Question 1

A 5 year-old child is recovering from Varicella. The father would like to have the child return to school as soon as possible. In order to ensure that the disease is no longer communicable, what must the nurse assess for?

Accepted Answer

The rash begins as a macule with elevated body temperature and progresses to a vesicle that breaks open and then crusts over. When all lesions are crusted, the child is no longer in a communicable stage.

Question 2

A nurse enters the room of Jamal, a 3 year-old child, who is having a generalized seizure. Which intervention should the nurse do first?

Accepted Answer

Protecting the airway is the top priority in a seizure. If a child is actively convulsing, a patent airway and oxygenation must be assured. Children usually have both cardiac and respiratory arrest.

Question 3

Upon assessing the mouth of a 4 year-old child, the nurse noted that the teeth have chalky white-to-yellowish staining with pitting of the enamel. Which of the following conditions would most likely explain these findings?

Accepted Answer

The findings are indicative of Fluorosis, a condition characterized by an increase in the extent and degree of the enamel''s porosity. This problem is associated with repeated swallowing of toothpaste with fluoride and or drinking water with high levels of fluoride.

Question 4

A nurse is caring for a child who has just returned to the pediatric unit following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate at this time?

Accepted Answer

The nurse should observe for increased swallowing frequency to check for hemorrhage.

Question 5

While planning care for a preschool aged child, a nurse understands developmental needs. Which of the following would be of the highest concern?

Accepted Answer

Erikson describes the stage of the preschool child as being the time when there is normally an increase in initiative. The child should have resolved the sense of shame and doubt in the toddler stage

Question 6

The nurse is caring for a 16 year-old boy with Hemophilia A, who was admitted after falling from a tree. In understanding his behavior and in planning care for this client, what must the nurse understand about adolescents with hemophilia A?

Accepted Answer

Adolescent hemophiliacs should be aware that contact sports may trigger bleeding. However, developmental characteristics of this age group such as impulsivity, inexperience and peer pressure, place adolescents in unsafe environments.

Question 7

A 3 year-old child is being treated with Metronidazole suspension, 200 mg per dose. The child weighs 30 lbs. and the daily dose range is 20-40 mg/kg of body weight, in three divided doses every 8 hours. Knowing the principles os safe drug administration, what should the nurse do?

Accepted Answer

The dose range is 20-40 mg/kg/day divided every 8 hours. 15kg x 40mg = 600mg, divided by 3 = 200 mg per dose. The prescribed dose is correct and should be given as ordered.

Question 8

The nurse is caring for a 10 year-old with an acute illness. Which of the following indicates that the nurse understands common sibling reactions to hospitalization?

Accepted Answer

Contact with the hospitalized child helps siblings understand the reasons for hospitalization and maintain their relationship.

Question 9

A mother of a 7 year-old child telephones the clinic nurse because her daughter was sent home from school due to rashes. The child had been seen the day before by a doctor and diagnosed with Erythema Infectiosum or fifth disease. What is the most appropriate action by the nurse?

Accepted Answer

Fifth Disease is a viral disease with an uncertain period of communicability (perhaps 1 week prior to and 1 week after onset). Isolation of the child with Fifth Disease is not necessary.

Question 10

A 4 year-old child is treated in the emergency room after ingesting an ounce of a liquid narcotic. What should the nurse do first?

Accepted Answer

The initial step in treatment of a toxic exposure or ingestion is to assess the airway, breathing and circulation; then stabilize the client. The other nursing interventions will follow.

Question 11

An anxious father consults a nurse for guidance on how to answer the question, of his child Daniel who is only 5 years old. The father said that Daniel asked "Where do babies come from?" What is the nurse's best response to the father?

Accepted Answer

Topics related to sexuality should be answered with honesty. However, honesty does not mean imparting every fact of life associated with the question. When a child asks 1 question, he is looking for 1 answer. When he is ready, he will ask about the other pieces.

Question 12

Daniel's mother called the clinic and said to the nurse on duty that her baby started crying and started to turn blue on his lips and face. After crying her baby passes out and took a deep breath. The nurse also learned that Daniel is already 18 month-old. What response should the nurse give?

Accepted Answer

The data indicates a normal spell and does not cause any harm. The mother should just hold the baby until the spell passes. This behavior usually starts between 3 and 12 months of age. If the baby developed seizure, it is the time to consult a doctor.

Question 13

The nurse is caring for a pediatric client who has pink eye. The mother asks the nurse if her child can resume playing with her friends at the park after 48 hours. The nurse responds correctly based on her understanding that pink eye?

Accepted Answer

Conjuntivitis caused by a bacterium is no longer contagious after 36 to 48 hours of antibiotic drops. A doctor should be contacted if it doesn't improve after 5 days.

Question 14

What would a nurse expect to see while assessing the growth of Daniel who is in 4th grade primary school?

Accepted Answer

School age children gain about 5.5 lbs per year and gain about 2 inches in height.

Question 15

While assessing a 3 week old infant, which finding should a nurse report immediately:

Accepted Answer

Inspiratory grunt is abnormal and could be a sign of respiratory distress in this infant.

Question 16

A nurse prepares a care plan for a 6 year-old child admitted for Rhabdomyosarcoma. The nurse must alert the staff to pay more attention to the function of which area of the body?

Accepted Answer

Rhabdomyosarcoma is the most common soft tissue sarcoma in pediatric client. It originates in striated (skeletal) muscles and can be found anywhere in the body. Remember that the term "myo" means muscle.

Question 17

A 7 year-old child was rushed at the ER after a sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, fever, leaning forward while in a sitting position, protruding tongue, salivation and suprasternal retractions. What should the nurse do first?

Accepted Answer

These findings suggest a medical emergency and may be due to epiglottises. Any child with an acute onset of an inflammatory response in the mouth and throat should receive immediate medical attention in a hospital equipped with Intubation or a Tracheostomy in the event of further or complete obstruction.

Question 18

The mother called the attention of the community nurse because her toddler develops high grade fever for 3 days and red rash almost on the child's entire body. The nurse found out that the fever already subsided. The child had a case of:

Accepted Answer

It is a usually harmless illness caused by a virus. It occurs almost only in children age 3 months to 3 years, most often between 9-12 months. It is probably the most common cause of fever in this age group. The virus generally causes 3 days of high fever then subsides, and the child breaks out in a flat or bumpy red rash, usually starting around the neck, back and chest, then spreading out.

Question 19

A mother asks the nurse about the immunization schedule for his 15 month-old toddler who is being treated for acute lymphoid leukemia. The nurse responds that the vaccine that is not to be given for a client who is receiving chemotherapy is:

Accepted Answer

MMR vaccine contains a live attenuated virus and is therefore contraindicated for a child who received chemotherapy due to compromised immune system.

Question 20

A mother asks the school nurse as her school age child has Encopresis. The nurse advised the mother to:

Accepted Answer

Let the child over six take responsibility for cleaning their soiled pants. It is not a punishment, but a way to help a child learn to take responsibility for his actions and motivate him to listen to his body signals.

Quiz 3: Pediatrics