Peds Exam 3

The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A. "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B. "I must make sure I use lukewarm water instead of hot water." C. "Oatmeal baths are helpful; we can add Aveno skin relief bath treatment." D. "We should leave his skin moist before applying medication or moisturizer."

A. "After bathing, I need to rub his skin everywhere to make sure he is completely dry." *Pat dry

The nurse is caring for a child w/ thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching? A. "I can have the nurse administer the chelation therapy if I am uncomfortable." B. "I must be very careful to strictly adhere to the chelation regimen." C. "The deferoxamine binds to the iron so it can be removed from the body." D. "The medication can be administered while my child is sleeping."

A. "I can have the nurse administer the chelation therapy if I am uncomfortable." *Important to emphasize to the mother that therapy must be maintained at home to continuously decrease the iron levels in the child's body.

The nurse is providing postoperative care for a 14 m/o girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A. "I will help you become comfortable in caring for you daughter." B. "You must learn how to care for your daughter at home." C. "You will need to learn to collaborate with all the caregivers." D. "There is a lot to learn, and you need to have a positive attitude."

A. "I will help you become comfortable in caring for you daughter."

A nurse is caring for a 12 y/o girl w/ a severe peanut allergy. The girl's parents are upset b/c the school does not permit her to carry her EpiPen w/ her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate? A. "She is allowed by law to carry her EpiPen w/ her; I will talk to school authorities." B. "Let's file an action plan and keep it in the school office in the event of anaphylaxis." C. "Make sure she wears a medical alert bracelet so that school staff know she has allergies." D. "I will be happy to train school authorities and staff to recognize anaphylaxis.

A. "She is allowed by law to carry her EpiPen w/ her; I will talk to school authorities."

A child with DMD is to receive prednisone as part of his tx plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A. "We should give this drug before he eats anything." B. "We need to watch carefully for possible infection." C. "The drug should not be stopped suddenly." D. "He might gain some weight on this drug."

A. "We should give this drug before he eats anything." *Can cause gastric upset, so take with food

A 15 y/o adolescent is brought to the ED by his parents. The adolescent is febrile w/ chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply A. Complaints of stiff neck B. Photophobia C. Absent headache D. Negative Brudzinski sign E. Vomiting

A. Complaints of stiff neck B. Photophobia E. Vomiting

The nurse is preparing a teaching plan for the family and their 6 y/o son who has just been diagnosed with DM. What would the nurse identify as the initial goal for the teaching plan? A. Developing management and decision-making skills B. Educating the parents about T1DM C. Developing a nutritionally sound 30-day meal plan D. Promoting independence w/ self-administration of insulin

A. Developing management and decision-making skills

The nurse is assessing a child w/ aplastic anemia. What would the nurse expect to assess? A. Ecchymoses B. Tachycardia C. Guaiac-positive stool D. Epistaxis E. Severe pain F. Warm tender joints

A. Ecchymoses B. Tachycardia C. Guaiac-positive stool D. Epistaxis *E and F are associated with sickle cell crisis

A 4 y/o boy has a hx of seizures and has been started on a ketogenic diet. Which food selection would be most appropriate for his lunch? A. Fried eggs, bacon, and iced tea B. A hamburger on a bun, french fries, and milk C. Spaghetti w/ meatballs, garlic bread, and a cola drink D. A grilled cheese sandwich, potato chips, and a milkshake

A. Fried eggs, bacon, and iced tea *Ketogenic diet is high fat, moderate protein, and low CHO

A child is diagnosed w/ a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? Select all that apply. A. Fruit juice B. Rice milk C. Yogurt D. Nondairy creamers E. Soy milk

A. Fruit juice B. Rice milk E. Soy milk

The nurse is caring for a 9 y/o pt newly dx w/ DM. The pt has polyuria, polydipsia, and weight loss. Which nursing dx will the nurse include in the care plan? Select all that apply. A. Imbalanced nutrition: less than body requirements B. Deficient fluid volume C. Deficient knowledge regarding disease process D. Noncompliance E. Delayed growth and development

A. Imbalanced nutrition: less than body requirements B. Deficient fluid volume C. Deficient knowledge regarding disease process

The nurse is caring for a 13 y/o boy w/ acute myelogenous leukemia who is experiencing feelings of powerlessness due to the effects of chemotherapy. What intervention will best help the teen's sense of control? A. Involving the boy in decisions whenever possible B. Acknowledging the boy's feelings of anger w/ the disease C. Providing realistic expectations of tx and outcomes D. Recognizing abilities that are unaffected by the disease

A. Involving the boy in decisions whenever possible

The physician has ordered rectal diazepam for a 2 y/o boy with status epilepticus. Which instruction is essential for the nurse to teach the parents? A. Monitor their child's level of sedation B. Watch for fever indicating infection C. Gradually reduce the dosage as seizures stop D. Monitor for an allergic reaction to the medication

A. Monitor their child's level of sedation

The nurse is planning a discussion group for parents w/ children who have cancer. How would the nurse describe a difference between cancer in children and adults? A. Most childhood cancers affect the tissues rather than organs B. Childhood cancers are usually localized when found C. Unlike adult cancers, childhood cancers are less responsive to treatment D. The majority of childhood cancers can be prevented

A. Most childhood cancers affect the tissues rather than organs *Most childhood cancers are metastasized when found *Childhood cancers are more responsive to tx *The majority of childhood cancers are not preventable; whereas about 80% of adult cancers are preventable

An 8 y/o girl was diagnosed w/ a closed fracture of the radius at approximately 2 PM. The fracture was reduced in the ED and her arm placed in a cast. At 11 PM, her mother brings her back to the ED due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A. Notifying the doctor immediately B. Applying ice C. Elevating the arm D. Giving additional pain medication as ordered

A. Notifying the doctor immediately *notify the provider immediately b/c the pain is a classic sign of compartment syndrome *Immediate tx is required to prevent excessive swelling and to detect neurovascular compromise *In this case, lower the arm below heart level to promote movement of oxygenated blood to the periphery *In this case, remove ice to promote blood flow (stop vasoconstriction)

The nurse is developing a plan of care for a child with thalassemia. What information would the nurse expect to include? Select all that apply. A. Packed RBC transfusions B. Deferoxamine therapy C. Heparin thearpy D. Opioid analgesics E. Platelet transfusions F. IV immunoglobulin

A. Packed RBC transfusions B. Deferoxamine therapy *Heparin is for DIC *Opioids for SCC *Platelets and IV immunoglobulins are for ITP

The nurse is providing care to a child w/ a long-leg hip spica cast. What is the priority nursing diagnosis? A. Risk for impaired skin integrity due to cast and location B. Deficient knowledge r/t cast care C. Risk for delayed development r/t immobility D. Self-care deficit r/t immobility

A. Risk for impaired skin integrity *Maslow's *Large size of the cast and location can lead to skin breakdown and soiling of cast edges or leakage of urine/stool

When providing care to a child w/ aplastic anemia, which nursing dx would be the priority? A. Risk for injury B. Imbalanced nutrition, less than body requirements C. Ineffective tissue perfusion D. Impaired gas exchange

A. Risk for injury *Failure of the bone marrow to produce cells and decreased numbers of all blood cells *Safety is of the utmost concern in children with aplastic anemia in order to avoid hemorrhage *Administer stool softeners to prevent anal fissures

When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A. Skeletal traction B. Physical therapy C. Orthotics D. Occupational therapy

A. Skeletal traction

The mother of a 5 y/o girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this? A. Spooned nails B. Negative splenomegaly C. O2 saturation of 99% D. Bradycardia

A. Spooned nails *Indicative of chronic hypoxia *Other findings aligned with iron-deficiency anemia would include decreased O2 saturation, tachycardia, and possible splenomegaly

A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists causes of meningitis. What would the nurse highlight as the most common cause of meningitis in newborns? A. Streptococcus group B B. Haemophilus influenzae type B C. Streptococcus pneumoniae D. Neisseria meningitides

A. Streptococcus group B

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply. A. Tuna B. Salmon C. Tofu D. Cow's milk E. Dried fruits

A. Tuna B. Salmon C. Tofu E. Dried fruits *Foods high in Fe include red meats, tuna, salmon, eggs, tofu, enriched grains, dried beans/peas, dried fruits, leafy green vegetables, and Fe-fortified breakfast cereals

When reviewing the history of a child with suspected primary immunodeficiency, what would the nurse be least likely to find? A. Weight appropriate for height B. ABX therapy for the past 3 months w/out effect C. Ten episodies of otitis media in the last year D. Three bouts of sinusitis w/in a year's time

A. Weight appropriate for height *Typically see failure to thrive and underweight in primary immunodeficiency *May also see recurrent abscesses, pneumonia, candidasis, infections that do not clear w/ ABX

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

A. hypovolemic shock

The nurse is providing parental teaching about home care for an 8 y/o boy with widespread sunburn on his back and shoulders. Which response indicates a need for further teaching? A. "Cool compresses may help cool the burn." B. "He should manually peel off any flaking skin." C. "Non-steroidal anti-inflammatory drugs like ibuprofen are helpful." D. "He should avoid hot showers or baths for a couple of days."

B. "He should manually peel off any flaking skin." *Peeling the skin can cause further injury

The nurse is caring for an infant with osteogenesis imperfecta and is providing instructions on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching? A. "I need to avoid pushing or pulling on an arm or leg." B. "I must carefully lift the baby from under the armpits." C. "I should not bend an arm or leg into an awkward position." D. "We must avoid lifting the legs by the ankles to change diapers."

B. "I must carefully lift the baby from under the armpits." *The mother must not lift a baby or young child with osteogenesis imperfecta from under the armpits b/c it may cause harm

The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A. "We will leaved fireworks displays to the professionals." B. "I will set our water heater at 130 degrees." C. "All sleepwear should be flame retardant." D. "The handles of pots on the stove should face inward."

B. "I will set our water heater at 130 degrees." *The recommended maximal home water heater temperature is 120 degrees.

The nurse is providing a class for a group of childcare providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction? A. "Most allergic reactions will happen w/in a few minutes of eating a problematic food." B. "If a child has previously eaten a food and not had a reaction, they are not 'truly' allergic to it." C. "Allergic reactions can happen hours after eating something." D. "In addition to hives some children may also have vomiting and diarrhea when having an allergic reaction to a food."

B. "If a child has previously eaten a food and not had a reaction, they are not 'truly' allergic to it."

A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occured. Which response by the nurse would be most appropriate? A. "This condition is due to a genetic defect in the bones." B. "It's most likely from how the baby was positioned in utero." C. "They really don't know what causes this condition." D. "There is probably an underlying deformity of the baby's hip."

B. "It's most likely from how the baby was positioned in utero."

A nurse is providing instructions to the parents of a 3 m/o w/ DDH who is being treated w/ a Pavlik harness. Which statements by the parents demonstrate understanding of the instructions? Select all that apply. A. "We need to adjust the straps so that they are snug but not too tight." B. "We should change her diaper w/out taking her out of the harness." C. "We need to check the area behind her knees for redness and irritation." D. "We need to call the doctor if she is not able to actively kick her legs." E. "We need to send the harness to the dry cleaners to have it cleaned."

B. "We should change her diaper w/out taking her out of the harness." C. "We need to check the area behind her knees for redness and irritation." D. "We need to call the doctor if she is not able to actively kick her legs."

A 5 y/o child w/ T1DM is brought to the clinic by his mother for a follow-up visit after having his HbA1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A. 9.0% B. 8.2% C. 7.3% D. 6.9%

B. 8.2% *In children 6 y/o and under, HbA1C level should be less than 8.5% but over 7.5%. For children between 6-12 y/o, HbA1C should be lower than 8%. For children and adolescents between 13-19 y/o, the target HbA1C level would be less than 7.5% The looser control is seen with young children because there are greater risks associated with hypoglycemia at that age than there are with poorly controlled BG

The nurse is conducting a physical examination of a child w/ suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis? A. Abduction occurs to 75 degrees and adduction to within 30 degrees w/ a stable pelvis B. A distinct clunk is heard with Barlow and Ortolani maneuvers C. A high pitched click is heard with hip flexion or extension D. The thigh and gluteal folds are symmetric

B. A distinct clunk is heard with Barlow and Ortolani maneuvers *The clunk sound is dislocation occuring A- normal finding C- these sounds are benign D- normal finding; gluteal folds will be asymmetric w/ DDH b/c of pelvic drop

When teaching a group of students about the skeletal development in children, what information would the instructor provide? A. The growth plate is made up of the epiphysis B. A young child's bones commonly bend instead of break with an injury C. The infant's skeleton has undergone complete ossification by birth D. Children's bones have a thin periosteum and limited blood supply

B. A young child's bones commonly bend instead of break with an injury

When assessing a child for slipped capital femoral epiphysis, what would the nurse identify as possible risk factors? Select all that apply A. Age younger than 8 yr B. African American ethnicity C. History of cystic fibrosis D. Excessive activity E. Obesity

B. African American ethnicity E. Obesity *Risk factors for SCFE include obesity, age 9-16 yr, AA or Polynesian ethnicity, sedentary lifestyle, rapid growth spurt, and male gender

The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? A. Corticosteroids B. Antifungals C. Antibiotics D. Retinoids

B. Antifungals

A nurse is preparing a presentation for a local parent group about burn prevention and care in children. What would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A. Using cool water over the burned area until the pain lessens B. Applying ice directly to the burned skin area C. Covering the burn with a clean, nonadhesive bandage D. Giving the child acetaminophen for pain relief

B. Applying ice directly to the burned skin area *Ice should never be applied directly to the skin

A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. What action should the nurse take first? A. Inspect the child's skin color B. Assess for a patent airway C. Observe for symmetric breathing D. Palpate the child's pulse

B. Assess for a patent airway *These are all related to primary survey, but make sure to follow ABCs Patency, breathing pattern, color/pulse

The nurse is assessing an 11 y/o girl with scoliosis. What would the nurse expect to find? Select all that apply. A. Complaints of severe back pain B. Asymmetric shoulder elevation C. Even curve at the waistline D. Pronounced one-sided hump on bending over E. Diminished motor function F. Hyperactive reflexes

B. Asymmetric shoulder elevation D. Pronounced one-sided hump on bending over

The nurse is caring for a 2 m/o w/ cerebral palsy. The infant is limp and flaccid w/ uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations? A. Spastic B. Athetoid C. Ataxic D. Mixed

B. Athetoid *These movements increase in periods of stress

A nurse is instituting neutropenic precautions for a child. What information would the nurse most likely include? Select all that apply. A. Placing the child in a semiprivate room B. Avoiding rectal exams, suppositories, and enemas C. Placing a mask on the child when outside the room D. Encouraging an intake of raw fruits and vegetables E. Discouraging fresh flowers in the child's room

B. Avoiding rectal exams, suppositories, and enemas C. Placing a mask on the child when outside the room E. Discouraging fresh flowers in the child's room

What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A. Positioning supine with a pillow under the buttocks B. Covering the sac with saline-soaked nonadhesive gauze. C. Wrapping the infant snugly in a blanket D. Applying a diaper to prevent fecal soiling of the sac

B. Covering the sac with saline-soaked nonadhesive gauze. *Important to keep the sac from drying out *A, C, D all place pressure on the sac and should be avoided

A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe? A. Erythematous papulovesicular rash B. Dark, red, scaly rash with lichenification C. Pustular vesicles with honey-colored exudates D. Hypopigmented oval scaly lesions

B. Dr, red, scaly rash with lichenification

The nurse is caring for an 8 y/o girl who has been dx w/ leukemia and will have a variety of tests, including an LP, before beginning chemotherapy. What action would be the priority? A. Applying EMLA to the LP site B. Educating the child and family about the testing procedures C. Administering promethazine as ordered for nausea D. Educating the family about chemotherapy and its side effects

B. Educating the child and family about the testing procedures *Keep the family involved so they know what to expect and understand why the tests are being performed

A nurse is preparing a presentation for a parent group about MSK injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A. Growth plate B. Epiphysis C. Physis D. Metaphysis

B. Epiphysis

A nurse is preparing a presentation for a parent group about MSK injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A. Growth plate B. Epiphysis C. Physis D. Metaphysis

B. Epiphysis *Growth plate refers to the combination of the epiphysis and physis *The epiphyseal region is vulnerable and structurally weak; traumatic force applied to the epiphysis during injury may result in fracture in that are of the bone

The nurse is assessing a child w/ suspected thalassemia. What would the nurse expect to assess? A. Dactylitis B. Frontal bossing C. Presence of clubbing D. Presence of spooning

B. Frontal bossing *Anemic state creates increased erythroid activity which causes bone marrow expansion which causes thinning of the bony cortex--> skeletal deformity (frontal and maxillary bossing)

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick BG level is 70 mg/dL. What would the nurse do next? A. Administer a sliding scale dose of insulin B. Give 10-15 g of simple CHO C. Offer a complex CHO snack D. Administer glucagon IM

B. Give 10-15 g of simple CHO

A nurse is preparing a plan of care for a child w/ a primary immunodeficiency. Which nursing diagnosis is the priority? A. Imbalanced nutrition, less than body requirements r/t poor appetite. B. Ineffective protection r/t impaired humoral defenses C. Acute pain r/t inflammatory processes D. Risk for delayed growth and development r/t chronic illness

B. Ineffective protection r/t impaired humoral defenses *Risk for infection is the priority

A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A. Subcutaneous injection B. Intramuscular injection C. Oral D. Intravenous infusion

B. Intramuscular injection

The nurse is caring for a 15 y/o boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection? A. Burn wound cellulitis B. Invasive burn cellulitis C. Burn impetigo D. Staphylococcal scalded skin syndrome

B. Invasive burn cellulitis *Invasive burn cellulitis results in the burn developing a dark brown, black, or purplish color w/ a discharge and foul odor

A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia? A. Aplastic anemia B. Pernicious anemia C. Folic acid anemia D. Sickle cell anemia

B. Pernicious anemia

The mother of a 15 y/o girl has contacted the clinic to report that her daughter has burned the back of her hand w/ a curling iron. The child's mother reports the burn is mild but states her daughter is complaining of pain. After consulting with the physician, what instructions can the nurse anticipate will be recommended? Select all that apply A. Apply a thin film of protective cocoa butter B. Run cool water over the injured area C. Apply ice for 15-20 min each hr until the pain subsides D. Take acetaminophen using the manufacturer's guidelines E. Apply a thin layer of petroleum jelly to the burned area

B. Run cool water over the injured area D. Take acetaminophen using the manufacturer's guidelines *Do not apply cream or gel of any variety to the burned area *Do not apply ice to the burn

The nurse is caring for a 10 y/o with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A. Deep-breathing exercise B. Upright positioning C. Coughing D. Chest percussion

B. Upright positioning *A- useful for strengthening and maintaining respiratory muscles *C- helps clear the airways *D- helps loosen secretions in the lungs

A nurse is preparing a class for parents of infants about managing diaper dermatitis. What advice would the nurse include in the presentation? Select all that apply. A. Applying topical nystatin to the diaper area B. Using a blow dryer on warm to dry the diaper area C. Refraining from using rubber pants over diapers D. Using scented diaper wipes to clean the area E. Washing the diaper area w/ an antibacterial soap

B. Using a blow dryer on warm to dry the diaper area C. Refraining from using rubber pants over diapers

A nurse is assessing the skin of a child with cellulitis. What would the nurse expect to find? A. Red, raised hair follicles B. Warmth at skin disruption site C. Papules progressing to vesicles D. Honey-colored exudate

B. Warmth at skin disruption site

The nurse is teaching the mother of a 5 y/o boy with a myelomeningocele who has developed a sensitivity to latex. Which response from his mother indicates a need for further teaching? A. "He needs to get a medical alert identification." B. "I will need to discuss this with his caregivers." C. "A product's label indicates whether it is latex-free." D. "He must avoid all contact with latex."

C. "A product's label indicates whether it is latex-free." *FDA only requires medical supplies to be labeled regarding latex content, not other consumer products

A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement? A. "Having the shunt put in decreases his risk for developmental problems." B. "If he doesn't get an infection in the first week, the risk is greatly reduced." C. "He will need more surgeries to replace the shunt as he grows." D. "The shunt will help to prevent any further complications from his disease."

C. "He will need more surgeries to replace the shunt as he grows."

A 6 y/o with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A. "Would you like me to bring you a blanket and pillow?" B. "You are doing such a wonderful job with your son." C. "He's in good hands; consider going home and getting some sleep." D. "Are you planning to spend the night or to go home?"

C. "He's in good hands; consider going home and getting some sleep." *Child being admitted to the hospital can be a time of respite for family and primary caregivers

The nurse is caring for an active 14 y/o boy who has recently been diagnoses w/ scoliosis. He is dismayed that a "jock" like himself could have this condition and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? A. "If you wear your brace properly, you may not need surgery." B. "The good news is that you have very minimal curvature of your spine." C. "Let's talk to another boy with scoliosis who is winning trophies for his swim team." D. "Let's talk to the doctor about your treatment options."

C. "Let's talk to another boy with scoliosis who is winning trophies for his swim team."

A 5 y/o girl is dx w/ iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement indicates the need for additional teaching? A. "She needs to eat foods that are high in fiber so she doesn't get constipated." B. "We'll try to get her to drink lots of fluids throughout the day." C. "We will place the liquid in the front of her gums just below her teeth." D. "We need to measure the liquid carefully so that we give her the correct amount."

C. "We will place the liquid in the front of her gums just below her teeth." *Place the solution behind the teeth *Fiber and fluids are appropriate b/c iron supplementation can cause constipation *Measure carefully to prevent iron toxicity

A nurse is conducting a physical examination of a 5 y/o w/ suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning? A. "Open your mouth so I can look inside your cheeks and lips." B. "Do you have any bruises on your feet or shins?" C. "Will you show me how you walk across the room?" D. "Let me see the palms of your hands and soles of your feet."

C. "Will you show me how you walk across the room?"

When developing the plan of care for a child w/ burns requiring fluid replacement therapy, what information would the nurse expect to include? A. Administration of colloid initially followed by a crystalloid B. Determination of fluid replacement based on the type of burn C. Administration of most of the volume during the first 8 hr D. Monitoring of hourly UO to achieve less than 1 mL/kg/hr

C. Administration of most of the volume during the first 8 hr *Use crystalloids before colloids *Replacement is based on BSA *Want to achieve AT LEAST 1 mL/kg/hr

A 4 y/o is brought to the ED w/ a burn. What would alert the nurse to the possibility of child abuse? A. Burn assessment correlates w/ mother's report of contact w/ a portable heater. B. Parents state that the injury occurred approximately 15-20 min ago C. Clear delineations are noted between burned and non-burned skin areas D. The burn area appears asymmetric and non-uniform

C. Clear delineations are noted between burned and non-burned skin areas *Glove/stocking appearance is indicative of immersion or purposeful scalding *Story of the parent may be inconsistent w/ abuse *In abuse case, parents may wait a long time to seek tx *D is indicative of a spatter-like burn caused by hot liquids

A nurse is preparing a presentation for a group of parents with children diagnosed w/ T1DM. The children are all adolescents. What issues would the nurse need to address? Select all that apply. A. Self-monitoring of BG levels B. Feelings of being different C. Deficient decision-making skills D. Body image conflicts E. Struggle for independence

C. Deficient decision-making skills D. Body image conflicts E. Struggle for independence

The nurse suspects that a 4 y/o with T1DM is experiencing hypoglycemia based on what findings? Select all that apply. A. Blurred vision B. Dry, flushed skin C. Diaphoresis D. Slurred speech E. Fruity breath odor F. Tachycardia

C. Diaphoresis D. Slurred speech F. Tachycardia

A 3 y/o child has sustained severe burns and is ordered to receive 100% O2. What would the nurse use to administer the O2? A. Nasal cannula B. Venturi mask C. Nonrebreather mask D. Oxygen hood

C. Nonrebreather mask *All children w/ severe burns should receive 100% O2 via a NRB mask or BVM ventilation *O2 hoods are used for infants only

An 8 y/o boy w/ a fractured forearm is to have a fiberglass cast applied. What information would the nurse include when teaching the child about the cast? A. The cast will take a day or two to dry completely B. The edges will be covered w/ a soft material to prevent irritation C. The child initially may experience a very warm feeling inside the cast D. The child will need to keep his arm down at his side for 48 hr

C. The child initially may experience a very warm feeling inside the cast *A fiberglass cast only takes a few min to dry and will cause a warm feeling in the cast *Fiberglass casts will not cause rubbing, thus do not need soft material or padding to prevent irritation *Keep the arm elevated for 48 hr to reduce swelling

The nurse is assessing a 13 y/o boy with T2DM. What would the nurse correlate with disorder? A. The parents report that their child had "a cold or flu" recently B. BP is decreased when checking VS C. The parents report that their son "can't drink enough water." D. Auscultation reveals Kussmaul breathing

C. The parents report that their son "can't drink enough water."

While providing care to a 5 m/o girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching? A. "She cannot have any cow's milk." B. "I should continue breastfeeding until at least 6 months." C. "Peanuts in any form should be avoided." D. "Any kind of fruit is acceptable"

D. "Any kind of fruit is acceptable" *Avoid kiwi

The mother of a 5 y/o child w/ allergies to a variety of foods including eggs, milk, peanuts, and shellfish, asks if her child will "always have these problems". What response by the nurse is most accurate? A. "Sadly, allergies to foods will persist." B. "Most children with allergies will outgrow them." C. "We cannot be sure at this point, but most children who are allergic to peanuts will not have this allergy in adulthood." D. "In most cases allergies to peanuts and shellfish persist into adulthood, but the others may diminish and disappear."

D. "In most cases allergies to peanuts and shellfish persist into adulthood, but the others may diminish and disappear."

The nurse is caring for a 2 y/o boy w/ hemophilia. His parents are upset by the possibility that he will become infected with hepatitis of HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate? A. "Parents commonly fear the worst; however, the factor will help your child lead a normal life." B. "There are risks w/ any tx including using blood products, but these are very minor." C. "Although factor replacement is expensive, there's more financial strain from missing work if he has a bleeding episode." D. "Since dry heat tx of the factor began in 1986, there have been no reports of virus transmission."

D. "Since dry heat tx of the factor began in 1986, there have been no reports of virus transmission."

A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which instruction would the nurse include when teaching the parents about caring for their child? A. Waiting 48 hr before allowing the child to take a tub bath B. Not allowing the child to sleep on his side for about 4 weeks C. Calling the physician if the child's temperature is over 100.5F D. Discouraging the child from stretching or bending forward for 4 weeks

D. Discouraging the child from stretching or bending forward for 4 weeks *Wait 2 wk before tub baths *Do not allow child to sleep on their stomach for 4 wk *Call the physician if the temp is over 101.5F

After teaching a class of nursing students about MD, the instructor determines that the teaching was successful when the students identify which type of MD as demonstrating an X-linked recessive pattern of inheritance? A. Limb-girdle B. Myotonic C. Distal D. Duchenne

D. Duchenne

A nurse is caring for a 14 y/o girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A. Pulse oximetry B. Fiberoptic bronchoscopy C. Xenon ventilation-perfusion scanning D. Electrocardiographic monitoring

D. Electrocardiographic monitoring *ECG monitoring is important for the child who has suffered an electrical burn to identify possible cardiac arrhythmias, which can be noted for up to 72 hr after a burn injury. *B and C are used to evaluate inhalation injuries *Pulse oximetry is used to evaluate pulmonary function and would not be indicated specifically for electrical burns

A 6 y/o boy has been admitted to the hospital w/ burns. The nurse notes carbonaceous sputum. What action would be the priority? A. Determining the burn depth B. Eliciting a description of the burn C. Estimating burn extent D. Ensuring a patent airway

D. Ensuring a patent airway

A group of students are reviewing information about the various types of insulin used to treat T1DM. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration? A. Lispro B. Regular C. NPH D. Glargine

D. Glargine

The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management? A. Administer NSAID as ordered B. Use guided imagery and therapeutic touch C. Administer meperidine as ordered D. Initiate pain assessment w/ a standardized pain scale

D. Initiate pain assessment w/ a standardized pain scale *Do not use meperidine b/c of risk of seizures

The nurse has developed a plan of care for a 12 m/o hospitalized w/ dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? A. Encouraging consumption of fruit juice B. Offering Kool-Aid or popsicles as tolerated C. Encouraging milk products to boost caloric intake D. Maintaining the IV fluid rate as ordered

D. Maintaining the IV fluid rate as ordered

A 4 y/o boy has a febrile seizure during a well-child visit. What action would be a priority? A. Hyperextending the child's head while placing him on his side B. Using a tongue blade to pry open the child's jaw C. Loosening the child's clothing to ensure a patent airway D. Protecting the child from harm during the seizure

D. Protecting the child from harm during the seizure

The nurse has developed a plan of care for a 6 y/o w/ MD. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? A. Recommend the bed's side rails be raised throughout the day and night B. Suggest a caregiver be present continuously to prevent falls from bed C. Encourage a loose restraint to be used when he is in bed. D. Recommend raising the bed's side rails when a caregiver is not present.

D. Recommend raising the bed's side rails when a caregiver is not present.

The nurse is caring for a 16 y/o boy w/ acute myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster immunization. Which is the priority nursing diagnosis? A. Pain r/t A/E of tx verbalized by the child B. Nausea r/t S/E of chemotherapy verbalized by the child C. Constipation r/t the use of opioid analgesics for pain D. Risk for infection r/t neutropenia and immunosuppression

D. Risk for infection r/t neutropenia and immunosuppression

A child is diagnosed with atopic dermatitis. Which lab test would the nurse expect the child to undergo to provide additional evidence for this condition? A. Erythrocyte sedimentation rate B. Potassium hydroxide prep C. Wound culture D. Serum IgE level

D. Serum IgE level

As part of a clinical conference w/ a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full thickness burns? A. Skin that is reddened, dry, and slightly swollen B. Skin appearing wet w/ significant pain C. Skin w/ blistering and swelling D. Skin that is leathery and dry w/ some numbness

D. Skin that is leathery and dry w/ some numbness *A-> superficial *B-> deep partial thickness *C-> partial thickness

The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. What information would the nurse include? A. Applying petroleum jelly to lubricate the catheter B. Cleaning the reusable catheter w/ peroxide after each use C. Storing the reusable cleaned catheter in a brown paper bag D. Soaking the catheter in a vinegar and water solution to sterilize

D. Soaking the catheter in a vinegar and water solution to sterilize

A 16 y/o boy reports to the school nurse about HA and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis? A. Fixed and dilated pupils B. Frequent urination C. Sunset eyes D. Sunlight is "too bright"

D. Sunlight is "too bright"