A 2 year old would fall into which age group?

1. Infant

2. Early Childhood (Toddler)

3. Early Childhood (Preschooler)

4. Middle Childhood

An adolescent is likely to respond to pain in what manner?

1. loud crying

2. stalling behavior

3. thrashing of limbs

4. more verbalizations

By what age does the anterior fontanel usually close?

1. 6-8wks

2. 10-12wks

3. 4-6mos

4. 12-18mos

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

1. 1mo

2. 2mos

3. 3mos

4. 4mos

When teaching a mother how to prevent accidents while caring for her 6mo old, the nurse should emphasize that at this age the child can usually:

1. sit up

2. roll over

3. crawl lengthy distances

4. stand while holding furniture

A9mo Megan reaches to touch an outlet. Her father firmly says “No” & removes her. The nurse should use this opportunity to teach that Megan:

1. is old enough to understand “No”

2. is too young to understand “No”

3. should already know the electrical outlet is dangerous

4. will learn safety issues better if she is spanked

9mo infant has foods such as peas & corn in stools that are not digested. The nurse explains

1. child should not be given fibrous foods until digestive tract matures at 4yrs

2. child should not be given solid foods until this digestive problem is solved

3. this is abnormal & requires further investigation

4. this is normal because of immaturity of digestive process at this age.

What is normally the earliest age at which an infant begins teething w/ eruption of lower central incisors?

1. 4mo

2. 6mos 3. 8 mos

4. 12mos

Which immunizations would you anticipate for a 4mo old well baby visit?

1. DTaP, MMR, IPV

2. MMR, Hib, Dtap

3. Dtap, Hib, IPV

4. Varicella, Hep B

A 6mo old develops swelling & redness at site of DtaP injection. Nurse tells mother to:

1. apply warm pack

2. bring infant back to clinic

3. apply ice pack

4. monitor for fever

Contraindication to receiving an immunization is if a child has:

1. cold

2. otitis media

3. mild diarrhea

4. severe febrile illness

Nurse asks which question before administering a 2nd DtaP to a child?

1. did the child spit up

2. did the child seem more fussy than usual

3. did you notice any seizure activity after the 1st

4. was your child’s leg red & swollen

Nurse suggest to a mother of a 2mo old baby w/ colic that she:

1. give her son a warm bath to calm him down

2. arrange for some time away from her son each day to rest

3. provide her son w/ warm sweetened tea when he begins to cry

4. sit comfortably in a quiet, darkened room to hold her son when he cries

The best strategy for feeding a child w/ failure to thrive is

1. avoid having the same nurse feed the child

2. distract child during meals w/ TV & toys

3. maintain calm, even temperament during feedings

4. vary feeding routines to make feeding time more interesting

Suggestion to help minimize the risk of SIDS include all of the following except:

1. place baby bumpers in crib

2. put infant on back to sleep

3. avoid co-sleeping

4. avoid exposure to 2nd hand smoke

By 2 ½ yrs a child’s birth wt:

1. doubles

2. triples

3. quadruples

4. is not important

Which of the following is characteristic of development of a 2 ½ yr old?

1. birth wt doubles

2. primary dentition is complete

3. anterior fontanel is open

4 binocularity may be established

A 2 yr old @ play:

1. builds a house w/ bricks

2. is extremely possessive w/ toys

3. attempts to stay in the lines when coloring

4. amuses himself w/ a picture book for 15mins

To assess normal physical task for a 15mo in playpen, nurse observes the toddler is able to:

1. build tower of 6 blocks

2. walk across play pen w/ ease

3. throw toys out of play pen

4. stand holding onto sides

At what age should a child understand prepositional phrases such as over, under, on?

1. 2 yrs

2. 3 yrs

3. 4yrs

4. 5 yrs

A 5 year old stutters a lot when he is excited. The nurse explains that

1. children at this age react negatively for no reason. Ignore it.

2. your child will need speech therapy, but it’s more successful w/ older children

3. do either of you stutter? It’s often inherited.

4. stuttering is common at this age. We can evaluate later if it continues

A hospitalized 4 yr old tells the nurse he is sick because he was “bad”. The best interpretation is:

1. sign of stress

2. common at this age

3. suggestive of maladaptation

4. suggestive of excessive discipline at home

Which of following interventions is helpful for child scratching varicella lesions?

1. warm baths & antifungal powder

2. tepid sponge baths & lubricating creams

3. oatmeal baths & short fingernails

4. baths w/ baby soap & antibiotic ointments

Which statement accurately describes physical development during school age years?

1. wt almost triples

2. grows an average of 2 inches per year

3. few physical differences apparent among children at end of middle childhood

4. fat gradually increases, which contributes to child’s heavier appearance in the early school age period.

Which describes moral development in younger school age children?

1. standards of behavior now come from within themselves

2. do not yet experience a sense of guilt when they misbehave

3. know the rules & behaviors expected but do not understand the reasons behind them

4. they no longer interpret accidents & misfortunes as punishments for misdeeds

When planning activities for a 6 yr old leukemia pt the nurse should include:

1. action toys such as a hula hoop

2. stuffed animals, large puzzles, large blocks

3. table games, simple card games & crayons

4. record player, portable radio, children’s magazines

The school nurse has been asked to begin teaching sex ed in 5th grade. The nurse should recognize that:

1. children in 5th grade are too young for sex ed

2. children should be discouraged from asking too many questions

3. correct terminology should be reserved for children who are older

4. sex can be presented as a normal part of growth & development

Characteristics of Turner’s Syndrome include all of the following except:

1. XO chromosomes

2. XXY chromosomes

3. sexual infantilism

4. webbed neck

Klinefelter Syndromde is usually diagnosed in infancy?

1. True

2. False

School nurse tells adolescents in the clinic that confidentiality & privacy will be maintained unless a life-threatening situation arises. This practice is:

1. not appropriate in a school setting

2. never appropriate because adolescents are minors

3. important in establishing trusting relationship

4. suggestive that the nurse is meeting his or her own needs

Adolescents feel an increased need for sleep because:

1. an inadequate diet

2. rapid physical growth

3. dec’d activity that contributes to a feeling of fatigue

4. lack of ambition typical of this age group

SAD CHILDRENS- sexA- alcohol/drugsD- depression

C- communicationH- hostilityI- impulsivityL- lethalityD- demographyR- recent eventsE- epidemiology (STD’s)N- no hope

HEADSSH-homeE-educationA- activitiesD- drugsS- suicide/depressionS- savagery

Stroking sole of foot causes toes to fan & big toe to dorsiflex?

1. moro reflex

2. extrusion reflex

3. rooting reflex

4. babinski reflex

Which age group thinks their thoughts are all powerful?

1. school-age

2. toddler

3. pre-schooler

4. infant

The pre-K physical is an important indicator of a child’s readiness to attend school?

1. True

2. False

What are cues that a toddler is ready to begin potty training?

1. child expresses a desire to be clean & dry

2. child is able to sit, walk & squat

3. child stays dry for 2 hours

4. all of the above

Erikson’s task of school-age children:

1. industry v inferiority

2. trust v mistrust

3. autonomy v shame & doubt

4. initiative v guilt

When should Denver II be performed?

1. when child turns 8yrs

2. as soon as child begins to walk

3. before 6yrs

MMR & varicella can be given before 12mos.

1. true

2. false

Children less than 1 yr are obligate nose breathers.

1. true

2. false

After a tonsillectomy, child begins to vomit bright red blood. Most appropriate initial nursing action would be to:

1. administer prescribed antiemetic

2. turn child to the side

3. notify physician

4. maintain NPO status

Treatments for croup include all of the following except:

1. steroids (Dexamethasone)

2. racemic epi

3. high humidity

4. CPT

A child is hospitalized w/ epiglottitis. All of the following are appropriate interventions except:

1. keep trach tray @ bedside

2. throat swab to determine cause

3. initial IV Rocephin f/b po

4. corticosteroids

Hospitalized infant w/ acute bronchitis is NPO & receiving IV fluids. What statement explains the rationale for eliminating feedings.

1. baby does not need as many calories now

2. there is an inc’d risk of fluid overload

3. feeding would be too much of an effort for baby right now

4. baby’s digestive system is slugglish because of the infection

2yr old hospitalized w/ bacterial pneumonia. Which manifestation would nurse ID as earliest indication of respiratory difficulty?

1. RR 40-48

2. BP 80/60

3. cyanosis of mucous membranes

4. circumoral/periorbital pallor

4yr old boy needs to use MDI to treat asthma. He cannot coordinate breathing in order to use it effectively. Nurse should suggest he use a:

1. spacer

2. nebulizer

3. peak flow meter

4. trial of CPT

Child w/ asthma having PFT’s. What is the purpose of PEFR?

1. confirm diagnosis of asthma

2. determine cause of asthma

3. ID triggers of asthma

4. assess severity of asthma

A child w/ CF is predisposed to bronchitis mainly because of:

1. neuromuscular irritiability that causes spasm & constriction of bronchi

2. inc’d salt content in saliva that can irritate & necrose mucous membranes in nasopharynx

3. the associated heart defects of CF that cause CHF & resp distress

4. tenacious secretions that obstruct the bronchioles & resp tract & provide a favorable medium for growth of bacteria

CF is sometimes first noted by the nurse in the newborn nursery because of the infant’s:

1. excessive crying

2. sternal retractions

3. inc’d HR

4. abdominal distention

What change indicates that digestive replacement enzymes in CF client are effective?

1. inc’d mucus excretion in stools

2. dec’d fat excretion in stools

3. inc’d expectoration of mucus

4. wt loss

4 yr old w/ colostomy due to Hirschsprung’s is admitted b/c of poor wt gain. Which food should the nurse recommend be avoided?

1. ripe bananas

2. spaghetti

3. cheese

4. apples

Which symptom most likely led to mother seeking health care for child w/ Hirschsprung’s?

1. diarrhea

2. projectile vomiting

3. regurgitation of feedings

4. foul-smelling, ribbon-like stools

Which assessment would RN do first when child returns to unit after an emergency appendectomy?

1. bladder

2. IV fluid infusion site

3. NG tube function

4. dressing

Nurse should carefully observe infant w/ tentative dx of pyloric stenosis for:

1. quality of cry

2. quality of stool

3. signs of dehydration

4. coughing & gagging after feeding

Infant returned to unit 4 hrs ago after surgery to correct pyloric stenosis. Most important nursing intervention:

1. feed small amounts frequently & assess emesis

2. keep infant NPO & encourage parent to perform oral care

3. monitor I/O & administer meds

4. monitor hydration status & encourage parents to rest.

A barium enema can dx & may also treat intussusception.

1. true

2. false

Which measure is inappropriate for pediatric client returning to unit after repair of cleft palate?

1. close observation for early manifestations of resp obstruction

2. position on abd or side to provide adequate drainage

3. frequent sxn of oropharynx to clear secretions

4. arm restraints to prevent hands or other objects from getting in mouth

1hr after admission to nursery, nurse observes infant RR 70 w/ excessive drooling. 1st action should be:

1. continue to observe closely for other s/s

2. reposition to side-lying position & call physician

3. sxn mouth & place supine w/ HOB elevated

4. provide supplemental O2 when RR>70

What is the reason for positioning an infant w/ TEF supine w/ HOB elevated prior to surgery?

1. reduce resp & cardiac workload

2. alleviate press of distended abd contents on diaphragm

3. inc pooling of secretions in bottom of upper esophageal pouch

4. reduce gastric distention by allowing air bubbles from fistual to escape

Characteristics of celiac disease include all except:

1. constipation

2. general malnutrition

3. abdominal distention

4. vitamin deficiencies

The normal life span for a sickled cell is:

1. 120 days

2. 40-60 days

3. 20-25 days

4. 7-10days

10yr old client w/ sickle cell crisis. Which action is contraindicated?

1. administer O2 via NC as prescribed

2. encourage increase oral fluid intake

3. administer narcotics for pain

4. encourage as much exercise as possible

To prevent thrombus formation in capillaries, as well as other problems from stasis & clotting of blood in the sickling process, the nurse should:

1. administer O2

2. see client maintains bed rest

3. increase fluids by mouth

4. administer ordered heparin or other anticoagulant

Describe the cause of the clinical manifestations that occur in sickle cell disease.

1. sickled cells increase the blood flow through the body & cause a great deal of pain

2. sickled cells mix w/ unsickled cells & cause the immune system to become depressed

3. bone marrow depression occurs b/c of dev’t of sickled cells

4. sickled cells are unable to flow easily through the microvasculature & their clumping obstructs blood flow

A home care nurse instructing parents of child w/ iron deficiency anemia regarding the admin of liquid oral iron agent supplement tells them to:

1. admin through a straw

2. admin at mealtimes

3. add to formula for easy admin

4. mix w/ cereal to admin

Child w/ B-thalassemia (Cooleys Anemia) receiving long term blood transfusion therapy. Chelation therapy is prescribed to prevent organ damage from presence of too much Fe as result of transfusions. Which med would nurse anticipate to be prescribed in chelation therapy?

1. dalterparin sodium (Fragmin)

2. meropenem (Merrem)

3. molindone (Moban)

4. deferoxamine (Desferal)

Medical management/interventions for hemophilia may include all of the following except:

1. DDAVP

2. transfusions

3. aspirin

4. shaving only w/ electric razor

8yr old has neutrophil count of 200 after prolong course of Cytarabine & methotrexate. Primary nursing action:

1. initiate strict isolation

2. notify physcian

3. increase fluid intake

4. restrict staff & visitors

Child w/ leukemia has mucosal ulceration in mouth & throat d/t neutropenia. An intervention to ease discomfort is:

1. suck on lemon glycerin swabs

2. apply milk of mag w/ soft applicator

3. rinse w/ NS frequently

4. gargle w/ hydrogen peroxide q2

What is the major assessment parameter that would lead the nurse to conclude that an infant has coarctation of the aorta?

1. lower extremity BP is >10mm less than upper extremity

2. tachycardia & cyanosis

3. washing machine murmur

4. tet spells

Nurse caring for infant w/ congenital heart disease monitoring closely for signs of CHF. Nurse assesses for which early sign?

1. cough

2. tachycardia

3. slow & shallow breathing

4. pallor

Prostaglandin prescribed for child w/ transposition of great arteries. Mother asks why child needs this medicine. Most appropriate response:

1. maintains adequate hormone control

2. maintains position of great arteries

3. provides adequate O2 saturation & maintains cardiac output

4. prevents Tet spells

RN caring for child w/ Kawasaki’s. Mother asks about disorder. RN responds that:

1. it is an acquired cell-mediated immunodeficiency disorder

2. it is an inflammatory autoimmune disease that affects connective tissue of heart, joints & subq tissue

3. chronic multi-system autoimmune disease characterized by inflammation of connnective tissue

4. aka mucocutaneous lymph node syndrome & is a febrile, generalized vasculitis of unknown origin

5yr old w/ autism lives w/ mother, 2 brothers, grandmother. Child was recently w/ resp infection & has special needs b/c of autism. Which of following describes family’s composition.

1. nuclear family

2. blended family

3. extended family

4 same sex family

Above scenario:what would be best approach for nurse to take when first assessing this child?

1. ask child’s family to step out of room

2. ask child’s mother what approach would work best

3. ask child if she is allergic to anything

4. ask child’s grandmother to interpret child’s behavior

Match the parenting styles• Democratic

• Dictatorial

• Permissive

• A. your curfew is 10pm. You know that

• As long as you have your homework done, I don’t care when you come home

• Tonight is a school night, so you need to come by 10pm

When providing care to a child, the nurse should not be concerned about what the child thinks about care.

1.True

2.false

When a child is admitted to the pediatric unit, the RN should keep in mind the family of child also needs nursing care.

1. true

2. false

Info: guidelines for promoting healthy behaviors in children:-set realistic limits & expectations based on developmental tasks-validate child’s feelings-provide reinforcement for appropriate behavior-focus on child’s behavior when disciplining the child-explain expectations to a child in a manner the child can understand

List 5 basic assessments that should be included in the physical assessment of a child over 3 years of age:

List 5 basic assessments that should be included in the physical assessment of a child over 3 years of age:-height-weight-temperature-RR-HR-BP

Rank the following in the order they should be performed on a 9mo old.__axillary temp__RR__wt__HR

Match the reflex• Rooting

• Palmar

• Plantar

• Moro

• Asymmetric tonic neck

A. Extension of arm & leg on side when head is turned to that side w/ flexion of arm & leg on opposite side

B. Legs flex, arms & hands extend when startled by loud noise

C. Turns head to side when cheek or mouth is touched

D. Will grasp object when palm is touched

E. Toes will curl downward when sole of foot it touched

Parent of a 17mo old toddler is frustrated w/ toddler’s behavior. Parent tells RN the child is “bad” but doesn’t know how to make toddler behave better. Which response should RN make?1. allow your child to learn by trial & error

2. consistently enforce well-defined limits, such as no climbing on the counters

3. reward your child’s good behavior, but ignore the bad behaviors

4. punish your child when he behaves badly

2 yr old throws tantrums & says “No” every time parent tries to help her. Parent knows toddlers do this but does not understand why. Nurse explains it is normal expression of desire to:

1. increase independence

2. develop sense of trust

3. gratify oral fixation

4. finish project they set out to do

Parent asks why 4yr old is always talking about “George” when family doesn’t even know a George. Child tells of George’s escapades like climbing onto counter to raid the cookie jar. What explanation can be given?

Which strategies can be used to help a preschool child go to sleep? (all that apply)

1. let child fall asleep in another room

2. place a night light in child’s room

3. keep a regular bedtime schedule

4. insist child take a nap to make up for lost nighttime sleep

5. read a bedtime story to child

6. allow child to play quietly in room

Magical thinking can be the cause of preschooler’s feelings of guilt.

1. true

2. false

Which statement indicates that the parent of a preschooler understands the need for injury prevention?

1. my hcild is able to watch his younger brother when they play outside

2. now that my child does not put everything in his mouth, I can remove the locks on my cabinets

3. I programmed the number to poison control into my cell phone

4. my child rides his bike in the street w/ the bigger kids

Which activity demonstrates a school-age child is working toward a healthy achievement of Erikson’s task of industry?

1. child brings home completed school work to show parents

2. child prefers to watch cartoons on TV rather than practice piano

3. child depends on older siblings to tell him what to wear to school

4. child refuses to play by rules of a board game

What should be included in a course on safety during school-age years? (all that apply)

1. keeping stair gates closed

2. wearing helmets when riding bikes or skateboards

3. playing safely on trampolines

4. firearm safety

5. wearing seat belts

Info: strategies to decrease risk of obesity in school-age children:-avoid or reduce fast-food meals-encourage physical activities-do not use food as a reward-provide nutritious meals

ID order of sexual maturation in males:__voice changes__pubic hair appears__size of testes increase__downy hair appears on upper lip__axillary hair grows__rapid growth of genitalia occurs

Sleep habits change w/ puberty due to _____ & _____.

Adolescents are likely to take risks because

1. they are incapable of thinking at an adult level

2. they see themselves as invincible to bad outcomes

3. they have a short attention span

4. they have no respect for the rules

Adolescent see school nurse for shoulder pain. Nurse discovers he’s lifting weights daily to prepare for baseball. Nurse should:

1. encourage use of braces when lifting

2. discourage continuation of weight lifting

3. instruct him to consult w/ coach to make sure proper technique is being used

4. discuss possibility of arthritis d/t shoulder injury

Info: behavioral changes that may indicate an adolescent is socially isolated or depressed:

-poor school performance-lack of interest in things that had been of interest in the past-disturbances in sleep or appetite-expression of suicidal thoughts

When working w/ a child who is developmentally delayed, the nurse should use diversional activities appropriate for the child’s age.

1. true

2. false

Match the play activities w/ the appropriate age

1. Wacthing black & white mobiles

2. Playing peek-a-boo3. Holding a soft rattle4. Playing w/ cloth books5. Banging large blocks

A. 1-3yrsB. 3-6mosC. Birth-3mosD. 9-12mosE. 6-9mos

Which activity is expected for a preschooler?

1. playing on a soccer team

2. reading a book quietly

3. playing the violin

4. finger painting

What age group is most likely to engage in collecting trading cards?

1. toddler

2. preschooler

3. school-age

4. adolescent

Which of following interventions is most appropriate for needs of a 7yr old being hospitalized for an extended time?

1. bring security items such as a toy & blanket

2. provide play activities that foster sense of normal routine

3. limit choices whenever possible

4. restrict family visiting hours

Which tests will be most accurate for diagnosing asthma?

1. ABG’s

2. CXR

3. PFT’s

4. allergy tests

Which med should nurse prepare for an acute asthma attack?

1. terbutaline (Brethine)

2. beclomethasone dipropionate (QVAR)

3. prenisone (Deltasone)

4. albuterol (Proventil)

Which of the following is an adverse reaction to fluticasone propionate (Flovent) that should be reported to the PCP?

1. change in mood

2. difficulty speaking, hoarseness, &/or white patches in mouth

3. tachycardia & tremors

4. fatigue & malaise

Which of the following should be included in client teaching to eliminate allergens?

1. avoid keeping pets in the home2.prepare meals w/ foods that contain no allergens3. enforce a no-smoking policy in the house & car4. maintain humidity in home between 30-50%5. avoid excessive temperature extremes6. keep air & heating ducts clean & change filters monthly7. keep furniture, floors & walls clean & dry8. dust near sleeping & personal spaces9. monitor periods of exercise for exacerbations10. cover mouth in cold weather11. try to remain calm during periods of extreme emotions

6yr old pre-op for tonsillectomy. Temp 38 (100.6), HR 104, RR 32, BP 96/62, SpO2 97%. Child c/o sore throat. What is the next appropriate action the nurse should take?

1. record VS & prepare for transport to OR2. ask parents how long child has had sore throat & document 3. notify OR & PCP & await response4. offer analgesic & warm fluids until PCP evaluates child for surgery

Post-op tonsillectomy. Which of following is s/s of post-op bleeding?

1. Hgb 11.6 & Hct 37%

2. inflamed & reddened throat

3. frequent swallowing & clearing of throat

4. blood tinged mucus

A pediatric resp disorder that is considered a medical emergency is:

1. pharyngitis

2. bronchitis

3. bacterial epiglottitis

4. acute spasmodic laryngitis

Manifestations of bacterial epiglottitis include:

1. hoarseness & difficulty speaking

2. difficulty swallowing

3. low-grade fever

4. drooling

5. dry, barking cough

6. stridor

How do you prevent most cases of bacterial epiglottitis?

RSV is dx’d w/:

1. collection of sputum specimen

2. throat culture

3. nasal aspiration

4. obtaining blood for CBC

Info: cystic fibrosis is hereditary & transmitted as an autosomal recessive trait’ thus, both parents must be carriers of the gene.

Which best describes the stools of a child w/ CF?

1. hard & dry w/ difficult evacuation

2. dark-colored tarry stools

3. blood-streaked w/ mucus strands

4. fatty & foul-smelling

Which of the following are seen in CF? (all that apply)

1. wheezy respirations

2. clubbing of fingers & toes

3. barrel shaped chest

4. thin watery mucus drainage

5. rapid growth spurts

Appropriate intervention for CF?

1. admin fat-soluble forms of vit A, D, E & K

2. admin pancreatic enzymes w/ food & snacks

3. place child on low-cal, low-protein diet

4. limit fluids

Info: Manifestations of Digoxin toxicity:

decreased appetiteN&Vincreased sweatingdecreased urine output

Match1. VSD2. ASD3. PDA4. Pulm stenosis5. Aortic stenosis6. Coarctation of

aorta7. Transposition of

great arteries8. Tricuspid atresia9. Tetrology of Fallot

A. Narrowing @, above or below aortic valve

B. Hole in septum between R & L ventricleC. Complete closure of tricuspid valveD. Hole in septum between R & L atriaE. Four anomalies: pulm stenosis, VSD,

overriding aorta, R ventricular hypertrophy

F. Normal fetal circulation conduit between pulm artery & aorta that fails to close

G. Narrowing of pulm valve or arteryH. Aorta connected to R ventricle instead

of L; pulm art connect to L ventr instead of R

I. Narrowing of lumen of aorta usually at or near ductus arteriosus

match

1. Digoxin (Lanoxin)

2. Furosemide (Lasix)

3. Captopril (Capoten)

4. oxygen

A. Rids body of excess fluid & sodium

B. Increases tissue oxygenation

C. Improves myocardial contractility

D. Reduces afterload

Match condition w/ possible manifestation/complication

1. Anemia

2. Neutropenia

3. Thrombocytopenia

A. Bruising, nosebleed

B. Fever, pneumonia

C. Fatigue, SOB

Child w/ leukemia is experiencing severe thrombocytopenia. Which nursing interventions will avoid the risk for injury based on this dx?

1. avoid injections & skin punctures2. wash hands frequently3. limit visitors4. monitor platelet count5. avoid rectal temperatures6. monitor for fever

Child w/ leukemia is hospitalized w/ lethargy, HA, vomiting, blurred vision. Which complication do these suggest?

1. anemia

2. hypermetabolism

3. increased intracranial pressure

4. infiltration of leukemic cells into bone marrow

List nursing interventions to promote adequate nutritional intake in a child w/ leukemia undergoing chemotherapy.

-Involve child in food selection-do not give favorite foods when nauseated-medicate for nausea before meals-encourage small, frequent meals-encourage high protein, high calorie foods-give high protein, high calorie shakes-weigh daily to monitor wt loss or gain-make food attractive & unusual (cut sandwich into star shape)-allow parents to bring child’s favorite food from home-involve parents in order to learn about child’s preferences

Info: foods high in iron-red meats-legumes (dried beans & peas)-green leafy vegs (spinach, chard, beet greens)-iron-fortified breads & cereals & whole grains-nuts & seeds-dried fruits

List s/s of Iron Deficiency Anemia:

-fatigue, lethargy, irritability, muscle weakness-SOB-tachycardia, tachypnea, possible low-grade fever-dizziness or fainting w/ exertion-pallor-nail bed deformities-impaired healing, loss of skin elasticity, thinning of hair-systolic heart murmur, heart failure

Normal H & H for a 7 yr old:

1. Hgb 6g/dL, Hct 18%

2. Hgb 10g/dL, Hct 30%

3. Hgb 14g/dL, Hct 42%

4. Hgb 20g/dL, Hct 60%

Parents understand the effects of oral iron therapy if they state:

1. my child may develop diarrhea while on iron

2. I should call dr. if my child has tarry stools

3. I will give iron w/ milk to help prevent upset stomach

4. my child should rinse mouth after taking

What is the priority nursing diagnosis for child w/ sickle cell crisis?

Info: Sickle cell interventions include:

-bedrest-around the clock pain management or PCA-frequent assessment of pain rating-fluids @ 125-150% of 24hr maintenance requirements-application of warm packs to painful joints

Possible causes of jaundice in 9yr old w/ frequent sickle cells crisis include: (all that apply)

1. liver failure caused by chronic vaso-occlusive crisis2. cardiomegaly3. obstruction of bile ducts4. rapid destruction of sickled RBC’s5. an aplastic crisis

Interventions to prevent infection in child hospitalized w/ sickle cell crisis include:1. IV fluids w/ electrolyte replacment2. IV narcotics for pain relief3. pneumococcal vaccine4. exchange transfusions

Encouraging appropriate physical activity in children w/ hemophilia strengthens muscles & joints & may actually prevent frequent bleeding episodes.

1. true2. false

Sudden onset of slurred speech & HA in child w/ hemophilia may indicate the onset of an episode of hemarthrosis.

1. true2. false

Aspirin & ibuprofen are best choices for pain relief in child w/ hemophilia.

1. true2. false

Which are manifestations of rheumatic fever? (all that apply)

1. erythema marginatum (rash)2. continuous joint pain of digits3. tender, subq nodules4. dec’d ESR5. elevated C-reactive protein6. uncoordinated movements of extremities

which is most definitive for diagnosing rheumatic fever?

1. throat swab & culture2. ECG & echo3. CRP or ESR4. elevated or rising serum antistreptolysin-O (ASO) titre

Which med should nurse admin for comfort in a 6yr old w/ rheumatic fever.

1. aspirin2. ibuprofen3. penicillin4. erythromycin

Chorea leads to permanent nerve damage & seizures.

1. true2. false

w/ rheumatic fever, antibiotics may need to be continued for an extended period of time for prophylaxis.

1. true2. false

Which of the following fluids is appropriate choice to rehydrate a child who has experienced diarrhea due to E. coli for the past 3 days?

1. oral rehydration therapy2. IV isotonic saline w/ glucose3. gelatin4. chicken broth

match

1. Hirschsprung’s disease2. Intussusception3. Hypertrophic pyloric

stenosis4. GERD5. Meckel’s diverticulum

A. Olive-shaped mass RUQB. Painless, bloody stoolsC. Severe constipation w/

bouts of diarrhea; failure to pass meconium in newborns

D. Stool of currant jelly consistency

E. Excess spitting up or forceful vomiting

Infant w/ severe GERD may have orders to be placed on his stomach to sleep, rather than the usual back to sleep position.

1. true2. false