If there is a foreign body in the larynx, how will the client present?
With stridor
A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia?
Increased RBC
A parent is asking for more information about their infant's patent ductus arteriosus (PDA). What would be included in the education?
This is caused by an opening that usually closes by 1 week of age.
A nurse manages the interdisciplinary care for a client with pancreatitis. What are recommended interventions for this condition? Select all that apply.
-Providing glycemia control
-Keeping the child NPO to rest the pancreas
-Administering analgesics for pain
-Positioning the client in a fetal position
In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate that she would:
prepare the infant for surgery.
A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6� F (39.2� C). The caregiver has tried to get the c
Epiglottitis
In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason?
Relief of acute symptoms
A group of nurses is reviewing the diagnosis of cystic fibrosis. With regard to the effect of this disease on the body, in addition to the lungs which parts of the body are most affected by this disease?
Pancreas and liver
The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be:
Chronic lack of oxygen
In caring for the child with rheumatic fever, which medication would the nurse likely administer?
Tylenol
The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?
Projectile vomiting
After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma?
Shellfish
The school nurse is caring for a 12-year-old boy with a bloody nose. Which action would be most appropriate for the nurse to do?
Seat the child leaning forward and pinch the anterior portion of the nose closed.
A parent brings an infant in for poor feeding. Which assessment data would most likely indicate a coarctation of the aorta?
Pulses weaker in lower extremities compared to upper extremities
The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate?
Offer 'magic mouthwash' followed by a popsicle.
A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?
We should not stop this medication abruptly.
A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed?
We can stop the penicillin when her symptoms disappear.
A 6-year-old girl is diagnosed with pulmonary stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother?
Insertion of a catheter with an uninflated balloon tip into the affected valve, followed by inflation of the balloon to break up adhesions
Inguinal hernia usually occurs in girls.
False
The nurse is caring for an 8-month-old infant with a suspected congenital heart defect. The nurse examines the child and documents which expected finding?
Softening of the nail beds
When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?
The liver size increases in right-sided heart failure.
The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in his stools. The clinical manifestation this caregiver is describing is:
steatorrhea.
During a class for caregivers of children with asthma, a caregiver asks the nurse the following question when medications are being discussed. "They told me about a plastic device my child can hold in his a hand which will give him a premeasured and exact
Metered-dose inhaler
The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet?
Bananas
What measure at home could help a child with an upper respiratory infection breathe more easily?
Increasing room humidity
A 4-year-old girl has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. Her parents are extremely distraught over her condition and the fact she has not wanted to eat anything for the past 2 days. Which nursing approach would be mo
Allow the parents to remain with the child as much as possible.
You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if:
she has a temperature.
At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important?
Taking pedal pulses for the first 4 hours
The nurse identifies a nursing diagnosis of Ineffective airway clearance related to inflammation and copious thick secretions. What action is the priority?
Suctioning secretions from the airway
The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching?
The feeling of the heart skipping a beat is common.
After assessing a child, the nurse suspects coarctation of the aorta based on a finding of:
femoral pulse weaker than brachial pulse.
A child with heart disease is receiving digoxin and a diuretic. Which laboratory test result would be most important for the nurse to monitor?
Serum potassium level
An 8-year-old girl presents with drooling and a complaint of painful swallowing. She has a high fever and is lethargic. On examination the nurse sees that her palatine tonsils are bright red and swollen. The girl's mother says that she has never had these
Antipyretic, analgesic, and antibiotic
The young child has been diagnosed with group A streptococcal pharyngitis. The physician orders amoxicillin 45 mg/kg in three equally divided doses. The child weighs 23 lb (10.45 kg). Calculate how many milligrams the child will receive with each dose of
157
A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate?
Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment.
The nurse is assessing the heart rate of a healthy 6-month-old. In which range should the nurse expect the infant's heart rate?
90 to 160 bpm
A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse?
Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses.
The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond?
It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain.
The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond?
I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately.
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?
In this disorder the sphincter that leads into the stomach is relaxed.
A parent asks if the reason her infant has a congenital heart defect is because of something she did while she was pregnant. What is the best response by the nurse?
There are several reasons a baby can have a heart defect, let's talk about those causes.
A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see?
Peeling hands and feet and fever
What is a symptom of bacterial pharyngitis?
Fever
What is a complication of cystic fibrosis?
Pneumothorax
A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. What would be the b
I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?
An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority?
Place the infant in the knee-chest position.
A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention?
Notify the doctor immediately.
A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect?
The child will need the blood pressure checked two more times.
Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes?
Before meals and snacks with milk
A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting br
Acute upper GI bleeding
A nurse explains to the family of an infant with an inguinal hernia that the surgeon will attempt manual reduction prior to surgical repair. Which statement describes this technique?
The client is sedated and the incarcerated contents of the hernia are manipulated back into the peritoneal cavity.
A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointe
Gastroenteritis
A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?
Lower right
The caregivers of an 8-year-old bring their child to the pediatrician and report that the child has not had breathing problems before, but since taking up lacrosse the child has been coughing and wheezing at the end of every practice and game. Their frien
a bronchodilator and mast cell stabilizers.
The nurse is caring for a child admitted with asthma. Which clinical manifestations would likely have been noted in the child with this diagnosis?
Wheezing
The nurse is reinforcing teaching with the parents of a 2-year-old who has cystic fibrosis regarding medications. The nurse suggests that pancreatic enzymes may be given by which method?
Sprinkled onto the food
The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed?
Digoxin
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after v
Pyloric stenosis
The infant has been hospitalized and develops hypercyanosis. The physician has ordered the nurse to administer 0.1 mg of morphine sulfate per every kilogram of the infant's body weight. The infant weighs 15.2 lb (6.81 kg). Calculate the infant's morphine
0.7
The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to:
be at risk for respiratory distress.
A nurse is interviewing a mother who is about to deliver her baby. Which response would alert the nurse for a higher potential for a heart defect in the infant?
The mother states she has lupus.
The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breath. The signs the nurse noted indicate the child likely has:
epiglottitis.
What statement is the most accurate regarding the structure and function of the newborn's respiratory system?
Most infants are nasal breathers rather than mouth breathers.
The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child?
Sweat sodium choloride test
A 7-year-old child has been scheduled for a tonsillectomy. What would be most important to assess prior to surgery?
Bleeding and clotting time
You see a 3-year-old boy in an ambulatory setting for localized wheezing on auscultation. Which statement by his mother would be most important to report?
The child was eating peanuts yesterday.
Which nursing diagnosis would be most appropriate for a child with pneumonia during the acute phase of illness?
Activity intolerance related to poor oxygen-carbon dioxide exchange
An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care?
He will become fatigued easily.
A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet?
Eggs and orange juice
The nursing diagnosis you anticipate that would best apply to a child with allergic rhinitis is:
pain related to sinus edema and headache.
When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover?
Polycythemia
The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority?
Place the child in a knee-to-chest position.
The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. What is the most important instruction to emphasize to the mother to avoid an emergency situation?
Call the doctor immediately if the stoma is not pink/red and moist.
The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching?
I can tape a quarter over the hernia to reduce it.
A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention?
Prevention of hypoglycemia
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?
Tenting of skin
A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child?
Lower extremities
The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their
Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs.
The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore� Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply.
-"We will be sure to not allow our child to ride a bicycle for at least 2 weeks."
-"We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed."
-"We will be sure to monitor our child f
A child will be undergoing a Holter monitor test. Which statement by the mother indicates the need for further instruction?
My child cannot have any thing to eat or drink after midnight the day of the test.
A nurse is caring for a child that just had open-heart surgery and the parents are asking why there are wires coming out of the chest of the infant. What is the best response by the nurse?
These wires are connected to the heart and will detect if your child's heart gets out of rhythm.
A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate?
Esophageal atresia (EA)
An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse?
It will determine if the heart is enlarged.
The nurse working at the child community clinic must administer the influenza vaccine to the high-risk kids first. Which child would she choose?
23-month-old Ava who had heart surgery as an infant for a defect
The nurse is administering medications to a child with cystic fibrosis. Which method would the nurse most likely use to give medications to treat the pancreatic involvement seen in this disease?
Open capsule and sprinkle on food
The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea.
Pancreatic enzymes
The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child's caregiver that the child may:
Vomit dark, old blood, but the caregiver should call the clinic if the child has bleeding between the fifth and seventh days postoperatively
The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and
Epiglottitis
The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?
The treatment for the disorder will be a surgical procedure.
Which nursing diagnosis would best apply to a child with rheumatic fever?
Activity intolerance related to inability of heart to sustain extra workload
Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition?
Assessing for the presence of femoral pulses
The nurse is reviewing the laboratory test results of several children who have come to the clinic for evaluation. Which child would the nurse identify as having the least risk for hyperlipidemia?
Child A with a total cholesterol of 150 mg/dL and low-density lipoprotein (LDL) of 80 mg/dL.
The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that
High-frequency sound waves are directed toward the heart
The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond?
You will most likely have a blood test to check for certain antibodies.
The nurse is caring for a 14-month-old boy with cystic fibrosis. Which sign of ineffective family coping requires urgent intervention?
Compliance with therapy is diminished.
The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disord
Esophageal atresia
The nurse is caring for a newborn following delivery who has been diagnosed with gastroschisis. Which actions by the nurse indicated knowledge of appropriate care for this disorder?
-The nurse assesses the color of the newborns abdominal organs
-The nurse places the newborn in a radiant warmer to maintain the newborn's temperature
-The nurse closely monitors the hydration status of the newborn for signs of dehydration
The nurse is caring for an infant recently diagnoses with thrush and was prescribed nystatin. Which statement by the infant's mother would suggest a need for further education?
I will add the nystatin to her bottle four times per day.
A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply.
-Reduced hemoglobin levels
-Elevated erythrocyte sedimentation rate (ESR)
Which age of children have a trachea 4 mm long?
Newborn
What is the most common debilitating disease of childhood among those of European descent?
Cystic fibrosis
Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to:
gastroesophageal reflux disease.
The nurse is caring for a 6-month-old infant who has chronic apneic episodes. Which intervention should the nurse institute?
Place on a cardiopulmonary monitor and do frequent assessments.
What would the appropriate nursing intervention be for a child with an ineffective breathing pattern?
Provide oxygen as needed to maintain oxygen saturation above 93%.
A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response?
The surgery creates an opening between the stomach and abdominal wall.
The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:
Painless rectal bleeding
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?
Hirschsprung disease
The nurse is admitting a child who is experiencing an asthma attack. Which clinical manifestation would likely be noted in this child?
Wheezing
The nurse is working with a group of caregivers of children diagnosed with asthma. Which statement made by the caregivers is most accurate regarding the triggers that may cause an asthmatic attack?
My sister and her family love animals, and when we go to their house my daughter always has an asthma attack.
After tonsillectomy surgery, the preferred position of a child until fully awake is on the:
abdomen with a pillow under the chest.
During an assessment, a child exhibits an audible high-pitched inspiratory noise. The nurse documents this as:
stridor.
A child with asthma has been monitoring his peak expiratory flow rate (PEFR) and has been maintaining it within 90% of his personal best. Today, the child is experiencing symptoms and his PEFR is at 40% of his personal best. The child's mother calls the o
Have him use his short-acting bronchodilator right away.
A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason?
Detect Helicobacter pylori
A Mantoux skin test is used to screen for tuberculosis.
True
The child has been admitted to the hospital with a possible diagnosis of pneumonia. Which findings are consistent with this diagnosis? Select all that apply.
-The child's chest x-ray indicates the presence of perihilar infiltrates.
-The child's respiratory rate is rapid.
-The child's white blood cell count is elevated.
-The child is producing yellow purulent sputum.
The nurse is working with the mother of a toddler experiencing constipation. What information regarding childhood constipation should the nurse share with the mother? Select all that apply.
-"Have your son sit on the toilet twice a day, after breakfast and dinner, for 5 to 15 minutes."
-"If your child has a fecal impaction, you can give him an enema."
-"Reward your child for sitting on the toilet as asked, not just when they have a bowel
The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time?
Improving hydration
The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?
Hard, moveable "olive-like mass" in the upper right quadrant
The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.
-"Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders."
-"The only treatment for celiac disease is a strict gluten-free diet."
-"Gluten is found in most wheat products, rye, barley and possibly oats.
The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents, regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred?
I have to be careful because I am prone to not absorbing nutrients.
The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred?
-"I should be sure my child receives 50 to 100 mL/kg of oral rehydration solution (ORS) over 4 hours."
-"Oral rehydration solutions (ORS) are good sources of fluids for rehydration."
-"I should not give my child any fluids for 1 to 2 hours after an episod
The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?
Mother age 42 with pregnancy
A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which findings would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply.
-Sunken fontanels.
-Cool mottled extremities.
-Bradycardia.
The nurse is collecting data on a 2 �-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?
Tell me about the types of stools you child has been having.
What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn?
Hematocrit and WBC counts elevate
The nurse is caring for a child with burns in a pediatric hospital. What would be an appropriate nursing diagnosis for this client?
Acute pain related to thermal injuries and procedures
In caring for a child with nephrotic syndrome, which interventions will be included in the child's plan of care?
Weighing on the same scale each day
The nurse is working with a group of caregivers of school-age children discussing fractures. The nurse explains that if the fragments of fractured bone are separated, the fracture is said to be:
Complete
The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at:
Reducing swelling and relieving itching
A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she
There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months.
The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?
Tea-colored urine
The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea, the students make the following statements. Which statement made by the nursing students is the m
Emotional stress can be a cause of this disorder.
The nurse is caring for a newborn with facial nerve palsy from birth trauma. The mother is very upset and concerned about the child's prognosis. Which response by the nurse would be most appropriate?
In most cases treatment is not necessary, only observation.
A nurse is preparing a plan of care for an infant who has undergone surgery to repair a myelomeningocele. The nurse would include placing the infant in which positions postoperatively? Select all that apply.
-Prone.
-Right side lying.
-Left side lying.
The nurse is teaching the parents of a 6-year-old who has sustained a large laceration about providing care to the wound at home. The nurse determines that the parents need additional teaching when they state:
We need to keep the wound tightly bandaged for at least 3 days.
A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame?
1 week
A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?
Creatinine clearance rate
A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure?
Encouraging fluid intake after dinner
When a child is suspected of having muscular dystrophy, a nurse should expect which muscles to be affected first?
Muscles of the hip
Idiopathic scoliosis is the most common form that occurs.
True
A nurse is providing instructions for home cast care. Which response by the parent indicates a need for further teaching?
Pale, cool, or blue skin coloration is to be expected.
The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy?
Gowers sign
A nurse is caring for a 13-year-old boy with end-stage renal disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?
Withhold his routine medication until after dialysis is completed
A child has an order for an erythrocyte sedimentation rate (ESR). The child's mother asks what the purpose of the test is. What is the best response by the nurse?
This test will tell if your child has an infection or inflammation somewhere in their body.
A parent is asking how she can help her son deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?
Demonstrate love and acceptance at home.
The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions?
Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.
In caring for a child in traction, of the following interventions, which is the highest priority for the nurse?
The nurse should monitor for decreased circulation every four hours.
The nurse is caring for a child admitted with partial thickness burns. What is most characteristic of this type of burn?
Blisters appear
The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?
Spica cast
A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since
The child has been sexually abused, maybe on the fishing trip
The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their die
A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily.
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:
Obtaining a clean catch voided urine
Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant?
Risk for infection related to immunocompromised state
The nurse is caring for a child recently fitted with braces on both legs due to cerebral palsy (CP). What would the nurse emphasize in the discharge teaching?
Check the skin that is covered by the braces for redness and breakdown.
The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe?
Edema with wet blistering skin
An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do?
Premedicate the child before changing the dressing.
Based on knowledge of the progression of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first?
Standing
The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. The
Duchenne muscular dystrophy
The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?
Our son's condition may resolve on its own.
A young female has been prescribed corticosteroids for dermatomyositis. Which statements by her mother indicates the need for further education? Select all that apply.
We are taking her to Disney in the summer."
"I give it to her first thing in the morning before breakfast.
The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?
Grilled chicken, half of a banana, and flavored water
The nurse is caring for a child, weighing 100 pounds, on the burn unit who has partial-thickness burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse?
Urine output of 15 mL per hour over the last 4 hours
The nurse is caring for a child with an order for silver sulfadiazine 1% for a burn. What would make the nurse question this order?
The burn is on the child's face.
The nurse is caring for a child with an order for PO prednisone. Which statement by the child's mother would indicate a need for further education?
I will give it to her at least 1 hour before all of her meals.
A newborn is diagnosed with hypospadias and the parents want him to be circumcised. What would be the best response by the nurse?
The foreskin is needed for repair.
The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation?
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is:
Skeletal traction
Urinary tract infections are usually successfully treated by what means?
Administering antibiotics
A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz i
A dull, aching abdominal pain at ovulation
A 3-year-old is scheduled for a surgery to correct undescended testes. An important postoperative consideration the nurse would want to prepare the parents for is:
some discomfort at the surgery site.
An adolescent asks you how to best prevent vulvovaginitis. Your best answer would be to:
wipe from front to back after urinating or defecating.
The nurse is providing discharge teaching to an adolescent who has been treated for pelvic inflammatory disease (PID). What would the nurse include as a preventive measure?
Insisting that sexual partners use condoms
The nurse is caring for a 10-year-old girl in traction. The girl is experiencing muscle spasms associated with the traction. What would the nurse expect to administer if ordered?
Diazepam
An infant with a femur fracture is placed in Bryant traction. What would the nurse include in the infant's plan of care?
Keeping the buttocks slightly elevated
The nurse is caring for a 2-year-old boy with a burn. What finding would warrant referral to a burn unit?
A chemical burn
A client with muscular dystrophy has lost complete control of his lower extremities. He has some strength bilaterally in the upper extremities, but poor trunk control. Which mechanism would be the most important to have on the wheelchair?
Wheelchair belt
Through which mechanism is Duchenne muscular dystrophy acquired?
Heredity
A 16-year-old girl visits her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she was prescribed an oral contraceptive at her
Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that.
A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client?
Teach the client not to rest with the crutch pad pressing on the axilla.
The nurse is conducting a physical examination of a boy with erythema multiforme. Which assessment finding should the nurse expect?
Lesions over the hands and feet, and extensor surfaces of the extremities with spread to the trunk
The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching?
We should avoid using petroleum jelly.
An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client?
Disturbed body image
A 10-year-old has been bitten on the lower posterior arm by a dog, requiring several stitches. The child was just admitted to the hospital for 3 days of antibiotic therapy. When developing the care plan, the nurse identifies which nursing diagnoses as bei
-Impaired skin integrity.
-Risk for infection.
The nurse is caring for a child brought to the emergency department by the parents. Upon assessment the physician suspects the child has been bitten by a spider. While obtaining the nursing history of the present condition, which statement by the parent w
Since my child just has a rash around the area of the bite there is nothing to worry about.
A neonatal nurse examines an infant and notes decreased hip motion that causes pain upon movement. This nurse suspects Legg-Calv�-Perthes disease, a common pediatric hip disorder that causes pain and decreased hip motion, possibly leading to a femoral hea
True
The nurse is caring for a pediatric client with multiple wounds from a bike accident. What is the best method for cleansing or washing out the wound?
Use normal saline solution to wash the wound.
The nurse knows this is a description of peritoneal dialysis when compared to hemodialysis:
The child can live a more normal lifestyle.
The nurse is caring for a child diagnosed with Legg-Calv�-Perthes disease. Of the following nursing interventions, which would be most important for the nurse to include in working with this child and the child's caregivers?
The nurse should help the caregivers to understand and the child to effectively use the corrective devices.
The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children. The nurse most likely is referring to:
impetigo.
A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this?
Take over-the-counter ibuprofen for its prostaglandin action.
The nurse is caring for a 10-year-old boy with end-stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to administer if ordered?
Sodium bicarbonate tablets
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?
Testis cannot be "milked" down inguinal canal
The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record?
Low serum calcium levels
Which nursing diagnosis will the nurse prepare for the infant who is placed prone to protect the myelomeningocele repair site?
Risk for impaired skin integrity
The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as:
Hypospadias
The nurse receives a report on a child admitted with severe muscular dystrophy. The nurse suspects the child has been diagnosed with the most severe form of the disease, known as:
Duchenne.
The mother of a 3-year-old with a myelomeningocele is thinking about having another baby. The nurse should inform the woman that she should increase her intake of which acid?
Folic acid above 0.4 mg/day
A 6-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?
Wait a year or two to see whether the testes will descend on their own
A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching?
We should bathe our child in hot water, twice a day.
The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?
Second degree frostbite
The nurse is conducting a physical examination of a 9-month-old infant with a suspected neuromuscular disorder. Which finding would warrant further evaluation?
Presence of Moro reflex
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?
Hypertension
The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall
Community acquired MRSA
The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?
Impetigo
The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most import
You and your coaches need to understand that you cannot play soccer for at least six weeks.
The nurse is caring for a 10-year-old child in traction. After performing a skin assessment, she notices that the skin over the calcaneus appears slightly red and irritated. What should be the first intervention?
Reposition the child's foot on a pressure-reducing device.
Which intervention is the most beneficial for a burn client undergoing a skin graft?
Provide around-the-clock pain medication as soon as pain is reported.
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?
Encourage high fluid intake.
In discussing the treatment for children with scoliosis, a group of pediatric nurses makes the following statements. Which statement is most accurate related to the treatment of scoliosis?
Children treated for scoliosis by using braces have to wear the brace almost all the time.
An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable ap
That's not an uncommon reaction, although it's hard on you and on your child.
The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse
The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place.
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his t
acute glomerulonephritis.
A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, the nurse would want to prepare her to:
void during the procedure.
The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.
-Color.
-Sensation.
-Pulse.
-Capillary refill.
The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a child abuse-induced burn?
Stocking-glove pattern on hands or feet
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?
Absence of a thrill
A pediatric client was brought to the emergency department by the parents after experiencing extensive urticaria following consumption of a seafood dinner. Upon discharge from the facility the nurse provided client teaching. Which statement by the parents
We need to get our child a medical alert bracelet as soon as possible in case this happens again.
The nurse is monitoring the intake and output of a client with deep partial-thickness burns. The child weighs 75 pounds. The nurse will contact the physician if the child's urine output drops below how many milliliters per hour? (Round you answer to the n
34
The school nurse cares for children with overuse injuries and refers them for treatment. Which statements accurately describe conservative interventions to prevent or care for these types of injuries? Select all that apply.
-Encourage 1 to 2 days off per week of competitive athletics.
-Perform appropriate stretching during a 20-to 30-minute warmup.
-Apply ice to the injured area to reduce inflammation.
The nurse is working in a community setting and receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo, and the director of the day care center wants to know whether she should be concerned. The nu
Impetigo is highly contagious and can spread quickly.
In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?
Cartilage
In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder?
Asthma
While an adolescent wears a body brace for scoliosis, you would teach her:
to continue with age-appropriate activities.
The nurse is caring for an 11-year-old presenting with tenderness in the shoulder. He is the pitcher for his baseball team and reports shoulder pain with active internal rotation but is able to continue past the pain with full range of motion. Based on th
epiphysiolysis of the proximal humerus.
The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification?
Type II
A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as:
significant bending without actual breaking.
The nurse is caring for a child with urticaria. What is the priority action?
Assessing the child's airway and breathing and noting any wheezing or stridor
The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal?
Creatine kinase
The nurse caring for a client with suspected muscular dystrophy would prepare her client for which diagnostic test?
Muscle biopsy
Which diagnostic measure is most accurate in detecting neural tube defects?
Significant level of alpha-fetoprotein present in amniotic fluid
A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast?
Assess the fingers for warmth, pain, and function
The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instru
Peanut butter and jelly sandwich
The nurse has completed client teaching with a 16-year-old female who has been prescribed Accutane (isotretinoin) for cystic acne. Which statements indicate learning has occurred? Select all that apply.
If I am sexually active I need to let my doctor know."
"It's important I get my CBC blood test when my doctor orders it."
"This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her.
The parents of a child diagnoses with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse?
Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis.
The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education?
As long as he takes a shower as soon as he gets inside, he shouldn't get this again.
The parents of an 8-year-old boy diagnosed with frostbite are distraught and state to the nurse, "We can't believe we didn't make our child come inside when he complained about his fingers being numb and hurting." How should the nurse respond?
I can't imagine how you are feeling right now, but I'm sure you had no idea frostbite could happen. We will take good care of your son.
The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test?
Skin scrapings
The nurse is caring for an 8-year-old girl in traction. She has been in an acute care setting for two weeks and will require an additional 10 days in the hospital. She is showing signs of regression with thumb sucking and pleas for her tattered baby blank
Let's ask your mom to bring your friends for a visit.
Which intervention is the most effective in treating burn wound infections?
Topical antibiotics applied to the wound site
The nurse is caring for a child who has just had a plaster cast applied to the arm. The nurse is correct in performing which action with this child?
Handling the cast with open palms when moving the arm.
The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris?
Sometimes I get acne when I use my sister's makeup.
The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct t
Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?
Blood pressure 136/84
The nurse is evaluating parents' understanding of atopic dermatitis. Which statement shows their understanding?
Flare-ups of lesions are not uncommon following therapy.
After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant?
Baclofen
A nurse is performing a physical examination of a child with a suspected musculoskeletal dysfunction. Which assessment technique would the nurse assume would not be used?
Auscultation
A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful?
I should not cover the area with plastic wrap after applying the cream.
The nurse is providing postoperative care for a boy who has undergone surgical correction for pectus excavatum. The nurse should emphasize which instruction to the child's parents?
Do not allow him to lie on either side.
The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?
Weigh the old dialysate
The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education?
I will use rubber pants over the cloth diapers in the future.
A nurse is caring for an infant who is experiencing heart failure. What would be the most appropriate care for this infant?
Administer oxygen.
The nurse is administering medications to the child with congestive heart failure. Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level?
Digoxin (Lanoxin)
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?
Eyes
The nurse is conducting a presentation for a group of nurses who work with adolescents. The group of nurses discusses dysmenorrhea. Which statement is most accurate related to dysmenorrhea?
A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.
The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis?
We have taken the carpet out of our house and let my mom take our dog.
A 4-year-old girl has acute nasopharyngitis (a common cold). What measure would the nurse want to teach her parents?
A cough that accompanies a cold should rarely be suppressed.
Infants with congenital heart disease should not be allowed to become dehydrated because this makes them prone to:
cerebrovascular accident.
An 8-month-old has a ventricular septal defect. Which nursing diagnosis would best apply?
Ineffective tissue perfusion related to inefficiency of the heart as a pump
A group of nursing students are reviewing information about variations in the anatomy of a child's respiratory tract structures in comparison to adults. The students demonstrate an understanding of the information when they describe the shape of the laryn
funnel.
A nurse is providing supplemental oxygen therapy to a young child. Based on the nurse's understanding of oxygen delivery methods, what would the nurse expect to be used to deliver the highest concentration of oxygen to the child?
Nonrebreathing mask
The nurse is preparing a presentation for a local community parent group about measures to prevent the common cold. What would the nurse stress as a vital prevention measure?
Frequent hand washing
The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use?
Apply a urine bag to the anal area.
A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?
Barium enema
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?
Sudden onset of severe scrotal pain with significant hemorrhagic swelling
A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis?
Tetralogy of Fallot
A 12-year-old girl reports pain and a burning sensation on urination. The nurse suspects a urinary tract infection. Which diagnostic test would be most appropriate for confirming this condition?
Urine culture