A nurse is planning care for a newly admitted client diagnosed with acute nephrotic syndrome

A child diagnosed with acute glomerulonephritis will most likely have a history of:

Recent illness such as strep throat.

The nurse is collecting data on an 18-month-old child with a diagnosis of autism spectrum disorder (ASD). What clinical manifestation would likely have been noted in the child with this diagnosis?

The child does not make eye contact.

The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions?

Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.

The nurse is caring for a small child who has been admitted with a diagnosis of abusive head trauma (shaken baby syndrome). Which condition or concern often occurs with shaken baby syndrome?

loss of vision and intellectual disability

Children have less lung elasticity in the alveoli. Which response would the nurse give a mom who wants to know what risks this poses to her child?

“They are at risk for pulmonary edema.”

What is a true statement regarding status epilepticus?

It is a common neurologic emergency in children.

The nurse admits an 11-year-old boy who reports lower leg pain after he was hit with a lacrosse stick during a game. The level of pain is not consistent with the description of the incident. With further questioning, the nurse discovers the child has had pain in that spot off and on for several months. The child has a biopsy, a bone scan and a bone marrow aspiration ordered by the care provider. What is the most likely condition the care provider is looking for?

A nurse is caring for a 10-year-old who is in skeletal traction following injuries sustained in a car accident. Which statement accurately describes a recommended nursing measure for this type of traction?

Perform pin-site care on a daily or weekly basis after the first 48 to 72 hours.

The nurse is performing an assessment on an adolescent after the parents report concern about a risk for suicide. Which statement by the adolescent is of greatest concern?

"Sometimes I just wish I would not wake up."

The nurse is discussing teenage substance use with a group of caregivers of adolescent children. Which statement made by the caregivers is most accurate regarding substance use disorders in teens?

"The most common drug used by teenagers is alcohol."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever?

“Children who have this diagnosis may have had strep throat.”

The nurse is caring for a child admitted with asthma. Which clinical manifestations would likely have been noted in the child with this diagnosis?

The caregiver of a 2-year-old who has a polyurethane resin cast on her arm calls the clinic to report that her child is crying and says that the cast has sand in it. The caregiver states that she has had casts herself and knows how badly they can itch. She says she always used a hanger to scratch but is worried that it will be too sharp for the child. Which statement would be appropriate for the nurse to make to this caregiver?

“Nothing should be put into the cast. You can blow cool air into it with a hair dryer.”

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant?

v

The nurse is doing in-service training with nurses who will be working with children who have concerns with drugs and alcohol. In discussing this topic, one of the nurses says she has heard that there may be physical and psychological signs that occur when a drug is no longer being used. Which term best describes what the nurse is referring to?

In developing a plan of care for the child diagnosed with rheumatic fever, the nursing intervention that takes highest priority for this child is to:

promote rest periods and bed rest.

The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of the treatment?

"At least when I take a shower I have a few minutes out of this brace."

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate?

Take the child to a private room and interview her regarding her sexual history and partners.

A 10-year-old girl has a pattern of school success, solid peer relationships, and a healthy family life. The girl's caregiver reports for the past 3 weeks the child has reported abdominal pain with vomiting and diarrhea, and tells the caregiver she doesn't feel good just before it's time to go to school. However, after the caregiver lets her stay home, she is fine by mid-morning. She is also fine on weekends. Which question should the nurse prioritize to this caregiver?

"Have you explored with your child if something is causing her to be afraid to go to school?"

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, “The teacher tells us that our child has to use the restroom many more times a day than other students do.” The caregiver's statement indicates the child most likely has:

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child?

The child has a greater risk for trauma to the kidney.

The nurse is administering 8 p.m. medications when a 9-year-old child expresses concern about dying sometime during the night. Which action by the nurse is most appropriate?

Stay with the child and encourage further discussion.

The nurse is caring for a child with gastroenteritis. Which nursing actions would the nurse include in the plan of care? Select all that apply.

• Documenting the number and characteristics of stools
• Following standard precautions
• Monitoring the child's fluid balance

The nurse is caring for a pediatric client with the injury pictured. When asking the caregivers about the way in which the client received these injuries, which communication manner is essential?

The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate?

"Handwashing is an effective way to prevent infection."

The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their child. What is the best response by the nurse?

"Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs."

A nurse caring for a child wearing a brace to correct scoliosis provides client and family teaching for home care of the brace. Which of these are accurate interventions for this situation? Select all that apply.

- Avoid sitting in one position for long periods of time.

- Tell the client to loosen the brace during meals if necessary.

- Wear a 100%-cotton T-shirt under the brace to absorb moisture.

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

obtaining a clean catch voided urine.

A child is brought to the emergency department late one evening and is diagnosed with croup. The child was noted to have a shrill, harsh respiratory sound when breathing in. This symptom is referred to as:

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease?

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention?

Prepare the infant for surgery.

The caregiver of a child with a recent puncture wound on the arm calls the pediatrician's office reporting that after seeming well at bedtime last night, the child now has a temperature of 101℉ (38.3℃), pain at the site of the injury, and is unable to fully bend the elbow of the arm which had been injured. The nurse recommends the child be brought in to see the health care provider. What would likely be ordered for this child?

Infectious mononucleosis (“mono”) is caused by which of the following?

The father of a 4-year-old boy with leukemia tells the nurse that he believes his son was misdiagnosed by his two previous oncologists and that the lab results were in error. Thus, he has switched doctors in hopes of "finding someone who can diagnose his son accurately." Which stage of grief does the nurse suspect this father to be in?

A mother is concerned about her adolescent daughter’s depression. What is the major problem associated with depression that the mother needs to be monitoring her daughter for?

Which observation would demonstrate that the adolescent client suffers from attention deficit hyperactivity disorder (ADHD)?

Forgets to turn in homework, does not follow directions, cannot stay in the assigned seat in class and is always talking excessively and inappropriately.

Which of the following is a common viral upper respiratory infection in an older child?

What is the priority nursing diagnosis in the plan of care for a child with a congenital heart disorder?

Ineffective Tissue Perfusion related to inadequate cardiac output

What is a definitive test for cystic fibrosis?

The nurse is collecting data for a child who is having a routine checkup. The caregiver tells the nurse that her child eats things such as laundry starch, clay, paper, and paint. The nurse recognizes that the child's behavior indicates that the child likely has which disorder?

The nurse is instructing a group of parents about transmission of infectious diseases in children. Which would the nurse cite as the primary method for prevention?

In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care?

Weighing on the same scale each day

An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician’s office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?

“Tell me what makes you think the medication is not working.”

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. What food will the nurse recommend as an appropriate diet choice?

A nurse admits an infant with a possible diagnosis of congestive heart failure. Which signs or symptoms would the infant most likely be exhibiting?

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother?

“The infant is born with immunity to some diseases, but those immunities decrease over the first year of life.”

The mother of a child newly diagnosed with an intellectual disability tells the nurse that her partner disagrees with the diagnosis and believes that the child is perfectly normal. The mother shares with the nurse that she finds this reaction frustrating and confusing. Which action by the nurse would be appropriate in supporting this mother?

Reassure the mother that her partner's reaction is a normal stage in the grieving process.

The nurse is teaching a group of peers regarding different types of fractures seen in children. Which statement best describes a complete fracture?

A fracture in which the bone breaks into two pieces

A 6-year-old is brought to the emergency department numerous times over 3 months with the same symptoms of gastric upset and nightmares. The child acts very hostile with the nurses while there. What should the nurse suspect?

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

The nurse is caring for a child who is being evaluated for a possible nephroblastoma. Which nursing intervention would be important for this child?

Protect the child from having the abdomen palpated.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child?

Effortless vomiting just after the child has eaten

The nurse enters the room of a client who has pneumonia. The client has a low oxygen level and is working hard to breathe. The nurse raises the head of the bed and has the client tilt her head back. What is the next appropriate action by the nurse?

Provide oxygen therapy to the client.

A nursing student is reviewing information about medications used to treat congestive heart failure in children. The student demonstrates understanding of the information by identifying which drug as prescribed to increase myocardial contractility?

Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes?

Before meals and snacks with milk

In which situation would the nurse expect parents to experience the stages of anticipatory grief?

9-year-old with terminal bone cancer

A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?

Demonstrate love and acceptance at home.

The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis (thrush). Which medication would most likely be prescribed for the child?

A nurse is interacting with a new mother whose infant is 6 weeks old. The mother appears exhausted and anxious. Which of the following statements by the mother most indicates a potential risk for maltreatment of the child?

"She cries all the time. I don't know what to do with her. She's just a bad baby, I guess."

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?

“A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily.”

A child is hospitalized with a diagnosis of sickle cell crisis. The nurse has completed an assessment with the above findings. Which intervention is the nurse’s priority in providing care?

Administer intravenous fluids as prescribed.

The caregiver of a 2-year-old child reports to the nurse that the child vomits at least five or six times a day, sometimes continuously. The child is admitted for observation and the mother continues to report the child is vomiting, but the nurses never see the child vomit or any evidence the child has vomited. The child will likely be found to have:

Munchausen syndrome by proxy.

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?

A child is at risk for infection related to a respiratory disorder. What would the nurse educate the family on to prevent infection?

The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child:

feels increasing severe pain.

In caring for a child in traction, which intervention is the highest priority for the nurse?

The nurse should monitor for decreased circulation every 4 hours.

Which disorder is a concern in adulthood as well as in childhood for the person who is overweight or obese during childhood?

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is:

The nurse is caring for a child diagnosed with Legg–Calvé–Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?

The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.

A 12-year-old girl with terminal leukemia has chosen to die in a local hospice facility. The nurse understands that which of the following is an advantage of a hospice facility over a hospital and the home in terms of an environment for death?

a homelike setting combined with access to skilled professional health care

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine “looks funny.” He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

acute glomerulonephritis.

The ability of body tissues to endure and adapt to continued or increased use of a substance, so that the drug user requires larger doses of the drug to produce the desired effect, is called:

The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is:

An adenosarcoma found in the region of the kidney in a child would most likely be:

While making a home visit, the nurse suspects that a child is experiencing psychological maltreatment. What did the nurse observe in the home?

Belittling the child in front of the nurse and other siblings

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child?

preventing spread of infection

The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope?

“Use this information to teach family and friends.”

The nurse is collecting data on a child who has been brought to the clinic. The child has urticaria, pruritus, stomach pains, and respiratory symptoms. The nurse recognizes that the clinical manifestations noted in this child are commonly seen in which disorder?

The emergency room nurse is taking a history of a 1-year-old child whose parent said that she had a “fit" at home. Which inquiry would be best to start with?

“What happened just before the seizures?”

The nurse is caring for a newborn who was delivered vaginally. The infant has a white coating in the mouth that looks like milk curds. The nurse suspects that the infant has:

oral candidiasis (thrush) caused by Candida albicans.

Which client statement indicates the possibility of emotional abuse experienced by an adolescent?

“I am a failure and should have never been born.”

The nurse is performing a respiratory assessment on a child. The nurse includes five steps in her assessing technique: observation, inspection, palpation, and percussion. Which step was left out of her techniques?

Listening to the lung sounds

The mother of a 5-year-old girl with terminal brain cancer tells the nurse, "I'm not ready to throw in the towel yet. I just made a big donation to the American Cancer Society (ACS) and told God that I would support that organization for the rest of my life if my girl will just pull through." Which stage of grief does the nurse suspect this mother to be in?

The client is a 9-month-old whose babysitter brings her to the ER. An x-ray shows a spiral fracture of the femur. The babysitter tells the nurse that she found the infant in this condition when she showed up to watch her an hour ago. How should the nurse respond to this situation?

Arrange for the parents to come in for an evaluation for possible physical abuse.

What is the most dangerous effect from alcohol abuse by adolescents that is seen in families in the United States?

driving under the influence of alcohol

Absence seizures are marked by what clinical manifestation?

Loss of motor activity accompanied by a blank stare

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?

The nurse is presenting information related to intestinal parasite infections to a group of community health nurses. One member of the group asks the nurse how she might know if a child had a pinworm infestation. The nurse correctly answers this question by stating which of the following?

The primary symptom of pinworms is intense perianal itching.

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?

The nurse is assessing a 4-year-old child whose parent reports that the child is more irritable since falling down the steps. Which questions would suggest suspected increased intracranial pressure (IICP)?

“Does she have headaches when she gets out of bed?”

What is one of the most commonly reported communicable diseases in the United States?

The nurse is caring for a child with rheumatic fever who has polyarthritis. Which lab result would the nurse most anticipate with this child's diagnosis and symptoms?

Increased erythrocyte sedimentation rate (ESR)

The nurse is teaching a group of new nurses about the stages of grieving. Teaching has been successful when the new nurse can teach-back the stages of grieving in order as follows:

• Denial
• Isolation
• Anger
• Bargaining
• Depression
• Grief
• Acceptance

The nurse is caring for a 6-year-old child who has a history of febrile seizures and is admitted with a temperature of 102.2°F (39°C). What is the nurse's highest priority?

Institute safety precautions.

The nurse gives a preschool-age child two anatomically correct dolls to play with in efforts to determine if the child has been sexually abused. Which observation indicates to the nurse that this is a possibility?

Child inserts the male doll's penis into the female doll's mouth.

The nurse is taking a respiratory history of a newly admitted child. While documenting the symptoms the child has, what other item is important to document when taking a history on an altered respiratory status?

The triggers in the environment

Which of the following infections is often contracted by having contact with an infected dog or cat?

The nurse is caring for a child with a fractured femur in traction. Which action will the nurse complete while caring for this client?

Ensure traction weights are hanging freely, not touching the bed or floor.

The parents of a child with a bleeding disorder ask the nurse about appropriate activities and sports that they should encourage the child to participate in. What activity would be the safest for the nurse to suggest?

The nurse is caring for a child admitted with congenital aganglionic megacolon. Which clinical manifestation would likely have been noted in the child with this diagnosis?

What signs and symptoms would the nurse expect to assess in a client diagnosed with acute pericarditis?

What information should a nurse include when preparing discharge education for a client diagnosed with gastroesophageal reflux disease GERD )?