Exam 2 Review Qs Flashcards
(20 cards)
The nurse is preparing to give a 5-year-old child preoperative teaching for abdominal surgery. Which of the following nursing actions is most appropriate?
Allow the child to dress up in surgical attire.
The nurse is planning care for an 18 month-old child. Which of the following should be included the in the child’s care?
Encourage the child to feed himself finger foods
The nurse is caring for an immigrant child who has tuberculosis. The child has been receiving treatment for several weeks without showing signs of improvement. Which of the following statements made by the parent would offer the nurse a valuable clue as to the reason for this lack of improvement?
“It is a good thing she has no appetite, we don’t have money for food anyway.”
Parents have a 15M old child at clinic who has been diagnosed with otitis media three times in the last four months. Which of the following should the nurse ask the parents about? Select all that apply.
Does the child use a pacifer?
Does the child frequently have a runny nose?
Does anyone smoke around the child?
An 8-year-old child, who has a history of asthma, is seen in the school nurses’ office with coughing and wheezing. Which of the following actions should the nurse perform first?
Assess the child’s peak expiratory flow.
The nurse is caring for a 2 year old child with acute laryngotracheobronchitis. Which of the following nursing interventions should be included in the discharge teaching?
Advise parents cool mist may help liquidify secretions and be soothing to the child’s throat and help the child feel better
Which of the following should be a priority nursing intervention for an infant with bronchiolitis?
Maintain a strict record of the child’s intake and output.
The nurse is discussing optimal nutrition with a client who has cystic fibrosis. Which of the following menu choices would indicate the need for further teaching?
Skim chocolate milk
The nurse is preparing to insert an intravenous catheter into the scalp of a newborn infant. Which of the following techniques might help to decrease the pain the infant feels from this procedure?
Apply a local anesthetic cream such as EMLA 0.5-1 hour before inserting the IV.
A child who weighs 26.4 pounds is prescribed an antibiotic medication. The safe dose range is 40 mg to 50 mg/kg of body weight per day divided q 12 hours. The dose prescribed is 750 mg PO q 12 hours.
Calculate the safe dose range per dose for this child.
Is the prescribed dose appropriate for this patient?
240-300
No
Furosemide (Lasix) 4 mg PO BID is prescribed for an infant in congestive heart failure. Available is a multidose bottle containing Furosemide 40 mg/5 mL.
Calculate the correct volume per dose in ml.
0.5
The nurse is inserting a peripheral IV in an infant with Tetralogy of Fallot. The child experiences a hypercyanotic episode. Which of the following actions should the nurse take first?
Place the infant in a knee chest position.
Which of the following as an appropriate nursing action to include in the care of an 4 month old infant with a congenital heart defect who is admitted with congestive heart failure.
Offering small frequent feedings.
A home health nurse is assigned to supervise daily digoxin administration to a four-month-old infant with a ventricular septal defect. Assessment today reveals a fussy infant who has vomited several times. Vital signs are 98.6*, 88, 32, 104/62. Which is the most appropriate nursing action?
Withhold the digoxin. Phone the physician and suggest that a serum digoxin level be drawn
Signs of digoxin toxicity include: Confusion
Irregular pulse
Loss of appetite
Nausea, vomiting, diarrhea Palpitations
Vision changes
Since the child has vomited her digoxin levels should be checked. This is the only suitable action to be taken.
When doing discharge teaching with the parents of a child diagnosed with Kawasaki disease, which is most important for the nurse to include?
Continuing the aspirin therapy as ordered.
Physical activity is not limited. Children with Kawasaki are not immunosuppressed and their steroid regimen should have been completed at the time of discharge from the hospital. Although aspirin has important anti-inflammatory (at high doses) and antiplatelet (at low doses) activity. Children will be placed on low-dose aspirin until they show no evidence of coronary changes by 6 to 8 weeks after the onset of illness.
The mother of a newborn asks the nurse for advice regarding her infant’s constipation. The infant has one bowel movement every two to three days and “she scrunches her face up like she is in pain.” The infant is eating and sleeping well. What should the nurse do next?
Ask the mother to describe the consistency of the baby’s stool.
Constipation in Pediatrics is not defined by frequency but by consistency. If the stool is soft the infant is not constipated. Infant’s frequently cry and make faces when having BMs. With the information mom gave, the RN doesn’t have enough info yet to know how to proceed, so asking about stool consistency is next step.
A 21kg, 8-year old girl presents to the ED with nausea, vomiting and diarrhea. Vitals at triage: BP: 70/palp, HR 140, Temp 101.2°F (38.4°C.) She has dry mucous membranes, sunken eyes, and decreased skin turgor. The ED nurse practitioner orders a rapid fluid bolus to increase her perfusion. After receiving the bolus the child has orders to be started on maintenance rate of 0.45NS. What rate would the nurse set the infusion to?
63 ml/hr
The child needs 1520 ml of fluid daily. This divided by 24 is 63 ml/hr
The nurse on the pediatric unit is calculating intake and output for the past 4-hours on a 12-month-old who weighs 17.6 pounds. The infant was admitted with an upper respiratory infection. The output total is 30 ml. Which of the following should the nurse do first?
Conduct a focused assessment for signs of dehydration.
Normal expected UOP is 1-2 ml/kg/hour. This child weighs 8 kg which translates to 8-16 ml per hour or 32-64 ml in an 4-hour period. The 30 ml represents an output that is less than expected. Infants with URIs are at increased risk for dehydration. This is the most likely explanation. Further assessment is needed before any interventions can be started.
The nurse providing discharge teaching to the parents of an infant with cleft lip and cleft palate should include which of the following? Choose All That Apply
- Strategies for encouraging early attempts to make sounds.
- Clear guidelines on how to feed baby.
- Being alert for increased fussiness and pulling at his ears.
Infants with cleft palate have difficulty feeding effectively. parents need clear feeding guidelines. Complications of this condition include speech delay, ear infections, and altered dentition. Parents therefore, need to be provided information on how to promote speech development, how to recognize ear infections, and how to care for teeth. Tracheomalacia is not associated with this condition.
The nurse caring for a child with the medical diagnosis of suspected appendicitis would anticipate the child presenting with which of the following signs/symptoms?
Normal or low grade fever, abdominal pain that is most severe between the right anterior superior iliac crest and the umbilicus.
Classic symptoms of appendicitis are pain at McBurney’s point (between the right anterior superior iliac crest and the umbilicus) and low grade fever. High fever would only be seen in perforation and peritonitis.
