peds exam

When discharging a newborn, which injury prevention instruction would be of highest priority to tell the parents?

"Never leave the baby unattended on a raised, unguarded area."

Which nursing action would help foster a hospitalized 3-year-old's sense of autonomy?

Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe

Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever?

Ankle and knee joint pain Joint pain/arthritis is the most common symptom of rheumatic fever. 60-80% first attacks and is in two or more large joints like ankle, knee, wrist, or elbow.

What would be the best response to a mother who tells the nurse that the only way she can get her 2-year-old to take medicine is to call it "candy"?

Discuss the importance of not calling medicine candy to prevent accidental drug ingestion

What would be the priority nursing action on finding the varicella vaccine at room temperature on the shelf in the medication room?

Do not administer this batch of vaccine.

Which intervention should the nurse implement for a newborn diagnosed with galactosemia?

Eliminate all milk and lactose-containing foods.

Which clinical assessment of a neonate with bacterial meningitis would warrant immediate intervention?

Respiratory rate of 24 breaths per minute Neonates RR is 30-60

A young girl is being discharged from the pediatric unit after a left nephrectomy for Stage 1 Wilms' tumor of the left kidney and the first round of chemotherapy. The nurse is providing the parents with discharge planning. Which of the following statements would the nurse include?

child will be able to live a normal life after the surgical site heals

A child, who is bleeding heavily, is in hypovolemic shock. The nurse determines that the child is currently compensating for the loss of blood when the nurse notes which of the following?

tachycardia

The nurse is educating the parents of a child with Duchenne Muscular Dystrophy (DMD) regarding priority actions that they should take when caring for their child. Which of the following actions should the nurse include during the teaching session? Immediately report to the child's primary health care provider if the child:

the parents must report immediately if their child with dmd develops an upper respiratory infection.

An Orthodox Jewish couple deliver a baby boy with hypospadias. The parents state, "We are so excited, we are planning the baby's bris (ritual circumcision) for next week. Which of the responses by the nurse is appropriate?

this is the most appropriate statement for the nurse to make. the baby will not be able to be circumcised at the bris.

A nurse has determined that a 10 month old child has an obstructed airway. The child is making no vocalizations and is not breathing. Which of the following actions by the nurse is appropriate at this time?

while tipping the child's head down, slap the child five times between the shoulder blades.

A school age child has sickle cell anemia. The child's parents ask the school nurse regarding the high risk nature of 4 activities the child is requesting to participate in. Which of the following activities should the nurse advise the parents is the most high risk for the child?

wrestling most likely would precipitate a vaso- occlusive crisis.

What would be the nurse's best advice to a mother who says her 3-year-old ingested Visine eye solution?

"Call the Poison Control Center."

A 3-year-old boy has been hospitalized because he fell down the stairs. His mother is crying and states," This is all my fault." Which is the nurse's best response?

"Falls are one of the most common injuries in this age group

Which statement by an infant's mother leads the nurse to believe that she needs further education about the nutritional needs of a 6-month-old?

"I will start my son on fruits and gradually introduce vegetables. vegetables should be introduced before fruit since fruit is sweet

The nurse is using the FLACC scale to rate the pain level in a 9-month -old. Which is the nurse's best response to the father's questions of what the FLACC scale is?

"It estimates a child's level of pain utilizing behavioral and physical responses."

The mother of a 3 year old child who is diagnosed with an ear infection states, "I can't understand why you won't give my child antibiotics. Can't you see that she is sick?" Which of the following responses by the nurse is appropriate at this time?

"It is likely that the ear infection is caused by a virus, and antibiotics do not kill viruses."

An 8-day-old infant was admitted to the hospital weigh vomiting and dehydration. The newborn's heart rate is 170, respiratory rate is 44, blood pressure is 85/52 and temperature is 99 degrees F ( 37.2 C) . What is the nurses' best response to the parents who ask if the vital signs are normal?"

"The heart rate is elevated, but the other vital signs are within normal limits." a normal respiratory rate for a child from birth to 1 month is 30 to 60. 4. a normal heart rate for a child from birth to 1 month is 90 to 160.

An 18-year-old with a rash and itching in the groin area is concerned that he has contracted a sexually transmitted infection and does not want his parent to find out. The nurse's best response is:

"We will not contact your parents regarding this visit."

Which would be the most therapeutic response for the mother of a 6-month old who tells the nurse she does not want her infant to have the DTaP vaccine because the infant had localized redness the last time she received the vaccine?

"Would you mind if we discussed your concerns."

Which would be the most appropriate discharge instructions for a child with a right wrist sprain 3 hours ago?

"You should rest, apply ice wrapped in a towel, elevate the wrist above the heart, and use the sling when walking."

The mother of an adolescent complains that he has and some recent behavioral changes. He comes home from school every day, closes his door, and refrains from interaction with his family. The nurse's best response to the mother is:

"Your son's behavior is normal. You should listen to him without being judgmental."

The mother of a 15-year-old is frustrated because he spends much of his weekend time sleeping. Which is the nurse's best response to the mother's frustration?

"teens require more sleep due to the rapid physical growth that is occurring."

The mother of a newborn asks the nurse when the infant will receive the first hepatitis B immunization. Which is the nurse's best response?

"the first dose of the hepatitis b vaccine will be given prior to discharge today."

A pediatric nurse is having a discussion with a father whose child has recently been diagnosed with spastic cerebral palsy. Which of the following statements made by the nurse is appropriate?

"the treatment plan for your child will focus on enabling him to have as normal of movements as possible"

An adolescent is being admitted to the pediatric intensive care unit following rod placement for a diagnosis of scoliosis. Which of the following assessments is highest priority for the nurse to perform?

. blood loss

A 2 and a half year old child is in the hospital with Kawasaki disease. Which of the following actions by the nurse is important for the child's psychosocial care?

. transition objects (e.g., blankets, dolls, pacifiers) help toddlers to deal with stressful situations. unless medically contraindicated, nurses should make sure that young children are in possession of their transition objects at all times while in the hospital.

The school nurse notifies the mother of a 7 year old girl that her child has head lice (pediculosis capitis). Which of the following information should the nurse advise the mother regarding the problem?

."after using the lice medicine, you will need to comb your child's hair with a fine-toothed comb."

A child has been diagnosed with Hirschsprung's disease. Which of the following findings would the nurse expect the parents to report in the child's history?

1. the nurse would expect the parents to report that the child has ribbon-like stools. 2. the nurse would expect the parents to report that the child has chronic constipation. 4.the nurse would expect the parents to report that the child has a distended abdomen. 5. the nurse would expect the parents to report that the child has delayed meconium passage.

The mother of an 11 month old remarks to a nurse in the pediatric clinic, "We are so lucky. Our daughter has never had an ear infection!" Which of the following factors can the nurse tell the mother have protected her daughter from the disease? Select all that apply

2. cigarette smoke places children at high risk for ear infections. 3. breastfeeding has been shown to have a protective effect on the incidence of ear infections. 4. day-care attendance places children at high risk for ear infections

A 12-month-old boy weighed 8 lb 2 oz at birth. Understanding developmental milestones, what should the nurse caring for the child expect the current weight to be?

24 lb 6 oz rationale: children triple their birth weight by 12-months.

A child has been diagnosed with Kawasaki disease. Which of the following signs and symptoms would the nurse expect to see?

4. reddened and crusty eyes 5. skin peeling from hands and feet

A 5-month-old girl's arms are restrained in elbow restraints following facial surgery. Which of the following situations would warrant removal of the restraints?

A responsible adult is holding the baby and preventing her from touching the operative site.

A nurse is caring for a child who has cellulitis on the hand. Which of the following actions should the nurse take?

Administer oral antibiotics

A nurse is caring for an infant who has a myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care?

Apply a sterile, moist dressing on the sac

Which action is a developmentally appropriate method for eliciting a 4-year-old's cooperation in obtaining the blood pressure?

Ask the child if he feels a squeezing of his arm

A 2 month old infant with a cleft lip is transferred to the pediatric floor immediately following surgical repair of the defect. Which of the following interventions should the nurse perform?

Assess placement of the elbow restraints

A 6-month-old male is at his well-child checkup. The nurse weighs him and his mother asks if his weight is normal for his age. The nurse's best response is:

At 6 months his weight should be approximately twice his birth weight

Which would be the priority nursing intervention for a newly admitted child with Kawasaki disease?

Continuous cardiovascular and oxygen-saturation monitoring

The nurse in the delivery room suspects that a newly birthed baby may have an esophageal atresia with tracheoesophageal fistula because the baby is exhibiting which of the following signs and symptoms?

Copious quantities of oral mucus

Which families would be appropriate to refer for genetic counseling?

Couple with a history of multiple miscarriages

A baby is admitted with a diagnosis of intussusception. Which of the following signs/symptoms would the nurse expect to see?

Currant jelly stools

The best method to explain a procedure to a hospitalized pre-schooler -age child is to:

Demonstrate the procedure on a doll.

Which is the most appropriate nursing intervention when caring for a child newly admitted with a mild head concussion and no cervical spine injury?

Elevate head of bed flat, side rails up, and safety measures in place. the head of the bed should be elevated to decrease intracranial pressure. side rails should be up to help ensure the child stays in bed, and age-appropriate safety measures should be instituted.

How can the nurse best facilitate the trust relationship between infant and parent while the infant is hospitalized? The nurse should:

Encourage the parents to hold their child as much as possible.

A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development?

Encourage the teen's friends to visit him in the hospital.

A nurse is coordinating an educational session for middle school students regarding Human Immunodecifiency Virus (HIV). The nurse should advise the students that which of the following behaviors place them at risk for contracting HIV. Select all that apply.

Engaging in oral intercourse with an individual with HIV. Using natural skin condoms while having sex with an individual with HIV.

Which should the nurse do to prevent separation anxiety in a hospitalized toddler?

Establish a routine similar to that of the child's home.

A nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include?

Evaluate the toddler's need for an evaluation of hearing ability.

A child is seen in the emergency department. The nurse hears a high pitched squeal every time the child inhales. The parent states that the child's fever is very high and, in addition, the child is gasping for breath and sitting in the tripod position. Which of the following actions would be appropriate for the nurse to perform at this time?

Get immediate medical attention for the child

During an adolescent's initial physical assessment, the nurse notes signs and symptoms of nutritional deficit. Which assessment led the nurse to this initial conclusion?

Hair and nails are brittle and dry.

A nurse is assessing a 1 day old sleeping baby in the well-baby nursery. Which of the following assessments should the nurse report to the neonatologist?

Intercostal retractions

Which comment should the parent expect from the toddler about a new baby brother?

It is time to put him away so we can play

What is the most likely cause of a child's illness if it is unexplained, prolonged, recurrent, and extremely rare, and usually occurs when the mother is present?

Munchausen syndrome by proxy.

Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay?

My child is able to stand but is not yet taking steps independently.

A child with a newly applied left leg cast initially feels fine, then starts to cry and tells his mother his leg hurts. Which assessment would be the nurse's first priority?

Neurovascular integrity

Expected nursing assessments of a newborn with suspected cystic fibrosis would include:

Observe frequency and nature of stools. Cystic fibrosis is inherited and often leads to a meconium ileus so assessing stool frequency and consistency is critical.

An adolescent has a diagnosis on new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet?

Peers and their dietary choices.

A nurse is caring for an infant who is post-operative following cleft-lip and palate repair. Which of the following actions should the nurse take?

Place the infant in the upright position It is important that the infant be placed in an upright position in order to maintain patency of the airway and prevent aspiration, especially during feedings.

The mother of a child 2 years 6 months has arranged a play date with a neighbor and her child 2 years 9 months. Suring the play date the two mothers should expect the children will do which of the following?

Play alongside one another but not actively with one another.

A nurse is caring for a toddler who has Wilm's tumor. Which of the following actions should the nurse take?

Prepare the child for surgery removal of the tumor occurs within 24-48hr after admission

A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the time. The nurse' s best response to the child's parents about this behavior is that the child is in the:

Protest stage of separation anxiety

Which activity can the nurse provide for a 9-year-old to encourage a sense of industry?

Provide the child with the homework his teacher has sent.

Which nursing intervention should take place prior to all vaccination administrations?

Provide the vaccine info statement hand out and answer all questions

A nurse is to administer ear drops into the right ear of a 6 year old child. Which of the following actions by the nurse is appropriate?

Pull the client's auricle down and back to open the canal when administering the ear drops

Which statement by the mother would lead the nurse to suspect sexual abuse in a 4-year-old?

She has lots more temper tantrums increased temper tantrums, increased sleep disorders, and depression may indicate sexual abuse.

A nurse is providing teaching about the management of epistaxis to a child and his family. Which of the following positions should the nurse instruct the child to take when experiencing a nosebleed?

Sit up and lean forward (to prevent aspiration when experiencing a nosebleed.)

A nurse is caring for an adolescent who has a new diagnosis of osteosarcoma. Which of the following actions should the nurse take?

Spend time with the adolescent to answer any questions he can have.

Which approach should the nurse use to gather information from a child brought to the ED for suspected child abuse?

Tell the child that the abuse is not her fault and that she is a good person.

A 4-year-old hospitalized with FTT (Failure to Thrive) has orders for daily weight, strict intake and output, and calorie counts. Which action by the nurse would be a concern?

The nurse weighs the child every morning before the child eats breakfast.

Which statement is true of shaken baby syndrome?

There may be an absence of external signs of injury

A newborn baby has been diagnosed with Cystic Fibrosis. Regarding which of the following characteristics of the disease should the nurse forewarn the parents?

Thick respiratory mucus

A baby, with a history of cystic fibrosis, is admitted to the emergency department. The baby is crying loudly and drawing his legs up towards his abdomen. A diagnosis of intussusception is made. Which of the following orders would the nurse expect to receive at this time?

To prepare the baby for an air enema

Which method is the most effective way to present an educational program on abstinence to adolescents?

Use peer-led programs that emphasize the consequences of unprotected sexual contact

Which should the nurse recommend to the parents of a 9-year-old hospitalized following a bicycle injury? To prevent future, their child should:

Wear safety equipment while riding bicycles.

What information should a school nurse include in a discussion on nutrition with a fourth-grade class?

a list of nutritious foods with basic scientific information about how they affect the body organs and systems

A nurse is caring for a child who is post-operative following surgical removal of a Wilm's tumor. Which of the following assessments is an indication to continue NPO status.

absent bowel sounds

A nurse is caring for a toddler who has acute otitis media. Which of the following is a priority action for the nurse to take?

administer analgesics

A nurse is to administer 2 opthalmic medications-an ointment and drops. Which of the following actions by the nurse is appropriate?

administer the eye drop medication before administering the medicated ointment

A nurse is teaching adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?

albuterol a beta2-agonist used for bronchodilator. the nurse should instruct the adolescent the medicine is quick acting, should be administered prior to exercise, and is used to provide immediate relief for bronchoconstriction

A 5 year old child was diagnosed with a fracture of the left ulna after a witnessed fall from the trampoline. The child is being discharged home in a fiberglass cast. Which of the following actions should the nurse take at this time?

assess the neurovascular status

A 12 week gestation African American woman asks at her obstetrician's office whether or not her baby could be born with sickle cell disease. Which of the following replies is appropriate for the nurse to give

baby could only have sickle cell anemia if both the woman and the baby's father carry a sickle cell gene.

Which toy is the best choice for a 12-month-old?

musical rattle. rationale: a musical rattle is the perfect toy for this child. infants have short attention spans and enjoy auditory and visual stimulation.

A child has been diagnosed with rheumatic fever. Which of the following physical findings would the nurse expect to assess?

polyarthritis, one of the major manifestations of rf, is manifested by warm, swollen, and painful joints

A nurse is caring for a child who has Hirschsprung's Disease. Which of the following actions should the nurse take?

prepare the family for surgery rationale: a client who has hirschsprung's disease requires surgery to remove the affected segment of the intestine. preparing the family for surgery is an appropriate action to take.

An 8-year-old child is seen in the pediatrician's office for primary nocturnal enuresis. Which of the following nursing diagnoses should the nurse include in the child's nursing care plan?

situational low self-esteem

According to developmental theories, which important event is essential to the development of the toddler?

the child participates in being potty-trained

A 10-year-old has been prescribed an MDI administered bronchodilator. Which of the following actions should the nurse teach the child to perform while taking the medication?

the child should place the medication mouthpiece in the mouth after exhaling

The nurse is educating the parents of a child who has been diagnosed with febrile seizures. Which of the following actions should the nurse advise the parents to perform if their child has another seizure?

the parents should be taught to protect their child's head.

The parents of a child who has had multiple respiratory infections since birth, tell the nurse, "When we kiss our child, all we taste is salt." It would be appropriate for the nurse to suggest to the primary healthcare provider that the child be assessed for which of the following illnesses?

there is a high concentration of salt in the sweat of children

A 13-year-old boy is hospitalized for a femur fracture. He was hit by a car while he and his friends were racing bikes near a major intersection. The child's parents are concerned about his judgment. The nurse should tell the parents that the behavior is:

typical of young teens. rationale: the brains of young teens are not completely developed, which often leads to poor judgment and impulse control.

A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching?

use an over the counter medication containing 1% permethrin