1. What will the nurse tell parents of a child with a positive throat culture for group A hemolytic streptococcus that the treatment is most likely to be?
a. Acetaminophen and plenty of fluids
b. Oral penicillin for 10 days
c. Penicillin until his sore th
b. Oral penicillin for 10 days
When a throat culture is positive for group A beta-hemolytic streptococcus, penicillin is administered for 10 days even if symptoms are alleviated before the medication is finished.
Which initial intervention will the nurse suggest to the parents of a child experiencing laryngeal spasm?
a. Take the child outside in the cool air.
b. Bring the child directly to the emergency department.
c. Take the child to the bathroom and turn on a h
c. Take the child to the bathroom and turn on a hot shower.
The nurse would observe a child for frequent swallowing after a tonsillectomy and adenoidectomy (T&A). What might this indicate?
a. Bleeding from the surgical site
b. Pain at the incision area
c. Sore throat from postnasal drip
d. Potential vomiting
a. Bleeding from the surgical site
Hemorrhage is the most common postoperative complication. Blood trickling down the back of the child's throat could cause frequent swallowing.
What is the best choice for fluid replacement that the nurse can offer a child who has just had a tonsillectomy?
a. A popsicle
b. Chocolate milk
c. Orange juice
d. Cola drink
a. A popsicle
Small amounts of clear liquids can be offered to the child. Synthetic fruit juices are not as irritating as natural juices. A popsicle is usually well-tolerated.
When auscultating breath sounds of an infant with respiratory syncytial virus, which assessment would the nurse immediately report?
a. Respiration rate decrease from 40 to 32 breaths/min
b. Heart rate decrease from 110 to 100 beats/min
c. "Quiet chest" fr
c. "Quiet chest" from previous assessment of wheezing
A "quiet chest" after assessment of wheezing indicates occlusion of air pathways and impending respiratory arrest. All other options are within normal range for infants undergoing oxygen administration
What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find?
a. Fine crackles
b. Coarse rhonchi
c. Expiratory wheezing
d. Decreased breath sounds at lung bases
c. Expiratory wheezing
The child experiencing an acute asthma attack wheezes as air moves in and out of the narrowed airways. The expiratory wheeze is most pronounced.
What is the best intervention for the nurse caring for a child experiencing an acute asthma attack?
a. Offer plenty of fluids, particularly carbonated beverages.
b. Place the child in a humidified cool mist tent with oxygen.
c. Administer sedatives as ord
d. Position the child with arms resting on the overbed table.
This position is comfortable and allows maximum use of the accessory muscles for breathing. Sedatives would mask symptoms of increasing air hunger. Carbonated beverages are contraindicated in p
What should the nurse explain to the parent of a child with exercise-induced asthma about when to inhale Cromolyn?
a. Before exercise to prevent attacks
b. At the initial onset of the attack
c. During the attack to relieve symptoms
d. As often as 4 times
a. Before exercise to prevent attacks
Anti-inflammatory inhalants are taken before exercise to prevent attacks. These drugs can do nothing for the attack in progress. They are meant to be used as prophylactic therapies.
The parents of a 3-month-old infant with cystic fibrosis (CF) want to know how their child got this disease, because no one in either of their families has CF. What is the nurse's best response based on the understanding of CF?
a. Only one parent carries
b. Both parents are carriers of the CF gene.
Cystic fibrosis is an inherited disease. Both parents must be carriers of the CF gene for the child to have the disease.
Which statement indicates that the child's parents understand how to perform respiratory therapy?
a. "We do her postural drainage before the aerosol therapy."
b. "We give her respiratory treatments when she is coughing a lot."
c. "We give the aerosol foll
c. "We give the aerosol followed by postural drainage before meals."
Postural drainage for the child with CF is done following nebulization. Therapy is best scheduled before meals or at least 1 hour after eating to prevent vomiting.
What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients?
a. Pancreatic enzymes
b. Water-soluble minerals
c. Fat-soluble vitamins
d. Salt supplements
a. Pancreatic enzymes
An oral pancreatic enzyme is given to the child with every meal and with snacks to replace the pancreatic enzymes that the child's body cannot produce.
How would the nurse advise a mother to clear the nostrils when her infant has a cold?
a. Clear the nasal passages after the infant has a feeding.
b. Use over-the-counter nose drops to clear passages.
c. Remove nasal secretions with a bulb syringe.
d. Inst
c. Remove nasal secretions with a bulb syringe.
The nasal passages can be cleared by instilling a few drops of saline into the nose and then suctioning the secretions with a bulb syringe.
The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the fluid loss through dyspnea. Which fluids are most appropriate?
a. Room temperature water
b. Carbonated beverages
c. Iced fruit juice
d. Cold milk
a. Room temperature water
Room temperature fluids are the best. Carbonated and iced beverages increase spasm. Milk stimulates mucus production.
The asthmatic child who has been taking theophylline complains of stomachache and tachycardia and is sweating profusely. What does the nurse recognize as the cause of these symptoms?
a. Severe asthma attack
b. Allergic response to theophylline
c. Onset of
d. Drug toxicity
The symptoms described are the signs of theophylline toxicity.
The nurse is planning to teach parents about preventing sudden infant death syndrome (SIDS). What significant information would the nurse include?
a. Wrapping the infant snugly for rest periods
b. Positioning the infant prone for sleep
c. Sitting the infa
d. Placing infants on their backs or sides for sleep
The American Academy of Pediatrics recommends that all healthy infants be placed in the supine or side-lying position on a firm mattress to prevent SIDS.
An infant is hospitalized with RSV bronchiolitis. What is the priority nursing diagnosis?
a. Fatigue related to increased work of breathing
b. Ineffective breathing pattern related to airway inflammation and increased secretions
c. Risk for fluid volume d
b. Ineffective breathing pattern related to airway inflammation and increased secretions
An ineffective breathing pattern is the priority nursing diagnosis for an infant hospitalized with RSV infection.
The nurse is caring for a toddler with acute laryngotracheobronchitis. Which assessment finding would indicate the child is experiencing increased respiratory obstruction?
a. Restlessness
b. Tachycardia
c. Brassy cough
d. Expiratory wheezing
a. Restlessness
Restlessness is a primary sign of increased respiratory obstruction.
The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder. What does this prevent?
a. Discoloration of tooth enamel
b. Halitosis
c. Irritation of oral membrane
d. Candidiasis
Inhalant powders can cause candidiasis (yeast) infection of the mouth.
The nurse is caring for a 3-year-old who suffered a smoke inhalation injury. How long is this patient at the highest risk for pulmonary edema after exposure?
a. 2 hours
b. 4 hours
c. 18 hours
d. 72 hours
d. 72 hours
Pulmonary edema appears in a child with smoke inhalation injury 6 to 72 hours after exposure.
Which is the most appropriate nursing action when planning care for a child with cystic fibrosis?
a. Provide chest physiotherapy before meals every day.
b. Assess weight monthly.
c. Administer pancrease with protein food at mealtime.
d. Ensure high-protei
d. Ensure high-protein, high-calorie diet.
The maintenance of adequate nutrition is essential. The diet is high in protein and calories. Chest physiotherapy should be done between meals. Pancreatic enzyme powder should be given with applesauce or other no
The first child of a couple is being treated for bronchopulmonary dysplasia (BPD). They ask how to prevent this from happening with the child they are currently expecting. What will the nurse explain as the best way to prevent BPD?
a. Maternal intake of f
c. Prevention of preterm birth
Bronchopulmonary dysplasia (BPD) is a fibrosis, or thickening, of the alveolar walls and the bronchiolar epithelium. It occurs in premature infants (less than 32 weeks) who have abnormal or arrested lung development and rece
What does the nurse explain that a ventricular septal defect will allow?
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
c. No shunting becaus
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This par
Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
a. A loud, harsh murmur with a systolic thrill
b. Cyanosis when crying
c. Blood pressure higher in the arms than in the legs
d. A machinery-like murmur
a. A loud, harsh murmur with a systolic thrill
A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
a. Blood pressure higher on the right side
b. Blood pressure higher on the left side
c. Blood pressure lower in the arms th
d. Blood pressure lower in the legs than in the arms
The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and dec
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse's best response?
a. Squatting increases the return of venous blood back to the heart.
b. Squatting decreases arterial blood flow away from the hear
a. Squatting increases the return of venous blood back to the heart.
The squatting position allows the child to breathe more easily because systemic venous return is increased.
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
b. Blood is shunted past th
a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?
a. Counting the apical rate for 30 seconds before administering the medication
b. Withholding a dose if the apical heart rate is less than 100 be
b. Withholding a dose if the apical heart rate is less than 100 beats/min
As a rule, if the pulse rate of an infant is below 100 beats/min, the medication is withheld and the physician is notified.
A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
a. Coronary arteries
b. Heart muscle and the mitral valve
c. Aortic and pulmonic valves
d. Contractility of the ventricles
b. Heart muscle and the mitral valve
The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral valve is frequently involved.
Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
a. "He is always hungry."
b. "He tires out during feedings."
c. "He is fussy for several hours every day."
d. "He sleeps all the time.
b. "He tires out during feedings."
Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" On what understanding is the nurse's response based?
a. Inflammation weakens bl
a. Inflammation weakens blood vessels, leading to aneurysm.
Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions?
a. "If the baby turns blue, I will hold him against
a. "If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest."
In the event of a paroxysmal hypercyanotic or "tet" spell, the infant should be placed in a knee-chest position.
The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" On what understanding does the nurse base a response?
a. Clubbing occurs as a result of untreated congestive heart failure.
b. Clubbin
d. Clubbing occurs as a result of chronic hypoxia.
Clubbing of the fingers develops in response to chronic hypoxia.
A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?
a. Subcutaneous nodules and fever
b. Painful, tender joints and carditis
c. Erythema mar
b. Painful, tender joints and carditis
The presence of two major Jones criteria would indicate a high probability of rheumatic fever.
An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?
a. Restlessness
b. Decreased respiratory rate
c. Increased urinary output
d. Vomiting
d. Vomiting
Symptoms of digoxin toxicity include: nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?
a. The patent ductus arteriosus
b. A ventricular septal defect
c. The closure of the foramen ovale
d. An atrial septal defect
d. An atrial septal defect
Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.
A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates?
a. Seizure activity
b. Hypoxia
c. Sydenham's chorea
d. Decreasing level of consciousness
c. Sydenham's chorea
As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham's chorea, manifested by involuntary, purposeless movements of the limbs.
How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?
a. 1 year
b. 2 years
c. 5 years
d. 10 years
c. 5 years
Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the age of 18 to prevent further bouts of rheumatic fever.
What is accurate about the characteristics of high-density lipoproteins (HDLs)?
a. They have high amounts of triglycerides.
b. They have only small amounts of protein.
c. They have little cholesterol.
d. They aid in steroid production.
c. They have little cholesterol.
HDLs have low amounts of triglycerides, large amounts of proteins, low amount of cholesterol, and are excreted via the liver. They have no role in the production of steroids.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
a. A fat intake reduction of 5-10% of total calories
b. A fat intake reduction of 10-15% of total calories
c. A fat intake reduction of 15-20%
d. A fat intake reduction of 25-35% of total calories
For a child with increased cholesterol a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information?
a. Pharmacological treatment
b. Surgical interventions available
c. Patient education
d. Reduction of aerobic exercise
c. Patient education
The main focus of a hypertension-prevention program is patient education.
A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate?
a. Barium swallow
b. Chest x-ray
c. Electrocardiogram
d. Echocardiogram
d. Echocardiogram
Echocardiography is a noninvasive procedure that localizes murmurs and determines if theheart is structurally normal.
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?
a. An egg white
b. Cream of Wheat
c. A banana
d. A carrot
b. Cream of Wheat
Good nutritional sources of iron include boiled egg yolk, liver, green leafy vegetables, Cream of Wheat, dried fruits, beans, nuts, and whole-grain breads.
Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia?
a. "Formula is so expensive. We switched to regular milk right away."
b. "She almost never drinks water."
c. "She doesn't really like peaches or pears, so we st
a. "Formula is so expensive. We switched to regular milk right away."
Because cow's milk contains very little iron, infants should drink iron-fortified formula for the first year of life.
What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?
a. With milk
b. With orange juice
c. With water
d. On a full stomach
b. With orange juice
Vitamin C aids in the absorption of iron, whereas food and milk interfere with the absorption of iron.
What is the result of a deficiency of factor IX?
a. Thalassemia
b. Idiopathic thrombocytopenic purpura
c. Hemophilia A
d. Christmas disease
d. Christmas disease
Christmas disease, or hemophilia B, is caused by the deficiency of factor IX.
A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?
a. If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
b. Children's aspirin in lowered doses may
a. If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
When bleeding occurs, the traditional approach is to follow RICE�rest, ice, compression, and elevation.
What will the nurse teach the parents of a child with a low platelet count to avoid?
a. Ibuprofen
b. Aspirin
c. Caffeine
d. Prednisone
b. Aspirin
Aspirin interferes with platelet function and should be avoided to prevent the risk of prolonged bleeding.
What should the nurse closely assess in a child receiving a transfusion?
a. Fever
b. Lethargy
c. Jaundice
d. Bradycardia
a. Fever
The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills, itching, fever, rash, headache, and back pain.
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention?
a. Assessing neurological status
b. Inserting an intravenous line
c. Monitoring vital signs during platelet transfusi
a. Assessing neurological status
When platelets are low, the greatest danger is spontaneous intracranial bleeding. Neurological assessments are therefore a priority of care.
An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?
a. I
b. II
c. III
d. IV
c. III
Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage III Hodgkin's disease.
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?
a. Aplastic
b. Hyperhemolytic
c. Vaso-occlusive
d. Splenic sequestration
c. Vaso-occlusive
Vaso-occlusive crisis, or painful crisis, is caused by obstruction of blood flow by sickle cells, infarctions, and some degrees of vasospasm.
Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
a. "I should give my child a daily iron supplement."
b. "It is important for my child to drink plenty of fluids."
c. "He needs to wear p
b. "It is important for my child to drink plenty of fluids."
Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.
A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?
a. Every fourth child will have the disease; two others will be ca
c. Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
The sickle cell gene is inherited from both parents; therefore each offspring has a one in four chance of inheriting the disease.
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
a. Hemarthrosis
b. Hematuria
c. Hemoptysis
d. Hemosiderosis
d. Hemosiderosis
As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis) are stored in tissues.
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?
a. Decreased T-cell production
b. Decreased hemoglobin
c. Increased blood clotting
d. Increased su
d. Increased susceptibility to infection
An overproduction of immature white blood cells increases the child's susceptibility to infection.
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep li
d. Clamp off blood and keep line open with normal saline.
If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.
What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?
a. Use commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.
b. Clean teeth with a soft toothbrush.
A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents bleeding and infection. Commercial mouthwashes may kill oral flora that combat infection. Water-Pik is useful for toughening gums.
A 6-year-old with leukemia asks, "Who will take care of me in heaven?" What is the best response by the nurse?
a. "Who do you think will take care of you?"
b. "Your grandparents and God will take care of you."
c. "Your mom will know more about that than I
a. "Who do you think will take care of you?"
This response gives the child an opportunity to verbalize his or her feelings and concerns, whereas closed responses shut off communication. The asking of a "why" question is not therapeutic as it calls for jus
The nurse is dealing with a preschool-age child with a life-threatening illness. What should the nurse remember the child's concept of death is at this age?
a. That it is final
b. Only a fear of separation from her parents
c. That a person becomes alive a
c. That a person becomes alive again soon after death
The preschooler views death as reversible and temporary.
The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
a. Platelet count of 25,000/mm3
b. Hemoglobin level of 8 g/dL
c. Hematocrit level of 36%
d
a. Platelet count of 25,000/mm3
The normal platelet count is 150,000 to 400,000/mm3. This finding is very low, indicating an increased bleeding potential.
The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
a. Peripheral neuropathy
b. Stomati
a. Peripheral neuropathy
Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.
The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, "I am so scared." What is the most appropriate nursing response to this comment?
a. "I understand how you must feel."
b. "You shouldn't feel that way."
c. "Is this the stron
d. "Tell me what's got you scared."
The nurse should encourage the adolescent to express her feelings and concerns.
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?
a. Risk for infection
b. Risk for hemorrhage
c. Altered skin integrity
d. Disturbance in body image
a. Risk for infection
The child with neutropenia is at risk for infection.
What important focus of nursing care for the dying child and the family should the nurse implement?
a. Nursing care should be organized to minimize contact with the child.
b. Adequate oral intake is crucial to the dying child.
c. Families should be made a
c. Families should be made aware that hearing is the last sense to stop functioning before death.
Hearing is intact even when there is a loss of consciousness.
The nurse is presenting information on the congentital disorder of hemophilia A. What fact will the nurse include?
a. It is seen in males and females equally.
b. It is transmitted by symptom-free females.
c. It is a sex-linked dominant trait.
d. It is a d
b. It is transmitted by symptom-free females.
Hemophilia A affects mostly males who received the sex-linked recessive trait from a symptom-free female. The defective gene is on the X chromosome.
A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?
a. Hemorrhage
b. Heart failure
c. Infection
d. Pulmonary embolism
b. Heart failure
Untreated iron deficiency anemias progress slowly, and in severe cases the heart muscle becomes too weak to function. If this happens, heart failure follows.
Which finding in a newborn is suggestive of tracheoesophageal fistula?
a. Failure to pass meconium in 24 hours
b. Choking on the first feeding
c. Palpable mass in the sternal area
d. Visible peristalsis across abdomen
b. Choking on the first feeding
After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.
A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting?
a. Hyperkalemia
b. Hypernatremia
c. Acidosis
d. Alkalosis
d. Alkalosis
Hydrochloric acid and sodium chloride from the stomach are lost from persistent vomiting. This results in alkalosis.
On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?
a. Weight loss of 4 ounces
b. Dry mu
a. Weight loss of 4 ounces
Weight loss is the most significant indicator of dehydration because an infant's weight comprises 77% water.
Why are rapid respirations a possible cause of dehydration?
a. They prevent the child from drinking.
b. They increase circulation, thus increasing urine production.
c. They cause evaporation of fluid on the mucous membranes.
d. They often lead to vomiting
c. They cause evaporation of fluid on the mucous membranes.
Rapid respirations cause increased insensible fluid loss.
Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux?
a. Position the infant in the crib on his or her abdomen, with the head elevated.
b. Administer medication as ordered to stimulate the pyloric sphincter.
a. Position the infant in the crib on his or her abdomen, with the head elevated.
After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.
The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report?
a. Diarrhea
b. Projectile vomiting
c. Poor appetite
d. Constipation
b. Projectile vomiting
Vomiting is the outstanding symptom of pyloric stenosis. Food is ejected with considerable force, which is described as projectile vomiting.
A mother reports that her child has been scratching the anal area and complaining of itching. What does the nurse suspect based on this information?
a. Pinworms
b. Giardiasis
c. Ringworm
d. Roundworm
a. Pinworms
With pinworms, the nurse or parent may notice that the child scratches the anal area and complains of itchiness. The other choices do not cause this reaction.
The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects?
a. Diarrhea
b. Skin rash
c. Red stool
d. Metallic taste
c. Red stool
The nurse should advise parents that pyrvinium stains clothing and turns stools red.
What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms?
a. Keep children's nails short.
b. Dress child in loose-fitting underwear.
c. Clean the bathroom with bleach solution.
d. Wash bed linens in cold wate
a. Keep children's nails short.
One intervention to prevent the further spread of pinworms is to keep the child's fingernails short. Pinworms are not spread from person to person.
A mother reports that her 2-year-old child experiences constipation frequently. Which food would the nurse recommend to include in the child's diet?
a. Cooked vegetables
b. Pretzels
c. Whole-grain cereal
d. Yogurt
c. Whole-grain cereal
Dietary modifications for constipation include eating more high-roughage foods such as whole-grain breads and cereals.
What description of a child's stool characteristic leads the nurse to suspect intussusception?
a. Currant jelly
b. Black and tarry
c. Green liquid
d. Greasy and foul-smelling
a. Currant jelly
Bowel movements of blood and mucus that contain no feces ("currant jelly" stools) are common about 12 hours after the onset of the obstruction.
What is the treatment of choice for a child with intussusception?
a. A barium enema
b. Immediate surgery
c. IV fluids until the spasms subside
d. Gastric lavage
a. A barium enema
A barium enema is the treatment of choice for intussusception because the passage of the barium frequently "un-telescopes" the bowel. Surgery is scheduled only if reduction is not achieved.
Parents ask the nurse how their infant developed a Meckel's diverticulum. What condition, will the nurse explain, is present causing this diagnosis?
a. The yolk sac remains connected to the intestine.
b. There is inflammation of the ileocecal valve.
c. A
c. A pouch forms when the vitelline duct fails to disappear.
If the vitelline duct fails to disappear completely after birth, a blind pouch may form.
An infant is admitted to the hospital with severe isotonic dehydration. For what is this child at the highest risk?
a. Metabolic alkalosis
b. Hypocalcemia
c. Sepsis
d. Shock
d. Shock
Shock is the greatest threat to life in isotonic dehydration.
A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage?
a. Activated charcoal
b. N-acetylcysteine
c. Vitamin K
d. Syrup o
b. N-acetylcysteine
Gastric lavage is followed by N-acetylcysteine (Mucomyst), the antidote for acetaminophen.
The nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community?
a. Increased lead content of air
b. Use of aluminum cookware
c. Deteriorating paint in older buildi
c. Deteriorating paint in older buildings
The primary source of lead is paint from old, deteriorating buildings.
A frightened mother calls the pediatrician's office because her child swallowed dishwashing detergent. What is the most appropriate action?
a. Induce vomiting by giving the child syrup of ipecac.
b. Take the child to the local emergency department.
c. Giv
b. Take the child to the local emergency department.
Inducing vomiting is no longer recommended because it may pose additional problems. The child should be taken immediately to the nearest emergency department along with the packaging of the ingested sub
A child has been diagnosed with ascariasis (roundworm). Which statement made by her mother that may suggest a cause for her condition?
a. "I've been airing out the house on these nice breezy days."
b. "My child often goes out to the garden and pulls up a
b. "My child often goes out to the garden and pulls up a carrot to eat."
The child can ingest roundworm eggs from contaminated soil.
What does the nurse expect the appearance of the stools of a child with celiac disease to be?
a. Ribbon like
b. Hard, constipated
c. Bulky, frothy
d. Loose, foul-smelling
c. Bulky, frothy
Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may indicate malabsorption.
The nurse has reviewed dietary restrictions for celiac disease with concerned parents. Which grain will the nurse explain can be eaten with celiac disease?
a. Wheat
b. Oats
c. Barley
d. Rice
d. Rice
Rice is a gluten-free grain that can be eaten by children afflicted with celiac disease. These children will have a lifelong restriction of wheat, oats, barley, and rye.
. A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nurses's priority goal of the infant's care?
a. Prevent fluid and electrolyte imbalance.
b. Prevent nutritional deficiency.
c. Prevent skin brea
a. Prevent fluid and electrolyte imbalance.
The priority goal of care in gastroenteritis is preventing fluid and electrolyte imbalance.
The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise?
a. Soft foods with rice, bananas, toast, and applesauce
b. Small amounts of clear fluids such as gelatin
c. An oral rehydrat
c. An oral rehydrating solution, such as Pedialyte
An oral rehydrating solution is recommended to replace fluids and electrolytes lost from frequent bowel movements.
What would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive?
a. Cry to be picked up
b. Be limp like a rag doll
c. Be responsive to cuddling
d. Weigh in the 10th percentile for age
b. Be limp like a rag doll
Some children with failure to thrive have rag-doll limpness (hypotonia) and appear wary of their caregivers.
Which nursing interventions will be implemented for the mother of a 10-month-old infant with nonorganic failure to thrive?
a. Pointing out errors that the nurse observes when the mother is caring for the infant
b. Discussing negative characteristics of th
d. Teaching the mother about the developmental milestones to expect in the next few months
The nurse can increase parent's knowledge of growth and development by providing anticipatory guidance about normal developmental milestones.
Which statement by a mother may indicate a cause of her son's vitamin C deficiency?
a. "We get our fruits from homemade preserves."
b. "We use milk from our own goats."
c. "We grow all our own vegetables."
d. "We're not big meat eaters.
a. "We get our fruits from homemade preserves."
Vitamin C is destroyed by heat.
The nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include?
a. Pour the prescribed amount into a nipple and have the infant suck the medication.
b. Squirt the prescribed dose into t
d. Use a sterile applicator to swab the medication on the oral mucosa.
An appropriate way to administer nystatin is to moisten a sterile applicator with the medication and then swab it on the inside of the mouth.
Why are infants more vulnerable to fluid and electrolyte imbalances than adults?
a. They have a smaller surface area than adults in proportion to body weight.
b. Water needs and losses per kilogram are lower than those for adults.
c. A greater percentage
c. A greater percentage of body water in infants is extracellular.
A greater percentage of body water is contained in the extracellular compartment of children under 2 years of age.
An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO2 40, HCO3- 21. How does the nurse interpret these values?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
a. Metabolic acidosis
A pH lower than 7.35 indicates acidosis. If the child's pH falls in the same line as the HCO3-, the problem is metabolic (see Table 27-4).
Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action?
a. Delay feeding the child for 6 hours.
b. Offer regular formula thinned with water.
c. Give small amounts of regular f
d. Allow 1 ounce of glucose water at frequent intervals.
Small oral feedings of glucose water are given after recovery from anesthesia. Feedings are gradually increased to larger amounts of regular formula.
The nurse is caring for an 18-pound child who has had one stool of diarrhea. The nurse knows that the child needs to consume how many milliliters of oral fluid to make up for the fluid loss?
a. 18
b. 36
c. 64
d. 81
d. 81
The formula for oral fluid replacement is 10 mL/kg. 18 pounds = 8.1 kg � 10 = 81 mL.
Which statement made by a parent alerts the nurse to the need for additional education about poison prevention?
a. "I keep the poison control center phone number easily accessible."
b. "All medication is kept out of reach in a locked cabinet."
c. "I keep
c. "I keep a bottle of syrup of ipecac handy."
Traditionally, syrup of ipecac was the treatment of choice to remove some types of poisons from a child's system and parents were advised to keep a supply on hand in the home. However, the American Academy of
Which assessment would the nurse report to the physician immediately?
a. 2-month-old with a urine output of 150 mL in 24 hours
b. 3-year-old with a urine output of 650 mL in 24 hours
c. 8-year-old with a urine output of over 1000 mL in 24 hours
d. 14-year
a. 2-month-old with a urine output of 150 mL in 24 hours
The urine output of a 2-month-old should be between 400 and 500 mL/24 hours.
The nurse is careful to apply only the prescribed amount of ointment to the skin of a 2-month-old. How is infant skin different from adult skin?
a. Less perfusion
b. Greater moisture
c. More perspiration
d. Greater absorption
d. Greater absorption
The child's skin has a dramatically greater ability to absorb than does that of the adult.
What risk is increased with children who have been diagnosed with infantile eczema?
a. Pneumonia
b. Acne
c. Sun sensitivity
d. Asthma
d. Asthma
Some children with eczema also develop asthma and hay fever-type allergies.
What is the appropriate technique for the application of a topical treatment for a child with eczema?
a. Apply skin lotions in a circular motion.
b. Apply prescribed ointments with a gloved hand.
c. Apply as much and as frequently as relieves the symptoms
b. Apply prescribed ointments with a gloved hand.
The prescribed amount of ointment is usually applied to the skin by a gloved hand in long, smooth strokes. Lanolin-based preparations should be avoided because of a possible allergy to wool.
A 2-day-old infant is noted to have small pustules on her skin. What is the best nursing action?
a. Report it immediately because it may be a staphylococcus infection.
b. Keep the affected area dry and clean.
c. Teach the parents how to care for seborrhei
a. Report it immediately because it may be a staphylococcus infection.
A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately.
The home health nurse discovers a family infected with pediculosis. What information can the nurse provide to the mother to start eradication of the lice?
a. Cover the hair with Vaseline.
b. Apply a soda-vinegar solution to the hair.
c. Comb through the h
c. Comb through the hair with a vinegar-water solution.
Combing a vinegar and water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.
A group of football players is taking oral griseofulvin for tinea pedis. What should the school nurse caution them to avoid?
a. Citrus fruit and juice
b. Eating shellfish
c. Alcohol consumption
d. Taking corticosteroids
c. Alcohol consumption
Consumption of alcohol while taking griseofulvin will cause severe tachycardia.
What should the nurse suggest before a 17-year-old girl starts a protocol of isotretinoin (Accutane) for her acne?
a. Get a prescription for oral contraceptives.
b. Increase the dose of the present medication.
c. Limit intake of chocolate, cola, and peanu
a. Get a prescription for oral contraceptives.
Oral contraceptives are often prescribed for adolescents with acne. Accutane can cause birth defects, so pregnancy should be prevented.
A child had a burn, evidenced by pink skin and blistering. The child complains of pain and is crying. How does the nurse classify this burn when documenting?
a. First-degree
b. Second-degree superficial
c. Second-degree deep dermal
d. Third-degree
b. Second-degree superficial
A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.
A child has sustained a second-degree deep thermal burn to the hand. What is the best first action to take?
a. Immerse the burned area in cold water.
b. Apply ice to the burned area.
c. Break any blisters that are present.
d. Apply petroleum jelly to the
a. Immerse the burned area in cold water.
First-aid treatment of a second-degree deep thermal burn is immersion of the burned area in water to halt the burning process.
Which allergy would contraindicate the use of silver sulfadiazine (Silvadene) as a topical agent for burns?
a. Penicillin
b. Iodine
c. Tetanus immunizations
d. Sulfa
d. Sulfa
The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.
What would help the child with a serious burn meet nutritional needs during the subacute phase of recovery?
a. Decrease calories because the child will be on bed rest and will not need as many.
b. Increase calories and protein to compensate for the healin
b. Increase calories and protein to compensate for the healing process.
Frequent meals and snacks high in calories, protein, and iron are needed to meet the increased metabolic needs of the child with burns.
Which statement made by a parent indicates an understanding of the topical application of medications for a skin condition?
a. "I apply the medication after I give my child a bath."
b. "I rub the ointment in a circular motion over the rash."
c. "I increas
a. "I apply the medication after I give my child a bath."
Absorption of topical medications is best when preparations are applied after a warm bath.
On the first day following a severe burn, the body's fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. What should the nurse monitor for very closely in the burn victim?
a. Increasing intracranial p
b. Reduced urine output
With the fluid shift associated with severe burns, the nurse must be observant for the reduction of urine, an indication of altered renal function.
At a 2-month well-child visit, parents ask the nurse about the red area on the infant's neck. They tell the nurse that the mark appeared a few weeks after birth. What does the nurse recognize this skin lesion as?
a. A port wine nevus
b. A strawberry nevus
b. A strawberry nevus
The strawberry nevus is a common hemangioma consisting of dilated capillaries in the dermal space, which may not become apparent for a few weeks after birth.
A mother is concerned about what might have caused a heat rash on her infant. The nurse observes tiny pinhead-sized reddened papules on the infant's neck and axilla. What does the nurse explain as the most likely cause of this rash?
a. Sun exposure
b. All
d. Heat and moisture
Miliaria, or prickly heat rash, is caused by excess body heat and moisture.
What is the correct nursing response to a mother who asks, "How can I get rid of the baby's cradle cap?"
a. "Rub baby oil on the infant's head at night and shampoo the hair the next morning."
b. "Use a brush with firm bristles to loosen the scales on the
a. "Rub baby oil on the infant's head at night and shampoo the hair the next morning."
Scales may be softened by applying baby oil to the head the evening before, and shampooing the hair in the morning.
Which statement made by a parent indicates the need for further teaching about strategies to control itching for the infant with eczema?
a. "Wool is the best fabric for the infant's clothing."
b. "I should avoid laundry detergents with fragrances."
c. "I
a. "Wool is the best fabric for the infant's clothing."
Clothing should be made of cotton. Wool is avoided because of its allergy potential.
What will the nurse include when teaching about general skin care measures that could help prevent acne?
a. Eliminating chocolate, peanuts, and cola from the diet
b. Washing the face with a cleansing product frequently
c. Planning indoor activities to avo
d. Eating a balanced diet and getting sufficient rest
General hygienic measures of cleanliness, rest, and avoidance of emotional stress may help prevent exacerbations.
The nurse caring for a patient with severe frostbite observes a purple flush on the hands and feet. What is the most appropriate nursing action?
a. Report this sign immediately.
b. Place a warm towel over the extremities.
c. Gently sponge with cool water.
d. Medicate for pain.
A purple flush indicates the return of sensation and causes extreme pain.
A child is brought to the emergency department with burns on the face and chest. What is the nurse's first priority?
a. Assess respiratory status.
b. Administer pain medication.
c. Remove clothing.
d. Insert a Foley catheter.
a. Assess respiratory status.
Airway assessment and establishing an airway are the initial priorities.
An adolescent girl with acne is being treated with an antibiotic in addition to topical applications. What side effect does the nurse caution the girl to expect?
a. Lessened effectiveness of oral contraceptives
b. Urinary burning and frequency
c. Breast e
d. Vaginitis
Antibiotic therapy can cause a monilial vaginitis.
The nurse observes a tarry stool from a 16-year-old burn victim who has been in the ICU for 2 weeks. Which complication does the nurse document and report?
a. Diverticulitis
b. Stress diarrhea
c. Curling's ulcer
d. Perforated bowel
c. Curling's ulcer
Curling's ulcer is a complication of burn victims resulting from the stress of their trauma.
A child is brought to the emergency department with severe frostbite. Which body parts should be warmed first?
a. Hands and arms
b. Feet and legs
c. Fingers and toes
d. Head and torso
d. Head and torso
In extreme cases of exposure to freezing temperatures, the head and torso should be warmed before the extremities.
An adolescent is at the pediatrician's office because he has been experiencing intense itching, particularly in the axilla and between the fingers. The itching is worse during the night and he has not been sleeping well. With what is this symptom associat
a. Scabies
Intense itching, especially at night, is characteristic of scabies.
What should the nurse stress to the mother of a child with impetigo?
a. The condition is caused by the herpes simplex virus type I.
b. The crusts on the lesions should be left in place.
c. The lesions may spread, but the disease is not contagious.
d. Smal
d. Small cuts and bites should be treated promptly.
Small cuts and bites should be treated promptly to prevent the invasions of the bacteria that cause impetigo. The crusts from the lesions should be gently removed. The disease is contagious.
The nurse is caring for a 3-year-old with severe burns. What is the nurse aware is the minimum adequate hourly urine output?
a. 5 mL/hr
b. 10 mL/hr
c. 15 mL/hr
d. 20 mL/hr
d. 20 mL/hr
The minimum acceptable hourly urine output for children over the age of 2 years is 20 to 30 mL/hr.
An adolescent patient at a pediatric clinic presents with a butterfly rash. What diagnosis does the nurse suspect?
a. Tuberous sclerosis
b. Eczema
c. Psoriasis
d. Systemic lupus erythematosus
d. Systemic lupus erythematosus
Butterfly rash over the nose and cheeks can be associated with photosensitivity and may be associated with systemic lupus erythematosus (SLE).
The nurse is documenting a description of a skin assessment. What term can be used for an elevated, fluid-filled blister?
a. Pustule
b. Papule
c. Wheal
d. Vesicle
d. Vesicle
A vesicle is an elevated, fluid-filled blister (cold sore, chickenpox).
hat should the nurse keep in mind when providing care to the school-age child hospitalized with a burn injury?
a. Hospitalization will be brief.
b. Analgesics should be given immediately after dressing changes.
c. Contact with peers should be maintained.
c. Contact with peers should be maintained.
A burn injury is taxing to the child and parents. It requires long periods of hospitalization and frequent readmissions. The accident itself is terrifying for the child but is made even worse if caused by disobe
A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about the pattern of inheritance for inborn errors of metabolism?
a. They are usually autosomal recessive.
b. They are usually autosomal dominant.
c. They are usually
a. They are usually autosomal recessive.
The pattern of inheritance is generally autosomal recessive.
What occurs as a result of an inadequate secretion of insulin?
a. Protein synthesis is increased.
b. Increased fat breakdown leads to ketonemia.
c. Serum glucose levels are markedly decreased.
d. More rapid conversion and storage of carbohydrates to gluco
b. Increased fat breakdown leads to ketonemia.
When insulin is deficient, the body cannot metabolize carbohydrates for energy. The body is also unable to store and use fat properly. Incomplete fat metabolism produces ketone bodies that accumulate in the b
On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus?
a. There is an absolute deficiency of insulin.
b. Insufficient quantities of insulin are produced by the pancreas.
c. Oral hypoglycemic agents
a. There is an absolute deficiency of insulin.
Type 1 insulin-dependent diabetes mellitus is characterized by an absolute or complete deficiency of insulin.
A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse?
a. Notify the charge nurse.
b. Give the patient a snack of graham crackers an
b. Give the patient a snack of graham crackers and milk.
A child who receives regular insulin before meals may have an insulin reaction if food is not eaten within 20 minutes. A snack of graham crackers and milk will prevent an episode of hypoglycemia.
Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the child is complaining of hunger and thirst and is drowsy at 10:30 AM. What should the nurse do first?
a. Walk the patient in the hall for 10 minutes.
b. Allow the patient a
c. Give her a cup of orange juice.
The immediate remedy is to give orange juice to raise the blood glucose. Giving more sugar will increase the blood glucose in a hyperglycemic child. Walking exercise will use up even more glucose. The treatment for hyper
Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?
a. "I carry a piece of hard candy with me in case I start to feel shaky."
b. "I make sure I have emergency money when I have soccer practi
c. "Sometimes I skip my breakfast when I have a game in the morning."
Blood glucose is high after meals. The child with type 1 diabetes mellitus who skips a meal before exercise is at risk for hypoglycemia.
Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more teaching?
a. "My pancreas is sick and needs insulin until it is well."
b. "I will need to take my insulin every day."
c. "I need to keep a piece of candy in
a. "My pancreas is sick and needs insulin until it is well."
The child with type 1 diabetes mellitus has an insulin deficiency and will require lifelong management of this disease. Insulin does not cure the pancreas.
Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus?
a. Control intake of carbohydrates and consume fewer calories.
b. Focus on complex carbohydrates and eat foods high in fiber.
c. Obtain
b. Focus on complex carbohydrates and eat foods high in fiber.
The nutritional needs of a child with diabetes mellitus are essentially the same as those of the nondiabetic child, with the exception of the elimination of concentrated carbohydrates such as
A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing?
a. Somogyi p
c. Ketoacidosis
In ketoacidosis, the child's skin is dry, and the face is flushed. Patients appear dehydrated. They may perspire and be restless. The breath has a fruity odor, and there is no rest period between inspiration and expiration.
A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes these signs are characteristic of what?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay-Sachs disease
Hypothyroidism
The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged, causing noisy respiration.
What is an important consideration for the school-age child taking DDAVP for diabetes insipidus?
a. Observe for signs of water deprivation.
b. Restrict his physical education program.
c. Arrange for the child to use the bathroom when needed.
d. Limit flui
c. Arrange for the child to use the bathroom when needed.
The child with diabetes insipidus needs liberal access to bathrooms and water fountains. Arrangements may have to be made with the school to allow access.
Which laboratory result indicates good metabolic control for a child with type 1 diabetes mellitus?
a. Glycosylated hemoglobin value of 8%
b. Fasting blood glucose level less than 140 mg/dL
c. Glucose tolerance test result of 190 mg/dL
d. No glucose or ke
a. Glycosylated hemoglobin value of 8%
Glycosylated hemoglobin reflects glycemic levels over a period of months. Levels of 6% to 9% represent good metabolic control.
What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
b. Somogyi phenomenon
The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is lowered to the point at which the body's counter-regulatory hormones are released, producing the symptoms described.
What would be the most appropriate nursing response to a woman who says, "My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition"?
a. "The disease is rare. It is unlikely that you would have a child wi
b. "A screening test can be done to determine if you are a carrier of the gene."
Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive pattern of transmission.
What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid) correctly?
a. "I stopped giving the medication because my daughter was losing her hair."
b. "I am using a different brand now because it costs less
d. "I give the medication at 8:00 AM every day."
Synthroid should be given at the same time each day, preferably in the morning.
After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does the nurse suspect has developed?
a. Diabetes insipidus
b. Diabe
a. Diabetes insipidus
Diabetes insipidus can be acquired as the result of a head injury or tumor, and suppression of the posterior pituitary causes copious urine output with an attendant drop in BP. The child can become dehydrated very quickly if some rem
The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The nurse would tell the parents to be alert for what symptom? For
a. Polyuria
b. Cough
c. Weight loss
d. Lethargy
d. Lethargy
Signs of water intoxication include edema, lethargy, nausea, and central nervous system signs.
The parents of a child newly diagnosed with diabetes mellitus tell the nurse, "Our son's body is resistant to insulin." With what does the nurse recognize this description is consistent?
a. Type 1, insulin-dependent diabetes mellitus
b. Type 2, non-insuli
b. Type 2, non-insulin-dependent diabetes mellitus
Type 2, non-insulin-dependent diabetes mellitus is caused by insulin resistance or failure of the body to use the insulin.
What does the nurse instruct a 12-year-old to do when teaching how to administer insulin?
a. Make sure injection sites are 6 inches apart.
b. Select an injection site that was recently exercised.
c. Inject the needle at a 90-degree angle.
d. Give the inje
c. Inject the needle at a 90-degree angle.
Children often find it easier to learn to inject the needle at a 90-degree angle.
The nurse discussed treatment of hypoglycemia with an adolescent. Which statement by the adolescent leads the nurse to determine the patient understood the instructions?
a. "When my blood glucose is low or if I begin to feel hungry and weak, I will eat si
a. "When my blood glucose is low or if I begin to feel hungry and weak, I will eat six LifeSavers."
The immediate treatment of hypoglycemia consists of administering sugar in some form such as orange juice, hard candy, or a commercial product. Cheese will
Why does the nurse instruct an 11-year-old diabetic child to use the side of the finger for blood testing?
a. It has fewer capillaries.
b. It is easier to puncture.
c. It is less likely to become infected.
d. It has fewer nerve endings.
d. It has fewer nerve endings.
The sides of the finger have fewer nerve endings and more capillaries but are not easier to puncture than the fingertip. The risk for infection is remote for either site.
What is the function of an insulin pump?
a. Releases insulin as blood glucose rises
b. Provides continuous infusion of insulin
c. Decreases need for painful glucose monitoring
d. Delivers a prescribed amount of insulin twice a day
b. Provides continuous infusion of insulin
The insulin pump that is attached to a subcutaneous tube releases a continuous infusion of insulin.
The nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting?
a. Lispro
b. Aspart
c. Glargine
d. Regular
c. Glargine
Insulin glargine is a long-acting insulin. Regular is short acting. Lispro and Aspart are rapid acting.