Study guide wk2

The nurse would assess respirations in a 9-month-old infant when the client is: a. Playing in the playroom b. Crying c. Laughing d. Quiet in caregiver's lap

D

The nurse is taking care of a child with osteomyelitis. Which of the following signs and symptoms of the disease would the nurse suspect? SELECT ALL THAT APPLY. a. Fever b. Irritability c. Pallor d. Tenderness e. Swelling

A, B, D, E

A 4 month old child rolled off of the couch and sustained a dislocated hip. The baby's hips are now immobilized with a hip spica cast due to the incident. Which of the following is the priority nursing action immediately after the application of the cast? a. Keep the cast clean and dry b. Cover the peri-area c. Elevate the cast d. Perform neurovascular checks

D

A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question? a. "Did you use any medications like aspirin for the fever?" b. "Did you give your child any acetaminophen, such as Tylenol?" c. "What type of fluids did your child take when he had a fever?" d. "How high did his temperature rise when he was ill?"

A

A child is admitted with a fracture of the femur and placed in skeletal traction. What should the nurse assess first? a. The pull of traction on the pin b. The Ace bandage c. The pin sites for signs of infection d. The dressings for tightness

A

After talking with the parents of a child with Down syndrome, the nurse should help the parents establish which goal? a. Encourage self-care activities in the child b. Teach the child something new each day c. Encourage more lenient behavior limits for the child d. Achieve age-appropriate social skills

A

Mrs. Cooper is concerned about her 4 month old son's condition. Which of the following statements made by her would indicate that the child may have cerebral palsy? a. He holds his left leg so stiff that I have a hard time putting on his diapers. b. My baby won't life his head up and look at me. He is so floppy. c. My baby's left hip tilts when I pull him to a standing position. d. My baby has not yet rolled over.

A

The emergency department nurse has admitted an infant with bulging fontanelles, setting sun eyes, and lethargy. Which diagnostic procedure would be CONTRAINDICATED in this infant? a. Lumbar puncture b. MRI c. Arterial blood draw d. CAT Scan

A

The mother of an infant with a myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that myelomeningocele is commonly associate with which disorder? a. Excessive CSF within the cranial cavity b. Abnormally small head c. Congenital absence of the cranial vault d. Overriding of the cranial sutures

A

The nurse is assessing the growth of a premature infant. What would be the appropriate action by the nurse to complete this assessment? a. Plot the infant's weight, height, and length on a growth chart b. Weigh the diapers c. Ask the Mom if the baby eats enough d. Take vital signs

A

The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on this child? a. Taking her on an adventure down the hall b. Helping her do a simple craft project c. Introducing her to children in the playroom d. Limiting the staff providing care for her

A

The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding? a. Indications of increased intracranial pressure b. An increase in the blood glucose level c. A decrease in the liver enzymes d. A presence of protein in the urine

A

The nurse is caring for a child diagnosed with osteomyelitis in the tibia. What prescription would the nurse question? Select all that apply. a. Ambulating QID b. Intravenous antibiotics for 3 days c. Blood cultures to be drawn before giving antibiotic d. CT scan of the lower leg e. Oral antibiotics for 4 weeks after completing intravenous antibiotics

A, B

The nurse is assessing a child with Reye's syndrome. Which of the following signs and symptoms would the nurse expect to find? SELECT ALL THAT APPLY. a. Vomiting 3-7 days after the flu b. Listlessness c. Disorientation d. Seizure e. Increased urine output

A, B, C, D

Parents bring a 10 month old with a myelomeningocele and hydrocephalus with a shunt, to the emergency department. His symptoms include vomiting, poor feeding, lethargy, and irritability. What interventions by the nurse are most appropriate? SELECT ALL THAT APPLY. a. Weigh the child b. Listen to bowel sounds c. Palpate the posterior fontanelle d. Obtain vital signs e. Assess pitch and quality of child's cry

A, B, D, E

You are assessing your patient load for the patients who are at MOST risk for seizures. Which of the following patients are at risk for a seizure? SELECT ALL THAT APPLY. a. A 12 year old with a blood glucose of 20 b. A 3 year old who has had a fever of 104F for 4 days c. A 2 month old who is 5 days post op from open heart surgery d. A 16 year old with bacterial meningitis e. An 8 year old newly diagnosed with Reye's Syndrome

A, B, D, E

The nurse is preparing an education program for parents of a child diagnosed with Legg-Calvé-Perthes disease (coxa plana) disorder. What information does the nurse need to include? Select all that apply. a. This disorder has four stages that last over several years. b. The initial stage symptoms include a limp and guarding of the hip while moving. c. The second stage can last up to 2 years and includes breakdown or fragmentation of the bone in the head of the femur. d. In children over 6, surgical placement of a containment device over the head of the femur is the typical treatment. e. If left untreated, the femur head will deform, which can lead to chronic pain

A, B, E

You have just admitted a child who has a brain tumor and is at risk for seizures. In the patient's plan of care, you incorporate seizure precautions. Which of the following are proper steps to take in initiating seizure precautions for this patient? SELECT ALL THAT APPLY. a. Oxygen at bedside b. Suction at bedside c. Bed in highest position d. Remove all pillows e. Have restraints on standby f. Padded bed rails g. Remove restrictive objects or clothing from the patient's body h. Insert an IV

A, B, F, G, H

The nurse is teaching a 7-year-old girl about her upcoming tonsillectomy. Which techniques would be appropriate for this child? Select all that apply. a. Allowing the child to do as much self-care as possible b. Explaining the procedure that will happen later in the day c. Offering choices of drinks and gelatin after the procedure d. Explaining that anesthesia is a lot like falling asleep e. Using plays or puppets to help explain the procedure

A, C, D

The nurse is preparing to perform the Denver II screening test on a 3-year-old child. Which items should the nurse prepare for use in the assessment? Select all that apply. a. Ball b. Four plastic rings c. Screwdriver d. Doll e. Crayon

A, D, E

A child is to receive IV antibiotics for osteomyelitis. Before administering the initial dose, the nurse needs to confirm that a blood sample for which test has been drawn? a. Creatinine b. Culture c. Hemoglobin d. White blood cell count

B

A nurse witnesses an accident involving an adolescent being thrown from a motorcycle, and stops to help. The adolescent reports that he is now unable to move his legs. While waiting for the emergency medical services to arrive, what should the nurse do? a. Flex his knees to relieve the stress on his back b. Leave him as he is, staying close by c. Remove the adolescent's helmet as soon as possible d. Assess the adolescent for abdominal trauma

B

A parent of a child with a moderate head injury asks the nurse, "how will you know if my child is getting worse"? The nurse should tell the parents that the BEST indicator of the child's brain function is: a. Vital signs b. Level of consciousness c. Reactions of the pupils d. Motor Strength

B

Which procedures can the RN safely delegate to a LPN? SELECT ALL THAT APPLY. a. Refilling a baclofen pump b. Administering enteral tube feedings c. Inserting hearing aids d. Giving an IV push medication e. Notifying the doctor of the morning blood sugar readings

B, C

The parent of a preschool-aged child asks the nurse for ideas on preparing the child for abdominal surgery requiring general anesthesia. What would the nurse recommend for this parent? Select all that apply. a. Remind the child that parent will be there when the child wakes up. b. Encourage the child to ask questions and talk about fears c. Help the child select a couple of toys appropriate to take to the hospital d. Use play to demonstrate procedures on the child's toy dolls e. Assure the child that pain medication will take all the 'hurt' away

B, C, D

What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? a. Bradycardia b. Cheyne-Stokes respirations c. Fixed, dilated pupils d. Projectile vomiting

D

When assessing the development of a 15 month old child with Cerebral Palsy, which milestones should the nurse expect a typically developing toddler of this age to have achieved? a. Walking up steps b. Using a spoon c. Copying a circle d. Putting a block in a cup

D

Which part(s) of the body are most affected by Reye's syndrome? a. Brain b. Liver c. Skin d. Both A & B e. Both A & C f. Both B & C

D

The child with a surgically repaired myelomeningocele has a neurogenic bladder. How will the nurse best explain this problem to the parents? a. "Your child cannot properly control holding urine or emptying the bladder. " b. "Old urine remains in the bladder because of poor emptying or overfilling, putting your child at risk for urinary tract infection." c. "Your child dribbles urine because the bladder either is overactive, pushing urine out, or is not active enough, becoming overfilled and causing urine to leak." d. "While your child is young, urine leaking from the bladder will not be a problem because diapering is expected."

B

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child: a. Cannot plantar-flex the foot b. Feels increasing severe pain c. Has a weak femoral pulse d. Has blue-looking nailbeds on fingers and toes

B

The nurse is caring for a child in the emergency department that has meningitis. The nurse would suspect which of the following diagnostics/labs to be ordered and performed? a. CBC, Urine culture, CMP b. CBC, LP, ESR c. CBC, CRP, EVD placement d. CBC, CT, MRI

B

The nurse suspects sexual maltreatment in a 10-year-old girl. The nurse would assess which primary finding to help make this determination? a. Onset of menses b. Vaginal discharge c. Vaginal bleeding d. Tanner 4 breast development

B

A child who limps and has pain has been found to have Legg-Calve-Perthes disease. What should the nurse expect to include in the child's plan of care? a. Initiation of pain control b. Promote ambulation c. Prevention of flexion in the affected hip and knee d. Avoidance of weight bearing on the head of the affected femur

D

A nurse is working at a busy pediatric clinic and is scheduled to see several children this morning to conduct health supervision. Which child would the nurse expect to screen for hypertension? a. A 1-year-old child who was born at term b. An 18-month-old with a history of ear infections c. A 2-year-old child with a fever d. A 3-year-old child in for a well-child visit

D

Veronica is a 12 year old girl who has to wear a back brace for scoliosis. Which of the following indicates an effective understanding for the use of the brace? a. I sure am glad that I only have to wear this awful thing at night b. I am really glad that I can take this thing off whenever I get tired c. I wonder if I can take this brace off when I go to the dance d. I will look forward to taking this cast off with my bath every day

D

The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure? a. "His arms had jerking movements in his legs and face." b. "He was just staring into space and was totally unaware." c. "He kept smacking his lips and rubbing his hands." d. "He usually is very coordinated, but he couldn't even walk without falling."

B

What is the best benefit of the nurse providing family-centered care to a family with a medically fragile child? a. The family will be included in all decisions regarding care for the child b. The child's developmental potential will be maximized c. The nurse will have opportunity to treat the family holistically d. The child will be the center of the care and the family will be educated

B

An 8 year old child is not responding to anti-seizure medications and is prescribed to start a ketogenic diet. This diet will include: a. High carbs and high fat b. Low fat, high salt, and high carbs c. High fat and low carbs d. High glucose, high fat, and low carbs

C

Parents of a child that was diagnosed with Duchenne's muscular dystrophy ask the nurse what is typically the first indication of the disorder. The nurse's best response is which of the following? a. Inability to suck in a newborn b. Lateness in walking in a toddler c. Difficulty running for a preschooler d. High IQ for a toddler

C

The nurse notes a child started a seizure at 1402. The time now is 1408 and the patient is still seizing. What should the nurse do next? a. Continue to monitor the patient b. Suction the patient c. Initiate the emergency response system d. Restrain the patient to prevent injury

C

When developing the plan of care for a child with early Duschenne's muscular dystrophy, which nursing goal is a priority? a. Encourage early wheelchair use b. Foster social interactions c. Maintain function of unaffected muscles d. Prevent circulatory impairment

C

A 7-year-old child diagnosed with Duchenne muscular dystrophy (DMD) uses a wheelchair for mobility. The child's parent tells the nurse "I want my child to participate in activities with peers but I am so concerned about my child's health." Which comment(s) is appropriate for the nurse to make? Select all that apply. a. "You can assist your child in riding a stationary bicycle." b. "Each day engage in active or passive range-of-motion exercises." c. "Your child's diagnosis will not allow him or her to engage in activities with peers." d. "Wheelchair team sports might be something your child would enjoy." e. "Encourage your child to remain active but to also take time to rest."

D, E

Which other diagnosis is Reye's syndrome often mistaken for? a. Meningitis b. Kawasaki's Disease c. Acute Rheumatic Fever d. Redman's Syndrome

A

The nurse is providing postop care for an infant who had a CP shunt placed to correct hydrocephalus. Which clinical finding warrants immediate intervention? a. Abdominal distension b. Lethargy c. Facial edema d. Headache

A

The parents of an infant diagnosed with a chronic illness ask the nurse, "How will this affect our baby's growth and development?" How will the nurse respond? a. "Children with chronic illnesses may grow and develop at a slower pace." b. "Your child will need intensive therapy to be able to function with limited assistance." c. "Growth and development will not be measured for your baby." d. "Don't worry about that now. Enjoy your baby and don't stress!"

A

A parent asks the nurse about using a car seat for a toddler who is in a hip spica cast. The nurse should tell the parent: a. You can use a seat belt because of the spica cast b. You will need a specially designed car seat for your toddler c. You can still use the car seat you already have d. You will need to get a special release from the police so that a car seat will not be needed

B

A public health nurse is speaking to a group of adolescents about the potential outbreaks of bacterial meningitis. Which population is most at risk for an outbreak? a. Clients recently discharged from the hospital b. Residents of a college dorm c. Individuals who travel outside of the USA d. Employees in a high rise office building

B

A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? a. A room with a 12-month-old infant with a urinary tract infection b. A room with an 8-month-old infant with failure to thrive c. A private room near the nurses' station d. A two-bed room in the middle of the hall

C

A preschooler with meningitis is receiving IV antibiotics. When discontinuing this therapy, the nurse allows the child to apply a dressing to the area where the catheter is removed. The nurse's rationale for doing so is based on the interpretation that a child in this age group has a need to accomplish which goal? a. Trust those caring for her b. Find diversional activities c. Protect the image of an intact body d. Relieve the anxiety of separation from home

C

The nurse notes a period of daydreaming for a 7 year old child. You time this event to be 10 seconds. After the 10 seconds, the child appropriately responds and doesn't recall the event. This is known as what type of seizure? a. Focal Impaired b. Atonic c. Tonic-Clonic d. Absence

D