Nursing Care for Children with Various Health Conditions, Exams of Nursing

Download Nursing Care for Children with Various Health Conditions and more Exams Nursing in PDF only on Docsity! [NGN] RN PEDIATRICS NURSING CARE VERIFIED QUESTOINS AND ANSWERS 2023-2024 NEXT GENERATION EXAM A nurse is caring for an adolescent following a lumbar puncture. which of the following actions should the nurse take? - initiate NPO status for the adolescent - place the adolescent in a supine position - place a moist, warm pack on the adolescents lower back - apply a eutectic mixture of local anesthetics to the adolescent's puncture site Place the adolescent in supine position (The nurse should place the adolescent in a supine position for 30 minutes to an 1 hour following a lumbar puncture to decrease the risk of a post Dural puncture headache) A nurse is assessing a child who is receiving IV chemotherapy. assessment findings include extravasation of the tissues surrounding the IV insertion site. In which order should the nurse take the following actions? -Remove IV line -Elevate the extremity -Stop the infusion -Notify the provider Stop the infusion Elevate the extremity Notify the provider Remove the IV line A nurse is discussing the causes of chronic diarrhea with a client. which of the following conditions is caused by malabsorption -Celiac disease -Ulcerative colitis -Hirschsprung's disease -Crohn's disease Celiac Disease (the nurse should recognize that celiac disease causes chronic diarrhea due to malabsorption. other malabsorption conditions include short bowel syndrome, lactose intolerance, and congenital enzyme deficiency) A nurse is caring for an 8 year old child who has sickle cell anemia. which of the following actions should the nurse take? -Apply cool compresses to the painful area -Initiate contact isolation precautions -Give the child flavored popsicles -Administer phytonadione Give the child flavored popsicles (Maintaining hydration with a child who has sickle cell anemia is important to prevent sickling. children often accept flavored popsicles as a source of fluid A nurse is caring for a toddler who has a fever, a high pitched cry, irritability, and vomiting. which of the following actions should the nurse take? -Administer 81 mg of aspirin to the toddler -Give the toddler a cold bath -Place the toddler in a supine position -Pad the rails of the toddler's bed Pad the rails of the toddler's bed (When caring for a toddler who has manifestations of bacterial meningitis, the nurse should implement seizure precautions, which includes padding the side rails of the bed) A Nurse is teaching the guardian of a preschooler. The guardian states that the preschooler has had an imaginary playmate for about 3 months. which of the following pieces of information should the nurse give to guardian? -children commonly begin having imaginary friends when they reach school age -Notify your provider if the imaginary friend persists longer than 6 months -Have your child take responsibility for actions if he tries to blame the imaginary friend -Set limits by not allowing your child to have the imaginary friend present during family meals Have your child take responsibility or actions if he tries to blame the imaginary friend (the nurse should inform the guardian that imaginary playmates are common during the preschool years due to the high level of imagination among this age group. Although having an imaginary friend is considered healthy, the preschooler might try to use this imaginary friend as a means of avoiding responsibility or punishment for unacceptable behavior. the nurse should inform the guardian of the need to have the preschooler take responsibility for his actions) A nurse in a providers office enters an examination room to assess an 8 month old infant for the first time. which of the following reactions by the infant should the nurse expect. -The infant gives the nurse a social smile -the infant turns away when the nurse approaches -The infant reaches out to the nurse to be held -The infant is responsive and alert as the nurse comes closer the infant turns away when the nurse approaches (the nurse should expect an 8 month old infant to have a heightened fear of strangers. the infant is expected to cling to her parent and turn away when approached by a stranger.) A nurse is caring for an infant who has pertussis. which of the following actions should the nurse take? -assess for edema of the extremities -apply warm compresses to the neck area -initiate airborne precautions -maintain a cardiorespiratory monitor Maintain a cardiorespiratory monitor (Infants with pertussis typically present with apnea in response to coughing spasms and mucus plugs. Humidified oxygen and suction equipment should be used as needed) A nurse is caring for a 7 year old child who is in skeletal traction following a complete fracture of the femur. which of he following diversional activities should the nurse offer the child? -Puzzle with large pieces -Building blocks -Finger paints -Chapter books Chapter books (the nurse should offer chapter books as an appropriate diversional activity for a school age child who has limited movement due to skeletal traction) A nurse is creating a plan of care for a 6 month old infant who requires continuous pulse oximetry monitoring. Which of the following interventions should the nurse include. -Reposition the sensor to a new site once every 24 hr -Secure the oximetry sensor to the infant's wrist -apply conduction gel to the skin before attaching the sensor -Cover the oximetry sensor with clothing Cover the oximetry sensor with clothing (the nurse should cover the sensor with clothing to prevent outside light from causing an altered or false reading) A nurse is caring for a toddler who has otitis media and a temperature of 39.1 (102.4F). Which of the following actions should the nurse take first? -Reduce the temperature of the Childs room -redress the child in minimal clothing -apply cool compresses to the Childs forehead -administer an antipyretic to the child Administer an antipyretic to the child (when using the urgent vs. nonurgent approach to client care, the nurse should first administer an antipyretic to decrease the toddler's body temperature) A nurse is providing teaching to a 12 y3ear old client who is recovering from an acute episode of hemophilia A. which of the following statements should the nurse include in the teaching? -have your parent stretch and mover your legs for you -apply heat to joints that become painful, stiff, and swollen. -take aspirin at the first sign of a headache -you will be able to participate in physical exercises You will be able to participate in physical exercises (physical exercise is important for the maintenance of joint mobility and muscle strengthen. participation in non contact sports and the use of protective equipment such as knee pads are encouraged, although high impact athletic activities such as karate should be avoided) A school nurse is assessing a child who has been stung by a bee. the childes hand is swelling and the nurse notes that the child is allergic to insect stings. which of the following findings should the nurse expect if the child develops anaphylaxis -Bradycardia -Nausea -Hypertension -Urticaria -Stridor Nausea, Urticaria, and stridor (A common gastrointestinal response to excessive histamine release is nausea. A common skin manifestation of excessive histamine release is hives, also known as urticaria. A serious, life threatening response to excessive histamine release is airway narrowing, which presents as dyspnea and stridor) A nurse is developing a health education program for the parents of school aged females. which of the following pieces of information regarding sexual maturation should the nurse include -hgihe4r body fat content is associated with earlier onset of menarche -pubic hair is typically present prior to breast development -ovulation begins after sexual maturation is complete -menarche signals the beginning of puberty higher body fat content is associated with earlier onset of menarche (the nurse should inform the parents that the onset of menarche is expected to occur around 10.5 to 15.5 years of age. females who have a higher body fat content have been shown to have earlier onset of menarche) After reviewing the information in the child's medical record, which of the following findings should the nurse report to the provider? Select the 4 findings that the nurse should report to the provider. Arterial blood gases Cardiovascular assessment WBC count Hemoglobin Oxygen saturation level Respiratory assessment Arterial blood gases WBC count Oxygen saturation level Respiratory assessment A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse assess first? An adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a scale of 0 to 10 An adolescent who has infective endocarditis and reports having a headache A toddler who has a concussion and is experiencing an episode of forceful vomiting A school-age child who has acute glomerulonephritis and brown-colored urine A toddler who has a concussion and is experiencing an episode of forceful vomiting For each assessment finding, click to specify if the finding is consistent with nightmares, sleep terrors, or insomnia. Each finding may support more than 1 disease process. A. Timing of child's crying B. Daytime alertness C. child's concentration D. Impulsivity E. Child's description of the dream F. Child's return to sleeping G. Child's responsiveness to guardian A nurse is providing discharge teaching to the guardians of a toddler who had a lower leg cast applied 24 hr ago. The nurse should instruct the guardians to report which of the following findings to the provider? A. Capillary refill time less than 2 seconds B. Restricted ability to move the toes C. Swelling of the casted foot when the leg is dependent D. Pedal pulse +3 bilateral B. Restricted ability to move the toes A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include? A. "You should give your child their salmeterol inhaler every 4 hours when they are having an acute episode of wheezing." B. "You should monitor your child's weight weekly while they are receiving inhaled corticosteroid therapy." C. "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy." D. "When using the peak expiratory flow meter, record your child's average of three readings." C. "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy." A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider? A nurse is providing dietary teaching to the parent of a school-age child who has celiac disease. The nurse should recommend that the parent offer which of the following foods to the child? A. Wheat crackers B. Rye bread C. Barley soup D. White rice D. White rice A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler? A. Apple juice B. Peanut butter C. Chicken broth D. Oral rehydration solution D. Oral rehydration solution A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority for the nurse to report to the provider? Reports headache as 6 on a scale of 0 to 10 Petechiae on the lower extremities Nuchal rigidity Positive Kernig's sign Petechiae on the lower extremities A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan? Administer pancreatic enzymes 2 hr after meals. Discontinue the use of pancreatic enzymes if steatorrhea develops. Limit fluid intake to 750 mL per day. Increase fat content in the child's diet to 40% of total calories. Increase fat content in the child's diet to 40% of total calories. A nurse is providing discharge teaching to the guardian of a child who is 1 week postoperative following a cleft palate repair. For which of the following members of the interprofessional team should the nurse initiate a referral? Occupational therapist Speech therapist Respiratory therapist Physical therapist Speech therapist A nurse is caring for an infant who has respiratory syncytial virus (RSV). Which of the following actions should the nurse implement for infection control? Have a designated stethoscope in the infant's room. Place the infant in a room equipped with negative airflow. Administer palivizumab as prescribed for the infant. Remove gloves after leaving the infant's room. Have a designated stethoscope in the infant's room. A nurse is caring for an infant who is receiving IV fluids for the treatment of tetralogy of Fallot and begins to have a hypercyanotic spell. Which of the following actions should the nurse take? Place the infant in a knee-chest position. Administer a dose of meperidine IV. Discontinue administration of IV fluids. Apply oxygen at 2 L/min via nasal cannula. Place the infant in a knee-chest position. The nurse should identify that which of the following findings require immediate follow-up? Select the 3 findings that require immediate follow-up. Child is awake and crying Partial- and full-thickness burns to the left upper anterior chest and anterior neck Non-productive cough SaO2 89% on room air Heart rate 150/min Temperature 37.7° C (99.9° F) Blood pressure 100/52 mm Hg Partial- and full-thickness burns to the left upper anterior chest and anterior neck SaO2 89% on room air Heart rate 150/min Which of the following potential provider prescriptions should the nurse identify as anticipated or contraindicated? For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the child. A. Apply sterile gauze soaked with cool 0.9% sodium chloride to the burn areas B. Insert an indwelling urinary Catheter C. Provide 100% oxygen via face mask D. Weigh the child A. contrainidcated B. Anticipated C. Anticipated D. Anticipated After reviewing the child's assessment, which of the following findings should the nurse address first? Complete the following sentence by using the lists of options. The nurse should first address the client's BLANK followed by the clients BLANK Temperature, Pain After examining the child during hydrotherapy, the provider enters prescriptions into the child's medical record. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the child. A. Change the morphine route to family-controlled analgesia via a PCA pump B. Obtain a wound culture C. Place the child on a pressure-reduction mattress D. Limit daily protein intake A. Anticipated B. Anticipated C. Anticipated D. Contraindicated The child has returned to the unit following the procedure. Which of the following actions should the nurse take? Select all that apply. Monitor SaO2 every 2 hr. Provide 100% oxygen via face mask. Check anterior neck and chest dressing for bleeding. Replace the dressing on the left thigh. Place a warm blanket on the child. Keep the child's head in a neutral position. Provide 100% oxygen via face mask. Check anterior neck and chest dressing for bleeding. Place a warm blanket on the child. Keep the child's head in a neutral position. Select 6 statements by the parent that indicate an understanding of the discharge teaching. "I will give my child hydroxyzine to prevent bacterial infection." "I should apply a moisturizer to the scar tissue." "I will use a measured spoon or medicine cup to give my child hydroxyzine." "I can give my child hydroxyzine every 6 hours as needed." "Puppet play can be helpful for my child." "I should avoid giving hydroxyzine at bedtime." "I will avoid massaging the scar tissue." "My child is too young to be concerned about their body image." "I need to assess for any redness or open skin areas before applying my child's left arm splint." "My child will need to use a compression garment to decrease blood supply to the scarred tissue." "I should apply a moisturizer to the scar tissue." "I will use a measured spoon or medicine cup to give my child hydroxyzine." "I can give my child hydroxyzine every 6 hours as needed." "Puppet play can be helpful for my child." "I need to assess for any redness or open skin areas before applying my child's left arm splint." "My child will need to use a compression garment to decrease blood supply to the scarred tissue." A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should the nurse expect? Loud, harsh murmur Increased curvature of the thoracic spine Lateral flexion of the neck A unilateral rib hump A unilateral rib hump A nurse is assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure? Hypotension Reports insomnia Difficulty concentrating Tachycardia Difficulty concentrating A school nurse is providing an in-service for faculty about improving education for students who have ADHD. Which of the following statements by a faculty member indicates an understanding of the teaching? "I will plan to increase the amount of homework I assign to students who have ADHD." "I will give students who have ADHD the same amount of time as other students to complete tests." "I will allow students who have ADHD one rest break throughout the day." "I will teach challenging academic subjects to students who have ADHD in the morning." "I will teach challenging academic subjects to students who have ADHD in the morning." A nurse is assessing a 3-year-old toddler at a well-child visit. Which of the following manifestations should the nurse report to the provider? Blood pressure 90/50 mm Hg Respiratory rate 45/min Weight 14.5 kg (32 lb) Heart rate 110/min Respiratory rate 45/min A school nurse is assessing an adolescent who has multiple burns in various stages of healing. Which of the following behaviors should the nurse identify as a possible indication of physical abuse? Expresses a reluctance to leave home Provides a detailed description of how the burns occurred Denies discomfort during assessment of injuries Describes strong relationships with peers Denies discomfort during assessment of injuries A nurse is planning care for a school-age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the plan? Use sterile scissors to remove the dressing from the site. Irrigate each lumen weekly with 10 mL of 0.9% sodium chloride solution when not in use. Access the site using a noncoring angled needle. Use a semipermeable transparent dressing to cover the site. Use a semipermeable transparent dressing to cover the site. A nurse is teaching the guardian of a 6-month-old infant about car seat use. Which of the following statements by the guardian indicates an understanding of the teaching? "I should secure the car seat using lower anchors and tethers instead of the seat belt." "I should position the car seat harness 1 inch above my baby's shoulders." "I will make sure that the car seat is placed at a 90-degree angle." "I will pad my baby's car seat with a blanket for traveling long distances." "I should secure the car seat using lower anchors and tethers instead of the seat belt." A nurse in a provider's office is caring for a school-age child who has varicella. The parent asks the nurse when their child will no longer be contagious. Which of the following responses should the nurse make? "When your child no longer has an increased temperature." "Three days after you first noticed the rash appear on your child." "When your child's lesions are crusted, usually 6 days after they appear." "Two to three weeks, when your child's lesions completely disappear." "When your child's lesions are crusted, usually 6 days after they appear." A nurse in an emergency department is caring for a toddler who has partial- thickness burns on their right arm. Which of the following actions should the nurse take? Insert a nasogastric tube. Initiate prophylactic antibiotic therapy. Cleanse the affected area with mild soap and water. Apply a topical corticosteroid to the affected area. Cleanse the affected area with mild soap and water. A nurse is reviewing the lumbar puncture results of a school-age child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? Decreased cerebrospinal fluid pressure Decreased WBC count Increased protein concentration Increased glucose level Increased protein concentration A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following actions should the nurse plan to take? Obtain a sputum specimen. Perform an Allen test. Perform a finger stick. Obtain a stool specimen. Perform a finger stick. A nurse is caring for an infant who is receiving treatment for severe dehydration. The nurse should identify which of the following findings as indicators that the treatment is effective? Irritability Capillary refill less than 2 seconds Weight loss greater than 10% Oliguria Capillary refill less than 2 seconds Which of the following statements by a guardian indicate that the discharge teaching was effective? Select all that apply. "We should apply a skin emollient immediately after bathing our child." "We should keep our child's fingernails trimmed short." "We should rub the sores vigorously to remove scabs." "We should allow our child to take a bubble bath prior to bed." "We should use a mild detergent for our laundry." "We should apply a large amount of the ointment to the sores." "We should apply a skin emollient immediately after bathing our child." "We should keep our child's fingernails trimmed short." "We should use a mild detergent for our laundry." Click to highlight the findings that require follow-up. To deselect a finding, click on the finding again. 0900, Today: Toddler presents to office today with parent. Toddler appears lethargic. Parent reports the toddler is uninterested in eating. Parent states the child is having ribbon-like, foul-smelling stools in diaper since last visit. S1 and S2 auscultated. Respirations are symmetric and unlabored, breath sounds clear. Hypoactive bowel sounds. Abdomen distended and palpable fecal mass noted on palpation. Temperature 37.3° C (99.2° F) axillary Heart rate 138/min Respiratory rate 26/min Blood pressure 110/70 mm Hg Oxygen saturation 98% on room air toddler appears lethargic, toddler is uninterested in eating, hypoactive bowel sounds, distended abdoment, palpable ffecal mass, ribbon-like, foul-smelling stools and elevated blood pressure After reviewing the information in the medical record, the nurse should identify that the child is at risk for developing which of the following conditions? Complete the following sentence by using the list of options. The nurse should identify that the child is at risk for developing BLANk as evidenced by BLANK splenomegaly, positive monoculeosis rapid test A nurse is teaching the guardian of a 6-month-old infant about teething. Which of the following statements should the nurse make? "Place a beaded teething necklace around your baby's neck." "Rub your baby's gums with an aspirin to decrease discomfort." "Your baby might pull at their ears when they are teething." "Your baby's upper middle teeth will erupt first." "Your baby might pull at their ears when they are teething." A nurse is caring for a child who has leukemia. What discharge teaching would be provided to the parents prior to discharge? Select one: a. Encourage parents not to palpate the stomach. b. Side effects of radiation therapy. c. Report developmental delays to the provider. d. How to properly use vascular access devices. How to properly use vascular access devices. A client is diagnosed with rheumatic fever. Which clinical manifestation would the nurse recognize associated with the presentation of rheumatic fever? Select one: a. Irritability, poor concentration and behavioral problems b. Cough c. Polyarthritis d. Purulent nasal discharge C. Irritability and changes in behavior and concentration are not rheumatic fever clinical manifestations. The nurse is conducting a physical examination of a 2-month-old with suspected pyloric stenosis. Which finding indicates pyloric stenosis? Select one: a. Abdominal pain and irritability b. Sausage-shaped mass in the upper mid abdomen c. Hard, moveable "olive-like mass" in the upper right quadrant d. Perianal fissures and skin tags Hard, moveable "olive-like mass" in the URQ Abdominal pain and irritability is common with pyloric stenosis but are seen with many other conditions. FLACC should be given to what age range 2 mo to 7yrs Oucher 3 yr to 13 years 6 photos of children faces showing "no hurt" to "biggest hurt you could ever have" dictatorial parenting style parenting style in which parents rigidly set the rules and demand obedience democratic parenting style a parenting style that offers support with firm expectations (i.e. play video games after studying for an hour) Passive parenting style Parents are uninvolved, indifferent, and emotionally removed Permissive parenting style parents make few demands and rarely use punishment A nurse has provided discharge education to a school age client and his parents following a radius fracture with cast application. Which of the following statements by the client's parent indicates a need for additional teaching? Select one: a. "When we get home we will use a hair dryer to finish drying the cast." b. "We will notify the provider if his fingers become swollen and dark." c. "We will reposition him every 2 hours until the cast is dry." d. "We will keep the cast elevated about his heart for the next 24 hours." A. The client should be repositioned every 2 hr so that dry air circulates around and under the cast for faster drying. This also will prevent pressure from changing the shape of the cast. How often should blood glucose be taken in a child who is sick Q3H The nurse is caring for a child with cystic fibrosis. What provider order would the nurse question? Select one: a. High protein diet b. Limit physical activity c. Administer the influenza vaccine d. Oxygen therapy via nasal cannula at 2 L/min B. It is recommended that the influenza vaccination be given to all clients with cystic fibrosis regardless of their nutritional, respiratory or immunologic status. The flu can cause a viral-related exacerbation which can be associated decrease in the quality of life. The nurse is assisting the parents of a school-aged child with a plan to prepare him for the impending death of a family member. What would be the potential behavior of the school-aged child when faced with this stressor? Select one: a. Accepting behavior of this situation b. Uncooperative behavior c. Believe that death is temporary d. Same emotional demonstration as his parents B. Correct: School-aged children will often display fear of the unknown through uncooperative behavior. With heart failure pulses are weak or bounding? Weak due to poor systole Osteomylitis pain is usually (pulsating / sharp) pulsating Hypertonic or hypotonic DTRs are usually what happens in increased ICP Hypertonic Can you use a used car seat No You should use a rear facing car seat until the infant weighs how much 20lbs What is the time limit for a client visitation who is receiving internal radiation 30 mins once a day What pain scale can you use for a 3 year old FACES What pain scale can you use for a 5 year old numeric Which is more injurious - a corrosive liquid or a corrosive solid? A corrosive liquid What happens when treatment for bleach ingestion is focused on neutralization of the chemical Neutralization causes heat injury due to exothermic reaction. Is activated charcoal given for bleach poisoning no - it can infiltrate any tissue that is burned Do you need an arm board for a PICC line to stay in place No Which of the following requires further intervention of a 7 year old - Child complains daily about going to school Varicella is administered to children older or younger than 12 months? older than 12 months Live attenuated infleunza vaccine is given to children older or under 2 years of age older When feeding a child, parents should sit beside or in front of the child? In front of the child Which of the following should be included in feeding: - FOllow the child's cues as to when food and fluids are provided - Follow a consistent, structured routine of feeding the child at the same time and place - Follow a consistent, structured routine of feeding the child at the same time and place Will a failure to thrive child offer feeding cues? No What is the highest temperature water heater should be set to prevent burn injuries 120F / 49C Should infant walkers be wheeled? No Sexual characteristics should initiate at what age in boys 9 years Sexual characteristics should initiate at what age in girls 8 years precocious puberty a condition in which puberty begins before the age of 8 in girls and 9 in boys The head circumference of a school age child (increases / decreases) when compared to full height due to skeletal lengthening decreases The lower central incisors begin to shed at what age 6 Which of the following should be included in the plan of care of a child who underwent a surgical procedure that resulted in temporary loss of vision? - Assign an assistive personnel to feed the child - Explain sounds the child is hearing - Explain sounds the child is hearing The client should engage in as much self care as possible. The final dose of rotavirus is administered at ___ months 8 The herpes zoster vaccine is given to clients over the age ____ 60 Hopping on one foot is not developed until around the age of ___ years 4 Which of the following requires further assessment by the nurse for a 30 month old toddler? - Primary denition is complete - Unable to hop on one foot - Birth weight is tripled - Able to state first and last name - Birth weight is tripled The weight should be quadrupled The birth weight should triple by ___ months of age 12 The birth weight should quadruple by ___ months of age 30 Which of the follow is a risk factor for a stress-related reaction to hospitalization? - Age 10 - Frequent hospitalizations Frequent hospitalizations Which child is most at risk for hospitalization-related stress reaction - 10 year old - 3 year old - 3 year old Ages 6mo to 5 year most at risk for hospitalization related stress reaction Is it acceptable for an infants scrotum to be inside a urine collection bag? Yes, this assures a snug fit and prevention of leakage Your child should be referring to himself using the appropriate pronoun by ___ months of age - 18 - 30 - 10 30 Identification of the self does not occur until this time A toddler's interest in looking at pictures occurs at ___ months of age - 5 - 15 15 When should a toddler have daytime control of his bowel and bladder? 30 months Which is the most common food allergy in children? - Cows milk - Eggs Cows milk A dying preeschooler would or not view death as similiar to sleep would A dying preschooler would or would not be interested in what happens to his body after death would not A dying preschooler would or would not recognize death as permanent would not A dying preschooler would or would not believe his thoughts can cause death would A dying preschooler would or would not think his death is a punishment would Which should be done first when a kid ingests a toxic substance - Go to ED - Call poison control Call poison control How often are pinworm specimines collected? In the morning as soon as the child wakes up, and before the child bathes or has a bowel movement. Which of the following indicates an understanding of teaching for pinworm tx - I will give my child a dose of albendazole today and again in 2 wks - I will collect specimens immediately after my child has a bowel movement - I will give my child a dose of albendazole today and again in 2 wks Specimens are collected BEFORE BMs Which should be done for a pinworm-infected child: - Tub bath - The pneumococcal and influenza vaccines are recommended for your child Immunizations do NOT need to be restarted once the client is no longer immunocompromised nephrotic syndrome group of clinical signs and symptoms caused by excessive protein loss in urine RESTRICT SODIUM INTAKE RISK FOR INFECTION Which electrolyte should be restricted in a child who has acute glomerulonephritis? potassium Which electrolyte should be restricted in a child who has nephrotic syndrome sodium Which of the following is teaching for a kid who has nephrotic syndrome? - Restrict the child's potasisum intake - Keep the child away from people who have an infection - Keep the child away from people who have an infection Nephrotic syndrome has a higher chance of infection Which of the following is a legal food for celiac disease? - Plain flour - Wheat cereal - Scrambled eggs - Rye toast - Scrambled eggs Celiac = LOW GLUTEN What kind of foods should be avoided in celiac disease gluten Which of the following is appropriate for a 1 month old with GERD - I will give the lansoprazole 30 min after my baby's feedings - I will add rice cereal to my baby's feedings - I will add rice cereal to my baby's feedings This will thicken the feedings and decrease the number of vomiting episodes. Lansoprazole should be given 30min before feeding Lansoprazole for a 1 month old GERD client should be given 30 min before or after feedings before feedings Which of the following is appropriate teaching for a child who has cystic fibrosis? - Increase protein - Increase fiber Increase protein. Increasing fiber can increase bulk and malabsorption might occur. tracheomalacia softening of the trachea Which of the following is a manifestation of tracheomalacia? - Absence of bowel sounds - Neck contortions - Barking cough - Projectile vomiting Barking cough Which of the following is a manifestation of hiatal hernia? - Absence of bowel sounds - Neck contortions - Barking cough - Projectile vomiting Neck contortions Which of the following is a manifestation of hypertrophic pyloric stenosis? - Absence of bowel sounds - Neck contortions - Barking cough - Projectile vomiting Projectile vomiting In dehydration, urine specific gravity would increase or decrease? increase - because urine is more concentrated How often should fingers be exercised when the arm is in a cast Q4H first 24hr Which of the following indicates appropriate pediatric hypoglycemia care? - I will make sure my child drinks 240mL of milk ASAP - I will insist that my child lies down to rest for 30 mins - I will make sure my child drinks 240mL of milk ASAP Milk has carbs I guess congenital hypotonia Lack of normal muscle tone in neonate hydrocephalus accumulation of fluid in the spaces of the brain A nurse is caring for an infant following a cleft lip and palate repair. Which is indicated? - Clean the infant's incision with CHG - Use a suction catheter to gently remove the infant's oral secretions PRN - Use a suction catheter to gently remove the infant's oral secretions PRN Nurse should be using sterile water or sterile saline to clean the incision after each feedings Which of the following should the nurse use to clean an infant's cleft palate and lip - CHG - Sterile water Sterile water Boston Brace Molded plastic jacket. Used for low thoracolumbar and lumbar curves. In an entire 24 hours, how much time should be in a boston brace for a child with scoliosis? 23, 1hr only to shower or to participate in PT Should the straps of a boston brace be adjusted for any reason? No, this can decrease compression and contraction. Should a boston brace be worn over or under a t-shirt over a t shirt Which of the following indicates epiglottitis? - Lethargy - Spontaneous coughing Droplet What kind of precaution for meningococcal pneumonia Droplet What kind of precaution for measles Airborne What kind of precaution for varicella Airborne What kind of precautions for RSV contact What kind of precautions for shigella contact Which age will be able to ride a tricycle: - 3 - 4 - 5 3 Which age will be able to jump off bottom step: - 3 - 4 - 5 3 Which age will be able to stand on one foot for a few seconds: - 3 - 4 - 5 3 Which age will be able to Skip and hop on one foot: - 3 - 4 - 5 4 Which age will be able to throw a ball overhead: - 3 - 4 - 5 4 Which age will be able to reliably catch a ball: - 3 - 4 - 5 4 Which age will be able to jump rope: - 3 - 4 - 5 5 Which age will be able to walk backward with heel to toe: - 3 - 4 - 5 5 Which age will be able to throw and catch a ball with ease (not just overhead): - 3 - 4 - 5 5 At how many months will an infant have head lag? - 1 - 2 - 3 1, it goes away at 2nd month At how many months will an infant have a strong grasp reflex but does not yet hold hands in an open position? - 1 - 2 - 3 1, the grasp reflex should fade at 2 months At how many months will an infant be able to lift their head off their mattress when prone, and hold their hands in an open position? - 1 - 2 - 3 2 At how many months will an infant be able to raise their head and shoulders off the mattress when prone with only a slight head lag, and no longer have a grasp reflex? - 1 - 2 - 3 3 At how many months will an infant be able to roll from back to side and grasp objects with both hands? - 4 - 5 - 6 4 At how many months will an infant be able to roll from front to back and use palmar grasp dominantly? - 4 - 5 - 6 five - Preschool (3-6) - School age (6-12) - Adolescent (12-20) School age In terms of death, which one will rely more on their peers than their parents, increasingly stressed over physical appearance, experience guilt and shame, and may have difficulty accepting death ? - Infant/toddler (0-3) - Preschool (3-6) - School age (6-12) - Adolescent (12-20) Adolescent What foods should be avoided with celiac disease Gluten: Milk, cheese, rice, corn, eggs, potatoes, fruits, vegetables, fresh meats and fish, dried beans The ear should be pulled up and out for what age Adults The ear should be pulled down and back for what age <3 years How should clients be positioned when instilling eardrops Sit upright or lie on their side Infants with increased ICP would have what manifestations? High pitched cry, lethargy, vomiting, bulging fontanels, widening cranial suture lines, increased head circumference What will happen to DTRs in hypercalcemia decreased reflexes A high calcium level is what 10.5 or greater GI symptoms related to hypercalcemia Anorexia, nausea, vomiting, constipation Should you remove the dressing of a spina bifida? No, if it becomes dry (it should be moist), re-moisten it with NaCl How should a spina bifida infant be positioned Prone with hips flexed, legs abducted Should you give children their favorite foods during chemo No, they might end up developing an aversion to those foods Tetralogy of Fallot Four deficits: Pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Cyanosis at birth, systolic murmur, episodes of acute cyanosis and hypoxia (Tet spells) nocturnal enuresis bed wetting Should you rock a toddler at night to help them sleep? No. Briefly reassure the child if they wake up in the middle of the night before leaving the room. Rocking will result in trained night crying. Which of the following is an expected finding for coarctation of the aorta? - Low BP in the upper extremities - Weak or absent femoral pulses - Weak or absent femoral pulses Increase pressure will happen proximal to the affected limbs- so higher pressure in the upper extremities, lower pressure to the distal extremities Breastfeeding provides a complete diet for the first ____ months of life 6 Solid foods are introduced at around how many months of life 4 - 6 Fruits and vegetables should be introduced to the diet at how many months of life 6 Chopped, cooked, and unseasoned table foods are appropriate by how many months of age 12 months Honey cannot be introduced until how many months or years of life First year of life Drinking from a cop usually occurs at how many months of life Six Crib slats should be no farther than how many centimeters apart 6 cm or 2.375 in Can you heat breast milk or formula in the microwave No Newborn infant should be placed in a federally approved car seat at how many degree angle 45 Car seat shoulder harnesses should be in slots at or below the level of the infants _____ shoulders Where should the retainer clip be placed on the Infant who is going inside a car seat Axillary level Infant should be in a rear facing car seat until how many years of life 2 The anterior fontanelle should be closed by how many months of life 18 Toddler should grow about how many inches per year 3 in The head circumference should be equal to the chest circumference by how many years of life One to two years Walks without help, creeps upstairs, uses a cup well, build a tower of two blocks - 15 months - 18 months - 2 years - 2.5 years 15 months Runs clumsily, Falls often period throws ball overhand, jumps in place with both feet period pushes and pulls toys. Manages a spoon without rotation, turns pages in a book, two or three pages at a time, builds Tower of 3 or 4 blocks - 15 months - 18 months - 2 years - 2.5 years 18 months Walks up and downstairs by placing both feet on each step, runs with a wide stance, kicks ball forward without falling period. Build a tower of six or seven blocks,turns pages in a book one at a time - 15 months - 18 months - 2 years - 2.5 years 2 years Jumps across the floor, off a chair or step using both feet period takes a few steps on tiptoe, stands on one foot momentarily. Draw circles and Crosses, has good hand finger coordination - 0 - 3yrs - 3 - 6 yrs - 6 - 12 yrs - 12 - 20 yrs 0 to 3 years Egocentric thinking, magical thinking allows this age to believe thoughts may cause an event such as death, may feel guilt or shame, interpret separation from parents as punishment for bad behavior,views death as temporary, believes that are gone to sleep - 0 - 3yrs - 3 - 6 yrs - 6 - 12 yrs - 12 - 20 yrs 3 to 6 years When Cooperative Behavior in death - 0 - 3yrs - 3 - 6 yrs - 6 - 12 yrs - 12 - 20 yrs 6 to 12 years Patent ductus arteriosus Blood shunts from aorta to pulmonary artery. Causes mixing of oxygenated blood with deoxygenated blood Press charges dress, murmur, bounding pulses, widened pulse pressure, poor feeding Ventricular septal defect Opening of the septum between the left and right ventricle Loud, harsh murmur oscillated at the left sternal border, mild cyanosis that increases with crying, and heart failure Atrial septal defect Opening in the septum between the left and right Atria Murmur, shortness of breath with activity, frequent respiratory infections,and frequent heart palpitations Tetralogy of Fallout 4 heart defects which causes cyanosis and hypoxia, cardiomegaly, hard failure, and systolic murmur Repair must be completed within the first year of life Transposition of great vessels Aorta exits the right and ventricle instead of the left, pulmonary artery originates from the left ventricle instead of the right Causes cyanosis,cardiomegali, and heart failure Coarctation of the aorta Nearing of the aortic Lumen,resulting in obstruction of blood flow from The ventricle Elevated blood pressure in the upper extremities, decrease blood pressure in the lower extremities,dizziness, Syncopy, headache, heart failure Infants with spina bifida should be placed in what position Prone For common foods links to a latex Allergy Bananas, avocado, chestnuts, kiwi Hypertrophic pyloric stenosis Thickening of the pyloric sphincter, which causes obstruction. Most common within the first five weeks of life Projectile vomiting, constant hunger,poppable Olive shaped mass in the right upper quadrant,dehydration, failure to thrive Hirschsprung's Disease Colon becomes aganglionic, resulting in decreased motility and obstruction In infants, indicated by failure to pass monocam stole within 48 hours period with constant vomiting episodes, and abdominal distension And infants,includes constipation, abdominal distention, failure to thrive, and episodes of vomiting An older children, presents with ribbon-like stool Intussusception Telescoping of the intestine upon itself. Palpable, sausage-shaped mass in the right upper quadrant Souls are mixed with blood and mucus and has the consistency of red currant jelly Should be placed in po Acute Epiglottitis Usually from H. Influenzae - Strider, drooling, tripod position,high fever, dysphagia, dyspnea, muffled frog-like voice, tachypnea, tachycardia This is considered a medical emergency. Do not put anything in the mouth Acute Laryngotracheal Bronchitis Inspiratory Stridor, barking, brassy cough, hoarseness, restlessness, irritability, substernal retractions, low grade fever Elevated with cold air, steroids Acute Spasmodic Laryngitis We suddenly with Dyspnea usually at night, barking, metallic cough, Strider, horseness, disappears usually during the day Manifestations are reduced with cool mist and steroids Nothing should be given to infants with a respiratory rate greater than how many breaths per minute for your mouth 60 Why is Meperidine not used for the treatment of pain and single cell anemia Produces and metabolite that can cause tremors, anxiety,and generally seizures Which of the following interventions is appropriate for a child who has a tunnel central venous access site Use sterile scissors to remove the dressing from the site Each Lumen weekly with 10 mL of sodium chloride when not in use Access the site using a non-coring angled needle Uses semi permeable transparent dressing to cover the site Uses semi permeable transparent dressing to cover the site Each lumen should be flushed with Heparin daily when not in use Which of the following is expected for a 6 month old who was teething They will pull attheir ears as their teething The upper middle teeth will erupt first They will pull attheir ears as they are teething The lower Central incisors are the first teeth that will erupt Which of the following is appropriate teaching for a child who is postoperative cardiac catheterization Wait 3 days before taking a tub bath Apply a pressure dressing to the site for 3 days