peds exam 2

A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement? "Families should be helped to accept the child's developmental delay." "Families should work to facilitate the child's progress." "A definitive cause can be found for every developmental disorder." "Families should not be blamed for causing a developmental delay."

"A definitive cause can be found for every developmental disorder."

The nurse is speaking with the parents of a child who has a cast. The parents state that the child reports itching in the area of the cast. What is the best response by the nurse? "You can put a pencil or coat hanger and scratch the area but don't let your child put anything down the cast without you there." "Itching is common. It's nothing to worry about." "A small amount of lotion or baby oil can be poured in the cast to moisturize the area." "Blowing cool air with a fan or hair dryer may relieve the feeling."

"Blowing cool air with a fan or hair dryer may relieve the feeling."

The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes and the parents. Which comment by a parent demonstrates a need for additional teaching? "Blood glucose level, food intake, and activity need to all be considered when calculating insulin dosage." "We should check our child's blood glucose levels before meals." "During exercise we should wait to check blood sugars until after our child completes the activity." "If our child is sick we should check blood glucose levels more often."

"During exercise we should wait to check blood sugars until after our child completes the activity."

A child is brought to the emergency center after sustaining a seizure at home. When taking the child's history, which question(s) would the nurse ask the parents? Select all that apply. "Did you give your child any fever medicine prior to the seizure?" "How long did the seizure last?" "Did your child lose bladder or bowel control?" "Did your child stop breathing during the seizure?" "What time did the seizure occur?" "Can you describe to me the movements your child experienced?"

"How long did the seizure last?" "Did your child lose bladder or bowel control?" "Did your child stop breathing during the seizure?" "What time did the seizure occur?" "Can you describe to me the movements your child experienced?"

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse? "We installed smoke detectors on every floor in our home." "I had our plumber lower our water heater temperature to 130°F (53°C). "We made a song out of 'stop, drop and roll' to teach our children fire safety." "I always make sure the little ones stay out of the kitchen when I am cooking."

"I had our plumber lower our water heater temperature to 130°F (53°C).

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education? "The next time he has a fever, I need to make sure I read the dosage on the acetaminophen bottle carefully." "When he gets his next set of immunizations, I need to make sure I give him some ibuprofen so he doesn't spike a fever." "I hate to think that I will need to be worried about my child having seizures for the rest of his life." "I need to set an alarm to wake up and check his temperature during the night when he is sick."

"I hate to think that I will need to be worried about my child having seizures for the rest of his life."

The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond? "Meningococcal conjugate vaccine covers only two types of bacterial meningitis." "Maybe your child's immune system is not strong enough to fight off the infection, even with having received the vaccine." "I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection." "Your child may have been exposed to the type of meningitis that is not covered by the vaccine received."

"I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."

The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? "When my son's breath smells fruity, it almost always indicates high blood sugar." "If my son says he feels shaky, his blood sugar may be low." "Dry flushed skin may be a sign if high blood sugar." "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."

"If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."

After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question? "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?" "Do you mean that hypothyroidism may be caused by a problem in the way the body makes thyroxine?" "So, hypothyroidism can be treated by exposing our baby to a special light, right?" "So, hypothyroidism can be only temporary, right?"

"So, hypothyroidism can be treated by exposing our baby to a special light, right?"

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system? "One role of the integumentary system is to distribute oxygen to the body cells." "The sebaceous and sweat glands are fully functional in the infant." "The integumentary system is not in place until after the child is born and then takes many years to mature." "The largest organ of the body helps regulate body temperature."

"The largest organ of the body helps regulate body temperature."

A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective? "This is a hereditary disease that is transmitted by one affected gene." "Sickle cell anemia is common in people of Asian descent." "The sickle shape of red blood cells decreases oxygen to tissues." "Fluid restriction is necessary to control sickle cell anemia."

"The sickle shape of red blood cells decreases oxygen to tissues."

The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope? "If he is out of bed, the helmet's on the head." "You'll always need a monitor in his room." "Bike riding and swimming are just too dangerous." "Use this information to teach family and friends."

"Use this information to teach family and friends."

The nurse is assessing children in an ambulatory clinic. Which child would be most likely to have iron-deficiency anemia? An 8-year-old child who carries lunch to school A 3-month-old infant who is totally breastfed A 15-year-old adolescent who has heavy menstrual periods A 7-month-old infant who has started table food

A 15-year-old adolescent who has heavy menstrual periods

A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast? Apply a tube of stockinette over the cast Assess the fingers for warmth, pain, and function Cut a window in the cast over the wrist X-ray the cast to make sure the bones are aligned properly

Assess the fingers for warmth, pain, and function

A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform? Notify the primary health care provider. Place the child on fall precaution. Place a patch over the client's affected eye. Assess the level of consciousness (LOC).

Assess the level of consciousness (LOC).

The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is most characteristic of this type of burn? Muscle damage occurs. Blisters appear. Skin is red and edematous. Pain is minimal.

Blisters appear.

The nurse is admitting to an examination room a child with the diagnosis of "probable acute lymphoblastic leukemia (ALL)." What will confirm this diagnosis? History of leukemia in twin Lethargy, bruising, and pallor Bone marrow aspiration Complete white blood count

Bone marrow aspiration

The nurse is caring for a child with an external ventricular drainage device. The nurse is concerned about the minimal drainage in the past few hours. What action(s) by the nurse should be performed now? Select all that apply. Ensure the tubing is not kinked. Check the child's temperature. Encourage the child to cough and deep breathe to facilitate drainage. Check tubing clamps to ensure they are open. Ensure the drip chamber is below the child's clavicles.

Check tubing clamps to ensure they are open. Ensure the tubing is not kinked.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply. Color Sensation Pulse Vital signs Capillary refill

Color Sensation Pulse Capillary refill

The nurse is concerned that a school-aged child has iron-deficiency anemia. What did the nurse assess in this client? Shyness Thumb-sucking Asking many questions Craving for ice cubes

Craving for ice cubes

The nurse knows that which condition is caused by excessive levels of circulating cortisol? Graves disease Cushing syndrome Turner syndrome Addison disease

Cushing syndrome

The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level? Ferrous sulfate Digoxin Spironolactone Albuterol sulfate

Digoxin

The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed? Alprostadil Indomethacin Furosemide Digoxin

Digoxin

A nurse is administering a blood transfusion to a child. About 35 minutes after beginning the transfusion, the child develops pruritus and urticaria. Some wheezing is noted. Which action would the nurse take first? Discontinue the transfusion. Obtain a blood culture. Give an iron-chelating agent. Ask the health care provide for a prescription for a diuretic.

Discontinue the transfusion.

The nurse is caring for a 13-year-old girl with a nursing diagnosis of "Ineffective coping related to inability to deal with life stressors as evidenced by few or no meaningful friendships and low self-esteem." Which intervention would be the priority to promote coping skills? Demonstrate unconditional acceptance of the child as a person. Encourage her to discuss her thoughts and feelings. Set clear limits on behavior. Role model appropriate social and conversation skills.

Encourage her to discuss her thoughts and feelings.

The nurse is preparing a plan to educate the parents of a 10-year-old boy with a learning disorder. What will be part of this plan? Have parents learn the child's facial expressions. Tell parents to check on the child regularly. Explain the child's strengths and weaknesses. Encourage parents to give the child personal space.

Explain the child's strengths and weaknesses.

The nurse is teaching a health and wellness course to young women of childbearing age. Which vitamin will the nurse encourage all to take daily? Folic acid Niacin Calcium Ascorbic acid

Folic acid

A child is diagnosed with sickle cell anemia. Which test will the nurse expect the primary health care provider to prescribe for this client? Thrombocyte level Hemoglobin level Metabolic screening test Leukocyte level

Hemoglobin level

A nurse caring for a child with Graves disease is administering propylthiouracil (PTU). The child has been on this drug for a few weeks and now has sudden symptoms of a sore throat. What is the priority intervention for the nurse? Hold the dose and call the health care provider. Offer throat lozenges to soothe the throat. Ask the child if there is a reason he or she does not want to go back to school. Continue medication to relieve the signs of Graves disease.

Hold the dose and call the health care provider.

A nurse caring for a child with Graves disease is administering propylthiouracil (PTU). The child has been on this drug for a few weeks and now has sudden symptoms of a sore throat. What is the priority intervention for the nurse? Offer throat lozenges to soothe the throat. Ask the child if there is a reason he or she does not want to go back to school. Continue medication to relieve the signs of Graves disease. Hold the dose and call the health care provider.

Hold the dose and call the health care provider.

The community nurse receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo. Which information related to impetigo will the nurse provide to the day care center? Impetigo cannot be treated with medication and has to run its course. Impetigo usually develops because of sensitivity to pollens and molds. The facility staff should wear masks until all children and adults are healthy. Impetigo is highly contagious and can spread quickly.

Impetigo is highly contagious and can spread quickly.

A 6-year-old girl is diagnosed with aortic stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? Insertion of Dacron-coated stainless-steel coils by interventional cardiac catheterization No treatment is necessary, as the defect will resolve spontaneously Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing Surgical closure by ductal ligation

Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing

A nurse is giving instructions to the father of a boy who is receiving chemotherapy (including methotrexate) regarding how best to care for the boy during this period of treatment. What should the nurse mention to him? Keep him away from people with known infections Give him aspirin to help manage pain Be sure that the boy receives only live-virus vaccines Give the boy folic acid supplements

Keep him away from people with known infections

When reviewing the medical record of a child, what would the nurse interpret as the most sensitive indicator of intellectual disability? Vision deficit Language delay Preterm birth History of seizures

Language delay

A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention? Observe vitals every two hours. Elevate the head of the bed. Notify the doctor immediately. Administer epinephrine.

Notify the doctor immediately.

The nurse is completing the health history of a 6-month-old infant with retinoblastoma with the child's parents. Which symptom should the nurse expect that the parents have observed? The infant's eye appears to be protruding. The infant tugs and pulls at one ear. The infant always keeps her eyes tightly closed. One pupil appears white.

One pupil appears white.

The nurse is assessing a 2-year-old girl whose parents noticed that one of her pupils appeared to be white. Which assessments should the nurse expect to find if the girl has retinoblastoma? Select all that apply. History reveals strabismus. Assessment discloses hyphema in one eye. Observation confirms cat's eye reflex in pupil. Parents report that the child has headaches. Observation of eyes reveals yellow discharge.

Parents report that the child has headaches. Observation confirms cat's eye reflex in pupil. Assessment discloses hyphema in one eye. History reveals strabismus.

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? Peeling hands and feet; fever Decreased heart rate and impalpable pulse Low blood pressure and decreased heart rate Irritability and dry mucous membranes

Peeling hands and feet; fever

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority? Provide supplemental oxygen. Place the child in a knee-to-chest position. Administer morphine as prescribed. Use a calm, comforting approach.

Place the child in a knee-to-chest position.

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has: Polydipsia Polyuria Pica Polyphagia

Polyuria

A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child? Disturbed body image related to loss of hair after chemotherapy Risk for imbalanced nutrition, less than body requirements, related to inflammation Pain due to neoplastic process in bone Compromised family coping related to long-term chemotherapy regimen

Risk for imbalanced nutrition, less than body requirements, related to inflammation

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note? The posterior spine when bending sideways The angle of the iliac crest when bending forward The posterior spine when bending forward The angle of the lower chest when sitting down

The posterior spine when bending forward

A mother asks the nurse if the reason the infant has a congenital heart defect is because of something she did while pregnant. What is the best response by the nurse? There are several reasons an infant can have a heart defect; let's talk about those causes. Yes, there is a chance you caused this defect. The studies show it is impossible to know what causes heart defects. No, heart defects are mainly caused by genetic factors.

There are several reasons an infant can have a heart defect; let's talk about those causes.

Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family? There are no surgeries that can help the child live with this heart defect. The infant will have immediate surgery to completely correct the heart defect. This is a problem where the left side of the heart did not develop properly. This is a problem where the right side of the heart did not develop properly.

This is a problem where the left side of the heart did not develop properly.

To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take? Use a repetitive series of movements. Allow the child to ask questions about the procedure. Use an authoritarian manner to gain control. Do not allow the child to see the spoon approach the mouth.

Use a repetitive series of movements.

The nurse is caring for an infant with a candida diaper rash. Which topical agent would the nurse expect the physician to order? antibiotics antifungals retinoids corticosteroids

antifungals

The parents of a 9-year-old child tell the nurse, "We are so frustrated with our child. We do not know what to do. Our child makes careless mistakes on tests and homework despite being intelligent, is very disorganized, and never follows through with chores at home." The nurse anticipates this child may have which disorder? obsessive-compulsive disorder attention deficit disorder antisocial personality disorder bipolar disorder

attention deficit disorder

The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding? lordosis kyphosis idiopathic scoliosis sway back

idiopathic scoliosis

The nurse is educating parents of a child recently diagnosed with autism spectrum disorder. A description of the characteristics of autism spectrun disorder are explained within categories. The nurse becomes concerned when the mother states that the categories of autism spectrum disorder are associated with: inability to communicate with others. inability to relate to others. limited activities and interests. inability to properly synthesize glucose.

inability to properly synthesize glucose.

The nurse is examining a child with fetal alcohol spectrum disorder. Which assessment finding should the nurse expect? short philtrum with thick upper lip low nasal bridge with short upturned nose macrocephaly clubbing of fingers

low nasal bridge with short upturned nose

The nurse has administered oral penicillin as ordered for prophylaxis of endocarditis. The nurse instructs the parents to immediately report which reaction? wheezing nausea with diarrhea abdominal distress stomach upset

wheezing

A nurse is discussing concerns about possible child abuse (child mistreatment) with the nursing supervisor. Which statement by the nurse requires correction by the supervisor? "I realize that nurses have an obligation to report suspected child abuse (child mistreatment)." "I understand nurses can lose their license for not reporting suspected child abuse (child mistreatment)." "I will need to look up the protocol for reporting suspected child abuse (child mistreatment)." "HIPAA prevents nurses from disclosing confidential information from parents."

"HIPAA prevents nurses from disclosing confidential information from parents."

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? "I should apply the medicine at bedtime and rinse it off in the morning." "I should use the highest-potency steroid cream I can find." "I should not cover the area with plastic wrap after applying the cream." "I need to shake the preparation before using it."

"I should not cover the area with plastic wrap after applying the cream."

The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse, "What causes this disease?" Which response by the nurse would be most appropriate? "ITP occurs when the body's iron stores are depleted due to rapid physical growth, inadequate iron intake, inadequate iron absorption, or loss of blood." "ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason." "ITP is a serious bleeding disorder characterized by a decreased, absent, or dysfunctional coagulation." "ITP is characterized by the loss of surface area on the red blood cell membrane."

"ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate? "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate." "I always give the ferrous sulfate with meals." "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." "When I give my son ferrous sulfate I know he also needs potassium supplements."

"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

The nurse is reviewing the laboratory test results of several children who have come to the clinic for evaluation. Which child would the nurse identify as having the least risk for hyperlipidemia? Child D with a total cholesterol level of 220 mg/dl and LDL of 138 mg/dl. Child C with a total cholesterol level of 190 mg/dl and LDL of 125 mg/dl. Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl. Child B with a total cholesterol level of 175 mg/dl and LDL of 105 mg/dl.

Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl.

The nurse is preparing a care plan for the child diagnosed with Tourette syndrome. Which nursing interventions should the nurse include? Select all that apply. Encourage the parents to arrange for testing at school to take place in a different room than the classroom. Educate the child and family that tics may worsen during times of stress. Inform parents that drug therapy is not recommended. Support the family in pursuing different therapy options. Suggest the family makes note if tics are less prominent during focused activity.

Educate the child and family that tics may worsen during times of stress. Encourage the parents to arrange for testing at school to take place in a different room than the classroom. Support the family in pursuing different therapy options. Suggest the family makes note if tics are less prominent during focused activity.

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this? Complete Greenstick Epiphyseal Spiral

Greenstick

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would mostlikely be seen in a client experiencing polycythemia? Increased RBC Increased WBC Decreased RBC Decreased WBC

Increased RBC

The nurse is working with a 6-year-old child recently diagnosed with Legg-Calvé-Perthes disease. The child's parents tells the nurse they understand exercise is important for their child but are not sure which activities are appropriate. Which activity will the nurse recommend for this client? Swimming Jumping jacks Soccer Brisk walking

Swimming

The nurse is caring for a child who is suspected to have a growth hormone deficiency. Which finding after further testing supports this diagnosis? Physical examination finds excessive foot and finger growth for age. Computed tomography identifies a tumor on the child's kidney. The bone age is found to be two or more deviations below normal. Magnetic resonance imaging shows a brain tumor.

The bone age is found to be two or more deviations below normal.

The pediatric nurse practitioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this? The head is held tilted with limited side-to-side motion. Severe lordosis is evident in the lumbar spine. The boy has a large tan skin lesion on his torso. The boy rises from the floor by walking his hands up his legs.

The boy rises from the floor by walking his hands up his legs.

The nurse is conducting an assessment of a 7-year-old client. During the assessment, the nurse notes that the child does not maintain eye contact or speak. The nurse suspects an autism spectrum disorder. Which additional finding supports the nurse's suspicion? The child constantly opens and closes the hands. The child is highly active and inattentive. The child has a slight decrease in head circumference. The child has difficulty reading.

The child constantly opens and closes the hands.

The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)? While stimulating the child's foot, the big toe points upward and other toes fan outward. While turning the child's head to the left, the eyes turn to the right. While calling the child's name, the child stares straight ahead and does not turn to the sound. While assessing the child's pupils, there is no change in diameter in response to a light.

While assessing the child's pupils, there is no change in diameter in response to a light.

An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate? frequent arrests and conflict with legal authorities angry outbursts directed at authority figures typical teenage defiance behavior with parents disruptive behavior toward siblings and peers

angry outbursts directed at authority figures

A nurse is to see a child. Assessment reveals the chief complaints of urinating "a lot" and being "really thirsty." The nurse interprets these symptoms as being associated with which condition? syndrome of inappropriate antidiuretic hormone secretion precocious puberty diabetes insipidus hypopituitarism

diabetes insipidus

The nurse is caring for a child with a tinea corporis infection involving several sites. Which information would be the most important for the nurse to include in the teaching plan for the parents? applying oils and petroleum jelly to the affected areas allowing the child to return to school after 3 days of treatment keeping socks on before, during, and after athletic events finishing all prescribed oral medication, even after lesions fade

finishing all prescribed oral medication, even after lesions fade

The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder? cardiomyopathy infective endocarditis Kawasaki Disease heart failure

heart failure

Preterm infants have more fragile capillaries in the periventricular area than term infants. This put these infants at risk for which problem? moderate closed-head injury early closure of the fontanels (fontanelles) intracranial hemorrhaging congenital hydrocephalus

intracranial hemorrhaging

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child? face hands presacral region lower extremities

lower extremities

When caring for a child with Kawasaki disease, the nurse would know that: antibiotics should be administered every 8 hours by IV. joint pain is a permanent problem. steroid creams are used for the hand peeling. management includes administration of aspirin and IVIG.

management includes administration of aspirin and IVIG.

Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele? delayed growth and development impaired physical mobility risk for infection constipation

risk for infection

The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure? "He gets sweaty when he eats." "He seems to have a normal appetite." "He does not seem sick." "He does not seem short of breath."

"He gets sweaty when he eats."

A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective? "Fluid restriction is necessary to control sickle cell anemia." "Sickle cell anemia is common in people of Asian descent." "This is a hereditary disease that is transmitted by one affected gene." "The sickle shape of red blood cells decreases oxygen to tissues."

"The sickle shape of red blood cells decreases oxygen to tissues."

A 2-year-old child has been diagnosed with autism spectrum disorder. The parents ask the nurse for a treatment that will cure the disorder. Which is the best response by the nurse? "Sometimes hiring a professional to give your child music therapy can cure this." "Your child can be put on a strict diet to guarantee that the medication works." "When your child is older, you can try nutrition supplements for a cure." "There are no medications available to cure autism spectrum disorder."

"There are no medications available to cure autism spectrum disorder."

What will be the nurse's next action after noting dimpling and a tuft of hair located in the lumbosacral area of the preschool child during examination? Record and refer the finding for follow-up to the pediatrician. Snip the tuft of hair off close to the skin for hygienic reasons. Inspect for precocious hair growth in the genital and underarm areas. Move on to other assessments without calling attention to the difference.

Record and refer the finding for follow-up to the pediatrician.

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about? The child is allergic to shellfish. The child wears a medical alert bracelet for diabetes. The child is taking a vitamin supplement. The child has had an MRI of their leg within the past 6 weeks.

The child is allergic to shellfish.

The nurse is conducting a primary survey of a 12-year-old child involved in a motor vehicle accident. Which assessment finding most concerns the nurse? the presence of stridor burns on both of the child's hands inability to state name a broken tibia protruding through the skin

the presence of stridor

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? "That is an infection that you get under your fingernails." "My son got that infection when he was at the swimming pool." "My husband had that once and his groin itched so much." "I always tell my daughter to use her own hairbrush."

"I always tell my daughter to use her own hairbrush."

The nurse is teaching a group of caregivers of children diagnosed with diabetes. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur? "If my child eats as much as their older brother eats they could have an insulin reaction." "On the weekends we encourage our child to participate in lots of sports activities and stay busy so they don't have an insulin reaction." "My child measures their own medication but sometimes doesn't administer the correct amount." "My child monitors their glucose levels to keep them from going too high."

"My child measures their own medication but sometimes doesn't administer the correct amount."

A 9-year-old child with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the parents make which statement? "This drug will have an effect on our child in about 2 weeks." "We'll bring our child in every week to get blood levels drawn." "Our child may have some side effects, like insomnia, headache, or stomach ache." "Our child knows to take this medication once every 12 hours."

"Our child may have some side effects, like insomnia, headache, or stomach ache."

A school-age child is seen in the family clinic. The parents ask the nurse if their child should start taking growth hormones to help the child grow because the parents are short. What is the best response by the nurse? "Growth hormones work only if the child has short bones." "How tall would you like your child to be?" "Research shows that there must be a diagnosis of deficiency before growth hormones can be started at this age." "Will your child be able to swallow oral pills every day?"

"Research shows that there must be a diagnosis of deficiency before growth hormones can be started at this age."

The nurse caring for a 14-year-old scheduled for magnetic resonance imaging (MRI) explains to a family how the test works. Which response accurately describes this test? "The MRI uses sound waves to create images that visualize body structures and locate masses." "The MRI uses radio waves and magnets to produce a computerized image of the body." "The MRI uses radiation to examine soft tissue and bony structures of the body." "The MRI is a nuclear scanning test to rule out cancer involving the bones or determine extent of bone involvement."

"The MRI uses radio waves and magnets to produce a computerized image of the body."

A high school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told their adolescent not to play football. Which health teaching points will the nurse include in the teaching plan for the adolescent and parents? There will be some discoloration of the leg following chemotherapy. Tumor growth is related to the adolescent's dislike of milk. Osteosarcoma often follows trauma, such as a football injury. Football injuries do not contribute to the development of a tumor.

Football injuries do not contribute to the development of a tumor.

During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take? Document that the infant has microcephaly. Report the findings to the pediatric health care provider. Tell the parent the infant's brain is underdeveloped. Reassess the head circumference in 24 hours.

Report the findings to the pediatric health care provider.

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority? Risk for delayed development Risk for injury Risk for self-care deficit: bathing and dressing Risk for ineffective tissue perfusion: cerebral

Risk for injury

The nurse is performing a physical assessment of 16-year-old girl who is intellectually disabled. This client attended her local public elementary school through fifth grade and has since been enrolled at a special education school where she has received social and vocational training. She plans on getting a job in the coming month and on living independently in a few years. The nurse recognizes this client's level of intellectual disability as: moderate. severe. mild. profound.

mild.

A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who reports headaches. The child's grades have dropped, and the child is sleeping late and going to bed early every night. Which would the nurse identify as the priority? asking the school psychologist to do psychometric testing scheduling an immediate history and physical examination discussing the situation with the teacher calling for an appointment with a psychologist

scheduling an immediate history and physical examination

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? "This disorder is caused by genetic factors." "Children who have this diagnosis may have had strep throat." "Being up-to-date on immunizations is the best way to prevent this disorder." "The onset and progression of this disorder is rapid."

"Children who have this diagnosis may have had strep throat."

The nurse is reinforcing teaching with the caregivers of a child who has had a head injury and is being discharged. Which statement made by the caregiver indicates an accurate understanding of the follow-up care for this child? "If he vomits again, we will bring him back immediately." "If he falls asleep, we will wake him up every 15 minutes." "We can give him acetaminophen for a headache, but no aspirin." "Even if the flashlight bothers him, we will check his eyes."

"Even if the flashlight bothers him, we will check his eyes."

The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells? "He likes to stop and squat wherever he walks." "He walks very quickly and never stops moving." "He does not seem to have difficulty breathing." "He takes one nap a day and is fairly active."

"He likes to stop and squat wherever he walks."

A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching? "We need be aware of odor or drainage from the cast." "Pale, cool, or blue skin coloration is to be expected." "The casted arm must be kept still." "We must avoid causing depressions in the cast."

"Pale, cool, or blue skin coloration is to be expected."

The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris? "There is a new immunization that you can get to keep from having acne." "Sometimes I get acne when I use my sister's makeup." "My next door neighbor told me that acne was caused by a fungus." "My mom says I have acne because I eat too much chocolate."

"Sometimes I get acne when I use my sister's makeup."

The nurse is assessing a child diagnosed with Cushing syndrome. Which statement by the parents demonstrates a need for further teaching? "My child may experience excessive weight gain." "We need to pay close attention to any wounds our child gets to monitor for adequate healing." "My child's round, full face appearance is reversible with appropriate treatment." "This disorder is most likely due to an infection my child had recently."

"This disorder is most likely due to an infection my child had recently."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? "If she needs dental surgery, we might need additional medication." "She needs to take the drug for the full 14 days." "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years." "We can stop the penicillin when her symptoms disappear."

"We can stop the penicillin when her symptoms disappear."

A nurse is educating a family about the Chvostek sign after their teen tested positive for Chvostek sign. Which statements by the caregivers shows the nurse that they understand the Chvostek sign? "The sign occurs when there is muscle pain and the muscle is stimulated." "When I tap on my child's facial nerve, the reaction is a facial muscle spasm." "The sign occurs because my child is having increased intracranial pressure." "The sign means my child is not getting enough vitamin D."

"When I tap on my child's facial nerve, the reaction is a facial muscle spasm."

A 16-year-old male who is diagnosed with tinea pedis questions the nurse about how he may have contracted the condition. How should the nurse respond? "This condition is common in individuals with lowered immunity." "You may have gotten the condition from a community shower or gym area." "It is unlikely you will be able to determine the cause of the infection." "You likely had an infection in another area of your body and it has spread."

"You may have gotten the condition from a community shower or gym area."

The nurse is caring for a child who fractured the arm in an accident. A cast has been applied to the child's right arm. Which action(s) should the nurse implement? Select all that apply. Check capillary refill time in the both arms. Wear sterile gloves when removing or touching the cast. Document any signs of pain. Wear a protective gown when moving the child's arm. Monitor the color of the nail beds in the right hand.

Document any signs of pain. Check capillary refill time in the both arms. Monitor the color of the nail beds in the right hand

The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of: Hodgkin disease. non-Hodgkin lymphoma. Ewing sarcoma. neuroblastoma.

Ewing sarcoma.

A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? Constipation Weight gain Heat intolerance Facial edema

Heat intolerance

On assessment immediately following cardiac surgery, which condition would the nurse expect to find in an infant? Hypothermia Hypertension Hypovolemia Hyperexcitability

Hypothermia

The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which finding will the nurse expect to assess? Indifferent attachment to a parent Engaging in dangerous activities Frequently losing things Slow motor actions

Indifferent attachment to a parent

A 9-year-old boy was in a car accident. The child is suffering from posttraumatic stress disorder. Which would be the best approach for treatment? Individual psychotherapy sessions Psychostimulant medications Sensory integration technique Antipsychotic medications

Individual psychotherapy sessions

The nurse is caring for a 13-year-old boy with acute myeloid leukemia (AML) who is experiencing feelings of powerlessness due to the effects of chemotherapy. What intervention will best help the teen's sense of control? Involving the boy in decisions whenever possible Acknowledging the boy's feelings of anger with the disease Providing realistic expectations of treatments and outcomes Recognizing abilities that are unaffected by the disease

Involving the boy in decisions whenever possible

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? The skin is pink and healthy looking. It is difficult to keep the child awake. The child is active and playful. The child has above-normal growth for his age.

It is difficult to keep the child awake.

The adolescent client has become bored with the video game system, which had been the positive reward for cleaning one's room. Which intervention would be most effective intervention at this time? Tell the adolescent that he or she no longer has to clean the room in order to play. Tell the adolescent that he or she has to use the video game anyway because it was expensive. Let the adolescent choose another reward that would be more fun. Reinforce to the adolescent that he or she selected the video game and needs to stick with it.

Let the adolescent choose another reward that would be more fun.

A nurse is administering digoxin to a 3-year-old child. What would be a reason to hold the dose of digoxin? Nausea and vomiting Hypertension Fever and tinnitus Ataxia

Nausea and vomiting

The nurse is teaching the parents of a young client who has recently been diagnosed with diabetes insipidus about the disease. The child is not secreting enough of which hormone? antidiuretic hormone (ADH) adrenocorticotropic hormone (ACTH) luteinizing hormone (LH) thyroid stimulating hormone (TSH)

antidiuretic hormone (ADH)

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem? congenital hydrocephalus positional plagiocephaly head trauma intracranial hemorrhaging

head trauma

A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child? infection symptoms vital signs mucositis bleeding

infection symptoms

The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record? high serum phosphate levels x-ray confirmation of adequate bone shape low alkaline phosphate levels low serum calcium levels

low serum calcium levels

The nurse is caring for a child who has been hospitalized repeatedly at multiple hospitals. There is no clear medical diagnosis and the parent is threatening to leave the hospital against medical advice. The nurse suspects what issue? bipolar disorder medical child abuse (formerly Munchausen syndrome by proxy) anxiety disorder sexual abuse

medical child abuse (formerly Munchausen syndrome by proxy)

A hospice nurse is providing at-home care to a child with end-stage cancer. The nurse is developing a plan of care to manage the child's pain. Which medications will the nurse likely include? topical anesthetics mild analgesics sedatives opioids

opioids

The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the nurse teach the parent has the highest amount of iron? pork, broccoli, white rice, and strawberries chicken, corn, brown rice, and oranges red meat, eggs, oatmeal, and dried fruit tuna salad with eggs, whole wheat crackers, and blueberries

red meat, eggs, oatmeal, and dried fruit

Based on knowledge of the progression of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first? standing sitting breathing swallowing

sitting

A 10-year-old child is brought to the clinic by the parent. Assessment reveals small circular patches of hair loss on the scalp. The nurse suspects which condition? tinea cruris Ttnea corporis tinea capitis tinea faciei

tinea capitis

Which of these age groups has the highest actual rate of death from drowning? infants preschool children school-aged children toddlers

toddlers

The charge nurse is observing a student nurse perform skeletal traction pin care. What action by the student nurse would indicate a need for intervention by the charge nurse? mixing hydrogen peroxide with sterile water to make half-strength hydrogen peroxide unhooking a weight while providing pin care using latex free sterile gloves placing sterile cotton gauze squares around the ends of the pins

unhooking a weight while providing pin care

The nurse suspects sexual maltreatment in a 10-year-old girl. The nurse would assess which primary finding to help make this determination? Tanner stage 4 development regular menses decreased skin turgor vaginal discharge

vaginal discharge

A 14-year-old girl who is a vegetarian has recently developed anemia. Blood smear results show large, fragile, immature erythrocytes. She claims to take an iron supplement regularly and is surprised to learn that she is anemic, as she is otherwise healthy. As the nurse considers all of the data in the case, which anemia will the nurse discuss when collaborating with the primary healthcare provider? sickle-cell disorder acute blood loss iron deficiency vitamin B12 deficiency

vitamin B12 deficiency

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? "The onset and progression of this disorder is rapid." "Being up-to-date on immunizations is the best way to prevent this disorder." "This disorder is caused by genetic factors." "Children who have this diagnosis may have had strep throat."

"Children who have this diagnosis may have had strep throat."

The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post? "Do not palpate abdomen." "No intramuscular injections." "No milk or milk products allowed." "No blood sampling in lower extremities."

"Do not palpate abdomen."

The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first? "Is your child allergic to peanuts or other foods?" "Does anyone in your family have any food allergies?" "Have you ever given your child antihistamines?" "Has the child ever eaten shellfish before now?"

"Has the child ever eaten shellfish before now?"

The parents of a child recently diagnosed with atopic dermatitis voice concern to the nurse that their child may develop asthma at some point. How should the nurse respond? "I am not sure why you think a skin disorder would lead to asthma?" "All children with atopic dermatitis develop both asthma and hay fever, so we will monitor your child for both conditions." "I can understand your concern. We will closely monitor your child for asthma development." "If your child starts having respiratory difficulties, be sure to let your health care provider know."

"I can understand your concern. We will closely monitor your child for asthma development."

The nurse is assessing a child for signs of an endocrine disorder. Which statement by the parent would alert the nurse to further assess the child for an endocrine disorder? "My child tells me that his knees hurt at night, especially after running around all day." "My child's skin is red after a bath or shower." "I have all of a sudden noticed my child is always thirsty...even at night." "My child says he has trouble seeing the print in the chapter books the teacher sends home."

"I have all of a sudden noticed my child is always thirsty...even at night."

An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug? "This drug can affect my lungs so I need a chest radiograph done first." "I have to make sure that I do not become pregnant while taking this drug." "I'm going to have to have a blood count done every couple of months." "The drug might cause staining of my clothing."

"I have to make sure that I do not become pregnant while taking this drug."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? "My child takes ferrous sulfate after meals." "I mix ferrous sulfate with milk in a bottle." "My child's stools are darker than usual." "I brush my child's teeth once every day."

"I mix ferrous sulfate with milk in a bottle."

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? "I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out." "I should only use ointments and creams as instructed by the health care provider." "I should not overdress the infant." "I should be certain to use fabric softener in the care of the infant's clothes."

"I should be certain to use fabric softener in the care of the infant's clothes."

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response? "A plugged tear duct would not be unusual." "Most parents mention a red color." "I will report this to the pediatrician." "Has your baby been rubbing either eye?"

"I will report this to the pediatrician."

The nurse is caring for a child recently diagnosed with growth hormone deficiency. After providing education regarding this disorder, which statement by the parent demonstrates a need for further teaching? "My child will follow up with an endocrinologist every 3 to 6 months to monitor growth." "If growth hormone therapy is used, it will continue for the rest of my child's life." "It is important I treat my child according to the child's age not based on the child's size." "This early diagnosis and treatment will lead to a better prognosis that my child will reach normal adult height."

"If growth hormone therapy is used, it will continue for the rest of my child's life."

The nurse is providing teaching about medication management of attention deficit hyperactivity disorder (ADHD). Which response indicates a need for further teaching? "If he takes this medicine he will no longer have ADHD." "We should give it to him after he eats breakfast." "This may cause him to have difficulty sleeping." "We should see an improvement in his schoolwork."

"If he takes this medicine he will no longer have ADHD."

The parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse bestrespond? "The infant should have a thorough shampooing every day to prevent things like this." "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo." "Cradle cap (seborrhea) will resolve by itself. There is no intervention needed." "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

"Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil."

A nurse is preparing to administer a prescribed dose of digoxin to an 6-month-old infant. After assessing the infant's apical pulse, the nurse decides to withhold the dose and notify the health care provider. The nurse bases this decision on which apical pulse rate? 118 beats/min 80 beats/min 102 beats/min 94 beats/min

80 beats/min

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings? Explain the preparation for an 8-hour fasting blood glucose test. Prepare the parent for a neurology consult. Discuss preparing for a thyroid function test. Explain why the child might need to schedule an eye exam.

Discuss preparing for a thyroid function test.

The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching? Suggest the child participate in sports activities without restriction. Treat upper respiratory infections with over-the-counter medication. Ensure a consistent and daily intake of adequate fluids to prevent dehydration. Remind parents that the child should avoid immunizations to prevent the introduction of bacteria into the body.

Ensure a consistent and daily intake of adequate fluids to prevent dehydration.

Nursing students are reviewing information about childhood cancers. They demonstrate understanding of the information when they identify what as the most frequent type? Wilms tumor Leukemia Brain stem tumor Non-Hodgkin lymphoma

Leukemia

The nurse is talking with the parents of a child diagnosed with autism spectrum disorder. Together, they set specific goals of care for the child. Which goals may be included? Select all that apply. Promotion of normal development Learning Specific language development Promotion of a low-carbohydrate diet Social interaction

Promotion of normal development Learning Social interaction Specific language development

A nurse is caring for a 12-year-old girl who is recovering from surgery for removal of a brain tumor. Which intervention should the nurse implement to avoid increasing intracranial pressure? Regulate the rate of IV fluid infusions carefully Place a sterile towel under wet dressings Sponge the client's face Apply saline eye drops, as prescribed

Regulate the rate of IV fluid infusions carefully

A 6-year-old client has been diagnosed with an autism spectrum disorder. Which symptom will the nurse expect the client to display? The client becomes overly attached to those around him or her. The client has a irresistible urge to pull out one's hair. The client has multiple motor tics and several vocal tics. The client spends time alone in repetitive play activities.

The client spends time alone in repetitive play activities.

A group of students is reviewing information about bone healing in children. The students demonstrate understanding of this information when they state: a child's bones heal more quickly than those of an adult. a fracture closer to the growth plate heals much slower than one in the metaphysis. the process of breaking down and forming new bone is decreased in children compared with adults. callus production is slower (but greater in amount) in children than in adults.

a child's bones heal more quickly than those of an adult.

A group of students is reviewing information about the skeletal development in children. The students demonstrate understanding of the information when they identify that ossification is complete by what age? school age toddlerhood adolescence preschool age

adolescence

Which problem-based nursing care plan will the nurse indicate as priority for the child following cardiac surgery for tetralogy of Fallot? acute parental anxiety surgical site infection risk altered cardiopulmonary tissue perfusion risk fluid overload risk

altered cardiopulmonary tissue perfusion risk

What potential side effect of smoking crack should the nurse teach adolescents about to ensure their understanding of the drug's possible impact? a high that lasts hours drop in temperature cardiac arrest a rapid high followed by a slow letdown

cardiac arrest

The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect? staphylococcal scalded skin syndrome (SSSS) impetigo cat scratch disease cellulitis

cellulitis

The nurse will select which meal as the best choice for a child with iron-deficiency anemia? cheeseburger, broccoli, and fresh strawberries two slices of pepperoni pizza and a glass of skim milk chicken breast, French fries, and sweetened tea peanut butter sandwich, cheese stick, and applesauce

cheeseburger, broccoli, and fresh strawberries

A 16-year-old client is highly disruptive in class and has been in trouble at home. The parent recently found the adolescent torturing a cat. When questioned, the adolescent laughed. What condition might the client be suffering from? Asperger syndrome bipolar disorder conduct disorder Tourette syndrome

conduct disorder

Assessment of a newborn reveals that the child has hypothyroidism. How does the nurse document this finding? congenital hypothyroidism acquired hypothyroidism autoimmune thyroiditis secondary hypothyroidism

congenital hypothyroidism

The nurse is educating a group of caregivers about fractures seen in children. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in the: humerus. epiphyseal plate. joint. xiphoid process.

epiphyseal plate

The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all that apply. fontanels (fontanelles) eye opening posture motor response verbal response

eye opening verbal response motor response

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: narrow pulse. femoral pulse weaker than brachial pulse. bounding pulse. hepatomegaly.

femoral pulse weaker than brachial pulse.

The nurse is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to: curling ulcer. graft placement. wound care. hypovolemic shock.

hypovolemic shock.

The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection? scabies impetigo atopic dermatitis folliculitis

impetigo

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to: miliaria rubra (heat rash). seborrheic dermatitis. candidiasis. impetigo.

impetigo

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply. padding for side rails oxygen gauge and tubing smelling salts suction at bedside tongue blade

oxygen gauge and tubing suction at bedside padding for side rails

A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding: putting child safety locks on kitchen cabinets. putting medicine away where children cannot reach it. removal or covering of flaking paint on the walls of the home. placing house plants out of reach of children.

removal or covering of flaking paint on the walls of the home.

A child with a cardiac structural defect is receiving oxygen therapy. In which position should the child be placed to promote optimal benefits? prone semi-Fowler side-lying lithotomy

semi-Fowler

Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n): diuretic. antihistamine. anticonvulsant. steroid.

steroid.

The nurse working with the child diagnosed with type 2 diabetes recognizes the disorder can be managed by: increasing carbohydrates in the diet, especially in the evening. conserving energy with rest periods during the day. decreasing amounts of daily insulin. taking oral hypoglycemic agents.

taking oral hypoglycemic agents.

The school nurse is providing information to parents of adolescents about prevention of cervical cancer. Which information is included in the teaching? vaccine against human papillomavirus (HPV) Papanicolaou tests for adolescent girls use of condoms for sexually active teens abstinence from sexual intercourse

vaccine against human papillomavirus (HPV)

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply. "It's important I get my CBC blood test when my doctor orders it." "I am young so I won't need to have the liver tests the pamphlet suggests." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." "If I am sexually active I need to let my doctor know." "As long as I use two forms of birth control I don't need to have monthly pregnancy testing."

"If I am sexually active I need to let my doctor know." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." It's important I get my CBC blood test when my doctor orders it."

The parents of a 2-year-old toddler newly diagnosed with tricuspid atresia ask the nurse, "I do not understand why our toddler's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is best? "The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes." "The number of red blood cells has significantly increased from the heart defect, resulting in the cells pooling in the fingertips." "This is a common complication of tricuspid atresia. Unfortunately, there is nothing we can do to treat it." "Increased cardiac workload from your toddler's heart defect affects various parts of the body, including the fingers."

"The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

A child who has been having seizures is admitted to the hospital for diagnostic testing. The child has had laboratory testing and an EEG, and is scheduled for a lumbar puncture. The parents voice concern to the nurse stating, "I don't understand why our child had to have a lumbar puncture since the EEG was negative." What is the best response by the nurse? "A lumbar puncture is a routine test that is performed anytime someone has a seizure disorder." "Since the EEG was negative there must be some other cause for the seizures. The lumbar puncture is necessary to determine what the cause is." "I know it must be frustrating not having a diagnosis yet, but you have to be patient. Seizure disorders are difficult to diagnose." "The lumbar puncture can help rule out any infection in fluid surrounding the brain and spinal cord as the cause of the seizures."

"The lumbar puncture can help rule out any infection in fluid surrounding the brain and spinal cord as the cause of the seizures."

The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunchtime dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond? "You may want to talk to your physician about an extended-release medication." "I can have the teacher speak with the other children." "He will need to learn to ignore the children; he needs this medication." "Remind him that his schoolwork may deteriorate."

"You may want to talk to your physician about an extended-release medication."

The nurse is caring for children at a local hospital. Which child warrants immediate attention from the nurse? 1-year-old child with a temporal temperature of 101°F (38.3°C) 6-month-old infant with edema on the face and presacral area 1-week-old newborn whose oxygenation is not improving with oxygen 2-year-old child with clubbing noted on the fingers

1-week-old newborn whose oxygenation is not improving with oxygen

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system? Hormonal secretion Regulation of water balance Cellular metabolism Growth stimulation

Hormonal secretion

A nurse is assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. What should the nurse ask the mother? "Has she been exposed to poison ivy?" "Tell me about your family history of allergies." "Does she wear sleepers with metal snaps?" "Do you change her diapers regularly?"

"Does she wear sleepers with metal snaps?"

The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse? "Unfortunately, bracing is the only option for treating this disorder. I'm sure your child will get used to it after a few weeks." "Braces have been replaced with surgical intervention. Your child will only wear a brace for a few weeks after the surgery." "The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be." "The newer braces only have to be worn while the child is asleep and don't have to be worn at school."

"The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."

The nurse is collecting data on an 18-month-old child with a diagnosis of autism spectrum disorder (ASD). What clinical manifestation would likely have been noted in the child with this diagnosis? The child smiles when the caregiver shows her a stuffed animal. The child sits quietly in the caregiver's lap during the interview. The child does not make eye contact. The child cries and runs to the door when the caregiver leaves the room.

The child does not make eye contact.

The parents of an 8-year-old boy diagnosed with frostbite are distraught and state to the nurse, "We can't believe we didn't make our child come inside when he complained about his fingers being numb and hurting." How should the nurse respond? "Local damage occurs when the tissue temperature drops to 32°F (0°C). That was the temperature of your child's fingers." "Did you briskly massage your son's fingers when he complained of pain and numbness?" "Let's just hope he doesn't have second or third-degree frostbite." "I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son."

"I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son."

The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises, the child appears frightened and offers inconsistent accounts about how they got the bruises. The nurse suspects abuse. Which initial action by the nurse is appropriate? Ask the child to provide a written statement of how they got the bruises. Take photographs of the bruises. Interview the child's parents about the origin of the bruises. Document the bruises and any statements made by the child relating to them.

Document the bruises and any statements made by the child relating to them.

The nurse is caring for a child diagnosed with low functioning parathyroid. Which is a treatment goal of a child with hypoparathyroidism? Provide the parents a specific dietary plan for high-phosphorus foods to be eaten. Maintain the child's calcium level at a normal level with calcium replacement as prescribed. Provide the child and parent with a referral to a pediatric gastrointestinal specialist. Assure the parents have a plan in place for periods of low glucose levels if noted.

Maintain the child's calcium level at a normal level with calcium replacement as prescribed.

A nurse has provided care to several children during their well-child visits. The nurse has assessed each child's neurologic status. Which assessment finding indicates a problem requiring intervention? a 10-month-old infant who is able to ambulate with assistance a 2-year-old toddler who can walk up the steps one at a time a 2-month-old infant who reaches for a rattle several times before connecting with it a 4-year-old preschool-age child who consistently walks on tiptoes

a 4-year-old preschool-age child who consistently walks on tiptoes

The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as a possible trigger? drinking three cans of diet cola 11 p.m. bedtime; 6:30 a.m. wake-up use of nonaccented soap swimming twice a week

drinking three cans of diet cola

A 7-year-old child is diagnosed with a learning disability involving reading, writing, and spelling. The nurse identifies this as: dyspraxia. dyslexia. dysgraphia. dyscalculia.

dyslexia

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism? allowing rooming in early identification encouraging fluid intake promoting bonding

early identification

The nurse is caring for a 7-year-old girl diagnosed with precocious puberty. The child is tearful when talking with the nurse about the signs and symptoms of the disorder. She states, "I don't look like my friends." When preparing the care plan for this child, which nursing diagnosis has the highest priority? Deficient knowledge Imbalanced nutrition Disturbed body image Interrupted family process

Disturbed body image

After teaching a group of students about endocrine disorders, the instructor determines that the teaching was successful when the students identify insulin deficiency, increased levels of counterregulatory hormones, and dehydration as the primary cause of which condition? glucosuria ketone bodies diabetic ketoacidosis ketonuria

diabetic ketoacidosis

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism? promoting bonding early identification encouraging fluid intake allowing rooming in

early identification

Which intervention is the most beneficial for a burn client undergoing a skin graft? Provide diversional activities for the client. Provide an egg-crate mattress or gel mattress for the client to lie upon. Provide pain medication on a PRN schedule as soon as pain is reported. Provide around-the-clock pain medication as soon as pain is reported.

Provide around-the-clock pain medication as soon as pain is reported.

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client? Abnormal facial features Enlarged clitoris Divergent vision Small for gestational age

Enlarged clitoris

The parents of a 2-year-old toddler newly diagnosed with tricuspid atresia ask the nurse, "I do not understand why our toddler's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is best? "This is a common complication of tricuspid atresia. Unfortunately, there is nothing we can do to treat it." "The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes." "Increased cardiac workload from your toddler's heart defect affects various parts of the body, including the fingers." "The number of red blood cells has significantly increased from the heart defect, resulting in the cells pooling in the fingertips."

"The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be: "We put these on so the child will not pull the padding from under the cast." "These will help the cast look more attractive so the child won't feel self-conscious." "In case the child has an accident and misses the bedpan, these can be changed to keep the area dry." "These make a smooth edge on the cast so the skin is better protected."

"These make a smooth edge on the cast so the skin is better protected."

Which assessment finding by the nurse would warrant immediate action? A child with impetigo has honey-colored drainage noted on the skin area. A child with cellulitis has a temporal temperature of 101°F (38.3°C). A child has a red, warm, edematous area over an old spider bite. A child with periorbital cellulitis reports changes in vision and pain with eye movement.

A child with periorbital cellulitis reports changes in vision and pain with eye movement.

The nurse is teaching a group of peers regarding different types of fractures seen in children. Which statement best describes a complete fracture? A fracture in which the bone breaks into two pieces An incomplete fracture of the bone A fracture in which the bone bends without breaking A fracture in which the bone buckles rather than breaks

A fracture in which the bone breaks into two pieces

The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.

Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.

A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client? Surgery Bracing Exercise Traction

Bracing

What will the nurse include in the feeding plan for a breastfed infant with congenital heart disease? Feed on schedule every 4 hours to promote rest. Assess weight gain monthly. Ensure output of a minimum 5 wet diapers daily. Breastfeed with small, frequent feeds.

Breastfeed with small, frequent feeds.

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? Hirsutism or striae Malar rash Strawberry tongue Café au lait spots

Strawberry tongue

A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client? Assess the tips of the crutches to be certain the rubber tip is intact. Be certain the child is walking with the crutches about 6 inches to the side of the foot. Caution parents to clear articles such as throw rugs out of paths at home. Teach the client not to rest with the crutch pad pressing on the axilla.

Teach the client not to rest with the crutch pad pressing on the axilla.

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is: skeletal traction. Buck extension traction. skin traction. Russell traction.

skeletal traction.

The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test? a blood specimen skin scrapings a urine specimen a strand of hair with the root attached

skin scrapings

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)? spattering pattern stocking-glove pattern on hands or feet nonuniform pattern splash patterns

stocking-glove pattern on hands or feet

A child is admitted to the acute care facility with a burn injury. The nurse would check the child's immunization status, specifically for which of the following? diphtheria meningitis pertussis tetanus

tetanus

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? vagus nerve stimulation use of anticonvulsant medications ketogenic diet frequent temperature assessment

use of anticonvulsant medications