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Peds Exam 2 Questions with Complete
Solution
1. subjective data: Information spoken by the child or family in a client interview
2. Obtaining a Client History: -Chief complaint
- Example -History of present health concern -Health history -Family health history -Review of systems
- For current health problem -allergies, medication, substance abuse
- lifestyle -developmental level
3. chief complaint: reason for the child's visit to the health care setting
4. At what age should children be included in the client history interview?: -
preschool
5. objective data: -Information you collect by observation
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- Noting general status
- General appearance
- Height/weight
- Head circumference Vital signs, BP, pulse, RR, etc.
6. The reason rectal temperatures are not recommended for newborns is that intestinal perforation
is common.: false danger of irritation of the intentional mucosa
7. social history: child's environment including home setting, parent's occupation, pets, religion, economic factors
8. personal history: hygiene, sleeping, and elimination patterns.
-activities, exercise, special interests, and the child's favorite toys.
9. when do we start doing BP on children?: 3
10. school history: child's current grade level and academic performance
11. Head and neck assessment: General shape and movement Symmetry
of facial features Eyes Ears Nose, mouth, and throat
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a. Head and neck
b. Chest
c. Genitalia
d. Extremities: Genitalia
18. Stressors when a child is in the hospital: Stressors when a child is in the hospital Child's
developmental level Child-life program
19. First stage (protest): Cries, refuses to be comforted, and constantly seeks the primary caregiver
20. Second stage (despair): ‒Becomes apathetic and listless and gives up
21. Third stage (denial): Begins taking interest in the surroundings and appears to accept the situation
22. Some hospital pediatric units have a program to make the hospitalization less
frightening for both children and their parents. This program is overseen by whom?
a. Head nurse
b. Charge nurse
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c. Child psychologist
d. Child life specialist: d. Child life specialist
23. Admission physical examination:: -Occurs after orientation to unit
-Caregiver may undress the child for the physical examination -Caregiver may stay with the child during the physical exam
24. There are several components to the admission interview. Which of the following is one of
them?: Determining what the child and caregiver understand about reason for hospitalization
25. Signs/symptoms of pain in children: Rigidity
Thrashing Facial expressions Orally Routine intramuscular or IV routes Patient-controlled analgesia (PCA) Programmed IV infusion of narcotic analgesia that the child may control within set limits
26. Jimmy is six years old. He has been admitted to your unit for gastric surgery the following
day. The surgeon has ordered a pre-operative enema to be given. When would you expect to give this enema?: b. The evening before surgery
27. play therapy: -A technique used to uncover a disturbed child's underlying thoughts, feelings, and motivations to help
understand them better
28. therapeutic play: play technique used to help child better understand what will be happening to him or her in a specific
situation
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34. elevated body temp controlling from within: - Hydrate
- Medications
- Tepid sponge baths (not recommended)
- Educate caregivers
35. Control of environmental factors related to temps: -Removing excess coverings
- Changing to lightweight clothes
- Removing clothes -Lowering the room temperature -Applying cool compresses to the forehead
- Shivering
36. cooling factors for fevers: Hypothermia pad or blanket
Document Child's baseline temperature and additional temperature measurements Information regarding the child's response to the treatment
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37. When lowering a child's temperature and shivering occurs you must stop what you
are doing to lower the temperature. This is because shivering
a. Is very uncomfortable for a child with a fever
b. Is the body's mechanism for raising the temperature
c. Means you have lowered the temperature to fast
d. Lowers the temperature faster: b. Is the body's mechanism for raising the temperature
38. gavage feeding: Also called enteral tube feeding Can
be intermittent (bolus feeding) or continuous Verification of tube placement (aspirating stomach contents)
39. gavage feeding documentation: •Type and amount of contents aspirated by the nurse
- Amount of feeding given and name of formula
- The child's tolerance for the procedure
- The positioning of the child after completion
40. gastrostomy feeding: -Surgically inserted through the abdominal wall into the stomach
-Long-term feedings -G-button use after feeding they should be on the right side in fowler's position
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b. Do x-ray to check placement
c. Aspiration for stomach contents
d. Ask the patient to talk: a. Inserting air into tube and listening for sound
45. role of the nurse with medication admin: Understand the factors that influence or alter how the child absorbs,
metabolizes, and excretes the medication Be aware of any allergies the child may have Administer the medications properly Teach the patient and the family caregivers about the ettects and possible side ettects of medications given
46. infant and toddler intramuscular injections: vastus lateralis in the leg
make sure you have a swift and sure injection thrust (to minimize pain)
47. Because giving medication to children can be so difficult, it is an acceptable practice to
place the medication in a favorite food.: false
48. One of the common concerns that arise when a child with a chronic illness is
diagnosed is how the well siblings are going to react.: true
49. A major concern for a child with a chronic illness is education. What is one of these
concerns?
a. Delayed learning opportunities
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b. Acceptance of the child by teachers
c. Discrimination on the playground
d. Size of classes: b. Acceptance of the child by teachers
50. The child's perception of their illness is not based on whether or not the affected
body part is visible.: false
51. The nurse is doing an admission interview with a toddler and the child's family
caregiver. Which of the following statements that the nurse makes to the caregiver indicates the nurse has an understanding of this child's growth and development needs?: "If you would like to hold your child on your lap, that would be fine."
52. When interviewing an adolescent, which of the following is the most impor- tant for the
nurse to keep in mind?
A. The adolescent will be able to give accurate details regarding his or her history.
B. The adolescent may feel more comfortable discussing some issues in pri- vate.
C.The adolescent may have a better understanding if books and pamphlets are provided.
D. The adolescent will be more cooperative if age-appropriate questions are ask.: B. The adolescent may
feel more comfortable discussing some issues in private.
53. The nurse obtains the following vital sign measurements on a 6-month-old infant.
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58. When caring for a child in a pediatric setting, which action by the nurse indicates an
understanding of standard precautions?: cleaning reusable equipment before using for another client
59. When discussing postoperative pain management with a family caregiver of a school-
aged child, which statement made by the caregiver indicates a need for further information?: i am relieved to know my child will have less pain than do adults
60. a 5-year-old child placed on transmission-based precautions has a nursing diagnosis of
risk for loneliness as part of the child's care plan. which action would best help the child cope with the loneliness?
a. talking to the child about how he or she feels being alone
b. answering the call light over the intercom immediately
c. encouraging the child to talk to friends on the telephone
d. providing age-appropriate activities that can be played alone: encouraging the child to talk to friends on the
telephone
61. the hospitalized child away from his or her home and normal environment goes
through stages of separation. which behavior by the child might indicate the child is in the "denial" stage of separation?
a. crying loudly even when being held by the nurse
b. searching for the caregiver to arrive
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c. ignoring caregivers when they visit
d. quietly lying in the crib when no one is in the room: ignoring caregivers when they visit
62. after the discharge of a preschool-aged child from the hospital, which behav- ior by the
child might indicate he or she is afraid of another separation?
a. the child plays with siblings for long periods of time
b. the child plays with siblings for long periods of time
c. the child requests to go visit the nurses at the hospital
d. the child wakes up very early in the morning: the child carries a favorite blanket around the house
63. the nurse is following standard precautions when caring for a child on the pediatric
unit when the nurse does which of the following? Select all that apply
a. washes hands when gloves are removed
b. wears gloves when touching contaminated articles
c. cleans reusable equipment with hot water before using on another client
d. removes needle from syringe immediately after medication administration
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69. The nurse is working with the family caregivers of a child who has a chronic condition.
Which statement made by the child's caregiver is an example of the common response called overprotection?: I know I should let her try new activates, but she just gets frustrated
70. The nurse is working with the caregivers of a child who has a chronic con- dition.
Which statement made by the child's caregivers is an example of the common response called acceptance?: My child was born with this, and it will always be part of our lives
71. In working with families of children who have chronic conditions, what is an important
nursing intervention for the nurse to encourage family members to do?: Openly express their feelings
72. In working with siblings of children who have chronic conditions, it is impor- tant for the
nurse to recognize which statement may be true about the siblings in many cases?: Siblings may feel embarrassed about their brother or sister's condition
73. When working with the family caregivers of a child with a chronic condition, the nurse
may note the family experiences a grief reaction before coming to an acceptance of the child's condition. Which of the following behaviors by the nurse would be helpful in working with these family caregivers?: A. Encouraging the family to express their feelings. B. Responding in a nonjudgmental way.
E. Staying quietly with the family.
74. Shaken baby syndrome Clinical manifestations: •Lethargy
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- Irritability
- Vomiting
- Seizures
- MRI
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- May become overachievers in school but remain isolated emotionally from their peers and teachers
78. parental substance abuse clinical manifestations continued: -Another child in the family may try to
deflect the embarrassment and anger of the other siblings by trying to make everyone feel good
- As these children become adolescents or young adults, they may have problems such as substance abuse or eating disorders -Child in the family who "acts out" and engages in delinquent behavior is most likely to come to the attention of social services
- May be identified as a child who needs help
79. Behaviors That May Alert to an Addiction Problem in the Family Include:: •The loner child who
avoids interaction with classmates
- The child who is failing in school or has numerous episodes of unexcused absences or truancy
- The child with frequent minor physical complaints, such as headaches or stomachaches
- The child who steals or commits acts of violence
- The aggressive child
- The child who abuses drugs or alcohol
80. The nurse is assisting with a physical examination on a child who has been admitted
with a diagnosis of possible child abuse. Which of the following findings in the child might alert the nurse to the possibility that the child has been abused?
A. A fracture bone.
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B. Bruises on the knees and elbows.
C. Hyperactive and angry behavior.
D. A burn that has not been treated: D. A burn that has not been treated
81. In caring for a child who has been admitted after being sexually abused, which of
the following interventions would be included in the child's plan of care?
a) Test the urine for glucose upon admission
b) Observe for signs of anxiety
c)Encourage frequent family visits
d) Weigh on the same scale each day: b) Observe for signs of anxiety
82. The nurse is interviewing the caregiver of a 5-year-old child who has been admitted
with bruises on the abdomen and thighs as well as additional bruises in various stages of healing. Which of the following statements made by the caregiver might alert the health care team to the possibility of child abuse?
a) "When he is in trouble I make him go to his room."
b) "His brother just plays too rough with him."
c)"He just learned to ride his bicycle."
d) "My child goes to daycare after school.": "His brother just plays too rough with him."
83. The nurse is discussing the topic of bullying with a group of parents of school-age-
