Peds Final Quizzes 1-11 (some are duplicated)

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The RN is reviewing the discharge plans for a newborn with hypospadias. What statement by the parents indicates their understanding of the plan of care for hypospadias?

"Our child won't be circumcised until after surgery so the skin can be used during the repair."

Congenital myelomeningocele (meningomyelocele) is commonly associated with which of the following conditions?

. Hydrocephalus

Mumps has an incubation period of:

12-25 days

Care for an infant with osteogenesis imperfecta should include A. Support of the trunk and extremities when moving. B. Traction care. C. Cast care. D. Postop spinal-surgery care.

Obese children are vulnerable to a number of health problems, including: (Select all that apply) (pp. 293-295 [new], 325-326 [old]) A. Abnormal acceleration of growth in childhood B. Early onset of puberty in girls and abnormalities in sexual development in boys C. Hypotension D. Type 2 diabetes E. Dyslipidemia F. Coronary heart disease G. Gallbladder disease H. Osteoarthritis

A. Abnormal acceleration of growth in childhood B. Early onset of puberty in girls and abnormalities in sexual development in boys D. Type 2 diabetes E. Dyslipidemia F. Coronary heart disease G. Gallbladder disease H. Osteoarthritis

The nurse is working with a school-age child who is hospitalized. In planning care that will promote a sense of industry in this child, the nurse should (pp. 226 [new], 252-253 [old]) A. Allow the child to assist with her care. B. Encourage parents to participate in the child's care. C. Give the child a detailed scientific explanation of the illness. D. Speak to the child in a high-pitched voice.

A. Allow the child to assist with her care.

If a disorder is (fill in the blank), it means the affected person only needs to get the abnormal gene from one parent to inherit the disease. One of the parents has to have the disorder. These disorders involve altered genes on autosomes rather than the sex chromosomes X and Y. Both males and females have an equal chance of being affected. There is a 50% chance of an affected child. (pp. 51-52 [new], 58 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

A. Autosomal dominant

QUESTION 24 The nurse observes a child who had a tonsillectomy a few hours earlier is swallowing frequently. What is the appropriate action for the nurse to take? (pp. 470-471 [new], 513-514 [old]) A. Offer the child a drink B. Reposition the child C. Give the child an analgesic such as aspirin D. Notify the primary care provider

ANS: D

A 12-year-old child has just been diagnosed with end-stage renal disease. The nurse gives the child instructions in which foods to avoid, including

Apricots

The nurse is caring for a child who has been sedated for a painful procedure. The priority nursing activity for this child should be A. Allow parents to stay with the child. B. Monitor pulse oximetry. C. Assess the child's respiratory effort. D. Place the child on a cardiac monitor.

C. Assess the child's respiratory effort.

The 20-month-old child appears to be happy and content with multiple caregivers and other children. She also ignores her parents when they reappear on the unit. The pediatric nurse determines that the child is experiencing which stage of separation anxiety? A. Contentment B. Despair C. Detachment D. Protest

C. Detachment

Which of the following is the best example of appropriate communication with a young child in the hospital setting? (pp. 78-81, 234 [new], 99; 260 [old]; Powerpoint slides # 83-86) A. "I'm going to take your pulse now." B. "I'm going to give you a little stick in the arm." C. "I'm going to count how fast your heart beats." D. "I will give you a shot in the arm." E. "This will hurt or burn."

C. "I'm going to count how fast your heart beats."

A child has been admitted to the hospital with osteomyelitis. Which statement should the nurse understand as correct for this medical diagnosis? A. Cultures should be done immediately after the first dose of antibiotic infuses. B. Antibiotics are ineffective against this virus. C. Penicillin is the antibiotic of choice. D. Antibiotic therapy should continue for 3-6 weeks.

A 15-year-old has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which of the following signs and symptoms require the most immediate nursing intervention?

Fever and petechiae

During a routine pediatric visit, a 12 month old patient will need which of the following vaccines?

Hib, PCV, MMR, Varicella, HepA

Which role would the pediatric nurse be serving when reading and analyzing new research findings and applying those findings to practice? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

Researcher

Fine red rash, swollen glands, joint pain

Rubella virus

In examining a child's pupils: (pp. 111 [new], 125-126 [old]) 1. Size, shape, and symmetry of both pupils should be the same. 2. Each pupil should constrict briskly when a light is shined into the eyes. 3. Each pupil should have consensual light reflex. True or false?

True

With cyanotic heart defects, there is a right-to-left shunt: blood is shunted from the right side of the heart (pulmonary) to the left (systemic) side. Pulmonary circulation is bypassed. True or false?

True

The pediatric nurse understands that the most common cancer found in children is

acute lymphocytic leukemia

A fibrous band on the ventral side of the penis resulting in a ventral curvature of the penis

chordee

Urethral meatus located on the ventral (lower) side of the glans penis

hypospadias

A nurse enters the room of a teenager after the physician has obtained informed consent for a voiding cystourethrogram. The teenager asks the nurse to explain the procedure again. The nurse tells the client that the client is asked to void after:

injection of contrast dye into the bladder via a catheter

The nurse should expect to administer this drug for a sickle cell pain crisis

morphine sulfate

A nurse is assisting with the admission of a toddler who has nephrotic syndrome. Which of the following objective data should the nurse anticipate collecting from the child?

3+ or 4+ protein in the urine

Which of the following patients should the nurse suspect to have pyloric stenosis?

A five-week-old infant with projectile vomiting.

Match the color-coded category of the Pediatric Early Warning Score with the correct numerical score. Each choice will be used only once. (Slides # 102-103, Lecture PowerPoint) Green Yellow Orange Red A. 0-2 B. 3 C. 4 D. ≥ 5

A. 0-2 B. 3 C. 4 D. ≥ 5

The pediatric nurse takes into consideration that the primary cause of infant mortality is: (pp. 6-7) A. Congenital deformities B. Low birth weight C. Sudden infant death syndrome D. Systemic infection

A. Congenital deformities

Harness straps should fit (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. snug and tight without any slack B. loosely so the child can get out of the car easily C. below the child's shoulders in a forward facing seat D. snug, but with one finger-width of slack

A. snug and tight without any slack

An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Appropriate management of a tet spell in these children include: (Select all that apply). A. Place the child in knee-chest position. B. Draw blood for a serum hemoglobin. C. Administer oxygen. D. Administer morphine and propranolol intravenously as ordered. E. Administer Benadryl as ordered.

ACD

The pediatric nurse understands that characteristics of pulmonary hypertension include (select all that apply): A. The causes are lung disease and some congenital heart diseases. B. Characterized by mean pulmonary arterial pressure (PAP) less than 25 mmHg. C. Caused by narrowing of the pulmonary arterioles within the lung; the narrowing of the arteries creates resistance and an increased work load for the heart. D. Symptoms include chest pain, weakness, shortness of breath, and fatigue. E. Untreated, the disease usually develops into cyanotic heart defect and right-to-left shunting. F. Must treat this condition early while still reversible to prevent permanent destructive pulmonary vascular remodeling. G. Treatments include sildenafil, calcium channel blockers, diuretics, nitric oxide, and lung transplantation.

ACDFG

QUESTION 22 The pediatric nurse understands that which of the following medications used to treat asthma, is a therapeutic antibody? (pp. 499-550 [new], 544-545 [old]) A. fluticasone and salmeterol (generic), Brand name: Advair discus B. omalizumab (generic), Brand name: Xolair C. cromolyn sodium (generic), Brand name: Intal D. budesonide (generic), Brand name: Pulmicort E. beclomethasone (generic). Brand name: Qvar

ANS: B

QUESTION 33 The nurse is caring for a 15-year-old child newly diagnosed with type 1 diabetes mellitus (DM). In preparing to administer insulin, the nurse should complete the following steps in what sequence? 1. Withdraw the dose of NPH insulin. 2. Inject air into the regular insulin vial. 3. Withdraw the dose of regular insulin. 4. Inject air into the NPH insulin vial. A. 2, 3, 4, 1 B. 2, 4, 3, 1 C. 4, 1, 2, 3 D. 4, 2, 3, 1

ANS: D

A nurse is preparing to administer low-dose erythromycin (E.E.S.) to a 6-year-old child. In reviewing this medication, the nurse understands that the mechanism of action is to

Accelerate gastric emptying

Which intervention should the nurse include in care of an infant following surgical repair of a cleft lip?

Administer pain medications as ordered.

Which of the following problems is expected in a child who is in end-stage renal failure?

Anemia

A client with hemophilia has a very swollen knee after falling from riding a bicycle. Which of the following should be the first nursing action?

Apply an ice pack and compression dressings to the kn

Which of the following statements by the mother of a child with osteogenesis imperfecta demonstrates to the nurse understanding of safety measures needed to prevent injury? A. "I will use my hands to gently turn her in the bed." B. "I will use a wrinkle-free lift sheet to reposition her." C. "I will pad her floor with plenty of soft throw rugs." D. "I will confine clutter to just one section of her bedroom floor." E. "I will gently spank her when she misbehaves."

The nurse explains that the statistics of infant mortality are expressed in number of infant deaths per: (pp. 6-7) A. 100 live births B. 1000 live births C. 10,000 live births D. 100,000 live births

B. 1000 live births

The nurse explains that the statistics of infant mortality are expressed in number of infant deaths per: (pp. 6-7) A. 100 live births B. 1000 live births C. 10,000 live births D. 100,000 live births

B. 1000 live births

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that the hospitalized child at highest risk to experience separation anxiety when parents cannot stay is the (pp. 224-225 [new], 250-252 [old]) A. 6-month-old. B. 18-month-old. C. 3-year-old. D. 4-year-old.

B. 18-month-old.

Which role would the pediatric nurse be serving when providing support and assisting with resources and referrals? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

B. Case Manager

Which role would the pediatric nurse be serving when providing support and assisting with resources and referrals? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

B. Case manager.

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3-year-old experiences each morning when blood is drawn for lab studies. The most appropriate method the nurse can suggest to relieve pain associated with the venipuncture is (pp. 326-328 [new], 362-363 [old]) A. Intravenous sedation 15 minutes prior to the procedure. B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure. C. Use of guided imagery during the procedure. D. Use of muscle-relaxation techniques.

B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure.

The neonatal nurse understands that factors contributing to the development of bronchopulmonary dysplasia (BPD) include which of the following? (Select all that apply) (pp. 837-838, Lowdermilk) A. Concentrated enteral formula B. Extra oxygen for breathing C. Low amounts of surfactant D. Overnutrition E. Prematurity F. Radiant warmers G. Steroids H. Use of a mechanical ventilator

B. Extra oxygen for breathing C. Low amounts of surfactant E. Prematurity H. Use of a mechanical ventilator

The nurse is caring for a preterm infant who is at risk for an intraventricular hemorrhage (IVH). Which daily assessment is most critical for this infant? (pp. 838-839, Lowdermilk) A. Blood pressure B. Head circumference C. Intake and output D. Pupillary light reflex

B. Head circumference

The client has been diagnosed to have glomerulonephritis. What should the nurse observe in the urine?

Blood

An intramuscular injection has been prescribed for an 8-month-old child. The pediatric nurse determines which of the following anatomic sites as most appropriate for this child? A. Deltoid B. Dorsogluteal C. Vastus lateralis D. Ventrogluteal

C. Vastus lateralis

An infant weighted 7 lbs, 11 oz. at birth. What should the nurse expect this infant to weigh at 12 months of age? (pp. 80-83 [new], 92-94 [old]) A. 15 lbs. B. 20 lbs. C. 23 lbs. D. 25 lbs.

C. 23 lbs.

A child should be able to pull off her shoes by which age? (p. 85 [new], 97 [old]) A. 13 months B. 18 months C. 24 months D. 36 months

C. 24 months

Tina is 33 inches tall at 24 months. The nurse anticipates that Tina will be how many inches tall when fully grown? (pp. 85 [new], 92-94 [old]) A. 48 inches B. 60 inches C. 66 inches D. 72 inches

C. 66 inches

The nurse is caring for a child who has been sedated for a painful procedure. The priority nursing activity for this child should be (pp. 314-316 [new], 353-355 [old]) A. Allow parents to stay with the child. B. Monitor pulse oximetry. C. Assess the child's respiratory effort. D. Place the child on a cardiac monitor.

C. Assess the child's respiratory effort.

The nurse is providing anticipatory guidance to the parents of a young child on how to handle a suspected poisoning. If their child ingests poison, what should the parents do first? A. Administer ipecac syrup B. Call 911 to summon an ambulance immediately C. Call the nationwide poison control center at 1-800-222-1222 D. Punish the child for bad behavior

C. Call the nationwide poison control center at 1-800-222-1222

According to Piaget, the 7- to 11-year-old-child is at which of the following stages of cognitive development? (pp. 70-72 [new], 80-83 [old]) A. Sensorimotor B. Formal operations C. Concrete operations D. Pre-operational

C. Concrete Operations

According to the CDC schedule, which immunizations are expected for a child at 6 months of age? (pp. 160 [new], 195; 372-373 [old]) A. DTaP Rotavirus Meningococcal Hib Inactivated Polio Virus (IPV) PCV Influenza B. DTap Rotavirus Hib HPV PCV C. DTap Rotavirus Hep B Hib IPV PCV Influenza D. Hib Varicella PCV MMR DTap

C. DTap Rotavirus Hep B Hib IPV PCV Influenza

A 2-year-old child recently diagnosed with a seizure disorder will be discharged home on an oral anticonvulsant medication. Which of the following actions by the mother best demonstrates understanding of how to give the medication? The mother (p. 233 [new], 259 [old]) A. Verbalizes how to give the medication. B. Acknowledges understanding of written instructions. C. Draws up the medication correctly in an oral syringe and administers it to the child. D. Observes the nurse draw up the medication and administer it to the child.

C. Draws up the medication correctly in an oral syringe and administers it to the child.

A client and her husband are positive for the sickle cell trait. The client asks the nurse about chances of her children having sickle cell disease. Which of the following is an appropriate response by the nurse? A. one of her children will have sickle cell disease B. only the male children will be affected C. each pregnancy carries a 25% chance of the child being affected D. if she had four children, one of them would have the disease

C. Each pregnancy carries a 25% chance of the child being affected

A child is 5 years old and has been recently admitted into the hospital. According to Erikson, in which of the following stages is this child? (pp. 70-71 [new], 80 [old]) A. Trust vs. mistrust B. Autonomy vs. shame C. Initiative vs. guilt D. Intimacy vs. isolation

C. Initiative v. Guilt

Which of the following features is NOT commonly seen in children with Down syndrome? (pp. 814-815 [new], 885 [old]) A. Epicanthal folds in the eyes B. Low muscle tone C. Muscle spasticity D. Flattened mid-face E. Low-set ears

C. Muscle spasticity

Which of the following features is NOT commonly seen in children with Down syndrome? (pp. 814-815 [new], 885 [old]) A. Epi-canthal folds in the eyes B. Low muscle tone C. Muscle spasticity D. Flattened mid-face

C. Muscle spasticity

1. The nurse conducts developmental screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to: (pp. 103-105 [new], 118-120 [old]) A. Reverse degenerative processes that have occurred. B. Recognize early infection in order to prevent spread to individuals in close contact with the child. C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay. D. Measure intelligence and readiness for school. E. Diagnose a developmental impairment in physical, learning, language, or behavior areas.

C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay.

The pediatric nurse is formulating a disaster preparedness plan for disadvantaged children in a rural community. This plan includes allocation of supplies and equipment, sheltering-in-place, and roles/ assignments for healthcare personnel. This meticulous planning demonstrates which level of preventive health maintenance? (pp. 145, 213-219 [new],164, 238-245 [old]) A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention

C. Tertiary prevention

A client and her husband are positive for the sickle cell trait. The client asks the nurse about chances of her children having sickle cell disease. Which of the following is an appropriate response by the nurse? (pp. 52-53 [new], 58-59 [old]) A. one of her children will have sickle cell disease B. only the male children will be affected C. each pregnancy carries a 25% chance of the child being affected D. if she had four children, one of them would have the disease

C. each pregnancy carries a 25% chance of the child being affected

A nurse is caring for a preschooler who has muscular dystrophy. For which of the following findings should the nurse assess? (Select all that apply.) A. Purposeless, involuntary, abnormal movements B. Spinal defect and sac-like protrusion C. Muscular weakness in lower extremities D. Unsteady, wide-based or waddling gait E. Upward slant to the eyes F. Gower's sign

CDF

Identity vs. role confusion

Consumed with looks and viewpoints of others.

A newborn infant is diagnosed with tracheoesophageal fistula (TEF). The nurse assesses the infant, knowing that a typical finding in this disorder is:

Cyanosis, coughing, and choking

A client is admitted with a diagnosis of "rule out rheumatic fever." Based on Jones criteria, the nurse assesses for A. Polyarthritis and dental caries. B. Fever, headache, and low red blood cell count. C. Chorea, muscle weakness, and decreased erythrocyte sedimentation rate. D. Erythema, polyarthritis, and elevated antistreptolysin-O (ASO) titer.

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities. The next assessment the nurse should perform is to check: A. Pedal pulses. B. Pulse oximetry level. C. Hemoglobin and hematocrit values. D. Blood pressure of the four extremities.

The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia in a preop parental meeting, the nurse should explain that PCA is most appropriate for the A. A 16-year-old who is developmentally delayed and postop from bone surgery. B. A 5-year-old, postop from tonsillectomy. C. A 10-year-old who has a fractured femur and concussion from a bike accident. D. A 12-year-old, postop from spinal fusion for scoliosis.

D. A 12-year-old, postop from spinal fusion for scoliosis.

Normal heart rate (HR) and respiratory rate (RR) for an adolescent is: (choose the best response) (pp. 122, 125 [new], 137, 140 [old]) A. 100-150 HR, 33- 55 RR B. 80-120 HR, 25-40 RR C. 65-110 HR, 14-22 RR D. 60-100 HR, 12-20 RR

D. 60-100 HR, 12-20 RR

The nurse cautions a group of parents that the leading cause of childhood mortality (after the first year of life) is: (pp. 6-7) A. Chronic disease B. Homicide C. Suicide D. Accidents

D. Accidents

Symptoms of a food intolerance can include: (pp. 284-285 [new], 318 [old]) A. Bloating B. Diarrhea C. Gas D. All of the above

D. All of the above

Which of the following developmental delays are seen in children with Down syndrome? (pp. 814-815 [new], 885 [old]) A. Expressive and receptive language delays B. Cognitive impairments C. Fine and gross motor delays D. All of the above

D. All of the above

While teaching a 10 year-old child about his impending heart surgery, the nurse should: (pp. 70-72 [new], 80-83 [old]) A. Provide a verbal explanation just prior to the surgery B. Provide the child with a booklet to read about the surgery C. Introduce the child to another child who had heart surgery three days ago D. Explain the surgery using a model of the heart

D. Explain the surgery using a model of the heart

What types of disorders are abnormalities that result from an abnormal sex chromosome? (pp. 53-54 [new], 60 [old]) A. Autosomal dominant B. Autosomal recessive C. Multifactorial D. X-linked

D. X-linked

What types of disorders are abnormalities that result from an abnormal sex chromosome? (pp. 53-54 [new], 60 [old]) A. Autosomal dominant B. Autosomal recessive C. Multifactorial D. X-linked

D. X-linked

When are most children ready for regular seat belts? http://www.buckleupnc.org/occupant-restraint-laws/child-passenger-safety-law-faqs/ A. when they are 5 years old B. when they are 6 years old C. when they are 7 years old D. it depends on the child's height and how the seat belts fit

D. it depends on the child's height and how the seat belts fit

The best position for an infant to sleep is: (pp. 159, 483-484 [new], 180; 528-529 [old]) A. on the abdomen B. in an infant seat C. with the caregiver D. on the back E. lateral recumbent F. on the side

D. on the back

A nurse is developing a plan of care for 5-year-old child with a diagnosis of sickle cell anemia and formulates the following nursing diagnoses. The nurse should select which nursing diagnosis as the priority?

Deficient Fluid Volume

An infant diagnosed with hypertrophic pyloric stenosis is admitted with history of vomiting for several days. Which nursing diagnosis should be the priority?

Deficient fluid volume related to prolonged vomiting

An 8-month-old is admitted for severe diarrhea. Which of the following would be a significant finding for this child?

Depressed anterior fontanel

A child is being prepared for immediate surgery due to risk of life-threatening respiratory distress. Which of the following gastrointestinal illness is a priority consideration for this problem?

Diaphragmatic hernia

The pediatric nurse understands that first-line medication therapy for tonic-clonic status epilepticus, with prolonged or repetitive seizures, is/are:

Diazepam or lorazepam

A nurse is obtaining a history on an 18-month old child with diarrhea. Which of the following questions might help to identify the cause of this condition?

Does the child have any food sensitivities? Has the child traveled recently? Has the child been on antibiotics recently? Do any other family members have diarrhea?

Initiative vs. guilt

During this stage which occurs from ages 3 to 6 years, children develop direction and purpose. Teaching impulse control and cooperative behaviors during this stage help the child to avoid risks of altered growth and development. Develops conscience.

Industry vs. inferiority

During this stage, children develop a sense of competency. Learns to socialize.

Autonomy vs. shame and doubt

During this stage, toddlers learn to achieve self-control and willpower. Learns to control bodily functions.

The pediatric nurse understands that sildenafil (Revatio, Viagra) is prescribed to A. Decrease systemic blood pressure (afterload). B. Decrease the stickiness of the platelets in the blood. C. Decrease heart rate and increase contractility. D. Increase the central venous pressure (preload). E. Relax and widen the blood vessels in the lungs.

A child has been diagnosed with epilepsy and is on daily phenytoin (Dilantin). Client education should include

Good dental hygiene

Four-year-old Anna is seen by her pediatric nurse practitioner today. If she received prior immunizations on schedule, she is due to receive:

IPV, DTaP, and MMR and varicella

A child with myelomeningocele (meningomyelocele), corrected at birth, is now 5 years old. What is a priority nursing diagnosis for a child with corrected spina bifida at this age?

Impaired urinary elimination

Which of the following situations represents the best example of natural (innate) immunity?

Intestinal flora and gastric acid

Hirschsprung's disease

Megacolon Failure to pass meconium as neonate

Head lice

Pediculosis humanus capitis

A child presents to the local health department with scabies. The nurse is aware that the family nurse practitioner will most likely order:

Permethrin (Nix)

During a routine pediatric visit, a 4 month old patient will need which of the following vaccines?

RV, DTaP, Hib, PCV, IPV

A 10-year-old patient is admitted to 2 West by the family nurse practitioner who suspects a diagnosis of acute glomerulonephritis. The pediatric nurse would expect to see which of the following findings?

Serum creatinine of 2.2 mg/dL. Gross hematuria. Urine output of 350 ml in 24 hours. Mild periorbital edema. Brown ("tea-colored") urine. Hypertension. Blood urea nitrogen (BUN) of 40 mg/dL.

Splenic sequestration

Splenic sequestration happens when a large number of sickle cells get trapped in the spleen and cause it to suddenly get large. Symptoms include sudden weakness, pale lips, fast breathing, extreme thirst, abdominal (belly) pain on the left side of body, and fast heartbeat. When the spleen doesn't work well, a person is more likely to have serious, life-threatening infections with certain types of bacteria. If splenic sequestration happens suddenly, it can be a life-threatening emergency. Parents of a child with sickle cell disease (SCD) should learn how to feel and measure the size of their child's spleen and seek help if the spleen is enlarged.

Impetigo contagiosa

Staphylococcus or Streptococcus

A 2-year-old starts to have a tonic-clonic seizure while in a crib in the hospital. The child's jaws are clamped. The most important nursing action at this time is to

Stay with the child and observe the respiratory status

Scenario: A child with acute poststreptococcal glomerulonephritis (APSGN) is admitted to the pediatric ICU for overnight observation. When obtaining a nursing history from the child's mother, the nurse should expect a recent ________________ infection.

Streptococcal

When assessing a newborn with cleft lip, the nurse should be alert that which of the following will most likely be compromised?

Sucking ability

Hand-foot syndrome

Swelling in the hands and feet usually is the first symptom of SCD. This swelling, often along with a fever, is caused by the sickle cells getting stuck in the blood vessels and blocking the flow of blood in and out of the hands and feet. Treatment: The most common treatments for swelling in the hands and the feet are pain medicine and an increase in fluids, such as water.

Health promotion/disease prevention is an important role for nurses to prevent spina bifida. It would be most important for the nurse to explain that women of childbearing age should:

Take folic acid supplements during pregnancy

Irreversibility

They cannot reverse a sequence or logical operations. A child displaying irreversibility says 2 x 4 is different from 4 x 2. Likewise a child may be able to perform multiplication, but can't divide.

Symbolic Thinking

They start to use words, images, and symbols to represent their world. Such behaviors are characterized by: D. They start to use words, images, and symbols to represent their world. Such behaviors are characterized by: * the use of language (the word "fly" represents an annoying, buzzing creature), and * use of fantasy and imagination (remember when you built a fort out of the couch cushions?).

Egocentrism

This does not mean selfishness or conceit as social psychologists use the word. This means that children lack the ability to consider another person's point of view or perspective.

Which of the following are characteristic or descriptive of an intravenous pyelogram (IVP)? (Select-all-that-apply)

Visualize kidneys, ureters and bladder Laxatives or enemas may be ordered prior to remove gas or fecal material Nephrotoxic dye Use of intravenous contrast medium Ask about allergies to contrast or shellfish Increase fluids afterwards to flush contrast

A child with hemophilia plans on participating in a bicycling club. The nurse should recommend the child

Wear kneepads, elbow pads, and a helmet while bicycling.

Nocturnal enuresis (bedwetting) is a common problem that can be troubling for children and their families. The evaluation of nocturnal enuresis requires a thorough history, a complete physical examination, and urinalysis. Treatment options include nonpharmacologic and pharmacologic measures. Which of the following are recommended treatment strategies for this condition? (Select-all-that-apply)

a bed wetting alarm system positive reinforcement system, such as rewarding the child with a prize for staying dry at night desmopresssin (DDVAP) by nasal spray or by tablet scheduled awakenings during the night to void limit fluid intake int he evening and before the child goes to bed have the child urinate before going to bed

The nurse is developing a plan of care for a child being admitted to the hospital who is immunosuppressed and who will be placed on neutropenic precautions. With regard to neutropenic precautions, which intervention is incorrect?

admitting the client to a semiprivate room

A child with a renal condition has developed oliguria. Which action(s) should the nurse anticipate performing?

continue monitoring intake and output draw blood to check potassium and creatinine weigh the child monitor the child's bp

The nurse admitting and assessing a teenage boy with suspected testicular torsion (twisted testicle) will most likely find which of the following manifestations in addition to possible nausea and vomiting and acute testicular pain? (Select the one best answer.)

cremasteric reflex depressed or absent

Failure of one or both testicles to descend into the scrotum

cryptorchidism

The client in end-stage of renal failure had undergone kidney transplant. Which of the following assessment findings indicate kidney transplant rejection?

decreased urinary output, sudden weight gain

Which nursing diagnosis is highest-priority for a 3-year-old child undergoing chemotherapy and experiencing nausea and vomiting?

deficient fluid volume

Urethral meatus located on the dorsal (upper) side of the glans penis

epispadias

Collection of fluid in the scrotal sac

hydrocele

The administration of prednisone to children with nephrotic syndrome creates the problem of:

increased risk of infection

Place in chronological order the correct sequence for the stages of infection.

1. Incubation 2. Prodromal Stage 3. Acute Illness 4. Convalescent stage

On initial exam of a child with newly diagnosed Kawasaki disease, the nurse should expect to document: A. Dry, swollen, fissured lips. B. Non-palpable lymph nodes. C. Conjunctivitis with exudates. D. Cyanosis of the hands and feet.

The mother of a child with a heart defect is questioning the nurse about the child's medication. When discussing the diuretic the child is on, the nurse should place an emphasis on teaching about: A. Close monitoring of output. B. The digitalization process. C. The possibility that pulses in the child might be weak. D. The child's increased appetite.

The pediatric nurse understands that furosemide (Lasix): (select all that apply) A. Decreases preload B. Decreases afterload C. Increases contractility of the heart D. Has side effects of nausea, vomiting, anorexia, and bradycardia E. Has side effects of hypokalemia, metabolic alkalosis, and hypotension F. Has side effects of hyperkalemia and hypotension G. Promotes rapid diuresis by blocking reabsorption of sodium and water in the renal tubules.

AEG

QUESTION 16 A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 50 lbs. The child will receive ____ milligrams daily. (Round the answer to the tenths place.)

ANS: 45.5 mg daily

School-age children engage in a type of play that is goal-oriented (in other words, the children play in an organized manner toward a common goal). The children plan, assign roles, and play together with established rules. (p. 92 [new], 104 [old]) This type of play is known as: A. Associative play B. Cooperative play C. Goal-oriented play D. Social recreation play

B. Cooperative play

QUESTION 32 The school nurse is conducting a seminar about diabetes mellitus in the pediatric population. Learners should recognize that manifestations of type 1 diabetes in children include which of the following? (Select all that apply) (pp. 876-877 [new], 953 [old]) A. Iron-deficiency anemia B. Unexplained weight loss C. Increased thirst D. Abdominal pain E. Vomiting F. Diarrhea G. Drowsiness H. Enuresis (bed wetting) in a previously continent child

ANS: B, C, D, E, G, H (6 total)

QUESTION 15 A nurse is caring for an infant with bronchiolitis. Diagnostic tests have confirmed respiratory syncytial virus. Based on this finding, which of the following would be the appropriate nursing action(s)? (Slides 82-87, Respiratory PowerPoint lecture. pp. 490-491 [new], 536-537 [old]) (Select all that apply.) A. Institute airborne precautions. B. Institute droplet precautions. C. Institute contact precautions. D. Prepare to administer intravenous antibiotics. E. Prepare to administer nebulized albuterol. F. Cluster nursing care to allow the child to rest. G. Elevate the head of bed to ease the work of breathing. H. Initiate strict enteric precautions. I. Institute continuous cardiopulmonary monitoring.

ANS: B, C, E, F, G, I

QUESTION 13 A nurse provides care to a 10-year-old child with pharyngitis. Which clinical manifestations indicate streptococcal rather than viral pharyngitis? (p. 469 new, 512 old edition): Select all that apply. A. Mild sore throat B. Abrupt onset C. Painful cervical nodes D. Conjunctivitis E. Fever greater than 101 degrees F F. Tonsillar exudate G. Abdominal pain H. Hoarseness/ abnormal voice changes I. Cough J. Anorexia, nausea, vomiting

ANS: B, C, E, F, G, J (6 answers)

QUESTION 21 The pediatric nurse understands that which of the following medications used to treat asthma, is a mast cell inhibitor? (pp. 499-550 [new], 544-545 [old]) A. fluticasone and salmeterol (generic), Brand name: Advair discus B. omalizumab (generic), Brand name: Xolair C. cromolyn sodium (generic), Brand name: Intal D. budesonide (generic), Brand name: Pulmicort E. beclomethasone (generic), Brand name: Qvar

ANS: C

QUESTION 20 The pediatric nurse practitioner has prescribed salmeterol (Serevent) for a child with asthma. The mother asks the nurse what this medication will do. The nurse should explain that salmeterol (Serevent) is used to treat asthma because the drug (pp. 499-500 [new], 544-545 [old]) A. Is an anti-inflammatory. B. Decreases mucous production. C. Controls allergic rhinitis. D. Is a bronchodilator.

ANS: D

QUESTION 1 A nurse is assessing a neonate who is 2 hours old. The assessment finding that indicates that the neonate's respiratory status is worsening is (pp. 474- 481 [new], 520-527 [old]) A. Acrocyanosis. B. Arterial CO2 of 40. C. Periorbital edema. D. Grunting respirations with nasal flaring.

ANS: D. Grunting respirations with nasal flaring. Response Feedback: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate during the first 24 to 48 hours. CO2 of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

QUESTION 27 Pertussis (whooping cough) is spread through feces and oropharyngeal secretions of infected persons, especially young children. (pp. 354-355 [new], 390 [old]) True or false?

ANS: False

Centration

This is the tendency to focus or center on one aspect of the situation and ignore other important aspects of the situation.

Which of the following interventions are appropriate in providing care for a child in skeletal traction? (Select all that apply). A. Make sure the weights hang freely and do not touch the floor. B. Apply an antibiotic ointment around the pin, if ordered. C. Rotate pins every hour while traction is in place. D. After traction equipment is removed, provide skin care every four hours. E. Clean the pins with normal saline, when ordered. F. Adjust the pulleys and weights as needed.

ABDE

A fracture to the epiphyseal plate of a child's left arm occurs. What complication may result? A. Early-onset osteoporosis B. Reduced future growth C. Stenosis D. Juvenile arthritis

A nurse is caring for a child who has an arm cast. Which of the following is an early sign of altered neurovascular function? A. Decreased capillary refill time. B. Pain, dramatically out of proportion for the severity of injury. C. Inability to detect a pulse distal to the cast. D. Inability to move distal extremity. E. The arm is cool to the touch (the same temperature as the local environment).

A nurse is caring for a preschooler who walks but has difficulty keeping up with peers. The nurse is assessing the preschooler for possible right developmental dysplasia of the hip (DDH). Which of the following assessments should the nurse use to assess for DDH? A. Barlow test B. Trendelenburg sign C. Manipulation of right foot and ankle D. Ortolani test

A nurse is evaluating the pin sites of a child with an external fixator. The nurse is least concerned with A. Redness and inflammation B. Serous drainage C. Pain at pin site D. Purulent drainage E. Pain and tenderness over the affected area of bone

An infant has just returned from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. The nurse should A. Call the physician to report the edema. B. Elevate the legs on pillows. C. Apply a warm, moist pack to the feet. D. Encourage movement of toes.

Hypertrophic pyloric stenosis

Constriction of the pyloric sphincter with obstruction of the gastric outlet Olive shaped mass in the right upper quadrant

Which of the following nursing interventions is most effective in relieving joint stiffness and muscle spasm in a 10-year-old girl with juvenile arthritis? A. Provide support to flexed joints with pillows and pads. B. Position her on her abdomen several times a day. C. Massage the inflamed joints with creams and oils. D. Assist her with heat application and ROM exercises.

Which of the following instructions should be provided to parents of an infant with gastroesophageal reflux?

Elevate the head of the crib

What notable sign may indicate increased intracranial pressure in an infant?

High-pitched cry

Which intervention should NOT be included in the preoperative plan of care for an infant with gastroschisis or omphalocele?

Push the abdominal contents back into the abdomen.

Which of the following statements by a teenager with a seizure disorder should indicate to the nurse that she has understood client teaching regarding her extended-release carbamazepine (Tegretol) medication?

"I will be careful not to crush my Tegretol pill, because I might get too much medication at once."

Match the following types of traction to the accurate description. Each item is used only once. 1. Skin traction. Used to TEMPORARILY immobilize a fractured leg or injured knee. Also used to correct lower extremity contractures or deformities. 2. Skin traction. Both lower extremities flexed 90° at hips (even if only one extremity is affected). Keep the buttocks slightly elevated off the bed. Used in children younger than 3 years old to stabilize hips or to reduce femur fractures (developmental hip dysplasia, fractured femur, after bladder exstrophy repair). Traction may be followed by application of a hip-spica cast. 3. Skin traction. Two lines of pull on lower extremity, perpendicular and longitudinal. Fracture of hip or femur (thigh bone). 4. Skin or skeletal traction. Two lines of pull on the arm. Fracture of the humerus (long bone in upper arm) or elbow fracture. 5. Skeletal traction. Used on femur if skin traction isn't suitable. 90degree flexion of both hip and knee; lower extremity in a boot cast. Weights are suspended by a pin through the lower portion of the thighbone. Fracture of femur (thighbone). 6. Skin or skeletal fraction. Stabilizes a spinal fracture or muscle spasm. A. Buck Traction B. Bryant Traction C. Russell's Traction D. Dunlop Traction E. 90-90 Degree Traction F. Cervical Traction

1 - A 2 - B 3 - C 4 - D 5 - E 6 - F

Match the following fractures to the accurate descriptions. Each item is used only once. 1. Perpendicular to the long axis of bone. 2. Only one cortex of the bone has a fracture. In other words, cracks in only one side of the cortex. 3. Instead of a right angle, the bone has broken at an angle to the long axis of the bone. 4. A twisting motion causes the fracture. A. Greenstick B. Transverse C. Oblique D. Spiral

1 - B 2 - A 3 - C 4 - D

Match the descriptor with the condition. Each term is used only once. 1. Use of arms and hands in rising from a sitting to a standing position by "climbing up the thighs" in grasping and pulling on body parts from the knees to hips. 2. C-shaped (one curve) or S-shaped curvature (two curves) in the spine. 3. Fasciotomy to relieve pressure on nerves and blood vessels 4. Asymmetrical buttock creases, hip click or pop, hips with limited range of motion (hips can't fully spread). 5. Bones in the front half of the foot bend or turn in toward the body. Foot can be manually straightened out. 6. The foot turns inward and downward. Cannot be manually straightened out. 7. Extremely fragile bones 8. Long-term (chronic) disease resulting in joint pain and swelling. May also have red eyes and eye pain (uveitis). 9. A condition in which the knees stay wide apart when the child stands with the feet and ankles together. It is considered normal in children under 2 to 3 years of age. 10. Occurs when the ball of the thighbone in the hip does not get enough blood, causing the bone to die. 11. EOccurs when the femoral head displaces from the femoral neck, most often during the adolescent growth spurt. Happens more in boys than girls. A. Osteogenesis imperfecta B. Developmental dysplasia of the hip C. Scoliosis D. Congenital talipes equinovarus (clubfoot) E. Juvenile idiopathic arthritis F. Muscular dystrophy G. Slipped Capital Femoral Epiphysis (SCFE) H. Legg-Calve-Perthes disease I. Compartment syndrome J. Genu varum (bowlegs) K. Metatarsus adductus

1 - F 2 - C 3 - I 4 - B 5 - K 6 - D 7- A 8 - E 9 - J 10 - H 11 - G

A 14-year-old female will receive a Milwaukee brace to correct scoliosis with a 24 degree curve. Reviewing her discharge instructions, the nurse recognizes that the client has received adequate teaching when she says she will A. Wear the brace all day and remove it only to bathe. B. Put the brace on a minimum of one hour, three times per day. C. Wear the brace after school and at night. D. Take off the brace if her skin gets sore or starts to break down.

A child must wear a brace for correction of scoliosis. The nursing diagnosis that should be included in this child's plan of care is A. Risk for Impaired Skin Integrity. B. Risk for Delayed Development. C. Risk for Activity Intolerance. D. Risk for Decreased Cardiac Output. E. Risk for Disuse Syndrome.

An 8-year-old boy with Duchenne muscular dystrophy (DMD) is being seen in the clinic for a routine health visit. A high-priority nursing diagnosis for this patient is A. Risk for Falls Related to Breakdown of Muscles. B. Risk for Infection Related to Altered Immune System. C. Risk for Impaired Skin Integrity Related to Loss of Sensation. D. Risk for Corneal Injury Related to Eye Inflammation (Uveitis).

The nurse in the newborn nursery is doing the admission assessment on a neonate. Developmental dysplasia of the hip (DDH) should be suspected when the nurse observes A. Asymmetry of the gluteal and thigh fat folds. B. Trendelenburg sign. C. Telescoping of the affected limb. D. Lordosis.

Which statement would reassure the nurse that the parents understand the teaching regarding their 4-year-old with genu valgum? A. "This is a normal developmental issue that will improve as the child grows." B. "Casting will be needed to correct the deformity." C. "This deformity is a manifestation of arthritis and osteoporosis." D. "This deformity was caused by a vitamin D deficiency."

A school health nurse is screening for scoliosis. What assessment findings should the nurse look for? (Select all that apply.) A. Uneven shoulders and hips. B. A one-sided rib hump. C. Prominent scapula. D. Lordosis. E. Pain.

ABC

A child with developmental dysplasia of the hip has a spica cast applied. Which action(s) specific to the spica cast should be taken? (Select all that apply) A. Check for cracks or breaks in the cast. B. Ensure the child's head is higher than his feet. C. Assess for circulation, movement, and sensation. D. Measure the blood pressure frequently. E. Auscultate the bowel sounds. F. Use the rod between the child's legs to lift and turn the child. G. Check for swelling and tightness. H. Position with feet elevated above heart level. I. Place a disposable diaper inside the edges of the rear part of the cast.

ABCEGI

The nurse is caring for a child in Bryant skin traction. Which nursing interventions ensure proper care of this client? Select all that apply. A. Inspect traction weights regularly to make sure they hang freely. Weights should not touch the floor, bed, or each other. B. Check pin sites and surrounding skin regularly for signs of infection. C. Make sure ropes are positioned properly in the pulley track, the pulleys move freely, and the pulleys hang freely. D. Adjust pulleys and weights to provide the proper pull and alignment on the affect part. E. Place the child in a prone position to maintain good alignment. F. Check the traction frequently to ensure that proper alignment is maintained. G. Check feet for color, pulses, warmth, and sensation, every 2 hours. H. Observe frequently for skin breakdown on both legs. I. Move the child as infrequently as possible to maintain traction.

ACFGH

A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following are appropriate home care instructions? (Select all that apply.) A. Sleep on a firm mattress. B. Use cold compresses for joint pain. C. Take ibuprofen (Motrin) on an empty stomach. D. Take frequent rest periods throughout the day. E. Perform range-of-motion exercises when inflammation has subsided.

ADE

The pediatric nurse is caring for a neonate with congenital clubfoot. The child has a cast to correct the defect. Before discharge, what should the nurse tell the parents? A. The cast will be removed in 6 weeks. B. A new cast is needed every week. C. A short leg cast is applied when the baby is ready to walk. D. The cast will be removed when the baby begins to crawl. E. A foot abduction brace is applied after the first week of casting.

Which situation should alert the school nurse that a child requires additional assessment for Legg-Calvé-Perthes disease? A. A 7-year-old girl complaining of a muscle spasm in her calf B. A 7-year-old boy who is limping and states that his hip hurts C. A 10-year-old boy with a fever and complaints of knee pain D. A 16-year-old girl with swollen knees and ankles who is limping

Which type of medication is most commonly used to treat juvenile arthritis? A. Glucocorticoids (prednisone) B. Non-steroidal ant-inflammatory drugs (NSAIDs) C. Disease-modifying antirheumatic drugs (DMARDs) D. Biologic response modifiers (immunomodulators)

A nurse is caring for a child hospitalized for osteomyelitis of the left lower extremity. Which of the following interventions should be included in the child's plan of care? (Select all that apply.) A. Avoid administration of opioid analgesics for pain. B. Administer intravenous antibiotics. C. Encourage increased fluid intake. D. Assess for rising ESR levels, which indicate healing. E. Assess the child for signs of infection. F. Ambulate three times daily, to prevent blood clots.

BCE

A nurse is assessing a child after a fractured femur. Signs that compartment syndrome is occurring are: (Select all that apply.) A. Pink, warm extremity. B. Pain not relieved by pain medication. C. Dorsalis pedis pulse present. D. Prolonged capillary-refill time with paresthesia.

Which of the following foods are allowed on the ketogenic diet?

Bacon Avocado Beef hot dog Heavy cream Green beans Cottage cheese

A nurse is doing a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment would indicate a malfunction in the shunt?

Bulging fontanel

A nurse is caring for a child who has just received a cast. Which of the following considerations is important in providing care for this child? A. Apply powder to the inside edges of the cast to help decrease moisture. B. When handling the cast in the first 24 hours, use fingertips only. C. Assess the casted extremity every 15-30 minutes the first two hours after cast application. D. Give the child a blunt object to help with the itching under the cast. E. To decrease irritation, put lotion on the skin.

A nurse notes blue sclerae during a newborn assessment. The infant should be checked for A. Anemia. B. Juvenile idiopathic arthritis. C. Osteogenesis imperfecta. D. Muscular dystrophy. E. Hypoxia of tissue. F. Elevated bilirubin.

A child has just returned from surgery after spinal-fusion surgery. The nurse should check for signs of A. Increased intracranial pressure. B. Seizure activity. C. Impaired pupillary response during neurological checks. D. Impaired color, sensitivity, and movement to lower extremities.

A nurse is educating a family about the type of fracture their 8-year-old son has experienced. Which of the following would be an accurate way to explain a closed fracture of the radius to the family? A. "One in which a wound through the overlying soft tissues communicates with the site of the break." B. "One of the bones in the leg is broken incompletely, like a green twig." C. "One of the bones in the arm broke completely and penetrated the skin." D. "One of the bones in the arm broke completely, but did not penetrate the skin." E. "One of the bones in the leg is crushed and broken into little pieces."

A nurse performs triage in a pediatric orthopedic clinic. Which of the following should the nurse recognize as a symptom of slipped capital femoral epiphysis (SCFE)? A. Intense knee pain while at rest. B. Presence of a limp in a younger school-age child. C. Painful external rotation of the affected leg. D. Pain in the hip of a preadolescent child.

A school nurse is evaluating a child who hurt her leg in gym class. The nurse believes it is a muscle strain, but is still going to refer her to her pediatric nurse practitioner. Which instruction should the child follow until she is seen by the PNP? A. Increase motion to the extremity quickly to increase circulation. B. Try to walk on it, even if she experiences pain. C. Go back to gym class and participate. D. Apply ice for 15 minutes at a time.

The school nurse is performing musculoskeletal screening examinations for students in the fifth grade class. The nurse notes that a student's shoulders are at different heights—one shoulder blade is more prominent than the other. The student also has a raised, prominent hip and an uneven waist. These findings may indicate: A. Torticollis. B. Kyphosis. C. Lordosis. D. Scoliosis.

A child is being discharged after surgery for a myelomeningocele (meningomyelocele) repair. Before discharge, the nurse works with the parents to establish a catheterization schedule to prevent urinary tract infection. With what frequency should the nurse instruct the parents to catheterize the child

Every 3-4 hours

GERD

Excess spitting up or forceful vomiting

Which assessment finding should lead the nurse to suspect esophageal atresia in an infant?

Excessive drooling

A child has sustained a traumatic brain injury and is being monitored in the pediatric intensive-care unit. The nurse is using the Glasgow Coma Scale to assess the child. What will the nurse be assessing for this scale? Select all that apply

Eye opening Verbal response. Motor response.

A child with a known seizure disorder is hospitalized for an unrelated procedure. After walking the child back from the restroom, the nurse notes tonic-clonic movements. Which action should the nurse take first?

Note the time

A child with leukemia is being discharged after beginning chemotherapy. Which of the following instructions should the nurse include when teaching the parents of this child?

Notify the provider if the child's temperature exceeds 101 F (38 Avoid fresh vegetables that are not cooked or peeled. do not take the child's temperature by the rectal route live, attenuated vaccines should not be administered to children with weakened immune systems

A child is admitted with gastroenteritis from suspected rotavirus. To prevent the spread of this disease, the nurse should

Observe enteric contact precautions

After striking his head on a tree while falling from a ladder, a 17-year-old male is admitted to the emergency department. He is unconscious and his pupils are nonreactive. Which intervention would be the most dangerous for the client?

Perform a lumbar puncture

A child with a mild traumatic brain injury is being sedated with a mild sedative so that pain and anxiety are minimized. The nurse should

Place a continuous-pulse oximetry monitor on the child. Place the child in a room near the nurse's station.

A 15-year-old wrestler who suffered a concussion after being thrown on his head during a match was seen in the emergency room for assessment and observation. After providing the parent with discharge instructions about post-concussion syndrome, the nurse knows that the parents have understood the instructions if they state they

Plan to speak to his teachers about the injury

A nurse is preparing an educational session with parents of newborns. Which of the following should be included in the teaching in relation to the differences seen in newborns and their gastrointestinal system?

Safe and successful oral feeding in the neonate is dependent on the proper development of sucking and swallowing, and their coordination with breathing. Newborns get more gas in the abdomen. Newborns have a smaller stomach capacity. Newborns have faster movement of contents through the alimentary canal.

A 4-year-old-child has been admitted with a diagnosis of sickle cell anemia. The nurse should expect to see which of the following lab results for this child?

Serum hemoglobin 7.7 g/dL

A 7-year-old child has been admitted with a diagnosis of appendicitis. The nurse should expect to see which of the following lab results for this child?

Serum leukocytes 22,000/microliter

Infants less than 1 year of age who present with apnea, seizures, lethargy, respiratory difficulty, coma, or death should be suspected of:

Shaken baby syndrome

A child with gastroesophageal reflux disease (GERD) is prescribed omeprazole (Prilosec) to treat this condition. The pediatric nurse understands that the mechanism of action of omeprazole (Prilosec) is which of the following?

This medication binds to the proton pump, inhibiting acid secretion by the parietal cells of the stomach lining.

Which assessment finding would be most likely found on an infant diagnosed with Hirschsprung's disease?

Weight less than normal for height and age

Which question would be most helpful in obtaining a nursing history from the mother of an infant with suspected intussusception?

What do your child's stools look like?

The nurse concludes that a parent of an otherwise healthy child with varicella (chickenpox) has an accurate understanding of the disease when the parent states which of the following?

"I will send my child back to school when all the lesions are dry and crusted over."

A nurse is discharging an infant after a pyloric stenosis repair. Which statement by the mother would indicate the need for further instructions prior to discharge?

"If my infant vomits, I should hold feedings for 6 hours."

Match the following congenital heart defects with the correct descriptor. There is only one descriptor per each defect. 1. Tetralogy of Fallot (TOF) 2. Atrial Septal Defect (ASD) 3. Truncus Arteriosus (TA) 4. Coarctation of the Aorta (COA) 5. Atrioventricular Septal Defect 6. Transposition of the Great Arteries (TGA) 7. Patent Ductus Arteriosus (PDA) A. Aorta is lined up just over the hole between the bottom two chambers of the heart. B. There is a hole between the top two chambers of the heart. C. One large blood vessel with a single valve leaves the heart. D. There is a narrowing of the major artery from the heart to the body. E. There is a hole between the top two chambers and the bottom two chambers of the heart. Common with Down syndrome. F. The pulmonary artery and the aorta are in opposite position of where they should be. Two noncommunicating circulatory systems—a condition incompatible with life. G. There is an open connection between the aorta and the pulmonary artery.

1 - A 2 - B 3 - C 4 - D 5 - E 6 - F 7 - G

Tina is 33 inches tall at 24 months. The nurse anticipates that Tina will be how many inches tall when fully grown? (pp. 85 [new], 92-94 [old]) A. 48 inches B. 60 inches C. 66 inches D. 72 inches

66 inches

A 2-year-old child is being discharged home and will have palliative surgery for tetralogy of Fallot at a later date. The mother wants to know about how much physical activity she can allow for the child. The nurse's best answer is: A. "Allow the child to regulate her activity." B. "Keep her on complete bedrest." C. "Limit her activities to a few hours." D. "Keep the child from crying."

A 7-year-old client is diagnosed with rheumatic fever. The physician orders throat cultures of all family members. The nurse explains that: A. "Family members can carry streptococcus and be asymptomatic." B. The child must have infected others." C. "Rheumatic fever is familial." D. "Family members can carry the virus for rheumatic fever."

A baby is observed at birth to be noncyanotic. On physical examination the patient is found to have a continuous "machinery-type" murmur that is present in both systole and diastole. A nonsteroidal anti-inflammatory drug is prescribed, and on follow-up the murmur has disappeared. Which of the following is the most likely congenital lesion? A. Patent ductus arteriosus B. Tetralogy of Fallot C. Transposition of the great arteries D. Truncus arteriosus

A child is being seen in the ambulatory clinic for a sore throat diagnosed as caused by group A beta hemolytic streptococcus. The nurse provides care with the understanding that the risk of developing rheumatic fever is greatest: A. Two weeks later. B. Prior to the administration of an antibiotic. C. Once the child has begun antibiotic therapy. D. With the onset of the strep infection.

A school-age child is admitted with a suspected acyanotic heart disease. After learning that the heart defect is a congenital disorder, the parents ask the nurse how they could have missed the problem all these years. The nurse's response should include the information that: A. Acyanotic heart disease may be asymptomatic. B. The child would only be cyanotic with great exertion. C. The parents should have recognized the symptoms associated with an acyanotic heart defect. D. The parents were probably ignoring the symptoms and hoping they would go away.

In assessing children with congenital heart defects, the nurse would expect to see clubbing of the fingers and toes in the child diagnosed with: A. Tetralogy of Fallot. B. Atrial septal defect. C. Coarctation of the aorta. D. Patent ductus arteriosus.

The nurse has admitted a child with a ventricular septal defect (VSD) to the unit. An appropriate nursing diagnosis for this child is A. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow. B. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect. C. Acute Pain Related to the Effects of a Congenital Heart Defect. D. Hypothermia Related to Decreased Metabolic State.

The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calve-Perthes disease. The nurse knows further teaching is needed about the condition if the family states, A. "We're glad this will only take about six weeks to correct." B. "We understand swimming is a good sport for Legg-Calve-Perthes." C. "We know to watch for areas on the skin the brace may rub." D. "We understand that abduction of the affected leg is important."

The nurse is developing a discharge teaching plan for the family of a child with Kawasaki's disease. Which of the following is the first priority? A. Teaching parents to administer aspirin and watch for side effects. B. Monitoring the child's temperature and notifying the doctor if it is over 98.6 degrees F. C. Recommending the child avoid contact sports. D. Establishing home schooling for 6 months.

A 10-year-old child has just received his first immunization of influenza vaccine. His lips begin to swell, and he states, "It feels like my throat is closing shut and my chest is tight when I breathe." The nurse recognizes these as signs of which of the following?

A life-threatening reaction to the influenza vaccine

Stroke

A stroke can happen if sickle cells get stuck in a blood vessel and clog blood flow to the brain. About 10% of children with SCD will have a symptomatic stroke. Stroke can cause learning problems and lifelong disabilities. Prevention: Children who are at risk for stroke can be identified using a special type of exam called, transcranial Doppler ultrasound (TCD). If the child is found to have an abnormal TCD, a doctor might recommend frequent blood transfusions to help prevent a stroke. People who have frequent blood transfusions must be watched closely because there are serious side effects. For example, too much iron can build up in the body, causing life-threatening damage to the organs.

During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. The nurse should A. Administer prescribed analgesic. B. Ask the child's parents if they think the child is hurting. C. Reassess the child in 15 minutes to see if the pain rating has changed. D. Do nothing, since the child appears to be resting.

A. Administer prescribed analgesic.

The nurse is working with a school-age child who is hospitalized. In planning care that will promote a sense of industry in this child, the nurse should A. Allow the child to assist with her care. B. Encourage parents to participate in the child's care. C. Give the child a detailed scientific explanation of the illness. D. Speak to the child in a high-pitched voice.

A. Allow the child to assist with her care.

The nurse is working with an adolescent who will be admitted to the hospital in two days. The appropriate nursing approach to prepare the adolescent for hospitalization is A. Have teens who have had similar experiences talk to the adolescent about hospitalization. B. Provide an opportunity for the child to talk with an adult who has had a similar experience. C. Teach parents what to expect so the information can be shared with the adolescent. D. Provide an opportunity for the teen to try on surgical attire.

A. Have teens who have had similar experiences talk to the adolescent about hospitalization.

A 2-year-old is hospitalized with a fractured femur. In addition to pain medication, which of the following will best provide pain relief for this child? A. Parents' presence at the bedside. B. Age-appropriate toys. C. Deep-breathing exercises. D. Videos for the child to watch.

A. Parents' presence at the bedside.

The nurse is working with a hospitalized preschool-age child. The nurse is planning activities to reduce anxiety in this child. The most appropriate action by the nurse is to A. Provide the child with a doll and safe medical equipment. B. Read a story to the child. C. Use an anatomically correct doll to teach the child about the illness. D. Talk to the child about the hospitalization.

A. Provide the child with a doll and safe medical equipment.

Which of the following are accurate statements concerning avoidant-restrictive food intake disorder (ARFID)? (ARFID was formerly known as failure to thrive.) Select all that apply: (pp. 299-300 [new], 332-333 [old]) A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weight-for-length that is less than 80%. B. The cause of ARFID can be organic or nonorganic. C. Most cases of ARFID are organic, such as inborn errors of metabolism, congenital heart defect, or neurologic disease. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parent-child interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs. G. ARFID accounts for 25% of pediatric hospitalizations in children under 1 year of age.

A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weight-for-length that is less than 80%. B. The cause of ARFID can be organic or nonorganic. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parent-child interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs.

Which of the following are accurate statements concerning avoidant-restrictive food intake disorder (ARFID)? A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weightforlength that is less than 80%. B. The cause of ARFID can be organic or nonorganic. C. Most cases of ARFID are organic, such as inborn errors of metabolism, congenital heart defect, or neurologic disease. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parentchild relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parentchild interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs. G. ARFID accounts for 25% of pediatric hospitalizations in children under 1 year of age.

A. ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and weight-for-length that is less than 80%. B. The cause of ARFID can be organic or nonorganic. D. Most cases of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues. E. A multidisciplinary approach to treatment, including home nursing visits and nutritional counseling, has been shown to improve weight gain, parent-child relationships, and cognitive development. F. Nursing care centers on performing a thorough history and physical assessment, documenting accurate weight and height, observing parent-child interactions during feeding times,and providing teaching to enable parents to respond appropriately to their child's needs.

A nurse admits a three-month-old infant to the pediatric floor for observation, with a medical diagnosis of Brief Resolved Unexplained Event (BRUE) (formerly Apparent Life-Threatening Event [ALTE]). A brief examination reveals that the child is alert, has an even and unlabored respiratory rate and effort, warm and pink skin, an instant capillary refill, oxygen saturation of 99%, and the pulse rate is regular at 124. An excerpt from the History of Present Illness is as follows: "The mother says she was holding the infant in her arms when the child stopped breathing. She had just had a bowel movement in her diaper. The mother yelled for her husband, who came, grabbed the infant and blew in her face. The mother states the child had 'turned a blue color' and didn't breathe until the husband blew in her face. She remained limp, moving little, and never cried. After approximately three minutes, the child returned to her normal active state." According to Gordon's Functional Health Patterns, which focus is priority for the nurse to assess? (pp. 481-482 [new],527-528 [old]) A. Activity Exercise Pattern B. Elimination Pattern C. Nutritional-Metabolic Pattern D. Sleep-Rest Pattern

A. Activity Exercise Pattern

During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. The nurse should (pp. 318-327 [new], 353-361 [old]) A. Administer prescribed analgesic. B. Ask the child's parents if they think the child is hurting. C. Reassess the child in 15 minutes to see if the pain rating has changed. D. Do nothing, since the child appears to be resting.

A. Administer prescribed analgesic.

Which stage of development is most unstable and challenging regarding development of personal identity? (pp. 70-71 [new], 80 [old]) A. Adolescence B. Preschool age C. School age D. Toddler

A. Adolescence

Which stage of development is most unstable and challenging regarding development of personal identity? (pp. 70-71 [new], 80 [old]) A. Adolescence B. Preschool age C. School age D. Toddler

A. Adolescence

A 3-year-old child with a history of strabismus has an eye-patch over her eye. This is likely due to: (p. 447 [new], 490 [old]) A. Amblyopia B. Astigmatism C. Conjunctivitis D. Myopia E. Ptosis F. Uveitis

A. Amblyopia

Huntington's disease, neurofibromatosis-1, achondroplasia, and Marfan syndrome are examples of genetic conditions transmitted by which pattern of inheritance? (p. 52 [new], 59 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

A. Autosomal Dominant

If a disorder is (fill in the blank) , it means the affected person only needs to get the abnormal gene from one parent to inherit the disease. One of the parents has to have the disorder. These disorders involve altered genes on autosomes rather than the sex chromosomes X and Y. Both males and females have an equal chance of being affected. There is a 50% chance of an affected child. (pp. 51-52 [new], 58 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

A. Autosomal Dominant

A. Autosomal dominant

The Pediatric Early Warning Score (PEWS) has been found to be a reliable tool for use by the bedside nurse to identify early patient instability. This score is generated from an assessment of which three parameters? (Slide # 103, Lecture PowerPoint) Select all that apply: A. Behavior B. Blood pressure C. Cardiovascular D. Level of consciousness E. Communicative skills F. Respiratory G. Skin status H. Vital signs

A. Behavior C. Cardiovascular F. Respiratory

The Pediatric Early Warning Score (PEWS) has been found to be a reliable tool for use by the bedside nurse to identify early patient instability. This score is generated from an assessment of which three parameters? Select all that apply: A. Behavior B. Blood pressure C. Cardiovascular D. Level of consciousness E. Communicative skills F. Respiratory G. Skin status H. Vital signs

A. Behavior C. Cardiovascular F. Respiratory

Which assessment finding by the nurse would be least suggestive of respiratory distress syndrome (RDS) in an infant? (pp. 836-837, Lowdermilk) A. Bloating or swelling of the belly (abdominal distention) B. Breathing that stops and starts (apnea) C. Chest retractions (pulling in at the ribs and sternum during breathing) D. Tachypnea (rapid breathing)

A. Bloating or swelling of the belly (abdominal distention)

A characteristic sign of necrotizing enterocolitis (NEC) in the newborn is: (Lowdermilk, pp. 839-840) A. Bloody diarrhea B. Necrosis of the abdomen C. Projectile vomiting D. High fever

A. Bloody diarrhea

Neonatal abstinence syndrome (also called NAS) is a group of conditions a newborn can have if he's exposed to addictive street or prescription drugs in the womb before birth. A baby can get addicted to these drugs and then go through drug withdrawal after birth. Which of the following are signs and symptoms of NAS? (p. 770 [new], 837 [old]) Select all that apply: A. Body shakes B. Excessive crying C. Poor feeding D. Respiratory depression E. Excessive sleepiness F. Stuffy nose G. High-pitched cry

A. Body shakes B. Excessive crying C. Poor feeding F. Stuffy nose G. High-pitched cry

Neonatal abstinence syndrome (also called NAS) is a group of conditions a newborn can have if he's exposed to addictive street or prescription drugs in the womb before birth. A baby can get addicted to these drugs and then go through drug withdrawal after birth. Which of the following are signs and symptoms of NAS? A. Body shakes B. Excessive crying C. Poor feeding D. Respiratory depression E. Excessive sleepiness F. Stuffy nose G. High-pitched cry

A. Body shakes B. Excessive crying C. Poor feeding F. Stuffy nose G. High-pitched cry

The pediatric nurse is performing a developmental screen on a 15-month-old child. This child should typically be able to: (See: "Toddler Developmental Grid" in the Course Packet) A. Build a 3-block tower. B. Speak with a vocabulary of 10 words. C. Throw a ball without falling. D. Turn the pages of a book.

A. Build a 3-block tower.

A child must be able to sit before he can walk. This is an example of which directional pattern of development? (pp. 66-67 [new], 77-78 [old]) A. Cephalocaudal B. Proportional C. Proximodistal D. Linear

A. Cephalocaudal

A. Congenital deformities

A maternity nurse is providing instruction to a new mother regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse should instruct the mother to: (Choose the one best answer.) (pp. 70-71 [new], 80 [old]) A. Consistently meet the infant's needs, when the newborn signals a need. B. Anticipate all of the needs of the newborn infant. C. Avoid the newborn infant during the first 10 minutes of crying. D. Attend to the newborn infant immediately when crying.

A. Consistently meet the infant's needs, when the newborn signals a need.

Please match the Erikson stage with the correct descriptor. Only one descriptor will be used with each item. (pp. 70-71 [new], 80 [old]) Trust vs. mistrust D Autonomy vs. shame and doubt B Initiative vs. guilt E Industry vs. inferiority C Identity vs. role confusion A

A. Consumed with looks and viewpoints of others. B. During this stage, toddlers learn to achieve self-control and willpower. Learns to control bodily functions. C. During this stage, children develop a sense of competency. Learns to socialize. D. The first stage, during which children develop faith and optimism. Develops mistrust if the needs are not adequately met. E. During this stage which occurs from ages 3 to 6 years, children develop direction and purpose. Teaching impulse control and cooperative behaviors during this stage help the child to avoid risks of altered growth and development. Develops conscience.

Preterm infants are at risk for cold stress. Which signs should alert the nurse that the preterm infant may be hypothermic? (p. 818, Lowdermilk) (Select all that apply) A. Cyanosis B. Hypoglycemia C. Irritability D. Periodic breathing pattern E. Bradycardia F. Abdominal distention

A. Cyanosis B. Hypoglycemia C. Irritability E. Bradycardia

Clinical manifestations of prematurity include: (p. 554, Lowdermilk) A. Disproportionately large head B. Fine hair (lanugo) covering much of the body C. Abundant scalp hair D. Lack of fat stores E. Sunken fontanels F. Thin, translucent skin G. Dry, loose, peeling skin H. Visible creases on palms and soles of feet

A. Disproportionately large head B. Fine hair (lanugo) covering much of the body D. Lack of fat stores F. Thin, translucent skin

Which of the following are accurate statements concerning anticipatory guidance? (Select all that apply.) (pp. 145-146 [new], 163-164 [old]) A. Examples of anticipatory guidance are informing parents of newborns about physical changes in their infant (e.g., teething), and anticipating concerns in parents of adolescents due to alcohol and drug abuse. B. Anticipatory guidance is key to achieving a primary goal of pediatric nursing care, which is health promotion. C. Anticipatory guidance, when implemented correctly and consistently, prevents all accidents and injuries from occurring in young children. D. This is guidance provided by the pediatric nurse to parents, in anticipating likely upcoming concerns with the child. E. A thorough knowledge of the principles of growth and development is not always necessary. F. Anticipatory guidance is challenging because of the range and complexity of appropriate issues, the enormous individual differences among normal children and their families, and the limited time in health supervision visits.

A. Examples of anticipatory guidance are informing parents of newborns about physical changes in their infant (e.g., teething), and anticipating concerns in parents of adolescents due to alcohol and drug abuse. B. Anticipatory guidance is key to achieving a primary goal of pediatric nursing care, which is health promotion. D. This is guidance provided by the pediatric nurse to parents, in anticipating likely upcoming concerns with the child. F. Anticipatory guidance is challenging because of the range and complexity of appropriate issues, the enormous individual differences among normal children and their families, and the limited time in health supervision visits.

A 5-year-old is hospitalized with a fractured femur. Which of the following assessment tools are appropriate for this age child? Select all that apply. A. FACES pain scale. B. Numeric Rating Scale. C. Visual Analog Scale. D. Oucher Scale. E. PAT Tool. F. FLACC Scale.

A. FACES pain scale. D. Oucher Scale. F. FLACC Scale.

Eight-year old Steven has a difficult time making friends at school. He has trouble completing his schoolwork accurately and on time, and as a result, receives little positive feedback from his teacher and parents. According to Erikson's theory, failure at this stage of development results in _____________? (pp. 70-71 [new], 80 [old]) A. Feelings of inferiority B. A sense of guilt C. A poor sense of self D. Mistrust

A. Feelings of inferiority

Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) When child abuse is suspected, the nurse's initial assessment should include: A. Gathering information from many sources to determine how the injury occurred. B. Talking with the parents only about the injury. C. Looking for risk factors of abuse to confirm suspicions. D. Making sure the parents are aware that abuse is suspected.

A. Gathering information from many sources to determine how the injury occurred.

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) When child abuse is suspected, the nurse's initial assessment should include: A. Gathering information from many sources to determine how the injury occurred. B. Talking with the parents only about the injury. C. Looking for risk factors of abuse to confirm suspicions. D. Making sure the parents are aware that abuse is suspected.

A. Gathering information from many sources to determine how the injury occurred.

Factors that contribute to childhood morbidity are: (Select all that apply.) (pp. 7-8) A. General health B. Ethnicity C. Psychosocial factors D. Climate E. Socioeconomic factors

A. General health C. Psychosocial factors E. Socioeconomic factors

Factors that contribute to childhood morbidity are: (Select all that apply.) (pp. 7-8) A. General health B. Ethnicity C. Psychosocial factors D. Climate E. Socioeconomic factors

A. General health C. Psychosocial factors E. Socioeconomic factors

The actual time that the fetus remains in the uterus is termed: (Lowdermilk, pp. 554, 817) A. Gestational age B. Intrauterine growth rate C. Neurological age D. Level of maturation

A. Gestational age

Match the color-coded category of the Pediatric Early Warning Score with the correct numerical score. Each choice will be used only once. Green Yellow Orange Red A. 0-2 B.3 C.4 D. ≥ 5

A. Green B. Yellow C. Orange D. Red

The nurse is working with an adolescent who will be admitted to the hospital in two days. The appropriate nursing approach to prepare the adolescent for hospitalization is (pp. 226-227; 234 [new], 253; 260 [old]) A. Have teens who have had similar experiences talk to the adolescent about hospitalization. B. Provide an opportunity for the child to talk with an adult who has had a similar experience. C. Teach parents what to expect so the information can be shared with the adolescent. D. Provide an opportunity for the teen to try on surgical attire.

A. Have teens who have had similar experiences talk to the adolescent about hospitalization.

Nurses should make which of the following recommendations to parents, to prevent childhood obesity? (Select all that apply) (pp. 293-295 [new], 325-326 [old]) A. If possible, breast-feed children rather than bottle feeding them. B. Insist that the child finish every feeding or meal. C. Put the child on a low-carbohydrate diet. D. Limit the high-calorie and sugary foods kept in the house. E. Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat. F. Do not use food as a reward or bribe a child to finish a meal by offering sweets. G. Limit the child's television viewing or video games to no more than two hours per day.

A. If possible, breast-feed children rather than bottle feeding them. D. Limit the high-calorie and sugary foods kept in the house. E. Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat. F. Do not use food as a reward or bribe a child to finish a meal by offering sweets. G. Limit the child's television viewing or video games to no more than two hours per day.

Nurses should make which of the following recommendations to parents, to prevent childhood obesity? (Select all that apply) (pp. 293-295 [new], 325-326 [old]) A. If possible, breastfeed children rather than bottle feeding them. B. Insist that the child finish every feeding or meal. C.Put the child on a lowcarbohydrate diet. D. Limit the highcalorie and sugary foods kept in the house. E. Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat. F. Do not use food as a reward or bribe a child to finish a meal by offering sweets. G. Limit the child's television viewing or video games to no more than two hours per day.

QUESTION 18 Match each medication with its therapeutic action in asthma. Each answer may be used only one time. (pp. 499-500 [new], 544-545 [old] A. This medication is a leukotriene inhibitor. Leukotrienes are chemicals the body releases when a person breathes in an allergen (such as pollen). These chemicals cause swelling in the lungs and tightening of the muscles around the airways, which can result in asthma symptoms. This is a controller medication, not a rescue medication. This medication is used to prevent asthma attacks in adults and children as young as 12 months old. It is NOT used as a rescue medication for acute asthma attacks. B. This medication is an oral corticosteroid. It prevents the release of substances in the body that cause inflammation (in this case, in the airways). It also suppresses the immune system. This medication is used as an anti-inflammatory. It diminishes airway inflammation, secretions,and obstruction. This medication is primarily used as a rescue medication. This oral medication is used in combination with short acting beta agonists (also called bronchodilators or rescue medicines) to treat moderate to severe asthma flare-ups. To treat acute asthma flare-ups, this medication is usually prescribed in "short bursts" of five days up to two weeks C. This medication is a short-acting bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. It is a short-acting beta-adrenergic agonist, specifically targeting the beta-2 receptors in the lungs. This is a rescue medication. It is used in inhalation form to treat bronchospasm (wheezing or difficulty in breathing) in people with asthma. It is used for acute asthma attacks. It relaxes smooth muscle in the airways leading to rapid bronchodilation. This medication has been promoted to have fewer cardiac side effects (in other words, less tachycardia) than other beta-adrenergic agonists. D. This aerosol solution is used for preventing asthma symptoms. It will not stop an asthma attack once one has started. This is a controller medication, not a rescue medication. This aerosol solution is an inhaled corticosteroid. It works by decreasing irritation and swelling in the airways, which helps to control or prevent asthma symptoms. The most commonly prescribed medications in maintenance control of asthma are inhaled steroids. Oral corticosteroids are more likely to cause side effects than inhaled corticosteroids because the oral corticosteroids are carried to all parts of the body. Inhaled corticosteroids, such as this medication, only go to the lungs. However, in aerosol form, it can affect the mouth and throat by causing oral candidiasis (thrush). To prevent thrush, the child should rinse his or her mouth or brush teeth and tongue immediately after inhalation. E. This is the most commonly prescribed medication for rescue of asthma symptoms. It a short-acting beta-2 adrenergic agonist. This rescue medication can be administered via an inhaler or aerosolized with a nebulizer. Typically this medication can be given every 4 to 6 hours as needed. This medication is a bronchodilator that relaxes smooth muscles in the airways, leading to rapid bronchodilation and mucus clearing. Thus, it increases air flow to the lungs and does so rapidly. Side effects can include tremor, rapid heart rate and nervousness. F. This medication is a bronchodilator that dilates airways. This is a rescue medication. It is used in treating acute symptoms of asthma. This medication blocks the effect of acetylcholine on airways. Acetylcholine is a chemical that nerves use to communicate with muscle cells. In asthma, cholinergic nerves going to the lungs cause narrowing of the airways by stimulating muscles surrounding the airways to contract. The "anti-cholinergic" effect of this medication blocks the effect of cholinergic nerves, causing the muscles to relax and airways to dilate. It also decreases mucus production. By blocking acetylcholine, this medication helps relieve the symptoms of asthma. When inhaled, this medication travels directly to airways, and very little is absorbed into the body. This medication is recommended for children age 12 and older.

A. Montelukast (generic) Brand Name: Singulair B. Prednisone C. Levalbuterol inhalation (generic) Brand Names: Xopenex, Xopenex Concentrate, Xopenex HFA D. Beclomethasone (generic) Brand Name: Qvar E. Albuterol inhalation (generic) Brand Names: ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA F. Ipratropium bromide (generic) Brand name: Atrovent HFA, Atrovent

Which of the following are accurate statements concerning multifactorial inheritance? (pp. 55-56 [new], 59-62 [old]) (Select all that apply) A. Most common genetic malfunction. B. Fathers do not pass these disorders to their daughters or sons. C. Combination of environmental and genetic factors. D. Often occurs in people with no history of the disorder in their family. E. Examples are cleft palate and neural tube defects. F. Examples are Duchenne muscular dystrophy and hemophiliaA. G. These disorders do not have a clearcut pattern of inheritance. H. These conditions tend to run in families

A. Most common genetic malfunction C. Combination of environmental and genetic factors D. Examples are cleft palate and neural tube defects G. These disorders do not have a clear-cut pattern of inheritance. H. These conditions tend to run in families

Which of the following are accurate statements concerning multifactorial inheritance? (pp. 55-56 [new], 59-62 [old]) (Select all that apply) A. Most common genetic malfunction. B. Fathers do not pass these disorders to their daughters or sons. C. Combination of environmental and genetic factors. D. Often occurs in people with no history of the disorder in their family. E. Examples are cleft palate and neural tube defects. F. Examples are Duchenne muscular dystrophy and hemophilia-A. G. These disorders do not have a clear-cut pattern of inheritance. H. These conditions tend to run in families.

A. Most common genetic malfunction. C. Combination of environmental and genetic factors. E. Examples are cleft palate and neural tube defects. G. These disorders do not have a clear-cut pattern of inheritance. H. These conditions tend to run in families.

An infant weighed 2.9 kg (6.4 lbs) at birth. Now, at her 6-month well-child checkup, she weighs 5.8 kg (12.75 lbs). How should you describe her weight gain? (Choose the one best answer.) (p. 79 [new], 91 [old]) A. Normal for age B. Small for age C. Large for age D. Excessive for age

A. Normal for age

Risk factors for child abuse and neglect include which of the following (select all that apply): (pp. 388-394 [new], 427 [old]) A. Parents who were abused as children B. Female gender C. Low socioeconomic status D. Chinese ethnicity E. Age 5 through 15 F. Substance abuse and violence in the family

A. Parents who were abused as children B. Female gender C. Low socioeconomic status F. Substance abuse and violence in the family

A 2-year-old is hospitalized with a fractured femur. In addition to pain medication, which of the following will best provide pain relief for this child? (p. 326 [new], 362 [old]) A. Parents' presence at the bedside. B. Age-appropriate toys. C. Deep-breathing exercises. D. Videos for the child to watch.

A. Parents' presence at the bedside.

A mother questions the nurse regarding car seat safety for her infant. Which of the following information should the nurse include in the discussion? A. Place the infant seat rear facing in the back seat of the car. B. Move the car seat to the forward-facing position when the child reaches 1 year of age. C. Keep the child in a bucket seat until the child is at least 12 months of age. D. Tighten the straps of the seat so that only an adult fist fits under the straps.

A. Place the infant seat rear facing in the back seat of the car.

A ten-month-old infant is seen in the well-child clinic. Which of the following behaviors should the nurse expect to see? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) Select all that apply. A. Plays peek-a-boo and patty cake B. Walks independently C. Feeds self with a spoon D. Stacks two blocks into a tower E. Transfers objects from hand to hand

A. Plays peek-a-boo and patty cake E. Transfers objects from hand to hand

Match each of the following four terms with the phrase that most closely describes it. Each answer may be used only once. (Lowdermilk, p. 817) Length of time spent in the uterus Less than 38 weeks gestation More than 42 weeks of gestation 38 to 42 weeks of gestation

A. Postterm gestation B. Term gestation C. Preterm gestation D. Gestational age

A nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that the child is in which stage of Kohlberg's Theory of Moral Development? (pp. 72-73 [new], 83-84 [old]) A. Pre-conventional Moral Reasoning B. Conventional Reasoning C. Post-conventional Moral Reasoning D. Universal Principles Moral Reasoning

A. Pre-conventional Moral Reasoning

A nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that the child is in which stage of Kohlberg's Theory of Moral Development? (pp. 72-73 [new], 83-84 [old]) A. Preconventional Moral Reasoning B. Conventional Reasoning C. Postconventional Moral Reasoning D. Universal Principles Moral Reasoning

A. Preconventional Moral Reasoning

The nurse is working with a hospitalized preschool-age child. The nurse is planning activities to reduce anxiety in this child. The most appropriate action by the nurse is to (pp. 225-226 [new], 265-268 [old]) A. Provide the child with a doll and safe medical equipment. B. Read a story to the child. C. Use an anatomically correct doll to teach the child about the illness. D. Talk to the child about the hospitalization.

A. Provide the child with a doll and safe medical equipment.

According to Piaget, this is the first stage of cognitive development. This is the period where the infant explores the environment and acquires knowledge through sensing and manipulation of objects. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

A. Sensorimotor

The nurse correctly recognizes that a shared goal of early intervention for both maple syrup urine disease (MUSD) and phenylketonuria (PKU) is avoidance of which complication? (pp. 893-896 [new], 970 [old]) A. Severe neurologic impairment B. Secondary liver disease C. Obesity D. Heart disease

A. Severe neurologic impairment

Match the behavior that is typical of a child in the preoperational stage of cognitive development with its descriptor. (pp. 70-72 [new], 80-83 [old] Object permanence B Egocentrism C Irreversibility E Centration A Symbolic thinking D

A. This is the tendency to focus or center on one aspect of the situation and ignore other important aspects of the situation. B. An object continues to exist even when it can no longer be seen. C. This does not mean selfishness or conceit as social psychologists use the word. This means that children lack the ability to consider another person's point of view or perspective. D. They start to use words, images, and symbols to represent their world. Such behaviors are characterized by: •the use of language (the word "fly" represents an annoying, buzzing creature), and •use of fantasy and imagination (remember when you built a fort out of the couch cushions?). E. They cannot reverse a sequence or logical operations. A child displaying irreversibility says 2 x 4 is different from 4 x 2. Likewise a child may be able to perform multiplication, but can't divide.

The stage that occurs between birth and one year of age is concerned with: (pp. 70-71 [new], 80 [old]) A. Trust vs. Mistrust B. Autonomy vs. Shame and Doubt C. Initiative vs. Guilt D. Identity vs. Role Confusion

A. Trust v. Mistrust

A. Trust vs. Mistrust

Which of the following strategies should be employed to reduce pediatric medication errors? (Select all that apply) (pp. 11-12) A. Use capital letters to distinguish between medications B. Open all medications at the nurses station, for accuracy and ease of administration C. Include the child's weight, age, and calculated dose D. Use bar code medication scanning in place of the six rights of medication administration E. Weigh the child in pounds and ounces

A. Use capital letters to distinguish between medications C. Include the child's weight, age, and calculated dose

The nurse is admitting a 9-year-old child who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is alert and oriented. An appropriate action by the nurse is which of the following? Select all that apply. (pp. 315-317 [new], 350-353 [old]) A. Use the Numeric Rating Scale to determine the child's pain level. B. Tell the child to ring the call bell if the leg starts hurting. C. Administer pain medication as ordered and as needed per provider specification. D. Ask the child's parents to push the PCA button if the child complains of pain.

A. Use the Numeric Rating Scale to determine the child's pain level. B. Tell the child to ring the call bell if the leg starts hurting. C. Administer pain medication as ordered and as needed per provider specification.

The nurse is admitting a 9-year-old child who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is alert and oriented. An appropriate action by the nurse is which of the following? Select all that apply. A. Use the Numeric Rating Scale to determine the child's pain level. B. Tell the child to ring the call bell if the leg starts hurting. C. Administer pain medication as ordered and as needed per provider specification. D. Ask the child's parents to push the PCA button if the child complains of pain.

Which of the following are true concerning the Babinski reflex? (Select all that apply.) (Lowdermilk, p. 548) A. With a positive Babinksi response, the infant's smaller toes fan out and the big toe dorsiflexes slowly. B. Indicates equilibrium and cerebellar function. C. Usually disappears by 1 year of age. D. Abnormal in a child > 2 years of age (indicates central nervous system dysfunction). E. To elicit the Babinski response, the lateral side of the sole of the foot is rubbed with a blunt instrument or device so as not to cause pain, discomfort, or injury to the skin; the instrument is run from the heel along a curve to the toes. F. A positive Babinski response occurs in infancy because the corticospinal pathways that run from the brain down the spinal cord are not fully myelinated.

A. With a positive Babinksi response, the infant's smaller toes fan out and the big toe dorsiflexes slowly. C. Usually disappears by 1 year of age. D. Abnormal in a child > 2 years of age (indicates central nervous system dysfunction). E. To elicit the Babinski response, the lateral side of the sole of the foot is rubbed with a blunt instrument or device so as not to cause pain, discomfort, or injury to the skin; the instrument is run from the heel along a curve to the toes. F. A positive Babinski response occurs in infancy because the corticospinal pathways that run from the brain down the spinal cord are not fully myelinated.

Copy of Please match the infant reflex with the correct descriptor. Only one descriptor corresponds with each item. (Lowdermilk, pp. 546-549) Babinski Moro (startle) Palmar grasp Stepping. Rooting. Sucking. Tonic neck (fencing).

A. With stimulation (stroking) the cheek, the neonate turns toward the stimulus. B. When a finger is placed in the neonate's palm, the fingers grasp tightly. C. When the head is turned to one side, the arm and leg on that side extend (stretch out to fullest length) and the opposite arm and leg flex (curl upward). D. Immediate sucking when something placed in the mouth. E. When there is a loud noise, or when lifted above the crib and lowered quickly, there is symmetrical abduction and extension of the arms with the fingers extended to form a 'C'. F. When held in an upright position with the feet in contact with a hard surface, the infant will alternatively raise feet as if stepping or dancing. G. When the side of the foot on the side of the little toe is stroked, the infant's toes fan upward.

1. The nurse is aware that emancipated minors and those who qualify under the mature minor doctrine may sign consents for their own medical treatment without parent approval. Persons not needing parent approval for medical care would be: (Select all that apply.) (pp. 11-12 [new],13-14 [old]) A. a 14-year-old girl married to a 16-year-old boy B. a 17-year-old serving in the U.S. Navy C. a 17-year-old college freshman living in a school dormitory D. a 17-year-old seeking medical care for a sexually transmitted disease E. a 15-year-old seeking an abortion

A. a 14-year-old girl married to a 16-year-old boy B. a 17-year-old serving in the U.S. Navy D. a 17-year-old seeking medical care for a sexually transmitted disease

The nurse is aware that emancipated minors and those who qualify under the mature minor doctrine may sign consents for their own medical treatment without parent approval. Persons not needing parent approval for medical care would be: (Select all that apply.) (pp. 11-12 [new],13-14 [old]) A. a 14yearold girl married to a 16yearold boy B. a 17yearold serving in the U.S. Navy C. a 17yearold college freshman living in a school dormitory D. a 17yearold seeking medical care for a sexually transmitted disease E. a 15yearold seeking an abortion

A. a 14-year-old girl married to a 16-year-old boy B. a 17-year-old serving in the U.S. Navy D. a 17-year-old seeking medical care for a sexually transmitted disease

When a preterm infant who is being gavage fed has a bloody stool, the nurse should: (pp. 839-840, Lowdermilk) A. assess for abdominal distention. B. decrease the amount of the next feeding. C. institute enteric precautions. D. get a culture of the next stool.

A. assess for abdominal distention.

When using an infant seat, the 5-point harness straps should be located: (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. at or slightly below the infant's shoulders B. at or slightly above the infant's shoulders C. above the infant's shoulders D. an infant seat doesn't need harness straps

A. at or slightly below the infant's shoulders

Which of the following nursing interventions are appropriate for a child with muscular dystrophy? (Select all that apply.) A. Suggest swimming as a good exercise for this child. B. Provide resources to the parents related to developmental norms for the child's age. C. Teach the family proper body mechanics. D. Immunize the child on the recommended schedule. E. Encourage the child to perform as much self-care as possible.

ACDE

Signs and symptoms of congenital heart disease in infants include (Select all that apply) A. Dyspnea with crying or eating B. Pink blood-tinged phlegm C. Pallor D. Poor feeding E. Sweating F. Elevated blood pressure G. Murmur H. Cyanosis with crying or eating I. Fatigue J. No weight gain K. Irritable L. Vomiting

ACDEGHIJK

Tetrology of Fallot is characterized by which cardiac defects? (Select all that apply) A. Overriding aorta B. Patent ductus arteriosus C. Right ventricular hypertrophy D. Ventricular septal defect E. Coarctation of the Aorta F. Tricuspid atresia (TA) G. Pulmonary stenosis

ACDG

The pediatric nurse understands that spironolactone (aldactone): (select all that apply) A. Decreases preload B. Decreases afterload C. Increases contractility of the heart D. Has side effects of nausea, vomiting, anorexia, and bradycardia E. Has side effects of hypokalemia, metabolic alkalosis, and hypotension F. Has side effects of hyperkalemia and hypotension G. Is a potassium-sparing maintenance diuretic

AFG

QUESTION 14 An appropriate nursing diagnosis for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV) should be (pp. 490-491 [new], 536-537 [old]) A. Activity intolerance. B. Decreased cardiac output. C. Acute pain. D. Ineffective peripheral tissue perfusion.

ANS: A

QUESTION 19 A child with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following medications right away? (pp. 499-500 [new], 544-545 [old]) A. albuterol (generic) Brand names: Ventolin, ProAir HFA, Ventolin HFA, Proventil B. budesonide and formoterol (generic) Brand name: Symbicort C. montelukast (generic) Brand name: Singulair D. theophylline (generic) Brand Name: Elixophyllin, Theo-24, Uniphyl E. salmeterol (generic) Brand Name: Serevent Diskus

ANS: A

QUESTION 23 Following parental teaching, the nurse is evaluating the parents' understanding of environmental control for their child's asthma management. Teaching has been understood by the parents if they state (pp. 495-506 [new], 540-552 [old]) A. "We will replace the carpet in our child's bedroom with tile." B. "We're glad the dog can continue to sleep in our child's room." C. "We'll be sure to use the fireplace often to keep the house warm in the winter." D. "We'll keep the plants in our child's room dusted."

ANS: A

QUESTION 25 What is the best liquid for the nurse to give to a child who has had a tonsillectomy? (pp. 470-471 [new], 513-514 [old]) A. Apple juice B. Milk C. Pepsi D. Lemonade

ANS: A

QUESTION 28 A 14 year old male with type 1 diabetes mellitus has been found wandering around in a state of confusion and is transported to the emergency department. He is sweaty and pale. The emergency nurse should recognize which of the following tests as priority for this child? (pp. 888-889 [new], 964-965 [old]) A. Blood sugar check B. CT scan of the head C. Blood cultures D. Arterial blood gas

ANS: A

QUESTION 35 A nurse is caring for a 10-year-old female who was admitted for diabetic ketoacidosis and new-onset diabetes. She has a normal FSBS (within her target blood sugar range) prior to lunch. She consumes no carbohydrates for lunch, although she did eat some protein and fat foods. Which of the following should the nurse administer after the nurse verifies with the girl what she consumed at lunch? A. No insulin B. Rapid-acting insulin to cover carbohydrates only C. Rapid-acting insulin to cover carbohydrates and pre-meal FSBS D. Rapid-acting insulin to cover pre-meal FSBS only

ANS: A

QUESTION 39 The pediatric nurse understands that blood sugar is well controlled when hemoglobin A1C is: (pp. 878, 957 [new], 954, 1037 [old]) A. Between 4%-5.6% B. Between 12%-15% C. Less than 180 mg/dL D. Between 90 and 130 mg/dL

ANS: A

QUESTION 4 A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). The nurse should be prepared to (pp. 485-488 [new]. 529-532 [old]) A. Administer nebulized epinephrine and oral or IM dexamethasone. B. Administer antibiotics and assist with possible intubation. C. Swab the throat for a throat culture. D. Obtain a sputum specimen after administering an albuterol sulfate inhalation solution.

ANS: A

QUESTION 34 The private duty nurse is caring for a 10-year-old child who is taking 4 units of regular insulin and 30 units of NPH insulin at 0800. The nurse keeps which of the following in mind regarding this regimen? (Select all that apply) (p. 878 [new], 954 [old]) A. Child may experience hypoglycemia shortly after breakfast. B. Child may experience hypoglycemia at dinnertime. C. Shake vial of insulin to disperse insulin particles evenly. D. Administer room temperature insulin only. E. Neither insulin can be administered intravenously.

ANS: A, B, D

QUESTION 38 The pediatric nurse understands that advantages of an external insulin infusion pump include which of the following? (Select all that apply) (p. 879 [new], 955 [old]) A. Delivers a continuous infusion of insulin B. Helps maintain blood glucose control between meals C. Costs less than other insulin therapies D. Reduces number of injections E. Results in fewer incidences of diabetic ketoacidosis F. Reduces the need to monitor blood glucose frequently

ANS: A, B, D, E

QUESTION 12 One factor that predisposes young children to development of otitis media include: (Choose the one best answer) (pp. 456-457 [new], 498-500 [old]) A. Children's eardrums are thin and easily perforate, which makes it easier for bacteria to make its way into the body and cause infections. B. The Eustachian tubes are short, wide, and straight, and lie in a horizontal plane. C. The lining of the ear in children is slightly alkalotic, which allows bacteria or fungi to invade the outer ear. D. The ears contains many tiny blood vessels that lie close to the surface and are susceptible to bleeding and infections.

ANS: B

QUESTION 26 The school nurse sees a 10-year-old child who presents with fatigue and a nagging cough of three weeks' duration that has become productive with thick mucus and is much worse at night. The school nurse suspects pertussis (whooping cough), because the child recently arrived from an impoverished country where he did not receive any immunizations. What should be the school nurse's first nursing action? (pp. 354-355 [new], 390 [old]) A.Report the case to the Centers for Disease Control and Prevention (CDC). B. Isolate the child and contact the parents. C. Provide emotional support to parents. D. Encourage fluids to prevent dehydration.

ANS: B

QUESTION 3 A child is admitted to the hospital with pneumonia. The child's oximetry reading is 88 percent upon admission to the pediatric floor. The priority nursing activity for this child should be to (pp. 490-491, 491-493 [new], 536-537, 538-539 [old]) A. Obtain a blood sample to send to the lab for electrolyte analysis. B. Begin oxygen per nasal cannula. C. Medicate for pain. D. Begin administration of intravenous fluids.

ANS: B

QUESTION 30 A 6-year-old child is admitted to the pediatric intensive care unit (PICU) with metabolic acidosis secondary to diabetic ketoacidosis (DKA). Which of the following should the nurse formulate as the priority nursing diagnosis? (pp. 881-883, 886-889 [new], 957-959, 962-965 [old]) A. Impaired Urinary Elimination related to reduced output and muscle function B. Decreased Cardiac Output related to fluid and electrolyte imbalance C. Ineffective Breathing Pattern related to hyperventilation. D. Parental Anxiety related to fears of long-term outcomes and discomfort

ANS: B

QUESTION 31 The nurse is providing education to a teenage client newly diagnosed with type 1 diabetes mellitus. Which of the following statements made by the client indicates to the nurse that the client understands type 1 diabetes? (pp. 876-877 [new], 951-953 [old]) A. "The changes in my pancreas are reversible, after I receive insulin treatment." B. "My immune system mistakenly destroys the beta cells, resulting in an absence of insulin." C. "I can control my blood glucose with healthy eating, being active, and taking oral medications." D. "My body can't respond properly to the insulin it makes. This results in high blood sugar levels."

ANS: B

QUESTION 9 The nurse is teaching the parents of a child with newly diagnosed cystic fibrosis how to administer the pancreatic enzymes. The nurse should advise the parents to administer the enzymes (p. 508 [new], 558 [old]) A. Twice daily. B. With meals and snacks. C. Every 6 hours around the clock. D. Four times daily.

ANS: B

QUESTION 10 A nurse is caring for a 2-year-old child who has had three ear infections in the past 5 months. The nurse should know that the child is at risk for developing which of the following as a long-term complication? (pp. 455-460 [new], 497-500 [old]) Select all that apply A. Balance difficulties B. Prolonged hearing loss C. Rheumatic heart disease D. Speech delays E. Chronic respiratory infections

ANS: B, D

QUESTION 11 An infant who has signs and symptoms of acute otitis media (AOM) is brought to an outpatient facility by his parent. The nurse should recognize that which of the following factors, if present, place the infant at risk for otitis media? (Select all that apply.) (p. 456 [new], 497 [old]) A. The infant is breastfed. B. The infant attends day care. C. The infant is up to date with immunizations. D. The infant was born with a cleft palate. E. The infant's father smokes cigarettes.

ANS: B, D, E

QUESTION 2 Parents of a child admitted with respiratory distress are concerned because the child won't lie down and wants to sit in a chair leaning forward. The nurse should tell the parents that: (pp. 122, 485-487 [new], 137, 533 [old]) A. This helps the child feel in control of his situation. B. The child needs to be encouraged to lie flat in bed. C. This position helps keep the airway open. D. This confirms the child has asthma.

ANS: C

QUESTION 29 A 3-year-old child with diabetic ketoacidosis (DKA) is given intravenous (IV) normal saline infusion and regular insulin. In addition to hourly blood glucose monitoring, the pediatric intensive care nurse should look to what assessment data as early signs of clinical improvement? (pp. 886-889 [new], 962-965 [old]) A. Respiratory rate of 12 to 15 and normal blood pressure in standing position. B. Temperature and pulse in normal range. C. Improved level of consciousness (LOC) and decreasing urine output. D. Child eats a full meal and respiratory rate is normal. E. Serum potassium level of 6.2 milliequivalents per liter (mEq/L). F. Serum pH of 7.20 and serum bicarbonate level of 15 mEq per L.

ANS: C

QUESTION 37 Which of the following children would most likely be diagnosed with type 2 diabetes mellitus? (pp. 889-891 [new], 953, 965-967 [old]) A. 8 year-old with chronic fatigue B. 10 year-old with weight gain C. 12 year-old with dark patches of skin D. 16 year-old who is sedentary

ANS: C

QUESTION 40 A child with a history of pituitary hypofunction (hypopituitarism) presents with weakness, hypoglycemia, seizure and hypotension. Which of the following represents the nurse's most appropriate immediate action? (pp. 861, 865, 866 [new], 935, 940 [old]) A. Assess the child for presence of infection B. Assess the child for compliance with medication therapy C. Establish an intravenous access D. Give the child some orange juice to drink

ANS: C

QUESTION 41 A mother brings in a 6 yr old girl who is growing pubic hair, has had a rapid growth spurt, and has started her menses. What medical diagnosis should the nurse anticipate? (868-869 [new], 943-944 [old]) A. Cushing syndrome B. Hypothyroidism C. Precocious puberty D. Turner syndrome

ANS: C

QUESTION 6 A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse what symptoms made the physician suspect cystic fibrosis. The nurse should reply that the clinical manifestation of cystic fibrosis that is seen first is (pp. 506-508 [new], 554-558 [old]) A. Bulky, greasy, foul-smelling stools (steatorrhea). B. Constipation. C. Meconium ileus. D. Rectum protruding from the anus (rectal prolapse).

ANS: C

QUESTION 17 A 3-year-old child presents to the well-child clinic with reports of intermittent asthma. Her asthma reportedly is triggered only by seasonal viral respiratory infections, no allergic component exists, and her asthma symptoms do not interfere with her daily activities. The child has asthma symptoms two days per week or less, with no nighttime awakenings. Using the stepwise approach, the pediatric nurse correctly anticipates that the family nurse practitioner will prescribe which medication to control the child's symptoms? (pp. 498-501 [new], 543-547 [old]) A. An inhaled glucocorticoid such as beclomethasone, budesonide, flunisolide, fluticasone, mometasone, and triamcinolone. B. A long-acting bronchodilator (also called long-acting beta-2 agonist, or LABA) such as salmeterol or formoterol. C. A leukotriene modifier such montelukast or zafirlukast. D. A short-acting bronchodilator (also called short-acting beta-2 agonist, or SABA) such as albuterol.

ANS: D

QUESTION 5 A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is MOST appropriate for this client? (pp. 491-492 [new], 538-539 [old]) (Please refer to this resource: http://www.cdc.gov/mrsa/healthcare/clinicians/precautions.html ) A. Reverse isolation B. Respiratory or airborne isolation C. Standard precautions D. Contact and droplet isolation

ANS: D

QUESTION 7 Which study provides a definitive diagnosis of cystic fibrosis? (Choose the correct answer.) (p. 508 [new], 556 [old]) A. Chest radiography B. Pulmonary function test C. Sputum culture D. Sweat chloride test

ANS: D

A child is being treated for strep throat. The nurse tells the parent to report any abrupt onset of mid-abdominal pain along with malaise, irritability and fever. The nurse is teaching the parent signs of:

Acute post-streptococcal glomerulonephritis

Infants are more susceptible to brain injury during a shaking episode because:

An infant's brain has higher water content and less myelination and is easily compressed within the skull during a shaking episode

Object permanence

An object continues to exist even when it can no longer be seen.

Morphine sulfate

An opioid analgesic that is used to treat the severe pain of a vaso-occlusive crisis.

The nurse teaches parents that absolute contraindications for pediatric immunizations would include which of the following?

Anaphylactic reaction to previous immunization

____________ is a condition where a person's skin becomes chronically dry, itchy, and inflamed. It's not contagious, so no one can get it from another person. A combination of genetics and environmental factors are involved. It's caused by an error in the immune system that triggers germ-fighting cells to attack the body's own skin cells. The primary function of the skin is to act as a barrier. The skin provides protection from mechanical impacts and pressure, variations in temperature, micro-organisms, radiation and chemicals. When something triggers the immune system, the protective skin barrier cells form gaps, diminishing the skin's effectiveness as a barrier against harmful substances and bacteria. Moisture is then lost from the deeper layers of the skin, allowing bacteria or irritants to pass through more easily. As a result of the barrier dysfunction, the skin quickly becomes irritated, cracked and inflamed.

Atopic dermatitis

The nurse is providing teaching to the mother to help prevent another UTI. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Avoid giving the child bubble baths Change the child's bathing suit immediately after swimming have the child wear cotton, rather than nylon, underpants instruct the child to wipe from front to back after voiding

A nurse is caring for a 14 year-old child who has been diagnosed with Congestive Heart Failure (CHF). Treatment began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear and equal bilaterally, and heart rate is 70 beats per minute while the child sleeps. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes that the child's urine output is A. 0.4 mL/kg/hr B. 1 mL/kg/hr C. 2 mL/kg/hr D. 3 mL/kg/hr E. 30 mL/hr F. 1 ounce/hr

The nurse is teaching the parents of a group of cardiac patients. The nurse includes in the information that a child who has undergone cardiac surgery A. Should be restricted from most play activities. B. Should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary. C. Should not receive routine immunizations. D. Can be expected to have a fever for several weeks following the surgery.

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that the hospitalized child at highest risk to experience separation anxiety when parents cannot stay is the A. 6-month-old. B. 18-month-old. C. 3-year-old. D. 4-year-old.

B. 18-month-old.

The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. The nurse should A. Escort the parents to the waiting room and assure them that they can see their child soon. B. Allow the parents to stay with the child. C. Ask the physician if the parents can stay with the child. D. Tell the parents that they do not need to stay with the child.

B. Allow the parents to stay with the child.

As an advocate for the child undergoing bone-marrow aspiration, the nurse should most appropriately suggest A. General anesthesia. B. Conscious sedation. C. Intravenous narcotics ten minutes before the procedure. D. Oral pain medication for discomfort after the procedure.

B. Conscious sedation.

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3-year-old experiences each morning when blood is drawn for lab studies. The most appropriate method the nurse can suggest to relieve pain associated with the venipuncture is A. Intravenous sedation 15 minutes prior to the procedure. B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure. C. Use of guided imagery during the procedure. D. Use of muscle-relaxation techniques.

B. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin at least one hour prior to the procedure.

The pediatric nurse understands that the rooting reflex typically disappears at which age? (Choose the correct answer.) (Please refer to Lowdermilk, pp. 541-544; See also "Normal Infant Reflexes" section in the Infant & Toddler PowerPoint.) A. 1-2 months B. 3-4 months C. 5-6 months D. 7-8 months

B. 3-4 months

The nurse should teach a parent to introduce solid foods to an infant at what age? (p. 284 [new], 317 [old]) A. 3 months B. 6 months C. 8 months D. 10 months

B. 6 months

The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. The nurse should (pp. 228, 230-232, 260-269 [new], 254; 257; 290-298 [old]) A. Escort the parents to the waiting room and assure them that they can see their child soon. B. Allow the parents to stay with the child. C. Ask the physician if the parents can stay with the child. D. Tell the parents that they do not need to stay with the child.

B. Allow the parents to stay with the child.

Where should a harness chest clip be positioned? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. Near the child's neck B. At the level of his armpits C. Over his belly D. Near his waist

B. At the level of his armpits

Jane, who is 32-months, insists on dressing herself each morning, even though she generally selects mismatching outfits, misses buttons, and wears her shoes on the wrong feet. When her mother tries to dress Jane or fix her outfit, Jane brushes her mother off and insists on doing it herself. What stage of psychosocial development best describes Jane's behavior? (pp. 70-71 [new], 80 [old]) A. Trust vs. Mistrust B. Autonomy vs. Shame and Doubt C. Initiative vs. Guilt D. Industry vs. Inferiority

B. Autonomy vs. Shame and Doubt

Beta-thalassemia, cystic fibrosis, Guacher disease, phenylketonuria, sickle cell disease, and Tay-Sachs disease are examples of genetic conditions transmitted by which pattern of inheritance? (p. 52 [new], 59 [old]) A. Autosomal dominant B. Autosomal recessive C. X-linked recessive D. Multifactorial

B. Autosomal Recessive

B. Autosomal recessive

Childhood obesity is defined as: (pp. 293 [new], 325-326 [old]) A. BMI between the 85th and 94th percentile B. BMI at or above the 95th percentile C. Weight between the 85th and 94th percentile D. Weight at or above the 95th percentile

B. BMI at or above the 95th percentile

The pediatric nurse is conducting an examination of a nine-month-old baby. During the examination, the nurse should be able to elicit which reflex? (See pp. 139 [new],156-158 [old]; Lowdermilk, p. 546) A. Moro B. Babinski C. Stepping D. Palmar grasp E. Plantar grasp

B. Babinski

A six-month-old child received the following play things as a gift from a relative. The nurse should advise the parents that which of the following items is potentially dangerous for the child to play with? (pp. 72, 82 [new], 83,97 [old]; slides 56, 66 Infant & Toddler PowerPoint) A. Stuffed animal B. Balloon C. Toy cell phone D. Shape sorter

B. Balloon

The nurse is teaching parents of an infant about introduction of solid food to their baby. What is the first food they can add to the diet? (p. 284 [new], 317 [old]) A. Vegetables B. Cereal C. Fruit D. Meats

B. Cereal

As an advocate for the child undergoing bone-marrow aspiration, the nurse should most appropriately suggest (pp. 329-330 [new], 364-365[old]) A. General anesthesia. B. Conscious sedation. C. Intravenous narcotics ten minutes before the procedure. D. Oral pain medication for discomfort after the procedure.

B. Conscious sedation.

School-age children engage in a type of play that is goal-oriented (in other words, the children play in an organized manner toward a common goal). The children plan, assign roles, and play together with established rules. (p. 92 [new], 104 [old]) A. Associative play B. Cooperative play C. Goal-oriented play D. Social recreation play

B. Cooperative play

Applications of the principle of atraumatic care in the pediatric setting include which of the following? (Select all that apply) (pp. 222-229; 232-236 [new], 249-256; 259-261 [old]) A. Use of "white lies" to minimize stress B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain E. Working independently of the parents

B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain

Applications of the principle of atraumatic care in the pediatric setting include which of the following? (Select all that apply) A. Use of "white lies" to minimize stress B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain E. Working independently of the parents

B. Encouraging the family to room in with child C. Identifying child/ family stressors D. Effectively managing pain

Overarching goals of Healthy People 2020 include: (Select all that apply.) (p. 7 [new], 8 [old]) A. Promotion of oral health and reduction of tooth decay B. High-quality, longer lives free of preventable disease, disability, injury and premature death C. Create social and physical environment that promote good health for all D. Health equity, eliminate disparities, improve the health of all groups E. Elimination of addictive habits such as smoking, drinking and abuse of substances

B. High-quality, longer lives free of preventable disease, disability, injury and premature death C. Create social and physical environment that promote good health for all D. Health equity, eliminate disparities, improve the health of all groups

The nurse is aware that the prevalence of chronic health conditions in children is: (pp. 7, 246-248 [new], 9, 274-276 [old]) A. Decreasing as a result of advances in health care and treatment B. Increasing as a result of advances in health care and treatment C. Increasing as a result of increased incidence of childhood injury D. Decreasing as a result of decreased incidence of childhood injury

B. Increasing as a result of advances in health care and treatment

When caring for a preterm infant at 30 weeks of gestation, the nurse should recognize that the newborn's priority nursing diagnosis is: (pp. 820-822, Lowdermilk) A. Risk for Infection related to decreased immune response B. Ineffective Breathing Pattern related to surfactant deficiency and weak respiratory muscle effort C. Ineffective Thermoregulation related to immature thermoregulation center D. Imbalanced Nutrition Less than Body Requirements related to ineffective suck and swallow

B. Ineffective Breathing Pattern related to surfactant deficiency and weak respiratory muscle effort

Infections in the newborn require prompt intervention because: (Lowdermilk, p.843) A. They spread more quickly. B. Infections that are relatively harmless to an adult can be fatal to the newborn. C. The portals of entry and exit are more numerous. D. The newborn has no defense against infection.

B. Infections that are relatively harmless to an adult can be fatal to the newborn.

The pediatric nurse understands that the infant mortality rate is important because: (pp. 6-8) A. It demonstrates the benefits of healthy eating in preventing coronary heart disease, boosting the immune system, and helping maintain a healthy lifestyle, in the overall health of a nation or people group. B. It represents or describes the overall state of health of a country, region, ethnic group, and/or community. C. It emphasizes the importance of avoiding potential hazards that the infant may encounter during the first year of life. D. It highlights the importance of primary, secondary, and tertiary prevention care strategies to prevent or slow the progression of disease.

B. It represents or describes the overall state of health of a country, region, ethnic group, and/or community.

For an eight-month-old infant, which toy promotes cognitive development? (pp. 72, 82 [new], 83, 97 [old]) A. Finger paint B. Jack-in-the-box C. A small rubber ball D. A play gym strung across the crib

B. Jack-in-the-box

A child with nystagmus should demonstrate: (p. 442 [new], 484 [old]) A. One eye gazing in a different direction during the cover/uncover test. B. Jerky eye movements during the 6 Cardinal Positions of Gaze test. C. Droopy eyelids that partially or completely cover the pupil. D. Nicking of the retinal blood vessels during the internal eye examination.

B. Jerky eye movements during the 6 Cardinal Positions of Gaze test.

An inborn error of metabolism that makes it impossible for the body to use the amino acid valine is: (pp. 893-896 [new], 969-972 [old]) A. Galactosemia B. Maple syrup urine disease C. Phenylketonuria D. Sickle cell disease

B. Maple syrup urine disease

A 28-month old child, 30-month old child, and 33-month old child are playing with blocks, dolls, and musical instruments in the hospital playroom. Closer observation reveals they are playing alongside one another, rather than interacting with each other. The nurse is observing: (p. 86 [new], 96 [old]) A. Solitary play B. Parallel play C. Associative play D. Cooperative play

B. Parallel play

Which of the following statements concerning Down syndrome is FALSE? (pp. 48-49, 59, 110. 814-815 [new], 885 [old]) A. Down syndrome is also known as Trisomy 21, which is the presence of a third copy of chromosome 21 B. People with Down syndrome have profound intellectual disability and cannot function meaningfully in society C. Down syndrome is the most common chromosomal abnormality D. Children with Down syndrome are at higher risk for congenital heart disease, gastrointestinal abnormalities, and hearing loss

B. People with Down syndrome have profound intellectual disability and cannot function meaningfully in society

According to Piaget, the second stage of cognitive development that is characterized by the increased use of symbols and prelogic thought processes. When Piaget uses the word "operational", "operations", etc., he refers to logical, mental activities. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Pre-operational C. Concrete operational D. Formal operational

B. Pre-operational

According to Piaget, the second stage of cognitive development that is characterized by the increased use of symbols and prelogic thought processes. When Piaget uses the word "operational", "operations", etc., he refers to logical, mental activities. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

B. Preoperational

Which of the following does NOT demonstrate atraumatic care for the hospitalized child? (pp. 223-229, 233-234 [new], 249-256; 259-261 [old]) A. Use numbing medication (EMLA cream) on the skin before venipuncture. B. Restrain the child, holding him down firmly during procedures to prevent injury. C. Avoid use of irritating chemicals (such as alcohol) on the skin. D. Never use needles and instruments which cause unnecessary pain.

B. Restrain the child, holding him down firmly during procedures to prevent injury.

The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Speaks in short sentences. B. Sits alone in tripod position. C. Can feed self with a spoon. D. Pulling up to a standing position.

B. Sits alone in tripod position

A day care nurse is observing a 2-year old child and suspects that the child may have strabismus. Which observation made by the nurse might indicate this condition? (p. 447 [new], 490 [old]) A. The child has involuntary, shaking, "to and fro" movement in the eyes. B. The child consistently tilts the head to see. C. The child consistently turns the head to see. D. The child does not respond when spoken to.

B. The child consistently tilts the head to see.

With phenylketonuria: (pp. 893-894 [new], 970 [old]) A. Transmission is by autosomal dominance B. The child typically has lighter skin, hair, and eyes C. The child is unable to metabolize galactose D. The child is unable to metabolie leucine

B. The child typically has lighter skin, hair, and eyes

The infant weighs 1300 grams (2 pounds, 14 ounces) at birth. The neonatal nurse correctly classifies this infant as: (p. 817, Lowdermilk) A. Low-birth-weight (LBW) infant B. Very low-birth-weight (VLBW) infant C. Extremely low-birth-weight (ELBW) infant D. Small-for-gestational age (SGA) infant

B. Very low-birth-weight (VLBW) infant

When taking the health history of a suspected victim of Munchausen syndrome by proxy, the nurse or other healthcare professional should pay close attention to: (pp. 393-394 [new], 432 [old]) A. The gender of the child B. Whether the perpetrator is always present when the child has symptoms C. Whether the mother is single D. Whether the child victim has any siblings

B. Whether the perpetrator is always present when the child has symptoms

When using a forward facing convertible seat, the harness straps should be located: (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. at or slightly below the child's shoulders B. at or slightly above the child's shoulders using the top set of harness slots C. below the child's shoulders D. at or below the child's feet, using the bottom set of harness slots

B. at or slightly above the child's shoulders using the top set of harness slots

The nurse explains that an infant born at 31 weeks of gestation may need to be fed by gavage during the first few weeks of life because the infant: (p. 829, Lowdermilk) A. is unable to digest food properly. B. has weak coordination of sucking and swallowing. C. refuses to take the breast by mouth. D. needs a larger quantity of formula at each feeding.

B. has weak coordination of sucking and swallowing.

Where should a 25 pound 9 month old ride in the car? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. in a front-facing car seat in the back seat B. in a rear-facing car seat in the middle of the back seat C. in a rear-facing car seat in the front seat, as long as there is an air bag D. in a booster seat in the back seat

B. in a rear-facing car seat in the middle of the back seat

Nursing interventions to promote a balanced dietary intake of food and fluids in an infant with congestive heart failure include: (select all that apply) A. Keep coaxing the infant to suck on the bottle and to drink all the formula until the bottle is empty, no matter how long it takes. B. Weigh the child daily. C. Hold the infant at a 90-degree angle while feeding. D. Use firm nipples with small openings to slow feedings. E. Use high-calorie concentrated formula. F. Space feedings 3 hours apart. G. Use supplemental tube feedings if the infant is too fatigued to ingest a sufficient amount by mouth. H. Provide large feedings every 5 hours to allow the infant to rest. I. Limit bottle feedings to 20-30 minutes. J. Provide small, frequent feedings

BEFGIJ

Jayson is a 1 year old child who has a staph skin infection. Her brother has also developed the same infection. Which behavior by the children is most likely to have caused the transmission of the organism?

Bathing together.

A child has been admitted to the hospital unit in congestive heart failure (CHF). Symptoms related to this admission diagnosis should include A. Weight loss. B. Bradycardia. C. Tachycardia. D. Increased blood pressure.

An athletic activity the nurse should recommend for a school-age child with pulmonary-artery hypertension is A. Cross-country running. B. Soccer. C. Golf. D. Basketball.

The nurse is teaching family members how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. The nurse should include in the parental education to A. Apply lotion or powder to minimize skin irritation. B. Put clothing over the harness for maximum effectiveness of the device. C. Check at least two or three times a day for red areas under the straps. D. Place a diaper over the harness, preferably using a thin superabsorbent disposable diaper.

Which assessment data is most indicative of a potential complication of Kawasaki's disease? A. Dermatitis of extremities; desquamation of the hands and feet. B. Strawberry tongue; redness of the mucous membranes and sores in the mouth. C. Change in blood pressure, pulse, and skin color; complaints of pain in the chest. D. Fever over 5 days; redness and swelling of the eyes.

Which evaluation would indicate a toxic dose of digoxin? A. Tachycardia and dysrhythmia. B. Headache and diarrhea. C. Bradycardia and nausea and vomiting. D. Tinnitus and nuchal rigidity.

A 5-year-old is being discharged from the outpatient surgical center. Which statement by the parent would indicate the need for further teaching? A. "I can expect my child to have some pain for the next few days." B. "I will plan to give my child pain medicine around the clock for the next day or so." C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow." D. "I will call the office tomorrow if the pain medicine is not relieving the pain."

C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow."

The nurse needs to administer a medication to a 4-year-old child. The medication is only available in tablet form. The nurse should: A. Place the tablet on the child's tongue and give the child a drink of water. B. Break the tablet in small pieces and ask the child to swallow the pieces one by one. C. Crush the tablet and mix it in a teaspoon of applesauce. D. Crush the table and mix it in a cup of juice.

C. Crush the tablet and mix it in a teaspoon of applesauce.

A 2-year-old child recently diagnosed with a seizure disorder will be discharged home on an oral anticonvulsant medication. Which of the following actions by the mother best demonstrates understanding of how to give the medication? The mother A. Verbalizes how to give the medication. B. Acknowledges understanding of written instructions. C. Draws up the medication correctly in an oral syringe and administers it to the child. D. Observes the nurse draw up the medication and administer it to the child.

C. Draws up the medication correctly in an oral syringe and administers it to the child.

A 3-year-old is hospitalized following surgery for a ruptured appendix. During assessment of the child, the nurse notes that the child is sleeping. Vital signs are as follows: temperature 97.8 degrees F axillary, pulse 90, respirations 12, and blood pressure 100/60. Based on this assessment, the nurse concludes that the child is: A. Comfortable and the pain is controlled. B. In shock secondary to blood loss during surgery. C. Experiencing respiratory depression secondary to opioid administration for postoperative pain. D. Sleeping to avoid pain associated with surgery.

C. Experiencing respiratory depression secondary to opioid administration for postoperative pain.

A 4-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child A. Was exposed to someone else with a sore throat. B. Did not eat the right foods. C. Yelled at his brother. D. Did not take his vitamins.

C. Yelled at his brother.

Which of the following is the best example of appropriate communication with a young child in the hospital setting? (pp. 78-81, 234 [new], 99; 260 [old]; Powerpoint slides # 78-81) A. "I'm going to take your pulse now." B. "I'm going to give you a little stick in the arm." C. "I'm going to count how fast your heart beats." D. "I will give you a shot in the arm." E. "This will hurt or burn."

C. "I'm going to count how fast your heart beats."

A 5-year-old is being discharged from the outpatient surgical center. Which statement by the parent would indicate the need for further teaching? (pp. 323-324 [new], 359-360 [old]) A. "I can expect my child to have some pain for the next few days." B. "I will plan to give my child pain medicine around the clock for the next day or so." C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow." D. "I will call the office tomorrow if the pain medicine is not relieving the pain."

C. "Since my child just had surgery today, I can expect the pain level to be higher tomorrow."

A mother complains that her 13-year-old has started to grow rapidly, and asks the nurse if this is normal and how long it will last. The best nursing response is: (pp. 94-96 [new], 105-106 [old]) A. "This is unusual at this age, and a physician should be contacted." B. "This is normal, but will only last a few months." C. "This is normal and can last until about age 20." D. "This is normal, but growth should be completed by about age 15 or 16."

C. "This is normal and can last until about age 20."

Baby Smith weighs 14 pounds. What is his hourly fluid needs? (p. 415 [new], 454 [old]; p. 14 Clinical Guidebook) A. 5.8 mL/hour B. 14 mL/hour C. 26.5 mL/hr D. 128.3 mL/hour

C. 26.5 mL/hr

Baby Smith weighs 14 pounds. What is his hourly fluid needs? (p. 415 [new], 454 [old]; p. 14 Clinical Guidebook) A. 5.8 mL/hour B. 14 mL/hour C. 26.5 mL/hr D. 128.3 mL/hour

C. 26.5 mL/hr Change 14 pounds to kilograms, by dividing by 2.2. Then, multiply by 100 mL for the 24 hour fluid needs. Then divide that number by 24 to find out the hourly fluid needs.

Most children are ready to begin the process of toilet training by which age? (pp. 85-86, 173 [new]; 97-98; 194 [old]) A. 18 months B. 24 months C. 27 months D. 32 months

C. 27 months

An infant seat should recline at an angle of: (p. 161-162, 176-177, 194 [new],183 [old]) A. 180 degrees B. 90 degrees C. 45 degrees D. 25 degrees

C. 45 degrees

A mother visits her primary care provider for the child's 12-month visit. The child weighed 2,800 grams at birth. Which of the following weights is most consistent with the expected weight for this child? A. 7,500 grams B. 8,000 grams C. 8,500 grams D. 9,000 grams

C. 8,500 grams

Which of the following developmental markers should the nurse expect to see in caring for an infant who is four months old? (Choose the correct answer.) ( See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Begins to feed self finger foods; sits alone steadily without support. B. Begins forming words out of previous sounds ("mama"); crawls and creeps. C. Begins to use consonant sounds; no head lag when pulled to sitting position. D. Uses pincer grasp to pick up small objects; turns from back to abdomen. E. Mimics sounds and facial expressions; understands words such as "no" and "cracker."

C. Begins to use consonant sounds; no head lag when pulled to sitting position.

Breastmilk is preferred over formula because: (pp. 282-283 [new], 314-316 [old]) A. Breastfed infants gain more weight B. Breastmilk has more calories C. Breastmilk contains antibodies D. Formula is nutritionally inadequate

C. Breastmilk contains antibodies

According to Piaget, this is the third stage of cognitive development that is characterized by the ability to think logically about concrete objects and situations. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

C. Concrete Operational

C. Concrete operational

C. Concrete operations

A common cause of food allergy in young children is: (p. 285 [new], 318 [old]) A. Breast milk B. Apples C. Cow's milk D. Rice

C. Cow's milk

The nurse needs to administer a medication to a 4-year-old child. The medication is only available in tablet form. The nurse should: (p. 233 [new], 259 [old]) A. Place the tablet on the child's tongue and give the child a drink of water. B. Break the tablet in small pieces and ask the child to swallow the pieces one by one. C. Crush the tablet and mix it in a teaspoon of applesauce. D. Crush the table and mix it in a cup of juice.

C. Crush the tablet and mix it in a teaspoon of applesauce.

C. Detachment

A 3-year-old is hospitalized following surgery for a ruptured appendix. During assessment of the child, the nurse notes that the child is sleeping. Vital signs are as follows: temperature 97.8 degrees F axillary, pulse 90, respirations 12, and blood pressure 100/60. Based on this assessment, the nurse concludes that the child is: (pp. 318-321 [new], 353-354 [old]) A. Comfortable and the pain is controlled. B. In shock secondary to blood loss during surgery. C. Experiencing respiratory depression secondary to opioid administration for postoperative pain. D. Sleeping to avoid pain associated with surgery.

C. Experiencing respiratory depression secondary to opioid administration for postoperative pain.

Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) Monique's explanation of how the child was injured is: A. Not really important. B. Not pertinent information for the nurse to chart. C. Inconsistent with the injury. D. The only reason the nurse suspects abuse.

C. Inconsistent with the injury.

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) Monique's explanation of how the child was injured is: A. Not really important. B. Not pertinent information for the nurse to chart. C. Inconsistent with the injury. D. The only reason the nurse suspects abuse.

C. Inconsistent with the injury.

A 10-year-old fifth-grader enjoys having his artwork displayed on the family refrigerator. This behavior is indicative of which developmental stage as described by Erikson? (pp. 70-71 [new], 80 [old]) A. Initiative versus guilt B. Intimacy versus isolation C. Industry versus inferiority D. Identity versus role confusion

C. Industry v. Inferiority

C. Industry versus inferiority

The mother of a one-month-old infant states that she is curious as to whether her child is developing normally. Which of the following developmental milestones should the nurse inform the mother that the infant is expected to perform at this age? (See "Infant Growth & Development Document" in the Course Packet; pp. 80-81; 84 (new), 92-93; 95 (old) in the textbook) A. Rolling from side to back B. Laughing and squealing C. Lifting head briefly D. Holding a rattle placed in hand

C. Lifting head briefly

A 2-week-old premature infant is experiencing periods of apnea, temperature instability, vomiting, and diarrhea. What is the best explanation for these clinical manifestations? (pp. 836-840, Lowdermilk) A. Respiratory distress syndrome B. Bronchopulmonary dysplasia C. Necrotizing enterocolitis D. Hydrocephalus secondary to intraventricular hemorrhage

C. Necrotizing enterocolitis

Providing high oxygen concentrations to a preterm newborn may cause:(Lowdermilk, pp. 837-838) A. Oral-tactile hypersensitivity (oral aversion) B. Acrocyanosis C. Retinopathy of prematurity D. Primary atelectasis

C. Retinopathy of prematurity

An infant, 6 weeks old, is brought to the Washington County Health Department clinic for a well-baby visit. To assess the fontanels, how should the public health nurse position the infant? (pp. 108-109 [new], 122-124 [old]) A. Supine B. Prone C. Seated upright D. Left lateral position

C. Seated upright

The nurse conducts developmental screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to: (pp. 103-105 [new], 118-120 [old]) A. Reverse degenerative processes that have occurred. B. Recognize early infection in order to prevent spread to individuals in close contact with the child. C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay. D. Measure intelligence and readiness for school. E. Diagnose a developmental impairment in physical, learning, language, or behavior areas.

C. See if there's cause to suspect that a baby or toddler has a disability or developmental delay.

Which of the following are examples of primary prevention activities or strategies? (pp. 145-146, 151-152 [new],163-164; 170-171 [old]) A. Using medication to treat conditions such as high blood pressure or high cholesterol, screening for sexually transmitted infections or utilizing nicotine patches to reduce smoking frequency B. For a child with juvenile arthritis, doing exercises, participating in physical therapy, and taking medication to control inflammation and pain C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition D. For a child with a disabling injury, intensive, long-term physical therapy to regain use of limbs or develop alternate means for independent functioning

C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition

A 4-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child (pp. 70, 89, 223 [new], 83,101, 252 [old]) A. Was exposed to someone else with a sore throat. B. Did not eat the right foods. C. Yelled at his brother. D. Did not take his vitamins.

C. Yelled at his brother.

A 4-year-old is seen in the clinic for a sore throat. In the child's mind, the most likely causative agent is that the child (pp. 72 [new], 83, 101, 252 [old]) A. Was exposed to someone else with a sore throat. B. Did not eat the right foods. C. Yelled at his brother. D. Did not take his vitamins.

C. Yelled at his brother.

Where is the safest place for a 55 pound 6 year old to sit in the car? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. in the front seat, as long as there is an air bag B. in seat belts in the back seat C. in a booster seat in the back seat D. in the front seat, as long as there is not an air bag

C. in a booster seat in the back seat

Where should most children ride in the car? (pp. 161-162, 176-177, 194 [new],195-196; 213; 757 [old]) A. in the back seat until they are 8 years old B. in the back seat until they are 10 years old C. in the back seat until they are 13 years old D. in the front seat no matter how old they are, as long as there is an air bag

C. in the back seat until they are 13 years old

The nurse clarifies that a preterm infant born at 34 weeks of gestation is placed in an incubator because: (pp. 528-529; 823, Lowdermilk) A. the infant has a small body surface-to-weight ratio. B. heat increases the flow of oxygen to the extremities. C. the infant's temperature control mechanism is immature. D. heat within the incubator facilitates drainage of mucus.

C. the infant's temperature control mechanism is immature.

A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is MOST appropriate for this client?

Contact and droplet isolation

A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses by the nurse appropriately addresses the mother's question? A. "The Pavlik harness is used for children with scoliosis, not hip dysplasia." B. "The Pavlik harness is used for school-age children." C. "The Pavlik harness cannot be used for your child because her condition is too severe." D. "The Pavlik harness is used for infants less than 6 months of age."

A toddler has been started on digoxin (Lanoxin) for cardiac failure. If the child develops digoxin (Lanoxin) toxicity, the first sign the nurse notes should be A. Lowered blood pressure. B. Tinnitus. C. Ataxia. D. A change in heart rhythm.

After a pediatric client has a cardiac catheterization, which intervention should have the highest priority in the immediate postoperative period? A. Encourage intake of small amounts of fluid. B. Teach the parents signs of congestive heart failure. C. Monitor the site for signs of infection. D. Observe cath insertion site for bleeding. If bleeding is found, the nurse should immediately glove, and apply direct manual pressure to the site (without leaving the patient's bedside) until hemostasis is obtained.

In a normal heart, the blood follows this cycle: body-heart-lungs-heart-body. When a child has this congenital heart defect, the blood leaving the heart does not follow this path. It has only one vessel, instead of two separate ones for the lungs and body. With only one artery, there is no specific path to the lungs for oxygen before returning to the heart to deliver oxygen to the body. In addition, there is usually a hole between the two lower chambers of the heart known as a ventricular septal defect. As a result of this heart defect, oxygen-poor blood that should go to the lungs and oxygen-rich blood that should go to the rest of the body are mixed together. This creates severe circulatory problems. What is the name of this congenital heart defect? A. Atroventricular canal defect B. Hypoplastic left heart syndrome C. Tetralogy of Fallot D. Truncus arteriosus E. Transposition of the great arteries

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. If there is adequate peripheral circulation, the nurse should find that the extremity A. Has a capillary refill of greater than three seconds. B. Has a palpable dorsalis pedis pulse but a weak posterior tibial pulse. C. Has decreased sensation with a weakened dorsalis pedis pulse. D. Is warm, with a capillary refill of two seconds or less.

A 5-year-old is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. The nurse should A. Reschedule the treatment for a later time. B. Show the respiratory therapist to the playroom so the treatment may be performed. C. Escort the child to his room and ask the child-life specialist to bring toys to the bedside. D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

The nurse must perform a procedure on a toddler. The technique most appropriate when performing the procedure is to A. Ask the mother to restrain the child during the procedure. B. Ask the child if it is okay to start the procedure. C. Perform the procedure in the child's hospital bed. D. Allow the child to cry or scream.

D. Allow the child to cry or scream.

A 10-year-old has been receiving morphine every two hours for postoperative pain as ordered. The medication relieves the pain for approximately 90 minutes, and then the pain returns. The nurse should A. Tell the child that pain medication cannot be administered more frequently than every two hours. B. Reposition the child and quietly leave the room. C. Inform the parents that the child is dependent on the medication. D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

The charge nurse is concerned with reducing the stressors of hospitalization. The nursing intervention that is most helpful in decreasing the stressors for the toddler is to A. Assign the same nurse to the toddler as much as possible. B. Let the child listen to an audiotape of the mother's voice. C. Place a picture of the family at the bedside. D. Encourage a parent to stay with the child.

D. Encourage a parent to stay with the child.

A group of children on one hospital unit are all suffering separation anxiety. When determining the stages of separation anxiety, the nurse recognizes that the child in the "despair" phase is the child who A. Does not cry if parents return and leave again. B. Screams and cries when parents leave. C. Appears to be happy and content with staff. D. Lies quietly in bed.

D. Lies quietly in bed.

Most children are able to feed themselves using a spoon by age: (p. 88 [new],100 [old]) A. 1 year B. 2 year C. 3 year D. 4 years

D. 4 years

Normal heart rate (HR) and respiratory rate (RR) for an adolescent is: (choose the best response) (pp. 122, 125 [new], 137, 140 [old]) A. 100-150 HR, 33-55 RR B. 80-120 HR, 25-40 RR C. 65-110 HR, 14-22 RR D. 60-100 HR, 12-20 RR

D. 60-100 HR, 12-20 RR

The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia in a preop parental meeting, the nurse should explain that PCA is most appropriate for the (p. 321 [new], 356 [old]) A. A 16-year-old who is developmentally delayed and postop from bone surgery. B. A 5-year-old, postop from tonsillectomy. C. A 10-year-old who has a fractured femur and concussion from a bike accident. D. A 12-year-old, postop from spinal fusion for scoliosis.

D. A 12-year-old, postop from spinal fusion for scoliosis.

Which seat is best for a 35 pound 4 year old? (pp. 161-162, 176-177, 194 [new], 183; 195-196 [old]) A. A booster seat with a shield B. He is old enough for seat belts without a car seat. C. A belt-positioning booster seat with lap/shoulder belts D. A forward-facing car seat with harness straps

D. A forward-facing car seat with harness straps

The home health nurse practices anticipatory guidance for a family with a 12-month-old child by giving information and brochures about: (pp. 145; 85-86 [new], 163; 97-98 [old]) A. Methods to decrease teething discomfort B. Methods to introduce solid food C. Advantages of breastfeeding D. Accident-proofing their home

D. Accident-proofing their home

D. Accident-proofing their home --> Covering electrical outlets, installing childproof catches on low cabinets, and padding sharp furniture edges can help avoid accidents. All other options are not timely for this family.

The nurse cautions a group of parents that the leading cause of childhood mortality is: (pp. 6-7) A. Chronic disease B. Homicide C. Suicide D. Accidents

D. Accidents

D. All of the above

The nurse must perform a procedure on a toddler. The technique most appropriate when performing the procedure is to (pp. 223-224, 234-236 [new], 252; 260; 261-263 [old]) A. Ask the mother to restrain the child during the procedure. B. Ask the child if it is okay to start the procedure. C. Perform the procedure in the child's hospital bed. D. Allow the child to cry or scream.

D. Allow the child to cry or scream.

Gestational age is best determined with: (Lowdermilk, p. 554) A. Weight of the infant at birth B. Stability of the blood glucose level C. The age at which the infant reaches developmental milestones D. Assessment of physical and neurological characteristics

D. Assessment of physical and neurological characteristics

A 5-year-old is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. The nurse should (pp. 238-240, 89-91, 263-264, 793 [new], 265-268; 101-102; 862 [old]) A. Reschedule the treatment for a later time. B. Show the respiratory therapist to the playroom so the treatment may be performed. C. Escort the child to his room and ask the child-life specialist to bring toys to the bedside. D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

D. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse's initial interventions are aimed at: A. Confronting Monique. B. Getting Monique to talk about the suspected abuse C. Providing psychosocial support to Monique D. Attending to the child's physical injuries

D. Attending to the child's physical injuries

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse's initial interventions are aimed at: A. Confronting Monique. B. Getting Monique to talk about the suspected abuse C. Providing psychosocial support to Monique D. Attending to the child's physical injuries

D. Attending to the child's physical injuries

Parents of a newborn are confused when their child is diagnosed with a genetic disorder because neither of them has a defect. Testing is done and it is determined that both parents are carriers of the disorder even though they are asymptomatic. Understanding the principles of the Mendelian Pattern of Inheritance, what condition is the likely reason for this genetic disorder? (pp. 51-55 [new], 52-62 [old]) A. X-linked dominant condition B. Autosomal dominant condition C. X-linked recessive condition D. Autosomal recessive condition

D. Autosomal Recessive condition

Parents of a newborn are confused when their child is diagnosed with a genetic disorder because neither of them has a defect. Testing is done and it is determined that both parents are carriers of the disorder even though they are asymptomatic. Understanding the principles of the Mendelian Pattern of Inheritance, the nurse determines what condition is the likely reason for this genetic disorder? (pp. 51-55 [new], 52-62 [old]) A. X-linked dominant condition B. Autosomal dominant condition C. X-linked recessive condition D. Autosomal recessive condition

D. Autosomal recessive condition

D. BMI at or above the 95th percentile

A very low birthweight infant has just been diagnosed with a Grade 4 intraventricular hemorrhage (IVH). The nurse should interpret this as which of the following? (pp. 838-839, Lowdermilk) A. Bleeding occurs just in a small area of the ventricles. B. Bleeding also occurs inside the ventricles. C. Ventricles are enlarged by the blood. D. Bleeding into the brain tissues around the ventricles.

D. Bleeding into the brain tissues around the ventricles.

A 10-year-old has been receiving morphine every two hours for postoperative pain as ordered. The medication relieves the pain for approximately 90 minutes, and then the pain returns. The nurse should (pp. 323-324 [new], 359-360 [old]) A. Tell the child that pain medication cannot be administered more frequently than every two hours. B. Reposition the child and quietly leave the room. C. Inform the parents that the child is dependent on the medication. D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

D. Call the family nurse practitioner to see if the child's orders for pain medication can be changed.

The charge nurse is concerned with reducing the stressors of hospitalization. The nursing intervention that is most helpful in decreasing the stressors for the toddler is to (pp. 223-225 [new], 250-252 [old]) A. Assign the same nurse to the toddler as much as possible. B. Let the child listen to an audiotape of the mother's voice. C. Place a picture of the family at the bedside. D. Encourage a parent to stay with the child.

D. Encourage a parent to stay with the child.

What is the best intervention a nurse can utilize to promote parental attachment with their preterm infant? (pp. 833-836, Lowdermilk) A. Allow for privacy. B. Contact support families who have been through the same diagnosis with their own child and allow time to discuss the situation. C. Provide an extensive handbook with information related to the preterm newborn. D. Encourage hands-on participation with infant care.

D. Encourage hands-on participation with infant care.

D. Explain the surgery using a model of the heart

According to Piaget, this is the fourth stage of cognitive development. This stage is characterized by the ability to think logically about abstract principles and hypothetical situations. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A.Sensorimotor B.Preoperational C.Concrete operational D.Formal operational

D. Formal Operational

According to Piaget, this is the fourth stage of cognitive development. This stage is characterized by the ability to think logically about abstract principles and hypothetical situations. (pp. 70-72 [new], 80-83 [old]) Which Piaget stage? A. Sensorimotor B. Preoperational C. Concrete operational D. Formal operational

D. Formal operational

After 6 months of age, which of the following mineral stores becomes depleted in infants? (pp. 283-286 [new], 316-319 [old]) A. Calcium B. Phosphorus C. Fluoride D. Iron

D. Iron

A group of children on one hospital unit are all suffering separation anxiety. When determining the stages of separation anxiety, the nurse recognizes that the child in the "despair" phase is the child who (pp. 224-225 [new], 250-251 [old]) A. Does not cry if parents return and leave again. B. Screams and cries when parents leave. C. Appears to be happy and content with staff. D. Lies quietly in bed.

D. Lies quietly in bed.

Moral development theory differs from cognitive development theory in what way? (pp. 70-73 [new], 80-84 [old]) A. Cognitive development theory deals with the formation of personality. B. Moral development theory predicts how a person will react in any situation. C. Cognitive development theory describes physical changes that take place in stages. D. Moral development theory characterizes the value system of people and their respect for others.

D. Moral development theory characterizes the value system of people and their respect for others.

Currently, the greatest source of lead poisoning in children is from: (pp. 399-400 [new], 437-438 [old]) A. Soil and dust B. Air C. Food and water D. Paint

D. Paint

Which of the following hereditary disorders is transmitted by autosomal recessive inheritance? (pp. 52-55 [new], 59; 61 [old]) A. Cleft lip B. Marfan syndrome C. Osteogenesis imperfecta D. Phenylketonuria

D. Phenylketonuria

To promote drainage of lung secretions in the preterm infant, the nurse should (p. 820, Lowdermilk) A. Position the infant with the face up B. Place a small roll under the buttocks to straighten the spine C. Position flat on the back with the feet higher than the head D. Position the infant's body lying face down

D. Position the infant's body lying face down

The newborn has a heelstick for studies. Which of the following is incorrect technique? (Lowdermilk, pp. 576-577) A. Dampen a diaper with warm water and fasten it over the heel for a few minutes. B. Clean the area with alcohol and dry with sterile gauze or allow to air dry. C. Wipe away the first drop of blood with gauze. D. Puncture the center of the heel with a lancet to a depth of less than 2 mm.

D. Puncture the center of the heel with a lancet to a depth of less than 2 mm.

A mother of a 2-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. The nurse most appropriately tells the mother to: (p. 172 [new], 193 [old]) A. Punish the child every time the child says "no", to change the behavior. B. Allow the behavior because this is normal and expected at this age period. C. Ignore him by walking away to another room, leaving him alone to cry it out. D. Remove him from the source of stimulation by taking him to a quiet, safe place to calm down.

D. Remove him from the source of stimulation by taking him to a quiet, safe place to calm down.

1. Which role would the pediatric nurse be serving when reading and analyzing new research findings and applying those findings to practice? (pp. 2-4) A. Advocate. B. Case manager. C. Educator. D. Researcher.

D. Researcher.

The nurse carefully assesses the preterm infant for respiratory distress syndrome (RDS) because of a deficiency of which substance? (pp. 836-837, Lowdermilk) A. Protein B. Estrogen C. Hyaline D. Surfactant

D. Surfactant

The nurse is teaching the parents about dental care for their toddler. Which of the following information is appropriate for the nurse to include? (pp. 171-172; 283 [new], 192; 316 [old]) A. Allow only a teaspoon-size amount of toothpaste per day B. Flossing is not necessary, due to the negativity and resistance to care of the toddler years C. The child should not take a bottle to bed, but may have a tippy cup D. Teeth should be brushed with a soft bristle nylon brush or washcloth

D. Teeth should be brushed with a soft bristle nylon brush or washcloth

A 4-year-old child is being evaluated for hydrocephalus. An early indication of hydrocephalus in this child would be

Early morning headache

A 4-year-old has acute glomerulonephritis and is admitted to the hospital. An appropriate nursing diagnosis for this child should be

Excess Fluid Volume Related to Decreased Plasma Filtration.

A newborn's failure to pass meconium within the first 24 to 48 hours after birth may indicate all of the following conditions EXCEPT:

Intussusception

A nurse is preparing a child for a barium enema. For which of the following conditions would this plan of care be appropriate?

Intussusception

During a routine pediatric visit, a 6 month old patient will need which of the following vaccines?

RV, DTap, Hib, PCV, IPV, HepB, influenza

A child is undergoing hemodialysis. The child should be monitored closely for (Select all that apply):

Shock, hypotension, infections, bleeding at the access site

Penicillin VK

Sickle cell disease patients are particularly vulnerable to infection. Children with sickle cell disease have a 20- to 100-fold higher rate of incidence of Streptococcus pneumoniae than the general population. This medication is given prophylactically on a daily basis throughout childhood to help prevent this infection from occurring.

Trust vs. mistrust

The first stage, during which children develop faith and optimism. Develops mistrust if the needs are not adequately met.

The West Nile virus is typically carried by a mosquito. A horse has recently been bitten by a mosquito that carries the virus. Which part of the 6 links in the chain of infection does this represent?

The fourth link: transmission

A child has been diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. The nurse should explain that

The mother and the father of the child have the sickle cell trait

Passive immunity is the transfer of active humoral immunity in the form of ready-made antibodies, from one individual to another. Which of the following situations best illustrates passive immunity?

There is a transfer of IgA antibodies found in breast milk when the baby nurses at the breast

Acute chest syndrome

This can be life-threatening and should be treated in a hospital. Symptoms and signs are similar to pneumonia. Signs and symptoms include chest pain, coughing, difficulty breathing, and fever. Prevention: Children with severe SCD can take a medicine called hydroxyurea to help prevent acute chest syndrome. People taking hydroxyurea must be watched closely because the medicine can cause serious side effects, including a low white blood cell count which increases the risk of dangerous some types of infections. A person who is on bed rest or has recently had surgery can use an incentive spirometer, also called "blow bottle," to help prevent acute chest syndrome. Treatment: Depending on the cause, treatment might include oxygen, medicine to treat an infection, medicine to open up airways to improve air, and blood transfusions.

Anemia

This is a very common complication of SCD. With SCD, the red blood cells die early. This means there are not enough healthy red blood cells to carry oxygen throughout the body. When this happens, a person might have: Tiredness; Irritability; Dizziness and lightheadedness; A fast heart rate; Difficulty breathing; Pale skin color; Jaundice (yellow color to the skin and whites of the eyes); Slow growth; and Delayed puberty

A child with acid reflux is given metoclopramide (Reglan). A family member asks why the child is receiving this medication. What is the best response by the nurse?

This medication helps prevent acid reflux by clearing food out of the stomach more quickly.

Deferoxamine mesylate (Desferal)

This medication helps prevent damage to the liver and bone marrow from iron deposition by promoting renal and hepatic excretion in urine and bile in feces. It readily chelates iron from ferritin and hemosiderin but not from transferrin. It does not affect iron in the cytochromes or hemoglobin. This agent is most effective when administered by continuous infusion. It gives urine a red discoloration.

Hydroxyurea

This medication increases fetal hemoglobin (HbF) production and slightly raises the total hemoglobin concentration in the body. Fetal hemoglobin reduces the chance that red blood cells will sickle in a person who has sickle cell disease. So increased production of HbF can reduce the occurrence of sickling-related complications such as vaso-occlusive crisis or acute chest syndrome.

Folic acid

This medication is necessary for erythropoiesis (formation of new red blood cells). Supplemental folic acid replenishes depleted folate stores secondary to hemolysis.

Andres, age 5, has rubeola. The nurse correctly recognizes which of the following as a sign of rubeola?

Tiny gray specks (Koplik's spots) on oral mucous membranes

A nurse is caring for a 4-year-old child who is being seen for the second time with a UTI. The child is to return to the office in 1 week for follow-up and is scheduled for a voiding cystourethrogram (VCUG) in 2 weeks. The purpose of the VCUG is as follows: The VCUG checks for problems of the urethra and bladder, specifically problems with bladder emptying. Having two UTIs in such a short time is unusual for an infant; therefore, it is important to find out the cause of the infection. The VCUG will be scheduled after eradication of the UTI. True or False?

True

Children in the preoperational stage lack the ability to understand the principle of conservation. The principle of conservation states that two equal quantities remain equal even though the form or appearance is rearranged, as long as nothing is added and subtracted. The lack of understanding of conservation can be reflected in centration and irreversibility. (pp. 70-72 [new], 80-83 [old])

True

Chronic conditions causing anemia in children include sickle cell disease, thalassemia major, cancer, aplastic anemia, folate deficiency, inflammatory bowel disease, infection, chronic renal disease, and liver disease. True or false?

True

For the infant, slowly instill liquid medication by dropper along the side of his tongue and the young child, crush pills and mix them with 1/2 teaspoon of baby food or any sweet-tasting substance. True or False?

True

Hypoplastic left heart syndrome consists of hypoplasia (i.e., underdevelopment or incomplete development) of the left ventricle and ascending aorta, maldevelopment and hypoplasia of the aortic and mitral valves (frequently aortic atresia is present), an atrial septal defect, and a large patent ductus arteriosus. Unless normal closure of the patent ductus arteriosus is prevented with prostaglandin infusion, cardiogenic shock and death ensue. The only cure is heart transplantation. This condition can be palliated through three-stage open-heart surgical procedures. This is not a cure, as the child's circulation is made to work with only two of the heart's four chambers. True or false?

True

Munchausen syndrome by proxy (factitious disorder) is usually difficult to diagnose. (pp. 393-394 [new], 432 [old]) True or False?

True

The Glasgow Coma Scale assesses how the brain functions as whole and not as individual parts. The scale assesses three major brain functions: eye opening, motor response, and verbal response. A completely normal child will score 15 on the scale overall. Using the scale consistently in the healthcare setting allows healthcare providers to share a common language and monitor for trends across time. True or false?

True

The core concepts of Family Centered Care on the inpatient hospital unit are: 1. Dignity and Respect-To Listen to and honor patient and family ideas and choices and to use patient and family knowledge, values, beliefs and cultural backgrounds to improve care planning and delivery. 2. Information Sharing-To communicate and share complete and unbiased information with patients and families in useful ways. Patients and families receive timely, complete and accurate details so they can take part in care and decision making. 3. Involvement-To encourage and support patients and families in care and decision making at the level they choose. 4. Collaboration-To invite patients and family members to work together with health care staff to develop and evaluate policies and programs. True or False? (pp. 6, 18-19, 226-228 [new], 6, 20-23, 254 [old]) True False

True

The purpose of adult-directed play in the hospital setting is to increase a young patient's sense of predictability regarding pending medical procedures and health care experiences, increase a sense of self-control, reduce stress from unrealistic fantasies about medical procedures, increase effective coping skills, and to clear up confusions and misconceptions. True or False? (pp. 238-241 [new], 265-268 [old])

True

With acyanotic heart defects, there is a left-to-right shunt. There is increased pulmonary blood flow and the blood is oxygenated. True or false?

True

The nurse is caring for a 4-year-old child with itchy, dry skin from eczema. The child's mother asks how to prevent flare ups. The best intervention to remedy this situation is to:

Use less soap, keep well hydrated, and apply emollient cream

A 4-year-old child with a head injury is demonstrating difficulty swallowing and talking. Which cranial nerve might be adversely affected with this head injury?

Vagus

The nurse is caring for a child who is in sickle cell anemic crisis and has severe pain. The most effective nursing intervention for this child should be

administering pain medication

A child, in renal failure, has hyperkalemia. The nurse plans to instruct that the child should avoid the following foods:

carrots and green, leafy vegetables

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. The nurse should explain that precipitating factors contributing to a sickle cell crisis include

fever dehydration altitude

A child undergoing chemotherapy treatment has the following laboratory values: Absolute neutrophil count of 400 mm3; Hematocrit (HCT) 32%; Platelet Count 150,000 per microliter; Serum Potassium 4.5 mmol/L. The pediatric nurse correctly determines that the child is at risk for:

infection

A child has been diagnosed with stage 3 chronic kidney disease (CKD). The nurse would question the medical order for:

intravenous pyelogram with contrast to visualize kidneys

A school-aged client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with glomerulonephritis. Which of the following interventions should receive the highest priority?

obtaining daily weight measurements

A child with nephrotic syndrome is severely edematous. The primary health-care provider has placed the child on bed rest. An important nursing intervention for this child should be to

reposition the child every two hours

Intussusception

telescoping of the intestines Stool of red currant jelly consistency

Accurate fluid intake and output records and daily weights are particularly important in patients with kidney disease because:

they aid in assessing kidney damage

Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart disease? A. Susceptibility to respiratory infection B. Bleeding tendencies C. Frequent vomiting and diarrhea D. Seizure disorder

A child has experienced a sprain of the right ankle. The school nurse should A. Apply ice to the extremity. B. Apply a warm, moist pack to the extremity. C. Perform passive range of motion to the extremity. D. Lower the extremity to below the level of the heart.

A 5-year-old is hospitalized with a fractured femur. Which of the following assessment tools are appropriate for this age child? Select all that apply. (pp. 315-317 [new], 350-353 [old]) A. FACES pain scale. B. Numeric Rating Scale. C. Visual Analog Scale. D. Oucher Scale. E. PAT Tool. F. FLACC Scale.

A. FACES pain scale. D. Oucher Scale. F. FLACC Scale.

QUESTION 43 Which of the following factors is a risk for the development of ambiguous genitalia (pseudohermaphroditism)? (pp. 873-875 [new], 949 [old]) A. Hypothyroidism B. Congenital adrenal hyperplasia C. Overproduction of aldosterone and cortisol D. Underproduction of adrenal androgens

ANS: B

QUESTION 8 A nurse is reviewing the results of a sweat test performed on a child with cystic fibrosis (CF). The nurse should expect to note which finding? (p. 508 [new], 556 [old]) A. a sweat sodium concentration less than 40 mEq/L B. a sweat potassium concentration less than 40 mEq/L C. a sweat chloride concentration greater than 60 mEq/L D. a sweat potassium concentration greater than 40 mEq/L

ANS: C

QUESTION 36 The pediatric nurse is caring for a 12-year-old child with type 1 diabetes mellitus. In developing a teaching plan, which of the following signs and symptoms of hypoglycemia should the nurse include? (p. 889 [new], 964 [old]) A.Fever B. Fruity breath C. Increased thirst D. Shakiness

ANS: D

QUESTION 42 The neonatal nurse is caring for an infant with a diagnosis of congenital hypothyroidism. Which nursing diagnosis should the nurse most seriously consider when analyzing the needs of the patient? (pp. 869-870 [new], 944-945 [old]) A. Risk for aspiration related to vomiting B. Diarrhea related to increased peristalsis C. Oral mucous membrane, altered related to disease process D. Hypothermia related to slowed metabolic rate

ANS: D

A newborn with possible hypoplastic left heart disease is to be admitted to the nursing unit. Which drug should be available for use? A. Digitoxin (Crystodigin). B. Prostaglandin E1 (Prostin VR). C. Morphine Sulfate. D. Testosterone (Andro).

The laboratory finding that would be seen in the cyanotic heart disease client but not in the acyanotic heart disease client would be a(an): A. Elevated pO2. B. Elevated red blood cell count. C. Decreased hematocrit. D. Decreased pCO2.

The nurse understands that primary dentition is usually completed by age: (p. 118 [new], 133 [old]) A. 18 months B. 3 years C. 4 years D. 6 years

B. 3 years

B. The child typically has lighter skin, hair, and eyes

The pediatric nurse understands that aspirin: (select all that apply) A. Is used on a prophylactic basis to prevent heart attack and stroke in children B. Is used to prevent blood clots from forming in the coronary arteries during the acute phase of Kawasaki disease C. Is used to treat fever in viral illness in children D. Is used to treat joint pain and inflammation in rheumatic fever E. Is used to treat infection in rheumatic fever F. Can be associated with Reye's syndrome, a serious and potentially deadly condition in children and teenagers G. Decreases platelet aggregation and inhibits thrombus formation

BDFG

The pediatric nurse understands that captopril (Capoten), an ACE-inhibitor: (Select all that Apply) A. Decreases preload B. Decreases afterload C. Increases contractility of the heart D. Has side effects of nausea, vomiting, and anorexia E. Has side effects of hypokalemia, metabolic alkalosis, and hypotension F. Has side effects of hyperkalemia and hypotension G. Promotes vascular relaxation and reduced peripheral vascular resistance

BFG

A nurse is preparing to admit a child with possible hydronephrosis. What labs should the nurse expect to draw on this child?

Blood urea nitrogen (BUN) and creatinine.

When assessing a child who has a neuroblastoma of the adrenal gland, which of the following findings indicate to the nurse that the child has developed metastasis from the primary site? (Select all that apply.)

Bone pain Varying degrees of paralysis Hepatomegaly

A 16 month old child diagnosed with Kawasaki Disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. Which of the following should the nurse interpret as the priority? A. applying lotions to the hands and feet B. offering foods the toddler likes C. placing the toddler in a quiet environment D. encouraging the parents to get some rest

A 5 year old child has been transferred to the pediatric unit after a cardiac catheterization. The nurse has checked the sheath insertion site for bleeding, oozing, or hematoma. In order of priority, which of the following interventions should the nurse do next? A. Monitor the child's comfort level B. Position the child's leg so that it is straight C. Assess the strength and presence of the distal pulses D. Take the vital signs, including blood pressure and oxygen saturation

Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse documents: A. Patient is a victim of child abuse. B. Abuse suspected by the mother. C. The location, shape, color and size of the burn D. Patient brought in due to accidental causes.

C. The location, shape, color and size of the burn

The following question stems from this scenario: Monique walks into the ED carrying her crying 18-month old daughter. She tells the nurse her daughter crawled into the leg of the ironing board. The hot iron tumbled off the board and the child touched it before she could interfere. But the burn is on the edge of the child's palm and on her wrist, not her fingers. "This isn't the first time she's touched the iron," Monique says. "You would think she'd learn." When the nurse examines the child, the mother complains that there is nothing wrong with her other than the burn on her hand. During her assessment, the nurse notes scars on the child's back and buttocks shaped like the tip of an iron. (pp. 388-394 [new], 426-432 [old]) The nurse documents: A. Patient is a victim of child abuse. B. Abuse suspected by the mother. C. The location, shape, color and size of the burn D. Patient brought in due to accidental causes.

C. The location, shape, color and size of the burn

Which of the following are examples of primary prevention activities or strategies? (pp. 145-146, 151-152 [new],163-164; 170-171 [old]) A. Using medication to treat conditions such as high blood pressure or high cholesterol, screening for sexually transmitted infections or utilizing nicotine patches to reduce smoking frequency B. For a child with juvenile arthritis, doing exercises, participating in physical therapy, and taking medication to control inflammation and pain C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition D. For a child with a disabling injury, intensive, longterm physical therapy to regain use of limbs or develop alternate means for independent functioning

C. Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition

An intramuscular injection has been prescribed for an 8-month-old child. The pediatric nurse determines which of the following anatomic sites as most appropriate for this child? (Slide # 114-117, Lecture PowerPoint) A. Deltoid B. Dorsogluteal C. Vastus lateralis D. Ventrogluteal

C. Vastus lateralis

At 30 months of age, the toddler should be expected to: (Refer to Toddler Developmental Grid) A. Copy a circle. B. Ride a tricycle. C. Walk on tiptoes. D. Walk up and down stairs.

C. Walk on tiptoes.

The pediatric nurse understands that lanoxin (digoxin): (select all that apply) A. Decreases preload B. Decreases afterload C. Increases contractility of the heart D. Has side effects of nausea, vomiting, anorexia, and bradycardia E. Has side effects of hypokalemia, metabolic alkalosis, and hypotension F. Has side effects of hyperkalemia and hypotension G. Can interact with over-the-counter medications, herbal preparations, and antibiotics.

CDG

An infant is born with bladder exstrophy. The nurse should:

Cover exposed bladder tissue with sterile plastic wrap. Assess skin surace around the exposed area for excoriation. Irrigate bladder mucosa with warm saline. Tie umbilical cord with 2.0 silk suture

D. Tertiary prevention

The nurse assessing a preterm infant understands that the infant's level of maturation refers to: (p. 554, Lowdermilk) A. actual time the baby remained in the uterus. B. age on the New Ballard scoring system. C. infant's weight as compared to the gestational age. D. ability of the organs to function outside of the uterus.

D. ability of the organs to function outside of the uterus.

A first-time mother asks you about the reasons for breastfeeding. You should state that: (pp. 157, 169; 282-283 [new], 178, 190; 315-316 [old]) A. breastfed infants do not have SIDS. B. breast milk hinders maturation of the GI tract. C. breastfed infants have a high incidence of allergies. D. breast milk contains antibodies that can protect against infections.

D. breast milk contains antibodies that can protect against infections.

A father refuses the measles, mumps, and rubella (MMR) immunizations for his child because he does not want the child to suffer pain or injury, and he believes the MMR vaccine injection might cause autism. The priority nursing diagnosis for this father should be which of the following?

Deficient Knowledge (Parent): Potential Side Effects of Vaccines, related to lack of correct information.

If respiratory depression occurs with opioid use, the pediatric nurse should use which reversal agent when oxygen and stimulation of the child are ineffective? A. Atropine sulfate B. Dexamethasone C. Epinephrine D. Methylprednisolone E. Nalaxone hydrochloride F. Sodium bicarbonate G. Dextroamphetamine H. Midazolam hydrochloride

E. Nalaxone hydrochloride

If respiratory depression occurs with opioid use, the pediatric nurse should use which reversal agent when oxygen and stimulation of the child are ineffective? (Slide # 72, PowerPoint lecture) A. Atropine sulfate B. Dexamethasone C. Epinephrine D. Methylprednisolone E. Nalaxone hydrochloride F. Sodium bicarbonate G. Dextroamphetamine H. Midazolam hydrochloride

E. Nalaxone hydrochloride

Which of the following are characteristics of hemophilia?

Easy bruising occurs. Gum bleeding occurs. It is a hereditary bleeding disorder. The blood does not clot properly, due to defects or the absence of clotting factors in the blood.

The ketogenic diet is used to treat:

Epilepsy

Discharge instructions for care of a child who has just had an orchiopexy should include

Explanation to the parents about the need for loose, nonrestrictive clothing.

Brain death is the same as persistent vegetative state. True or false?

False

Pertussis (whooping cough) is spread through feces and oropharyngeal secretions of infected persons, especially young children.

False

A nurse is assessing a child with a rash. Which finding should lead the nurse to conclude that the child has varicella?

Generalized rash, which is a combination of red papules, vesicles, and scabs in various stages

A nurse is teaching a client to perform peritoneal dialysis in preparation for discharge to home. The nurse tells the client to use which of the following to prevent infection when connecting and disconnecting the peritoneal dialysis system?

Gloves and mask

The nurse is teaching a group of mothers of infants about the benefits of immunization. The nurse will explain that the life-threatening disease epiglottitis can be prevented by immunization against

Haemophilus influenzae type B (Hib)

Hemodialysis and peritoneal dialysis are both used to treat kidney failure. Which of the following are correct statements? (Select all that apply)

Hemodialysis uses a man-made membrane (dialyzer) to filter wastes and remove extra fluid from the blood. Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) and a solution (dialysate) to remove wastes and extra fluid from the body. With hemodialysis, disequilibrium syndrome can occur. Disequilibrium syndrome of dialysis has essentially the same symptoms as cerebral edema: dizzy, faint, lightheaded, ringing in the ears, racing pulse, feeling warm, sweating, nausea, vomiting, yawning, itching and severe muscle cramps (anywhere on the body). It is due to a shift of water to the intracellular spaces as a result of the loss of urea With peritoneal dialysis, the child can ambulate and interact with the environment. Hemodialysis usually is done 3 days a week and takes 3 to 5 hours a day. With peritoneal dialysis, the fluid remains in the peritoneal cavity for 4 to 8 hours.

A child with acute lymphoblastic leukemia (ALL) who is receiving chemotherapy has the following lab results: WBC 9,000, Hemoglobin 12, and Platelets 20,000. When planning this child's care, which risk should the nurse consider most significant?

Hemorrhage

Which of the following are characteristics of hemophilia or recommended treatment for hemophilia? (Select all that apply).

In hemophilia, there is a deficiency of one of the factors necessary for blood coagulation. An abnormal clotting pattern occurs, resulting in an ineffective clot. Hemophilia is inherited as an x-linked recessive disorder. The mother passes this disorder to her male children. When a female inherits the gene from her father, she has a 50% chance of transmitting it to her son. Bleeding and bruising easily. Gum bleeding occurs. Joint hemorrhages or hemarthrosis. Early signs are stiffness, tingling or aching in the joint, and inability to move the joint. Other symptoms are warmth, redness, swelling, and pain. Intracranial bleeding is the major cause of death in children with hemophilia.

Chemotherapy is one of the therapeutic modalities for pediatric cancer. This treatment is contraindicated in which of the following conditions? (Select all-that-apply)

Infection Recent surgery Impaired renal and hepatic function Pregnancy

The nurse practitioner discusses the Varicella vaccine with 15-month-old Mario's father. Varicella vaccine should NOT be given if Mario:

Is currently immunocompromised

Which of the following is the best indicator of brain function in a child with a moderate brain injury?

Level of consciousness

An important nursing intervention when caring for an infant with a myelomeningocele (meningomyelocele) in the preoperative stage should be to

Measure head circumference every shift to identify developing hydrocephalus.

A nurse is caring for a child with sickle cell anemia who is suffering from a vaso-occlusive crisis. Which of the following interventions should the nurse employ to effectively monitor and to help improve the blood flow to the child's tissues?

Monitor vital signs carefully. Assess pulses for rate, rhythm, and volume. Note hypotension; rapid, weak, thready pulse; and tachypnea with shallow respirations. Assess skin for coolness, pallor, cyanosis, diaphoresis, and delayed capillary refill. Note changes in LOC; reports of headaches, dizziness; development of sensory or motor deficits, such as hemiparesis or paralysis; and seizure activity. Maintain adequate fluid intake. Monitor urine output. Maintain environmental temperature and body warmth without overheating. Avoid hypothermia. Administer oxygen to saturate circulating hemoglobin and increase the effectiveness of blood that is reaching the ischemic tissues.

The Glasgow Coma Scale is used to measure neurological functioning. Which of the following criteria would indicate the lowest level of functioning for an infant or young child?

No response to painful stimuli

A child with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which of the following actions should be taken by the nurse?

Obtain a blood pressure on the child; notify the physician.

Inguinal hernia

Painless swelling extending toward the scrotum

Scenario: A 3-year-old child with Wilms' tumor of the right kidney is admitted to the pediatric oncology unit. He is to undergo a course of chemotherapy, followed by radiation treatments to shrink the tumor before surgically removing it, along with the kidney and the adjacent adrenal gland. The child will receive additional radiation after surgery. When completing the child's admission assessment, which of the following components of the abdominal assessment should the nurse avoid?

Palpation

A nurse is educating a parent regarding the immunizations that a child is to receive during the first year of life. Which of the following immunizations did the nurse discuss?

Polio

By the age of 4 months, most infants should have received at least one dose of:

RV, DTaP, Hib, PCV, IPV, HepB

During a routine pediatric visit, a 2 month old patient will need which of the following vaccines?

RV, DTaP, Hib, PCV, IPV, HepB

A mother refuses to have her child receive any immunizations, based on her religious beliefs. The priority nursing diagnosis when planning health teaching for this family is which of the following?

Risk for Infection related to incomplete immunization series

The mother of a child who is immunosuppressed asks about continuation of the childhood vaccines. Which immunization is not recommended to be given to the child during immunosuppression?

Rotavirus Vaccine (RV)

The nurse assesses a 4-year-old who has had no immunizations. The child does not appear ill, but has a fine, pink, itchy maculopapular rash that progressed from the face to the neck, chest, and back, then to the extremities within three days. The child has a low-grade fever. Cervical and occipital lymph nodes are tender and enlarged. Which communicable disease should the nurse suspect?

Rubella (German measles)

Koplik's spots, and a rash which spreads from central body structures out towards the arms and legs

Rubeola (measles) virus

Ringworm

Trichophyton tonsurans

Munchausen syndrome by proxy (factitious disorder) is usually difficult to diagnose. (pp. 393-394 [new], 432 [old]) True or False? True False

True

The nurse is reviewing discharge instructions with the child and his parent for a school-age child with acute glomerulonephritis. Which of the following should the nurse include? (Select all that apply.)

Weigh the child daily Check the child's blood pressure daily Continue the prescribed antibiotics Elevate edematous body parts

The mother of a child with varicella asks the nurse when the child may return to daycare. The nurse correctly responds by telling the mother that the child can return:

When the lesions are crusted over

You are the triage nurse in an emergency room. Your initial assessment indicates that head lice may be part of the 10-year-old child's problem. Which assessment finding is typical of head lice?

White flecks on hair

Protrusion of bladder through lower abdominal wall

bladder exstrophy

Treshaun, age 5, has sickle cell anemia. His mother asks how he can avoid a sickle cell pain crisis. Which of the following can trigger a sickle cell crisis?

dehydration infection, such as the cold or flu low oxygen levels from difficult exercise, flying, or high altitude medical procedures or surgery strong emotions, such as anger or depression getting cold or going from warm to cold quickly stressful situations such as bullying at school, moving to a new house, parents divorcing, or death of a family member

Which of the following conditions or factors places the child at risk for development of renal failure? (Select-all-that-apply)

dehydration hydronephrosis vesicoureteral reflux glomerulonephritis pyelonephritis nephrotic syndrome gentamicin use history of intravenous pyelogram

Scenario: A nurse is caring for a 9-year-old child who is being seen for the second time with a UTI. Which of the following findings should the nurse expect during an initial assessment? (Select all that apply.)

dysuria foul smelling urine

A nurse is reviewing a patient's chart and notices that the child suffers from a urinary tract infection. Which of the following microorganisms is related to this condition?

escherichia coli

Which of the following clinical manifestations of a lower urinary tract infection (UTI) are commonly seen in infants? (Select-all-that-apply)

fever of the unknown origin failure to thrive poor feeding foul smelling urine vomiting and/or diarrhea irritability and lethargy failure to gain weight

A child with nephrotic syndrome has been placed on prednisone for several weeks. An important point of teaching with the parents should include:

never stop the med suddenly

When caring for the child with leukemia who is at risk for bleeding, which of the following measures should be avoided?

performing a rectal examination

Narrowing of the preputial opening of the foreskin that prevents retraction of the foreskin over the glans penis

phimosis

You are the nurse in charge on a pediatric unit. A child with sickle cell disease, in splenic sequestration crisis, is being admitted. You should assign this child to a

private room

A child who has nephrotic syndrome is admitted to the pediatric unit. Which of the following should the nurse expect to find?

proteinuria hypoalbuminemia hyperlipidemia

The pediatric nurse understands that which of the following is normal and expected for a child with end-stage renal disease (ESRD)?

serum of hemoglobin if 7.2 g/dL history of glomerulonephritis or nephrotic syndrome oliguria and hypertension history of pyelonephritis lack or loss of appetite

A nurse is taking care of a school-age child with acute glomerulonephritis who is taking potassium-sparing diuretics. The nurse anticipates discussing the diet with the child and his parents. The diet should include:

sodium restriction

A child has undergone a kidney transplant and is receiving tacrolimus and cyclosporine. The parents ask the nurse about the reason for these two medications. The nurse should explain that these medications are given to

suppress rejection

An adolescent with a history of surgical repair for undescended testes (cryptorchidism) comes to the clinic for a sports physical. Anticipatory guidance for the parents and adolescent would focus on which of the following as most important?

technique for monthly testicular self- examinations

The goal of chemotherapy is to target specific aspects of the cell cycle to maximize tumor cell death and minimize healthy cell damage. True or false?

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