PEDS EXAM 3

The nurse is preparing to care for a 5 year old who has been placed in traction folllowing a fracture of the femer. The nurse plans care, knowing that which is the most appropriate activity for this child? a. radio b. sports video 3. large picture books 4. crayons & coloring book

D: Crayons & coloring book

the school nurse is performing pediculosis capitis (head lice) assessments. which assessment finding indicates that a child has a positive head check for lice? a. maculopapular lesions behind the ears b. lesions in the scalp that extend to the hairline or neck c. white flaky particles throughout the entire scalp region d. white sacs attached to the hair shafts in the occipital area

D: white sacs attached to the hair shafts in occipital area

The nurse is monitoring a child with burns during treatment. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? A. skin turgor b. level of edema at burn site c. adequacy of capillary refilling d. amount of fluid tolerated in 24 hours

C: adequacy of capillary refilling

the nurse is caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? select all that apply 1. scarring is less severe in a child than in an adult 2. a delay in growth may occur after a bone injury 3. an immature immune system presents an increased risk of infection for young children 4. fluid resuscitation is unnecessary unless burned area is more than 25% of total surface area burned 5. The lower proportion of body fluid to body mass in a child increases risk of cardiovascular problems 6. infants & young children are at increased rate for protein & calories deficiency

2, 3, 6

the nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. which instructions should be included on the list? select all that apply 1. use fingertips to lift the cast while it is drying 2. keep small toys & sharp objects away from cast 3. used a padded ruler or another padded object to scratch the skin under the cast if it itches 4. place a heating pad on the lower end of the cast & over the fingers if the fingers feel cold 5. elevate extremity on pillows for first 24-48 hours after casting to prevent swelling 6. contact primary HCP if child complains of numbness or tingling

2, 5, 6

the nurse has provided home care instructions to the parents of a child is being discharged after cardiac surgery. which statement made by the parents indicates need for further teaching? 1. a balance of rest & activity is important 2. i can apply lotion or powder to the incision if it is itchy 3. activities in which my child could fall need to be avoided for 2 to 4 weeks 4. large crowds of people need to be avoided for at least 2 weeks after surgery

2: i can apply lotion or powder to incision if it is itchy

a 4-year-old child sustains a fall at home. after an xray examiniation, the child is determined to have a fractured arm & a plaster cast is applied. the nurse provides instructions to the parents regarding care for the child's cast. which statement by the parents indicates a need for further instruction? 1. the cast may feel warm as the cast dries 2. i can use lotion or powder around the cast edges to relieve itching 3. a small amount of white shoe polish can touch up a soiled white cast 4. if the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast

2: i can use lotion or powder around the cast edges to relieve itching

the clinic nurse reviews the record of a child just seen by the pediatrician & diagnosed with suspected aortic stenosis. the nurse expects to note documentation of which clinical manifestation found in this disorder? 1. pallor 2. hyperactivity 3. activity intolerance 4. GI disturbance

3. activity intolerance

the nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. which statement by the parents indicates a need for further instruction? 1. i will encourage my child to perform prescribed excersises 2. i will have my child wear soft fabric clothing under the brace 3. i should apply lotion under the brace to prevent skin breakdown 4. i should avoid use of powder because it will cake under the brace

3; i should apply lotion under the brace to prevent skin breakdown

a child with rheumatic fever will be arriving to the nursing unit for admission. on admission assessment, the nurse should ask the parents which question to elicit information specific to development of rheumatic fever? 1. has the child complained of back pain? 2. has child complained of headaches? 3. has the child had any nausea or vomiting? 4. Did the child have a sore throat or fever in the last 2 months?

4

A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care and includes which intervention? 1. Ensure that all ropes are outside the pulleys. 2. Ensure that the weights are resting lightly on the floor. 3. Restrict diversional and play activities until the child is out of traction. 4. Check the health care provider's (HCP's) prescriptions for the amount of weight to be applied

4. check the health care provider's prescriptions for amount of weight to be applied

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic. 2. Release the skin traction. 3. Apply ice to the extremity. 4. Notify the health care provider (HCP).

4: notify HCP

a child who has undergone spinal fusion for scoliosis complains of abdominal discomfort & begins to have episodes of vomiting. on further assessment, the nurse notes abdominal distention. on the basis of these findings, the nurse should take which actions? 1. administer an antiemetic 2. increase IV fluids 3. Place child in sims position 4: notify HCP

4: notify HCP

the mother of a 3 year old child arrives at a clinic & tells the nurse the child has been scratching the skin continuously & has developed a rash. the nurse assess the child & suspects presence of scabies. the nurse bases this suspicion on which finding noted on assessment? A. fine grayish red lines B. purple-colored lesions C: thick, honey colored crusts D. clusters of fluid-filled vesicles

a. fine grayish red lines

the school nurse has provided an instructional session about impetigo to parents of children attending school. which statement indicates a need for further instruction? a. it is extremely contagious b. it is most common in humid weather c. lesions most often are located on the arms & chest d. it might show up in an area of broken skin, such as an insect bite

c. lesions most often are located on the arms & chest