Peds Midterm
Which should the nurse expect of a healthy 3-year-old child?
Balance on one foot for a few seconds.
The nurse recommends to parents that peanuts are not a good snack food for toddlers. What is the nurse's rationale for this action
Can be easily aspirated
Which describes a child who is abused by the parent(s)?
Unintentionally contributes to the abusing situation
A school nurse is teaching a group of preadolescent girls about puberty. Which is the mean age of menarche for girls in the United States?
12
Miminum age for MMR?
12 months
The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula
12 months
You're providing a free educational clinic to new moms about immunizations. You inform the attendees that the Measles, Mumps, and Rubella (MMR) vaccine is given?
12 months and 4-6 years
The nurse administers an initial dose of Haemophilus influenzae type b (Hib) vaccine to a 2-month-old infant. When should the nurse administer the final dose of the vaccine to the infant?
12 to 15 months
Starting in the preteen years and through adolescence, daily calcium intakes should be between _________ and __________ mg/day.
1200-1500
The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately how many pounds
15
Inactivated Polio Virus (IPV) is administered every:
2 months, 4 months, 6-18 months, 4-6 years
The dosage for the DTaP vaccine is 0.5 ml given I.M. at ages [x] months, [y] months [z] months 12 to 18 months, and 4 to 6 years.
2,4,6
The parents of a 4-month-old infant with a diagnosis of acute otitis media and fever ask the nurse about the use of antibiotics to treat this condition. What is the best response by the nurse?
"Antibiotics are recommended for infants younger than 6 months with confirmed diagnosis of AOM (bulging tympanic membrane, ear pain, fever greater than 102.2 0 F
Which is the leading cause of death during the toddler period
Injuries
What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)
Make a follow-up home visit to parents as soon as possible after the child's death
A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?
RN to obtain throat culture
A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started?
Rapid venous access is not possible
The clinic is lending a federally approved car seat to an infant's family. The nurse should explain that the safest place to put the car seat is:
Rear-facing in back seat
The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. What is the priority nursing action?
Administer naloxone (Narcan)
When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration
Administer the medication with a syringe (without needle) placed along the side of the infant's tongue.
Which would be the best play activity for a 6-month-old infant to provide tactile stimulation?
Allow to splash in the bath
Which play is most typical of the preschool period?
Associative
A mother calls the pediatric clinic to ask when her daughter will receive the Varicella vaccine. Your answer to her question is:
At 12 months and 4-6 years
The child of 15 to 30 months is likely to be struggling with which developmental task?
Autonomy
A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infant's risk of a sudden infant death syndrome incident?
Recent viral illness Male sex Low Apgar scores
A nurse on a pediatric unit is practicing family-centered care. Which is most descriptive of the care the nurse is delivering?
Recognizing that the family is the constant in a child's life
Although infants may be allergic to a variety of foods, the most common allergens are
eggs, cow's milk, and whea
Parents need further teaching about the use of car safety seats if they make which statement?
"We won't need to use the car seat on short trips to the store."
A physician's prescription reads, "ampicillin sodium 125 mg IV every 6 hours." The medication label reads, "1 g = 7.4 ml." A nurse prepares to draw up __ milliliters to administer one dose. (Round your answer to two decimal places)
0.93
A parent asks the nurse "when will my infant start to teethe?" The nurse responds that the earliest age at which an infant begins teething with eruption of lower central incisors is __ months
6
A parent asks the nurse "at what age do most infants begin to fear strangers?" The nurse should give which response
6 months
A nurse is assessing a 12-month-old infant. Which statement best describes the infant's physical development a nurse should expect to find
Birth weight doubles by age 5 months and triples by age 1 year
A nurse is assessing a family's structure. Which describes a family in which a mother, her children, and a stepfather live together?
Blended
The nurse is caring for a client with a respiratory tract infection that started with a common cold but has progressed to whooping cough. The client also has coughing fits that last for several minutes. Which organism is responsible for the client's condition?
Bordetella pertussis
What is the initial indication of puberty in girls?
Breast development
According to Erikson, which psychosocial task is developing in the school-aged child
industry vs inferiority
An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development?
Cephalocaudal
Parent guidelines for relieving colic in an infant include
Change infant's position frequently
Which statement regarding chlamydia infection is correct?
Clinical manifestations include dysuria and urethral itching in males
Developmentally, what should most children at age 12 months be able to do
Eat the same food as the rest of the family
Which statement is correct about childhood obesity?
Heredity is an important factor in the development of obesity.
Play serves many purposes. In teaching parents about appropriate activities, the nurse should inform them that play serves which of the following function?
Intellectual development Socialization Creativity
A nurse who is caring for a 2-day-old neonate suspects that the infant has cystic fibrosis. What early sign of this disorder did the nurse identify?
Meconium ileus
A nurse is preparing to administer an oral iron supplement to a hospitalized infant. Which should not be given simultaneously with the iron supplement?
Milk
What is an appropriate method for administering oral medications that are bitter to an infant or small child?
Mix with a small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream
Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
Morphine
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action?
Move the infant to a room with another child with RSV.
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. What should the nurse recommend
Never heat a bottle in a microwave oven
Which is probably the single most important influence on growth at all stages of development?
Nutrition
What should the nurse do when caring for a child with an intravenous infusion?
Observe the insertion site frequently for signs of infiltration.
How are young people with anorexia nervosa often described?
Perfectionist, academically high achiever
Which is the preferred site for intramuscular injections in infants?
Vastus lateralis
Rickets is caused by a deficiency in
Vitamin D and calcium
Which characteristic best describes the gross motor skills of a 24-month-old child
Walks up and down stairs and runs with a wide stance
Which statement is correct about toilet training?
Wanting to please the parent helps motivate the child to use the toilet
What is the best age for solid food to be introduced into the infant's diet
What is the best age for solid food to be introduced into the infant's diet
A 12 month old receives a series of vaccinations which includes the Hepatitis A vaccine. When should the child receive the 2nd dose of this vaccine?
When the child is 4-6 years old
The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as positive or negative?
positive
A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?
respiratory acidosis
An 18-month-old toddler who stepped on a rusty nail is brought to the emergency department a week later. The nurse determines that the family lives in a rural area and that the toddler has never received health care. The child shows signs of neck and jaw stiffness and facial muscle spasms. What disease does the nurse suspect?
tetanus
At what blood level is chelation therapy for lead poisoning initiated in a child?
≥45 g/dl
Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida
Folic acid
A nurse is teaching a parent about administration of iron supplements to a 7-month-old infant. Which should the nurse include in the teaching session
Follow the iron supplement with 4 ounces of juice Your infant's stools may look tarry green Administer the iron supplement with a dropper toward the side and to the back of the mouth
Which information should the nurse give a mother regarding the introduction of solid foods during infancy
Foods should be introduced one at a time, at intervals of 4 to 7 days
Which vaccine is used to prevent a human papilloma virus infection?
Gardisil
Which is an appropriate action when an infant becomes apneic?
Gently stimulate trunk by patting or rubbing
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities
Give large push-pull toys for kinetic stimulation
During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain the _________ vaccine can help prevent most cases of this condition?
H. influenzae type B
Which childhood vaccine provides some protection against bacterial meningitis, epiglottitis, and bacterial pneumonia?
Hib
All of the following risk factors except one places a child at risk for increased morbidity. Which answer does not fit?
High birth weight
By which age should the nurse expect an infant to be able to pull to a standing position?
11 to 12 months
Kimberly's parents have been using a rearward-facing, convertible car seat since she was born. Most car seats can be safely switched to the forward-facing position when the child reaches which age
2
A 4-month-old infant is to receive the second diphtheria/tetanus/pertussis (DTaP) immunization. The nurse reviews the infant's medical history before administering the vaccine. What information in the infant's history will influence the decision whether to administer the vaccine?
High fever after the first dose Anaphylactic reaction after the first dose
How much oxygen is present in room air? _____ percent
21
stridor
High-pitched, wheezing sound caused by disrupted airflow. Airflow is usually disrupted by a blockage in larynx or trachea.
At what age does a child starting receiving a yearly flu vaccine?
6 months
A nurse is assessing a 6-month-old infant. The nurse recognizes the posterior fontanel usually closes at which age?
6 to 8 weeks
Parents of a 12-year-old child ask the clinic nurse, "How many hours of sleep should our child get?" The nurse should respond that 12-year-old children need how many hours of sleep at night? You respond __________ hours
9
What is the earliest age at which puberty begins?
9 for girls, 10 for boys
At what age can most infants sit steadily unsupported?
9 months
Recent studies indicate that a deficiency of which vitamin correlates with increased morbidity and mortality in children with measles?
A
crackles
A bubbling or crackling sound originating from the base of the lungs. Usually brief, this may be described as sounding wet or dry. Excess fluid in the airways causes these sounds.
The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?
A chronic multisystem disorder affecting the exocrine glands
wheezing
A high-pitched whistling sound, usually heard on expiration, and common to asthma. This is caused by narrowed airways or inflammation.
When teaching a mother how to administer eye drops, where should the nurse tell her to place them
In the conjunctival sac that is formed when the lower lid is pulled down
A nurse places some x-ray contrast the toddler is to drink in a small cup instead of a large cup. Which concept of a toddler's preoperational thinking is the nurse using?
Inability to conserve
Which should the nurse expect for a toddler's language development at age 18 months?
Increasing level of comprehension
The nurse is teaching a group of parents about the side effects of vaccines. Which side effect should the nurse include in teaching about the Haemophilus influenzae (Hib) vaccine?
Low-grade fever
Which strategies should the school nurse recommend implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)?
Accompany verbal instructions by written format. Reduce homework and classroom assignments. Allow more time for testing.
A nurse is conducting a teaching session for parents of infants. The nurse explains that which behavior indicates that an infant has developed object permanence?
Actively searches for a hidden object
An adolescent has been diagnosed with Chlamydia infection. Which medication should the nurse expect to be prescribed for this condition?
Azithromycin (Zithromax) PO
A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made, and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care?
Maintain standard and contact precautions
The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play?
Brian playing with his truck next to Kristina playing with her truck
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. What should the nurse recommend the infant be given
Commercial iron-fortified formula
A father tells the nurse that his child is "filling up the house with collections" like seashells, bottle caps, baseball cards, and pennies. What should the nurse recognize the child is developing?
Concrete operational thinking
Which is the leading cause of death in infants younger than 1 year?
Congenital anomalies
rhonchi
Continuous, snoring, low-pitched sounds heard throughout inspiration. May clear with coughing.
Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
Culture
An adolescent teen has bulimia. Which assessment finding should the nurse expect to assess?
Erosion of tooth enamel
A child is admitted to the hospital with pneumonia. In addition to ensuring a patent airway, all of the following interventions are appropriate except:
Exercise
The nurse is completing a pain assessment on a 4-year-old child. Which of the depicted pain scale tools should the nurse use with a child this age?
FACES
A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?
FLACC tool
A nurse recognizes which physiologic responses as a manifestation of pain in a neonate?
Diaphoresis Decreased SaO2 Increased heart rate Diaphoresis
Which should the nurse teach to parents of toddlers about accidental poison prevention
Discard empty poison containers correctly Know the number of the nearest poison control center Caution child against eating nonedible items, such as plants, cosmetics, etc.
In terms of fine motor development, which should the 3-year-old child be expected to do?
Draw a circle and name what has been drawn
Which of the following statements are true about acute childhood lead poisoning?
Drinking water from older, lead-containing plumbing. Lead-based paint in houses built before 1978 is the most frequent source of lead poisoning Some folk remedies and unglazed pottery.
Austin, age 6 months, has six teeth. How should the nurse interpret this finding
Earlier-than-normal tooth eruption
What should injury prevention efforts emphasize during the preschool period?
Education for safety and potential hazards
A parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." What is the nurse's best action?
Encourage parent to verbalize feelings.
Which is the most commonly used method in completed suicides?
Firearms
A 12-year-old child enjoys collecting stamps, playing soccer, and participating in Boy Scout activities. The nurse recognizes that the child is displaying which developmental task?
Industry
Guidelines for intramuscular administration of medication in school-age children include which action?
Insert needle quickly, using a dart like motion.
A nurse is teaching a parent about introduction of solid foods into an infant's diet. Which should the nurse include in the teaching session?
Introduce egg white in small quantities (1 tsp) toward the end of the first year
A nurse is teaching a parent about introduction of solid foods into an infant's diet. Which should the nurse include in the teaching session
Introduce egg white in small quantities (1 tsp) toward the end of the first year Rice cereal is introduced first Introduce one food at a time, usually at intervals of 4 to 7 days
A teen asks a nurse, "What is physical dependence in substance abuse?" Which is the correct response by the nurse
Involuntary physiologic response to drug
Which gross motor milestones should the nurse assess in an 18-month-old child
Jumps in place with both feet Pushes and pulls toys Throws ball overhand without falling
The parent of a 4-year-old boy tells the nurse that the child believes that monsters and boogeymen are in his bedroom at night. What is the nurse's best suggestion for coping with this problem?
Keep a night-light on in the child's bedroom
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?
Let the mother hold the child and direct the cool mist over the child's face.
A nurse is recommending strategies to a group of school-age children for prevention of obesity. Which should the nurse include?
Limit television viewing to 2 hours a day Have frequent family meals with parents present Eat breakfast daily.
A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. How should the nurse interpret this action
Normal development
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. How should the nurse interpret this finding
Normal finding
The vaccine pneumococcal conjugate vaccine (PCV13) is recommended for preventing and decreasing the severity of pneumococcal infections caused by Streptococcus pneumoniae. These invasive infections include:
Otitis media Pneumonia and meningitis Sepsis
The parent of a newborn asks a nurse why, except for hepatitis B vaccine, the immunization schedule does not start until the infant is 2 months old. Which response from the nurse is best?
Passive immunity from the mother will be diminished by age 8 weeks (2 months) and will no longer interfere with the development of active immunity to most communicable diseases."
To prevent plagiocephaly, the nurse should teach parents to
Place infant prone for 30 to 60 minutes per day
A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodic croup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend?
Placing him near a cool-mist humidifier
Which is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
Playing peek-a-boo
A 4-year-old child tells the nurse that she does not want another blood sample drawn because "I need all my insides, and I don't want anyone taking them out." Which is the nurse's best interpretation of this
Preschoolers have poorly defined body boundaries
A parent asks the nurse about negativism in toddlers. Which is the most appropriate recommendation?
Reduce the opportunities for a "no" answer
Which vaccine is administered orally in children?
Rotavirus
According to Piaget, the 6-month-old infant should be in which developmental stage
Secondary circular reactions
Which refers to those times in an individual's life when he or she is more susceptible to positive or negative influences?
Sensitive period
Which play item should the nurse bring from the playroom to a hospitalized toddler in isolation
Set of large plastic building blocks
The nurse is teaching a 9-year-old child with asthma how to use a metered-dose-inhaler (MDI). Place the instructions in the appropriate order. All options must be used.
Shake MDI and attach it to spacer Exhale completely Place lips tightly around the mouth piece Deliver one puff of medication into spacer Take a slow deep breath and hold for 10 seconds Rinse mouth with water
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect? Answers: Congenital neurologic problem Sudden Infant death syndrome (SIDS) Shaken-baby syndrome Unintentional injury
Shaken-baby syndrome
Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?
Short-acting β2 agonist
Which statement is true about smoking in adolescence?
Smoking is related to other high-risk behaviors
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
Social isolation
Which characteristic best describes the language of a 3-year-old child?
Talks incessantly regardless of whether anyone is listening
The development of secondary sex characteristics occurs in an anticipated sequence for girls and boys and is divided into distinct stages called _________ stages. Although the timing of the stages is different for each individual, the sequence remains the same.
Tanner
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?
The child is leaning forward, with the chin thrust out
A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory tract infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. What is the nurse's best response?
The nurse practitioner ordered the drug based on weight, which is a more accurate way of determining a therapeutic dose."
During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF?
This disease causes dilation of the passageways of many organs
A school-aged child who has cystic fibrosis complains to the nurse about having to undergo chest physiotherapy and wonders why it is necessary. You are the nurse. How do you explain the primary purpose of chest physiotherapy in terms the child can understand?
This form of therapy helps loosen up some of the phlegm in your chest to help you cough it up so it doesn't sit there.
A nurse is assessing a preschool-age child and notes the child exhibits magical thinking. According to Piaget, which describes magical thinking?
Thoughts are all-powerful
Which bite causes Rocky Mountain spotted fever
Tick
Which is a useful skill that the nurse should expect a 5-year-old child to be able to master?
Tie shoelaces
In the clinic waiting room, a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks. What should the nurse recognize in this situation
Toddlers are capable of building a tower of blocks
Which factor is most important in predisposing toddlers to frequent infections?
Toddlers have a short, straight internal ear canal and large lymph tissue.
In terms of fine motor development, what should the infant of 7 months be able to do?
Transfer objects from one hand to the other and bang cubes on a table
Which statement is true about gonorrhea?
Treatment of all sexual contacts is an essential part of treatment
Which is the major cause of death for children older than 1 year?
Unintentional injuries
The parents of an 18-month-old toddler are anxious to know why their child has experienced several episodes of acute otitis media. What should the nurse explain to the parents about why infants and toddlers are prone to middle ear infections?
Young children have short, horizontally positioned eustachian tubes The child's tympanic membrane slants horizontally rather than vertically
An adolescent girl tells the nurse that she is very suicidal. The nurse asks her whether she has a specific plan. Asking this should be considered:
an appropriate part of the assessment.
A nurse is reviewing hormone changes that occur during adolescence. What is the hormone responsible for the growth of beard, mustache, and body hair in the male?
androgen
A nurse is planning a teaching session for a group of adolescents. The nurse understands that by adolescence the individual is in which stage of cognitive development?
formal operations
When should a child receive the first dose of the Hepatitis B vaccine?
birth
The nurse finds that an adolescent has episodes of binge eating followed by self-induced vomiting and strenuous exercise. Which condition is the adolescent likely to have?
bulimia
This vaccination is the first vaccine, given I.M. at birth (or before hospital discharge).
hepatitis B
Which immunization protocol should be followed by a nurse administering a hepatitis B vaccine to an infant whose mother is diagnosed HBsAg-positive during pregnancy?
hepatitis B immune globulin
The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Should the diet be high in calories or low?
high
According to Erikson, which psychosocial task is developing in adolescence?
identity versus role confusion
Common side effects from the rotavirus vaccine include irritability, mild diarrhea, or vomiting. A small but increased risk for developing __________ has been noted after receiving the first dose of rotavirus vaccine.
intussusception
What is the most common cause of death in the adolescent age group?
motor vehicle accidents
The nurse reviews the health record of a 2-year-old child. The health care provider has documented that the results of a tuberculin skin test have indicated an area of induration measuring 5 mm. Is this a positive or negative result? It is a __________ result.
negative
A client is scheduled for a pulmonary function test. The nurse explains that during the test one of the instructions the respiratory therapist will give the client is to breathe normally. What should the nurse teach is being measured when the client follows these directions?
tidal volume
Croup, also known as acute laryngotracheobronchitis, is a self-limiting upper airway obstructive disease that affects younger children. Is croup caused by a viral infection or a bacterial infection?__________ infection
viral
