PEDS
Which food selection indicates the parents understand discharge teaching for a preschooler who has undergone a Tonsillectomy and Adenoidectomy?
Chicken soup broth and mashed potatoes
Prior to the administration of chest physiotherapy for a teenager with Cystic Fibrosis, what is the priority nursing assessment?
Confirm a bronchodilator medication was given 30 minutes prior to initiation
A child has returned to the pediatric unit following a cardiac catheterization. The insertion site is located in the right groin. Peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. Which findings should be reported to the child's physician? Select All That Apply
- The child's right foot is cool with a pulse assessed only with the use of a Doppler - The child has a temperature of 102.4°F (39.1°C) - The child is reporting nausea
Your client has been diagnosed with influenza. In which order will the nurse initiate these infection control measures?
- Wash hands - Don gown - Don mask - Don gloves
The nurse is applying direct pressure to a deep leg laceration and the bleeding has not stopped. Which action should the nurse take NEXT to try to stop the bleeding?
Elevate the leg to above the level of the heart
What is the most appropriate response to a school-age child who asks if she can talk to her dying sister?
"Even though she will probably not answer you, she can still hear what you say to her."
A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 10 minutes ago. Which of the following is the most important instruction the nurse can give the parent?
"Hang up and call Poison Control Center immediately."
A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?
"Has your son had a sore throat recently?"
The nurse determines that it is necessary to implement airborne precautions for children with which of the following infections?
Measles
The nurse is promoting learning and school attendance to a 13-year-old girl. Which factor will affect the child's attitude most?
Peer group behaviors and attitudes
The nurse is applying direct pressure to a deep leg laceration and the bleeding has not stopped. Which action should take NEXT to try to stop the bleeding?
Place a tight tourniquet proximal to the laceration
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group?
Do not blame toddlers for aggressive behavior, instead, point out the results of their behavior
The client was admitted with pneumonia. Which task can be delegated by the nurse to the unlicensed assistive personnel (UAP)?
Ensure the door to the client's room remains closed
A child is admitted with possible coarctation of the aorta. The admitting nurse reviews the medical orders for the child and should questions which of the following orders?
Vital signs on admission, then daily
The nurse is teaching the student nurse the sequence for performing the assessment technique during a physical examination. What is the appropriate order?
Inspection, palpation, percussion, auscultation
Which of these nursing actions require the charge nurse to intervene with the LPN who is taking care of a child with hemophilia?
LPN administers DDAVP to increase plasma factor VIII
Which nursing intervention is not appropriate when caring for a child with pertussis?
Maintaining enteric precautions
A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with increased pulmonary blood flow?
Patent ductus arteriosus
A school nurse is assessing a school-age child and notices white flakes that don't brush off the hair and a rash on the back of the child neck. The nurse should suspect which of the following disorders?
Pediculosis capitis
A mother brings her 6-month-old infant to the homeless shelter nurse. The infant is breathing 52 breaths per minute, retracting and wheezing. Which action by the nurse would be most appropriate?
Refer the infant to the Emergency Department
A 15 year old female is admitted to the hospital with diagnosis of "anorexia nervosa". The nurse knows that this patient has a history of:
Refusing to maintain a minimally normal body weight
The physical manifestations of fetal alcohol syndrome include:
Short philtrum and prenatal growth retardation
A child is admitted with infective endocarditis. What is the priority nursing action?
Start an intravenous line
The child reports severe pain midway between the anterior iliac crest and the umbilicus, nausea, vomiting, and can't get up on the exam table in ED. How should the nurse document the finding?
c/o pain 10/10 at the McBurney point, n/v, refused to transfer to exam table
A 3 year old child with nephrotic syndrome is admitted to pediatric floor, which only has semiprivate rooms. Which pediatric client would be the most appropriate roommate for the child with nephrotic syndrome?
A 4 yr old with a fractured femur
A 3 year old is brought to the ED with abrupt onset of fever of 103 F, substernal retractions, stridor and excessive drooling. The child's O2 sat is 93%, HR 120, RR 40. What should the nurse do first?
Allow the child to remain in the mothers arms and call RT
The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. How should it be administered?
Before chemotherapy administration, as a prophylactic measure
A nurse is caring for a child who has Kawasaki disease. Which of the following system should the nurse monitor in response to this diagnosis?
Cardiovascular
A baby is admitted with diagnosis of intussusception. Which of the following signs/symptoms would the nurse expect to see?
Currant jelly stools, hem occult-positive stools
A child involved in an MVC has baseline VS of BP 136/74; HR 82; R20 on admission to the ER. Which assessment findings after 2 hours would the nurse suspect were related to increased intracranial pressure?
- R: 12 - complaints of nausea
What response by the family indicates understanding of the care of their child diagnosed with sickle cell disease?
"Increased fluid intake and reducing stress can help keep my child's blood from sickling."
Which statement by the caregiver of an infant diagnosed with CHF would require immediate action by the registered nurse?
"She hasn't been as fussy."
A nurse is caring for a 6 yr old girl recently diagnosed with celiac disease and is discussing dietary restriction with her mom. Which response indicates a need for further teaching?
"She is beginning to like rice flour bread, rice cereals, and cornbread."
Which would be the most appropriate teaching to the parents of a child in the ER who is awake, alert, and has no respiratory distress after a near-drowning experience?
"She will most likely be admitted for at least 24 hours and observed for respiratory distress or any other complications."
The grandparents of an infant with CHF secondary to a newly diagnosed congenital heart defect ask the nurse why there is a sign on the door that reads "decreased stimuli". What is the nurse's best response?
"We want to remind visitors that they are welcome to support the family but the baby needs a quiet environment to limit the hearts' workload."
A child is to begin radiation therapy after the removal of Wilms' tumor. Which statement by the parents indicates a need for further teaching?
"We will keep the area moist with petroleum jelly."
What should the nurse include in the discharge teaching plan for a 3 year old with viral croup?
- "Call the physician if the child has an increase in work of breathing such as retractions or stridor." - "It is a good idea to keep a record of how much your child is drinking and going to the bathroom." - "You may notice that the symptoms get worse at night so using a humidifier may help."
Which of the following corresponds to a 5-year-old child's understanding of death?
Reversible and temporary
A 10 year old patient with osteomyelitis is receiving IV gentamicin BID. Which nursing action is most appropriate prior to administering the gentamicin?
Review the patient's BUN and creatinine levels
The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?
Ring-like rash on lower leg
A child with a type I DM has been diagnosed with ketoacidosis. Which of the following laboratory findings would be consistent with the diagnosis?
Serum pH: 7.24
The nurse is admitting a 9 year old client with a seizure disorder to the Pediatrics floor. Which action is appropriate to delegate to the LPN?
Set up oxygen and suction equipment at bedside
A topical corticosteroid is prescribed by a health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream?
Apply a thin layer of cream to affected areas and rub in thoroughly
The mother of a 6-month-old states that since yesterday, the child cries when anyone touches her arm. Which would be the priority nursing assessment after the airway, breathing, and circulation has been assessed and found stable?
Assess child for other signs of potential physical abuse
A 12 year old with right lower lobe pneumonia calls out to the nurse's station complaining of shortness of breath and chest pain. What is the priority nursing action?
Assess the patient's O2 sat and breath sounds
When should the nurse expect that the Respiratory Therapist (RT) will perform the prescribed chest physiotherapy (CPT) on an adult male client diagnosed with Cystic Fibrosis who is admitted with an acute respiratory infection?
At least 2 hours after a meal
A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments in the nurse's highest priority immediately after admission?
Auscultating the rate and characteristics of the child's heart sounds
A six month old with RSV bronchiolitis has a sat of 92%, HR 130, RR 40. The nurse notices that the child has intercostal retractions and copious amounts of thin white secretions draining from the nose. What should the nurse do first?
Suction the nose and the mouth for secretions
The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition?
Support for maintaining self-esteem because of his altered lifestyle
A 17 year-old boy with diabetes mellitus tells the school nurse that he has recently started drinking alcohol with his friends on weekends. The nurse should do which of the following?
Teach him about the effects of alcohol on diabetes and how to prevent problems associated with alcohol intake
The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse?
The toddler's anterior fontanel is not fully closed
How do children with Asperger Syndrome differ from children with Classic Autism?
They do not have problems with language and intellect
A nine-year-old child is admitted to the emergency room with a sore throat, drooling and a fever of 103 F. He is agitated and insists on sitting up. Which order would the nurse question?
Throat culture stat
What is appropriate teaching for a 21 year old female with vitamin B12 deficient anemia?
Vitamin B12 is found in animal foods: meat, eggs, and dairy
A neural tube defect that is not visible externally in the lumbosacral area would be called:
meningocele
What is a priority nursing action while caring for a 10 yr old complaining of steady pain of 10 in right peri-umbilical area and reports a pain of 10 in his right lower abdominal quadrant area in the ED and then suddenly reports no pain on his right side?
notify the HCP stat relating to assessment finding
Which hemophilia intervention would the nurse teach the child and family upon discharge? SELECT ALL THAT APPLY
- No rectal temps or enemas - Avoid contact sports and rough play - Eat a balanced diet to avoid constipation - Use a soft toothbrush
A nurse is assessing a child after an open reduction of a fractured femur. Which assessment findings would alert the nurse that compartment syndrome could be occurring? SELECT ALL THAT APPLY
- Pain not relieved by pain medication - Paresthesia and Pallor - Prolonged capillary refill
A 4-year-old client is brought to the emergency room after ingesting a bottle of vitamins with iron. Emergency care of the child would include treatment of which reversal agent?
Deferoxamine
The charge nurse is making patient assignments and has an LPN working on the floor today. Which clients would be appropriate for the RN to assign to the LPN? SELECT ALL THAT APPLY
- A client who is 3 days post-op and needs assistance with ambulation in the hallway and to the restroom - A client who is undergoing a 24 hours urine collection - A client who on day two, requires a follow up nursing assessment of her current pain level
What assessment findings would be present in a client with scoliosis? SELECT ALL THAT APPLY
- A one-sided rib hump - Uneven shoulders and hips - Prominent scapula
A nurse is caring for a child with a terminal condition. Which of the following are physical manifestations of impending death? SELECT ALL THAT APPLY
- Cheyene-Stoke respirations - Hypotension - Decreased sensation and movement of the lower extremities - Tachycardia
Which tasks can be delegated to the UAP for an aplastic anemia client in protective isolation? Select All That Apply
- Display the PPE equipment and supplies outside the clients door - Obtain VS Q2 hours and report temp greater than 100.4
The nurse is caring for a school-age child with tine wapitis. The child has open lesions from the disease and has lost hair in the area affected. Which nursing diagnoses would be a part of this client's care plan? Select all that apply
- Disturbed body image - Impaired skin integrity - Risk for infection
What would be included in the discharge teaching plan for a client prescribed an oral iron supplement for iron deficiency anemia? SELECT ALL THAT APPLY
- For iron elixir, make sure you drink it through a straw - Make sure you get a balance of rest and activities
A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (Select all that apply.)
- Hypotension - Murmur - Weak pulses
Which statement by the new nurse indicates understanding for the care of the client with fatigue secondary to anemia?
"I am expecting him to have pale, cool skin."
The pediatric nurse has digoxin ordered for each of five children. The nurse should withhold digoxin for which children? Select all that apply.
- 16 year-old child with a heart rate of 54 bpm - 2-year-old child whose digoxin level was 2.4 ng/mL from a blood draw this morning - 5-year-old child who developed vomiting and diarrhea, and is difficult to arouse
The nurse is performing triage in an emergency. Which patient should she see first?
A 12 year old with dyspnea and chest asymmetry
On reviewing information about glomerulonephritis, the nurse knows that which of the following children is at risk for developing the disease?
A 3-year-old who had impetigo 1 week ago
A child has been diagnosed with Wilms' tumor. What would the preoperative nursing care include?
Careful bathing and handling
The parents of a 3-week-old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. Which intervention would the nurse suggest the parent do first?
Check the neuromuscular status of the foot
Which medication will the nurse anticipate to administer to the client with Hemophilia A?
Factor VIII
What nursing action promotes ideal nutrition in an infant with CHF?
Feeding formula that is supplemented with additional calories
A 4-month-old infant is admitted to the Emergency Department with severe diarrhea. Which assessment when performed by the nurse suggests the infant is severely dehydrated?
Fontanels depressed; capillary refill greater than three seconds
A child presents to ED with axillary temperature of 38.7 Celsius, stridor, gasping breath, difficulty speaking, and sitting in tripod position. What action should the nurse perform at this time?
Get immediate medical attention for the child
An 8-year-old has stomatitis secondary to chemotherapy. Which task would be best to delegate to the UAP?
Helping the child eat a bland, moist, soft diet
What should the nurse anticipate as a priority medical intervention for the child admitted with vast-occlusive (pain) crisis?
IV pain medication and fluids
During assessment of an infant, the nurse notices that the child has resistance to extension of his leg from a flexed position. How should the nurse document this finding?
Kernigs sign
The male client presents to the clinic for testosterone replacement therapy with physical S/S of gynecomastia. The nurse identifies the clients condition as?
Klinefelter Syndrome
The parent of a 3 month old child tells the health care provider (HCP) that their child has had a mild fever, cough, runny nose for 2 weeks and now the cough is much worse and continuous. Which finding should the nurse report to the HCP?
periods of apnea lasting longer than 10 seconds
