Question 1

When a child is hospitalized, the family may experience moderate to severe stress. In what manner does applying principles of family-centered care (FCC) provide a structure of support?

Accepted Answer

Family-centered care (FCC) focuses on the promotion of well-being by involving the family in the care process, ensuring their needs and preferences are considered, and supporting them through the stress of hospitalization.

Question 2

If a parent presents with an injured child, which of the following parental actions would be suspicious for abuse?

Accepted Answer

A history that includes a high-impact accident as the cause of injury can be suspicious for abuse if the explanation does not match the child's developmental capabilities or the physical evidence. It may indicate an attempt to justify severe injuries with unlikely explanations.

Question 3

In life-threatening situations such as a skull fracture, even when the history offers clear evidence of maltreatment, what nursing action should take precedence?

Accepted Answer

Stabilizing the patient is the most immediate and critical action to take in life-threatening situations, including cases of suspected maltreatment. Ensuring the patient's physical health and safety is the priority before proceeding with further actions such as reporting or investigation.

Question 4

If a child presents with multiple, repeated complaints of unknown etiology, as a pediatric nurse, for what syndrome should you be suspicious?

Accepted Answer

Munchausen syndrome by proxy is a form of abuse where a caregiver fabricates or induces illness in a person under their care, often leading to multiple medical visits and procedures without a clear medical cause. This fits the description of a child with repeated complaints of unknown etiology.

Question 5

As a pediatric nurse, you should be aware that only severe dietary deficiencies, such as those associated with which medical condition, are apt to trigger the need for vitamin K administration?

Accepted Answer

Cystic fibrosis is a severe dietary deficiency that can trigger the need for vitamin K administration.

Question 6

If a child with celiac disease presents with classic symptoms of intussusception, including "currant jelly" stool, pain, abdominal distention, and vomiting, which imaging modality would be used to positively confirm the diagnosis of intussusception?

Accepted Answer

Ultrasound is the preferred imaging modality for diagnosing intussusception in children due to its high sensitivity and specificity, non-invasiveness, and lack of ionizing radiation. It can visualize the characteristic "target" or "doughnut" sign of intussusception.

Question 7

If a patient presents with urgent diarrhea, weight loss, and bloody stools, with blood work revealing abnormal liver function tests, what medical condition should be suspected?

Accepted Answer

Ulcerative colitis is characterized by symptoms such as urgent diarrhea, weight loss, and bloody stools, and can also affect the liver, leading to abnormal liver function tests.

Question 8

If you are caring for a child who was recently diagnosed with phenylketonuria, as a pediatric nurse, whcich action should you take?

Accepted Answer

Phenylketonuria (PKU) is a metabolic disorder that requires dietary management to prevent intellectual disability and other complications. A referral to a nutritionist is crucial for dietary planning and management, as individuals with PKU must adhere to a diet low in phenylalanine.

Question 9

If a patient presents with diabetic ketoacidosis, the pediatric nurse should rapidly establish IV access and carefully initiate rehydration with which type of fluids?

Accepted Answer

Isotonic fluids, such as normal saline, are recommended for the initial treatment of diabetic ketoacidosis to restore the circulating volume and correct dehydration without causing rapid shifts in fluid balance that could lead to cerebral edema.

Question 10

As a pediatric nurse educating a diabetic patient with an insulin pump, you should be aware that only what type of insulin is used in insulin pumps?

Accepted Answer

Rapid-acting insulin is used in insulin pumps because it allows for quick adjustments to blood glucose levels, mimicking the body's natural insulin response more closely than other types of insulin.

Question 11

A child presents with cyanosis and bursts of rapid, short coughs followed by a sudden "whooping" inspiration. This is a classic presentation for pertussis. As a pediatric nurse, what stage of pertussis is this child currently in?

Accepted Answer

The child is in the paroxysmal stage of pertussis, characterized by bursts of rapid, short coughs followed by a "whooping" inspiration. This stage follows the catarrhal stage and can last for several weeks.

Question 12

Nursing care for a child with apnea is based on careful monitoring with an apnea machine and/or cardiac monitoring. Careful monitoring of which serum level may also assist in the treatment of a child with apnea?

Accepted Answer

Caffeine is sometimes used as a treatment for apnea in infants, and monitoring serum caffeine levels can help ensure therapeutic levels are maintained without reaching toxic levels.

Question 13

If you are caring for a child who was treated in the emergency room for acute exacerbation of asthma, what medication would you administer this child as prophylaxis against relapse?

Accepted Answer

Oral corticosteroids are commonly prescribed as prophylaxis against relapse in patients who have been treated for acute exacerbations of asthma. They help reduce inflammation in the airways, preventing symptoms from returning.

Question 14

If you are caring for a child who requires wound care and the physician orders wet-to-dry dressing changes, which of the following actions is the most correct for you to take as a pediatric nurse?

Accepted Answer

Wet-to-dry dressings are no longer considered best practice for wound care due to the potential for tissue damage and pain during dressing changes. It's important for nurses to advocate for evidence-based practices and discuss any concerns about prescribed treatments with the physician to ensure the best care for the patient.

Question 15

If you are caring for a child who presents with skin vesicles, this finding should elicit prompt evaluation for what medical condition?

Accepted Answer

Skin vesicles in a child, especially a newborn, can be indicative of a congenital herpes simplex virus infection. Herpes simplex virus (HSV) can be transmitted from mother to child during delivery and can present with vesicular lesions on the skin, among other symptoms.

Question 16

If a child with cellulitis presents with skin tears in the area of infection, what advice would you give the family regarding treatment of this condition?

Accepted Answer

Covering skin tears with a non-occlusive dressing helps protect the area from further injury and infection, allowing it to heal while still letting the skin breathe. This is a supportive care measure that can be advised in addition to other treatments for cellulitis.

Question 17

Fresh-frozen plasma is administered to a child to increase coagulation factors including factor IX (stable) or factor V (unstable). Under what conditions would a child receive fresh-frozen plasma?

Accepted Answer

The answer of Fresh-frozen plasma is administered to a child...

Question 18

If a child with sickle cell disease develops signs of shock, including tachycardia, hypotension, syncope, dizziness, and overall reduced circulatory volume, what type of crisis is this child experiencing?

Accepted Answer

Sequestration crisis is characterized by the sudden pooling of blood in the spleen and sometimes the liver, leading to a rapid decrease in circulating blood volume, which can cause signs of shock such as tachycardia, hypotension, syncope, and dizziness. This is a life-threatening condition requiring immediate medical intervention.

Question 19

If you are caring for a child with sickle cell disease in the emergency department, which of the following methods would you use for rapid pain management for this condition?

Accepted Answer

The answer of If you are caring for a child...

Question 20

If a child presents with tetralogy of Fallot, the nurse and family should attempt to prevent crying, dehydration, constipation, fever, and pain because these actions can provoke what medical condition in this child?

Accepted Answer

Hypercyanosis, also known as a "tet spell," can be triggered in children with tetralogy of Fallot by conditions that increase oxygen demand or decrease oxygen supply, such as crying, dehydration, constipation, fever, and pain. These conditions can exacerbate the right-to-left shunting of blood, leading to increased cyanosis.

Quiz 31: Strategies for Goal-Setting, Cultural Sensitivity, and Error-Prevention