Peds Exam 1

During a home visit, the parents report to the nurse that they are worried about their 3-year-old child's behavior. The child lacks discipline and writes on the walls. Which nursing advice would be helpful for the parents for limiting the child's behavior? "Send the child to his or her bedroom for a time-out." "Instruct the child to stand in play yard for some time." "Seclude the child in the store room for a punishment." "Scold the child in a firm, loud tone for the misbehavior."

"Instruct the child to stand in play yard for some time."

It is time to give a 3-year-old boy his medication. Which approach is MOST likely to receive a positive response? "It's time for your medication now. Would you like water or apple juice afterward?" "Wouldn't you like to take your medicine?" "You must take your medicine, because the doctor says it will make you better." "See how nicely this boy took his medicine? Now take yours."

"It's time for your medication now. Would you like water or apple juice afterward?"

. The parent of an 18-month-old child tells the nurse that the child has become a picky eater and is eating less. What does the nurse teach the parent to improve the eating habits of the child?

"Make sure that one type of food does not touch another type on the same plate." (psychologic anorexia)

. A pregnant patient says to the nurse, "I don't know how my 3-year-old child will react after the birth of the baby." Knowing that toddlers have sibling rivalry, what does the nurse suggest to the patient?

- "Alert your visitors to spend time equally with the child and the newborn."

A 6-month-old infant's parent asks the nurse, "What is the best alternative to breastfeeding?" What appropriate response should the nurse give to the infant's parents?

- "Commercial iron-fortified formula is an alternative."

The nurse has prepared feeding guidelines for an infant with failure to thrive (FTT). The nurse instructs the student nurse to feed the infant. Which guidelines should the nurse explain to the student nurse before feeding? (Select all that apply.)

- "Continue to talk to the infant while providing the feeding." - "Provide a quiet, unstimulating atmosphere to the infant." - "Maintain a calm, even temperament throughout the meal."

The nurse is educating a group of mothers about injury prevention for infants. Which statements by the nurse indicate effective teaching?

- "Diaper pins should be kept away from the child." - "The floor should be clean where the child crawls." - "A smoke detector should be installed in the home."

The primary health care provider (PHP) prescribed HepB (Recombivax HB) vaccine for a child. Which question should the nurse ask the child's parents to ensure it is safe to administer the vaccine?

- "Does your child have a history of being hypersensitive to yeast?"

The nurse is instructing a group of obese adolescents about managing obesity. What instructions will the nurse include in the teachings? Select all that apply. 1"Eat a healthful breakfast daily." "Engage in sedentary activities." "Avoid eating at fast food joints." "Drink sugar-sweetened beverages." "Eat plenty of vegetables."

- "Eat a healthful breakfast daily." - "Avoid eating at fast food joints." - "Eat plenty of vegetables." The nonpharmacologic management of obesity includes lifestyle changes. Eating breakfast daily helps increase metabolism. Fast food is high in fat and low in nutrients; therefore eating at fast food restaurants should be avoided. Vegetables are rich sources of vitamins and minerals and contain very few calories, so they should be included in the diet. Sedentary activities lead to obesity because the extra calories are deposited as fat in the body. Consuming sugar-sweetened beverages increases the risk of obesity and should be avoided.

A 5-year-old child has a vesicular rash over the body and head and is diagnosed with chickenpox. The child keeps on scratching the skin. What instructions should be given to the parents? Select all that apply.

- "Give oatmeal baths to the child." - "Keep the child at home until the vesicles dry."

The nurse is preparing a written contract agreement from an adolescent who has been contemplating suicide. Which statement should be included in the written contract? Select all that apply. "I will abide by the unit's behavior conduct code." "I will not communicate with anybody else in the unit." "I will not accept phone calls from my family members." "I will not accept phone calls from my friends who abuse drugs." "When I feel like hurting myself, I will notify the staff immediately."

- "I will abide by the unit's behavior conduct code." - "I will not accept phone calls from my friends who abuse drugs." - "When I feel like hurting myself, I will notify the staff immediately."

The nurse is assessing an adolescent who has suicidal ideation and is habituated to alcohol and drugs. During counseling, which statement given by the adolescent indicates that he feels guilty?

- "I wish I had never used alcohol in the first place."

The nurse is removing the tape of an intravenous catheter in a child. What is the most appropriate instruction given by the nurse? "Stay calm while I remove the catheter." "This will cause just a little bit of pain." "Let's remove the tape together." "You are the bravest kid in the world."

- "Let's remove the tape together." When it is time to discontinue an intravenous infusion, many children are distressed by the thought of catheter removal. Encouraging children to remove or help remove the tape from the site provides them with a measure of control and often fosters their cooperation. The nurse should not remove the tape without first asking the child for cooperation, so asking he child to remain calm and then remove the catheter is inappropriate. The nurse should not use the word pain; saying that it would cause discomfort is more appropriate. Telling children that they are bravest in the world may actually make them fear removal of the catheter as children are used to such statements during distress.

The nurse educates the mother of an 8-year-old girl about the sequences of maturational changes. Which response of the mother indicates effective learning? Appearance of pubic hair is not a sign associated with maturation." "Abrupt deceleration of height is followed by the breast development." "Appearance of axillary hair is the first change associated with maturation." "Menstruation begins 2 years after the appearance of the first signs of maturation."

- "Menstruation begins 2 years after the appearance of the first signs of maturation."

The nursing instructor is teaching a group of students about the use of enemas in children. The instructor says, "We usually do not use Fleet enemas for children." What statement by the student indicates a need for additional teaching? "They have harmful ingredients." "They can cause diarrhea." "They can cause metabolic acidosis." "They may cause hypernatremia." "They are hypotonic."

- "They are hypotonic." Plain water is hypotonic, not the Fleet enema. The Fleet enema is not advised for children because of the harsh action of sodium biphosphate and sodium phosphate. The osmotic effect of the Fleet enema may produce diarrhea, which can lead to metabolic acidosis. Other potential complications of using the enema are hyperphosphatemia and hypernatremia.

The nurse is assessing a 2-year-old child who was discharged from the hospital after a chronic illness. The child's parent tells the nurse that the child has forgotten all the rhymes that were learned before being hospitalized. Which response given by the nurse is appropriate?

- "You should ignore it and encourage the child by praising the existing behavior."

The parents tell the nurse that every time the child receives good grades, they reward the child with candy and snacks. What response should the nurse give to the parents? "Your parenting method is really appreciable." "You should try giving other rewards to your child." "You should not spoil your child by giving rewards." "Your child's studies may be affected due to this habit."

- "You should try giving other rewards to your child." Because the parents tend to give foods as reward for achieving good grades, there is a high possibility that the child may depend on food for comfort and to cope with depression. This tendency may cause the child to become obese. The nurse should ask the parents to give other rewards instead of giving foods. Rewards serve as motivation for better performance in future. Thus the nurse should ask the parents to give rewards for desired behaviors. Giving foods as reward would still motivate the child to perform well in academics. However, this habit would affect the child's health.

The nurse is assessing a healthy 8-year-old child. The nurse notices that the child's height is 130 cm (51 inches). What was the child's approximate height in centimeters at 7 years of age? Record your answer using a whole number.

- 125 cm

The nurse is completing a comprehensive health assessment on a 15-year-old female who weighs 75 kg and is 64 inches tall. The adolescent's body mass index (BMI) is: ___________________. Record your answer with one decimal place.

- 28.3

For which pediatric client is it most appropriate for the nurse to use the FLACC pain assessment tool? 6-year-old patient with a continuous IV 3-year-old patient receiving a lumbar puncture 5-year-old patient who has an ongoing stomachache 10-year-old patient with recurrent pain in the left elbow

- 3-year-old patient receiving a lumber puncture The FLACC pain assessment tool is most appropriate and effective for young children or for short, sharp procedural pain, such as during lumbar punctures. Therefore, the patient getting the lumbar puncture is best suited for use of the FLACC tool. The patient with the ongoing stomachache, the continuous IV, and the recurrent pain have recurrent or chronic pain, which do not always correlate with the children's own reports of pain intensity. Also, since they are not infants, the FLACC pain assessment tool would not be appropriate.

The healthcare provider prescribes hydroxyzine syrup 2 mg/kg/day by mouth in three equal divided doses to a school-aged child with allergic contact dermatitis from poison ivy. The nurse instructs the parent to give 2 teaspoons of hydroxyzine syrup by mouth every 8 hours for itching. Hydroxyzine syrup is available in 10mg/5ml. What is the child's weight? 30 kg 250 kg 355 kg 460 kg

- 30 kg The child weighs 30 kg. It is helpful to work backwards with this problem. First, recall that 1 teaspoon = 5 mL. The nurse instructed the mother to give 2 teaspoons, so that dose should be 5 mL x 2 = 10 mL. The available dose is 10 mg/5 mL, so each dose contains 10 mg/5 mL x 2 = 20 mg/10 mL. Giving this dose every 8 hours per day is three times a day (24 hours/8 hours = 3), so 20 mg x 3 = 60 mg per day. The order was for 2 mg/kg/day, so 60 mg/2 mg x kg = 30 kg. Dimensional analysis: 30 kg = 1 kg/2 mg x 3 doses/day x 10 mg/5 mL x 5 mL/1 tsp x 2 tsp/dose.

The nurse expects that most children should be using sentences of six to eight words by what age? 18 months 24 months. 3 years. 5 years.

- 5 years

. A 3-year-old girl has been brought to the emergency department by her parents after a fall down the porch steps. X-ray films indicate a fractured tibia and fibula, which require a closed reduction under anesthesia. The nurse caring for this preschooler postoperatively utilizes the FLACC scale to perform a accurate pain assessment. The patient is moaning and whimpering, grimacing, squirming and restless, and difficult to console and has the unaffected leg drawn up. Using the FLACC scale, calculate this patient's pain score based on the clinical presentation. 2. 4 6 8

- 8 Face—grimace (1) + Legs—drawn up (2) + Activity—squirming (2) + Cry—moaning and whimpering (1) + Consolability—difficult to comfort (2) = 8.

The nurse is teaching a group of adolescents about obesity. What information should the nurse include in the teaching plan? Select all that apply. Excessive use of the Internet can lead to obesity in adolescents. Diseases involving metabolic variations can lead to obesity in adolescents. Increased risk of low blood pressure is a cause of mortality in adolescents. Obesity in adolescents is not related to the presence of respiratory disorders. Girls of lower socioeconomic groups have a greater prevalence of obesity.

- Excessive use of the Internet can lead to obesity in adolescents. - Girls of lower socioeconomic groups have a greater prevalence of obesity. - Diseases involving metabolic variations can lead to obesity in adolescents. Excessive use of the Internet promotes a sedentary life. This decrease in physical activity leads to obesity in adolescents. Diseases that involve metabolic variations may also lead to obesity in adolescents. Girls of lower socioeconomic groups have a greater prevalence of obesity than those of high socioeconomic groups. Obesity leads to excess fat deposition in the arteries, which may increase blood pressure. Obesity is also related to respiratory disorders in adolescents.

What are the symptoms associated with anorexia nervosa? Select all that apply.

- Fatigue - Low heart rate - Difficulty with defecation

The school nurse knows that which attribute is characteristic of the psychosocial development of school-age children? Peer approval is not yet a motivating power. A developing sense of initiative is very important. Motivation comes from extrinsic rather than intrinsic sources. Feelings of inferiority or lack of worth can be derived from children themselves or from the environment.

- Feelings of inferiority or lack of worth can be derived from children themselves or from the environment. All children are not able to do all tasks well, and the child must be prepared to accept some feeling of inferiority. Developing initiative is characteristic of preschoolers. Peer group formation is one of the major characteristics of this age group. School-age children gain satisfaction from independent behaviors. This age child is eager to develop skills and participate in activities.

The nurse is caring for a toddler who is hospitalized. The nurse finds that the toddler is afraid of the new environment and gets cranky. What does the nurse tell the parents to do to make the toddler comfortable?

- Give appropriate play objects to the child for comfort.

The nurse is caring for a child weighing 30 kg (66.1 lb) who has been prescribed morphine (Avinza). The nurse reports to the primary health care provider that the patient is having apnea. Which treatment does the primary health care provider prescribe for the patient? A dosage of 0.5 mcg/kg naloxone (Narcan) Discontinuation of morphine (Avinza) after 2 days A standard maintenance dosage of 0.6 mg/kg/day A dosage that is less than 75% of the previous dosage

- A dosage of 0.5mcg/kg naloxone (Narcan) Apnea and respiratory depression are the side effects of opioids such as morphine (Avinza). During this condition naloxone (Narcan), an opioid antagonist, should be administered to treat apnea. Given the child's weight, the drug must be diluted in saline to adjust the dosage. For children who weigh less than 40 kg, a dosage of 0.5 mcg/kg should be administered by diluting 0.1 mg naloxone (Narcan) in 10 mL sterile saline. Suddenly reducing the dosage of morphine to 75% of the initial dosage can worsen the child's condition and cause withdrawal symptoms. The dosage should be gradually reduced until it reaches 0.6 mg/kg/day. Therefore 0.6 mg/kg/day is not a standard maintenance dosage for children in general. The drug should not be stopped immediately after 2 days, because that can cause withdrawal symptoms. A gradual reduction in the dosage will be helpful for the child.

The nurse observes that a 13-year-old male has gynecomastia (breast enlargement). What should the nurse explain that this is?

- A normal occurrence during puberty

The most appropriate recommendation for relief of teething pain is to instruct the parents to do what?

- Give child a cold teething ring to relieve inflammation

The nurse is caring for a child who is hospitalized with bruises on the soles of her feet and on her back. The nurse observes that the child is not ready to return home and is scared of her parents. What could be the possible reason for the child's behavior? Abused at school Abused at home Scared of hospitals Shock due to the injury

- Abused at home Bruises on the soles, feet, and back indicate that the child is being physically abused. The fact that the child is unwilling to go home and is afraid of her parents is evidence that the child is being abused by her parents at home. If the child is unwilling to go to school or afraid of her teachers, then the nurse could assume the child is being abused at school. If the child is scared of hospitals, she would be ready to go home as soon as possible. The child who is in a shock because of injury usually requires her parents' support.

The nurse is caring for a child with severe trauma due to an accidental fire. The nurse administered oral oxycodone (OxyContin) as a part of treatment; however, the pain was not relieved. Which action taken by the nurse is effective for pain management? Replace the drug with morphine (Astramorph) Prolong the action of the oxycodone medication Add a nonsteroidal antiinflammatory drug (NSAID) Administer a midazolam (Versed)-acetaminophen combination

- Administer a midazolam (Versed)-acetaminophen combination Trauma due to a fire warrants deep sedation; therefore, it is advisable to administer drugs in combination. This includes acetaminophen and midazolam in combination with oxycodone for effective pain management. Morphine and oxycodone have similar effects. Therefore because the patient is not responding to oral oxycodone, the patient is unlikely to respond to morphine too. Prolonging the oxycodone alone may not be effective in managing pain. Adding a nonsteroidal antiinflammatory drug and replacing the drug with morphine may not bring about effective pain relief.

The nurse is caring for a child after surgery. The child refuses to eat any food for lunch. What is an appropriate intervention by the nurse? . Call the child's parents Give the child a favorite food. Refer the matter to the dietician. Insist that the child eat some more food.

- Give the child a favorite food. Although it is best to provide high-quality, nutritious foods, the child may desire foods and liquids that contain mostly empty or non-nutritional calories. Some well-tolerated foods include gelatin, diluted clear soups, carbonated drinks, flavored ice pops, dry toast, and crackers. Even though these substances are not nutritious, they can provide necessary fluid and calories. The nurse should not force the child to eat. Forcing a child to eat meets with rebellion and reinforces the behavior as a control mechanism. Calling the child's parents may make the child more irritated. The dietician is referred to before meal planning, and is consulted only if the child refuses to have any hospital food.

. Which statement about early childhood caries (ECC) is correct?

- Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome.

The nurse finds that a patient has developed tachycardia and tachypnea after administration of a muscle relaxant. What is an appropriate nursing action? . Administer an inhaled anesthetic. Administer dantrolene sodium intravenously. Use hot compresses on the neck and axillae Assess the patient's history of surgical procedures.

- Administer dantrolene sodium intravenously. The nurse should administer dantrolene sodium intravenously as the patient is showing signs of malignant hyperthermia (MH). Symptoms of MH include hypercarbia, elevated temperature, tachycardia, tachypnea, acidosis, muscle rigidity, and rhabdomyolysis. The nurse uses ice packs on the groin, axillae, and neck as MH is usually accompanied by hyperthermia. A family or previous history of sudden high fever associated with a surgical procedure and myotonia increase the risk for MH. But the patient will not be assessed for it now as MH has already set in. Use of inhaled anesthetics increase the risk of MH; therefore, they should not be administered as the patient is exhibiting symptoms of MH.

Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to these changes include? giving reassurance that these changes are normal. suggesting dietary measures to control weight gain. recommending increased exercise to control weight gain. encouraging low-fat diet to prevent fat deposition.

- Giving reassurance that these changes are normal A certain amount of fat is increased along with lean body mass to fill the characteristic contours of the child's gender. A healthy balance must be achieved between expected healthy weight gain and obesity. Suggesting dietary measure to control weight would not be given unless weight gain is excessive; eating disorders can develop in this group. Some fat deposition is essential for normal hormone regulation. Menarche is delayed in girls with body fat content that is too low.

A child who has been receiving morphine intravenously now will start receiving it orally. The nurse should anticipate that, to achieve equianalgesia (equal analgesic effect), the oral dose will be what? The same as the intravenous (IV) dose One fourth of the IV dose One half of the IV dose Greater than the IV dose

- Greater than the IV dose When the route of morphine administration is changed from IV to PO (by mouth), it is essential that the dosage be increased to achieve an equianalgesic effect. Oral morphine is not as effective at the same dose as IV morphine. The dosage of morphine is increased, not decreased, when the administration route changes from IV to PO. The dosage of morphine is increased, not decreased, when the administration route changes from IV to PO.

The nurse is using a pain tool that rates the intensity, location, and quality of a patient's pain. Which pain tool is the nurse using? The visual analog scale The numeric rating scale Adolescent Pediatric Pain Tool Face, Legs, Activity, Cry, Consolability (FLACC) Pain Assessment Tool

- Adolescent Pediatric Pain Tool A pain scale in which pain location, intensity, and quality are measured is called a multidimensional pain scale. The Adolescent Pediatric Pain Tool is a multidimensional pain scale. A visual analogue scale uses a vertical/ horizontal line, the ends of which are marked as no pain and worst pain respectively. The child is made to place mark on line that best describes the amount of own pain. The numeric rating scale evaluates the intensity of pain in a child. In this scale the child rates the pain numerically, with 0 indicating no pain and 10 indicating the worst pain. The FLACC scale is a behavioral measure scale in which pain intensity is assessed by observing the child's behavior.

During assessment, the nurse finds that an adolescent has a swollen testis and a solid mass in the testis. what will the nurse do? (testicular cancer)

- Advise the adolescent to undergo direct biopsy immediately

What are the primary goals in the nutritional management of children with failure to thrive (FTT)? Allow for catch-up growth Correct nutritional deficiencies Achieve ideal weight for height Restore optimum body composition Educate the parents or primary caregivers on child's nutritional requirements Educate the parents or primary caregivers that the child will need tube feedings first

- Allow for catch-up growth - Correct nutritional deficiencies - Achieve ideal weight for height - Restore optimum body composition - Educate the parents or primary caregivers on child's nutritional requirements

The nurse is teaching a group of parents about therapeutic management for preventing plagiocephaly in the infant. What instructions should the nurse give to the parents?

- Alternate the infant's head position." - "Place the infant prone when awake." - "Use a protective helmet for the infant."

The nurse is caring for a child with severe pain and injuries due to an accident. The primary health care provider has prescribed lidocaine-tetracaine (Synera) transdermal patch to relieve pain. Which steps does the nurse follow while applying the patch to the child? SATA Ensures that the patch is placed on broken skin applies the patch for a duration of 20-30 minutes immediately applies the patch after opening the package cuts and removes the layers of the patch before applying ensures that the pores (hole) on the patch are covered by a cloth

- Applies the patch for a duration of 20 to 30 minutes - Immediately applies the patch after opening the package The Synera patch is used to produce analgesic and local anesthetic effects during painful procedures. The patch must be used for only 20-30 minutes to prevent skin irritation. After it is removed from the package, the patch must be applied immediately on the desired site to prevent contamination due to moisture and microbes in the atmosphere. The active ingredients are embedded in the layers of the transdermal patch, so the nurse should not cut or remove the layers of the patch. The patch should never be placed on broken skin because it can irritate the skin surrounding the wound. The holes in the patch should not be covered by a cloth because this will affect absorption of the drug into the skin.

The nurse plans to use tasks based on the concept of conservation to assess the cognitive development of a 5-year-old child. What is the appropriate method used by the nurse? Asking the child to differentiate the weight of two similar things Asking the child to determine the area occupied by two objects Asking the child to compare two differently sized glasses of water Asking the child to find the volume occupied by three or more objects

- Asking the child to compare two differently sized glasses of water Rational: According to Piaget, the school-age child uses thought processes to experience events and actions. They understand the concept of conservation and differentiate things based on their volume, size, and area. To assess the cognitive development in the child, the nurse can ask the child to compare two different sized glasses of water to determine which has more. Only a 9- to 10-year-old child will be able to understand the concept of conservation related to weight, area, and volume occupied by the objects. Therefore these concepts cannot be tested in a 5-year-old child.

An adolescent is brought to the emergency department in an nonconscious state by his friends who have been partying overnight. On examination, the nurse finds that pupils off the boy are constricted, his respiratory rate is 5 BPM, and he is turning blue. There are no needle marks on arms or legs. What should be the most appropriate steps taken by the nurse? (opioid overdose)

- Assess for presence of any injury - Arrange for gastric lavage procedure - Prepare for administration of naloxone

A 9-year-old patient is scheduled for a surgical procedure next week. What teachings will the nurse include to ensure the patient's assent? Select all that apply. . Assess patient understanding. Tell the patient what can be expected Inform the patient how consent is obtained Solicit an expression of the patient's willingness. Inform the patient about the nature of the condition.

- Assess patient understanding. - Tell the patient what can be expected. - Solicit an expression of the patient's willingness. - Inform the patient about the nature of the condition. Assent of the patient should include four key teachings. The nurse should help the patient achieve a developmentally appropriate awareness of the nature of their condition. The nurse should tell the patient what can be expected. The nurse should also make a clinical assessment of the patient's understanding, and solicit an expression of the patient's willingness to accept the proposed procedure. Such measures help reduce anxiety in the patient and are important for their assent. Information about the legal procedures of obtaining consent is not related to the surgical procedure and will not be as helpful in reducing anxiety.

The nurse is caring for a 4-year-old child with severe injuries. The parents of the child inform the nurse that the child is afraid of the dark and does not like to go to bed alone. Which intervention should the nurse follow for encouraging the child to sleep alone and cope with fear? Seek professional help Tell bedtime stories to the child Assure the absence of monsters Leave a night lamp on in the child's room Teach deep breathing exercise to the child

- Assure the absence of monsters - Leave a night lamp on in the child's room

Which drugs are used for treating rapid-sequence intubation (RSI)? .

- Atropine (Atropine) - Fentanyl (Sublimaze) - Vecuronium (Norcuron) - Rocuronium (Zemuron)

. The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem?

- Beginning to put her to bed while still awake.

What does the nurse teach the parents when providing anticipatory guidelines to the parents of children who are 12 to 18 months old?

- Behavioral changes are expected - The child will gradually wean from bottle-feeding

39. Which behaviors can the nurse expect to find in an adolescent with bulimia? Select all that apply.

- Being extroverted - Turning to food to cope with issues - Seeking intimacy from relationships

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake?

- Being persistent through 10 to 15 minutes of food refusal

. Which developmental changes are observed in a 5-month-old infant? Birth weight has doubled. The rooting reflex is present. There are signs of tooth eruption .Head and chest circumference are equal. Length has increased by 50% from length at birth.

- Birth weight has doubled. - There are signs of tooth eruption.

The nurse assesses pain in a child through vocal, social, facial, activity, body, and physiologic signs and rates the pain as an 8. What pain type the child have? Brain injury Orthopedic injury Lumbar puncture Pain due to chemotherapy

- Brain injury The scale that measures the child's vocal, social, facial, activity, body, and physiologic signs is called the Non-Communicating Children's Pain Checklist. This tool is used when a child is not able to communicate. A child with brain injury would probably be unable to communicate. A child with orthopedic injury may not need non-communicating measurements of pain. Pain associated with lumbar puncture is temporary, and non-communicating techniques usually are not needed. Pain due to chemotherapy is generally treated with opioids, and a pain scale that uses verbal communication is most commonly used for patients with cancer.

The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. What teaching should be included?

- Brush teeth with plain water if child does not like toothpaste.

An adolescent reports tiredness. The adolescent also has decreasing school grades. The nurse learns that the adolescent has been finding it difficult to cope since his parents divorced. The nurse also finds that the adolescent has been planning to commit suicide with a gun. What should be the most appropriate next steps of the nurse? Select all that apply. Inform the adolescent's parent about his intention of committing suicide Do not inform the parent about the adolescent's plan, as it is breach of confidentiality Advise the adolescent to inform his parents about the suicide plan after going home Advise the adolescent to call a 24-hour crisis line immediately if he has suicidal ideation. Get a contract signed stating that the adolescent will not attempt suicide until hospitalization

- Inform the adolescent's parent about his intention of committing suicide - Advise the adolescent to call a 24-hour crisis line immediately if he has suicidal ideation. - Get a contract signed stating that the adolescent will not attempt suicide until hospitalization

the nurse is caring for aa 9 year old patient who is scheduled for an elbow surgery. the patient is anxious and is worried the surgery will be painful. What is an appropriate nursing action in this context? Assure the patient that the procedure is pain-free. Keep details about the procedure hidden from the patient Inform the patient that the procedure involves some discomfort. Consult the health care provider for stronger doses of analgesics.

- Inform the patient that the procedure involves some discomfort procedure involves some discomfort. The nurse should be honest with the child about the unpleasant aspects of a procedure but avoid creating undue concern. When discussing that a procedure may be uncomfortable, the nurse should state that it feels differently to different people. The nurse should not say that the procedure is painless just to allay the child's concerns. Stronger analgesics can be harmful for minors. The nurse should not keep any details hidden from the patient, because it is unethical.

A child is about to begin kindergarten, and she is nervous about being in a new environment. What should the nurse suggest to the parents to relieve the child's stress? Introduce the child personally to the teachers in the school Inform the child about extracurricular activities in the school Inform the child that regular homework will be given in the school Provide the details of the child's favorite food and color to the school Inform the child that she will be punished if she does not do well in school

- Introduce the child personally to the teachers in the school - Inform the child about extracurricular activities in the school - Provide the details of the child's favorite food and color to the school

. A child with appendicitis has been treated with preemptive analgesia before undergoing appendectomy. What would be the benefits of this treatment to the child? SATA It decreases postoperative pain. It improves the success of surgery. It increases the need for analgesics It decreases the risk of neuropathic pain. It reduces the length of the patient's hospital stay.

- It decreases postoperative pain - It reduces the length of the patient's hospital stay Preemptive analgesia is a treatment in which local or regional anesthetics and analgesics are administered to the child before a surgery such as appendectomy. It helps reduce postoperative pain and shortens hospital stays. It reduces the need for analgesics by reducing pain in children. Preemptive analgesia does not affect the success of the surgery. Preemptive analgesia has no effect on neuropathic pain, which is seen mostly in patients with cancer.

The parents of 9-year-old twin children tell the nurse, "They have filled their bedroom with collections of rocks, shells, stamps, and cars." What should the nurse recognize about this behavior? indicates giftedness indicates typical "twin" behavior. is characteristic of cognitive development at this age is characteristic of psychosocial development at this age

- It is characteristic of cognitive development at this age. Classification skills are developed during the school-age years. This age group enjoys sorting objects according to shared characteristics. This behavior is characteristic of the age group, not giftedness or a twin status. Psychosocial development at this age is focused on accomplishment.

The nursing instructor is teaching a group of students about gastrostomy feeding. Which statement by the student indicates a need for additional teaching? 1 "...when tube passage is not possible through the mouth." 2 "...when tube passage is possible through the pharynx." 3 "...when tube passage is not possible through the cardiac sphincter." 4 "....to avoid the constant irritation of an NG tube."

- It is used when tube passage is possible through the pharynx. Feeding by way of gastrostomy, or G tube, is often used for children in whom passage of a tube through the pharynx, mouth, esophagus, and cardiac sphincter of the stomach is contraindicated or impossible. It is also used to avoid the constant irritation of an NG tube in children who require tube feeding over an extended period.

The nurse is caring for an infant on gastrostomy feeding. The nurse gives the infant a small and safe pacifier to suck on. What is the rationale behind this? Nutritive sucking is essential during gastrostomy feeding. It keeps the child from crying too much. It prevents the risk of aspiration during gastrostomy feeding. It enhances the nutritive value of gastrostomy feeding.

- It keeps the child from crying too much. Infants are giving a pacifier as non-nutritive sucking can help decrease crying and aid in weight gain. Pacifiers do not increase the risk of aspiration as children suck on them. Pacifiers do not mix with gastrostomy feedings and cannot enhance the nutritive value of gastronomy feeding.

The nurse is caring for a comatose child with multiple injuries. What should the nurse recognize about pain? It cannot occur if a child is comatose. It may occur if a child regains consciousness. It requires astute nursing assessment and management. It is best assessed by family members who are familiar with the child.

- It requires astute nursing assessment and management Because the child cannot communicate pain through one of the standard pain-rating scales, the nurse must focus on physiologic and behavioral manifestations to accurately assess pain. Pain can occur in the comatose child. The family can provide insight into the child's different responses, but the nurse should be monitoring physiologic and behavioral manifestations. Test-Taking Tip: Because few things in life are absolute without exceptions, avoid selecting answers that include words such as always, never, all, every, and none. Answers containing these key words are rarely correct.

What should the nurse teach a group of adolescents about the quadrivalent human papillomavirus (HPV) vaccine?

- It should be administered at 9 years of age.

A child is being treated with methylphenidate hydrochloride (Ritalin). After assessing the child, the nurse decides to administer the medicine early in the day. What effect of the drug does the nurse note in the child? Keeps the child awake Causes some seizure activity Results in decreased appetite Caused the development of foot numbness

- Keeps the child awake The child who is taking methylphenidate hydrochloride (Ritalin), a psychostimulant, may experience sleeplessness as a side effect. Therefore the nurse should administer the medication early in the day to counteract the effect. Seizures are not a side effect of Ritalin. Reduced appetite is a side effect of Ritalin, and therefore the nurse should administer the drug after the meals. The child doesn't develop numbness when administered Ritalin.

The nurse is talking with the parents of a toddler to obtain the dietary history. The nurse learns that the child consumes dairy products and has fish sticks on rare occasions but does not eat any other meat at all. Which type of vegetarian diet does the child's family follow?

- Lacto-ovo vegetarian

The nurse is caring for an unconscious patient in the intensive care Unit(ICU). Which assessment tool does the nurse use to assess the patient's pain? COMFORT scale Visual analog scale Children's Hospital of Eastern Ontario Pain Scale Face, Legs, Activity, Cry, Consolability (FLACC) pain assessment tool

- COMFORT scale The COMFORT scale is a pain assessment tool that is used in ICUs to measure the distress in an unconscious and ventilated patient. Each indicator is scored between 1 and 5 based on the behaviors exhibited by the patient. The visual analog scale is a 10-cm scale marked with numbers and words such as "no pain" on the left and "worst pain" on the right. It is used to measure the pain intensity in conscious patients. FLACC assessment is done by rating the patient's facial expressions, leg movement, activity, cry, and consolability to measure pain. The Children's Hospital of Eastern Ontario Pain Scale reports the most frequently observed behavior to measure pain. Therefore the visual analog scale, FLACC pain assessment tool, and Children's Hospital of Eastern Ontario Pain Scale cannot be used to assess pain in unconscious patients.

The nursing student who is posted in the pediatric unit asks the nurse, "Which behaviors would be expected in 8-month-old infants?" Which appropriate answers does the nurse state to the nursing student? The child: (Select all that apply.)

- Can play peek-a-boo." - "Exhibits stranger anxiety." - "Can stand by holding furniture."

The nurse is administering an antipyretic medication to a child with a high fever. What action does the nurse take in the first hour after giving the medication? Check the temperature again. Administer another dose. Check the child's weight. Check for aspirin toxicity.

- Check the temperature again. The temperature is usually retaken 30 minutes after the antipyretic is given to assess its effect but should not be measured repeatedly. Another dose is not administered before 4 hours but no more than 5 times in 24 hours. The child's weight is taken if fluid imbalance is suspected. Aspirin toxicity can cause hyperthermia and is only assessed for if such toxicity is suspected.

The nursing instructor is teaching a group of students about using chest tubes in children. Which statement by the student indicates a need for additional teaching? .Chest tubes clear air from lungs. Chest tubes eliminate leaked blood. Pneumothorax may need chest tubes. Excess fluid is removed by chest tubes.

- Chest tubes eliminate leaked blood.

The community nurse is educating a group of parents about sleep and rest requirements of school-age children. What information does the nurse provide? Children 5 years of age need approximately 11 hours of sleep a night. Children 6 years of age should be encouraged to read before bed time. Children 7 years of age should be encouraged to read before bed time. Children 12 years of age need approximately 6 hours of sleep per night. School-aged children need to have 1- to 2- hour long good naps per day.

- Children 5 years of age need approximately 11 hours of sleep a night. - Children 6 years of age should be encouraged to read before bed time. - Children 7 years of age should be encouraged to read before bed time.

What information does the nurse include when teaching pool safety to a group of parents who have toddlers?

- Children like to explore areas.

A community nurse is educating parents regarding calcium and vitamin D requirements for children aged 1 to 8 years. What information should be included in the session?

- Daily calcium requirement for children aged 1 to 3 years is 700 mg. - Daily calcium requirement for children aged 4 to 8 years is 1000 mg. - Milk and its products are excellent sources of vitamin D and calcium.

The nurse is teaching the importance of dental health to a group of parents in the community. Which points does the nurse emphasize in order to prevent dental caries in children? Do not let the child have too much sleep Decrease excessive fat intake in the diet Demonstrate how to correctly brush their teeth Teach children how to correctly floss their teeth Reduce the intake of fermentable carbohydrates

- Demonstrate how to correctly brush their teeth - Teach children how to correctly floss their teeth - Reduce the intake of fermentable carbohydrates Proper oral hygiene is the most effective means practiced to prevent dental caries. Not only is it important to teach children how to floss their teeth, but the nurse should also teach the parents to reinforce correct brushing techniques. This helps promote oral hygiene and prevent dental caries. Fermentable carbohydrates tend to increase the risk of dental caries and should be limited in the diet. Excess fat in the diet should not be included in the diets of children who are obese. Excess sleep in a child should not be encouraged as it makes the child more sedentary.

The nurse is assessing a child who is taking tricyclic antidepressants. The nurse advises the child to decrease the intake of refined carbohydrates in the diet. What side effect of the drug is the nurse trying to prevent? Dental caries Increased appetite Impaired glucose levels Weight gain and obesity

- Dental caries Children who are taking tricyclic antidepressants have a high incidence of developing dental caries. Therefore the nurse should recommend decreasing the intake of refined carbohydrates because they would worsen the effect. Children who are obese are asked to cut down sugar and carbohydrates in their dietary intake. These are not major side effects observed in children taking antidepressants. Children who are taking antidepressants do not experience an increase in their appetite levels but may sometimes have a decreased appetite. Impairment of the glucose levels of the child is not a side effect of antidepressants.

The nurse is teaching a group of school teachers about a smoking ban in schools. Which statements does the nurse include in the teaching? Select all that apply. Smoking bans:

- Discourage students from starting to smoke. - Promote a smoke-free environment as the norm. - Reinforce knowledge of the health hazards of smoking

During the home visit, the nurse finds that the parent of a 2-year-old child is serving food to the child immediately after coming in from play. The parent reports that the child avoids eating and has a reduced growth rate. What are appropriate responses given by the nurse?

- Don't worry, children of this age gave a reduced growth pattern - You should call the child in from play 15 minutes before mealtime

A child who is terminally ill with bone cancer is in severe pain. Nursing interventions should be based on what? Children tend to be overmedicated for pain. Giving large doses of opioids causes euthanasia. Narcotic addiction is common in terminally ill children. Large doses of opioids are justified when there are no other treatment options.

- Large doses of opioids are justified when there are no other treatment options Large doses of opioids may be needed because the child has become physiologically tolerant to the drug, requiring higher doses to achieve the same degree of pain control. Pain is considered the fifth vital sign, and management of pain is critical to treatment of a child with bone cancer. Continuing studies report that children are consistently undermedicated for pain. The dosage of opioids is titrated to relieve pain, not cause death. Addiction refers to a psychologic dependence on the narcotic medication, which does not occur in terminal care.

The nurse is teaching a group of new parents about long-term consequences of untreated pain in infants. Which statement made by a parent indicated teaching was effective "Some types of pain are good and are fine to be left untreated." "Leaving pain untreated can give kids a higher tolerance to pain later in life." "Untreated pain in infants is linked with higher incidents of pediatric cancers." "Leaving pain untreated can cause my child to have a learning deficit later in life."

- Leaving pain untreated can cause my child to have a learning deficit later in life Long-term consequences of pain include poor adaptive behaviors, learning deficits, attention deficits, psychosocial problems, and other kinds of problems. Therefore, the nurse includes this in the teaching and the reiteration by the parent indicates learning was effective. It is not true that some types of pain are good, that untreated pain builds tolerance, or that untreated pain contributes to pediatric cancers.

The parents of an 8 yeara old child tell the nurse that they are going to get a pet dog for the child. However, they are worried as their 4yo child is very scared of dogs. What advice should the nurse give to the parents?

- Let the younger child watch other children play with the dog - Do not let the younger child touch the dog unless the child is fearless

The community nurse is conducting a teaching session on good dietary habits to prevent obesity in adolescents for a group of parents and adolescents. What information does the nurse include in the teaching? Select all that apply.

- Limit eating at fast food restaurants. - Have frequent meals with other family members. - Perform mild to moderate intensity exercises regularly.

The nurse finds a child to be unmotivated and disheartened due to dysfluency in speech. What advice should the nurse give the parents to build the child's confidence in speaking? Select all that apply.

- Listen attentively to what the child says - Resist completing the child's sentences - Speak to the child in a slow and relaxed way

Which pedestrian safety rule does the nurse teach a toddler?

- Look left, right, and left again before crossing the street

The nurse is caring for a 2-year-old child who returns to the hospital floor after undergoing an operation. Which action implies that the child is in pain? SATA Loud crying Drowsiness Confused look Furrowed brow Puckering of lips

- Loud crying - Furrowed brow - puckering of lips Crying is the most common manifestation of underlying pain. The child can have furrowed brow, puckered lips, clenched teeth, and turning down of mouth as outward signs of pain. Drowsiness and confused looks are not common body signs to express pain.

Parents of a 12-year-old child inform the nurse that their child prefers spending more time with friends rather than with family members. What should the nurse inform the child's parents? "During this age, children do not like social gatherings." "During this age, children avoid interacting with others." "During this age, children enjoy the company of their peers." "During this age, children are more focused on their studies."

- During this age, children enjoy the company of their peers. Middle school-aged children tend to spend more time with their peers and enjoy their company rather than spending time with family members. Children 12 years of age and older want to be independent and tend to reject some of the parental values. The child is comfortable spending time with peers and interacting with them. Therefore the nurse cannot infer that children of age 12 years do not like social gatherings or interacting with others. Avoiding spending time with family members does not indicate that the children are more focused on their studies. However, peer influence may cause distraction from studies in some children during middle school age.

A 6-year old is hospitalized with a fractured femur. Based on the nurse's knowledge of opioid side effects, which actions should the nurse include in the patient's plan of care to prevent constipation? SATA Encourage fluid intake Encourage the child to eat fruit Administer docusate sodium (Colace) Administer diphenhydramine (Benadryl) Instruct the child to remain supine while in bed

- Encourage fluid intake - Encourage the child to eat fruit - Administer docusate sodium (Colace) Administration of Colace, a stool softener, can help prevent constipation. Increased fluid and fruit intake (high fiber content) can help prevent constipation. Increased activity helps stimulate peristalsis. Diphenhydramine does not increase peristalsis or prevent constipation.

The nurse is caring for a child recovering from ankle surgery. The child was administered an anesthetic for pain relief. What does the nurse do to prevent respiratory complications during the postoperative care? Encourage respiratory movement with incentive spirometers. Conduct hyperventilation with 100% oxygen. Initiate cooling measures such as ice packs to the groin and axillae. Change the child's position every 24 hours.

- Encourage respiratory movement with incentive spirometers. To prevent pneumonia and other respiratory complications after surgery, the nurse encourages respiratory movement with incentive spirometers or other motivating activities. Hyperventilation with 100% oxygen and cooling measures such as applying ice packs to the groin and axillae are done when malignant hyperthermia (MH) is diagnosed. The child's position is changed every 2 hours and deep breathing is encouraged.

A parent of a preschooler informs the nurse that the child spends most of the time watching television and playing computer games. On assessing, the nurse finds that the child has impaired motor skills. Which instruction should the nurse give to the parent to improve the child's motor skills?

- Encourage the child to play in a water park

After speaking with a 12-year-old child, the nurse finds that the child is a victim of bullying. Which behavioral symptoms of the child might have led the nurse to conclude this? Select all that apply. Poor academic performance High levels of enthusiasm3 Withdrawal from social activities Low self-esteem5 Readily joins in with peers

- Low self-esteem - Withdrawal from social activities Social isolation and low self-esteem are symptoms of psychological distress seen in victims of bullying. The child's poor academic performances are related to cognitive development. Therefore poor academic performance does not indicate that the child is a victim of bullying. The children are usually enthusiastic during their growth and development period, but if they are intolerably hyperactive, the child might be checked for attention deficit disorder. A bullied child is usually depressed and not enthusiastic. Bullied children tend to withdraw from social activities, and they do not readily involve in interacting with peers.

The parents tell the nurse that they are having conflicts about independence with their child. The nurse infers from this that the child is which subphase? Early childhood subphase Late adolescence subphase Early adolescence subphase Middle adolescence subphase

- Middle adolescence subphase

The nurse assess pain in a patient and rates it as 8 ( on a 0-10 numeric pain-rating scale). Which drug is the patient most likely to be prescribed? brain injury orthopedic injury 3umbar puncture pain due to chemotherapy

- Morphine (Avinza) The scale that measures the child's vocal, social, facial, activity, body, and physiologic signs is called the Non-Communicating Children's Pain Checklist. This tool is used when a child is not able to communicate. A child with brain injury would probably be unable to communicate. A child with orthopedic injury may not need non-communicating measurements of pain. Pain associated with lumbar puncture is temporary, and non-communicating techniques usually are not needed. Pain due to chemotherapy is generally treated with opioids, and a pain scale that uses verbal communication is most commonly used for patients with cancer.

The nurse is instructing aa group of parents about the prevention of sexual abuse in preschoolers. What should the nurse teach the parents to protect their children from abuse? Talk about sexual abuse with the child Leave the child with a trustworthy person Encourage the child to say no to offending touches Pay careful attention and monitor the child's activities Encourage communication with the child and take them seriously

- Encourage the child to say no to offending touches - Encourage communication with the child and take them seriously A parent should encourage the child to say no to offending touches and speak about those things with his parents. Parents need to communicate with children and make sure that there are no secrets. Often the offenders are among the trusted; therefore the parents need to be careful when leaving the child in anybody's company. In order to prevent sexual abuse, it is more important that the parents carefully monitor the people who are around the child rather than the child's activities. Unlike school-age children and adolescents, preschoolers may not understand sexual abuse. Therefore discussing sexual abuse may not be helpful for the child.

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?

- Encourage the toddler to do things for himself or herself when he or she is capable of doing them

The nurse assesses an adolescent girl and finds stage 2 development of the breasts. What changes in the girl support the observations?

- Enlargement of the areolar diameter and small area of elevation around the papilla the physical changes of puberty are primarily the result of hormonal activity. The initial indication of puberty is the appearance of breast buds. Nurses should assess physical and psychological changes as part of routine health checkups. Stage 2 is the breast bud stage, characterized by a small area of elevation around the papilla and enlargement of the areolar diameter. Stage 4 includes projection of areola and papilla to form a secondary mound, with increased breast size and elevation. In stage 3, the breast begins to appear more elevated, without separation of the contours. In stage 5, the breast reaches final adult size, and projection of the papilla only is caused by recession of the areola into the general contour.

The nurse is assessing an adolescent with anorexia nervosa. Which test should be done to detect inflammation?

- Erythrocyte sedimentation rate

The nurse is educating a 7-year-old patient and the patient's family about a scheduled ankle surgery. The patient is very distractible and seems to show little interest. What is an appropriate nursing action in this context? Ask parent to teach the child later. Give sweets to the child to attract attention. Administer coffee to the child to retain attention. Schedule another individual session with the child

- Schedule another individual session with the child. Schedule another individual session with the child.Children who are distractible and highly active or those who are "slow to warm up" may need individualized sessions that are slowly paced. One session may not be sufficient for educating them if they are not paying attention. Giving sweets to the child may make the child demand sweets in every session, and will not result in effective learning. Giving coffee to children is inappropriate as caffeine can be too strong for them. Asking parents to teach the child later may not be effective because parents may not be able to recall enough information.

The nurse assesses a toddler who is anxious because the parents are getting divorced. What behaviors does the nurse see when caring for this child? .

- Separation anxiety - Fear and confusion - Regressive behaviors

The nurse is organizing a parenting program to prevent behavioral problems in adolescents. What topics will the nurse cover in this parenting program?

- Sexuality education - Importance of peer relations

The nurse is giving sexual education to a group of late adolescents. What sort of language should the nurse use for this audience?

- Simple scientific terminology while educating

A parent asks the nurse in the well-baby clinic, "Which toy should be given to the 3-month-old infant?" Which toy does the nurse suggest to the infant's parent?

- Soft stuffed toy

. How can poisoning in toddlers best be prevented?

- Storing poisonous substances in a locked cabinet

A child undergone a lumbar puncture for chemotherapy. As a result, this child has developed a postdural puncture headache. How should the nurse position this child in order to relieve the postdural puncture headache? Sitting position for 1 hour after the procedure Supine position for 1 hour after the procedure Supine position for 10 minutes after the procedure Walking slowly for 20 minutes after the procedure

- Supine position for 1 hour after the procedure Postdural puncture headache is a common complication after a lumbar puncture. In this scenario, the nurse should position the patient properly. The nurse should make this patient lie down in the supine position for 1 hour after the procedure. Twenty minutes is insufficient to relieve the headache. Sitting or walking around will not relieve the headache.

The nurse is caring for a child after a heelstick procedure. What is the best measure to reduce the child's pain and discomfort after the procedure? Switching off all the lights in the child's room Playing music in the room and dimming the lights Swaddling the child after the procedure is finished leaving the child alone and allowing relaxation time

- Swaddling the child after the procedure is finished It has been proven that children who get physical contact while in pain are more comforted. Swaddling is the most appropriate technique to comfort a child. Switching off the lights, leaving the child alone in the room, or playing music will not comfort the child. The child may feel frightened and distressed if such measures are taken.

An adolescent female has a moderate flow of menstrual blood and there are no clots in it. She has frequent menses. On examination, her skin is pale. What should the nurse advise this girl? "Take calcium-rich food, it will prevent osteoporosis." "Start hormonal replacement therapy for blood loss." "Take iron-rich foods such as green leafy vegetables." "Do not take iron pills; it will aggravate your blood loss.

- Take iron rich foods such as green leafy vegetables.. Blood loss due to menstruation causes iron-deficiency anemia in adolescents. Therefore, the nurse should advise the patient to take iron-rich food or iron pills to improve the levels of hemoglobin. Calcium tablets are not required for anemic patients. Calcium supplements are indicated for postmenopausal women. Hormone replacement therapy is not indicated for this girl, as it will not improve hemoglobin level.

A 9-year-old child reports having a headache, stomach pain, and neck pain. On examination the nurse finds that the child is jittery and has a flushed face and a fast heartbeat. What is the nurse's next intervention? Talk to the child and explore in depth the child's symptoms Advise the parents to provide complete bed rest for the child Inform the parents that the child needs immediate hospitalization Advise the parents that these symptoms are common for this age

- Talk to the child and explore in depth the child's symptoms The signs and symptoms of the child are indicative of stress. Once stress is suspected, the nurse should talk to the child and explore more of the symptoms to determine the reason behind the stress. Parents and children should be taught the symptoms to recognize stress and also formulate strategies to be used to cope with it. It is not necessary for the child to have complete bed rest or hospitalization. These symptoms are not common in this age group.

The parents of a toddler ask the nurse how to handle their child's increasing number of temper tantrums. Which positive reinforcement methods for reducing the number of tantrums should the nurse include?

- Tell parents not to give in to the original request that started the temper tantrum - Suggest that parents ignore the behavior as long as child is not harming himself - Encourage the parents to provide comfort once the child has calmed down - Ask parents to praise the child for positive behavior when not having a tantrum

A male adolescent asks the nurse, "How will I know if I'm going through puberty?" The nurse discusses physical changes that usually occur, the first change being what?

- Testicular enlargement

The nursing student asks the senior nurse, "Which are the suitable play items for an 8-month-old infant?" Which suitable play items does the nurse suggest to the nursing student? Textured book Modeling clay Stuffed animal Play telephone Hanging mobile

- Textured book - Stuffed animal - Hanging mobile

. An adolescent is brought to the emergency department after sustaining a small clean cut to his right thumb. The nurse learns that the adolescent sustained injury with a clean, unused knife. On examination, the nurse finds that the cut measured 1 x 1 cm and is not contaminated. The adolescent has been immunized against tetanus in childhood but has never taken a booster dose. The most appropriate step of the nurse would be to inform the parent of what?

- The adolescent requires a tetanus booster dose.

The nurse suspects tissue injury in an infant on intravenous therapy. What parameters will the nurse assess to determine tissue injury? Select all that apply. The amount of redness Blanching The amount of swelling Quality of pulses above infiltration Coolness of the area

- The amount of redness - Blanching - The amount of swelling - Coolness of the area The nurse adheres to certain guidelines available for determining the severity of tissue injury. Staging characteristics, such as the amount of redness, blanching, the amount of swelling, pain, capillary refill, and warmth or coolness of the area, are used to determine severity. The quality of pulses below infiltration is assessed and not above it.

. What appropriate growth and developmental changes can be observed in a toddler?

- The anterior fontanel closes at 18 months of age. - The toddler is able to take a few steps on tiptoes by the age of 30 months. - The toddler can run fairly fast with a wide stance by the age of 24 months.

The nurse is caring for a child who is scheduled to undergo an ostomy procedure. What are possible causes for a child to need undergo an ostomy procedure? . Necrotizing enterocolitis Hirschsprung disease Crohn disease Diseases of the bladder Difficulty urinating

- Necrotizing enterocolitis - Hirschsprung disease - Crohn disease - Diseases of the bladder A stoma is an opening, either natural or surgically created, which connects a portion of the body cavity to the outside environment. Children may require stomas for various health problems such as necrotizing enterocolitis, imperforate anus, and Hirschsprung disease. In older children, the most frequent causes are Crohn's disease and ureterostomies due to bladder defects. Difficulty in urinating is not reason enough for an ostomy unless the health care provider has diagnosed an underlying disorder that requires an ostomy. The nurse is caring for a child who is scheduled to undergo an ostomy procedure. What are possible causes for a child to need undergo an ostomy procedure? Select all that apply.1Necrotizing enterocolitis2Hirschsprung disease3Crohn disease4Diseases of the bladder5Difficulty urinating 2

Which assessment scales rate pain using the straight line method? SATA Face, Legs, Activity, Cry, Consolability (FLACC) scale Numeric scale Color tool scale Visual analog scale Word-graphic rating scale

- Numeric scale - Visual analog scale - Word-graphic rating scale The numeric scale is a pain assessment method that uses a straight line with divisions marked as scores, with one end written as "No Pain" and the other as "Worst Pain." The child is asked to point at the divisions, and the pain is scored accordingly. The visual analog scale also uses a straight line where the divisions are marked as scores. One end of the scale is marked "No Pain" and other as "Worst Pain." The word-graphic rating scale uses descriptive words marked on the line to denote varying intensities of pain. The FLACC scale involves observing and rating the behavioral patterns of the child. The color tool scale uses markers for a child to create his or her own scale by representing the pain experienced using different colors.

An adolescent arrives at the clinic with the parent for a routine examination. The parent reports to the nurse that the adolescent has irregular sleep patterns and watches television until late at night. What nursing intervention will the nurse perform next?

- Obtain a history of sleep patterns

The nurse is caring for an adolescent who is scheduled to undergo an appendectomy. What does the nurse ensure prior to the surgical procedure? 1 Obtain the patient's consent only. 2 Obtain consent from patient and patient's parents. 3 Obtain patient's assent and consent from parents. 4 Obtain assent from parents and patient's consent

- Obtain patient's assent and consent from parents. Assent means that the child or adolescent has been informed about the proposed treatment. The patient may not have enough maturity to give consent. Decision making involving the care of older children and adolescents should include the patient's assent (if feasible) and the parent's consent. Assent means that the child or adolescent has been informed about the proposed treatment. The patient may not have enough maturity to give consent. So obtaining the patient's consent is not necessary. Parents are the legal guardians of the patient so their consent is mandatory. Obtaining only their assent is a violation of law.

Parents report that their child is often fussy during mealtimes. After assessment, the nurse finds that the child has very strong taste preferences. Which instructions should the nurse give the parent to encourage good eating habits in the child?

- Offer the child a variety of healthy foods - Encourage the habit of having the entire family at meals - Be a proper role model to the child while teaching healthy eating habits

A 10-year-old patient is scheduled for a minor surgery of the ankle. The patient's parents' are divorced. What is an important consideration for this patient while obtaining consent? Consent of both father and mother is mandatory. Either the father or the mother can give consent. Consent of father, mother, and the child is mandatory. Only the parent with legal custody is required to give consent.

- Only the parent with legal custody is required to give consent As long as children are under the age of legal consent, their parents or legal guardians are required to give informed consent before medical treatment is rendered or any procedure is performed. If the parents are divorced, consent usually rests with the parent who has legal custody. Consent of both parents is not necessary. If the parents are still married, consent from only one parent is required for nonurgent pediatric care. The child's assent is taken, not consent.

A patient who is on opioid therapy reports having no pain relief from the previously prescribed dosage. The primary health care provider increases the dosage. The dosage is increased because the patient has symptoms of what? Opioid addiction Opioid tolerance Opioid withdrawal Opioid dependence

- Opioid tolerance If the patient reports having no pain relief for the prescribed dosage of opioids, it indicates that the patient has developed opioid tolerance. In this condition the dosage may be increased to provide effective pain relief to the patient. If the patient feels the need to administer the drugs without cause (pain), then the patient has opioid addiction or opioid dependence. Depression, lacrimation, irritability, and anorexia are symptoms of opioid withdrawal.

A 16-year-old obese adolescent has body mass index more than 2 units above the 95th percentile for his age and sex approaches the nurse for pharmacologic management of obesity. What drug does the nurse expect to be included in the treatment plan in addition to diet management?

- Orlistat (Alli)

The nurse assesses pain in a 9-year-old using a Hispanic version numeric scale with pain intensity ratings of 0 to 100. Which scale is the nurse using? Bieri scale Oucher Pain Scale Numeric rating scale Adolescent Pediatric Pain Tool

- Oucher Pain Scale The Adolescent Pediatric Pain Tool is a multidimensional scale where intensity, quality, and type of pain are assessed; it is available in a Spanish version. The Bieri scale is a face scale where pain is assessed with faces. It does not assess the intensity, quality, and type of pain. The Oucher Pain Scale was developed to assess pain intensity in children who do not communicate in English and is designed to avoid cultural influences in pain management. The numeric rating scale uses numeric ratings on a line from 0 to 10 to measure pain intensity.

The nurse assesses pain in a child by determining the child's functioning in school as one of the assessment parameters. What type of pain is the nurse assessing in the child? Pain due to migraine Pain due to skin burns Pain due to appendectomy Pain due to orthopedic injury

- Pain due to migraine The assessment tool in which a child's school functioning is noted, PedsQL, is usually used for assessing chronic pain. Migraine pain is chronic or recurrent and may have a major impact on the child's performance in school. Skin burns, surgeries such as appendectomies, and orthopedic injury are all associated with acute pain, and assessment of acute pain does not include the assessment of the child's performance in school.

The nurse is assessing a child for attention deficit hyperactivity disorder (ADHD). The nurse rates the child's characteristics as eight symptoms of hyperactivity-impulsivity and three symptoms of inattention. What type of ADHD does the child have?

- Predominantly hyperactive-impulsive Rational: When the child has eight symptoms of hyperactivity-impulsivity and three symptoms of inattention, then these characteristics belong to the predominantly hyperactive-impulsive type of ADHD. A cognitive learning disability is a serious disorder where the child is unable to listen, understand, reason, or use mathematical skills. This requires medical supervision for treatment. The combined type of ADHD occurs when a child shows six symptoms of hyperactivity-impulsivity and six inattention symptoms. The predominantly inattentive type is one of the major forms of inattention seen in children. Children with predominantly inattentive type of ADHD have fewer than six symptoms of hyperactivity and impulsivity.

an infant died in the hospital due to unexplained reasons. the hospital staff intends to keep the infant for a postmortem examination. what is an appropriate next step?

- Proceed with the postpartum examination

A community health nurse is planning to develop a program for prevention of drug abuse in a community where most of the adolescent are addicted to cocaine. What kinds of programs are most likely to be successful?

- Programs focusing on academic achievement - Programs focusing on resisting peer pressure - Programs aiming at promoting good parenting skills

The nurse is organizing a school-based antismoking program. Which goals should the nurse include in the antismoking program to motivate the youth against smoking? Select all that apply.

- Promoting a smoke-free environment - Discouraging students from starting to smoke - Educating about the health hazards of smoking

The nurse is providing care to a child with chronic back pain. The parents express hesitation in giving the child pain medication. What is the best response by the nurse? Suggest the parents ask other parents what they use for their children's pain. Ask the parents if something traumatic happened to them regarding the use of pills. Tell the parents that there is nothing wrong with drugs, and children use them all the time. Recommend the parents ask the health care provider about chiropractors and massage therapy.

- Recommend the parents ask the health care provider about chiropractors and massage therapy The nurse can tell parents who are hesitant about using pharmacologic methods of pain treatment about complementary and alternative medicine options, such as going to the chiropractor or getting massage therapy. What works for one child may not work for another, so it is unsafe to suggest the parents ask other parents. Telling the parents drugs are fine for children and asking about their own experiences with pills are responses that do not address the question and are nontherapeutic

The nurse is caring for an adolescent with severe malnutrition. What will the nurse keep in mind when planning nutrition therapy for malnutrition? refeeding syndrome is avoided with slow refeeding. Nutrition therapy is not based on stage of puberty. The goal is eventual intake of 2000 to 3000 kcal per week. The goal includes weight gain of 0.22 to 0.45 kg (0.5-1 pound) per day.

- Refeeding syndrome is avoided with slow refeeding. Refeeding syndrome is manifested by cardiovascular, neurologic, and hematologic complications that occur when nutritional replacement is given too rapidly in patients with malnutrition. This syndrome can be avoided with slow refeeding. Nutrition therapy is based on stage of puberty, growth, and development. The goal of nutrition therapy is to reach an eventual intake of 2000 to 3000 kcal per day, not per week. During nutrition therapy, a weight gain of 0.22 to 0.45 kg (0.5-1 pound) per week, not per day, is desirable.

A 7-year-old female child has a fever associated with a viral illness. She is being cared for at home. The nurse should recognize that the principal reason for treating fever in this child is what? Relief of discomfort Reassurance that illness is temporary Prevention of secondary bacterial infection . Prevention of life-threatening complications

- Relief of discomfort Relief of discomfort is the primary reason for treating a fever with pharmacologic or environmental interventions. Treatment does not provide reassurance that illness is temporary. Fever-reducing medications (acetaminophen and ibuprofen) do not have antibacterial actions and may inhibit the fever-enhancing effects on the immune system. Fever-reducing medications do not prevent life-threatening complications.

The nurse is educating parents about ways to prevent and treat burns to a group of families. What first aid measures does the nurse teach the parents?

- Remove the burned clothes and jewelry - Cover the burn area, ideally with a cling film - Remove the person away from the source of the heat

When changing a dressing on the leg of a 16-year-old patient who suffered second-degree burn injuries, which characteristics of pain expression does the nurse expect to observe? SATA Stomping feet on the ground and screaming, "No!" Attempting to move leg out of reach of the nurse. Repeatedly stating, "You're hurting me." Clinching fists and tensing arms in anticipation. Scooting away and asking parents to stop the nurse.

- Repeatedly stating, "You're hurting me." - Clinching fist and tensing arms in anticipation Developmental characteristics of the adolescent's response to pain include: less vocal protest; less motor activity; more verbal expressions (such as "It hurts" or "You're hurting me"), and increased muscle tension and body control. Stating, "You're hurting me" and muscle tension are expected responses to pain for the adolescent.

A 5 y/o child presents with a fever, cough, and flu-like symptoms. On examination, the nurse finds that the child's temperature is elevated and respiratory rate is increased. The nurse also notices wheezing on auscultation, a fracture in the right forearm, and bruises near the elbow and knees. What should be the most appropriate response of the nurse?

- Report to the child welfare department as it can be aa case of child abuse - Confer with the HCP and admit the child into the hospital immediately

The school nurse is interacting with a school principal to implement measures to prevent smoking in their school. What instructions should the nurse give to the principal? Select all that apply

- Request for order of complete ban on smoking within the school premises - Organize a peer-led program emphasizing social consequences of smoking - Emphasize on short-term effects of smoking rather than on long-term effects - Consider expanding school-based programs to include parents and mass media

What is a common postoperative complication of anesthesia?

- Respiratory tract infections

At the beginning of the school year, the school nurse identifies several new children at the school. The nurse knows that which factors place the children at high risk for adjustment problems? Select all that apply. The child is from a middle class family. The child appears physically immature. The child exhibits signs of emotional immaturity. The child has not attended a preschool program. The parents of a child demonstrate warm, loving behaviors.

- The child appears physically immature. - The child exhibits signs of emotional immaturity. - The child has not attended a preschool program. Successful adjustment is related to the child's physical and emotional maturity and the parent's readiness to accept the separation associated with school entrance. Unfortunately, some parents express their unconscious attempts to delay the child's maturity by clinging behavior, particularly with their youngest child. Middle-class children have fewer adjustments to make and less to learn about expected behavior because schools tend to reflect dominant middle-class customs and values. If the child has attended a preschool program, the focus of the preschool program also affects the child's adjustment. Some preschool programs provide custodial care only, but others emphasize emotional, social, and intellectual development.

The nurse is working with the parents of an 8-year-old child and discovers that the child has bedtime problems. The nurse instructs the parents to encourage a quiet activity before bedtime. Why does the nurse recommend this intervention? The child often wets the bed. The child snores during sleep. The child does not go to sleep. The child talks in his or her sleep.

- The child does not go to sleep. Rational When children have difficulty going to bed, they need quiet activities such as reading or coloring. These activities decrease the amount of stimuli and help them relax and be ready to go to sleep. This, in turn, helps resolve bedtime problems. Talking in the sleep is common in children and does not require intervention. Bed-wetting is normal in preschoolers and occasionally in young school-age children. However, if the problem continues in later ages, a medical consultation is necessary. The child may snore a little during sleep, but this does not necessitate quiet activities before bedtime.

The nurse is assessing the oral cavity of a child. The nurse instructs the child to floss the teeth regularly and use a fluoride toothpaste for brushing. Why did the nurse give this instruction to the child?

- The child had bleeding gums with plaque. Rational: Dental problems are commonly observed in children, but most of them are ignored. The child who has inflammation that causes the gums to bleed and has plaque most likely has gingivitis. The nurse should recommend that the child regularly brush and floss the teeth. Fluoride-based toothpaste is also used to reduce plaque. When the child experiences a dental injury from sports or any other cause, it may cause a fracture, chipping, and dislocation of the teeth. This needs immediate attention by a dentist. When a tooth is reimplanted in a child, it is recommended to not floss for a particular duration of time. Children develop their permanent teeth when they are school-age.

A child is on opioid therapy has come for a follow-up visit to a pain clinic. After assessment, the health care provider adds methylphenidate (Methylin) to the child's regimen. What could be the reason for adding this drug? The child had: pruritus. experienced sedation. dysphonia. respiratory depression.

- The child had experienced sedation Pruritus, sedation, dysphoria, and respiratory depression are side effects of opioid therapy. Methylphenidate (Methylin) is given as an adjuvant drug to reduce the sedation caused by opioids. Hydroxyzine (Hypam) is used to treat pruritus. Haloperidol (Haldol) is used to treat dysphoria. Naloxone (Narcan) is used to treat respiratory depression.

The primary health care provider (PHP) prescribes a psychostimulant drug for a child. The nurse checks the medical history of the child and requests that the PHP change the drug. What would be the possible reason for the nurse to make such a request? The child has malocclusion. The child has had physical trauma. The child demonstrates dysgraphia. The child has a history of facial tics.

- The child has a history of facial tics. Psychostimulant drugs are given to children for the treatment of attention deficit hyperactivity disorder (ADHD). These drugs should be avoided in children who have a history of tic like behaviors because they can worsen the symptoms. Physical trauma refers to a serious injury resulting from an assault, a natural disaster, or a sports injury. Dysgraphia is a condition where a child has difficulty with writing. Psychostimulant drugs do not affect the oral health of the child. These drugs are not known to aggravate malocclusion problems. Orthodontic treatment is successful for malocclusion problems.

The nurse is assessing a child with attention deficit hyperactivity disorder (ADHD) and finds underdeveloped fine motor skills. The nurse instructs the teacher to provide the child with a computer. Which findings in the child prompt the nurse to do so?

- The child has difficulty in writing. Rational: The child who has ADHD would face difficulty in writing, which is referred to as dysgraphia. The child should be assisted by integrating a computer into the classroom for the child's use because handwriting may not improve. A visual defect is not a sign of ADHD. In such a case, the child must be evaluated by a medical professional. A learning disability is a disorder in which children find difficulty in learning new things. Children with ADHD have reduced attention span, which may impair their ability to learn. However, learning disability is not a sign of fine motor impairment. Hearing impairment is not a sign associated with ADHD.

After assessing a 24-month-old child, the nurse tells the child's parent that the child has age-appropriate growth and development. Which characteristics does the nurse observe in the child?

- The child is able to build a tower of seven cubes. - The child is able to turn the pages of a book one at a time. - The child is able to kick a ball forward without overbalancing

The nurse is caring for a hospitalized child suffering from Munchausen syndrome by proxy. What findings in the child are supportive of the diagnosis? The caregiver ignores the child's symptoms. The child is managed with basic medical treatment. The child's medical history has minimal diagnostic evidence. The child is being primarily treated to satisfy the caregiver's demand.

- The child is being primarily treated to satisfy the caregiver's demand. Munchausen syndrome by proxy is a form of medical child abuse where the primary health care providers are misled by parents. The parents exaggerate the child's symptoms and history, and the child undergoes physical, emotional, or psychological abuse. The caregiver's demand for unnecessary medical procedures and exaggerating of the symptoms are indicative of Munchausen syndrome by proxy. The long medical history and unnecessary and inconclusive diagnostic reports also support the diagnosis.

A child is brought to the emergency department after falling down the basement stairs. On assessment, what findings may cause the nurse to suspect child maltreatment? The child's bruises are located only on the right arm and leg. The child is brought to the emergency department by an unrelated adult. The child has a history of a broken arm last year from falling off a swing. The child's caregiver is anxious that the child get immediate medical attention. The child has red, green, and yellow bruises on more than one plane of the body.

- The child is brought to the emergency department by an unrelated adult. - The child has red, green, and yellow bruises on more than one plane of the body.

The nurse advises a working single parent to enroll his or her child in an after-school program. What could be the reason behind the nurse's advice? The child may be lonely and fearful. The child fails to have snacks available. The child has a developmental disorder. The child prefers to spend time outdoors.

- The child may be lonely and fearful. After-school programs are generally arranged for latchkey children. These children usually have working parents or may live with one parent who works. They have no proper supervision after coming home from school. These children may feel lonely and fearful, and parents are advised to enroll the children in an after-school program. An after-school program is not necessary just because the child does not have an after-school snack available. Children with developmental disorders need to attend special training programs rather than an after-school program. When the child plays outdoor games, it signifies that the child is developing good social interactions. These children do not have to attend an after-school program.

The nurse assesses a child with cerebral palsy. Which response from the child indicates to the nurse the child is in pain?

- The child moans.

A 9-year-old child is put on tricyclic antidepressants for attention deficit hyperactivity disorder (ADHD). How does the nurse advise the parents of this child? Select all that apply. The child should be advised to limit physical exercise. The child should have a dental checkup done regularly. The child should be encouraged to have plenty of oral fluids. The child should have limited intake of refined carbohydrates. The child should be referred to a cardiologist at the earliest date possible.

- The child should have a dental checkup done regularly. - The child should be encouraged to have plenty of oral fluids. - The child should have limited intake of refined carbohydrates The anticholinergic action of tricyclic antidepressants leads to increased viscosity of saliva and dry mouth. These drugs lead to increased incidences of dental caries. Therefore the nurse should advise the parents to encourage the child to take more oral fluids, take the child for regular dental visits, and limit the intake of refined carbohydrates. Tricyclic antidepressants do not affect the cardiac system, and so it is not required for the child to limit physical activity or to have regular visits to the cardiologist.

A child is diagnosed with attention deficit hyperactivity disorder (ADHD). What symptoms in the child support the diagnosis? Select all that apply. The child squirms when sitting in a seat. The child does not talk to others frequently. The child is interested in quiet-time activities. The child refuses to work on a jigsaw puzzle. The child cannot remember instructions given.

- The child squirms when sitting in a seat. - The child refuses to work on a jigsaw puzzle. - The child cannot remember instructions given. Rational: Children with attention deficit hyperactivity disorder (ADHD) have three major symptoms: inattentiveness, hyperactivity, and impulsiveness. The children squirm when seated, which signifies hyperactivity. Children with ADHD dislike engaging in activities that require concentration and a lot of mental effort. Therefore putting together a jigsaw puzzle would be difficult for a child with ADHD to perform. Children with ADHD tend to forget things very easily because they have difficulty paying attention to the directions given. Children tend to talk too much when they are hyperactive. This is a sign of ADHD. Children with ADHD show less interest in activities that keep them quiet or that are time consuming.

A child is supposed to be administered opioids, and the nurse finds that the child's weight is 56 kg (123 lb). How would this child's dosage differ from that of average-sized of the same age? The dosage would be smaller. The dosage would be greater. The dosage would be the same. An adjuvant drug would be added.

- The dosage would be greater Generally children metabolize the drugs faster than adults. Therefore the recommended dosages for normal-size children are lower than those of adults. Drug availability and absorption are lower in children who have more adipose tissue. Therefore children who weigh more than 50 kg (123 lb) need a higher dosage of drug than average-sized children of the same age group. A lower dosage will not yield the desired therapeutic effects in this child. Adding another drug may result in harmful drug interactions and therefore should be avoided. Administering same dosage of the drug will not yield the desired therapeutic effect.

The nurse assess an older infant's response to pain. Which finding concerns the nurse?

- The infant does not show a localized body response

Which activity does the nurse expect to observe in a 4-month-old infant?

- The infant grasps an object by using both hands.

. The parents report to the nurse that their infant has difficulty sleeping because of prolonged nighttime feedings. What instructions does the nurse give to the parents?

- The infant should go to bed awake - Increase daytime feeding intervals - Offer last feeding as late as possible

The nurse finds that a child has several dental caries. The nurse learns that the child refuses to go to sleep without a bottle full of juice. How does the nurse promote dental health in the child?

- The nurse tells the child to drink juice in a cup. - The nurse instructs that dental caries can be prevented. - The nurse uses the reward technique to change behavior.

After administering an injection, the nurse provides containment by covering the infant with a blanket roll. What are the probable reasons for this nursing intervention? SATA To decrease stress To keep the child awake To increase the heart rate To make the child feel warm To make the infant feel secure

- To decrease stress - To make the infant feel secure Containment is a nonpharmacological approach that helps the child feel secure and reduces stress. It can help the infant settle down and stop crying. This therapy is not performed to keep the child awake, and in fact it can help the child sleep. Containment is intended to reduce or maintain the heart beat, not increase it.

The nurse gives a pacifier coated with sugar syrup to an infant before a heel puncture. What is the reason for it? SATA To relieve the pain To energize the infant To increase drug absorption To increase hormonal activity To decrease behavioral activity

- To relieve the pain - To decrease behavioral activity In this situation, the nurse is using the nonnutritive sucking technique in reducing pain. The nurse gives a pacifier to the infant before minor painful procedures such as heel punctures. This helps reduce behavioral, physiologic, and hormonal responses to pain. This technique does not energize the neonate. Nonnutritive sucking is believed to reduce hormonal activity and thus reduce pain perception. Nonnutritive sucking has no effect on the kinetics of the drug.

The nurse caring for a child with cancer reports to the primary health care provider (PHP) that the child has stabbing and burning sensations in the legs and arms. The PHP prescribes amitriptyline (Elavil) to the child. What is the reason for prescribing amitriptyline to the child? To treat cancer To treat seizures To treat neuropathic pain To treat myocardial infarction

- To treat neuropathic pain Stabbing and burning sensations in the arms and legs are symptoms of neuropathic pain. Amitriptyline is prescribed for the treatment of neuropathic pain, which is associated with cancer. Unlike anticancer medications such as cisplatin (Platinol), amitriptyline cannot be prescribed for the treatment of cancer. Amitriptyline is a tricyclic antidepressant, and it cannot treat seizures, which are treated with anticonvulsant medications. Aspirin (Acuprin) is prescribed to treat the pain associated with myocardial infarction.

The school nurse is called to attend to a 7-year-old child whose tooth is avulsed while playing. The nurse finds the avulsed tooth on the ground. What is the most appropriate step taken by the nurse? Transport the child immediately to a dentist for further care Hold the tooth by its root and rinse it in running water to wash off dirt Dispose of the tooth and apply a dressing on the wound to prevent infection Insert the tooth back into the socket with the concave surface facing front towards the lip side

- Transport the child immediately to a dentist for further care An avulsed tooth should be replanted and stabilized as soon as possible to reestablish the blood supply. This increases the chances of the tooth being kept alive. Therefore the child should be immediately transported to the dentist. The nurse should hold the tooth by its crown and rinse it under running water. Then the nurse should insert it back into the socket with the convex side facing front towards the lip side. Disposing of the tooth is not advisable as the tooth can be reimplanted.

The nurse is caring for a child who is prone to pressure ulcers. What interventions by the nurse would ensure appropriate skin care? a. Use minimum tape. b. Alternate electrode sites .c. Always keep the skin wet. d. Massage reddened bony prominences. e. Use non-alcohol-based moisturizing agents.

- Use minimum tape - Alternate electrode sites - Use non-alcohol-based moisturizing agents

An adolescent is brought to the emergency department with multiple injuries sustained during a drag race. After the treatment, what does the nurse instruct the adolescent about safe driving? Select all that apply. Use safety apparel pants Use safety apparel like helmets Do not use of alcohol when driving Avoid drag racing on regular streets Use text messages instead of calls while driving

- Use safety apparel pants - Use safety apparel like helmets - Do not use of alcohol when driving - Avoid drag racing on regular streets

The nurse is caring for a 17-year-old obese adolescent who has a body mass index (BMI) more than 2 units above the 95th percentile for age. Which vitamins does the nurse expect to be included in the prescription along with orlistat (Alli)? Select all that apply.

- Vit A - Vit D - Vit K - Vit E

The nurse is assessing an adolescent who lost 4.5 kg (10 lb) of weight suddenly. Which assessments are needed to identify the cause of weight loss? Select all that apply.

- Vital signs - Changes in behavior - Patient characteristics

The nurse finds that an intravenous fluid has leaked into the surrounding tissue of a child. Which characteristics is the nurse likely to assess in the child? Warmth of the area Blanching The amount of swelling Quality of pulses above infiltration Erythema

- Warmth of the area - Blanching - The amount of swelling - Erythema The nurse follows guidelines available for determining the severity of tissue injury by staging characteristics such as the warmth or coolness of the area, blanching, the amount of swelling, pain, capillary refill, and erythema. The quality of pulses below infiltration is assessed and not above it

The nurse is instructing a group of parents about the prevention of communicable diseases, what measures do the parents need to follow to prevent the spread of diseases?

- Wash hands frequently - Vaccinate the child on time - Follow the hygiene measures

The nurse asks the patient's surrogate to rate a global judgment of satisfaction with the patient's pain treatment. What parameters should the nurse assess? SATA

- What side effects were observed? - To what extent was the pain relieved? - Has the patient emotionally recovered?

The nurse is caring for a child with a head injury. After a few days, the child is again hospitalized with a fractured leg. What could be the possible reason for the child's frequent injuries? Low cognitive development Physical abuse by the parents Physical neglect by the parents Aggressive behavior of the child

- physical neglect by the parents A child who is physically neglected by the parents is prone to frequent injury due to lack of supervision. A physically abused child typically has injuries such as burns or belt marks, not leg fractures and head injuries. An aggressive child usually harms his peers, not himself. Low cognitive development is indicated by reduced thought processes and reduced intelligence. Frequent injuries do not reflect low cognitive development.

The nurse is doing preoperative teaching with a child and his parents. The parents say that he is "dreading the shot" for premedication. The nurse's response should be based on the knowledge that: Preanesthetic medication can only be given intramuscularly The child will have no memory of the injection because of amnesia In children, the intramuscular route is safer than the intravenous (IV) route. Preanesthetic medication should be atraumatic, using oral, existing intravenous, or rectal routes.

- preanesthetic medication should be atraumatic, using oral, existing intravenous, or rectal routes. The necessity of premedication is being investigated. If necessary, numerous drug regimens and routes exist. Preanesthetic medicines can be given in a variety of routes other than intramuscular. The IV route is preferable. The muscle may be sore following the injection.

A 3.5 years old boy talks to himself and sometimes talks to the toys. The child has telegraphic speech. What should the nurse tell the parent of the boy? "Talking to toys is normal but talking to oneself is abnormal." "Talking to oneself is normal but talking to toys is abnormal." "Read stories to your child as it programs words into the memory bank." "By this age, your child should be able to form sentences of about 14 words."

- read stories to your child as it programs words into the memory bank

. A 4-year-old boy has been having increasingly more frequent angry outbursts in preschool. He is very aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. The MOST appropriate intervention is to:

- refer to professions

The nurse is assessing a child with stomach pain. The child's parents tell the nurse that the child had similar symptoms last month, which resolved spontaneously. After the assessment, the nurse finds that the child is free of infection. What does the nurse suggest to the child's parents? Avoid giving foods high in dietary fiber Continue follow-up visits every 6 months Regularly monitor the symptoms of pain in the child Prevent the child from doing deep breathing exercises

- regularly monitor the symptoms of pain in the child Recurrent abdominal pain is defined as abdominal pain that occurs at least once a month for 3 consecutive months. Treatment must be given even if there is no evidence of infection. The nurse should ask the parents to continuously monitor the symptoms of pain in the child. Food rich in fiber must be given to the child, because it prevents constipation and prevents abdominal pain. Because recurrent abdominal pain occurs for at least 3 consecutive months, a follow-up visit every 3 to 4 months is necessary. The child may feel stressed by the pain, so the nurse should teach the child relaxation techniques such as deep breathing.

An infant's parent reports to the nurse that the infant is very irritable has difficulty sleeping, and refuses to eat solid foods due to teething. What nursing interventions should the nurse include in the plan of care to make the infant comfortable? Provide hard candy for the infant Give ibuprofen (Advil) to the infant Use frozen liquid-filled teething rings Rub the infant's gums with salicylates

-Give ibuprofen (advil) to the infant

What interventions does the nurse take to ensure appropriate skin care for a child on a ventilator? Select all that apply.

-Place gel pillows under pressure points. - Keep the bedding smooth and free from wrinkles. - Keep tubes and wires from lying under the bedding. - Apply a hydrocolloid barrier to protect the facial cheeks.

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's BEST reply? A pacifier should be substituted for the thumb. Thumb-sucking should be discouraged by age 12 months. There is no need to restrain nonnutritive sucking during infancy. Thumb-sucking should be discouraged when the teeth begin to erupt.

-There is no need to restrain nonnutritive sucking during infancy.

Which normal findings (age and developmentally appropriate) does the nurse find during the assessment of a 5-month-old child? . Startle reflex Tooth eruption Babinski reflex Tonic neck reflex Doubling of birth weight

-Tooth eruption - Babinski reflex - Doubling of birth weight

The nurse is preparing to insert a nasogastric (NG) tube for a child with impaired swallowing capacity. Arrange the steps of the procedure in the correct order.

1) Place child supine with head slightly hyperflexes. 2) Measure the tube for approximate length and insert 3) Once inserted, stabilize the tube by holding or taping it to the cheek. 4) Prior to feeding, warm the formula to room temperature. 5) following feeding, flush the tube with sterile water.

Steps for placing an NG tube and administering feeding

1) supine position 2) Measure the tube for length of insertion 3) Insert the tube after it has been lubricated 4) confirm placement 5) stabilize the tube 6) warm the pumped breast milk and administer slowly 7) flush the tube 8) clamp the tube 9) record the feeding

What is the daily requirement of calcium for children 1 to 3 years of age? Record your answer using a whole number.

500 mg/day

During an assessment, the nurse finds that a child is depressed, frightened, and has low grades in school. By which age-group do children usually worry about school grades? 5 and 6 years of age 6 and 7 years of age 7 and 8 years of age 8 and 9 years of age

8 and 9 years of age Worrying about school grades is an adaptive behavior in children that happens between 8 and 9 years of age. Children who are between 5 and 6 years of age are at their initial schooling age, and their development is not sophisticated enough to bother about the grading system at school. Children who are between 6 and 7 years of age try to be independent in their school environment. They are less bothered about grading. Children who are between 7 and 8 years of age are more involved in playing with their peers.

The nurse is assessing a child during a checkup and notes the child has all permanent teeth and is a healthy weight for his age. What would be the approximate weight of the child? 116 to 26.3 kg (35.5 to 58 pounds) 217.7 to 30 kg (39 to 66.5 pounds) 319.5 to 39.5 kg (43 to 87 pounds) 424.5 to 58 kg (54 to 128 pounds)

24.5 to 58 kg (54 to 128 pounds) By the age of 10 to 12 years, the permanent teeth have erupted in children. Therefore the child is probably in this age group. A healthy weight of a child in the age group of 10 to 12 years is 24.5 to 58 kg (54 to 128 pounds). A 6-year-old child may have a weight of 16 to 26.3 kg (35.5 to 58 pounds). This is the age where loss of first teeth occurs in the children. A 7-year-old may have a weight of 17.7 to 30 kg (39 to 66.5 pounds). The child's teeth start forming at this stage. An 8-year-old child may have a weight of 19.5 to 39.5 kg (43 to 87 pounds). Lateral incisors (maxillary) and mandibular cuspids erupt at this age.

The nurse is assessing the behavior of a child with pain using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The nurse notes that the child is restless and maintains a disinterested face. However, the child is consolable by hugging. What score does the nurse give the child based on FLACC scale?

3 The FLACC pain assessment tool is used to assess pain. Using this scale, the nurse notes each behaviors and rates them. The variables include face, leg, activity, cry, and consolability. The child has a disinterested face, is restless, and is consoled by hugging. The nurse rates each behavior as 1, and the sum yields a score of 3. If the child has no facial expression or has a smiling face with a normal sleep pattern, then the score is 0. A score of 1 is given for variables such as grimacing, restlessness, squirming, moaning, and distractibility. Variables such as constant frowning, kicking, jerking, steady crying, and difficulty being consoled are assigned a score of 2.

Fifteen-year-old Brandon has been admitted to the pediatric unit with acute pancreatitis. This is the second time that the patient has been admitted for the same condition. A pain assessment reveals that Brandon has a pain score of 8 (on a 0-10 scale). The nurse understands that this is severe pain and the patient will likely need an opioid for optimal pain relief. The provider has ordered hydromorphone (Dilaudid) 0.05 mg/kg intravenously 4 hours. Brandon weighs 136 pounds. Calculate both the dose rounded to a whole number that the patient should receive as well as the maximum amount that he can safely receive in a 24-hour period. Provide answer as whole numbers separated by comma and space (ex. 2, 3)

3, 18 136/2.2 = 61.8 kg / 61.8 x 0.05 = 3.09 (rounded to 3 mg). 3 mg x 6 doses = 18 mg. It is also important for the nurse to monitor Brandon for side effects. The most common side effect of opioids is respiratory depression. Evaluation of pain should be done every time vital signs are assessed. When pain scores reach 4 to 6, acetaminophen and nonsteroidal antiinflammatory drugs are suitable medications for pain relief.

A 13-year-old patient with an ankle injury requires minor surgery. The parents of the patient have given their consent but are unable to wait during the procedure. What is the best nursing action in this context? Persuade the parents to be with the patient. Ask the patient's school teacher to be present. Adhere to the parents' wishes of not participating. Conduct the surgery when either parent is available.

Adhere to the parents' wishes of not participating. The nurse should support parents who do not want to be present in their decision and encourage them to remain close by so they can be available to support the child immediately after the procedure. The nurse should not insist that the parents sit through the procedure as it can create tension between the parents and the child. Reaching the patient's school teacher is inappropriate if parents are around and have decided not to stay. Waiting for either parent to sit through the procedure may delay treatment unnecessarily.

The school nurse is assessing a child who has already attended a daycare center. What different features does the nurse observe in this child from the child who does not attend daycare? Shows frustration easily Avoids group cooperation Displays evident dissatisfaction Adjusts to sociocultural differences

Adjusts to sociocultural differences

Transdermal fentanyl (Duragesic) is being used for an adolescent with cancer who is in hospice care. The adolescent has been comfortable for several hours but now complains of severe pain. What is the most appropriate nursing action? Use a nonpharmacologic strategy Place another fentanyl patch on the adolescent Administer meperidine (Demerol) intramuscularly (IM) Administer morphine sulfate immediate release (MSIR) intravenously (IV)

Administer morphine sulfate immediate release (MSIR) intravenously (IV) The nurse should administer an immediate-release opioid such as MSIR IV for the breakthrough pain. Intramuscular injections should be avoided in cancer patients because of increased risk of bleeding and the fact that they do not act immediately. Nonpharmacologic strategies are not effective in severe pain. Transdermal fentanyl will take up to 24 hours to reach peak effect and thus is not effective for severe breakthrough pain.

The nurse is educating a group of parents about the dental health for infants. Which statement made by the parent indicates effective learning?

A damp cloth can be used to wipe the child's teeth

The nurse educates the mother of a 10-year-old child about the changes that occur in adolescence. Which information will the nurse include in the teaching?

Body growth ceases between 18 and 20 years of age.

One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child's readiness for toilet training, what is it important for the nurse to emphasize?

Bowel control is accomplished before bladder control, so the parent should focus on bowel training first.

An adolescent female is brought to the hospital by the parent with complaints of vomiting and diarrhea. The nurse finds that the girl is preoccupied with thoughts of her weight and appearance. The girl is on a diet, but accepts that sometimes she eats lots of ice cream and chips. On assessment, the girl is overweight. What is the most likely cause of her presentation?

Bulimia nervosa

The school nurse is asked to speak with the parents of a 10-year-old boy who has been bullying other children. On what should the nurse's response be based? Bullying at this age is considered normal. Children who bully others usually join gangs. Children who bully others usually have low self-esteem. Bullies often have difficulties developing and maintaining relationships.

Bullies often have difficulties developing and maintaining relationships. Children who bully are defiant toward adults, antisocial, and likely to break school rules. They have little anxiety, strong self-esteem, and may come from homes where physical punishment is used and there is a lack of parental involvement and warmth. Long-term this negativity continues into adulthood, causing difficulties developing and maintaining relationships. Bullying is a maladaptive response to poor relationships with peers and lack of group identification. Bullying is a maladaptive response to poor relationships with peers and lack of group identification. These individuals usually have strong self-esteem and little anxiety.

As the nurse is assessing an infant, the nurse notices that the teeth are erupting and the infant's skin color is bluish. After assessing oxygenation, the nurse reviews the laboratory report and finds that the infant has methemoglobinemia. What would be the probable reason for this? Application of topical anesthetics Excessive use of cold teething ring Administration of aspirin (Acuprine)Excessive consumption of hard candy Application of topical anesthetics The nurse is

Application of topical anesthetics (benzocaine cause is)

What are the factors that increase the absorption of iron in the diet? SATA

Ascorbic acid - Acidity (low PH)

The nurse is assessing a 14-month-old child. The child's mother is worried as the child is able to say only one word, "Maa." To reduce panic the nurse educates the mother about language development. Which statement made by the nurse is appropriate?

At the age of 1 children start using one-word sentences and gestures

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. What should be part of the discharge teaching by the nurse for the parents?. Cardiopulmonary resuscitation (CPR) Administration of intravenous (IV) fluids Reassurance that the infant cannot be electrocuted during monitoring Advice that the infant not be left with other caretakers such as baby-sitters

CPR

What information should the nurse include when giving parents guidelines about helping their children in school? Punish children who fail to perform adequately Help children as much as possible with their homework Accept responsibility for children's successes and failures Communicate with teachers if there appears to be a problem

Communicate with teachers if there appears to be a problem Parents should communicate with teachers if there is a problem and not wait for a scheduled conference. Children need to do their own homework. This cultivates responsibility. Discipline should be used to help children control behaviors. School-age children can use reasoning skills. School-age children need to develop responsibility. This helps with keeping promises and meeting deadlines, thereby laying successful foundations for adulthood.

A patient with severe pain was prescribed pentazocine (Talwin). After few weeks the patient tells the nurse that she has severe sweating, tears, a runny nose, and nasal irritation. What is the most likely reason for the patient to have these symptoms? Drug overdose Drug addiction Drug withdrawal Drug Dependence

Drug withdrawal Pentazocine is a mixed opioid agonist and antagonist. Sudden discontinuation of the medication causes withdrawal symptoms. The symptoms of opioid withdrawal are severe sweating, tears (lacrimation), and rhinorrhea, which is characterized by runny nose and nasal irritation. The symptoms of drug overdose (opioid overdose) are sedation, respiratory depression, nausea, and vomiting. Drug addiction (opioid addiction) and drug dependence (opioid dependence) are characterized by strong desire or sense of compulsion to take the drug, suicidal ideation, and depression

What is an important consideration for the school nurse planning a class on injury prevention for adolescents?

During adolescence a need exists for discharging energy, often at the expense of logical thinking.

What do nursing interventions to promote health during middle childhood include? Stressing the need for increased calorie intake to meet increased demands Instructing parents to defer questions about sex until the child reaches adolescence Advising parents that the child will need decreasing amounts of rest toward the end of this period Educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt

Educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt Rational: Because the permanent teeth are present, it is important for the child to learn how to care for these teeth. Caloric needs are diminished; however, a balanced diet is important to prepare for the adolescent growth spurt. Parents should approach sex education with a life span approach and respond to a child's questions with an answer appropriate to the child's age. School-age children often need to be reminded to go to sleep.

The school teacher speaks with the school nurse about a child who has improper conduct and tends to be aggressive with younger children. The school nurse observes that the child also influences the behavior of others in the group. What is the most appropriate nursing approach for the child's behavior? Suggest the child undergo behavioral therapy Use corporal punishment to discipline the child Advise the child to participate in safety training Encourage the child to join an antibullying program

Encourage the child to join an antibullying program The child who is isolated from the family or under poor supervision tends to develop unacceptable behavior and acts against established rules. These children also try to influence other weaker groups such as small children. This behavior is considered bullying. The child should be encouraged to join an antibullying program to help set the behavior right. The nurse should not use corporal punishment on the child because it can worsen the child's behavior. Limits should be set and time-outs utilized for punishment. Safety training is given to the child for protection from injuries. Behavioral therapy is given to the child with attention deficit hyperactivity disorder.

The parent expresses to the nurse that the child refuses to go to sleep, repeatedly gets out of bed, and wakes up very late in the morning. Which nursing intervention is helpful to manage sleep disturbances in the child?

Enforce consistent limits about the child's bedtime behavior.

The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. The nurse's suggestions regarding participation in sports at this age should include what? Organized sports such as soccer are not appropriate at this age. Competition is detrimental to the establishment of a positive self-image. Sports participation is encouraged if the sport is appropriate to the child's abilities. Girls should compete only against girls because at this age boys are larger and have more muscle mass.

Sports participation is encouraged if the sport is appropriate to the child's abilities. Parents and coaches need to recognize the child's abilities and teach proper techniques so the child can compete safely. Organized sports can provide safe, appropriate activities with supportive parents and coaches. School-age children enjoy competition. The parent should help the child select a sport that is suitable to her capabilities and interests. These changes occur at puberty -- before that, boys and girls can compete on the same teams.

When discussing sex and sexual activities with adolescents, what should the nurse do? present normal body functions in a straightforward manner. refer the adolescents to their parents for sexual information. use scientific terminology to convey content. defer giving information about pregnancy unless the adolescents are sexually active.

Present normal body functions in a straightforward manner The nurse should provide accurate and complete information that is presented using correct terminology. Parents are important influences regarding the morals and values surrounding sexual activities; nurses should provide the adolescent with accurate, complete information about the normal physical aspects of sex. The adolescent may not understand the scientific names. Adolescents should have information before they become sexually active.

The school nurse is assessing a child who is taking psychostimulants. The child is instructed to approach the nurse for the medication soon after lunch. What is the most appropriate reason for giving this instruction to the child?

Psychostimulants reduce the appetite. Rational: Children who are taking psychostimulants commonly experience a decrease in appetite as a side effect. Therefore the nurse should administer medication with or after meals. Keeping the child awake is also a side effect of psychostimulant drugs. However, this has nothing to do with why the medication would be administered after lunch. Reduced or suppressed growth is also observed as a side effect of psychostimulant drug and should be monitored regularly. Food intake does not affect the efficacy of psychostimulant drugs.

The nurse is teaching the parents of a 5-year-old child about the importance of providing sex education to children. What suggestion should the nurse include in the teaching?

Read age-appropriate sex education booklets along with the child

A parent of a 7-year-old girl reports that the girl spends most of her time alone at home. The girl does not like to play with boys and needs help with eating at the dining table. The girl copies the shape of a diamond correctly when asked to do so by the nurse. What is the most appropriate step taken next by the nurse? Refer the girl to a pediatrician- Refer the girl to a psychiatrist- Reexamine her after observation- Reassure the parent that she is fine

Reassure the parent that she is fine

What do nursing responsibilities include when caring for the suicidal adolescent? emphasizing that a suicide attempt is an immature way of dealing with stress. recognizing the warning signs that indicate a young person might attempt suicide. ignoring threats of suicide because they are usually bids for attention. recognizing a suicide attempt as an impulsive act resulting from a temporary crisis.

Recognizing the warning signs that indicate a young person might attempt suicide It is imperative that the nurse recognize warning signs of a potential suicide. For the depressed young person, suicide may appear to be the only way out. All threats must be taken seriously. Even if the crisis is temporary, the child's perception still may be that suicide is the only way out.

A 16-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics occurred about 4 years ago. What should the nurse do?

Refer the adolescent for an evaluation (primary amenorrhea)

The school health nurse observes that a high school student is depressed, uninterested in playing or talking to others, and cries often. What nursing action would be suitable for this student?

Refer the adolescent for thorough psychological assessment

After conducting the fine motor skill assessment of a 2-year-old child, the nurse concludes that the child has the fine motor skill development of an 18-month-old child. Which fine motor activities can the child do?

Release a pellet in a narrow-necked bottle Use a cup for drinking water without spilling

An adolescent is admitted to the hospital with anorexia nervosa. What does the nurse monitor in this patient? Select all that apply. Accommodation reflex of the eyes Electrolyte levels in the blood Blood pressure in sitting position Levels of ketones and protein in urine Blood pressure in sitting and standing position

Serum electrolyte levels - Levels of ketones and protein in the urine - Blood pressure in the sitting and standing positions . A nurse should be aware of the physical side effects of anorexia nervosa. Severe electrolyte disturbances can occur in these adolescents as a result of self-induced vomiting or diarrhea and inadequate intake of required nutrients. As a result of breakdown of fat and protein, ketones and protein can be found in urine. This can lead to urinary tract problems. Orthostatic hypotension is common in these children; therefore, it is important to measure blood pressure in both sitting and standing positions. Pupillary reaction to light is assessed to find the integrity of optic nerve. This assessment is not needed in patient with anorexia nervosa. Taking blood pressure in sitting position is not sufficient. Assessment of orthostatic hypotension requires measurement of blood pressure in both sitting and standing positions.

The nurse finds that a child under care for a gastrostomy experienced fecal incontinence. What is a priority intervention by the nurse? Use a disinfectant immediately on the skin. Gently clean the skin and remove moisture. Elevate the bed no more than 30 degrees. Use an adhesive remover to remove fecal matter

Gently clean the skin and remove moisture. especially when mixed with urine, wound drainage, or gastric drainage around gastrostomy tubes can erode the epidermis. The nurse should gently clean the skin and remove the excess moisture. A disinfectant is used when there is a risk of infection and the skin barrier is damaged. Elevating the bed to no more than 30 degrees for short periods prevents friction injuries. Adhesive remover is used to remove adhesives and may not be effective for removing fecal matter.

A 4-year-old female child sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened -- yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This is most likely described as A nightmare Sleep terror Sleep apnea Seizure activity

Sleep terror

What is an important consideration related to childhood stress? Children do not have coping strategies. Children should be protected from stress. Parents cannot prepare children for stress. Some children are more vulnerable to stress than others.

Some children are more vulnerable to stress than others. Children's age, temperament, life situation, and state of health affect their vulnerability, reactions, and ability to handle stress. It is not feasible to protect children from all stress. Children can be taught coping strategies. Supportive interpersonal relationships are essential to the psychological well-being of children. Adults need to recognize signs of stress before they become overwhelming. Providing children with interpersonal security helps them develop coping strategies for dealing with stress.

A 6-year-old child with attention deficit hyperactivity disorder (ADHD) is brought to the hospital with reports of weight loss and loss of appetite. The child has been on the psychostimulant methylphenidate (Ritalin) for the past few months. The child has shown improvement in school since taking the medication. What is the most appropriate instruction given to the parents?

Give the medication with a meal. Rational: Loss of appetite and weight loss are possible side effects of psychostimulant medication administration. Parents should be advised to give the medication with or after a meal to help relieve these symptoms. It is not recommended to stop the drug immediately because the child shows improvement after the administration of the drug. Reducing the dose would deprive the child of the therapeutic effect of the drug. Parents should also be advised to give a nutritious snack to the child in the evening, when the drug's effect is decreasing.

which normal finding does the nurse expect to find when assessing an 8-month old infant? Doubled birth length Eruption of the upper lateral incisors Eruption of the lower central incisors Equal head and chest circumference

Eruption of the lower central incisors

A 10-year-old female child requires daily medications for a chronic illness. Her mother tells the nurse that she is always nagging her to take her medicine before school. What is the most appropriate nursing action to promote the child's compliance? Establishing a contract with her, including rewards Suggesting time-outs when she forgets her medicine Discussing with her mother the damaging effects of nagging Asking the child to bring her medicine containers to each appointment so they can be counted

Establishing a contract with her, including rewards For school-age children, behavior contracting associated with desirable rewards is an effective method for achieving compliance. Time-outs should be used only if the behavioral contracting is not successful. Although nagging is not an effective strategy, the nurse needs to assist the mother in problem-solving rather than criticize the actions. Monitoring the medicine supply may be tried if the contracting is not successful.

The parent of a 12-month old infant says to the nurse, he pushes the teaspoon right out of my hand when I feed him. I can't let him feed himself, he makes too much of a mess. What Is the nurse's best response? "It's important to let him make a mess. Just try not to worry about it so much." "It's important not to give in to this kind of temper tantrum at this age. Simply ignore the behavior and the mess." "You need to try different types of utensils, bowls, and plates. Some are specifically designed for young children." "Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable

The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. What should the nurse recommend?

Fluids in addition to breast milk are not needed.

The nurse is assessing the concept of conservation in a group of children 7 years of age. The nurse pours 200 mL water in a small glass, 200 mL water in a big glass, and 100 mL water in a tea cup. The capacities of the small glass (s), big glass (B), and tea cup (t) are 250 mL, 500 mL, and 100 mL respectively. A 7-year-old child is asked to choose the glass with more water. Which glass or glasses would the child choose if the child understands the concept of conservation? Glass B Glass s Glass B and s Glass t and s

Glass B and s The concept of conservation is one of the cognitive tasks mastered by children aged 5 to 7 years. They are able to understand that when the same amount of water is poured into glasses or containers of different sizes and shapes, the volume remains the same. Therefore, the child will choose glass B and s. Conservation of volume is usually the last concept mastered by school-aged children. Glass B has the same amount of water as glass s. Glass t has less water compared to glasses B and s.

A parent phones the nurse and says that her child just knocked out a permanent tooth. What should the nurse's instructions to the parent include? Rinsing the tooth in hot water Taking the child and tooth to a dentist within 48 hours Holding the tooth by the crown and not by the root area Taking the child to the hospital emergency room if mouth is bleeding

Holding the tooth by the crown and not by the root area The root area should not be touched. The tooth should be rinsed with running water only if it is dirty. Reimplantation should occur within 30 minutes by the child, parent, or nurse and stabilized by a dentist as soon as possible. The child needs to be seen by a competent dentist, not emergency room, as soon as possible.

A 4-year-old child is playing while the parent is watching television. After some time the child comes to the parent and says, "Dad! Anna broke the glass." There was nobody else in the house at that time. What should be the most appropriate response of the father?

I see only you here, so you are responsible for that

The nurse is caring for a child who has developed dyslalia. The primary health care provider recommends that the child take the Denver Articulate Screening Exam. What should the nurse suspect the child has? Decreased sight Impaired speech Reduced motor skills Hearing impairment

Impaired speech

During an assessment of a late school-age child, the nurse advises the parents to seek immediate orthodontic treatment for the child. What condition does the nurse find in the child?

Improperly arranged teeth Rational: Malocclusion is a dental condition where the relationship between the upper and lower arches of the jaw is inappropriate. This condition may sometimes be a cosmetic concern, which may be the reason for the child's parents to worry. Orthodontic treatment is more effective when started in late school-age than in adolescence. Bleeding gums is a sign of periodontal disease, which can be resolved by maintaining proper oral hygiene such as careful and regular brushing. Teeth discoloration or plaque formation is a common cosmetic concern of all age groups. Flossing of teeth helps in managing this condition. Dental cavities are a universal dental issue that requires treatment in order to reduce the incidence. It can be prevented by maintaining oral hygiene conditions.

The nurse notices that a toddler is more cooperative when taking medicine from a small cup rather than from a large cup. This is an example of which characteristic of preoperational thought?

Inability to conserve

Which activities are indicative of the teething process in an infant? Increased need for sleep Infant rubbing on the gums Infant biting on hard objects Eating a lot more solid foods Increased sucking on fingers

Infant rubbing on the gums Infant biting on hard objects Increased sucking on fingers

What is an important consideration for the child receiving intravenous (IV) therapy?

Infiltration is hard to detect

A child with severe pain has been prescribed morphine (Avinza). Which route of administration is the nurse most likely to prefer for providing quick relief from pain and preventing morphine toxicity? Sublingual Intramuscular Subcutaneous Intravenous bolus

Intravenous bolus Drugs such as morphine, fentanyl (Abstral), and hydromorphone have short half-lives. Opiates such as morphine have a narrow therapeutic index. To prevent drug toxicity and provide quick relief, the nurse should administer morphine as an intravenous bolus. pg.848

The nurse working at a day care center finds that a child is obedient at home but bullies peers at the day care center. What does the nurse infer from the child's behavior? The child: The child is aggressive. The child respects elders. The child likes to play alone. The child is scared of the parents.

Is scared of the parents. A child who is obedient at home and not at school is usually scared of his or her parents and takes out the aggression on peers or outsiders. Aggression is commonly seen in children; it is not an illness but indicates that the child needs attention. The nurse cannot interpret whether the child respects elders or not based on his or her behavior with peers and parents. A child who likes to play alone may not bully others and usually spends time alone.

A mother observes that her 7 month old infant Bears full weight on the feet when held in a standing position what is the reason for this? It indicates that the child will start walking within 2 months. It indicates that the child's growth and development is normal. It indicates that infant physical development is occurring slowly. It reflects that the infant's upper limbs are not developing properly.

It indicates that the child growth and development is normal

An 8-months old infant is able to pick up pieces of food. The parent is impressed with this skill and tells the nurse about it. What does the nurse tell the infant's parent about this behavior? It indicates that the infant is hyperactive. It is pincer grasp, which is expected at this age. It is palmar grasp, which is expected at this age. It is an abnormal finding that requires evaluation.

It is a pincer grasp, which is expected at this age

A 16-year-old adolescent male tells the school nurse that he is gay. The nurse's MOST appropriate response should be based on knowledge that he is too young to have had enough sexual activity to determine this. it is important to provide a nonthreatening environment in which he can discuss this. the nurse should be open to discussing his or her own beliefs about homosexuality. homosexual adolescents do not have concerns that differ from heterosexual adolescents.

It is important to provide a nonthreatening environment in which he can discuss this. The nurse needs to be open and nonjudgmental in interactions with adolescents. This will provide a safe environment in which to provide appropriate health care. Adolescence is when sexual identity develops. The nurse's own beliefs should not bias the interaction with this student. Homosexual adolescents face very different challenges as they grow up because of society's response to homosexuality.

The parents of a child report that their child has difficulty chewing and they are worried about the arrangement of the child's teeth. What type of dental issue should the nurse assess for in the child? Malocclusion Gingivitis Caries Periodontal disease

Malocclusion Rational: Malocclusion is the condition where the relationship between upper and lower arches of the jaw is inappropriate. This condition may result in difficulty in chewing and sometimes causes a cosmetic concern. The patient with gingivitis would primarily complain about bleeding gums. Malocclusion of the teeth is not related to gingivitis. Dental caries or cavities are common problems that occur at all ages; when left untreated, they result in total destruction of the teeth. Periodontal diseases are inflammatory diseases involving gums and tissues of the teeth. Bleeding gums and loss of teeth observed in the child would hardly impact the arrangement of the teeth

To which class of complimentary and alternative medicine does chiropractic therapy belong? Biologic Manipulative Energy based Mind-body training

Manipulative The complementary and alternative medicine therapies are classified into five groups of methods. Chiropractic is a manipulative method of therapy. Food and special diets belong to the biologic class of therapy. Bioelectric and magnetic treatments are energy-based therapies. Hypnosis and spiritual healing are mind-body training methods.

The nurse is preparing a health teaching session for school-age children. What information should the nurse include about injury prevention in the plan? Most injuries occur in or near school or home. Peer pressure is not strong enough to affect risk-taking behavior. Injuries from burns are the highest at this age because of fascination with fire. Lack of muscular coordination and control results in an increased incidence of injuries.

Most injuries occur in or near school or home. Most injuries occur in or near school or home. Peer pressure is significant in this age group. Automobile accidents account for the majority of severe accidents, either as a pedestrian or passenger. School-age children have more refined muscle development, which results in an overall decrease in the number of accidents.

A 5-year-old child is prescribed an opioid analgesic after surgery. Which side effects should the nurse monitor the child for? SATA Nausea Bleeding Sedation Dementia Constipation

Nausea Sedation Constipation Morphine is the most appropriate medication for severe pain. This drug has a few side effects. The most common side effects are nausea, sedation, constipation, hallucinations, and respiratory depression. Bleeding is not a complication associated with morphine. Dementia is not a side effect associated with morphine. The patient who is administered morphine may experience mental clouding but does not have memory loss.

A parent tells the nurse, "I am worried about my 13-year-old son. He hasn't started puberty, and my daughter did when she was 11 years of age." The nurse should explain to this parent that this is what? Unusual and requires further evaluation of the son Unusual because the onset of pubescence is usually the same in siblings Normal because the onset of pubescence is usually earlier in girls than it is in boys Abnormal because the onset of pubescence is usually earlier in boys than it is in girls

Normal because the onset of pubescence is usually earlier in girls than it is in boys The average age of onset for puberty in boys is 12 years old. Age of pubescence is gender related. Girls begin puberty an average of approximately 2 years before boys.

The nurse is assessing a 12-montth old child during a well-child visit. The nurse notices that the child's birth weight has tripled, birth length is increased by 50%, head and chest circumference are equal, and the child has six deciduous teeth. What does the nurse conclude that the child has from these findings? A calcium deficiency Normal development Delayed development Excessive weight gain

Normal development

A minor patient is scheduled for appendectomy and a diagnostic test prior to the surgery. The nurse has obtained consent for the surgery from both the patient and the parents. What is an appropriate next step?

Obtain consent for diagnostic procedure as well.

During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. His birthday is close to the cutoff date, and he has not attended preschool. The nurse's BEST recommendation is to:

Perform developmental screening.

What is the most important complication associated with the use of peripheral venous catheters? Phlebitis Cardiac dysfunction Hirschsprung disease Oxygen-induced carbon dioxide narcosis

Phlebitis

The nurse is assessing a 5-month-old infant. Which behavior does the nurse observe in the infant? Taking out objects hidden under a pillow Transferring toys from one hand to the other Picking up a toy and putting it into the mouth Grasping the feet and pulling them toward mouth

Picking up a toy and putting it into the mouth

. The nurse is assessing a child who is macrobiotic and has inadequate intake of proteins and calories. What is the right nursing intervention to promote protein intake?

Plan a diet according to the child's requirements

Parents bring their child in for a well-child visit before moving to a different city. The child tells the nurse that he doesn't want to move and is sad because he will miss his friends and family. What should the nurse suggest to the child's parents to relieve the stress in the child? Prepare the child to relocate to a different city Tell the child that he will get new playmates in the new location Tell the child he will get a new gift daily after relocating to the new city Assure the child that the family will spend a few days in the previous city every month

Prepare the child to relocate to a different city

A 10-year-old boy reports vomiting, diarrhea, and stomach pain for the past couple of days. The child does not go to school because of these symptoms. However, the child is usually healthy on weekends and whenever allowed to stay at home. On examination the nurse finds that the child's temperature is mildly elevated. What does the nurse inform the parents?

The child has school phobia, which is the likely reason for the child's presentation. Rational: School phobia can occur in children of all ages, but it is more common in those 10 years of age and above. It can be manifested by the child reporting vomiting, diarrhea, stomach pain, mild fever, and headache during weekdays. A striking feature of this condition is that the child is healthy on weekends and whenever the child is allowed to stay at home. It is also important to find out the reason behind it and eliminate the cause. Though the symptoms of the child are similar to gastroenteritis, the absence of symptoms during weekends indicates school phobia as the most likely diagnosis. Therefore antibiotics are not required in this case.

The nurse observes that a child is fidgety, restless, and easily distracted. What does the nurse interpret from these symptoms? The child has many of the signs and symptoms of dysgraphia. The child demonstrates characteristics of conversion reaction. The child exhibits signs of posttraumatic stress disorder (PTSD). The child may have attention deficit hyperactivity disorder (ADHD).

The child may have attention deficit hyperactivity disorder (ADHD). If a child displays fidgetiness and restlessness and is easily distracted, the child may have ADHD. Dysgraphia is the difficulty of the child with writing. Abdominal pain, fainting, pseudoseizures, paralysis, headaches, and visual field restriction are the symptoms of conversion reaction. The symptoms of PTSD include persistent re-experiencing of the traumatic event and avoidance of stimuli associated with the event or trauma.

The nurse is assessing the oral cavity of a child who is approximately 7 to 8 years of age. The nurse notices that the lateral incisor in the mandible and central incisor in the maxilla have already been lost. Which teeth would erupt when the child is about 11 to 12 years old? The first molar in both the maxilla and in the mandible The third molar in both the maxilla and in the mandible The second bicuspid in both the maxilla and the mandible The second bicuspid in the mandible and the cuspid in the maxilla

The second bicuspid in the mandible and the cuspid in the maxilla

The nurse is giving information about latchkey children to a group of nursing students. What information does the nurse include in the session? A majority of these children develop paranoid schizophrenia when they grow older. These are children who have chronic illnesses and are left alone to care for themselves. These are children who are left to care for themselves unsupervised before or after school. These children may use hiding or playing television at a loud volume to cope with their own fears. These children are more likely to feel lonely and isolated than those who have someone to care for them.

These are children who are left to care for themselves unsupervised before or after school. - These children may use hiding or playing television at a loud volume to cope with their own fears. - These children are more likely to feel lonely and isolated than those who have someone to care for them. Latchkey children is the term used for children who are left alone to care for themselves before or after school. These children are more likely to be lonely, isolated, and fearful than those who have someone to care for them. Therefore they may use strategies like playing television at a loud volume or hiding to cope with their own fears. The nurse should be able to identify such children and offer help to the parents. There are services like after-school programs or telephone hotlines that keep a check on children. There is no evidence suggesting that most of these children will have paranoid schizophrenia when they grow older. Some of these children can have chronic illness, but children with chronic illness are not called latchkey children.

What is true of nonpharmacologic strategies for pain management

They may reduce pain perception

A parent of an 8 month old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse replies should be based on the knowledge that what is true? The infant is most likely spoiled. This is a normal reaction for this age. This is an abnormal reaction for this age. The grandparents are not responsive to that infant.

This is normal reaction for this age

The nurse is caring for a patient with severe burns. The primary health care provider advises the nurse to administer diazepam (Valium) before administering ketamine (Anesket) to the patient. Why does the primary health care provider give this advice to the nurse? To prevent: urticaria dysphoria hepatotoxicity respiratory depression

To prevent dysphoria Ketamine is an anesthetic that is given to patients who have pain due to severe burns. It can cause dysphoria, which is associated with anxiety. Therefore, to prevent dysphoria, the patient must be pretreated with benzodiazepines such as diazepam, which has anxiolytic activity. Urticaria is characterized by skin rashes, and anxiolytic medications such as diazepam do not treat skin rashes. Diazepam does not prevent hepatotoxicity. Diazepam can cause respiratory depression, because it depresses the central nervous system.

Which fine motor activity is likely to be observed in a 7 month old infant? Searching for a toy that was hidden Attempting to build a two-block tower Putting objects one at a time in a box Transferring objects between both hands

Transferring objects between both hands

Parents of a 10-year-old child are concerned that their child recently has been showing signs of low self-esteem. What should the nurse consider when discussing this issue with the parents? A. Changing self-esteem is difficult after about age 5 years. B. Self-esteem is the objective judgment of one's worthiness C. Transitory periods of lowered self-esteem are expected developmentally. D. High self-esteem develops when parents show adequate love for the child.

Transitory periods of lowered self-esteem are expected developmentally. Rational: Self-esteem changes with development. Transient declines are expected and (with positive encouragement and support) are only temporary. Self-esteem is influenced throughout adolescence. One aspect of self-esteem is a subjective judgment of one's worthiness. Self-esteem is based on several factors, including competence, sense of control, moral worth, and worthiness of love and acceptance.

The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What should be the NEXT action by the nurse? Notifying the surgeon Performing oral intubation Trying to insert a larger-size tube Trying to insert smaller-size tube

Trying to insert smaller-size tube

The nursing instructor is teaching students about the prevention of falls in children. Which statement by the student indicates a need for additional teaching? 1. Keep dim lights while sleeping. Offer toileting on a regular basis. Ensure appropriate gowns for the child. Unlock wheelchairs before transferring.

Unlock wheelchairs before transferring. To maintain skin integrity in the mechanically ventilated patient, the nurse applies a hydrocolloid barrier to protect the facial cheeks. The nurse places gel pillows under pressure points such as occiput, heels, elbows, and shoulders to relieve pressure. No tubes, lines, wires, or wrinkles should be allowed in bedding under the patient, as their presence is a risk for pressure ulcer formation. The nurse repositions the patient at least every 2 hours as the patient's condition tolerates.

What action does the nurse take to prevent ventilator-associated pneumonia for the patient receiving mechanical ventilation? Keep oral care to a minimum. Use aggressive hand hygiene Provide the prescribed analgesia. . Elevate the bed to about 90 degrees.

Use aggressive hand hygiene Ventilator-associated pneumonia is a complication that can be prevented through the use of aggressive hand hygiene. The nurse ensures oral care as oral care prevents the development of harmful bacteria in the mouth. The nurse also elevates the head of the bed between 30 and 45 degrees, unless contraindicated. Analgesia is given to relieve pain and does not reduce the risk of ventilator-associated pneumonia.

The nurse is caring for an infant in the pediatric intensive care unit. What appropriate intervention does the nurse use to minimize shear injuries? .Using moisturizing lotions and creams Using customized splinting over infants' heels Using gel pillows under the heads of the infant Using lift sheets when repositioning the patient

Using lift sheets when repositioning the patient Using lift sheets when repositioning the patientPrevention of shear injury includes using lift sheets when repositioning a patient, and elevating the bed no more than 30 degrees for short periods. A knee gatch is also used to interrupt the pull of gravity on the body toward the foot of the bed. Prevention of friction injury includes the use of customized splinting over infants' heels, gel pillows under the heads of infants and toddlers, and using moisturizing creams and lotions.

The nurse is caring for a 2-month-old infant with the flu. The infant is crying due to colicky pain. The nurse tries to soothe the infant, but the infant continues to cry. What does the nurse do in this situation?

Walk with the infant's face down and with the body across a parent's arm

The health care provider has prescribed a liquid iron supplement for an infant with iron deficiency. What advice does the nurse give to the parents to prevent the infant's teeth from staining from the liquid iron supplement?

Use a dropper toward the back of the mouth

3. A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend? prophylactic antibiotics. condom use. any type of contraception method. withdrawal method of contraception

condom use Condoms provide a barrier to the organisms that cause STIs. Prophylactic antibiotics are not recommended; they are only effective against bacteria, not viruses. Only condoms create a physical barrier that prevents contact with the organisms.

Myelination of the spinal cord is almost complete by 2 years of age. As a result of this, what can the toddler gradually achieve?

control of anal and urethral sphincters

During an assessment, the nurse notices that a school-age child is under stress. What signs of stress in the child warrant further investigation? Slightly increased heart rate Red and flushed face Jittery and flustered behavior Sucking their thumb Trouble concentrating

Sucking their thumb Trouble concentrating Many factors may cause stress in children. Stress in children can manifest itself in many ways, and the nurse should be alert to these signs. Thumb-sucking in school-age children is a sign of regression and needs further assessment of what may be causing the stress. When the child has difficulty concentrating, the nurse should explore further for the cause. A slightly increased heart rate is a standard sign of stress that does not need to be explored further. The red face and jittery appearance are also common signs of stress that do not need to be investigated.

The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. What is the nurse's initial action?

Take a thorough, detailed history of usual daily events

A 12-year-old patient has been admitted to the emergency department with significant physical trauma. Health care providers area ready to perform an urgent surgical procedure, but only the patient's teacher is available. What is an important consideration for the patient?

Take the teacher's consent

In planning sex education and contraceptive teaching for adolescents, the nurse should consider which information?

Teenagers need contraception education in both oral and written form.

A hospitalized toddler clings to a worn, tattered blanket. She screams when anyone tries to take it away. What is the nurse's best explanation to the parents for the child's attachment to the blanket?

The blanket is an important transitional object

What does the nurse keep in mind while administering an enema to a child? The nurse should not give details about the procedure. The buttocks of the child should be held together briefly. Pillows should not be used during the procedure. Administration of enemas should be noninvasive in children

The buttocks of the child should be held together briefly. Infants and young children are unable to retain the solution after it is administered, so the buttocks must be held together for a short time to retain the fluid. A careful explanation may help ease any concerns or fears the child may have about the procedure. The enema is administered and expelled while the child is lying with the buttocks over the bedpan and with the head and back supported by pillows. An enema is an intrusive procedure.

The nurse is assessing a child who can count backward from 20 to 1. Based on the child's age, what concepts of conservation is the child able to determine? The child can determine the permanence of an object's mass and volume. The child can select the one face from a chart that is different from the rest. The child can determine that the length is the same if objects placed differently. The child can count marbles placed in different rows and decide whether they are equal

The child can determine the permanence of an object's mass and volume.

Which statement describes the growth and development in a 24-month-old child?

The child can go up and down stairs alone.

The nurse is assessing a 5-year-old child who was previously withdrawn and had poor social behavior. The nurse finds that after starting kindergarten, the child's social behavior improves and the child interacts with peers and others. What does the nurse infer from the child's behavior?

The child has developed the ability to be independent.

A patient is diagnosed with female athlete triad. What characteristics does the nurse expect to find in the patient? Select all that apply Amenorrhea Osteoporosis Sports injury Schizophrenia Eating disorder

amenorrhea - osteoporosis - eating disorder A nurse should be aware that the term female athlete triad is used for an adolescent with an eating disorder, amenorrhea, and osteoporosis. This is because many sports activities, like gymnastics, running, or ballet, require adolescents to be lean and adolescents interested in these activities tend to have eating disorders. Schizophrenia and sports injury are not included in female athlete triad.

The nurse is assessing a toddler and notices that the toddler kicks his/her feet and screams as loud as possible. What type of emotion does the nurse document?

anger

Parents report to the school nurse that their child is hesitant to play with other kids in school. During the assessment, the nurse instructs the parents to avoid giving high-calorie foods to their child. What condition is the nurse helping the parents control? The child has gained too much weight. The child watches too much television. The child spends a lot of time sleeping. The child received low grades in school.

The child has gained too much weight. Rational; Children who are obese or overweight generally have difficulty in playing with peers. These children need to be guided in order to find activities that meet their needs. Excess sugar consumption in the diet is responsible for weight gain, so the nurse should instruct the parents to reduce sugar in the child's diet. The child who is spending more time sleeping should be involved in active play. It is not necessarily related to eating too much sugar. Low grades in school may be related to cognitive impairment. When a child spends excess time watching television, the child should be redirected to playing outside.

The nurse is assessing a 4-month-old infant. Which reflex should the nurse expect to find in the infant? Rooting Crawling Drooling Tonic neck

drooling

A 2-year-old child has recently started having temper tantrums during which she holds her breath and sometimes faints. The nurse should:

explain to the parent that this is not harmful.

The nurse is assessing a 15-month-old child. The child uses a cup well but rotates the spoon before it reaches the mouth. The nurse interprets from this observation that this is an appropriate development of what?

fine motor skills

The nurse is planning a diet chart for a child with diarrhea and dental caries. Which food does the nurse exclude in the child's diet chart? Milk Legumes Fruit juices Baked food

fruit juices

The parent reports to the nurse that their child throws temper tantrums whenever the child wants something. Which instruction provided by the nurse is most likely to help?

give comfort when the child calms down

The parent of a 26-month-old child reports to the nurse that the child spends most of the time talking to a doll and cares for it as if it is a small baby. The parent also reports that sometimes the child throws toys around with force. What does the nurse interpret about the child's behavior?

he child has normal behavior

During the assessment of 12 month old infants to nurse finds that the chest circumference are equal to length of the infant has increased by 50% since birth and the weight is triple that of the birth weight what does the nurse interpret from these findings? The infant has slow development. The infant has normal development. The infant has inadequate weight gain. The infant has insufficient dietary protein.

infant has normal development

Which activity of a 10-month old infant indicates the development of object performance? Looking for a hidden object that the infant had seen earlier Transferring the objects from the right hand to the left hand Grasping the foot and pulling it to the mouth to suck the toe Picking up a toy from the ground and putting it in the mouth

looking for hidden object that the infant had seen earlier

A 4-month old infant is scheduled for heart surgery. Which nursing action is most appropriate to follow 2 hours before the surgery? Give a doll to the infant to play with Place a pacifier in the infant's mouth to suck Give a toy cell phone to the infant to play with Place a bottle of milk in the infant's mouth to suck

place a pacifier in the infant's mouth to suck

The nurse assesses that the infant has difficulty breathing, decreased heart rate, change in skin color, and an ill-looking appearance. What should be the first nursing intervention in this situation? Alternate the infant's head position Place the infant in the prone position Place the infant in side-lying rub the trunk gently to wake the child

rub the trunk gently to wake the child

A 12-year-old child being seen in the clinic has not received the hepatitis B (HBV) vaccine. The nurse should recommend that: only one dose of HBV will be needed sometime during adolescence. one dose of HBV is needed at age 14. the three-dose series of HBV should be started. the three-dose series of HBV should be started at age 16 or sooner if the adolescent becomes sexually active

the three-dose series of HBV should be started. Adolescents should be vaccinated against hepatitis B at this age if not done previously. Three doses are necessary to achieve immunity. The recommendation is that the hepatitis B vaccine series be started at birth. The American Academy of Pediatrics recommends vaccination by age 13

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is breastfeeding exclusively. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant?

vit D

The nurse has taught the parent's of an 18-month-old child about the behavior of toddlers. Following the teaching session, the nurse asks the parents what they would do if their child accidentally falls down from the staircase and starts scolding the staircase. What response given by the parents indicates effective understanding?

we would join the child in scolding the staircase

A 4-month old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? "Keep doors of appliances closed at all times." "Never shake baby powder directly on your infant because it can be aspirated into his lungs." "Do not permit your child to chew paint from window ledges because he might absorb too much lead." "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall."

when your baby learns to roll over, you must supervise him whenever he is on surface from which he might fall

The nurse is educating a group of mothers about injury prevention for infants which statements by the nurse indicates effective teaching select all that apply "The mattresses in the house should be covered with plastic." "It is okay to give the child colored latex balloons at playtime." "Diaper pins should be kept closed and away from the infant." "Infant formula should be microwaved before feeding the child."

· -Diaper pins should be kept away from the child · the floor should be clean where the child crawls ·a smoke detector should be installed in the home

While assessing a child for pain, the nurse asks the child to describe the pain using a list containing 56 words. Which pain tool is the nurse using? Color Tool Poker Chip Tool COMFORT scale pain tool Adolescent Pediatric Pain Tool

- Adolescent Pediatric Pain Tool The Adolescent Pediatric Pain Tool allows the child to describe the pain by using a list of 56 words. The words in the list are clustered according to sensory, affective, and evaluative qualities of pain. The Color Tool is a pain assessment tool in which a child's pain is rated by using colors. The Poker Chip Tool helps assess pain by using poker chips, not a word list. The COMFORT scale is used to assess pain in an unconscious and ventilated patient in a critical care unit. This is an unobtrusive method in which pain is assessed by observing the patient. Test-Taking Tip: Calm yourself by closing your eyes, putting down your pencil (or computer mouse), and relaxing. Deep-breathe for a few minutes (or as needed, if you feel especially tense) to relax your body and to relieve tension.

The nurse assesses a Spanish-speaking child who is undergoing chemotherapy to determine the intensity, quality, and type of pain. Which scale might the nurse be using? Bieri scale Oucher Pain Scale numeric rating scale Adolescent Pediatric Pain Tool

- Adolescent Pediatric Pain Tool The Adolescent Pediatric Pain Tool is a multidimensional scale where intensity, quality, and type of pain are assessed; it is available in a Spanish version. The Bieri scale is a face scale where pain is assessed with faces. It does not assess the intensity, quality, and type of pain. The Oucher Pain Scale was developed to assess pain intensity in children who do not communicate in English and is designed to avoid cultural influences in pain management. The numeric rating scale uses numeric ratings on a line from 0 to 10 to measure pain intensity.

What does the nurse instruct the parents to keep away from the child's diet when the child is receiving iron supplementation?

- Antacids - Whole milk - Tea or coffee

While dressing a child's burns, the primary health care provider (PHP) asks the child to inhale nitrous oxide. The PHP asks the nurse to continuously monitor the child, because the medications prescribed to the child may cause sedation by interacting with nitrous oxide. Which categories of medications were prescribed for the child? SATA Antibiotics Antihistamines Corticosteroids Benzodiazepines Opioid analgesic

- Antihistamines - Benzodiazepines - Opioid analgesics Nitrous oxide is used as an anesthetic during procedures such as burn dressing, catheter insertion, venipuncture, and cannulation. Nitrous oxide can cause sedation and respiratory depression due to synergistic effects with other sedative drugs such as antihistamines, benzodiazepines, and opioid analgesics. Therefore this medication must be used with caution, and continuous monitoring is needed to prevent adverse effects. Corticosteroids and antibiotics do not cause sedation, and they do not produce respiratory depression due to synergistic effects with nitrous oxide.

Which antipyretic is associated with Reye syndrome in children? Acetaminophen (Tylenol) Aspirin (Bayer) Ibuprofen (Advil) Norfloxacin (Noroxin)

- Aspirin (Bayer) Aspirin should not be given to children because of its association in children with influenza virus or chickenpox and Reye syndrome. Other antipyretics include acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs). Acetaminophen (Tylenol) is the preferred drug. One nonprescription NSAID, ibuprofen (Advil), is approved for fever reduction in children as young as 6 months of age. Norfloxacin (Noroxin) is an antibiotic and is usually prescribed for bacterial infection of the gastrointestinal system.

The nurse is caring for a teenager scheduled for surgery. What criteria does the nurse use to obtain valid consent from the patient? The patient should: . Be intelligent. Be over the age of majority. Be well-informed. Act voluntarily. Be healthy

- Be over the age of majority. - be well-informed - act voluntarily To obtain valid informed consent, health care providers must meet three conditions. The person must be capable of giving consent; he or she must be over the age of majority. The person must receive the information needed to make an intelligent decision. The person must act voluntarily when exercising freedom of choice. The intelligence of the patient is not measured; the patient is only required to be competent enough to make decisions.

When is bronchial (postural) drainage generally performed? immediately before all aerosol therapy. before meals and at bedtime. immediately on arising and at bedtime. thirty minutes after meals and at bedtime.

- Before meals and at bedtime The most effective time for bronchial drainage is before meals and at bedtime. It is more effective after other respiratory therapy, such as bronchodilators or nebulizer treatments. The procedure should be done 3 to 4 times each day. When drainage is done after meals, it may cause the child to vomit.

The nurse is teaching a community health-promotion class to parents and school-age children related to bicycle safety. Issues to cover in the sessions include what? Bicycles should be walked through busy intersections. Bicycle helmets need to be worn only if the child is planning to ride in traffic. Reflectors should be installed only on bicycles that are to be ridden at night. Bicycles should be ridden against the traffic so that the rider can see the cars

- Bicycles should be walked through busy intersections. Bicycles should be walked through busy intersections to allow the child to have full view of the traffic and be able to react accordingly, with safety the number one priority. Bicycle helmets should be worn at all times to prevent head injuries. Reflectors should be installed on all bicycles, whether they are ridden during the daytime or at night only. Bicycles should always be ridden with the traffic, not against the traffic. This will assist in preventing accidents.

The nurse is caring for a patient after surgery and emphasizing skin care. What measures can contribute to skin injury? Select all that apply

- Changing the child's position - Changing diapers - Using electrodes - Using restrains

The nurse administers isoflurane (Forane) to a child for pain relief. What complication does the nurse anticipate in the child? . Increased temperature Increased respiratory rate . Increased risk of infection Decreased blood pressure

- Decreased blood pressure Vasodilating anesthetic agents such as halothane (Fluothane), isoflurane (Forane), or enflurane (Ethrane) cause a decrease in blood pressure. Increased respiratory rate can be caused by fluid volume excess, hypothermia, or respiratory distress. Vasodilating anesthetic agents decrease the temperature as opposed to increasing it. Anesthetic agents have no effect on the risk of infection.

The nurse notes that the heart rate of an infant has suddenly increased. What could be the possible cause of this increase?

- Decreased perfusion

The nurse is organizing a school-based summer camp for obese young people. What essential teaching will the nurse include for obesity management in the camp? Select all that apply.

- Diet planning - Nutrition education - Development of a positive self-image

What is the most important strategy to use when teaching about smoking prevention in teenagers?

- Emphasize the immediate effects of smoking

What is the most consistent indicator of pain in infants? Increased heart rate Increased respirations Clenching the teeth and lips Facial expression of discomfort

- Facial expression of discomfort Facial expression of discomfort is the most consistent behavioral manifestation of pain in infants. Respiratory pattern may be markedly variable in an infant in pain and thus is not a consistent indicator of pain. Heart rate may initially decrease in some infants with pain and then increase; thus it is not a consistent indicator of pain. Clenching the teeth and lips are signs of pain often assessed in the toddler, not the infant.

The nurse is obtaining a minor patient's assent for a bowel resection. What is the rationale behind this?

- It is an ethical requirement

The nurse finds that a 4-year-old child stutters. What instructions should the nurse give to the child's parents?

- Listen to the child very attentively - Do not criticize the child's speech - Speak to the child slowly and calmly

The parents of a 7-month-old infant report to the nurse that the solid food they feed to the baby passes through the gastrointestinal tract unchanged. Which response of the nurse would help to relieve the parent's anxiety?

"It is a normal finding at this age."

A parent of an 18-month-old child reports to the nurse that the child has become a "finicky eater" and is eating less. Knowing that 18-month-old children have physiologic anorexia, what suggestion does the nurse provide to improve the eating habits of the child?

"Make sure that one variety of food does not touch another variety on the plate."

The parents of a 5-year-old child are worried because the child stutters when speaking. On examination the nurse finds that the child has no problem with hearing. What should the nurse tell the parents?

- "Stuttering is common at this age and usually resolves during late childhood."

The nurse is assessing a 15-month-old girl. The child's mother reports that the child is bed-wetting and throws tantrums when made to sit on the potty seat. Which response by the nurse is appropriate?

- "You can start toilet training when the child is 18 months old."

An adolescent tells the nurse, "I feel like eating all the time. Food is the most important thing in my life." What is the SCOFF score for this adolescent? Record your answer using a whole number.

- 2

. The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. What should the nurse recognize is true?

- A developmental/neurologic evaluation is needed. (4month head lag no no; should be gone by this time.)

The nurse is caring for a child receiving mechanical ventilation. What steps does the nurse include in the basic assessment of this patient?

- Record the level of consciousness - Examine and measure the vital signs - Assess the capillary refill and skin color - Observe the chest rise and fall for symmetry

The nurse is assessing a child who is on opioid therapy for pain. Which adverse effect should the nurse be aware of in the patient

- Respiratory depression

What do characteristics of physical development of a 30-month-old child include?

- Sphincter control is achieved. - Primary dentition is complete.

The nurse is teaching students about the use of pressure-reduction devices. What statement by a student indicates a need for additional teaching? Such devices:

- Such devices prevent capillary closure.

A nurse is assessing a 4-year-old child. What age-appropriate language skills does the nurse expect the child to have fulfilled

- The child uses complete sentences of 3 to 4 words - The child at this age has a vocabulary of 1500 words

The nurse completes a pain assessment of an unconscious patient in the the critical care unit and finds that the total pain score is 20. What does the nurse interpret from this assessment? The patient had the worst pain. The patient had jerks due to pain. The patient had restlessness due to pain. The patient had adequate sedation and pain control.

- The patient had a adequate sedation and pain control (17-26 good) (26 above PAIN) The COMFORT scale is the preferred scale for assessing pain in patients in the critical care unit. It is an unobtrusive method of measuring distress in unconscious and ventilated patients. If the patients' pain score lies between 17 and 26 on this pain scale, it indicates that the patient has adequate sedation and pain control. Therefore a score of 20 on the COMFORT scale indicates that the patient is free of distress. A score greater than 26 on the COMFORT scale would indicate that the patient is in pain. The patient in this situation has adequate pain control, which means that the patient does not perceive pain or have jerks or restlessness due to pain.

The nurse preparing a nutritional teaching plan for the parents of a preschool child should include which information?

- The quality of the food consumed is more important than the quantity.(1800 cal)

What is an important consideration when using the FACES pain-rating scale with children? that children color the face with the color they choose to best describe their pain. the scale can be used with most children, including those as young as 3 years old. the scale is not appropriate for use with adolescents. the scale is useful in pain assessment but is not as accurate when assessing physiologic responses.

- The scale can be used with most children, including those as young as 3 years old. The FACES scale has been validated for children as young as 3 years old to rate pain. The child points to the face that best describes the pain being experienced. The scale is useful for all ages above 3 years, including adults. The scale does not have a means of assessing physiologic data.

The relative of a child receiving oxygen therapy brings the child a remote-controlled airplane as a gift. What safety risk does the toy present to the patient? The toy can cause fire The toy may distract the child. The toy may cause suffocation. The toy may have toxic lead paint.

- The toy can cause fire. Electrical or friction toys are not safe because sparks can cause oxygen to ignite. Bags made of plastic or other material are more likely to cause suffocation. Toxic lead paint is usually a concern for toys from unknown manufacturers. Distraction can be an advantage for the child because it is likely to bring some joy and solace.

Which statement is correct about young children who report sexual abuse? In most cases, the child has fabricated the story. They may exhibit various behavioral manifestations. Their stories are not believed unless other evidence is apparent. They should be able to retell the story the same way to another person.

- They may exhibit various behavioral manifestations. There is no diagnostic profile of the child who is being sexually abused. Many different behavioral manifestations may be exhibited. Adults are reluctant to believe children, and sexual abuse goes unreported. The physical examination is normal in 80% of the abused children. The child will usually try to protect parents and may accept responsibility for the act. A young child may not be able to retell the story the same way multiple times.

The nurse is teaching a group of parents about the importance of children building peer relationships. What points should the nurse plan to incorporate in the teaching plan? Select all that apply. This is the time when children develop best friends. Teach the child to behave in an acceptable manner. Teach the children to appreciate differences in others. Children become more egocentric in their peer group. Peers help to improve the cognition level in many children.

- This is the time when children develop best friends. - Teach the child to behave in an acceptable manner. - Teach the children to appreciate differences in others. Daily interactions and maintaining of peer relations have a great impact in the social development of children. Peer relationships teach children to appreciate the differences in others and others' opinions. Peer relationships help to develop good friends, and children develop best friends with whom they share secrets and have fun. The peer relationship teaches the child to behave in an acceptable manner by watching appropriate behavior in others. Children's cognition levels are developed according to their age and their coordination. Peer relationships do not affect the child's cognition level. Peer relationships have a great impact in reducing the egocentric outlook in children and help in maintaining healthy relations

. A child is being seen in the emergency department with multiple facial abrasions and lacerations. The combination agent lidocaine, adrenaline, and tetracaine (LAT) is applied topically to the wounds. What is the purpose of this combination therapy?

- To provide anesthesia to the wound

The nurse allows a 2-year-old child to play in the play area of the clinic. Which play items are suitable for this child?

- Wood puzzles - Construction sets

The nurse administers morphine (Avinza) through lumbar puncture for a terminally ill child. What is the preferred route of administration if the pain is resistant to the drug? Intrathecal Intravenous Intradermal Intramuscular

- intrathecal Administering analgesics for terminally ill patients helps in relieving pain but does not treat the cause of pain. Analgesics such as opioids are administered at double dosages for effective pain management for these patients. The intrathecal route is preferred for administering morphine if the pain is resistant to the drug. Intrathecal administration entails administering the drug into arachnoid or subarachnoid spaces. Intravenous administration is preferred if the pain is sensitive to the drug. Intradermal and intramuscular routes are not used for administering opioids in terminally ill patients. Administering the drug through these routes may reduce absorption.

The best explanation for why pulse oximetry is used on young children is that it: It is noninvasive. It is better than capnography. It provides intermittent measurements of O2. It is more accurate than arterial blood gases.

- is noninvasive. Pulse oximetry is a noninvasive method to determine oxygen saturation. Capnography measures carbon dioxide exhalation. It does not reflect oxygen perfusion. Pulse oximetry is less invasive and easier to test than arterial blood gases. Pulse oximetry provides continuous or intermittent measurements of oxygen saturation.

What type of enema is the nurse most likely to use for a child? 1. Plain water 2. Fleet enema 3. An isotonic solution 4. Commercial enema

- isotonic solution An isotonic solution is used in children. Plain water (hypotonic) is not used because it can cause rapid fluid shift and fluid overload. The Fleet enema is not advised for children because of the harsh action of sodium biphosphate and sodium phosphate. Commercial enemas can be dangerous to patients with megacolon and dehydrated or azotemic children.

The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.)

- large blocks - Alphabet flash cards - dolls - hand puppets

A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after the child receives his gastrostomy feeding, there is often a backup of formula feeding into the tube. As a result, the nurse should: position the child in a supine position after feedings. position the child on his or her left side after feedings. leave the gastrostomy tube open and suspended after feedings. leave the gastrostomy tube clamped after feedings.

- leave the gastrostomy tube open and suspended after feedings. By keeping the tube open to air, the buildup of pressure on the operative site will be prevented. The child should be positioned on the right side with head elevated at approximately 30 degrees. The formula is backing up into the tube because of the delayed emptying. Leaving the tube clamped will create pressure on the operative site.

. A parent of a toddler reports to the nurse that the child always says no at mealtimes. Which corrective actions does the nurse suggest to the parents?

- meals should be set at regularly scheduled times - decrease the opportunities for a negative answer - feed the child with the child's favorite plate/spoon

At what age should the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning? A. 4 months B. 6 months C. 10 months D. 14 months

10 months Consonants are added to infant vocalizations. Babbling resembles one-syllable sounds. At this age infants say sounds with meaning. This is late for the development of sounds with meaning.

. A parent of a 5-year-old child reports that the child weighs 18 kg (41 lbs), is able to draw geometric shapes, and tries to tie his shoelaces. The parent also informs the nurse that the child tries to make sentences with two to three words, understands the concept of conservation, and can count objects irrespective of their arrangement. What does the nurse infer from this regarding the child's development?

- The child has slow language development. (complete sentence w/ 6-8 words)

The nurse assessing a 12-year-old child with fever who is prescribed acetaminophen (Tylenol). The child's body weight is 55 kg (121.25 lbs). What is the maximum safe dosage of drug that the nurse can administer to the child daily?

2000

The nurse is teaching the parents of a toddler about toilet training. What is the right age to start toilet training a child?

25 to 30 months

The nurse is preparing a plan to teach a mother how to administer 1.5 teaspoons of medicine to her 6-month-old child. What should the nurse recommend using? A household measuring spoon A regular silverware teaspoon A paper cup measure in 5-mL increments A plastic syringe (without needle) calibrated in milliliters

A plastic syringe (without needle) calibrated in milliliters

What should the nurse recommend to help a toddler cope with the birth of a new sibling?

Give the toddler a doll on which he or she can imitate parenting

The nurse asks the parents to give food to a toddler on the same plate daily. Which characteristic of preoperational thought process is this instruction based on?

Global organization

The nurse should provide further teaching about SIDS prevention when hearing the mother of an 8 week old make which statement? "I only smoke in the kitchen." "I put my baby to sleep on her back." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

I only smoke in the kitchen I have my baby sleep with me instead of alone in the crib · I make sure my baby wears a flannel sleeper and has 2 blankets to keep warm in her crib ·I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night

A 3-year-old-child is brought to the hospital by a parent and presents with a fever and rash. The father tells the nurse that his wife is pregnant and he is very worried about the health of his son. After examination, the child is diagnosed with rubella. What instructions should the nurse give to the father? Select all that apply.

Inform the parent that the child needs only antipyretics and analgesics - Advise the parent that the child should not be in contact with his pregnant wife The nurse is giving anticipatory guidance to the parent of a 5-year-old. In this guidance, it is MOST important to: - inform the parent to expect a more tranquil period at this age.

. A 4-year-old female child is afraid of dogs. What should the nurse recommend to her parents to help her with this fear?

Let her watch other children play with a dog

The school nurse is discussing dental health with some children in first grade. What should the nurse include in the discussion? Teach how to floss teeth properly Recommend a toothbrush with hard nylon bristles Emphasize the importance of brushing before bedtime Recommend nonfluorinated toothpaste approved by the American Dental Association

Emphasize the importance of brushing before bedtime Rational: Children should be taught to brush their teeth after meals, after snacks, and before bedtime. Parents should help with flossing until children develop the dexterity required, which occurs at about the time of third grade. A toothbrush with soft nylon bristles is recommended. The American Dental Association recommends fluoridated toothpaste for this age group.

The nurse is educating new parents about the prevention of sudden infant death syndrome (SIDS). What position does the nurse tell the parents is the best sleeping position for their infant? Supine Prone On the side4 On a chair

Supine The safest sleeping position to prevent SIDS is wholly supine. No pillows should be placed in a young infant's crib while the infant is sleeping. Lying prone or lying on the side can raise the risk of sudden infant death syndrome as the infant's nose may get covered by the bed. Putting the child on a chair may be unsafe as the child may fall off of the chair.

The nurse is assessing a 4-year-old child with delayed motor development. The nurse notes that the child stands with a wide base. What does the nurse interpret from this finding?

The child has impaired balance of the body

. The school nurse is teaching a class on injury prevention. What should be included when discussing firearms? Adolescents are too young to use a gun properly for hunting. Gun carrying among adolescents is on the rise, primarily among inner-city youth. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns. Adolescence is the peak age for being a victim and/or offender in the case of injury involving a firearm.

adolescence is the peak age for being a victim and/or offender in the case of injury involving a firearm Gun carrying among adolescents is on the rise. Adolescents can be taught to safely use guns for hunting, and that they must be stored properly and used only with supervision. Gun carrying is on the rise among adolescents and is not limited to the inner-city youth population. Air rifles and BB guns can cause almost as many injuries as powder guns.

The parents of a toddler express frustration to the nurse because their child is a "fussy eater." What is the nurse's best response?

becoming a fussy eater is expected during the toddler years

The nurse is caring for a child who has just had the eruption of lateral maxillary incisors and mandibular cuspids. Which developmental activity corresponds with this child's age? (8-9)

The child plans to wake up early just to read

The parents of a 3-year-old child are worried as their child seems to have imaginary friends. They report that their child talks to friends who do not exist. What should the nurse tell the parents?

The child's behavior is normal for a girl her age.

The nurse is assessing a 2-year-old child as part of a general examination. Which phase of cognitive development does the nurse assess?

The preconceptual stage of the preoperational phase

The nurse educator instruct a nursing students that according to Erikson's infancy is concerned with acquiring a sense of what? Trust Industry Initiative Separation

Trust

When explaining the proper restraint of toddlers in motor vehicles to a group of parents, the nurse should include:

placing the car seat in the back seat of the car facing forward.

Which symptoms does the nurse expect to find in the teething infant? Irritability Drooling Vomiting Skin rashes Facial edema

· -Irritability - Drooling

The nurse is teaching nursing students about vaccine administration. Which statement made by the nursing student indicates effective learning? Vapocoolant spray should apply to the skin after administering the vaccine." "The influenza vaccine should not be administered to the patient with asthma." All vaccines should be given to adults by using a 25-mm (1-in) length needle." "A 16-mm (5/8-inch) length needle is used to administer the vaccine to newborns."

"A 16-mm (5/8-inch) length needle is used to administer the vaccine to newborns."

A parent expresses to the nurse that the parents delayed sending their child to school because the child did not want to leave home. What information should the nurse give to the parent to improve the child's adaptability to school? "Provide special care and a lot of attention to the child at home after school." "Let the child be at home until the child feels comfortable attending the school." "Enroll the child as well as the child's best friend in the school at the same time." "I know it is hard to see your child mature, but you need to let your child go to school."

"I know it is hard to see your child mature, but you need to let your child go to school." The child's adaptation to school is a major milestone for the developmental stage. The child's adaptation to school depends on various factors. Clinging behavior by the parents is a major factor. This behavior prevents the child from becoming mature and adapting to the school. It is not necessary to enroll the child with a friend; the child may develop relations once adapted to the school. Special care and extra attention is not required for a child with normal growth and development. Delaying the schooling would hamper the cognitive development in the child. Therefore the parents should enroll the child in the school as per the age.

The nurse is preparing to administer an intramuscular immunization to a 5-year-old child. The child says to the approaching nurse, "Please don't do that. My blood can leak out from my body and I may die." Which is the best response of the nurse to the boy?

"I will apply a bandage; it will not allow blood to come out."

The nurse is teaching the parent of a 16-month-old child about safety measures that should be taken while storing medications at home. Which statement made by the nurse is most appropriate to prevent accidental poisoning of the child?

"Always keep lozenges and transdermal patches in a closed locked cabinet."

The school nurse has asked a group of 8-year-old children to write a sentence about what they have learned from the class regarding bicycle safety. Which statement indicates the need for further teaching in the children? "Always keep as close to the curb as possible." "Always ride with traffic and towards parked cars." "Stay in a single file when riding bikes with friends." "Walk bikes across busy streets only at crosswalks."

"Always ride with traffic and towards parked cars." Nurses play a vital role in educating children about bicycle safety. Children must be instructed to always ride with the traffic and away from parked cars to prevent accidental collisions. It is also important to stay in a single file when riding with friends, keeping as close to the curb as possible, and to walk bikes across busy streets only at crosswalks. All these measures help in reducing accidents and preventing serious injuries to children.

An adolescent hospitalized after a suicide attempt states, "I have recovered, and I am able to sleep well. I have lot of things to do when I get home, and I don't need to stay in the hospital anymore." What question does the nurse ask to confirm the adolescent's statement?

"Are you still having thoughts of suicide?"

The nurse is educating a group of parents about safety promotion and injury prevention in the infant. Which statement made by a parent indicates effective teaching?

"Diaper pins should be kept closed and away from the infant."

The nurse is interviewing an obese adolescent. What questions does the nurse ask the patient during the assessment? Select all that apply.

"Do you have pain in your joints?" - "Do you have skin discoloration?" - "Do you have difficulty swallowing?"

Parents report that their 13-year-old child is eating excessive amounts of food. What does the nurse suggest to the parents? "Give only fruit juices to the child for several days." "Encourage the child to have nutritious food regularly." "Give small amounts of food to the child frequently." "Encourage the child to skip breakfast and have brunch."

"Encourage the child to have nutritious food regularly." Nutritional needs are high during adolescence to accommodate rapid physical growth and high levels of physical activity. Therefore the nurse should tell the parents to encourage the child to eat food that is rich in nutrients. This helps the child avoid eating junk food, which contains high amounts of fat. The child needs a balanced diet that contains carbohydrates and other important nutrients. Giving only juices to the child may not fulfill the child's nutritional needs. Unlike infants, adolescents need not be given food frequently, because it may cause obesity. Adolescents tend to skip breakfast because of time pressure. Therefore the parents should encourage the child to eat breakfast because it helps control weight and reduces hunger throughout the day.

The parents of a 2-year-old child are worried and report to the nurse that their child always sleeps on the rocking chair and not the bed. They add that the child is afraid to sleep on the bed due to a fear of a monster under the bed. What does the nurse recommend to the parents?

"Encourage the child to sleep on the child's own bed by putting the child to bed when awake."

An adolescent with hypertension reports having sudden enlargement of the breasts. Which statement given by the patient will help the nurse understand the reason for this? I am on a low-salt diet for hypertension." "I am on a low-cheese diet for hypertension. "I am taking calcium channel blockers for hypertension." "I am doing physical exercise regularly for hypertension."

"I am taking calcium channel blockers for hypertension." (gynecomastia)

. A parent has a 2-year-old in the clinic for a well-child checkup. Which statement by the parent indicates to the nurse that the parent needs more instruction regarding accident prevention?

"We stopped using the car seat now that my child is older."

The nurse notices a child refuses to drink milk at the hospital. When the nurse asks the child about it, the nurse discovers that at home the child drinks milk in a small glass. What is the most acceptable nursing intervention?

The nurse pours the milk into a small glass for the child to drink.

The nurse is teaching motor vehicle injury prevention measures to a group of parents. Which statement made by a parent indicates effective learning?

The parent will only use federally approved car restraints.

The nurse is caring for a 10-year-old patient after surgery. The nurse gives the patient an inhaled anesthetic for pain relief. What is an important consideration for the patient? The patient may develop asthma. The patient may develop tachycardia. The patient may still feel intense pain. The patient may need hyperventilation.

The patient may develop tachycardia. In susceptible children inhaled anesthetics and the muscle relaxant succinylcholine trigger malignant hyperthermia (MH), producing hypermetabolism. Symptoms of MH include hypercarbia, elevated temperature, tachycardia, tachypnea, acidosis, muscle rigidity, and rhabdomyolysis. Inhaled anesthetics are used for asthma; they are not contraindicated for asthma. The patient will require hyperventilation only when MH gets confirmed through diagnosis. The patient is likely to feel less pain after the administration of the anesthetic.

The nurses caring for a child are concerned about the child's frequent requests for pain medication. During a team conference, a nurse suggests that they consider administering a placebo instead of the usual pain medication. What should this decision be based on this practice is unjustified and unethical. this practice is effective in determining whether a child's pain is real. the absence of a response to a placebo means the child's pain has an organic basis. a positive response to a placebo will not occur if the child's pain has an organic basis.

The practice is unjustified and unethical Placebos should never be given by any route in the assessment or management of pain. Placebos should never be given as a means to determine whether pain is real. Individuals respond differently to placebos; thus the patient's response may not be an accurate measure of pain. Response to a placebo is not a measure of the origin of pain and should never be used as a means of assessing pain.

The nurse at an educational camp is explaining to parents about the growth and developmental changes in a preschooler. Which changes should the nurse mention?

The preschool age child is curious about sexual reproduction.

The nurse is educating a group of adolescents about body piercing. Which infections that can be transmitted by body piercing should the nurse include in patient teaching for this group? Select all that apply.

- Hepatitis B virus - Hepatitis C virus - Human immunodeficiency virus

When preparing parents to teach their preschool child about human sexuality, what should the nurse emphasize?

- Parents should determine exactly what the child wants to know before answering a question about sex.

What is the nurse's best approach for effective communication with a preschool-age child through? Play Actions Speech Drawing

- Play

A 4-year-old child is diagnosed with an inguinal hernia. The parents are informed that their child needs to be admitted in the hospital for elective surgery. They are upset about receiving the news. What advice should the nurse give the parents?

"Prepare the child for hospital admission and surgery by explaining it in simple language."

Parents reports to the nurse that their 12-year-old child resists going to bed at night. Which advice does the nurse give to the parents to help the child go to bed on time? "Promote daytime naps on a daily basis." "Promote reading a book before bedtime." "Urge video game playing before bedtime." "Allow the child to go to bed at a later time."

"Promote reading a book before bedtime." Bedtime resistance can be resolved by allowing the child to read before bedtime. Many 12-year-olds prefer to read before bed. The child's bedtime should not be changed because school-age children need adequate sleep. School-age children do not require naps, which can hamper sleeping at night. Children should not play video games before going to bed. This may stimulate and excite the child and make it harder to fall asleep.

. Nurse is educating parents about SIDS. How to prevent? SATA "The side-lying position is the best for the infant." "Smoking should be prohibited around the infant."" Adults should not share their bed with the infant." "Soft bedding should be used for the infant's bed." "Preterm infants can be placed in the supine position."

"Smoking should be prohibited around the infant." · "Adults should not share their bed with the infant." ·"Preterm infants can be placed in the supine position."

The nurse is educating a group of mothers about expressing breast milk for feeding the infant. Which statement made by the parents indicates the need for further teaching?

"The expressed breast milk should be heated in a microwave before feeding my baby."

The student nurse working in a pediatric ward asks the clinical instructor, "Why do most toddlers have several episodes of tonsillitis and upper respiratory tract infections?" Which response given by the clinical instructor is appropriate?

"The respiratory tract of toddlers is short and straight."

The nurse is teaching a student nurse about the growth and development in school-age children. The nurse states that there are few prominent changes that can be found in the school-age child as compared to a preschooler. Which statement should the nurse include in the teaching? Permanent teeth appear too large for the face. Excess fat deposition provides a bulky appearance. Head circumference decreases in relation to height. Leg length increases in relation to the child's height. Calorie needs are smaller due to low physical activity.

- Head circumference decreases in relation to height. - Leg length increases in relation to the child's height. - Permanent teeth appear too large for the face. During the school-age period, children's height rapidly increases to meet their physical needs. As a result, the head circumference of a school-age child is smaller when compared to overall height. Due to the loss of baby teeth, early deciduous teeth are lost and secondary teeth start to appear in the school-age child. These secondary permanent teeth may appear too large for the child's face. The child's leg increases when compared to increase in the height. Therefore the school-age child has long legs. The school-age child appears to be thinner when compared to the preschooler due to the excessive physical activity. The fat gets distributed evenly, and the child does not have a bulky appearance. The caloric needs of the child gradually decrease in the school-age child as compared to the preschooler. However, the parents must be informed to give a balanced diet to children for proper physical growth.

The nurse is assessing a 5-year-old child and finds the child to be physically fit. After further discussion with the parent, the nurse finds that the child talks, plays, and interacts with an imaginary playmate more than with other children. What advice does the nurse give to the parent?

- Help the child to differentiate between make believe and reality - Develop positive interactions with the child through mutual play

After abdominal surgery, a 12-year-old child is receiving morphine (Avinza) for pain control via a patient-controlled analgesia (PCA) infusion. What statement indicated the nurse that the patient understands the instructions about the PCA pump?

- I can push the button to take a dose of the medicine whenever I feel pain.

The nurse is educating a group of parents about stranger safety guidelines. Which statements by the parents indicate effective teaching?

- I should teach my child to say "No" to gifts from strangers - I should listen to my child's concerns regarding other people - I should teach my child to never go anywhere with a stranger - I should pay attention if my child is uncomfortable with others

Following an assessment, the nurse suspects that a child is subjected to emotional abuse. What interventions does the nurse perform to provide care to the emotionally abused child? Select all that apply Identify the instance of abuse or neglect Keep the child alone in a separate room Report the findings to the local authorities Tell the child's teacher about her condition Take care of the child's physical and developmental needs

- Identify the instance of abuse or neglect - Report the findings to the local authorities - Take care of the child's physical and developmental needs A child suffering from emotional abuse and neglect may have poor nutrition, low self-esteem, and reduced immunization. The nurse should inform the local authorities about the situation so they can prevent further abuse. The nurse should provide a balanced diet by enrolling the child in support programs and should take care of the child's needs for proper growth and development. The emotionally abused child may feel lonely. To improve socialization, the nurse should encourage the child to mingle with peers, not keep her alone in a separate room. The child may feel rejected and inferior if her teacher is informed of the situation.

The nurse observes erythema, pain, and edema at a child's intravenous (IV) site with streaking along the vein. What should the nurse do FIRST? Immediately stop the infusion. Check for a good blood return. Ask another nurse to check the IV site. Increase the IV drip for 1 minute and recheck.

- Immediately stop the infusion.

When discussing pubertal growth changes with an adolescent male, what information should the nurse include?

- In girls, puberty occurs about 1 year before it appears in boys.

Parents of a newborn report to the nurse that their toddler does not allow them to provide care to the new baby. What does the nurse instruct the parents?

- Include the toddler during caregiving activities

Nursing responsibilities in the management of adolescent obesity include? planning a low-calorie, low-protein diet. incorporating favorite foods into the child's diet. encouraging diversional activities during mealtimes. using nutritious foods as a method of reward.

- Incorporating favorite foods into the child's diet Incorporating small amounts of the adolescent's favorite foods will increase adherence to the nutritional plan. A food plan high in nutrients, with calories and fats kept at a healthy level, is recommended. Diversional activities such as television watching may contribute to overeating. Foods should not be used as a reward.

What points should the nurse keep in mind when administering analgesics to a patient? SATA Increase dosage gradually Administer a safe initial dose Provide optimal pain relief with sedation Control pain without regard to side effects Administer the maximum safe dose initially

- Increase dosage gradually - Administer a safe initial dose The nurse should be alert in maintaining the dosage when administering analgesics to a patient. The dosage should be increased gradually until the pain is relieved. Initially, a safe dosage should be administered to the patient. The nurse should administer a dosage that gives maximum pain relief and minimal side effects. Administering a high dosage of analgesic may precipitate adverse effects in the patient and thus should be avoided. The dosage of the analgesic drug should give optimal pain relief with little or no sedation.

A child's parents report that the child spends all his time watching cartoons and amusement programs on the television. What could be the consequences if the child continues this behavior?

- Increased risk of obesity - Reduced physical activity - Reduced academic efficiency

What information should the nurse include when teaching parents about interventions to help their children in school? Select all that apply. Parents should help the children by doing their homework for them. Parents should demonstrate an interest in what the child is learning. Parents should use a rewards system rather than using punishment. Parents should try to stimulate creative thinking and problem solving. Parents should send their child to school based on the child's comfort.

- Parents should demonstrate an interest in what the child is learning. - Parents should use a rewards system rather than using punishment. - Parents should try to stimulate creative thinking and problem solving. Rational: Parents should take an active part in their child's schooling. Parents should reward their child for good performance; it helps to reinforce good behavior. In order to prevent the fear of making mistakes, parents should stimulate creative thinking and problem-solving skills in the child. Parents should show interest in what their child does at the school. This encourages the child to perform better. Parents should ensure that their children go to school regularly and not leave it to the child's willingness or comfort. Parents should explain a question instead of answering it when they are helping with their child's homework. This would improve the thinking abilities of a child.

The nurse is assessing musculoskeletal pain in a child who has juvenile rheumatoid arthritis. As part of the assessment, the nurse asks about about the family history related to arthritis. The nurse also includes visual analog scales in the assessment. Which pain instrument is the nurse using?

- Pediatric Pain Questionnaire

The nurse is assessing a 9-month-old infant. Which type of play should the nurse suggest to the infant's parents? Peekaboo Pat-a-cake Push-pull toy Soft stuffed toy Large plastic ball

- Peekaboo - Pat-a-cake

The nurse is assessing an adolescent suspected of having bulimia nervosa. Which behaviors does the nurse identify as compensatory methods for binge eating? Select all that apply.

- Periods of starving - Self-induced vomiting - Repeated use of laxatives

The nurse needs to take the blood pressure of a preschool boy for the first time. Which action is best in gaining his cooperation? Take his blood pressure when a parent is there to comfort him. Tell him that this procedure will help him get well more quickly. Permit him to handle equipment and see the dial move before putting the cuff in place. Explain to him how the blood flows through the arm and why the blood pressure is important.

- Permit him to handle equipment and see the dial move before putting the cuff in place. Permitting the child to handle the equipment and see the dial move allows him to play out the experience ahead of time. The parent's presence will be helpful, but it will not alleviate fear of the unknown. The child will not be able to understand the relationship between blood pressure and feeling better. Additionally, there is no evidence that this procedure will help him get well more quickly. Explaining how blood flows through the arm is too complex for this age group.

The nurse is caring for a child who is frequently hospitalized with either an injury or infection. On further assessment of the child's medical history, the nurse finds that the child had delayed immunization and malnutrition. What possible reason does the nurse consider for delayed immunization and malnutrition in the child? Severe illness of the child Improper growth of the child Physical abuse by the parents Physical neglect by the parents

- Physical neglect by the parents. A child who is physically neglected by parents may not get the attention to basic needs that he or she requires. Consequently, the child may have delayed immunization and malnutrition and frequently fall ill and develop infections. Delayed immunization and malnourishment are not caused by severe illness. Improper growth is a consequence of malnourishment, not the reason for malnourishment. Physical abuse involves causing injury to the child, not necessarily malnourishment or delayed immunization.

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other trauma resulting from a motor vehicle injury. The child is experiencing severe pain. An important consideration in managing the child's pain is to: Give only an opioid analgesic at this time Plan a preventive schedule of pain medication around the clock Increase the dosage of analgesic until the child is adequately sedated Give the child a clock and explain when he or she can have pain medications

- Plan a preventive schedule of pain medication around the clock An around-the-clock administration strategy should be used for a child recovering from trauma and surgery. This schedule will help prevent low plasma levels of the drug, leading to breakthrough pain. Giving an opioid analgesic is appropriate for the immediate pain but will not facilitate the more long-term plan of pain management. The dosage of analgesic is increased until pain is controlled, not until sedation is adequate. The child should be frequently assessed for pain, and medication doses titrated accordingly. It is inappropriate to give a child a clock with instructions as to when pain medication can be given, especially a child who has experienced a traumatic event. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

The nurse is assessing a 5-year-old obese child and finds that the child has unusual eating habits. What advice should the nurse give to the parents to help improve the child's health? Compare the child to peers Exclude fiber from the child's diet Play outdoor games with the child Provide skim milk in the child's diet Supplement fruit juices in the child's diet

- Play outdoor games with the child - Provide skim milk in the child's diet

Which fine motor activity can be observed in a 4-month-old infant? Holding a bottle Grasping objects Playing with a rattle Taking objects directly to mouth

- Playing with a rattle

When teaching about the effects of social media on the adolescent population, the nurse should include which negative impacts? Select all that apply A. Possibility of cyberbullying B. Opportunity for adolescents without many friends to interact with others C. Disruptive texting during school D. Sharing of personal information with sexual predators E. Time management

- Possibility of cyberbullying - Disruptive texting during school - Sharing of personal information with sexual predators

Informed consent is valid when: 1. Universal consent is used 2. It is completed only for major surgery. 3. A person is over the age of majority and competent. 4. Information is provided to make an intelligent decision. 5. The choice exercised is free of force, fraud, duress, or coercion.

- a person is over the age of majority and competent. - information is provided to make an intelligent decision. - the choice exercised is free of force, fraud, duress, or coercion. The age of majority is usually 18 years. The term competent is defined as possessing the mental capacity to make choices and understand their consequences. Enough information is provided so that the person can make an intelligent decision. The person giving consent does so voluntarily; that is, freely without coercion, any form of constraint, force, fraud, duress, or deceit. Universal consent is not sufficient. Informed consent must be obtained for each surgical or diagnostic procedure. Informed consents must be obtained for major and minor surgery, diagnostic tests, medical treatments, release of medical information, postmortem examination, removal of a child from the health care provider against medical advice, and photographs for medical, educational, or public use. The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What should be the next action by the nurse?1. Notifying the surgeon2. Performing oral intubation3. Trying to insert a larger-size tube4. Trying to insert a smaller-size tube 4. Trying to insert a smaller-size tube

What does the nurse include in a program designed to teach parents and children about preventing childhood poisoning?

- adequate supervision by parents - appropriate first aid care at home - safe storage of hazardous materials

A hospitalized teenager and family are praying at the bedside. The nurse is aware that the most accurate description of the spiritual development of the older adolescent is that: (Most descriptive of the spiritual development of the older adolescent is that:)

- beliefs become more abstract.

The nurse is assessing a 16-year-old obese adolescent. The clinical reports indicate high serum triglyceride levels. The nurse advises the adolescent to undergo an electrocardiogram (ECG). What could be the reason behind it? The adolescent is at risk for: Renal disorders Hepatic diseases Cardiac disorders Pulmonary diseases

- cardiac disorder High levels of triglycerides in serum and obesity are the major risk factors for cardiovascular disease in adolescents. Therefore the adolescent is advised to undergo an ECG to determine the presence of cardiovascular disease. Obesity does not increase the risk of renal, hepatic, or pulmonary disease.

The nurse is assessing a preschool age child who is stuttering when answering the nurse's questions. The nurse should offer alternate methods of responding to the stuttering when observing the parent:

- completing the child's sentences.

When caring for an individual with anorexia nervosa, what is the most important nursing intervention?

- correct malnutrition

The nurse is caring for a 10-year-old child with a body mass index (BMI) in the 95th percentile for age. Which complications will the nurse evaluate in the child? Select all that apply. Diabetes Hypotension Hypertension Hyperlipidemia Hypolipidemia

- diabetes - Hypertension - Hyperlipemia Children with BMIs in the 85th to 95th percentile range should be evaluated for secondary complications such as diabetes, hypertension, and hyperlipidemia. These conditions can result from obesity and should be assessed in the obese child. Obesity leads to hypertension and hyperlipidemia but not hypotension or hypolipidemia.

Several types of long-term central venous access devices are used. A benefit of using an implanted port (e.g., Port-a-cath) is that it: is easy to use for self-administered infusions. does not need to pierce the skin for access. does not need to limit regular physical activity, including swimming. cannot dislodge from the port, even if child plays with port site.

- does not need to limit regular physical activity, including swimming. Because this device is totally under the skin, there are no activity limitations for the child. The port has to be accessed with a special needle. Because the port is totally under the skin, a needle must be used to access the port. The port site is under the skin, so there is nothing for the child to play with.

When completing the health assessment for a 2-year-old child, what should the nurse expect the child to do?

- engage in parallel play

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age group? Select all that apply.

- falls - drowning - poisoning - tricycle and bicycle accidents

When caring for a preschool age child, the nurse should incorporate knowledge that body image has developed to include:

- fear of intrusive procedures.

An infant's parent reports to the nurse that the infant is very irritable, has difficulty sleeping, and refuses to eat solid foods due to teething. What nursing interventions should the nurse include in the plan of care to make the infant comfortable? Provide hard candy for the infant Give ibuprofen (Advil) to the infant Use frozen liquid-filled teething rings Rub the infant's gums with salicylates

- give ibuprofen (ADVIL) to the infant

Standard Precautions for infection control include that: gloves are worn any time a patient is touched. needles are capped immediately after use and disposed of in a special container. gloves are worn to change diapers when there are loose or explosive stools. masks are needed only when caring for patients with airborne infections

- gloves are worn to change diapers when there are loose or explosive stools. Aspirin should not be given to children because of its association in children with influenza virus or chickenpox and Reye syndrome. Other antipyretics include acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs). Acetaminophen (Tylenol) is the preferred drug. One nonprescription NSAID, ibuprofen (Advil), is approved for fever reduction in children as young as 6 months of age. Norfloxacin (Noroxin) is an antibiotic and is usually prescribed for bacterial infection of the gastrointestinal system.

Which instructions should the nurse give to the parents of a preschooler to promote optimal growth and development?

- ignore focusing on the dysfluency of speech. - Anticipate a stable appetite. - Provide up-to-date immunity

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of:

- initiative

A teacher asks a school nurse what sports should be included in the curriculum for school-aged children. What is the nurse's response? Girls should only compete with girls when they are preadolescents. Sports activities should include both practice sessions and unstructured play. The actual sporting event should aim to stress the point of winning the game. Common sports for school-aged children include baseball, soccer, and swimming. All participants should be recognized in special ceremonies, not just the winners.

- sports activities should include both practice sessions and unstructured play. - Common sports for school-aged children include baseball, soccer, and swimming. - All participants should be recognized in special ceremonies, not just the winners Teachers should include only age-appropriate sports activities in schools, which a school nurse can help in determining. It is appropriate to have activities that include practice sessions and unstructured play. Common sports for school-aged children include baseball, soccer, and swimming. It is important to recognize all the participants in special ceremonies and not just the ones who excel. In the preadolescence stage, there is no difference between strengths of boys and girls; therefore girls can compete with boys at this age. It should be emphasized to the school management that actual sporting events should aim to stress the point of mastering a sport or enhancing self-image rather than winning.

The nurse is assessing a child who has frequent headaches. The nurse teaches breathing exercises to the child to help relieve the headaches. What condition in the child is the nurse trying to treat?

- stress Rational: Children at different developmental stages undergo different types of stress that manifests as abdominal pain, headaches, and breathlessness. These symptoms can be relieved by practicing relaxation techniques such as deep breathing. Meningitis is an infection of the meninges. It may be treated by antibiotics; breathing exercises play no role in treating meningitis. Children with asthma are prescribed medications used to treat the disease and instructed to stay away from triggers. Children with influenza are provided supportive measures such as complete bed rest and good nutrition for recovery.

Cooper is an 8-year-old who is very excited about attending Lacrosse camp this summer. His mother has received registration forms along with a request for a physical examination and recommendations to have all immunizations up to date. The nurse is preparing the examination room for Cooper's visit and is responsible for administering the necessary boosters. Using the chart below, determine which catch-up doses Cooper will need. He is not considered high risk.

- tdap - mmr -varicella - hep B

The nurse is teaching the parents of a 24-month-old about motor skill development. Which statement should the nurse include in the teaching?

- the toddler's activities begin to produce purposeful results

The nurse is caring for a child with a nasogastric tube. What conditions may be seen in children that can make them incapable of taking nourishment by mouth? SATA

- unconsciousness - Respiratory distress - disease of the throat - disease of the esophagus

The parents of a toddler state their child is having trouble sleeping. What is the nurse's best suggestion to improve sleep habits?

- use a transitional object

When caring for a child with an intravenous (IV) infusion, the most appropriate nursing interventions are to:

- use an infusion pump with a microdropper to ensure the prescribed infusion rate. - check IV fluids and infusion rate with another licensed professional. - observe the insertion site frequently for signs of infiltration.

The nurse is assessing a 12-month-old child. The child's parent reports, "My child has the habit of having a bedtime bottle and sleeps only when a bottle of milk is given." What does the nurse say to the parents?

- you can give a bottle of water rather than a bottle of milk to the child

The nurse is caring for an infant who has an iron deficiency. The primary health care provider (PHP) has prescribed oral iron supplements to the infant. What instruction should the nurse give to the infant's parents for the safe administration of the supplement? Administer the medication mixed with fluids Administer the medication with all the meals Administer the medication in between meals Administer the medication with milk products

-Administer the medication in between meals

The nurse is explaining the care guidelines to the parents of a newborn baby. Which information should the nurse include in the teaching? Select all that apply. Avoid shaking the baby violently Feed the baby at proper time intervals Vaccinate the baby according to schedule Put the baby to bed immediately after feeding Expose the baby to sunlight for three hours daily

-Avoid shaking the baby violently - Feed the baby at proper time intervals - Vaccinate the baby according to schedule

Which characteristic of fine motor skills does the nurse expect to find in a 5-month-old infant?

Able to grasp object voluntarily

The parent of an 8-year-old child is worried about their child's stealing behavior. The parent informs the nurse that they have punished the child several times for stealing, but the child still repeats the act. What is the most appropriate nursing action? Advise the parent to ignore this behavior and to not discuss it with the child Advise the parents to give a reasonable punishment including returning the stolen item Inform the parents that the child has antisocial behavior and needs psychiatric consultation Advise the parent to tell the child that being jailed is possible if the child is caught stealing again

Advise the parents to give a reasonable punishment including returning the stolen item Stealing can be expected in children 5 to 8 years of age as their sense of property rights is limited. They may steal things simply because they are attracted to them. Parents should be advised to admonish such behavior and give a reasonable punishment like asking the children to return the stolen items. This would be enough for most children to learn from. Telling children that they could be jailed for the act of stealing may scare them. However, in some children this kind of behavior can indicate that there is something lacking in the child's life. For example, the child could be stealing to make up for a lack of love and affection. Therefore it is not recommended to ignore such behavior. It is also not appropriate to inform the parent that the child needs a psychiatric referral.

What is an important consideration for the patient receiving gavage feeding? The tube may infect the mouth. Careful hand washing is necessary The tube should not be changed for 1 week The tube is routed through the small intestine.

Careful hand washing is necessary. The nurse should practice meticulous hand washing during the procedure to prevent bacterial contamination of the feeding, especially during continuous-drip feedings. Infection of the mouth is not a risk; contamination of feeding is the concern. In older children, the tube is usually taped securely in place between feedings. When this is done, the tube should be removed and replaced with a new tube frequently. The gavage tube is passed directly into the stomach through either the nostrils or the mouth.

A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BEST option for a substitute is: Goat's milk Soy-based formula Skim milk diluted with water Casein hydrolysate milk formula

Casein hydrolysate milk formula.

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching?

Caution parents not to switch to a low-iron-containing formula or milk - Place iron toward the back side of the mouth with a dropper

A parent reports to the nurse that the child refuses to wear long zipped pants and prefers short button pants. Which characteristic of preoperational thought is exhibited by the child?

Centration

The nurse should teach volunteers in the after-school program that which characteristic is most descriptive of the social development of school-age children? Identification with peers is minimal. Children frequently have "best friends." Peer approval is not yet an influence toward conformity. Boys and girls play equally well with children of either gender.

Children frequently have "best friends. Same-sex peers form relationships that encourage sharing of secrets and jokes and coming to each other's aid. Identification with peer group is an important factor toward gaining independence from families. During the school-age years there are more gender-specific groups. Conforming to the rules is an essential part of group membership.

The nurse is starting an intravenous (IV) line on a school-age child with cancer. The child say's, "I have had a million IVs. They hurt." The nurse's response should be based on what? Children tolerate pain better than adults. Children often lie about experiencing pain. Children become accustomed to painful procedures. Children often demonstrate increased behavioral signs of discomfort with repeated painful procedures.

Children often demonstrate increased behavioral signs of discomfort with repeated painful procedures Children often demonstrate increased behavioral signs of discomfort with repeated painful procedures. Children with chronic illnesses are more likely to identify invasive procedures as stressful compared with children with acute illnesses. There are no data to support the theory that children tolerate pain better than adults. The child has increasing difficulty with numerous and repeated painful procedures rather than becoming accustomed to them. Pain is whatever the experiencing person defines it to be.

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is what? unsafe play that should be discouraged. creative play that should be encouraged. suggestive of limited family resources. suggestive of limited adult supervision.

Creative play that should be encouraged

An adolescent female is unusually preoccupied by her appearance. When the nurse asks the adolescent, "Do you make yourself sick because you feel uncomfortably full?" the adolescent replies no. The nurse asks her if she has lost control over how much she eats; the adolescent says no. The child says that she has lost more than 8 kg of weight in the last 3 months and she believes that she is fat, whereas her parents tell her that she is too thin. She does not think that food dominates her life. What can the nurse interpret about this girl? Needs further assessment for the presence of cancer. Is normal and does not require any other treatment. May have depression and needs psychiatric referral. Most likely has anorexia nervosa or bulimia nervosa.

The child most likely has anorexia nervosa or bulimia nervosa. Eating disorders like anorexia nervosa and bulimia nervosa are common in adolescents and can be seen in children as young as 10 years. It is important to conduct a screening test in all children who are at high risk. Screening can be done using medical interview such as a questionnaire like SCOFF, as physical findings could be normal in early stages of disorder. In SCOFF questionnaire, each question is scored as 1, if the child's response is yes, and a score of 2 or more indicates that he or she most likely has anorexia nervosa or bulimia nervosa. The score of the girl in the current scenario is 2. Though weight loss can be seen in cancer and depression, there are no other symptoms indicating the possibility of either of them. It would be incorrect to say that the child is normal.

Following an assessment, the nurse concludes that the child has a learning disability. Which activities of the child support the conclusion? The child runs useful errands. The child shows trouble listening. The child takes part in group play. The child has difficulty in speaking. The child demonstrates stubborn behavior.

The child shows trouble listening. The child has difficulty in speaking.

Which fine motor activity does the nurse observe in a 6-month-old infant? The infant can hold a milk bottle .The infant drops a cube in the cup .The infant is able to hold two cubes .The infant grabs a bell by the handle.

The infant can hold a milk bottle.

While assessing an infant, the nurse notices a typical bald spot, a symmetric distortion of the skull, and torticollis. What should the nurse interpret from this assessment? The infant has a bacterial infection. The infant has a vitamin E deficiency. The infant has a vitamin C deficiency. The infant has positional plagiocephaly.

The infant has positional plagiocephaly

An adolescent is brought to the hospital by the parent. The adolescent has a slump and cannot sit upright, On examination, the nurse finds a painless curvature of spine side to side. What should the nurse advise the parent? "Your child has got scoliosis and would require immediate surgery." "Do not worry as this is very common problem in this age group, just ignore it." "Your child has a serious problem with the spine, which needs immediate surgery." "Your child has scoliosis and needs to see the primary health care provider."

Your child has scoliosis and needs to see the PHP" Altered posture is seen in many adolescents. This occurs because the skeletal growth is rapid when compared to muscular growth in teenagers. As a result they may have a slump and may not be able to sit upright. One of such abnormality is scoliosis, where there is a painless side-to-side curvature of the spine. Although most of the curvatures do not require treatment, it is difficult to know how these curvatures would progress. Therefore, all the curvatures of spine should be referred to a health care provider for further assessment. Lordosis is the term given to normal inward curvatures of cervical and lumbar spines. It would be inappropriate to ignore a spinal curvature, as all of these require referral. Most of the curvatures do not require treatment, so it would be inappropriate to alarm the parent by saying that the child needs surgery.

A child has learned to put on his shoes by remembering that the buckle is to be placed outside the foot. Which possible developmental theory can be used to explain this behavior? The child has normal motor development. The child has slow language development. The child has limited physical development. The child has increased cognitive development.

cognitive development