Peds Children Practice A 2019

A nurse is teaching the parent of an infant about ways to prevent sudden infant death syndrome (SIDS). Which of the following instructions should the nurse include?

"Give the infant a pacifier at bedtime." The nurse should inform the parent that protective factors against SIDS include breastfeeding and the use of a pacifier when the infant is sleeping.

A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates an understanding of the teaching?

"I will place my infant's diapers under the harness straps." To prevent soiling of the harness, the parent should apply the infant's diaper under the straps

A nurse in an ED is performing a physical assessment on a 2 week old male newborn. Which of the following findings is the priority for the nurse to report to the provider?

Substernal retractions When using the ABC approach to client care, the nurse should determine that the priority finding to report to the provider is substernal retractions. This finding indicates the newborn is experiencing increased resp effort, which could quickly progress to resp failure.

A nurse is assessing a school age child immediately following a perforated appendix repair. Which of the following findings should the nurse expect?

Absence of peristalsis The nurse should expect absence of peristalsis immediately following a perforated appendix repair, until the bowl resumes functioning.

A nurse in an ED is caring for a toddler who has partial thickness burns on their right arm. Which of the following actions should the nurse take?

Cleanse the affected area with mild soap and water. The nurse should wash the affected area with mild soap and water to remove any loose tissue that could cause infection.

A nurse is caring for an infant who has respiratory syncytial virus (RSV). Which of the following actions should the nurse implement for infection control?

Have a designated stethoscope in the infant's room. The nurse should initiate droplet precautions for an infant who has RSV because the virus is spread by direct contact with resp secretions. Therefore, designated equipment, such as a blood pressure cuff and a stethoscope, should be places in the infant's room.

A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury. Which of the following interventions should the nurse include in the plan?

Implement seizure precautions for the infant. An infant who has an epidural hematoma is at great risk for seizure activity. Therefore, the nurse should implement seizure precautions for the child.

A nurse is teaching the parent of a preschooler about way to prevent acute asthma attacks. Which of the following statements by the parent indicates an understanding of the teaching?

"I should keep my child indoors when I mow the yard." The nurse should instruct the parent to keep the preschooler indoors during lawn maintenance or when the pollen count is increased. Guarding against exposure to known allergens found outdoors, such as grass, tree, and week pollen, will decrease the frequency of the preschooler's asthma attacks.

A nurse is teaching the guardian of a 6 month old infant about car seat use. Which of the following statements by the guardian indicates an understanding of the teaching?

"I should secure the car seat using lower anchors and tethers instead of the seat belt." Lower anchors and tethers, or the LATCH child seat system, should be used to secure an infant's car seat in the vehicle. This system provides anchors between the front cushion and the back rest for the car seat. Therefore, if this system is available, the seat belt does not have to be used.

A nurse is providing teaching to the parent of a school-age child who has a new prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nurse include?

"Shake the medication prior to administration." The nurse should instruct the parent to shake the medication prior to administration to disperse the medication evenly within the suspension.

A nurse is admitting a school age child who has pertussis. Which of the following action should the nurse take?

Initiate droplet precautions for the child. The nurse should initiate droplet precautions for a child who has pertussis, also known as whopping cough. Pertussis is transmitted through contact with infected large droplet nuclei that are suspended in the air when the child coughs, sneezes, or talks

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan?

Initiate seizure precautions for the child. A sodium level of 129mEq/L indicates hyponatremia and places the child at risk for neurological deficits and seizure activity. The nurse should complete a neurolgic assessment and implement seizure precautions to maintain the child's safety,

A nurse is caring for a 15 year old client following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing syndrome of inappropriate antidiurectic hormone secretion (SIADH)?

Mental Confusion A child who has a head injury can develop SIADH as a result of altered pituitary function, leading to an oversecreation of antidiuretic hormone

A nurse is assessing a 4 year old child at a well child visit. Which of the following developmental milestones should the nurse expect to observe?

Cuts an outlined shape using scissors The nurse should recognize that an expected developmental milestone of a 4 year old child is using scissors to cut out a shape

A nurse is caring for a school age child who has experienced a tonic clonic seizure. Which of the following actions should the nurse take during the immediate postictal period?

Place the child in a side lying position The nurse should place the child in a side lying position to prevent aspiration

A school nurse is assessing an adolescent who has multiple burns in various stages of healing. Which of the following behaviors should the nurse identify as a possible indication of physical abuse?

Denies discomfort during assessment of injuries The nurse should suspect child maltreatment in the form of physical abuse if the adolescent has a blunted response to painful stimuli or injury

A nurse is reviewing the lumbar puncture results of a school age child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis?

Increased protein concentration The nurse should identify that in increased protein concentration in the spinal fluid is a finding that can indicate bacterial meningitis.

A nurse is creating a plan of care for a school age child who has heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan?

Provide small, frequent meals for the child. The metabolic rate of a child who has heart failure is high because of poor cardiac function. Therefore, the nurse should provide small, frequent meals for the child because it helps to conserve energy.

A nurse is reviewing the lab report of an infant who is receiving treatment for severe dehydration. The nurse should identify that which of the following lab values indicates effectiveness of the current treatment?

Sodium 140mEq/L The nurse should identify that a sodium level of is within the expected reference range of 134-150 and indicates the current treatment regimen the infant is receiving for dehydration is effective.

A nurse is providing discharge teaching to the parent of a child who is 1 week postoperative following a cleft palate repair. For which of the following members of the inter professional team should the nurse initiate a referral?

Speech therapist The nurse should initiate a referral for a speech therapist who is postoperative following a cleft palate repair. A child who has a cleft palate will require speech therapy immediately following the repair to support speech development and future articulation.

A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the sound as which of the following?

Tachypnea The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid, regular breathing patter. This breathing pattern often occurs with anxiety, fever, metabolic acidosis, or severe anemia.

A nurse is assessing the vital signs of a 10 year old child following a burn injury. The nurse should identify that which of the following findings is an indication of early septic shock?

Temperature 39.1 C (102.4 F) The nurse should identify that a temp of 39.1 C is above the expected reference rage of 37-37.5 C (98.6-99.5 F) for a 10 year old child. The nurse should expect a child who has early septic should to have a fever a chills.

A nurse is providing dietary teaching to the parent of a school age child who has celiac disease. the nurse should recommend that the parent offer which of the following foods to the child?

White rice The nurse should recommend that the parent offer white rice to the child because it is a gluten free food. The nurse should instruct the parent that the child will remain on a lifelong gluten free diet and the child should not consume oats, rye, barley, or wheat, and sometimes lactose deficiency can be secondary to this disease

A nurse in a provider's office is preparing to administer immunizations during a well child visit. Which of the following actions should the nurse plan to take?

Withhold the measeals, mumps, and rubella vaccine. The nurse should recognize that an allergy to neomycin with an anaphylactic reaction is a contraindication for receiving the MMR vaccine. Clients who have a severe allergy to eggs or gelatin should not receive this vaccine.

A nurse is preparing to administer an immunization to a 4 year old child. Which of the following actions should the nurse plan to take?

Administer the immunization using a 24 gauge needle The nurse should administer an immunization for a 4 year old child using a 22-25 gauge needle to minimize the amount of pain the child experiences.

A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following actions should the nurse plan to take?

Perform a finger stick The nurse should perform a finger stick on a toddler as a component of the sickle turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the diease

A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. which of the following nutritional items should the nurse offer to the toddler?

Oral rehydration solution A toddle who has an acute diarrhea should consume an oral rehydration solution to replace electrolytes and water by promoting the rebsorption of water and sodium. This promotes recovery from dehydration .

A nurse is assessing a 3 year old toddler at a well child visit. Which of the following manifestations should the nurse report to the provider?

The nurse should identify that a resp rate of 45/min is above the expected reference rage of 20-25/min for a 3 year old toddler and can indicate resp dysfunction and acute resp distress. Therefore, the nurse should report this finding to the provider

A nurse is interviewing the parent of an 18 month old toddler during a well child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss?

The toddler received tobramycin during a hospitalization 2 weeks ago. The nurse should identify tobramycin as an aminoglycoside, which is an ototoxic medication that can cause mild to moderate hearing loss, and should assess the toddler for a hearing impairment.

A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take?

Apply topical analgesic cream to the site 1 hr prior to the procedure. The nurse should apply a topical analgesic to the lumbar site 1 hr prior to the procedure to decrease the adolescent's pain while the lumbar needle is inserted.

A nurse in an urgent care clinic is assessing an adolescent who has an upper respiratory tract infection. Which of the following findings should the nurse identify as a manifestation of pertussis?

Dry, hacking cough The nurse should identify that a dry, hacking cough is a manifestation of petrussis. This disease usually begins with indications of an upper respiratory tract infection, which includes a dry hacking cough that is sometimes more severe at night.

A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. This child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?

Epinephrine This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence-based practice, the nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the hear, causes vasoconstriction of blood vessels in the skin and mucous membranes, and trigger brochodilation in the lungs.

A nurse is assessing a school age child who has meningitis. Which of the following findings is the priority for the nurse to report to the provider?

Petechiae on the lower extremities The presence of a petechial of purpuric rash on a child who is ill can indicate the presence of minigococcemia. This type of rash indicates the greatest risk of serious rapid complications from sepsis and should be reported immediately to the provider.

A nurse is providing teaching about play activities for social development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child?

Playing dress up The nurse should instruct the parents that at the preschool age, play should focus on social, mental, and physical development. Therefore, playing dress up is a recommended activity for this child

A hospice nurse is caring for a preschooler who has a terminal illness. One of the preschooler's parent tells the nurse that they cannot cope anymore and are thinking about moving out of the house. Which of the following statements should the nurse make?

"Let's talk about some of the ways you have handled previous stressors in your life." This statement offers a general lead to allow the parent to express their feelings and previous actions when faced with stressful situations. It also helps the parent to focus on ways that they can cope with the current situation.

A nurse if receiving change of shift report for four children. Which of the following children should the nurse see first?

A school age child who has sickle cell anemia and reports decreased vision in the left eye When using the urgent vs. non urgent approach to client care, the nurse should determine the priority finding is a report of decreased vision in the left eye. This finding indicates that he child is experiencing a vaso-occlusive crisis and should be reported to the provider immediately. Therefore, the nurse should see this child first.

A nurse in an ED is caring for a school age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

Administer epinephrine IM to the child When uring the urgent vs nonurgent approach to clinet care, the nurse should determine that the priority action is administering epinephrine

A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy. Which of the following findings should the nurse expect? SATA

Ankle clonus Exaggerated stretch reflexes contractures A nurse should expect a child who has spastic cerebral palsy to exhibit ankle clonus, which is a rhythmic reflex tremor when the foot is dorsiflexed. The nurse should expect a child who has spastic cerebral palsy to exhibit spasticity or exaggerated stretch reflexes. The nurse should expect a child who has spastic cerebral palsy to exhibit contractures due to the tightening of the muscles

A nurse is reviewing the lab report of a school age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia?

Hematocrit 28% The nurse should recognize that this hematocrit level is below the expected reference range of 32-44% for a school age child. This child can exhibit fatigue, lightheadedness, tachycardia, dyspnea, and pallor due to the decreased oxygen carrying capacity.

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area?

Zinc oxide Diaper dermatitis is a common inflammatory skin disorder caused by contact with an irritant such as urine, feces, soap, or friction, and take the form of scaling, blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide, against the irritants allows the skin to heal