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The nurse instructs parents of a school-age client about how
to collect a 24-hour urine specimen at home using a clean,
empty jar. Which size does the nurse recommend that the
client use for the collection?
a. An 8-ounce jar
b. A 16-ounce jar
c. A 48-ounce jar
d. A 128-ounce jar
c. A 48-ounce jar
The expected amount of urine output for a school-age child is
about 1,200mL. Since 30mL equals 1 ounce, 1,200mL equals 40
ounces. A 48-ounce jar would be best to hold 40 ounces of
urine. For a 24-hour urine test, all urine is collected during a
24-hour period and placed into a single container with a
preservative or the container is placed in ice. An 8-ounce
(240mL) jar is not big enough to hold all the urine produced in
a 24-hour period for school-age child. A 16-ounce (480mL) jar
is not big enough to hold all the urine produced for a school-
age child. A 128-ounce container is equivalent to 1 gallon. This
container would be too large for an average amount of urine in
a 24-hour period for a school-age child.
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,A school-age client is admitted to the hospital with a diagnosis
of idiopathic hypopituitarism. Which clinical manifestation is
the nurse most likely to observe?
a. Hyperglycemia
b. Early sexual maturation
c. Short stature
d. Decreased urination
c. Short stature
Pediatric clients with idiopathic hypopituitarism
characteristically have short stature and slow growth.
Children typically fall off the growth curve in height and may
have weight gain that is out of proportion to height. Idiopathic
hypopituitarism is diminished or deficient secretion of one or
more of the pituitary hormones, including adrenocorticoids and
growth hormone. Evidence of hypoglycemia is more common.
Sexual development is usually absent or delayed due to the
lack of pituitary hormones that stimulate sexual development.
Increased thirst and urination may be seen in hypopituitarism
due to a lack of antidiuretic hormone.
The nurse observes a child client walk up and down steps. The
nurse notes the child has a steady gait and can use short
sentences. The nurse estimates the child's age to be how many
months?
Page 2 of 64
,a. 8 months
b. 12 months
c. 16 months
d. 24 months
d. 24 months
The 24-month-old child goes up and down stairs alone, runs
well with a wide stance, builds a tower of six to seven blocks,
and has a vocabulary of about 300 words. The 8-month-old
child can roll over from stomach to back and begins to
distinguish and recognize strangers. The 12-month-old child
needs help walking, eats with fingers, and says three to five
words other than "dada" and "mama." The 16-month-old child
walks without help, kneels without support, and says four to
six words including names.
A child at this stage of development should be able to walk
down stairs using alternating feet. This indicates a delay.
Throwing and catching a ball is an appropriate skill for a child
at this stage of development. Neatly tying knots is an
appropriate skill for a child at this stage of development. While
a child at this stage of development is more aware of hands as
a tool, it is not unusual to revert to finger feeding.
Which guideline is appropriate for the nurse to give a parent
concerning the normal development of a young school-aged
child?
Page 3 of 64
, a. The child's periods of shyness should be tolerated
b. Nightmares are characteristic at this age
c. The child's participation in group activity should be
mandated
d. Punishment may be necessary for any acts of independence
a. The child's periods of shyness should be tolerated
A young school-age child may become shy at times because of
experiencing a conflict regarding independence from the
parent. In order to allow the child to become independent, the
parent should allow these episodes of shyness. School-age
children do experience nightmares, but nightmares are more
common in preschool children. Nightmares that occur with
school-age children are a reflection of conflict. Therefore,
resolving the child's worry will reduce incidence of
nightmares. While clubs and peer groups are important to the
school-age child, the child should not be forced to participate.
Children are working toward independence during the school-
age years. It is not appropriate to recommend any form of
punishment with acts of independence.
During a well child check-up for a 6-month-old client, the
parent reports the client received the first DTaP at two months
of age, and has received no other vaccinations. Which action by
the nurse is most appropriate?
a. Repeat first DTaP, starting the schedule again
b. Give second DTaP
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