A toddler is hospitalized for a chronic illness. What is the most appropriate nursing intervention for development?

Reassure the parents that regression is common & will resolve after d/c.

Which sign must be present to confirm anaphylaxis in a child with facial edema and difficulty breathing?

Two or more body systems affected

What is the most important intervention for a 6-year-old with a 15% TBSA partial-thickness burn to the arm?

Initiate fluid resuscitation for hypovolemia

A 6mo is being evaluated for hypertrophic pyloric stenosis. which diagnostic test is likely to confirm this condition?

Ultrasound showing elongation and thickening of the pylorus

What should the nurse include in the education plan for a child receiving iron supplements for iron deficiency anemia?

"Expect the stools to become dark and tarry in color."

Which symptom would confirm DKA in a 7-year-old with weight loss, abdominal pain, thirst, and glucose of 325 mg/dL?

Fatigue, nausea, fruity-smelling breath, and low blood pressure

Which of the following is a key component in the prevention of sleep disorders in children?

Recognizing sleep issues early and understanding the underlying cause.

Which of the following findings is most likely in a child with diabetes insipidus?

Polyuria, polydipsia, and irritability

A rn is caring for a child w/ Graves’. Which signs and symptoms would the nurse expect to observe in this child?

Tachycardia, goiter, and bulging eyes

A 4yo is brought to the clinic w/ s/s of anaphylaxis following exposure to a bee sting. which action is appropriate?

Administer epinephrine IM and monitor airway

What interventions should be included in the care plan to reduce discomfort for a kid in traction post femur fracture?

Reposition the child every 2 hours and assess the pin sites every 8 hours.

A 5yo w/ celiac disease is about to be d/c. Which statement by the parent indicates the need for further teaching?

"I can give my child gluten-free processed foods occasionally."

A nurse is caring for a toddler whose parent has a terminal illness. Which intervention helps the toddler cope?

Allow the parents to stay with the child for 24-hour unlimited visitation.

What is an important consideration when administering furosemide (Lasix) to a 2-year-old with congestive heart failure?

Monitor for signs of dehydration due to excessive fluid loss

What should the nurse include in teaching a 12-year-old and family about wearing a brace for scoliosis treatment?

"You will need to wear the brace for at least 16 hours a day."

A rn is caring for a child w/ Tetralogy of Fallot. Which symptoms are most characteristic of a "TET spell"?

Sudden cyanosis and fainting after crying or playing

A nurse is observing a 3-month-old infant. Which of the following behaviors is expected at this developmental stage?

The infant can grasp objects with their hands.

A rn is caring for an infant dx w/ GERD. The mother asks how to reduce reflux episode episodes? what is appropriate?

Hold the infant upright for at least 30 minutes after feedings

A 2yo has s/s of resp distress, nasal flaring, tachypnea, & retractions. the RN should know what consideration:

The child's airway is narrow and more easily occluded

A pediatric rn is providing care to a child nearing the end of life. Which intervention is part of palliative care?

Maintain child's quality of life & address all needs, holistically.

A child dx w/ epilepsy is being started on antiepileptic therapy. Priority nursing intervention w/ starting treatment?

Monitor the child for potential side effects, including sedation

A child is diagnosed w/ type 1 diabetes. What is a priority in educating the parents about insulin therapy?

Insulin may need to be adjusted based on exercise, stress, & food intake.

The rn is educating the parents of a child about immunizations. what statement indicates that further teaching is needed

"It's fine to delay vaccines if my child has a mild cold."

A 6-month-old infant with sickle cell disease has a fever of 102°F. The rn knows that the most appropriate action is to:

Provide fluids and rest, and notify the physician immediately.

A toddler with a terminal illness shows distress due to parent separation. What is the best nursing intervention?

Allow 24-hour, unlimited visitation to maintain the parent-child bond.

What is the most important nursing intervention for a child receiving daily subcutaneous GH injections for GHD?

Rotate injection sites to prevent tissue damage.

When preparing a preschool-aged child for a medical procedure, which of the following strategies is most appropriate?

Delay talk of the procedure until just before it begins to minimize worry.

A child w/ meningitis is receiving antibiotics. The rn should know that what intervention is needed if dx w/ meningitis

Administer antibiotics right after collecting blood cultures.

What signs should the nurse assess every 1-2 hours for a child at risk for compartment syndrome with a long leg cast?

Numbness and tingling in the fingers or toes

A child with Reye’s syndrome is admitted to the hospital. The nurse should anticipate which of the following treatments?

Administering IV fluids with glucose and electrolytes

What is the most important intervention in the immediate care of a child diagnosed with a Wilms tumor?

Ensure a warning sign is placed on the door to prevent abdominal palpation

A rn is caring for a child post-tonsillectomy. Which action should the rn avoid to minimize the risk of postop bleeding?

Instruct the child not to cough, clear the throat, or blow the nose

Which sign would most likely indicate increased intracranial pressure (ICP) in an infant with a suspected brain tumor?

Projectile vomiting in the morning

a child w/ Fifth’s disease has a "slapped cheek" rash. The rn knows which symptom is characteristic of later stages?

Recurrent rash triggered by heat exposure

A rn is preparing to d/c a child who has seizures. What should the rn include in the teaching plan for the Childs family

"Ensure the child wears a medical alert bracelet at all times."

A 6yo has been diagnosed w/ meningitis. Which is the most important consideration for Childs environment?

Keep the room dark and quiet to reduce stimulation

What instruction should the nurse give parents about proper iron supplementation for a child w/ iron deficiency anemia?

"Give the iron supplement w/ a glass of orange juice to enhance absorption.

A rn is caring for a child w/ hemolytic uremic syndrome. The rn knows that which intervention is most important?

Monitor for signs of bleeding and elevated blood pressure.

A rn is caring for a child w/ a partial-thickness burn to the hand. Which nursing interventions is most important?

Elevate the affected hand above the level of the heart

A rn is educating parents on how to prevent hemolytic uremic syndrome. Which is most important for the rn emphasize?

Cooking ground beef to a minimum internal temperature of 160°F.

A child w/ DKA is receiving fluid resuscitation. The rn knows that it is crucial to monitor the child’s potassium bc:

DKA causes hyperkalemia, which can lead to arrhythmias.

A 3 yo is brought to the clinic w/ a tick bite. The parent asks about Lyme disease prevention. What is recommended?

Apply DEET to your child’s skin before playing outside

What intervention should the nurse prioritize for a 4-year-old with honey-colored crusty exudate, suspecting impetigo?

Apply topical mupirocin (Bactroban) to the lesions

When assessing the respiratory system of a 6mo, the rn should observe which to determine normal respiratory function?

Rate and depth of respirations, looking at the abdomen for movement

A 3 yo presents w/ fever, headache, & a stiff neck. The rn suspects meningitis. Which diagnostic test will confirm?

Lumbar puncture (LP) for cerebrospinal fluid (CSF) analysis

A child is diagnosed w/ osteomyelitis. The rn knows that what is the priority action for initial treatment?

Administer broad-spectrum IV antibiotics after blood cultures are drawn.

A child is diagnosed w/ coarctation of the aorta. Which of the following findings is most consistent w/ this condition?

decreased blood pressure in the legs compared to the arms

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Peds final review

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Questions 107

Answers

1
A toddler is hospitalized for a chronic illness. What is the most appropriate nursing intervention for development?
Reassure the parents that regression is common & will resolve after d/c.
Encourage the parents to discipline the kid to maintain normal development.
parents are to avoid interacting with the kid to prevent emotional distress
Assure the parents the child’s development will be unaffected.
2
Which sign must be present to confirm anaphylaxis in a child with facial edema and difficulty breathing?
Elevated white blood cell count
A positive skin test for allergens
Two or more body systems affected
Persistent fever and cough
3
What is the most important intervention for a 6-year-old with a 15% TBSA partial-thickness burn to the arm?
Apply cold compresses to the burn area to reduce swelling
Initiate fluid resuscitation for hypovolemia
Administer pain relief with over-the-counter medication
Monitor for signs of infection at the burn site
4
A 6mo is being evaluated for hypertrophic pyloric stenosis. which diagnostic test is likely to confirm this condition?
Ultrasound showing elongation and thickening of the pylorus
Blood cultures and stool analysis
Upper GI series with barium contrast
Abdominal X-ray showing air-fluid levels
5
What should the nurse include in the education plan for a child receiving iron supplements for iron deficiency anemia?
"Iron supplements are best given with a glass of water to aid absorption."
"Expect the stools to become dark and tarry in color."
"Administer the iron with a meal to reduce the risk of stomach upset."
"You can mix the liquid iron with milk to make it more palatable."
6
Which symptom would confirm DKA in a 7-year-old with weight loss, abdominal pain, thirst, and glucose of 325 mg/dL?
Fatigue, nausea, fruity-smelling breath, and low blood pressure
Increased appetite, hyperventilation, and fever
Lethargy, elevated blood pressure, and rapid weight gain
Dry skin, rash, and headache
7
Which of the following is a key component in the prevention of sleep disorders in children?
Implementing bedtime restrictions and encouraging late-night activities.
Recognizing sleep issues early and understanding the underlying cause.
Providing caffeine to the child during the day to improve alertness.
Ignoring early signs of sleep difficulty to avoid over-medicalizing.
8
Which of the following findings is most likely in a child with diabetes insipidus?
Polyuria, polydipsia, and irritability
Weight gain, polyphagia, and constipation
Fever, rash, and diarrhea
Weight loss, hypotension, and irritability
9
A rn is caring for a child w/ Graves’. Which signs and symptoms would the nurse expect to observe in this child?
Tachycardia, goiter, and bulging eyes
Hypotension, cold intolerance, and fatigue
Weight gain, constipation, and dry skin
Muscle weakness, depression, and weight loss
10
A 4yo is brought to the clinic w/ s/s of anaphylaxis following exposure to a bee sting. which action is appropriate?
Administer a histamine blocker (e.g., Benadryl)
Administer epinephrine IM and monitor airway
Apply a cold compress to the sting site
Place the child in a supine position with legs elevated
11
What interventions should be included in the care plan to reduce discomfort for a kid in traction post femur fracture?
Ensure the child remains in 1 position for 8 hrs to prevent skin breakdown
Limit neurovascular assessments to once every 4 hours.
Reposition the child every 2 hours and assess the pin sites every 8 hours.
Keep the childs affected leg in a dependent position to improve circulation
12
A 5yo w/ celiac disease is about to be d/c. Which statement by the parent indicates the need for further teaching?
"I will make sure to eliminate gluten from my child’s diet entirely."
"I can give my child gluten-free processed foods occasionally."
"I will monitor my child for signs of abd discomfort after eating gluten."
"I need to carefully read food labels to avoid hidden gluten."
13
A nurse is caring for a toddler whose parent has a terminal illness. Which intervention helps the toddler cope?
Encourage the child to talk about their fears and concerns.
tell them that death is not permanent & they will see their parent again
Recommend the parents begin separation therapy to help the toddler adjust
Allow the parents to stay with the child for 24-hour unlimited visitation.
14
What is an important consideration when administering furosemide (Lasix) to a 2-year-old with congestive heart failure?
Monitor for signs of dehydration due to excessive fluid loss
Administer the medication with milk to reduce gastric upset
Monitor for hyperkalemia due to potassium retention
Ensure the child receives a fluid restriction to prevent fluid overload
15
What should the nurse include in teaching a 12-year-old and family about wearing a brace for scoliosis treatment?
"Bracing therapy will eliminate the need for future surgery."
"You can remove the brace during physical activity."
"It is important to wear the brace continuously, even while sleeping."
"You will need to wear the brace for at least 16 hours a day."
16
A rn is caring for a child w/ Tetralogy of Fallot. Which symptoms are most characteristic of a "TET spell"?
Clubbing of the fingers and toes
Sudden cyanosis and fainting after crying or playing
Sudden sharp chest pain and diaphoresis
Increased respiratory rate and oxygen saturation
17
A nurse is observing a 3-month-old infant. Which of the following behaviors is expected at this developmental stage?
The infant can roll from front to back.
The infant begins to say "mama" and "dada."
The infant can grasp objects with their hands.
The infant can sit up without support.
18
A rn is caring for an infant dx w/ GERD. The mother asks how to reduce reflux episode episodes? what is appropriate?
Allow the infant to lie flat for 30 minutes after feedings
Offer larger, less frequent feedings to the infant
Hold the infant upright for at least 30 minutes after feedings
Increase the frequency of burping during feedings
19
A 2yo has s/s of resp distress, nasal flaring, tachypnea, & retractions. the RN should know what consideration:
The child’s epiglottis is rigid and less susceptible to swelling
The child’s trachea is longer and wider compared to an adult
The child's airway is narrow and more easily occluded
The child’s alveoli are fully mature, making gas exchange more effective
20
A pediatric rn is providing care to a child nearing the end of life. Which intervention is part of palliative care?
Discontinuing all medications to hasten death.
Providing curative measures to improve the child’s prognosis.
Maintain child's quality of life & address all needs, holistically.
Focus solely on pain management w/o addressing the childs emotional needs.
21
A child dx w/ epilepsy is being started on antiepileptic therapy. Priority nursing intervention w/ starting treatment?
Monitor the child for potential side effects, including sedation
Encourage the child to engage in activities that may trigger seizures
Increase the dosage of the AED if the child continues to have seizures
Educate the child’s school about the medication regimen
22
A child is diagnosed w/ type 1 diabetes. What is a priority in educating the parents about insulin therapy?
Insulin should be adjusted based on the child’s height.
Insulin should be given only if the blood glucose level is greater than 250
The child will need insulin every 3-4 hours, regardless of food intake.
Insulin may need to be adjusted based on exercise, stress, & food intake.
23
The rn is educating the parents of a child about immunizations. what statement indicates that further teaching is needed
"I need to report any unusual reactions to the doctor after immunizations."
"It's fine to delay vaccines if my child has a mild cold."
The rn will provide info about the vaccine schedule and any side effects.
I should make sure my kid gets vaccinated on schedule to prevent diseases.
24
A 6-month-old infant with sickle cell disease has a fever of 102°F. The rn knows that the most appropriate action is to:
Give antibiotics and wait 24 hours to see if the fever resolves.
Provide fluids and rest, and notify the physician immediately.
Administer acetaminophen and continue to monitor the fever.
Increase oral hydration and schedule a blood transfusion.
25
A toddler with a terminal illness shows distress due to parent separation. What is the best nursing intervention?
Restrict parental visitation to avoid overstimulation of the child.
Allow 24-hour, unlimited visitation to maintain the parent-child bond.
Use sedation to prevent the kid from expressing distress during separation
Encourage the parents to leave the hospital for periods of respite to rest.
26
What is the most important nursing intervention for a child receiving daily subcutaneous GH injections for GHD?
Give the injection only when growth is slower than expected.
Administer the injection in the morning before breakfast.
Teach the child to inject at the same time every day.
Rotate injection sites to prevent tissue damage.
27
When preparing a preschool-aged child for a medical procedure, which of the following strategies is most appropriate?
Set limits but allow the child to express frustration.
Allow the child to choose their preferred procedure and equipment.
Use complex medical terms to explain the procedure in detail.
Delay talk of the procedure until just before it begins to minimize worry.
28
A child w/ meningitis is receiving antibiotics. The rn should know that what intervention is needed if dx w/ meningitis
Administer antibiotics right after collecting blood cultures.
Isolate the child in a private room after the first dose of antibiotics
Delay antibiotics until blood cultures are confirmed positive
Encourage fluids and administer antipyretics only for comfort
29
What signs should the nurse assess every 1-2 hours for a child at risk for compartment syndrome with a long leg cast?
Presence of a bounding pulse distal to the cast
Discomfort relieved by repositioning the limb
Pain that is relieved by administering pain medication
Numbness and tingling in the fingers or toes
30
A child with Reye’s syndrome is admitted to the hospital. The nurse should anticipate which of the following treatments?
Administering IV fluids with glucose and electrolytes
Encouraging the child to eat solid foods to aid recovery
Administering aspirin to reduce fever
Giving the child vitamin K to prevent bleeding
31
What is the most important intervention in the immediate care of a child diagnosed with a Wilms tumor?
Ensure a warning sign is placed on the door to prevent abdominal palpation
Encourage the kid to engage in physical activities to maintain muscle.
Administering antipyretics for fever management
Regularly palpating the abdomen to assess tumor size
32
A rn is caring for a child post-tonsillectomy. Which action should the rn avoid to minimize the risk of postop bleeding?
Allow the child to eat soft foods such as mashed potatoes and yogurt
Apply an ice pack to the child’s throat for comfort
Instruct the child not to cough, clear the throat, or blow the nose
Offer clear liquids such as apple juice immediately after surgery
33
Which sign would most likely indicate increased intracranial pressure (ICP) in an infant with a suspected brain tumor?
Crying when being held
Decreased head circumference
Projectile vomiting in the morning
Hyperactivity and irritability
34
A 7-year-old with ADHD showing both inattention and hyperactivity symptoms. Which ADHD presentation is this?
Neurodevelopmental presentation
Combined presentation
Predominantly hyperactive-impulsive presentation
Predominantly inattentive presentation
35
Which of the following reflexes in a newborn should the nurse be concerned about if it persists beyond 9 months of age?
Rooting reflex
Grasping reflex
Sucking reflex
Moro reflex
36
a child w/ Fifth’s disease has a "slapped cheek" rash. The rn knows which symptom is characteristic of later stages?
Persistent high fever for up to 2 weeks
Recurrent rash triggered by heat exposure
Hives and urticaria on the face
Rash confined to the extremities and trunk
37
A rn is preparing to d/c a child who has seizures. What should the rn include in the teaching plan for the Childs family
"Ensure the child wears a medical alert bracelet at all times."
"Your child can return to sports after six weeks without a seizure."
"It is important for your child to avoid all physical activities."
It is safe for your child to drive once they are seizure-free for a month.
38
A 6yo has been diagnosed w/ meningitis. Which is the most important consideration for Childs environment?
Keep the room dark and quiet to reduce stimulation
Increase the room temperature to promote circulation
Allow the child to eat a large meal to boost energy levels
Encourage the child to engage in quiet activities
39
A child w/ diabetes insipidus is prescribed desmopressin. What is most important for the nurse to monitor during therapy
Serum potassium levels
Fluid intake and output
Blood glucose levels
Blood pressure
40
A rn is performing a routine assessment on a 4 yo child. Which of the following assessments should be completed last?
Respiratory assessment
Head circumference measurement
Eye examination
Oral cavity inspection
41
What instruction should the nurse give parents about proper iron supplementation for a child w/ iron deficiency anemia?
"Give the iron supplement w/ a glass of orange juice to enhance absorption.
"It is best to administer the iron after meals to prevent nausea."
"Liquid iron should be mixed with milk to prevent staining of the teeth."
"Administer the iron with milk to increase absorption."
42
A rn is caring for a child w/ hemolytic uremic syndrome. The rn knows that which intervention is most important?
Measure vital signs every 12 hours and monitor for fever.
Monitor for signs of bleeding and elevated blood pressure.
Administer antibiotics as prescribed to treat E. coli infection.
Encourage the child to increase fluid intake to improve hydration.
43
A rn is caring for a child w/ a partial-thickness burn to the hand. Which nursing interventions is most important?
Use a topical antibiotic ointment on the burn immediately
Apply ice to the burn area to reduce pain
Administer acetaminophen every 4 hours for pain
Elevate the affected hand above the level of the heart
44
A rn is educating parents on how to prevent hemolytic uremic syndrome. Which is most important for the rn emphasize?
Cooking ground beef to a minimum internal temperature of 160°F.
Providing unpasteurized juice and milk to improve immunity.
Avoiding unclean swimming areas and pools.
Teaching the child proper hand hygiene before meals.
45
A child w/ DKA is receiving fluid resuscitation. The rn knows that it is crucial to monitor the child’s potassium bc:
Potassium should be given only if levels are below normal.
DKA causes hyperkalemia, which can lead to arrhythmias.
Fluid resuscitation will immediately correct potassium imbalances.
DKA leads to hypokalemia due to fluid shifts.
46
A 3 yo is brought to the clinic w/ a tick bite. The parent asks about Lyme disease prevention. What is recommended?
"It’s best to wait for symptoms to appear before seeking medical care."
Your child should be tested for Lyme disease immediately after a tick bite.
Apply DEET to your child’s skin before playing outside
Allow ur kid to play in wooded areas as long as tick is removed by 24 hrs
47
What intervention should the nurse prioritize for a 4-year-old with honey-colored crusty exudate, suspecting impetigo?
Keep the child in isolation until the infection resolves
Apply topical mupirocin (Bactroban) to the lesions
Administer IV antibiotics
Encourage the child to scratch the lesions to reduce itching
48
When assessing the respiratory system of a 6mo, the rn should observe which to determine normal respiratory function?
Use of accessory muscles during breathing
Abdominal breathing with periods of apnea longer than 10 seconds
Any sounds of crackles, wheezes, or rhonchi
Rate and depth of respirations, looking at the abdomen for movement
49
A 3 yo presents w/ fever, headache, & a stiff neck. The rn suspects meningitis. Which diagnostic test will confirm?
Urinalysis
EEG to evaluate brain activity
Lumbar puncture (LP) for cerebrospinal fluid (CSF) analysis
Chest X-ray to assess for pneumonia
50
A child is diagnosed w/ osteomyelitis. The rn knows that what is the priority action for initial treatment?
Provide nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
Administer broad-spectrum IV antibiotics after blood cultures are drawn.
Apply heat to the affected limb to reduce inflammation.
Restrict all activity and encourage bed rest only.
51
A child is diagnosed w/ coarctation of the aorta. Which of the following findings is most consistent w/ this condition?
A difference in blood pressure between the right and left arms
Decreased blood pressure in the upper limbs compared to the lower limbs
Low blood pressure in all four limbs
decreased blood pressure in the legs compared to the arms
52
a 6 yo lacks confidence when they can't finish a puzzle. what psychosocial development might they be struggling with?
Autonomy vs. Shame & Doubt
Trust vs. Mistrust
Initiative vs. Guilt
Industry vs. Inferiority
53
A child presents w/ periumbilical pain, vomiting, anorexia, & fever. What indicates appenidceal rupture?
Pain relieved suddenly without intervention
Severe pain in the left lower quadrant
Vomiting without any abdominal pain
A low-grade fever that persists over several days
54
Which statement by the parent about using an EpiPen indicates the need for further teaching?
"I should administer the EpiPen as soon as I notice signs of anaphylaxis."
"If my child is feeling better, I can wait to call for help."
"I should keep the EpiPen with me at all times in case of exposure."
"I will call 911 immediately after administering the EpiPen."
55
A child is dx w/ Lyme disease & is started on a 2-weeks of oral antibiotics. The rn should include which education?
The antibiotic treatment should be stopped as soon as the rash disappears.
full course of antibiotics should be completed even if s/s resolve early
"Your child can return to school once they start antibiotics."
"You will need to apply a topical antibiotic to the site of the tick bite."
56
What instructions should the nurse include in the discharge teaching plan for a child with congestive heart failure?
"Encourage increased physical activity to strengthen the heart muscle."
watch for s/s of worsening heart failure, ie. rapid weight gain & dyspnea
Monitor vital signs regularly, especially during periods of rest."
Limit fluid intake to prevent dehydration."
57
A rn is teaching a parent about the s/s of an allergic reaction to immunizations. Which signs should the parent report?
Hives or difficulty breathing
Mild fever and irritability
Redness and swelling at the injection site
Local pain and tenderness
58
A 10yo is experiencing difficulty falling asleep & wakes up feeling tired. which is like the diagnosis?
Generalized anxiety disorder
Sleep disorder
Attention-Deficit/Hyperactivity Disorder (ADHD)
Depressive disorder
59
A toddler often becomes frustrated when unable to button their shirt. According to Erikson's theory, which development?
Initiative vs. Guilt
Industry vs. Inferiority
Trust vs. Mistrust
Autonomy vs. Shame & Doubt
60
Which statement by parents indicates a need for further teaching on managing a mild sickle cell crisis at home?
give our kid the prescribed pain medication & encourage physical activity
We will watch for s/s of infection and take a fever over 101.5°F seriously.
"We will make sure our child drinks fluids and rests during the crisis."
"If the pain worsens, we will take our child to the hospital."
61
your educating the parent of a newborn about developmental milestones. At what age will it be able to roll from to back?
5-6 months
1-2 months
7-9 months
3-4 months
62
A rn is caring for a child dx w/ hemolytic uremic syndrome. The rn should prioritize which of the following actions?
Monitor intake and output and assess for signs of fluid overload.
Administer oral antibiotics as prescribed.
Provide aspirin to reduce fever and inflammation.
Encourage high-protein foods to prevent malnutrition.
63
A child w/ a chronic condition is regressing by bedwetting & thumb-sucking, while hospitalized. what should the rn do?
Begin the childs developmental plan asap to prevent further regression
Criticize the child for regressing in behavior.
Discourage the child from engaging in these behaviors.
Explain to the parents that this behavior is temporary & will get better.
64
A kid has acute epiglottitis & has s/s of resp distress: drooling, difficulty swallowing, & fever. what is the priority?
Place the child in a comfortable position and prepare for intubation
Administer antipyretic medication to lower the child’s temperature
Start an IV line and administer fluids to prevent dehydration
Perform a throat examination with a tongue blade to assess for swelling
65
A 6 mo is diagnosed w/ a UTI. Which of the following symptoms is most indicative of a UTI in this age group?
Increased thirst, headache, and diarrhea
Enuresis and dysuria
Fever, poor feeding, and abdominal pain
Malaise, flank pain, and foul-smelling urine
66
A rn is caring for a child who has <6 months to live. The family wants to be at home. what intervention is best?
Provide hygiene such as regular repositioning & oral care to ensure comfort
Discourage fam from being present during the final moments to allow privacy
Avoid any emotional support, as this can lead to false hope for the family.
Discontinue all medications & treatments that do not directly address pain.
67
A rn is educating the parents of a kid who is receiving palliative care. Which statement by the rn is most appropr
"Palliative care focuses only on pain relief & not on curative treatments."
provides comfort & also supports curative treatments when appropriate
is the same as hospice care, & no further medical treatment is given.
is provided only in the final stages of life & not used for chronic illness
68
A rn is assessing a 5yo child’s pain using the Wong-Baker Faces Scale. Which is the most appropriate way to explain it?
"Let me know if your pain is more or less than a 5 out of 10."
"Point to the face that looks like how you feel."
"Tell me if your pain is mild, moderate, or severe."
"Point to the number that matches how much your pain hurts."
69
A family grieving the loss of a child says, "If only we had noticed sooner." Which grieving phase is this?
High anxiety
Denial
Reconciliation
Remorse
70
A rn is educating a parent about the risks of vaccine-preventable diseases. Which statement should be included?
vaccines only prevent mild illness & dont affect long-term health outcomes.
Immunizations help prevent diseases like measles, whooping cough, & polio.
Immunization schedules are flexible, & can be delayed until they are older
Only kids w/ known allergies should receive vaccines at the scheduled times
71
A rn is caring for a child who recently had a seizure. Which action should the nurse take during the seizure event?
Place a tongue depressor in the child’s mouth
Administer an oral anticonvulsant medication
Position the child on their side to prevent aspiration
Hold the child down to prevent injury
72
Which sign should the rn report immediately to the provider for a postoperative child after brain tumor surgery?
Increased appetite and energy levels
Clear drainage from the incision site
Decreased level of consciousness and increased confusion
Decreased body temperature
73
A rn is caring for a newborn w/ esophageal atresia & tracheoesophageal fistula. What should we do before surgery?
Place the infant in a supine position for optimal breathing
Insert a nasogastric tube to assist with feedings
Administer antibiotics to prevent pneumonia
Begin oral feedings with small amounts of formula
74
When educating parents of a child w/ ADHD about medication management, which of the following should the rn emphasize?
Meds should be stopped during the school months to give the child a break.
Medications should be used as the only treatment option.
Medications should be combined w/ behavioral interventions and strategies.
Medications should be avoided if the child has any sleep issues.
75
A toddler is crying & unable to express where they are experiencing pain. The rn should use which tool to assess?
Wong-Baker Faces Scale
FLACC Scale
Numeric scale
CHEOPS Scale
76
A rn is caring for a child who has had multiple febrile seizures. what is a priority to prevent further injury?
Administer an intravenous anticonvulsant immediately
Place the child in a supine position
Pad and raise the side rails of the bed
Restrict the child’s movement to prevent muscle spasms
77
A 5-year-old child with sickle cell disease is admitted with severe pain. What is the nurse's priority intervention?
Begin a blood transfusion to prevent hemolysis.
Administer the prescribed pain medication and provide rest.
Encourage the child to drink fluids and monitor vital signs.
Assess for signs of infection and start prophylactic antibiotics.
78
A child has wheezing, tachy, hypotension, & hives after eating peanuts. What is a priority intervention for anaphylaxis?
Administer an antihistamine
Offer fluids to the child and monitor for improvement
Administer an epinephrine injection and call 911
Apply a cold compress to the child’s face
79
The rn is educating a mom about preventing UTIs in her child. what statement indicates further teaching is needed?
I will wipe my child’s bottom from front to back.
I will let my kid hold their urine as long as possible to avoid accidents.
"I will make sure my child wears cotton underwear."
"I will encourage my child to drink plenty of fluids throughout the day."
80
What should the rn teach parents about using a Pavlik harness to treat an infant w/ developmental dysplasia of the hip?
The parents should adjust the harness if it appears too tight.
The child should wear the harness for 12 hours a day.
The harness should be worn 23 hours a day for several weeks.
The harness should be removed for skin checks only during bathing.
81
A 3-yo is dx w/ Fifth's disease. The nurse provides education to the parents. Which should be included in the teaching?
"Your child will need to be isolated for several weeks."
"Your child can return to daycare once the rash appears."
"Avoid exposure to pregnant women who are not immune."
"Ensure your child receives aspirin to treat the fever."
82
A parent of a 2yo expresses concern that the child has frequent tantrums. The rn should advise the parent to focus on?
Praise the child frequently
Use physical punishment to discourage tantrums.
Avoid any triggers for the tantrums.
Ignore the tantrums to avoid reinforcing the behavior.
83
A child w/ GERD is taking PPIs & having a barium swallow. The parents ask about long-term effects. Best response by rn?
"PPIs are not typically recommended for long-term use in children."
PPIs are safe when used as a long-term plan, but we will watch for s/s
PPI therapy is not necessary if ur childs reflux is only occasional & mild.
These meds will only be used for a short period.
84
A 4yo w/ cystic fibrosis is admitted for a respiratory infection. Which is a priority to promote growth and development?
Withhold antibiotics until a culture is obtained
Administer pancreatic enzymes with meals to improve digestion
Monitor for the development of salty skin and tears
Encourage the child to participate in physical activities as tolerated
85
A 7yo w/ asthma presents w/ wheezing, shortness of breath, & chest tightness. The rn knows what intervention is priority
Encourage the child to drink fluids to improve airway patency
Administer a quick-relief (rescue) medication as prescribed
Have the child lie flat to optimize lung expansion
Encourage deep breathing exercises to calm the child
86
A child is diagnosed with sleep apnea. Which of the following symptoms is commonly associated with this condition?
Frequent nightmares
Excessive daytime energy
Snoring and periods of disrupted breathing during sleep
Difficulty falling asleep
87
Which statement by the parent of a child with asthma indicates the need for further teaching?
I will make sure to avoid my child’s asthma triggers, such as dust & smoke.
"I need to track my child’s peak flow readings & adjust meds accordingly."
"I should give my child their quick-relief medication when symptoms start."
"I will limit my child’s physical activity to prevent asthma attacks."
88
A child is receiving treatment for metatarsus adductus. Which is an appropriate nursing intervention for this condition?
Schedule surgery immediately if the deformity persists beyond birth.
tell the parents to do stretch exercises & use of shoes on opposite feet.
Administer analgesics to manage pain from corrective surgery.
Recommend a Pavlik harness for consistent foot alignment.
89
A rn is caring for a child w/ DKA. Which intervention should the rn prioritize in the initial management?
Check blood glucose every 4 hours
Administer fluids after correcting acidosis
Assess neurological status every 15 minutes
Administer IV glucose immediately
90
A rn is educating a parent about preventing febrile seizures in a child. what is an appropriate statement to include?
"You should keep the child’s fever below 102°F to prevent a seizure."
Febrile seizures can be reduced by keeping the child’s temp under control
Seizures are inevitable during any fever > 101°F, nothing will prevent it
Avoid administering any fever-reducing meds during a febrile episode.
91
A child w/ a brain tumor presents w/ subtle changes in personality & speech. The rn should immediately assess for what?
Dehydration
Hypoglycemia
Increased intracranial pressure (ICP)
Acute respiratory distress syndrome (ARDS)
92
A child w/ Wilms tumor is being discharged after surgery. Which teaching point should the nurse emphasize to the parents
dont put pressure on the abd during activities & watch for s/s of infection
Encourage the child to resume normal physical activities asap after d/c.
Monitor the childs weight & report significant loss due to dehydration risk
"You should gently palpate the abdomen daily to monitor the surgical site."
93
A rn is assessing a kid for anaphylaxis after being stung. Which sign should the nurse expect to find in early stages?
Wheezing, tachycardia, and facial edema
Bradycardia and hypothermia
Diarrhea and abdominal cramping
Cyanosis and loss of consciousness
94
A rn is educating parents of a child w/ ADHD. Which strategy should the rn recommend to help the child focus & manage?
Increase screen time to distract the child from disruptive thoughts.
Encourage the child to stay in a quiet environment w/ limited distractions.
Use physical punishment to reinforce behavioral limits.
Limit any form of medication to avoid dependency.
95
A 7-year-old can describe pain but doesn't understand its cause. Which Piaget developmental stage fits this?
Sensorimotor
Preoperational
Formal operational
Concrete operational
96
What is the most important nursing intervention before obtaining a urine sample for culture from a 3-year-old w/ a UTI?
Obtain the sample using catheterization if the child is ill.
Ask the child to void directly into a sterile container.
Administer antibiotics before obtaining the sample to ensure coverage.
Perform a clean-catch urine sample for culture.
97
A rn is educating a parent on Lyme disease prevention. Which statement by the parent indicates need for further teaching
I can let my kid play in wood areas as long as they dont get bit by a tick.
I will make sure my child wears long sleeves & pants while playing outside.
After playing outside, I will check my child for ticks & shower within 2 hr
I will apply DEET spray to my child’s exposed skin when they are outside
98
A rn is assessing an infant suspected of having hypertrophic pyloric stenosis. Which s/s are most characteristic of HPS?
Projectile vomiting after feedings & an olive-shaped mass in the abdomen
Excessive drooling and difficulty swallowing
Constipation and low-grade fever
Frequent diarrhea and abdominal distention
99
During a well-child visit, the rn advises a parent of a toddler to limit screen time < 1-2 hours daily. why?
To prevent excessive stimulation of the child
To reduce the risk of obesity
To promote physical activity and social interaction
To encourage better sleep patterns
100
A rn is teaching a fam about the prevention of Graves’ complications. Which should the nurse include in the teaching?
Graves’ typically improves on its own without the need for medication
Thyroid storm is a chronic condition that requires long-term med adjustment
Thyroid hormone replacement will be needed for life once disease resolves
If your child experiences a thyroid storm, seek immediate medical attention
101
A rn is assessing a 6 mo w/ congestive heart failure. Which of the following signs is most likely to be observed?
Severe chest pain and fever
Increased activity tolerance and improved growth
Puffy eyelids and swelling of the hands and feet
Cold, clammy extremities and absent pulses
102
A child is diagnosed w/ Reye's syndrome. Which intervention is most critical for the nurse to emphasize during the care?
Administer aspirin for pain relief
Encourage physical activity to promote circulation
Ensure the child remains hydrated with oral fluids
Monitor liver function and Acid-Base Balances
103
A rn is teaching a mom how to manage the child’s type 1 diabetes. What statement indicates a need for further education?
If my child has a low bg reading, I will give them a snack w/ 30 g of carbs
I should adjust the insulin dose based on their stress level & exercise
"I will monitor my child’s blood glucose 3 to 6 times a day."
If my child’s blood glucose is greater than 240, I will check for ketones.
104
A child w/ hypoparathyroidism is being treated w/ calcium & vitamin D. Which should the nurse prioritize for this child?
Educate the family about the importance of a low-calcium diet.
Assess for signs of dehydration due to excessive calcium supplementation.
Monitor for signs of hypercalcemia, such as nausea and vomiting.
Monitor for signs of hypocalcemia, such as muscle spasms and seizures.
105
parents of a kid w/ a chronic condition expresses overwhelming sadness. According to Epperson’s, what phase is this?
denial
remorse
high anxiety
grief
106
What should the nurse teach parents about growth hormone injection therapy for a child with pituitary hypofunction?
The injections should be administered at bedtime to promote growth.
GH therapy should be stopped once the kid reaches the expected adult height
The child should receive GH injections only when s/s are severe.
The child should rotate injection sites to minimize tissue irritation.
107
A rn is caring for an infant w/ clubfoot. Which nursing intervention should be included in the care plan?
Encourage the infant to crawl as soon as possible to promote mobility.
Teach the parents to apply and remove the cast every 2-3 days.
Begin serial casting immediately after birth.
Apply the Pavlik harness to maintain proper foot alignment.

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