Pediatrics (Peds) Final Exam - Questions, Answers and Rationales The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which of the following adverse effe
...
Pediatrics (Peds) Final Exam - Questions, Answers and Rationales The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which of the following adverse effects of the medication? Select one: A. Respiratory depression B. Epidural hematoma C. Spinal headache D. Arachnoiditis Rationale: The nurse needs to monitor for signs of respiratory depression, a potential adverse effect of the opioid medication. Epidural hematoma, arachnoiditis, and spinal headache are potential adverse effects of the insertion of the epidural catheter. A 5-month-old child comes to the clinic for a well-child check and catch-up immunizations. Family has low income, but child's weight and length are appropriate for age. What teaching can the nurse provide to promote good oral health? Select all that apply. Select one or more: a. Baby teeth are important for speech development and good nutrition. b. Start brushing the child's teeth every day when the first molars come in. c. Wipe the gums every day with a clean cloth or gauze. d. Baby bottle tooth decay rarely occurs in infants under 18 months of age, so the child should stop using a bottle at one year old. e. As soon as the baby's teeth come in, brush them every day. Rationale: Even if the infant doesn't have teeth yet, encourage the parent to wipe the gums with a cloth every day. Stress the importance of brushing the teeth as soon as they come in. Talk about baby bottle tooth decay and ask if the child goes to sleep with a bottle (or at the breast). Teach parents that it is important to preserve the baby teeth to promote good nutrition, appropriate speech development, and proper placement of the adult teeth. Half of children in low-income homes have not had any dental care in the past year. Many of these will have unmet dental needs. What is the term for the presence of excess fat in the feces (commonly seen in cystic fibrosis)? Steatorrhea A group of students are reviewing information about the anatomic differences in the eyes and ears of a child in comparison to an adult. The students demonstrate a need for additional study when they identify which of the following? Select one: A. Visual acuity develops from birth throughout childhood. B. Binocular vision is usually achieved by 2 months of age. C. The ability to discriminate colors is completed by birth. D. Hearing is completely developed at the time of birth. Rationale: The optic nerve is not completely myelinated at birth, so color discrimination is incomplete. Hearing is intact at birth and visual acuity develops from birth throughout childhood. Binocular vision is achieved by 4 months of age. The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, which of the following would be least appropriate for the nurse to perform? Select one: A. Auscultating for lung sounds B. Providing 100% oxygen C. Having the child sit forward D. Visualizing the throat The child is exhibiting signs and symptoms of epiglottis, which can be life-threatening. Under no circumstances should the nurse attempt to visualize the throat. Reflex laryngospasm may occur, precipitating immediate airway occlusion. Providing 100% oxygen in the least invasive manner that is most acceptable to the child is a sound intervention, as is allowing the child to assume a position of sitting forward with the neck extended. Auscultation would reveal breath sounds consistent with an obstructed airway. A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. Which of the following would the nurse have most likely assessed? Select one: A. High fever B. Toxic appearance C. Dysphagia D. Inspiratory stridor Rationale: A child with croup typically develops a barking-like cough often at night. This may be accompanied by inspiratory stridor and suprasternal retractions. Temperature may be normal or slightly elevated. A high fever, dysphagia, and toxic appearance are associated with epiglottitis. The nurse is caring for a child brought to the emergency department by a babysitter. The child needs emergency treatment and the parents cannot be contacted. What would be the nurse's best response to this situation? Select one: A. Have the babysitter sign the consent form even if she does not have signed papers to do so. B. Document failed attempts to obtain consent to allow emergency care without consent. C. Have the primary care physician for the child sign the consent form. D. Delay medical care until the child's next of kin can be contacted. Rationale: Health care providers can provide emergency treatment to a child without consent if they have made reasonable attempts to contact the child's parent or legal guardian (American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, 2007). If the parent is not available, then the person in charge may give consent for emergency treatment if that person has a signed form from the parent or legal guardian allowing him or her to do so. During an emergency situation, a verbal consent via the telephone may be obtained. In urgent or emergent situations, appropriate medical care never should be delayed or withheld due to an inability to obtain consent. The nurse working with children in a hospital setting notes that they are being discharged earlier and earlier. Which of the following is a primary reason for this trend? Select one: A. Cost containment B. Increased funding for home care C. Nursing shortages D. National health care initiatives Rationale: Over the past century changes in health care, such as strained health care funding, shorter hospital stays, and cost containment, have led to a shift in responsibilities of care for children from the hospital to homes and communities. Nursing shortages influence the delivery of health care. National health care initiatives may or may not affect earlier discharge to home health care. Which of the following is the most accurate regarding the structure and function of the infant of child's respiratory system? Select one: a. The respiratory tract in the child is fully developed by age 2 b. Infants and young children have smaller tongues in proportion to their mouths. c. Most infants are nasal breathers rather than mouth breathers d. The diameter of the child's trachea is the same as that of adults. A child weighs 5 pounds 12 ounces. How many grams is that? The correct answer is: 2614 Rationale: 5.75 lbs/2.2 lbs/kg = 2.6136 kg * 1000 g/kg = 2613.6 g -> 2614 g is reasonable. The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted?
[Show More]
