RN Nursing Care of Children Online Practice 2019 A (A+) answers and correct ANSWERS A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statements by the parent indicates an understanding of the teaching? Correct: - "I should keep my child indoors when I mow the yard." Guarding against exposure to known allergens found outdoors, such as grass, tree, and weed pollen, will decrease the frequency of the preschooler's asthma attacks. Dehumidifiers or air conditioners are recommended because heat and humidification can cause an asthma exacerbation. Instruct the parent to wet mop bare floors weekly because sweeping floors can trigger an asthma attack due to the inhalation of the dust that becomes airborne during sweeping. - correct answer -Ways to prevent acute asthma attacks: - Avoid smoking areas - Exercise safely with asthma - Identify and avoid asthma triggers - Stay away from allergens - Take your asthma medications - Get Vaccinated for flu - Allergy treatment and testing - Know your inhalers - Prevent colds - Use a home peak flow meter - Utilize immunotherapy The nurse should instruct the parent to keep the preschooler indoors during lawn maintenance or when the pollen count is increased. Cough suppressants are contraindicated for children who have asthma because they need to be able to cough up mucus to keep their airway open. A nurse in an urgent care clinic is assessing an adolescent who has an upper respiratory tract infection. Which of the following findings should the nurse identify as a manifestation of pertussis? Correct: - Dry, hacking cough The nurse should identify that a dry, hacking cough is a manifestation of pertussis. This disease usually begins with indications of an upper respiratory tract infection, which includes a dry, hacking cough that is sometimes more severe at night. - correct answer -
The nurse should identify that an inflamed throat with exudate is a manifestation of acute streptococcal pharyngitis. The nurse should identify that purulent eye drainage is a manifestation of bacterial conjunctivitis. The nurse should identify that Koplik spots on buccal mucosa are a manifestation of rubeola, or measles. A nurse is caring for a school -age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction? Correct: - Flank pain The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic reaction to the blood transfusion. - correct answer -Muscle weakness is an indication of an electrolyte disturbance, which is a complication of a blood transfusion. Distended neck veins are an indication of circulatory overload, which is a complication of a blood transfusion. Laryngeal edema is an indication of an allergic reaction to the blood transfusion. A nurse is caring for a school -age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should t he nurse administer first? Correct: - Epinephrine This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence -based practice, the nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the heart, causes vasoconstriction of blood vessels in the skin and mucous membranes, and triggers bronchodilation in the lungs. - correct answer - A nurse is teaching the guardian of a 6 -month -old infant about car seat use. Which of the following statements by the guardian indicates an understanding of the teaching? Correct: - - "I should secure the car seat using lower anchors and tethers instead of the seat belt." Lower anchors and tethers, or the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides anchors between the front cushion and the back rest for the car seat. Therefore, if this system is availabl e, the seat belt does not have to be used. - correct answer -The car seat should be positioned at a 45° angle to prevent slumping and injury to the infant. Padding placed underneath the infant or anywhere in the car seat can compress and/or create space between the infant and the harness. This can increase the risk for injury to the infant and should be avoided. The car seat harness in rear -facing car seats should be positioned at or just below the infant's shoulders. 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? Correct: - Schedule the toddler for a yearly rescreening. The nurse should schedule the toddler for a lead level rescreening in 1 year and educate the family on ways to prevent exposure. CDC lead level is 3.5 mcg/dL. - correct answer -Chelation therapy is required for a lead level of 45 mcg/dL or greater and, depending on the situation, can be initiated for lead levels over 10 mcg/dL. The nurse should instruct the toddler's parents to provide a diet rich in calcium because calcium, vitamin C, and iron decrease lead absorption. A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy. Which of the following findings should the nurse expect? (Select all that apply.) Correct: - Ankle clonus, which is a rhythmic reflex tremor when the foot is dorsiflexed. - Exaggerated stretch reflexes - Contractures due to the tightening of the muscles. Also: - Positive Babinski reflex. - correct answer -Spastic cerebral palsy is the most common type of cerebral palsy. The muscles of people with spastic cerebral palsy feel stiff and their movements may look stiff and jerky. Spasticity is a form of hypertonia, or increased muscle tone. This results in stiff muscles which can make movement difficult or even impossible. Common symptoms of spastic CP are: Stiff, tight muscles (hypertonia) on one or both sides of the body. Exaggerated movements. Limited mobility. Abnormal gait. Crossed knees. Joints don't full extend. Walking on tiptoes. Contractures. A nurse is assessing a school -age child immediately following a perforated appendix repair. Which of the following findings should the nurse expect? Correct: - Absence of peristalsis The nurse should expect absence of peristalsis immediately following a perforated appendix repair, until the bowel resumes functioning. - correct answer -Expect brown to green -tinged drainage from the NG tube. Expect a WBC count greater than 20,000/mm3 in a client who has had a ruptured appendix. Appendicitis is inflammation of the lining of the appendix, manifested by intense pain in the right lower quadrant. When the appendix rupture pain goes away temporarily, and peritonitis sets in. A nurse is planning care for a school -age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan? Correct: - Initiate seizure precautions for the child. A sodium level of 129 mEq/L indicates hyponatremia and places the child at increased risk for neurological deficits and seizure activity. The nurse should complete a neurologic assessment and implement seizure precautions to maintain the child's
The nurse should identify that an inflamed throat with exudate is a manifestation of acute streptococcal pharyngitis. The nurse should identify that purulent eye drainage is a manifestation of bacterial conjunctivitis. The nurse should identify that Koplik spots on buccal mucosa are a manifestation of rubeola, or measles. A nurse is caring for a school -age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction? Correct: - Flank pain The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic reaction to the blood transfusion. - correct answer -Muscle weakness is an indication of an electrolyte disturbance, which is a complication of a blood transfusion. Distended neck veins are an indication of circulatory overload, which is a complication of a blood transfusion. Laryngeal edema is an indication of an allergic reaction to the blood transfusion. A nurse is caring for a school -age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should t he nurse administer first? Correct: - Epinephrine This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence -based practice, the nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the heart, causes vasoconstriction of blood vessels in the skin and mucous membranes, and triggers bronchodilation in the lungs. - correct answer - A nurse is teaching the guardian of a 6 -month -old infant about car seat use. Which of the following statements by the guardian indicates an understanding of the teaching? Correct: - - "I should secure the car seat using lower anchors and tethers instead of the seat belt." Lower anchors and tethers, or the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides anchors between the front cushion and the back rest for the car seat. Therefore, if this system is availabl e, the seat belt does not have to be used. - correct answer -The car seat should be positioned at a 45° angle to prevent slumping and injury to the infant. Padding placed underneath the infant or anywhere in the car seat can compress and/or create space between the infant and the harness. This can increase the risk for injury to the infant and should be avoided. The car seat harness in rear -facing car seats should be positioned at or just below the infant's shoulders. 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? Correct: - Schedule the toddler for a yearly rescreening. The nurse should schedule the toddler for a lead level rescreening in 1 year and educate the family on ways to prevent exposure. CDC lead level is 3.5 mcg/dL. - correct answer -Chelation therapy is required for a lead level of 45 mcg/dL or greater and, depending on the situation, can be initiated for lead levels over 10 mcg/dL. The nurse should instruct the toddler's parents to provide a diet rich in calcium because calcium, vitamin C, and iron decrease lead absorption. A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy. Which of the following findings should the nurse expect? (Select all that apply.) Correct: - Ankle clonus, which is a rhythmic reflex tremor when the foot is dorsiflexed. - Exaggerated stretch reflexes - Contractures due to the tightening of the muscles. Also: - Positive Babinski reflex. - correct answer -Spastic cerebral palsy is the most common type of cerebral palsy. The muscles of people with spastic cerebral palsy feel stiff and their movements may look stiff and jerky. Spasticity is a form of hypertonia, or increased muscle tone. This results in stiff muscles which can make movement difficult or even impossible. Common symptoms of spastic CP are: Stiff, tight muscles (hypertonia) on one or both sides of the body. Exaggerated movements. Limited mobility. Abnormal gait. Crossed knees. Joints don't full extend. Walking on tiptoes. Contractures. A nurse is assessing a school -age child immediately following a perforated appendix repair. Which of the following findings should the nurse expect? Correct: - Absence of peristalsis The nurse should expect absence of peristalsis immediately following a perforated appendix repair, until the bowel resumes functioning. - correct answer -Expect brown to green -tinged drainage from the NG tube. Expect a WBC count greater than 20,000/mm3 in a client who has had a ruptured appendix. Appendicitis is inflammation of the lining of the appendix, manifested by intense pain in the right lower quadrant. When the appendix rupture pain goes away temporarily, and peritonitis sets in. A nurse is planning care for a school -age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan? Correct: - Initiate seizure precautions for the child. A sodium level of 129 mEq/L indicates hyponatremia and places the child at increased risk for neurological deficits and seizure activity. The nurse should complete a neurologic assessment and implement seizure precautions to maintain the child's
