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Chapter 21, 22, 23 LeiferWhich child would have the most difficulty in coping with separation from parents because of hospitalization? A 2-year-old child has been crying constantly for his mother since he was hospitalized 3 days ago. What does this behavior suggest? A. The toddler feels abandoned by his mother Which statement best corresponds to a preschoolers understanding of hospitalization? B. "I got sick because I was mad at my brother. The parents of a hospitalized toddler are upset because she seems more interested in her toys when they come to visit her. In which stage of separation anxiety is the toddler? The nurse must make a room assignment for a 16-year-old with cystic fibrosis. Which roommate would be the most appropriate for this patient? C. A 15-year-old with type 1 diabetes mellitus The parents of a hospitalized 9-month-old infant ask if their preschool child may visit his younger sibling. What understanding would assist the nurse most in formulating a response? D. The preschooler needs to visit his infant sister to reassure himself that she is all right A hospitalized toddler was drinking from a cup at home but now refuses to drink from anything except his favorite bottle. What is the most likely reason for this behavior? A. He is dealing with the anxiety of hospitalization by regressing A nurse encourages a school-age child to draw a picture after a painful procedure. What is the best rationale for this nursing intervention? B. Providing a way for the child to express his feelings What is the best suggestion by the nurse when parents ask, "When is the best time to begin to prepare a 5-year-old for surgery and hospitalization? C. "About 4 days before surgery The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around 12:00 pm. The next morning, the child asks the nurse, "When is my mommy coming?" What is the nurses best response? B. "Your mommy will be here when you have lunch A 13-year-old girl has been hospitalized for the past week. When discussing the girls feelings about her illness, what would the nurse expect the girl to express as her biggest concern? The nurse notices that the mother of a child with cerebral palsy corrects and redoes many of the things the nurse does for her child. What is the nurses most appropriate response to this mother? D. "Id love for you to share with me some of the special things you do for your child. The mother of a hospitalized toddler states, "He cries when I visit. Maybe I should just stay away." What is the nurses best response? B. "It is important that you are here. This is a common reaction in children when they are separated from their parents. What should the nurse, preparing to collect an admission history from parents who have recently emigrated from Russia, keep in mind? C. Smiling is inappropriate in a serious situtation Which nursing action would facilitate rapport with a child and the childs parents during the admission process? B. Answer questions in a calm and matter-of-fact way When a 2-year-old returns to her hospital room following a diagnostic procedure, her parents are not available, and the child is crying loudly. Which technique is most appropriate to alleviate the childs distress? B. Play with the child using pop-up toys A 4-year-old begins to cry when his mother tells him it is time for his operation. The nurse understands this is an expected reaction. On which particular fear of the preschooler does the nurse base this understanding? What statement by the parent of a hospitalized toddler leads the nurse to determine the parent understands a hospitalized toddler's need for transitional objects? A. "This stuffed animal makes him feel secure An 8-year-old child will be hospitalized for several weeks in skeletal traction to treat a fractured femur. What does the nurse realize immobilization in this age-group can generate feelings of in planning care of this child? The nurse explains to the parents of a hospitalized child that their child will receive fentanyl for an upcoming procedure. What advantage of fentanyl will the nurse explain? The nurse shares the information and timelines recorded on the interdisciplinary outline of care for a child. What is this document? The anxious parent asks if there is a danger of her 2-year-old child becoming addicted to the opioid pain reliever. What is the nurse's most helpful response? C. "Addiction is rare in children when opiates are given for pain The nurse is preparing to start an IV on an infant admitted to the pediatric unit. What intervention is appropriate for the nurse to implement? The pediatric nurse is caring for child that weighs 15 kilograms and calls the physician for an order for Acetaminophen for pain control. What is the maximum amount of medication per dose the nurse anticipates ordering? What will the nurse include when documenting the discharge of a pediatric patient? (Select all that apply) A. Time of discharge The nurse suggests to parents that they use the outpatient surgical center for their childs upcoming surgery. What advantage(s) does this type of facility have to offer? (Select all that apply) A. Lower cost What are the basic fears of a young child being hospitalized? (Select all that apply) A. Separation What information will the nurse include when taking a developmental history? (Select all that apply) A. Previous experience with hospitalization The nurse is preparing to obtain a throat culture on a toddler patient. What interventions are appropriate for the nurse to implement? (Select all that apply) A. Model desired behavior Parents are preparing the child for admission to the pediatric unit for minor surgery. What should they expect to see when visiting the pediatric unit? (Select all that apply) C. Availability of a playroom What is the best pulse location for the nurse to use when assessing the pulse rate on a 12-month-old infant? The nurse preparing to administer medication to a 2-month-old infant discovers there is no ID bracelet on the child. What should be the next action by the nurse? C. Confirm the identity with the charge nurse, make a new bracelet, and give the medicine. The nurse instructed an adolescent female about collecting a clean-catch urine specimen. What statement made by the adolescent led the nurse to determine she understood the instructions? B. "I clean the perineum from front to back with an antiseptic wipe before I urinate. Which strategy might the nurse use when administering oral medications to a young child who is reluctant? D. Offer the child fruit juice after the medication is swallowed A parent tells the nurse, "Im not sure how to give this medicine to my infant." How would the nurse teach the parent to best administer an oral suspension? C. Use an oral syringe and placing the medication in the side of the infants mouth Gentamicin ear drops are prescribed for a 4-year-old child. How would the nurse position the auricle when administering the ear drops? Why is a tympanic thermometer considered more accurate than other types of thermometers? C. The tympanic membrane shares circulation with the hypothalamus Which intervention is correct when a nurse is administering a gastrostomy feeding by gravity? D. Position the child on the right side after a feeding Which restraint is most appropriate for the insertion of an intravenous line in a scalp vein of an infant? How often would a child who has a continuous intravenous infusion should be assessed? The prescription for a 4-month-old is penicillin G 150,000 units intramuscularly bid. The drug is supplied as a unit dose of 600,000 units in a 5-mL vial. How many millimeters (mL) should the nurse provide? Which intervention will the nurse implement when suctioning a tracheostomy? C. Apply suction for no more than 15 seconds What emergency action should be implemented for airway obstruction in the infant? B. Five back blows followed by five chest thrusts
A 4-year-old asks tearfully if the IM injection will hurt. What is the nurses most effective response? B. "Yes. It will sting a little Where is the best site for giving an IM inject to a 15-month-old child? D. Vastus lateralis muscle What factor does the nurse explain affects the infants physiological response to medications? C. Immature kidney function What intervention should the nurse implement after topical administration of hydrocortisone cream to the buttocks and abdomen of an infant? Which observation on entering the hospital room lets the nurse know that there is a need for the parents to receive safety education to prevent unintentional injury? B. Diapers and wipes are stacked at the foot of the crib A 9-year-old child is preparing for a lumbar puncture. What position will the nurse explain the child will assume for this procedure? D. "On your side with the knees bent and the head close to the knees. The nurse is caring for a 4-year-old child. What will the nurse expect the child's daily urinary output to be? An infants dry diaper weighs 2.5 grams. The wet diaper weighs 47 grams. How would the nurse record the infants urine output? The nurse instructs the mother of a 2-year-old who is taking iron supplements for anemia that some foods reduce the absorption of iron. What would be the best example provided by the nurse? The pediatric nurse completes an assessment on all patients assigned during evening shift at the hospital. Which patient assessment require immediate intervention? B. School-age child with widening pulse pressure A 15-year-old patient returns to the pediatric unit following a lumbar puncture. What initial position will the nurse maintain for this patient? Informed consent for a minor guarantees that the parent or legal guardian understands what aspect(s) of a procedure? (Select all that apply) A. Purpose of the procedure Which specific drug(s) should be checked with a second licensed nurse prior to administration? (Select all that apply) A. Insulin A 3-year-old patient is admitted to the pediatric unit with a fever of 103*F. Which actions will the nurse implement? (Select all that apply) B. Administer Acetaminophen as ordered What should the nurse assess to determine the method of transportation for a pediatric patient? (Select all that apply) A. Age A parent comments that her infant has had several ear infections in the past few months. Why are infants more susceptible otitis media? D. The eustachian tube is short, straight, and wide What statement by a patients mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media? D. "I will administer prescribed doses until all the medication is used Which situation would cause the nurse to suspect a hearing impairment? D. 24-month-old toddler who communicates by pointing What is the best way for the nurse to communicate with a 10-year-old child who has a hearing impairment? C. Face the child and speak clearly in short sentences What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes? C. Avoiding getting water in the ears What assessment made by the school nurse would lead to the suspicion of strabismus? B. Child covers one eye to read the chalkboard What might the nurse explain as a common treatment for amblyopia? A. Patching the good eye to force the brain to use the affected eye What assessment does the school nurse recognize s the cardinal sign of a hyphema? C. A dark-red spot in front of the iris The nurse is planning to teach parents about prevention of Reye's syndrome. What information would the nurse include in this teaching? C. Avoid giving salicylate-containing medications to a child who has viral symptoms What symptom leads the nurse caring for a 5-month-old with viral influenza to suspect the development of Reye's syndrome? C. Sudden vomiting without effort What does the nurse explains to parents of a child with febrile seizures? D. They occur when the temperature rises quickly A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse call 911? A. The seizure lasts more than 5 minutes What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure? B. Move objects out of the childs immediate area A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds. What would the nurse expect to assess after a generalized tonic-clonic seizure? What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)? C. Gums should be massaged regularly to prevent hyperplasia The nurse observes that the legs of a child with cerebral palsy cross involuntarily, and the child exhibits jerky movements with his arms as he tries to eat. The nurse recognizes that he has which type of cerebral palsy? Which assessment finding in a child with meningitis should be reported immediately? A. Irregular respirations The nurse observes a child position is supine with his arms and legs rigidly extended and the hands pronated. How does the nurse identify this posture? What will the nurse teach parents when giving instructions for acute conjunctivitis? C. Clear drainage from the inner to the outer part of the eye A child is brought to the emergency department after he fell and hit his head on the ground. Which nursing assessment suggests the child has a concussion? C. Cannot remember what happened to him A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches, with vomiting, that are worse in the morning. What does the nurse suspect? The nurse urges the mother of a 6 month old to get her child inoculated with Haemophilus influenzae type B. What does this immunization protect against? The nurse is caring for a 3-year-old with a head injury. Which assessment would lead the nurse to report the probability of increasing intracranial pressure (ICP)? B. Increase in blood pressure with an attendant decrease in pulse A child is diagnosed with nonparalytic strabismus. How will this disorder most likely be corrected? Parents of a 10-year-old child diagnosed with an intellectual deficit are sharing multiple approaches they implement in dealing with various challenges. Which of the following a statements by the parents alerts the nurse that they need further instruction A. "We dress our son every morning for school What would the nurse include in teaching when preparing to teach parents about air travel instructions to prevent barotrauma in infants? C. Letting the infant nurse during descent Which assessments would cause the pediatric nurse to suspect the probability of an ear infection in a 6-month-old child? (Select all that apply)
B. Irritability Which aspect(s) of a childs development does the nurse caution parents that hearing impairment can affect? (Select all that apply) A. Speech clarity What intervention(s) would the nurse caring for a child with infectious meningitis include? (Select all that apply) A. Isolation precautions What will the nurse include then documenting a grand mal seizure? (Select all that apply) A. Presence of incontinence The nurse is educating parents on prevention of eyestrain in their 5-year-old child. What information will the nurse include? (Select all that apply) A. Encourage books with large type The nurse is performing a neurological assessment on a 10-month-old infant using a modified Glasgow Coma Scale. What score will the nurse give if the child is babbling? An 8-year-old near-drowning victim is rushed into the ED. What priorities of care will be implemented? (Select all that apply.) B. Respiratory support What information will the nurse include when taking a developmental history?The developmental history has information about the child and the child's developmental and cultural needs and personal preferences. The information relative to history of illness or allergies would be covered in the medical history. The nurse is preparing to obtain a throat culture on a toddler patient.
Which child would have the most difficulty in coping with separation from parents?Elementary school age (6–12) This is arguably the toughest age for children to deal with the separation or divorce of their parents. That's because they're old enough to remember the good times (or good feelings) from when you were a united family.
What age would a child have the most difficulty in coping with separation from parents because of hospitalization?Younger children, especially those between the ages of 6 months and 4 years are most vulnerable. Individual factors such as the children's temperament and intelligence contribute to their style of coping and thus may influence both the short term and long term effects of hospitalisation.
Which age group of hospitalized children will have the most difficulty with separation?Separation anxiety occurs in infants age 6 months and older and is most pronounced at the toddler age.
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What should the nurse preparing to collect an admission history from parents who have recently immigrated from Russia keep in mind?
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