PEDS FINAL (Quizzes 1-9)
The nurse should teach a parent to introduce solid foods to an infant at what age?
6 months
Normal heart rate (HR) and respiratory rate (RR) for adolescents is:
60-100 HR. 12-20 RR
Tina is 33 inches tall at 24 months. The nurse anticipates that Tina will be how many inches tall when fully grown?
66 inches
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 change in heart rhythm
Chordee
A fibrous band on the ventral side of the penis resulting in a ventral curvature of the penis
Which seat is the best for a 35 pound 4 year old?
A forward-facing car seat with harness straps
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
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?
A short-acting bronchodilator (also called short-acting beta-2 agonist, or SABA) such as albuterol.
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:
A sodium restriction
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.
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?
A sweat chloride concentration greater than 60 mEq/L
Neonatal Abstinence Syndrome (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 the drug withdrawal after birth. Which of the following are signs and symptoms of NAS?
- Body shakes - Excessive crying - Poor feeding - Stuffy nose - High-pitched cry
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?
- Bone pain - Varying degrees of paralysis - Hepatomegaly
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?
- Child may experience hypoglycemia shortly after breakfast - Child may experience hypoglycemia at dinnertime - Administer room temperature insulin only
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 blood pressure
An infant is born with bladder exstrophy. The nurse should:
- Cover exposed bladder tissue with sterile plastic wrap - Assess skin surface around the exposed area for excoriation - Irrigate bladder mucosa with warm saline - Tie umbilical cord with 2.0 silk suture
Preterm infants are at risk for cold stress. Which signs should alert the nurse that the preterm infant may be hypothermic?
- Cyanosis - Hypoglycemia - Irritability - Bradycardia
The pediatric nurse understands that captopril (capoten), an ace-inhibitor:
- Decreases afterload - Has side effects of hyperkalemia and hypotension - Promotes vascular relaxation and reduced peripheral vascular resistance
The nurse understands that spironolactone (aldactone):
- Decreases preload - Has side effects of hyperkalemia and hypotension - Is a potassium-sparing maintenance diuretic
The pediatric nurse understands that furosemide (Lasix):
- Decreases preload - Has side effects of hypokalemia, metabolism acidosis, and hypotension - Promotes rapid diuresis by blocking reabsorption of sodium and water in the renal tubules
Which of the following conditions or factors places the child at risk for development of renal failure?
- Dehydration - Hydronephrosis - Vesicoureteral reflux - Glomerulonephritis - Pyelonephritis - Nephrotic syndrome - Gentamicin use - History of intravenous pyelogram
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 a cold or the 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
The pediatric nurse understands that advantages of an external insulin infusion pump include which of the following?
- Delivers a continuous infusion of insulin - Helps maintain blood glucose control between meals - Reduces number of injections - Results in fewer incidences of diabetic ketoacidosis
Clinical manifestations of prematurity include:
- Disproportionately large head - Fine hair (lanugo) covering much of the body - Lack of fat stores - Thin, translucent skin
Signs and symptoms of congenital heart disease in infants include:
- Dyspnea with crying or eating - Pallor - Poor feeding - Sweating - Murmur - Cyanosis with crying or eating - Fatigue - No weight gain - Irritable
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?
- Dysuria - Foul-smelling urine
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.
Applications of the principle of atraumatic care in the pediatric setting include which of the following?
- Encouraging the family to room in with the child - Identify child/family stressors - Effectively managing pain
The classic signs and symptoms of eczema are which of the following?
- Erythema - Lesions (weep and crust) - Pruritus - Small papules and vesicles
Which of the following are accurate statements concerning anticipatory guidance?
- Examples of anticipatory guidance are informing parents of newborns about physical changes in their infant (ex. teething), and anticipating concerns in parents of adolescents due to alcohol and drug abuse - Anticipating guidance is key to achieving a primary goal of pediatric nursing care, which is health promotion - This is guidance provided by the pediatric nurse to parents, in anticipating likely upcoming concerns with the child - 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
Which of the following developmental delays are seen in children with Down Syndrome?
- Expressive and receptive language delays - Cognitive impairments - Fine and gross motor delays (All of the above)
The neonatal nurse understands that factors contributing to the development of bronchopulmonary dysplasia (BPD) include which of the following?
- Extra oxygen for breathing - Low amount of surfactant - Prematurity - Use of a mechanical ventilator
A 5-year-old is hospitalized with a fractured femur. Which of the following assessment tools are appropriate for this age child?
- FACES pain scale - Oucher scale - FLACC scale
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
Which of the following clinical manifestations of a lower urinary tract infection (UTI) are commonly seen in infants?
- Fever of unknown origin - Failure to thrive - Poor feeding - Foul-smelling urine - Vomiting and/or diarrhea - Irritability and lethargy - Failure to gain weight
Factors that contribute to childhood morbidity are:
- General health - Psychosocial factors - Socioeconomic factors
Nursing interventions to promote a balanced dietary intake of food and fluids in an infant with congestive heart failure include:
- Weigh the child daily - Use high-calorie concentrated formula - Space feedings 3 hours apart - Use supplemental tube feedings if the infant to too fatigued to ingest a sufficient amount by mouth - Limit bottle feedings to 20-30 minutes - Provide small, frequent feedings
Which of the following are true concerning the Babinski reflex?
- With a positive Babinski response, the infant's smaller toes fan out and the big toe dorsiflexes slowly - Usually disappears by 1 year of age - Abnormal in a child >2yeas of age (indicated central nervous system dysfunction) - 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 - 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 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:
1 ml/kg/hr
The nurse explains that the statistics of infant mortality are expressed in number of infant deaths per:
1,000 live births
Stages of Infection...
1. Incubation 2. Prodromal Stage 3. Acute Illness 4. Convalescent Stage
Mumps has an incubation period of:
12-25 days
Which of the following children would most likely be diagnosed with type 2 diabetes mellitus?
12-year-old with dark patches of skin
The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that the hospitalized child who is at highest risk for experiencing separation anxiety when parents cannot stay is the:
18-month-old
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.)
22.7 X 2 = 45.5
An infant weighted 7 lbs, 11 oz at birth. What should the nurse expect this infant to weigh at 12 months of age?
23 lbs
A child should be able to pull off her shoes by which age?
24 months
Most children are ready to begin the process of toilet training by which age?
27 months
The nurse understands that the primary dentition is usually completed by age:
3 years
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+ to 4+ protein in the urine.
The pediatric nurse understands that the rooting reflex typically disappears at which age?
3-4 months
Term Gestation
38-42 weeks gestation
Most children are able to feed themselves using a spoon by age:
4 years
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.
4, 2, 3, 1
An infant seat should recline at an angle of:
45 degrees
Tetralogy of Fallot (TOF)
Aorta is lined up just over the hole between the bottom two chambers of the heart
What is the best liquid for the nurse to give to a child who has had a tonsillectomy?
Apple juice
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 knee
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
When a preterm infant who is being gavage fed has a bloody stool, the nurse should:
Assess for abdominal distention
The nurse is caring for a child who has been sedated for a painful procedure. The priority nursing activity for this child should be:
Assess the child's respiratory effort
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?
Assess the strength and presence of the distal pulses
Gestational age is best determined with:
Assessment of physical and neurological characteristics
When using a forward facing convertible seat, the harness straps should be located:
At or slightly above the child's shoulders using the top set of harness slots
When using an infant seat, the 5-point harness straps should be located:
At or slightly below the infant's shoulders
Where should a harness chest clip be positioned?
At the level of his armpits
____________ 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
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?
Autonomy vs. Shame and Doubt
Huntington's disease, neurofibromatosis-1, achondroplasia, and Marfan syndrome are examples of genetic conditions transmitted by which pattern of inheritance?
Autosomal dominant
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.
Egocentrism
This does not mean selfishness or conceit as social psychologists use this word. This means that children lack the ability to consider another person's point of view or perspective.
Trust vs. Mistrust
This first stage, during which children develop faith and optimism. Develops mistrust if the needs are not adequately met.
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
Albuterol inhalation (generic) Brand Names: ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA
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.
Centration
This is the tendency to focus or center on one aspect of the situation and ignore other important aspects of the situation.
Deferoxamine Mesylate
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.
Ipratropium bromide (generic) Brand name: Atrovent HFA, Atrovent
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.
Montelukast (generic) Brand Name: Singulair
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.
Levalbuterol inhalation (generic) Brand Names: Xopenex, Xopenex Concentrate, Xopenex HFA
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.
Prednisone
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
Follic Acid
This medication is necessary for erythropoiesis (formation of new red blood cells). Supplemental folic acid replenishes depleted folate stores secondary to hemolysis.
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:
This position helps keep the airway open
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 preoperational stage lack the ability to understand the principle of conservation. The principle of conservation states that two equal quantities remain equal 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. True or False?
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 is usually difficult to diagnose. 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
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?
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?
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
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
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?
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:
Two weeks later
Epispadias
Urethral meatus located on the dorsal (upper) side of the glans penis
Hypospadias
Urethral meatus located on the ventral (lower) side of the glans penis
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
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?
Vastus lateralis
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:
Call the family nurse practitioner to see if the child's orders for pain medication can be changed
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?
Call the nationwide poison control center at 1-800-222-1222
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
Which role would the pediatric nurse be serving when providing support and assisting with resources and referrals?
Case manager
A child must be able to sit before he can walk. This is an example of which directional pattern of development?
Cephalocaudal
The nurse is teaching parents of an infants about introduction of solid food to their baby. What is the first food they can add to the diet?
Cereal
Which assessment data is most indicative of a potential complication of Kawasaki's disease?
Change in blood pressure, pulse, and skin color; complaints of pain in the chest
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:
Close monitoring of output
Hydrocele
Collection of fluid in the scrotal sac
According to Piaget, the 7-10-year-old-child is at which of the following stages of cognitive development?
Concrete Operational
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.
Concrete Operational
Which of the following factors is a risk for the development of ambiguous genitalia (pseudohermaphroditism)?
Congenital adrenal hyperplasia
The pediatric nurse takes into consideration that the primary cause of infant mortality is:
Congenital deformities
As an advocate for the child undergoing bone-marrow aspiration, the nurse should most appropriately suggest:
Conscious sedation
A maternity nurse is providing instruction to a new mother regarding the psychosocial development of her newborn infant. Using Erikson's psychosocial development theory, the nurse should instruct the mother to:
Consistently meet the infant's needs, when the newborn signals a need
Identity vs. Role Confusion
Consumed with looks and viewpoints of others.
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 common cause of food allergy in young children is:
Cow's milk
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?
Cremasteric reflex depressed or absent
The pediatric nurse understands that which of the following medications used to treat asthma, is a mast cell inhibitor?
Cromolyn Sodium (generic) Brand name: Intal
The nurse needs to administer a medication to a 4-year-old child. The medication is only available in tablet form. The nurse should:
Crust the tablet and mix it in a tablespoon of applesauce
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.
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
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
The nurse carefully assesses the preterm infant for respiratory distress syndrome (RDS) because of a deficiency of which substance?
Surfactant
Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart disease?
Susceptibility to respiratory infection
Which study provides a definitive diagnosis of cystic fibrosis?
Sweat chloride test
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.
A child has been admitted to the hospital unit in congestive heart failure (CHF). Symptoms related to this admission diagnosis should include:
Tachycardia
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?
Teaching parents to administer aspirin and watch for side effects
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 nurse is teaching the parents about dental care for their toddler. Which of the following information is appropriate for the nurse to include?
Teeth should be brushed with a soft bristle nylon brush or washcloth
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 preventative health maintenance?
Tertial prevention
In assessing children with congenital heart defects, the nurse would expect to see clubbing of the fingers and toes in the child diagnosed with:
Tetralogy of Fallot
Baby Smith weighs 14 pounds. What is his hourly fluid needs?
26.5 ml/hr
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?
8,500 grams
The nurse is working in a pediatric surgical unit. In discussing patient-controlled analgesia in a preop parental meeting, the nurse should explain the PCA is most appropriate for the:
A 12-year-old, postop from spinal fusion for scoliosis
During the nurse's 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:
Administer prescribed analgesic
Which stage of development is most unstable and challenging regarding development of personal identity?
Adolescence
Object Permanence
An object continues to exist when it can no longer be seen.
School-age children engage in a type of play that is goal-oriented. The children plan, assign roles, and play together with established rules.
Cooperative play
Industry vs. Inferiority
During this stage, children develop a sense of competency. Learns to socialize.
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:
EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to the skin at least one hour prior to the procedure
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 appropriate response by the nurse?
Each pregnancy carries a 25% chance of the child being affected
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:
Encourage a parent to stay with 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:
Experiencing respiratory depression to opioid administration for postoperative pain.
While teaching a 10 year-old child about his impending heart surgery, the nurse should:
Explain the surgery using a model of the heart
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........?
Feelings of inferiority
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.
Formal Operational
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:
Have teens who have had similar experiences talk to the adolescent about hospitalization
Moral development theory differs from cognitive development theory in what way?
Moral development theory characterizes the value system of people and their respect for others
Which of the following features is NOT commonly seen in children with Down Syndrome?
Muscle spasticity
If respiratory depression occurs with opioid use, the pediatric nurse should use which reversal agent when oxygen and stimulation of the child are ineffective?
Nalaxone Hydrochloride
Which of the following hereditary disorders is transmitted by autosomal recessive inheritance?
Phenylketonuria
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?
Preconventional Moral Reasoning
According to Piaget, the second stage of cognitive development that is characterized by the increase use of symbols and prelogic thought processes. When Piaget uses the word "operational", "operations", etc... he refers to logical, mental activities.
Preoperational
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:
Provide the child with a doll and safe medical equipment
With phenylketonuria:
The child typically has lighter skin, hair, and eyes
The stage that occurs between birth and one year of age is concerned with:
Trust vs. Mistrust
Which of the following are examples of primary prevention activities or strategies?
Vaccination, behavioral counseling for smoking cessation, physical activity, and nutrition
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
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
The pediatric nurse understands that which of the following is normal and expected for a child with end-stage renal disease (ESRD)?
- Serum hemoglobin of 7.2 g/dL - History of glomerulonephritis or nephrotic syndrome - Oliguria and hypertension - History of pyelonephritis - Lack or loss of appetite
A child is undergoing hemodialysis. The child should be monitored closely for:
- Shock - Hypotension - Infections - Bleeding at the access site
The pediatric nurse understands that characteristics of pulmonary hypertension include:
- The causes are lung disease and some congenital heart diseases - 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 - Symptoms include chest pain, weakness, shortness of breath, and fatigue - Must treat this condition early while still reversible to prevent permanent destructive pulmonary vascular remodeling - Treatments include sildenafil, calcium channel blockers, diuretics, nitric oxide, and lung transplantation
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?
- The infant attends daycare - The infant was born with a cleft palate - The infant's father smokes cigarettes
A phone triage nurse receives a call from a father who reports possible head lice on his child. Which of the following information should the nurse tell the father?
- Treat the head lice with an over-the-counter preparation - Avoid hair-to-hair contact with the child - Brushes, hats, or hair clips needs to be sanitized
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?
- Unexplained weight loss - Increased thirst - Abdominal pain - Vomiting - Drowsiness - Enuresis (bed wetting) in a previously continent child
Which of the following strategies should be employed to reduce pediatric medication errors?
- Use capital letters to distinguish between medications - 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?
- Use the Numeric Rating Scale to determine the child's pain level - Tell the child to ring the bell if the leg starts hurting - Administer pain medication as ordered and as needed per provider specification
Which of the following are characteristic or descriptive of an intravenous pyelogram (IPV)?
- Visualize kidneys, ureters, and bladder - Laxatives or enemas may be ordered prior to remove gas or fecal material - Nephrotoxic dye - Use of IV contrast medium - Ask about allergies to contrast or shellfish - Increase fluids afterwards to flush contrast
A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). The nurse should be prepared to:
Administer nebulized epinephrine and oral or IM dexamethasone
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 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?
Balloon
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 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:
Begin oxygen per nasal cannula
Which of the following developmental markers should the nurse expect to see in caring for an infant who is four months old?
Begins to use consonant sounds; no head lag when pulled to sitting position
The pediatric nurse understands that blood sugar is well controlled when hemoglobin A1C is:
Between 4% - 5.6%
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?
Bleeding into the brain tissues around the ventricles
Which assessment finding by the nurse would be least suggestive of respiratory distress syndrome (RDS) in an infant?
Bloating or swelling of the belly (abdominal distention)
The client has been diagnosed to have glomerulonephritis. What should the nurse observe in the urine?
Blood
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:
Blood pressure of the four extremities
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?
Blood sugar check
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
A characteristic sign of necrotizing enterocolitis (NEC) in the newborn is:
Bloody diarrhea
Which evaluation would indicate a toxic dose of digoxin?
Bradycardia and nausea and vomiting
A first-time mother asks you about the reasons for breastfeeding. You should state that:
Breast milk contains antibodies that can protect against infections
The pediatric nurse is performing a developmental screen on a 15-month-old child. This child should typically be able to:
Build a 3-block tower
Rubella Virus
Fine red, rash, swollen glands, joint pain
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
The actual time that the fetus remains in the uterus is termed:
Gestational age
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
An athletic activity the nurse should recommend for a school-age child with pulmonary-artery hypertension is:
Golf
Match the color-coded category of the Pediatric Early Warning Score with the correct numerical score.
Green 0-2 Yellow 3 Orange 4 Red >5
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:
Grunting respirations with nasal flaring
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 Influenza Type B (Hib)
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:
Has a weak coordination of sucking and swallowing
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?
Head circumference
Pediculosis Humanus Capitis
Head lice
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
During a routine pediatric visit, a 12 month old patient will need which of the following vaccines?
Hib PCV MMR Varicella HepA
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?
Hypothermia related to slowed metabolic rate
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 MMR Varicella
Sucking
Immediate sucking when something placed in the mouth.
The nurse has admitted a child with a ventricular septal defect (VSD) to the unit. An appropriate nursing diagnosis for this child is:
Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow
Staphylococcus or Streptococcus
Impetigo Contagiosa
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?
Improved level of consciousness (LOC) and decreasing urine output
Where is the safest place for a 55 pound 6 year old to sit in the car?
In a booster seat in the back seat
Where should a 25 pound 9 month old ride in the car?
In a rear-facing car seat in the middle of the back seat
Where should most children ride in the car?
In the back seat until they are 13 years old
The administration of prednisone to children with nephrotic syndrome creates the problem of:
Increased risk of infection
The nurse is aware that the prevalence of chronic health conditions in children is:
Increasing as a result in health care and treatment
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?
Industry vs. Inferiority
When caring for a preterm infant at 30 weeks of gestation, the nurse should recognize that the newborn's priority nursing diagnosis is:
Ineffective breathing pattern related to surfactant deficiency and weak respiratory muscle effort
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
Infections in the newborn require prompt intervention because:
Infections that are relatively harmless to an adult can be fatal to the newborn
A child is 5 years old and has been recently admitted to the hospital. According to Erikson, In which of the following stages is this child?
Initiative vs. Guilt
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.
Autosomal dominant
Beta-thalassemia, cystic fibrosis, Gaucher disease, phenylketonuria, sickle cell disease, and Tay-Sachs disease are examples of genetic conditions transmitted by which pattern of inheritance?
Autosomal recessive
Parents of a newborn are confused when their child is diagnosed with a genetic disorder because neither of them have the 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 the genetic disorder?
Autosomal recessive condition
The nurse is aware the 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:
- A 14-year-old girl married to a 16-year-old boy - A 17-year-old serving in the US Navy - A 17-year-old seeking medical care for a STD
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:
Assist the child back to his room for treatment but reassure the child that he may return when the procedure is complete
Which of the following is the best example of appropriate communication with a young child in the hospital setting?
"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?
"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 growing rapidly, and asks the nurse if this is normal and how long it will last. The best nursing response is:
"This is normal and can last until about age 20."
Childhood obesity is defined as:
BMI at or above the 95th percentile
Breastmilk is preferred over formula because:
Breastmilk contains antibodies
Which role would the pediatric nurse be serving when reading and analyzing new research findings and applying those findings to practice?
Researcher
Which of the following does NOT demonstrate atraumatic care for the hospitalized child?
Restrain the child, holding him down firmly during procedures to prevent injury
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:
See if there's cause to suspect that a baby or toddler has a disability or developmental delay
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.
Sensorimotor
The nurse correctly recognizes that a shared goal of early intervention for both Maple Syrup Urine Disease (MSUD) and Phenylketonuria (PKU) is avoidance of which complication?
Severe neurologic impairment
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.
The nurse's initial interventions are aimed at: - Attending to the child's physical injuries. When child abuse is suspected, the nurse's initial assessment should include: - Gathering information from many sources to determine how the injury occurred. Monique's explanation of how the child was injured is: - Inconsistent with the injury The nurse documents: - The location, shape, color, and size of the burn.
Irreversibility
They cannot reverse a sequence or logical operations. A child displaying irreversibility says 2x4 is different than 4x2. Likewise a child may be able to perform multiplication but not division.
Symbolic Thinking
They start to use words, images, and symbols to represent their world. Such behaviors are characterized by: - The use of language ("fly" represents an annoying, buzzing creature) - Use of fantasy and imagination (remember when you built a fort out of couch cushions)
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:
Whether the perpetrator is always present when the child has symptoms
What types of disorders are abnormalities that result rom an abnormal sex chromosome?
X-linked
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 acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following medications right away?
Albuterol (generic) Brand names: Ventolin, ProAir HFA, Ventolin HFA, Proventil
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:
Allow the child to assist with her care
The nurse must perform a procedure on a toddler. The technique most appropriate when performing the procedure is to:
Allow the child to cry or scream
The parents of a critically injured child wish to stay in the room while the child is receiving emergency care. The nurse should:
Allow the parents to stay with the child
A 3-year-old child with a history of strabismus has an eye-patch over her eye. This is likely due to:
Amblyopia
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
Which of the following problems is expected in a child who is in end-stage renal failure?
Anemia
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
Which of the following situations represents the best example of natural (innate) immunity?
Intestinal flora and gastric acid
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
After 6 months of age, which of the following mineral stores becomes depleted in infants?
Iron
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:
Is a bronchodilator
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
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:
Is warm, with capillary refill of two seconds or less
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?
Isolate the child and contact the parents
When are most children ready for regular seat belts?
It depends on the child's height and how the seat belts fit
The pediatric nurse understands that the infant mortality rate is important because:
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?
Jack-in-the-box
A child with nystagmus should demonstrate:
Jerky eye movements during the 6 cardinal positions of gaze test
Rubeola (measles) Virus
Koplick's spots, and a rash which spreads from central body structures out towards the arms and legs
Gestational Age
Length of time spent in the uterus
Preterm Gestation
Less than 38 weeks gestation
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:
Lies in bed quietly
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?
Lifting head briefly
An inborn error of metabolism that makes it impossible for the body to use amino acid valine is:
Maple Syrup Urine Disease
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:
Meconium Ileus
Possterm Gestation
More than 42 weeks gestation
The nurse should expect to administer this drug for a sickle cell pain crisis:
Morphine Sulfate
Phimosis
Narrowing of the preputial opening of the foreskin that prevents retraction of the foreskin over the glans penis
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?
Necrotizing enterocolitis
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 medication suddenly
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?
No insulin
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?
Normal for age
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?
Notify the primary care provider
After a pediatric client has a cardiac catheterization, which intervention should have the highest priority in the immediate postoperative period?
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.
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
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
The best position for an infant to sleep is:
On the back
Truncus Arteriosus
One large blood vessel with a single valve leaves the heart
Currently, the greatest source of lead poisoning in children is from:
Paint
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 28-month old child, 30-month old child, and a 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:
Parallel play
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?
Parents presence at the bedside
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?
Patent Ductus Arteriosus
Which of the following statements concerning Down Syndrome is FALSE?
People with Down Syndrome have profound intellectual disability and cannot function meaningfully in society
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
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)
A mother questions the nurse regarding car seat safety for her infant. Which of the following information should the nurse include in the discussion?
Place the infant seat rear facing in the back seat of the car
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?
Placing the toddler in a quiet environment
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
To promote drainage of lung secretions in the preterm infant, the nurse should:
Position the infant's body lying face down
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?
Precocious puberty
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 newborn with possible hypoplastic left heart disease is to be admitted to the nursing unit. Which drug should be available for use?
Prostaglandin E1 (Prostin VR)
Bladder Extrophy
Protrusion of bladder through lower abdominal wall
The newborn has a heelstick for studies. Which of the following is INCORRECT technique?
Puncture the center of the heel with a lancet to a depth of less than 2 mm
During a routine pediatric visit, a 4 month old patient will need which of the following vaccines?
RV DTap Hib PCV IPV
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
During a routine pediatric visit, a 6 month old patient will need which of the following vaccines?
RV DTap Hib PCV IPV HepB Influenza
The pediatric nurse understands that sildenafil (Revatio, Viagra) is prescribed to:
Relax and widen the blood vessels in the lungs
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:
Remove him from the source of stimulation by taking him to a quiet, safe place to calm down
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
Providing high oxygen concentrations to a preterm newborn may cause:
Retinopathy of prematurity
Trichophyton Tonsurans
Ringworm
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)
An infant, 6 weeks old, is brought to the clinic for a well-baby visit. To assess the fontanels, how should the nurse position the infant?
Seated upright
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
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?
Shakiness
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:
Should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary
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:
"Allow the child to regulate her activity."
A 7-year-old client is diagnosed with rheumatic fever. The physician orders throat cultures of all family members. The nurse explains that:
"Family members can carry streptococcus and be asymptomatic."
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."
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?
"My immune system mistakenly destroys the beta cells, resulting in an absence of insulin."
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."
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:
"We will replace the carpet in our child's bedroom with tile."
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?
- A bed-wetting alarm system - A positive reinforcement system, such as rewarding the child with a prize for staying dry at night - Desmopressin (DDAVP) by nasal spray or by tablet - Schedules awakenings during the night to void - Limit fluid intake in the evening and before the child goes to bed - Have the child urinate before going to bed
Which of the following are accurate statements concerning avoidant-restrictive food intake disorder (ARFID) ? Formerly known as Failure to Thrive
- ARFID is defined as a weight that falls below the 5th percentile on a growth chart, and a weight-for-length that is less than 60% - The cause of ARFID can be organic or inorganic - Most causes of ARFID involve inadequate caloric intake caused by behavioral or psychosocial issues - 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 - Nursing care centers on performing a thorough history and physical assessment, documenting accurate height and weight, observing parent-child interactions during feeding times, and providing teaching to enable parents to respond appropriately to their child's needs
Obese children are vulnerable to a number of health problems, including:
- Abnormal acceleration of growth in childhood - Early onset of puberty in girls and abnormalities in sexual development in boys - Type 2 diabetes - Dyslipidemia - Coronary heart disease - Gallbladder disease - Osteoarthritis
A nurse provides care to a 10-year-old child with pharyngitis. Which clinical manifestations indicate streptococcal rather than viral pharyngitis?
- Abrupt onset - Painful cervical nodes - Fever greater than 101 degrees F - Tonsillar exudate - Abdominal pain - Anorexia, nausea, vomiting
The nurse is caring for a hospitalized 5-year-old patient with chicken pox. Which of the following precaution levels is appropriate for this patient?
- Airborne precautions - Standard precautions - Contact precautions
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?
- 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 front to back after voiding
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?
- Behavior - Cardiovascular - Respiratory
Symptoms of a food intolerance can include:
- Bloating - Diarrhea - Gas (All of the above)
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?
- Weigh the child daily - Check the child's blood pressure daily - Continue the prescribed antibiotics - Elevate edematous body parts
Hemodialysis and peritoneal dialysis are both used to treat kidney failure. Which of the following are correct statements?
- 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
Overarching goals of Healthy People 2020
- High quality, longer lives free of preventable disease, disability, injury, and premature death - Create social and physical environment that promotes good health for all - Health equity, eliminate disparities, improve health of all age groups
The pediatric nurse understands that aspirin:
- I used to prevent blood clots from forming in the coronary arteries during the acute phase of Kawasaki Disease - Is used to treat joint pain and inflammation in rheumatic fever - Can be associated with Reye's syndrome, a serious and potentially deadly condition in children and teenagers - Decreases platelet aggregation and inhibits thrombus formation
Nurses should make which of the following recommendations to parents, to prevent childhood obesity?
- If possible, breast-feed children rather than bottle feeding them - Limit the high calorie and sugary foods kept in the house - Provide a nutritious diet with ample fiber from fruits and vegetables, with no more than 30 percent of calories derived from fat - Do not use food as a reward or bride a child to finish a meal by offering sweets - Limit the child's television viewing or video games to no more than two hours per day
Which of the following are characteristics of hemophilia or recommended treatment for hemophilia?
- 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.
The pediatric nurse understands that lanoxin (digoxin):
- Increases contractility of the heart - Has side effects of nausea, vomiting, anorexia, and bradycardia - Can interact with over-the-counter medications, herbal preparations, and antibiotics
Chemotherapy is one of the therapeutic modalities for pediatric cancer. This treatment is contraindicated in which of the following conditions?
- Infection - Recent Surgery - Impaired renal and hepatic function - Pregnancy
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)?
- Institute droplet precautions - Institute contact precautions - Prepare to administer nebulized albuterol - Cluster nursing care to allow the child to rest - Elevate the head of the bed to ease the work of breathing - Institute continuous cardiopulmonary monitoring
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
Which of the following are accurate statements concerning multifactorial inheritance?
- Most common genetic malfunction - Combination of environmental and genetic factors - Examples are cleft palate and neural tube defects - These disorders do not have a clear-cut pattern of inheritance - These conditions tend to run in families
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 C) - Avoid fresh vegetables - Do not take the child's temperature by the rectal route - Live, attenuated vaccines should not be administered to children with weakened immune systems
Tetralogy of Fallot is characterized by which cardiac defects?
- Overriding aorta - Right ventricular hypertrophy - Ventricular septal defect - Pulmonary stenosis
Risk factors for child abuse and neglect include which of the following:
- Parents who were abused as children - Female gender - Low socioeconomic status - Substance abuse and violence in the family
An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Appropriate management of a tet spell in these children include:
- Place the child in knee-chest position - Administer oxygen - Administer morphine and propranolol intravenously as ordered
A ten-month-old infant is seen in the well-child clinic. Which of the following behaviors should the nurse expect to see?
- Plays peek-a-boo and patty cake - Transfers objects from hand to hand
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?
- Prolonged hearing loss - Speech delays
An appropriate nursing diagnosis for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV) should be:
Activity intolerance
The pediatric nurse understands that the most common cancer found in children is:
Acute Lymphocytic Leukemia
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
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:
Acyanotic heart disease may be asymptomatic
The nurse assessing a preterm infant understands that the infant's level of maturation refers to:
Ability of the organs to function outside of the uterus
The home health nurse practices anticipatory guidance for a family with a 12-month-old child by giving information and brochures about:
Accident-proofing their home
The nurse cautions that the leading cause of childhood mortality (after the first year of life) is:
Accidents
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?
Activity exercise pattern
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.
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?
Babinski
The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected?
Sits alone in tripod position
Harness straps should fit...
Snug and tight without any slack
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?
Decreased cardiac output related to fluid and electrolyte imbalance
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
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
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
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 of anxiety?
Detachment
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?
Draws up the medication correctly in an oral syringe and administers it to the child.
On initial exam of a child with newly diagnosed Kawasaki disease, the nurse should expect to document:
Dry, swollen, fissured lips
According to the CDC schedule, which immunizations are expected for a child at 6 months of age?
Dtap Rotavirus Hep B HIB IPV PCV Influenza
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 conscious.
Autonomy vs. Shame and Doubt
During this stage, toddlers learn to achieve self-control and willpower. Learns to control bodily functions.
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):
Elevated red blood cell count
What is the best intervention a nurse can utilize to promote parental attachment with their preterm infant?
Encourage hands-on participation with infant care
A client is admitted with a diagnosis of "rule out rheumatic fever." Based on Jones criteria, the nurse assesses for:
Erythema, polyarthritis, and elevated antistreptolysin-o (ASO)
A nurse if 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
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?
Establish an intravenous access
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
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
Cryptorchidism
Failure of one or both testicles to descend into the scrotum
Pertussis (whooping cough) is spread through feces and oropharyngeal secretions of infected persons, especially young children. True or False?
False
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
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?
The child consistently tilts the head to see
One factor that predisposes young children to development of otitis media include:
The eustachian tubes are short, wide, and lie in a horizontal plane
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
The nurse clarifies that a preterm infant born at 34 weeks of gestation is placed in an incubator because:
The infant's temperature control mechanism is immature
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
Transposition of the Great Arteries (TGA)
The pulmonary artery and the aorta are in the opposite position of where they should be. Two noncommunicating circulatory systems -- a condition incompatible with life.
Atrioventricualr Septal Defect
There is a hole between the top two chambers and the bottom two chambers of the heart. Common with Down Syndrome.
atrial septal defect (ASD)
There is a hole between the top two chambers of the heart
Coarctation of the Aorta (COA)
There is a narrowing of the major artery from the heart to the body
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
Patent Ductus Arteriosus (PDA)
There is an open connection between the aorta and the pulmonary artery
Accurate fluid intake and output records and daily weights are particularly important in patients with kidney disease because:
They aid in assessing kidney damage
Beclomethasone (generic) Brand Name: Qvar
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.
The infant weighs 1,300 grams (2 lbs, 14 ounces) at birth. The neonatal nurse correctly classifies this infant as:
Very low-birth-weight (VLBW) infant
At 30 months of age the toddler should be expected to:
Walk on tiptoes
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
Palmar Grasp
When a finger is placed in the neonate's palm, the fingers grasp tightly.
Stepping
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.
Tonic Neck (Fencing)
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).
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
Babinski
When the side of the foot on the side of the little toe is stroked, the infant's toes fan upward.
Moro (Startle)
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'.
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
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:
With meals and snacks
Rooting
With stimulation (stroking) the cheek, the neonate turns toward the stimulus.
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:
Yelled at his brother
The pediatric nurse understands that which of the following medications used to treat asthma, is a therapeutic antibody?
omalizumab (generic) Brand name: Xolair
