NC of Children 2 Flashcards
(245 cards)
1
Q
ATI Standard Quiz
A
Nursing Care of Children 2
2
Q
A nurse is creating a plan of care for a child who has leukopenia secondary to chemotherapy. Which of the following interventions should the nurse include in the plan?
Maintain the child on bed rest.
Monitor the child for increased temperature.
Administer oxygen to the child.
Monitor the child for bleeding.
A
Monitor the child for increased temperature.
3
Q
The nurse should maintain bed rest for the child who has decreased ___
A
RBCs.
4
Q
Leukopenia places the child at risk for
A
infection; therefore, the nurse should monitor the child for a fever.
5
Q
W/ leukopneia, what should the nurse monitor
A
the nurse should monitor the child for a fever.
6
Q
The nurse should administer oxygen to a child who has decreased what? And low what?
A
RBCs and low oxygen saturations.
7
Q
The nurse should monitor a child who has a low ______ _____for bleeding.
A
platelet level
8
Q
A nurse is reviewing the laboratory results of a child who has experienced diarrhea for the past 24 hr. Which of the following values for urine specific gravity should the nurse expect?
1.010
1.035
1.020
1.005
A
1.035
9
Q
What is the expected reference range for urine specific gravity for infants?
A
?? 1.010 to 1.030 CONFIRM
10
Q
1.035 is a ________ specific gravity, which is an expected value for a child who is _______
A
concentrated
dehydrated;.
11
Q
1.005 is ________ urine specific gravity, which could indicate what?
A
decreased
excessive fluid intake
12
Q
A nurse is providing dietary teaching to the parent of a child who has cystic fibrosis. Which of the following dietary recommendations should the nurse make?
Increase the child’s protein intake.
Decrease the child’s calorie intake.
Increase the child’s fiber intake.
Decrease the child’s salt intake.
A
Increase the child’s protein intake.
13
Q
The nurse should recommend an increase in _______ intake for the child who has cystic fibrosis.
A
protein
14
Q
children w/ cystic fibrosis require up to _____ of the recommended daily allowances to meet their nutritional needs.
A
150%
15
Q
The calorie intake for a child who has cystic fibrosis should be _______, rather than ______
A
increased
decreased.
16
Q
Increasing fiber intake could result in
A
increase bulk and malabsorption
17
Q
Why is increasing fiber intake not recommended for children w/ cystic fibrosis
A
increase bulk and malabsorption
18
Q
Decreasing salt intake is____ _______ for the child who has cystic fibrosis.
A
not indicated
19
Q
A nurse is assessing a 6-month-old infant following a cardiac catheterization. Which of the following findings should the nurse report to the provider?
Temperature of 37.5° C (99.5° F)
Apical pulse rate 140/min
BP 86/40 mm Hg
Respiratory rate of 32/min
A
BP 86/40 mm Hg
20
Q
What is temperature expected reference range for a 6-month-old infant.
A
??
21
Q
What is apical pulse level expected reference range for a 6-month-old infant.
A
??
22
Q
What is BP ERR for a 6 month old infant?
A
??
23
Q
A BP of 86/40 mm Hg in a 6 month old infant is indicative of what?
A
hypotension and bleedingand should be immediately reported to the provider.
24
Q
What is ERR respiratory rate for a 6-month-old infant.
A
??
25
A nurse is caring for a child who is in skeletal traction. Which of the following actions is the nurse's priority?
Perform passive range of motion for unaffected joints.
Apply a pressure-reducing overlay to the child's mattress.
Increase the child's fluid intake.
Encourage the child to use an incentive spirometer.
Encourage the child to use an incentive spirometer.
Encouraging the child to use an incentive spirometer will assist the child in adequate oxygenation and is the priority nursing action.
26
For a child who is in skeletal traction, the nurse should perform _____ range of motion for unaffected joints
passive
27
For a child who is in skeletal traction, The nurse should apply a pressure-reducing overlay to the child's mattress to
reduce the risk of skin breakdown related to immobility;
28
For a child who is in skeletal traction, The nurse should increase the child's what?
fluid intake
29
For a child who is in skeletal traction, The nurse should apply what priority-setting framework.
ABC
30
A nurse is caring for a child who has a possible intussusception. The parents of the child ask the nurse how the diagnosis is made. Which of the following responses should the nurse make?
"An abdominal ultrasound will confirm the pocket in the intestine."
"Genotyping will be done to identify this condition."
"A biopsy will be done on a small amount of tissue from the colon."
"An upper GI series should identify the area involved."
An abdominal ultrasound will confirm the pocket in the intestine.
31
intussusception
a condition in which part of the intestine folds into the section next to it.
32
Intussusception usually involves what part of the bowel?
the small bowel and rarely the large bowel.
33
Symptoms of intussusception include
abdominal pain, which may wax and wane, vomiting, bloating, and bloody stool. It may result in small bowel obstruction
34
Intussusception is the invasion of one part of the intestine into the other, creating a
pocket.
35
The presence of an intussusception is confirmed by
an abdominal x-ray, ultrasound, or CT scan.
36
Genotyping is performed to determine a child’s
gene composition and is used for hereditary disease identification.
37
A biopsy of a small amount of tissue from the colon is done to identify what?
a defect of nerve innervation in the colon
38
An upper gastrointestinal series focuses on an area that is
too high to see an intussusception
39
An upper gastrointestinal series fis used to diagnose what condition
pyloric stenosis.
40
A biopsy of a small amount of tissue from the colon is done to diagnosie what disease
Hirschprung’s disease.
41
Hirschprung’s disease.
a birth defect in which some nerve cells are missing in the large intestine, so a child's intestine can't move stool and becomes blocked
42
pyloric stenosis.
a thickening or swelling of the pylorus — the muscle between the stomach and the intestines — that causes severe and forceful vomiting in the first few months of life. It is also called infantile hypertrophic pyloric stenosis.
43
A nurse in an emergency department is caring for a 4-year-old child who has burns to the neck and face following a house fire. Which of the following actions should the nurse take first?
Cover the child's wounds with a clean, dry cloth.
Establish IV access for the child with a large-bore catheter.
Provide reassurance to the child's parents.
Determine the child's breathing pattern.
Determine the child's breathing pattern.
44
for a 4-year-old child who has burns to the neck and face, The nurse should cover the child’s wounds w/ what?
a clean, dry cloth
45
for a 4-year-old child who has burns to the neck and face, The nurse should establish IV access for the child using a
large-bore catheter
46
for a 4-year-old child who has burns to the neck and face, The nurse should provide what to the childs parents
reassurance
47
for a 4-year-old child who has burns to the neck and face,
ABC
48
A nurse is caring for an infant following surgical repair of a cleft lip and palate. Which of the following actions should the nurse take?
Keep the infant's mouth open by using a tongue blade for 4 hr following surgery.
Use a suction catheter to gently remove the infant's oral secretions PRN.
Place the infant in prone position.
Clean the infant's incision with chlorhexidine.
se a suction catheter to gently remove the infant's oral secretions PRN.
49
After surgical repair of a cleft lip and palate, The nurse should avoid doing what and why?
placing objects in the infant’s mouth during the postoperative period
to avoid trauma to the incision.
50
After surgical repair of a cleft lip and palate, The nurse should use a suction catheter to
gently remove the infant's oral secretions to prevent aspiration and maintain a patent airway.
51
After surgical repair of a cleft lip and palate, The nurse should position the infant in what position?
upright to facilitate drainage of secretions. Placing the infant in prone position could lead to aspiration.
52
After surgical repair of a cleft lip and palate, The nurse should clean the operative incision with what after each feeding?
sterile saline or sterile water after each feeding and as needed.
53
A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child's parent asks the nurse to explain the purpose of the test. Which of the following responses should the nurse make?
"The test determines the level of antibiotics in your child's blood."
"The test tells us if your child ever had the measles."
"The test verifies the amount of albumin in your child's blood."
"The test shows us if your child had a recent strep infection."
"The test shows us if your child had a recent strep infection."
54
antistreptolysin O (ASO) titer
a blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria.
55
Acute glomerulonephritis (AGN) comprises a specific set of kidney diseases in which
an immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, mesangium, or capillary endothelium.
56
A therapeutic blood level indicates a medication, such as an antibiotic, is
effective.
57
Which type of titer will indicate the presence of measles.
A rubella titer
58
A serum albumin level is monitored in a child who has what type of syndrome
nephrotic syndrome.
59
An ASO titer indicates that the child has had a recent _____ infection.
strep
60
In determining a definitive diagnosis for acute glomerulonephritis, what be documented as it is usually the result of this type of infection.
ASO titer
61
A nurse is reviewing the laboratory report of a toddler who is receiving chemotherapy for leukemia. Which of the following laboratory values should the nurse report to the provider?
Platelets 150,000/mm3
Hgb 6 g/dL
WBC 6,000/mm3
Potassium 4.5 mEq/L
Hgb 6 g/dL
62
Platelets ERR for a toddler?
??
63
Hgb ERR for a toddler?
?? (Hgb <6g.dL is below ERR)
64
WBC ERR for a toddler?
??
65
Potassium ERR for a toddler?
??
66
A nurse is caring for an 8-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse expect?
Hypotension
Stomatitis
Bloody diarrhea
Periorbital edema
Periorbital edema
67
What blood presure is an expected finding in a child who has acute glomerulonephritis.
elevated
68
Stomatitis is an expected finding in a child who has what condition
chronic renal failure.
69
Stomatitis
inflammation and redness of the oral mucosa that can lead to pain and difficulty talking, eating, and sleeping. Stomatitis can affect the inner cheeks, gums, inner lips, and tongue. The inflammation causes the formation of single or multiple painful mouth ulcers as well as white lesions
70
Bloody diarrhea is an expected finding in a child who has what condition?
hemolytic uremic syndrome.
71
hemolytic uremic syndrome.
a condition that affects the blood and blood vessels. It results in: the destruction of blood platelets (cells involved in clotting) a low red blood cell count (anemia) kidney failure due to damage to the tiny blood vessels of the kidneys.
72
Periorbital edema is an expected finding in a child who has what condition?
glomerulonephritis.
73
glomerulonephritis.
nflammation and damage to the filtering part of the kidneys (glomerulus). It can come on quickly or over a longer period of time. Toxins, metabolic wastes and excess fluid are not properly filtered into the urine. Instead, they build up in the body causing swelling and fatigue
74
A nurse is providing teaching to the parents of a school-age child who has type 1 diabetes mellitus about management of hypoglycemia. Which of the following responses by the parents indicates an understanding of the teaching?
"I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible."
"I will give my child 2 units of regular insulin."
"I will insist that my child lies down to rest for 30 minutes."
"I will check my child's urine for glucose twice daily."
"I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible."
75
Giving the child 10 to 15 g of simple carbohydrates, such as 240 mL (8 oz) of milk, will do what to glucose blood levels
elevate the blood glucose level and alleviate the hypoglycemia.
76
Administering additional insulin could have what effect?
worsen the child's hypoglycemia and lead to neurologic effects such as seizures, shock, and coma.
77
Rest is important for overall health; however, rest will not alleviate symptoms related to what condition
Type 1 DM
78
Checking the child’s urine for glucose is not doing what?
managing a hypoglycemic episode.
79
Children who are hyperglycemic will have what in their urine.
glucose
80
A nurse is teaching about clinical manifestations of tracheomalacia to a parent of an infant who had tracheoesophageal fistula repair as a newborn. Which of the following findings should the nurse include in the teaching?
Absence of bowel sounds
Neck contortions
Barking cough
Projectile vomiting
Barking cough
81
Tracheomalacia
is the collapse of the airway when breathing. This means that when your child exhales, the trachea narrows or collapses so much that it may feel hard to breathe. This may lead to a vibrating noise or cough
82
Tracheoesophageal fistula is an
upper gastrointestinal disorder; therefore,
83
Because Tracheoesophageal fistula is an upper gastrointestinal disorder; what are the expected bowel sounds?
bowel sounds would not be absent in this condition.
84
Neck contortions are an expected finding in an infant who has what condition?
a hiatal hernia.
85
Infants who have tracheomalacia have a _______ trachea, which leads to collapse.
weakened
86
Clinical manifestations of tracheomalacia include
barking cough, stridor, wheezing cyanosis, and apnea.
87
Projectile vomiting is an expected finding in an infant who has what condition?
hypertrophic pyloric stenosis.
88
A nurse is teaching an adolescent who has asthma about how to use a peak expiratory flow meter (PEFM). Which of the following responses by the adolescent indicates an understanding of the teaching?
"I will breathe in through the mouthpiece, hold my breath for 5 seconds, and then exhale."
"If I get a reading in the green zone, I will tell my parents immediately so they can call the doctor."
"I will slowly exhale through the mouthpiece over a 10 second interval."
"I will record the highest reading of three attempts."
I will record the highest reading of three attempts.
89
peak expiratory flow meter (PEFM) works by
measuring how fast air comes out of the lungs when you exhale forcefully after inhaling fully. This measure is called a "peak expiratory flow," or "PEF."
90
Keeping track of your PEF, is one way you can know if
your symptoms of asthma are in control or worsening
91
The nurse should instruct the adolescent to do what w/ a PFM
take a deep breath, place the lips around the mouthpiece, and then blow into the mouthpiece as hard and fast as possible.
92
Values in the green zone represent what percentage of the child’s personal best; therefore, this does not warrant calling the provider.
80 to 100%
93
Is Slowly exhaling over a 10 second interval - correct or incorrect method of using the PEFM.
incorrect
94
Once the client establishes a personal best, she should routinely check the PEFM by performing how many attempts?
three attempts and recording the highest reading of the three.
95
A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. Which of the following findings should alert the nurse to the possibility of epiglottitis?
Lethargy
Spontaneous coughing
Drooling
Hoarseness
Drooling
96
A toddler who has epiglottitis is what rather than lethargic.
very restless and appears anxious
97
A toddler who has epiglottitis has an absence of of this and why?
spontaneous coughing due to inflammation of the epiglottis.
98
Epiglottitis is a disorder caused by
an inflammation of the epiglottis.
99
Epiglottitis results in rapid swelling of the epiglottis, which can do what to breathing
obstruct breathing.
100
Hoarseness is a finding present in a toddler who has what condition?
acute spasmodic laryngitis
101
acute spasmodic laryngitis
Croup is a childhood condition that causes an inflammation of the upper airways – the voice box and windpipe. It often results in a characteristic barking cough or hoarseness, particularly when the child cries
most common cause of acute laryngitis is viral upper respiratory infection (URI)
102
Why is Drooling a common finding w/ epiglotitis
due to the toddler’s inability to swallow saliva.
103
A nurse is assessing a 2-month-old infant who has a ventricular septal defect. Which of the following findings should the nurse report to the provider?
Weight gain of 1.8 kg (4 lb)
Heart rate 125/min
Soft, flat fontanel
Systemic murmur
Weight gain of 1.8 kg (4 lb)
104
ventricular septal defect
is a birth defect of the heart in which there is a hole in the wall (septum) that separates the two lower chambers (ventricles) of the heart. This wall also is called the ventricular septum
105
A weight gain indicates what?
increased fluid and worsening of the child’s heart failure; therefore, the nurse should report this finding to the provider.
106
What type of fontanel is an expected finding in a 2-month-old infant.
A soft, flat fontanel
107
What type of murmur is an expected finding in an infant who has a ventricular septal defect.
A systemic murmur
108
A nurse is providing discharge teaching to the parent of a school-age child who has leukemia and is receiving chemotherapy. Which of the following statements by the parent indicates an understanding of the teaching?
"I will take my child's rectal temperature daily."
"I will make sure my child gets his MMR vaccine this week."
"I will inspect my child's mouth every day for sores."
"I will allow my child to ride his bicycle tomorrow."
"I will inspect my child's mouth every day for sores."
109
In a school-age child who has leukemia and is receiving chemotherapy, The parent should avoid taking temps how to avoid trauma
taking rectal temperatures to prevent trauma to the child.
110
A child who has leukemia will have a _______ immune system and should not receive what vaccine?
compromised
the MMR vaccine.
111
A child who has leukemia is at an increased risk for
mucositis; therefore, the parent should inspect the child’s mouth daily for lesions or ulcerations.
112
mucositis;
when your mouth or gut is sore and inflamed. It's a common side effect of chemotherapy and radiotherapy for cancer. Although mucositis is usually painful, it can be treated. It should get better within a few weeks of finishing cancer treatment.
113
Because the child is at an increased risk for mucositis, the parent should do what
inspect the child’s mouth daily for lesions or ulcerations.
114
In a school-age child who has leukemia and is receiving chemotherapy, The nurse should advise the parents to avoid any activities that could cause what?
injury or bleeding, such as riding bicycles or climbing on playground equipment.
115
A nurse is assessing pain in a 3-year-old child following a tonsillectomy. Which of the following rating scales should the nurse use to determine the child's pain level?
Word-Graphic Rating Scale
Color Tool
Poker Chip Tool
FACES Rating Scale
FACES Rating Scale
116
Word-Graphic Rating Scale - scale used to measure pain in children who are what age
ages 4 to 17 years old.
117
Color Tool is used to measure pain in children as young as what age and who know how to do what?
4 years old who know how to recognize colors.
118
Poker Chip Tool is used to measure pain in children at what age and who can do what?
as young as 4 years old who have the cognitive ability to use numbers.
119
The nurse should use the FACES rating scale to assess this child’s pain level. This scale is appropriate for what age child
a 3 year old and provides a series of facial expressions representing amounts of pain.
120
A clinic nurse is providing teaching to the parent of a 1-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching?
"I will give the lansoprazole 30 min after my baby's feedings."
"I will lay my baby on her side after feedings."
"I will give my baby a bottle just before bedtime."
"I will add rice cereal to my baby's feedings."
"I will add rice cereal to my baby's feedings."
121
In a 1-month-old infant who has gastroesophageal reflux, The mother should give lansoprazole to her infant when
30 min before feeding because it is most effective during mealtime when the infant’s plasma concentration is at its peak.
122
In a 1-month-old infant who has gastroesophageal reflux, , The infant should be placed how for 1 hr after feedings.
in an infant seat or at a 30° angle
123
In a 1-month-old infant who has gastroesophageal reflux, The nurse should instruct the parent to avoid feedings when
just before bedtime.
124
In a 1-month-old infant who has gastroesophageal reflux, The mother should add what to each ounce of formula or expressed breast milk to thicken the feedings because this will decrease the number of vomiting episodes.
1 tsp to 1 tbsp of rice cereal per ounce
125
Why is adding rice or cereal or thickening w/ breast milk good for gastroesophageal reflux in a 1 month old infant
will decrease the number of vomiting episodes.
126
A nurse is teaching a school-age child and his parents how to self-administer insulin. Which of the following actions should the nurse take first?
Allow a parent to administer an injection to the nurse.
Have the child teach the injection technique to the parents.
Have a parent administer the insulin injection to the child.
Demonstrate the injection technique on an orange.
Demonstrate the injection technique on an orange.
127
When teaching a school-age child and his parents how to self-administer insulin, The nurse should allow the parent to do what?
give the nurse an injection while the child observes
also, give the insulin injection to the child
128
When teaching a school-age child and his parents how to self-administer insulin, The nurse should have the child do what?
teach the injection technique to the parents
129
When teaching a school-age child and his parents how to self-administer insulin, The nurse should apply which priority setting framework.
the safety and risk reduction
130
safety and risk reduction framework assigns priority how?
This framework assigns priority to the factor or situation posing the greatest safety risk to the client.
131
When there are several risks to client safety, the one posing what is the highest priority.
the greatest threat
132
A nurse is teaching the parent of a preschool-age child about the treatment for pinworms. Which of the following statements by the parent indicates an understanding of the teaching?
"I will give my child a dose of albendazole today and again in 2 weeks."
"I will collect specimens immediately after my child has a bowel movement."
"I will give my child a tub bath twice each day."
"I will place my child's bed linens in a sealed plastic bag for 7 days."
"I will give my child a dose of albendazole today and again in 2 weeks."
133
In a preschool-age child about the treatment for pinworms, The nurse should instruct the parent to do what with the medication albendazole
repeat the dose of albendazole in 2 weeks to completely eradicate the parasite and prevent reinfection.
134
Pinworm specimens are collected when?
in the morning as soon as the child wakes up and before the child bathes or has a bowel movement.
135
When there -an infection of pinworms, To prevent reinfection, how should bathing be handled?
the child should be given a shower rather than a tub bath.
136
When there -an infection of pinworms, The child’s bed linens and clothing should be handled how?
washed in hot water because pinworms can survive on surfaces for an extended period of time.
137
A nurse is providing teaching about immunizations to the parents of a severely immunocompromised child who has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching?
"Your child's immunizations today will be half-doses."
"The pneumococcal and influenza vaccines are recommended for your child."
"Immunizations will be delayed until your child tests HIV negative."
"Your child will need to start the immunization schedule over once his laboratory values are within reference range."
The pneumococcal and influenza vaccines are recommended for your child.
138
Half doses of immunizations do not provide what?
the immunity necessary to protect the child from common childhood illnesses.
139
Immunization against common childhood illnesses, including what two diseases, is recommended for all children exposed to and infected with HIV.
the influenza and pneumococcal disease
140
Delaying immunizations until a child tests HIV negative places the child at risk for what?
contracting an illness.
141
Immunizations do not need to be restarted once the client is what?
no longer immunocompromised.
142
A nurse is caring for a 6-week-old infant following a pyloromyotomy. Which of the following forms of feeding should the nurse anticipate for the infant 6 hr after the procedure?
Bottle formula with added protein
Small, frequent bottle feedings of electrolyte solution
Continuous nasoduodenal tube feedings
Bolus feedings via gastrostomy tube
Small, frequent bottle feedings of electrolyte solution
143
6-week-old infant following a pyloromyotomy, when should feeding resume?
Small increment formula feedings will resume 24 hr after surgery if small, frequent feedings of electrolyte solution are retained by the infant.
144
6-week-old infant following a pyloromyotomy, when do Feedings begin
4 to 6 hr after the surgical procedure. The nurse should anticipate feeding the infant small, frequent increments of an electrolyte solution or sterile water.
145
Nasoduodenal tube feedings are indicated for children who have what conditions?
brain injuries or are on mechanical ventilation.
146
Gastrostomy feedings are indicated for children who cannot have what?
any foods or fluid by mouth or for whom passage of a tube through the esophagus is contraindicated.
147
A nurse in an emergency department is assessing a school-age child who is experiencing an acute asthma exacerbation. Which of the following findings is the priority for the nurse to report to the provider?
Excessively prolonged expiration
Increased diaphoresis
Increased production of frothy sputum
Sudden decrease in wheezing
Sudden decrease in wheezing
148
a school-age child who is experiencing an acute asthma exacerbation, The nurse should report what findings?
excessively prolonged expiration to the provider
increased diaphoresis
an increased production of frothy sputum
149
a school-age child who is experiencing an acute asthma exacerbation, The nurse should apply what priority setting framework.
the urgent versus nonurgent
150
the urgent versus nonurgent priority frameworks, why do you consider the urgent as the priority
because they pose a larger risk to the client.
151
a school-age child who is experiencing an acute asthma exacerbation, a Sudden decrease in wheezing can be an indication of what?
the child is experiencing decreased air movement
(ventilator failure and an imminent respiratory arrest.)
152
A nurse is providing teaching to an adolescent who has scoliosis and a new prescription for a Boston brace. Which of the following responses by the adolescent indicates an understanding of the teaching?
"I can take my brace off to sleep every night at bedtime."
"I can take my brace off for about an hour daily to shower."
"I should loosen the straps on my brace if it is rubbing my skin."
"I should place the pads of brace against my skin with a t-shirt over them."
"I can take my brace off for about an hour daily to shower."
153
an adolescent who has scoliosis and a new prescription for a Boston brace, The child should wear the brace for how long each day?
23 hr each day. At night, the child might be prescribed a bending brace that confines the spine to an over-corrected positon.
154
an adolescent who has scoliosis and a new prescription for a Boston brace, The nurse should instruct the child to wear the brace for 23 hr each day and to only remove it when?
for showering or participating in physical therapy.
155
an adolescent who has scoliosis and a new prescription for a Boston brace, The nurse should instruct the adolescent to avoid loosening the straps of the brace if rubbing occurs because why?
this can decrease compression and contraction.
156
an adolescent who has scoliosis and a new prescription for a Boston brace, The brace should be worn over a t-shirt to prevent what?
the plastic pads from touching the skin and causing excoriation.
157
A nurse is assessing a 6-month-old infant who was recently admitted with acute vomiting and diarrhea. Which of the following findings indicates the infant has moderate dehydration?
Bulging anterior fontanel
Bradycardia
Tachypnea
Polyuria
Tachypnea
158
An infant who has moderate dehydration will have what type of fantanel?
a flat or sunken fontanel.
159
An infant who has moderate dehydration will have what type of heart rate?
a slightly increased heart rate.
160
An infant who has moderate dehydration will have what type of breathing?
a slight tachypnea.
161
An infant who has moderate dehydration will have what type of urinary output?
decreased urinary output.
162
A nurse is providing teaching to an adolescent who has a fiberglass arm cast. Which of the following instructions should the nurse include in the teaching?
Place a plastic bag over the cast when showering.
Insert a dull knitting needle into the cast to rub itchy skin.
Exercise fingers every 8 hr for the first 24 hr.
Draw on the cast using magic markers.
Place a plastic bag over the cast when showering.
163
Will water damage a fiberglass cast?
Although water will not damage the fiberglass cast, water can enter the openings of the cast and result in maceration of the skin.
164
W/ a fiberglass cast, The nurse should instruct the adolescent to dow hat w/ the cast when showering?
keep the cast dry by placing a plastic bag over it while showering.
165
W/ a fiberglass cast, Placing any instruments inside do what to the skin?
the cast can injure the skin and cause an infection.
166
W/ a fiberglass cast, The fingers should be moved and exercised how often during the first 24 hours?
every 4 hr for the first 24 hr.
167
W/ a fiberglass cast, Fiberglass cast material is ______; therefore, magic markers should not be used to draw on or autograph the cast.
porous
168
A nurse is reviewing the laboratory report of a 2-year-old child who has diarrhea and has been vomiting for 24 hr. Which of the following findings should the nurse report to the provider?
Hct 40%
Potassium 2.5 mEq/L
Serum creatinine 0.4 mg/dL
BUN 6 mg/dL
Potassium 2.5 mEq/L
169
What is ERR of Hct for a 2 year old child?
??
170
What is ERR of Potassium for a 2 year old child?
??
171
hypokalemia can cause what?
arrhythmias or even cardiac arrest
172
A potassium level of 2.5 mEq/L indicates what?
hypokalemia
173
What is ERR of BUN for a 2 year old child?
??
174
A nurse is caring for a child who is postoperative following a tonsillectomy. Which of the following findings is the nurse's priority?
Nausea
Hoarse voice
Frequent swallowing
Sore throat
Frequent swallowing
175
Nausea is a common adverse effect of
anesthesia
176
A hoarse voice is an expected finding following what procedure?
a tonsillectomy
177
After a tonsillectomy, Frequent swallowing can be an indication of
bleeding, therefore is the nursing priority finding to address.
178
A sore throat is an expected finding following what procedure?
a tonsillectomy
179
A nurse is providing nutritional teaching to an adolescent client who has celiac disease. Which of the following breakfast foods should the nurse recommend?
Plain flour pastry
Wheat cereal
Scrambled eggs
Rye toast
Scrambled eggs
180
The client who has celiac disease should be on what type of diet?
a low-gluten diet.
181
Gluten is found primarily in what foods?
wheat and rye, but also is found in smaller quantities in barley and oats; therefore, plain flour pastries are an inappropriate breakfast item for the nurse to recommend to the client.
182
A nurse is providing teaching to the parent of a 2-year-old toddler about nutrition. Which of the following statements by the parent indicates an understanding of the teaching?
"My child should consume 1,000 calories per day."
"My child should have 4 ounces of protein per day."
"I should give my child 32 ounces (4 cups) of milk per day."
"I should feed my child 4 ounces (1/2 cup) of vegetables per day."
"My child should consume 1,000 calories per day."
183
Toddlers who are 2 years old should consume how many calories each day?
1,000 calories daily.
184
Toddlers who are 2 years old should have how much protein each day?
2 oz of protein daily.
185
Toddlers who are 2 years old should have how much milk each day?
no more than 24 oz (3 cups) of milk per day.
186
Toddlers who are 2 years old should consume how much begetables each day?
8 oz (1 cup) of vegetables per day.
187
A home health nurse is developing a plan of care for the parents of a toddler who has hemophilia. Which of the following instructions should the nurse include in the plan?
Administer low-dose aspirin for pain.
Inspect the toddler's toys for sharp edges.
Perform passive range-of-motion to the affected joint during a bleeding episode.
Avoid contact with people who have respiratory infections.
Inspect the toddler's toys for sharp edges.
188
For a toddler w/ hemophilia, The nurse should not instruct the parents to administer aspirin or medications that contain aspirin, because
this could increase the toddler’s risk of bleeding.
189
For a toddler w/ hemophilia, The nurse should instruct the parents to inspect the toddler’s toys for sharp edges or parts because
this decreases the risk of injury and bleeding to the toddler.
190
For a toddler w/ hemophilia, The nurse should instruct the parents to do what w/ affected joints during a bleeding episode?
elevate and rest the affected joint during a bleeding episode.
191
Risk for infection is a concern for a toddler who has what condition rather than hemophilia.
an immunodeficiency disorder
192
A nurse is teaching a newly hired nurse about the care of an infant who is postoperative following myelomeningocele repair. The nurse should teach the newly hired nurse to monitor the infant for which of the following complications?
Hydrocephalus
Congenital hypotonia
Otitis media
Osteomyelitis
Hydrocephalus
193
In the surgical repair of the myelomeningocele, the pathway for the cerebral spinal fluid is altered; therefore, the infant is at risk for what?
hydrocephalus and the nurse should monitor the infant for this condition.
194
Congenital hypotonia is a paralytic form of spinal muscular atrophy and is characterized by
progressive weakness and wasting of skeletal muscles; therefore, the infant should not be monitored for this complication.
195
Otitis media results from blocked eustachian tubes and is not related to
neural tube defects (otitis media)
196
Osteomyelitis results from what?
an organism gaining access into the bone
197
A nurse is caring for a 12-month-old infant following surgical repair of a cleft palate. The nurse should plan to feed the infant using which of the following instruments?
Spoon
Straw
Firm nipple
Cup
Cup
198
After cleft palate repair, Feeding the infant using a spoon is contraindicated because
placing objects in the mouth could rub or disturb the suture line.
199
After cleft palate repair, The infant should be fed clear liquids using what and why?
a cup for 7 to 10 days following a cleft palate repair to prevent trauma and injury to the suture line.
200
A nurse is assessing a toddler who has measles (rubeola). Which of the following findings should the nurse expect?
Koplik spots
Parotitis
Strawberry tongue
Paroxysmal cough
Koplik spots
201
Koplik spots are accompanied by manifestations of
fever, malaise, conjunctivitis, and other cold manifestations.
202
Koplik spots appear about how long before the maculopapular rash appears
2 days
203
Koplik spots
are small, irregular oral lesions with a bluish-white center and are characteristic of measles (rubeola).
204
Parotitis
Swollen parotid glands
205
Swollen parotid glands are and expected finding of a child who has what?
mumps.
206
Strawberry tongue is an expected finding in a child who has what?
scarlet fever.
207
Paroxysmal cough is an expected finding in a child who has what?
pertussis.
208
A nurse is providing teaching to the parents of an infant who has acute otitis media about how to administer antibiotic eardrops. Which of the following instructions should the nurse include?
Chill the medication prior to administration.
Massage the anterior area of the infant's ear following administration.
Hyperextend the infant's neck during administration.
Pull the auricle up and back during medication administration.
Massage the anterior area of the infant's ear following administration.
209
Otic solution should be what temp before instilling into a childs ear?
warm or room temperature
210
The nurse should instruct the parents to massage what part of the ear following administration of eardrops? Why?
massage the anterior area
to facilitate instillation of the medication.
211
Hyperextending the neck is for what type of medication administration rather than otic medication administration.
nasal medication administration
212
The nurse should instruct the parents to pull the auricle up and back for what age children?
children older than 3 years of age
213
The nurse should instruct the parents to pull the auricle downward and straight back for what age children?
children younger than 3 years of age.
214
A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions should the nurse include in the plan?
Apply cold compresses to the child's extremities.
Administer meperidine every 4 hr until the crisis has resolved.
Maintain the child on bed rest.
Decrease the child's fluid intake for 8 hr.
Maintain the child on bed rest.
215
vaso-occlusive crisis
A vaso-occlusive crisis, or VOC, occurs when sickled red blood cells block blood flow to the point that tissues become deprived of oxygen. This in turn sets in motion an inflammatory response as the body tries to rectify the problem.
216
Cold compresses are contraindicated fro vaso occlusive crisis because
they enhance sickling and vasoconstriction.
217
Meperidine is not recommended for vaso occlusive crises because meperidine is what type of drug
a central nervous system stimulant
218
a central nervous system stimulants can produce what symptoms
anxiety, tremors, and generalized seizures.
219
The nurse should maintain bed rest for the child who is experiencing a vaso-occlusive crisis why?
to minimize energy expenditure and avoid additional oxygen needs.
220
A child who has sickle cell anemia and is in a vaso-occlusive crisis requires what type of fluid intake?
increased fluid intake to prevent sickling.
221
A nurse is providing discharge teaching to the parents of a child who has nephrotic syndrome. Which of the following instructions should the nurse include in the teaching?
Restrict the child's potassium intake.
Administer acetaminophen to the child twice daily.
Weigh the child once each week.
Keep the child away from people who have an infection.
Keep the child away from people who have an infection.
222
The child who has acute glomerulonephritis should have what electrolyte intake restricted?
potassium
223
For a child who has nephrotic syndrome, The nurse should instruct the parents to restrict which electrolyte?
sodium intake, and, in severe cases, restrict fluids.
224
In sever cases of nephrotic syndrome, besides sodium what other item should have restricted intake?
fluids
225
For a child who has nephrotic syndrome, what meds are the first-line treatment
Corticosteroids
226
The parents should weigh the child who has nephrotic syndrome how often and why?
daily to determine the effectiveness of the therapy.
227
Children who have nephrotic syndrome are at increased risk for what?
infection and should avoid contact with people who have infections.
228
A nurse is admitting a child who has Wilms' tumor. Which of the following actions should the nurse take?
Initiate contact precautions for the child.
Explain to the parents that chemotherapy will start 3 months following surgery.
Put a "no abdominal palpation" sign over the child's bed.
Prepare the child for a spinal tap.
Put a "no abdominal palpation" sign over the child's bed.
229
Contact precautions are indicated for children who are suspected to have what type of illnesses?
illnesses transmitted by client contact or contact with items in the client’s environment.
230
In a child w/ a Wilmis Tumor, when do Radiology and chemotherapy begin
immediately following surgery.
231
In a child w/ Wilms tumor, The nurse should place a sign over the child’s bed reading "no abdominal palpation" because
palpation is not necessary to confirm diagnosis and could aid in metastasis.
232
A spinal tap is a diagnostic test which provides samples of spinal fluid to confirm what?
infection or abnormal cells.
233
A nurse is assessing a child who has a ventricular septal defect. Which of the following findings should the nurse expect?
Diastolic murmur
Murmur at the left sternal border
Cyanosis that increases with crying
Widened pulse pressure
Murmur at the left sternal border
234
Diastolic murmur
??
235
A diastolic murmur is an expected finding in a child who has what type of septal defect?
an atrial septal defect.
236
A ventricular septal defect is what
a hole in the septal wall between the ventricles
237
A ventricular septal defect is what type of heart defect?
acyanotic heart defect.
238
A systolic murmur can be best heard at what location?
the lower left sternal border.
239
Why - systolic murmur best heard at the left sternal border.
Sound is transmitted in the direction of blood flow, so any backflow of blood from the left to the right ventricle through the septal defect is best heard in this area.
240
Sound is transmitted in what direction?
the direction of blood flow
241
Cyanosis that increases with crying is an expected finding in a child who has what type of defect
an atrioventricular canal defect.
242
Widened pulse pressure is an expected finding in a child who has what condition?
patent ductus arteriosus.
243
acyanotic heart defect.
is where the blood contains enough oxygen but it's pumped abnormally around the body. Babies born with acyanotic heart disease may not have any apparent symptoms but, over time, the condition can cause health problems.
244
atrioventricular canal defect.
a type of congenital heart defect. A person born with atrioventricular canal defect has a hole in the wall separating the heart's chambers and problems with the heart valves. The condition may be partial, involving only the two upper chambers, or complete, involving all four chambers
245
patent ductus arteriosus.
a persistent opening between the two main blood vessels leaving the heart. Those vessels are the aorta and the pulmonary artery. The condition is present at birth. Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart.
