NCLEX- Pediatrics for test 4
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A 3-month-old infant is doing 3. Anything that can be put in the mouth is inappropriate for a
well after the repair of a cleft lip. child with cleft lip repair. A rattle and beads can go in the mouth.
The nurse wants to provide the Button eyes are a hazard for any infant because the infant may
client with appropriate swallow them. A mobile with a music box is appropriate for a 3-
stimulation. What is the best toy month-old who lays in a crib, and this item cannot be put in the
for the nurse to provide? mouth. Note that a colorful rattle is also age appropriate but not
1. Colorful rattle condition appropriate.
2. String of large beads
3. Mobile with a music box
4. Teddy bear with button eyes
An 18-month-old child is 2. An 18-month-old child cannot understand explanations. The
admitted for a repeat cardiac nurse needs to assess the clients' knowledge and base teaching
catheterization. The parents are on that assessment. The nurse should not assume that no
continuously present and do teaching is needed just because the child has had the procedure
everything for the child—dress before. There are no data to indicate that the parents upset the
him, feed him, and even play for child. They do appear to be smothering the child, but at this time,
him. The nurse wants to prepare the child would probably be more miserable without the parents.
the child and the parents for the The nurse may want to teach parents about growth and
procedure. Which of the development needs of the toddler.
following should be included in
the care plan?
1. Give the child simple
explanations.
2. Talk with the parents to assess
their knowledge and how they
can help with the child's care.
3. No specific action will be
necessary because the child and
family have been through a
cardiac
catheterization previously.
4. Ask the parents to stay away
as much as possible because
they upset the child.
,The nurse is preparing a 6-year- 1. A 6-year-old learns best by doing. A 6-year-old cannot
old child for cardiac surgery. conceptualize what he or she cannot see. Touring the operating
Which preoperative teaching room and surgical intensive care unit can be very frightening for
technique is most appropriate? a 6-year-old. Drawing pictures of the procedure would be more
1. Have the child practice appropriate postoperatively, when the nurse may want to help
procedures that will be him in understanding what happened to him. Drawing pictures is
performed postoperatively, such a good way to express feelings that a 6-year-old cannot put into
as coughing words. Group discussion is more appropriate for an adolescent. A
and deep breathing. 6-year-old does not have the verbal skills to participate in and
2. Arrange for the child to tour learn from a discussion group.
the operating room and surgical
intensive care unit.
3. Encourage the child to draw
pictures illustrating the
operation.
4. Arrange for the child to
discuss heart surgery and
postoperative events with a
group of children who have
undergone heart surgery.
3. Craft work allows her to accomplish something while meeting
A 10-year-old girl is being
her needs for rest. Industry is the developmental task for school-
treated for rheumatic fever.
age children. The joint pains with rheumatic fever tend to be in
Which would be an appropriate
the large joints, not the small ones, so craft work using finger
activity while she is on bed rest?
activity would probably not be painful. Stringing large wooden
1. Stringing large wooden beads
beads is appropriate for younger children. Pillow fighting
2. Engaging in a pillow fight
requires too much energy for a child on bed rest and is not
3. Making craft items from felt
appropriate for a hospital environment. Watching television is a
4. Watching television
solitary activity with no sense of accomplishment.
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A 10-year-old boy who is 2. Pounding movements allow for the expression of aggression.
immobilized in a cast following The other activities would not allow for an expression of
an accident has been squirting aggression. The scenario describes a child who is expressing
other children and the staff with aggression in a very physical manner. This child is not likely
a syringe filled with water. The to respond well to writing a story. Writing a story could be used
nurse wants to provide other to help a child express aggression, but pounding clay is more
activities to help him express his appropriate given the child's aggressive behavior.
aggression. Which activity would
be most appropriate?
1. Cranking a wind-up toy
2. Pounding clay
3. Putting charts together
4. Writing a story
A 6-year-old boy has tetralogy 1. Atrial septal defect is not associated with tetralogy of Fallot.
of Fallot. He is being admitted The four defects are pulmonary stenosis, which causes right
for surgery. The nurse knows that ventricular hypertrophy, ventricular septal defect, and overriding
which problem is not associated aorta.
with tetralogy of Fallot?
1. Severe atrial septal defect
2. Pulmonary stenosis
3. Right ventricular hypertrophy
4. Overriding aorta
, A 6-year-old child with tetralogy 1. The squatting position will help the child with tetralogy of Fallot
of Fallot is being admitted for to have better hemodynamics. It increases intra-abdominal
surgery. While the nurse is pressure and increases pulmonary blood flow. Placing the child
orienting the child to the unit, in a lying or standing position will increase his symptoms and be
the child suddenly squats with counterproductive. It is not necessary to call for help because
the arms thrown over the knees this is not an emergency situation.
and knees drawn up to the
chest. What is the best
immediate nursing action?
1. Observe and assist if needed
2. Place the child in a lying
position
3. Call for help and return the
child to the room
4. Assist the child to a standing
position
A 6-year-old child with tetralogy 2. The child will have to learn to cough and deep breathe
of Fallot is being admitted for postoperatively. Studies demonstrate that preoperative teaching
surgery. What is most important makes it easier for the client to perform coughing and deep
to teach the child during the breathing exercises in the postoperative period. The nurses will
preoperative period? do strict hand washing, not the client. Fluids will likely be
1. Strict handwashing technique. restricted postoperatively. It is important to teach the client
2. How to cough and deep about positions of comfort, but it is more important to teach the
breathe. child how to deep breathe and cough.
3. The importance of drinking
plenty of fluids
4. Positions of comfort
A 6-year-old with tetralogy of 3. Chest bottles are always positioned below bed level to
Fallot has open heart surgery. prevent the reflux of material into the chest cavity.
The septal defect was closed,
and the pulmonic valve was
replaced. When the child returns
to the unit, he has oxygen, IVs,
and closed chest drainage. How
should the nurse position the
chest drainage system?
1. Above the level of the bed
2. At the level of the heart
3. Below the level of the bed
4. Alternating above and below
the bed every two hours