N 212 ATI RN Nursing Care of Children Online Practice A
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the
... [Show More] tibia. The nurse should identify that which of the following statements by the parents indicates an understanding of the teaching?
my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is discharged.
My child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4 weeks. Surgery might be indicated if the antibiotics are not successful.
A - incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it will be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the sound as which of the following? Click the audio button to listen.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D - Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid, regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic acidosis, or severe anemia.
A- Biot's respirations are periods of apnea alternating with two or three shallow breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?
A- Elevate the head of the child's bed
B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child's reaction
D- administer IM epinephrine to the child
Answer- d
When using the urgent vs nonurgent approach to client care, the nurse determines that the priority action is administering IM epinephrine to the child. During an anaphylactic reaction, histamine release causes bronchoconstriction and vasodilation. This is an emergency because ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child's bed is important to facilitate breathing and circulation. However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child's reaction is important to prevent any additional episodes of anaphylaxis. However, it is not the priority action the nurse should take.
The nurse is preparing to administer an immunization to a four-year-old child. Which of the following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child's caregiver leave the room during the immunization
C- administer the immunization using a 24 gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer - c
The nurse should administer an immunization for a 4-year-old child using a 24-gauge needle to minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the immunization because this decreases the child's fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the immunization to provide a sense of security and reduce the child's anxiety level.
D- The nurse should inject the immunization rapidly and avoid aspiration. These actions decrease the risk of needle displacement and lower the child's fear and anxiety level by decreasing the amount of time it takes to administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The nurse should identify which of the following laboratory values indicates effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the expected reference range and indicates the current treatment regimen the infant is receiving for dehydration is effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range and indicates hypokalemia.
C- A urine specific gravity of 1.035 is above the expected reference range and indicates concentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates the kidneys are not excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child?
A- Play pat-a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer - d
The nurse should instruct the parents that at the preschool age, play should focus on social, mental, and physical development. Therefore, playing dress-up is a recommended play activity for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden infant death syndrome SIDS. Which of the following instructions should the nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant's crib.
D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include breastfeeding and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to sleep. Prone and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation, asphyxiation, and SIDS.
C- The nurse should instruct the parent to use a firm mattress and avoid the use of waterbeds, beanbags, or soft mattresses when placing the infant to bed. The use of a soft mattress in the infant's crib is a risk factor for SIDS and can lead to asphyxiation.
A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider?
A- Nasal flaring
B- WBC 11,300
C- diarrhea
D- abdominal distension
Answer- a
When using the airway, breathing, circulation approach to client care, the nurse should place the priority on nasal flaring. Nasal flaring indicates that the infant is experiencing acute respiratory distress.
B- The nurse should report a WBC of 11,300/mm3 because it is above the expected reference range and indicates infection. However, another finding is the priority for the nurse to report.
C- The nurse should report diarrhea because it is a manifestation of pneumonia in infants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report.
D- The nurse should report abdominal distension because it is a manifestation of pneumonia in infants and indicates the current treatment is not effective. However, another finding is the priority for the nurse to report.
A school nurse is assessing a school-age child blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
A- Clear the immediate area around the child of hazardous objects
B- loosen the child restrictive clothing
C- assist the child to a side-lying position on the floor
D- apply an oxygen mask to the child
Answer- c
The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to floor in a side-lying position immediately. This position enables the child's secretions to drain from the mouth, preventing aspiration, and maintaining a patent airway.
A- The nurse should clear the area around the child of hazardous objects. However, this is not the first action the nurse should take.
B- The nurse should loosen the child's restrictive clothing. However, this is not the first action the nurse should take.
D- The nurse should apply an oxygen mask to the child to prevent hypoxia. However, this is not the first action the nurse should take.
A nurse is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 100 + 1.2 degrees Fahrenheit. Available is ibuprofen liquid 100mg/ 5 ml. how many milliliters should the nurse administer to the infant per dose? Round the answer to the nearest whole number. Use a leading zero if it applies.
Answer: 2 mL
A nurse is receiving change-of-shift Report on for children. Which of the following children should the nurse assess first?
A- A toddler who has a concussion and an episode of forceful vomiting
B- an adolescent who has infective endocarditis and reports having a headache
C- an adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
D- school-age child who has acute glomerulonephritis and brown colored urine
Answer- a
When using the urgent vs. nonurgent approach to client care, the nurse should assess this child first. An episode of forceful vomiting is an indication of increased intracranial pressure in a toddler who has a concussion.
B- A report of a headache is nonurgent because it is an expected finding for a child who has infective endocarditis; therefore, the nurse should assess another child first.
C- A report of moderate pain is nonurgent because it is an expected finding for a child who has a new halo traction device; therefore, the nurse should assess another child first.
D- Brown-colored urine is nonurgent because it is an expected finding for a school-age child who has acute glomerulonephritis; therefore, the nurse should assess another child first.
A nurse in the emergency department is caring for an adolescent who has severe abdominal pain due to appendicitis. Which of the following locations should the nurse identify as mcburney's point?
Answer: a
A is correct. The nurse should identify the lower right quadrant of the abdomen between the umbilicus and the anterior iliac crest as the location of McBurney's point.
B is incorrect. The nurse should not identify the left lower quadrant as the location of McBurney's point.
C is incorrect. The nurse should not identify the right upper quadrant as the location of McBurney's point.
A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include in the teaching?
A- Limit the movement of the child large joints.
B- Encourage the child to perform independent self care.
C- Provide the child with a soft mattress for sleeping.
D- Schedule a 2-hour daily nap for the child in the afternoon.
Answer- b
The nurse should teach the family the importance of encouraging the child to perform independent self-care. This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for independence will also increase his self-esteem.
A- Large joints should be exercised regularly to maintain mobility and strengthen muscles.
C- Children who have juvenile idiopathic arthritis should sleep on a firm mattress to enhance comfort and rest. A soft mattress can increase pressure to the affected joints and increase the child's pain.
D- Daytime naps are discouraged because stiffness can occur quickly and easily with inactivity, and naps can interfere with nighttime sleeping.
A nurse is assessing a client who has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?
A- Steatorrhea
B- projectile vomiting
C- sunken abdomen
D- weight gain
Answer- a
The nurse should realize that clients who have celiac disease are unable to digest gluten. This will cause damage to the cells in the bowel, leading to malabsorption, steatorrhea, and diarrhea.
B- Clients who have pyloric stenosis will exhibit projectile vomiting rather than celiac disease.
C- A distended abdomen, rather than a sunken abdomen, is a manifestation of celiac disease.
D- Weight loss, rather than weight gain, is a manifestation of celiac disease.
A nurse is providing teaching to an adolescent about how to manage tinea pedis. Which of the following statements by the Adolescent indicates an understanding of the teaching?
A- I should buy some plastic shoes to wear at the swimming pool
B- I should wear sandals as much as possible
C- I should place the permethrin cream between my toes twice-daily
D- I should I seal my non washable shoes in plastic bags for a couple of weeks
Answer- a
The use of plastic shoes increases the occurrence of tinea pedis. The nurse should instruct the adolescent to avoid wearing plastic shoes.
B- Sandals allow air to circulate around the feet, decreasing perspiration and eliminating the medium for bacteria and fungus to grow. The nurse should inform the adolescent that wearing sandals, open-toed, or well-ventilated shoes will promote healing of his fungal infection.
C- Permethrin 5% cream is a scabicide used to place on the lesions created by scabies. This treatment is not recommended for tinea pedis.
D- Sealing non-washable items in plastic bags for 14 days is a recommended practice for clients who have pediculosis. This practice is not recommended for tinea pedis.
A nurse at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the nurse recognize as a manifestation of pertussis?
A- Inflamed throat with exudate
B- purulent eye drainage
C- dry, hacking cough
D- koplik spots on buccal mucosa
Answer- c
The nurse should recognize that a dry, hacking cough is a manifestation of pertussis. This disease usually begins with indications of an upper respiratory tract infection, which includes a dry, hacking cough that is sometimes more severe at night.
A- An inflamed throat with exudate is a manifestation of acute streptococcal pharyngitis.
B- Purulent eye drainage is a manifestation of bacterial conjunctivitis.
D- Koplik spots on buccal mucosa are a manifestation of rubeola (measles).
A nurse is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching?
A- I should secure the car seat using lower anchors and tethers instead of the seat belt
B- I should position the car seat harness one inch above my baby's shoulders
C- I will make sure that the car seat is placed at a 90 degree angle
D- I will pad my baby's car seat with a blanket for traveling long distances
Answer- a
Lower anchors and tethers, or the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides anchors between the front cushion and the back-rest for the car seat. Therefore, if this system is available, the seatbelt does not have to be used.
B- The car seat harness in rear-facing car seats should be positioned at or just below the infant's shoulders.
C- The car seat should be positioned at a 45 degree angle to prevent slumping and injury to the infant.
D- Padding placed underneath the infant or anywhere in the car seat can compress and/or create space between the infant and the harness. This could increase the risk for injury to the infant and should be avoided.
A nurse is assessing the pain level of a three-year-old toddler. Which of the following pain assessment scales should the nurse use?
A- FACES Pain rating scale
B- numeric pain rating scale
C- CRIES pain assessment scale
D- non communicating children's pain checklist
Answer- a
The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts the current level of pain. The nurse can then determine the need for pain management.
B- The nurse should use the numeric pain rating scale when assessing the need for pain management in pediatric clients who are 5 years old and older. The nurse should identify that the 3-year-old toddler does not yet possess a concept of numbers and numerical value to effectively use this pain rating scale.
C- The nurse should use the CRIES pain assessment scale when assessing the need for pain management in infants.
D- The nurse should use the noncommunicating children's pain checklist when assessing the need for pain management in pediatric clients who have a cognitive impairment.
A nurse is caring for a preschooler who is scheduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the following actions should the nurse take prior to the procedure?
A- Apply topical antimicrobial ointment to the child wound
B- place a mesh gauze dressing over the child wound
C- administer an analgesic to the child
D- initiate prophylactic antibiotic therapy for the child
Answer- c
Hydrotherapy for debridement of a wound is an extremely painful procedure which requires analgesia and/or sedation. When pain is controlled, it leads to reduced physiological demands on the body caused by stress and decreases the likelihood of children developing depression and post-traumatic stress disorder.
A- A nurse should apply topical antimicrobial ointment to the child's wound following hydrotherapy to prevent infection.
B- A nurse should apply mesh gauze to the child's wound following hydrotherapy to prevent infection.
D- Prophylactic antibiotic therapy is not recommended for children who have burns.
A nurse is caring for a 10 year old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus?
A- Urine specific gravity of 1.045
B- sodium 155
C- blood glucose 45
D- urine output 35 ml per hour
Answer- b
A child who has a head injury can develop diabetes insipidus as a result of pituitary hypofunction leading to a deficiency of antidiuretic hormone. Underexcretion of antidiuretic hormone leads to polyuria and polydipsia and possibly dehydration. With the excessive loss of free water, sodium levels rise above the expected reference range.
A- Urine specific gravity of 1.045 is above the expected reference range. A child who has diabetes insipidus is more likely to have diluted urine and urine specific gravity below the expected reference range.
C- Blood glucose of 45 mg/dL is below the expected reference range. A child who has diabetes insipidus should have a blood glucose level within the expected reference range.
D- Urine output of 35 mL/hr is within the expected reference range. A child who has diabetes insipidus is more likely to have polyuria.
A nurse is creating a plan of care for a toddler who has minimal change nephrotic syndrome mcns and 3 + pitting edema. Which of the following interventions should the nurse include in the plan?
A- Encourage an increased fluid intake for the toddler
B- place the child in an Airborne infection isolation room
C- increase the toddler's dietary sodium intake
D- administer corticosteroids to the toddler
Answer- d
The nurse should recognize that corticosteroids are the treatment of choice for providers caring for children who have MCNS. Therefore, the nurse should include administration of prescribed corticosteroids in the plan of care for this toddler.
A- Children who have MCNS are on dietary fluid restriction during the edema phase. Therefore, the nurse should not encourage fluid intake for the toddler who has 3+ pitting edema.
B- Children who have MCNS do not require isolation precautions. Airborne infection isolation room is used for clients who have airborne infections, such as tuberculosis.
C- Children who have MCNS are on a low-sodium diet during the edema phase. Therefore, the nurse should not increase dietary sodium intake for the toddler who has 3+ pitting edema.
A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?
A- You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
B- You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy
C- pulmonary function test will be performed every 12 to 24 months to evaluate how your child is responding to therapy
D- when using the peak expiratory flow meter, record your child average of three readings
Answer- c
The nurse should inform the parent that her child will need pulmonary function tests every 12 to 24 months to evaluate the presence of lung disease and how the child is responding to the current treatment regimen. As children grow, sometimes their symptoms can improve or decline and treatment needs to change accordingly.
A- salmeterol - The nurse should inform the parent that long-acting beta2 agonists are to be used in conjunction with a low or medium dosage inhaled corticosteroid, and never used alone. Using this medication alone on an as-needed basis during an acute asthma attack is dangerous and can lead to worsening of the child's condition.
B- The nurse should instruct the parent that the use of inhaled corticosteroids has not been shown to have any negative effects on growth. The provider might monitor the child's growth for systemic absorption; however, it is not necessary for the parent to weigh the child weekly.
D- The nurse should instruct the parent to measure the child's airflow using a peak expiratory flow meter. This should be done twice daily with the skill repeated in a sequence of three, waiting 30 seconds between each measurement. The parent should record the highest of the three readings, rather than the average.
A nurse is assessing a three-year-old toddler at a well-child visit. Which of the following manifestations should the nurse report to the provider?
A- Blood pressure 90/ 50
B- respiratory rate 45/min
C- weight 14.5 kg or 32 lb
D- heart rate 110/min
Answer- b
A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and can indicate respiratory dysfunction and acute respiratory distress. Therefore, the nurse should report this finding to the provider immediately.
A- A blood pressure of 90/50 mm Hg is within the expected reference range for a 3-year-old toddler.
C- A weight of 14.5 kg (32 lb) is within the expected reference range for a 3-year-old toddler.
D- A heart rate of 110/min is within the expected reference range for a 3-year-old toddler.
A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take?
A- Place a cardiac monitor on the Adolescent prior to the procedure
B- apply topical analgesic cream to the site one hour prior to the procedure
C- keep the Adolescent in a semi Fowler's position for 4 hours following the procedure
D- restrict fluids for 2 hours following the procedure
Answer- b
The nurse should apply a topical analgesic to the lumbar site 60 min prior to the procedure to decrease the adolescent's pain while the lumbar needle is inserted.
A- Cardiac monitoring is not necessary during a lumbar puncture.
C- The nurse should place the adolescent in the prone position or flat in bed for up to 12 hr to prevent post procedural spinal headache.
D- The adolescent should be encouraged to drink extra fluids following the procedure to replace the cerebrospinal fluid removed during the procedure.
A nurse is providing teaching to the parents of a toddler about the administration of a prescribed eye drops and eye ointment. Which of the following instructions should the nurse include?
A- Apply the eye ointment within 30 minutes of your toddler Awakening in the morning
B- apply the eye ointment from the outer canthus to the inner campus
C- use one hand to pull the upper eyelid upward when instilling the eye drops
D- administer the eye drops 3 minutes before the ointment
Answer- d
The nurse should instruct the parents to administer the eye drops first and then wait 3 min before administering the eye ointment. This action provides adequate time and spacing for each separate medication to work.
A- The nurse should instruct the parents to administer the eye ointment prior to a nap or bedtime since the medication can cause temporary blurred vision.
B- The nurse should apply the eye ointment from the inner canthus to the outer canthus to prevent the entry of infectious organisms into the lacrimal duct.
C- The nurse should instruct the parents to use one hand to pull the lower eyelid downward when instilling the eye medication to ensure placement of the medication in the conjunctival sac.
The nurse is providing discharge teaching to the parent of an 18 month old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching?
A- I will offer my child small amounts of fruit juice frequently
B- I will avoid giving my child solid foods until his diarrhea has stopped
C- I will monitor my child's number of wet diapers
D- I will give my child polyethylene glycol daily for 7 days
Answer- c
The nurse should teach the parent to closely monitor the child's number of wet diapers. Monitoring the number of wet diapers per day is the best way for the parent to monitor adequate output and hydration status.
A- Children recovering from dehydration should not be encouraged to drink frequent, small amounts of fruit juice because it is high in carbohydrates, low in electrolytes, and has a high osmolality value.
B- The nurse should teach the parent to encourage solid foods even when the child has diarrhea.
D- Polyethylene glycol is an osmotic agent that will pull fluid into the bowel, increasing the frequency of stools, which will increase the level of dehydration.
A nurse is preparing to collect a sample from a toddler for a sickle turbidity test. Which of the following actions should the nurse plan to take?
A- Obtain a sputum specimen
B- perform an allen test
C- perform a finger stick
D- obtain a stool specimen
Answer- c
The nurse should perform a finger stick on a toddler as a component of the sickle-turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease.
A- Sputum specimens are collected to identify the infectious organism in a child who has as acute respiratory tract infection. Therefore, this is not a component of the sickle-turbidity test.
B- An Allen test determines adequate circulation by observing capillary refill before an arterial puncture. Therefore, this is not a component of the sickle-turbidity test.
D- Stool specimens are collected to identify organisms or parasites that cause diarrhea or to check for the presence of occult blood. Therefore, this is not a component of the sickle-turbidity test.
A nurse is caring for a school-age child who has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema?
A- Palpate the dorsum of the child's feet
B- play the child daily using the same scale
C- assess the child's skin turgor
D- observe the child for periorbital swelling
Answer- a
The nurse should palpate the dorsum of the feet by pressing her fingertip against a bony prominence for 5 seconds to assess for peripheral edema.
B- Weighing the child daily might indicate that the child has retained fluid; however, this is not an acceptable method for assessing for peripheral edema.
C- Assessing the child's skin turgor measures the elasticity and mobility of the skin; however, this is not an acceptable method for assessing for peripheral edema.
D- Observing the child for periorbital swelling is an appropriate method for assessing central edema; however, this is not an acceptable method for assessing for peripheral edema.
A nurse in the emergency department is caring for a toddler who has partial thickness burns on his right arm. Which of the following actions should the nurse take?
A- Insert a nasogastric tube
B- initiate prophylactic antibiotics therapy
C- cleanse the affected area with mild soap and water
D- apply a topical corticosteroid to the affected area
Answer- c
The nurse should wash the affected area with mild soap and water to remove any loose tissue that could cause infection.
A- Inserting a nasogastric tube to empty the contents of the stomach and maintain decompression is an intervention for major burn management.
B- Prophylactic antibiotics are not recommended for burns of any type.
D- The nurse should apply an antibiotic ointment to the affected area to prevent infection.
A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation?
A- A toddler who is 18 months old and has unintelligible speech
B- an infant who is 3 months old and has an exaggerated startle response
C- a preschooler who is 4 years old and prefers playing with others rather than alone
D- an infant who is 8 months old and is not yet making babbling sounds
Answer- d
The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for more extensive evaluation of hearing.
A- The nurse should refer a toddler who does not possess intelligible speech by the age of 24 months to a provider for more extensive evaluation of hearing.
B- The nurse should refer infants who are under the age of 4 months and lack a startle response to a provider for more extensive evaluation of hearing.
C- The nurse should refer a preschooler who prefers playing alone and avoids interaction with others to a provider for more extensive evaluation of hearing.
A nurse is providing dietary teaching to the parent of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make?
A- You should offer your child high protein meals and snacks throughout the day
B- your child should decrease dietary fats to less than 10% of her caloric intake
C- your child will need to take a 1 gram sodium chloride tablet daily throughout her lifetime
D- you should calculate your child carbohydrate needs based on her daily activities
Answer- a
The parent should provide a diet that is well-balanced and high in protein and calories. Children who have cystic fibrosis require a higher percentage of the recommended dietary allowances of all nutrients in order to meet their energy requirements. Children who have good nutritional intake have improved lung function and decreased risk of infection.
B- Children who have cystic fibrosis need a diet that is unrestricted in fat. They also require 35% to 40% of their calories to come from fats.
C- Children who have cystic fibrosis are at risk for losing sodium and chloride through perspiration, especially when the weather is hot. The parent should monitor the child during hot weather and ensure adequate fluid intake. There is no need for the child to take supplemental sodium chloride tablets, because the child's regular diet should provide adequate amounts.
D- Children who have cystic fibrosis need to eat a diet high in calories, protein, and carbohydrates. Children who have diabetes mellitus usually calculate carbohydrate needs according to their daily activities.
The nurse is providing dietary teaching to the parent of a school-age child who has celiac disease. The nurse should recommend that the parent offer which of the following foods to the child?
A- Wheat bread
B- vanilla malt
C- barley soup
D- rice pudding
Answer- d
The nurse should instruct the parent that the child will remain on a lifelong gluten-free diet. The child cannot consume oats, rye, barley or wheat, and sometimes lactose deficiency can be secondary to this disease. The nurse should recognize that rice pudding is a gluten-free food. Therefore, it is an acceptable choice for the nurse to recommend to the parent of a child who has celiac disease.
A- Wheat bread contains gluten and should be avoided by children who have celiac disease.
B- Malt contains gluten and should be avoided by children who have celiac disease.
C- Barley soup contains gluten and should be avoided by children who have celiac disease.
A nurse is providing teaching to the parents of a preschooler who has heart failure and who is to begin taking Digoxin twice-daily. Which of the following instructions should the nurse include in the teaching?
A- Use a kitchen teaspoon to measure the medication
B- brush the child teeth after giving the medication
C- double the next dose If the child misses a dose
D- repeat the dose If the child vomits
Answer- b
The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste.
A- The nurse should instruct the parents to use the calibrated device that comes with the medication when measuring the medication to avoid accidental overdose.
C- The parent should administer digoxin at regular intervals, usually twice daily, or every 12 hr. The nurse should instruct the parents not to double the medication amount if they miss a dose because this can result in digoxin toxicity.
D- Nausea, vomiting, and decreased appetite are common manifestations of digoxin toxicity in children. The nurse should instruct the parents not to administer a second dose if the child vomits and to notify the provider.
A nurse is providing teaching to the parent of a school-age child who has oral candidiasis and is to begin taking oral Nystatin. Which of the following instructions should the nurse include?
A- Check the medication prior to Administration
B- provide the medication through a straw
C- rinse the child mouth with water immediately after giving the medication
D- next the medication with applesauce If the child dislikes the taste
Answer- a
The nurse should instruct the parent to shake the medication prior to administration in order to disperse the medication evenly within the suspension.
B- The nurse should instruct the parent to put the medication directly in the child's mouth and make sure the child swishes it around before swallowing.
C- The nurse should instruct the parent to have the child keep the medication in his mouth for as long as possible before swallowing it. Rinsing his mouth can wash some of the medication away and decrease effectiveness.
D- The parent should not mix the medication with food because this will interfere with the absorption.
The nurse is providing anticipatory guidance to the mother of a toddler. Which of the following expected Behavior characteristics of toddlers should the nurse include in the teaching?
A- Controls impulsive feelings
B- understand right from wrong
C- usually separated from parents for a long periods of time
D- expresses likes and dislikes
Answer- d
The nurse should teach the mother that her toddler will begin to express her likes and dislikes. This is the time in life when a toddler is developing autonomy and self-concept. She will try to assert herself and frequently refuse to comply. The parent should allow the child to have some control but also set limits in order for her to learn from her behavior and learn to control her actions.
A- The mother should expect a school-age child to be able to control impulsive feelings. A toddler is more likely to have difficulty controlling strong and impulsive feelings as she tries to [Show Less]