PEDS CMS

A nurse is reinforcing teaching with a school-aged child who has a new diagnosis of acute lymphoblastic leukemia (ALL). Which of the following statements from the child indicates an understanding of the teaching?

"I have a good chance of surviving this cancer." explanation: most children who have ALL and receive chemotherapy are expected to survive, with up to 95% achieving remission.

A nurse is reinforcing teaching with a school-aged child who has asthma about how to use a metered-dose inhaler. In which order should the nurse instruct the child to perform the following steps and evaluate return demonstration? (move steps into the box on the right, placing them in correct order)

1. shake the inhaler while holding it upright 2. position the mouthpiece in the mouth 3. slowly inhale the medication 4. hold the breath for 5-10 sec

A nurse is preparing to administer diphenhydramine 5mg/kg/day po divided equally every 8 hours to a school aged child who weighs 50lb. Diphenhydramine 12.5mg/5ml available. How many ml should the nurse administer per dose?

15

A nurse is assisting with a nutritional screening for a 12-year-old client who weighs 41 kg(90lbs) and has a height of 1.5m (60in). Which of the following values is the client's body mass index (BMI)?

18.2

A nurse is assessing a 3-year-old during a well-child assessment. Which of the following findings should the nurse report to the provider?

the child cannot walk on tip toe

A nurse is collecting data from a newborn at birth to assign Apgar scores. At 1 min of age, the newborn is crying vigorously with limbs flexed and a heart rate of 120/min. The newborn's trunk is pink, but his hands and feet are cyanotic, and he cries when the soles of his feet are stimulated. Which of the following Apgar scores should the nurse assign this infant?

9

A nurse is discussing the causes of chronic diarrhea with a client. Which of the following conditions is caused by malabsorption?

Celiac disease

A nurse is caring for a toddler who has asthma. The parents are concerned about the toddlers reaction to the hospitalization. Which of the following actions should the nurse take to decrease the child's anxiety?

Encourage rooming-in

A nurse working on a maternal-newborn unit is assisting with planning an in-service-training session for staff about assisting new mothers with breastfeeding. Which of the following infant conditions should the nurse recommend including in the teaching as a contraindication for breastfeeding?

Galactosemia

A school nurse is reinforcing teaching with an adolescent who has type 1 diabetes mellitus. Which of the following responses by the adolescent indicates an understanding of the teaching? (select all that apply)

I should eat extra food on busy days when I am more active. I should increase my intake of sugar-free fluids when I am sick. I should eat a snack 30 min before my baseball games start.

A nurse is reinforcing teaching about injury prevention with the parent of an infant. Which of the following statements by the parent indicates an understanding of the teaching?

I should make sure my baby's clothing does not have buttons on it

A nurse is reinforcing teaching with a parent of an infant who has developmental hip dysplasia and a new prescription for a Pavlik harness. Which of the following parent statements indicates understanding of the teaching?

I will apply the harness over a t-shirt and knee socks

A nurse is reinforcing post op teaching with a parent of a 3-month-old infant who is recovering from umbilical hernia repair. Which of the following statements by the parent indicates understanding of the teaching?

I will fold my baby's diaper away from the incision

A nurse is reinforcing teaching with a parent of a preschooler who has impetigo. Which of the following statements by the parent indicates understanding of the teaching?

I will wash my child's clothes in hot water

A nurse is reinforcing teaching with a parent of a child who has type 1 diabetes mellitus. The nurse is explaining how to manage the child's disorder during an illness such as a cold. Which of the following statements by the parent indicates an understanding of the teaching?

I'll check his blood glucose more often

A nurse is contributing to the plan of care for a child who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the priority for the nurse to recommend?

Monitor the child's oxygen saturation level- Increase child's fluid intake-

A nurse is assisting a child who has been stung by a bee. The child's hand is swelling, and the nurse notes that the child is allergic to insect stings. Which of the following findings should the nurse expect if the child develops anaphylaxis? (select all that appy)

Nausea Urticaria Stridor

A nurse is reinforcing teaching with the guardian of a 10-year-old child whos weight is in the 95th percentile on a growth chart. Which of the following instructions should the nurse include?

Plan menu that provides the child with 1,200 calories each day- set a goal with the child to lose weight- choose an exercise plan for child based on abilities-

A nurse is reviewing the morning laboratory results of an infant who is receiving digoxin and furosemide for the treatment of heart failure. Which of the following findings should the nurse report to the provider?

Potassium 3.2 mEq/L- Sodium 140 mEq/L- Calcium 10.2 mg/dL- Chloride 100 mEq/L-

A nurse is caring for an adolescent client who has a prescription for opioids. Which of the following findings should the nurse recognize as an adverse effect of opioids?

Pruritus

A nurse is preparing to administer an oral liquid medication to a 6-month-old infant. Which of the following interventions should the nurse plan to perform?

administer medication into the side of the infants mouth

A nurse is assisting with the care of a child who has paralytic poliomyelitis. Which of the following actions should the nurse take?

administer oral analgesics prior to exercises

A nurse is reinforcing teaching with the guardian of an adolescent. The guardian reports that the adolescent sleeps for about 10 hours on weekend nights. Which of the following responses should the nurse make?

adolescents need more sleep due to rapid growth

A nurse in a pediatric psychiatric unit is caring for an 8-year-old school aged child who has intermittent explosive disorder (IED). The child is currently having a temper tantrum. Which of the following communication techniques should the nurse use?

adopt a non threatening posture

A nurse is reinforcing teaching about nutritional needs with the parents of a 2-year-old toddler. Which of the following pieces of information should the nurse include?

an appropriate serving size of solid foods is 2 tablespoons

A nurse is reinforcing discharge teaching with the guardian of an infant following a hypospadias repair. Which of the following instructions should the nurse include?

apply antibiotic ointment to penis once per day

A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following items of data should the nurse share as a common example of a suggestive finding?

arm cast for a spiral fracture of the forearm

A nurse is caring for a preschooler who has acute leukemia and MRSA. The parents are not allowed to take the client to the hospital playroom, and the child appears bored. Which of the following actions should the nurse take?

ask the parents to bring toys from home

A nurse is assisting with the admission of a child who has a urinary tract infection and a history of myelomeningocele. After the child's admission history is complete, which of the following actions should the nurse recommend?

attack a latex allergy alert identification band

A nurse is caring for a preschooler who has a terminal illness. The nurse should expect the preschooler to have which of the following perspectives about death?

believes that her own thoughts can cause death

A nurse is collecting data from an adolescent who takes insulin for treatment of type 1 diabetes mellitus. The nurse should identify that which of the following findings indicates effective management of the clients diabetes mellitus?

blood glucose value at bedtime 140mg/dL- blood glucose 80 before meals hgbA1c 9% 24 hr urine 400mg

A nurse is collecting data from a 1-week-old infant at a well baby visit. The nurse should notify the provider about which of the following assessment findings?

blue coloring of the sclera

A nurse is caring for a 7-year-old child who is in skeletal traction following complete fracture of the femur. Which of the following diversional activities should the nurse offer the child?

chapter books

A nurse is caring for a toddler in the immediate postoperative period following the placement of a ventriculoperitoneal (VP) shunt. Which of the following interventions should the nurse perform?

check for abdominal distention

A nurse is planning care for a 3-month-old infant who has an ileostomy. Which of the following interventions should the nurse include in the plan?

check the bag for stool every 4 hours

A nurse is caring for a school-aged child who had an arm cast applied 8 hours ago. Which of the following findings should alert the nurse to a complication related to the casting?

child reports tightness at the wrist- child's hands are cool bilaterally-

A charge nurse is reinforcing teaching about child maltreatment with a group of newly licensed nurses. Which of the following pieces of information should the charge nurse include in the teaching?

children who were born prematurely are more likely to be maltreated

A nurse is collecting data from a child who is post operative and received a unit of RBCs during a surgical procedure. Which of the following findings indicates that the child is experiencing a hemolytic transfusion reaction?

chills and flank pain

A nurse is reinforcing teaching with the parent of a school-aged child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching?

corn tortilla with black beans

A nurse is caring for a 6-year-old child who is experiencing encopresis. Which of the following actions should the nurse take?

determine if there are any recent stressors in the child's environment

A nurse is collecting data about a 4-year-old client's cognitive development during a well-child visit. Which of the following should the nurse expect the child to display?

development of superego

A nurse is reinforcing teaching with the parents of a child who has a cleft palate. The parents ask how long they should wait before the infant should have corrective surgery. The nurse explains that the parents should wait no longer than 6 to 12 months to avoid which of the following outcomes?

difficulty with language acquisition

A nurse is assisting with the plan of care for a child who has meningococcal meningitis. Which of the following isolation precautions should the nurse plan to implement?

droplet precautions

A nurse is caring for an infant who is 6 months old and has moderate dehydration. Which of the following findings should the nurse expect?

dry mucous membranes- absent tears- weight loss of >10%- lethargy-

A nurse is reinforcing teaching with at 17-year-old client about managing manifestations of polycystic ovary syndrome (PCOS). Which of the following client statements indicates understanding of the teaching?

eating more lean meats and veggies will help me lose weight

A nurse is planning to use guided imagery for an early school-aged child who continues to have mild discomfort following the administration of an analgesic. Which of the following techniques should the nurse plan to use?

encourage the child to focus on a recent pleasurable experience

A nurse is caring of a newborn who has spina bifida. The newborns parents are upset by the diagnosis. Which of the following actions should the nurse take?

encourage the parents to touch and care for the newborn

A nurse is assisting with admission of a 12-year-old child who is blind and is scheduled to have open reduction internal fixation of the right arm. Which of the following actions should the nurse take?

explain the different sounds that can be heard at the child's bedside

A nurse is reinforcing education with the parent of a toddler who has phenylketonuria and is prescribed a restricted phenylalanine diet. Which of the following foods would be an appropriate choice for this child?

french fries- peanut butter- scrambled eggs- slice of cheese-

A nurse is reinforcing teaching with the guardian of a preschooler. The guardian reports the preschooler has had an imaginary playmate for about 3 months. Which of the following pieces of information should the nurse reinforce with the guardian?

have the child take responsibility for actions if they try to blame the imaginary friend.

A nurse is collecting data on a 6-month-old infant. Which of the following findings should the nurse identify as unexpected and report to the provider?

head lag when pulled to sitting up position

A nurse is assisting with the development of a health education program for the parents of school-aged females. Which of the following pieces of information regarding sexual maturation should the nurse include?

higher body fat content is associated with earlier onset of menarche- pubic hair is typically present prior to breast development- incorrect ovulation begins after sexual maturation is complete- menarche signals the beginning of puberty-

A nurse is reinforcing teaching with an adolescent who was recently diagnosed with type 1 diabetes mellitus. Which of the following insulin injection sites should the nurse recommend that the client use during basketball competition?

hip

A nurse is reinforcing teaching with a family of a child about hospice care. Which of the following statements should the nurse include in teaching?

hospice staff members consider the family's needs to be just as important as those of the child.

A nurse is reinforcing teaching with a group of parents of toddlers about measures to reduce the risk of choking. Which of the following foods should the nurse state increases the risk of choking in toddlers? (select all that apply)

hot dogs, grapes, bagels, marshmallows

A nurse is collecting data from a 12-year-old during a well-child check up. Which of the following physical findings should the nurse report to the provider?

hyperopia

A nurse is reinforcing teaching with a 12-year-old child who is recovering from an acute bleeding episode of hemophilia. Which of the following statement should the nurse make?

if you have a bleeding injury, you should immediately apply pressure and ice to the site

A nurse is caring for a child who has cystic fibrosis and a pulmonary infection. Which of the following findings is the nurse's priority?

inability to clear secretions

A nurse is contributing to the plan of care for a child who has aplastic anemia. Which of the following interventions should the nurse suggest?

initiate protective environment isolation for the child

A nurse is reinforcing teaching with a guardian of a child about bicycle safety. Which of the following pieces of information should the nurse include?

instruct the child to walk their bike through intersections

The clinic nurse is collecting data from a 6-week-old infant who's guardian states "I'm concerned about my baby's hearing." Which of the following manifestations should the nurse report to the provider?

lack of startle reflex to a loud noise

A nurse is inspecting the eyes of a 5-day-old infant. Which of the following is the correct technique for the nurse to use?

lift the infants head while the infant is lying in a supine position

A nurse is caring for a child who has gastroenteritis and is dehydrated. Which of the following characteristics places the infant at a higher risk for electrolyte imbalances compared to an adult client?

longer intestinal tract- reduce body surface area-

A nurse is reviewing laboratory findings of an adolescent who has acute renal failure. Which of the following findings should the nurse expect?

metabolic acidosis

A nurse is caring for a 7-year-old child who has Kawasaki disease. Which of the following interventions should the nurse perform?

monitor for signs of fluid retention

A nurse is reinforcing teaching with the guardian of a preschooler who has cystic fibrosis. Which of the following instructions should the nurse reinforce?

monitor the preschooler for a decrease activity level

A nurse is reinforcing teaching about baclofen with the guardian of a toddler who has cerebral palsy. Which of the following adverse affects should the nurse include?

muscle weakness

A nurse is reinforcing teaching with the parent of a toddler who has bacterial conjunctivitis. Which of the following instructions should the nurse include?

notify the provider immediately if the sclera becomes inflammed

A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately?

oxygen saturation of 85%- blood glucose 140mg- rbc 3.2 million/uL- serum sodium level 156 mEq-

A nurse is contributing to the plan of care for an infant who has an unrepaired myelomeningocele. Which of the following actions should the nurse take?

palpate the abdomen for bladder distension

A nurse is caring for an infant receiving phototherapy for hyperbilirubinemia. Which of the following should the nurse recognize as an indication of increase bilirubin excretion?

passage of several loose green stools

A nurse is assisting with an informational session about otitis media for a group of parents. Which of the following should the nurse identify as a risk factor for this illness?

passive smoking

A nurse is caring for a 4-month-old infant who has tetralogy of Fallot and experiences a hypercyanotic spell. Which of the following actions should the nurse take?

place infant in knee chest position- begin CPR

A nurse is assisting with the care of a school aged child who is having tonic-clonic seizures. Which of the following actions should the nurse take first?

position child on his side

A nurse is assisting with the plan of care for a child who has hyperthermia. Which of the following actions should the nurse take?

position the child on a cooling blanket and cover her with a sheet

A nurse is reinforcing teaching about preventing poisoning with a group of parents who have toddlers. Which of the following statements should the nurse make?

put all cleaning supplies in a locked cabinet.

A nurse is collecting data for a developmental assessment on a 3-year old client. Which of the following commands should the nurse expect the child to successfully complete?

put on your shoes

A nurse is contributing to a plan of care for a preschooler who was admitted for the treatment of measles. Which of the following activities should the nurse recommend for the child?

putting together a puzzle with large pieces

A nurse is caring for a child who has a tracheostomy. Which of the following techniques should the nurse use to suction the child's tracheostomy?

remove catheter while applying intermittent suction

A nurse is planning to perform chest physiotherapy (CPT) for an infant who has cystic fibrosis. Which of the following techniques should the nurse plan to include?

repeatedly strike the infants chest using a cupped hand

A newly licensed nurse in an urgent care center is caring for a child who has bruises that raise suspicion for child abuse. Which of the following actions should the nurse take?

report the suspected abuse to local authorities

A nurse in a providers office receives a phone call from the guardian of an infant who just vomited after the administration of digoxin. Which of the following actions should the nurse take first?

tell the guardian that a repeat dose should not be given

A nurse is caring for a child who has a ruptured appendix. Which of the following positions should the nurse encourage the child to maintain?

semi-fowler's

A nurse is collecting data from a 4-year-old child for growth and developmental milestones during a well child visit. Which of the following findings suggest a possible delay in development?

speaking using 2- or 3-word sentences- inability to tie shoes- adding 3 parts to a stick figure- inability to walk backward-

A nurse is caring for an 18-month-old infant who has chronic otitis media. The nurse should recognize that otitis media will affect which of the following?

speech patterns

A nurse is checking the gross motor development of a 3-year-old child. Which of the following skills should the nurse expect the child to be able to do?

standing on 1 foot- skipping around the room- hopping on 1 foot- throwing ball overhead-

A nurse is caring for a 4-year-old child who has superficial partial-thickness burns over 50% of his body. To meet nutritional needs of the child, which of the following actions should the nurse plan to take?

supplement the child's feedings with enteral feedings

A nurse on a pediatric mental health unit is caring for a school aged child. Which of the following questions or statements should the nurse make to foster rapport and engage him in conversation?

tell me about your favorite video game

A nurse is preparing a 3-month-old infant for a wellness visit with the physician. Which of the following observations should the nurse expect?

the infant looks at his hands- crude pincer grasp- infant has no head lag- infant can independently roll from back to abdomen-

A nurse is collecting data from a 10-month-old infant at a well child check up. Which of the following assessment findings should the nurse report to the provider?

the infant needs assistance to sit up- the infants anterior fontanel is open- the infants Moro reflex is absent- the infant is unable to walk independently-

A nurse is reinforcing teaching with the guardians of an infant who has mild gastroesophageal reflux (GER). Which of the following instructions about feeding therapies should the nurse recommend?

thicken feedings with rice cereal

A nurse is reinforcing teaching with a guardian of a 9-month-old infant who has a new prescription for an oral liquid medication. Which of the following points should the nurse include in the teaching?

use an oral syringe to measure your infant's medication accurately

A nurse is assisting with developmental plan of care for a 5-year-old child who has a new diagnosis of type 1 diabetes mellitus. Which of the following actions should the nurse include in the plan?

use short explanations immediately prior to collecting a blood glucose level to explain what will happen when the fingerstick occurs

A nurse is checking a meal tray of a school-aged child who has a new diagnosis of celiac disease. Which of the following foods should the nurse instruct the child to remove from the tray?

wheat roll (NO BROW) NO- Barley, Rye, Oat, Wheat

A nurse on a pediatric oncology unit is helping the parents of a child who is terminally ill to prepare for the impending loss of their child. Which of the following statements should the nurse make?

would you like assistance in planning where your child will die?

A nurse is reinforcing teaching about exercise with an adolescent client who has type 1 diabetes. Which of the following points should the nurse reinforce?

you might need to decrease your routine insulin dose before exercise

A nurse is reinforcing teaching with an adolescent client who has type 1 diabetes mellitus about managing hypoglycemia. Which of the following statements should the nurse include in the teaching?

you should drink 4 oz of orange juice if you experience hypoglycemia.

A nurse is reinforcing teaching with the parents of a toddler who had an anaphylactic reaction to peanut butter about administering injectable epinephrine. Which of the following instructions should the nurse include?

you will need to increase the dose as your child gains weight

A nurse is reviewing recommended immunizations with the guardian of a 2-month-old infant. Which of the following statements should the nurse make?

your baby can start the pneumococcal vaccine now ( 2m imms B Dr.Hip, 4m Dr.Hip, 6m B Dr.Hip + flu) ( 12- 18m MAD HPV 4-6yrs Very DIM)

A nurse is reinforcing teaching with the parent of a toddler who is hospitalized and has varicella. Which of the following points should the nurse reinforce?

your toddler will be unable to leave the room unless absolutely necessary.