NRSG 4502 PEDS FINAL EXAM TEST BANK QUESTIONS AND ANSWERS

NRSG 4502 PEDS FINAL EXAM TEST BANK QUESTIONS AND ANSWERS MORBIDITY/MORTALITY STATISTICS: The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? -The United States is ranked last among 27 countries. Which is the leading cause of death in infants younger than 1 year in the United States? -congenital anomalies What is the major cause of death for children older than 1 year in the United States? -Unintentional injuries In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? -Suicide and homicide The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries? -more deaths occur in males What do mortality statistics describe? -the number of individuals who have died over a specific period The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? -late school age and adolescents Parents of a hospitalized toddler ask the nurse, what is meant by family-centered care? The nurse should respond with which statement? -Family-centered care recognizes that the family is the constant in a child’s life The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which? -95th percentile The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) -hypertension, dyslipidemia, and altered glucose metabolism COMPLICATIONS OF JAUNDICE What is an infant with severe jaundice at risk for developing? -encephalopathy When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant? -2-4 days Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant? -institute early and frequent feedings What is an important nursing intervention for a full-term infant receiving phototherapy? -observing for signs of dehydration When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease? -within 24 hours after birth The nurse is caring for an infant who will be discharged on home phototherapy. What instructions should the nurse include in the discharge teaching to the parents? -Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy IMMUNIZATIONS Pertussis vaccination should begin at which age? -2 months A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain? -A topical anesthetic can be applied before injections are given. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which? -DTaP and IPV can be safely given Which serious reaction should the nurse be alert for when administering vaccines? -allergic reaction Which muscle is contraindicated for the administration of immunizations in infants and young children? -dorsogluteal The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination? -after 6 months The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? -the child has a disorder that causes a deficient immune system The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine? (Select all that apply.) -the hepatitis B vaccination series should be begun at birth -an unimmunized 10-year-old child should receive 3 doses administered 4 weeks apart The nurse is planning to administer immunizations to a 6-month-old infant. Which interventions should the nurse implement to minimize local reactions from the vaccines? (Select all that apply.) -select a needle length of 1 inch -inject the vaccine into the vastus lateralis The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.) -a child with asthma -a child with diabetes -a child with cancer receiving chemo What immunization should not be given to a child receiving chemotherapy for cancer? -MMR A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination. The nurse should give which response? -the sibling can get a Varicella vaccination COMMUNICATION STYLE (only Q’s that were not totally common sense included) Which is considered a block to effective communication? -using clichs Which is the single most important factor to consider when communicating with children? -child’s developmental level Because children younger than 5 years are egocentric, the nurse should do which when communicating with them? -focus communication on the child The nurse’s approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle? -child may think equipment is alive When the nurse interviews an adolescent, which is especially important? -allow an opportunity to express feelings The nurse understands that blocks to therapeutic communication include what? (Select all that apply.) -socializing -using clichs -defending a situation RESPIRATORY DISTRESS IN INFANTS Which is a central factor responsible for respiratory distress syndrome in a newborn? -deficient surfactant production A preterm infant of 33 weeks of gestation is admitted to the neonatal intensive care unit. Approximately 2 hours after birth, the neonate begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. What should the nurse recognize? -further evaluation is needed The nurse is caring for a preterm neonate who requires mechanical ventilation for treatment of respiratory distress syndrome. Because of the mechanical ventilation, the nurse should recognize an increased risk of what? -pneumothorax What are possible premature infant complications from oxygen therapy and mechanical ventilation? -bronchopulmonary dysplasia and retinopathy of prematurity A preterm infant with respiratory distress syndrome is receiving inhaled nitric oxide (NO). What is the reason for administering the inhaled nitric oxide? -to reduce pulmonary vasoconstriction and pulmonary hypertension The nurse is caring for a neonate with respiratory distress syndrome. The infant has an endotracheal tube. What should nursing considerations related to suctioning include? -suctioning should not be carried out routinely The health care provider has prescribed surfactant, beractant (Survanta), to be administered to an infant with respiratory distress syndrome (RDS). The nurse understands that the beractant will be administered by which route? -via the ET tube NURSING INTERVENTIONS FOR PAIN REDUCTION What describes nonpharmacologic techniques for pain management? -they may reduce pain perception Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? -oral sucrose and nonnutritive sucking The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse’s response should be based on which characteristic about preterm infant’s pain? -they perceive and react to pain in much the same manner as child