legs • A 5-year-old with a broken humerus and bruising on the forehead

A 7-month-old with multiple bruises on the legs

A caregiver who works in the hospital brings his 9-year-old son to the emergency room with a spiral fracture of the tibia. The caregiver reports that the injury occurred when the boy's 5-year-old sister hit him with wooden bat. The injury is inconsistent with an impact and with the sister's strength. Which of the following would be appropriate for the nurse to do in this situation? • Tell the caregiver that the story is not plausible and ask what really happened. • Leave the treatment area and call the police. • Leave the treatment area and call the social services department in the hospital. • Let the hospital administrator know so that the hospital can take any necessary action.

Leave the treatment area and call the social services department in the hospital.

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? • Remind the adolescent about the consequences of misbehavior. • Stress to the client that he or she is in control of the outcome of the care. • Encourage the caregivers to take responsibility for the adolescent. • Reward the client after several days of successful behavior.

Stress to the client that he or she is in control of the outcome of the care.

The public health nurse is providing immunizations to a family that includes three children. Which requires investigation for possible child neglect? • The children state having peanut butter and jelly sandwiches for supper. • The clothing appears tattered and shoes appear large on the children. • Two have an ear infection (in one of which the eardrum is ruptured) and one has scabies. • The children's clothes are dirty and the oldest child is not wearing a coat. •

Two have an ear infection (in one of which the eardrum is ruptured) and one has scabies.

The nurse is assessing a school-aged child for clinical manifestations of abuse. Which finding requires further follow up by the nurse? • report of genital itchiness • bruise on the elbow, partially healed • bruise on the knee that appears new • the child's picky eating habits

report of genital itchiness

A school nurse is working with a group of adolescents. Which assessment findings might prompt the nurse to screen for eating disorders? Select all that apply. • weight fluctuation • erosion of teeth • menstrual irregularity • absence of hunger • frequent nurse visits •

weight fluctuation • erosion of teeth • menstrual irregularity

The nurse has performed the medical history at a follow-up client visit (above). Which intervention(s) will the nurse include in the revised plan of care? Select all that apply. • Make a request to change the prescribed medication. • Instruct the parent to weigh the child biweekly. • Ensure the medication is administered at night. • Assess for the development of suicidality. • Schedule the client for periodic liver function tests.

• Instruct the parent to weigh the child biweekly. • Schedule the client for periodic liver function tests.

If the following data was collected on a group of children, which of the following would most likely be evaluated as possibly related to child abuse (child maltreatment)? Select all that apply. • a child whose X-ray shows bone fractures in various stages of healing • a child who has a spiral fracture in the femur • a child whose CT scan shows an unexplained cerebral hemorrhage • a child whose blood work shows evidence of anemia • a child who has frequent nausea and diarrhea

• a child whose X-ray shows bone fractures in various stages of healing • a child who has a spiral fracture in the femur • a child whose CT scan shows an unexplained cerebral hemorrhage

A nurse is assessing an adolescent who is suspected of having an eating disorder. What factor(s) in the adolescent's history leads the nurse to suspect anorexia nervosa? Select all that apply. • parents overly involved in a child's life • poor communication with parents • perfectionist personality • satisfaction with appearance • intake of regular meals

• parents overly involved in a child's life • poor communication with parents • perfectionist personality