Weeks 1 & 2 Chapters 1-6 PEDS

During a well baby visit, the mother of a 6 month old comments, "I want to go back to work, but I don't want my baby to suffer because I'll have less time with him." A therapeutic response by the nurse includes which statement?

"Let's talk about the child care options that will be best for your baby."

A nurse is formulating a clinical question for evidence based practice? Place in sequential order the steps the nurse should use to clarify the scope of the problem and clinical topic of interest: Intervention Outcome Population Time Comparison

(P) Population (I) Intervention (C) Comparison (O) Outcome (T) Time

At which age would the nurse expect the anterior fontanel to close?

12-18 months

Which is the earliest age at which a satisfactory radial pulse can be taken in children?

2 years

An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year?

21 lbs

Parents of a newborn are concerned because the infant's eyes often look crossed when the infant is looking at an object. The nurse's response is that this is normal based on the knowledge that binocularity is normally present by which age?

3-4 months

A dose of oxycodone 2mg/kg has been ordered for a child weighing 33 lbs. How many milligrams of OxyContin should the nurse administer?

30mg

By which age does birth length usually double?

4 years

The nurse accurately relates which body mass index (BMI) for age percentile as overweight?

85th percentile

Which is descriptive of clinical reasoning?

A cognitive process used to analyze data

A nurse is conducting a teaching session on the use of time out as a discipline measure to parents of toddlers. Which strategies would the nurse include?

A rule for the length of time out is 1 minute per year When the child misbehaves, one warning should be given The area for time out is safe, convenient, and where the child can be monitored

A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. Which would the nurse explain?

A topical anesthetic, EMLA, can be applied before injections are given

Turner syndrome is suspected in an adolescent girl with short stature. Which is the cause of this syndrome?

Absence of one of the X chromosomes

Which statement is most characteristic of a preschooler's stage of moral development according to Kohlberg?

Actions are determined as good or bad in terms of their consequences

Which depicts accurate documentation for a dressing change on a child who has an appendectomy incision? a. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present b. No complications noted during dressing change to appendectomy incision c. Appendectomy incision non-reddened, sutures intact, no drainage noted on old dressing, new dressing applied, procedure tolerated well by child d. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure, new dressing clean, dry and intact

Appendectomy incision non-reddened, sutures intact, no drainage noted on old

Which is an important nursing consideration when caring for a child with herpetic gingivostomatitis?

Apply topical anesthetics before eating

The nurse is taking a health history on an adolescent. Which best describes how the chief complaint would be determined?

Ask adolescent, "Why did you come here today?"

The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?

Ask her, "Are you having sex with anyone?"

The nurse is having difficulty communicating with a hospitalized 6 year old child. Which technique might be most helpful?

Ask the child to draw a picture

Which strategy by the nurse is most likely to encourage parents to talk about their feelings related to their child's illness?

Asking open-ended questions

Which behaviors by the nurse indicate a therapeutic relationship with the children and families?

Asking questions if families are not participating in the care Clarifying information for families Learning about the family's religious preferences

A nurse is collecting subjective and objective information about target populations to diagnose problems based on community needs. This describes which step in the community nursing process?

Assessment

In which type of play are children engaged in similar or identical activity, without organization, division of labor, or mutual goal?

Associative

A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest?

Bacterial conjunctivitis

A nurse makes the decision to apply a topical anesthetic to a child's skin before drawing blood. Which ethical principle is the nurse demonstrating? a. Autonomy b. Beneficence c. Justice d. Truthfulness

Beneficence

Which describes a family in which a mother, her children, and a stepfather live together?

Blended

Which recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration?

Bran cereal Prune juice Physical activity

Which nursing consideration is important when caring for a child with impetigo?

Carefully wash hands when caring for an infected child

An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development?

Cephalocaudal

A 5 year old girl is having a check up before starting kindergarten. The nurse asks her to do the finger to nose test. Which is the nurse testing for?

Cerebellar function

Dunst, Trivet, and Deal identified qualities of strong families that help them function effectively. Which qualities are included?

Clear set of family values, rules, and beliefs Ability to engage in problem solving activities Sense of balance between the use of internal and external family resources

A parent of a school age child is going through a divorce, and the parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse would recognize this as which implication?

Common reaction to divorce

When the parents of a newborn ask the nurse about the causative factor in clubfoot, which response is appropriate?

Condition is often caused by uterine constraint

The following account for nearly half of all deaths in infants younger than 1 year? (select all that apply)

Congenital anomalies Sudden infant death syndrome Disorders relating to short gestation

A nurse is monitoring a patient for side effects associated with opioid analgesics. For which side effects should the nurse expect to monitor?

Constipation Diarrhea Pruritus Respiratory depression

A nurse is planning play activities for school age children. Which type of a play activity would the nurse plan?

Cooperative

A nurse is planning a class on accident prevention for parents of toddlers. Which safety topic is the priority for this class?

Correct use of car seat restraints

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

Acyclovir (Zovirax) is given to children with chickenpox to?

Decrease the number of lesions

Which is the single most important factor to consider when communicating with children?

Developmental level of language

Which factor most impacts the type of injury a child is susceptible to, according to the child's age?

Developmental level of the child

A nurse recognizes which physiologic responses as a manifestation of acute pain in a neonate?

Diaphoresis Increased heart rate Increased blood pressure

A mother reports that her 6 year old child is highly active, irregular in habits and adapts slowly to new routines, people, or situations. How would the nurse chart this type of temperament?

Difficult

Divorced parents of a preschool child are asking whether their child will display any behaviors related to the divorce. The nurse is correct when explaining that the parents should be prepared for which types of behaviors?

Displaying fears of abandonment Verbalizing that he or she is the reason for the divorce Engaging in fantasy to understand the divorce

Which family theory best describes a series of tasks for the family throughout its life span?

Duvall's developmental theory

A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines would the nurse include when using an interpreter?

Elicit one answer at a time Arrange for the family to speak with the same interpreter if possible Introduce the interpreter to the family

Trauma to which site can result in a growth problem for children's long bones?

Epiphyseal cartilage plate

Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?

Extended

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 (Face, Legs, Activity, Cry, Consolability)

Which is the causative agent of scarlet fever?

Group A (hemolytic streptococci)

Which second-leading cause of death topic would the nurse emphasize to a group of boys ranging in age from 15 to 19 years? a. Suicide b. Cancer c. Homicide d. Occupational injuries

Homicide

The first term pregnant adolescent has understood the nurse's teaching if she makes which statement?

I will seek help immediately if I have a fever I should avoid any alcoholic beverages I will ensure my vaccinations are current and talk to my physician if they are not

A nurse has established several health programs, such as bicycle safety, to improve health status of a target population. This describes which step in the community nursing process?

Implementation

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

When palpating he child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. Which is the best explanation for this?

Infection or inflammation close to the site

What is the correct sequence used by experienced examiners when performing an abdominal assessment?

Inspect Auscultate Percussion Palpation

Which statement is accurate about lymphoid tissue?

Is twice the adult size by ages 10-12 years

Which statement is true about the basal metabolic rate (BMR) in children?

It is slightly higher in boys than in girls at all ages

Place in order the sequence of cephalocaudal development that the nurse expects to find in the infant. Begin with the first development expected, sequencing to the final. Provide answers separated by commas (e.g., a, b, c, d). a. Crawl b. Sit unsupported c. Lift head when prone d. Gain complete head control e. Walk

Lift head when prone Gain complete head control Sit unsupported Crawl Walk

When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of veggies, legumes, and starches. How would the nurse assess this diet?

May provide sufficient amino acids

Nonpharmacologic strategies for pain management..

May reduce pain perception

In which communicable diseases are Koplik spots present?

Measles (rubeola)

Vitamin A supplementation may be recommended for the young child who has which disease?

Measles (rubeola)

A nurse is admitting a child to the hospital with a diagnosis of giardiasis. Which medication would the nurse expect to be prescribed?

Metronidazole (Flagyl)

Which is most characteristic of the physical punishment of children, such as spanking?

Misbehavior is likely to occur when parents are not present

Which drug is usually the best choice for a patient controlled analgesia for a child in the immediate postoperative period?

Morphine

Airborne isolation is required for a child who is hospitalized with?

Mumps

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. Which would the nurse recognize regarding this finding?

Normal because the lower back and leg muscles are not yet well developed

During a funduscopic examination of a school age child, the nurse notes a brilliant, uniform red reflex in both eyes. How would the nurse interpret this finding?

Normal finding

The nurse is taking care of a 7-year-old child with severe herpetic gingivostomatitis. Which prescribed medication would the nurse expect to be included in the treatment plan?

Oral antiviral agent Topical anesthetic

Which causes Enterobius vermicularis (pinworm)?

Parasite

When discussing discipline with the mother of a 4-year-old child, the nurse would include which instruction?

Parental control should be consistent

When assessing a family, the nurse determines that the parents exert little or no control over their children. This is reflective of which parenting style?

Permissive

A patient on an intravenous opioid analgesic has become apnea. The nurse should implement which interventions?

Place the patient on continuous pulse oximetry to assess SaO2 Administer the prescribed naloxone (Narcan) dose by slow IV push Prepare to calm the child as analgesia is reversed

Which intervention would the nurse include when providing atraumatic care?

Prepare the child before any unfamiliar treatment or procedure

How does the nurse assess a child's capillary refill time?

Pressing the pad of the fingertip

Nitrous oxide is being administered to a child with extensive burn injuries. Which is the purpose of this medication?

Provide anesthesia

Fentanyl and midazolam (Versed) are given before debridement of a child's burn wounds. Which is the rationale for administration of these medications?

Provide pain relief

Which is an appropriate screening test for hearing that can be administered by the nurse to a 5 year old child?

Pure tone audiometry

Which action by the nurse demonstrates use of evidence based practice?

Questioning the practice of daily central line dressing changes

How is a 5 year old child's skeletal age best determined?

Radiographs of the hand and wrist

A nurse on a pediatric unit is practicing family centered care. Which is most descriptive of care the nurse is delivering?

Recognizing that the family is the constant in the childs life

While gathering a history, the school age child reports migraines every 2-3 months for the last year. The nurse documents this as which type of pain?

Recurrent

The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action?

Refer for immediate medical evaluation

When communicating with other professionals, which is important for the nurse to do?

Restrict communication to clinically relevant information

Which of the following data would be included in a health history?

Review of systems Past medical history Nutritional assessment Family medical history

A nurse is admitting a toddler to the hospital and the parents state they will need to leave for a brief period. Which type of nursing diagnosis would the nurse formulate for this child?

Risk for anxiety

Which is a common childhood communicable disease that may cause severe defects in the fetus when it occurs during pregnancy?

Rubella

A lumbar puncture is needed on a school age child. What should the nurse apply to provide the most appropriate analgesia during this procedure?

Saner (lidocaine and tetracaine) EMLA (eutectic mixture of local anesthetics) LMX4 (Lidocaine)

A nurse is assigned to four children of different ages. In which age group would the nurse understand that body integrity is a concern?

School-age child

Parents tell the nurse that their child keeps scratching the areas where he has bed bugs. The nurse's response would be based on which statement?

Scratching the lesions may cause them to become secondarily infected

Which is suggestive that a nurse has a non therapeutic relationship with a patient and family?

Staff is concerned about the nurse's closeness with the patient and family

A parent has asked the nurse about how her child can be tested for pinworms. The nurse responds by stating that which is the most common test for diagnosing pinworms in a child?

Tape test prior to defecating

The parents of a 3 year old adopted daughter have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption would the nurse use in planning a response?

Telling the child is an important aspect of their parental responsibilities

Which would the nurse consider when discussing language development with parents of toddlers?

The toddler expresses himself or herself with verbs or combination words

Because a visitor arrives at a daycare center during lunchtime, preschool children thing that every time they have lunch a visitor will arrive. Which preoperational characteristic is being displayed?

Transductive reasoning

The nurse would include which associated risk when planning a teaching session about childhood obesity?

Type 2 Diabetes

A nurse is conducting parenting classes for parents of children ranging in ages 2-7 years. The parents understand the term egocentrism when they indicate it means?

Unable to put self in another's place

A school nurse notes that school age children generally obey the rules at school and attributes this to which stage of moral development?

Undifferentiated

Which is the major cause of death for children older than 1 year?

Unintentional injuries

A nurse is performing an otoscopic exam on a school age child. Which direction would the nurse pull the pinna for a child this age?

Up and back

Which of the following parameters correlates best with measurements of the body's total protein stores?

Upper arm circumference

The nurse should prepare to monitor the patient for which side effects of an opioid epidural catheter?

Urinary retention Nausea Itching

Which is an important consideration for the nurse who is communicating directly to a young child?

Use transition objects, such as a doll

Shingles are caused by which virus?

Varicella zoster virus

Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

Vesicular

The nurse would expect to assess which causative agent in a child with warts?

Virus

Which behaviors by the nurse indicate non-therapeutic relationship with children and families?

Visits family on days off Purchases clothes and toys for the child