Quiz: Medical-Surgical Nursing: Cardiovascular, Hematologic, and Lymphatic Systems; Pediatric Nursing: Toddlers, Preschoolers

A nurse is assessing a 15-month-old girl at the well-child clinic. The nurse determines that further education about toddler development is necessary when the mother says what?

"She has a temper tantrum every time I put her on the potty chair." Most 15-month-old toddlers are not ready for toilet training. Voluntary sphincter control develops between 18 and 24 months of age. A tantrum on being placed on the potty chair is autonomous behavior, typical of a 15-month-old toddler. Crying when the mother leaves her at the daycare center demonstrates separation anxiety, common in 15-month-old toddlers. Scattering toys everywhere demonstrates autonomous behavior, typical of a 15-month-old toddler.

To prepare a client for surgery, which explanation by a nurse would be accurate related to pneumatic compression devices?

They help the venous blood return to the heart.

Which treatment should the nurse anticipate when providing care to a toddler-age client who ingested bleach?

Analgesics, per order. The nurse should anticipate an order for analgesics for a toddler-age client who presents after the ingestion of bleach. Gastric lavage, activated charcoal, and vomiting are contraindicated because each can cause more harm to the child.

A 13-month-old child is admitted with a tentative diagnosis of bacterial meningitis, and the practitioner schedules a lumbar puncture. What is the most important action the nurse should take in preparation for the lumbar puncture?

Asking the parents what they were told about the test Informed consent is required. The procedure should be explained to the parents by the practitioner, and the nurse should confirm the parents' comprehension and have them sign the consent form. The child is too young to comprehend a demonstration of the procedure. Although staying with the child may be important to the parents, it is not the priority. Although a pacifier may keep the child calm, this is not the priority, either.

Which areas are sources of stress in four-year-old children? Select all that apply.

Attention, insecurity, and activity level are sources of stress in four-year-old children. School and separation anxiety are sources of stress in five-year-old children.

Which gross motor skill is exhibited by 3-year-olds?

Riding a tricycle Riding a tricycle is a gross motor skill exhibited by 3-year-olds. Repeatedly catching a ball, skipping, and hopping on one foot are gross motor skills exhibited by 4-year-olds. Walking backward with heel to toe is a gross motor skill exhibited by 5-year-olds.

The parents of a toddler with newly diagnosed cystic fibrosis (CF) tell a nurse that even though they were told it is an inherited disorder, there is no history of CF in the family. How can the nurse clarify the way in which the disease was inherited?

The inheritance is autosomal recessive. Both parents are carriers; the gene for CF is recessive, not dominant, and the parents do not have the disease. The gene for CF is not a mutant gene, nor is it located on the X or Y chromosome.

Which statement is true regarding the development of body image in preschoolers?

They can become conscious of their size. By 5 years of age, children compare their size with that of their peers and can become conscious of being large or short, especially if others refer to them as "so big" or "so little" for their age. Despite the advances in body image development, preschoolers have poorly defined body boundaries and little knowledge of their internal anatomy. They recognize differences in skin color and racial identity and are vulnerable to learning prejudices and biases. They are aware of the meaning of words such as "pretty" or "ugly," and they reflect the opinions of others regarding their own appearance.

A client is admitted to the hospital with the diagnosis of myocardial infarction. The nurse should monitor this client for which signs and symptoms associated with heart failure? Select all that apply.

Unusual fatigue, dependent edema, nocturnal dyspnea. Unusual fatigue is attributed to inadequate perfusion of body tissues because of decreased cardiac output in response to cardiac ischemia; women more commonly report unusual fatigue than men. Dependent edema occurs with right ventricular failure because of hypervolemia. Dyspnea at night, which usually requires the assumption of the orthopneic position, is a sign of left ventricular failure. Orthopnea, a compensatory mechanism, limits venous return, which decreases pulmonary congestion and promotes ventilation, easing the dyspnea. Weight gain, not loss, occurs because of fluid retention. Urinary output decreases, not increases, with heart failure because the sympathetic nervous system and the renin-angiotensin-aldosterone system stimulate the retention of sodium and water in the kidneys.

A nurse has difficulty palpating the pedal pulse of a client with venous insufficiency. What action should the nurse take next?

Verify the pulse by using a Doppler. Clients with venous insufficiency often have edema, which may make palpation of an arterial pulse difficult. A Doppler uses sound waves so that the pulse can be heard. The quality of the pedal pulse, not the rate, is assessed to determine the adequacy of peripheral arterial circulation; the most distal site is preferred. The nurse must make other assessments of circulation before notifying the primary healthcare provider. Lowering the legs will increase edema and make palpation of pulses more difficult.

A nurse on the pediatric unit is planning recreational activities for a 4-year-old with an exacerbation of nephrotic syndrome. What are the most appropriate activities in light of the child's developmental level and physical status?

Watching cartoon videos and listening to stories Enjoyment of fantasy and listening to stories are quiet, pleasurable pastimes for a 4-year-old. Riding a tricycle requires too much energy, and playing with large blocks is below a 4-year-old child's developmental level. Although preschool children may enjoy video games, they are not expected to be able to read for enjoyment. The pull toy is below a 4-year-old child's developmental level, and a map puzzle is too advanced.