Deck 22: Pediatric Variations of Nursing Interventions

Question 1

The nurse is planning how to prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include which of the following?

A)Plan for a short teaching session of about 30 minutes.
B)Tell the child that procedures are never a form of punishment.
C)Keep equipment out of the child's view.
D)Use correct scientific/medical terminology in explanations.

Answer 1

Tell the child that procedures are never a form of punishment.

Question 2

The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should do which of the following?

A)Ask the group, "Who is Sam Hart?"
B)Call out to the group, "Sam Hart?"
C)Ask each child, "What's your name?"
D)Check the patient's identification name band.

Answer 2

Check the patient's identification name band.

Question 3

The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells the nurse she wants her mother with her "like before." The most appropriate nursing action is which of the following?

A)Grant her request.
B)Explain why this is not possible.
C)Identify an appropriate substitute for her mother.
D)Offer to provide support to her during the procedure.

Answer 3

Grant her request.

Question 4

Tepid water or sponge baths are indicated for hyperthermia in children. The nurse should do which of the following?

A)Add isopropyl alcohol to the water.
B)Direct a fan on the child in the bath.
C)Stop the bath if the child begins to chill.
D)Continue the bath for 5 minutes.

Question 5

A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this:

A)Is unsafe.
B)May help child relax.
C)Is against hospital policy.
D)Is unnecessary because of child's age.

Question 6

Using knowledge of child development, which of the following is the best approach when preparing a toddler for a procedure?

A)Avoid asking the child to make choices.
B)Demonstrate the procedure on a doll.
C)Plan for teaching session to last about 20 minutes.
D)Show necessary equipment without allowing child to handle it.

Question 7

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics:

A)May cause malignant hyperthermia.
B)May cause febrile seizures.
C)Are of no value in treating hyperthermia.
D)Are of limited value in treating hyperthermia.

Question 8

A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. The nurse's best response is which of the following?

A)"The doses are close enough; it doesn't really matter which one is given."
B)"It is not appropriate to use dosages based on age because children have a wide range of weights at different ages."
C)"From your description, medications are not necessary.They should be avoided in children at this age."
D)"The nurse practitioner order the drug based on weight, which is a more accurate way of determining a therapeutic dose."

Question 9

In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is which of the following?

A)Apnea
B)Bradycardia
C)Muscle rigidity
D)Decreased blood pressure

Question 10

An 8-month-old infant is restrained to prevent interference with the IV infusion. The nurse should do which of the following?

A)Remove the restraints once a day to allow movement.
B)Keep the restraints on constantly.
C)Keep the restraints secure so infant remains supine.
D)Remove restraints whenever possible.

Question 11

The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. Which of the following is an appropriate approach by the nurse?

A)Explain that it will not be painful.
B)Discuss with him how his body is always in the process of making blood.
C)Suggest to him that he not worry about losing just a little bit of blood.
D)Tell the child that he will not even need a Band-Aid afterward because it is a simple procedure.

Question 12

Which of the following should the nurse consider when having consent forms signed for surgery and procedures on children?

A)Only a parent or legal guardian can give consent.
B)The person giving consent must be at least 18 years old.
C)The risks and benefits of a procedure are part of the consent process.
D)A mental age of 7 years or older is required for a consent to be considered "informed."

Question 13

The nurse is caring for an unconscious child. Skin care should include which of the following?

A)Avoid use of pressure reduction on bed.
B)Massage reddened bony prominences to prevent deep tissue damage.
C)Use draw sheet to move child in bed to reduce friction and shearing injuries.
D)Avoid rinsing skin after cleansing with mild antibacterial soap to provide a protective barrier.

Question 14

Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is which of the following?

A)Allow her to wear her underpants.
B)Discuss with her mother why this is important to Katie.
C)Ask her mother to explain to her why she cannot wear them.
D)Explain in a kind, matter-of-fact manner that this is hospital policy.

Question 15

The nurse gives an injection in a patient's room. The nurse should do which of the following to with the needle for disposal?

A)Dispose of syringe/needle in a rigid, puncture-resistant container in patient's room.
B)Dispose of syringe/needle in a rigid, puncture-resistant container in an area outside of patient's room.
C)Cap needle immediately after giving injection and dispose of in proper container.
D)Cap needle, break from syringe, and dispose of in proper container.

Question 16

An appropriate intervention to encourage food and fluid intake in a hospitalized child is which of the following?

A)Force child to eat and drink to combat caloric losses.
B)Discourage participation in noneating activities until caloric intake is sufficient.
C)Administer large quantities of flavored fluids at frequent intervals and during meals.
D)Give high-quality foods and snacks whenever child expresses hunger.

Question 17

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should do which of the following?

A)Wash hands thoroughly.
B)Check the gloves for leaks.
C)Rinse gloves in disinfectant solution.
D)Apply new gloves before touching the next patient.

Question 18

Kimberly, age 3 years, has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though she had acetaminophen 2 hours ago. The nurse's action should be based on which of the following?

A)Fevers such as this are common with viral illnesses.
B)Seizures are common in children when antipyretics are ineffective.
C)Fever over 102° F indicates greater severity of illness.
D)Fever over 102° F indicates a probable bacterial infection.

Question 19

The emergency department nurse is cleaning multiple facial abrasions on 9-year-old Mike. His mother is present. He is crying and screaming loudly. The nurse should do which of the following?

A)Ask him to be quieter.
B)Have his mother tell him to relax.
C)Tell him it is okay to cry and scream.
D)Suggest he talk to his mother instead of crying.

Question 20

Mark, age 6 years, is hospitalized for intravenous antibiotic therapy. He eats very little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which of the following is the best nursing action?

A)Request these favorite foods for him.
B)Identify healthier food choices that he likes.
C)Explain that he needs fruits and vegetables.
D)Reward him with ice cream at end of every meal that he eats.

Question 21

An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with which of the following?

A)Bottle of formula or milk
B)Any food the child is going to eat
C)Small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream
D)Large amounts of water to dilute medication sufficiently

Question 22

The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. To perform percussion, the nurse should instruct her to:

A)Cover the skin with a shirt or gown before percussing.
B)Strike the chest wall with a flat-hand position.
C)Percuss over the entire trunk anteriorly and posteriorly.
D)Percuss before positioning for postural drainage.

Question 23

When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

A)In the conjunctival sac that is formed when the lower lid is pulled down
B)Carefully under the eye lid while it is gently pulled upward
C)On the sclera while the child looks to the side
D)Anywhere as long as drops contact the eye's surface

Question 24

The nurse has just collected blood by venipuncture in the antecubital fossa. Which of the following should the nurse do next?

A)Keep arm extended while applying a Band-Aid to the site.
B)Keep arm extended, and apply pressure to the site for a few minutes.
C)Apply a Band-Aid to the site, and keep the arm flexed for 10 minutes.
D)Apply a gauze pad or cotton ball to the site, and keep the arm flexed for several minutes.

Question 25

The nurse must do a heel stick on an ill neonate to obtain a blood sample. Which of the following is recommended to facilitate this?

A)Apply cool, moist compresses.
B)Apply a tourniquet to ankle.
C)Elevate foot for 5 minutes.
D)Wrap foot in a warm washcloth.

Question 26

The nurse must suction a child with a tracheostomy. Interventions should include which of the following?

A)Encourage child to cough to raise the secretions before suctioning.
B)Select a catheter with diameter three-quarters as large as the diameter of the tracheostomy tube.
C)Each pass of the suction catheter should take no longer than 5 seconds.
D)Allow child to rest after every 5 times the suction catheter is passed.

Question 27

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, the nurse should do which of the following?

A)Prepare child for conscious sedation during the test.
B)Set up a tray with equipment the same size as for adults.
C)Reassure the parents that the test is simple, painless, and risk-free.
D)Apply EMLA to puncture site 15 minutes before procedure.

Question 28

An 8-year-old has just had a central venous access device line inserted in the intensive care unit. The peripheral intravenous line (PIV) is still in place and patent. A dose of antibiotic is due now. As the nurse, which venous access site would you use?

A)Central venous catheter; this will help determine the patency.
B)Central venous catheter, because the child is in the intensive care unit; these must be given systemically as quickly as possible.
C)The PIV must be used until placement of central venous catheter is confirmed by radiograph.
D)The PIV because the central venous catheter is to be reserved for fluids.

Question 29

The Allen test is performed as a precautionary measure before which one of the following procedures?

A)Heel stick
B)Venipuncture
C)Arterial puncture
D)Lumbar puncture

Question 30

When giving liquid medication to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

A)Administer the medication with a syringe (without needle) placed along the side of the infant's tongue.
B)Administer the medication as rapidly as possible with the infant securely restrained.
C)Mix the medication with the infant's regular formula or juice and administer by bottle.
D)Keep the child upright with the nasal passages blocked for a minute after administration.

Question 31

Guidelines for intramuscular administration of medication in school-age children include which of the following?

A)Inject medication as rapidly as possible.
B)Insert needle quickly, using a dartlike motion.
C)Penetrate skin immediately after cleansing site, before skin has dried.
D)Have child stand, if at all possible, and if child is cooperative.

Question 32

It is important to make certain that sensory connectors and oximeters are compatible, because wiring that is incompatible can cause which of the following?

A)Hyperthermia
B)Electrocution
C)Pressure necrosis
D)Burns under sensors

Question 33

Nursing considerations related to the administration of oxygen in an infant include which of the following?

A)Humidify oxygen if infant can tolerate it.
B)Assess infant to determine how much oxygen should be given.
C)Ensure uninterrupted delivery of the appropriate oxygen concentration.
D)Direct oxygen flow so that it blows directly into the infant's face in a hood.

Question 34

When caring for a child with an intravenous infusion, the nurse should do which of the following?

A)Use a macrodropper to facilitate the prescribed flow rate.
B)Avoid restraining the child to prevent undue emotional stress.
C)Change the insertion site every 24 hours.
D)Observe the insertion site frequently for signs of infiltration.

Question 35

Which of the following is an important nursing consideration when performing a bladder catheterization on a young boy?

A)Clean technique, not Standard Precautions, is needed.
B)Insert 2% lidocaine lubricant into the urethra.
C)Lubricate catheter with water-soluble lubricant such as K-Y jelly.
D)Delay catheterization for 20 minutes while anesthetic lubricant is absorbed.

Question 36

Which of the following is the preferred site for intramuscular injections in infants?

A)Deltoid
B)Dorsogluteal
C)Rectus femoris
D)Vastus lateralis

Question 37

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which of the following best explains why an intraosseous infusion is started?

A)It is less painful for small children.
B)Rapid venous access is not possible.
C)Antibiotics must be started immediately.
D)Long-term central venous access is not possible.

Question 38

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. Which of the following is the most appropriate way to collect small amounts of urine for these tests?

A)Apply a urine-collection bag to perineal area.
B)Tape a small medicine cup to inside of diaper.
C)Aspirate urine from cotton balls inside diaper with a syringe.
D)Aspirate urine from superabsorbent disposable diaper with a syringe.

Question 39

A nurse must do a venipuncture on a 6-year-old child. Which of the following is an important consideration in providing atraumatic care?

A)Use an 18-gauge needle if possible.
B)If not successful after four attempts, have another nurse try.
C)Restrain child only as needed to perform venipuncture safely.
D)Show child equipment to be used before procedure.

Question 40

Several types of long-term central venous access devices are used. Which of the following is considered an advantage of a Hickman/Broviac catheter?

A)No need to keep exit site dry
B)Easy to use for self-administered infusions
C)Heparinized only monthly and after each infusion
D)No limitations on regular physical activity, including swimming

Question 41

In preparing to give "enemas until clear" to a young child, the nurse should select which of the following?

A)Tap water
B)Normal saline
C)Oil retention
D)Fleet solution

Question 42

A 3-year-old child with a tracheostomy will soon be discharged. Which of the following should the nurse recommend to the family?

A)Avoid tub baths.
B)Avoid playing outdoors.
C)Avoid exposure to noxious fumes such as paint or varnish.
D)Cover tracheostomy with a plastic bib when exposed to cold air.

Question 43

When administering a gavage feeding to a school-age child, the nurse should do which of the following?

A)Lubricate the tip of the feeding tube with Vaseline to facilitate passage.
B)Check the placement of the tube by inserting 20 mL of sterile water.
C)Administer feedings over 5 to 10 minutes.
D)Position on right side after administering feeding.

Question 44

The nurse is planning home care for a 2-year-old child with a tracheostomy. Recommendations should include which of the following?

A)Child can go outdoors as long as protective clothing does not cover the stoma.
B)Child must wear a plastic bib when eating or drinking to prevent aspiration into the stoma.
C)Play activities must be sedentary (e.g., reading books, working on puzzles).
D)Child can take a tub bath, but safety precautions are essential.

Question 45

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 mL per 8 hours is being infused rather than the ordered amount of 300 mL per 8 hours. The nurse should adjust the rate so that how much will infuse during the next 8 hours?

A)200 mL
B)300 mL
C)350 mL
D)400 mL

Question 46

An important nursing consideration when caring for a child who is receiving hyperalimentation is which of the following?

A)Test urine frequently for the presence of blood and protein.
B)Attach a special filter to the intravenous setup.
C)Increase the flow rate if, for some reason, the infusion rate slows down.
D)Change tubing only when infusion site is changed.

Question 47

The advantages of the ventrogluteal muscle as an injection site in young children include which of the following? (Select all that apply.)

A)Less painful than vastus lateralis
B)Free of important nerves and vascular structures
C)Cannot be used when child reaches a weight of 20 pounds
D)Increased subcutaneous fat, which increases drug absorption
E)Easily identified by major landmarks