Deck 45: Pediatric Variations of Nursing Interventions

Question 1

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

A) Allow Katie 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 removing all clothing is hospital policy.

Answer 1

Allow Katie to wear her underpants.

Question 2

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

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

Answer 2

Using a draw sheet to move the child in bed to reduce friction and shearing injuries.

Question 3

What is one important nursing consideration when performing a bladder catheterization on a young boy?

A) Use a clean technique, not routine practices.
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 anaesthetic lubricant is absorbed.

Answer 3

Insert 2% lidocaine lubricant into the urethra.

Question 4

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

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.

Question 5

The nurse approaches a group of school-age patients to administer medication to one child named Sam Hart.What should the nurse do to identify the correct child?

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.

Question 6

An 8-month-old infant is restrained to prevent interference with the intravenous infusion.What should the nurse do?

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 7

What should the nurse do when giving a child with hyperthermia a tepid water or sponge bath?

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 8

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

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 that he talk to his mother instead of crying.

Question 9

In some genetically susceptible children,anaesthetic agents can trigger malignant hyperthermia.In addition to an increased temperature,what is one early sign of this disorder?

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

Question 10

The nurse gives an injection in a patient's room.What should the nurse do to dispose of the needle?

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

Question 11

Kimberly,age 3 years,has a fever associated with a viral illness.Her mother calls the nurse,reporting a fever of 38°C even though she had acetaminophen 2 hours ago.What knowledge should the nurse's response be based upon?

A) Fevers such as this are common with viral illnesses.
B) Seizures are common in children when antipyretics are ineffective.
C) Fever over 38°C indicates greater severity of illness.
D) Fever over 38°C indicates a probable bacterial infection.

Question 12

Using your knowledge of child development,what is the best approach to prepare a toddler for a procedure?

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

Question 13

A venipuncture will be performed on a 7-year-old girl.She wants her mother to hold her during the procedure.What should the nurse recognize about this request?

A) It is unsafe.
B) It may help the child relax.
C) It is against hospital policy.
D) It is unnecessary because of the child's age.

Question 14

The nurse wore gloves during a dressing change.What should the nurse do after removing the gloves?

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

Question 15

What 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 16

The Allen test is performed as a precautionary measure before which procedure?

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

Question 17

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

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

Question 18

A nurse must do a venipuncture on a 6-year-old child.What is one important element of providing atraumatic care?

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

Question 19

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant.What 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 the inside of the diaper.
C) Aspirate urine from cotton balls inside the diaper with a syringe.
D) Aspirate urine from a superabsorbent disposable diaper with a syringe.

Question 20

The nurse is planning how to prepare a 4-year-old child for some diagnostic procedures.Which guideline should be included to prepare this preschooler?

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 and medical terminology in explanations.

Question 21

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock.What statement 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 22

What should the nurse do when caring for a child with an intravenous infusion?

A) Use a macrodropper to facilitate reaching 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 23

Which guideline is most appropriate for intramuscular administration of medication in school-age children?

A) Inject the medication as rapidly as possible.
B) Insert the needle quickly, using a dart-like motion.
C) Penetrate the skin immediately after cleansing the site, before it has dried.
D) Have the child stand, if possible, and if he or she is cooperative.

Question 24

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 25

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 26

An appropriate method for administering bitter oral medications to an infant or small child is to mix them with which one of the following?

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

Question 27

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

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

Question 28

The nurse must suction a child with a tracheostomy.Which intervention should the nurse include?

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

Question 29

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/8 hr is being infused rather than the ordered amount of 300 mL/8 hr.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 30

What is one advantage of the ventrogluteal muscle as an injection site in young children?

A) It is more painful than vastus lateralis.
B) It is free of important nerves and vascular structures.
C) It cannot be used when child reaches a weight of 20 pounds.
D) It has increased subcutaneous fat, which increases drug absorption.

Question 31

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

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 32

When teaching a mother how to administer eyedrops,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 eyelid 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