NURS 247 PEDS FINAL 2020 | NURS247 PEDS FINAL

NURS 247 PEDS FINAL 2020 The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching? “I will use precautions when administering oral medications to a school-age child.” A teen has a scoliosis curve of 35°. What treatment option does the nurse prepare the child and family for? Bracing A nurse is caring for a child with suspected epilepsy. Which diagnostic test does the nurse facilitate as the priority for this child? Electroencephalogram (EEG) An adolescent child has just had surgery and has an abdominal dressing Which question should the nurse expect the child to initially ask? “Will I have a large scar?” A child, age 3 years, refuses to have his temperature checked by the nurse. What nursing action should the nurse implement? Do the procedure quickly as possible, involving the parent, if present. After returning from cardiac catheterization, the nurse monitors the child’s vital signs. The heart rate should be counted for how many seconds? 60 The nurse is planning home care for a 2-year-old child with a tracheostomy. What recommendation should be included? Parents are able to change the tracheostomy tube when needed. What factor is most important for parents implementing do not resuscitate (DNR) orders? Acknowledgement by health care team of what will and will not be done for the child The nurse must suction a 6-month-old infant with a tracheostomy. What intervention should be included? Perform each pass of the suction catheter for no longer than 5 seconds. The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse’s response should be based on which knowledge? Parents need to learn specific, important guidelines for administration of digoxin. According to Erikson, the psychosocial task of adolescence is developing what? Identity Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience? Adolescents Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend? Invite the siblings to attend meetings to develop plans for the child with special needs. A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose? Let’s the child express thoughts and feelings through pictures rather than words - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - A nurse is caring for a 5-year-old who broke his arm and is complaining of pain. What statement by the nurse to the child would be most helpful? “You didn’t do anything wrong that caused the hurt” A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain? A Topical anesthetic can be applied before injections are given. After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? Neutrophils What physiologic defect is responsible for causing anemia? Decreased oxygen-carrying capacity of blood What term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? Stupor What is a principle of palliative care that can be included in the care of children? Child and family as the unit of care What is the role of the peer group in the life of school-age children? Provides them with security as they gain independence from their parents. At which developmental period do children have the most difficulty coping with death, particularly if it is their own? Adolescence Cardiopulmonary resuscitation is begun on a toddler. What pulse is usually palpated because it is the most central and accessible? Carotid Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power? School-age children The nurse should suspect a hearing impairment in an infant who fails to demonstrate which behavior? Babbling by age 12 months The nurse is promoting learning and school attendance to a 13-year-old girl. Which factor will affect the child’s attitude most? Peer group behaviors and attitudes A child has a tracheal tube in place and will be receiving medications via this tube. Which medications would the nurse expect to be administered in this manner. Select all that apply. Lidocaine, Epinephrine, Atropine, and Naloxone (LEAN) A student nurse asks a pediatric nurse what cephalocaudal development means. Which response by the nurse is most accurate? Growth that occurs from top to bottom The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause? Urinary stasis What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction? Marking the point of measurement with a pen The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse’s response should be based on remembering that discipline is which? Essential for the child Chapter 25-Growth and Development of the Newborn and Infant 1. The nurse is examining a 10-month-old boy who was born 10 weeks early. Which of the following findings is cause for concern? C) The child's head circumference is 19.5 inches. 2. The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which of the following describes a developmental milestone occurring in infancy? A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth. 3. The nurse measures the head circumference of a 6-month-old infant. Which measurement would the nurse interpret as most appropriate? C) 43.5 cm 4. The nurse is helping a new mother prepare for breastfeeding her infant. During which of the following newborn states of consciousness would the nurse recommended attempting the feeding? C) Quiet alert state 5. The nurse is assessing the respiratory system of a newborn. Which of the following anatomic differences place the infant at risk for respiratory compromise? Select all answers that apply. A) The nasal passages are narrower. D) The larynx is more funnel shaped. F) There are significantly fewer alveoli. 6. A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? B) "This is a primitive reflex known as the palmar grasp." 7. Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned? B) Step 8. A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? A) "This is normal behavior for infants unless the stool passed is hard and dry." 9. The neonatal nurse assesses newborns for iron-deficiency anemia. Which of the following newborns is at highest risk for this disorder? D) A premature newborn 10. The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which of the following statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply. A) At 1 month the infant lifts and turns the head to the side in the prone position. D) At 7 months the infant sits alone with some use of hands for support. E) At 9 months the infant crawls with the abdomen off the floor. F) At 12 months the infant walks independently. - - - - - - - - - - - - - - - - - - - - - - 21. The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years what major stress should the nurse relate to the students? Separation anxiety 22. The nurse assesses newborns for iron-deficiency anemia. Which newborn is at highest risk for this disorder? A premature newborn 23. Using knowledge of child development, what approach is best when preparing a toddler for a procedure? Demonstrate on a doll how the procedure will be done. 24. When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction? Peer relationships 25. The adolescent continues to develop self-concept and self-esteem. What is most important to a teen’s self-esteem? Body image 26. A nurse is assessing several children during a shift at the well-child clinic. Which child demonstrates successful resolution of the Erickson stage of autonomy verses shame and doubt? A 24-month –old being allowed to independently dress himself 27. The mother asks the nurse for advice about discipline for her 18-month old child. Which discipline strategy should the nurse suggest that the mother use? Time out 28. The nurse is teaching the parent of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan? Continuous peer relationships provide the most important social interaction for school-age children. 29. A mother is worried that her 3-month-old child id not holding her own head up. Which action by the nurse is most appropriate? Explain that sturdy head control occurs around 6 months. 30. The pediatric nurse teaches the mother of a toddler how to choose appropriate toys/activities to stimulate growth and development of her child. Which activities are appropriate for the nurse to include in the teaching session? SATA Large crayons Sliding down a slide Tricycle 31. A new nurse caring for a toddler in pain after a procedure is reluctant to medicate the child for feat of causing a respiratory arrest. What action by the nurse’s preceptor is best? Explain that pain has detrimental health effects and needs treatment. 32. The nurse is performing a physical assessment of a 3-year-old girl. What finding would be concern for the nurse? The toddler’s anterior fontanel is not fully closed 33. The nurse is teaching parents about instilling a positive body image for the preschool age. What statement made by the parents indicates the teaching understood? We will be sure our child understands about being little for his or her age. 34. A nurse notes that when an infant is startled, she looks at her mother. What conclusions can the nurse make about this infant’s development? The infant can develop other relationships because he is secure. 35. The nurse teaching safely to teens knows that which of these is the leading cause of death among adolescents? Unintentional injuries 36. A teenager is in the family practice clinic for a school physical. When the parent leaves the room; the teen admits to “cutting myself” after a relative touched me in my private area.” What action by the nurse is most appropriate? Explain that this information must be shared. 37. A nurse in the pediatric clinic suspects a patient is the victim of child abuse. What action takes priority? Report the suspicions according to state law. 38. A nurse has identified substance abuse in an adolescent. In addition to a treatment center referral, what other referral is most important? Mental health provider 39. The pediatric nurse is examining a newborn infant and notes a turning in of the foot and turning out of the toes when the sole of the foot is stroked. Which action by the nurse is most appropriate? Document findings in the patients chart 40. A nurse is making a referral for a family whose teenage daughter has anorexia nervos. Which referral is the most appropriate? Multidisciplinary team Exam 2 Questions: The nurse is teaching the family of an infant with cerebral palsy how to administer a Diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session? (Select all that apply) The pill should be crushed and mixed with a small amount of water The nurse is preparing to administer medication to a child with a gastronomy tube in place. What is a recommended guideline for this procedure? Select all that apply. Verify proper tube placement prior to instilling medication. Crush tablets and mix with warm water to prevent tube occlusion. Open up capsules and mix the contents with warm water Flush the tube with water after administering medications A nurse is caring for a 9-year-old patient who is considered a fall risk because of her history of seizures. Which of the following interventions should be implemented to prevent falls in a pediatric patient? Select all that apply. Keep the patient’s bed in the lowest position Provide non-slip socks for the patient to wear while ambulating Move furniture and room items so that there is a clear walkway A child is being cared for in the ICU after suffering a head injury. The patient requires a ventilator and he is sedated. The child is at risk of pressure ulcers because of his immobility. Which of the following nursing interventions is most appropriate to prevent skin breakdown in this child? Turn or reposition the child in bed every 2 hours A physician orders a medication dosage that is above the safe dosage range. The nurse administers the medication without questioning the dosage. What error did the nurse make? The nurse violated one of the “rights” of medication administration due to not calculating the dosage based on patient's safe range. When providing end-of-life care to a 4-year-old child who is dying of cancer, which of the following interventions would the nurse utilize to ensure that she is providing adequate pain control? Encourage the child to verbalize pain by using appropriate pain scale. A nurse is caring for a child who has been diagnosed with measles. The nurse must wear a N95 respirator when caring for a child and the parents ask the nurse why the mask is necessary. Which of the following statements by the nurse is accurate? “This mask filters out a certain size of particles that can be transmitted through the air and breathed in.” A nurse is working with a family whose child has an intellectual disability that occurred as a result of trauma. Which of the following situations would best describe an example of this type of event? Falling down a flight of stairs A 7-year-old boy has reentered the hospital for the second time in a month. Which intervention is particularly important at this time? Assessing his parents’ coping abilities Which of the following is an example of a non-pharmacological comfort measure that may be developmentally appropriate for a preschool-age child? Select all that apply. Art therapy Watching a movie Blowing bubbles The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last? Throat A 7-year old girl is being seen at a healthcare clinic; the nurse suspects that the child is being neglected and physically abused at home. Beyond physical markings on the child, which of the following can also indicate signs of a child being abused or neglected? Select all that apply. The patient is wearing dirty, poorly-fitted clothes The patient misses school approximately once per week The child has body odor and rotting teeth The parents of a 4-month old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant? Assign her to the same nurse as much as possible The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? “What are your new classmates like?” The nurse is caring for a 14-year-old girl with special health needs. What is the priority intervention for this child? Monitoring for compliance with treatment A community health nurse provides screening for a family whose child has a likelihood of developing cystic fibrosis because of their genetic background. Which of the following community health intervention does this describe? Risk identification The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child? Provide age-appropriate toys and games. A nurse is preparing to take a pediatric patient to surgery. She places an identification band on the child’s wrist. Which of the following statements by the nurse is most appropriate when explaining the ID band to the child and his parents? “This band tells us who you are so that you are not mixed up with anyone else.” Which would be least effective in gaining the cooperation of a toddler during a physical examination? Taking her on an adventure down the hall A nurse is performing a clinic intake assessment on a 16-year-old patient. When the nurse asks the patient about alcohol consumption, the patient admits that he sometimes drinks to excess with his friends. Which response should the nurse utilize to talk about this topic with the patient? Explain short- and long-term effects of alcohol use on health The nurse is caring for a hospitalized 13-year-old girl who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? “Let’s work together to plan your day along with your treatments.” A nurse is caring for a 13-year-old girl who is sexually active and whose partner is her 19-year-old boyfriend. The girl asks the nurse not to tell her parents about her sexual activity. This patient’s situation is best described as: statutory rape A nurse is working with the family of a 1-day-old infant who was born prematurely and who is dying, which of the following interventions would most likely demonstrate that the nurse recognizes the family’s grief in this situation? Letting the family baptize the child and dress him The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? “What are your new classmates like?” A 4-year-old child is being prepared for surgery for an umbilical hernia repair. Which best identifies the most appropriate method of providing comfort for a child before surgery? Allow a support person, such as a parent, to remain with the child as long as possible The parents of a 12-year-old girl complain to the nurse that their daughter never listens to them when they talk. Which of the following skills should the nurse teach to the parents about conflict resolution with their child? Find a reasonable solution that the child will accept The nurse is preparing a nursing care plan for an 8-year old child hospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the “building a trusting relationship” stage? Select all that apply. Preparing the child for a procedure by playing games Explaining in simple terms what will be happening during surgery What is the role of the peer group in the life of school-age children? Provides them with security as they gain independence from their parents. The nurse is conducting a health history for a 9-year-old with stomach pains. What is a recommended guideline when approaching the child for information? Allow the child to control the pace and order of the health history. The nurse is administering pain medication for a child with continuous pain from internal injuries. Which method would be ordered to dispense the medication? Administer the medication around the clock at timed intervals The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using? Distraction The nurse caring for a 6-year-old enters the room to administer an oral medication in the form of a pill. The dad at the bedside looks at the pill and tells the nurse that his daughter has a hard time swallowing pills. What is the best response by the nurse? Call the pharmacy and ask if the pill can be crushed. During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse’s best response? “Tell me what concerns you.” The nurse is preparing to administer insulin to a diabetic child. Which would be the recommended route for this administration? Subcutaneous The nurse is caring for an 11-year-old child who is experiencing pain related to chemotherapy treatment. What is a behavioral factor that might affect the child’s pain experience? Participation in normal routine activities The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). What accurately describes the use of TPN? It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. Which of the following situations would involve mandatory reporting? A nurse suspects that an 11-year-old child is being abused in his home An 11-year-old boy has been diagnosed with depression after his parents’ divorce. The nurse understands that depression in most children of this age most commonly manifests as: Lack of interest with friends and families The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacological methods. Which parent statement signifies successful child teaching? “I will begin using the technique before he experiences pain.”