peds exam one

using the formula for bladder capacity what would you expect the volume for a 9 year old?

11 ounces (age + 2=bladder capacity )

the 3 year old requires _ hours of sleep per day

12

During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? -"Acceptance by friends, especially of the same sex, is very important at this age." -"Your child will rarely talk to you about his friends." -"The children will cheer for each other regardless of the sport being played." -"The child's best friends will continue playing soccer."

"acceptance by friends, especially of the same sex, is very important at this age"

_ is the key disease prevention activity during childhood health supervision visits.

immunization

nurse observes child walk up and down steps. nurse notes child has steady gait and can use short sentences. nurse estimates client's age to be how many months? -8 mth -12 mth -16 mth -24 mth

24 months (goes up and down stairs alone, runs well with wide stance, builds tower of 6-7 blocks, vocab of about 300 words)

The nurse is preparing to administer medication to a 10-year-old who weighs 70 lb (32 kg). The prescribed single dose is 3 to 4 mg/kg per day. Which dose range is appropriate for this child? -210 to 280 mg -420 to 560 mg -105 to 140 mg -96 to 128 mg

96-128 mg

assessing 3 year old child which in concerning

anterior fontanel not fully closed (should be by 3 yo)

Which facility fulfills the characteristics of a medical home? 1. An urgent care center 2. A primary care pediatric practice 3. A mobile outreach immunization program 4. A dermatology practice

a primary care pediatric practice

potential sources of errors in a pulse oximeter reading include abnormal _ value, hypotension, hypothermia, ambient light interference, motion artifact, and skin breakdown.

abdnormal hemoglobin value

school nurse planning a screening program. what items should be included to address issues r/t 'new morbidity' -academic difficulties, violence, other mental health issues -number of kids with chronic illness at the school -stats r/t health insurance coverage of the children -HIV infection, asthma, resp allergy testing

academic difficulties, violence, and other mental health issues

gross motor skills develop in a _ fashion.

cephalocaudal

10 month old baby born 10 weeks early which is a cause for concern

head circumference is 49.53 cm

_ is the ability to obtain, read, process, understand, an use healthcare information to make appropriate healthcare decisions.

health literacy

The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as A. Problematic, as it interferes with needed nursing care. B. Normal for this stage of growth and development C. Normal because the child is hospitalized and out of his routine.

normal for this stage of growth and development

toddler with n/v/d. what should nurse due to maintain adequate fluid intake? -keep npo -force fluids -provide gelatin and ice pops -offer oral rehydration solution

oral rehydration solution to rehydrate

which assessment finding is considered normal in children? a. irregular rr and rhythm b. split s2 and sinus arrhythmia c. decreased hr with crying d. genu varum past age of 5

split s2 and sinus arrythmias

gastrostomy is an opening into the _.

stomach

corporal punishment is not recommended for use in toddlers. t or f

true

signs of _ include cool, blanched, or puffy skin around the IV insertion site.

infiltration

The parents of a child with a developmental disability ask the nurse for advice about disciplining their child. What is the best response by the nurse? 1. "You should choose methods that are most congruent with your values about discipline." 2. "Children like this really can't follow directions, so they may be very hard to discipline." 3. "Punish your child only for socially unacceptable or offending behaviors." 4. "Spanking works well for this type of child, as they really don't like pain."

'you should choose methods that are most congruent with your values about discipline'

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best? -"I need to take some blood." -"Why don't you sit on your mom's lap?" -"I need to remove a little blood." -"We need to put a little hole in your arm."

"why don't you sit on your mom's lap?" *include families whenever possible to assist the child in coping with fears

The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn't want the child to go to school. What is the best response by the nurse? 1. "Do you need some time alone to collect yourself?" 2. "You've known for a while this time would come." 3. "Can I call your husband or a friend for you?" 4. "It is normal to feel stressed or sad at this time."

'it is normal to feel stressed or sad at this time'

During the admission assessment of a child for a well-child check-up, the father of the child tells the nurse, "It is so tough being a single parent. Sometimes I wonder if I am doing a good job?" Which is the best response by the nurse? -"If your child does well in school and doesn't get into any trouble you will know that you are doing a good job with being a single parent." -"I have been a single mother for many years. My mother was a single mother too. I would think being a single dad would be a little easier." -"I am sure you are. You always seem like such a good dad when you are here." -"Being a single parent must be really difficult. Can I offer you some information about a support group, Parents Without Partners?"

"being a single parent must be really difficult. can i offer you some information about a support group, parents without partners?" *acknowledging the father's comments with empathy and offering support from outside source addresses the concerns.

The nurse suspects poor literacy skills in a child's family member when which statement is made? -"We communicate with the special education teachers and school daily with a notebook." -"I forgot my glasses, so I'll read this when I get home and let you know if I have questions." -"He gets a suppository every 3 days to prevent constipation." -"I need you to review once more the best way to be sure he swallowed all his medicine."

"i forgot my glasses, so i'll read this when i get home and let you know if i have questions" (many work to hide this)

The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates understanding of the instructions regarding the medication? -"Between meals is the best time to give the enzymes." -"I should reduce the dose if she has large, malodorous stools." -"I should give the enzymes before each meal or snack." -"I should stop the enzymes if my child is taking antibiotics."

"i should give the enzymes before each meal or snack" *needed for digestion and absorption of food/nutrient. no interactions between enzymes and antibiotics. large stool can be sigh of no pancreatic enzyme activity. usually it will be in smaller doses for a snack and then larger dose for meals

When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? -"I see you have a car seat, that is great." -"With the car seat in front, you can keep an eye on your baby." -"You should never put the car seat in the front." -"Let me go over car seat safety with you, so you can install your car seat properly."

"let me go over the care seat safety with you, so you can install your car seat properly" *nurse should know this isn't proper placement, car seat should be rear facing in the center of the back seat of the car

The nurse is caring for an 8-year-old girl. She is reviewing her nutritional requirements and describing interventions that promote healthy eating habits. Which response by the girl's mother indicates a need for further discussion? -"My daughter must stay at the table until she has cleaned her plate." -"My daughter likes to have a glass of milk with her meal." -"My daughter likes many different kinds of fruits and vegetables." -"My daughter eats one item at a time."

"my daughter must stay at the table until she has cleaned her plate" *school aged children need to understand the concept of satiety/feeling full and shouldn't ignore this feeling, do not force child to eat at all because it can lead to obesity

A teen diagnosed with terminal cancer reports to the nurse that although she wishes to live the remaining months of her life without treatment, her parents are insistent that she continue "trying to beat the disease and take chemotherapy". What response by the nurse is most appropriate? -"You can be emancipated to avoid this conflict between your parents." -"Sadly, since you are still a minor you do not have any choice in this difficult decision." -"I can understand how your parents want to continue to have hope." -"Perhaps a conference with your parents, members of the health care team, and you is needed to outline your treatment options."

"perhaps a conference with your parents, members of the health care team, and you is needed to outline your treatment options" *parents are needed parties for selection of the plan of treatment for a minor, treatment plans ideally incorporate the wishes of both parents and child, with a lack of agreement a conference needs to happen, best attempt to resolve and incorporate both wishes

A mother reports to the nurse that her 4-year-old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother? -"I can imagine that it would be very irritating." -"Preschoolers' imitating is a healthy behavior. It is part of their imagination and normal growth and development." -"I am sure there are ways to get your daughter to stop imitating you." -"This is not normal behavior. I am going to get the doctor's advice."

"preschoolers imitating is a healthy behavior. it is part of their imagination and normal growth and development"

A nurse has just finished a presentation on how divorce can affect a child. Which statement by a participant would suggest a need for further education? -"I have found a divorce support group that I go to every month." -"We told my 3-year-old that Daddy was going on a long work trip before he moved out." -"I encourage my daughter to call her dad every night before bed." -"My wife and I will tell the child about the divorce when everyone is together."

"we told my 3 year old that daddy was going on a long work trip before he moved out" *tell kids about divorce and the reasons for divorce in terms they can understand, never lie to children, keep parents involved in child's life, parents need to find support so kids aren't expected to be or act like adults, both parents need to be present when telling child, tell all children at same time

during tube feedings in bed, the head of the bed should be elevated at least _ degrees to help prevent vomiting.

30

toddlers need at least _ minutes of structured physical activity per day

30

the normal newborn's respiratory rate ranges from _ to _

30-60

nurse performs assessment on infant. identifies which finding as early indication of cerebral palsy? -4mt lacks head control -7mth sits with support -8mth unable to crawl -3mth smiles at parents

4mth that lacks head control *infant can't crawl until around 9 months

the average 2 year old will have a vocabulary of _ words

50

The nurse is assessing a 9-month-old child that was born at 32 weeks' gestation. The nurse is aware that the child's growth and development expectations would be at what age group? -8 months old -6 months old -9 months old -7 months old

7 months old *determine child's adjusted age, to determine this substract how early child was delivered by chronological age

the nursing process is applicable to all health care settings and consists of 5 steps: 1. assessment 2. nursing diagnoses 3. ???? 4. planning 5. implementation 6. evaluation

outcome identification

family centered care leads to better _ and a higher level of consumer satisfaction.

outcomes

assessment of _ in children is considered to be the "fifth vital sign"

pain

improvement of _ managements and shortened recovery times are benefits of family centered care.

pain

when a child is receiving _ the focus is on symptom relief rather than curative care.

palliative care

an infant's individual normal behavior is referred to as the infant's _.

temperament.

foster care is a situation in which a child is cared for in an alternative living situation apart from their our parents or legal guardian. t or f

true

in the toddler, receptive language outpaces expressive language contributing to frustration. t or f

true

negativism means the toddler is always saying "no" and is normal part of healthy development, occurring as a result of the toddler's attempt to assert his or her independence. t or f

true

neonatal mortality is determined by the # of deaths per 1000 live births during the first 28 days of life. t or f

true

parenting style and the family child relationship have an influence on the family's hospital experience. t or f?

true

parents commonly feel anger or guilt related to the hospitalization of their child. t or f?

true

preterm births and low birth weight are important risk factors for infant death. t or f

true

spanking is less effective than time out or other discipline measures to reduce may have negative effects on the child's future behavior, leads to pro-violence attitude, creates resentment and anger in some children, and contributes to the cycle of violence.

true

stool should not be hard, dry, difficult to pass, or watery. t or f

true

the WHO defines health as a state of complete physical, mental, and social well being. t or f

true

the child's sex and race, biological traits, and certain diseases or illnesses are directly linked to genetic inheritance and influence child health. t or f

true

the children's bureau was an important step toward improving the standards of care for children's health. t or f

true

the disappearance of the extrusion reflex is a sign that the infant is ready for solid food. t or f

true

the role of the family is caring for the child includes physical and emotional care and also imparting the rules and expected behaviors of society. t or f

true

the tongue extrusion reflex is necessary for reflexive sucking in early infancy. disappearance of the reflex better allows for spoon feeding of solids. t or f

true

therapeutic play is a type of play that provides an emotional outlet or improves the child's ability to cope with the stress of illness and hospitalization. t or f?

true

toddler is able to understand language and follow commands, far sooner than he is able express himself via language. t or f

true

when possible, perform all invasive procedures in the treatment room over the child's room. t or f?

true

TPN solutions can cause hyperglycemia if given too rapidly. t or f?

true *TPN solutions are highly concentrated glucose solutions that can cause hyperglycemia if given too rapidly

a written plan for transition of a child with special needs to adult care should be initiated in midadolescence. t or f?

true *begin transition play by midadolescence allows time no only for ensuring all elements are in place, but also for psychological and emotional preparation by adolescent *transition is hard for young adults and adolescents with chronic illness

hospitalized children may view physical restraints to immobilize a body part as a punishment. t or f?

true *can promote physical distress

infants and young children are at increased risk for fluid volume overload as compared with adults. t or F?

true *infants and young kids are at increased risk for fluid volume overload compared with adults

nurse delivers 8lb 2oz infant, mom says to nurse that baby's soft spot bulges when they cry. what statement by nurse is most appropriate? -anterior fontanel should close within 1 month -baby could be brain damaged if soft sport in injured -baby's posterior fontanel should close after 1 year -anterior fontanel will normally bulge out when baby coughs or cries

anterior fontanel will normally bulge out when baby coughs or cries

medication administration via the rectal route is steady and predictable. t or f?

false *rectal route not preferred route in children because absorption may be erratic and unpredictable, very invasive

the scalp vein is the preferred site for peripheral intravenous therapy in infants. t or f?

false *scalp vein may be used in infants, but only if attempts at other site are unsuccessful

children with special needs are best educated in classes with other children who have special needs whenever possible. t or f?

false *children with special needs are best educated in a typical environment with typical children

children are less vulnerable to the effects of illness and hospitalization than adults becomes of their limited understanding. t or f?

false *more vulnerable because of changes to their health and routine, limited understanding and coping mechanisms to resolves stressors

the infant's facial expression is an inconsistent indicator of pain or bodily injury. t or f?

false *most consistent indicator of pain or bodily injury

to assess the growth and development of an infant or child who was premature, use the infant's chronological age. t or f?

false *prematures are at disadvantage in areas of growth and development due to missing portion of gestation, need to assess growth and development based on adjusted age until at least 2 years old

the average toddler gains 5-10 lbs per year. t or f

false, average toddler gains 3-5 lbs a year

infant hearing develops over the first few months of life. t or f

false, hearing should be intact at birth

a benefit of formula is its greater iron concentration compared to breast milk. t or f

false, iron available in breast milk is more bioavailable than iron supplemented in formula

the newborn's respiratory pattern is very regular in nature. t or f

false, newborns display an irregular breathing pattern with periodic pauses.

nurses need to learn about the general practices of various cultures and apply this to the care of children and families. t or f?

false, nurse should assess each family's individual beliefs and practices rather than generalizing/ need to ask them and then listen.

teaching meanings learning has occurred. t or f?

false, teaching doesn't mean learning has occurred, need to evaluate learning

all primitive reflexes disappear over the first few months of life. t or f

false, the babinski doesn't disappear until 12 months of age

when performing vision screening on a 3 month old infant, use objects with bright colors. t or f?

false, use objects with black and white patterns. try checkerboards or concentric circles/pandas or dalmatians. should use black and white patterns on infant younger than 6 months.

hepatitis b, mmr, varicella, hib vaccines are all administered via subcutaneous route. t or f?

false. hep b, hep a, dtap, hib, pcv, hpv, mcv4 administered via IM route. mmr and varicella are administered subQ route.

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Choose all that apply.) a. Accept the adolescent as a unique individual b. Provide strict, inflexible rules c. Listen and try to be open to the adolescent's views d. Screen all of his or her friends e. Respect the adolescent's privacy f. Provide unconditional love

accept adolescent as unique individual listen and try to be open to adolescent's views respect adolescent's privacy provide unconditional love

leading cause of death of children over 1 in late 20th century

accidental injury

doing health assessment on school age child, what problem should you focus on?

accidents and injuries

the primary role of the pediatric nurse is to provide direct nursing care to children and their families, being an _, educator, and manager. .

advocate

The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action? A. Allow the mother to remove the underwear. B. Tell the boy he is acting childishly. C. Notify the OR that the underwear is on. D. Allow the boy to keep his underwear on

all boy to keep his underwear on

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child's visual acuity? 1. Snellen 2. Ishihara 3. Allen figures 4. CVTME

allen figures

child has imaginary friend. nurse advises parents to do what? -encourage kid to play with other kids more often -tell child that playmate isn't real -allow child to engage in imaginary play -never leave child alone

allow child to engage in imaginary play

When providing atraumatic care to a child, which action would be most appropriate? 1. Applying restraints for any procedure that would be uncomfortable 2. Keeping the lights on in the child's room throughout the day and night 3. Limiting the use of topical anesthetics for painful injections 4. Allowing parents and children an informed choice about being together

allow parents and children an informed choice about being togehter

infants may experience psychological _ at 2 or 3 months of age due to the shorter lifespan of HgbF.

anemia

kid admitted with chronic lead poisoning. what s/s does nurse expect to see? -anemia, seizures, learning disabilities -tinnitus, confusion, hyperthermia -polycythemia, hypoactivity, impaired liver function -SOB, dependent edema, bounding pulse

anemia, seziures, learning disabilities (also n/v, excess salvation, abd pain, muscle cramps, kidney failure, joint pain, encephalopathy)

just as nurses in the acute care setting develop nursing care plans, nurses in the school setting develop _ _ _.

individualized health plan

isolation rooms are used for situations involving the risk for _.

infection

When 12-year-old Chelsie comes in for her annual check-up, the nurse must take a health history and do a physical exam. What is the most appropriate manner for the nurse to obtain a health history? -Ask Chelsie if she minds if her mother is in the room with her. -Ask Chelsie to wait outside while the nurse talks with her mother. -Ask Chelsie to fill out the health form and return it herself. -Ask Chelsie's mom to leave the room.

ask chelsie if she minds if her mother is in the room with her (child this age likes choice, needs modesty and privacy)

A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? A. Ask that the child's desired foods be sent up from the kitchen. B. Negotiate with the child to eat at least part of the food on the tray. C. Remove a privilege. D. Offer the child cereal and milk from stock on the nursing unit.

ask the child's desired foods be sent up from the kitchen

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation? -Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment -Ask the parents to step out of the room and tell them the nurse's suspicion -Ask the teen, with the parents present, if she might be pregnant. -Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy

ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment *adolescent may have concerns that they are hesitant to say in front of parents, need to talk alone with teen so they can ask

The nurse is caring for a 2-year-old girl who is wheezing and has difficulty breathing. Which interview question would provide the most useful information related to the symptoms of the child? -Asking the parents if they smoke in the home -Asking about the child's diet -Inquiring about child safety in the home -Asking about the temperament of the child

asking the parents if they smoke in the home *if they smoke, nurse could explain how it affects child's health and urge them to stop

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? -Allow the child unlimited access to the sippy cup to ensure adequate hydration. -Encourage sweets for the extra caloric content. -Teach the mother about nutritional needs of the preschooler. -Assess the child's usual intake pattern at home.

assess the child's usual pattern at home

_ care is defined as therapeutic care that minimizes or eliminates the psychological/physical distress experienced by children and their families in the health care system

atraumatic care

When working with children and families, which is a critical strategy for promoting therapeutic communication? 1. Detailed explanations 2. Attentive listening 3. Comforting touch 4. Closed-ended questions

attentive listening

The mother of a 2-month-old child reports her baby "breathes fast". When questioned further, the child's mother states she has counted the times using her watch and it was sometimes as high as 30 breaths in a minute. What is the best response by the nurse? -"The respiratory rates of infants that age is variable." -"There is not cause for concern." -"That is a little high for his age and we will need to evaluate this." -"Babies breathe rapidly and the amount you are reporting is within normal limits."

babies breathe rapidly and the amount you are reporting is within normal limits (20-30 RR is normal for children this age)

The nurse is assessing a newborn child. The mother asks why the newborns feet are blue. What is the best response by the nurse? -"Blueness in the feet of a newborn is called pallor. This is a normal finding in babies up to several days old." -"Blueness of hands and feet is a common finding in newborns. It is a result of their circulatory system switching from being in the womb to life outside the mom's body." -"A blue tint to skin means that there is a lack of oxygen. I will need to notify the physician of this immediately." -"When a foot or hand is blue, it's called peripheral cyanosis. Peripheral cyanosis is not normal in newborns."

blueness of hands and feet is a common finding in newborns. it is a result of their circulatory system switching from being in the womb to life outside the mom's body (called acrocyanosis, normal for up to several days)

The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? -"Breastfeeding my baby will pass on passive immunity." -"Breastfeeding my baby will help to stimulate my baby's immune system to activate." -"Breastfeeding my baby will pass on lifelong immunity."." -"Breastfeeding my baby will pass on a type of active immunity."

breastfeeding my baby will pass on passive immunity

nurse is doing health record, notices toddler is on a delayed immunization schedule per parents request. 17 mth old, and has been 3 wks since initial administrations of mmr vaccine. what is best response by nurse? -nothing, completely normal and goes with catch up schedule by cdc -call parents and harshly explain dangers of delayed immunization schedule -call parents, explain kid will need to be seen in next week to receive second dose of mmr vaccine to keep on schedule -call cps, child is in abusive situation

call parents, explain child will need ot be seen in next week to receive second dose of mmr vaccine to keep on schedule

A 15-month-old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child's immunization record but believes she is fully immunized: "She had immunizations 3 months ago at the local health department." Which would be the best action by the nurse? 1. Ask the mother to bring the records to the 18-month health supervision visit. 2. Start the "catch-up" schedule because there are no immunization records. 3. Keep the child at the facility while the mother returns home for the records. 4. Call the local health department and verify the child's immunization status.

call the local health department and verify the child's immunization status

A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action? 1. Crush the tablet and mix it with applesauce. 2. Dissolve the medication in the child's milk. 3. Place a pill in the posterior part of the pharynx and tell the child to swallow. 4. Check with the prescriber to see if an alternative form can be used.

check with prescriber to see if alternative form can be used

The school nurse is providing nutritional guidance to a 9th-grade health class. Which foods should the nurse recommend as good sources for calcium? -Beans, poultry, and fish -Cheese, yogurt, and white beans -Peanut butter, tomato juice, and whole grain bread -Strawberries, watermelon, and raisins

cheese, yogurt, and white beans *cheese, yogurt, white beans, milk, broccoli are good sources of calcium *strawberries, watermelon, raisins, peanut butter, tomato juice, whole grain bread are all high in iron

the _ is a member of the multidisciplinary team and works in conjunction with the health care provider and parents to foster an atmosphere that promotes the child's well being.

child life specialist

what is appropriate for nurse to give to parent concerning the normal development of young school age child? -child's periods of shyness should be tolerated -nightmares aren't characteristic of this age -child's participation in group activity should be mandated -punishment may be necessary for acts of independence

child's periods of shyness should be tolerated

The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? A. Start brushing her teeth after all the baby teeth come in. B. Use a washcloth with toothpaste to clean her mouth. C. Clean your baby's gums, then new teeth, with a washcloth. D. Rinse your baby's mouth with water after every feeding.

clean your baby's gums, then new teeth, with a washcloth.

the nurse should use a _ type of knot to secure restraints with ties to allow quick, easy access and release of the restraint.

clove hitch

Which would the nurse identify as a protective factor for youth violence? A. Exposure to family violence B. Limited involvement in social activities C. Inconsistency of parental support D. Commitment to academic performance

commitment to academic performance

The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is: A. She just needs love and attention. Don't worry; she's too young to spoil. B. Consistently meeting the infant's needs helps promote a sense of trust. C. Infants need to be fed and cleaned; if you're sure those needs are met, just let her cry. D. Consistency in meeting needs is important, but you're right, holding her too much will spoil her.

consistently meeting the infant's need help promote a sense of trust

A sleeping 5 month old girl is being held by the mother when the nurse comes in to do a physical examination. What assessment should be done initially? a. listen to bowels b. count hr c. check temp d. look in ears

count hr

A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response? A. It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. B. Cow's milk is iron poor and does not provide the proper balance of nutrients for the infant. C. As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. D. If the mother cannot afford the infant formula, she should dilute it to make it last longer.

cow's milk is poor in iron and doesn't provide the proper balance of nutrients for the infant

The nurse is caring for an 18-month-old boy hospitalized with a gastrointestinal disorder. The nurse knows that the child is at risk for separation anxiety. The nurse watches for behaviors that indicate the first phase of separation anxiety. For which behavior should the nurse watch? -Embracing others who attempt to comfort him -Crying and acting out -Losing interest in play and food -Exhibiting apathy and withdrawing from others

crying and acting out *if the first phase they protest aggressively to separation and reject comfort from others

all nurses must establish _, the ability to apply knowledge about a child's culture so that health care interventions can be adapted to meet the needs of the child.

cultural competence

the continued existence of iron deficiency anemia and the increasing evidence of childhood obesity in america are symptoms of nutritional _ or excesses in the US.

deficiencies

before being discharged, premature infants are tested for oxygen _ while seated in the car seat.

desaturation

When planning education for a child and parents, what is the first step the nurse should take? 1. Decide which procedures and medications the child will be discharged on. 2. Determine the child's and family's learning needs and styles. 3. Ask the family if they have ever performed this type of procedure. 4. Tell the child and family what the goals of the teaching session are.

determine child and family learning needs and styles

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: 1. Learning from repeating tasks 2. Developing a sense of worth and competence 3. Using fantasy and magical thinking to cope with problems 4. Developing a sense of trust

developing a sense of worth and competence

health supervision has 3 components...?

development surveillance and screening injury and disease prevention health promotion

an ongoing collection of skilled observations made over time, called _ surveillance, occurs during health care visits.

developmental supervision

dTaP vaccine protects against which diseases?

diphtheria, tetanus, pertussis

The nurse providing home care to a 2-year-old listens to the child's parents talk about how the child and family are adjusting to the child's current illness. Which of the following roles is the nurse participating in? A. Case management B. Child and family advocacy C. Direct nursing care D. Child and family education

direct nursing care

for the child younger than 3 years of age, the nurse pulls the pinna of the ear _ and _.

down and back

What has the most influence in deterring an adolescent from beginning to drink alcohol? A. Drinking habits of parents B. Drinking habits of peers C. Drinking philosophy of adolescent's culture D. Drinking philosophy of adolescent's religion

drinking habits of peers

_ is the inadvertent infusion of a nonirritant solution or medication into the surrounding tissue.

infiltration

In developing a weight-loss plan for an adolescent, which would the nurse include? (Choose all that apply.) a. Have parents make all of the meal plans. b. Eat slowly and place the fork down between each bite. c. Have the family exercise together. d. Refer to an adolescent weight-loss program. e. Keep a food and exercise diary.

eat slowly and place fork down between each bite have family exercise together refer to weight loss program keep food and exercise diary

What is the best advice about nutrition for the toddler? A. Encourage cup drinking and give water between meals and snacks. B. Encourage unlimited milk intake, because toddlers need the protein for growth. C. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. D. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.

encourage cup drinking and give water between meals and snacks

A preschooler is admitted to the pediatric floor for dehydration and is frightened. Which nursing intervention would be least effective in alleviating the child's anxiety? -Assign the child to the same nurse each day. -Encourage a caregiver to stay with the child when possible. -Allow the child to handle the blood pressure cuff before using it. -Explain all procedures using medical terminology.

explain all procedures using medical terminology *will not understand and increase anxiety

A parents are discussing a recent story in the local news about a child being abducted. The parents are concerned about the safety of their preschool child and wonder what to tell the child to keep the child safe but without frightening the child. Which would be the best recommendation for the nurse to give these parents? -Explain in a calm and everyday manner how the child should stay away from strangers in cars. -It is your responsibility to keep your child safe, not your child's; keep the child in your sight at all times. -Don't worry about it; the odds of your child being abducted are very low. -Wait until the child is school-aged before telling the child what to do, so the child will be better able to handle it.

explain in a calm and everyday manner how the child should stay away from strangers in cars. *preschool years is not too early of a time to educate about strangers, hard for parents to give this info to preschoolers because they don't want to terrify them and don't want their child in that situation, can build safe habits with it if given in calm manner and help for when old enough to walk alone from school or play with friends unsupervised

which approach by nurse would most likely encourage child to cooperate with an assessment of physical and developmental health? a/ explain to child what's going to happen when child asks questions b. explain what's goin to happen in words child can understand c. force child to cooperate by having parent hold them down d. give child sticker before beginning exam

explain what is going to happen in words child can understand

time out is an effective _ discipline method.

extinction

_ is sometimes diagnosed when children fail to demonstrate appropriate weight gain over a prolonged period of time.

failure to thrive

child mortality rate is often used as an index of the general health of a country. t or f

false

discipline is the same as punishment. t or f

false

family is defined only by the legal ties or genetic relationships of people living in the same household. t or f

false

health status and specific lifestyle choices that influence child health include physical characteristics, temperament, race, heredity. t or f

false

morbidity is easy to define and it measures how many days a child is sick, misses school, and is confined to bed. t or f

false

negativism refers to a negative feeling about toys and dolls. t or f

false

reliance upon a security item (blanket, doll, bear) in a stressful situation is indicative of a potential problem in the household. t or f

false

standard of care is the maximum level of care that should be provided by a caregiver in a given situation? t or f

false

the overarching philosophy of pediatric nursing includes providing patient centered care, focusing on team nursing and using evidence based practice. t or f

false

the proportion of children is increasing in relationship to the adult population. t or f

false

to prevent obesity later in life, toddlers should be weaned from breast milk by 12 months. t or f

false

IM administration of medication is used frequently in children due to its rapid rate of medication absorption. t or f?

false *IM used as infrequently as possible because painful for kids, often lack adequate muscle mass for med absorption

a high chair safety belt is considered a restraint and appropriate documentation is necessary. t or f?

false *appropriate safety interventions that are age and developmentally appropriate *other ex) stroller, swing, high chair safety belt, crib rails, crib covers, enclosed cribs, raised padded side rails for seizure restraints

when caring for a child in isolation minimize the time spent in the room to limit the spread of infection. t or f?

false *can experience sensory deprivation, introduce self before entering room and putting mask on so they can see your face first, continue contact- hold, touch often

metabolism of medication in children is identical to that in adults. t or f?

false *children is altered b/c of difference in hepatic enzyme production and child's increased metabolic rate

parents of chronically ill children are often able to donate their child's organs and tissues when they die. t or f?

false *healthy children who die unexpectedly are qualified organ donors, many children with chronic illness don't qualify for organ donation

because of their young age and particular special needs, children may only receive hospice care within a special facility. t or f?

false *hospice allows for family centered care in child's home or hospice facility, with focus on providing comfort to entire family and enhancing QOL for child and family through individualized plan of care

recommended timing for health supervision visit in a healthy child is birth, first week of life, 3 mths, 6 mths, 12 mths, the yearly until age of 18. t or f?

false. recommend for health supervision visits for children without health problems and appropriate growth and development are at birth, within first week of life, 1 mth, 2 mths, 4 mths, 6 mths, 9 mths, 12 mths, 15 mths, 18 mth, 24 mths, 30 mths, then yearly until age 21.

universal screening is performed when a risk assessment indicates there is one or more risk factors present. t or f?

false. an entire population is screened regardless of child's individual risk. this type of screening is performed when reliable risk assessment procedure isn't available. selective screening is done when a risk assessment indicates child has one or more risk factors for the disorder.

the american academy of pediatrics recommends hearing screening only for infants born before 33 weeks gestation. t or F?

false. hearing screening of all infants. hearing loss is a common condition in newborns- can lead to delays in social and emotional development, language acquisition, cognitive function

an infant in deep sleep may startle to a noise and begin screaming.

false. infants typically move through several states ranging from deeply asleep to wide awake and screaming. ordinarily somewhat gradual process, rather than an abrupt immediate change in state.

infants' respirations are primarily thoracic. t or f?

false. primarily diaphragmatic, count abdominal movements in infant's RR.

when measuring the oxygen saturation level, make sure the pulse oximetry probe is tightly secured. t or f?

false. probe should be not applied too tightly, prevents venous flow. **should rotate every few hours if using adhesives

questions about the use of car seats or smoke detectors should be included in developmental history portion of health assessment. t or f?

false. safety measure are included in the functional history section of health history.

the use of an english speaking sibling to assist with child and family education is an invaluable aid. t or f?

false. well trained translators can help

in the infant, always palpate the anterior _ to determine size, shape, and whether flat or distended.

fontanel

during a _ a toddler desires to eat one certain food and refuses others.

food jag

An infant who was born prematurely has been discharged to home. When discussing sleep positions, which condition would warrant avoidance of placing the infant on their back to sleep? -Umbilical hernia -Bronchopulmonary dysplasia -Rickets -Gastroesophageal reflux disease

gastroesophageal reflux disease *don't place former premature infant on back to sleep with GERD

A 7-year-old child with sickle-cell disease who comes to the hospital frequently appears withdrawn and depressed. The client refuses to talk to anyone or even admit to feeling sad. What would be the best thing for the nurse to do that might help the child deal with his or her feelings? -Tell the client a joke -Get the client to draw a picture -Play a happy song for the client -Leave the client alone

get the client to draw a picture (useful nonverbal technique to understand how they feel about a frightful experience)

6 month comes in, parents report they received first DTaP at 2 months, has no other vaccinations. what action by nurse is most appropriate? -repeat first dtap, starting schedule again -given second dtap -give mmr -give two dtap vaccinations today

give second dtap

A single mother asks the nurse for suggestions on disciplining her 2-year-old son. Which suggestion would be most appropriate? A. Encourage the mother to emphasize the inappropriate behavior B. Wait an hour or so before enforcing the discipline C. Have the child spend 2 minutes in time-out. D. Withhold a privilege from the toddler for a week.

have the child spend 2 mins in time out

the nurse implements _ through education and anticipatory guidance.

health promotion

_ is the process of transmitting genetic characteristics from parent to offspring.

heredity

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? -Hesitancy and dysfluency are normal during this period of development. -Reading to the child will help model appropriate speech. -Expressive language concerns warrant a developmental evaluation. -The mother should ask her child's physician for a speech therapy evaluation.

hesitancy and dysfluency are normal during this period of development (usually resolves by about age 4 as vocaubulary and speaking grows)

horseback riding for the child who is handicapped is specifically called _.

hippotherapy

families of children with serious chronic illnesses or special needs often turn to _ and herbal supplements in an effort to improve their child's life.

homeopathic

A pediatric nurse will state that the priority reason to have a thorough grasp of the growth and development of children is to: -give parents anticipatory guidance as their children grow and change -interact with children in age appropriate, nonthreatening ways -thoroughly enjoy working with the different age groups -identify developmental risks or delays promptly.

identify developmental risks or delays promptly

nurse observes preschool age pt playing with several other child of about the same age. what play activity is the one in which the child is most likely to engage in? -take part in group play activities with several kids -imitate actions of nurse -playing doctor with another child taking sick role -play independently with doctor doll, doesn't share

imitate nurse's actions

active _ is acquired when a person's own immune system generates the immune response.

immunity

weaning is a highly _ decision. toddlers should be weaned from the bottle by _ months of age to discourage excess milk or juice intake and the development of dental caries in toddle who carry a bottle around. weaning from breast may occur at _ age the mom and toddler are comfortable with.

individualized decision weaned by 15 months can occur at any age

Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation? a. introduce self, ask about problems, take history, do physical exam b. perform physical exam, then ask family is any problems in child's life c. do physical exam while at same time asking about child's pervious illnesses; then talk about family's concerns d. get complete history of family's health beliefs and practices, then assess child

introduce self, ask about any problems, take history, do physical exam

_ procedures such as venipuncture should never be performed in the crib, bed, or playroom.

invasive

The nurse is caring for a child who has received all possible medical care for cancer, yet continues to experience relapse and metastasis. It is time to make the transition from curative care attempts to palliative care. What is the most important nursing consideration at this time? 1. The health care professionals should make the decision about the child's care. 2. The family may lose a sense of hope, so cancer treatments should continue. 3. Involve the family in the decision-making process about the shift to palliative care. 4. Palliative care can take place only at home, so the child should be discharged.

involve family is decision making process about the shift to palliative care

To gain cooperation from a toddler, what is the best approach by the nurse?A. Immediately pick the toddler up from the mother's lap. B. Kneel in front of the toddler while he or she is on the mother's lap. C. Do the nursing tasks quickly so the toddler can play. D. Ask the toddler if it is okay if you begin the needed task.

kneel in front of the toddler while they are on the mother's lap

systolic pressure in children is read at the moment the first _ sound is heard as one lowers the manometer pressure.

korotkoff

A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention? A. Tie the restraint loosely to prevent skin breakdown. B. Leave the baby unrestrained when directly observed. C. Position the restrained infant prone to prevent aspiration. D. Place the infant in a room near the nurses' station.

leave the baby unrestrained when directly observed

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? -A lack of fully developed hearing. -A less discriminating sense of touch. -Visual acuity that has not fully developed. -A less discriminating sense of taste.

less discriminating sense of taste

The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother? 1. Having the boys on the same team will make it more convenient for the mother. 2. Levels of coordination and concentration differ, so the boys need to be on different teams. 3. Put the boys on the same team because they are both school-age children. 4. It is best to avoid putting the boys on the same team to prevent sibling rivalry.

levels of coordination and concentration differ, so the boys need to be on different teams

_ thinking is a type of thinking in preschool age children that allows for fantasies and creativity to be part of their cognitive abilities.

magical

5 year old has surgery states it is raining because the sky is sad about her pain, this is an example of what

magical thinking

increase in chronic illness in early childhood can be a result of

mechanical ventilation in premature babies

evidence is clear that _ exposure can contribute to many different risks and health problems in children.

media

the nurse must confirm that _ screening was performed after 48 hours of age and before discharge from the birthing unit.

metabolic

the nurse is developing a community outreach program to help reduce childhood mortality. what topic is essential to include? -HIV -congenital anomalies -motor vehicle accidents -low birth weight

motor vehicle accidents

when _ of the spinal cord occurs around age 2, the toddler is capable of exercising voluntary control over the sphincters.

myelination

A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location? A. Increased risk for infection B. Increased health care costs C. Need to be transferred if overnight stay is required D. Increased disruption of family functioning

need to be transferred if overnight stay is required

_ is also referred to as body language

non-verbal language

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: -Problematic; the child is old enough to begin to have a basis in reality. -Normal, because the child is hospitalized and out of her routine. -Normal for this stage of growth and development. -Problematic, as it interferes with needed nursing care.

normal for this stage of growth and development

The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying: -mental combinations. -concrete thinking. -object permanence. -preoperational thinking.

object permanence *means they know objects that are out of sight still exist

fruit juice should be limited to 4-6 _ per day

ounces

When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as: -solitary play. -parallel play. -associative play. -onlooker play.

parallel play *toddlers play moves from solitary play of the infant to parallel play, in which the toddler plays alongside other children but not with them *onlooker play is when the child watches others play but doesn't engage with them *associative play, toddlers form a group and may even play with the same toy, but there is not formal structure of the group

total _ nutrition is the administration of a highly concentrated solution of carbohydrates, protein, electrolytes, vitamins, and mineral with a fat emulsion to meet all of the child's nutritional needs.

parenteral

family centered care refers to caregivers working in _ with the family to determine goals and plans for the child's health care.

partnership

paren who has few rule or boundaries has what parentig styles

permissive

the _ parenting style involves little parental control over the behavior of their children.

permissive

_ is movement of drugs through the body via absorption, distribution, metabolism, and excretion.

pharmokinetics

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? -If spanking is not working, then time-out is not likely to be helpful either. -Place the child in time-out for 4 minutes. -Use time-out only if removing privileges is unsuccessful. -The child should stay in time-out until crying ceases.

place the child in time out for 4 minutes (1 min per year of age for time out)

major aspect of preparations in children involves _

play (toys and dolls can be used to demonstrate procedures)

When planning to teach a toddler about coughing and deep breathing, which would be most effective? -Discussing the importance of coughing -Sharing an audiovisual -Playing a game with coughing and breathing -Demonstrating the technique

playing a game with coughing and breathing (toddlers respond best to teaching that includes games so feel like they are playing rather than learning)

scoliosis screening begins in the preschool age child. t or f?

preadolescent

adjusted age is determined by subtracting the number of weeks the infant was _ from child's chronological age.

premature

_ provides reassurance and comfort to the child and allows him or her to know what will happen and what is expected of him or her.

preparation

A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks you about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. As the nurse, what reminders should you give her for when she discusses sex? -Discuss with the teen the experiences that you had so that she can connect on a personal level. -Do not initiate any conversation; let the teen come and seek the advice of the parent. -Encourage her to talk to her peers and teachers in health class. -Promote open lines of communication; listen instead of lecture; and share family values.

promote open lines of communication; listen instead of lecture; and share family values

_ reflexes develop later in infancy and are gross motor responses related to equilibrium maintenance.

protective

nurse teaching parenting class. what action does nurse include as most important to promote mobility in infants? -encourage daily exercise program -use playpen whenever possible -provide safe toys and play area -teach noncompetitive activities

provide safe toys and play area

atraumatic care employs interventions that minimize physical and _ stress to the child and family.

psychological

When administering ear drops to a 2-year-old, which action would be most appropriate? 1. Tell the child that the drops are to treat his infection. 2. Pull the pinna of the child's ear down and back. 3. Have the child turn his head to the opposite side after giving the drops. 4. Massage the child's forehead to facilitate absorption of the medication.

pull pinna down and back (younger than 3 pull down and back / older than 3 up and back)

A nurse is administering ear drops to a 7-year-old girl. What should the nurse do? -Administer the medication while it is still cold from the refrigerator. -Warn the child that the drops will hurt. -Pull the pinna of the ear up and back to straighten the external ear canal. -Hold the child's head in the sideways position while counting to 5 to ensure the medication fills the entire ear canal.

pull the pinna of the ear up and back to straighten the external ear canal *hold head in sideways position counting to 60 to ensure med fills entire ear canal

evidence based practice can increase _ and standardize care.

quality

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? A. The toddler should have a developmental evaluation as soon as possible. B. If the mother would read to the child, then speech would develop faster. C. Receptive language normally develops earlier than expressive language. D. The mother should ask her child's physician for a speech therapy evaluation.

receptive language normally develops earlier than expressive language

The nurse is caring for a 3-year-old with a gastrostomy tube and tracheostomy who is on supplemental oxygen and multiple medications. The mother is rooming in during this hospitalization. What is the priority nursing action? 1. Incorporate the mother's assistance in care when convenient. 2. Recognize the mother as the expert on her child's needs and care. 3. Recommend that the mother go home to get some rest. 4. Provide family-centered care since the mother is there.

recognize the mother as the expert on her child's needs and care

_ temperature measurement should be avoided in the neonate and the immunosuppressed child.

rectal

priority teaching for parents of adolescents

reducing risk taking behaviors

The nurse is observing the behavior of a preschool-aged child and becomes concerned. Which observation suggests that the child's thinking is inconsistent with normal preschooler growth and development? -Insisting that an imaginary friend have dinner with the family -Refusing to play with "real" children -Refusing to go to bed without the imaginary friend -Insisting that an imaginary friend watch television with the child

refusing to play with "real" children *many preschoolers have imaginary friends who play with them, they are normal and creative part of these years, as long as they have exposure to real playmates as well this is okay

_ is a defense mechanism used by children to deal with conflict by returning to a previous stage that may be more comfortable for them.

regression

when families become exhausted with home care of their child with special needs, _ care resources may be able to provide relief.

respite

Which activities will promote weight loss in an obese school-age child? (Choose all that apply.) 1. Unlimited computer and TV time 2. Role modeling by family 3. Becoming active in sports 4. Eating unstructured meals 5. Involving child in meal planning and grocery shopping 6. Drinking three glasses of water per day

role modeling by family becoming active in sports involving child in meal planning and grocery shopping

An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his examination. You review all his birth records and find no documentation that a newborn hearing screening was performed. What is the best action by the nurse? 1. Do nothing; responding to the bell proves the infant does not have a hearing deficit. 2. Schedule the infant immediately for newborn hearing screening. 3. Ask the mother to observe for signs that the infant is not hearing well. 4. Screen again with the bell at the infant's 2-month health supervision visit.

schedule the infant immediately for newborn hearing screening

a security item brings the ability to _, is function of autonomy and is viewed as a sign of nurturing environment, rather than as a problem.

self soothe

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior? A. Crying when left with the sitter may indicate difficulty with building trust. B. Stranger anxiety should not occur until toddler-hood; this concern should be investigated. C. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. D. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.

separation anxiety is normal at this age; the infant recognizes parents as separate beings.

_ refers to the bonds between individuals that assist social networks in communities to achieve a variety of goals.

social capitol

Which is associated with early adolescence? (Choose all that apply.) A. Uses scientific reasoning to solve problems B. Still at times wants to be dependent upon parents C. Incorporates own set of morals and values D. Is influenced by peers and values memberships in cliques

still at times want to be dependent on parents influenced by peers and values memberships in cliques

A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing: -changes in temperament. -stranger anxiety. -separation anxiety. -cephalocaudal development.

stranger anxiety *occurs around 8 months, infants sees himself as a separate person

In an effort to control healthcare costs, what is the best recommendation by the nurse? A. "Shop around to find the most inexpensive health insurance plan." B. "Find a job that provides family health insurance at a minimal cost." C. "Stress primary prevention, using the healthcare system for check-ups." D. "Avoid seeing a physician until your child becomes ill."

stress primary prevention, using the healthcare system for check-ups

toddlers rely on a security item (blanket, doll, bear) to comfort themselves in _.

stressful situation

The parents of a 5-year-old with special health care needs talk to the parents of a 10-year-old with a similar condition for quite a while each day. What is the nurse's interpretation of this behavior? 1. The nurse has not provided enough emotional support for the parents. 2. This relationship between the children's parents is potentially unhealthy. 3. Support between parents of special children is extremely valuable. 4. Confidentiality is a pressing issue in this particular situation.

support between parents of special children is extremely valuable

pubertal stage is determined using the _ stages of sexual development.

tanner

when toddlers speak with only essential words they are demonstrating _ speech.

telegraphic

During the health interview, the mother of a 4-month-old says, "I'm not sure my baby is doing what he should be." What is the nurse's best response? 1. "I'll be able to tell you more after I do his physical." 2. "Fill out this developmental screening questionnaire and then I can let you know." 3. "Tell me more about your concerns." 4. "All mothers worry about their babies. I'm sure he's doing well."

tell me more about your concerns

nurse is assessing vitals of child being evaluated in urgent care. child seen by PNP. mom asks 'why is my child seeing PNP and not the dr' what is the best response by the nurse ? -PNP is similar to physician's assistant, so should be at ease -we can have you see the physician if you would like -seeing the PNP is just one more step in child being evaluated in this setting -the PNP is an experienced RN with advanced education in diagnosis and treatment of kids

the PNP is an experienced RN with advanced education in the diagnosis and treatment of kids

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that the child is an emancipated minor. What does this mean? -The nurse must contact the child's guardian for consent to treatment. -A court-appointed guardian is needed to ensure that the child's rights are maintained. -The nurse needs to check with the child to determine which parent has custody. -The child has the legal right to consent to and make decisions for treatment.

the child has the legal right to consent to and make decisions for treatment *emancipation is process by which an individual becomes liberated from authority and control of another person, this minor can consent to medical/dental/psychiatric care without parental knowledge, consent, liability

The nurse is teaching a group of students about the possible effects of immigration on the health status of children. Which response by the group would indicate the need for additional teaching? A. The children of immigrants have better access to preventive care. \B. The children of immigrants have limited involvement in activities due to the language barrier C. The children of immigrants lack adequate support systems. D. The children of immigrants face increased stressors due to relocation.

the children of immigrants have better access to preventative care

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated? -The nurse should discourage the child from talking about the imaginary friend. -The nurse should explain to the child that there are no friends present. -The nurse should document the reports of hallucinations by the child. -The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

the nurse should recognize this behavior as normal for the child's developmental age and do nothing. *preschool aged children often interact with imaginary friends, normal for them

The parents of a 12-year-old girl report their daughter is missing an increasing amount of school. They further share that the child says she feels ill and begs to stay home. What action by the parents will be most therapeutic? -The parents need to demand the child go to school. -The parents need to establish a contract with their child about attending school. -The parents need to attempt to determine why the child is avoiding school. -The parents should allow the child to stay home if necessary.

the parents need to attempt to determine why the child is avoiding school *many times school phobia is a symptom of deeper problems, don't demand they go because doesn't address underlying problem

When testing the deep tendon reflexes of a child, a four-point grading scale is used. What would a 1+ result mean for a reflex tested? -The reflex is hyperactive -The reflex is absent -The reflex is brisk -The reflex is diminished

the reflex is diminished (+1 = diminshed response, +2 average, +3 brisker than average, +4 hyperactive)

A 2-year-old is having a temper tantrum. What advice should the nurse give the mother? A. For safety reasons, the toddler should be restrained during the tantrum. B. Punishment should be initiated, as tantrums should be controlled. C. The mother should promise the toddler a reward if the tantrum stops. D. The tantrum should be ignored as long as the toddler is safe.

the tantrum should be ignored as long as the toddler is safe

The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse? A. It's okay to start puréed solids at this age if fed via the bottle. B. Infants don't require solid food until 12 months of age. C. Solid foods should be delayed until age 6 months, when the infant can handle a spoon on his own. D. The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods.

the tongue extrusion reflex disappears at age 4-6 months, making it a good time to start solid foods.

The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statements by the nurse will be most helpful to the mother in accepting the vaccine? -"It is one of the most commonly used childhood vaccines." -"This vaccine is recommended by the Centers for Disease Control and Prevention." -"This vaccine is approved by the American Academy of Pediatrics." -"The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

the vaccine is shown to be effective and safe and will reduce the number of injections your child will need

The nurse is caring for a special needs child who is preparing for hippotherapy. The nurse is aware that this is what type of therapy? -Therapeutic bicycle riding -Relaxation therapy -Therapeutic horseback riding -Pet therapy

therapeutic horseback riding

_ is a holding position that promotes close physical contact between the child and a parent or caregiver.

therapeutic hugging

The nurse is admitting a medically fragile child. When planning care for the child and the family, what is the priority for the nurse at this time? -To provide information about the child's educational needs -To ensure the family has contact information for resources available in the community -To develop a trusting relationship with the family -To assist the family in defining the role each member will have in caring for the child after discharge

to develop a trusting relationship with the family *need to develop trusting relationship with family in order to provide optimal care

Which of the following are reasons that stealing occurs in school-age children? (Choose all that apply.) 1. To escape punishment 2. High self-esteem 3. Low expectations of family/peers 4. Lack of sense of propriety 5. Strong desire to own something To escape punishment 6.Lack of sense of propriety 7. Strong desire to own something

to escape punishment lack sense of property strong desire to own something

children who are homeless are exposed to an environment that isn't conducive to appropriate growth and development. t or f

true

the preferred injection site for infants 12 months or less is the vastus lateralis or anterolateral thigh muscle. t or f?

true *preferred injection site for infants 12 mths or less is the vastus lateralis or anterolateral thigh muscle *gluteal muscle can be considered for certain circumstances *older than 12 months, vastus lateralis or anterolateral thigh muscle remains preferred site, but deltoid can be considered if sufficient mass is present

A family that makes too much money to qualify for Medicaid, but who cannot afford to purchase health insurance, should be referred to the Children's Health Insurance Program (CHIP). true or false?

true *balanced budget act of 1997 authorized the CHIP as title XXI of social security act, purpose of this program is to expand health insurance to children whose families make too much money to qualify for medicaid, but can't afford to purchase health insurance

children receive most of their health care, well and ill care, in the community setting. t or f?

true *changing in health care like strained fundings shorter hospital stays, cost containment lead to shift in responsibilities of care from hospital to homes and communities

the best place for special needs children to receive care is in their home. t or F?

true *home is the most developmentally appropriate environment for all children

providing end of life care to a dying child focuses on the family as the unit of care. t or f?

true *nurse are advocates, constant presence, manage pain and discomfort, provide nutrition, assist with emotional support, grief process, all while focusing on family as the unit care

parents of children with special needs become experts on their child's care and should be supported and listened to as such experts.

true *should be be taken seriously, not ignored, they have reliable and vulnerable info on their children

children experience less pain and decreased fear if they are sitting vs. lying down when receiving an injection. t or f?

true *supports children experience less pain and decreased fear if sitting vs. lying down when receiving injection

when working with a toddler participate in parallel play to help start communication. t or f?

true (approach carefully, fearful and resistant at first. parallel play is a good way to help start communication)

unlike vision, hearing is fully developed at birth. t or f

true (hearing is fully developed at birth, vision is not)

school age children and adolescents may not outwardly demonstrate behavior indicating the need for comforting. t or f?

true (provide with opportunities to express their feelings)

the steps of patient and family education are similar to the steps of the nursing process. t or f?

true the nurse must asses, plan, implement, evaluate, document education.

a 20 month old that doesn't speak 15 words is a warning sign of possible developmental delay. t or f?

true, developmental warning signs in an 18 mth old child includes not walking, not speaking 15 words, not showing imitative play

universal hypertension screening for children begging at age 3 is recommended. t or f?

true, increased childhood high bp and htn can be from heart or kidney issues

increased maternal bonding occurs with breastfeeding. t or f

true, increased maternal infant bonding is a benefit to both moms and infants when breastfeeding

one stool every day or two is considered normal if the stool remains soft.

true, infants stool patterns vary widely.

drowning is the leading cause of unintentional injury and death in US kids. t or f

true, nearly half of children drowning victims are under 4 years of age.

the heart rate in infants is much faster than in adults. t or f?

true. average for infant ranges from 80-150

the radial pulse is difficult to palpate accurately on children younger than 2 years of age. t or f?

true. blood vessels lie so close to skin surface so are easily obliterated.

questions about parent's employment status and occupation are relevant to the overall well being of a child. t or F?

true. employment and occupation are important- may impact ability to spend time with child and determine financial status.

children who are severely immunocompromised should not receive live vaccines. t or f?

true. should not receive live vaccines if immunocopromised child or pregnant (mmr, varicalla would be examples)

the FLACC pain scale rating should be used in the young pre-verbal child. t or f?

true. too young or verbally/conceptually quantify pain or with a language barrier

when caring for an adolescent, in which case must the nurse share info with the parents no matter which state care is provided in? -pregnancy counseling -depression -contraception -tuberculosis

tuberculosis (all others are confidential)

A 5-year-old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level? a. play game with child b. talking with child about teddy bear next to him c. use screening tool during a follow up office visit d. ask 10 year old sibling about child

use a screening tool during follow up office visit

When caring for children, how does the nurse best incorporate the concept of family-centered care? 1. Encourages the family to allow the physician to make health care decisions for the child 2. Uses the concepts of respect, family strengths, diversity, and collaboration with the family 3. Advises the family to choose a pediatric provider who is on the child's health care plan 4. Recognizes that families undergoing stress related to the child's illness cannot make good decisions

use concepts of respect, family strengths, diversity, collaboration with family

Parents of a 2-year-old girl are having a conversation with the nurse about tantrums. Which technique would the nurse most likely suggest? -Promise a reward if she behaves. -Tell her she is bad and will be punished. -Vary the response based on the situation. -Use short "time-outs" and remain calm.

use short time outs and remain calm *best response to tantrums is to remain calm and use short time outs, need to have consistent responses rather than varied, telling the child she is bad is negative, promising reward will result in rewarding bad behavior

A nurse is preparing to administer an intramuscular injection to an infant. What is the most appropriate site for this injection? 1. Deltoid muscle 2. Vastus lateralis 3. Dorsogluteal 4. Rectus femoris

vastus laterlais

communicating through the use of words, either written or spoken, is termed _ communication

verbal

_ child syndrome refers to a clinical state in which parental reactions to a serious illness or event in the child's past continue to have long term psychologically harmful effects on the child and parents for many years.

vulnerable

school nurse assess kindergarten children. would be most concerned if which finding is observed? -child throws and catches a ball with others in play group -child able to nearly tie shoelaces on discovery board -child chooses to ear with fingers at snack table -walks down stairs by placing both feet on one step

walking down stairs by placing both feet on one step

The nurse is caring for a 2-year-old in the hospital, and the mother expresses concern that the toddler will be scared. Which response by the nurse would be most appropriate? 1. "Don't worry; we practice family-centered and atraumatic care here." 2. "We will do our best to minimize the stress that your child experiences." 3. "It will probably be upsetting for you as well, so you should stay home." 4. "Our practice of atraumatic care will eliminate all pain and stress for your child."

we will do our best to minimize the stress your child experiences

children's play is so important to their development that is considered the _ of children.

work

the nurse should inspect the infant's throat during a _ or cry.

yawn