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Nursing Interventions and Considerations for Various Childhood Conditions, Exams of Nursing

Nursing interventions and goals for managing various childhood conditions such as sickle cell anemia, juvenile idiopathic arthritis, congenital heart failure, myelosuppression from leukemia or chemotherapeutic agents, and adolescent obesity. It also includes nursing responsibilities for caring for suicidal adolescents and children experiencing seizures.

Typology: Exams

2023/2024

Available from 03/13/2024

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NURS 2864 Chapter Review Question
A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the
nurse that he is difficult to hold; that "He is like a rag doll. He does not cuddle up to me
like my other babies did." The nurse's best interpretation of this lack of clinging or
molding is that it is:
A. a sign of maternal deprivation
B. a sign of detachment and rejection
C. suggestive of autism associated with Down syndrome
D. the result of the physical characteristics of Down syndrome - ansD. the result of the
physical characteristics of Down syndrome
A 3-year-old child is status postshunt revision for hydrocephaly. Part of the discharge
teaching plan for the parents is signs of shunt malformation. Which signs are of shunt
malformation? (Select all that apply)
A. Personality change
B. Bulging anterior fontanel
C. Vomiting
D. Dizziness
E. Fever - ansA, C, E
A 5-year-old girl's sibling dies from sudden infant death syndrome. The parents are
concerned because she showed more outward grief when her cat died than she is
showing now. The nurse should explain that:
A. this is suggestive of maladaptive coping and referral for counseling is needed
B. the child is not old enough to have a concept of death
C. the child is not old enough to have formed a significant attachment to her sibling
D. the death may be so painful and threatening that the child must deny it for now -
ansD. the death may be so painful and threatening that the child must deny it for now
A 5-year-old male child has bilateral eye patches that were put in place after surgery
yesterday morning. Today he can be allowed to get out of bed. The MOST important
nursing intervention is to:
A. provide reassurance to the child and allow his parents to stay with him
B. allow him to assist in feeding himself
C. speak to him when entering the room
D. orient him to his immediate surroundings - ansD. orient him to his immediate
surroundings
A 6-year-old child has difficulty hearing faint or distant speech. His speech is normal,
but he is having problems with his school performance. This hearing loss would MOST
likely be classified as:
A. slight
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NURS 2864 Chapter Review Question

A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold; that "He is like a rag doll. He does not cuddle up to me like my other babies did." The nurse's best interpretation of this lack of clinging or molding is that it is: A. a sign of maternal deprivation B. a sign of detachment and rejection C. suggestive of autism associated with Down syndrome D. the result of the physical characteristics of Down syndrome - ansD. the result of the physical characteristics of Down syndrome A 3-year-old child is status postshunt revision for hydrocephaly. Part of the discharge teaching plan for the parents is signs of shunt malformation. Which signs are of shunt malformation? (Select all that apply) A. Personality change B. Bulging anterior fontanel C. Vomiting D. Dizziness E. Fever - ansA, C, E A 5-year-old girl's sibling dies from sudden infant death syndrome. The parents are concerned because she showed more outward grief when her cat died than she is showing now. The nurse should explain that: A. this is suggestive of maladaptive coping and referral for counseling is needed B. the child is not old enough to have a concept of death C. the child is not old enough to have formed a significant attachment to her sibling D. the death may be so painful and threatening that the child must deny it for now - ansD. the death may be so painful and threatening that the child must deny it for now A 5-year-old male child has bilateral eye patches that were put in place after surgery yesterday morning. Today he can be allowed to get out of bed. The MOST important nursing intervention is to: A. provide reassurance to the child and allow his parents to stay with him B. allow him to assist in feeding himself C. speak to him when entering the room D. orient him to his immediate surroundings - ansD. orient him to his immediate surroundings A 6-year-old child has difficulty hearing faint or distant speech. His speech is normal, but he is having problems with his school performance. This hearing loss would MOST likely be classified as: A. slight

B. severe C. moderate D. moderately severe - ansA. slight A 9-year-old child has several physical disabilities. His father explains to the nurse that his son concentrates on what he can, rather than cannot do and is as dependent as possible. The nurse's best interpretation of this is that: A. the father is experiencing denial B. the father is expressing his own views C. the child is using an adaptive coping style D. the child is using a maladaptive coping style - ansC. the child is using an adaptive coping style A 12-year-old child being seen in the clinic has not received the hepatitis B (HBV) vaccine. The nurse should recommend that: A. only one dose of HBV will be needed sometime during adolescence B. only a booster will be needed C. the three-dose series of HBV should be started D. the three-dose series of HBV should be started at age 16 or sooner if the adolescent becomes sexually active - ansC. the three-dose series of HBV should be started A 16-year-old adolescent male tells the school nurse that he is gay. The nurse's MOST appropriate response should be based on knowledge that: A. he is too young to have had enough sexual activity to determine this B. it is important to provide a nonthreatening environment in which he can discuss this C. the nurse should be open to discussing his or her own beliefs about homosexuality D. homosexual adolescents do not have concerns that differ from heterosexual adolescents - ansB. it is important to provide a nonthreatening environment in which he can discuss this A 16-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics occurred about 4 years ago. The nurse should: A. explain that this is not unusual B. refer adolescent for an evaluation C. assume that the adolescent is pregnant D. suggest that adolescent stop exercising until menarche occurs - ansB. refer adolescent for an evaluation A 17-year-old boy with diabetes mellitus tells the school nurse that he has recently started drinking alcohol with his friends on weekends. The nurse should: A. tell him not to do this B. ask him why he is drinking alcohol C. teach him about the effects of alcohol on diabetes and how to prevent problems associated with alcohol intake

B. rituals and practices become increasingly important C. strict observance of religious customs is common D. emphasis is placed on external manifestations, such as whether a person goes to church - ansA. beliefs become more abstract A neonate with a goiter has just been admitted to the newborn nursery. A PRIORITY nursing intervention is to: A. position the infant on the left side B. explain transient paralysis to parents C. have tracheostomy set at bedside D. suction the infant at least every 5 to 10 minutes - ansC. have tracheostomy set at bedside A nurse is caring for an infant with developmental dysplasia of the hip (DDH). Based on the nurse's knowledge of DDH, which clinical manifestation should the nurse expect to observe? (Select all that apply) A. Lordosis B. Positive Babinski sign C. Asymmetric thigh and gluteal folds D. Positive Ortolani and Barlow tests E. Shortening of limb on affected side - ansC, D, E A parent phones the nurse and says that her child just knocked out a permanent tooth. The nurse's instructions to the parent should include: A. rinsing the tooth in hot water B. holding tooth by the crown and not by the root area C. taking the child and tooth to a dentist within 48 hours D. taking the child to the hospital emergency room if the mouth is bleeding - ansB. holding tooth by the crown and not by the root area A parent tells the nurse, "I am worried about my 13-year-old son. He has not started puberty, and my daughter did when she was 11 years of age." The nurse should explain to this parent that this is: A. unusual and requires further evaluation of the son B. unusual because the onset of pubescence is usually the same in siblings C. normal because the onset of pubescence is usually earlier in girls than it is in boys D. abnormal because the onset of pubescence is usually earlier in boys than it is in girls

  • ansC. normal because the onset of pubescence is usually earlier in girls than it is in boys A pediatric oncology patient has been discharged home following a course of chemotherapy. Which information should be included as part of discharge planning with regard to health promotion? A. No further treatments are needed and the patient can resume routine health assessments as developmentally appropriate.

B. There are no restrictions based on activity and/or contacts with friends and family members. C. Certain restrictions will be in place related to immunizations that can be administered. D. The patient should limit fluid intake for several months in order to prevent overhydration from occurring. - ansC. Certain restrictions will be in place related to immunizations that can be administered. A pediatric oncology patient has developed a nose bleed. Which finding would account for this occurrence? A. Increased white blood cell count B. Increased neutrophils C. Decreased hemoglobin and hematocrit D. Decreased platelet count - ansD. Decreased platelet count A pediatric oncology patient is undergoing chemotherapy. Which observation would lead the nurse to suspect that the patient has developed sterile hemorrhagic cystitis? A. Absence of hematuria B. Presence of proteinuria C. Complaints by the patient that it burns upon urination D. Increased sensation of thirst - ansC. Complaints by the patient that it burns upon urination A pediatric patient has been diagnosed with leukemia and presents with a white blood cell (WBC) count of 80,000. Which statement if provided by a nursing student indicates that additional teaching is needed with regard to pathophysiological mechanisms of leukemia? A. The increase in WBC provides protection against bacterial infections. B. Although the WBC count is elevated, there are increased blast cells which help to protect the patient against infection. C. The amount of white blood cells is greatly increased, which affords protection against viral infections. D. Increases in white blood cells are expected but associated with a low leukocyte count. - ansB. Although the WBC count is elevated, there are increased blast cells which help to protect the patient against infection. A poor prognosis following surgical treatment for operable cancers is associated with: A. when there is evidence of metastasis B. presence of postoperative nausea C. the amount of pain medication that the patient takes in the first 24 hours postsurgery D. if the tumor is encapsulated and localized - ansA. when there is evidence of metastasis A school-age child recently diagnosed with type 1 diabetes mellitus asks the nurse if he can still play soccer, baseball, and swim. The nurse's response should be based on knowledge that:

Administration of colony stimulating agents for the pediatric oncology patient are used to: A. decrease nausea B. shrink tumor size C. increase bone marrow response D. decrease production of stem cells - ansC. increase bone marrow response After a patient returns from cardiac catheterization, the nurse assesses that the pulse distal to the catheter insertion site is weaker. The nurse should: A. elevate the affected extremity B. record the data on the nurse's notes C. notify the physician of the observation D. apply warm compresses to the insertion site - ansB. record the data on the nurse's notes An adolescent asks the nurse, "How will I know if I am going through puberty?" The nurse discusses physical changes that usually occur, the first change being: A. testicular enlargement B. voice changes C. growth of dark pubic hair D. increased size of penis - ansA. testicular enlargement An adolescent who had a lower leg amputated after a motorcycle accident complains of pain in the missing extremity. The nurse's MOST appropriate action is to: A. withhold pain medications because of narcotic addiction B. refer the patient for psychologic counseling C. teach the parents and adolescent child about nerve damage D. reassure the child that it is normal and is called phantom limb sensation - ansD. reassure the child that it is normal and is called phantom limb sensation An appropriate nursing intervention when caring for the child with chronic osteomyelitis is to: A. provide active range-of-motion exercises for the affected extremity B. administer pain medications with meals C. encourage frequent ambulation D. move and turn the child carefully and gently to minimize pain - ansD. move and turn the child carefully and gently to minimize pain An early sign of congestive heart failure that the nurse should recognize is: A. tachypnea B. bradycardia C. inability to sweat D. increased urine output - ansA. tachypnea An example of a disease process that is based on a "two-hit" hypothesis leading to a cancer diagnosis is:

A. Fanconi anemia B. Wiskott Aldrich syndrome C. Klinefelter syndrome D. Retinoblastoma - ansD. Retinoblastoma An important consideration for the school nurse planning a class on injury prevention for adolescents is that: A. adolescents generally are not risk takers B. adolescents can anticipate the long-term consequences of serious injuries C. during adolescence a need exists for discharging energy, often at the expense of logical thinking D. during adolescence participation in sports should be limited to prevent permanent injuries - ansC. during adolescence a need exists for discharging energy, often at the expense of logical thinking An important nursing responsibility when a dysrhythmia is suspected is to: A. order an immediate electrocardiogram B. count the radial rate at 1-minute intervals 5 times in a row C. count the apical rate for 1 full minute and compare it with the radial D. have someone else take the radial rate while the nurse simultaneously checks the apical rate - ansC. count the apical rate for 1 full minute and compare it with the radial An infant is born with ambiguous genitalia. Tests are being done to assist in gender assignment. The parents tell the nurse that family and friends are asking what caused the baby to be this way. The nurse's MOST appropriate action is to: A. explain the disorder so parents can explain it to others B. help parents understand that no one knows how this occurs C. suggest that parents avoid family and friends until the gender is assigned D. encourage parents not to worry while the tests are being done - ansA. explain the disorder so parents can explain it to others An infant is born with one lower limb deficiency. When is the optimum time for the child to be fitted with a prosthetic device? A. As soon as possible after birth B. When the infant begins sitting up and can maintain balance C. At about age 12 to 15 months, when most children are walking D. At about 4 years, when the healthy limb is not growing so rapidly - ansB. When the infant begins sitting up and can maintain balance At the beginning of the school year, the school nurse identifies several new children at the school. The nurse knows that which factors place the children at high risk adjustment problems? (Select all that apply) A. This child is from a middle class family B. The child has not attended a preschool program C. The child exhibits signs of emotional immaturity D. The parents of a child demonstrate warm, loving behaviors

C. recommending increased exercise to control weight gain D. encouraging low-fat diet to prevent fat deposition - ansA. giving reassurance that these changes are normal In planning sex education and contraceptive teaching for adolescents, the nurse should consider which information? A. Most teenagers today are knowledgeable about reproductive anatomy and physiology B. Both sexual activity and contraception require planning C. Most teenagers who become pregnant do so as an act of hostility, especially toward their parents D. Teenagers need contraception education in both oral and written form - ansD. Teenagers need contraception education in both oral and written form In taking care of a pediatric oncology patient, which diagnostic finding would indicate a critical concern for the development of bleeding? A. Absolute neutrophil count of 1000 mm B. Temperature of 99.2 F C. White blood cell count 18,000 mm D. Platelet count 50,000 mm3 - ansD. Platelet count 50,000 mm Major goals of the therapeutic management of juvenile idiopathic arthritis are to: A. prevent joint discomfort and regain proper alignment B. prevent loss of joint function and achieve cure C. prevent physical deformity and preserve joint function D. prevent skin breakdown and relieve symptoms - ansC. prevent physical deformity and preserve joint function Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the: A. importance of reducing caloric intake to decrease cardiac demands B. importance of relaxing discipline and limit-setting to prevent crying C. need to be extremely concerned about cyanotic spells D. desirability of promoting normalcy within the limits of the child's condition - ansD. desirability of promoting normalcy within the limits of the child's condition Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include: A. restricting oral fluids B. instituting strict isolation C. using good handwashing D. giving immunizations appropriate for age - ansC. using good handwashing Nursing care of the infant or child with congestive heart failure would include: A. forcing fluids appropriate to age B. monitoring respirations during active periods

C. organizing activities to allow for uninterrupted sleep D. giving larger feedings less often to conserve energy - ansC. organizing activities to allow for uninterrupted sleep Nursing considerations related to the administration of chemotherapeutic drugs include: A. many chemotherapeutic agents are vesicants that can cause severe cellular damage if the drug infiltrates B. good hand washing is essential when handling chemotherapeutic drugs, but gloves are not necessary C. infiltration will not occur unless superficial veins are used for the intravenous infusion D. anaphylaxis cannot occur because the drugs are considered toxic to normal cells - ansA. many chemotherapeutic agents are vesicants that can cause severe cellular damage if the drug infiltrates Nursing interventions to promote health during middle childhood include: A. stressing the need for increased calorie intake to meet increased demands B. instructing parents to defer questions about sex until the child reaches adolescence C. educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt D. advising parents that the child will need decreasing amounts of rest toward the end of this period - ansC. educating the child and parents to the need for good dental hygiene because these are the years in which permanent teeth erupt Nursing responsibilities in the management of adolescent obesity include: A. planning a low-calorie, low-protein diet B. incorporating favorite foods into the child's diet C. encouraging diversional activities during mealtimes D. using nutritious foods as a method of reward - ansB. incorporating favorite foods into the child's diet Nursing responsibilities when caring for the suicidal adolescent include: A. emphasizing that a suicide attempt is an immature way of dealing with stress B. recognizing the warning signs that indicate a young person might attempt suicide C. ignoring threats of suicide because they are usually bids for attention D. recognizing a suicide attempt as an impulsive act resulting from a temporary crisis - ansB. recognizing the warning signs that indicate a young person might attempt suicide Parents ask the nurse for advice when telling their 4-year-old about a grandmother's death. The nurse's best response involves teaching the parents that the child's concept of death is: A. temporary B. permanent C. personified in various forms D. inevitable at some age - ansA. temporary

C. "The mother should be tested if she is over age 35." D. "The parents can be tested themselves because the child's condition might be hereditary." - ansD. "The parents can be tested themselves because the child's condition might be hereditary." The MOST appropriate nursing interventions when caring for a child experiencing a seizure include: (Select all that apply) A. restraining the child when a seizure occurs to prevent bodily harm B. placing a padded tongue between the teeth if they become clenched C. avoid suctioning the child during the seizure D. describing and documenting the seizure activity observed E. applying supplemental oxygen after inserting an artificial oral airway - ansC, D The MOST common cause of secondary hyperparathyroidism is: A. diabetes mellitus B. chronic renal disease C. congenital heart disease D. growth hormone deficiency - ansB. chronic renal disease The MOST important nursing consideration related to congenital hypothyroidism is: A. early identification of the disorder B. facilitation of parent-infant attachment C. initiating referrals for cognitive impairment D. helping parents deal with future prospects for the child - ansA. early identification of the disorder The MOST important nursing consideration when caring for a child with sickle cell anemia is to: A. teach parents and child how to minimize crises B. refer parents and child for genetic counseling C. help the child and family adjust to a short-term disease D. observe for complications of multiple blood transfusions - ansA. teach parents and child how to minimize crises The mother of a child with type 1 diabetes mellitus asks why her child cannot avoid all those "shots" and take pills as an uncle does. The nurse's BEST reply is: A. "The pills work with an adult pancreas only." B. "The drugs affect fat and protein metabolism, not sugar." C. "Your child needs insulin replaced, and the oral hypoglycemics only add to an existing supply of insulin." D. "Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemics." - ansC. "Your child needs insulin replaced, and the oral hypoglycemics only add to an existing supply of insulin." The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. The PRIORITY of nursing care is to:

A. initiate isolation precautions as soon as the diagnosis is confirmed B. initiate isolation precautions as soon as the causative agent is identified C. administer antibiotic therapy as soon as it is ordered D. administer sedatives/analgesics on a preventative schedule to manage pain - ansC. administer antibiotic therapy as soon as it is ordered The nurse is assessing a pediatric oncology patient's nutritional status. Which diagnostic tests would provide best practice approach? (Select all that apply) A. Albumin B. Transferring C. Total iron binding capacity D. Prealbumin E. Blood urea nitrogen (BUN) - ansA, B, D The nurse is caring for a 2-year-old girl who is unconscious but stable following a car accident. Her parents are staying at the bedside most of the time. An appropriate nursing intervention is to: A. suggest that the parents go home until she is alert enough to know that they are present B. use ointment on her lips but do not attempt to cleanse her teeth until swallowing returns C. encourage the parents to hold, talk, and sing to her as they usually would D. position her with proper body alignment and head of bed lowered 15 degrees. - ansC. encourage the parents to hold, talk, and sing to her as they usually would The nurse is caring for a child dying from cancer. Physical signs that the child is approaching death include: A. rapid pulse B. change in respiratory pattern C. sensation of cold, although body feels hot D. loss of hearing followed by loss of other senses - ansB. change in respiratory pattern The nurse is caring for a child hospitalized with acute adrenocortical insufficiency. Which treatment option should be implemented to restore fluid volume? A. Provide hypertonic saline dextrose solution (5%) with parenteral hydrocortisone. B. Increase rate of intravenous fluids. C. Restrict intake of fluids for 8 hours. D. Provide isotonic fluids as needed to restore fluid balance. - ansA. Provide hypertonic saline dextrose solution (5%) with parenteral hydrocortisone. The nurse is caring for a child with multiple injuries who is comatose. The nurse should recognize that pain: A. cannot occur if the child is comatose B. may occur if the child regains consciousness C. requires astute nursing assessment and management

D. most usual childhood activities must be restricted - ansC. shunt malfunction or infection requires immediate treatment The nurse is doing a neurologic assessment on a 2-month-old infant following a car accident. Moro, tonic neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes suggest: A. neurologic health B. severe brain damage C. decorticate posturing D. decerebrate posturing - ansA. neurologic health The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. The MOST appropriate nursing assessment in this case is: A. reactivity of pupils B. doll's head maneuver C. oculovestibular response D. funduscopic examination to identify papilledema - ansA. reactivity of pupils The nurse is explaining blood components to an 8-year-old child. The nurse could best describe platelets by explaining that they: A. help keep germs from causing infection B. make up the liquid portion of blood C. carry the oxygen you breath from your lungs to all parts of your body D. help your body stop bleeding by forming a clot (scab) over the hurt area - ansD. help your body stop bleeding by forming a clot (scab) over the hurt area The nurse is explaining that the destruction of pancreatic beta-cells is the cause of which disorder? A. Type 1 diabetes B. Type 2 diabetes C. Impaired glucose tolerance D. Gestational diabetes - ansA. Type 1 diabetes The nurse is planning care for a child recently diagnosed with diabetes insipidus. The plan should include: A. encouraging the child to wear medical identification B. discussing with the child and family ways to limit fluid intake C. teaching the child and family how to do required urine testing D. reassuring the child and family that this is usually not a chronic or life-threatening illness - ansA. encouraging the child to wear medical identification The nurse is planning care for a school-age child with bacterial meningitis. The plan should include: A. keeping environmental stimuli at a minimum B. avoiding giving pain medications that could dull sensorium

C. measuring head circumference to assess developing complications D. having child move head side to side at least every 2 hours - ansA. keeping environmental stimuli at a minimum The nurse is preparing a health teaching session for school-age children. The nurse should include which information about injury prevention in the plan? A. Peer pressure is not strong enough to affect risk-taking behavior B. Most injuries occur in or near school or home C. Injuries from burns are the highest at this age because of fascination with fire D. Lack of muscular coordination and control results in an increased incidence of injuries - ansB. Most injuries occur in or near school or home The nurse is preparing to administer ondansetron (Zofran) to a pediatric patient. For which clinical symptom is this considered to be the drug of choice? A. Headache relief B. To promote increased energy C. Nausea and vomiting D. Pain relief - ansC. Nausea and vomiting The nurse is preparing to give digoxin to a 9-month-old infant. He or she checks the dose and draws up 4 mL of the drug. The MOST appropriate nursing action is to: A. not give the dose; suspect dosage error B. mix the dose with juice to disguise its taste C. check heart rate; administer the dose by placing it to the back and side of the mouth D. check heart rate; administer the dose by letting the infant suck it through a nipple - ansA. not give the dose; suspect dosage error The nurse is teaching a community health promotion class to parents and school-age children related to bicycle safety. Issues to cover is A B C D - ansD. bicycles should be walked through busy intersections The nurse is teaching an adolescent, newly diagnosed with type I diabetes, ways to minimize discomfort with insulin injections. Which interventions are helpful in minimizing injection discomfort? (Select all that apply) A. Do not reuse needles B. Inject insulin when it is cold C. Flex or tense the muscle during injection D. Rotate sites E. Do not move the direction of the needle-syringe during insertion or withdrawal - ansA, D, E

C. Cardiac catheterization D. Electrophysiology - ansA. Echocardiography The nurse should recognize that, when a child develops diabetic ketoacidosis, it is: A. an expected outcome B. a life-threatening situation C. best treated at home D. best treated at the practitioner's office/clinic - ansB. a life-threatening situation The nurse should teach volunteers in the after school program that which characteristic is MOST descriptive of the social development of school-age children? A. Identification with peers is minimal B. Children frequently have "best friends" C. Boys and girls play equally well with children of either gender D. Peer approval is not yet an influence toward conformity - ansB. Children frequently have "best friends" The nurse suspects that a child is having an adverse reaction to a blood transfusion. The FIRST action by the nurse should be to: A. notify the physician B. take vital signs and blood pressure and compare them with baseline C. dilute infusing blood with equal amounts of normal saline D. stop transfusion and maintain a patent intravenous line with normal saline and new tubing - ansD. stop transfusion and maintain a patent intravenous line with normal saline and new tubing The nurse who is concerned about increased intracranial pressure in an infant should assess for: A. irritability B. photophobia C. pulsating anterior fontanel D. vomiting and diarrhea - ansA. irritability The parent of a child receiving an iron preparation tells the nurse that the child's stools are a tarry green color. The nurse should explain that this is a/an: A. symptom of iron-deficiency anemia B. adverse effect of the iron preparation C. indicator of an iron preparation overdose D. normally expected change caused by the iron preparation - ansD. normally expected change caused by the iron preparation The parents of 9-year-old twin children tell the nurse, "They have filled their bedroom with collections of rocks, shells, stamps, and cars." The nurse should recognize that this behavior is: A. indicates giftedness B. indicates typical "twin" behavior

C. is characteristic of cognitive development at this age D. is characteristic of psychosocial development at this age - ansC. is characteristic of cognitive development at this age The parents of a child with fragile X syndrome want to have another baby. They tell the nurse they worry that another child might be similarly affected. The MOST appropriate nursing action is to: A. reassure them that the syndrome is not inherited B. assess for family history of the syndrome C. recommend that they not have another child D. explain that prenatal diagnosis of the syndrome is now available - ansD. explain that prenatal diagnosis of the syndrome is now available The parents of a cognitively impaired child ask the nurse for guidance with discipline. The nurse's BEST response is: A. "Discipline is ineffective with cognitively impaired children." B. "Discipline is not necessary for cognitively impaired children." C. "Behavior modification is an excellent form of discipline." D. "Physical punishment is the most appropriate form of discipline." - ansC. "Behavior modification is an excellent form of discipline." The parents of an 8-year-old girl tell the nurse that their daughter wants to join a soccer team. The nurse's suggestions regarding participation in sports at this age should include: A. organized sports such as soccer are not appropriate at this age. B. competition is detrimental to the establishment of a positive self-image C. sports participation is encouraged if the sport is appropriate to the child's abilities D. girls should compete only against girls because at this age boys are larger and have more muscle mass - ansC. sports participation is encouraged if the sport is appropriate to the child's abilities The pediatric nurse is performing a well child assessment. Which finding if noted would require further investigation? A. Bruises observed following light touch to the extremities. B. Report of a headache. C. Buccal mucosa pink and intact. D. Fever of acute origin accompanied by flu-like symptoms which has resolved. - ansA. Bruises observed following light touch to the extremities. The postoperative care of a preschool child who has had a brain tumor removed should include which information? A. Clear drainage is to be expected B. Close supervision is needed while the child is regaining consciousness C. Positioning is on the side in the Trendelenburg position D. Analgesics are contraindicated because of altered consciousnesness - ansB. Close supervision is needed while the child is regaining consciousness