Peds Test #1

The nurse recognizes the need to update knowledge related to the most common cause of hospitalization in children. On which body system should continuing education focus? Gastrointestinal. Respiratory. Cardiac. Musculoskeletal.

Respiratory.

Indicators of hearing loss in an infant:

-No startle reaction to loud noises -Does not turn towards sounds by 4 months of age* -Babbles as a young infant, but stops babbling and does not develop speech sounds after 6 months of age

The mother of a newborn is attempting to breastfeed. Which statement on breastfeeding should the nurse include? -"Breastfed babies will experience more ear infections." -"Babies who nurse have lower likelihood of SIDS." -"Diabetes is more common in breast fed babies." -"Respiratory tract infections are more common in nursed babies."

-"Babies who nurse have lower likelihood of SIDS." Rationale: Breastfeeding has many advantages, including the decreased incidence of common infections (otitis media, respiratory tract infections, and meningitis.) Allergies, diarrhea, and vomiting are also less common. Nursing also provides protection from SIDS, diabetes, asthma, and obesity

Which statement should the nurse make to parents who are considering circumcising their infant? -"Penile cancer is much more common in men who are not circumcised." -"The hospital stay will be lengthened by one day if he is circumcised." -"Complications of circumcision are rare, but bleeding may occur." -"Circumcised infants do not develop urinary tract infections."

-"Complications of circumcision are rare, but bleeding may occur." Rationale: The decision on whether or not to circumcise a child has several factors, many of which are religious or cultural. Circumcision can be performed as a neonate while still in the hospital, or as an outpatient procedure after discharge. Bleeding as a complication of circumcision occurs in 0.1% of cases. Penile cancer occurs slightly more commonly in men who are not circumcised, and urinary tract infections are slightly more frequent as well.

The parents of a newborn are requesting information on car seats. Which statement should the nurse include? -"Infants should always be placed in rear- facing car seats." -"Car seats are easily installed and checked for placement." -"Short trips in the car don't require the full car seat straps." -"Harness straps should be above shoulder level on your child."

-"Infants should always be placed in rear- facing car seats." Rationale: -Infants should always be in rear-facing car seats, placed in the back seat, and used every time the infant is in the car. Harness straps should be at or below shoulder level. Installation can be tricky, and should be assessed at an examiner station for correct placement.

The nurse is discussing umbilical cord care with the parents of a newborn. Which statement should the nurse include? -"The cord with fall off in 4 or 5 days." -"A bad smell is normal in a cord." -"You can pull gently on the cord." -"Keep the cord clean and dry."

-"Keep the cord clean and dry." Rationale: Cord care varies from hospital to hospital and provider to provider. Evidence indicates that applying alcohol, triple dye, povidone-iodine, or antimicrobial ointments decreases bacterial colonization, but slows cord separation. The cord will spontaneously fall off in 7-10 days, and should not be pulled on.

Which of the following milestones are specific to the toddler stage of development? --Walks alone, climb stairs --Explores environment, no understanding of danger --Language development; no, dada, mama --Engages in parallel play --Less protest at naptime, but dislikes bedtime

--Walks alone; climbs stairs --Language development: no dada/mama --Engages in parallel play --Issues with bedtime tend to arise in the preschool phase of development.

The circumference of infants' heads increases approximately ____ per month the first 6 months of life?

-1.5 cm (0.6 in)

At which age should infants be able to put objects in mouth?

-4 months

At which age should the baby be able to hold bottle?

-6 months

Stranger anxiety starts at what age?

-6 months

The nurse is assessing an 11-year-old patient receiving conscious sedation to set a fractured leg. Which assessment finding indicates that the patient might need respiratory support? -Absent gag reflex. -Regular respiratory rate. -Coughing. -Sleeping.

-Absent gag reflex Rationale: The child who does not have a gag reflex is demonstrating signs of deep sedation. In deep sedation, protective reflexes are lost, and respiratory support is needed. A child with a regular respiratory rate does not require respiratory support. Coughing is an indicator that the airway is intact. The child who is sleeping might just be under light sedation. This alone is not an indicator for respiratory support.

Freud's 2nd stage:

-Anal (1 to 3 Years)→ The young child's pleasure is centered in the anal area with control over body secretions as a prime force in behavior -Nursing Application→Ask about toilet training and the child's rituals and words for elimination during the admission history. Continue the child's normal patterns of elimination in the hospital. Do not begin toilet training during illness or hospitalization. Accept regression in toileting during illness or hospitalization. Have potty chairs available in the hospital and childcare centers

What type of family is one where parents have terminated spousal roles but continue their parenting roles?

-Binuclear family

When should head be steadily supported when sitting and can raise head & chest when prone?

-By 4 months

When should infants sit in tripod position?

-By 6 months

When should the infant be able to roll over in both directions and transfer objects from hand to hand?

-By 6 months (ATI)- -at 4 months should roll from BACK to SIDE -at 5 months rolls from FRONT to BACK -at 6 months BACK to FRONT

During a health supervision visit, the nurse is attempting to develop a partnering relationship with the child and family. Initially, the nurse should: -Discuss with the family a plan to address the child's health needs. -Set goals for the family related to the child's health. -Tell the family what the child should be doing physically for the age level. -Tell the family that the physician will answer any questions they might have related to their child's growth and development.

-Discuss with the family a plan to address the child's health needs. Rationale: Discussing and developing a plan with the family will actively involve the family members and will build more trust, as they are not just being told what to do. The nurse should not set the goals without family involvement. Not all children develop each skill at the same age.

The parents of a jaundiced newborn want to know why this happened. How should the nurse address their concerns? -Inform the parents that breastfeeding caused the jaundice. -Tell the parents that a blood incompatibility caused the jaundice. -Explain that infants born at 35 weeks have immature livers. -Reassure the parents that jaundice does not lead to permanent problems.

-Explain that infants born at 35 weeks have immature livers. Rationale: Jaundice in the newborn is a common occurrence, especially in infants born at 35 weeks or less, due to liver immaturity. Breastfeeding jaundice is rare, and occurs after lactation is established. Blood incompatibilities like Rh factor can create hemolysis, and resulting in jaundice occurring within 24 hours of birth. *Kernicterus is permanent neurologic damage caused by excessive bilirubin levels, and is mostly preventable through prompt treatment of jaundice.

Which of the following infants should receive a nutritional supplement? A baby whose: -Family has well water. -Mother is anemic. -Brother has cystic fibrosis. -Grandmother has diabetes.

-Family has well water. Rationale: Well water lacks fluoride, which should be given as a supplement for healthy teeth development. An anemic mother should receive iron supplements, but not the infant. No supplements are required for family history of either cystic fibrosis or diabetes.

A pediatric healthcare nurse visit should include: -Family-centered care and partnership for primary care provision. -Different nurses for each visit to gather different perspectives. -Instruction on how to raise children according to U.S. norms. -Brief record keeping to prevent other staff from accessing the information.

-Family-centered care and partnership for primary care provision. Rationale: Pediatric home healthcare visits by the nurse should be family-centered, a trusting relationship, provision of unbiased information, primary care of acute and chronic conditions, continuously available care with nurse continuity, referrals as needed with care coordination, maintenance of comprehensive records, and provided in a culturally appropriate manner.

What gross motor skills/fine motor skills should a 2 month old exhibit?

-Gross motor skills: Lifting head off mattress -Fine motor skills: Holds hands in an open position

A teenager refuses to wear the clothes his mother bought for him. He states he wants to look like the other kids at school and wear clothes like they wear. The nurse explains this behavior is an example of teenage rebellion related to internal conflicts of: -Autonomy vs. shame and doubt. -Trust vs. mistrust. -Identity vs. role confusion. -Initiative vs. inferiority.

-Identity vs. role confusion.

Freud's 4nd stage:

-Latency (6 to 12 Years)→ Sexual energy is at rest in the passage between earlier stages and adolescence. -Nursing Application→Provide gowns, covers, and underwear. Knock on door before entering. Explain treatments and procedures.

A 6-month-old infant is in for a well baby  check-up. Which of the following is an unexpected finding? -There is no head lag when pulled to a sitting position. -The baby vocalizes through babbling "baba baba". -The baby passes a rattle from one hand to the other. -No interest is shown in surroundings or in toys present.

-No interest is shown in surroundings or in toys present. Rationale: The developmental milestones for a 6-month-old infant include babbling with repetitive sounds, interest in surroundings and toys, no head lag when pulled to a sitting position, sitting with support, grasping objects and placing them in the mouth, transferring objects from one hand to the other, and bearing weight on the legs when held in a standing position.

Which fine motor skills should a 3 month old exhibit?

-No longer has grasp reflex -Keeps hands loosely open

Indicators of hearing loss in a young child:

-No speech by 2 years of age -Speech sounds are not distinct at appropriate ages

Which of the following pain assessment tools is most appropriate for a 14-year-old client? -FLACC behavioral pain assessment scale. -Poker chip tool. -Faces pain-rating scale. -Numeric scale.

-Numeric pain scale Rationale: The FLACC scale is an observation scale used primarily in infants and preverbal children. While the Faces scale and poker chip tool can be used for adolescents, a client this age should be very capable of using a numeric scale. The Faces scale and the poker chip tool are most appropriate with preschool and young school-age children.

Freud's first stage:

-Oral (Birth to 1 Year)→The infant derives pleasure largely from the mouth, with sucking and eating as primary desires. -Nursing application→When a baby is NPO, offer a pacifier if not contraindicated. Alter painful procedures, offer a baby a bottle or pacifier or have the mother breastfeed.

Freud's 3rd stage:

-Phallic (3 to 6 Years)→ Sexual energy becomes centered in the genitalia as the child works out relationships with parents of the same and opposite sexes. -Nursing Application→Be alert for children who appear more comfortable with male or female nurses, and attempt to accommodate them. Encourage parental involvement in care. Plan for playtime and offer a variety of materials from which to choose

As part of the assessment process, the pediatric nurse often utilizes a standardized tool for a developmental screening. Which nursing action is appropriate related to the use of a developmental screening tool? -Practice administering the screening tool. -Have the parent administer the screening tool. -Select the tool the nurse is most comfortable using. -Administer the part of the tool that will assess the child's problem area first.

-Practice administering the screening tool. Rationale: The nurse must feel comfortable administering the tool as it is directed to be used. There are certain tools that should be used depending upon the child's age and what information is being sought. It is not the parent's role to administer the tool, although they may answer questions during the use of the tools.

When using the otoscope to examine the ears of a 2-year-old child, the nurse should: Pull the pinna up and back. Pull the pinna down and back. Hold the pinna gently but firmly in its normal position. Commonly expected side effects.

-Pull the pinna down and back. Rationale: The ear canal in infants and young children is shorter, wider, and more horizontally positioned than in older children. To adequately examine the tympanic membrane in young children the pinna must be pulled back and down.

At 3 months what gross motor skills should the infant exhibit?

-Raises head and shoulders off mattress

A mother of a 4-year-old tells the nurse that her son is a "picky eater." The nurse should inform the mother that she should: Increase the amount of carbohydrates in the daily menu plan. -Administer vitamins twice a day to her child. -Be more concerned with the quantity of food than the quality of food. -Recognize this is common for preschoolers as their caloric requirements have decreased slightly.

-Recognize this is common for preschoolers as their caloric requirements have decreased slightly. -The preschooler will be influenced by others' eating habits and demonstrate their likes and dislikes for food preferences. The caloric requirement decreases slightly, to 90 kcal/kg/day. Quality, not quantity, is important. It is not necessary to give vitamins after infancy unless the child is at nutritional risk.

A nurse assesses the height and weight measurements on an infant and documents these measurements at the 75th percentile. The nurse notes that the measurements two months ago were at the 25th percentile. How should the nurse interpret these data? -The infant is not gaining enough weight. -The infant has gained a significant amount of weight. -The previous measurements were most likely inaccurate. -These measurements most likely are inaccurate.

-The infant has gained a significant amount of weight. Rationale: A comparison of these two sets of measurements shows that the infant has crossed two percentiles, going from the 25th to the 75th percentile, and therefore has gained a significant amount of weight. This rationale makes all other answers incorrect.

Older school-age children may communicate their feelings about surgery or treatment through

-Through journaling or direct conversation

At what age should an infant be able to sit down from a standing position without assistance?

12 months

When does the infant's anterior fontanel close?

12-18 months of age

When assessing a preschool age child's mouth, how many deciduous teeth should the nurse expect to find? Up to 10. 11 to 15. 16 to 20. Up to 32.

16-20 Rationale: Children get the first of 20 deciduous teeth between the ages of 6 months and 5 years. . All 32 permanent teeth are usually erupted in late adolescence.

The nurse understands that stranger anxiety in an infant is: -An abnormal developmental stage. -A sign of attachment to parents. -Crying when mother leaves the room. -An indication of mental illness.

A sign of attachment to parents. Rationale: Stranger anxiety is a normal and common development that occurs at about 6 months of age, characterized by crying when another person holds them. Crying when the parent leaves is separation anxiety.

When does the infant's posterior fontanel close?

2-3 months of age

How much do infants grow per month in the first month of age?

2.5 cm or 1 inch per month

When assessing the fontanels of a 6-week-old infant, how soon does the nurse expect the posterior fontanel to close? By 3 months. By 6 months. By 12 months. By 18 months.

3 months Rationale: The posterior fontanel closes by 3 months of age. The anterior fontanel closes by 18 months.

How many ounces should infants gain per week the first 6 months of age?

5-7 oz Birth weight is tripled by the end of the 1st year

Birth weight doubles by which month?

6 months

The nurse who is examining a child understands that visual acuity of 20/20 as measured by the Snellen chart is reached by age: 2 years. 4 years. 6 years. 8 years.

6 yrs of age Rationale: While difficult to assess directly in infants and young children, visual acuity does not approach that of adults until school age or about 6 years.

When assessing a 4-year-old child with a persistent cough, the nurse would assess respirations by observing which muscle group? Thoracic. Abdominal. Accessory. Intercostal.

Abdominal Rationale: Infants and young children use the diaphragm and abdominal muscles for respiration, so the nurse would watch the rise and fall of the abdomen to count respirations. Use of accessory or intercostal muscles may be observed in respiratory distress.

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

Administer the prescribed analgesic. Rationale: School-age children are old enough to report their pain level accurately. A pain score of 6 is an indication for prompt administration of pain medication. The child might be trying to be brave, or might be lying still because movement is painful.

Mature Minors

Adolescents btwn 14-18 years able to understand treatment risks: -may give independent consent to receive or refuse treatment for limited conditions, such as testing and treating sexually transmitted infections, family planning, drug and slcohol abuse, blood donation, and mental health care

While waiting for a physical exam from the physician, the mother of a 4-month-old female begins changing a soiled diaper. The nurse notes a reddened diaper area on the baby. Which of the following interventions would be most appropriate in this situation? Say nothing, as the mother appears comfortable with diaper care. Ask the mother what care she provides to the diaper area during routine diaper changes. Report the red area to the physician. Give the mother a pamphlet on diaper rashes as she leaves the office.

Ask the mother what care she provides to the diaper area during routine diaper changes. Rationale: Discussing the care the mother generally provides opens up the opportunity for the nurse to ask detailed assessment questions about the red area and to provide information on a health maintenance activity for the infant.

Preschool Age Play

Associative play Plays in groups Rules may or may not be defined

Which nursing role is being exhibited? A process of coordinating the delivery of health care services in a manner that focuses on both quality and cost outcomes -Often a collaborative practice with other health care providers that promotes continuity of care -Discharge planning

Case Management

What nursing role is being exhibited? The nurse must be aware of the needs of the child and family, the family's resources, and the health care services available in the community → can then assist the family and child to make informed choices about these services and to act in the child's best interest

Client advocacy

Preschool Age Development

Climbs stairs, jumps, and runs with increasing skill Increased mobility Language development: Egocentric, knows colors Is developing socialization skills, differentiates gender of peers and/or siblings Less protest related to naptime but dislikes bedtime Magical thinking Prefers routine

Piaget

Cognitive development (Birth to 24 months): Sensorimotor stage

A 6-month-old child returns from surgery. PRN orders are available for pain management. The nurse would administer the pain medication when the baby is observed: -Crying loudly, grimacing, restlessness. -Displaying a change of color, decreased temperature. -Demonstrating shortness of breath, lack of responsiveness. -Sleeping more, refusing to eat.

Crying loudly, grimacing, restlessness. Rationale: A child's response to pain depends on his or her developmental stage. The infant is unable to describe or quantify pain because of limited vocabulary. Infant behaviors, such as crying, facial expressions, and change of activity are used to identify pain and distress.

The Child Abuse and Treatment Act of 1984, also known as the Baby Doe Regulations:

Defines withholding of medically indicated treatment as child abuse, except when care is futile

Preschool Age Children Nutrition

Develops strong preferences Prefers to eat the same food at each meal Can feed self Growth slows By the end of this period, has all primary teeth

The nurse would assess for which of the following as the most frequent cause of decreased hemoglobin and hematocrit levels in children? Dietary deficiency. Excess fluid intake. Chronic blood loss. Frequent cuts and bruises.

Dietary deficiency Rationale: The major reason for low hemoglobin and hematocrit in infants and children is deficiency of iron intake through diet. Iron-fortified rice cereal is the first solid food recommended for infants beginning about 4 months of age as fetal iron stores are depleted. Children need iron daily in their diets. Hemodilution and blood loss are uncommon causes of low hemoglobin and hematocrit in children.

What nursing role is being exhibited? -Nurse assesses the child, IDs the health concerns, and lists the nursing diagnoses describing the responses of the child and family to those health concerns in the nursing care plan

Direct Care

What nursing role is exhibited?: -Nurses help children adapt to the hospital setting and prepare them for procedures

Educator

Birth weight triples by?

End of 12 months (1st year)

When examining the child, the nurse should remember that tonsillar tissue: Enlarges until adolescence and then shrinks. Continues to enlarge throughout childhood and adolescence. Is readily visible in toddlers. Normally has a small amount of exudate.

Enlarges until adolescence and then shrinks. Rationale: Tonsils enlarge throughout childhood and gradually begin to shrink with puberty. Exudate should not be present on tonsils.

In infants, a positive Babinski reflex is: An indication of a neurological problem. Dorsiflexion of the toes. Fanning of the toes. Withdrawing the foot from the stimulus.

Fanning of the toes. Rationale: A positive Babinski in infants is a fanning of the toes when a stimulus is applied to the foot along the lateral edge and across the ball. The response disappears by about age 2.

The nutrition teaching that is appropriate to give the family of a 2-month-old includes: -Food safety for partially used bottles of formula or breast milk. -Introducing solids such as vegetables to the infant soon. -Instruction on how to teach the infant to use a cup to drink from. -Feedings should be focused on nutrition rather than social interactions.

Food safety for partially used bottles of formula or breast milk. Rationale: Nutrition teaching for a 2-month-old should support continued nursing, food safety for partially used bottles, avoidance of honey, and the need for supplements as appropriate. Feedings should continue to be viewed as social interactions to facilitate attachment. A cup is usually introduced at 6 months, as are solid foods.

Believe that early childhood experiences form the unconscious motivation for actions in later life. -developed a theory that sexual energy is centered in specific parts of the body at certain ages. -Unresolved conflict and unmet needs at a certain stage lead to a fixation of development at that stage

Freud's theory of psychosexual development

In assessing a child, the nurse should be aware that autonomic infant reflexes: Disappear at about 1 year of age. Include palmar grasp, stepping, and rooting. Begin about 6 months of age. Continue until the preschool years

Include palmar grasp, stepping, and rooting. Rationale: The autonomic infant reflexes are present at birth in full-term infants, and some, like the Babinski, may persist until 2 years of age. The palmar grasp, stepping, and rooting reflexes are three of several autonomic reflexes.

Regardless of the child's age, which assessment technique is always used first? Palpation. Percussion. Auscultation. Inspection.

Inspection

The common causes of child mortality and reasons for hospitalization in adolescence

Leading cause of death: unintentional injuries/motor vehicle accidents Leading cause for hospitalizations: mental disorders

The common causes of child mortality and reasons for hospitalization in preschoolers

Leading cause of death: unintentional injury/Motor Vehicle Accidents Leading cause for hospitalization: respiratory disorders

The common causes of child mortality and reasons for hospitalization in toddlers

Leading cause of death: unintentional injury/Motor Vehicle Accidents Leading cause for hospitalization: respiratory disorders

The common causes of child mortality and reasons for hospitalization in children 10-14

Leading cause of death: unintentional injury/Motor Vehicle accidents Leading cause for hospitalization: dz of digestive system

The common causes of child mortality and reasons for hospitalization in infants

Leading cause of mortality: unintentional injury (suffocation), congential malformations, short gestation/LBW, and SIDS Leading cause for hospitalization in infants: Respiratory disorders

Developmental Stage: Preschool-Age

MNL says 3-5 years

Which of the following should be included in the child's health history? Blood pressure 80/40. Mother states child has a rash. Child appears feverish. Diminished reflexes.

Mother states child has a rash. Rationale: The history deals with subjective data, that which is reported by parents, for example. Other data listed is objective data.

To assess a child's gait, the nurse should: Perform Barlow's maneuver. Ask the child to stretch out the legs as far as possible. Ask the parent if the child has any problems ambulating. Observe the child moving about the examining room.

Observe the child moving about the examining room. Rationale: The easiest way for a nurse to observe a child's gait is to unobtrusively observe the child move about the examining room. If that is not possible, the nurse can ask the child to walk across the room at the conclusion of the physical assessment. Barlow's maneuver is performed to assess for congenital hip dislocation in infants.

When do permanent teeth begin to erupt?

Permanent teeth begin to erupt about he age of 6 as deciduous teeth fall out

Freud: Personality: Structure: 3 parts

Personality has a structure with 3 basic parts: -id→basic sexual energy that is present at birth and drives the individual to seek pleasure -ego→the realistic part of the person, which develops during infancy and searches for acceptable methods of meeting impulses -superego→ the moral and ethical system, which develops in childhood and contains a set of values and conscience

In providing her 8-month-old child's medical history, the mother states the child has received one MMR vaccine. The nurse taking the history should: -Ask the mother if the child has received the MMR booster. -Plan to administer the MMR booster. -Explain that one MMR vaccine is all that is required. -Plan to administer another MMR vaccine after the child is 1-year-old.

Plan to administer another MMR vaccine after the child is 1-year-old. Rationale: This mother may have been mistaken about the vaccine. Maternal antibodies interfere with the vaccine when it is given before 12 months of age. Even if the child has had the vaccine, it will need to be repeated. The first measles-mumps-rubella (MMR) should be administered to the child between the ages 12 to 15 months. The second is given at age 4 to 6 years or 11 to 12 years.

Toddler Developmental Stage

Play Parallel play Rules may or may not be defined Communicates, imitates Toys must be developmentally appropriate and safe, that is, push-pull, rocking, balls, containers, sand, water, play dough Nutrition Varied degree of consistency to table food; can feed self, prefers finger foods Has acquired food taste and preferences By the end of this period, has some primary teeth Growth is slower than during infancy Quadruples birth weight by age 2 Less appetite than infants Development (12 to 15 months): Begins walking with help, gait unsteady, progresses to climbing and running Increased mobility Language development: no, dada, mama 16 to 36 months: Walks alone, climbs stairs, picks up objects from floor by stooping Begins to ride a tricycle Runs, jumps Feeds self, uses eating utensils

Screening for strabismus (crossed eyes) and amblyopia (reduced vision in one or both eyes) should be part of the physical assessment of which children? -All children under 18. -Infants. -Preschool children. -School-age children.

Pre-school children Rationale: Strabismus is detected with the cover-uncover test that can first be reliably administered to children over the age of 2. It is important to detect the problem early to prevent amblyopia. By school age, vision loss would have occurred.

By the end of this period, has primary teeth

Preschool age: 3-6 yrs

While interviewing the parents of a 2-year-old female, the nurse notes the mother is pregnant. At the end of the visit, the nurse decides to give a new pamphlet to the parents about car seat usage for newborns. This action is an example of: Developmental screening. Primary preventative health maintenance. Tertiary preventative health maintenance. Secondary preventative health maintenance.

Primary Preventative Health Maintenance Rationale: The teaching regarding proper car seat use is an example of an activity that might decrease the opportunity for injury in a newborn. The tertiary level of preventative care is related to restoring a level of functioning that is below an expected level, such as in a rehabilitation situation. This is education, and not a developmental screening to elicit data. -The secondary level of prevention is focused on diagnosis of a problem, usually medical in nature, in order to address it and make a plan of care.

In order to administer a medication safely to a pediatric client, what drug information must the nurse be aware of that is not always essential when administering a medication to an adult client? Indicators of drug toxicity. Recommended dose per kg of body weight. Incompatibilities with other medications. Commonly expected side effects.

Recommended dose per kg of body weight.

A mother asks the pediatric nurse about what she should begin to feed her 6-month-old infant. The correct response is: Egg whites are the least allergenic food to be introduced into the baby's diet. Rice cereal is the first solid introduced that is least allergenic of the cereals. Formula is the only source of nutrition given for the first year. Fruits and vegetables are good sources of iron.

Rice cereal is the first solid introduced that is least allergenic of the cereals. Introduction of solid food is recommended at age 4 to 6 months, when the gastrointestinal system has matured sufficiently to handle complex nutrients. The suck reflex and tongue-thrust reflex diminish at 4 months of age. Rice cereal is the first solid food because it is a rich source of iron and rarely induces allergic reactions. **Fruits and vegetables, good sources of vitamins and fiber, are introduced after cereal, one at a time to determine allergic reactions. Egg whites are highly allergenic.

When does growth plateau?

School age 6-12 yrs

At what age is it appropriate to change the sequence of the examination of the child from that of chest and thorax first to head-to-toe? -Infant. -Toddler. -Preschool child. -School-age child.

School-age child Rationale: The school-age years are the first time a child is able to reliably cooperate with the examiner and not squirm, talk, or otherwise interrupt the exam. In younger children, it is essential to begin with the chest and thorax because the child needs to be quiet and at rest.

When does separation anxiety become an issue with infants?

Separation anxiety becomes an issue around age 6 months when the infant

When are solids begun?

Solids are begun around age 6 months w/ pureed forms of food

When observing an 18-month-old child, the nurse notes a rounded belly, sway back, bowlegs, and slightly large head. The nursing conclusion is that: The child appears to be a normal toddler. The child is likely developmentally delayed. The child may be malnourished, especially with respect to calcium. The enlarged head is of great concern and requires a thorough neurological exam.

The child appears to be a normal toddler. Rationale: The typical toddler has lordosis and a protruding belly. The head still appears somewhat large in proportion to the rest of the body. Because these are normal findings, there is no need to be concerned about developmental delays, malnutrition, or neurological problems.

A 4-year-old scores two failures on the Denver II. Which of the following statements is most accurate? -The child is not as intelligent as expected for age and should be referred to a learning specialist. -The child has a speech problem and should be referred to a speech therapist. -The child is at risk for school problems and should be retested. -The failures are to be expected in preschoolers who may not be cooperative with testing.

The child is at risk for school problems and should be retested.

When assessing a child for strabismus, the nurse should select which of the following eye tests? The Snellen eye chart. The cover-uncover test. An ophthalmoscope exam. The convergence test.

The cover-uncover test Rationale: The cover-uncover test assesses coordination of eye muscle movement. In strabismus, one muscle is weaker and the eye wanders rather than focusing forward. Undetected and untreated strabismus can lead to amblyopia.

The toddler period covers ages:

The toddler period covers ages: 12 months through 36 months.

How should the nurse communicate with toddlers?

Toddlers respond well to clear, concise verbal messages.

T/F Infants are unable to digest the large molecules of cow's milk.

True

T/F Infants younger than age 6 months have little or no concept of differentiating family and caregiver from the general public.

True

An example of objective information about a child obtained by the nurse is: Allergy to peanuts. Uses inhaler once a day for asthma. Two-inch scar on right lower leg. Appendectomy 6 months ago.

Two-inch scar on right lower leg. Rationale: Objective data is that which the nurse obtains through physical assessment or diagnostic studies. The presence of a scar is objective data. Other selections listed are part of the health history and therefore are subjective data.

The nurse is planning educational interventions to reduce the incidence of the number one cause of mortality in children ages 1-4. Recognizing the developmental needs of this age group, the nurse would focus the session on which topic? Seizure disorder management. Sudden infant death syndrome (SIDS) recognition. Child abuse prevention. Unintentional injury awareness.

Unintentional injury awareness.

To assess the height of an 18-month-old child who is brought to the clinic for routine examination, the nurse should: Measure arm span to estimate adult height. Use a tape measure. Use a horizontal measuring board. Have the child stand on an upright scale and use the measuring arm.

Use a horizontal measuring board. Rationale: Children younger than 2- or 3-years-old should be measured lying down, preferably on a HORIZONTAL MEASURING BOARD, to get an accurate assessment of height. A tape measure would be used to measure head circumference. An arm-span measure is not an appropriate estimation of adult height.

For which age group could the nurse use play as an effective means of communicating?

Younger school-age children *Infants communicate non-verbally