RN Pediatric Nursing Practice 2023

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Questions and Answers

What is an indication of impaired kidney function in the child?

Low-grade fever

Normal platelet count

Elevated BUN level (correct)

Increased temperature

It is anticipated to administer factor VIII for a toddler with hemophilia A experiencing an acute episode.

True

What should be applied to the affected joints of a toddler with hemarthrosis?

Ice packs

Which sign indicates improvement in an infant with moderate acute laryngotracheobronchitis?

SpO2 of 96% with cool mist oxygen Signup and view all the answers

A child who has a head injury can develop ______ as a result of altered pituitary function.

syndrome of inappropriate antidiuretic hormone secretion (SIADH) Signup and view all the answers

What should be applied daily to an infant's suture line following cheiloplasty?

A thin layer of antibiotic ointment Signup and view all the answers

What is the priority action by the nurse for a school-age child experiencing an anaphylactic reaction?

Administer epinephrine IM Signup and view all the answers

Which actions should the nurse plan for an adolescent with potential pneumothorax? (Select all that apply)

Apply supplemental oxygen Signup and view all the answers

What should the nurse monitor for a child with epiglottitis?

Oxygen saturation Signup and view all the answers

What play activity should a nurse recommend for a preschooler?

Playing dress-up Signup and view all the answers

Which child should the nurse see first?

A school-age child who has sickle cell anemia and reports decreased vision in the left eye Signup and view all the answers

What instruction should the nurse include for parents administering digoxin to a preschooler?

Brush the child's teeth after giving the medication Signup and view all the answers

What should a nurse recommend for treating diaper dermatitis?

Zinc oxide Signup and view all the answers

Match the steps to discontinue IV fluids:

Turn off the IV pump = First Occlude the IV tubing = Next Remove tape securing the catheter = Then Apply pressure over the catheter insertion site = Last Signup and view all the answers

What action should the nurse take for a child receiving chemotherapy and is severely immunocompromised?

Screen the child's visitors for indications of infection Signup and view all the answers

What instruction should the nurse give regarding oral nystatin for oral candidiasis?

Shake the medication prior to administration Signup and view all the answers

What causes infectious mononucleosis?

Infection with the Epstein-Barr virus Signup and view all the answers

What intervention should be included in the care plan for a child with heart failure?

Provide small, frequent meals for the child Signup and view all the answers

What expected behavior characteristic should a nurse include for toddlers?

Expresses likes and dislikes Signup and view all the answers

What is the nurse's priority consideration for room assignment for a newly admitted child?

Disease process Signup and view all the answers

What action should a nurse take prior to hydrotherapy treatment for a preschooler?

Administer an analgesic to the child Signup and view all the answers

What preventive advice can a nurse give parents to avoid asthma attacks?

Keep the child indoors when mowing the yard Signup and view all the answers

Which food has the highest amount of nonheme iron?

½ cup raisins Signup and view all the answers

What should the nurse teach families of children with juvenile idiopathic arthritis?

Encourage the child to perform independent self-care Signup and view all the answers

What action should a nurse take for an adolescent prior to a lumbar puncture?

Apply topical analgesic cream to the site 1 hr prior to the procedure Signup and view all the answers

What findings in a 2-year-old child indicate a need for follow-up?

Pale pink mucous membranes and decreased activity Signup and view all the answers

What risks should a nurse identify for a child exposed to lead?

Intellectual deficits and decreased kidney function Signup and view all the answers

The nurse should first address the child's , followed by the child's .

elevated blood lead level, hemoglobin Signup and view all the answers

What should the nurse include in discharge teaching for a parent of a child with lead poisoning? (Select all that apply)

Open the succimer capsule and sprinkle on applesauce Signup and view all the answers

Which conditions should the nurse identify as improving since the child's visit one month ago? (Select 4 of the following conditions)

Nutritional status Signup and view all the answers

What indicates an improvement in the child's condition based on urine glucose levels?

The amount of glucose in the urine has decreased. Signup and view all the answers

Which hematocrit level indicates anemia in a school-age child?

28% Signup and view all the answers

Which action should a nurse take when a toddler has an allergy to neomycin?

Withhold MMR vaccine Signup and view all the answers

What should the nurse do next after stabilizing the child's airway and respirations in shock?

Initiate IV access. Signup and view all the answers

What finding might indicate kidney rejection in an adolescent?

Serum creatinine 3.0 mg/dL. Signup and view all the answers

What action should a nurse take for a toddler with a serum lead level of 4 mcg/dL?

Schedule the toddler for a yearly re-screening. Signup and view all the answers

What is McBurney's point?

A specific location in the right lower quadrant of the abdomen. Signup and view all the answers

What finding should be reported to the provider during an assessment of a 6-month-old infant?

Presence of strabismus. Signup and view all the answers

What advice should the nurse give to guardians of a child with neutropenia?

Avoid using your child's daycare center. Signup and view all the answers

What indicates effectiveness of sodium polystyrene sulfonate enema?

Serum potassium level 4.1 mEq/L. Signup and view all the answers

What precautions should a nurse initiate for a child with pertussis?

Initiate droplet precautions. Signup and view all the answers

What indicates understanding of hydration monitoring by a parent of a child with dehydration?

I will monitor my child's number of wet diapers. Signup and view all the answers

What sodium level might indicate diabetes insipidus in a child?

Sodium 155 mEq/L. Signup and view all the answers

What action should a nurse take for a child in Buck's traction following a leg fracture?

Assess peripheral pulses once every 4 hr. Signup and view all the answers

What finding might indicate physical abuse in a child?

Symmetric burns of the lower extremities. Signup and view all the answers

What safety information should be included for a bike safety program for children?

The child should be able to stand on the balls of their feet when sitting on the bike. Signup and view all the answers

What developmental milestone should be expected for a 4-year-old?

Cuts an outlined shape using scissors. Signup and view all the answers

What finding should be expected after a perforated appendix repair?

Absence of peristalsis. Signup and view all the answers

What should a nurse do for an emancipated adolescent with an STI?

Have the adolescent sign a consent form for treatment. Signup and view all the answers

What finding is a priority for a nurse assessing a 4-month-old infant with heart failure?

Episodes of vomiting. Signup and view all the answers

What action minimizes pain for a breastfeeding infant requiring a heel stick?

Allow the mother to breastfeed while the sample is being obtained. Signup and view all the answers

What should a nurse do before surgery for a child with Wilms' tumor?

Avoid palpating the abdomen. Signup and view all the answers

What precaution should a nurse include in the plan for an infant with an epidural hematoma?

Implement seizure precautions for the infant. Signup and view all the answers

What should a nurse do first when discussing organ donation with the parents of a brain-dead child?

Explore the parents' feelings and wishes regarding organ donation. Signup and view all the answers

What finding indicates pertussis in an adolescent with a respiratory tract infection?

Dry, hacking cough. Signup and view all the answers

What statement should a nurse make to reassure a preschooler about their guardian's return?

Your guardian will be back after you eat. Signup and view all the answers

What ESR value indicates a potential complication for a child 1 week postoperative from an open fracture repair?

Erythrocyte sedimentation rate 18 mm/hr. Signup and view all the answers

What finding should a nurse address first in a school-age child with low hemoglobin levels?

The child's oxygen saturation. Signup and view all the answers

What findings should a nurse identify as potential complications after an appendectomy? (Select all that apply)

Rigid and distended abdomen Signup and view all the answers

What can poor personal hygiene in a toddler indicate?

Physical neglect. Signup and view all the answers

Study Notes

Anaphylactic Reaction Management

Priority action for a child in anaphylactic shock is administering epinephrine IM to counteract histamine-induced bronchoconstriction and vasodilation.

Pneumothorax Care

Apply supplemental oxygen for breathing support in a potentially pneumothorax-afflicted adolescent.
Prepare for chest tube insertion to promote lung re-expansion in case of air or fluid accumulation in the pleural space.

Epiglottitis Monitoring

Monitor oxygen saturation in children with epiglottitis to assess treatment response and respiratory distress.

Developmental Play Activities

Recommend dress-up play for preschoolers as it fosters social, mental, and physical development.

Priority in Sickle Cell Anemia

A school-age child with sickle cell anemia reporting decreased vision should be prioritized due to the risk of vaso-occlusive crisis.

Digoxin Administration in Heart Failure

Instruct parents to brush a heart failure child's teeth after administering digoxin to prevent dental decay from the sweet liquid form of the medication.

Diaper Dermatitis Treatment

Use zinc oxide to create a protective barrier for infants battling diaper dermatitis, allowing skin healing.

IV Catheter Discontinuation Procedure

Turn off the IV pump, occlude tubing, remove tape, and apply pressure to the catheter site for safe discontinuation.

Biceps Reflex Assessment

Tap the appropriate area to elicit the biceps reflex in school-age children with spinal cord injuries.

Infection Control in Immunocompromised Children

Screen visitors of severely immunocompromised children for infections to prevent overwhelming risk of contagion.

Oral Nystatin Administration

Shake oral nystatin suspension before administration to ensure even distribution of medication.

Understanding Infectious Mononucleosis

Mononucleosis is predominantly caused by the Epstein-Barr virus.

Heart Failure Dietary Care

Provide small, frequent meals to a child with heart failure to help conserve energy.

Toddler Behavior Characteristics

Expect toddlers to express likes and dislikes as they develop autonomy and self-concept.

Disease Process Considerations

Prioritize the patient's disease process to minimize infectious disease transmission risks in hospitalized children.

Hydrotherapy Pain Management

Administer analgesics prior to hydrotherapy for pain management in burn wound debridement.

Asthma Attack Prevention

Advise parents to keep their asthmatic child indoors during activities like lawn mowing to limit exposure to allergens.

Iron-Deficiency Anemia Dietary Focus

Encourage adolescents with iron deficiency anemia to consume non-heme iron-rich foods, with raisins being a top choice.

Encouraging Self-Care in Juvenile Idiopathic Arthritis

Promote independent self-care in children with juvenile idiopathic arthritis to enhance mobility and self-esteem.

Preparing for Lumbar Puncture

Apply topical analgesic cream to the lumbar site one hour before a lumbar puncture for pain relief.

Monitoring for Lead Poisoning

Follow up on signs of lead poisoning in toddlers living in older homes, such as pale pink mucous membranes and decreased activity.

Cognitive Risk from Elevated Lead Levels

Assess and address elevated blood lead levels (BLL) to prevent long-term cognitive impairment in children.

Anticipating Provider Prescriptions

Expect prescriptive interventions for children with elevated BLL, including medications like succimer and ferrous sulfate, as well as dietitian consults.

Discharge Education for Parents

Provide guidance on administering medications, monitoring hydration, and preventing lead exposure for toddlers with lead poisoning.

Indicators of Improved Health

Identify improvements in a child's health related to lead poisoning, kidney function, exposure levels, and nutritional status.

Anemia Laboratory Findings

Recognize hematocrit below the reference range (28% in a child) as an indication of anemia and its associated fatigue symptoms.

Immunization Administration Consideration

Withhold the MMR vaccine for a toddler with a known allergy to neomycin, indicating contraindications in vaccine administration.

Managing Shock in Children

After ensuring airway and respiratory stability in an 8-year-old child showing early shock signs, further assessment and intervention are essential.### IV Access and Kidneys
Initiating IV access is crucial after establishing airway and respiratory stabilization in children to maintain circulatory volume.
Elevated serum creatinine (3.0 mg/dL) indicates potential kidney rejection in adolescents post-transplant; normal range is 0.4 to 1.0 mg/dL.

Lead Screening and Appendicitis

A toddler with a serum lead level of 4 mcg/dL requires yearly re-screening and education on exposure prevention.
McBurney's point, located in the right lower abdomen, is significant for identifying appendicitis pain.

Vision and Neutropenia

Presence of strabismus in a 6-month-old should be reported as it may lead to blindness if uncorrected.
Guardians of a child with neutropenia should be advised to avoid daycare centers to minimize infection risk.

Hyperkalemia and Pertussis Care

Serum potassium level of 4.1 mEq/L confirms effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Droplet precautions are necessary for children diagnosed with pertussis, as it's transmitted during coughing or sneezing.

Hydration Monitoring and Diabetes Insipidus

Parents of a toddler with dehydration should monitor the number of wet diapers to assess hydration status.
Sodium levels above 145 mEq/L can indicate impending diabetes insipidus after head injury.

Neurovascular Checks and Child Maltreatment

Peripheral pulses should be assessed every 4 hours in children in Buck's traction to monitor neurovascular integrity.
Symmetric burns on lower extremities may suggest physical abuse in children.

Bicycle Safety and Developmental Milestones

For bicycle safety, children should be able to touch the ground with their feet while seated to ensure proper sizing.
A 4-year-old should be able to cut an outlined shape using scissors, indicating appropriate developmental milestones.

Postoperative Assessment

Absence of peristalsis is expected immediately following a perforated appendix repair as bowel function resumes.
Erythrocyte sedimentation rate increased to 18 mm/hr (normal is up to 10 mm/hr) may indicate postoperative infection.

Physical Neglect and Nephrotic Syndrome

Poor personal hygiene in toddlers can signal physical neglect due to insufficient supervision.
Elevated temperature and BUN levels could point towards either acute poststreptococcal glomerulonephritis or hemolytic uremic syndrome.

Hemophilia Management

Administering factor VIII is anticipated for toddlers experiencing acute hemophilia episodes due to recent falls.
Ice packs can be beneficial in managing discomfort from hemarthrosis during acute episodes of hemophilia.

Signs of Improvement in Infants

Improved status in an 8-month-old with laryngotracheobronchitis is indicated by the infant sleeping in parent's arms and improved SpO2 levels (96% with oxygen).
Assessment should consider urine output, with 34 mL indicating better hydration status compared to prior absence of voiding.### Head Injury and SIADH
A head injury in adolescents can disrupt pituitary function.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) can result from this disruption.
SIADH leads to excessive secretion of antidiuretic hormone (ADH).
Key indicators of SIADH include decreased urine output and hyponatremia (low sodium levels).
Mental confusion is a critical symptom that may develop as hyponatremia worsens.
Severe cases can cause additional neurologic manifestations, such as seizures.

Cheiloplasty Care for Infants

Post-operative care for a 3-month-old infant following cheiloplasty is crucial for healing.
Parents should apply a thin layer of antibiotic ointment daily on the suture line for three days.
After three days, transitioning to petroleum jelly for an extended period is recommended.
This routine helps in promoting effective healing of the surgical site.

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Description

This quiz focuses on pediatric nursing practices with an emphasis on emergency scenarios such as anaphylactic reactions. It highlights critical actions nurses must take in urgent situations, ensuring safe and effective care for children. Test your knowledge and prepare for real-life nursing challenges.