Pediatrics

Which statement does the nurse include in discharge teaching to the parents of the 9-year-old who underwent tonsillectomy and adenoidectomy?

The child is brought to the emergency department for lacerations and abrasions to the knees, palms, and face after falling at recess. The parent informs the nurse, “He always bleeds so much with any injury." The nurse suspects which condition?

The baby requires phototherapy for moderate hyperbilirubinemia, but the baby’s mother wants to breastfeed. Which response by the nurse is most appropriate?

The nurse is providing medication teaching to the mother of a 4-year-old patient with recurrent otitis media infections who requires daily instillation of antibiotic drops into the ear. Which action indicates effective teaching?

The school nurse is creating a health pamphlet to send home with the students prior to summer break on how to prevent otitis externa. Which information does the nurse include on the cause of otitis externa?

The nurse is educating the 2-year-old patient’s parents on how to instill ear drops to treat acute otitis media. Which statement indicates a need for further teaching?

Which phonocardiogram tracing indicates a common heart condition associated with prematurity?

During a well-child visit for the 4-month-old child, the nurse palpates hard nodules where each rib joins the sternum. The nurse reports this finding to the provider and requests which lab studies for this patient? Select all that apply.

The nurse is creating a presentation on rickets in the community. The nurse focuses on which group of individuals for this teaching?

The mother of a 1-month-old neonate brings the child to the clinic with concerns that the child’s head seems large. The nurse measures the occipitofrontal circumference (OFC) and notes a 4 cm increase in the OFC since birth. When reporting this information to the provider, the nurse requests which test?

The pediatric patient has simple otitis externa (swimmer’s ear) and is afebrile. The nurse prepares educational materials for which treatment?

The woman with human immunodeficiency virus (HIV) who has a high CD4 count is concerned her fetus may be infected with the virus. Which statement by the nurse is appropriate?

Following traumatic bilateral leg amputations, the 5-year-old child requires a STAT blood transfusion to treat hemorrhagic shock. The child's blood type is unknown. Which action is most appropriate? 

Which is the best action by the nurse in the neonatal intensive care unit (NICU) in response to a tornado warning?

The parents of an 18-month-old with cystic fibrosis (CF) are in the office for a well-child visit and ask the nurse about immunization against influenza. Which response from the nurse is correct?

The nurse working in the pediatric unit finds the two-year-old patient crying on the floor near his hospital crib. The child's parents were present for the fall, are visibly upset, and tell the nurse that she crawled over the edge and fell to the floor. Which action by the nurse is appropriate?

Which information is true regarding developmental coordination disorder (DCD)?

At which age does the nurse instruct the parent to bring the child in to the clinic for the measles, mumps, and rubella (MMR) vaccine?

Which sport does the nurse recommend to the child with osteogenesis imperfecta who is interested in physical fitness?

A high school wide receiver suffered substantial head trauma during a tackle. The school nurse is concerned about concussion. The nurse provides which information to the adolescent and parents? Select all that apply.

A six-year-old child presents to a primary care appointment with curved tibias and fibulas, protruding forehead, pigeon chest, and protruding abdomen. Which vitamin deficiency does the nurse immediately suspect?

Parents of a four-year-old boy are worried because their son has been wetting the bed. The nurse informs the parents the child may continue to have nocturnal enuresis for how many more years? Enter your answer using a whole number.

The mother of a six-year-old child brings the child to the pediatrician requesting treatment for nocturnal enuresis. The nurse prepares information for the mother about which treatment?

The nurse is developing a care plan with a nine-year-old girl to end her nocturnal enuresis. The nurse is focused on which goal when communicating with the child?

The parent of the 5-year-old child reports that the child, who was potty trained at 3-years-old, has been stooling in places other than the toilet a couple times per month for 4 months. The nurse uses which term to document this symptom?

The nurse is collecting data from the parents of a seven-year-old boy who often has liquid stool in his underwear. The parents report he developed urinary and stool incontinence at four years of age and this problem started about six months ago. Their son excretes small pellets of stool every night before bed, and the parents wonder if he is soiling his clothing on purpose. Which additional testing does the nurse anticipate at this point?

A ten-year-old patient presents to the emergency department (ED) complaining of abdominal pain. He states, “I poop every day. It sometimes hurts to go and the poop is small, hard pieces. Which response does the nurse anticipate when the child is asked, “How much water do you drink in a day?”

The American Academy of Pediatrics recommends children remain in rear-facing car seats away from airbags until which age?

Which information does the nurse include when preparing an informational session for expectant first-time parents about car seat safety? Select all that apply

A baby is born precipitously to a mother who did not have prenatal care. The neonate requires only the initial steps of resuscitation but is found to have a bilateral cleft lip and palate. Review the patient’s assessment here: Position at rest: Complete flexion Square window: 0° Arm recoil: 75° Popliteal angle: 80° Scarf sign: Elbow does not cross midline Heel to ear: Foot does not reach the umbilicus Skin: No veins visible, cracking of skin at joints, dry Lanugo: Mostly bald skin Plantar surface: Creases over entire sole Breast: 4 mm bud with raised areola Ear: Formed pinna with instant recoil Genitals: Descended testes bilaterally, rugae over entire scrotum For which referrals does the nurse advocate for the baby prior to discharge? Select all that apply.

The 2-day-old full term child has been rooming in with the mother who reports successful breastfeeding. Which information is most important to report to the provider?

The nurse is supervising a nursing student in the emergency department. Which actions by the nursing student indicate effective learning? Select all that apply.  

The nurse is caring for the 16-year-old patient undergoing treatment for Ewing sarcoma. Which intervention is most helpful for the patient?  

The 8-month-old patient has had 4 skin abscesses in the past 3 months that have required draining. Each abscess drains less than 5 mL non-purulent fluid. The infant appears well otherwise and the parents deny respiratory infections. The infant’s complete blood count shows an elevated white blood cell count without bands or segmented cells. Immunoglobulin levels are appropriate for the age of the infant. The patient has a positive nitroblue test. The nurse plans care to include which intervention? 

A 16-year-old boy is brought to the clinic by his mother with complaints of strange noises and movements. The boy states, “I can’t stand that I make this weird noise with my mouth. I can feel it coming, and I try to stop it for as long as I can, but eventually it just comes out. The other kids at school make fun of me. It’s so embarrassing.” The mother reports that the boy gets good grades and has no trouble concentrating at home when doing homework. Which information does the nurse give the patient and his mother about the medication he will be prescribed?  

The 36-hour-old neonate who was born at 37 weeks gestation to a G3P2 mother has yet to pass meconium. The baby was born by cesarean section due to refractory preeclampsia with severe features. The mother reports the baby has been breastfeeding well after a slow first 12 hours. Upon assessment, the baby appears well with good tone and responsiveness. The baby’s anus is patent and the abdomen is soft and rounded; bowel sounds present. The mother denies emesis in the baby. An abdominal x-ray is obtained, which is normal. The nurse informs the mother that which test will be performed next? 

During the 1-hour assessment of the healthy, full-term neonate born to the 25-year-old G1P1 mother, the nurse notes the urethral meatus is on the ventral part of the penile shaft just proximal to the glans. The assessment is also notable for widely-spaced, downward-slanting eyes that resemble the baby’s father. The nurse provides which information to the parents?  

During the shift assessment of the healthy, full-term neonate born 24 hours ago to the 25-year-old G1P1 mother who had an uncomplicated pregnancy and delivery, the nurse notes the urethral meatus is on the ventral part of the penile shaft. The assessment is also notable for wide-spaced, downward-slanting eyes that resemble the baby’s father. The baby is pink, well-perfused, and breathing comfortably with normal heart and lung sounds. The mother reports the child is breastfeeding every 2 hours and has voided and stooled several times. Which additional assessment is most important? 

The 5-day-old 38-week-gestation neonate was born to a 25-year-old primigravida woman after a pregnancy and vacuum-assisted delivery complicated by gestational diabetes, large for gestational age fetus, and shoulder dystocia. The neonate required vigorous stimulation and positive pressure ventilation. Apgar scores were 3 and 8 at 1 and 5 minutes of life. At the pediatrician’s appointment after discharge, the neonate is found to have a large bruise at the back of the head that was sustained during birth and eyes glued shut with yellow, mucopurulent discharge. A gram stain of the drainage reveals gram-negative cocci in pairs. The mother states, “No matter what I do, it keeps coming back. I’ve used warm compresses and washed it away.” Additionally, the mother reports the infant is breastfeeding well with 4 wet diapers and 1 stool per day. The nurse informs the provider of the assessment and requests which order first?  

The 4-week-old neonate in the neonatal intensive care unit was born at 29 weeks gestation. The patient is stable on room air and has been tolerating nasogastric feedings of expressed breast milk. Generally an active and responsive patient, the nurse notes the patient is lethargic and does not react to his diaper change. Additionally, the patient’s heart rate is 194 bpm, respiratory rate is 82 breaths per minute, and the blood pressure is 54/21 mm Hg. The patient’s abdomen is distended and discolored; dark green emesis is noted as well. An abdominal x-ray is ordered and performed. Which x-ray findings are consistent with the patient’s clinical picture? Select all that apply.  

The 22-month-old child is brought to the emergency department with large, blistered burns to both buttocks by his mother’s boyfriend. The mother’s boyfriend states the child has been in his care while the mother is away on a business trip. He reports the child accidentally fell into the bath during the preparation before the water had had a chance to cool. The child’s second-degree wounds are dressed after intravenous morphine is administered. The nurse works with the healthcare team to perform which intervention? 

During the provider’s exam of the 6-hour-old neonate, the provider reports observing a red reflex in the neonate’s right eye, but not the left. The provider observes whiteness at the back of the eye. Enucleation is performed and the diagnosis of retinoblastoma with clear tumor margins is confirmed. No chemotherapy or radiation is required. The infant is ready to be discharged home as a healthy baby. Which health screening information is most relevant to this family? 

The 7-year-old child is being evaluated for attention deficit or learning disability. The child’s teachers report a lack of attention to detail and an inability to follow direction. The child’s parents report issues at home, too – not doing what is asked and not remembering what has been said. While being evaluated, the child begins to blink rapidly for 20 seconds. Once the episode ends, the child does not remember what happened or the purpose of the appointment. The nurse prepares education for the parents about which medication? 

The 7-year-old child is being evaluated for attention deficit or learning disability. The child’s teachers report a lack of attention to detail and an inability to follow direction. The child’s parents report issues at home, too – not doing what is asked and not remembering what has been said. While being evaluated, the child begins to blink rapidly for 20 seconds. Once the episode ends, the child does not remember what happened or the purpose of the appointment. The nurse educates the parents about which adverse effects of first line therapy? Select all that apply.  

The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7°C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. Which lab studies does the nurse obtain? Select all that apply.  

The nurse is observing the student nurse preparing a 6-year-old for the insertion of an intravenous catheter. Which statement by the student nurse prompts the nurse to intervene? 

A 4-year-old child presents for a well-child visit. The parents report the child is doing well, has a good appetite, and has been meeting developmental milestones appropriately. Two months ago, the child was treated with antibiotics for an upper respiratory tract infection. Otherwise, the child is quite healthy. Upon assessment, the nurse notes a left-sided flank mass. The child denies urinary issues including pain or frequency, and the parents report that the child has had no incontinence episodes for a full year. The urinalysis is normal with the exception of 2+ blood. The nurse prepares to educate the family on which condition that most likely explains the child’s symptoms?