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Pediatric Nursing Test 1

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Declining mortality rates during childhood can be attributed to
Antibacterial agents and immunizations
Major cause of death in children older than age 1 is
injury
In addition to injuries, which of the following are leading causes of death in adolescents and young adults?
Suicide, Injuries, and Homicide
The type of injury a child is susceptible to at a specific age is related to
The development level of the child
Which of the following is descriptive of family-centered care?
Recognizing the family is constant
Which of the following nursing interventions is most descriptive of atraumatic care in children?
Preparing the child for an unfamiliar procedure
The role of the pediatric nurse is influenced by trends in health care. Which if the a major trend in health care in the United States?
Shift in focus to prevention of illness and maintenance of health
The second step in the nursing process is...
Planning
The nurse is going to care for a patient with a different ethnic background. What is an approp. goal?
Adapt, as necessary, the ethnnic practices into the healthcare setting (wording not exact)
What type of family would the nurse call one in which a maternal grandmother, 2 parents, and 2 minor children share a home?
Extended
Which of the following is descriptive of homosexual or gay/lesbian families?
Quality of care is consistent with other families
Which of the following statements would describe a health risk?
Children from poor families are less likely to be immunized
The nurse is seeing an adolescent male and his parents in the clinic for the first time. Which of the following would the nurse do FIRST?
Make the family comfortable
Which type of questions is the most likely to encorage parents to talk about feelings related to their child's illness?
Open ended questions
Which of the following is considered to block effective communication?
The use of cliches
What is the single most important factor to consider when communicating with children?
Their developmental level
Which approach would be best to use to ensure friendly response from a toddler?
Sit at eye level and talk quietly
The nurses approach for introducing hospital equipment to a preschooler should be based on...
The child may think the equipment is alive
An 8 year old girl asks how the BP apparatus works. The most approp. nursing action is...
Tell her in terms she can understand
When the nurse interviews an adolescent -- what is the most effective approach to communication?
Allow them an open opportunity to express their feelings
The nurse is doing a history on a child. At the beginning of the interview the parent says she brought him here because he always has diarrhea. This should be recorded where in the health assessment?
Under 'chief compliant'
When a preschool child is hospitalized without adequate preparation the nurse should recognize the child may see hospitalization as
Punishment
Because of their striving for independence and productivity, which age groups of children is particularily vulnerable to events that may lessen their feelings of control and power?
School-age child
What is usually the greatest threat to the hospitalized adolescent?
Fear of altered body image
The parents of a 4 month old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant?
Assign him/her to the same nurse as much as possible
An appropriate nursing intevention to minimize separation anxiety in a hospitalized toddler would be to...
Get a parent to stay
Samantha, who is five years old, tells the nurse that she needs a Band-aid where she had an injection. What is the best action by the nurse?
Apply a Band-aid
The nurse is planning to prepare a 4 year old child for diagnostic procedures. Guidelines for preparing a preschooler should include...
Tell them that it is not a form a punishment
The nurse needs to take the BP of a preschool boy for the first time. What action by nurse would be best to engage the child's cooperation?
Permit him to handle the equipment
Katie is 4 years old, she is going to the OR and she wants her panties. What should the nurse do?
Let her wear her panties
Using knowledge of childhood development, what is the best approach for preparing a toddler for a procedure?
Demonstrate it on a doll right before you do it
The nurse is preparing a 9 year old boy before obtaining a blood specimen by venipuncture. The boy tells the nurse he doesn't want to lose his blood. What would be an appropriate approach by the nurse?
Discuss with him how his body always makes blood
It is time to give 3 year old David his medication. What approach by the nurse would receive a positive response?
It is time for your medication. What would you like with it?
An appropriate intervention to encourage food and fluid intake in a hospitalized child is to...
Give them high quality food/drink any chance you get
The nurse needs to do a heel stick on an ill neonate to obtain a blood sample. What would be the best approach to facilitate this?
Wrap the foot in a warm, moist towel
The nurse is assessing a 6 month old who has a head lag. The nurse should recognize that...
They need an evaluation because that is not normal

(Should have no head lag by 4 months old)
What behaviors indicates an infant has developed object permanence?
They seek that hidden object

(Developed around 9 - 10 months)
The parents of a 8 month old infant tells the nurse the child cries and screams whenever he is left with his grandparents. The nurse's response shoudl be based on what?
Her understanding that this is normal 'separation anxiety'

(Develops between 4 - 8 mos.)
Parents of a 2 month old boy are concerned about spoling their son by picking him up when he cries. The nurs's best response is ...
Babies need to be picked up and cuddled
A 10 lb baby safest plan for a car seat would be?
The middle of the back seat facing rearward
Amy comes to the clinic for a well visit checkup. Immunizations she should receive are DTaP and IPV. Amy is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations sh
The immunization can be safely given
What symptoms best describe colic?
Abdominal pain
Which of the following interventions lowers the risk of SIDS?
Sleeping in the supine position
The nurse plans care with respect to the client's cultural beliefs. Which
concept related to culture is important for the nurse to consider?
The dynamic nature of culture precludes "stability over time," and immigrants do not
generally "switch allegiance" to dominant cultures. Culture is learned, not
inherited.
A parent of a 4-year-old diabetic child tells the nurse that the child's illness resulted from disobedience, and that the entire family has been affected. In order to plan educational interventions for this parent, the nurse needs to understand the paren
Magico-religious

(In the magico-religious health belief view, the illness of a child might be
perceived as the result of "being bad" or opposing God's will. Faith healing
also is part of a magico-religious belief system, and the nurse might encounter
many parents who share this view.)
A newly admitted child emigrated with her parents from a country with a
predominant-past time orientation. As the nurse delivers care to this
6-year-old, particular attention should be paid to assisting the parents with
Medication scheduling
In planning a child's care, the nurse should develop interventions that address
cultural differences considered by families to be major barriers to health care.
These differences include:
The perception that the health care system is unresponsive
to their unique needs results in underutilized services and increased risk for
children.
The nurse recognizes that lack of health coverage is a significant problem for
many hospitalized children. Which of the following populations of youngsters
suggests the greatest need for collaboration with Social Services to ensure that
th
A child's immigration status is one of the most important risk factors for lack
of health coverage, particularly significant since one in five American children
is a member of an immigrant family.
The nurse assumes that the parents of a Native American child newly diagnosed
with asthma will not adhere to a discharge planning regimen. Which of the
following factors is influencing the nurse's assumption?

Bias
Prejudice
Stereotyping
What is the major cause of death for newborns?
Congential anomaly
What is the major cause of death for infants?
SIDS
List the nursing processes in order.
1- Assessment
2- Diagnosis
3- Planning
4- Implementation/Interventions
5- Evaluation
What are the Fears of hospitalized infants?
Separation Anxiety

(Trust has been disrupted)
What are the fears of hospitalized toddlers?
Separation Anxiety

(Control has been taken away & disruption of routines)
What are the fears of hospitalized Preschool children?
Punishment
Fear of dark
Loss of self-control
What are the fears of hospitalized School age children?
Loss of control and power

Complaining will be viewed with disapproval
What are the fears of hospitalized Adolescents?
Loss of control & Independeance

Fear of altered body image
What are some contraindications that must be considered when administered immunizations?
1- Child is sick or ill
2- Allergic reaction in one of child's other siblings
3 -Parent's religion beliefs forbid it
What is the medication calculation for Tylenol?
10-15 mg/kg per dose
What are the medication calculations for Motrin?
5-10 mg/kg per dose
What is 'crisis theory'?
an event that lasts 6 weeks or beyond
You are assigned to care for 4 children. Which one is a priority?

1- 4 yr old hosp. with acute asthmatic episode. HR 128-135; RR 30-35; BP 93/48; T 98
2- 7 yr old CP with gastro reflux. HR 100-110; RR 20-30; BP 96/54, T 99.5
3- 8 mo
8 month old with pneumonia

(acute resp. illness w/ tachypnea, tachcardia with bradycardic episodes
Which is second priority?

1- 4 yr old hosp. with acute asthmatic episode. HR 128-135; RR 30-35; BP 93/48; T 98
2- 7 yr old CP with gastro reflux. HR 100-110; RR 20-30; BP 96/54, T 99.5
3- 8 mo old w/ pneumonia. HR 160-170 dropping to
2 month old with fever and otitis media

(need to address fever)
Which is third priority?

1- 4 yr old hosp. with acute asthmatic episode. HR 128-135; RR 30-35; BP 93/48; T 98
2- 7 yr old CP with gastro reflux. HR 100-110; RR 20-30; BP 96/54, T 99.5
3- 8 mo old w/ pneumonia. HR 160-170 dropping to
4 year with acute asthmatic

(potentially unstable child with acute illness)
Which theories is based on psychodynamic?
Freud & Erkson
Which theories are based on developmental?
Kohlberg & Gilligan
What is often the first symptom of asthma?
cough
What does ICE mean in regards to asthma?
Inhaler technique
Compliance
Environment
What is the #1 myth about asthma in children?
they will outgrow it
What does the Green Zone sign in asthma control?
No asthma symptoms are present.
What is the yellow warning sign (zone) for asthma?
CAUTION

Early warning signs : cough, drop in peak flow reading, wheezing, tightness or pain in chest; itchy, sore throat, watery eyes, runny nose

If child remains in yellow 24-48 hrs or occurs more than 2 times a week - control plan needs to be re-evaled by MD
What is the RED Zone in asthma control?
EMERGENCY

Labored breathing, flaring nostrils, diff completing routine activities, retractions, obvious wheezing, changes in skin color
What is asthma?
chronic inflammation of the airways
What is the advantage of using a peak flow meter?
It can detect changes in the lungs hours, even days, before asthma symptoms appear
What are the 4 classifications of Asthma?
1- mild intermittent
2- mild persistant
3- moderate persistant
4- severe persistant

NOTE: any 'persistanat' will usually be on daily control
Should a humidifier be used to help with asthma symptoms?
NO - can actually be a trigger

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