A nurse is teaching a parent how to administer antibiotics at home to a toddler with acute otitis media. Which statement by the parent indicates that teach... [Show More] ing has been successful?
Which statement by the parent of a child with otitis media indicates an understanding of the nurse’s discharge instructions about the use of antibiotics?
A mother asks the nurse why her 12-month-old baby gets otitis media more frequently than her 10-year-old son. What should the nurse tell her?
A 1-year-old child is brought to the emergency department with a mild respiratory infection and a temperature of 101.3° F (38.5° C). Otitis media is diagnosed. Which sign would the nurse also expect to find?
A toddler develops acute otitis media and is ordered cefpodoxime proxetil 5 mg/kg P.O. every 12 hours. If the child weighs 22 lb (10 kg), how many milligrams will the nurse administer with each dose?
A nurse is preparing to instill ear drops in a 28-year-old client with otitis externa. What is the correct procedure for instillation?
An 18-month-old is diagnosed with otitis media, and his mother asks what she can do to help ease his pain. Which medication would the nurse anticipate for pain relief?
The parents report that their child has a runny nose, fever, and cough and is irritable and constantly rubbing his ears. When assessing the ear, how should the nurse expect the child's tympanic membrane to appear
A nurse is teaching a group of parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
A 15-month-old child is being discharged after treatment for severe otitis media and bacterial meningitis. Which statement by the parents indicates effective discharge teaching?
Which assessment finding puts a client at increased risk for epistaxis?
What is the priority nursing measure for a client with von Willebrand’s disease who is having epistaxis?
A client is admitted to the emergency department with severe epistaxis. The health care provider inserts posterior packing. Later, the client is anxious and says they do not feel they are breathing right. Which nursing action is priority?
A client with thrombocytopenia, secondary to leukemia, develops epistaxis. The nurse should instruct the client to:
The nurse is caring for a teen-aged client with a suspected cardiac defect.
The nurse suspects coarctation of the aorta when the history and physical reveal which findings? Select all they apply.
Which statement obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure?
Which suggestions should the nurse include when teaching the parents of a child who has viral tonsillitis? Select all that apply.
A college student comes to the campus health care center with reports of headache, malaise, and a sore throat that has worsened over the past 10 days. The nurse measures a temperature of 102.6° F (39.2° C) and finds an enlarged spleen and liver and exudative tonsillitis. Laboratory tests reveal a leukocyte count of 20,000/mm3, antibodies to Epstein-Barr virus, and abnormal liver function tests. What are the nurses priority action(s)?
A staff nurse on a pediatric unit has a four-client assignment. Which child should the nurse assess first?
A nurse should monitor a client with a pelvic fracture receiving an opium derivative, such as morphine, for what common adverse reaction?
A 19-year-old client comes to the emergency department with acute asthma. His respiratory rate is 44 breaths/min, and he is in acute respiratory distress. What is the nurse’s priority action?
After discussing asthma as a chronic condition, which statement by the parent of a child with asthma best reflects the family's positive adjustment to this aspect of the child's disease?
A child has just received a dose of theophylline I.V. for asthma. What assessment finding should the nurse expect?
A nurse is preparing to teach a 13-year-old adolescent with asthma to administer his own breathing treatments. Which principle should the nurse keep in mind when planning the teaching session?
An 11-year-old is admitted for treatment of an asthma attack. Which finding indicates immediate intervention is needed?
The nurse understands that a client with acute respiratory distress related to asthma may experience:
When preparing the teaching plan for the mother of a child with asthma, what information should the nurse include as a sign to alert the mother that her child is having an asthma attack?
A nurse is caring for a client experiencing an acute asthma attack. The client stops wheezing and breath sounds aren't audible. This change occurred because:
A client with acute asthma is experiencing inspiratory and expiratory wheezing, and decreased forced expiratory volume. What is the nurse’s priority intervention?
The nurse is caring for a child with asthma. Which symptom would cause the most concern if observed in the child?
The nurse is caring for a client with asthma. The nurse should conduct a focused assessment to detect:
A client is experiencing an acute asthmatic attack. Prior to treatment with levalbuterol, respirations were 40 breaths per minute, pulse 132 beats per minute, oxygen saturation 86% on room air, and with audible wheezing. Which findings indicate achievement of the desired outcome of asthma treatment?
A nurse is teaching the parents of an infant with cystic fibrosis about chest percussion therapy. Which statement by the nurse is most effective in explaining the rationale for using chest percussion on infants with cystic fibrosis?
The nurse is caring for a child with cystic fibrosis who is admitted to the floor with an upper respiratory tract infection. The child has labored breathing and a congested, nonproductive cough. Which nursing diagnosis is the immediate priority for the nurse?
A nurse is caring for a 10-year-old child with cystic fibrosis. The child's parents tell the nurse that they're having difficulty coping with their child's disease. Which action should the nurse take?
A child with cystic fibrosis does not like taking a pancreatic enzyme supplement with meals and snacks. The mother does not like to force the child to take the supplement. The most important reason for the child to take the pancreatic enzyme supplement with meals and snacks is:
An adolescent male with cystic fibrosis tells the nurse he wants to marry and raise a large family. How should the nurse respond?
The parents of a child with cystic fibrosis express concern about how the disease was transmitted to their child. The nurse should explain that:
When explaining the risk for having a child with cystic fibrosis to a husband and wife, the nurse should tell them:
The nurse receives a change-of-shift report on the following four clients. Which client should the nurse assess first?
A nurse is reviewing a client's prenatal history. Which finding indicates a genetic risk factor?
The nurse refers the parents of a child with cystic fibrosis to an organization that helps families with children who have this disease. Such organizations are especially beneficial for parents by helping them:
A 9-year-old child is admitted to the pediatric unit for treatment of cystic fibrosis. A nurse assessing the child's respiratory status should expect to identify:
Parents of a child with cystic fibrosis ask the nurse why their child must receive supplemental pancreatic enzymes. Which response by the nurse is most appropriate?
Which outcome criteria would the nurse develop for a child with cystic fibrosis who has ineffective airway clearance related to increased pulmonary secretions and inability to expectorate?
A 7-year-old boy is hospitalized with cystic fibrosis. To help him manage secretions and avoid respiratory distress, the nurse should:
What toy should the nurse included as part of a recreational therapy plan of care for a 3-year-old child hospitalized with pneumonia and cystic fibrosis?
At a previous visit, the parents of an infant with cystic fibrosis received instruction in the administration of pancrelipase. At a follow-up visit, which finding in the infant suggests that the parents require more teaching about administering the pancreatic enzymes?
Which finding requires immediate intervention when planning care for an adolescent with cystic fibrosis (CF)?
Ceftazidime has been ordered for a client with cystic fibrosis. The order states to give 40 mg/kg q8h. The child is two years old and weighs 38 lb 5 oz (17.5 kg). How many milligrams of the ceftazidime should be given in one dose?
A nurse is teaching the parents of a child with cystic fibrosis about proper nutrition. Which instruction should the nurse include?
A client with cystic fibrosis develops pneumonia. To decrease the viscosity of respiratory secretions, the physician orders acetylcysteine. Before administering the first dose, the nurse checks the client's history for asthma. Acetylcysteine must be used cautiously in a client with asthma because it:
A primigravid client admitted to the labor area in early labor tells the nurse that her brother was born with cystic fibrosis and she wonders if her baby will also have the disease. The nurse can tell the client that cystic fibrosis is:
An adolescent with cystic fibrosis has been hospitalized several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and failure to thrive. Which initial nursing actions are most important?
A 2-year-old child is brought to the emergency department with suspected croup. The child appears frightened and cries as the nurse approaches him. The nurse needs to assess the child's breath sounds. The best way to approach the 2-year-old child is to:
A 19-month-old child with croup is crying as a nurse tries to auscultate breath sounds. What is the nurse’s most appropriate intervention?
A two-year-old child comes to the emergency department with inspiratory stridor and a barking cough. A preliminary diagnosis of croup has been made. What is the nurse’s most important intervention?
A nurse, working in the triage area of an emergency department, sees several pediatric clients arrive simultaneously. Which client should be treated first?
A nurse, working in the triage area of an emergency department, sees several pediatric clients arrive simultaneously. Which client should be treated first?
What should the nurse do first when admitting a toddler with croup?
Assessment of a term neonate at 2 hours after birth reveals a heart rate of less than 100 bpm, periods of apnea approximately 25 to 30 seconds in length, and mild cyanosis around the mouth. The nurse notifies the health care provider (HCP) based on the interpretation that these findings may lead to which condition?
A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?
Which of the following is a priority nursing action for a child with croup?
A child, age 3, is brought to the emergency department in respiratory distress caused by acute epiglottiditis. Which assessment finding is most concerning for the nurse?
A 2-year-old child is brought to the emergency department with suspected croup. Which assessment finding reflects increasing respiratory distress?
The nurse is caring for a child with a diagnosis of croup. What advice should the nurse give to the parent when concern is expressed about the child waking at night due to the cough?
When a toddler with croup is admitted to the facility, a physician orders treatment with a mist tent. As the parent attempts to put the toddler in the crib, the toddler cries and clings to the parent. What should the nurse do to gain the child's cooperation with the treatment?
The nurse is obtaining data from a new client in the cardiovascular clinic. When asking about childhood diseases and disorders associated with structural heart disease, the nurse should consider which finding significant?
A 4-year-old child who has been ill for 4 hours is admitted to the hospital with difficulty swallowing, a sore throat, and severe substernal retractions. The child's temperature is 104° F (40° C), and the apical pulse is 140 bpm. The white blood cell count is 16,000/mm3 (16,000 X 109/L). What is priority for nursing intervention?
The triage nurse in the emergency department must prioritize the care of children waiting to be seen. Which child is in the greatest need of emergency medical treatment?
A toddler with croup is given a racemic epinephrine treatment because of increasing respiratory distress. The nurse evaluates the treatment as being effective when the child’s:
A 21-month-old child admitted with the diagnosis of croup now has a respiratory rate of 48 breaths/minute, a heart rate of 120 bpm, and a temperature of 100.8° F (38.2 ° C) rectally. The nurse is having difficulty calming the child. What should the nurse do next?
The nurse is assessing breath sounds of a child admitted to the unit. Based on the following progress notes, which respiratory illness would the nurse suspect?
Which finding would indicate that an infant with a tracheoesophageal fistula (TEF) needs suctioning?
When assessing a child with bronchiolitis, which finding does the nurse expect?
A toddler is admitted to the pediatric unit. Based on the progress notes, which developmental intervention should the nurse implement?
A parent brings their child to the ED reporting difficulty swallowing, increased drooling, restlessness, and stridor. The position of comfort is observed to be tripod-sitting position. What does the nurse suspect may be occurring?
A 2-year-old child is brought to the emergency department with a history of upper airway infection that has worsened over the last 2 days. The nurse assesses the child and finds a hoarse voice, inspiratory stridor, fever, and a barking cough. What would the nurse anticipate for admission orders?
The mother of a child with tetralogy of Fallot asks the nurse why her child has clubbed fingers. The nurse bases the response on the understanding that clubbing is due to which factor?
The nurse is planning care with the parents of a 4-month-old infant with heart failure and congenital heart disease. The parents report that their child tires easily. Which intervention is a priority for this child?
When teaching parents of a toddler with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction?
A school-age child has a fever, joint inflammation, and a nonpruritic rash. Knowing that these are signs of rheumatic fever, the nurse should ask the parents:
The nurse is caring for an infant with a congenital heart defect. What priority health teaching should the nurse offer to the parents of this infant?
The nurse is talking with the parent of a 3-year-old child who has congenital heart disease. The parent reports feeling concerns that the child does not seem to be maturing emotionally in a manner that is at the same rate as the two older children in the family. Which response by the nurse is most appropriate?
The parents of a 3-year-old with a congenital heart disease are being seen for a check-up. They report that they are concerned about giving a flu vaccine to their child. Which statement is appropriate for inclusion in the nurse’s response?
A child, age 4, is admitted with a tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, the nurse suspects that the child has:
Laboratory results for a child with a congenital heart defect with decreased pulmonary blood flow reveal an elevated hemoglobin (Hb) level, hematocrit (HCT), and red blood cell (RBC) count. These data suggest which condition?
A child presents with a congenital heart defect and increased pulmonary blood flow. Which of the following signs or symptoms will alert the nurse that congestive heart failure is occurring? Select all that apply.
After the physician explains the prognosis and medical management for atrial septal defect to a primiparous client whose 2-day-old female neonate was diagnosed with this condition, the nurse determines that the mother needs further instructions when she says which of the following?
A toddler is hospitalized for evaluation and management of congenital heart disease (CHD). During discharge preparation, the nurse should discuss which topic with the parents?
The school nurse is teaching parents of school-age children about prevention of rheumatic fever. What should be included?
A 13-year-old has been admitted with a diagnosis of rheumatic fever and is on bed rest. He has a sore throat. His joints are painful and swollen. He has a red rash on his trunk and is experiencing aimless movements of his extremities. Use the chart above to determine what the nurse should do first.
When obtaining a health history from the mother of a 7-year-old child diagnosed with acute rheumatic fever, the nurse should focus questions to determine if the child was recently ill with which condition?
Which of the following should the nurse expect to include in the plan of care for a child who is diagnosed with rheumatic fever and carditis and admitted to the hospital?
A nurse is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity is most appropriate for the nurse to schedule in the care plan?
A nurse is planning care for a 12-year-old with rheumatic fever. The nurse should teach the parents to:
The nurse is talking with the parent of a 5-year-old child. The parent reports having recently read an article about rheumatic fever and heart disease and questions how to prevent this from happening to the child. What is the best response by the nurse?
A 14-year-old with rheumatic fever who is on bed rest is receiving an IV infusion of dextrose 5% r administered by an infusion pump. The nurse should verify the alarm settings on the infusion pump at which times? Select all that apply.
A nurse is reviewing orders for a client having an acute asthma attack. Which of the following medications should the nurse administer?
Which statement by the mother of a neonate diagnosed with bronchopulmonary dysplasia (BPD) indicates effective teaching?
The family of a client, stung by a bee, is rushed the client to the emergency room. The client is experiencing hives and redness at the site. Upon arrival, the client states, “I feel a lump in my throat and I am sweating. I can’t breathe! I think I am going to die!” The nurse anticipates which emergency treatment next?
A client, diagnosed with asthma, is experiencing an anaphylactic reaction to a medication. After administering initial emergency care, the nurse would:
A client with a history of asthma is brought to the emergency department in respiratory distress. Which is the priority action by the nurse?
A client with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/min, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. What should the nurse do first?
A preterm infant born 2 hours ago at 34 weeks' gestation is experiencing rapid respirations, grunting, no breath sounds on one side, and a shift in location of heart sounds. The nurse should prepare to assist with which procedure?
A physician orders triamcinolone and salmeterol for a client with a history of asthma. What action should the nurse take when administering these drugs?
A toddler is admitted to the facility for treatment of a severe respiratory infection. The child's recent history includes fatty stools and failure to gain weight steadily. The physician diagnoses cystic fibrosis. By the time of the child's discharge, the child's parents must be able to perform which task independently?
A nurse prepares to perform postural drainage. How should the nurse ascertain the best position to facilitate clearing the lungs?
A 3-year-old client is admitted to the pediatric unit with pneumonia. The child has a productive cough and appears to have difficulty breathing. The parents tell the nurse that the child hasn't been eating or drinking much and has been very inactive. Which interventions to improve airway clearance should the nurse include in the care plan? Select all that apply.
Chest physiotherapy and postural drainage work together to break up congestion and then drain secretions. Coughing and deep breathing are also effective to remove congestion. A cool mist humidifier helps loosen thick mucous and relax airway passages. Fluids should be encouraged, not restricted. The child should be placed in semi-Fowler's to high Fowler's position to facilitate breathing and promote optimal lung expansion.
The nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What action should the nurse take after realizing the mistake?
A physician writes an order for a client that says: "Digoxin .125 mg P.O. once daily." To prevent a dosage error, how should the nurse transcribe this order onto the medication administration record?
A client is admitted to the cardiac unit with a diagnosis of heart failure. The health care provider prescribes furosemide and digoxin to manage the condition. Which laboratory value should be monitored during hospitalization?
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best?
A physician orders digoxin elixir for a toddler with heart failure. Immediately before administering this drug, the nurse must check the toddler's:
A preschooler with a history of heart failure is prescribed digoxin. Which nursing intervention is most important to perform before administering this drug to a child?
A client newly diagnosed with heart failure is placed on bed rest and states, “Why do I have to stay in the bed?” What is the nurse’s best response to this concern?
Before administering digoxin, a nurse reviews information about the drug. She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:
The nurse should teach the client that signs of digoxin toxicity include:
A client with chronic heart failure is receiving digoxin, 0.25 mg by mouth daily, and furosemide, 20 mg by mouth twice daily. The nurse instructs the client to notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause:
The nurse monitors the serum electrolyte levels of a client who is taking digoxin. Which electrolyte imbalance is a common cause of digoxin toxicity?
The nurse is preparing to administer oral digoxin to a child and notes that the child has nausea, has vomited, and has a pulse rate of 45 beats per minute. Which of the following is the appropriate nursing action?
A child who has been treated for an acute episode of bronchial asthma is ready for discharge. The nurse is instructing the parents on medications that the child will need at home for the long-term treatment of asthma. Which of the following medications should the nurse expect to review with the parents regarding long-term treatment of the child’s asthma?
A client is admitted to the emergency department with crushing chest injuries sustained in a car accident. Which sign indicates a possible pneumothorax?
A premature infant has been placed on a home apnea monitor. The nurse is giving discharge instructions to the parents. The nurse begins teaching by stating:
The parent of a 2-week-old infant brings the child to the clinic for a checkup. The parent expresses concern about the baby’s breathing because the infant breathes quickly for a while and then breathes slowly. The nurse interprets this finding as an indication of what factor?
When assessing a client with chest trauma, the nurse notes that the client is taking small breaths at first, then bigger breaths, then a couple of small breaths, then 10 to 20 seconds of no breaths. The nurse should record the breathing pattern as:
When reinforcing discharge education for a parent and newborn, which statement made by the parent indicates a need for further instruction?
A nurse is preparing for the discharge of a neonate born 7 weeks premature. The neonate has had several apneic episodes and will need a home apnea monitor but will require no other specialized care. Which nursing diagnosis is most appropriate for the neonate's parents?
A nurse is monitoring a client for adverse reactions to atropine eyedrops. Systemic absorption of atropine sulfate through the conjunctiva can cause which adverse reaction? [Show Less]