Vati peds pre-assessment Questions and Answers

Vati peds pre-assessment Questions and Answers A nurse is teaching a parent of a 2-year-old child about safe food choices. Which of the following foods should the nurse recommend? Grapes Bananas Celery Raw Carrots Bananas Bananas are a safe choice for a 2-year-old child because they are easy to chew and swallow. A nurse is developing a health program for the parents of school-age boys. Which of the following information about the pubescent changes should the nurse include in the program? Changes in the voice signal the beginnings of puberty Gynecomastia commonly occurs during late puberty Puberty might be delayed if scrotal changes have not occurred by the age of 11 Growth spurts in height occur toward the end of mid-puberty Growth spurts in height occur toward the end of mid-puberty Growth spurts in height occur toward the end of midpuberty. Boys grow an average of 10 to 30 cm (4 to 12 inches) during this period. A nurse is caring for a toddler who is 24 hr postoperative following a cleft palate repair. Which of the following actions should the nurse take? Offer fluids through a straw. Apply bilateral wrist restraints. Administer opioids for pain. Implement a soft diet. Administer opioids for pain Administering opioids for pain is an appropriate action by the nurse. Opioids control pain in the immediate postoperative period are followed by administration of acetaminophen PRN. A nurse is assessing a 10-day-old client. Which of the following should the nurse understand is a clinical manifestation of pyloric stenosis? Absent bowel sounds Increased sodium levels Projectile vomiting after feedings Golf ball-sized mass over the left quadrant Projectile vomiting after feedings Pyloric stenosis is a narrowing and thickening of the pyloric canal between the stomach and the duodenum, resulting in projectile vomiting. A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child? Barley Rye Rice Wheat rice Because rice is naturally gluten-free, it is an acceptable food choice for a child who has celiac disease. A nurse is presenting an in-service about the use of postural drainage for infants who have cystic fibrosis. Which of the following positions should the nurse identify as being contraindicated for the infant? Trendelenburg Sitting on a nurse's lap leaning forward Supine Sitting on a nurse's lap leaning backward Trendelenberg Infants who have cystic fibrosis are placed in various positions to allow gravity to facilitate the removal of tenacious secretions. The nurse should identify the Trendelenburg position (head lower than body) as being contraindicated for the infant because infants do not have autonomic regulation of blood flow to the head. This position is also contraindicated for children who have head injuries. A nurse is assessing an adolescent client who has ADHD. Which of the following findings should the nurse expect? Emotional numbing Elevated mood Anxiety Impulsivity Impulsivity The nurse should expect to find impulsivity for ADHD. A nurse is teaching a client who has a family history of hemophilia A about manifestations of the disorder. The nurse should include which of the following manifestations in the teaching? Frequent rapid bleeding Tendency to bruise minimally Immediate clotting from a minor cut Disabling joint pain Disabling joint pain A client who has hemophilia A can have disabling joint pain over time, especially of the knee and hip, because of hemorrhage into the joints. A nurse is assisting in the care of a 6-year-old child. Vital Signs-Temperature: 36.7° C (98° F)Heart rate: 88/min Respiratory rate: 22/min Blood pressure: 108/66 mm Hg Diagnostic Results-Hgb: 12.5 g/dL (10 to 15.5 g/dL) Hct: 38% (32% to 44%) Platelets: 280,100/mm3 (150,000 to 400,000/mm3) PT: 11.7 seconds (11 to 12.5 seconds) PTT: 118 seconds (60 to 70 seconds) WBC count: 7600/mm3 (5000 to 10,000/mm3) Factor VIII assay: 28% (55% to 145%) C-reactive protein: 0.75 mg/dL (less than 1.0 mg/dL) X-ray of left leg: No fractures are observed. Choose condition, 2 actions, 2 parameters The nurse should apply ice (RICE: Rest, ice, compression, elevation) to the child's left knee and give factor replacement via IV because this child has hemophilia and is most likely experiencing an episode of hemarthrosis based on the manifestations, the prolonged PTT, and the decreased Factor VIII assay.The nurse should monitor for other spontaneous bleeding episodes such as hematuria that may occur, the urine dipstick, which will show if blood is present in the urine, and the nurse should also continue to monitor the anti-hemophiliac factor (Factor VIII) results. The child may require another dose of the factor replacement to avoid further spontaneous bleeding episodes. A nurse is caring for an infant. Vital Signs 1500:Temperature 37.6° C (99.7° F) Apical pulse 138/min Respiratory rate 36/min Oxygen saturation 97% on room air. 1630: Temperature 38.3° C (101° F) Apical pulse 160/min Respiratory rate 56/min Oxygen saturation 94% on room air Which of the following actions should the nurse plan to take? For each potential action, click to specify if the action is indicated, nonessential, or contraindicated for the infant. Administer antipyretics : indicated. Administering antipyretics is indicated to treat fever in children. The infant has a temperature of 38.3° C (101° F), which is above the expected reference range and indicates the infant has an infection. Perform nasal suctioning with aspirator : indicated. Performing nasal suctioning with an aspirator is indicated to rid the infant's nose of excessive mucus, which then assists with promoting air exchange. Encourage oral fluids: contraindicated. The infant is displaying manifestations of respiratory distress, as evidenced by tachypnea and retractions. Attempting to administer oral fluids could further worsen the respiratory distress and result in aspiration. Perform routine chest percussion: nonessential. Performing routine chest percussion is not helpful for infants who have bronchiolitis. Infants benefit from routine nasal suctioning (aspiration) to help clear secretions. Administer oxygen: nonessential. Supplemental oxygen is not necessary for infants whose oxygen saturation is 90% or higher. Administer a bronchodilator: nonessential. Bronchodilators are not beneficial to infants who have bronchiolitis. Initiate IV fluids: indicated. Because the infant has tachypnea and might not be able to take oral fluids, IV fluids are indicated for fluid replacement and to prevent dehydration. A nurse is teaching about safety recommendations for car seats with the parents of a 24-month-old toddler who is in the 50th percentile for height and weight. Which of the following instructions should the nurse include in the teaching? Position the toddler rear-facing in the middle of the back seat. Position a booster seat forward-facing in the middle of the back seat. Position a convertible seat rear-facing in the front passenger side. Position a convertible seat forward-facing in the front passenger side and inactivate the airbag. Position the toddler rear-facing in the middle of the back seat A child should remain in a rear-facing car seat until the child outgrows the height or weight limits of a rear-facing seat. Car seat manufacturers provide specifics regarding use. A nurse is caring for a 5-year-old child in the acute care setting. Medical History: 5-year-old child who has sickle cell anemia is admitted for management of a vaso-occlusive crisis (VOC). The guardian reports the child has been experiencing joint pain and a low-grade fever for 3 days prior to admission. Guardian administered acetaminophen per provider's prescription. Initially the acetaminophen decreased the pain, but now the pain is worse, and the acetaminophen is no longer helping. Had a recent upper respiratory infection about 2 weeks prior to the start of the joint pain. Vital Signs 1300 Admission: Temperature 37.8°C (100°F) Heart Rate120/min Respiratory Rate 24/min BP 90/48mm Hg SaO2 89% on room air. Nurses' Notes 1300: 5-year-old child who has SCA and is experiencing a VOC is admitted. Guardian is accompanying child. Child reports pain in both knees and elbows. They rate the pain a 10 using the Faces Scale. T Child remains in bed is incorrect. Children who are experiencing a VOC are encouraged to rest to decrease tissue deoxygenation. This finding does not require additional action by the nurse. Child uncooperative and agitated is correct. This an expected behavior seen in preschool age children who are hospitalized and separated from their guardians. It will require further action from the nurse to use distraction techniques or other actions to gain the child's trust and cooperation. Refusing PO fluids is incorrect. While hydration is important to decrease sickling and vasoocclusion, the child is receiving IV fluids. This finding does not require further action by the nurse. Child reports chest pain and joint pain as a 4 on the Faces Scale is correct. While the intensity of the joint pain has decreased, there is a new finding of reported chest pain. Chest pain during a vasoocclusive crisis can be a manifestation of acute chest syndrome (ACS) which can occur as a result of occlusion and stasis of blood in the small vessels of the lungs. Additional findings associated with ACS include fever, cough, tachypnea, wheezing and hypoxia. This finding requires additional nursing action. Nasal flaring and moderate subcostal and substernal retractions are noted is correct. Increasing respiratory distress is a manifestation of acute chest syndrome (ACS) ) which can occur as a result of occlusion and stasis of blood in the small vessels of the lungs. Additional findings associated with ACS include chest pain, fever, cough, tachypnea, wheezing and hypoxia. This finding requires additional nursing action. Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation is correct. Wheezing is a manifestation of acute chest syndrome (ACS) which can occur as a result of occlusion and stasis of blood in the small vessels of the A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? Select all that apply Decreased platelet count Increased hemoglobin count Decreased leukocyte count Increased platelet count Decreased erythrocyte count Decrease platelet count, decreased leukocyte count, decreased erythrocyte count The nurse should expect to see a decreased counts due to bone marrow suppression from the chemotherapy treatment. A nurse is providing health promotion teaching to the parents of an infant. Which of the following conditions should the nurse identify as the leading cause of death among this age group? Congenital anomalies Respiratory distress Low birth weight Sudden infant death syndrome Congenital anomalies Congenital anomalies are the leading cause of infant mortality in the U.S. A nurse is caring for a child who is postoperative following VP shunt placement. In which of the following positions should the nurse place the client? On the unoperated side The nurse should position the child flat on the unoperated side to prevent a rapid reduction of intracranial fluid and to protect the child for injuring the operative site. A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective? Heart rate 130/min Respiratory rate 24/min Urine specific gravity 1.015 Capillary refill greater than 3 seconds Urine specific gravity 1.015 The expected reference range for urine specific gravity is 1.010 to 1.025. A result of 1.015 indicates the child is hydrated. A result greater than 1.025 indicates dehydration. Dehydration results when the total output of fluid exceeds the total intake. Infants and children who have diarrhea and dehydration should be treated first with oral rehydration therapy, such as Pedialyte and Infalyte. After rehydration, oral rehydration therapy can be alternated with a low-sodium solution, such as water, breast milk, lactose-free formula, or half-strength lactose-containing formula. A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make? "The blood supply to the bone is disrupted." "Normal bone growth can be affected." "Bone marrow can be lost though the fracture." "The younger the child the longer the healing process will take." Normal bone growth can be affected A fracture of the epiphyseal plate can affect growth in a child. A nurse is caring for a 6-month-old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which of the following fluids should the nurse select for the infant? Oral electrolyte solution Half-strength infant formula Half-strength orange juice Sterile water Oral electrolyte solution After gastrointestinal surgery, infants should receive clear liquids that contain glucose and electrolytes, such as an oral electrolyte or rehydration solution. They should then advance to formula or breast milk as they demonstrate tolerance. A school nurse is performing a routine health assessment for a school-age child. Which of the following findings indicates the nurse should investigate further for pediculosis capitis? Bald patches on the scalp Blisters on the scalp Pruritus of the scalp Dry patches on the scalp Pruritus (itching) of the scalp Pediculosis capitis is an infestation of head lice. Generally, the only manifestation is scalp itchiness. A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority? Provide the client with antipyretic therapy. Administer antibiotics to the client. Increase the client's protein intake. Teach relaxation breathing to reduce the client's pain. Administer antibiotics to the client The greatest risk to this client is bacteremia caused by the infection which can lead to septic shock; therefore, the priority intervention is antibiotic therapy. The client might require multiple antibiotics for an extended time. A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? Administer glucagon for hyperglycemia. Obtain an influenza vaccine annually. Inject insulin in the deltoid muscle. Take glyburide with breakfast. Obtain an influenza vaccine annually A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with increased pulmonary flow? Coarctation of the aorta Patent ductus arteriosus Tetralogy of Fallot Tricuspid atresia Patient ductus arteriosus With patent ductus arteriosus, the area between the pulmonary artery and aorta remains open, allowing the blood to flow through the patent ductus arteriosus and back to the pulmonary artery and lungs. A nurse is assessing a female child in an area struck by an earthquake. The child, who is crying, walks well, can state her first name, and says "all done" and "go bye-bye now" during assessment. The child has 24 deciduous teeth and anterior fontanel is closed. Based on these observations, the nurse should estimate that the child is how many months old? 12 18 24 30 30 The nurse should estimate that the child is at least 30 months in age because the child has completed her primary dentition (24 deciduous teeth), which occurs by 30 months (2 ½ years) of age. In addition, the nurse should recognize that the child is at least 18 months of age because the anterior fontanel is closed and should suspect that the child is at least 24 months (2 years) of age because the child speaks in two- and three-word phrases. A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take? Wrap the arm of the child's doll or toy prior to the procedure. Tell the child, "This will make your arm feel better." Place a heated fan at the bedside to facilitate drying. Support the casted arm with a firm grasp. Wrap the arm of the child's doll or toy prior to the procedure The nurse should consider the developmental age before the cast is applied. A preschooler might fear bodily harm and fantasize about the loss of an extremity. Using a doll or stuffed animal helps to explain the procedure. During this stage of development, the child is a "magical thinker" and might believe stuffed animals are alive. This action shows the child that it does not hurt the doll or stuffed animal, and, in turn, will not hurt the child. A nurse is providing anticipatory guidance about child development to the parents of a toddler. Which of the following developmental tasks should the nurse include as expected of a toddler? Explains the difference between right and wrong Prints letters and numbers Separates easily from primary care giver for short periods of time Cooperates in doing simple chores Separates easily from primary care giver for short periods of time By 3 years of age, a toddler's psychosocial development should include the ability to accept separating from a primary care giver for short periods of time. A toddler should also be able to express likes and dislikes and begin to play with children and others outside the family. A nurse is preparing to administer acetaminophen 10 mg/kg/dose to a child who weighs 28 lb. The amount available is 120 mg/5ml. How many ml should the nurse administer? Round to nearest tenth 5.3 mL