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Pediatric

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Exam of 22 pages for the course Pediatric at Pediatric (Pediatric)

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Pediatric Assessment A/59
Questions and Verified
Answers/Graded A+
A nurse is providing discharge teaching to the parents of a 3 month old
infant following a cheiloplasty. Which of the following instructions shoule
the nurse include? - -Apply a thin layer of antibiotic ointment on your
baby's suture line daily for the next 3 days.


The nurse should instruct the parents to apply a thin layer of antibiotic
ointment on the infant's suture line daily for 3 days and then continue to
apply petroleum jelly to the area for several weeks to promote healing.

-A charge nurse in an ED is preparing an in-service for a group of newly
licensed nurses on the clinical manifestations of child maltreatment.
Which of the following clinical manifestation should the charge nurse
include as suggestive of potential physical abuse

recurrent urinary tract infections

symmetric burns of the lower extrmeties

growth failure

lack of subcutaneous fat - -symmetric burns of the lower extremities



The nurse should include in the teaching that symmetric burns of the
lower extremities are a suggestive clinical manifestation of physical
abuse. The patterns are usually characteristic of the method or object
used, such as cigar or cigarette burns, or burns in the shape of an iron.

-A nurse is providing teaching to an adolescent about how to manage
tinea pedis. Which of the following statements by the adolescent
indicates an understanding of the teaching?

I should buy some plastic shoes to wear at the swimming pool

i should wear sandals as much as possible

I should place the permethrin cream between my toes twice daily

I should seal my non-washing shoes in plastic bags for a couple of
weeks - -I should wear sandals as much as possible

,allow air to circulate the feet to decrease sweat in which bacteria like to
grow
Sandals allow air to circulate around the feet, decreasing perspiration
and eliminating the medium for bacteria and fungus to grow. The nurse
should inform the adolescent that wearing sandals, open-toed, or well-
ventilated shoes will promote healing of his fungal infection.

-A nurse is planning care for a toddler who has a serum lead level of 4
mcg/dL. Which of the following actions should the nurse plan to take?

A. instruct the parents to decrease the calcium in their toddler's diet
B. prepare the toddler for chelation therapy
C. refer the family to child protective services
D. schedule the toddler for a yearly rescreening - -schedule the toddler
for a yearly screening
The nurse should schedule the toddler for a lead level rescreening in 1
year and educate the family on ways to prevent exposure.

cheliation therapy not required unless lead level >45mcg/dl could be
initiated once over 10

-A nurse is creating a plan of care for a newly admitted adolescent who
has bacterial meningitis. How long should the nurse plan to maintain the
adolescent in droplet precautions?

until the adolescent is afebrile

for 7 days following admission to the facility

until the adolescent has a negative blood culture

for 24 hours following initiation of antimicrobial therapy - -for 24 hours
following initiation of antimicrobial therapy
The nurse should plan to maintain the adolescent on droplet precautions
for at least 24 hr following initiation of antimicrobial therapy. This
practice will ensure that the adolescent is no longer contagious, which
protects family members and the personnel caring for the client.
Prophylactic antibiotics might be prescribed to individuals who were in
close contact with the adolescent.

shouldn't be contagious anymore
could still show a positive blood culture wihthout being contagious

-A nurse is caring for a 15 year old client following a head injury. Which
of the following findings should the nurse identify as an indication that
the child is developing syndrome of inappropriate antidiuretic hormone
secretion (SIADH)?

sodium 148

, urine specific gravity 1.020

mental confusion

weak peripheral pulse
mental confusion - -mental confusion - correct answer

A child who has a head injury can develop SIADH as a result of altered
pituitary function, leading to an oversecretion of antidiuretic hormone.
Oversecretion of antidiuretic hormone leads to a decrease in urine
output, hyponatremia, and hypoosmolality due to overhydration.

A sodium level of 148 mEq/L is above the expected reference range for
a 15-year-old adolescent. SIADH is caused by the secretion of excess
antidiuretic hormone, which results in a decreased serum sodium level
due to increased circulation of free water.

A urine specific gravity of 1.020 is within the expected reference range.
A child who has SIADH is more likely to have concentrated urine and
urine specific gravity above the expected reference range.

A child who has SIADH is more likely to have fluid overload, full,
bounding pulses, increased blood pressure, and tachycardia.

-A nurse is assessing the vital signs of a 10 year old child following a
burn injury. Which of the following clinical manifestations indicate early
septic shock?

blood pressure 130/90

HR 60/min

temp 39.1 (102.4)

urinary output 100ml/hr - -temp 39.1 (102.4)

The nurse should expect a child who has early septic shock to have a
fever and chills.

-A nurse is providing teaching about social development to the parents
of a preschooler. Which of the following play activities should the nurse
recommend for the child?

playing pat a cake

using a push-pull toy

creating a scrapbook

playing dress up - -playing dress up

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