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309 notecards = 78 pages (4 cards per page)

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Final peds

front 1

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

back 1

6-12

front 2

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

back 2

1-3

front 3

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

back 3

3-6

front 4

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

back 4

13-21

front 5

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

back 5

Formal operational thought

front 6

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

back 6

Sensorimotor stage

front 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?

back 7

Startle

front 8

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

back 8

Moro,

Startle,

Rooting

front 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?

back 9

Neurologic health

front 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?

back 10

16 lb

front 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

back 11

Commonly has an imaginary playmate,

Tends to be selfish and impatient,

Fears are common

front 12

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

back 12

Two to three word sentences

appears to be bowlegged and potbellied

front 13

At what age can most infants sit steadily unsupported?

back 13

8 months

front 14

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

back 14

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

front 15

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

back 15

11 to 12 months

front 16

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

back 16

2 months

front 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?

back 17

School age

front 18

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

back 18

10 months

front 19

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

back 19

Unable to pull to a standing position

front 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?

back 20

Turn head to locate sound

front 21

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

back 21

Turn from the abdomen to the back

front 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?

back 22

Iron rich formula only

front 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?

back 23

Head circumference exceeds chest circumference (hydrocephaly)

front 24

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

back 24

12 months

front 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?

back 25

Rice cereal

front 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?

back 26

Age 3

front 27

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

back 27

Separation Anxiety- PROTEST PHRASE

front 28

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

back 28

Primary prevention

front 29

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

back 29

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

front 30

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

back 30

Children with anemia absorb lead more easily

front 31

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

back 31

12 months

front 32

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

back 32

Hematologic and neurologic

front 33

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

back 33

Initiation of chelation therapy

front 34

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

back 34

Congenital anomalies

front 35

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

back 35

Complications from childhood unintentional injuries

front 36

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

back 36

Motor vehicles

front 37

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

back 37

Lead-based paint

front 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.)

back 38

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.”

front 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?

back 39

Neurocognitive impairment

front 40

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

back 40

N-acetylcysteine (Mucomyst

front 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?

back 41

edema of the lips, tongue, and pharynx

front 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?

back 42

Bring the child to the hospital immediately.

front 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?

back 43

Rear facing in back seat

front 44

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

back 44

On the parent’s lap

front 45

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

back 45

From least to most intrusive

front 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?

back 46

Myopia or nearsightedness

front 47

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

back 47

Use minimum physical contact initially.

front 48

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

back 48

Low-set ears

front 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.

back 49

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

front 50

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

back 50

Current weight is 6 times greater than birth weight

front 51

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

back 51

Encourage the parent to be involved with the child

front 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.

back 52

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

front 53

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

back 53

Renal anomalies

front 54

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

back 54

Behavioral

front 55

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

back 55

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

front 56

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

back 56

Consolability

front 57

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

back 57

Facial expression of discomfort

front 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?

back 58

Not useful as the only indicator for pain

front 59

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

back 59

FACES Pain Rating Scale

front 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?

back 60

APPT scale

front 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.)

back 61

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.

front 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?

back 62

Administer naloxone (Narcan)

front 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?

back 63

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

front 64

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

back 64

May reduce pain perception.

front 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?

back 65

This practice is unjustified and unethical.

front 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?

back 66

Plan a preventive schedule of pain medication around the clock.

front 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?

back 67

Request a psychologic consultation

front 68

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

back 68

Requires astute nursing assessment and management.

front 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?

back 69

Discontinue intravenous infusion

front 70

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

back 70

Child’s developmental level

front 71

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

back 71

Provide supplies for the child to draw a picture

front 72

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

back 72

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

front 73

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

back 73

First words not uttered before age 2 years

front 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.

back 74

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

front 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?

back 75

Spina Bifida Oculta

front 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?

back 76

Overflow incontinence with constant dribbling of urine

front 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?

back 77

Myelomeningocele

front 78

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

back 78

Avoid using any latex product.

front 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?

back 79

Medicate the child with pain meds before the procedure

front 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?

back 80

Sac formation containing meninges and spinal fluid

front 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.

back 81

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

front 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?

back 82

Cover with a sterile, moist, nonadherent dressing

front 83

What problem is most often associated with myelomeningocele?

back 83

Hydrocephalus

front 84

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

back 84

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

front 85

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

back 85

Hib vaccine

front 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:

back 86

When the medication is received from the pharmacy

front 87

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

back 87

Keep environmental stimuli to a minimum

front 88

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

back 88

Assess for signs of increased intercranial pressure

front 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?

back 89

Place the child in a side-lying position

front 90

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

back 90

Administer antibiotic therapy as soon as it is available.

front 91

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

back 91

Administer 400 mg ceftriaxone IV every 12 hours

front 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?

back 92

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

front 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.

back 93

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

front 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?

back 94

Fontanel assessment

front 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?

back 95

Fontanel assessment

front 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?

back 96

Hydrocephalus

front 97

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

back 97

Monitor closely for signs of infection.

front 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? “

back 98

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

front 99

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

back 99

Complex partial seizures result in no loss of consciousness

front 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?

back 100

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

front 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?

back 101

My child May stare and seem inattentive.”

front 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?

back 102

“My child may seem confused afterwards”

front 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?

back 103

Brief loss of consciousness.

front 104

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

back 104

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

front 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?

back 105

Spasticity

front 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?

back 106

Cerebral palsy

front 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?

back 107

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

front 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?

back 108

Pyloric Stenosis

front 109

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

back 109

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

front 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.)

back 110

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

front 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?

back 111

Hematocrit of 57% (0.57)

front 112

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

back 112

metabolic Alkalosis

front 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?

back 113

Intussusception

front 114

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

back 114

Currant jelly stools

front 115

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

back 115

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

front 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?

back 116

Passed a normal brown stool.

front 117

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

back 117

Stools mixed with blood and mucus.

front 118

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

back 118

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

front 119

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

back 119

Abdominal rigidity with guarding

front 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

back 120

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.

front 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?

back 121

Popcorn

front 122

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

back 122

Corn on the cob with butter

front 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?

back 123

Wheat.

front 124

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

back 124

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

front 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.

back 125

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

front 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?

back 126

potato chips

front 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?

back 127

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

front 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?

back 128

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

front 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)

back 129

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

front 130

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

back 130

Supine with the head turned to the side

front 131

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

back 131

Faulty dentition

front 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?

back 132

Encourage her to express her feelings.

front 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?

back 133

The client is prone while playing with the parent

front 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.

back 134

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

front 135

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

back 135

Assessing bowel function.

front 136

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

back 136

Skin and stoma care.

front 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?

back 137

Hirschsprung disease

front 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?

back 138

Hirschsprung.

front 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?

back 139

Hirschsprung disease.

front 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?

back 140

Episode of foul-smelling diarrhea and fever.

front 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?

back 141

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

front 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?

back 142

Choking with feedings

front 143

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

back 143

Risk of injury related to increased potential for aspiration

front 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?

back 144

Excessive amount of frothy saliva in the mouth

front 145

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

back 145

Choking and cyanosis during feeding

front 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?

back 146

Suction as needed

front 147

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

back 147

Zantac (Ranitidine)

front 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)?

back 148

Vomiting

front 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)

back 149

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

front 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?

back 150

Urine output will increase

front 151

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

back 151

Hematuria and proteinuria

front 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?

back 152

Reduction of edema

front 153

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

back 153

Antecedent streptococcal infection

front 154

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

back 154

Dizziness

front 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?

back 155

Daily weight measurements.

front 156

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

back 156

blood pressure

front 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?

back 157

Increased urine output

front 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?

back 158

Urine output will increase

front 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?

back 159

Diuresis occurs as urinary protein excretion diminishes

front 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?

back 160

Massive proteinuria, hypoalbuminemia, and edema

front 161

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

back 161

Massive proteinuria, hypoalbuminemia, and edema.

front 162

What are the common clinical manifestations of nephrotic syndrome?

back 162

Proteinuria, hypoalbuminemia, and edema

front 163

What is included in the therapeutic management of nephrotic syndrome?

back 163

Corticosteroids

front 164

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

back 164

Promote adherence to the antibiotic regimen

front 165

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

back 165

Nephrotic syndrome

front 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?

back 166

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

front 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?

back 167

Glomerular injury

front 168

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

back 168

Response to steroid therapy

front 169

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

back 169

The urethral meatus opens on the underside of the penis

front 170

Hypospadias refers to what?

back 170

Urethral opening along ventral surface of penis

front 171

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

back 171

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

front 172

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

back 172

Circumcision

front 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?

back 173

Ensure clear liquid intake of 2 L/day

front 174

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

back 174

Recurrent urinary tract infections

front 175

What factors predisposes the urinary tract to infection?

back 175

Short urethra in girls

front 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

back 176

“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”

front 177

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

back 177

Wiping front to back

front 178

What child has a cyanotic congenital heart defect?

back 178

2 month old with tetralogy of Fallot

front 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?

back 179

Suction the infant’s mouth

front 180

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

back 180

Infant client with ventricular septal defect with reported grunting during feeding

front 181

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

back 181

Infant client with ventricular septal deficit with reported grunting during feeding

front 182

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

back 182

Serum Potassium

front 183

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

back 183

Tachypnea

front 184

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

back 184

Organize activities to allow for uninterrupted sleep.

front 185

What structural defects constitute tetralogy of Fallot?

back 185

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

front 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?

back 186

Place the child in knee to chest position

front 187

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

back 187

Tetralogy of Fallot

front 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

back 188

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

front 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?

back 189

Place infant in knee to chest position

front 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.)

back 190

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

front 191

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

back 191

Refer children with sore throats for throat cultures

front 192

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

back 192

Polyarthritis

front 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?

back 193

Positive antistreptolysin titer

front 194

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

back 194

Administration of penicillin

front 195

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

back 195

Group A beta- hemolytic Streptococcus

front 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?

back 196

Coronary artery aneurysm

front 197

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

back 197

IVIG

front 198

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

back 198

Electrocardiograph(ECG) changes

front 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?

back 199

Fever

front 200

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

back 200

Monitor for a gallop heart rhythm and decreased urine output.

front 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.

back 201

Measles, mumps, rubella (MMR) Varicella

front 202

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

back 202

Therapeutic management includes administration of gamma globulin and salicylates.

front 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?

back 203

Absent or diminished femoral pulses

front 204

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

back 204

High blood pressure in the upper extremities

front 205

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

back 205

Diminished pulse in the lower extremities

front 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?

back 206

Bounding pulses in the upper extremities

front 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?

back 207

Status Asthmaticus

front 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?

back 208

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

front 209

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

back 209

Short acting beta2- agonists

front 210

.Which of the following describes moderate persistent asthma symptoms?

back 210

Symptoms seen on a daily basis

front 211

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

back 211

Administer beta 2 agonists as ordered

front 212

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

back 212

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

front 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?

back 213

oxygen saturation has increased from 88% to 93%.

front 214

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

back 214

Client with an acute asthma exacerbation but no wheezing

front 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?

back 215

Asses the clients peak expiratory flow.

front 216

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

back 216

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

front 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?

back 217

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

front 218

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

back 218

Exocrine Gland

front 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?

back 219

Cover the skin with a shirt or gown before percussing.

front 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?

back 220

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

front 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? “

back 221

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

front 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?

back 222

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

front 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.

back 223

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.”

front 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?

back 224

perform manual chest physiotherapy

front 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?

back 225

Aerobic exercise, Chest physiotherapy, Financial needs.

front 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?

back 226

Chronic hypoxemia, Frequent respiratory infections, vitamin deficiencies.

front 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

back 227

“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”

front 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?

back 228

High calorie, high protein, high fat

front 229

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

back 229

Hib vaccine

front 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?

back 230

Epiglottitis

front 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?

back 231

Acute epiglottitis

front 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?

back 232

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

front 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?

back 233

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

front 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?

back 234

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

front 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?

back 235

RSV Bronchlolitis

front 236

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

back 236

RSV, influenza, and adenovirus

front 237

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

back 237

Fever, cough, chest pain

front 238

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

back 238

Bacterial meningitis, Epiglottitis ,Bacterial pneumonia, Septic arthritis Sepsis

front 239

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

back 239

Use picture books and puppets and repeat explanations

front 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?

back 240

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

front 241

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

back 241

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

front 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?

back 242

Encourage mobility.

front 243

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

back 243

Hypotonic musculature

front 244

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

back 244

Atlantoaxial instability

front 245

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

back 245

Decrease auditory and visual simulation

front 246

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

back 246

Provide individualized care

front 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?

back 247

Ability to maintain eye contact

front 248

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

back 248

Provide a structured routine for the child to follow

front 249

What is a common clinical manifestation of autism?

back 249

Early abnormal eye contact

front 250

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

back 250

Assign the child to a private room

front 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?

back 251

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

front 252

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

back 252

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

front 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?

back 253

Check for moist mucous membranes.

front 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?

back 254

Monitor child for sign of dehydration.

front 255

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

back 255

Headache, weakness, visual disturbances.

front 256

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

back 256

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

front 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?

back 257

When they are medically indicated, children rarely become addicted.

front 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?

back 258

APPT scale

front 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?

back 259

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

front 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?

back 260

Enlarged spleen on palpation

front 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?

back 261

Monitor child for signs of dehydration

front 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.

back 262

Increase the amount of oxygen available to tissues

front 263

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

back 263

Children with anemia absorb lead more easily

front 264

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

back 264

Anemia

front 265

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

back 265

Excessive intake of milk

front 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?

back 266

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

front 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?

back 267

Provide intravenous (IV) infusion of factor VIII concentrates.

front 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?

back 268

Elevate the arm above the level of the heart.

front 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?

back 269

Administer IV factor VIII.

front 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?

back 270

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

front 271

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

back 271

Joint destruction

front 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.

back 272

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.”

front 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?

back 273

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

front 274

Where are Wilms tumors (nephroblastomas) located?

back 274

Kidney

front 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

back 275

Instructions not to palpate the abdomen

front 276

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

back 276

Careful bathing and handling

front 277

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

back 277

Carefully monitor fluids because of cerebral edema.

front 278

Which of the following describes the pathophysiology of leukemia?

back 278

Unrestricted proliferation of immature white blood cells (WBCs)

front 279

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

back 279

Petechiae, fever, and fatigue

front 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?

back 280

Varicella-zoster vaccine for client recently diagnosed with leukemia.

front 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

back 281

Facial grimacing, groaning, knees bent up near chest

front 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?

back 282

Bone marrow biopsy

front 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

back 283

weight gain

front 284

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

back 284

Retinoblastoma

front 285

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

back 285

Absent of red reflex

front 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)

back 286

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

front 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.

back 287

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

front 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.

back 288

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

front 289

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

back 289

X linked recessive trait

front 290

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

back 290

Recommend genetic counseling.

front 291

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

back 291

It had an X-linked inheritance problem

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

front 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?

back 292

Remove throw rugs from the home.

front 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?

back 293

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

front 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?

back 294

Obtain blood pressure manually to avoid cuff over-tightening.

front 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?

back 295

3-8 week

front 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?

back 296

Scoliosis

front 297

When does idiopathic scoliosis become most noticeable?

back 297

During the preadolescent growth

front 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?

back 298

10-12.

front 299

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

back 299

Blood administration may be an option.

front 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?

back 300

Visits from friends.

front 301

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

back 301

Closed Reduction with Spica Casting.

front 302

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

back 302

Ortolani sign

front 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?

back 303

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.”

front 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?

back 304

Presence of extra gluteal folds on the right side

front 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?

back 305

Swaddle the infant with hips flexed and abducted.

front 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?

back 306

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

front 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?

back 307

Swaddle the infant with hips flex an abducted

front 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?

back 308

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

front 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?

back 309

Subluxation