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TABLE OF CONTENT
Chapter 01: Chip Jones: Bronchiolitis ................................................................................................................. 1
Chapter 02: Mollie Sanders: Asthma................................................................................................................. 11
Chapter 03: David Torez: Ulnar Fracture .......................................................................................................... 21
Chapter 04: Ellie Raymore: Urinary Tract Infection and Pyelonephritis .......................................................... 30
Chapter 05: Maalik Abdella: Gastroenteritis, Fever, and Dehydration ............................................................. 40
Chapter 06: Abigail Hanson: Leukemia ............................................................................................................ 52
Chapter 07: Caleb Yoder: Heart Failure ............................................................................................................ 63
Chapter 08: Andrew Hocktochee: Failure to Thrive.......................................................................................... 73
Chapter 09: Jessica Wang: Tonic-Clonic Seizures ............................................................................................ 82
Chapter 10: Sophia Carter: Diabetes Mellitus Type 1 ....................................................................................... 92
Chapter 11: Chase McGovern: Second-Degree Burns .................................................................................... 102
Chapter 12: Natasha Austin: Sickle Cell Anemia............................................................................................ 111
Chapter 13: Jack Wray Attention Deficit Hyperactivity Disorder................................................................... 120
Chapter 14: Adelaide Wilson: Obesity ............................................................................................................ 129
Chapter 15: Care of the Newborn and Infant................................................................................................... 139
Chapter 16: Care of the Toddler ...................................................................................................................... 147
Chapter 17: Care of the Preschooler ................................................................................................................ 155
Chapter 18: Care of the School-Age Child ...................................................................................................... 163
Chapter 19: Care of the Adolescent ................................................................................................................. 171
Chapter 20: Alterations in Respiratory Function ............................................................................................. 180
Chapter 21: Alterations in Cardiac Function ................................................................................................... 188
Chapter 22: Alterations in Neurologic and Sensory Function ......................................................................... 196
Chapter 23: Alterations in Gastrointestinal Function ...................................................................................... 204
Chapter 24: Alterations in Genitourinary Function ......................................................................................... 212
Chapter 25: Alterations in Hematologic Function ........................................................................................... 220
Chapter 26: Oncological Disorders.................................................................................................................. 228
Chapter 27: Alterations in Musculoskeletal Function ..................................................................................... 236
Chapter 28: Alterations in Neuromuscular Function ....................................................................................... 244
Chapter 29: Alterations in Integumentary Function ........................................................................................ 252
Chapter 30: Alterations in Immune Function .................................................................................................. 260
Chapter 31: Alterations in Endocrine Function ............................................................................................... 268
Chapter 32: Genetic Disorders......................................................................................................................... 276
Chapter 33: Alterations in Cognitive and Mental Health ................................................................................ 284
Chapter 34: Pediatric Emergencies.................................................................................................................. 293
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Chapter 01: Chip Jones: Bronchiolitis
1. A nurse is providing care for a 4-month-old infant at the pediatric clinic. During the
assessment the nurse should expect that the infant has reached which developmental
milestone(s)? Select all that apply.
A. Uses pincer grasp to pick up items
B. Can roll over from front onto back
C. Pulls self up to a standing position
D. Recognizes family members' faces
E. Pushes self up on arms from a prone position
F. Sits with support
ANS: B, D, E, F
Rationale: At 4 months of age, an infant is able to roll over from prone to supine position,
push the head/chest up on arms from a prone position, sit with support and recognize the faces
of close family members. The use of the pincer grasp and the ability to pull self up to a
standing position are expected at 10 months of age.
PTS: 1 REF: p. 4 OBJ: 1
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Understand
2. A nurse is assessing a 3-month-old infant during a pediatric clinic visit. The nurse believes the
infant is demonstrating early manifestations of respiratory distress. Which clinical
manifestation(s) should the nurse document? Select all that apply.
A. Bradycardia
B. Acrocyanosis
C. Intercostal retractions
D. Nasal congestion
E. Tachypnea
ANS: D, E
Rationale: Early signs of respiratory distress in an infant include fussiness, nasal congestion,
tachypnea and no interest in feeding. Intercostal retractions are signs of moderate distress;
bradycardia can be seen with severe respiratory distress. Acrocyanosis, in and of itself, is not
a sign of respiratory distress as it can be caused by poor circulation and cold extremities.
PTS: 1 REF: p. 8 OBJ: 4
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
3. A nurse is caring for an infant newly admitted for suspected bronchiolitis. The infant's parent
is very upset and states "I am so worried about my infant. What can you do to help my
infant?" What is the nurse's best response?
A. "There is no need to worry; we care for cases like this all the time."
B. "I know this is hard for you but do not worry. We will be able to discharge your
infant in a few days."
C. "No worries; having you hold the infant is very helpful. The infant will be back at
home in no time."
D. "I know it is difficult to see your infant like this. We will suction your infant and
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give oxygen to make the infant comfortable.
ANS: D
Rationale: The option that states that it is difficult to see the infant like this is the only
response that explains to the parent what the nurse can do to help the infant and acknowledges
the parent's concern. The remaining options recognize the parent's concern but do not answer
the parent's question.
PTS: 1 REF: p. 10 OBJ: 7
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
4. A 3-month-old infant is hospitalized with a diagnosis of bronchiolitis. The nurse is creating a
plan of care for the infant. Which intervention is a priority?
A. Provide parental teaching on the antibiotics the infant will need to take at home.
B. Administer oxygen to maintain the infant's oxygen saturation at or above 92%.
C. Allow the parents to remain by the infant's side throughout the hospitalization.
D. Keep the infant NPO until the condition has resolved.
ANS: B
Rationale: Therapeutic management of bronchiolitis includes the administration of oxygen to
maintain O2 saturation at 92% or higher. Current evidence shows that antibiotics do not
improve outcomes in the treatment of bronchiolitis. Infants with bronchiolitis are encouraged
to feed as tolerated to maintain nutrition and fluid balance. While it is important for the
parents to be allowed to remain at the infant's side, it is not the priority.
PTS: 1 REF: p. 14 OBJ: 7
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
5.
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TABLE OF CONTENT
Chapter 01: Chip Jones: Bronchiolitis ................................................................................................................. 1
Chapter 02: Mollie Sanders: Asthma................................................................................................................. 11
Chapter 03: David Torez: Ulnar Fracture .......................................................................................................... 21
Chapter 04: Ellie Raymore: Urinary Tract Infection and Pyelonephritis .......................................................... 30
Chapter 05: Maalik Abdella: Gastroenteritis, Fever, and Dehydration ............................................................. 40
Chapter 06: Abigail Hanson: Leukemia ............................................................................................................ 52
Chapter 07: Caleb Yoder: Heart Failure ............................................................................................................ 63
Chapter 08: Andrew Hocktochee: Failure to Thrive.......................................................................................... 73
Chapter 09: Jessica Wang: Tonic-Clonic Seizures ............................................................................................ 82
Chapter 10: Sophia Carter: Diabetes Mellitus Type 1 ....................................................................................... 92
Chapter 11: Chase McGovern: Second-Degree Burns .................................................................................... 102
Chapter 12: Natasha Austin: Sickle Cell Anemia............................................................................................ 111
Chapter 13: Jack Wray Attention Deficit Hyperactivity Disorder................................................................... 120
Chapter 14: Adelaide Wilson: Obesity ............................................................................................................ 129
Chapter 15: Care of the Newborn and Infant................................................................................................... 139
Chapter 16: Care of the Toddler ...................................................................................................................... 147
Chapter 17: Care of the Preschooler ................................................................................................................ 155
Chapter 18: Care of the School-Age Child ...................................................................................................... 163
Chapter 19: Care of the Adolescent ................................................................................................................. 171
Chapter 20: Alterations in Respiratory Function ............................................................................................. 180
Chapter 21: Alterations in Cardiac Function ................................................................................................... 188
Chapter 22: Alterations in Neurologic and Sensory Function ......................................................................... 196
Chapter 23: Alterations in Gastrointestinal Function ...................................................................................... 204
Chapter 24: Alterations in Genitourinary Function ......................................................................................... 212
Chapter 25: Alterations in Hematologic Function ........................................................................................... 220
Chapter 26: Oncological Disorders.................................................................................................................. 228
Chapter 27: Alterations in Musculoskeletal Function ..................................................................................... 236
Chapter 28: Alterations in Neuromuscular Function ....................................................................................... 244
Chapter 29: Alterations in Integumentary Function ........................................................................................ 252
Chapter 30: Alterations in Immune Function .................................................................................................. 260
Chapter 31: Alterations in Endocrine Function ............................................................................................... 268
Chapter 32: Genetic Disorders......................................................................................................................... 276
Chapter 33: Alterations in Cognitive and Mental Health ................................................................................ 284
Chapter 34: Pediatric Emergencies.................................................................................................................. 293
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Chapter 01: Chip Jones: Bronchiolitis
1. A nurse is providing care for a 4-month-old infant at the pediatric clinic. During the
assessment the nurse should expect that the infant has reached which developmental
milestone(s)? Select all that apply.
A. Uses pincer grasp to pick up items
B. Can roll over from front onto back
C. Pulls self up to a standing position
D. Recognizes family members' faces
E. Pushes self up on arms from a prone position
F. Sits with support
ANS: B, D, E, F
Rationale: At 4 months of age, an infant is able to roll over from prone to supine position,
push the head/chest up on arms from a prone position, sit with support and recognize the faces
of close family members. The use of the pincer grasp and the ability to pull self up to a
standing position are expected at 10 months of age.
PTS: 1 REF: p. 4 OBJ: 1
NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Understand
2. A nurse is assessing a 3-month-old infant during a pediatric clinic visit. The nurse believes the
infant is demonstrating early manifestations of respiratory distress. Which clinical
manifestation(s) should the nurse document? Select all that apply.
A. Bradycardia
B. Acrocyanosis
C. Intercostal retractions
D. Nasal congestion
E. Tachypnea
ANS: D, E
Rationale: Early signs of respiratory distress in an infant include fussiness, nasal congestion,
tachypnea and no interest in feeding. Intercostal retractions are signs of moderate distress;
bradycardia can be seen with severe respiratory distress. Acrocyanosis, in and of itself, is not
a sign of respiratory distress as it can be caused by poor circulation and cold extremities.
PTS: 1 REF: p. 8 OBJ: 4
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
3. A nurse is caring for an infant newly admitted for suspected bronchiolitis. The infant's parent
is very upset and states "I am so worried about my infant. What can you do to help my
infant?" What is the nurse's best response?
A. "There is no need to worry; we care for cases like this all the time."
B. "I know this is hard for you but do not worry. We will be able to discharge your
infant in a few days."
C. "No worries; having you hold the infant is very helpful. The infant will be back at
home in no time."
D. "I know it is difficult to see your infant like this. We will suction your infant and
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give oxygen to make the infant comfortable.
ANS: D
Rationale: The option that states that it is difficult to see the infant like this is the only
response that explains to the parent what the nurse can do to help the infant and acknowledges
the parent's concern. The remaining options recognize the parent's concern but do not answer
the parent's question.
PTS: 1 REF: p. 10 OBJ: 7
NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
4. A 3-month-old infant is hospitalized with a diagnosis of bronchiolitis. The nurse is creating a
plan of care for the infant. Which intervention is a priority?
A. Provide parental teaching on the antibiotics the infant will need to take at home.
B. Administer oxygen to maintain the infant's oxygen saturation at or above 92%.
C. Allow the parents to remain by the infant's side throughout the hospitalization.
D. Keep the infant NPO until the condition has resolved.
ANS: B
Rationale: Therapeutic management of bronchiolitis includes the administration of oxygen to
maintain O2 saturation at 92% or higher. Current evidence shows that antibiotics do not
improve outcomes in the treatment of bronchiolitis. Infants with bronchiolitis are encouraged
to feed as tolerated to maintain nutrition and fluid balance. While it is important for the
parents to be allowed to remain at the infant's side, it is not the priority.
PTS: 1 REF: p. 14 OBJ: 7
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 1: Chip Green: Bronchiolitis BLM: Cognitive Level: Apply
5.
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