Final peds Flashcards


Set Details Share
created 1 year ago by rtr585
258 views
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:

1

Identify the age group of children per Erickson in the development stage of industry vs inferiority

6-12

2

Identify the age group of children per Erickson in the developmental stage of Autonomy vs. Shame & Doubt

1-3

3

Identify the age group of children per Erickson in the developmental stage of Initiative vs Guilt.

3-6

4

Identify the age group of children per Erickson in the developmental stage of Identity vs. Role Confusion.

13-21

5

According to Piaget, adolescents tend to be in what stage of cognitive development?

Formal operational thought

6

A 17 month old child should be expected to be in which stage according to Piaget?

Sensorimotor stage

7

A Pediatric Nurse Practitioner (PNP) in the peds clinic is assessing the reflexes of a 6 month old infant. Which of the following reflexes should usually not be seen at this age?

Startle

8

Which of the following reflexes usually disappear in a newborn around 3-4 months of age? (Select all)

Moro,

Startle,

Rooting

9

The nurse is doing a neurologic assessment on a 2 month old infant after a car accident. Moro, tonic, neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes suggest which of the following?

Neurologic health

10

A parent brings a 6 month old to the pediatric clinic for her well baby examination. Her birth weight was 8.2 lbs. The nurse weighing the infant today would expect her weight to be at least?

16 lb

11

What developmental achievements are demonstrated by a 4 y.o child? (Select all) Commonly has an imaginary playmate, Tends to be selfish and impatient, Fears are common

Commonly has an imaginary playmate,

Tends to be selfish and impatient,

Fears are common

12

Select the developmental milestones usually seen in children during the toddler stage (1-3 years). (Select all)

Two to three word sentences

appears to be bowlegged and potbellied

13

At what age can most infants sit steadily unsupported?

8 months

14

A nurse is providing anticipatory guidance to the parents of a toddler. Which of the following should the nurse include in the teaching?

Expect negative behaviors associated with negativism and ritualism, Develop food habits that will prevent dental caries, and Expression of bedtime fears is common

15

By which age should the nurse expect that an infant will be able to pull to a standing position?

11 to 12 months

16

At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

2 months

17

A child begins to blame his father for his parent’s divorce and has displayed intense anger towards his father. In which age group of children is this most likely to occur?

School age

18

At what age should the nurse expect most infants to be saying Mama or Dada?

10 months

19

Which condition/behavior manifested by an 11 month old infant warrants further evaluation?

Unable to pull to a standing position

20

You are observing a 5 month old for developmental skills. Which of the following skills would concern you if the infant was not demonstrating?

Turn head to locate sound

21

In terms of gross motor development what should the nurse expect an infant age 5 months to do?

Turn from the abdomen to the back

22

The Pediatric Nursing student is educating a mother who plans to discontinue breast-feeding when the infant is 9 month old. The nursing student should advise her to include which foods in her infant’s diet?

Iron rich formula only

23

. A nurse is assessing a 2 1⁄2 y.o toddler at a well child visit. Which clinical finding should be reported to the healthcare provider?

Head circumference exceeds chest circumference (hydrocephaly)

24

At what age is it safe to give infants whole milk instead of commercial infant formula?

12 months

25

During a well-baby visit a parent asks the nurse when she should start giving solid foods. The nurse should instruct her to introduce which solid food first?

Rice cereal

26

A Pediatric nursing student, while assisting in teaching nutrition to new parents, informs them that eating preferences are influenced primarily by the family. At what age is lifelong eating habits usually established?

Age 3

27

A 14 month old boy is hospitalized with dehydration. He is inconsolable, screaming, and rejecting your physical contact. What best describes his response?

Separation Anxiety- PROTEST PHRASE

28

A school nurse decides to initiate a safety program for increasing the use of bicycle helmets. The program is an example of:

Primary prevention

29

What does the nurse recognize as physical signs of approaching death?(SELECT ALL)

Mottling of skin, Cheyne-Stokes respirations, decreased appetite and thirst

30

Select the rational for the relationship between children having anemia and lead poisoning.

Children with anemia absorb lead more easily

31

The Pediatric nurse should begin screening for lead poisoning when a child reaches which age?

12 months

32

Which of the following body systems can be severely affected with an increased lead level in a developing child?

Hematologic and neurologic

33

A child has been admitted to the hospital with a blood lead level of 42 mcg/dl. What treatment should the nurse anticipate?

Initiation of chelation therapy

34

Which is the leading cause of death in infants younger than 1 in the U.S?

Congenital anomalies

35

What is the leading cause of death in children older than 1 year in the U.S.?

Complications from childhood unintentional injuries

36

What is the leading cause of death from unintentional injuries in children?

Motor vehicles

37

What is the most frequent source of symptomatic lead poisoning in children?

Lead-based paint

38

A 12-month-old client has a high blood lead level of 18 mcg/dL. The nurse educates the parents about lead poisoning. Which statements made by the parent indicate that teaching is successful? (Select all that apply.)

I should get our home inspected for the source of lead.”
“I will wash my child’s hands often, especially before eating.”

“We will have to return for a follow-up lead level.”

39

A 12-month-old is found to have a moderately elevated blood lead level. Which of the following is the most serious concern for this child?

Neurocognitive impairment

40

A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?

N-acetylcysteine (Mucomyst

41

The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?

edema of the lips, tongue, and pharynx

42

A 7-year-old child has ingested a toxic dose of iron. The parent reports that the child vomited and had gastric pain an hour ago but “feels fine” now. The parent is not sure when the child ingested the iron tablets. What is the appropriate recommendation by the nurse?

Bring the child to the hospital immediately.

43

The parent of an 8.2 kg 9 month old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what?

Rear facing in back seat

44

The nurse is ready to perform a physical exam on a 9 month old infant. Where should the nurse place the infant?

On the parent’s lap

45

Which of the following is the best method for performing a physical examination on a toddler?

From least to most intrusive

46

The nurse is performing a physical assessment on a 7 y.o child. The parents state that the child has trouble seeing the board at school. What visual impairment should the nurse suspect?

Myopia or nearsightedness

47

What approach is the most appropriate when performing a physical assessment on a toddler?

Use minimum physical contact initially.

48

What findings on physical assessment of a neonate would indicate the need for further evaluation?

Low-set ears

49

The nurse is performing of physical examination on a 10-year-old client with abdominal discomfort. Which actions would be appropriate during the examination? Select all that apply.

Ask the client to describe the chief symptom
Conduct a head to toe assessment in the same manner as in adult assessment Honor the clients request to be examined without parent present

50

A nurse in a pediatric clinic is performing a physical examination of a 30-month-old child. Which finding requires further evaluation?

Current weight is 6 times greater than birth weight

51

A nurse is planning to complete a physical examination of a toddler. Which approach is an appropriate intervention by the nurse?

Encourage the parent to be involved with the child

52

The nurse is performing a physical assessment on a 2-year-old with cold symptoms and a fever at home of 101.7 F (38.7 C). The parent is concerned about the child's ability to cooperate during the examination. Place the components of assessment in the order the nurse would perform them.

Interact with the parent in a friendly manner, play with the child using a finger puppet, measure the child's height and weight, auscultate the child's heart and lungs, take the child's vital signs

53

When performing a physical examination on an infant, the nurse in charge notes abnormally low-set ears. This finding is associated with:

Renal anomalies

54

Which of the following is the most consistent and commonly used data for assessment of pain in infants?

Behavioral

55

Which of the following is an important consideration when using the APPT pain rating scale with children?

Children color the area with the color they choose to best describe their pain

56

The components of the FLACC scale include cry, leg movement, facial expression and activity.

Consolability

57

What is the most consistent and commonly used indicator of pain in infants?

Facial expression of discomfort

58

The nurse is educating a new nurse on identification of pain in children. What does the nurse teach about physiologic measurements in children’s pain assessment?

Not useful as the only indicator for pain

59

What self-report pain rating scales can be used in children as young as 3 years of age?

FACES Pain Rating Scale

60

Which of the following pain tool is most appropriate for use in a 10 yr old child with Sickle Cell Anemia, to outline the area of the child’s pain?

APPT scale

61

The nurse assists with a staff education conference about appropriate nonpharmacological pain-management interventions for newborns and infants. Which of the following strategies should be included in the presentation? (Select all that apply.)

Administer an oral sucrose solution to a newborn during a circumcision procedure.
Assist the parent to hold a newborn skin-to-skin during an immunization injection

Offer a pacifier to an infant while performing venipuncture.
Swaddle an infant while leaving one arm unwrapped during an IV dressing change.

62

The nurse is caring for a child receiving a continuous intravenous (IV) low dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first?

Administer naloxone (Narcan)

63

A 5 year old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

The pump allows for a continuous basal rate and delivers a constant amount of medication to control pain.

64

What information does the nurse include when teaching parents about nonpharmacologic strategies for pain management in children?

May reduce pain perception.

65

The nurses caring for a child are concerned about the child’s frequent requests for pain medication. During a team conference, a new nurse suggests they consider administering a placebo instead of the usual pain medication to see how the child responds. The team educates the nurse on why this is not appropriate and bases the decision on what knowledge?

This practice is unjustified and unethical.

66

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?

Plan a preventive schedule of pain medication around the clock.

67

The nurse is caring for a 12-year-old boy who sustained major burns when he put charcoal lighter on a campfire. The nurse observes that he is “very brave” and appears to accept pain with little or no response. What is the most appropriate nursing action?

Request a psychologic consultation

68

The nurse is caring for a child with multiple injuries who is comatose. What information is accurate related to pain in this child?

Requires astute nursing assessment and management.

69

The nurse is caring for an adolescent client receiving intravenous (IV) morphine for severe pain. The nurse observes a respiratory rate shallow, and the client cannot be aroused. What priority nursing action should the nurse take?

Discontinue intravenous infusion

70

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

Child’s developmental level

71

The nurse is having difficulty communicating with a hospitalized 6 yr old. Which technique should be most helpful?

Provide supplies for the child to draw a picture

72

What approach would be best to use to ensure a receptive response from a toddler?

Focus communication on the child and tell him or her how a procedure will feel.

73

The nurse would make a referral for communication impairment in what situations?

First words not uttered before age 2 years

74

What communication strategies would the nurse have in place when establishing rapport with the caregiver and an 8-year-old during a health history interview? Select all that apply.

Allow the child to describe their issue, Maintain an eye level position when speaking with the child, Use language that both the child and caregiver can understand

75

A 10 y.o female seen in specialty peds clinic has a diagnosis of Spina Bifida. On examination the peds nurse observes dark tufts of hair at the lumbar sacral region. Which of the following is the child’s diagnosis?

Spina Bifida Oculta

76

The pediatric nurse is preparing to admit a 5 y.o with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe?

Overflow incontinence with constant dribbling of urine

77

A 10 yr old female seen in a specialty peds clinic has a diagnosis of Spina Bifida. On examination the peds nurse observes the spinal sac with meninges and nerves. Which of the following is the child’s diagnosis?

Myelomeningocele

78

Latex allergy is suspected in a child with spina bifida. What are appropriate nursing interventions to include in care of this patient?

Avoid using any latex product.

79

A 4 yr old with Spina Bifida is prepared for a straight catherization by the peds nurse. Which of the following actions by the nurse is recommended for this child?

Medicate the child with pain meds before the procedure

80

Spina bifida is one of the possible neural tube defects that can occur during early embryological development. Which of the following definitions most accurately describes meningocele?

Sac formation containing meninges and spinal fluid

81

The nurse is preparing to admit a 5-year old with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe? SATA.

Lack of bowel control, flaccid, partial paralysis of lower extremites, overflow incontinence with constant dribbling of urine

82

A nurse is caring for an infant with myelomeningocele scheduled for a surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Cover with a sterile, moist, nonadherent dressing

83

What problem is most often associated with myelomeningocele?

Hydrocephalus

84

One of the most important interventions when caring for an infant with myelomeningocele in the preoperative stage is which?

Place the infant on the side to decrease pressure on the spinal sac.

85

What childhood vaccine provides some protection against bacterial meningitis, epiglottitis, and bacterial pneuomonia?

Hib vaccine

86

. A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that the antibiotic therapy will begin:

When the medication is received from the pharmacy

87

The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included?

Keep environmental stimuli to a minimum

88

The nurse is planning care for a school age child with bacterial meningitis. What intervention should be included?

Assess for signs of increased intercranial pressure

89

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. What is the appropriate nursing intervention when preparing for a lumbar puncture?

Place the child in a side-lying position

90

The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. What is a priority of nursing care?

Administer antibiotic therapy as soon as it is available.

91

The nurse receives new prescription for a 6-month-old client with bacterial meningitis. Which action is the priority of care?

Administer 400 mg ceftriaxone IV every 12 hours

92

The nurse is caring for an infant with suspected meningitis and preparing to assist with a lumbar puncture. What is the appropriate nursing intervention?

Hold the child with the head and knees tucked in and the back rounded out.

93

A nurse is caring for a 3-month-old infant who as bacterial meningitis. Which clinical findings support this diagnosis? Select all that apply.

Frequent seizures, High-pitched cry, Poor feeding, Vomiting.

94

A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial dose of antibiotics in the emergency department. Frequent assessment of which of the following is most important in the plan of care?

Fontanel assessment

95

A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial does of antibiotics in the emergency department. Frequent assessment of which of the following is most important in the plan of care?

Fontanel assessment

96

A pediatric nurse is caring for a newborn in the NICU with clinical manifestations of bulging fontanel and distended scalp veins and separated sutures. Which of the following diagnosis the symptoms suggest?

Hydrocephalus

97

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care would include what?

Monitor closely for signs of infection.

98

A child is brought to the emergency department after experiencing a seizure at school. He has no history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. What is the best response by the nurse?

The seizure may or may not mean that your child has epilepsy.”

99

After studying about seizures, the student nurse understands which of the following?

Complex partial seizures result in no loss of consciousness

100

The nurse is preparing for the admission of a 9- year-old client with new-onset tonic-clonic seizures. It is important for the nurse to ensure that what is in the room?

Oxygen delivery system, padding on the bed side rails, Suction equipment.

101

A nurse is teaching the parent of a child who has a new diagnosis of absence seizures. Which statement by the parent indicates understanding of the teaching?

My child May stare and seem inattentive.”

102

A nurse is teaching the parent of a child who has a new diagnosis of absence seizures. Which statement by the parent indicates understanding of the teaching?

My child may seem confused afterwards”

103

The school nurse is caring for a child with seizures. What is the initial clinical manifestation of absence seizures that nurse needs to be aware of?

Brief loss of consciousness.

104

Of the following which are possible signs of Cerebral Palsy (CP) ? Select All.

Poor head control after age 3 months -Persistent primitive reflexes -Feeding difficulties

105

A child with cerebral palsy is seen in peds specialty clinic and will receive a Botox injection. The peds nurse is aware the treatment is specifically for which of the following conditions?

Spasticity

106

A 6-month-old infant does not smile, has poor head control, has a persistent Moro reflex, and often gags and chokes while eating. What are these findings are most suggestive of in this infant?

Cerebral palsy

107

The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child’s spasticity. What is the basis for the nurse’s response?

Implantation of a pump to deliver medication into the intrathecal space decreases spasticity.

108

An infant was assessed in peds clinic with the following symptoms: visible peristalsis, failure to thrive, an infant who is ‘always hungry’, dehydration. What is the likely diagnosis?

Pyloric Stenosis

109

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestations would indicate pyloric stenosis? Select All. -

Non-bilious vomiting and weight loss -Projectile vomiting -Olive-shaped mass above umbilicus

110

The parent of a 21-day-old male infant reports that the infant is “throwing up a lot.” Which assessment should the nurse make to help determine if pyloric stenosis is an issue? (Select all that apply.)

Assess the parent’s feeding technique. Check if the vomiting is projectile. Compare current weight to birth weight

111

The nurse is gathering data on a 5-week- old admitted with a suspected diagnosis of pyloric stenosis. The nurse should expect to find which laboratory value?

Hematocrit of 57% (0.57)

112

a child with pyloric stenosis is having excessive vomiting, which of the following is a potential complication?

metabolic Alkalosis

113

A toddler with symptoms of sudden inconsolable screaming or crying, drawing up of the knees to the chest, vomiting, and a tender distended abdomen will probably be diagnosed with which of the following diseases?

Intussusception

114

A 2 y.o is hospitalized with suspected intussusception. Which finding is associated with intussusception?

Currant jelly stools

115

The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? Select all. -

Palpable sausage shaped abdominal mass -Vomiting -Stool mixed with blood and mucous

116

The nurse is caring for a 2-year-old who is receiving a saline enema for treatment of intussusception. Reporting which client finding to the health care provider (HCP) is most important?

Passed a normal brown stool.

117

A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding should the nurse expect?

Stools mixed with blood and mucus.

118

The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? (Select all that apply.)

Palpable sausage-shaped abdominal mass, Screaming and drawing of the knees up to the chest, Stool mixed with blood and mucus.

119

The nurse assesses a child with intussusception. Which assessment findings require priority intervention?

Abdominal rigidity with guarding

120

. The pediatric nurse cares for a 16-year- old client who is scheduled for an appendectomy in the morning. Which of the following interventions are appropriate to support the client’s psychosocial needs? (Select all that apply

Encourage the client to have peers visit while hospitalized.
Include the client as an active participant when planning care. Support the client in discussing concerns about body image changes.

121

A school age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?

Popcorn

122

The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

Corn on the cob with butter

123

An 11-year-old girl with celiac disease was discharged from the hospital. An appropriate teaching was carried out by the nurse if the parents are aware of avoiding which of the following?

Wheat.

124

Which of the following statements made by the mother of a child recently diagnosed with celiac disease indicates a need for further teaching? “

My child can have small amounts of foods containing wheat as long as she remains symptoms free.”

125

The school nurse creates a cafeteria menu for a newly enrolled child with celiac disease. Which lunches would be appropriate for this child? Select all that apply.

Grilled chicken, baked potato, and strawberry yogurt, Mexican corn tacos with ground beef and cheese, Rice noodles with chicken and broccoli

126

a school-age child with celiac disease asks for guidance about snack that will not exacerbate the disease, what snack should the nurse suggest?

potato chips

127

Parents ask the nurse if there was something that should have been done during the pregnancy to prevent the child’s cleft lip. Which statement should the nurse give as a response?

The malformation occurs at approximately 6 weeks of gestation, there is no known way to prevent this

128

The parents of an infant with a cleft palate ask the nurse “What follow-up care will our infant need after the repair?” Which is an accurate response by the nurse?

Your infant will need follow-up care with audiologists and orthodontists

129

An infant with an isolated cleft lip is admitted to the ICU for pre-op care. Which information should the nurse plan to discuss while educating the parents?(Select all)

Use check support while feeding with special nipples, the infant may be restrained after surgery, and multiple specialists will be assigned to infant’s care

130

In the recovery room, the best immediate post-op position for an infant who had cleft lip repair is?

Supine with the head turned to the side

131

What is a major long-term problem for a child with a cleft lip and palate?

Faulty dentition

132

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and anticipates good results. However, the mother refuses to see or hold her baby. What would be included in the initial therapeutic approach to the mother?

Encourage her to express her feelings.

133

The nurse is assessing a 3-month-old infant who was admitted to the floor 18 hours ago after undergoing surgical repair of a cleft lip. Which assessment finding would cause the nurse to be concerned?

The client is prone while playing with the parent

134

The nurse plans care for a pediatric client who has just undergone a cleft palate repair. which of the following interventions should the nurse include in the plan of care? Select all that apply.

Assist and encourage caregivers to hold and comfort the child
Position the child supine with an elevated head of bed after feedings Remove elbow restraints per policy for skin and circulatory assessment

135

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Assessing bowel function.

136

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Skin and stoma care.

137

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?

Hirschsprung disease

138

A pediatric nurse assesses a newborn with symptoms of failure to pass meconium within 48 hrs after birth. Which of the following diseases will be suspected in this newborn?

Hirschsprung.

139

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse expect?

Hirschsprung disease.

140

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery. Which assessment finding requires the nurse’s immediate action?

Episode of foul-smelling diarrhea and fever.

141

A newborn had a bowel resection with temporary colostomy for Hirschsprung's disease. The nurse should alert the health care provider (HCP) for which assessment finding post operatively?

Stoma is Gray-tinged at the edges but pink at the center on postoperative day 5

142

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which MOST LIKELY sign of this condition documented in the record?

Choking with feedings

143

Of the following diagnosis, which would the nurse identify as a priority for the infant with tracheoesophageal fistula (TEF)?

Risk of injury related to increased potential for aspiration

144

The nurse assesses a neonate after spitting up the first feeding and having a coughing episode during the feeding. What assessment finding would indicate possibility of esophageal atresia or tracheoesophageal fistula?

Excessive amount of frothy saliva in the mouth

145

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula. Which finding is the nurse most likely to observe?

Choking and cyanosis during feeding

146

a newborn is diagnosed with Tracheoesophageal Fistula at birth. An initial nursing function is to assure that which of the following orders are implemented?

Suction as needed

147

Which of the following pharmacology therapy is used to treat infants and children with Gastroesophageal Reflux Disease (GERD)?

Zantac (Ranitidine)

148

Which of the following parameters would the nurse monitor to evaluate the initial effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)?

Vomiting

149

The nurse provides feeding instructions to a parent of an infant diagnosed with gastro-esophageal reflux (GER). Which instruction should the nurse give the parent to assist in reducing the episodes of emesis? (Select all that apply)

Provide smaller more frequent meals, Thicken the feedings by adding rice cereal to the formula, Burp the infant frequently during feeding

150

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse’s best response?

Urine output will increase

151

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

Hematuria and proteinuria

152

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

Reduction of edema

153

What best describes the cause of most cases of acute glomerulonephritis?

Antecedent streptococcal infection

154

In acute glomerulonephritis, what is the nurse is aware that is an early warning sign of encephalopathy?

Dizziness

155

A client diagnosed with acute glomerulonephritis has pitting edema in both lower extremities, blood pressure of 170/80 mm Hg, and proteinuria. When developing a plan of care for this client, the nurse should include which most accurate indicator of fluid loss or gain?

Daily weight measurements.

156

A nurse is caring for a child with acute glomerulonephritis. Frequent monitoring of which of the following is a priority?

blood pressure

157

The nurse is evaluating a female child with acute post streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

Increased urine output

158

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What should be the nurse’s best response?

Urine output will increase

159

A 2 y.o child is on prednisone for minimal change nephrotic syndrome (MCNS). Which of the following indicates the effectiveness of prednisone therapy?

Diuresis occurs as urinary protein excretion diminishes

160

A 3 y.o is admitted to the peds unit with minimal change nephrotic syndrome. What clinical manifestations are usually seen with this diagnosis?

Massive proteinuria, hypoalbuminemia, and edema

161

Which of the following are clinical manifestations of minimal change nephrotic syndrome, usually seen in children with this disorder?

Massive proteinuria, hypoalbuminemia, and edema.

162

What are the common clinical manifestations of nephrotic syndrome?

Proteinuria, hypoalbuminemia, and edema

163

What is included in the therapeutic management of nephrotic syndrome?

Corticosteroids

164

A hospitalized child with minimal change nephrotic syndrome is receiving high dose prednisone. What nursing goal is appropriate for this child?

Promote adherence to the antibiotic regimen

165

A disorder in which the basement membrane of the glomeruli becomes permeable to plasma proteins describes which of the following disorders?

Nephrotic syndrome

166

The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon. Which statement by the parent indicates the need for further teaching?

“I’ll organize playdates to keep my child’s spirits up during relapses.”

167

A nurse is reviewing the laboratory values for a 3-year-old client with nephrotic syndrome. The nurse interprets the results to most clearly reflect which physiologic process related to nephrotic syndrome?

Glomerular injury

168

a child is admitted for minimal change nephrotic syndrome. The nurse recognizes that the child’s prognosis is related to what factor?

Response to steroid therapy

169

A full-term male has hypospadias. Which statement describes hypospadias?

The urethral meatus opens on the underside of the penis

170

Hypospadias refers to what?

Urethral opening along ventral surface of penis

171

The nurse has assessed 4 children. Which finding requires immediate follow-up with the health care provider?

Answer: child who had a surgical repair of hypospadias earlier today with no urinary output in the past two hours.

172

An infant in the NICU was born with hypospadias, which of the following should be avoided when a child has such condition

Circumcision

173

To assist in the prevention of urinary tract infections (UTIs) in children, which of the following is one of the best recommendations the nurse should make to parents?

Ensure clear liquid intake of 2 L/day

174

A young child is diagnosed with vesicoureteral reflux. What is a common recurrent complication in a child with this diagnosis?

Recurrent urinary tract infections

175

What factors predisposes the urinary tract to infection?

Short urethra in girls

176

A nurse is teaching the parent of a 6-year-old with a urinary tract infection (UTI) how to avoid repeat infections. Which statements by the patient indicate that the teaching has been effective? Select all that apply

“I will make sure my child does not hold urine”

“I will not give my child any more bubble baths”

“I will teach my child to wipe from the front to the back”

177

which of the following instructions would be included in the preventive teaching plan about urinary tract infections for a preschool female child?

Wiping front to back

178

What child has a cyanotic congenital heart defect?

2 month old with tetralogy of Fallot

179

a nurse in the neonatal intensive care unit discovers a cyanotic newborn with excessive frothy mucus in the mouth. What should be the nurse’s first action?

Suction the infant’s mouth

180

The nurse receives report on 4 pediatric clients on a telemetry unit. Which client should the nurse assess first?

Infant client with ventricular septal defect with reported grunting during feeding

181

The nurse has received report on 4 pediatric clients on a telemetry unit. Which client should the nurse assess first?

Infant client with ventricular septal deficit with reported grunting during feeding

182

A child with heart failure is in Lanoxin(digoxin). The laboratory value a nurse must closely monitor is which?

Serum Potassium

183

What is an early sign of heart failure that would be recognized by the nurse?

Tachypnea

184

What would be included in nursing care of an infant with heart failure?

Organize activities to allow for uninterrupted sleep.

185

What structural defects constitute tetralogy of Fallot?

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

186

A 2 y.o child diagnosed with tetralogy of Fallot becomes upset, crying, and thrashing around when a blood specimen is obtained. The childs color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?

Place the child in knee to chest position

187

What heart defects causes hypoxemia and cyanosis because desaturated venous blood is entering the systemic circulation?

Tetralogy of Fallot

188

A nurse is teaching the parents of an infant with tetralogy of Fallot. Which of the following actions should the nurse include to reduce the incidence of hypercyanotic spells? Select all that apply. The nurse is planning care for a child being

Encourage smaller, frequent feedings, Offer a pacifier when the infant begins to cry, promote a quiet period upon waking in the morning, Swaddle the infant during procedures

189

A nurse is assisting a new mother as she is breastfeeding her infant. The infant has been diagnosed with tetralogy of Fallot. During feeding, the infant becomes cyanotic and is having difficulty breathing. What should be the nurse's first action?

Place infant in knee to chest position

190
  1. The home health nurse is visiting an infant who recently had surgery to repair tetralogy of Fallot. Which of the following signs of heart failure should the nurse teach the parents to report to the health care provider? (Select all that apply.)

Cool extremities. Puffiness around the eyes. Reduction in number of wet diapers. Weight gain.

191

Which of the following actions by the school nurse is most important in the prevention of rheumatic fever(RF)?

Refer children with sore throats for throat cultures

192

What sign/symptom is a major clinical manifestation of rheumatic fever(RF)?

Polyarthritis

193

A nurse is reviewing the laboratory values of a child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition?

Positive antistreptolysin titer

194

What is included in the therapeutic management of the child with rheumatic fever?

Administration of penicillin

195

Which of the following organism is responsible for the development of rheumatic fever?

Group A beta- hemolytic Streptococcus

196

A 4 y.o child seen in the ER has symptoms of Kawasaki Disease(KD). Of the symptoms listed below which can potentially develop and pose a high risk for children with KD?

Coronary artery aneurysm

197

Which of the following medication is commonly used to treat Kawasaki’s Disease(KD)?

IVIG

198

A child is recovering from Kawasaki’s Disease(KD). The child should be monitored for which?

Electrocardiograph(ECG) changes

199

The nurse is providing discharge instructions to nurse report to the health care provider that could the parent of a child with Kawasaki disease. The possibly delay the procedure?

Fever

200

The nurse is planning care for a child being admitted with Kawasaki disease and should give priority to which nursing intervention?

Monitor for a gallop heart rhythm and decreased urine output.

201

A 12-month-old with Kawasaki disease received IV immunoglobulin (IVIG ) 2 months ago. The child is in the clinic for follow-up and scheduled immunizations. Which vaccine should be delayed? Select all that apply.

Measles, mumps, rubella (MMR) Varicella

202

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?

Therapeutic management includes administration of gamma globulin and salicylates.

203

A child diagnosed with Coarctation of Aorta is scheduled for a f/u visit. While assessing the pediatric nurse would expect to find which of the following symptoms?

Absent or diminished femoral pulses

204

What clinical finding may be present in an older child with Coarctation of the Aorta?

High blood pressure in the upper extremities

205

Which clinical finding may be present in an older child with Coarctation of the Aorta?

Diminished pulse in the lower extremities

206

A child diagnosed with Coarctation of aorta is scheduled for a follow up visit. While assessing, the pediatric nurse would expect to find which of the following symptom?

Bounding pulses in the upper extremities

207

A 4 y.o male is rushed to the emergency dpt during an acute severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following?

Status Asthmaticus

208

.A school age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone that means that the asthma control is what?

50-79% of a personal best and needs and increase in the usual therapy

209

.What drug is usually given first in the emergency treatment of an acute severe asthma episode in a young child?

Short acting beta2- agonists

210

.Which of the following describes moderate persistent asthma symptoms?

Symptoms seen on a daily basis

211

An initial action of the nurse in caring for a child with Status Asthmaticus is which of the following?

Administer beta 2 agonists as ordered

212

A nurse is evaluating the management of a child with a history of asthma. Which statement from the mother quires further investigation?

When my child has an attack she usually has to use her rescue inhaler 4x before her breathing improves

213

The nurse assesses a child who has been treated for an acute asthma exacerbation. Which client assessment is the best indicator that treatment has been effective?

oxygen saturation has increased from 88% to 93%.

214

Which pediatric respiratory presentation in the emergency department is a priority for nursing care?

Client with an acute asthma exacerbation but no wheezing

215

The school nurse assesses and 8-year-old with a history of asthma. The nurse notes mild wheezing and coughing. Which action should the nurse perform first?

Asses the clients peak expiratory flow.

216

Which of the following test aids in the diagnosis of cystic fibrosis(CF)?

Sweat test, stool for fat, chest x-ray films

217

A parent prepares to administer pancreatic enzymes to an infant with cystic fibrosis. As per education she received the best action to administer the enzymes is which of the following?

Increase the dose of pancreatic enzymes if infant is having frequent bulky stool

218

Which of the following is usually affected in cystic fibrosis, resulting in excess multisystem mucus build up that is difficult to clear?

Exocrine Gland

219

The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. What would the nurse include in the instructions for performing percussion?

Cover the skin with a shirt or gown before percussing.

220

A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having one to two bowel movements per day. The nurse action in regard to the pancreatic enzyme is based on the knowledge that the dosage is what?

Needs to be increased to decrease the number of bowel movements per day

221

The mother of a 6-year-old child with cystic fibrosis (CF) has received instruction on the use of pancreatic enzymes. Which statement made by the mother indicates a need for further teaching?

It is okay for my child to chew this medication.”

222

The nurse is caring for a 4-year-old client with cystic fibrosis who uses a high- frequency chest wall oscillation (HFCWO) vest for chest psychotherapy. After reinforcing education with the client’s parents, which statement by a parent requires further teaching?

“I will allow my child to have a snack while using the HFCWO vest to encourage cooperation.”

223

The nurse has provided teaching about home care to the parent of a 10-year-old with cystic fibrosis. Which of the following statements by the parent indicate that teaching has been effective? Select all that apply.

i will give my child pancreatic enzymes with all meals and snacks”, “I will increase my child’s salt intake during hot weather”, “Our child will need a high-carbohydrate, high- protein diet.”

224

A 6-month-old client has been diagnosed with cystic fribrosis. Which of the following would be appropriate for the registered nurse to teach the parents?

perform manual chest physiotherapy

225

The nurse cares for a child newly diagnosed with cystic fibrosis. What should be included in the clients multidisciplinary plan of care to be discussed with the parents?

Aerobic exercise, Chest physiotherapy, Financial needs.

226

A home health nurse is managing care for an adolescent client with cystic fibrosis. Which of the following potential complications should the nurse consider when developing a nursing care plan?

Chronic hypoxemia, Frequent respiratory infections, vitamin deficiencies.

227

The nurse has provided teaching about home care to a parent of a 10- year-old with cystic fibrosis. Which of the following statements by the parent indicates that teaching has been effective? Select all that apply

“I will give my child pancreatic enzymes with all meals and snacks”

“I will increase my child’s salt intake during the hot weather”

“Our child will need a high- carbohydrate, high-protein diet”

228

The nurse is teaching the parents of a child diagnosed with cystic fibrosis will advise the parents to choose foods that satisfy which recommended diet?

High calorie, high protein, high fat

229

What childhood vaccine provides some protection against bacterial meningitis, epiglottitis, and bacterial pneuomonia?

Hib vaccine

230

During the assessment of a 9 y.o child the nurse notes excessive drooling, the child is fearful refuses to lay down. Which condition does the nurse suspect?

Epiglottitis

231

A 5 y.o is seen in the urgent care clinic with the following history and symptoms:sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 102.2 F(39.0 C), clear breath sounds, and absence of cough. The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of?

Acute epiglottitis

232

The triage nurse is assessing an unvaccinated 4-month-old infant for fever, irritability, and open-mothers drooling. After the infant is successfully treated for epiglottis, the parents wonder how this could have been avoided. Which response by the nurse would be the most appropriate?

“Most cases of epiglottitis are preventable by standard immunizations.”

233

The nurse in a clinic is caring for an 8- month-old with a new diagnosis of bronchiolitis due to respiratory syncytial virus (RSV). Which instructions can the nurse anticipate reviewing with the parent?

Use of saline drops and a bulb syringe to suction nares.

234

.A 2 y.o has been placed in contact isolation because of diagnosis of respiratory syncytial virus(RSV)bronchlolitis. The father questions why the staff is wearing masks and gowns every time someone comes into the room. What is the best response by the nurse?

It is important for the staff to wear the equipment to prevent spreading it to others

235

A 2 month old seen in peds clinic has symptoms of tachypnea, retractions, anorexia, apneic spells, copious nasal secretions and wheezing. Which of the following do these symptoms best describe?

RSV Bronchlolitis

236

What illnesses does respiratory hygiene and cough etiquette by the Centers for Disease Control and Prevention (CDC) prevent? R

RSV, influenza, and adenovirus

237

.A 5 y.o is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process?

Fever, cough, chest pain

238

The Hib conjugate vaccine protects an infant against what diseases? (Select all that apply.)

Bacterial meningitis, Epiglottitis ,Bacterial pneumonia, Septic arthritis Sepsis

239

A 2 y.o is scheduled to have a tonsillectomy. How would you educate the patient?

Use picture books and puppets and repeat explanations

240

The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. Which of the following statements by the parent would indicate a correct understanding of the teaching?

I can use an ice collar on my child for pain control along with analgesics."

241

When planning care for an 8 y.o boy with Down syndrome, the nurse should:

Assess the child’s current developmental level and plan care accordingly

242

The home health nurse is planning care for a 3- year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. What is the most appropriate goal to promote normal development?

Encourage mobility.

243

What is one of the major physical characteristics of a child with Down syndrome?

Hypotonic musculature

244

A child with Down syndrome may be screened for what before participating in some sports?

Atlantoaxial instability

245

What intervention should be included in the nursing care of a child with autism spectrum disorder(ASD)?

Decrease auditory and visual simulation

246

.What intervention should be included in the nursing care of a child with autism spectrum disorder(ASD)?

Provide individualized care

247

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area with onset before age 3 years?

Ability to maintain eye contact

248

Which of the following should be included in the nursing care of a child with autism spectrum disorder(ASD)?

Provide a structured routine for the child to follow

249

What is a common clinical manifestation of autism?

Early abnormal eye contact

250

Which of the following should be included in the nursing care of a child with autism spectrum disorder (ASD):

Assign the child to a private room

251

When performing developmental screenings in the well-child clinic, the registered nurse understands that which child is at highest risk of developing autism spectrum disorder?

4-year-old whose 10-year-old sibling has the disorder.

252

A child with autism spectrum disorder is being admitted to an acute care unit. Which is the most important nursing action?

Placing a child in a private room away from the nurses station

253

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia–ischemia cycle. What information should the nurse share with parents in a teaching plan?

Check for moist mucous membranes.

254

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia–ischemia cycle. What information should the nurse share with parents in a teaching plan?

Monitor child for sign of dehydration.

255

Child with sickle cell crisis, which signs and symptoms shows a child is having minor cerebral attack?

Headache, weakness, visual disturbances.

256

What is a priority nursing consideration when caring for a child with sickle cell anemia?

Teach the parents and child how to recognize the signs and symptoms of crises.

257

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse would explain what concerning narcotic analgesics?

When they are medically indicated, children rarely become addicted.

258

Which of the following pain tool is most appropriate for use in a 10 yr old child with Sickle Cell Anemia, to outline the area of the child’s pain?

APPT scale

259

A teenage client with sickle cell disease is admitted with a diagnosis of crisis. The client’s current prescription is morphine 2 mg intravenous push every 4 hours prn. The client appears comfortable while watching television and tells the nurse “I have severe intolerable pain”, and rates it at a “10”. What action should the nurse take?

Call the HCP for the patient- controlled analgesia (PCA) at a high dose of the same drug

260

The nurse is triaging a 7-year-old with sickle cell crisis. The client is short of breath and vomiting and has severe generalized body and joint pain. Which assessment finding requires the most immediate intervention?

Enlarged spleen on palpation

261

In a child with sickle cell anemia, adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?

Monitor child for signs of dehydration

262

A child with severe anemia requires a unit of red blood cells (RBC’s). The nurse explains that the transfusion is necessary for which reason.

Increase the amount of oxygen available to tissues

263

Select the rational for the relationship between children having anemia and lead poisoning.

Children with anemia absorb lead more easily

264

Select from the list below a reason for ‘innocent’ heart murmur in infants:

Anemia

265

An overweight toddler is diagnosed with iron deficiency anemia. Which is the most likely explanation for the anemia?

Excessive intake of milk

266

The client nurse is caring for several clients during well-child visits. The nurse should recognize each client as most as being the most at risk for anemia?

3-month-old infant born at preterm gestation who is exclusively bottle-fed with breast milk

267

The nurse is teaching the family of a child, age 8-years-old, with moderate hemophilia about home care. What should the nurse tell the family to do to minimize joint injury?

Provide intravenous (IV) infusion of factor VIII concentrates.

268

The school nurse is caring for a child with hemophilia who fell on his arm during recess. What supportive measures would the nurse implement first?

Elevate the arm above the level of the heart.

269

The nurse receives 4 prescriptions for a child diagnosed with hemophilia A who was brought to the emergency department following an injury on the school playground. The child has vomited once and has a headache. Which prescription should the nurse carry out first?

Administer IV factor VIII.

270

The clinic nurse supervises a student nurse who is preparing to administer routine vaccinations to a child diagnosed with hemophilia period which instructions should the clinic nurse provide to the student?

Administer vaccines via the subcutaneous route.
Hold firm pressure on the site for 5 minutes.

271

The nurse is planning teaching for the parents of a child newly diagnosed with hemophilia will include information about which long- term complication?

Joint destruction

272

The nurse provides discharge teaching for the parents of a child newly diagnosed with hemophilia A. Which statements by the parents indicate that teaching has been effective? Select all that apply.

our child should wear a medical alert bracelet at all times.”
“we should avoid giving our child over-the- counter medicine containing aspirin.”
“we should encourage a non-contact sport such as swimming.”

273

A 3 y.o with a Wilms tumor is returning to the unit after surgery to remove the tumor. Which of the following is the highest post-op priority for the nurse?

Monitor vital signs especially blood pressure (b/c tumor of kidney)

274

Where are Wilms tumors (nephroblastomas) located?

Kidney

275

The nurse is admitting a 4-year-old diagnosed with Wilms tumor. The child is scheduled for a right nephrectomy in the morning. A

Instructions not to palpate the abdomen

276

A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

Careful bathing and handling

277

What is included in the postoperative care of a preschool child who has had a brain tumor removed?

Carefully monitor fluids because of cerebral edema.

278

Which of the following describes the pathophysiology of leukemia?

Unrestricted proliferation of immature white blood cells (WBCs)

279

What are the most common signs and symptoms of leukemia related to bone marrow involvement?

Petechiae, fever, and fatigue

280

. Several 12-month-old infants are brought to the clinic for routine immunizations. Which situation would be most important for the nurse to clarify with the provider before administering the vaccination?

Varicella-zoster vaccine for client recently diagnosed with leukemia.

281

The nurse is caring for pediatric client with end stage leukemia who is on comfort care and is unresponsive. The child's parents ask, “how can you tell if my child is in pain?” which of these would the nurse describe as signs of discomfort? Select all that apply

Facial grimacing, groaning, knees bent up near chest

282

A toddler is admitted to the hospital and report leg pain an fever. Assessment reveals the toddler is pale with body bruises. The health care provider suspects acute lymphoblastic leukemia (ALL). The nurse will inform the parents that confirmation of the disease will be determined by which test?

Bone marrow biopsy

283

a 7 year old child with acute lymphatic leukemia is on steroids. A common side effect of corticosteroid (prednisone) therapy is? ANS: weight gain

weight gain

284

Which of the childhood cancers listed below have a genetic link as a causative factor?

Retinoblastoma

285

A 2-year-old is suspected of having retinoblastoma. The nurse recognizes which sign as being most characteristics of this disease?

Absent of red reflex

286

The nurse is interpreting a tuberculin skin test. If the nurse finds a result of an induration 5 mm or larger in which should the nurse document this finding as positive?(SELECT ALL)

A child receiving immunosuppressive therapy, A child with a HIV infection, A child living in close contact with a known contagious case of tuberculosis

287

The most recent laboratory results for a 12- month-old who is HIV-positive show a CD4 lymphocyte count of 500/mm3 and a CD4 lymphocyte percentage of 10%. The nurse anticipates administering which immunizations? Select all that apply.

Haemophilus Influenzae type B (Hib), hepatitis A (Hep A), pneumococcal conjugate vaccine (PCV)

288

The nurse is assessing a 4 y.o boy in the pediatric clinic. Which behaviors by the client would concern the nurse for possible Duchenne muscular dystrophy? Select all.

-Frequent trips and falls at home
-Places hands on thighs to push up to stand -Walks on tiptoes and has disproportionately large calves

289

Duchenne Muscular Dystrophy (DMD) has which of the following inheritance patterns?

X linked recessive trait

290

A young boy has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. What is included in his plan of care for his family?

Recommend genetic counseling.

291

Which of the following statements best describes Duchenne (pseudo-hypertrophic) muscular dystrophy (DMD)?

It had an X-linked inheritance problem

It is characterized by presence of the Gower sign
Child exhibits a waddling gait, and lordosis

292

A 4-year-old boy is diagnosed with Duchenne muscular dystrophy. Which nursing teaching is most appropriate to reinforce for the child’s parents?

Remove throw rugs from the home.

293

The nurse teaches the mother of a young child with Duchenne’s muscular dystrophy about the disease and its management. Which of the following states by the mother indicates successful teaching?

My son will probably be unable to walk independently by the time he is 9 to 11 years old.

294

The nurse is caring for an infant with osteogenesis imperfecta admitted with a new fracture. The client also has old fractures in multiple stages of healing but no bruising, abrasions, or redness of the skin. What nursing intervention should be included in the plan of care?

Obtain blood pressure manually to avoid cuff over-tightening.

295

Among toddlers and children up to age five, femur fractures usually result from a low energy fall. In most cases, the orthopedic surgeon realigns the fracture using fluoroscopy or x-ray imaging as a guide and immobilizes the leg in a type of cast called a spica cast. Approximately how many weeks does it take for a fractured femur to heal in a 3- year-old?

3-8 week

296

A 12 y.o child is seen in specialty clinic has ill fitting clothes, a rib hump and hip asymmetry, recently noticed by parents. Which of the following is the likely diagnosis of this child?

Scoliosis

297

When does idiopathic scoliosis become most noticeable?

During the preadolescent growth

298

At which of the following ages is recommendation made by the American Academy of Pediatrics (AAP), for pre-adolescent and adolescent females to be screened for Scoliosis?

10-12.

299

The nurse is preparing an adolescent girl for surgery to treat scoliosis. What would the nurse include?

Blood administration may be an option.

300

A 14-year-old is scheduled for surgery to treat scoliosis. The child will be hospitalized for about a week and then discharged home to recuperate for 3-4 weeks before returning to school. What is the best activity the nurse can recommend to promote age-specific growth and development during this time?

Visits from friends.

301

Which of the following treatment is the best method for a 7-month-old infant with Developmental Dysplasia of the Hip (DDH)?

Closed Reduction with Spica Casting.

302

What clinical manifestations of developmental dysplasia of the hip would be assessed in a newborn?

Ortolani sign

303

A 2-month-old recently diagnosed with developmental dysplasia of the hip (DDH) is beginning treatment with a Pavlik harness. Which instructions should the nurse provide to the parents?

Dress the child in a shirt and knee socks under the straps.”, “Lightly massage the skin under the straps daily.”, “Place the diaper under the straps.”

304

The nurse is assessing a 4-week-old infant during a routine office visit. Which assessment finding is most likely to alert the nurse to the presence of right hip developmental dysplasia?

Presence of extra gluteal folds on the right side

305

The parent of a newborn is concerned about the possibility of the child developing hip dysplasia. Which intervention should the nurse encourage to help reduce the risk in this newborn?

Swaddle the infant with hips flexed and abducted.

306

A 3-month-old with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?

I will adjust the harness straps every 3-5 days.

307

The parent of a newborn is concerned about the possibility of the child developing hip dysplasia. Which intervention should the nurse encourage to help reduce the risk in this newborn?

Swaddle the infant with hips flex an abducted

308

A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?

I will adjust the harness straps every 3-5 days”

309

You have learned that in babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. Which of the following is the most common form of DDH?

Subluxation