Peds Final
You are working with a nurse who is new to your endocrine unit and has never worked with an infant born with congenital adrenal hyperplasia (CAH). You want to make sure he has a full understanding of this diagnosis. Which statement by the nurse indicates a need for further teaching?
"Blood studies to identify elevated calcium and decreased phosphorus levels are routinely performed."
You are working with a new graduate on the pediatric unit and your patient is returning from the cardiac catheterization laboratory. You feel the graduate understands the important nursing interventions when she says which of the following? Select all that apply.
"Check pulses, especially below the catheterization site, for equality and symmetry." "Check the dressing for evidence of bleeding or hematoma formation in the femoral or antecubital area."
A 4-year-old child with anemia is receiving oral iron supplements. What dietary recommendation would the nurse provide to this family?
Administer the iron with orange juice.
The mother of a hearing impaired infant asks if there is a form of communication that her daughter can learn. What response by the nurse is most accurate?
American Sign Language
Which heart defect and hemodynamic change pairing is correct?
Aortic stenosis and obstruction to blood flow out of the heart
Identify the interventions that can be safely used to manage diaper dermatitis.(select all that apply)
Apply a skin barrier paste like zinc oxide Keep skin surface irritants such as urine and stool off skin Expose skin to air
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet". The nurse finds the bed soaked with blood. What nursing action is most appropriate to institute initially?
Apply direct pressure above the catheterization site
Care of the child with a wound includes which of the following? Select all that apply.
Applying occlusive dressings, such as hydrocolloid dressings. Dressings adhere best if a wide margin is left around the wound and the dressing is gently pressed against intact skin until it adheres. The safest solution for cleansing and loosening sticky dressings is normal saline. Puncture wounds should initially be irrigated with sterile saline, then soaked in a basin of warm soapy water for several minutes before applying a clean dressing.
The mother of the hearing-impaired infant is describing the signs that caused her to suspect that her daughter had a severe deficit. What characteristics would the nurse expect the mother to mention?
The infant slept no matter how loud a noise was, including the vacuum cleaner
The parents of a child with Hodgkin disease ask how the physician will know what type of cancer their child has. Which of the following definitive signs and symptoms should the nurse describe? Select all that apply
The most common finding is enlarged, firm, nontender, movable nodes in the supraclavicular or cervical area. The presence of Reed-Sternberg cells is considered diagnostic of Hodgkin disease.
The nurse caring for a 4-month-old infant with biliary atresia and significant urticaria can anticipate administering:
Ursodiol (ursodeoxycholic acid)
The nurse admits 3-year-old Brian to the unit with a suspected diagnosis of medulloblastoma. Which of the following assessment findings would be most likely? Select all that apply
Waking in the morning with a headache Vomiting not related to eating
For a child with Type 1 diabetes mellitus, when is it recommended that the urine be tested for ketones?
When serum glucose exceeds 240 mg/dl
A nurse is caring for a child who is receiving oxygen and is on continuous oxygen saturation monitor that is 89%. Which of the following actions should the nurse take first?
Ensure proper placement of the sensor probe
The most common complication that should be anticipated and observed for in an infant with myelomeningocele after surgical repair of the defect is:
Hydrocephalus
A child with sickle cell anemia is admitted in a vasoocclusive crisis. Which of the following interventions should the nurse expect to see ordered? Select all that apply.
IV fluids started, and oral fluids encouraged High-calorie, high-protein diet Antibiotics ordered for any existing infection
Hepatitis A virus is transmitted by which of the following? Select all that apply.
Ingestion of contaminated food Fecal-oral route
You are caring for a child with hydrocephalus who is post-operative from a shunt insertion. Which of the following statements is true?
Position the child on the unoperated side.
The pulmonary problems associated with CF are caused by
increased viscosity of bronchial mucus
The potential physiologic and psychologic effects of prolonged immobilization on a 9 y/o child who has experienced significant trauma in a motor vehicle accident include which of the following? Select all that apply Doxycycline
orthostatic intolerance Deep vein thrombosis Pressure ulcer formation Pneumonia Kidney stones Constipation
Which is not a motor sign indicative of cerebral palsy?
stiff limb
Clinical manifestations of diabetes insipidus include which of the following?
uncontrolled diuresis, dehydration, polydipsia
A 2 month old with heart failure is sent home on digoxin.What findings would likely be present if the infant's digoxin level was toxic? (Select all that apply.)
vomiting poor feeding
The nurse is assembling the medication to administer to patient with otitis media.. Which type of medication would the nurse expect to administer?
An oral antibiotic
You are the nurse assigned to care for a child with a basilar skull fracture. Your most important nursing observation is change in level of consciousness. You will be highly alert for:
Changes in posturing, such as any signs of extension or flexion posturing, unusual response to stimuli, and random versus purposeful movement
A former preterm infant who had surgery for necrotizing enterocolitis is now 6 months old and has short-bowel syndrome. He is unable to absorb most nutrients taken by mouth and is totally dependent on parenteral nutrition, which he receives via a central venous catheter. The clinic nurse following this infant is aware that this infant should be closely observed for the development of:
Cholestasis
You are caring for a child on the pediatric unit with a suspected abdominal tumor. Which criterion would lead you to determine that this tumor is a neuroblastoma rather than a Wilms tumor?
Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain
A male infant was born with fractures of the left shoulder and clavicle and was diagnosed with osteogenesis imperfecta (OI) after his blue sclerae were seen Q1: The newborn is being discharged home and the parents want to know how to care for their child. What information should the nurse share with the parents?
Support the infant during a diaper change by lifting the buttocks
You are discharging a patient with hemophilia. Which of the following responses by the parents indicate an understanding of this disorder? Select all that apply
"Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge tipped disposable toothbrush may be helpful." "Signs of internal bleeding should be recognized, such as headache, slurred speech, loss of consciousness (from cerebral bleeding), and black, tarry stools (from gastrointestinal bleeding)." "All of my son's teachers need to be aware of what to do if he gets a bloody nose."
A father calls the pediatrician's office concerned about his 5-year-old type 1 diabetic child who has been ill. He reports that on checking the child's urine, it was positive for ketones. What is the nurse's best response to this father?
"Encourage the child to drink calorie-free liquids."
The parents ask about the treatment for their son's OI. What information should the nurse share with them?
"There are medications that can help promote increased bone density and prevent fractures as well as surgeries if needed."
A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease (HD) is suspected, and further testing is being scheduled.The infant's mother asks about the testing her little son needs to undergo. She is very worried because she does not understand what testing is involved even after the pediatrician has explained it. What response from the nurse would be most appropriate?
"There are several tests, including x-rays and a rectal biopsy, but we will keep your son comfortable."
You are working with a recent graduate on the pediatric unit. You are assigned to take care of an adolescent with β-thalassemia. The nurse needs more information about this disease if she states which of the following? Select all that apply
"We need to check the patient's iron level to make sure he is not anemic." "I believe this is most common in those of Hispanic descent, although this patient is Mediterranean." "This patient looks much younger than I would expect. I guess he's just a late bloomer."
The nurse is obtaining a history of an infant's early months. What question is most critical for the nurse to ask to aid in the diagnosis of HD?
"When did your son have his first bowel movement?"
Urinary system distress (neurogenic bladder) in children with spina bifida is managed by:
Clean intermittent catheterization
What interventions should be included in the nursing care of a child with autism spectrum disorder?
Communicate with the child at his or her developmental level
A 5-year-old is seen in the urgent care clinic with the following history and symptoms: sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 102.2°F (39.0°C), clear breath sounds, and absence of cough. The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of:
Acute epiglottitis
A 3-month-old infant is seen in the clinic with the following symptoms: irritability, crying, refusal to nurse for more than 2 to 3 minutes, rhinitis, and a rectal temperature of 101.8°F (38.8°C). The labor, delivery, and postpartum history for this term infant is unremarkable. The nurse anticipates a diagnosis of:
Acute otitis media (AOM)
After the sudden death of a 14-year-old seemingly healthy basketball player, his parents ask the school administration to install an automatic external defibrillator (AED) in a central area of the athletic center. The school nurse is asked to participate in a meeting with the parents in which the administrators insist that such a device is not necessary. The school nurse advocates by providing which information about AEDs and children?
An AED can be effective in the resuscitation of a child or adolescent with a shockable rhythm.
The nurse taking care of a 5-year-old cancer patient with ulcerative stomatitis is getting ready to perform mouth care. Which of the following principles should be followed? Select all that apply
A soft, bland diet, although not the favorite of the child, will help with the pain. Using a soft sponge-type toothbrush will decrease the tendency for gums to bleed. A solution of 1 tsp of baking soda and 1 2 tsp of table salt in 1 quart of water is helpful for mouth rinse.
A child is admitted to the pediatric unit. The mother reports that the doctor says her son is anemic. What laboratory findings/ manifestations would the nurse expect to see to confirm iron deficiency anemia?
A total iron-binding capacity (TIBC) that is elevated above the normal range
a nurse is caring for an infant who has myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care?
Apply a sterile moist dressing on the sac
A nurse is caring for a child in skeletal traction. Which of the following actions should the nurse take? Select all that apply
Assess the child's position frequently Assess pin sited every 4 hours Ensure the weights are hanging freely
A mother comments to a nurse working on the pediatric unit, "My second child just does not seem to be acting like or responding the same way as my first child." Nursing interventions to respond to this inquiry should include which of the following? Select all that apply
Assessment for dysmorphic syndromes (e.g., multiple congenital anomalies, microcephaly) Inquiring about temperament: irritability or lethargy Noting language development appropriate for the child's age
A 12-year-old child is in the urgent care clinic with a complaint of fever, headache, and sore throat. A diagnosis of group A β-hemolytic streptococcus (GABHS) pharyngitis is established with a rapid-strep test, and oral penicillin is prescribed. The nurse knows that which of the following statements about GABHS is correct?
Children with a GABHS infection are at increased risk for the development of rheumatic fever and glomerulonephritis
A 5-month-old infant is seen in the well-child clinic for a complaint of vomiting and failure to grow. His birth weight was 7 lb, and he now weighs 8 lb, 10 oz. The infant's mother reports that he is taking 4 to 7 oz of formula every 4 to 5 hours, but he "spits up a lot after eating and then is hungry again." The child is noted to be alert but appears malnourished. The mother reports that his stools are brown in color, and he has 1 to 2 bowel movements every day. Based on these findings, the nurse anticipates the infant has:
Hypertrophic pyloric stenosis
A new nurse is caring for a child with a wound and asks you to remind her about the phases of wound healing. You describe the order as:
Inflammatory phase: Erythema, heat, edema, pain, and functional disturbance occur Proliferation: Fibroblasts, immature connective tissue cells, migrate to the healing site and begin to secrete collagen into the meshwork spaces. Contraction: Fibroblast movement causes contraction of the healing area, which helps bring wound edges closer together Maturation: The scar becomes pale, does not tan when exposed to sunlight, will not sweat or produce hair, and may itch.
Discharge teaching for parents of a school-age patient with diabetes insipidus (DI) should include which of the following? Select all that apply.
Information for school personnel regarding the diagnosis so they can grant children unrestricted use of the lavatory A thorough explanation regarding the condition with specific clarification that DI is a different condition from diabetes mellitus Knowing that school-age children may assume full responsibility for their care
A 2-month-old formerly healthy infant born at term is seen in the urgent care clinic with intercostal retractions, respiratory rate of 62, heart rate of 128, refusal to breastfeed, abundant nasal secretions, and a pulse oximeter reading of 88% in room air. The diagnosis of respiratory syncytial virus is made. The infant's oxygen saturation remains 95% in room air, and the respiratory rate is 54, with intercostal retractions; heart rate is 120 beats per minute. After 2 hours of observation and an intravenous bolus of fluids, the infant is being discharged home. The nurse provides which of the following home care instructions for this infant? Select all that apply
Continue breastfeeding infant. Observe infant for labored breathing or apnea (cessation of breathing). Instill normal saline drops in both nares and suction thoroughly before feeding and before placing to sleep. Keep the infant out of day care or nursery
Children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have a resilience that is to be admired. Which of these statements reflect ways that they foster this resilience? Select all that apply.
Develop relationships with other children and their families with similar circumstances to build support. Focus on the child's strengths and encourage independence. Accept that chronic illness is part of living.
Identify the symptoms below that are associated with DI. (Select all that apply.)
Excessive urination Compensatory insatiable thirst Dehydration Electrolyte imbalance Circulatory collapse
When caring for a 4-year-old with a disability, the nurse notes that while encouraging the child to take part in his care, the mother constantly gives into the child, allowing him to have his own way. What anticipatory guidance can the nurse give to promote normalization in this relationship?
Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations.
at a visit to the pediatric clinic, a mother is concerned by her 4-yearold's symptoms over the last few weeks. Which of the following symptoms described by the mother would lead the nurse to be concerned about an oncologic disorder? Select all that apply.
Frequent complaints of respiratory infections, while siblings remain healthy Enlarged, firm lymph nodes Fever for more than 1 week
You are working in the emergency department, and a 10-year-old child with type 1 diabetes mellitus has just been admitted. He has been diagnosed with diabetic ketoacidosis. Which assessment data will you expect to note in this child?
Fruity breath odor and decreasing level of consciousness
What tool would the Emergency Room Nurse use to assess level of consciousness in a newly admitted child?
Glasgow Coma Scale
The nurse is working in the oncology unit of a pediatric hospital. A child is reported to have an ANC below 500. When planning the child's care, which of the following interventions would be most likely? Select all that apply.
Good hand washing Avoid administration of live vaccines
Steven is a 4-year-old child who is brought to the emergency department by his parents because he is "very sick". Symptoms include a fever of 40 C (104 F), stridor, and a sore throat. He is agitated, is drooling, and wants to sit up. Acute epiglottitis is the probable diagnosis.Which of the following should the nurse do first?
Have a pediatric tracheostomy set available
A child with sickle cell disease is in vasoocclusive crisis. What nonpharmacologic pain intervention should the nurse plan?
Heat to the affected area
The primary risk factor for the development of cerebral palsy is:
Premature birth
What test is used to diagnose idiopathic scoliosis?
Radiography examination of the spine
Identify the vital sign changes listed below that are associated with brainstem injury following acute head trauma (Select all that apply)
Rapid and intermittent respirations Wide fluctuations in pulse Widening pulse pressure Extreme fluctuations in blood pressure Elevated temperature
An adolescent sustained a spinal cord injury in a motor vehicle crash. The nurse suspects the development of autonomic dysreflexia. The most appropriate action of the nurse is which of the following?
Relieve bladder distension
Kimberly, age 9 years, is brought to the clinic because of acute respiratory distress. She appears anxious and is clinging to her father. The diagnosis is asthma.Epinephrine is ordered to be given subcutaneously. The nurse understands the action desired is to:
Relieve bronchospasms
A 2-day-old infant in the newborn nursery is diagnosed with developmental dysplasia of the hip, and treatment is started by the orthopedist. The nurse assists the parents by providing home care instructions that include:
Remove the Pavlik harness once a day for no more than an hour and inspect skin
As a nurse assigned to a child diagnosed with bacterial meningitis you know that:
Respiratory isolation will remain in place for 24 hours after antibiotics are started
As the nurse assigned to a child diagnosed with bacterial meningitis, you know that:
Respiratory isolation will remain in place for 24 hours after antibiotics are started
In some patients, ITP turns into a chronic condition. Which of the following is the best therapy for long-term remission of chronic ITP?
Splenectomy when the child is age 5 or older
The child's respiratory center has been affected, so a tracheostomy and ventilator assistance are required. He has been transferred to the intensive care unit. Nursing care to prevent further respiratory complications would include which set of nursing interventions?
Strict asepsis when suctioning and postural changes every 2 hours
Which of the following assessment findings are likely with a child with heart failure. (Select all that apply)
Sweating Weak thready pulses Dependent edema Fatigue Tachycardia
A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia?
Tachypnea
The parents are told to make certain that anyone caring for their child knows about his condition. When he is ready to go to school, school officials should know he has OI as well. What two reasons should the nurse discuss with the parents as major reasons for letting others know?
This alerts caregivers and teachers about the child's brittle bone condition. Because the injuries can occur unusually often, the parents could be suspected of child abuse.
The grandmother of an infant diagnosed with trisomy 21 reports that the 3-month-old is slow with nipple feedings. The most appropriate response by the nurse is which of the following?
This is common for children with Down syndrome.
The nurse is asked by a family member about how to tell if a child has cancer. Which of the following might be included in her list of symptoms associated with cancer in children? Select all that apply.
Unusual mass or swelling Unexplained paleness or loss of energy Sudden tendency to bruise Persistent localized pain or limping Frequent headaches, often with vomiting Sudden eye or vision changes Excessive, rapid weight loss
Disordered eating patterns, which may be observed in the female athlete triad, may include which of the following? Select all that apply.
Use of diet pills and laxatives Fasting Restriction of certain foods Inadequate caloric intake
What supportive measures would be appropriate for the nurse to use or to monitor to prevent contractures and maintain as much neuromuscular function as possible while the child is still paralyzed? Select all that apply.
Using neuropathic pain medications with other pain medications Using orthotic devices to maintain correct position Doing passive range-of-motion exercises several times daily
when interacting with a parent at her child's well visit, which statement by the mother would be an indication for a speech referral? Select all that apply.
failure to speak any meaningful words spontaneously in a 2-year old child Failure to use sentences of three or more words in a 3-year-old Stuttering or any other type of dysfluency Stuttering or any other type of dysfluency
An 11-month-old male child has been admitted to the cardiac section of a pediatric hospital after having a high fever, peeling of his hands and feet, and a bright red "strawberry tongue" for the past 3 days. Kawasaki disease (KD) is suspected. Initial treatment with intravenous antibiotics has not decreased the fever. What therapy would the nurse expect to administer?
intravenous gamma globulin (IVIG) and aspirin therapy
Which of the following would be the most appropriate play activity for a 3 year old child in a spica cast, considering both safety and development?
playing with toy telephone
Joey is upset after the pediatrician describes the treatment for his disease. He wants to finish the baseball season because he is the best hitter on the team. What is the treatment plan for Joey?
Joey's activities will be restricted to prevent weight bearing.
The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included?
Keep environmental stimuli to a minimum.
What diagnostic test is used to definitively diagnose Legg-Calvé-Perthes disease?
Magnetic resonance imaging (MRI)
Prevention of hearing loss in preterm infants is directed toward which of the following?
Maintaining therapeutic levels of ototoxic antibiotics
A 12-year-old who was in an ATV accident has a long-leg fiberglass cast on his left leg for a tibia-fibula fracture. He requests pain medication at 2:00 am for pain he rates at a 10/10 on the numeric scale. The nurse brings the pain medication and notes that he has removed the pillows that kept his leg elevated. He complains of pain in the left foot, and she notes that there is 3+ edema in the exposed leg and foot and she is unable to slip a finger under the cast. The nurse's priority interventions in this situation should include:
Notify the surgeon of the findings immediately
A 5-year-old is recovering from a tonsillectomy and adenoidectomy and is being discharged home with his mother. Home care instructions should include which of the following? Select all that apply. A. Observe the child for continuous swallowing.
Observe the child for continuous swallowing. Encourage the child to take sips of cool, clear liquids. Observe the child for restlessness or difficulty breathing. Administer an analgesic such as acetaminophen for pain.
A 16-month-old has a history of diarrhea for 3 days with poor oral intake. He received intravenous fluids, has tolerated some oral fluids in the emergency department, and is being discharged home. Instructions for diet for this child should include:
Offer a regular diet as child's appetite warrants
A nurse is teaching a parent of an infant about gastrointestinal reflux disease. Which of the following should the nurse include in the teaching? (Select all that apply)
Offer frequent feedings Thicken formula with rice cereal Position baby upright after feedings
A 10-year-old child has just been diagnosed with hyperthyroidism during a hospital admission. The nurse is providing discharge instructions to both parents. What information should the nurse include? Select all that apply.
Place a fan in the child's room for individual temperature regulation. Encourage the child to take sips of fluid all through the day, including while at school.
Which of the following clinical manifestations should lead the nurse to suspect that a child's appendix has ruptured?
Sudden relief from pain
The nurse is obtaining a history from the parents, who are distraught over their daughter's recurring ear infections. What information from the parents would be most important for the nurse to address during patient and parent education?
Both parents are smokers.
The patient is in the acute stage, and his paralysis is continuing to ascend. What actions by the nurse should be taken to monitor for respiratory complications of GBS? Select all that apply.
Stay with the child while he is eating or drinking. Check lung sounds with vital signs. Continually monitor his oxygen saturation.
Young children are at risk for Otitis Media because:
The Eustachian tube is horizontal compared to that of adults
A 13-year-old has just been diagnosed with type 2 diabetes mellitus and is interested in "getting on with my life." He asks how he will know that he is doing a good job if he is "going to be in charge of this thing." What response by the nurse would be most accurate?
"Maintain your glucose levels below 126 mg/dL and your hemoglobin A1c at 7% or less."
The physician has mentioned that the child should see a dentist once the first baby teeth come in. The parents don't understand the reason for an infant to see a dentist. What explanation by the nurse can best help the parents understand?
"When the baby teeth erupt, the dentist can examine them and determine whether they are also brittle."
Which is the most accurate genetic explanation for a family with hemophilia?
It is an X-linked recessive disorder
What would be most concerning assessment finding in a child with newly placed femur cast?
The toes feel like they are asleep
As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by:
Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition
Because children with celiac disease must limit their intake of products containing gluten in wheat, rye, oats, and barley, they are at risk for which of the following nutritional deficiencies? Select all that apply.
Iron deficiency anemia Folic acid deficiency Vitamin A, D, E, and K deficiency
What is the primary goal in caring for a child with cognitive impairment?
Promoting optimum development
You are working with a family that brought their child into the pediatric clinic. The mother describes what may be a type of seizure. What subjective data will help you determine the type? Select all that apply
The presence or absence of an aura If the child appeared disoriented after the seizure The duration of the seizure
he parent of an 18-year-old with Cystic Fibrosis is excited about the possibility of a double lung transplant. What does the parent need to understand about the transplant?
The transplant will not cure the child but will allow the child to have a longer life span.
You are working with a new graduate and explaining prevention of infection for a child with acute lymphoblastic leukemia. Which statement by this new nurse indicates understanding?
"Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer."
You are discharging a 5-week-old infant with a congenital heart defect who will be going home on digoxin. Which of the following answers by the father indicate the need for more teaching? Select all that apply.
"I know I give the drug carefully by slowly directing it to the side and back of the mouth." "If I miss a dose, I don't give an extra dose, but I give the next dose as ordered." "If more than two doses have been missed, I should call the doctor."
You are working with a family with a child who has a congenital heart defect. Future surgery is planned, and you are teaching the parent how to reduce cardiac demands. The parent needs more teaching when she says which of the following?
"I will wake my child for feeding every 2 hours so he can get enough calories to gain weight."
You are working with a pediatric nurse who has just transferred to the pediatric clinic. You are role-playing phone triage related to a child with a head injury. You ascertain that the nurse needs more teaching based on what response?
"If there is a language barrier, written instructions can be given, followed by discharge."
It is important to consider the child's developmental understanding of death when working with that child. Which option is the preschool child's developmental stage?
Children of this age believe their thoughts are sufficient to cause death.
A nurse is caring for a child who has cerebral palsy. Which of the following medications should the nurse expect to administer to treat painful spasms? Select all that apply
Baclofen Diazepam
When a child with a visual impairment is hospitalized, the nurse should ensure that which of the following interventions are carried out to decrease stress for the child during the hospitalization? Select all that apply.
Because the child cannot see what may be taking place, the nurse needs to reassure the child and family throughout every phase of treatment. Whenever possible, the same nurse should care for the child to ensure consistency in the approach. Each health care provider should identify himself or herself as soon as entering the child's room
You are caring for a child with hydrocephalus who is postoperative from a shunt revision. Which assessment finding is your priority for increased intercranial pressure?
Decrease in heart rate over the last hour
A nurse is teaching a group of caregivers about fractures. Which of the following information should the nurse include in the teaching?
Epiphyseal plate injuries can result in altered bone growth
A 9-year-old child in the emergency department is diagnosed with Lyme disease. The nurse anticipates that the health care provider's orders will include the administration of:
Doxycycline
Teaching for a patient with Sickle Cell Anemia should include the importance of which of these measures?
Drinking large amounts of fluids
A nurse working on a pediatric unit is assigned to an infant with hypothyroidism. She knows that the assessment may include:
Dry skin, puffiness around the eyes, sparse hair, constipation, sleepiness, lethargy, and mental decline
A mother of a child born with Down syndrome is overwhelmed with the future and asks many questions. Which of the following facts should the nurse be aware of? Select all that apply
Eighty percent of infants with Down syndrome are born to women younger than 35 years old because younger women have higher fertility rates. When feeding infants and young children, use a small, straight handled spoon to push food to the side and back of the mouth. Feeding difficulties occur due to a protruding tongue and hypotonia. Parents generally believe the experience of having this special child makes them stronger and more accepting of others. The child's lack of clinging or molding is a physical characteristic, not a sign of detachment or rejection.
Maria is a 10-year-old girl who is brought to the emergency department by her parents because of generalized abdominal pain. She has had slight diarrhea for the past few hours. Her temperature is 37.5° C (99.5° F). Bowel sounds are present. The diagnosis is possible appendicitis.Several diagnostic tests are ordered. Appropriate nursing interventions in this preoperative period include which of the following?
Ensure that diagnostic tests are administered as soon as possible to prevent delay in treatment.
Carlos is an overweight infant; therefore, he could not be anemic because of nutritional causes
False
Physical effects of anemia are very obvious; therefore, counseling families on medication and diet changes is easy and effective.
False
Therapeutic Management of infective endocarditis (IE) consists of high doses of prednisone.
False?
he potential physiologic and psychologic effects of prolonged immobilization on a 9-year-old child who has experienced significant trauma in a motor vehicle crash include which of the following? Select all that apply.
Orthostatic intolerance Deep vein thrombosis Pressure ulcer formation Pneumonia Kidney stones Constipation
which of the following factors should a nurse consider when managing the pain of a terminally ill child? Select all that apply
Pain medications are given on an as-needed schedule, and extra doses for breakthrough pain are available to maintain comfort. Opioid drugs, such as morphine, are given for severe pain, and the dosage is increased as necessary to maintain optimum pain relief.Nurses often express concern that administering dosages of opioids that exceed those with which they are familiar will hasten the child's death; in the principle of double effect In addition to pain medication, techniques such as music therapy, distraction, and guided imagery should be combined with medications to provide the child and family strategies to control pain.
A 14-year-old male with a spinal cord injury is placed on a standing table and suddenly begins to sweat profusely and complain of a headache. The nurse takes a set of vital signs and notes a significant increase in systolic blood pressure and a heart rate of 50 beats per minute. The most helpful intervention in this situation would be for the nurse to:
Palpate the bladder for distention
Understanding autism spectrum disorders (ASDs) is very important for those who care for children. Goals of treatment for these children include:
Providing a structured routine, whether at home or in the health care setting
Which of these statements accurately describes Duchenne muscular dystrophy (DMD)? Select all that apply.
The absence of dystrophin leads to muscle fiber degeneration. DMD is inherited as an X-linked recessive trait. Affected children have a waddling gait and lordosis and fall frequently. Ambulation usually becomes impossible by 12 years of age, and affected children are confined to a wheelchair.
You are working in the pediatric clinic, and a child presents with symptoms that are suspicious of the acute phase of Kawasaki disease. Which of the following symptoms are included? Select all that apply.
The bulbar conjunctivae of the eyes become reddened, with clearing around the iris. Inflammation of the pharynx and the oral mucosa develops, with red, cracked lips and the characteristic "strawberry tongue.
A school age child has been admitted to the hospital following a tonsillectomy. The nurse assesses the child 8 hours after surgery. Which of the following observations should be of the most concern for the nurse?
The child is swallowing excessively.
