ATI Nursing Care of Children Proctored
Exam Pack/ Test Bank
1. What is a dictorial or authoritarian parenting style?: parents try to control the
... [Show More] child's
behaviors and attitudes through unquestioned rules and expectations
2. What is an authoriatitive parenting style?: also known as democratic, parents direct the child's
behavior by setting rules and explaining the reson for each rule setting
3. What is passive parenting?: parents are uninvolved, indifferent, and emotion- ally removed
4. A nurse manager on a pediatric floor is preparing an education program on working
with families for a group of newly hired nurses. Which of the following should the nurse
include when discussing the developmental theory?
A. describes that stress is inevitable
B. emphasizes that change with one member affects the entire family
C. provides guidance to assist families adapting to stress
D. Defines consistencies in how families change: D
5. A nurse is assisting a group of parents of adolescents to develop skills that will improve
communication. The nurse heads one parent states "my son knows he better do what I say".
Which of the parenting styles is he exhibiting?
A. Authoritarian
B. Permissive
C. Authroitative
D. Passive: A
6. A nurse is performimg family assessment. Which of the following should the nurse
include? (select all that apply)
A. medical history
B. parents' education level C. child's physical growth D. Support systems
E. Stressors: A, B, D, E
7. What is the expected pulse rate of a newborn?: 80 to 180/min
8. What is the expected pulse of a baby 1 week to 3 months?: 12 to 180/min
9. What is the expected pulse of a child 3 months to 2 years?: 70 to 150/min
10. What is the expected pulse of a child 2 to 10 years?: 60 to 110/min
11. What is the expected pulse of a child 10 years and older?: 50 to 90/min
12. What are the expected respirations fo a newborn to one year?: 30 to
35/min
13. What are the expected respirations of a 1 to 2 year old?: 25 to 30/min
14. What are the expected respirations of a 2 to 6 year old?: 21 to 25/min
15. What are the expected respirations of a child 6 to 12 years old?: 19 to
21/min
16. What are the expected respirations of a 12 year old and older?: 16 to
19/min
17. What are the normal vitals of an infant?: HR: 80-180
RR: 30-35
BP: 65-80/40-50
18. Fontanels: should be flat and soft, posterior closes between 6 and 8 weeks, anterior closes
between 12 and 18 months
19. Teeth: 6 to 8 teeth by 1 year of age, 20 baby teeth and 32 permanent teeth
20. How long is the Moro reflex present?: until 4 months of age
21. How long is the Tonic neck reflex present?: until 3 to 4 months of age
22. How long does the Babinski reflex last?: usually until a year
23. Expected findings of the olfactory (I) nerve in infants , children, and adolescents: Infants:
difficult to test
Children and Adolescents: indentifies smell through each nostril individually
24. Expected findings of optic nerve (II)?: Infants: looks at face and tracks with eyes
Children and adolescents: has intact visual acuity, peripheral vision, and color vision
25. Expected findings for trigeminal nerve?: infants: has rooting and sucking relfex
children and adolescents: is able to clencg teeth together and can detect touch on face with eyes
closed
26. A nurse is preparing to assess a preschool-age child. Which of the following is an
appripirate action by the nurse to prepare the child?
A. Allow the child to role play using miniature equipment
B. use medical terminology to describe what will happen
C. separate th child from her parents during examination
D. keep medical equipment visible to the child: A
27. A nurse is checking the vital signs of a 3-year-old during a well child visit, which of the
following findings should the nurse report to the provider?
A. temperature 37.2C (99.0F) B. Heart rate of 106/min
C. Respirations 30/min
D. Blood pressure 88/54 mmHg: C
28. A nurse is assessing a child's ears. Which of the following is an expected finding?
A. Light reflex is located at the 2 o clock position
B. Tympanic membrane is red in color
C. bone landmarks are not visible
D. Cerumen is present bilaterally: D
29. A nurse is assessing a 6-month-old infant. Which of the following reflexes shoudl the infant
exhibit?
A. Moro
B. Plantar grasp
C. Stepping
D. Tonic necl: B
30. A nurse is performing a neurological assessment on an adolescent. Which of the
following is an appropriate reaction by the adolescent when the nurse checks the trigeminal
cranial nerve? (select all that apply)
A. clencing the teeth together tightly
B. recognizing a sour tast
C. identifying smells through each nostril
D. detecing facial touches when eyes closed
E. Looking down and in with the eyes: A, D
31. What happens to a baby's birth weight?: it should double by 6 months and triple by 1 year
32. How do infants grow?: 1 inch per month (2.5cm) for 6 months, then by 12 months,
height/length should be doubled
33. When do the first teeth arupt?: between 6 and 10 months
34. Gross and fine motor by 3 months: only have slight head lag
35. Gross and fine motor by 4 months: should be able to roll from back to side
36. Gross and fine motor by 5 months: should be able to roll from front to back
37. Gross and fine motor by 6 months: should be able to roll from back to fron and hold a
bottle
38. Gross and fine motor by 7 months: move object from hand to hand
39. Gross and fine motor by 8 months: sit unsupported
40. Gross and fine motor by 9 months: crude pincer grasp
41. Gross and fine motor by 10 months: prone to sitting positiion and grasp a ratty by the
handle
42. Gross and fine motor by 11 months: puts objects into a container and have a neater pincer
grasp
43. Gross and fine motor by 12 months: tries to build a 2 block tower and won't succeed
44. What Piaget congitive development stafe are infants in?: Sensorimotor stage, birth to 24
months, separation, object permanence around 9 months, mental representation
45. How many words should the infant know?: 3-5 words and has concept of numbers by 1
year
46. What is the Erikson's stage of development for infants?: Trust vs. Mistrust, birth to 1 year,
caretake meeteing the needs of the infant
47. When does separation anxiety begin to occur?: between 4 and 8 months
48. When is there stranger fear in infants?: 6 to 8 months
49. What toys should be used for an infant?: rattles, blocks, brightly colored toys, mirrors,
patty cake
50. Infant Immunizations: Birth: hep B
2 months: hep B, IPV, RV, PCV, dtap, HIB
4 months: all of the 2m, hep B
6 month: all the previous
Flu shots: 6m to 1 year
51. Infant Nutrition: breast milk first 6 months, solids 4 to 6 months and first solid is usually iron
fortified rice ceral, no juice or water is needed for first year, foods introduced one at a time over
4-7 day period to monitor for allergies
52. What are infant safety concers?: choking/aspiration (grapes, coins, candy) burns
(sunscnreen, handles turned away from stove, electrical outlets are cov- ered), drowning, rear
facing care seat until 2 years, crib slats are no more than
6cm, no pillows, and sleep on back
53. A nurse is assessing a 12 months old infant during a well-child visit. Which of the following
findings should the nurse report to the provider? A. closed anterior fontanel
B. eruption of 6 teeth
C. Birth weight doubled
D. Birth length increased by 50 %: C
54. A nurse is performing a developmental screening of a 10-month old infant. Which of the
following fine motor skills should the nurse expect to find? (select all that apply)
A. grasp a raddle by the handle B. try building a two-block tower C. use a crude pincer
grasp
D. Place objects into a container
E. Walkes with one hand held: A, C
55. A nurse is conducting a well-baby visit with a 4 motnh old infant. Which of the following
immunizations should the nurse plan to administer? (select all that apply)
A. MMR B. IPV C. PCV
D. varicella
E. RV: B, C, E
56. A nurse is providing education about introducing new foods to the par- ents of a 4
months old infant. The nurse should recommend that the parents introduce which of the
following foods first?
A. Strained yellow vegetables
B. Iron fortified cereals
C. Pureed foods
D. Whole Milk: B
57. A nurse is providing teaching about dental care and teething to the parent of a 9-month-old.
Which of the following statements by the parent indicates an understanding of the teaching?
A. I can give my baby a warm teething ring to relieve discomfort
B. I should clean my baby's teeth which a cool, wet washcloth
C. I can give Advil for up to 5 days while my baby is teething
D. I should place diluted juice in the bottle my baby drinks while falling asleep: B
58. Weight gain of todder: 4x their birth weight by 30 months
59. Height gain of toddler: 3 inches per year (7.5cm)
60. Head and chest growth of toddler: head and chest circumference are abotu equal, compared
to when they are born, and their head is wider than their chest
61. gross and fine motor skills of a 15-month toddler: expect walking without help, should be
able to build a 2 block tower
62. gross and fine motor skills of 18-month toddler: can throw a ball over head
63. gross and fine motor skills of 2 year old toddler: can walk up and down stairs by placing
feet on each step and build a 6-7 block tower
64. gross and fine motor skills of 2.5 year old toddler: can jump with both feet and draw
circles
65. Language of a toddler: 1 year = 1 word senteces/hollow phrases
2 year = 2-3 word senteces
66. Erikson's stage of Toddlers: autonomy vs shame and doubt, independence, begin to express
selves by saying no a lot, thrive on rituals, maintian routines
67. Toddler appropirate activities: blocks, push pull, thick crayons, puzzle
68. Bathroom needs of toddlers: toilet training begins when they have recog- nized the
sensation that they need to go potty
69. Immunizations of a toddler: 12-15 month: IPV, PCV, MMR, varicells, HIB
12-23 months: Hep A 2 doses 6 months apart
15-18months: dtap and annual flu
70. Nutrition of a toddler: breast milk or formula through 1 year, 1-2 year whole milk, after 2
can transition to low fat, limit juice consumption to 4-6oz per day, prevent choking, nuts, grapes,
hot dogs, peanut butter, raw carrots, tough meat, popcorn
71. What are safety hazards of toddlers?: burns, drowning, falls, aspiration, prevention
72. A nurse is assessing a 2.5-year-old toddler at a well-child visit. Which of the following
findings should the nurse report to the provider?
A. height increased by 7.5cm or 3inches in the past year
B. Head circumference exceeds chest circumference
C. anterior and posterior fontanels are closed
D. current weight equals four times the birth weight: B
73. A nurse is performing a develomental screening on an 18 month old. Which of the
following skills should the toddler be able to perform? (select
all that apply)
A. build a tower with 6 blocks
B. Throw a ball overhead C. walk up and down stais D. draw circles
E. use a spoon without rotation: B, E
74. A nurse is providing teaching about age-appropriate activities to the parent of a 2 year
old. Which of the following statemetns by the parent indicates an understanding of the
teaching?
A. I will send my child's favorite studdef animal when she will be napping away from home
B. My child should be able tot stand on one foot for a second
C. The soccer team my child will be playing on starts next week
D. I should expect my child to be able to draw circles: A
75. A nurse is providing anticipatory guidance to the parents of a toddler. Which of the
following should the nurse include? (select all that apply)
A. Develop food habits that will prevent dental caries
B. Metting caloric needs resulting in an increased appetite
C. expression of bedtime fears is common
D. Expect behaviors associated with negativism and ritualism
E. Annual screenings for phenylketonuria are important: A, C, D
76. Growth of preeschoolers: 4.5-6.5 pounds per year
2.3-3.5 inches per year or 6-9cm
77. Gross motor skills of 3 year old preeschooler: can ride tricycle and jump off bottom step on
stairs
78. Gross motor skills of 4 year old preschooler: can skip and hop on one foot and throw the
ball over head
79. Gross motor skills of 5 year old preschooler: can jump rope
80. Cognitive development of the preschooler?: Piaget, preoperational phase
4-7 years, moving from preconceptual phase to the phase of intuitive thought, magical thinking,
animisim, centration, time
Erikson, initiative vs guilt
81. Regression: in preschoolers, another baby in the family can cause the preschooler to regress
to bed wetting or thumb sucking, to be expected
82. What are appropirate activities for a preschooler?: playing ball, puzzles, tricyles, dress up,
role playing
83. Immunizations of preschooler: 4-6 years, dtap, mmr, IPV and annual flu
84. What does the sleep schedule of a preschooler look like?: 12 hours of sleep, bedtime
routine
85. Teeth of preschooler: eruption of primary teeth is finalized by the beginning of the preshool
years
86. What may be a safety initiative for preschooler?: protective gear with tricy- cles
87. A nurse is providing teaching to the parent of a preschool age shcil about methods to
promote sleep. Which of the following statements by the parent indicated an understanding
of the teaching?
A. I wil sleep in the bed with my child if she wakes up during the night
B. I will let my child stay up and additional 2 hours on weekend nights
C. I will et my child watch television for 30 minutes nust before bedtime each night
D. I will keep a dim lamp on in my child's room during the night: D
88. A nurse is conducting a well child visit with a 5 year old child. Which immunizations
shoudl the nurse plan to administer to the child? (Select all that apply)
A. DTaP B. IPV
C. MMR D. PCV
E. Hib: A, B, C
89. A nurse is preparing an education program for a group of parents of preschool-age
children about promoting optimum nutrition. Which of the following information should
the nurse include in the teaching?
A. saturated fats should equal 20% of total daily caloric intake
B. Average calorie intake should be 1800 calories per day
C. dailyintake of fruits and vegetables should total 2 servings
D. Healthy diets include a total of 8g of protein each day: B
90. A nurse is performing a developmental screening on a 3 year old child. WHich of the
following skills should the nurse expect the child to perform? A. ride a tricycle
B. Hop on one foot
C. jump rope
D. throw a ball overhead: A
91. A nurse is caring for a preschool age child who says she needs to leave the hospital
because her doll is scared to be at home alone. Which of the following characteristics of
preoperational thought is the child exhibiting? A. Egocentrism
B. Centration
C. Animism
D. Magical thinking: C
92. Growth of school age children: 4-6 pound weight gain per year and grown 2 inches (5cm)
per year, permanent teeth start to come in
93. Piaget cognitive development of school age children: concrete operations, perceptual to
conceptual thinking, learsn to tell time, see other perspectives, solve problems
94. Erikson's stage of school age children: industry vs inferiority, trying to make meaning
contributions to society and cooperative and compete with others, peer groups important,
competitive and cooperative play
95. What types of activites are appropriate for school age children?: board games, hop
scotch, bikes, jump rope, organized sports
96. Immunizations of school age children: 11-12 years: DTaP, HPV vaccine
(series of 3 shots)
97. How much sleep is recommended for a 12 year old?: 9 hours of sleep
98. What is a safety measure for school age children?: helmets
99. A nurse is discussing prepubesence and preadolescen with a group of parents of schoolage
children.
Which
of
the following
information
should
the nurse
include
in
the discussion?
A.
initial
phsyciologic
changes
appear
during
early
childhood
B.
changes
in
heigh
and
weight
occur
slowly
during
this
period
C.
growth
differences
between
boys
and
girls
become
evident
D.
signs
of
sexual
maturation
become
highly
visible
in
boys:
C
100.
A nurse is conducting a well child visit with a child who is scheduled to recive the
recommended immunizations for 11 to 12 year olds. Which of the following immunizations
should the nurse administer? (select all that apply) A. TIV
B. PCV C. MCV4
D. Tdap
E. RV: A,C, D
101. A nurse is teaching a course about safety during the school age years to a group of
parents. Which of the following information should the nurse include in the course? (select
all that apply)
A. gating stairs at the top and bottom
B. wearing helmets when riding bicyles or skateboarding
C. riding safely in bed of pickup trucks
D. implementing firearm safety
E. wearing seat belts: B, D, E
102. Growth in adolescents: girls stop growing 2-2.5 years after their period starts, boys stop
growing abotu 18-20
103. Sexual maturation is adolescent girls: breast development, pubic hair growth, underarm
hair, period
104. Sexual maturation in adolescent boys: testicular enlargement, pubic hair, penil
enlargement, underarm hair growth, facial hair, vocal changes
105. Piaget cognitive stage of development for adolescents: formal operations
106. Erikson's stage of development for adolescents: identity vs role confusion
107. What are appropriate activites for adolescents: video games, music, sports, pets, reading
108. Immunizations for adolescents: flu, 16-18 years, meningitis before college
109. Injury prevention for adolescents: helmet use, seat belts, driving, susb- tance abuse
110. Safe medication administration for children: oral is preferred, smallest measuring device
possible, dont mix oral meds in formula, put in side of mouth, hold cheeks, and stroke chin to
swallow
111. Administration of ear drops: pinna down and back
112. IM injections: preffered route is vastus lateralis, then the ventral gluteal or in the deltoid, 2225
guage
with half
inch to
1 inch needle
113.
IV
safe
administration:
procedure
room, away
from
bed, EMLA
cream
to
numb
area
is
recommneded,
avoid
terms
like
bee
stink
or
stick,
keep
stuff
out of
sit,
parents
can
stay,
swaddle
the
infant,
non-nutritive
sucking
is offered
before,
during,
and
after
to infants
114. A nurse is providing teaching about expected changes during puberty to a gorup of
parents of early adolescent girls. Which of the following state- ments by one of the parents
indicates and understanding of the teaching? A. girls usually stop growning abotu 2 years
after menarche
B. girsl are expected to gain about 65 pounds during puberty
C. girls experience menstartion prior to breast development
D. Girls typiucaly grow more than 10 inches during puberty: A
115. A nurse is providing anticipatory guidance to the parent of a 13 year odl adolescent.
Which of the following screenings shoudl the nurse reccomend for the adolescent? (select all
that apply)
A. body mass index
B. blood lead level
C. 24 hour dietary recall
D. Weight
E. Scoliosis: A, D, E
116. A nurse is caring for an adolescent whose mother expresses ocncersn about her child
sleeping such long hours. Which of the following conditions shoudl the nurse inform the
mother as requiring additional sleep during adolescnets?
A. sleep terrors
B. rapid growth
C. elevated zinc levels
D. slowed metabolism: B
117. A nurse is teaching class about puberty in boys. Which of the following should the nurse
include as the first manifestation of sexual maturation?
A. pubic hair growth
B. voval changes
C. testicular enlargement
D. facial hair growth: C
118. A nurse is planning to administer the influenza vaccine to a toddler. Which of the
following actions should the nurse take?
A. administer subq to the abdomen
B. use a 20guage needle
C. Divide the medicaiton into two injections
D. place the child in supine position: D
119. A nurse is preparing to administer an IM injection to a child. Which of the following
muscle gorups is contraindicated?
A. Deltoid
B. ventrogluteal
C. vastus lateralus
D. dorsogluteal: D
120. A nurse is teaching a parent of an infant about administration of oral medications.
Which of the following should the nurse include in the teach- ing? (select all that apply)
A. use a universal dropper for medication administration
B. as the pharamacy to add flavoringto the medication C. add the medication to a formula
bottle before feeding D. use the nipple of a bottle to administer the medication E. hold the
infant in a semireclining position: B, D, E
121. A nurse is preparing to administer medication to a toddler. Which of the following
actions should the nurse take? (select all that apply)
A. identiy the toddler by asking the parent
B. tell the parent to administer the medication
C. calculate the safe dosage
D. ask the toddler what toy he wants to hold during administration
E. offer juice after the medication: C, D, E
122. A nurse is caring for an infant who needs otic medicatioin. Which of the following is an
appropirate action for the nurse to take?
A. Hold the infant in an upright position
B. pull the pinna downward and straight back
C. hyperextend the infants neck
D. ensyure that the medication is cool: B
123. Pediatric pain management: self report is only used for children 4 and older, FLACC scale is
2m to 7 years, pain rate ona scale of 0-10 assessing behaviors of the child
FACES: 3 years and odler
Oucher scale: 3-13
Numeric scale: 5 and older
use play therapy to epxlain procedures
ive medications to kids routinely versus prn combining opioid and non-opioid medications
EMLA cream, apply 1 hour prior to small stick or 2.5 hours before a big stick, occlusive dressing
over it
124. A nurse is competing a pian assessment of an infant. Which of the following pian scales
should the nurse use?
A. FACES
B. FLACC C. Oucher
D. Non-communicating childrens pain checklist: B
125. A nurse is planning care for achild following a surgical procedure. Which of the following
interventions dhoul the nurse incldue in the plan of care?
A. administer NSAIDS for a pain grater than 7 on a scale fo 0 to 10
B. administer intranasal analgesics PRN C. Administer IM analgesics for pain
D. administer IV analgesics on a schedule: D
126. A nurse is assessing an infant. Which of the following are manifestations of pain in an
infant? (select all that apply)
A. Pursed lips
B. loud cry
C. lowered eybrows
D. Rigid body
E. pushes away stimulus: B,C,D
127. A nurse is planning care for an infant who is experincing pain. Which of the following
interventions should the nurse include in the plan of care? (select all that apply)
A. offer a pacifier
B. use of guided imagery
C. use swaddling
D. initiate a behavioral contract
E. encourage kangaroo care: A,C,E
128. A nurse is preparing a toddler for an IV catheter insertion using atrau- matic care.
Which of the following actions shoudl the nurse take? (select all that apply)
A. explain the procedure using the child's favorite toy
B. ask the paretns to leave during the procedure
C. perform the procedure with the child in his bed
D. allow the child to make on choice regarding the procedure
E. apply lidocaine and prilocaine cream to three potential insetion sites: A, D, E
129. Hospitalization, illness, and play for the infant: stranger anxiety 6 to 18 months
130. Hospitalization, illness, and play for the toddler: behavior may regress, separtion anxiety,
intense reaction to procedure, parallel play
131. Hospitalization, illness, and play for the preschooler: magical thinking, they may think
they caused an illness to happen, still experience separtion anxiety, explain the procedure in very
simple clear language, give them a choise if possible (cup or spoon), associate play, paly together
without much coordination
132. Hospitalization, illness, and play for the school age child: describe pain and increased
ability to understand cause and affect, give factual info, tell the truth, encouage contact with peer
groups, and express feelings, cooperative play, play in groups, more organized
133. Hospitalization, illness, and play in the adolescent: body image distur- bance, feels
isolated from peers, give factural info, tell the truth, encoruage contact with peer group, and
express feelings, friends can come visit
134. A nurse is caring for a preschooler. Which of the following is the expect- ed behavior of a
preschool-age child?
A. Describing manifestations of illness
B. relating fears to magical thinking
C. understanding cause of illness
D. awareness of body functioning: B
135. A nurse on a pediatric unit is caring for a toddler. Which of the following behaviors is an
effect of hospitalization? (select all that apply)
A. believes the experience is a punishment
B. experiences separtion anxiety
C. displays intense emotions
D. axhibits regressive behaviors
E. Manifests disturbance in body image: B, C, D
136. A nurse is teaching a parent about parallel play in children. Which of the following
should the nurse include in the teaching?
A. children sit and observe others playing
B. Children exhibit organized play when in a group
C. the child plays alone
D. The child plays independently when in a group: D
137. A nurse is teaching a group of parents about separation anxiety. Which of the following
information shoudl the nurse include in the teaching?
A. it is often observed int the school age child
B. detachment is the stage exhibited in the hospital
C. it results in prolonged issues of adaptibility
D. kicking a stranger is an example: D
138. anticipatory grief: when death is expected or a possible outcome
139. complicated grief: extends for more than 1 year following the loss
140. parenteral grief: intense, long lasting, and complex
141. sibling grief: differs from adult/parenteral; depend on age and developmental stage
142. Infant/toddler view of death/dying: no concpet of death
143. Preschoolers(3-6) view of death/dying: magical thinking, may feel guilt or shame, views
dying as temporary
144. School age (6 to 12) view of death/dying: adult concept of death, express fear through
uncooperative behavior
145. Adolescent (12-20) view of death and dying: adult concept of death, resul of peers vs
parents, stressed out by changes in physical appearance
146. Physical manifestations of death: senstaion of heat when body feels cool, decreased
sentation, loss of sesnes, decrease LOC, swallowing issues, bradycar- dia, hypotension, Cheyne
stokes respirations
147. Nursing responsibilty after death: allow family to stay with body, rock infant/todderl,
assist in post-mortem care
148. A nurse is caring for child who is dying. Which of the following are findings of
impending death? ( select all that apply)
A. heightened sense of hearing
B. tachycardia
C. difficulty swallowing
D. sensation of being cold
E. cheyne-stokes respirations: C, E
149. A nurse is teaching a parent about complicated grief. Which of the following statements
should the nurse make?
A. it is considred complicated gried if you are still grieving after 6 months
B. personal acitciites are affected wehn expericining complicated grief
C. parents will expeirce complicated grief together
D. complicated grief self-resolved in 12 months: B
150. A nurse is teaching a parent of a preeschol child about factors that affect the child's
perception of death. Which of teh following factors should the nurse include in the
teaching?
A. Preschool children have no concept of death
B. Preschool children percieve death as temporary
C. preschool children often regress to an earlier stage of behavior
D. preschool children experience fear related to the disease process: B
151. A nurse often care for children who are dying. WHich of the following are approporate
actions of rhte nurse to take to maintian professional effectiv- ness? (select all that apply)
A. remain in contact with the family after thier loss
B. develop a professional support system
C. take time off from work
D. suggest that a hospital representative attend the funeral
E. demonstrate feelings of sympathy toward the family: B, C
152. A nurse is caring for a child who has a terminal illnes and revies pallia- tive care with an
assistive personel (AP). Which of the following statements by the AP indicates understanding
of this review?
A. im sure the family is hopeful that the new medication will stop the illness B. Ill miss
wokring wit this client now that only nurses will be caring for him C. I will get all the clients
personal object out of his room
D. I will listen and respons as the family talks about thier child's life: D
153. Meningitis: Viral often resolves with supportive care, bacterial is more dnagerous, PCV and
Hib vaccine help prevent, s/s include photophobia, n/v, irritability, h/a
newborns: poor muscle tone, weak cry, refusal to eat, vomiting, diarrhea, poor sucking, possible
fever or hypothermia, neck is supple without nuchal rigidity, buldging fontanels are a late sign
3m to 2years: siezures with a high pitch cry, fever and irritability, bulding fontanels, nuchal
rigicity, poor feeding adn vommting
2 years to adolescents: siezures, nuchal rigicity, fever and chilld, headache, n/v, irritabiltiy,
petechia, positive brudsinksi's sign (puill head forward - extremities will also flex (bro why are
you pulling on my neck)
positive kernigs signs - leg is flexed and you try to extend, it causes pain
154. Meningitis labs: CSF analysis through lumbar puncture, empty bladder be- fore, EMLA
cream, side lying position, after procedure remain in bed 4-8 hours in a supine position
Bacterial: cloudy, increased WBC, increased protein, decrease glucode and +gram stain
Viral: clear, slightly elevated WBC, noraml or slightly elevated protein, normal glucose, negative
gram stain
155. Nursing managment for meningitis: it it is suspected put them into droplet precautions,
decrease LOC = NPO, provide quite environment, dim the lights, siezure preautions, bacterial
will need IV abx, maintian contact precautions for bacerial for 24 hours after abx treatment has
started, monitori for increased ICP** infants: bulging fintanels, increase in head circumference,
high pitch cyr, bradycari- da, adn respiraty changes
childre: irritability, headahce, n/v, siexures, braduycardia, adn respiratoruy changes
156. Reyes syndrome: liver dysfunction and cerebral edema, associated with giving hcildren
aspirin for a fever, follows a viral illness like the flu, gasterentritis, or varicella, lab tests include:
liver enzymes (AST/ALT increase), increased ammonia levels, liver biopsy for diagnosis, CSF
analysis
s/s: lethargy, irritiabilty, confusion, deliriu, vomtimg, LOC
157. A nurse is caring for a client who has suspected meningitis and a decreased level of
consiousness. Which fo the following actions by the nurse is appropriate?
A. place the patient on NPO status
B. prepare the client for a liver biopsy
C. position the patient in dorsal recumbent
D. put the client in a protective environment: A
158. A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected
meningitis. Which of the following findings shoudl the nurse identify as indicating viral
mengingits? (select all that apply)
A. negative gram stain)
B. normal glucose content
C. Cloudy color
D. decreased WBC count
E. normal protein count: A, B, E
159. A nurse is caring fro a 4 month old infant who has meningitis, Which fo the following
findings is associated with this diagnosis?
A. fepressed anterior fontanel
B. constipation
C. presence of rooting reflex
D. high pitched crying: D
160. A nurse is caring for a patient who possibly has Reye syndrome. Which of the following
is a risk factor for developing reye syndrome?
A. recent hisotyr of infectious cystitis cauased by candida
B. recent hisotrial of bacterial otitis media
C. recent epidose of gastrenteritis
D. Recent episode of Haemophilus influenzae meningitis: C
161. A nurse is developing an inservice about viral and bacterial meningiting. The nurse
shoudl include that the introduction of which of the following immunizations decreased the
incidence of bacterial meningitis in children? (select all that apply)
A. IPV B. PCV C. Dtap D. Hib
E TIB: B, D
162. Risk factors for siezures: cerebral edema, fever, trauma, bleeding, toxins in body (lead),
hypoglycemia, electrolyte imbalance, infection
163. What are the three phases of tonic-clonic siezures: tonic- arms and legs flex up and head
and neck extend; stiff, LOC
clonic- jerking movements postical- awake and confused
164. absense seizure: school age childre (4-12), loss of consiousness 5-10 sec- onds,
daydreaming look, drop whats in hands, lip smacking or twitching of face
165. myoclonic: no postical
166. seizure diagnosis: EEG to find cause, prior to EEG no caffien and wash hair
167. seizure medications: carbamasepine, valporic acid, phenytoin, and di- azepam
168. Complications of siezures: status epilepticus which a a seizure lasting longer than 30
minutes, medical emergency
169. A nurse is caring for a child who has absence seizures. Which of the following findings
should the nurse expect? (select all that apply)
A. loss of consciousness
B. appearance of daydreamimg
C. dropping held objects
D. falling to the floor
E having a piercing cry: A, B, C
170. A nurse is caring for a child who just experienced a generalized seizure. Which of teh
following is the priority actio for the nurse to take?
A. Maintain the child in a side ying position
B. loosen the childs restricitve clothing
C. reorient the hcild to the environment
D. not the time and characteristics of the seizure: A
171. A nurse is providing teaching to the parent of a child who is to have an EEG. Which of
the following responses hodul the nurse include in the teaching?
A. decaffieicated beverages should be offred on the morning of the proce- dure
B. do nto wash your child's care the night before the procedure
C. withold all foods the morning of the procedure
D. give your child an analgesic the night before the procedure: A
172. A nurse ic teaching a group of parents about the risk factors for seizures. Which of the
following factors shoudl the nurse include in the teaching? (select all that apply)
A. febrole episodes
B. hypoglycemia
C. sodium imbalances
D. low serum lead levels
E. presence of diphtheria: A, B, C
173. A nurse is reviewing treatment options with the parent of a child who has worsening
seizures. Which of the following treatment options shudlt hte nurse include in the
discussion? (select all that apply)
A. vagal nerv stimulator
B. additional antiepeltic medications
C. corpus callosotomy
D. focal resection
E. radiation therapy: A, B, C, D
174. minor head injury: confusion, vomiting, pallor, irritability or drowsiness, irri- tability is
sually one of teh first signs of increased ICP
175. infant signs of head injury: buldging fontanels, high pitched cry, poor feed- ing, increased
sleeping, reslessness, setting sun sign, distended scalp veins
176. children signs of head injury: nausea, vomtiing, headache, seizures, blurred vision
177. late signs of head injury: delayed or impaired pupillary responses, postur- ing, decreased
response to painful stimuli, cheyne-stokes respirations, optic dis swelling, decreased in LOC
178. interventions for head injury: stabalize the spine first, then vital signs, GCS, keep HOB
30, maintin head in midline/neutral position, minimize oral or endotracheal suctioning, avoid
coughing or blowing their nose, foley catheter, stool softeners, implemet seizre precautions
179. medications for head injuries: corticosteroids, mannitol (diuretic), anti-epileptics
180. surgical interventio for head injury: craniotomy, complications include he- morrhage, brain
herniation, s/s of hernia include loss of blinking, loss of gag reflex, unreactive pupils, coma, or resp
arrect
181. A nurse is in the emergency department assessing a child following a motor vehicle
crash. The child is unresponsive, has spontaneous respira- tions of 22/min, adn has a
laceration of the forehead that is bleeding. Whic of the following nursing actions should be
first?
A. Stabalize the neck first
B. cleanse the child's laceration with soap and water
C. implement siezure precautions for the child
D. initiate Iv access for the child: A
199. tonsilittis: fever meds, abx to cure the infection, culture to test for strep, tonsilectomy, side
lying position initially, assess for bleedig, frequent swalloing and clearing of the throat, clear
fluids afer hag reflex has returned, no citrus juices, no milk products, discourage coughing or
nose blowing, warn parten that there may besome blood clots, limit strenious acitivty, full
recovery in about 2 weeks, grow beta of strep ca laeas to kidney infection or rheumatic fever
200. bacterial epiglottitis: drooling, hoarseness, difficulty speaking and swallow- ing, and high
fever, most important, do not put anything in their throat, no throat culture, or tongue balses, cause
airway to lcose up, abx therapy, intubation supplies ready
201. influenza: fever, body aches, congestion, antiviral (usually within first 48 hours)
202. complications of acute and infectious respiratory illnesses: pneumotho- rax and pleural
effusion
203. bronchodilators for asthma: albuterol -> s/e is tachycardia and temors
204. anticholinergic like ipotropirum for asthma: s/e cant see, cant see, cant pee, cant spit, and
shit
205. steroid for asthma: prednisode, rinse mouth after steroid inhaler because they can get a
fungla infection
206. peak flow meters: stand up, 0 out machine, lips around device, blow out hard,
3x, highest reading
207. complications of asthma: status asthamticus, not relived by medications, intubation
208. cystic fibrosis: caused by a genetic mutation, autosomal recessive, both parent shave to carry
recessvie traits, iincreased thick tenacious mucous, pancrea, lings, liver, small intestines, and
reporductive organs
-carrel chest, finger clubbing, large loose fatty fould smelling stools (steatorrhea), not gain weight,
delayed growth, failure to thrive, deficieny of fat-soluble vitamines (ADEK), sweat and tears are
salty
209. diagnosis of cycstic fibrosis: sweat chloride test and DNA testing
210. cystic fibrosis treatment: Iv abx, and o2 therapy, diet high in calories, and protein, pancreatic
enzymes with thier meals to help with digestion, pancrelipase and vitamin supplements, albuterol,
anticholinergics, dornase afa (decreases the viscocity of the mucous), chronic managing, prents
find support groups
211. Congenital heart defects usually result in 2 things: hypoxemia and heart failure, s/s include
tachypnea, dyspnea, tachycardia, peripheral edema, cyanosis, exercise intolerance, and
polycythemia (increase in rbcs)
212. Increasing pulmonary blood flow defects: 1. ventricular septal defect
(VSD) * a. creates a harsh murmur that can be heard at the left sternal border
2. atrial septal defect (ASD) a. loud hard murmur; split sound 3. patent ductus arteriosus (PDA) *
a. creates bounding pul
213. Obstructive blood flow defects: 1. pulmonary stenosis a. systolic ejection murmur 2. aortic
stenosis 3. coarctication of the aorta * a. upper body: bounding pulses and high pressure, flushed
warm skin b. lower body: low pressure, faint pulses, cool skin
214. decreasing pulmonary blood flow defects: 1. tricuspid atresia a. complete closure of the
tricuspid valve also have to have an ASD 2. tet of fallot * PROV a. pulmonary stenosis, VSD,
overriding aorta, and right ventricular hypertrophy
215. Mixed blood flow defects: 1. transposition of the great arteries a. sx within first 2 weeks of
life - major cyanosis 2. truncus arteriosus a. no spetum between the ventricles b. requires sx after
birth 3. hypoplastic left heart syndrome
216. EKG, echo, cardiac catheterization: -Allergies to shellfish or iodine
-NPO 4-6 hours prior to procedure
-Both pedal pulses located
-Assess insertion site for bleeding
-Flat position 4-8 hours post-op
217. Nursing care of cardiovascular disorders: o Frequent rest periods; cluster care
o Small frequent meals
o Crying kept to a minimum
o Encourage semi-fowlers or fowlers o Car seat at 45-degree angle vs flat o Feed Q3 hours
o Enlarged opening on bottle nipple
200 or more + classic s/s of diabetes Oral glucose tolerance test of 200 or more in a 2-hour sample
o Balanced diet for 3 days prior o Fast for 8 hours o A fasting level is drawn at the start of the test o
Then instructed to consume a specific amount
of glucose - and blood levels are drawn every 30 minutes for 2 hours o Assess for hypoglycemia
throughout the procedure HbA1c [glycosylated hemoglobin] o Expected range is 4-5.9% but an
acceptable range for a child with diabetes can be
6-5-8% with a goal of <7% Less than 7% indicates that DM is being well managed
Self-monitored blood glucose - before meals and at bedtime
277. Foot care of Diabetes Mellitus: Pt. inspects feet daily for wounds Dry feet completely after
showers Mild foot powder - corn starch Never use commercial remedies for removing calluses or
corns Cut toenails straight across Separate overlapping toes with cotton or lamb's wool to avoid
injury Avoid open toe and heel shoes Leather is preferred to plastic Wear slippers with soles and
never go barefoot Check shoes and shake them out Clean absorbent socks made of cotton or wool
Not use hot water bottles or heating pads Check water temps with hands, not feet
278. Management of DM when a pt. is sick: Monitor BG every 3 hours Continue to take insulin
or oral meds Encourage sugar free non-caffeinated liquids to prevent dehydration Test urine for
ketones Q3 hours Rest Call HCP if BG >240 or with a fever 102 & if ketones are in urine, rapid
breathing, or confusion
279. Hypoglycemic patients [<60]: Treat with 10-15-gram simple carbohydrates
[1 table spoon of sugar] o 4 oz. of orange juice, 8 oz. of milk, 3-4 glucose tablets,
4 oz. regular soft drink Unconscious patients glucagon IM or subq + give a simple carb once they
wake up
280. Complications of diabetes mellitus: DKA life threatening condition when BG is over 330
& usually due to an acute illness, non-compliance, or stress o Ketonemia + glycosuria +
ketonuria + acidosis [pH 7.30 and bicarb 15] resulting in the breakdown of body fat for energy
and an accumulation of ketones in the
blood, urine, and lungs o Rapid onset o Fruity breath, deep breathing, kussmauls, confusion,
dyspnea, n/v, dehydration, and electrolyte imbalances o Metabolic acidosis - hyperkalemia o
Treatment - as we are bringing the glucose levels down, the potassium levels may switch from hyper
to hypo Cardiac monitor Sodium bicarb for metabolic acidosis slow IV infusion When BG levels
get around 250 - add glucose to IV fluids in order to maintain 120-240 BG Give IV insulin
continuously Monitor levels hourly
281. growth hormone deficiency: short stature, delayed bone closure, and de- layed sex
development
282. growth hormone treatment: - somatropin subcutaneous injections until the bones have
closed
283. Immunizations: Common cold or minor illness - not contraindications for getting
vaccinated Severe acute illness - contraindicated Immunosuppression - contraindicated from a
few Flu vaccine - hypersensitivity to eggs = c/a Varicella
- corticosteroids = c/a IPV - allergy to neomycin = c/a MMR - allergy to gelatin
& neomycin = c/a DTAP - occurrence of encephalopy, seizures, or inconsolable crying that lasted
a long time previously = c/a VL or ventral gluteal for smaller children Older children - deltoid
muscle Charting include date, route, site, type, manufacture lot number, and expiration Low grade
fever (common s/e) - don't give aspirin = Reyes syndrome Babies vaccine can give concentrated
oral sucrose solution on a pacifier 2 min before and for 3 min after the injection [Show Less]