Peds Exam 1
A nurse is preparing a 5 yr old child for surgery. What is the best nursing intervention?
○ allow the child to pick which arm to use to insert the IV
What is the appropriate site to administer IM vaccines to a 6-month old infant?
○ anterolateral thigh
The nurse is obtaining a stool specimen from a 15-month old toddler that presents with 6 days of watery diarrhea. Which of the following demonstrate the correct procedure method when obtaining the specimen?
○ clean method
You are a nurse on the pediatric med surg unit. You are caring for a 7yr old who has been hospitalized for 3 days. During an assessment, you discover that the child is experiencing anxiety because she is missing her parents. You make the nursing diagnosis fear r/t separation from a familiar environment and family. Which nursing intervention is likely to help the child cope with fear and separation? (select all that apply.)
○ encourage the parents to bring one of the child's stuffed animals from home ○ assist the parents to plan a schedule of overnight stays ○ maintain as many bedtime rituals as possible
Timothy, a two-year-old is examined and the physical exam is completely normal. The visual acuity in the chart is 20/50. What is the most appropriate step for the nurse to complete?
○ give reassurance regarding the normal vision screening
A mother calls the health clinic and tells the nurse that she found her 2 yr old with an open and empty bottle of acetaminophen. The mother asks the nurse what she should do. What is the nurse's priority intervention?
○ give the mother instructions on how to call poison control
Developmental theorists Freud and Erickson would argue that which of the following behaviors is important during the toddler development stage?
○ learning to potty train
Which statement by the mother of a 19-month old would lead the nurse to anticipate that the provider will refer the child for an evaluation for a developmental delay?
○ my child crawls and stands very well, but does not walk yet
A nurse is teaching parents about accident prevention for a toddler. Which guideline is most appropriate?
○ never leave a child unattended when at a location near a pool.
A four-day old African American newborn is examined during the initial primary care appointment. The nurse inspects the skin and documents a hyperpigmented bluish patch over the lower posterior torso and buttocks. What is the next best step?
○ offer reassurance regarding the eventual lesion resolution
The nurse is preparing to administer an Intramuscular vaccine. When she enters the room with the nurse manager she is reprimanded when she does which of the following?
○ prepares to administer varicella and rotavirus vaccine
While examining a 9-month old child, the nurse notes that the child can stand independently, but cannot walk well with support. Which action should the nurse take?
○ reassure the parents that this is a developmentally normal finding for this age
You are volunteering as a nurse in the community as a nurse in the community teaching nutrition classes. One of the clients discusses her 6-month old nephew with you. The child does not startle to loud noises, does not turn his head toward the sound and does not speak. She asks what they should do.
○ refer to audiology
A nurse is teaching the parents of a 7 yr. old child about the use of protective restraints in the car to help avoid spinal cord injuries in car accidents. The child weighs 20 kg (44lbs). Which of the following should the nurse emphasize?
○ using a booster seat
John is 13 and he presents to the clinic for a health supervision visit. Understanding developmental norms, social environmental exposures, which of the following should be covered during the patient/provider encounter?
○ vaping ○ smoking ○ alcohol consumption ○ sexuality
The nurse is administering vaccines to a 6-month old child. The charge nurse intervenes when she sees the nurse preparing to administer which of the following vaccines?
○ varicella and rotavirus
Mary is a thirteen-year-old that presents for her sports physical. She is Tanner IV and is worried that she has gained 20 pounds since last year. She has also grown 4 inches. The Body Mass Index is calculated and measured in the 75%ile. What is the most appropriate advice?
○ your weight gain is appropriate because of the rapid growth that occurs during puberty
The nurse in the pediatric outpatient clinic is preparing to administer an IM vaccine for a 10-month old toddler. What is appropriate needle size?
1 inch
You are the nurse caring for a 42 pound 6-year-old child with cerebral palsy, they have just been prescribed oral Baclofen 0.3mg/kg a day in 4 divided doses. The Baclofen solution comes 5mg/5mL. How many mL do you give each dose?
1.4 mL
When may an infant typically lift the head up briefly when prone?
by one month
A nurse is caring for an adolescent who is in the hospital for a long-term illness. Which of the following interventions would promote the development of the hospitalized adolescent?
connect the teen to their peer group as much as possible
A fifteen-year-old mother brings her almost a 3-month old client into the clinic and describes a soft area around the back of the infant's head. The mother is concerned that the infant will have brain damage. You assess the patient and determine this is a normal finding. How do you educate the mother?
○ This area is the soft spot and should be closing soon. We will continue to monitor this at the next scheduled appointment
An 11 yr. old female tells the nurse she is worried because she has a bump under both nipples. She states "they hurt especially if something rubs up against them and you can see them through my shirt". What should the nurse say next?
○ This is normal conditions of puberty. Let's talk more about puberty
It is developmentally common for most adolescent peers to feel invincible, leading to tragic car accidents, especially within the first 6 months of learning to drive. Which teenager presents the highest risk for a motor vehicle accident?
○ a 17 yr. old female transporting two classmates to school
The parents of a newborn (8-day-old) present to the clinic for a sick visit. The mother states, "I saw a small amount of dried blood near the belly button when I changed her diaper and the umbilical cord is still attached. What should I do? The most accurate statement by the nurse, would be which of the following?
○ a scant amount of blood is not uncommon, and the remainder of the cord will fall off on its own in a few days
A 12-month old weighed 7lb 6oz at birth. Which of the following would the nurse expect for the client's weight?
○ 22lbs 2oz
Car safety is important during all developmental ages. Which of the following demonstrated best practices for the school age child?
○ A nine-year-old uses a booster seat in the back seat of the vehicle
The mother of a 6-month old infant brings her infant in for a well-child appointment. She asks, "should my baby be able to sit alone and crawl at this point?" Which of the following is the nurse's best step?
○ Administer the Ages and Stages questionnaire
A mother of a 4-year-old child asks the nurse how to talk with her son about strangers. The little boy is very friendly to everyone. His mother is concerned that her child could be abducted or harmed. How can the nurse support the mother?
○ Ask the child what he knows about stranger
You are a nurse in the hospital caring for a 2yr old who is increasingly independent in many areas, you encourage them to participate in self-feeding opportunities, dressing and undressing themselves, to brush their teeth and to perform hand hygiene. Which of Erickson's developmental stages are you assisting them in achieving?
○ Autonomy vs shame and doubt
A physician has ordered the placement of a 10F NG tube for an infant. You are the assigned nurse. What is the next best step?
○ Delay the procedure and call the ordering physician to clarify the order
You are a nurse at an outpatient pediatric clinic and the Nurse Practitioner has ordered a urinary catheterization on a 9-month old female infant. How far should you advance the urinary catheter to obtain a specimen?
○ Direct the catheter upward and advance 1-2 inches
You are preparing to administer oral medication to a 7yr old child who is resistant to taking the medication. Which of the following is the most effective statement made by the nurse that would encourage the child to take the medication?
○ Do you want to take the medication in a cup or a syringe?
You are working in a vaccination clinic. Your next client is 4 months old. What are the required immunizations for this client? (select all that apply)
○ Dtap (diphtheria and tetanus toxoids and pertussis) ○ RV (rotavirus) ○ IPV (inactivated poliovirus) ○ Hib (Haemophilus influenzae type B) ○ PCv (pneumococcal vaccine)
Please match the developmental characteristic to the Theorist/Developmental stage (5)
○ Erickson- Trust Vs Mistrust ○ Erikson- Identity vs role confusion ○ Freud- oral stage ○ Piaget- concrete operational stage
The nurse is examining a newborn in the nursery. The neonate has passed the car seat test and the newborn screening is complete. Prior to discharge which of the following vaccines should be administered, according to the CDC?
○ Hepatitis B
The nurse must complete a head to toe examination of an infant. The mother is hesitant because the infant is sleeping so well. What is the best way to proceed?
○ I will listen to the heart and lungs first
The nurse is caring for a 5-year-old client in need of vaccines. He is up to date through 2yrs of age. What immunizations are currently recommended by the Center of Disease Control for the patient today?
○ MMR ○ Dtap ○ Varicella, ○ IPV
Which of the following statements made by a mother would be consistent with a developmental delay?
○ My 11-month old child does not get to a standing position
The nurse obtains vital signs on 4 clients. The nurse will report which of the following to the provider immediately?
○ Newborn respiratory rate: 22
Nurses are tasked to administer compassionate, culturally sensitive care. When the nurse presents the vaccine information statement sheet to the mother of a 2-month old infant, the mother states. "vaccines are dangerous". What is the best initial response to this situation?
○ Please explain what makes you feel this way
A two-year-old female has ear pain. Which of the following is the most appropriate method to examine the tympanic membrane?
○ Pull the auricle down and back
The father of a 9-month old client presents to the clinic for a well-child check. Which of the following statements made by the father indicates further teaching is required?
○ She is tolerating whole milk without any problems with constipation
The nurse working at a pediatric triage phone call center receives a frantic call from a new mother about the holes in her baby's head. The nurse first determines that the baby is breathing, is not in danger, and does not have actual open skin on the head. The nurse determines the mother is talking about the anterior and posterior fontanelles. What information will the nurse have in mind when advising the mother?
○ The anterior fontanelle usually closes at about 18 months and the posterior closes by 4 months.
A foster mother brings her 8-month old foster child into the clinic. She is concerned that something is wrong developmentally because the child puts everything in her mouth. Based on Freud's developmental stages what can you tell the foster mother?
○ The child is exhibiting behavior this is expected for her age
Parents of a newborn do not want blood drawn for newborn lab screening and questions the pediatric nurse about the need for that test. Which of the following will the nurse include as the most appropriate explanation?
○ The newborn screening may identify a genetic and/or metabolic disease
