Pediatrics Exam 2 Latest 2024 Update A+ SCORED WITH RATIONALE

Pediatrics Exam 2 Latest 2024 Update A+ SCORED WITH RATIONALE A nurse is assessing infants for visually related developmental milestones. Which infant is showing a delay in meeting an expected milestone? 1. A 4-month-old who has a social smile 2. An 8-month-old who has just begun to inspect her own hand 3. A 12-month-old who stacks blocks 4. A 7-month-old who picks up a raisin by raking - Answer: 2 Explanation: 1. an 8-month-old who has just begun to inspect her own hand is delayed. The infant usually inspects her own hand beginning at 3 months. A 4-month-old with a social smile, a 12-month-old who stacks blocks, and a 7-month-old who picks up a raisin by raking are all showing appropriate visually related milestones. A neonate has been diagnosed with a herpes simplex viral infection of the eye. Which medication will the nurse prepare to administer? 1. Fluoroquinolone eye drops or ointment 2. Intravenous penicillin 3. Oral erythromycin 4. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment - Answer: 4 Explanation: Neonatal herpes simplex virus is treated vigorously with parenteral acyclovir for 14 days or longer and topical ophthalmic medication (trifluridine, iododeoxyuridine, or vidarabine). Fluoroquinolone eye drops are used to treat bacterial eye infections. Intravenous penicillin treats selected bacterial infections. Oral erythromycin is used to treat chlamydial eye infections. The nurse suspects that an infant has a visual disorder caused by abnormal musculature. Which test will the nurse perform to detect this disorder? 1. A cover/uncover test 2. An ophthalmologic exam 3. A vision-acuity exam 4. A pupil-reaction-to-light test - Answer: 1 Explanation: The cover/uncover test can detect abnormal musculature of the eye that can lead to asymmetric eye movement. An ophthalmologic eye exam allows the practitioner to view the internal structures of the eye, not abnormal musculature. A vision acuity test is used to test for myopia. A pupil-reaction-to-light test evaluates neurological status. The nurse is caring for four clients. Which client has the highest risk of developing retinopathy of prematurity? 1. 30-week-gestation infant who was in an Oxy-Hood for 12 hours and weighed 1800 g. 2. 32-week-gestation infant who needed no oxygen and weighed 1850 g. 3. 28-week-gestation infant who has been on long-term oxygen and weighed 1400 g. 4. 28-week-gestation infant who was on short-term oxygen and weighed 1420 g. - Answer: 3 Explanation: 1. The 28-week-gestation infant on oxygen weighing 1400 g has the highest risk of retinopathy of prematurity because of gestational age (28 weeks or less), weight (less than 1500 g), and oxygen therapy. The other neonates have fewer risk factors. A nurse is caring for a visually impaired 20-month-old who has not begun to walk. Which nursing diagnosis is the most appropriate for this client? 1. Delayed growth and development 2. Impaired physical mobility 3. Self-care deficit 4. Impaired home maintenance - Answer: 1 Explanation: A 20-month-old child who is not walking is delayed in growth and development. The child's mobility is not due to a physiological problem, so impaired mobility is not appropriate. Self-care deficit does not apply to this age of child. There is not enough data to determine if home maintenance is impaired. A nurse is caring for a visually impaired school-age child. Which nursing intervention is the highest priority for this child during the admission process? 1. Explaining playroom policies 2. Orienting the child to where furniture is placed in the room 3. Letting the child touch equipment that will be used during the hospitalization 4. Taking the child on a tour of the unit - Answer: 2 Explanation: The priority intervention is to orient the child to furniture placement in the room. This is priority because it addresses basic safety for a client with a visual impairment. Policies, handling equipment, and tours can be done at a later time. An infant is diagnosed with acute otitis media. Which intervention is most appropriate for the nurse to teach the infant's parents? 1. Keep the baby in a flat lying position during sleep. 2. Administer acetaminophen (Tylenol) to relieve discomfort. 3. Administer a decongestant. 4. Place baby to sleep with a pacifier. - Answer: 2 Explanation: An infant with a bulging tympanic membrane because of acute otitis media will have pain. Parents are taught to administer acetaminophen (Tylenol) to relieve the discomfort associated with acute otitis media. A flat lying position may exacerbate the discomfort. Elevating the head slightly is recommended. Decongestants are not recommended for treatment of acute otitis media. Placing infants to sleep with a pacifier may increase the incidence of otitis media. The nurse teaches parents how to care for their child who has tympanostomy tubes inserted. Which actions by the parents indicate appropriate understanding of the teaching session? Select all that apply. 1. Encouraging the child to drink generous amounts of fluids 2. Administering a decongestant for 1 to 2 weeks following surgery 3. Restricting the child to quiet activities after surgery 4. Limiting diet to soft, bland foods 5. Avoiding getting water in ears during bath time - Answer: 1, 3, 5 Explanation: The correct responses include encouraging the child to drink generous amount of water, restricting the child to quiet activities after surgery, and avoiding water in the child's ears at bath time. Incorrect responses include administering a decongestant for 1 to 2 weeks following surgery and limiting diet to soft, bland foods-decongestants are not needed after surgery, and a regular diet should be resumed.