front 1 When caring for an infant w/an upper respiratory tract infection & elevated temperature, an appropriate nursing intervention is to: | back 1 Give small amounts of fluid frequently to prevent dehydration |
front 2 A parent whose 2 school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend | back 2 Swimming |
front 3 When introducing hospital equipment to a preschooler who seems afraid, the nurse's approach should be based on which principle? | back 3 The child may think the equipment is alive |
front 4 A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is to | back 4 Reduce the opportunities for a 'no' answer |
front 5 Imaginary playmates are beneficial to the preschool child because they | back 5 become friends in times of loneliness |
front 6 Which strategy would be the least appropriate for a child to use to cope | back 6 having parents solve problems |
front 7 What information could be given to the parent of a 12-month old child regarding appropriate play activities for this age? | back 7 Give large push-pull toys for kinetic stimulation |
front 8 The nurse is caring for a neonate w/suspected tracheoesophageal fistula. Nursing care should include | back 8 elevating the head but not giving nothing by mouth |
front 9 An infants parent asked the nurse about preventing otitis media (OM). What should the nurse recommend? | back 9 Avoid tobacco smoke |
front 10 A school-age child w/diarrhea has been rehydrated. The nurse is discussing the child's diet w/the family. Which statement by the parent would indicate a correct understanding of the teaching? | back 10 I should have my child eat a normal diet w/easily digested foods for the next 48hrs |
front 11 Which statement best describes fear in school-age children? | back 11 Most of the new fears that trouble them are related to school & family |
front 12 In terms of gross motor development, what would the nurse expect a 6-month old infant to have accomplished? CHOOSE ALL THAT APPLY: | back 12 A. Sit while propped |
front 13 Matthew, age 18 months, has just been admitted w/croup. His parent is tearful & tells the nurse, 'This is all my fault. I should have taken him to the doctor sooner so he wouldn't have to be here.' What is appropriate in the care plan for this parent who is experiencing guilt? | back 13 Clarify the misconception about the illness |
front 14 Kimberly's parents have been using a rearward-facing convertible car seat since she was born. Most car seats can be safely switched to the forward facing position when the child weighs | back 14 20 lbs |
front 15 What is most characteristic of the physical punishment of children, such as spanking? | back 15 Misbehavior is likely to occur when parents are not present. |
front 16 A child weighs 38.5 lbs & is 3'8" tall. Calculate the
child's BSA. Do not round until finished w/all calculations.
| back 16 0.74 |
front 17 The parents of a 2 year old tell the nurse that they are concerned because the toddler has started to use 'baby talk' since the arrival of their new baby. The nurse should recommend that the parents | back 17 ignore the 'baby talk.' |
front 18 What is probably the single most important influence on growth at all stages of development? | back 18 Nutrition |
front 19 A 10-year old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, 'wait a minute, 'and, I'm not ready.' The nurse should recognize that | back 19 This is normal behavior for school-age child |
front 20 When teaching injury prevention during the school-age years, the nurse should include | back 20 teach basic rules of water safety |
front 21 Caring for the newborn w/a cleft lip & palate before surgical repair includes | back 21 providing satisfaction of sucking needs |
front 22 A child comes to the clinic and needs a prescription of an
antibiotic. There is no pediatric dosage for this antibiotic. The
child has a BSA of 0.68 & the adult dose is 1500mg. What is the
pediatric dose | back 22 600 |
front 23 When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is | back 23 Infection or inflammation proximal to the site |
front 24 The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant's postoperative care include | back 24 Cleansing suture line, supine & side-lying positions, arm restraints. |
front 25 An objective of care for the child w/nephrosis is to | back 25 reduce excretion of urinary protein |
front 26 A child weighs 5kg & 59cm long. The adult dose is 250mg. Determine the pediatric dose. Do not round until all calculations are complete. Round to a whole number | back 26 42 |
front 27 The nurse encourages the mother of a toddler w/acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that | back 27 The mother's presence will reduce anxiety and ease child's respiratory efforts |
front 28 Which is characteristic of physical development of a 30-month old child? *CHOOSE ALL THAT APPLY | back 28 b. Primary dentition is complete |
front 29 Which statement best describes the infant's physical development? | back 29 Birth weight doubles by age 6 months & triples by 1 year |
front 30 A 3 month old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as | back 30 normal development |
front 31 The nurse is assessing a 6 month old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately | back 31 15 pounds |
front 32 In providing nourishment for a child w/cystic fibrosis (CF), which factor should the nurse keep in mind? | back 32 Diet should be high in carbohydrates and protein |
front 33 The nurse discussing w/a parent group the importance of fluoride for healthy teeth. The nurse should recommend that the parents | back 33 determine whether their water supply is fluoridated |
front 34 What behavior indicates that an infant has developed object permanence? | back 34 Actively searches for a hidden object |
front 35 The nurse has just started assessing a young child who is febrile & appears very ill. There is hyperextension of the child's head (opisthotonos)w/no pain on flexion. The most appropriate action is to | back 35 refer for immediate medical evaluation |
front 36 The nurse is caring for a 5yr old child who is scheduled for a tonsillectomy in 2hrs. Which actions should the nurse include in the child's postoperative care plan? (Choose all that apply) | back 36 a. Notify the surgeon if the child swallows frequently |
front 37 Determine a child's BSA based on the following measurements: Height,
66 cm & weight 6.8kg | back 37 0.35 |
front 38 Which factor is most important in predisposing toddlers to frequent infections such as otitis media, tonsillitis, and upper respiratory tract infections? | back 38 Short, straight internal ear/throat structures & large tonsillar tissue |
front 39 The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent would be expected about separation anxiety? | back 39 I hope my friends don't forget about visiting me |
front 40 A young child is brought to the emergency department who has lost 7lbs in the last week secondary to acute diarrhea & vomiting. The child has sunken eyes & dry mucous membranes. Therapeutic management of this child will begin with | back 40 Intravenous fluids |
front 41 The nurse is caring for an infant w/suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? | back 41 Visible peristalsis and weight loss |
front 42 An appropriate nursing intervention when caring for a child w/pneumonia is to | back 42 encourage rest |
front 43 The nurse is caring for a 10 month old infant w/respiratory syncytial virus (RSV)bronchiolitis. Which intervention should be included in the child's care? (Choose all that apply) | back 43 a. Cluster care to encourage adequate rest |
front 44 Therapeutic management of nephrosis includes | back 44 Corticosteroids |
front 45 A mother tells the nurse that she doesn't want her infant immunized because of the discomfort associated w/injections. The nurse should explain that | back 45 A topical anesthetic (like EMLA)can be applied before injections are given |
front 46 The nurse is doing a routine assessment on a 14 month old infant and notes that the anterior fontanel is closed. This should be interpreted as | back 46 a normal finding |
front 47 The best play activity for a 6 month old infant to provide tactile stimulation is to | back 47 allow to splash in bath |
front 48 A 3YO child comes to the clinical w/complaints of coughing and
purulent drainage from the nose. Medication dosage is determined based
upon the child's body surface area. The child weighs 25 lbs & is
30in tall. Calculate the child's BSA. | back 48 0.49 |
front 49 The nurse closely monitors the temperature of a child w/nephrosis. The purpose of this is to detect an early sign of | back 49 infection |
front 50 The nurse observes some children in the playroom. Which play situation exhibits is the characteristics of parallel play? | back 50 Brian playing w/his truck next to Kristina playing w/her truck |
front 51 Kawasaki Disease: Implementation | back 51 * Temp ↑104° 1. Monitor I&Os 2. Provide Passive ROM 3. ****Administer ASA**** 4. ***Administer IV immune globulin*** 5. Educate parent/patient |
front 52 Growth & development: Weight A: From 1-2 yrs B: From 2-3 yrs C: By 2 1/2 yrs | back 52 A: 1/2lb a month C: 4x birth weight |
front 53 Growth & development: Height A: From 1-2 yrs B: 2yrs C: From 2-3 yrs | back 53 A: 3-5" yr B: 50% of adult height C: 2-2.5" yr |
front 54 Growth & development: 15 mos | back 54 - Walks w/out help - Uses cup well - Builds tower of 2 blocks - Binocular vision |
front 55 Growth & development: 18 mos | back 55 -Jumps in place - Identifies geometric forms (18-24mos) - Uses short sentences (18-24mos) |
front 56 Tonsillitis: Implementation | back 56 * Larger than adults Manifestations: - Inflammation (obstruction) - Self limiting Mgmt: -Minimize discomfort -Tonsillectomy (malignant or obstructive) Post-op: Side lying & watch for excessive swallowing |
front 57 Bacterial Endocarditis: Assessment | back 57 * Infections of valves & inner lining of heart ~Clinical manifestation~
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front 58 Hospitalized Child/School age | back 58 * Major fears
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front 59 Hospitalized Child/School age: Nursing interventions * More realistic understanding of disease * Wants to know why * Become distressed over separation | back 59
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front 60 Discipline/ Analysis/ Evaluation | back 60
POSITIVE / NEGATIVE REINFORCEMENT |
front 61 Child assessment/ Television American Academy of Pediatrics | back 61
- Sedentary - Interferes w/play - Cannot tell difference between ads & shows - Substance use, violence, sex |
front 62 Bronchitis | back 62 4 or less Usually viral Persistent dry hacking cough (worse @ night) Nonproductive, becomes productive in 2-3 days |
front 63 Treatment for bronchitis | back 63
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front 64 Bronchiolitis | back 64 < 2 yrs * Virus (RSV usually) - Symptoms-
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front 65 Bronchiolitis Treatment | back 65 Supplement O2 Bronchodilators Suction Adequate fluid intake ** If not contraindicated (tachypnea- they can aspirate)** |
front 66 Tonsillitis | back 66 * Larger than adults ( protective mechanism) - Manifestations- 1. Inflammation (obstruction) 2. Self limiting |
front 67 Tonsillitis treatment | back 67 - Minimize discomfort - Tonsillectomy (malignant or obstructive) ~Post-op~ - Side lying |
front 68 Bacterial endocarditis | back 68 Definition: Infections of valves & inner lining of heart Clinical manifestations:
-Splinter hemorrhages, Osler nodes, Janeway lesions, Petechia |
front 69 Hospitalized child- School-age Major fears | back 69 * New fears r/t school, peers, & family * Pain & bodily injury * Loss of control |
front 70 Hospitalized child- School-age | back 70
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front 71 Hospitalized child- School-age: Nursing Intervention | back 71
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front 72 Pertussis | back 72 * Acute respiratory infection: Bordetella pertussis
- Clinical manifestations-
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front 73 Pertussis treatment/management | back 73
PREVENTION: Vaccination |
front 74 CHF Assessment: Early signs | back 74
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front 75 CHF Assessment: Right side | back 75 Increased pressure in right atrium & the systemic venous system |
front 76 CHF Assessment: Left side | back 76 Increased lung congestion |
front 77 CHF assessment & treatment | back 77 Assessment:
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front 78 CHF treatment | back 78 Maintain oxygenation ↓ fatigue Monitor I&Os Monitor lung sounds & supplement O2 |
front 79 Hypercyanotic spells: Implementation | back 79 1st: Knee to chest position 2nd: Give O2 3rd: Give morphine 4th: Give IV fluids |
front 80 CHD: Hypoxia | back 80 Severe- worse than hypoxemia Low O2 to tissue Poor perfusion * You will see child squat (tripod position) trying to relieve hypoxia |
front 81 CHD: Hypoxemia | back 81 Arterial O2 ↓ severe condition poor feeding, leading to poor weight tachypnea dyspnea polycythemia Clubbing of fingers (should return to normal when fixed) tissue hypoxia |
front 82 Cardiac cath manifestations/implementation: School age | back 82
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front 83 Cardiac cath manifestations/implementation: School age & adolescents | back 83
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front 84 Rheumatic fever: Clinical manifestations (Assessment) pg 242 | back 84 Inflammatory autoimmune disease Affects: Connective tissue of the ♥, joints, subcutaneous tissue, blood vessels of the CNS. Complications: Cardiac valve disease (mitral valve stenosis) 2-6 weeks post GABHS infection |
front 85 Cystic fibrosis: Implementation pg 203-205 | back 85 Maintain airway Provide Pulmonary hygiene Chest physiotherapy Postural drainage (allow gravity to work/move the bronchi and be coughed out) Chest percussion Vibration Coughing & deep breathing (incentive spirometer) Help to mobilize and eliminate secretions |
front 86 Cystic fibrosis:Medications | back 86 Aerosolized meds, low flow humidified air, beware of giving too much oxygen as it can depress respiratory drive to chronically hypoxic children. Monitor for infections
NEVER GIVE ANTIHISTAMINES TO CF pt.'s AS THEY HAVE A DRYING EFFECT, MAKING EXPECTROATION OF MUCOUS MORE DIFFICULT. |
front 87 General aspects of care for child w/respiratory issues: Implementation | back 87
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front 88 Croup: Epiglottis | back 88 Acute epiglottis (2-8 YO): inflammation of larynx & epiglottis. Can be life threatening, usually bacterial. *Rapid onset* S/S:
* Sitting up, leaning forward, lower jaw thrust forward in tripod position. |
front 89 Croup: Epiglottis- Implementation | back 89 If you suspect epiglottis, never inspect by hand or intubation kit in hand as it can cause bronchospasm & airway occlusion. Always use gloves. Monitor respiratory status Avoid letting them cry Hydrate them Palivizumab prophylactically & Abx ***GIVE HIB VACCINE= H. influenza *** |
front 90 Acute LTB (<5YO): | back 90 Viral S/S: Stridor, brassy cough, hoarseness, dyspnea, restlessness, irritability, low grade fever, seal call. Tx: Give racemic, epinephrine, corticosteroids & fluids |
front 91 Asthma: Triggers | back 91
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front 92 Asthma: manifestations | back 92
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front 93 Asthma: Exercise | back 93 Exercise is still necessary- baseball, gym, sprints & SWIMMING |
front 94 Asthma: Tx | back 94
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front 95 Pneumonia: Implementation- Viral | back 95 Wheezing, tachypnea, pt. looks very ill, lasts about 5-7 days. Give: O2, mist, suction, ↑ fluids, antipyretics, chest PT & postural drainage S/S: Wheezing is more common w/RSV. Consolidation on xray, HA, fatigue & malaise |
front 96 Pneumonia: Implementation-Bacterial | back 96 S/S: ↑Fever, productive cough, ill looking, retractions, grunting, chest pain, significant RDS, consolidation on xray. * Recent upper respiratory infection * Cough may linger for a few weeks Implementation: Monitor oxygenation, hydrate, monitor resp. status, Abx for bacterial pneumonia. Elevate HOB, avoid over feeding, burp frequently if bottle feeding. |