peds final
Which clinical manifestations should cause the nurse to suspect that a child, diagnosed with a digestive disorder, may be demonstrating signs of failure to thrive?
a) Avoidance of eye contact
The nurse is interviewing the mother of an infant. She reports, "I had a difficult delivery, and my baby was born prematurely." This information should be recorded under which heading?
a) Birth history
In providing nourishment for a child with cystic fibrosis (CF), what diet consideration should be stressed to both the child and caregivers?
a) Diet should be high in carbohydrates and protein
The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is
a) Erikson.
What nursing intervention should be included in the plan of care for a young child diagnosed with pneumonia?
a) Monitor for abdominal pain
Which of the following is descriptive of deaths caused by unintentional injuries?
a) More deaths occur in males
Which medication is the most effective choice for treating pain associated with sickle cell crisis in a newly admitted 5-year-old child?
a) Morphine
What is probably the single most important influence on growth at all stages of development?
a) Nutrition
A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents based on what knowledge concerning regressive behaviors
a) Regression is seen during hospitalization
Which assessment indicates to a nurse that a school-aged child is in need of pain medication
a) The child is lying rigidly in bed and not moving.
At what age do children tend to imitate the religious gestures and behaviors of others without understanding their significance?
a) Toddlerhood
What type of breath sound is normally heard over the entire surface of the lungs, except for the upper intrascapular area and the area beneath the manubrium?
a) Vesicular
The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should perform which initial action?
a) Wash hands thoroughly.
During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is:
a) a normal finding
The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to:
a) administer naloxone (Narcan).
The nurse has a 2-year-old boy sit in "tailor" position during palpation for the testes. The rationale for this position is that
a) it prevents cremasteric reflex
The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. The most appropriate action is to
a) refer for immediate medical evaluation.
The nurse gives an injection in a patient's room. Which method should the nurse use to dispose of the needle
a) Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room.
Which consideration should be considered when planning care for an infant diagnosed with failure to thrive?
a) Establishing a structured routine and follow it consistently
The nurse is observing parents playing with their 10-month-old daughter. What should the nurse recognize as evidence that the child is developing object permanence?
a) She looks for the toy the parents hide under the blanket.
From a worldwide perspective, infant mortality in the United States:
a)is the highest of the other developed nations
The nurse assessing a 6-month-old healthy infant who weighed 7 lbs at birth, shares with the parents that the infant should weigh approximately how many pounds?
b) 15 lbs
The nurse should expect the anterior fontanel to close at age
b) 2 to 4 months.
The earliest age at which a satisfactory radial pulse can be taken in children is
b) 2 years.
Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is normally present by what age?
b) 3 to 4 months
A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL/8 hr is being infused rather than the ordered amount of 300 mL/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?
b) 300 mL
The nurse is taking a health history on an adolescent. Which best describes how the chief complaint should be determined?
b) Ask the adolescent, "Why did you come here today?"
The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play?
b) Brian playing with his truck next to Kristina playing with her truck
Which tool measures body fat most accurately
b) Calipers
Using knowledge of child development, what is the best approach when preparing a toddler for a procedure?
b) Demonstrate the procedure on a doll
A mother reports that her 6-year-old child is highly active and irritable and that she has irregular habits and adapts slowly to new routines, people, or situations. According to Chess and Thomas, which category of temperament best describes this child?
b) Difficult child
What is an important nursing consideration when performing a bladder catheterization on a young boy?
b) Insert 2% lidocaine lubricant into the urethra
What distinguishing manifestation of spasmodic croup should parents be taught to identify?
b) It has a harsh, barky cough
A 6 year old, hospitalized again because of a chronic illness, is told by school-age siblings that, "We are sick of Mom always sitting with you in the hospital and playing with you. It is not fair that you get everything and we have to stay with the neighbors." What is the nurse's best assessment of the cause of the siblings' resentment?
b) Jealousy and resentment are common reactions to the illness or hospitalization of a sibling
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
b) Morphine
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse's primary rationale for this action?
b) The mother's presence will reduce anxiety and ease the child's respiratory efforts.
What is the characteristic of the preoperational stage of cognitive development?
b) Thinking is concrete.
The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as
b) a way to establish rapport.
The nurse is taking a sexual history on an adolescent girl. The best way to determine whether she is sexually active is to
b) ask her, "Are you having sex with anyone?"
In addition to injuries, the leading causes of death in adolescents ages 15 to 19 years are:
b) homicide, suicide
By the time children reach their 12 birthday, they should have learned to trust others and should have developed a sense of
b) industry
The appropriate placement of a tongue blade for assessment of the mouth and throat is the
b) the side of the tongue
What is the most appropriate statement for the nurse to make to a 5-year-old child who is undergoing a venipuncture?
b) "This will hurt like a pinch. I'll get someone to help hold your arm still so it will be over fast and hurt less."
Which statement best describes the process of critical thinking?
b) It is purposeful and goal directed.
Which statement is true about the basal metabolic rate (BMR) in children?
b) It is slightly higher in boys than in girls at all ages.
How does the onset of the pubertal growth spurt compare in girls and boys?
b) It occurs earlier in girls.
After collecting blood by venipuncture in the antecubital fossa, what intervention should the nurse implement in order to assure control of any bleeding?
b) Keep arm extended, and apply pressure to the site for a few minutes.
Which "expected outcome" would be developmentally appropriate for a hospitalized 4-year-old child?
b) The child will independently ask for play materials or other personal needs
The nurse is preparing staff in-service education about atraumatic care for pediatric patients. Which intervention should the nurse include?
b)Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.
The type of injury a child is especially susceptible to at a specific age is most closely related to
b)developmental level of the child
The karyotype of a person is 47, XY, +21. This person is a:
b)male with Down syndrome.
The nurse is caring for an adolescent hospitalized after a bicycle accident. Which statement by the adolescent would be expected about separation anxiety?
c) "I hope my friends don't forget about visiting me."
The nurse is testing an infant's visual acuity. By what age should the infant be able to fix on and follow a target?
c) 3 to 4 months
With the National Center for Health Statistics (NCHS) criteria, which body mass index (BMI)-for-age percentile indicates a risk for being overweight?
c) 85th percentile
A 14-year-old boy is being admitted to the hospital for an appendectomy. Which roommate should the nurse assign with this patient?
c) A 15-year-old boy admitted with a vaso-occlusive sickle cell crisis.
In what type of play are children engaged in similar or identical activity without organization, division of labor, or mutual goal?
c) Associative
A school-age child, admitted for intravenous antibiotic therapy for osteomyelitis, reports difficulty in going to sleep at night. Which intervention should the nurse implement to assist the child in going to sleep at bedtime?
c) Create a schedule similar to the one the child follows at home
Which strategy would be the least appropriate for a child to use to cope
c) Having parents solve problems
Where is the best place to observe for the presence of petechiae in dark-skinned individuals?
c) Oral mucosa
Where in the health history should the nurse describe all details related to the chief complaint?
c) Present illness
A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain?
c) Recurrent
During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action?
c) Refer the child for further evaluation
What important consideration in providing atraumatic care should the nurse consider when preforming a venipuncture on a 6-year-old child?
c) Restrain the child only as needed to perform venipuncture safely
Which age-group is most concerned with body integrity
c) School-age child
Which intervention for treating croup at home should be taught to parents?
c) Take the child outside if air is cool and moist
What is the single most important factor to consider when communicating with children?
c) The child's developmental level
Which action is most likely to encourage parents to talk about their feelings related to their child's illness?
c) Use open-ended questions.
Which term is used to describe breath sounds that are produced as air passes through narrowed passageways?
c) Wheezes
When interviewing the mother of a 3-year-old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered because these milestones are
c) an important part of the child's past growth and development
When doing a nutritional assessment on an Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet:
c) may provide sufficient amino acids.
An appropriate approach to performing a physical assessment on a toddler is to
c) use minimal physical contact initially.
By what age does birth length usually double?
c) 4 years
Frequent developmental assessments are important for which reason?
c) Critical periods of development occur during childhood
Which behavior is most characteristic of the concrete operations stage of cognitive development?
c) Increasingly logical and coherent thought processes
Which action by the nurse demonstrates use of evidence-based practice (EBP)?
c) Questioning the use of daily central line dressing changes
Which statement is most descriptive of pediatric family-centered care?
c)It recognizes that the family is the constant in a child's life.
What nursing action is appropriate for specimen collection?
c)Use Standard Precautions when handling body fluids
The leading cause of death from unintentional injuries in children is:
c)motor vehicle related fatalities.
A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?
d) FLACC tool
When caring for an infant with an upper respiratory tract infection and elevated temperature, which appropriate nursing intervention should the nurse implement
d) Give small amounts of favorite fluids frequently to prevent dehydration
Which type of dehydration results from water loss in excess of electrolyte loss?
d) Hypertonic dehydration
The predominant characteristic of the intellectual development of the child ages 2 to 7 years is egocentricity. What best describes this concept?
d) Inability to put self in another's place
A parent asks the nurse whether her infant is susceptible to pertussis. The nurse's response should be based on which statement concerning susceptibility to pertussis?
d) Most children are highly susceptible from birth.
The most frequently used test for measuring visual acuity is the
d) Snellen letter chart
A 13-year-old girl asks the nurse how much taller she will become. She has been growing about 2 inches per year but grew 4 inches this past year. Menarche recently occurred. The nurse should base her response on knowing that
d) approximately 95% of mature height is achieved when menarche occurs.
Three children playing a board game would be an example of:
d) cooperative play
When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is
d) infection or inflammation close to the site.
The nurse must assess a child's capillary refilling time. This can be accomplished by
d) palpating the skin to produce a slight blanching
A toddler playing with sand and water would be participating in _____ play
d) sense-pleasure
An infant who weighs 7 lbs at birth would be expected to weigh how many pounds at age 1 year?
d) 21 lbs
Trauma to which site can result in a growth problem for children's long bones
d) Epiphyseal cartilage plate
What is an appropriate intervention to encourage food and fluid intake in a hospitalized child?
d) Give high-quality foods and snacks whenever child expresses hunger
When administering a gavage feeding to a school-age child, the nurse should implement what intervention to assure safety?
d) Position the child on the right side after administering the feeding.
Which function of play is a major component of play at all ages?
d) Sensorimotor activity
A clinic nurse is planning a teaching session about childhood obesity prevention for parents of school-age children. The nurse should include which associated risk of obesity in the teaching plan?
d) Type II diabetes
Physiologic measurements in children's pain assessment are:
d) of limited value as sole indicator of pain
A child's skeletal age is best determined by:
d) radiographs of the hand and wrist.
Lymphoid tissues in children such as lymph nodes are:
d) twice their adult size by age 10 to 12 years.
The nurse caring for the child in pain understands that distraction
d)must be developmentally appropriate to refocus attention
During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is
d)normal because the lower back and leg muscles are not yet well developed.
