Burns Pediatrics Final Exam Already Solved 100%

Which approach is best for administering oral medication to a young child? 1. "Would you please take your medicine now, David?" 2. "Look how good Johnny takes his medication. Can you do that too, David" 3. "You must take your medication now if you want to get better." 4. "It's time for the medicine, David. Would you like water juice after it?" - Answer Correct answer: 4 Rationale: Allowing a young child autonomy, providing praise for cooperation, and providing a good-tasting liquid or a frozen treat following administration of a medication are all techniques that encourage compliance. Page reference: Page 501-502 The preferred site for an intramuscular injection in small infant is: 1. dorsogluteal 2. ventrogluteal 3. vastus lateralis 4. deltoid - Answer Correct answer: 3 Rationale: IM injections are given into the vastus lateralis muscle of the thigh in all infants. The site is free of major nerves and blood vessels. Page reference: Page 503 The physician orders 10 mg of Demerol for an infant after surgery. If the label reads 50 mg/ml, the nurse would administer 1. 2.0 mL 2. 0.8 mL 3. 0.5 mL 4. 0.2 mL - Answer Correct answer: 4 Rationale: Page reference: Page 509 Box 22-2 Which of the following medication can be crushed when administered to a pediatric patient? 1. Potassium chloride (Slo-K" capsule 2. Colace gel tablets ( Docusate) 3. Ditropan XL tablets (oxybutynin) 4. Simethicone tablet - Answer Correct answer: 4 Rationale: Most pediatric medications are available in liquid, suspension, or chewable tablets. Only scored tablets should be divided. Extended-release tablets and medication in capsule form, such as Ditropan XL (oxybutynin) and potassium chloride (Slo-K), should not be chewed or crushed. Gel tablets, such as Colace (docusate sodium) should not be cut or dissolved. Page reference: Page 501 The mother and grandmother of a child are at the bedside, rubbing the skin of a child when the nurse enters the room, the visitors a startled and drop the item they were rubbing against the child's skin. The nurse picks up the item and recognizes it as a penny. The best response of the nurse is to? 1. ask, "What on earth are you doing to that child with this penny?" 2. Give a penny back to mother leave the room to give them their privacy. 3. Tell them that they could hurt the child with the penny and there are many germs on coins. 4. Return the paint to the mother an open dialogue about the practices are using. - Answer Correct answer: 4 Rationale: Cultural practices need to be considered, and an open dialogue about these practices will help the health care team to understand the reasoning behind them. As long as patient safety is not compromised, the caregivers should allow these practices to take place. Communication should reflect a nonjudgmental attitude on the part of the caretaker. If the cultural practice compromises safety or is against hospital policy, the health care provider should educate the patient and family members as to why the practice should not take place in the hospital setting. Page reference: Page 490 (See also Chapter 24 Page 575.) What is the most effective position for the nurse to place a toddler in to administer medications? Semi-sitting position on a nurse's lap Sitting in a high chair Semi-Fowler's in a crib Standing after providing an explanation - Answer Semi-sitting position on a nurse's lap Toddlers are usually going to resist and this will allow for the most effective method to administer medications.REF: Page 501 A child on the pediatric unit has an order for a 24-hour urine specimen. Six hours after initiating the specimen collection the parents inform nursing staff that the child was incontinent. What instruction does the nurse provide to the parents at this time? Lost specimens necessitate restarting the test. The specimen can now be sent to the laboratory. They should continue collecting the child's urine. The child will now require a straight catheterization to obtain urine. - Answer Lost specimens necessitate restarting the test. At times a 24-hour urine specimen may be requested to determine the rate of urine production and measure the excretion of specific chemicals from the body. The nurses on each shift must closely supervise this test to maintain its accuracy, because lost specimens necessitate restarting the test.REF: Page 497 The nurse enters the room of a 2-month-old patient and observes the infant actively feeding with a propped formula bottle. What fact related to propping bottles should the nurse consider when preparing education for the family at this time? It is an effective technique for feeding. It significantly increases choking risk. It is a common cultural practice and requires respect. It will assist the infant to learn how to hold the bottle independently. - Answer It significantly increases choking risk. Propped nursing bottles or force-feeding small children can lead to choking.REF: Page 488 Which procedure could be performed to obtain spinal fluid for examination? Thoracentesis Needle aspiration Lumbar puncture Bone marrow aspiration - Answer Lumbar puncture A lumbar puncture is also referred to as a spinal tap and is done to obtain spinal fluid for examination or to reduce pressure within the brain in conditions such as hydrocephalus or meningitis.REF: Page 498 A 3-year-old patient requires a pulse assessment. Which anatomical area is the best to assess the toddler's pulse? Radial Popliteal Apical Carotid - Answer Apical The pulse of the older child is taken just like that of an adult. Apical pulses are advised for children younger than 5 years of age.REF: Page 491 Which of the following statements are appropriate when administering medications to children? Select all that apply. The nurse should plan additional time for administering medications to children. The nurse may leave non-narcotic pain relievers at the bedside for an adolescent. The nurse will find that resistive behavior to taking medications is at a peak with toddlers.. The nurse will find that chewable tablets are preferred for Preschool age children. The nurse may suggest that the parent give an injection, if infants are resistant to injections. - Answer The nurse should plan additional time for administering medications to children.,The nurse will find that resistive behavior to taking medications is at a peak with toddlers., The nurse will find that chewable tablets are preferred for Preschool age children. Children may be uncooperative, so extra time must be allowed. Resistance is higher with toddlers, so nurses must plan for this. Elixirs and chewable tablets are preferred for Preschoolers. The nurse should not leave medications with an adolescent to take at a later time. The nurse should always be the professional who gives the injection. This should not be delegated to the parents.REF: Page 511 How often should the nurse assess the IV line of a pediatric patient? Every hour Every 2hours Every 4 hours Every shift - Answer Every hour IV medications can cause phlebitis, and the nurse must observe the child's IV site hourly for reddened areas or signs of inflammation. Infiltration is a risk for children who are active, and the site should be observed hourly because infants cannot communicate the burning or pain that may accompany infiltration. The nurse should monitor the rate of the IV flow, refill the burettes hourly, observe the condition of the IV site, identify the responses of the child, and document findings.REF: Page 505 What is the most significant reason for obtaining an accurate weight on a child in the hospital? Plots their growth on the growth chart Helps determine dose of medication Allows for accurate nutrition orders Helps identify growth disorders - Answer Helps determine dose of medication The most significant reason for obtaining a weight is for calculating medications. The other ones are accurate reasons that nurses obtain weights, but the most significant reason is to allow for accurate dosing of medication. If the pharmacy doesn't have an accurate weight, then the medications can't be ordered accurately.REF: Page 507 Puberty starts in girls with breast development. True or False - Answer False , puberty is easily recognized in girls by menarche. A fear that is unique to 5-year olds is a fear of bodily harm. True or False - Answer False, the fear of bodily harm, particularly the loss of body parts, is unique to 3-year olds The pincer grasp is the accurate and coordinated opposition of index finger and thumb of the same hand. True or False - Answer True Pretension is the ability to grasp objects between all fingers of one hand and the opposing thumb of the same hand. True or False - Answer True What activity would the nurse choose to meet Erikson's developmental task of industry when caring for a 7-year old? - Answer Completing a 50-piece jigsaw puzzle A mother calls the pediatricians office because her infant is "colicky". What is the most helpful measure the nurse can suggest to the mother - Answer Rock the fussy infant slowly and gently The nurse is assessing development in a 9-month old infant. What would the nurse expect to observe? - Answer Creeping along the floor The nurse observes a 10-month old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed? - Answer The pincer grasp What instruction would the nurse include when planning anticipatory guidance for parents of a toddler? - Answer Limit-setting should include praise What is the most appropriate toy for the nurse to select for a normal 2-year old child - Answer Dump truck , toys that can be pushed or pulled What would be an expected finding whe assessing language development in a 2-year old? - Answer Use of two-word sentences The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." What is the most appropriate response by the nurse? - Answer How much milk does she drink in a day? Milk should be limited to 24 ounces a day, too few solid foods can lead to dietary deficiencies of iron. A 16-month old child is attending a well-child visit at a pediatric clinic. Which assessment would indicate the biggest cause for concern? - Answer Does not walk independently What is an example of associative play? - Answer Two children playing in a sand box, one building a wall and the other digging a hole What should the nurse keep in mind when planning to teach a class on nutrition to fourth grade students? - Answer School-age hildren think logically and concretely What can the nurse suggest as a good dietary source of zinc for an adolescent who is a vegetarian? - Answer Nuts The nurse is documenting the pediatricians assessment of a male patient. When assessing Tanners stages of genital development she notes skin on the scrotum has reddened and changed texture. What stage of development will the nurse document? - Answer Stage 2 The school nurse is educating high school students about. Guidelines to be followed when participating in sports. Which statement by a student alerts the nurse of the need for further information? - Answer "I drink large amounts of fluid when working out" Fluids lost by sweat must be replaced by drinking small amounts of fluid during a workout. The best way to weigh an infant is with a dry diaper on. True or False - Answer False, the best way to weigh an infant is completely naked The pediatric nurse is caring for a child that weighs 15kg and calls the physician for an order of acetaminophen for pain control. What is the maximum amount o medication per dose the nurse anticipates ordering - Answer 225mg/dose The maximum dose is 15mg/kg/dose with a maximum of 5 doses in 24 hours What are characteristics of a toddler - Answer Age at which separation anxiety is most pronounced What are characteristics of a infant - Answer Should have ear drops installed by pulling down and back to straighten the canal What are characteristics of preschoolers - Answer Are particularly fearful of bodily harm What are characteristics of adolescents - Answer Illness is perceived mainly as a threat to body image An adolescent with hyphenated is able to sleep laying flat in bed. True or False - Answer False, Treatment of hyphens is bed rest, topical medication and the head of the bed elevated 30 to 45 degrees to decrease IOP and ICP Parents should whip the eye of this child with conjunctivitis from the inner canthus downward and away from the opposite eye. True or False - Answer True The child with Pinkeye is considered infectious until they have completed their course of antibiotics. True or False - Answer False The pinkeye is considered no longer contagious after being on medication 24 hr Retention of Reye's Syndrome includes educating parents not to give aspirin-containing medication to children with viral symptoms. True or False - Answer True Excessive in-toeing will resolve by 4-years old. True or False - Answer True Principles for managing soft tissue injuries include range of motion exercises, ice, compression, and elevation. True or False - Answer False , RICE =. Rest, ice, compression, elevate Amputation is generally recommended treatment for Ewing's sarcoma. True or False - Answer False, Amputation is not generally recommended for Ewing's sarcoma because the tumor is sensitive to radiation and chemotherapy It is the primary nursing responsibility to visualize the throat to help confirm diagnosis i of epiglottis. True or False - Answer False, It is a primary nursing responsibility to be sure there is a tracheotomy set at the bedside before any examination of the throat is attempted A sweat chloride test is the test of choice for diagnosis cystic fibrosis. True or False - Answer True The prevention of preterm births is the best way to prevent bronchopulmonary dysplasia. True or False - Answer True A chronic case of child abuse is most likely non-intentional. True or False - Answer True All parents have the potential to be abusive to a child. True or False - Answer True Opisthotonos is the voluntary arching of the back and flexion of the neck. True or False - Answer False One of the most common causes of death in a child with muscular dystrophy is cardiac failure. True or False - Answer True What is the best way for the nurse to communicate with a 10-year old child who has a hearing impairment? - Answer Face the child and speak clearly in short sentences What would the nurse include in teaching when preparing to teach parents about air trave instructions to prevent barotrauma in infants? - Answer Letting the infant nurse during descent What might the nurse explain as a common treatment for amblyopia? - Answer Patching the good eye to force the brain to use the affect eye A child is daignosed with no paralytic strabismus. How will this disorder most likely be corrected? - Answer Corrective lenses What assessment does the school nurse recognize as the cardinal sign of a hyphema? - Answer A dark-red spot in the anterior chamber The nurse urges the mother of a 6-month old to get her child inoculated with Haemophilus influenza type B. What does this immunization protect against? - Answer Bacterial meningitis A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches, with vomiting, that are worse in the morning. What does the nurse suspect? - Answer Brain tumor What does the nurse explain to parents of a child with febrile seizures? - Answer They occur when the temperature rises quickly A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? - Answer Absence A child diagnosed with epilepsy had a generalized tonic-clinic seizure that lasted 90 seconds. What would the nurse expect to assess after a generalized tonic-clonic seizure? - Answer Sleepiness What would the nurse include hen creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)? - Answer Gums should be massaged regularly to prevent hyperplasia The nurse observes a child's position is supine with his arms and legs rigid with the arms and wrists flexed inward toward the chest. The feet are plantar flexed. Ho does the nurse identify this posture? - Answer Decorticate The nurse is caring for a 3-year old with a head injury. Which assessment would lead the nurse to report the probability of increasing intracranial pressure (ICP) - Answer Increase in blood pressure with an attendant decrease in pulse What would the nurse consider an abnormal finding on a musculoskeletal assessment of a 4-year old child? - Answer Walks on toes A pediatric nurse is assisting with the care of a child diagnosed with a fractured femur. What type of fracture would be the most likely to alert the nurse to the possibility of physical abuse? - Answer Spiral fracture On entering the room of a child in Buck's traction, the nurse makes all of the following observations. Which observation requires a nursing intervention? - Answer Childs heels are placed firmly against the foot of the bed What intervention will the nurse caring for a child in bucks skin traction implement? - Answer Assist the child to be pulled up in bed What nursing action will significantly decrease the risk of serious complications for a child in Bryants traction? - Answer Neuromuscular checks are done frequently A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end. How long will the nurse indicate that antibiotic therapy will probably last? - Answer 6 weeks The parent of a child with osteomyelitis asks why his child is in so much pain. What will the nurse respond causes the pain experienced with osteomyelitis? - Answer Purulent drainage in the bone marrow Which intervention would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis? - Answer Applying moist heat packs upon awakening What instruction would the nurse provide to an adolescent who has been fitted with a Milwaukee brace? - Answer Wear the brace over a T-shirt 23 hours a day what intervention is appropriate for a nurse assessing a preadolescent child for scoliosis? - Answer Ask the child to bend forward at the waist and observe the child's back for asymmetry A 13-year-old girl is diagnosed with functional scoliosis. What does the nurse explain as the cause of this spinal curvature defect? - Answer Poor posture Which observation may cause the nurse to consider the possibility of child abuse when a moth says that her young child fell down the basement stairs today? - Answer Red, green and yellow bruises on his body 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? - Answer Oral penicillin for 10 days How would the nurse advise aa mother to clear the nostrils when her infant has a cold? - Answer Remove nasal secretions with a bulb syringe The nurse is caring or a 3-year-old who suffered a smoke inhalation injury. How long is this patient at the highest risk for pulmonary edema after exposure? - Answer 72 hours The nurse would observe a child for frequent swallowing after a tonsillectomy and adenoidectomy. What might this indicate? - Answer Bleeding from the surgical site What classic sign would the nurse, auscultation the breath sounds of a child hospitalized for an acute stomach attack, expect to find? - Answer Expiration wheezing The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the flui loss through dyspnea. Which fluids are most appropriate? - Answer Room temperature water The teaching pla 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? - Answer Candidiasis What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients? - Answer Pancreatic enzymes The nurse is planning to teach parents about preventing sudden infant death syndrome. What significant information would the nurse include? - Answer Placing facts on their backs or sides for sleep ______________ occurs when there is a change in the atmospheric pressure between the internal body systems and the surrounding environment. - Answer Barotrauma The nurse records the finding of _____________ ______________ when te child with meningitis cries out in pain when his head is flexed toward his chest. - Answer Unchallenged rigidity The child with Duchenne's muscular dystrophy must push on his legs and "walk up the leg" in order to rise to a standing position. The nurse recognizes this characteristic behavior as __________ maneuver - Answer Growers The nurse reminds the adolescent boy with Ewing's sarcoma that he is prohibited from vigorous weight-Bearing activities during treatment with radiation to reduce the risk of a(n) ________________ fracture - Answer Pathological What is the definition of athetoid seizures - Answer Involuntary purposeless movements that interfere with normal motion; involves damage to the cortex of the brain What is the defenition of spastic seizures - Answer Involves damage tot he cortex of the brain; related to cerebra asphyxia What is the defeniton of Ataxic seizures - Answer Uncoordinated movements and ataxia from a lesion in the cerebellum What is the defenition of mixed seizures - Answer Usually a combo of spastic and athetoid